CRISS brings together the three major CCS stakeholder groups-- CCS programs, family support organizations, and pediatric providers and hospitals-- in a cohesive regional coalition for collaboration, planning, and action. The following are examples of current CRISS projects and activities:
We are working to implement regional and local strategies to promote medical homes for children with special health care needs, including distributing medical home materials customized for each county in our region. CRISS also participates with State CMS in development of state policy to promote medical homes for CCS children.
We are convening regional meetings to bring together CRISS members with representatives of other programs serving children with special needs including regional centers, county mental health, and special education to discuss strategies for improved care coordination for children in multiple systems. In 2007 CRISS held a very successful regional workshop on care coordination planned by this group. Materials from this workshop are available from CRISS.
We completed a survey of member CCS programs and hospitals regarding problems in access to durable medical equipment and medical supplies, and are making recommendations to the state to address barriers to access to DME. The survey analysis report is available from CRISS.
We conducted and completed analysis of a statewide survey of family-centered care activities in local CCS programs on behalf of state CCS. The survey analysis report is available from CRISS.
We conducted and completed a survey of staff and physicians of the Medical Therapy Program, including physician capacity in the program in our region, and are considering recommendations to strengthen the program. The survey analysis report is available from CRISS.
CRISS Medi-Cal Managed Care Rural
Council is the CRISS governing body, with representatives from all CRISS constituencies: family support organizations, county CCS programs, children’s hospitals and pediatric organizations. Council makes overall policy for the organization and determines CRISS activities.
CRISS STEERING COMMITTEE
The Steering Committee is the group elected by Council to act on its behalf between Council meetings. It sets Council meeting agendas, oversees CRISS planning, and represents CRISS in meetings with State officials. Specific slots on the Committee are dedicated to family support organizations (chosen by the Family-Centered Care Work Group), pediatric hospitals and organizations, CCS program administrators, and CCS medical consultants.
Claims: The Claims Work Group includes authorizations, billing and administrative staff from county CCS programs and member hospitals, as well as, representatives of the Medi-Cal Fiscal Intermediary. Its goals are to identify common billing problems and potential solutions.
Family-Centered Care: The Family-Centered Care Work Group includes family resource center parent health liaisons, CCS social workers, nurses, supervising therapists and administrators. The Work Group aims to support Family-Centered Care for all CCS children.
Medical Eligibility: The Medical Eligibility Work Group includes county medical consultants, administrators and case management staff, and representatives of member hospitals and pediatric organizations. MEWG aims to reduce inter-county variability in medical eligibility and benefits through such strategies as identifying questions concerning interpretation of medical eligibility regulations, Numbered Letters, and eligibility procedures, requesting clarification from regional and state CCS on topics where there are questions, and designing regional approaches where appropriate. MEWG maintains Medical Eligibility Matters, a compendium of its consensus on interpretation of CCS policy on medical eligibility and benefits to assist medical consultants and case management staff in the CRISS region.
Medical Therapy Program: The Medical Therapy Program Work Group includes supervising therapists from the 27 CRISS counties, CCS medical consultants and parent health liaisons from the family resource centers. Its goals are to reduce inter-county variability in MTP policies, share resources that benefit all children in the MTP program (camps, classes, adult providers, etc.) and recommend improvements to current practices in the program. This group strives to increase communications among all the disciplines involved with the MTP and to proactively assess the future needs of the program. This group also collaborates with the FCCWG in planning the CRISS annual conferences.
Whole Child Model Work Group: CRISS has established a new Whole Child Model Work Group to follow implementation of the WCM in the CRISS region.