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Substance Abuse Prevention and Control

    

Substance Abuse Prevention and Control


Contact Information
County of Los Angeles
Department of Public Health
Substance Abuse Prevention & Control
1000 S. Fremont Avenue
Building A9 East, 3rd Floor
Alhambra, CA 91803
Phone: (626) 299-4193
Fax: (626) 458-7637
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FY2014-15 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 15 following the end of the fiscal year.
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 SOW, Site, and Modality)
  2. Cost Certification with original signature
  3. Care Certification with original signature
Drug Medi-Cal (DMC)
  1. Original Cost Report (by Site and Modality)
  2. Cost Certification with original signature
  3. Care Certification with original signature
Drinking Driver Program (DDP)
  1. Original Cost Report (by Program)
  2. Cost Certification with original signature
  3. Care Certification with original signature
IMPORTANT:
All cost reports must be submitted by SOW, Site and Modality. No exception.

  • The annual Provider cost reports are due August 15, 2015 (45 days after end of Fiscal Year).
  • If the cost reports are not received by the due date, your agency will be listed as a delinquent provider.
  • After August 15, 2015, 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.

CHANGES FROM FY 13-14 TO FY 14-15:
  • PROGRAM NAME CHANGED – "NNA" Is now called "NON-DMC", and "Day Care Rehabilitation (DCR)" is now called "Intensive Outpatient Treatment (IOT)"

SETTLEMENT:
  • PARTICIPANT/CLIENT FEES, 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

CARE Certification & Cost Report Certifications: Must be attached to ALL cost reports

Medi-Cal Funded Contracts (DMC)

Provider Orientation

Mode of Service - Forms and Instructions - DMC Cost Report Forms

DMC Cost Report Reference

Non-Drug Medi-Cal funded Contracts

Provider Orientation

Mode of Service - Forms and Instructions

Non-Drug Medi-Cal Cost Report Reference

Drinking Driver Program

Provider Orientation

Forms and Instructions

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