Documents
Commonly Asked Questions
These questions
are a representative sample of those generated during the second round.
If you have a question that has not been addressed here, feel free to
contact
Laura Koch, Program Specialist.
Priorities
The Process
Co-Occurring Disorders
Budget
Miscellaneous
Priorities
Q: How were the priorities for
the second round of expansion identified?
A: The priorities were
established by examining the Children’s Mental Health Services
System in Alameda County. This included looking at all existing
programming, including the programs funded during the first round of EPSDT expansion, and gathering input from work groups and the county
steering committee for EPSDT expansion, to identify the gaps.
Q: Would you clarify the
statement that there is no money for expansion of existing programs
in the second round? What about a proposal to provide more services
to children already in treatment if it falls within one of the
priority groups?
A: Some providers funded in the
first round had hoped that the second round would allow them to
expand, now that they have gained expertise and built the
infrastructure to support their new programs. However the amount
available for the second round is less than initially predicted, and
BHCS made the decision to target the second round to specific
areas/groups where there are still large gaps in the system of care,
even after the tremendous growth made possible by the first round.
If you would like to extend existing services to a priority
population, submit this as a new RFI.
While second round funding is that it
will be targeted to programs that fill an identified need, this does
not mean there is a lack of awareness that there are other
populations with unmet needs and providers ready and willing to
serve them.
Q: Will there be an opportunity
for future expansion?
A: Future expansion is contingent
on the availability of additional Federal, State and local funding.
At this time it is difficult to predict when such funding will be
available.
Q: How should we handle a
proposal to begin providing services we currently provide (through EPSDT/Medi-Cal/other) to a priority group?
A: Submit a proposal for a new,
separate program to provide these services.
Q: The eastern and southern parts
of Alameda County are identified as priority areas. What cities are
included?
A: We consider South County to
include San Leandro to Fremont, and East County to include Castro
Valley to Livermore.
Q: How do children with
disabilities or children in families with disabilities fit into the
priority populations?
A: This is not a specific target
population for the second round, but if the program otherwise falls
within the identified priorities, it will be considered - as long as
it serves children with a primary mental health diagnosis. The
services also cannot be a duplication of those received through
another public funding source, such as AB 3632/SB 90 or the Regional
Center. Also, as with any EPSDT service, there must be a reasonable
expectation that treatment will ameliorate the condition.
Q: Will a provider with an
existing track record of serving one of the target populations have
priority over a new provider?
A: A provider’s experience with
the target population is one of many factors taken into
consideration in evaluating a proposed program.
The Process
Q: Since we have a current EPSDT
contract, will this allow us to start a new program more quickly?
A: Your start date will depend on
many variables, some of which are outside of our control. Some
programs will take longer than others to approve and implement.
Having an existing contract may speed the process slightly, but this
is not guaranteed. Therefore, it is impossible for us to predict a
start date.
Q: Would an existing EPSDT
provider with current Medi-Cal certification need an additional
certification to provide services in a new location?
A: Yes, each site where services
are provided needs to be certified. The only thing required to
certify an additional site when the provider is already certified is
a site visit to establish the safety of the environment and the
confidentiality and completeness of medical records. You will
discuss this issue with your liaisons when the time comes.
Q: If our program is selected,
what will be the next steps?
A: Once selected, new providers
will be required to complete the BHCS Provider Application and the
process for Medi-Cal certification. This includes items such as:
• A Provider Profile
• Financial and Contract Requirements
• Data Entry Requirements
• Administrative Requirements
• Clinical/Quality Assurance Requirements
• Site Certification
• A Fire and Safety Clearance
You will then complete a detailed
contract with BHCS. It will specify the amounts and types of
services you will provide. You will complete a budget that is more
detailed than the one submitted with the RFI. You will receive
assistance from your assigned program and fiscal liaisons in going
through this process.
Co-Occurring Disorders
Q: As an AOD provider, would we
have to be mental health certified?
A: Yes, mental health
certification is different from AOD certification.
Q: How can AOD treatment be
provided under mental health/EPSDT?
A: The
following criteria apply for EPSDT funding of AOD treatment:
-
the client is
under 21 with full-scope Medi-Cal and meets medical necessity
criteria
-
the primary
diagnosis is a qualifying mental health diagnosis. These are listed
on the web site.
-
the AOD diagnosis
is secondary, and can be treated in the course of treating the
mental health diagnosis.
-
all services must
be supervised by a Licensed Mental Health Professional.
Q: How is EPSDT different from
Drug Medi-Cal (DMC) for a provider serving AOD clients?
A: DMC requires that an AOD
diagnosis be the primary diagnosis. For more information on DMC
(which is not part of this expansion), call the State of
California’s Department of Alcohol & Drugs at (916) 445-1942.
Budget
Q: Can you explain how to reflect
the time and wages for a staff person who would not be working full
time in the proposed program?
A: List all staff associated with
the new program and show the percentage of time to be spent in that
specific program (percentage of FTE, based on a 40 hour work week).
Example A: A provider has one full-time supervisor who will spend 30
hours per week supervising staff of the new program and 10 hours per
week with a program that is not part of the RFI. In the EPSDT
program budget column, the line for the program supervisor would
show 75% of the person’s salary, and the FTE column would say “.75”.
Example B: A new program would bring in a licensed psychologist to
provide clinical supervision for staff, for a total of 8 hours per
week. The program’s budget column would list the psychologist’s
wages and “.20” under FTE, since the eight hours is 20% of a 40 hour
work week.
Q: If a program assistant would
be hired specifically for this program, should the cost be listed
under Salaries & Wages or Admin?
A: The program assistant would be
listed in the Salaries & Wages section, with the FTE percentage and
salary amount listed under the applicable program budget column.
Q: If a provider is already a
Level III provider and serving children with Medi-Cal, should the
Medi-Cal rate for services be included under Revenue?
A: Only list revenue that is
associated with a program or programs in the RFI that would come
from sources other than BHCS. If you currently have a Specialty
Mental Health Services Agreement with Alameda County (i.e., a
contract to provide Level III services), please explain this in the
“EPSDT Growth: Request for Information Document.”
Q: What is meant by the term
“appropriate allocation methodology” in the instructions for the RFI
budget?
A: Providers have a choice of
either showing all costs related to a program as direct costs
(listing an amount for each line-item) or allocating their admin
costs using an appropriate allocation methodology (and showing the
total on the “Admin” row). The RFI budget is a condensed version of
the more detailed budget that you will need to complete if your
program is accepted; on that budget, you will be required to
complete an Admin budget column detailing all costs included in the
amount you list on the Admin row.
“Direct costs” are those that can be identified specifically with a
particular program. This would include salaries, including
associated fringe benefits, of those personnel whose effort can be
directly identified to a particular program or cost objective; other
types of expenses would be treated similarly. An “indirect cost” is
defined as “a cost incurred for a common or joint purpose benefiting
more than one cost objective, and not readily assignable to cost
objectives specifically benefited.” This would include salaries or
operating expenses that relate to both your EPSDT program and other
programs in your organization where it is not possible to break out
the amounts as direct costs. An appropriate allocation methodology
would then need to be used to determine the indirect cost rate that
is applied to each program. For example, you may have administrative
costs that relate not only to your EPSDT program but to your entire
agency. To allocate these expenses, you could take a percentage
showing the total cost of the EPSDT program over the total cost of
all programs that benefit from this expense and distribute the costs
accordingly.
The decision to treat a certain cost as indirect or direct will
depend upon the treatment of that cost within your organization’s
accounting system. An expense that is treated as a direct cost at
one organization may be treated as an indirect cost at another
organization. Regardless of what cost allocation methodology is
adopted by an organization, it must be documented and applied
consistently, ensuring that all costs are charged in a uniform
manner to all other work of the organization. For direct costs that
are allocated, you would also want to use whatever allocation method
was most appropriate for that expense. For instance, you might want
to allocate the rent based on the square footage of space being
occupied by each program. Again, it is up to your organization to
determine the most appropriate methodology to use under each
circumstance and to maintain appropriate documentation in case of an
audit.
Miscellaneous
Q: Who needs to complete the
School Readiness Checklist?
A: School-based programs are the
only ones who need to submit the School Readiness Checklist. Programs that are not school-based but occasionally deliver services
at a school site do not need to submit the checklist.
Q: If we will be expanding to a
new site, do we need to have that secured before submitting the RFI?
A: No, that is not necessary. If
your proposal is accepted, you could proceed with securing the site
in coordination with the completion of your contract.
Q: If a second round RFI was
submitted earlier, is a new one required now?
A: Providers who have an RFI on
file for an EPSDT program to be considered as part of the second
round of expansion should have received an email detailing their
three options. They may choose to edit the current proposal,
continue with the earlier proposal as written, or withdraw their RFI
for evaluation in the second round.
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