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Substance Abuse Prevention and Control

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Annual Cost Report 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).

NEW:
  1. FY 2018-19 annual DMC cost report submission due date is undetermined at this point due to the processing of the denied units.  Once SAPC distribute the State Reconciliation Report in August 2021, the cost report submission due date will be informed.
  2. Contract Performance reports from sage are available upon request.
The following documents/files must be submitted by your Agency for the cost report to be considered complete:

Non-Drug Medi-Cal (NON-DMC)
  1. Original Cost Report - E-mail completed cost report(s) in Excel format to your assigned analyst.
  2. Mail "Provider Information and Certification" with original signature.
Drug Medi-Cal (DMC)
  1. Original Cost Report (by Site) - E-mail completed cost report(s) in Excel format to your assigned analyst.
  2. Mail "Provider Information and Certification" with original signature.
Driving Under the Influence (DUI) Program
  1. Original Cost Report (by Program) - E-mail completed cost report(s) in Excel format to your assigned analyst.
  2. Mail the original cost report with original signature.
IMPORTANT:
  • If the cost reports are not received by the due date, your agency will be listed as delinquent.
  • After the due date, 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.

COST REPORT 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) FY 2018-19
Drug Medi-Cal Cost Report PowerPoint FY 2018-19
Drug Medi-Cal Cost Report Forms and Instructions
  1. FY 17-18 ODS Cost Report
  2. FY17-18 DMC Cost Report for CB and R&B
  3. FY 17-18 ODS Waiver NTP Non-Perinatal
  4. FY 17-18 ODS Waiver NTP Perinatal
Drug Medi-Cal Cost Report Reference
  1. DMC Cost Report User Manual
  2. FY 17-18 Instructions for Completing Cost Report Forms
  3. Sample - DMC FY 2017-18 ODS Cost Report-Demonstration
  4. Sample - NTP Cost Report Demonstration
  5. Cost Report FAQ
  6. Allowable Costs-Federal Register Vol 78, No 248 (P78640 to P78662)
  7. Allowable & Disallowable Cost reference - additional
  8. NTP Cost Reporting new requirement starting FY 2019-20-Information-Notice-19-005-NTP
  9. Sample SAGE Report - Payment Summary Report
  10. Sample SAGE Report - Contract Performance Report - Details
  11. Sample SAGE Report - Contract Performance Report - Summary
  12. Sample of Monthly Payment Report
  13. Lower of Cost or Charges - Illustration
  14. Cost Allocation method - Staff Hours Cost Allocation Calculation from DMC
Non-Drug Medi-Cal funded Contracts Fiscal Year 2019-20
Non-Drug Medi-Cal Cost Report PowerPoint FY 2019-20
Non-DMC Cost Report Forms and Instructions
  1. Non-DMC Contract (Long Form) - OT, IOT, RES, RBH, Room and Board, Case Management, etc.
  2. Non-DMC Contract (Short Form) - Prevention, APS, CENS, TTA, CW, API, FSC, In-Custody, etc.
  3. NPR 10% Gross Budget Adj. Worksheet
Non-Drug Medi-Cal Cost Report Reference
  1. Sample - Statement of Work (SOW) Contract Maximum Obligation
  2. Sample NPR Cost Line Item Budget
  3. Sample - Non-DMC Cost Report
Driving Under The Influence (DUI) Program Fiscal Year 2020-21
DUI Cost Report PowerPoint 2020-21
Cost Report Forms and Instructions
  1. DUI Cost Report Form 2020-21
  2. Sample DUI Form 2020-21
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