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In order to ensure the best interests of the children and families involved, the Lucile Packard Foundation for Children’s Health commissioned interviews with key CCS stakeholders to identify the major issues and actions that would need to be addressed in the event the Legislature and the Governor ultimately decide to end or modify the current carve-out.

More than 50 stakeholders with a variety of perspectives on the program – including families, consumer advocates, Department of Health Care Services staff, Medi-Cal managed care plans, providers, county executives, and CCS medical directors – provided comment to Health Management Associates, which conducted the interviews and prepared this report. These stakeholders raised a wide range of issues for consideration. There was some agreement about the issues that would need to be addressed, but many divergent views on how they should be addressed. Some stakeholders expressed concern that discussing whether and how to end the carve-out was premature given that neither pilots for testing new models nor a comprehensive evaluation of the implications of ending the carve-out have been undertaken.

This report presents the stakeholders’ views on the decision process for making potential changes to CCS, a design framework for alternative options, and key issues and considerations for redesigning care for CCS-eligible children with chronic conditions and special health care needs.