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Support Files

Quarterly Federal Financial Management Report (QFFMR) 2008-09

• QFFMR - 1st Quarter FY 2008-09
• QFFMR - 2nd Quarter FY 2008-09
• QFFMR - 3rd Quarter FY 2008-09
• QFFMR - 4th Quarter FY 2008-09

Quarterly Federal Financial Management Report (QFFMR) 2007-08

• QFFMR - 1st Quarter FY 2007-08
• QFFMR - 2nd Quarter FY 2007-08
• QFFMR - 3rd Quarter FY 2007-08
• QFFMR - 4th Quarter FY 2007-08

County Contract Boilerplate (FY 07-08)

• Table of Contents for NNA-DMC 07-08 Boilerplate
  
• Table of Contents for NNA 07-08 Boilerplate
  
• NNA-DMC 07-08 Boilerplate - Exhibit B - Final
  
• NNA-DMC 07-08 Boilerplate - Exhibit C - Final
• NNA-DMC 07-08 Boilerplate - Exhibit D - Final

Direct Provider Contract Boilerplate (FY 07-08)

• Table of Contents for FY 2007-08 DMC Direct Contract Boilerplate
• DMC Direct Contract Boilerplate - Final

County Budget (FY 2007 - 08 V.2)

• Contract Procedures and Timelines
• County Worksheet Instructions
• County Contract Review Checklist
• County Worksheets
• Cover Letter to Counties
• Federal and State Funding Allocation and Budget and Cost Comparison Worksheet - SAMPLE
• Federal and State Funding Allocation and Budget and Cost Comparison Worksheet
• Funding Line Descriptions
• 0708-FMAB County Assignment Listing
• Master NTP-AD-0708
• Master NTP-P-0708
• NTP Perinatal Budget Worksheet Instructions
• NTP Non-Perinatal Budget Worksheet Instructions
• Program Code Listing
• Service Code Descriptions
• Local Assistance Funding Matrix
• Matrix of Documents and Reports-County Submission Requirements

Direct Provider Budget (FY 2007-08 V.2)

• V.2 Budget Transmittal Cover Letter
• V.2 Budget Form Instructions
• 0708 DP Budget Non NTP-AD Proposed Budget
• 0708 DP Budget Non NTP-P Proposed Budget
• 0708 DP Budget NTP-AD Proposed Budget
• 0708 DP Budget NTP-P Proposed Budget
• Direct Provider Assignment - March 2008

County Cost (FY 07 - 08)

• Average Instructions
• County Certification Form
• County Worksheets Instructions
• DCR-AD Instructions
• DCR-P Instructions
• Exhibit Listing-Counties
• Funding Line Desciptions
• Hours Instructions
• ODFG-AD Instructions
• ODFG-P Instructions
• ODFI-AD Instructions
• ODFI-P Instructions
• RES-P Instructions
• Service Code Descriptions
• Submission-Counties
• Unit Definitions
• NTP-AD County Instructions
• NTP-P County Instructions
• AVERAGE - Non Perinatal
• AVERAGE - Perinatal
• County Worksheets
• DCR-Alcohol and Drug
• DCR-Perinatal
• DMC Rates
• FMAB County Assignment Listing
• Funding Line Comparison Report
• HOURS - Non Perinatal
• HOURS - Perinatal
• Letter - Release of FY 2007-08 Cost Report
• NTP-Alcohol and Drug-County
• NTP-Perinatal-County
• ODF Group-Alcohol and Drug
• ODF Group-Perinatal
• ODF Individual-Alcohol and Drug
• ODF Individual-Perinatal
• Program Code Comparison Report
• RES-Perinatal
• Service Code Comparison Report

Direct Provider Cost (FY 07-08)

• Transmittal Letter
• Submission Instructions
• Direct Provider Certification Instructions
• Direct Provider Certification Form
• DCR Alcohol and Drug Instructions
• DCR Alcohol and Drug Forms
• DCR Perinatal Instructions
• DCR Perinatal Forms
• NTP Alcohol and Drug Instructions
• NTP Alcohol and Drug Forms
• NTP Perinatal Instructions
• NTP Perinatal Forms
• ODF Alcohol and Drug Instructions
• ODF Alcohol and Drug Forms
• ODF Perinatal Instructions
• ODF Perinatal Forms
• RES Perinatal Instructions
• RES Perinatal Forms
• FMAB Direct Provider Assignment Listing (May 2008)

Contracts Document Package (FY 07-08)

Web Based Documents

• Document 1A: Title 45, Code of Federal Regulations 96, Subparts C and L, Substance Abuse Prevention and Treatment Block Grant Requirements
• Document 1B: Title 42, Code of Federal Regulations, Charitable Choice Regulations
• Document 1G: Perinatal Services Network Guidelines 2004
• Document 1K: Drug and Alcohol Treatment Access Report (DATAR) and Provider Waiting List Record (WLR)
• Document 1V: Youth Treatment Guidelines
• Document 1T - CalOMS Prevention User Manual
• Document 2C: Title 22, California Code of Regulations
• Document 2Y: Companion Guide for HIPAA 837P and 835 Transactions (February 1, 2008)
• Document 3E: ADP Bulletin #05-03 – HIPAA Drug Medi-Cal Claim Submission Policy
• Document 3F: ADP Bulletin #05-10 – Acceptable Drug Medi-Cal Claim Format for Processing
• Document 3G: California Code of Regulations, Title 9 – Rehabilitation and Developmental Services, Division 4 – Department of Alcohol and Drug Programs, Chapter 4 – Narcotic Treatment Programs
• Document 3H: California Code of Regulations, Title 9 – Rehabilitation and Developmental Services, Division 4 – Department of Alcohol and Drug Programs, Chapter 8 – Certification of Alcohol and Other Drug Counselors
• Document 3J: CalOMS Data Collection Guide
  

Word Documents

• Document 1C: Driving-Under-the-Influence Program Requirements
• Document 1D(a): Services to California Department of Corrections and Rehabilitation (CDCR) – Parolee Services Network (PSN)
• Document 1D(b): SAPT Female Offender Treatment Project (FOTP)
• Document 1F: Matrix of Documents, Reports and/or Data
• Document 1H(a): Service Code Descriptions
• Document 1J(a): NNA Audit Appeals Process
• Document 1J(b): DMC Audit Appeals Process
• Document 1P: Alcohol and/or Other Drug Program Certification Standards (March 15, 2004)
• Document 1W: Certification Regarding Lobbying
• Document 1X: Disclosure of Lobbying Activities – Standard Form LLL
• Document 2E - Drug Medi-Cal Certification Standards for Substance Abuse Clinics (Updated July 1, 2004)
• Document 2F: Standards for Drug Treatment Programs (October 21, 1981)
• Document 2P: County Certification - Cost Report Year-End Claim For Reimbursement
• Document 2P(a)2: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Alcohol and Drug - Instructions
• Document 2P(b)2: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Perinatal (Instructions)
• Document 2P(c)2: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual Counseling – Alcohol and Drug (Instructions)
• Document 2P(d)2: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual Counseling – Perinatal (Instructions)
• Document 2P(e)2: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Group Counseling – Alcohol and Drug (Instructions)
• Document 2P(f)2: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Group Counseling – Perinatal (Instructions)
• Document 2P(g)2: Drug Medi-Cal Cost Report Forms – Residential – Perinatal (Instructions)
• Document 2P(h)2: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – County – Alcohol and Drug (Instructions)
• Document 2P(i)2: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – County – Perinatal (Instructions)
• Document 2Q1: Direct Provider Certification - Year-End Claim for Reimbursement (Form)
• Document 2Q2: Direct Provider Certification - Year-End Claim for Reimbursement (Instructions)
• Document 2Q(a)2: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual and Group Counseling – Direct Provider – Alcohol and Drug (Instructions)
• Document 2Q(b)2: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual and Group Counseling – Direct Provider – Perinatal (Instructions)
• Document 2Q(c)2: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – Direct Provider – Alcohol and Drug (Instructions)
• Document 2Q(d)2: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – Direct Provider – Perinatal (Instructions)
• Document 2Q(e)2: Drug Medi-Cal Cost Report Forms – Residential – Direct Provider – Perinatal (Instructions)
• Document 2Q(f)2: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Direct Provider – Alcohol and Drug (Instructions)
• Document 2Q(g)2: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Direct Provider – Perinatal (Instructions)
• Document 3K: Business Associate Agreement: County is the Business Associate of the Department of Alcohol and Drug Programs
• Document 3M: Business Associate Agreement: Direct Contract Provider is the Business Associate of the Department of Alcohol and Drug Programs
• Document 3N: Business Associate Agreement: Department of Alcohol and Drug Programs is the Business Associate of the Direct Contract Provider

Excel Documents

• Document 1H(b): Program Code Listing:
• Document 2H - Drug Medi-Cal Monthly Summary Invoice (ADP 1592)
• Document 2J: Provider Report of Drug Medi-Cal Claims Adjustments (ADP 5035C) – Form/Instructions
• Document 2K: Multiple Billing Override Certification (ADP 7700)
• Document 2L: Good Cause Certification (ADP 6065):
• Document 2P(a)1: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Alcohol and Drug (Forms)
• Document 2P(b)1: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Perinatal (Forms)
• Document 2P(c)1: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual Counseling – Alcohol and Drug (Forms)
• Document 2P(d)1: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual Counseling – Perinatal (Forms)
• Document 2P(e)1: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Group Counseling – Alcohol and Drug (Forms)
• Document 2P(f)1: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Group Counseling – Perinatal (Forms)
• Document 2P(g)1: Drug Medi-Cal Cost Report Forms – Residential – Perinatal (Forms)
• Document 2P(h)1: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – County – Alcohol and Drug (Forms)
• Document 2P(i)1: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – County – Perinatal (Forms)
• Document 2Q(a)1: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual and Group Counseling – Direct Provider – Alcohol and Drug (Forms)
• Document 2Q(b)1: Drug Medi-Cal Cost Report Forms – Outpatient Drug Free Individual and Group Counseling – Direct Provider – Perinatal (Forms)
• Document 2Q(c)2: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – Direct Provider – Alcohol and Drug (Forms)
• Document 2Q(d)1: Drug Medi-Cal Cost Report Forms – Narcotic Treatment Program – Direct Provider – Perinatal (Forms)
• Document 2Q(e)1: Drug Medi-Cal Cost Report Forms – Residential – Direct Provider – Perinatal (Forms)
• Document 2Q(f)1: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Direct Provider – Alcohol and Drug (Forms)
• Document 2Q(g)1: Drug Medi-Cal Cost Report Forms – Day Care Rehabilitative – Direct Provider – Perinatal (Forms)
• Document 3A: Exhibit A1, Proposed Budget Form – Non-Narcotic Treatment Program – Alcohol and Drug (for direct contract providers only)
• Document 3B: Exhibit A1, Proposed Budget Form – Non-Narcotic Treatment Program – Perinatal (for direct contract providers only)
• Document 3C: Exhibit A1, Proposed Budget Form – Narcotic Treatment Program – Perinatal (for direct contract providers only)
• Document 3D: Exhibit A1, Proposed Budget Form – Narcotic Treatment Program – Alcohol and Drug (for direct contract providers only)
  

Adobe Reader Documents

• Document 2E - Drug Medi-Cal Certification Standards for Substance Abuse Clinics (Updated July 1, 2004)
• Document 2F - Standards for Drug Treatment Programs (October 21, 1981)
• Document 2H:Drug Medi-Cal Monthly Summary Invoice (ADP 1592)

Scanned Documents

• Document 2A:Sobky v. Smoley, Judgment, Signed February 1, 1995