LA County Public Health - Alcohol and Drug Program Administration

The Alcohol and Drug Program Administration, Financial Services Division is making available for Contract Services Providers, the Annual Cost Report Forms and Instructions for FY 2008/09.

Medi-Cal Funded Contracts (DMC)

Provider Orientation - Power Point Presentation (Print Version)

Mode of Service - Forms and Instructions

1. Day Care Rehabilitative (DCR) Alcohol and Drug

2. Outpatient Drug Free (ODF) Individual – Alcohol and Drug

3. Outpatient Drug Free (ODF) Group – Alcohol and Drug

4. NTP Alcohol and Drug

5. Day Care Rehabilitative (DCR) Perinatal

6. Outpatient Drug Free (ODF) Individual – Perinatal

7. Outpatient Drug Free (ODF) Group – Perinatal

8. Residential (RS) Perinatal

9. NTP Perinatal

- CARE CERTIFICATION - APPLIES TO ALL COST REPORT (DMC AND NON-DMC)
Please retrieve, sign and attach to all cost report(s).
- Over Head Expenses
- Group Session illustration

Non-Medi-Cal funded Contracts

Provider Orientation - Power Point Presentation (Print Version)

Mode of Service - Forms and Instructions

1. Outpatient Drug Free (ODF) individual and Group

2. Non-Outpatient Drug Free (Non-ODF)

3. Proposition 36 (ODF)

4. Proposition 36 (Non-ODF)

5. Cal-Works (ODF)

6. Cal-Works (Non-ODF)

7. Ten Percent (10%) Gross Budget Adj. Worksheet (For NPR Contracts)

- CARE CERTIFICATION - APPLIES TO ALL COST REPORT (DMC AND NON-DMC)
Please retrieve, sign and attach to all cost report(s).
- Over Head Expenses
- Group Session illustration

Drinking Driver Program

Provider Orientation - Power Point Presentation (Print Version)

8. DDP Forms and Instructions

IMPORTANT:
• Per Contract, the annual Provider cost reports are due 45 days after end of Fiscal Year
• The last due date to submit cost report(s) to ADPA is August 31, 2009
• If the cost report(s) is/are not received by the due date, your agency will be listed as a delinquent provider
• Delinquent provider(s) could experience stop payment on current billings after August 31, 2009.
• Send cost report(s) original and copy with all working papers as applicable to:

County of Los Angeles Department of Public Health
Alcohol and Drug Program Administration
1000 S. Fremont Ave., Bldg A-9 East
3rd Floor, North Wing, Unit 34
Alhambra, California 91803