Cost Report Training Materials

FY 2022-23 Cost Report Training

• Video
• Powerpoint
• FY 2022-23 Cost Report Template (updated 02/05/24)
• Handouts
  • 1 – General Guidelines
  • 2 – Submission Criteria
  • 3 – List of Cost Report Forms
  • 4 – Certification Form
  • 5 – Source of Information for Units of Service
  • 7 – Allowable/Unallowable Cost References
  • 8 – False Claim
  • 9 – Instructions for Eligible CSS Expenditure
  • 11 – Cost Report Data Re-Enter Response Form
  • 12 – Settlement Contact
  • 13 – Current DHCS Audit Settlement Timeframe
  • 14 – FMAP_2011 Realignment, SGF, Local Match allocations
  • 15 – DHCS Info Notice BHIN 23-020 FMAP and COVID Rate Rollback  
  • 16 – FSP Incentive Recon Worksheet
  • 17 – CBO Bulletin_FY 2022-23 CMA

 

FY 2022-23 Final Shift Request Training

• Video
• Powerpoint
• Final Shift Request Form Sample
• Cost Report Worksheet Sample
• Cost Report Worksheet (Blank)
• NGA CBO Bulletin 23-002: Countywide Maximum Allowance
• BHIN 23-020: Rollback of Federal Medical Assistance Percentages (FMAP)

FY 2021-22 Final Shift Request Training

• Video
• Contract Reallocation/Shift Request Form (FY 2021-2022)

FY 2021-22 Cost Report Training

• Video
• Powerpoint

Cost Report Template
Cost and Financial Report Template (FY 2021-2022)

Frequently Asked Questions
Q & A for Cost Report (Coming Soon)

Handouts

1 – General Guidelines
2 – Submission Criteria
3 – List of Cost Report Forms
4 – Cost Report Letter of Certification
5 – FY 2021-22 Source(s) of Information for MH 1901 Schedule B, LAC102, and LAC 102 Supplement Forms
6 – Detailed Cost Report Instructions Manual 
7 – Allowable/Unallowable Cost References
8 – False Claim
9 – FY 2021-22 Cost Report Instructions for Eligible Client Support Services Expenditures 
9A – Schedule of Eligible Direct Costs
10A – Third Party Revenue Breakdown
11 – FY 2021-22 Cost Report Data Re-Enter Response Form
12 – LE Assigned Analyst List
13 – UOS Time Base for Rate Calculation
14 – Proposed DHCS Audit and Settlement Timeframe for SD/MC Cost Report
15 – FY 2021-22 Federal Financial Participation (FFP), 2011 Realignment, State General Fund, and Local Match Allocation Schedule
16 – Board Letter – Approval to Waive SMHS Countywide Maximum Allowances in the Determination of Reimbursable Costs for Legal Entity Cost Reports and Settlements due to COVID-19
17 – All County Information Notice No I-73-21 / Behavioral Health Information Notice No. 21-055

 

Archive of FY 2020-21 Cost Report Training Materials

• Beginner/Intermediate
  • Video
  • Powerpoint
• Advanced
  • Video
  • Powerpoint
• Hospital
  • Video
  • Powerpoint
• Q & A for Cost Report
• Cost and Financial Report Template (FY 2020-2021)
• Handouts
  • 1 – General Guidelines
  • 2 – Submission Criteria
  • 3 – Cost Report Required Forms
  • 4 – Cost Report Letter of Certification
  • 4A – Source of Units of Service Information
  • 5 – Cost Report Staff Contacts
  • 6 – DHCS Cost Report Instruction Manual (Revised 8/4/21)
  • 7 – Allowable/Unallowable Cost References
  • 8 – False Claim
  • 9 – Reporting Eligible Direct Cost Instructions 
  • 9A – Schedule of Eligible Direct Costs (Revised 8/24/21)
  • 10 – Cost Report Sample
  • 10A – Third Party Revenue Breakdown
  • 10B – EPSDT Units of Service (Revised 10/26/21)
  • 11 – Adult OTT & Child OTT Costs and Units Form (Revised 8/23/21)
  • 12 – -LE Assigned Analyst List
  • 13 – UOS Time Base for Rate Calculation
  • 14 – FY 2020-21 FFP, 2011 Realignment Fund, SGF, and Local Match Allocation Percentage
  • 15 – Proposed DHCS Audit and Settlement Timeframe for SDMC Cost Report
  • 16 – Post CR Shift Request Form FY 2020-21
  • Board Letter – Approval to Waive Specialty Mental Health Services Countywide Maximum Allowances in the Determination of Reimbursable Costs for Legal Entity Cost Reports and Settlements due to Covid-19