CCS Survey for Families
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Introduction

 
Thank you for taking the time to complete this survey. The Family Health Outcomes Project at the University of California, San Francisco is conducting this survey because we are interested in your opinions about the California Children’s Services (CCS) Program and how well it is meeting the needs of your child. This information will help determine what the priorities should be for the CCS Program for the next 5 years. All of your answers are anonymous and you may skip any question(s) you don’t want to answer.

The California Children’s Services (CCS) is a state program that covers the cost of treating certain diseases, physical limitations or chronic health problems in children that are financially eligible for these services. The CCS program also runs the Medical Therapy Program, which provides medical therapy (including occupational, physical and speech therapy to children with a CCS-eligible condition. The CCS program covers children with problems like:

• congenital heart disease
• cancers, tumors
• hemophilia, sickle cell anemia
• thyroid problems, diabetes
• serious chronic kidney problems
• liver or intestine diseases
• cleft lip/palate, spina bifida
• hearing loss, cataracts
• cerebral palsy, uncontrolled seizures
• rheumatoid arthritis, muscular dystrophy
• AIDS
• severe head, brain, or spinal cord injuries, severe burns
• problems caused by premature birth
• severely crooked teeth

Si prefiere completar la encuesta en español, utilice este enlace:
http://www.surveymonkey.com/s/EncuestadeCCS o haga click aquí.
1. Do you have a child that has been covered by CCS?
2. If YES, is your child currently covered by CCS?
3. Do you have any children who have received treatment or services from a CCS provider or through the CCS program?
NOTE: For all of the questions on this survey, when we ask about your child, we are asking about your child that is or was covered by CCS.
4. What services for your child does the California Children Services (CCS) program pay for? Please check all that apply.