CMS-07-021/023 - Los Angeles County Department of Children and ...

EXHIBIT A
If a Placed Child does not have valid proof of Medi-Cal coverage, the
CONTRACTOR shall immediately contact the Foster Care Payment
Hotline (800-697-4444) and notify the CSW.
3.8.2 Reimbursement for Medical, Dental, and Psychiatric Costs
The CONTRACTOR shall utilize the Medi-Cal program for all eligible
medical, dental, and psychiatric care costs for Placed Children.
For any services not eligible for Medi-Cal reimbursement and not covered
by private insurance, the CONTRACTOR shall, to the extent feasible,
obtain medical, dental, or psychiatric care services for the Placed Child
through a COUNTY or COUNTY contracted facility.
For any non-emergency services not eligible for Medi-Cal reimbursement,
not covered by private insurance, and not obtainable at a COUNTY or
COUNTY contract facility, the CONTRACTOR must request by facsimile
prior written approval from the CSW or the CSW’s supervisor (SCSW). If
the CSW does not respond to CONTRACTOR’S written request within
three (3) business days, CONTRACTOR shall attempt to contact the
SCSW. CONTRACTOR shall maintain written documentation of attempts
to obtain said written approval.
The CONTRACTOR shall, to the extent possible, utilize a Child Health
Disability Prevention (CHDP) provider doctor/dentist, who does CHDP
equivalent exams and performs the initial medical/dental assessment,
care, and follow through. See Exhibit A-IX, Requirements for
Medical/Dental Exams for Placed Children (Periodicity Schedule for Health
Assessment Requirements by Age Groups).
If CONTRACTOR needs assistance in locating a CHDP provider
doctor/dentist, CONTRACTOR may (1) log onto the web site of the Los
Angeles County Department of Health Services at
http://lapublichealth.org/cms/chdp/, (2) contact the Placed Child’s CSW,
(3) contact a DCFS Public Health Nurse, or (4) contact the DCFS Medical
Director’s Office at (213) 351-5614.
3.8.3 Physical/Dental Exams, Medical/Dental Care, and Medical/Dental
Instructions Prior to Emancipation
To the extent reimbursed by Medi-Cal or private insurance or otherwise
reimbursed by the COUNTY, the CONTRACTOR shall ensure that each
Placed Child receives routine physical and dental exams, any needed
medical or dental care, and information and instructions on any on-going
medical or dental treatment or medications needed within the three-month
period prior to Emancipation.
3.8.4 Emergency Psychiatric Treatment
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