Substance Abuse Prevention and Control


Fiscal Year 2017-18 Annual Cost Report Forms and Instructions
Pursuant to your Agency contracts with the Department of Public Health Substance Abuse Prevention and Control (SAPC), each Provider must submit accurate and complete cost reports for the previous fiscal year by August 30 following the end of the fiscal year except Drug Medi-Cal (DMC) which is pending for State to release the DMC cost report form.

  • NEW: To assist providers in submitting cost report on time, we have extended the cost report deadline for two (2) more weeks from August 15 to August 30.  No further extension requests will be accepted.

The following documents/files must be submitted by your Agency for the cost report to be considered complete:
Non-Drug Medical (NON-DMC)
  1. Original Cost Report (by Contract No., SOW, Site, and Level of Care)
  2. Cost Certification with original signature
Drug Medi-Cal (DMC)
  1. Original Cost Report (by Site) E-mail completed cost report (excel file) to your assigned analyst and send original copy with signature to SAPC
  2. Cost Report must be printed on legal size paper
  3. "Provider Information and Certification" with original signature
Driving Under The Influence (DUI)
  1. Original Cost Report (by Program)
  2. Cost Certification with original signature
IMPORTANT:
All Non-DMC cost reports must be submitted by Contract No., SOW, Site, and Level of Care. No exception.

  • The annual Provider cost reports are due August 30, 2018 (60 days after end of Fiscal Year).
  • If the cost reports are not received by the due date, your agency will be listed as delinquent.
  • After August 30, 2018, a stop payment will be placed on current billings for delinquent providers. The Stop payment order will remain until such time cost reports are received.
  • Do not staple or bind cost reports.

SETTLEMENT:
  • PARTICIPANT/CLIENT FEES and THIRD PARTY REVENUE (INSURANCE PAID) COLLECTED WILL BE OFFSET FROM ALLOWABLE COST.

SUBMISSION:
Please send original cost reports with all working papers as applicable to:

County of Los Angeles Department of Public Health
Substance Abuse Prevention and Control
Cost Reporting Unit
1000 S. Fremont Ave., Bldg A-9 East
3rd Floor, North Wing, Unit 34
Alhambra, California 91803


COST REPORT FORMS/INSTRUCTION AND POWERPOINT
Drug Medi-Cal Funded Contracts (DMC)
Drug Medi-Cal Cost Report PowerPoint 2018 Not available
Cost Report Forms and Instructions Not available
Non-Drug Medi-Cal funded Contracts
Non-Drug Medi-Cal Provider Orientation

Cost Report Forms and Instructions
Non-Drug Medi-Cal Cost Report Reference
Driving Under The Influence (DUI) Program
DUI Provider Orientation
Cost Report Forms and Instructions
 
Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.
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