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California Children Services:
CCS
What is CCS Due Process?
CCS is obligated to provide services to
children who are eligible. Occasionally, the child's family disagrees
with the eligibility decision made by CCS. The CCS Due Process procedure
allows families to appeal the decision for reconsideration.
How does it work?
When CCS decides a child is not eligible
for a CCS program, the family is notified with an official letter
called a Notice of Action. It explains that the child has been determined
to be not eligible and the reason for the decision, such as the
child does not meet the medical criteria for eligibility. It also
provides information on how to appeal the decision. Families need
to follow those directions.
What about children who are eligible
for CCS but CCS denies a requested service?
This is the other situation that the CCS
Due Process procedure covers and provides appeal options for families.
When a denial of a service request is made the family and requesting
health professional are notified and given instructions on making
an appeal.
Who decides an appeal?
At first, the appeal goes to the appropriate
administrator at the County CCS Office. Medical appeals are reviewed
by the CCS Medical Director and administrative appeals are reviewed
by the CCS Program Manager. They will work with the family to determine
how to proceed. Each case is different; so, there is no set of steps
that apply to every situation. Occasionally, a medical expert is
called upon to render an opinion if the diagnosis is uncertain.
Rarely, a fair hearing request is sent to the State Department of
Health Services for final determination of the issue.
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