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
FY 2021-22 Cost Report Training
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
- Advanced
- Hospital
- 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