California Dept., of Health: Genetically Handicapped Persons Program

The Genetically Handicapped Persons Program (GHPP) is a health care program for adults with certain genetic diseases. The GHPP helps people who are on GHPP with their health care needs. The GHPP works with doctors, nurses, pharmacists, and other members of the health care team in providing many types of health services.

BACKGROUND

Program Mission:

The mission of GHPP is to promote high quality, coordinated medical care through case management services that assure partnership among the Special Care Center team and the client’s community health care providers.

Program Goals:

To help each client achieve the highest level of health and functioning through:

  • Early identification and enrollment into the GHPP for persons with eligible conditions.
  • Prevention and treatment services from highly-skilled Special Care Center teams.
  • Ongoing care in the home community provided by qualified physicians and other health team members.

Program Highlights:

The GHPP provides clients with enhanced services through:

  • Special Care Center services
  • Centralized program administration
  • Case management services
  • Coordination of treatment services with managed care plans

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GHPP LEGISLATIVE HISTORY

The GHPP was established in 1975 (Senate Bill 2265) to provide medical care for individuals with specific genetically handicapping conditions.

  • Hemophilia was the first medical condition covered by the GHPP
  • Legislation throughout the years have added other medical conditions such as Cystic Fibrosis, Sickle Cell Disease, Phenylketonuria, and Huntington’s disease
  • The last genetic condition added to the GHPP was Von Hippel-Lindau Disease
  • Legislation is required to add a new condition to be covered by the GHPP

Health and Safety Code 12125 – 125191

  • Defines the genetically handicapping conditions eligible to receive services
  • Defines medical and social support services to be provided
  • Describes reimbursement process, enrollment fees
  • Describes staffing requirements to administer the program
  • Describes requirements of participation

California Code of Regulations, Title 17, Sections 2931-2932

  • Identify Special Care Centers for GHPP clients to receive diagnostic and medical services – inpatient, outpatient and home
    • Hemophilia Center
    • Cystic Fibrosis Center
    • Sickle Cell Disease Center
    • Special Inherited Neurologic Disease Center
    • Metabolic Disease Center
  • Provides the list of GHPP eligible conditions

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GHPP PROGRAM ADMINISTRATION

The GHPP is a statewide program with no county involvement. The GHPP office is located within the Children’s Medical Services Branch in Sacramento, California. All aspects of the program are conducted centrally such as:

  • Application/enrollment
  • Eligibility determination
    • Medical eligibility
    • Residential eligibility
    • Financial eligibility
    • Age Criteria
  • Case management
  • Authorization of services
  • Claims Processing
  • Appeal review

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