fiscal officers training manual - New York State Conference of Local ...

FISCAL OFFICERS TRAINING MANUALINTRODUCTIONWELCOME TO THE FISCAL OFFICERS TRAINING MANUAL!The Fiscal Officers Training Manual serves as a guiding document on various aspects of Mental Hygiene funding. Itis designed to provide new and current fiscal officers direction and instruction on how to perform their fiscalresponsibilities of oversight and management of Mental Health, Alcohol and Substance Abuse, and DevelopmentalDisabilities services within their county.The manual is divided into three sections: introduction, table of contents, and procedures. It is a dynamic documentand is intended for reference purposes only. The policies and procedures are not all inclusive and should not bemisconstrued as such.Sincere gratitude to the following members of the Fiscal Officers Manual Workgroup who contributed their timeand expertise to the development of this Business Process document:Peg LaWareJim MonfortJill TibbettLaurie DurhamSean GanterRob CareyKarolyn SaylesJason KubyAngelica TorresNYS OMH Central OfficeCCSICentral NYS OMH Field OfficeClinton CountyEssex CountyGreene CountyMadison CountyMonroe CountySuffolk CountyThe manual is maintained by a Fiscal Officers Manual Workgroup comprised of county Fiscal Officers and NYS Field Officestaff and membership may change annually. Please send any comments and/or suggestions to Mary CoppolaMC@clmhd.org and they will be directed to the appropriate workgroup members.The purpose of the Fiscal Officers Manual Workgroup is not meant to support Fiscal Officers, but to provide written directionand instruction. If you have any questions or need assistance with any of the procedures, please call your appropriateLocal Field Office for assistance.

FISCAL OFFICER TRAINING MANUALTABLE OF CONTENTSI. OverviewA. IntroductionB. Calendar Cycle Overview1. Calendar Year2. Fiscal YearII. State Aid Funding (Net Deficit)A. NYS State Aid Funding LetterB. NYS State Advance PaymentsIII. Other Revenue Sources (if applicable)A. MedicaidB. Comprehensive Outpatient Program Services (COPS)C. Community Support Program Services (CSP)D. Disproportionate Share Income (DSH)E. Federal Medicaid Salary Sharing (FSS)IV. County Reports and DeliverablesA. County Budget ProcessV. NYS Agency Reporting RequirementsA. NYS Deliverables and Sanctions1. OMH2. OASAS [under construction]3. OPWDDB. Preliminary Allocation Summary (PAS) (OMH - discontinued 2011)C. County Allocation Tracker (CAT) [under construction] (OMH)D. Budget Submission Process (CBR) (OMH, OPWDD, OASAS)9/30/2011

E. Program Budget Change Request (PBCR) (OASAS)1. PBCR Form (OASAS)F. Consolidated Quarterly Report (CQR) Submission (OASAS)G. Consolidated Fiscal Report (CFR) (OMH, OPWDD, OASAS)H. Final Year End Claim Submission (OMH, OPWDD, OASAS)VI. Closeouts / ReconciliationsA. NYS Closeout Review1. OMH2. OASAS3. OPWDDB. Provider Reconciliations and Recovery ProcessVII.Other NYS Requirements and ReportsA. Equipment Purchases Approval by Field Office1. OMH2. OASAS3. OPWDD [under construction]B. Federal Funds Certifications and Assurances (OMH)C. Single Audit (A133) (OMH, OPWDD, OASAS)D. Uncompensated Care Report (OMH)VIII. Programs and Program Fiscal ModelsA. Case Management Fiscal Models (OMH)B. Case Management Service Dollars (OMH)C. Personalized Recovery Oriented Services (PROS) (OMH)D. Child and Family Clinic Plus (OMH)E. Clinic Restructuring Overview (OMH, OASAS)IX. Applications / WebsitesA. Aid to Localities Fiscal System (ALFS) Access (OMH)9/30/2011

B. Mental Health Provider Database (MHPD) (OMH)C. State Aid Budget & Reporting System (SABRS) [under construction] (OASAS)X. Additional ResourcesA. AcronymsB. CBR & Claiming ManualC. CFR ManualD. Aid to Localities Spending Plan GuidelinesE. NYS OMH / OMR / OAS Websites1. CFRS mailing listF. Fiscal Officer MeetingsG. NYS Field OfficesH. What is?1. “Form AC1171”2. “NPI”3. Patient CharacteristicsI. Program Changes – What do you do?1. PAR2. MHPDJ. OMH Statistics and Reports9/30/2011

FISCAL YEAR CYCLE (NYC) – STATE DELIVERABLESLegend: CalendarFiscal CyclesPrior Year: (-1) Jan (-1) to Dec (-1) State: April 1 – March 31Current Year: (0) Jan (0) to Dec (0) OMH/OAS/OPW Community Budget: July 1 – June 30Next Year: (+1) Jan (+1) to Dec (+1) Upstate / Downstate Counties: January 1 – December 31NYC: July 1 – June 30Direct State Contracts: VariesJan 1/1 County - Provider Claims / Payment Reconciliations for Year (-1)1/15 NYS Closeout packages begin being received for Year (-1)1/21 OMH Federal Medicaid Salary Sharing (FSS) Quarter 2 for Year (-1)Feb 2/15 OAS Mid-Year Claims due for Year 0Mar 3/1 OAS CBR’s due for Year +1 (with work scope)3/31 Federal Single Audits due for Year (-1)Apr 4/21 OMH Federal Medicaid Salary Sharing (FSS) Quarter 3 for Year (-1)May 5/1 County Provider Contracts processed for Year +1 (varies)Jun 6/1 Final Equipment Requests due to NYS FO for Year 06/15 Federal Certifications Due for Year +16/31 OPW Budgets and Contract for Year +1July 7/21 OMH Federal Medicaid Salary Sharing (FSS) Quarter 4 for Year (-1)AugSep 9/1 OMH MHPD updates for Year 0Oct 10/1 OMH CBR’s due for Year 010/1 OMH Preliminary Allocation Summary (PAS) for Year 010/21 OMH Federal Medicaid Salary Sharing (FSS) Quarter 1 for Year 0Nov 11/1 OAS Estimated Claims Due for Year (-1)11/1 Pre-Approved 30 Day Extension Request Due for Year (-1) (OMH, OASAS, OPWDD)11/1 CFR’s Due w/o 30-Day Extension (OMH/OPW/OAS) for Year (-1)Dec 12/1 CFR’s Due with 30-Day Extension for Year (-1)12/15 Final Claims Due (OMH/OPW/OAS) for Year (-1)12/31 OPW Budgets and Contract for Year 012/1 County Budget Process Begins for Year +1 (varies)Updated: May 1, 2011

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALNYS STATE AID FUNDING LETTERState Aid funding for Local Governmental Units (LGU’s), county operated programs and county contracted serviceproviders are communicated via State Aid Funding Letter process. State Aid Funding Letters are issued to LGU’s by eachof the applicable Department of Mental Hygiene (DMH) State Agencies (the Office of Mental Health – OMH, the Office ofAlcoholism and Substance Abuse Services-OASAS, and the Office for People With Developmental Disabilities – OPWDD)for a specified fiscal reporting period.Brief Description of Process: (how does it work?)State Aid Funding Letters are usually issued to the LGUs by the applicable DMH State Agency (OMH/OASAS/OPWDD)prior to start of the fiscal period covered. Each DMH State Agency displays their State Aid allocations in differentformats.OMH: Funding Letters are issued by funding source code and are not service provider specific. OMH funding is allocatedthrough the LGU to subcontracted not-for-profit service providers and county operated programs (if applicable as not allcounties directly operate services).OASAS: Funding Letters are service provider, program, and funding source specific.OPWDD: Funding Letters are agency and funding source specific.It is the responsibility of the LGU to identify any changes in funding from previous funding letters and facilitate theallocation of the correct funding amounts to the service providers. Local services contracts between the LGU andsubcontract agencies are developed to reflect the funding being allocated and the service/program expectations.Direct State Contracts are contracts between NYS and a provider agency that does not include the County. The fundingflow direct from NYS to the provider and is not included on the County State Aid Funding Letter.Frequency:Initial funding letters from each DMH State Agency are generally issued prior to or close to the beginning of the fiscalperiod that they cover. There can be many revisions of these letters throughout the fiscal period that reflect additions,reductions or shifts in funding that may occur as a result of fiscal changes at the State level. OMH State Aid FundingLetters are issued quarterly and as needed on a county-specific basis.Instructions:The OMH State Aid Funding letters are not agency specific and funds must be allocated and approved by the LGU. OMHState Aid Funding Letters are transmitted to the LGU through the Aid to Localities Financial System (ALFS). OMH StateAid Funding Letter also includes; 1) a cover letter with instructions/important updates, 2) number of fundingslots/beds/managers in modeled programs, 3) county Case Management models, and 4) where applicable, DSHthresholds.The OASAS State Aid Funding letter is both agency and program specific. Note: Each State Aid Funding Authorizationmust be signed by the Director of Community Services and returned to NYS OASAS. OASAS State Aid Funding Lettersare mailed to the County Director of Community Services or designee on file.The OPWDD State Aid Funding letter is agency specific. OPWDD State Aid Funding Letters are mailed to the CountyDirector of Community Services or designee on file.The LGU is responsible for the verification of approved funding levels and contracting for all State Aid funding allocationsfor their County. Changes to funding may result in Contract amendments for subcontracted provider agencies. Providersshould be notified of any funding changes that may affect them.

It is the responsibility of the LGU to ensure that correct funding codes, funding code indexes, site codes, and fundingamounts, including calculations of funding increases or reductions, for the current fiscal period are relayed to the serviceproviders. This may result in contract amendments at the county level.Direct Contracts are service contracts between NYS and a provider agency. LGU’s are not responsible for any actionsrelated to the contracts including: reviewing, informing, auditing, reporting, etc. of any Direct Contracts. Direct Contractscan usually be identified on the CFRS submissions with Contract #’s starting with C###### or T#######. DirectContracts include all of the reporting requirements as Local Contracts (funding flowing through the County State AidFunding letter), but all submission requirements are sent directly to the state.Resources:1. NYS Consolidated Budget & Claiming Manual, “Local Governmental Unit (LGU) Responsibilities”2. NYS Consolidating Fiscal Reporting Manual, “Introduction to State Aid Claiming in the CFRS” sections. Themanuals can be accessed at http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFR.html.3. Aid to Localities Spending Plan Guidelines: http://www.omh.state.ny.us/omhweb/spguidelines/selectletter.aspDate: May 1, 2011OMH Review: 8/27/10OASAS Review: 2/9/11OPWDD Review: (none)

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALNYS STATE ADVANCE PAYMENTSEach disability, Office of Mental Health (OMH), Office of Alcoholism & Substance Abuse Services (OASAS), and Office ofPeople with Developmental Disabilities (OPWDD), send payments for local service contracts to County’s Local GoverningUnits. The basis for the payments is the County’s State Aid Funding Letter for that disability.Brief Description of Process: (how does it work?)Each state disability will process payments based upon their determined frequency, month, or under special instructions.The county will receive the payments as either an “ACH” wire transfer to their County accounts or as a check mailed tothe county.Note: Counties differ in the payment procedures, Counties may make payments to providers (which may includethemselves as a provider of services) based upon contracts, provider vouchers, or state advances received (moneyreceived is paid out to providers).Frequency:Each state disability has its own advance payment frequency as described: OMH makes 4 quarterly payments withadditional supplemental as needed, OASAS makes 4 quarterly payments for State funding and 12 monthly payments forFederal funding with additional supplemental as needed, OPWDD makes 4 quarterly payments with a 10% withhold untilfinal payment upon closeout.Final Closeouts: Upon receipt of final prior year closeout, NYS disabilities will make any final corrections foroverpayments/ underpayments in a future State Advance payment to the county.Instructions:Notifications that payments have been received, ACH wire transfer or check, are usually sent to the Director ofCommunity Services, the County Fiscal Officer, and/or Treasurer’s Office. After receiving notification/ receipt, the FiscalOfficer will follow the county procedures for processing the State Advances and depositing the payments into the properaccounts. Note: This process may initiate the Provider payment process.A tracking log should be setup to reconcile current State Aid Letter allocations and payments received for a given year. Itshould allow for prior year recoupments / recoveries to be identified. This document will assist in identifying balances,payment errors, and/or future payments.Note: OPWDD withholds 10% of the State Aid allocations from their payments and makes final payment upon closeout ofthe final county provider claims.It is the LGU’s responsibility to notify providers of any delay in anticipated payments. Providers may need to turn to otheroptions (i.e. lines of credit, restricted funding, etc) in the interim.For NYS closeouts that result in a recovery of state dollars, the recovery is taken out of a future state advance payment toa county. Any closeout recoveries are reflected in the State Advance Payment Remittance letter, which reflects theexpected advance payment minus the prior year recovery and the total state advance payment paid to the county.Note: OPWDD State Advance Payments Remittance letters do not provide as much detail, so it may be necessary tocontact NYS staff for additional information.Resources:

1. To Sign up for Electronic Payments - http://www.osc.state.ny.us/epay/index.htm2. Track a payment: NYS Comptroller Office – Payment Information Inquiry -https://wwe1.osc.state.ny.us/ach3/achpaf.cfmDate: May 1, 2010OMH Review: 1/4/11OASAS Review: (none)OPWDD Review: (none)

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALMEDICAIDMedicaid is a federal health insurance program for low income individuals and families. Medicaid is administered at thestate level and managed at the county level in NYS. Eligibility is based on federal poverty guidelines. Covered benefitsinclude minimum federal requirements and optional benefits identified in state medicaid plans. In NYS, Medicaid isfunded by federal, state and local shares.Medicaid is largest share of revenues for Behavioral Health services. In NYS, Medicaid is paid directly to licensed serviceproviders on a fee-for-service basis and through the Medicaid managed care program. Most individuals in NYSparticipate in managed care (HMO styled plans) on a mandatory basis. However, many behavioral health services areprovided outside the managed care benefit plan.Rules defining Medicaid covered services, payment rates and billing guidelines are set forth in NYS regulations (add link).Brief Description of Process: (how does it work?)Medicaid regulations outline the minimum requirements which mustbe met in order for a licensed provider to be able to bill Medicaid for a covered service to a Medicaid eligible individual.The Billing section summarizes the basic billing rules and limitations. The Documentation section summarizes therequirements which, when met, provide supporting documentation that the eligibility and billing requirements have beenmet. Even when there is not a specific documentation requirement included in the regulations, providers are advised toensure that they have sufficient documentation to verify compliance with other standards.Medicaid claims are auditable by federal and state agencies. (See NYS Office of Medicaid Inspector General websitebelow)Frequency:Medicaid covered services are billed according to rules set forth in regulation. For example, the frequency could be pervisit,hour, day of service or month of service. Medicaid covered services and payment rates are periodically updates inNYS regulations. Significant changes may require federal approval of Medicaid state plans.Instructions:Medicaid has various components; please refer to the websites listed below for additional subject matter.Resources:1. Medicaid Program – General Information: http://www.cms.gov/medicaidgeninfo/01_overview.asp2. Administrative Practices and Medicaid Requirements: http://www.omh.ny.gov/omhweb/012104letter/3. Medicaid Compliance Program: http://www.omh.ny.gov/omhweb/guidance/MFA/MedicaidCompliance.html4. Medicaid Self-Disclosure Guidance: http://www.omh.ny.gov/omhweb/guidance/medicaid_self_disclosure/5. Use of Electronic Records by Medicaid Providers:http://www.omh.ny.gov/omhweb/guidance/esra/attachment.html6. EMedNY electronic claiming: http://www.emedny.org/HIPAA/SupportDocs/ePACES.html

7. NYS Department of Health Medicaid Updates:http://www.health.state.ny.us/health_care/medicaid/program/update/main.htm8. NYS Office of the Medicaid Inspector General (OMIG): http://www.omig.state.ny.us/data/Date: May 1, 2011OMH Review: (none)OASAS Review: (none)OPWDD Review: (none)

Business Process (what is it?)FISCAL OFFICER TRAINING MANUALCOMPREHENSIVE OUTPATIENT PROGRAM SERVICES (COPS)Level I Comprehensive Outpatient Program Services (Level I COPS) is a program which enables a provider of licensedmental health outpatient services to be eligible to receive supplemental medical assistance reimbursement (Level I COPSMedicaid revenue – or simply Level I COPS) in exchange for the provision of enhanced outpatient services in accordancewith 14 New York Codes, Rules and Regulations (NYCRR) Part 592 (the Level I COPS regulations). The LocalGovernmental Unit (LGU) is responsible for ensuring the Level I COPS providers under its jurisdiction provide theenhanced outpatient services consistent with Level I COPS regulations, including a written agreement with designatedproviders, as required by 14 NYCRR Part 592.6 and 592.7.Brief Description of Process: (how does it work?)Level I COPS is paid to providers through the Medicaid payment system. Specifically, by Computer Sciences Corporation(CSC) – the State’s Medicaid paying agent, through the Medicaid Management Information System (MMIS), by way of aprovider and program-specific Level I COPS Medicaid rate add-on (the Level I COPS rate).Level I COPS payments are covered 50% by federal Medicaid and 50% by the State share of Medicaid. Historically, OMHhas recognized state savings by converting State Aid for outpatient mental health programs to Medicaid as part of COPSfunding.Frequency:Level I COPS rates are recalculated for each provider every year based on an updated three year average of Medicaidpaid claims. Rate sheets delineating rate, funding and thresholds are sent to the provider with a notification letter. A copyof the notification letter is sent to the County Mental Health Director.Instructions:1. Level 1 COPS Rates:a. The specifics of each provider’s Level I COPS program are contained in their Level I COPS ratesheet, which is maintained by the Office of Mental Health Comprehensive Outpatient ProgramServices/Community Support Program (OMH COPS/CSP) Rate Setting Unit.b. The Level I COPS rate is calculated by OMH, and is equal to the total Level I COPS funding asdetermined by the LGU (see Part 592.8(c)) for that particular outpatient program, divided by theproduct of (1) the three year average of paid Medicaid claims, from the three most recent fiscal yearsfor which data is available (Data Source: MMIS), (2) 90.9% (the Level I COPS constant – a vacancyfactor to increase the rate), and (3) the provider and program-specific Medicare/Medicaid crossover(crossover) percentage.c. This Level I COPS rate is then added to the Medicaid rates already in effect for that provider, for thatprogram. However, for Article 28 general hospitals, Level I COPS is not added to the clinic collateralor group collateral rate codes, or the CDT collateral or group collateral rate codes.d. Additional detail on the components of COPS rates is available at the first link below in Resources.2. Level 1 COPS Threshold:a. The amount of Level I COPS a provider can retain in any local fiscal year, for a particular Level ICOPS program, is equal to that program’s Level I COPS threshold. The Level I COPS threshold is aprovider and program-specific amount, and is equal to no more than the full annual amount of theLevel I COPS base supplement funding for that program, plus 10%.b. Level I COPS Thresholds for current and prior years are populated in ALFS. The LGU should ensureits subcontracted providers have the correct Level I COPS threshold for budgeting purposes.c. All Clinic services rendered on or after July 1, 2008 will no longer be subject to the Level I COPSReconciliation process. All other programs are subject to the Level I COPS Reconciliation process.3. Level 1 COPS Revenue Reconciliation:a. Level I COPS received in a local fiscal year in excess of that year’s Level I COPS threshold will berecouped by the State through MMIS (see Part 592.4(f)). The LGU or its providers are responsible

for the accounting/tracking of the amount of COPS received. Level I COPS payment report willbe sent to each provider detailing the amount of Level I COPS that OMH has determined the providerreceived, as compared to their threshold for the program for the fiscal year, during the reconciliationprocess. Providers will have an opportunity to verify the data used to calculate the recovery amountby the OMH before implementation of the recovery by MMIS. Included in any notice of recovery ofoverpayment will be a description of the recovery process, as well as the date the request forrecovery would be sent to MMIS.b. Any Level I COPS revenue received in excess of the Level I COPS threshold must be kept in areserve account for future recovery by the OMH.c. An LGU or provider may appeal the COPS recovery amount by following the instructions on thereconciliation notification letter that is sent with the Level I COPS payment report.NOTE: If an overpayment occurs, the recovery process can be a one-time reduction to the first Medicaid paymentprocessed and paid after OMH notifies DOH, a check payable to NYSDOH for the full amount or a series of 10%reductions (or larger if you request a percentage increase) of future Medicaid checks. Keep in mind that interestwill be charge equal to prime-plus 2% on any unpaid balance beginning 90 days after the date that DOH isnotified by OMH.4. Level 1 COPS Reporting and Claiming:a. Article 31 and D&TC providers should account for Level I COPS on the Level I COPS cash basis.According to this accounting basis, Level I COPS is considered paid consistent with the date on theMedicaid check, and assumes that any retroactive Level I COPS rate changes are repatriated to theiroriginal payment date by the provider.b. Article 28 general hospitals should account for Level I COPS on the Level I COPS accrual basis.According to this accounting basis, Level I COPS is considered paid consistent with the descriptionprovided above for Article 31 and D&TC providers.c. Additional detail and examples of Level 1 COPS Reporting and Claiming is available at the first linkbelow in Resources.d. Please see Appendix DD of the Consolidated Budget Report (CBR) and Consolidated Fiscal Reports(CFR) manuals for budgeting and claiming guidelines. See link to Appendix DD below in Resources.5. Level 1 COPS Reallocations and Program Closure:a. The LGU may reallocate a portion of a Level I COPS provider’s allocation to one or more of theirother Level I COPS providers, limited to the level of Level I COPS underachievement experienced byall providers in the county.b. If the program associated with the Level I COPS closes, the LGU can request that the Level I COPSallocation be reallocated to another provider operating a Level I COPS qualifying program or that theLevel I COPS funding be converted to State Aid for $.50 on the dollar.Resources:1. COPS Level 1 Description (OMH Website) -http://www.omh.state.ny.us/omhweb/spguidelines/HTML/cops_level_1.html2. CBR/CCR Manual – Appendix DD - http://www.omh.state.ny.us/omhweb/cbr/manual.pdf#page=3513. NYS OMH Regulations – Part 592 Comprehensive Outpatient Programs - link not available4. NYS OMH Regulations – Part 599 Clinic Treatment Programs (supersedes Part 592 for Clinic TreatmentPrograms) http://www.omh.state.ny.us/omhweb/policy_and_regulations/Adoption/Part_599_20100630.html5. NYS Conference of Local Mental Hygiene Directors – Fiscal Brief – COPS -http://clmhd.org/resources/resources.aspx#637 (bit outdated now…)Date: May 1, 2011OMH Review: (none)

Business Process (what is it?)FISCAL OFFICER TRAINING MANUALCOMMUNITY SUPPORT PROGRAM SERVICES (CSP)Community Support Program (CSP) Medicaid is a NYS Office of Mental Health initiative for certain community-basedmental health programs.Office of Mental Health (OMH) maintains the responsibility for CSP Medicaid rate setting, as described in 14 New YorkCodes, Rules and Regulations (NYCRR) Part 588.14.Brief Description of Process: (how does it work?)CSP Medicaid is paid to providers by the Medicaid payment system (MMIS) as an add-on to certain outpatient rates(Clinic, Continuing Day Treatment (CDT), or Day Treatment) on a program specific basis. Therefore, each Medicaid visitto an outpatient program may include the base Medicaid payment, plus the CSP Medicaid payment (and some providersmay also receive a Comprehensive Outpatient Program Services (COPS) Medicaid payment or a Level II COPS feesupplement Medicaid payment). The CSP Medicaid revenue generated in the outpatient program is then used by theagency in the designated CSP programs.Frequency:CSP Medicaid rates are recalculated annually based on an updated three-year average of the number of Medicaid paidclaims.Instructions:1. CSP Medicaid Rates:a. The OMH maintains rate sheets to document CSP Medicaid rate calculations on a provider specificbasis.b. The CSP Medicaid rate is calculated by OMH, and is equal to the CSP base supplement funding forall CSP programs eligible for CSP Medicaid, divided by the product of (1) the estimated annualnumber of Medicaid paid claims that will generate CSP payments (this estimate represents the threeyearaverage of the Medicaid paid claims for the specific program that the CSP rate will be added to,for the three most recent fiscal years for which data is available) and (2) the CSP constant of 89%.The constant represents a vacancy factor built into the rate calculation methodology.c. The calculated CSP Medicaid rate is added to the standard base Medicaid rate that is already ineffect for the provider and the program. However, for Article 28 general hospitals, the CSP Medicaidrate is not added to Clinic or CDT collateral or group collateral type visits.d. Additional detail on the components of CSP rates is available at the first link below in Resources.2. CSP Medicaid Threshold:a. The maximum amount of CSP Medicaid revenue that a provider can retain on an annual basis isequal to that provider’s CSP Medicaid threshold. The CSP Medicaid threshold is equal to the fullannual amount of provider’s CSP base supplement funding.b. The CSP threshold can be found in the COPS/CSP Table in ALFS. The table reflects the annual CSPthreshold by provider as well as a breakout of the anticipated CSP revenue by CSP program.3. CSP Revenue Reconciliation:a. CSP received in a local fiscal year in excess of that year’s CSP threshold will be recouped by theState through MMIS (see Part 588.14(f)). A CSP payment report will be sent to each providerdetailing the amount of CSP that OMH has determined the provider received during the reconciliationprocess. Providers will have an opportunity to verify the data used to calculate the recovery amountby the OMH before implementation of the recovery by MMIS. Included in any notice of recovery ofoverpayment will be a description of the recovery process, as well as the date the request forrecovery would be sent to MMISb. Any CSP revenue received in excess of the CSP threshold must be kept in a reserve accountfor future recovery by the OMH (CSP Liability).

c. When a provider’s CSP revenue is less than their threshold for a fiscal year, and a rate amendmentwill not ensure maintenance of funding, the underachievement amount will be paid to the providerthrough a state aid payment (see Part 588.14(g)).d. NOTE: If an overpayment occurs, the recovery process can be a one-time reduction to the firstMedicaid payment processed and paid after OMH notifies DOH, a check payable to NYSDOH for thefull amount or a series of 10% reductions (or larger if you request a percentage increase) of futureMedicaid checks. Keep in mind that interest will be charge equal to prime-plus 2% on any unpaidbalance beginning 90 days after the date that DOH is notified by OMH.4. CSP Reporting and Claiming:a. CSP Medicaid accounting for Article 31 providers is conducted on a cash basis while CSP Medicaidaccounting for Article 28 general hospitals is on an accrual basis. OMH payment reports fully explainthe accounting rules supporting both methodologies.b. CSP Medicaid accounting also results in determination of the amount of CSP Medicaid paid for theyear, and amounts in excess of the threshold, that will be recovered through the MMIS. If the CSPMedicaid amount paid through MMIS in a local fiscal year falls below the CSP Medicaid threshold,OMH will either recalculate the CSP rate, using actual paid claims for the specific rate period, or willmake a State Aid payment in an amount equal to the CSP Medicaid revenue shortfall.c. Additional detail and examples of CSP Reporting and Claiming, as well as a list of CSP eligibleprograms is available at the first link below in Resources.d. Providers are required to budget and claim CSP Medicaid on the Consolidated Budget Report (CBR),the Consolidated Claiming Report (CCR), and the Consolidated Fiscal Report (CFR) -- consistentwith Appendix DD of the CBR and CFR manuals. See link to Appendix DD below in Resources.5. Closure of a Program:a. The LGU should contact the Field Office and COPS/CSP Rate Setting Unit prior to the closure of aprogram that generates a CSP rate add-on or is funded by CSP. Where possible, an alternate eligibleprogram can be utilized. Such actions require both OMH and the Division of Budget (DOB) approval.b. Closure of a program with a CSP rate add-oni. When a Medicaid-eligible program with a CSP rate add-on closes but the program thatreceives the CSP funding continues, the LGU should request that the rate add-on berecalculated and “attached” to another CSP eligible Medicaid Program.ii. If the provider does not operate another eligible program, the LGU should request that theCSP funding be restored as State Aid. In such cases the State Aid is restored to the State AidApproval Letter at 100%.c. Closure of a program that receives CSP fundingi. When a CSP funded program closes or the LGU terminates funding for a CSP program, theLGU can request that an alternate program(s), eligible to receive CSP funding, be awardedthe CSP funding from the closed program.1. The LGU should identify the CSP eligible program(s) to receive the funding from theclosing program and request that the COPS/CSP Unit estimate the Total Fundingthat is eligible to be transferred.2. The OMH will verify that there is sufficient room under the CSP Rate Cap to allow thetransferring of funding.ii. Alternatively, the LGU may allocate the CSP Medicaid funds to a DSH-eligible article 28provider.1. The LGU should identify the DSH eligible program(s) to receive the funding from theclosing program and request that the COPS/CSP Unit estimate the Total Fundingthat is eligible to be transferred.2. The OMH will verify that there is sufficient room under the DSH Cap to allow theaddition of funding.3. Upon OMH and DOB approval of the request, an amended DSH MOU will be issuedto the LGU reflecting the increased funding. The LGU must approve the revisedMOU.iii. If there is no ability to “move” the funding associated with the closed program to another CSPeligible or DSH eligible provider, funding will be restored as State Aid. In such cases, theCSP regulations only allow the OMH to restore an amount equal to the State Share ofMedicaid (50%) to the LGU as State Aid. This will result in the loss of Federal funds that hadpreviously supported the services.

Resources:1. CSP Description (OMH Website) - http://www.omh.state.ny.us/omhweb/spguidelines/HTML/csp.html2. CBR/CCR Manual – Appendix DD - http://www.omh.state.ny.us/omhweb/cbr/manual.pdf#page=3513. NYS OMH Regulations – Part 587 Operation of Outpatient Programs - Part 587 Regulations Operation ofOutpatient Program4. NYS OMH Regulations – Part 588 Medical Assistance for Outpatient Programs - Part 588 Regulations MedicalAssistance for Outpatient Programs5. Clinic Restructuring Implementation Plan - Clinic Restructuring Implementation Plan6. NYS Conference of Local Mental Hygiene Directors – Fiscal Brief – CSP -http://clmhd.org/resources/resources.aspx#638 (bit outdated now…)Date: May 1, 2011OMH Review: (none)

FISCAL OFFICER TRAINING MANUALDISPROPORTIONATE SHARE INCOME (DSH)Business Process (what is it?)In accordance with Legislation signed by the Governor on June 19, 1997, (Bill No. 5550-A), a 1997-98 Budget initiativewill replace Office of Mental Health (OMH) and Office of Alcohol and Substance Abuse Services (OASAS) net deficitfinancing with Disproportionate Share funding (DSH) in some Article 28 voluntary hospitals.Brief Description of Process: (how does it work?)Beginning April 1, 1997 and for annual periods beginning April 1st thereafter, additional Disproportionate Share paymentsshall be paid to voluntary non-profit general hospitals. Payments shall not exceed such general hospital's cost ofproviding services to uninsured and Medicaid patients after taking into consideration all other Medical Assistancereceived, including Disproportionate Share payments made to such general hospital and payments from and on behalf ofsuch uninsured patients and shall also not exceed the amount of State aid and local aid grants for which the hospital or itssuccessor would have been eligible pursuant to Articles 25 and 41 of the Mental Hygiene Law for fiscal year 1996-97.Payments beginning April 1, 1998 and thereafter will be related to the hospital's willingness to continue to provide servicespreviously funded by State Aid grants.Frequency:The Commissioners of OMH and OASAS, in consultation with county directors of community services, will annuallydesignate to the Department of Health those general hospitals eligible for the additional disproportionate share payment,and the amount thereof.Instructions:1. Memorandum of Understanding (MOU):a. Chapter 119 of the Laws of 1997 requires the Commissioner of OMH, in consultation with the countydirector of community services, to annually certify those hospitals which will receive these additionalDSH payments.b. This annual certification is accomplished through use of a memorandum of understanding (MOU).Annually, the MOU and DSH Appendix A, which details annual amounts of DSH by provider, byprogram, will be mailed to the county director of community services. This MOU is to be executed bysignature of the county director of community services, return to NYS OMH, and subsequentsignature by Commissioner of OMH or agent thereof.2. Payments:a. DSH payments are to be made on a quarterly basis. The payment process begins with OMH, bygeneration of a payment request package. This package contains hospital and program specificdetail of amounts to be paid. The payment package is then forwarded to the New York StateDepartment of Health (NYS DOH). NYS DOH then processes the payments and remits checks for,where applicable, transmits funds through electronic transfer, for the quarterly DSH payment.3. Approval of DSH Payments by DOHa. As there exist Statewide DSH caps for each hospital that receives DSH, in accordance with the NYSfiscal year (April 1 – March 31), the OMH must provide the NYS Department of Health (NYS DOH)with estimated DSH payment, by hospital, for the upcoming fiscal year. NYS DOH compares the totalof all estimated DSH payments (from all agencies) to each hospital’s DSH cap.b. At times, the OMH may be notified that OMH DSH will cause a hospital to reach or exceed its DSHcap. In such an instance, the OMH may temporarily pay an amount equal to the amount in excess ofthe hospital’s DSH cap to the hospital in State Aid, via a voucher payment. Providers will be notifiedof such payments, and such notification will include details of the amount of the payment that isattributed to each program.c. In some instances, a hospital may perpetually be at its DSH cap. In such instances, the OMH mayconvert such a hospital’s DSH funding back to State Aid.4. Maintenance of Effort

a. Hospitals receiving DSH funds are still subject to all contracting, fiscal and programmatic reportingrequirements and guidelines, e.g., for model programs the Full Time Equivalent (FTE) requirementsmust be maintained. For all programs, gross cost and service levels must be maintained at a levelconsistent with the program's recent history under state aid funding. Therefore, beginning April 1,1997 and for annual periods thereafter, if effort is not maintained in both gross expenditures and non-DSH revenues, DSH overpayments shall be calculated and recovered.5. DSH Fiscal Policy Control Pointsa. Hospitals must continue to include programs designated to receive DSH funds on schedules DMH-2,DMH-3 and Consolidated Budget Report (CBR)-4 of the CBR.b. For OMH programs’ funding streams with a fiscal model (e.g. Intensive Case Management (ICM),Supportive Case Management (SCM), Assertive Community Treatment (ACT), CommunityResidence (CR)), providers continue to be subject to all programmatic and fiscal requirements.c. If a provider is designated as a DSH provider, the DSH revenue is to be reported on DMH-1, line 30(Other Revenue – see specific detail line) and DMH-2, line 29 (Other Revenue - see specific detailline). The reported DSH revenue must equal the full annual DSH amount by county, provider andprogram as maintained by OMH.d. Actual gross expenditures must be at least the same as budgeted gross expenditures and actual non-DSH "other" income must be at least the same as budgeted non-DSH other income. Actual reportedDSH must be the same as budgeted DSH.e. Providers must report any voucher payments made in lieu of DSH on DMH-1, line 30 (other revenue),and on DMH-2, line 29. In each case, the provider shall report such payments as "OMH VoucherPayment". The DSH payments a provider receives shall be reported in these lines as well, using thespecific detail line.f. A DSH profit exists if claimed expenses are less that reported DSH for that program. If a DSH profitexists, the Closeout process will check for State Aid in the same program. If State Aid exists in thatprogram, recovery will be made against the State Aid. If State Aid does not exist in that program, theDSH profit amount will then be moved to an internal funding code and marked for recovery.Recovery will be made either through reduction in an equal amount to future DSH payments, orthrough the request of remittance from the hospital should no future DSH payments exist.Resources:1. DSH Description (OMH Website) - http://www.omh.ny.gov/omhweb/spguidelines/HTML/dsh.html2. NYS Conference of Local Mental Hygiene Directors – Fiscal Brief – CSP -http://clmhd.org/resources/resources.aspx#632Date: May 1, 2011OMH Review: (none)

Business Process: (what is it?):FISCAL OFFICER TRAINING MANUALFEDERAL MEDICAID SALARY SHARING (FSS)Federal Salary Sharing (FSS) is a program enabling States and Counties to receive federal reimbursement for a portion ofexpenditures related to the administration of Medicaid programs. FSS is a revenue stream which a County LocalGovernmental Unit (LGU) may choose to participate in.Brief Description of Process: (how does it work?)OMH: To participate, the LGU must submit electronic quarterly claims to the Office of Mental Health (OMH) for OMHrelated County administration costs through the ALFS-Web application. OMH submits the LGU’s FSS claims to theDepartment of Health, who then submits them to the federal government (CMS), consistent with federal Medicaid policy.Currently, OMH receives and retains the funds until the LGU requests them i .OPWDD: LGU’s complete a FSS survey and Payroll Summary on an annual basis, submits paper claims to the Bureau ofCommunity Funding Administration and Revenue Support. OPWDD summarizes the data by county and submits oneclaim to DOH. The funds are kept by OPWDD to offset the state aid paid to the Counties for Administration.OASAS: The cost allocation methodology identifies OASAS and Local government expenses that are reimbursable underthe Federal Medicaid grant for the administration of the Federal Medicaid grant program. After identification of theseexpenses, federal reimbursement is calculated at fifty-percent of these costs. Information is extracted from OASAS’sStatewide Data Collection System to identify the percentage of clients enrolled in the federal Medicaid program byCounty. With these percentages, eligible expenses and the amount of funding made available to OASAS forreimbursement to Local governments determine the amount of each County reimbursement.Frequency:For OMH, claims are submitted quarterly and request for payments from the reserve can be made on an as needed basis.Claims can be submitted retroactively for two years, but it is recommended Counties claim as timely as possible in orderto be fully reimbursed. Note: The balance may be held for up to 4 years. OMH’s ability to pay against old year accounts(4+ years) is dependent upon their ability to access Federal funds.For OPWDD, claims are requested by OPWDD annually and there are no payments from OPWDD.For OASAS, no specific claims are submitted and a single payment by OASAS is made annually.Instructions:OMH Process:A TOKEN MUST BE REQUESTED TO PARTICIPATE IN THE OMH PROCESS.If you do not already have a token for the Aid to Localities Financial System (ALFS), complete an ALFS SecurityAgreement Authorization Form and a Request for Access Aid to Localities Financial System (ALFS) for non-OMHemployees and submit to these forms and the signed letter from the County Director of Community Services (DCS) onCounty letterhead that requests permission for their use of ALFS to: Peg LaWare or Shweta Gupta, Director ofAdministrative Services, NYS OMH Community Budget and Financial Management, 44 Holland Ave., Albany, NY 12229.It is important to submit this documentation as soon as possible as it generally takes up to 2 weeks to receive the takenafter materials are received by OMH. Once the token is received, the process begins by accessing the following website:https://mhprovider.omh.state.ny.us/websaluteNote: Do not use the OMH ‘Bridges’ website to access ALFS Web

The very first time you log into ALFS Web you must create a Personal Identification Number (PIN) at the salute login box.Type in your user ID in lower case in the user field. Type in the 6 digit number displayed on your token in the token fieldand click login. The Enter A New PIN box will pop up. Type in a 4 digit number in the new PIN field; re-type it and click ok.A new Salute login box will be displayed. Use your User ID, your PIN followed by your token number to sign in.1. The ALFS Web home page will be on your screen. Click on ‘Budget’ in the toolbar and then select ‘FederalSalary Sharing’.2. There are two options to select from– Claim Summary and Payment Summary.a. Under the claim summary, click on the quarter you need to work on. It contains the employee summary.You can view/edit each employee listed. You can add an employee. Employee details such as name,salary, employee type and a specific employee ID are assigned in the screen along with function/jobtasks and % time allocated to Medicaid and %NON-Medicaid. Click the save button. You must include anaggregated fringe percentage.Once your claim is complete, click the “Generate Appendix D” button. You must print this form and obtainthe County Mental Health Director or designee signature to mail or fax it to the claim administrator, BradTitus at the NYS Office of Mental Health, 44 Holland Avenue, Albany, NY 12229; fax 1-518-473-5167.You can also print and export the individual employee worksheets and computation report for yourrecords.b. The other option is Payment Summary. You can perform the following tasks in this field: view paymentsummary; add a request amount; edit a comment and view comment history by clicking on theappropriate button on this screen.Federal Salary Sharing funds are to be reported on line 29 on the CFR, and also to be clearly identified in the requireddetailed backup document for line 29. Funds may be utilized as an offset for one or more OMH programs forexpenses associated with the provision of services to the county’s mentally ill population. The Catalog of FederalDomestic Assistance (CFDA) number for Federal Salary Sharing program is 93.778.Note: There is no cap placed on FSS amounts claimed by counties, but counties are entirely responsible for theaccuracy of the claims, which are subject to state and federal audits.OPWDD Process:Counties complete a FSS survey and Payroll Summary on an annual basis.1. The Local Government Federal Salary Sharing Survey determines the percentage of time spent on:Providing technical assistance to community-based DD Medicaid programs and services (specificallyintermediate care facilities, certified clinics and day treatment and Home and Community BasedServices Program under the Waiver) for persons with developmental disabilities to ensure compliancewith Federal Medicaid regulations.Planning for, coordinating and overseeing the community-based DD Medicaid service system in yourcounty.2. Completion of the following forms for each individual who qualifies:Part I – Staff InformationPart II & III – Staff Percentage of time and certificationAppendix C – Work Functions Survey3. Completion of the Annual Payroll summary

4. Return Parts I, II, III and the Annual Payroll Summary to: Christine Doherty, Bureau of Community FundingAdministration and Revenue Support, New York State Office of People with Developmental Disabilities, 44Holland Avenue, Albany, NY 12209 - (518) 473-6064 or Christine.Doherty@opwdd.ny.govRetain Appendix C and a copy of all materials for your records.Counties should periodically review and update the documentation of employee functions and time spent on Medicaidactivities.OASAS Process:(None)Resources:1. Aid to Localities Financial System (ALFS) Web User Manual (contact field office for copy)2. helpdesk@omh.state.ny.us - Help desk Phone Numbers: 1-518-474-5554 OR 1-800-435-76973. OPWDD Local Government Federal Salary Sharing Manual (contact Christine Doherty or Bureau of CommunityFunding Administration and Revenue Support)Date: May 1, 2011OMH Review: 8/18/10OASAS Review: (none)OPWDD Review: (none)

Business Process (what is it?)FISCAL OFFICER TRAINING MANUALCOUNTY BUDGET PROCESSThe County budget is a process that estimates the expenses and revenues of County operations andcontract service providers for the following fiscal year (where applicable).Brief Description of Process: (how does it work?)The county budget process varies from county to county. The county Local Governmental Unit (LGU)receives a budget packet from the county budget officer for the upcoming year that includes instructions,forms, and deadlines. The LGU then distributes materials and instructions to county operations andcontract service providers (if applicable). LGU then collects the budget information from all serviceproviders, prepares and submits the completed package by the County budget deadline.Frequency:County budgets are prepared on an annual basis.Instructions:1) Receive instructions, forms, and deadlines from the County Budget Officer(s).2) Prepare budget in accordance with instructions. All expenses and revenue sources must betaken into account. The Budget Officer will likely provide some expense figures such assalaries and health insurance. Expense estimates should take into account past spendinglevels along with current needs. Revenue estimates should be based on current knowninformation and trending.3) Review the budgets of contract service providers (if applicable). Careful attention should bepaid to conformity with State Aid Funding levels.4) Presentation of budget package to Legislative committee, if applicable.5) Submit the budget(s) to the County Budget Officer(s).6) A hearing may be scheduled to discuss the budget(s) with the Budget Officer(s) and otherinterested parties.7) The Budget Officer(s) will make adjustments to suit the County tax levy. There may or maynot be an opportunity for negotiations regarding these adjustments.8) Present budget package to Finance Ways and Means committee, if applicable.9) As part of the County Annual session, the county budget is presented to the public forcomment.10) The County legislative body will consider the budgets and adopt them with any finaladjustments by the end of the fiscal year.11) Any budget amendments throughout the year are submitted to the Budget Officer(s) forapproval, if applicable.Date: May 1, 20111

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALNYS DELIVERABLES AND SANCTIONS - OMHThe Office of Mental Health (OMH) relies on budgeting and cost reporting tools to monitor and analyze the fiscaloperations of counties and mental health providers who receive Aid to Localities State Aid funding. A county LocalGovernment Unit (LGU) or county contracted provider that fails to meet the reporting deadlines may be subject tosanctions by the NYS OMH through State Aid or Medicaid payment withholds. The LGU is responsible for ensuring that itssubcontracted providers comply with reporting requirements.Brief Description of Process: (how does it work?)The OMH requires three types of financial reports to be submitted annually. These are the Preliminary AllocationSummary (PAS), the Consolidated Budget Report (CBR) and the Consolidated Fiscal Report (CFR). The LGU submits thecounty PAS. Both the county-operated provider and the county’s subcontracted providers are required to submit a CBRand a CFR. The LGU approves county-operated and subcontracted providers’ CBRs and a subcomponent of their CFRs,the Consolidated Claiming Report (CCR).PAS, CBR, CCRWhen the LGU fails to meet the required deadlines for submission and approvals, the local Field Office may contact theLGU for clarification. Note: LGU approval with errors does not satisfy reporting requirements. Noncompliance can includefailure to submit the required documents or failure to revise a submission that has errors which prevent OMH approval.A delinquent county may be requested to develop and submit a Plan of Corrective Action (POCA) to the appropriate FieldOffice for review and approval. The POCA identifies what steps the LGU will take to come into compliance.Before each scheduled quarterly advance, the NYS OMH sends a letter notifying the LGU County Mental Health Directorof an impending withhold for failure to come into compliance with OMH’s financial reporting requirements. A copy of theletter is sent to the County Fiscal Officer, the County Treasurer, and corresponding Field Office. If the LGU fails to complywith all reporting requirements prior to the scheduled payment date, the NYS OMH applies the payment withhold for thenext quarterly State Aid payment advance.State Aid withholds remain in place for each quarterly payment until the Field Office identifies that the reportingrequirements have been met. When the past due documents are submitted and approved by the LGU and the Field Officehas determined the documents are sufficient, the State Aid payment withhold will be removed.CFRAdditionally, for outstanding CFR documents, the OMH will impose sanctions on individual Article 31 providers through awithholding of a portion of the provider’s Medicaid payments. For a CFR that is overdue, a letter will be sent by the OMHCFR Unit to the provider warning of the application of a Medicaid Withhold that will be imposed if the provider fails tocome into compliance within a specified timeframe, typically the end of the next month. Once the final deadline haspassed, the CFR Unit will instruct the New York State Department of Health (DOH) to apply a Medicaid withhold to thedelinquent providers beginning at 20% of the payment amount. If the provider remains delinquent, the percentage to bewithheld is increased by 10% each month. When the provider has submitted a CFR and is in compliance, OMH will notifyDOH to discontinue the Medicaid withhold and restore the payment percentage to 100%, thereby restoring all funds beingheld in escrow to the provider.Frequency:The OMH deliverables are due annually. The financial reports must be submitted with LGU approvals, where applicable,by the following due dates:Preliminary Allocation Summary (PAS):

October 1st for LGUs on a July 1st to June 30th reporting cycle (NYC). April 1st for LGUs on a January 1st to December 31st reporting cycle (Upstate/Long Island).Consolidated Budget Reports: May 1st for county-operated and county subcontracted providers on a July 1st to June 30th reporting cycle (NYC). November 1st for county-operated and county subcontracted providers on a January 1st to December 31st reportingcycle (Upstate/Long Island).Consolidated Fiscal Report/Consolidated Claiming Report: November 1st for county-operated and county subcontracted providers on a July 1st to June 30th reporting cycle(NYC). May 1st for county-operated and county subcontracted providers on a January 1st to December 31st reporting cycle(Upstate/Long Island). A 30 day extension may be submitted online to the OMH for CFR submissions.Instructions:It is recommended that counties require their subcontracted agencies to submit CBR or CFR/CCRs prior to the OMH duedate to allow time for LGU review, revisions and approval.Counties that anticipate late submissions, or have missed the reporting deadline, should contact the local Field Office toidentify the outstanding issues which prevent the completed submission and approval. The county should outline theissues causing the delay and identify the action, with target dates, that it will take to resolve the delinquency. In somecases, it may be necessary for the county to withhold payment from a delinquent provider. In rare instances, at therequest of the county, OMH may facilitate an application of a Medicaid payment withhold to a single subcontractedprovider whose delinquency prevents the county from being up-to-date.Contact the CFR Unit for questions related to outstanding issues on the CFR core-schedules.* Please note that the reporting process and deadlines may be different for Direct Contracts with the OMH.Resources:New York State Office of Mental Health1. Spending Plan Guidelines - http://www.omh.state.ny.us/omhweb/spguidelines/selectletter.asp2. Consolidated Budget and Reporting Manual - http://www.omh.state.ny.us/omhweb/cbr/manual.pdf3. Consolidated Fiscal Reporting and Claiming Manual -http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFRManual/CurrentYear/Cal2010/1210CFRMANUAL.pdfDate: May 1, 2011OMH Review: 12/21/10

FISCAL OFFICER TRAINING MANUALFiscal Officer Manual WorkgroupNYS OASAS DELIVERABLES AND SANCTIONSCounty RequirementsBusiness Process: (what is it?)Brief Description of Process: (how does it work?)CBR, CCRCFRFrequency:Instructions for OASAS:Resources:Consolidated Budget and Reporting Manual - http://www.omh.state.ny.us/omhweb/cbr/manual.pdfConsolidated Fiscal Reporting and Claiming Manual -http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFRManual/CurrentYear/Cal2010/1210CFRMANUAL.pdfDate:OPWDD Review:

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALFiscal Officer Manual WorkgroupNYS OPWDD DELIVERABLES AND SANCTIONSCounty RequirementsThe Office for People with Developmental Disabilities [OPWDD] relies on budgeting and cost reporting tools tomonitor and analyze the fiscal operations of counties and mental health providers who receive Aid to LocalitiesState Aid funding. A county Local Government Unit (LGU) or county contracted provider that fails to meet thereporting deadlines may be subject to sanctions by the NYS OPWDD through the Central Office state aidclaims unit by withholding advances. The LGU is responsible for ensuring that its subcontracted providerscomply with reporting requirements.Brief Description of Process: (how does it work?)The OPWDD requires two types of financial reports to be submitted annually: the Consolidated Budget Report(CBR) and the Consolidated Fiscal Report (CFR). Both the county-operated provider and the county’ssubcontracted providers are required to submit a CBR and a CFR. The LGU approves county-operated andsubcontracted providers’ CBRs, contracts and a subcomponent of their CFRs, the Consolidated ClaimingReport (CCR). Paper copies of all documents must be submitted to the claims unit.CBR, CCRWhen the LGU fails to meet the required deadlines for submission and approvals, the Central Office ClaimsUnit will contact the LGU by e-mail. Noncompliance can include failure to submit the required documents orfailure to revise a submission that has errors which prevent OPWDD CFR approval. If the claimingdocumentation is not received after several e-mails have been sent; we will notify the county of our intent towithhold advances.At the time of a scheduled monthly advance, the NYS OPWDD sends a letter notifying the LGU County MentalHealth Director that advances are being withheld for failure to come into compliance with OPWDD’s financialreporting requirements. A copy of the letter is sent to the County Fiscal Officer, the County Treasurer, andCounty Mental Health Director.State Aid withholding remains in place for each monthly payment until the Claims Unit identifies that thereporting requirements have been met. When the past due documents are submitted and approved by theLGU and the Central Office Claims Unit has determined the documents are sufficient, the State Aid paymentwill be released.CFRAdditionally, for outstanding CFR documents, the OPWDD CFR Unit can impose sanctions as per regulationssection 635.

Frequency:The OPWDD deliverables are due annually. The financial reports must be submitted with LGU approvals,Consolidated Budget Reports, contracts [where applicable] and claiming schedules: May 1st for county-operated and county subcontracted providers on a July 1st to June 30th reporting cycle(NYC). November 1st for county-operated and county subcontracted providers on a January 1st to December 31streporting cycle (Upstate/Long Island).Consolidated Fiscal Report/Consolidated Claiming Report: November 1st for county-operated and county subcontracted providers on a July 1st to June 30th reportingcycle (NYC). May 1st for county-operated and county subcontracted providers on a January 1st to December 31streporting cycle (Upstate/Long Island). A 30 day extension may be submitted to OPWDD for CFR submissions; however, estimated claims shouldbe submitted if extension request is submitted.Instructions for OPWDD:It is recommended that counties require their subcontracted agencies to submit contracts, CBR andCFR/CCRs prior to the OPWDD due date to allow time for LGU review, revisions and approval.Counties that anticipate late submissions, or have missed the reporting deadline, should contact the CentralOffice Claims Unit to identify the outstanding issues which prevent the completed submission and approval.The county should outline the issues causing the delay and identify the action, with target dates, that it will taketo resolve the delinquency. In some cases, it may be necessary for the county to withhold payment from adelinquent provider.Contact the CFR Unit for questions related to outstanding issues on the CFR core-schedules.Please note that the reporting process and deadlines may be different for Direct Contracts with the OPWDD;check with the DDSO.Resources:Consolidated Budget and Reporting Manual - http://www.omh.state.ny.us/omhweb/cbr/manual.pdfConsolidated Fiscal Reporting and Claiming Manual -http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFRManual/CurrentYear/Cal2010/1210CFRMANUAL.pdfDate: May 1, 2011OPWDD Review: 3/31/11

FISCAL OFFICER TRAINING MANUALPRELIMINARY ALLOCATION SUMMARY (PAS)Business Process: (what is it?)The Preliminary Allocation Summary is a planning document, which is completed by the LGU, which reports the distribution ofOffice of Mental Health State Aid funding identified in the State Aid Funding Letter by provider and program type.Note: Effective January 2011, the PAS is no longer a required OMH deliverable. The PAS has been transitioned to theCounty Allocation Tracker (CAT). Inclusion of the PAS in this manual is for historical reference, please refer to CAT Procedure.Brief Description of Process: (how does it work?)The PAS is the mechanism whereby the distribution of funding by the LGU is compared with the State Aid Letter (SAL) and theMental Health Provider Directory (MHPD) to ensure that 100% of all funds have been distributed to OMH approved providersand programs.The county State Aid Funding Letter reflects the overall funding by funding source code and amount. These amounts are furtherdistributed by the LGU to providers, both subcontracted and county operated, for specific approved programs as identified in thePAS. An approved PAS includes only programs registered in MHPD, which is used to populate the NYS CONCERTS system.Frequency:Beginning in 2011 the Preliminary Allocation Summary is no longer an OMH reporting requirement. Prior to 2011, the PAS wasconstructed and approved by the County annually (April 1 st ).Instructions:OMH is the only Department of Mental Hygiene agency that utilized the PAS. Previously submitted PAS reports can be found inthe Aid to Localities Fiscal System (ALFS) and can be accessed by County LGU’s at https://mhprovider.omh.state.ny.us .Providers, programs, funding codes, funding levels and units of service were entered on the PAS. The approval processincluded running validation tests and a report to ensure that all funding received through a SAL is allocated and all programsreceiving funding were registered in MHPD/CONCERTS.Note: Only funding source codes associated with specific program codes as outlined in the Aid to Localities Spending PlanGuideline were eligible to be entered on the PAS.Each ALFS application has a ‘Milestones’ tab which identifies the date the document was approved by both the County LGU andthe NYS Field Office. Upon passing all validation requirements, the County approved the PAS in the Milestones tab. The PASwas then reviewed and approved by the Field Office.Resources:1. Aid to Localities Spending Plan Guideline: http://www.omh.state.ny.us/omhweb/spguidelines/selectletter.asp2. Mental Health Provider Directory (MHPD): http://www.omh.state.ny.us/omhweb/mhpd/3. Aids to Localities Fiscal System (ALFS): https://mhprovider.omh.state.ny.us/Date: May 1, 2011OMH Review: 2/2/11

FISCAL OFFICER TRAINING MANUALCOUNTY ALLOCATION TRACKER (CAT)Business Process: (what is it?)Brief Description of Process: (how does it work?)Frequency:Instructions:Resources:Date: May 1, 2011OMH Review: (none)

FISCAL OFFICER TRAINING MANUALBUDGET SUBMISSION PROCESS (CBR)Business Process: (what is it?)Each Department of Mental Hygiene agency (OMH, OASAS, and OPWDD) requires the submission of a ConsolidatedBudget Report (CBR) for any given fiscal year. The use of the budget varies between each disability, but it is a vitalcomponent of the closeout process for all three State agencies.Note: The OMH County Allocation Tracker (CAT) is expected to replace the CBR as the budgetary tool for the closeoutprocess.Brief Description of Process: (how does it work?)Contracted providers submit their Consolidated Budget Report (CBR) to the County. The LGU reviews the providers’budget schedules against the funding allocations (see State Aid Funding Letter Review process. The Countycommunicates to the provider any revisions that are needed and approves the budget and notifies appropriate MentalHygiene agency field office. (Note: LGU approves budgets for OMH in ALFS) The budget is then reviewed by the FieldOffice for approval.Frequency:Annually, with the possibility of revision(s) until the NYS closeout is finalized.Instructions:The LGU receives paper copies of the fiscal State Aid budgeting schedules from their providers. The budget schedulesincluded are referred to as the Consolidated Budget Report (CBR). CBRs consist of schedules CBR-i, CBR-4, DMH-2,and DMH-3 Note: all provider submissions must be uploaded to the NYS website using the Consolidated FiscalReporting System (CFRS) software.The LGU compares the budgeted expenditures and revenues by program and funding codes to the service provider’shistoric and trended revenue and expense levels and/or the LGU State Aid Approval letter. It is the LGU’s responsibility toidentify service provider expenditure overruns, revenue shortfalls, and significant service delivery performance variancesand get narrative responses on variances that exceed what would be considered a normal range.NYS OASAS considers increases in Administrative and Total Expenses over 10% from the previous year, as excessiveand requires that a narrative justification be submitted by the service provider/ LGU to OASAS for approval. If warranted,the LGU may request the service provider to provide expense/ revenue specific details of the program. NYS OASASrequires “Supplemental” schedules to be prepared that reflect details of expenses and revenues.For OMH, LGU’s must approve budgets using the ALFS web application to run ‘Validation’ compliance checks on fiscalpolicy and MHPD program listings. Any violations/exceptions must be amended or sufficiently explained when overriding.Once CBR’s have been approved by the LGU and the Field Office, they become the Budget of Record (BOR). For OMHand OPWDD, any modification to the budget of record comes in the form of a new budget submission (CBR) to replacethe existing Budget of Record. For OASAS, any modifications come in the form of a Program Budget Change Request(PBCR) form. This form lists the budget of record, the new budget, and reflects the variances between them. This formneeds county and Field Office approval to replace the active Budget of Record.The Budget of Record will be used during reconciliation between budget and claims in the closeout process. In mostsituations, if the claims exceed the budget, the claims will be disallowed to match the budget.

Note for OMH: Some programs (case management, residential, etc) must be budgeted according to specific fundingmodels. Additionally, programs that receive COPS, CSP, and DSH revenues must be budgeted to revenue thresholdsdefined by OMH. All programs must be budgeted according to the funding rules defined in the OMH Spending PlanGuidelines. See Case Management, COPS, CSP, and DSH procedures for information.Resources:1. Consolidated Budget Report manual:https://www.omh.state.ny.us/omhweb/cbr/manual.pdf#page=9https://www.omh.state.ny.us/omhweb/cbr/manual.pdf#page=92. Program Budget Change Request form: See Program Budget Change Request processDate: May 1, 2011OMH Review: 2/7/11OASAS Review: (none)OPWDD Review: (none)

FISCAL OFFICER TRAINING MANUALPROGRAM BUDGET CHANGE REQUEST (OASAS)Business Process: (what is it?)Program Budget Change Request (PBCR) form is a document that is used to facilitate a change to the current Budget ofRecord (BOR) for OASAS.Brief Description of Process: (how does it work?)The form is formatted as follows: the first column is the current approved Budget of Record, second column is the newproposed budget, third column is the difference between the current and proposed budget, and the fourth is the % changefrom current to the proposed budget. The agency prepares the document and submits the PBCR form along with anarrative explanation to the County for review and approval. The County validates that the first column is the accuratebudget of record, reviews the changes, and gives their approval by signing off on it, then forwards it to the NYSOASASfield office for approval and processing.Frequency:The PBCR is filed on an as needed basis. It is required if actual expenses will NOT follow the Claim Close OutGuidelines, for example if the Gross Expense increased by 10% over budget, Agency Admin increased by 10% overbudget OR if State Aid changed. If the gross expense is not increasing by 10% and revenue supports this expense, aPBCR is not required. A one-time state aid award does not require a PBCR.Instructions:1. Receive PBCR form from provider agency. Confirm Budget of Record ties to approved Budget or last approvedPBCR. (The totals can also be tied to State Aid Letter)2. Review the narrative explanation for the changes along with the $ Change and the % change.a. Does it seem justified and appropriate?b. What is the history of this program? Have the agency continually increased the budget of the program?c. Does the % change exceed 10%? If so, it will be scrutinized even further, especially for personal servicesand administrative administration.3. If satisfied, county will sign and approve the PBCR and forward onto the NYS OASAS field office for their reviewand approval.4. File PBCR form with agency budgets and/or state aid letters. (or where appropriate)Resources:1. PBCR FormDate: May 1, 2011OASAS Review: (none)

CountyNEW YORK STATE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICESAID TO LOCALITIESPROGRAM BUDGET CHANGE REQUEST (PBCR) FORMAgency NameAgency CodePRU NumberProgram Code+IndexLocal Fiscal YearRevision #Budget Expense/Revenue CategoriesEXPENSES:Personal ServicesFICA & Fringe BenefitsO.T.P.S.EquipmentProperty/SpaceAgency AdministrationTotal Gross ExpensesCurrent Approved Requested ProgramBudget of Record BudgetColumn 1 Column 2$ChangeColumn 3%ChangeColumn 4REVENUE:Patient FeesSSI and SSAHome Relief/Public AssistanceMedicaidMedicareState GrantThird Party/Private InsuranceFederal GrantFood StampsLocal TaxOther Rev:Other Rev:Other Rev:Total RevenueNET OPERATING COSTDeficit FundingState AidLocal GovernmentNon-FundedTotal000Is this an on-going change?The following information MUST be completed, if applicable.Units of ServiceGross Cost per Unit of ServiceNet Cost per Unit of ServiceYESNOAgency ApprovalCounty Approval (if necessary)Signature:Signature:Title: Date: Title: Date:FIELD OFFICE APPROVALDISTRICT DIRECTOR APPROVALSignature:Signature:Title: Date: Date:DIRECTOR OF STATEWIDE FIELD OPERATIONS APPROVALSignature:Date:BUREAU OF BUDGET MANAGEMENT APPROVALSignature:Date:PBCR (03/07)

FISCAL OFFICER TRAINING MANUALCONSOLIDATED QUARTERLY REPORT (CQR) SUBMISSIONBusiness Process: (what is it?)The OASAS Consolidated Quarterly Report (CQR-1) submission summarizes the fiscal activity for any given quarter (1st,2 nd , 3 rd , and mid-year) in a fiscal reporting period. Mid-year claims report expenses and revenues for all service providersreceiving funding through local contract with the Local Governmental Unit (LGU).Brief Description of Process: (how does it work?)This document is created in the free CFRS Software. Service providers report total expenses, revenues, net operatingcosts and funding source code information based on the first six months of the fiscal reporting period and submits this tothe LGU. After review and approval of all local contract funded service providers and county operated service providermid-year claims (CQR-1’s), the LGU submits all reports to NYS OASAS.Frequency:NYS OASAS mandates the submission of mid-year LGU claim packages no later than August 15 th . LGU’s may requireprovider submissions more frequently (monthly or quarterly) at their own discretion.Instructions:1. Note: For instructions on the completion and submission of year-end Consolidated Fiscal Reports (CFRs) andfinal state aid claim schedules, refer to the CFR Manual:http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFRManual/home.htm2. Note: For line-by-line instruction on the completion of CQR-1s and other OASAS mid-year and final state aidclaim submission requirements, policies and procedures, refer to the New York State Consolidated Budget andClaiming Manual:.http://www.omh.state.ny.us/omhweb/cbr/manual.pdf3. The LGU will receive mid-year CQR-1s and signed schedules CFR-i, and CFR-iii from all county operated andlocal contract funded not-for-profit service providers receiving state aid through the LGU. These mid-year CQR-1swill report expenses, revenues, net operating costs and funding code information for the first six (6) months of thefiscal reporting period.Note: Each provider CQR submission must be uploaded to the NYS website.4. LGUs should follow up immediately with service providers that are delinquent in reporting to ascertain the reasonsfor lateness and to obtain an estimate of the submission date. If the LGU has good reason to believe that adelinquent reporting service provider will not submit its mid-year claim prior to the required submission deadline,the LGU should submit all available CQR-1s and associated signature pages by the submission due date.5. It is the LGU’s responsibility to review county operated and local contract funded not-for-profit service providers’mid-year claims to ensure that:a. Fiscal information reported is in compliance with the service provider's approved budget.b. All required programs are reported.c. Correct program codes, program code indexes and site codes (OASAS Program/PRU Numbers) are usedfor all reported programs.6. LGUs will prepare a mid-year claim package consisting of the following documents for each county operated andnot-for-profit service provider receiving State Aid through the LGU:a. CFR-i.b. CFR-iiic. CFR-1

OASAS: OASAS expects all county operated and local contract funded not-for-profit service providers to completemid-year fiscal reporting documents and to submit those documents via the Internet. At this time, paper copiesare still required to be sent directly to:NYS Office of Alcoholism and Substance Abuse ServicesBureau of Financial Management4th Floor1450 Western AvenueAlbany, NY 12203-3526Note: Some LGUs use CQR-1s to review service provider financial performance on a monthly or quarterly basisduring a fiscal reporting period. Based on this review, advance payments may be adjusted if the provider is underspending.Resources:1. PDF copies of Consolidated Fiscal Reporting System (CFRS) documents including CQR-1s are available at:http://www.omh.state.ny.us/omhweb/cfrsweb/form_pages/index.htm2. Consolidated Fiscal Reporting System Home Page:http://www.omh.state.ny.us/omhweb/cfrsweb/default.asp3. NYS CFRS Software Download Page:http://www.omh.state.ny.us/omhweb/cfrsweb/cfr_pages/download.asp4. NYS CFRS Software Upload Page:https://www.omh.state.ny.us/omhweb/CFRSWeb/cfr_pages/upload.aspDate: May 1, 2011OMH Review: N/AOASAS Review: 2/9/11OPWDD Review: N/A

FISCAL OFFICER TRAINING MANUALCONSOLIDATED FISCAL REPORT (CFR)Business Process (what is it?)The Consolidated Fiscal Report (CFR) is required to be completed by service providers receiving funding from any or allof the following New York State agencies: Office of Alcoholism and Substance Abuse Services (OASAS), Office of MentalHealth (OMH), Office for People with Developmental Disabilities (OPWDD), and State Education Department (SED).Service providers operating programs under the jurisdiction of one or more of these state agencies must file an annualCFR to document the expenses and revenues related to those programs. A single CFR is required from a serviceprovider for each reporting period for which they are required to file. This single CFR includes all expenses and allrevenues of the service provider. The CFR is used as both a year-end cost report and a year-end claiming document.Brief Description of Process: (how does it work?)Each service provider must file a CFR submission. The type of submission is determined by the type of provider (Article31 Free Standing Clinic or Article 28 Hospital Based Clinic), the programs operated, and the amount of state and federalfunding received by the provider and the programs. Each CFR submission type (Full, Article 28 Abbreviated, Abbreviated,and Mini-Abbreviated) contains different combinations of schedules and has slightly different rules governing the methodsof accounting used on those schedules.The CFR is prepared by collecting program information including: program details, Expense detail, Revenue detail,Personal Services detail, Capital Equipment details, Units of Service and Persons Served detail, and other programinformation. It is recommended that collection and organization of expense, revenue and other required data into a formatreadily transferable into the CFRS software be done prior to the actual creation of the CFR document in the CFRSsoftware. All service providers are expected to use CFR Interagency Committee approved NYS CFRS software tocomplete and submit the appropriate CFR document via the internet. (check OMH website for latest available version)County contracted service provider have their CFR-i and CFR-iii schedules signed and then upload their CFR fileelectronically to the OMH CFRS website. At that time, service providers send copies of their CFR report with signed CFRi& CFR-iii schedules to the County LGU for review and signature. The County LGU reviews the CFR document,communicates to the provider any revisions that are needed, and approves the CFR by signing the Schedule CFR-iii.Depending on the state agency, the service provider mails any other requirement materials to the NYS agency, seemanual for details.When any CFRS submissions are uploaded to the OMH CFRS website for submission, the data is saved in a datarepository (database) and data is processed overnight and loaded into other NYS applications, Two such applications areALFS and SABRS. The tools, ALFS for OMH and SABRS for OASAS, are utilized to manage funding, budgets, claims,and other information. At this time, only ALFS is accessible for County LGU staff for use and neither is available to localservice providers. OPWDD has no such tool and, currently, there are no plans for any future application.Frequency:The CFR is completed annually with the possibility of submitting revisions until final NYS closeout. The due date of theCFR is 120 days from the close of the fiscal year. A thirty-day extension will be granted to providers who electronicallycomplete and submit the Pre-Approved 30-Day Extension Request by May 1, 2011. No response to this extension requestis sent. Retain a copy for your files prior to submitting the completed form. The pre-approved extension does not apply tothe required claiming schedules for all OASAS funded service providers. (Refer to Section 4.0 of the CFR Manual).The link to the Pre-Approved 30-Day Extension Request form is available from the NYS Education Department at:http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFRManual/home.htmlNOTE: A PAPER COPY OF THE EXTENSION FORM WILL NOT BE ACCEPTED BY ANY OF THE FUNDING STATEAGENCIES, ONLY ELECTRONIC FILING WILL BE ACCEPTED

Instructions:LGU Splits:The County LGU Program (0890) is reported as one program on the Core schedules (CFR-1 – DMH-1) and gets splitamong the three state agencies OMH, OASAS and OPWDD on the Claim schedules (DMH-2 – DMH-3). The split isbased on established percentages, which can be found in the CFR Manual Appendices. The percentage splits are alsohandled by the CFRS software for 0890 programs when transferring data from DMH-1 to DMH-2.CFR Schedules:The CFR is divided into several sections, each with their own schedules. Depending on which type of CFR is filed, notevery schedule may be required. Refer to the CFR Manual and Appendices for more detailed information about the CFRschedules.http://www.omh.ny.gov/omhweb/finance/main.htmSignature Page Schedules: CFR-i: Agency Identification and Certification Statement is used to report agency identifying data and servesas a certification statement by the service provider’s chief executive officer attesting to the validity of theinformation contained in the document. This schedule is required for all CFR submissions. CFR-ii / CFR-iiA: Accountant’s Report is required for most Full CFR filers and is signed by anaccountant/auditor after an independent audit or compliance review of the required schedules. CFR-iii: County/New York City Certification Statement is required for Abbreviated, Article 28 Abbreviated, andMini-Abbreviated CFRs. This schedule MAY be required for Full CFR Submissions. This schedule is onlyrequired of service provider receiving Aid to Localities funding (State Aid) from one (1) or more of the Departmentof Mental Hygiene (DMH) State Agencies. This schedule must be signed by the service provider’s ChiefExecutive Officer (on left) or county LGU’s Chief Fiscal Officer (in middle) and is signed by the county Director ofCommunity Mental Health Services (on right) as the County certification statement.Core Schedules: CFR-1: Program/Site Data is used to report Program Administration and Program/Site expenses and revenuesfor the designated reporting period on a program/site specific basis. CFR-2: Agency Fiscal Summary is used to capture total expenses and revenues that are attributable to theservice provider as a whole and should tie to the service provider’s financial statements. CFR-3: Agency Administration is used to report and allocate the administrative costs that are not directlyrelated to specific programs/sites, but are attributable to the overall operation of the agency. CFR-4 / CFR-4A: Personal Services is used to report the hours worked, amounts paid, and the full timeequivalents (FTE’s) associated with each position title employed by the service provider. CFR-4A: Contracted Direct Care and Clinical Personal Services is used to report the amount paid toindividuals/organizations that have contracted with the service provider to provide direct care and/or clinicalpersonal services. CFR-5: Transactions with Related Organizations/Individuals is used to report all transactions, includingcompensation, between the reporting entity, its affiliates, principal owners, management and members of theirimmediate families and any other party with which the reporting entity may deal when one party has the ability tosignificantly influence management or operating policies of the other to the extent that one of the transactingparties might be prevented from fully pursuing its own separate interests. CFR-6: Governing Board and Compensation Summary is used to report compensation provided to boardmembers, five highest paid employees and independent contractors, and to all employees whose earning exceedmore than $$125,000 in annualized salary/contracted payments. DMH-1: Program Fiscal Summary is used to aggregate expenses, revenues, and units of service by Stateagency, program type and index for all the individual sites operated by the service provider.Claiming Schedules (also referred to as the Consolidated Claim Report or CCR): DMH-2: Aid to Localities/Direct Contract Summary is used to report claiming expenses, revenues and deficitfunding amounts by county, program type or contract number. The DMH-2 is the state aid claiming document forOMH, OASAS and OPWDD.

DMH-3: Aid to Localities and Direct Contracts Program Funding Source Summary is used to list, byfunding code and funding source, claimed expenses, revenues and deficit funding amounts by county, programtype and contract number. A separate DMH-3 must be prepared for each State Agency and Local GovernmentalUnit (LGU) from which the service provider receives Aid to Localities funding either through direct contracts orindirectly through the LGU.Other Supplemental Schedules: OMH-1: Units of Service by Program/Site must include all units of service and, depending on program type,either the weighted visits or service hours rendered by program/site. OMH-2: Medicaid Units of Service by Program/Site captures all Medicaid Units of Service and, depending onprogram type, either the weighted visits or service hours rendered by program/site. OMH-3: Client Information is used to capture the number of persons served by program/site. OMH-4: Units of Service by Payor is completed based upon date of service rendered and only for servicesprovided during the reporting period. The OMH-4 is used for OMH licensed Clinic Treatment programs and is arequirement to participate in the Uncompensated Care Pool related to Clinic Restructuring. This schedule reportsunits of service by payer and any associated revenue. OPWDD-1: ICF/DD Schedule of Services is used to report services and supplies within ICF/DD programs. OPWDD-2: ICF/DD Medical Supplies is used to report medical supplies. OPWDD-3: HUD Revenues and Expenses is used to report all expenses and revenues associated with theHousing and Urban Development (HUD) funding. OPWDD-4: Fringe Benefit Expense and Program Administration Expense Detail is used to report detail offringe benefit expense and program administration that have been reported on the CFR-1 for a list of programs. SED-1: Program and Enrollment Data is to be completed by all service providers requiring tuition rates from theNYS Education Dept. for school age and preschool programs. SED-4: Related Service Capacity, Need and Productivity is used to determine the capacity, need andproductivity of related services for school age and preschool special education programs.Recommended Order of Completion:Generally the suggested order in which to complete the CFR schedules is as follows: CFR-4 / 4A CFR-1 CFR-2 CFR-3 CFR-5 CFR-6 DMH-2 DMH-3 Any required supplemental schedulesSome fields on various schedules are populated from other schedules. This order allows for schedules to bepopulated appropriately from other schedules and makes the process as efficient as possible.CFR Submission: Submission type is dependent on the type of program(s) operated by the service provider and the amount andtype of funding received from the CFR state agencies. Refer to the submission matrices (Section 2 of the CFRmanual) to determine the type of CFR submission required. Full CFR’s must be certified by an independent certified public accountant with the exception of certain OASASonly service providers or OMH only service providers that meet the criteria as described in Section 2 of the CFRmanual. County LGUs may submit any one of the following to meet certification requirements: ComplianceReview, Schedule CFR-ii, CFR-iiA. General CFR Submission requirements:o All service providers are expected to use CFR Interagency Committee approved NYS CFRS software tocomplete and submit the appropriate CFR document via the internet.

o Signed and dated paper copies of the certification schedules (CFR-i, CFR-ii or CFR-iiA, and CFR-iii) mustbe sent to each applicable State Agency along with a copy of the service provider’s certified financialstatements. (CFR Unit)o Signed and dated paper copies of the certification schedules (CFR-i and CFR-iii) must be sent directly toall certifying/funding State Agencies. (Budget and Claims Unit)o The Document Control Number (DCN) on the certification schedules must match the DCN of the Internetsubmission.o For mailing addresses, refer to Section 2 of the CFR manual.OASAS also requires a Preliminary (Estimated) claim submission to be submitted prior to the CFR due date. Ifthe filing deadline is not met, there is no 30 day extension for OASAS claims.OPWDD requires that a paper copy of the CFR be submitted to NYS OPWDD.CFR document must be transmitted via the OMH website: https://www.omh.ny.gov/omhweb/cfrsweb/default.aspCFR Recommendations and Tips: Create a Master list of programs, program codes & indexes, site codes, and units of service method. The CFR-4 Personal Services schedule preparation is the most time consuming and important schedule. Mostprograms expenses are made up of 70% personal services and fringe benefits, thus every programs’ overallmakeup is driven by this analysis. An average Full CFR will take 40 – 60 hours to complete, Abbreviated 20-40 hours, Article 28 Abbreviated 20-40hours, and Mini-Abbreviated, 1 – 10 hours. It is recommended to create worksheets of the CFR schedules in Excel and complete them before entering intothe CFRS software. This helps efficiency, effectiveness, provides backup and auditors like electronic files forvalidation. Compare CFR submission to CBR submission, CBR program and/or fiscal revisions may be necessary.Resources:Date: May 1, 2011OMH Review: 12/29/101. Consolidated Fiscal Report Manuals and software are available at the following website:http://www.oms.nysed.gov/rsu/Manuals_Forms/Manuals/CFRManual/home.html2. CFR Training is provided every year. Dates are usually available at the following websites:The SED Rate Setting Unit homepage at http://www.oms.nysed.gov/rsu/home.html or;The OMH CFR Unit homepage at http://www.omh..ny.gov/omhweb/finance/train.htm.3. CFRS Software training is also available through the NYS Helpdesk: 1-800-HELP-NYS4. To receive notification of new version releases, known problems, and other information related to theCFR, please join CFRS Announcement Mailing List:http://www.omh.ny.gov/omhweb/listserv/cfr.htmOASAS Review: (none)OPWDD Review: (none)

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALFINAL YEAR END CLAIM SUBMISSIONThe process utilized by the Local Government Unit (LGU) to reconcile and closeout all county operated and local contractfunded not-for-profit service providers based on their final year end claim submission.Brief Description of Process: (how does it work?)Contracted providers submit their Consolidated Fiscal Report (CFR), which includes their claim schedules (CCR) to theCounty. The LGU reviews the providers claim schedules against the budget of record and funding allocations. If thesubmission meets with the County approval, the Director of Community Mental Health Services signs the CFR-iii scheduleand completes a final claim package for each DMH state agency. In order to maximize funding, claims or budgets mayneed to be modified before submission to the appropriate state agency.Frequency:Annually – see claiming manual for due datesInstructions:The LGU receives the final year-end State Aid claiming schedules from their providers. The final year-end claimingschedules are included as part of the year-end Consolidated Fiscal Report (CFR) and are referred to as the ConsolidatedClaim Report (CCR). CCRs consist of CFR schedules CFR-i, CFR-iii, DMH-2 and DMH-3.The LGU compares the expenditures and revenues by program, program codes/indexes and funding codes/indexes to theservice provider’s approved budget and/or the county approved funding levels per the State Aid Funding letter. It is theLGU’s responsibility to identify service provider expenditure overruns, revenue shortfalls, and significant service deliveryperformance variances.In order to maximize funding, claims or budgets may need to be modified before submission to the appropriate stateagency. If warranted, the LGU may request the affected service provider to prepare a budget and/or claims modificationin accordance with the specific DMH State Agency and/or LGU requirements. In some cases, this may mean legislativeapproval (contract amendment and/or resolution).Once the submission meets with the County approval, the Director of Community Mental Health Services signs the CFR-iiischedule. When this is completed, the LGU will prepare a final claim package for each DMH State Agency as follows:New York State Office of Alcoholism and Substance Abuse ServicesSigned and dated paper copies of the certification schedules (CFR-i, CFR-iii, DMH2 claim schedules).Estimated claims are due no later than 120 days after the end of the fiscal reporting periodOASAS will consider preliminary (“estimated”) claim schedules to be “final”, if the final claim schedules associatedwith a completed CFR are not submitted within 60 days of the submission due datesNew York State Office of Mental HealthSigned and dated paper copies of the certification schedules (the CFR-i only for service providers and the CFR-iand CFR-iii for the County LGU).Due for receipt by OMH no later than 135 days after the end of the fiscal reporting period. (165 days if 30 dayCFR Extensions have been submitted.)County LGU are required to approve Consolidated Claims Reports (CCR’s) in ALFS, see following steps:o In ALFS, run validations on each service provider CCRo Review validations reports and follow-up with providers, if necessary, and add remarks for each rulevalidation failureo After passing county review and adding remarks, click ‘Milestones’ and ‘County Approval’ for each serviceprovider including the County ‘agency’

o After all individual service provider CCR’s have been approved, open the ‘Group CCR’ window and run‘validations’.o Review validations report and follow-up with any failures, if necessary, and add remarks for each rulevalidation failureo After passing county review and adding remarks, click ‘Milestones’ and ‘County Group Approval’Due for receipt by OPWDD no later than 135 days after the end of the fiscal reporting period. (165 days if 30 dayCFR Extensions have been submitted.)New York State Office of People With Developmental DisabilitiesPaper copies of CCRs (CFRi, CFRiii, DMH2 schedules) for each county operated and local contract fundedservice provider funded through a local contract. For LGU programs (0890), copies of the DMH2 schedules arerequired to be submitted as well to confirm the LGU County Administration Percentage Splits as calculated.A paper copy of an LGU Fiscal Summary (CQR-3) reporting funding code information for all county operated andlocal contract funded not-for-profit service providers.A State Aid Voucher (AC-1171) with an original signature.Due for receipt by OPWDD no later than 135 days after the end of the fiscal reporting period. (165 days if 30 dayCFR Extensions have been submitted.)Resources:1. CFR manual -2. Fiscal Shareware Tools at http://www.clmhd.org/resourcesDate: May 1, 2011OMH Review: 1/19/11OASAS Review: (none)OPWDD Review: (none)

FISCAL OFFICER TRAINING MANUALNYS CLOSEOUT REVIEW - OMHBusiness Process (what is it?)The NYS Office of Mental Health (OMH) closeout is a desk audit process that compares the State Aid claimed forallowable net operating costs to actual State Aid payments made using the latest State Aid Approval Letter, approvedConsolidated Budget Reports (CBR) and Consolidated Claiming Reports (CCR). The OMH closeout process is designedto determine the State Aid overpayment amount, by funding source code, to be recouped from a county due to unspentfunds or spending inconsistent with applicable OMH rules.Brief Description of Process: (how does it work?)The final closeout package is available through ALFS to the counties typically within a year after the end of the fiscal year.Upon issuance of a closeout package, a message notifying the ALFS user of a final OMH Closeout package will appear inthe message board when the user logs into ALFS. The message board identifies a final closeout date 45 days from thedate the closeout is issued. During this 45 day review period, the County Fiscal Officer reviews the closeout package,found in the State Aid Closeout Screen, for accuracy of approved claims.The final closeout package includes a closeout letter addressed to the County Director of Community Mental HealthServices or County Commissioner of Mental Health, a “Summary of Payments, Allowable Net Operating Costs andOver/(Under) Payment” report, a “Closeout County Recovery Summary” report and a “Closeout Adjustment” report.o The closeout letter identifies the total overpayment amount and lists adjustments/disallowances by ProviderName, Funding Code, and Program Code/Program Name.o The Summary of Payments, Allowable Net Operating Cost and Over/(Under) Payment report reflects Stateadvances, Prior Period adjustments, final claims, disallowances, adjustments, final approved state aid, and anyrecovery amounts.o The Closeout County Recovery Summary report displays the prior year’s recoveries applied to State Aidpayments made during the fiscal year of the closeout package. The report identifies the year and fund code inwhich the overpayment was generated, the recovery amount, and the voucher number and liability date in whichthe recovery was applied.o The Closeout Adjustment report is included in the closeout package if adjustments were made by OMH to theclaims during the closeout.The Fiscal Officer should contact NYS OMH regarding any questions and requests for additional information. Revisionsto CBR’s and/or CCR’s should be made to correct any errors that impact the closeout overpayment amount within the 45day review period. Once the review period is closed, the NYS OMH applies any final overpayment to future scheduledState Aid Letter payments made to the county.Frequency:The NYS OMH closeout package is typically completed within 6 months to 2 years of final claims submission. Largercounties typically take longer to receive a package due to their multiple dynamics and complexities.Instructions:1. Review error reports for NYS OMH deliverables (CBR & CCR) and apply county approvals by the requireddeadlines. Counties should read Validation-Exception Report messages to identify potential disallowances. Itis here that the county can make minor changes to the claims such as program index #'s and the correctingfunding sources. This will avoid any potential disallowances during the NYS closeout process. Failure toappropriately approve deliverables will delay the closeout process and could result in sanctions from NYSOMH. See “CBR” “CCR” and “NYS Deliverables and Sanctions” procedure for further details.2. Receive notification of a NYS Closeout package when logging into ALFS.3. Print the NYS closeout package from ALFS. This package includes Closeout Letter and Summary ofPayments, Allowable Net Operating Cost and Over/Under Payment report. Also included in the package arethe Closeout County Recovery Summary and the Closeout Adjustments report.

4. Reconcile, by agency by program site, approved state aid amounts against submitted claim state aid amounts(and/or internal records). In ALFS, this may be done within CBR or CCR windows by changing the versionbetween ‘County’ version and ‘NYS’ version and reviewing the DMH-3 schedules. Note: reports are availablewithin ALFS to print the details of the DMH-2 and DMH-3 schedules. Note: may require creation of an offlineworksheet5. Reconcile, by agency, approved state aid amounts against submitted claim state aid amounts (and/or internalrecords). Note: may require creation of an offline worksheet6. Review, by agency by program site, any disallowances by NYS OMH (expenses that failed OMH budgetcontrol points – see Aid to Localities Spending Plan Guidelines link below). These amounts will appear byfund code in the Summary of Payments, Allowable Net Operating Cost and Over/Under Payment report.Note: Disallowances do not always equate to an overpayment or recovery. Recovery amounts by fund codeappear in the “Overpayments” column of the report. After review, determine if a disallowance, that impacts therecovery of State Aid, is an error that should be corrected.7. If any discrepancy(s) or disallowances exist between internal records/submitted claims and approved stateaid funding, follow-up with the Local Field Office representative for clarification (the Field Office may direct theFiscal Officer to contact NYS OMH representative in Albany directly). Note: do so as quickly as possible tomaximize the opportunity to make changes to claims or budgets, if appropriate.8. If follow-up results in the submission of claim or budget changes to NYS OMH, return to step #1 and repeat.Note: Counties only have one (1) 45 day window for revisions, it does not restart upon resubmissionof CBR’s and CCR’s, and the closeout becomes final after the 45 days window has expired and NYSreview of any submitted corrections.9. If no follow-up with NYS OMH is required on claims or budgets, ensure that the Closeout CountyRecovery Summary report ties to County internal records. If the report is consistent with internal records,make any updates necessary to provider contracts and process final payments to/ recoup overpayments fromcontracted providers. If the report is not consistent with internal records, follow-up with NYS OMH PaymentUnit for clarification.FAQs:How can I avoid unnecessary recoveries? Follow steps 4, 5 & 6 outlined above. Recheck claiming documents for mechanical errors such as program codes and program indexes that appear inthe claim but do not appear in the budget. Review Spending Plan Guidelines when preparing budgets to remain consistent with updated funding rules. Track provider expenses in your county throughout the year to identify agencies that have been under spendingand revise your allocations before the end of the fiscal year.I want to fix an error on a CBR or CCR that is impacting State Aid. Why can’t I import a new CBR/CCR into ALFS orremove my approval from the old one? NYS OMH approvals must be removed before a new CBR or CCR can be imported into ALFS. Any submissionwill sit in Traffic Cop until both NYS OMH and County approvals have been removed, see the following steps. Contact the OMH Field Office when making CBR revisions and the OMH Central Office Claims Unit for CCRrevisions. The NYS OMH will require an explanation of the changes to be made and will require that a revised CBR or CCRbe uploaded before the approvals will be removed. Once NYS OMH approvals are removed the county approvals must be removed and the Fiscal Officer must go tothe Traffic Cop Screen in ALFS to import the new submission. It is recommended that the Fiscal Officer checka provider’s submission for accuracy prior to importing a new CBR or CCR using the “Compare” buttonin Traffic Cop.Resources:1. NYS OMH Aid to Localities Spending Plan Guidelines:http://www.omh.state.ny.us/omhweb/spguidelines/selectletter.asp

2. NYS Contracts and Claims Unit: (518) 473-7885Date: May 1, 2011OMH Review: 1/11/11

FISCAL OFFICER TRAINING MANUALNYS OASAS CLOSEOUT REVIEWBusiness Process (what is it?)The NYS OASAS closeout is a process that reconciles the final OASAS funding approval levels, by provider andcumulatively, to funding advances paid to the counties.Brief Description of Process: (how does it work?)The final closeout package is sent by NYS OASAS to the counties typically by the fall of the subsequent calendar year.The County Fiscal Officer reviews the closeout package (generated from NYS OASAS State Aid Budget & ReportingSystem (SABRS)) for accuracy of figures. The closeout package includes a notification letter, Final State Aid PaymentWorksheet, as well as Agency/Program/Site specific line item comparisons of approved budgets versus claims. The Stateshould be contacted with any discrepancies.Frequency:The closeout is done on a yearly basis.Instructions:1. Receive closeout package from NYS OASAS (typically sent to County DCS).2. Compare, by agency by program site, approved state aid amounts against submitted claim state aid amounts(and/or internal records).3. Compare, by agency, approved state aid amounts against submitted claim state aid amounts (and/or internalrecords).4. Review, by agency by program site, any disallowances (or expenses outside of guidelines). These amountswill show up under the Reconciliation area in the Non-Funded Amount cell.5. If discrepancy(s) from internal records/submitted claims and approved state aid funding, follow-up with LocalField Office representative for clarification (Field Office may direct Fiscal Officer to contact NYS OASASrepresentative in Albany directly). Note – do so as quickly as possible to maximize the opportunity tomake changes to claims, if appropriate. The County has 45 days for review and submit any revisedclaims.6. If follow-up results in claim changes to be submitted to NYS OASAS and a new NYS closeout is processedand received, return to step #1 and repeat.7. If no follow-up with NYS OASAS are required on claims, ensure that Final Payment Worksheet ties to Countyinternal records. If worksheet ties, make any updates necessary to provider contracts and process finalpayments / recoup overpayments. If worksheet does not tie, follow-up with NYS OASAS Payment Unit.Date: May 1, 2011OASAS Review: (none)

FISCAL OFFICER TRAINING MANUALFiscal Officer Manual WorkgroupNYS OPWDD STATE AID LETTER (COUNTY) CLOSEOUT PROCESSBusiness Process (what is it?)The NYS Office of People with Developmental Disabilities (OPWDD) closeout is a desk audit process that compares theState Aid claimed for allowable net operating costs to actual State Aid payments made using the latest State Aid ApprovalLetter, approved Consolidated Budget Reports (CBR); contracts [where applicable] and Consolidated Claiming Reports(CCR). The OPWDD closeout process is designed to determine the State Aid overpayment amount, by funding sourcecode, to be recouped from a county due to unspent funds or spending inconsistent with applicable OPWDD rules.Brief Description of Process: (how does it work?)The final closeout package is sent by NYS OPWDD to the counties typically within a year after the end of the fundingyear. It includes a closeout letter addressed to the County Director of Community Mental Health Services or CountyCommissioner of Mental Health, that details a “Summary of Payments, Allowable Net Operating Costs, and Over/(Under)Payments” along with any individual provider explanations of claim changes or disallowancesThe County Fiscal Officer reviews the closeout package for accuracy of figures and should contact NYS OPWDDregarding any questions and requests for additional information. Revisions to CBR’s and/or CCR’s should be made tocorrect any errors that impact the closeout overpayment amount. (No certain timeframe exists for this process.)Frequency:The NYS OPWDD closeout is typically completed within 6 months to a year of final claims submission.Instructions:1. Receive closeout package from NYS OPWDD.2. Compare figures on closeout to advances received and final funding letter. Final State Aid payment fromNYS OPWDD is released to Counties along with the closeout package (OPWDD holds back 10% of totalcounty state aid until final claims are reviewed and approved).3. Reconcile County approved provider claims to NYS Closeout. New Budgets or contracts may be required ifan agency receives more State Aid on the Final Claim than was originally budgeted.4. If any discrepancy(s) or disallowances exist between internal records/submitted claims and approved stateaid funding, follow-up with the NYS OPWDD representative listed on closeout letter for clarification.5. If follow-up results in the submission of claim; contract or budget changes to NYS OPWDD, return to step #1and repeat.6. NYS OPWDD will issue a new funding letter and make a final payment to the County if final approval levelsare higher than the previous funding letter.7. If no follow-up with NYS OPWDD is required on claims; contract or budgets, ensure that the Closeout CountySummary report ties to County internal records. If the report is consistent with internal records, make anyupdates necessary to provider contracts and process final payments to/ recoup overpayments fromcontracted providers. If the report is not consistent with internal records, follow-up with NYS OPWDDPayment Unit for clarification.Resources:NYS OPWDD Contacts: http://www.omr.state.ny.us/hp_contactlistwo.jsp

Date: January 25, 2011OPWDD Review: 2/22/11

FISCAL OFFICER TRAINING MANUALPROVIDER RECONCILIATION & RECOVERY PROCESSBusiness Process (what is it?)Provider reconciliation and recovery is an internal process in which the local government unit (LGU) compares the finalState funding approval levels to the funding disbursements made to individual providers for a fiscal year. Recoveries orpayments are made as necessary.Brief Description of Process: (how does it work?)The State (OMH, OASAS, OPWDD) sends the final closeout package to the LGU. The LGU reviews the closeout todetermine the final funding approval level for each provider. Any local County funding is added to the State approval toyield a total approved funding for the provider. A recovery is made if the total disbursements to the service providerexceed the total approved funding. A final payment is made if the total approved funding exceeds total disbursementsmade to the service provider.Frequency:The provider reconciliation and recovery is done each fiscal year.Instructions:1. Receive the final closeout package from the State funding office (OMH, OASAS, OPWDD). Each officeprovides separate closeouts. OMH sends a message via the Aid to Localities Financial System (ALFS) that acloseout is ready. The OMH closeout is printed from ALFS. The OASAS and OPWDD closeout are receivedin the mail to the Director of Community Services.2. The State closeout is broken down by funding source and/or program. Each State office provides theinformation in its own way and on its own time schedule.3. The LGU determines the funding that pertains to each provider. This can be done by referring to the StateAid Funding Letter and any other supporting documentation. Any discrepancies should be discussed with theapplicable State office. The County has 45 days from the date of the original NYS closeout letter to reviewand submit any revised documentation, if necessary.4. If revisions to the closeout are made and a revised closeout is processed, return to step 1. Note: OMH onlyallows the closeout package to be revised once; the 2 nd closeout becomes final and cannot be revised. Uponfinal closeout, NYS (OMH, OASAS, OPWDD) then recovers funding from the next State Advance to theCounty.5. The County LGU prepares a reconciliation schedule is that includes the final State approval amounts for eachprovider, county share/contribution, and county disbursements. Based upon the reconciliation schedule, theCounty notifies the provider of the amount of funding due to the provider or amount due to be recovered fromthe provider.6. The LGU makes arrangements with the appropriate County offices to create any necessary contractamendments or accounting adjustments.7. Once agreement is reached with the service provider on the reconciliation amount, the closeout is thenprocessed. If it resulted in an overpayment, a check is requested from the provider or the recovery amount istaken from the next county disbursement to the service provider. If a payment is due to the service provider,the County must process a final payment to the provider.Date: May 1, 2011

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALEQUIPMENT PURCHASES APPROVAL PROCESSOMH FIELD OFFICEAn agency that receives State Aid from the Office of Mental Health (OMH) is expected to adhere to the “prudent buyerconcept” when making purchases, whereby the purchase or rental of property, materials, supplies or services and the like,may not exceed the cost that a prudent person would pay in the open market to obtain these items under thecircumstances prevailing at that time. The OMH requires that providers follow a competitive bidding process, outlined bythe State, for purchases over $5,000 and that prior approval is obtained from the regional Field Office for equipmentpurchases over $5,000.Brief Description of Process: (how does it work?)The State has set the following requirements for purchases. These minimum State requirements may be supplemented bythe additional requirements of a Local Government Unit (LGU).o If the total purchase is for an amount less than $5,000, the local provider will select a reliable vendor at areasonable price.o If the total purchase is for an amount of more than $5,000 but less than $25,000, the local provider shall obtain atleast three telephone quotes and select the lowest bidder.o If the total purchase is for an amount in excess of $25,000, the local provider shall make a good faith effort toobtain at least five written bids, and shall enter into a written contract with the successful bidder.A written record (i.e., documentation) of the procurement, including bids and quotes, shall be maintained and madeavailable for review upon request by appropriate oversight agencies. LGU's and subcontract agencies will not be required,in all cases, to select the lowest quote or bid if it is determined that there is a good commercial reason not to do so. In theevent that the lowest bid or quote is not selected, the local provider shall maintain written justification and/or evidence ofthis decision.*As an alternative to competitive bidding, or as an additional bid or quote, mental health provider agencies can use prenegotiatedState contracts identified on the NYS Office of General Services (OGS) website.Equipment purchases greater than $5,000 requires prior Field Office approval to ensure that the required bidding processwas followed and that the purchase can be programmatically justified/is appropriate. Requests to purchase equipment atthe end of the year due to unexpended balances are not acceptable justification of programmatic need.Frequency:All requests relating to the current local fiscal year must be received by December 1 from Upstate and Long Islandcounties, and by June 1 from the New York City Department of Health and Mental Hygiene (NYCDH&MH). The OMH willnot recognize requests for equipment purchases that are submitted after these dates.Instructions:The LGU must submit a written request for prior approval to the local Field Office for an equipment purchase for a countyoperatedor sub-contracted program. Prior approval requests should include a justification of programmatic need for thepurchase, the bid amount and vendor name from the required number of bidders, the sub-contracted agency’s or county’sselection from the list of bids or quotes, and justification for the decision not to select the lowest bidder, if applicable.Note: Individual Field Offices may require additional information such as the funding source that will be used for thepurchase. This may lead to other questions including the appropriateness of the purchase with a given funding source.

The LGU should contact the local Field Office representative to determine the correct process for obtaining prior approvalprior to making a purchase.Resources:1. New York State Office of Mental HealthSpending Plan Guidelines: “General Provisions For State Aid Approval Letters”http://www.omh.state.ny.us/omhweb/spguidelines/2. Field Office Fiscal Representativehttp://www.omh.state.ny.us/omhweb/spguidelines/3. New York State Office of General Services (OGS) Customer Service at 518-474-6717http://www.ogs.state.ny.us/purchase/Default.aspDate: May 1, 2011OMH Review: 1/19/11

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALEQUIPMENT PURCHASES APPROVAL PROCESSOASAS FIELD OFFICEAn agency that receives State Aid from the OASAS is expected to adhere to the “prudent buyer concept” when makingpurchases, whereby the purchase or rental of property, materials, supplies or services and the like, may not exceed thecost that a prudent person would pay in the open market to obtain these items under the circumstances prevailing at thattime. Local Designated Agencies (LDA’s), Local Governmental Units (LGU’s) and direct contract providers will no longerbe required to secure OASAS approval for equipment purchases of $5,000 or less if such equipment is included in theapproved budget. Comparably, LDA’s/LGU’s are no longer required by OASAS to grant prior approval for such equipmentacquisitions. LDAs/LGUs retain the right to impose more stringent requirements for such equipment, should they deem itnecessary to fulfill their mandate.Brief Description of Process: (how does it work?)The State has set the following requirements for purchases. These minimum State requirements may be supplemented bythe additional requirements of a Local Government Unit (LGU).o If the total purchase is for an amount less than $5,000, the local provider will select a reliable vendor at areasonable price.o If the total purchase is for an amount of more than $5,000 but less than $25,000, the local provider shall obtain atleast three telephone quotes and select the lowest bidder.o If the total purchase is for an amount in excess of $25,000, the local provider shall make a good faith effort toobtain at least five written bids, and shall enter into a written contract with the successful bidder.A written record (i.e., documentation) of the procurement, including bids and quotes, shall be maintained and madeavailable for review upon request by appropriate oversight agencies. LGU's and subcontract agencies will not be required,in all cases, to select the lowest quote or bid if it is determined that there is a good commercial reason not to do so. In theevent that the lowest bid or quote is not selected, the local provider shall maintain written justification and/or evidence ofthis decision.*As an alternative to competitive bidding, or as an additional bid or quote, mental health provider agencies can use prenegotiatedState contracts identified on the NYS Office of General Services (OGS) website.Equipment purchases greater than $5,000 requires prior Field Office approval to ensure that the required bidding processwas followed and that the purchase can be programmatically justified/is appropriate. Requests to purchase equipment atthe end of the year due to unexpended balances are not acceptable justification of programmatic need.Frequency:All requests relating to the current local fiscal year must be received by December 1 from Upstate and Long Islandcounties, and by June 1 from the New York City Department of Health and Mental Hygiene (NYCDH&MH).Instructions:Formerly, many equipment purchases required OASAS prior approval even though included in an approved contract orbudget justification form. This has proven to be redundant, time consuming and has resulted in excessive paperwork.Revised ProceduresLDAs, LGUs and direct contract providers will no longer be required to secure OASAS approval for equipment purchasesof $5,000 or less if such equipment is included in the approved budget. Comparably, LDAs/LGUs are no longer required

y OASAS to grant prior approval for such equipment acquisitions. LDAs/LGUs retain the right to impose more stringentrequirements for such equipment, should they deem it necessary to fulfill their mandate.If an individual equipment purchase is expected to exceed $5,000, OASAS prior approval is required and at leastthree written bids must be received and reviewed competitively prior to purchase.Any purchase of computer hardware, information technology (IT) consultant services and/or contracts, networks or majorsoftware systems expected to exceed $5,000 will require prior written approval by OASAS based on the submission of anappropriate IT plan; this pertains to individual purchases or an aggregation of several purchases which are integralsystems components. For example, a provider planning to purchase six personal computers, with a total cost of $12,000,would need to obtain OASAS approval. In addition, OASAS strongly encourages providers to use OASAS technicalexpertise for all acquisitions which are either below the $5,000 threshold or planned to be accomplished over more thanone year.Unauthorized equipment purchases will be subject to retroactive disallowance.Resources:1. New York State Office of Alcoholism and Substance Abuse Serviceshttp://www.oasas.state.ny.us/mis/bulletins/sab94-01.cfm2. Field Office Fiscal Representativehttp://www.oasas.state.ny.us/pio/documents/OASASstaff.pdf3. New York State Office of General Services (OGS) Customer Service at 518-474-6717http://www.ogs.state.ny.us/purchase/Default.aspDate: May 1, 2011OASAS Review: (none)

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALEQUIPMENT PURCHASES APPROVAL PROCESSOASAS FIELD OFFICEAn agency that receives State Aid from the OASAS is expected to adhere to the “prudent buyer concept” when makingpurchases, whereby the purchase or rental of property, materials, supplies or services and the like, may not exceed thecost that a prudent person would pay in the open market to obtain these items under the circumstances prevailing at thattime. Local Designated Agencies (LDA’s), Local Governmental Units (LGU’s) and direct contract providers will no longerbe required to secure OASAS approval for equipment purchases of $5,000 or less if such equipment is included in theapproved budget. Comparably, LDA’s/LGU’s are no longer required by OASAS to grant prior approval for such equipmentacquisitions. LDAs/LGUs retain the right to impose more stringent requirements for such equipment, should they deem itnecessary to fulfill their mandate.Brief Description of Process: (how does it work?)The State has set the following requirements for purchases. These minimum State requirements may be supplemented bythe additional requirements of a Local Government Unit (LGU).o If the total purchase is for an amount less than $5,000, the local provider will select a reliable vendor at areasonable price.o If the total purchase is for an amount of more than $5,000 but less than $25,000, the local provider shall obtain atleast three telephone quotes and select the lowest bidder.o If the total purchase is for an amount in excess of $25,000, the local provider shall make a good faith effort toobtain at least five written bids, and shall enter into a written contract with the successful bidder.A written record (i.e., documentation) of the procurement, including bids and quotes, shall be maintained and madeavailable for review upon request by appropriate oversight agencies. LGU's and subcontract agencies will not be required,in all cases, to select the lowest quote or bid if it is determined that there is a good commercial reason not to do so. In theevent that the lowest bid or quote is not selected, the local provider shall maintain written justification and/or evidence ofthis decision.*As an alternative to competitive bidding, or as an additional bid or quote, mental health provider agencies can use prenegotiatedState contracts identified on the NYS Office of General Services (OGS) website.Equipment purchases greater than $5,000 requires prior Field Office approval to ensure that the required bidding processwas followed and that the purchase can be programmatically justified/is appropriate. Requests to purchase equipment atthe end of the year due to unexpended balances are not acceptable justification of programmatic need.Frequency:All requests relating to the current local fiscal year must be received by December 1 from Upstate and Long Islandcounties, and by June 1 from the New York City Department of Health and Mental Hygiene (NYCDH&MH).Instructions:Formerly, many equipment purchases required OASAS prior approval even though included in an approved contract orbudget justification form. This has proven to be redundant, time consuming and has resulted in excessive paperwork.Revised ProceduresLDAs, LGUs and direct contract providers will no longer be required to secure OASAS approval for equipment purchasesof $5,000 or less if such equipment is included in the approved budget. Comparably, LDAs/LGUs are no longer required

y OASAS to grant prior approval for such equipment acquisitions. LDAs/LGUs retain the right to impose more stringentrequirements for such equipment, should they deem it necessary to fulfill their mandate.If an individual equipment purchase is expected to exceed $5,000, OASAS prior approval is required and at leastthree written bids must be received and reviewed competitively prior to purchase.Any purchase of computer hardware, information technology (IT) consultant services and/or contracts, networks or majorsoftware systems expected to exceed $5,000 will require prior written approval by OASAS based on the submission of anappropriate IT plan; this pertains to individual purchases or an aggregation of several purchases which are integralsystems components. For example, a provider planning to purchase six personal computers, with a total cost of $12,000,would need to obtain OASAS approval. In addition, OASAS strongly encourages providers to use OASAS technicalexpertise for all acquisitions which are either below the $5,000 threshold or planned to be accomplished over more thanone year.Unauthorized equipment purchases will be subject to retroactive disallowance.Resources:1. New York State Office of Alcoholism and Substance Abuse Serviceshttp://www.oasas.state.ny.us/mis/bulletins/sab94-01.cfm2. Field Office Fiscal Representativehttp://www.oasas.state.ny.us/pio/documents/OASASstaff.pdf3. New York State Office of General Services (OGS) Customer Service at 518-474-6717http://www.ogs.state.ny.us/purchase/Default.aspDate: May 1, 2011OASAS Review: (none)

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALEQUIPMENT PURCHASES APPROVAL PROCESSOPWDD FIELD OFFICEAn agency that receives State Aid from the OPWDD is expected to adhere to the “prudent buyer concept” when makingpurchases, whereby the purchase or rental of property, materials, supplies or services and the like, may not exceed thecost that a prudent person would pay in the open market to obtain these items under the circumstances prevailing at thattime.Brief Description of Process: (how does it work?)The State has set the following requirements for purchases. These minimum State requirements may be supplemented bythe additional requirements of a Local Government Unit (LGU).o If the total purchase is for an amount less than $5,000, the local provider will select a reliable vendor at areasonable price.o If the total purchase is for an amount of more than $5,000 but less than $25,000, the local provider shall obtain atleast three telephone quotes and select the lowest bidder.o If the total purchase is for an amount in excess of $25,000, the local provider shall make a good faith effort toobtain at least five written bids, and shall enter into a written contract with the successful bidder.Comment [JM1]: This is a copy of OMH. Thisprocess has not been customized for OPWDD!A written record (i.e., documentation) of the procurement, including bids and quotes, shall be maintained and madeavailable for review upon request by appropriate oversight agencies. LGU's and subcontract agencies will not be required,in all cases, to select the lowest quote or bid if it is determined that there is a good commercial reason not to do so. In theevent that the lowest bid or quote is not selected, the local provider shall maintain written justification and/or evidence ofthis decision.*As an alternative to competitive bidding, or as an additional bid or quote, mental health provider agencies can use prenegotiatedState contracts identified on the NYS Office of General Services (OGS) website.Equipment purchases greater than $5,000 require prior Field Office approval to ensure that the required bidding processwas followed and that the purchase can be programmatically justified/is appropriate. Requests to purchase equipment atthe end of the year due to unexpended balances are not acceptable justification of programmatic need.Frequency:All requests relating to the current local fiscal year must be received by December 1 from Upstate and Long Islandcounties, and by June 1 from the New York City Department of Health and Mental Hygiene (NYCDH&MH). The OMH willnot recognize requests for equipment purchases that are submitted after these dates.Instructions:The LGU must submit a written request for prior approval to the local Field Office for an equipment purchase for a countyoperatedor sub-contracted program. Prior approval requests should include a justification of programmatic need for thepurchase, the bid amount and vendor name from the required number of bidders, the sub-contracted agency’s or county’sselection from the list of bids or quotes, and justification for the decision not to select the lowest bidder, if applicable.Note: Individual Field Offices may require additional information. The LGU should contact the local Field Officerepresentative to determine the correct process for obtaining prior approval prior to making a purchase.

Resources:1. New York State Office of Mental HealthSpending Plan Guidelines: “General Provisions For State Aid Approval Letters”http://www.omh.state.ny.us/omhweb/spguidelines/2. Field Office Fiscal Representative3. New York State Office of General ServicesOGS Customer Service at 518-474-6717http://www.ogs.state.ny.us/purchase/Default.aspDate: May 1, 2011OPWDD Review: (none)

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALFEDERAL FUNDS CERTIFICATIONS AND ASSURANCESAny County LGU that receives Federal Funds from the NYS Office of Mental Health (OMH) must complete and submitsigned original “Federal Certifications” and “Federal Assurances – Non-Construction Programs” forms to the OMH as acondition of payment.Brief Description of Process: (how does it work?)The forms can be found in the OMH Spending Plan Guidelines, along with the fiscal and auditing points. The forms aresigned by the Director of the LGU and sent to the address printed on the form. The form is completed and signed afterreceipt of the first State aid letter for the County. Any agency the LGU subcontracts Federal funds with must also submit asigned form agreeing to follow the guidelines for Federal funds. These completed forms do not have to go to OMH, butmust be kept on file at the LGU.Frequency:The forms are submitted on an annual basis.Instructions:The forms are located in the Spending Plan Guidelines and can be downloaded in PDF format. There are two certificationforms that must be signed by the Director of the LGU. The four Catalog of Federal Domestic Assistance (CFDA) types ofFederal grants are listed on the form. Your County may receive funding from one or more of these grants and the LGUmust indicate which grant funds they receive. Due to the nature of Federal funds, there are specific guidelines andconditions for their use.All sub recipients (LGUs, direct contract agencies and subcontract agencies) expending $500,000 or more annually fromall Federal grant sources (excluding Federal entitlement grants such as Medicaid and Medicare) must have an A-133Single Audit completed encompassing all Federally funded programs. Since the threshold increase does not relieve passthroughentities/recipient agencies, i.e., OMH, LGUs, direct contract agencies, and subcontract agencies of theresponsibility for monitoring their sub recipients expending less than $500,000 in Federal grant funds, such sub recipientsare required to provide assurances to their pass-through/recipient agency that Federal grant funds were expendedappropriately and were in compliance with laws, regulations, and the provisions of the State aid approval letter or directOMH contract, and that performance goals were achieved.Such assurances include one or more of the following:1. On-site monitoring visits by the pass-through/recipient agency;2. Independent reviews of documentation supporting requests for reimbursement of expenditures; or3. Obtaining an agreed-upon procedures report on specific procedures and compliance requirements.Steps for Completion, Signing and Submission:Retrieve the two Federal certification forms from the Spending Plan guidelines on OMH’s website;Complete Agency (or LGU) name, address, and name and title of Executive Director;Check off the corresponding CFDA number for your agency’s Federal Fund (s) code (s);The LGU sends original signed document to: Community Budget and Financial Management, Office of MentalHealth, 44 Holland Avenue, Albany, New York 12229. A copy must be maintained on file.Providers (sub recipients) should return completed and original signed certifications to the LGU to keep on file.Resources:

Date: May 1, 2011OMH Review: 9/23/10New York State Office of Mental Health1. Spending Plan Guidelines - http://www.omh.state.ny.us/omhweb/spguidelines/selectletter.asp2. Catalog of Federal Domestic Assistance - https://www.cfda.gov/3. CFR Manual, Appendix S- http://www.omh.state.ny.us/omhweb/cbr/OASAS Review: (none)OPWDD Review: (none)

FISCAL OFFICER TRAINING MANUALSINGLE AUDIT (A133)Business Process (what is it?)The Single Audit report is an audited report that details any federal funding received by counties and subcontractedservice providers in a fiscal year.Brief Description of Process: (how does it work?)The provider receives a request from its overseeing county government authority to report any federal awards or federalgrant funding received in the past fiscal year. The provider completes a form and submits it to the government authority toensure proper reporting.It is expected that counties have the report audited and that a copy be on hand in case the agency is selected to beaudited by the Federal government.Frequency:The single audit is done on a yearly basis.Instructions:1. Receive Single Audit reporting request from the county government authority.2. Identify any federal funding received for the past fiscal year from all revenues sources, including State Aidfunding letters, Federal Salary Sharing, etc.3. Complete the Single Audit Summary Information for Federal Programs form. Information includes programname, federal agency, Catalogue of Federal Domestic Assistance number, award amount and internalexpense and revenue account numbers.4. Submit the Single Audit form to the county government authority by the specified due date. The Departmentof Mental Health Federal Funding information will be combined with other departments’ reports to summary atotal Federal Funding report for the county.Resources:OMH's Spending Plan Guidelines - Federal Funds Guidelineshttp://www.omh.state.ny.us/omhweb/spguidelines/PDF/096_FederalFundsGuidelines.pdfChristopher C. KirmsNYS Office of Mental HealthCapital District Psychiatric CenterLower Unit N ‐ Bureau of Audit75 New Scotland AvenueAlbany, NY 12208(518) 474‐7653(518) 956‐9438 (Fax)Date: May 1, 2011OMH Review: 4/1/11

FISCAL OFFICER TRAINING MANUALSINGLE AUDIT (A133)Business Process (what is it?)The Single Audit report is an audited report that details any federal funding received by counties and subcontractedservice providers in a fiscal year.Brief Description of Process: (how does it work?)The provider receives a request from its overseeing county government authority to report any federal awards or federalgrant funding received in the past fiscal year. The provider completes a form and submits it to the government authority toensure proper reporting.It is expected that counties have the report audited and that a copy be on hand in case the agency is selected to beaudited by the Federal government.Frequency:The single audit is done on a yearly basis.Instructions:1. Receive Single Audit reporting request from the county government authority.2. Identify any federal funding received for the past fiscal year from all revenues sources, including State Aidfunding letters, Federal Salary Sharing, etc.3. Complete the Single Audit Summary Information for Federal Programs form. Information includes programname, federal agency, Catalogue of Federal Domestic Assistance number, award amount and internalexpense and revenue account numbers.4. Submit the Single Audit form to the county government authority by the specified due date. The Departmentof Mental Health Federal Funding information will be combined with other departments’ reports to summary atotal Federal Funding report for the county.Resources:OMH's Spending Plan Guidelines - Federal Funds Guidelineshttp://www.omh.state.ny.us/omhweb/spguidelines/PDF/096_FederalFundsGuidelines.pdfChristopher C. KirmsNYS Office of Mental HealthCapital District Psychiatric CenterLower Unit N ‐ Bureau of Audit75 New Scotland AvenueAlbany, NY 12208(518) 474‐7653(518) 956‐9438 (Fax)Date: May 1, 2011OMH Review: 4/1/11

FISCAL OFFICER TRAINING MANUALUNCOMPENSATED CARE REPORTBusiness Process: (what is it?)As part of the Clinic and Ambulatory Restructuring project, New York State has submitted a federal Medicaid waiverrequest to establish an uncompensated care funding pool for mental health clinics that is jointly funded by the state andfederal government. Assuming the waiver is approved, the pool will offset a portion of losses from uncompensated careexperienced by Diagnostic and Treatment Centers licensed by DOH and Mental health clinics licensed by OMH that arenot affiliated with hospitals or directly operated by OMH.Brief Description of Process: (how does it work?)Payments from the uncompensated care pool will be made in accordance with payment rules established by the OMHand DOH. Agencies that do not submit annual data for each of their clinic locations by the dates established by OMH willbe excluded from the pool for that year.Pending approval of the waiver request, periodic partial payments from the pool will be made by the Department ofHealth. After a transition period for mental health clinics (described below), payments from the pool will be based onannual data from two years prior.Units of Service by Payor and Program/Site is be used to determine the eligibility for possible payments through theUncompensated Care Pool.The percent of uncompensated care paid by the pool is dependent on the total funds in the pool and the total volume ofallowable uncompensated care visits. To be eligible for an allocation of funds from the pool, a mental health clinic mustdemonstrate that a minimum of five percent of total clinic visits during the applicable period were for visits covered by theuncompensated care pool.Mental health clinics qualifying for a distribution from the fund will need to provide OMH with assurances that it undertookreasonable efforts to maintain financial support from community and public funding sources and made reasonable effortsto collect payments for services from third-party insurance payers, governmental payers and self-paying patients. This issubject to audit. OMH anticipates that visits can be counted toward uncompensated care volume if they meet the certaineligibility conditions.Frequency:Agencies submit annual data for each of their clinic locations. Beginning with calendar year 2011-2012 for July-June CFRfilers and 2012 for calendar year CFR filers, uncompensated care data will be required as part of the CFR ScheduleOMH-4.Instructions:The CFR Schedule OMH-4 is used to determine the eligibility for possible payments through the Uncompensated CarePool.This schedule must be completed based on the date of service rendered and only for services provided during thereporting period. For the purposes of this schedule, a visit is defined as including all procedures provided to a patient onthe same day, and is referred to as a threshold visit.

OMH anticipates that visits can be counted toward uncompensated care volume if they meet the following conditions:1. Self pay, including partial pay or no pay visits (does not include partial payment associated with co-pays ordeductibles).2. Required or optional mental health clinic procedures (as defined in OMH regulations) provided but not coveredunder a clinic’s agreement with an insurer. The service must be provided by a practitioner qualified to deliver theservice under state regulations.3. Unreimbursed clinic visits/procedures appropriately provided to an insured recipient by a clinic staff member notapproved for payment by a third party payor in contract with the clinic. The provider must document that the clinicor recipient received a denial of payment.4. Unreimbursed clinic visits/procedures appropriately provided to an insured recipient by a clinic staff member whenthe procedure is not reimbursed by a third party payer not in contract with the clinic. Only visits for which the clinicreceived a denial of payment from the insurer or an attestation from the client/insured that the insurer made nopayment will be considered uncompensated. This documentation must be retained by the clinic and will besubject to an audit by the New York State Office of the Medicaid Inspector General or other party empowered toconduct such audits.Visits will not be counted if they meet the following conditions:1. Visits paid in whole or part by a third party payer (including Medicaid Managed Care).2. Visits not authorized (considered not medically necessary) by an insurer/managed care plan.3. Visits provided to a recipient who has coverage from a third party payer not in contract with the clinic when aninsurer does reimburse the insured for the visit.4. Visits delivered by persons unqualified to deliver the services under state regulations.Transition - Visit Value and Data CollectionThe method of pricing uncompensated care visits and calculating uncompensated care volume will transition over time asfollows:Uncompensated Care Value:1. In 2010, OMH will base uncompensated care reimbursement on the appropriate peer group Medicaid rate for a 45minute psychotherapy procedure delivered by an LCSW.2. In 2011, the uncompensated care pool rate will be based on the peer group average value of mental health clinicMedicaid APG payments (no blend) for at least the first six months of 2010.3. In 2012 and after, payments will be based on the current peer group average value of total Medicaid APGpayments (no blend).Uncompensated Care Volume:1. Uncompensated care payments to Article 31 clinics during calendar year 2010 will be based on annualizeduncompensated care visit volume and total care visit volume delivered July 1, 2009 through December 31, 2009.2. Uncompensated care payments to Article 31 clinics during calendar year 2011 will be based on uncompensatedcare visit volume and total care visit volume for the period January 2010 through June 2010.3. Uncompensated care payments to Article 31 clinics during calendar year 2012 will be based on data as follows:a. Payments to clinics in NYC will be based on data from July 09 through June 2010.b. Payments to clinics in the rest of the state will be based on data from calendar year 2010.Uncompensated Care payments are awaiting final Federal approval of the NYS OMH 14 NYCRR Part 599 “ClinicTreatment Programs” regulations.Resources:1. NYS Clinic and Ambulatory Restructuring:https://www.omh.state.ny.us/omhweb/clinic_restructuring/indigent_care_overview.html

2. NYS Uncompensated Care:https://www.omh.state.ny.us/omhweb/clinic_restructuring/uncompensated_care.htmlDate: May 1, 2011OMH Review: (none)

FISCAL OFFICER TRAINING MANUALCASE MANAGEMENT FISCAL MODELSAssertive Community Treatment (ACT)Intensive Case Management (ICM) Supportive Case Management (SCM)Blended Case Management (BCM) Adult Home Case Management (AHCM)Residential Treatment Facility Transition Coordinators (RTFT)Business Process:The various Mental Health Case Management Programs, Assertive Community Treatment (ACT), Intensive CaseManagement (ICM), Supportive Case Management (SCM), Blended Case Management (BCM), Adult Home CaseManagement (AHCM) and Residential Treatment Facility Transition Coordinators (RTFT) are classified as “Modeled”programs with an established Gross Manager Cost, Medicaid Revenue expectancy and Net Deficit** (State Aid) funding.(Note: ACT and AHSCM programs serve only adults, while RTFT programs serve children and youth. ICM, SCM andBCM programs serve adults or children & youth) Each Case Management Program has a caseload or slot expectancy permanager or team. Service dollars for modeled case management programs are allocated per manager or team. (SeeCase Management Service Dollar procedures).Brief Description of Process:The Case Management Fiscal Models are posted in the Spending Plan Guidelines by local fiscal year and region(Upstate/Downstate and New York City). County-specific fiscal models are attached to the State Aid Letter in the CaseManagement Report Chart. County-specific models are derived by multiplying the applicable Case Management Model bythe approved Manager FTE’s. Changes affecting the approved manager FTE’s, such as the addition or closure of anICM/SCM position or designation as a BCM team, must be authorized by the Field Office prior to implementation.Modeled Manager Costs (ICM, SCM, AHSCM, BCM)ICM and SCM Gross Expenditures are identical with revenue expectancies calculated at a different rate. Currently, theICM Medicaid revenue expectancy is 90% of the Gross Manager Costs, and the SCM Medicaid revenue expectancy is68% of the Gross Manager Costs. The remaining manager expenditures are covered by Net Deficit** funding. The AdultHome SCM model is based on a team of one SCM and one half-time (.5 FTE) Peer Specialist. The program is fundedbased on a Medicaid revenue expectancy of 100% of the Gross SCM Cost and a 100% net deficit funded half-time Peer.Blended Case Management (BCM) is a team of one of the following three configurations - 1 ICM and 1 SCM, 2 ICM and 1SCM, 1 ICM and 2 SCM, or multiples of one of these combinations. The BCM fiscal model is determined by the mix ofICMs and SCMs on the team. The ACT fiscal model is based on either a 68 capacity team or a 48 capacity team. TheMedicaid revenue expectancy is currently 92% of the Gross team operating cost. The remaining operating and trainingcosts for the ACT team are net deficit funded**. A portion of the funding for ACT training is retained by the OMH.Modeled Service Dollar CostsIncluded in the model costs are service dollar amounts per manager or team. Service dollars are net deficit funded** andare budgeted as a distinct program from the Manager program. For the ICM and ACT programs only: an ICM or ACTteam may be funded “locally”, through the County’s State Aid Funding Letter, or may be considered “State Operated”.Counties receive only Service Dollar funding for “State Operated” ICMs or ACT teams; the Manager cost is assumed bythe State. Refer to the Case Management Service Dollars Procedure for additional details on service dollars.**Net Deficit Funding: In some counties Net Deficit funding may be a combination of State Aid and DSH revenue.Counties should refer to the county-specific Case Management Report to determine the DSH amounts to be budgeted ifapplicable.Frequency:Case Management Fiscal Models are posted for each local fiscal year and may be adjusted yearly. Providers budget theirCase Management programs annually to match their model.Instructions:BudgetsProviders should be instructed to complete their budgets (CBR) per the associated Case Management Model pertaining tothe number of managers, program and year. Provider's budgeted Gross Costs, Income (Medicaid) and Net Deficit

Funding expectancies cannot exceed the totals of the Case Management Report (printed with the State Aid Allocationletter).Providers should be instructed to always budget the Medicaid Revenue on line 17 of the DMH-2 according to the model.For the ACT program, providers should budget only the “Provider” portion of the training costs that is defined on the ACTfiscal model or the Case Management Report.Effective 2010, (January for Upstate/LI, July for NYC), approved manager costs above the model can be budgeted infund code 200 & 001A for adults and in fund code 046L for children. These amounts must be included on an approvedbudget to avoid disallowance, with the exception of fund code 090 (non-funded), and are not used to calculate complianceagainst the model.Additional details on the Case Management Report (part of State Aid Letter) include: Program Code, Program Name,Fund Source Code, Number of Managers FTE’s and Caseload Slots.Fund code 034J is used for Adult Services; fund code 034K is used for Children’s Services. For funding code 034K, theprogram codes must budget with an index of “80”. For a provider with more than one children’s program, enter “80” for thefirst occurrence, “81” for the second occurrence, etc.Claims:Effective 2010, (January for Upstate/LI, July for NYC), all case management revenue generating programs can retain thesame percentage (70%) of excess revenue above the model threshold. The remaining 30% of excess revenue (StateShare of Medicaid take back) is recovered during the OMH closeout through a reduction in State Aid. The closeoutrecoupment is then recovered in the next state advance to the county.1) Excess Revenue must be used either in the current year or retained for the following year. It is forfeited after thesecond year.2) If an agency maintains an SCM and an ICM program, excess revenue can be interchanged between theprograms where needed.The gross expenditures cannot exceed budgeted expenditures, unless there is excess revenue from all sources. ForClaims, ALFS compares providers approved CBR’s to the Claims and performs a series of calculations in determining theamount of revenue that can be retained for use in enhancing the program in the current year or to retain for use in thefollowing year. The term “Float the Gross” or Retained Medicaid is a methodology where ALFS calculates the differencesbetween the budgeted and claimed expenditures and compares this amount with the sum of revenues. The program mayretain 70% of Medicaid revenue collected in excess of the budgeted revenue target. As noted above, this additionalrevenue may be spent in the current year (the year in which it is earned) or in the subsequent year. The revenue not spentin the current year must be shown on line 39 “Other” of the DMH 2 (CCR in the current year), and in the subsequent yearan equal amount should be applied to line 29 of the DMH 2 (CCR) “Other” revenue.See following example of a Retained Medicaid Calculation*:

Example of a Retained Medicaid Calculation**Figures reflect a 2 ICM Managers in the Hudson RegionModelBudgeted Model(2 ICM)Pre-RetainedMedicaid ClaimsVarianceFinalClaimsTotal Expenses 70,603 141,206 165,000 23,794 165,000Medicaid 63,788 127,576 150,000 22,424 150,000Other Revenues 0 10,000 10,000 10,000Retained Medicaid (ln 39) 0 0 0 0 (1,903)Net Operating Costs 6,815 13,630 10,000 (3,630) 6,903Net Deficit / DSH 6,815 13,630 6,903Retained Medicaid: 70% Medicaid overBudgeted ModelState Share Take-back: 30% Medicaidover Budgeted15,6976,727(reduction to Net Deficit Funding)a. Calculate the maximum Retained Medicaid:Actual Medicaid Revenue $150,000Budged Model Medicaid $127,576Variance; Medicaid over Model $ 22,424Retained Medicaid: 70% of Medicaid over Model $ 15,697State Share of Medicaid: 30% of Medicaid over Model $ 6,727b. Net Deficit Funding available::Model Net Deficit Funding $ 13,630State Share of Medicaid reduction ($ 6,727)Net Deficit Funding available $ 6,903c. Retained Medicaid Carryover:Total Expenses $ 165,000Total Medicaid ($ 150,000)Other Revenue ($ 10,000)Net Deficit Funding Available ($ 6,903)Balance = Retained Medicaid Carryover ($ 1,903)

Resources:SP Guidelines, Case Management Models -http://www.omh.state.ny.us/omhweb/spguidelines/case_mngmt_models/2010_model.htmlhttp://www.omh.state.ny.us/omhweb/spguidelines/case_mngmt_models/2010_nyc_model.htmlSP Guidelines, Case Management, Fund Code 34J (Adult) & Fund Code 34K (Children)http://www.omh.state.ny.us/omhweb/spguidelines/selectletter.aspDate: May 1, 2011OMH Review: 9/23/10

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALCASE MANAGEMENT SERVICE DOLLARSThe Intensive Case Management (ICM), Supportive Case Management (SCM), Blended Case Management (BCM) andthe Adult Home program all have access to “service dollars.” The purpose of the service dollars is to provide funds forconsumers’ immediate and/or emergency needs and is intended to be used as the payment of last resort. The use of theservice dollars in the case management programs should include participation of the consumer, who should play asignificant role in the planning for, and the utilization of, service dollars.Brief Description of Process: (how does it work?)Service dollars must be spent on services consistent with a consumer’s service plan, designed to be flexible andresponsible to current individual needs. These services may include emergency services, both immediate and notimmediate. The emergency dollars aimed at meeting immediate basic needs of the consumer to include transportation,medical/dental care, shelter/respite/hotel, food/meals, clothing, escort and other. Service dollars may also includefurnishings, utilities, tuition, job related costs, job coaching, education, vocational services, leisure time services andothers.Two options to expend service dollars1. Client-Specific Services: Client-Specific Service needs are characterized as those needs which can beanticipated. Therefore, they must be reflected in the individual service plan of the client for payment to beapproved and need to be documented in the Client's progress notes.2. Emergency Purchases: Emergency Purchases are designed to address the immediate needs of a client. Theseneeds are generally brief in duration and are not anticipated. Emergency Purchases do not need to be inthe individualized service plan, but do need to be documented in the Client's progress notes.Service dollar expenditures may include the following:• Furnishings: Costs of any home furnishings such as furniture, linen, dishes, bedding, etc.• Homemaker/Housekeeping Services: Generally this is available either through the department of public health orprivate providers in the community. These services would be paid on an hourly basis and assist clients when theyare unable to meet their own homemaking or housekeeping needs.• Housing: Costs associated with securing and stabilizing an appropriate living situation such as apartment orroom. (security deposits)• Educational: Costs associated with educating a person. Costs may be computer school, secretarial school, automechanic, higher education, GED, etc. Related expenses may be included in this category such as books,supplies, etc.• Vocational /Employment: Costs associated with securing or maintaining a job. Costs such as uniform, job coach,transportation, etc.• Leisure Time Services: Costs used to purchase beneficial leisure time activities. These costs may contribute toimprovement of the person physically or emotionally, assisting in network building or distracting clients fromdetrimental activities. The need for these services must be clearly documented in the ISP.• Escort: Costs associated with having assistance available to the person on a continuous basis. This service maybe in the person's home, emergency housing situation, day program, etc.• Food/Meals: Costs of meals, groceries, or other necessary food items. Not to be used for any alcoholicbeverages or cigarettes

• Lodging/Respite/Hotel: Money used to purchase shelter.• Clothing: Money to purchase essential clothing, clothing repair or cleaning.• Utilities: Money to pay utility bills such as telephone, electric or heating to avoid shutoff or to restore service• Medical Care: Costs related to the purchase of medical care services, medical supplies, medications and/or othermedical costs. Included in this category are Dental, Optical, etc.• Transportation: Costs associated with bus, cab or other public transportation fareFrequency:• On a weekly or monthly basis, the case manager will meet with his/her supervisor for account reconciliation. Thecase manager should bring in all receipts as well as the weekly report for reconciliation of expenditures on behalfof the client.• The supervisor will review the receipts and the cash expenditure weekly report for appropriateness and conformityto the client's service plan.• Additionally, the supervisor should ensure that all documentation supporting any cash expenditure is signed bythe client receiving the service. If the client is unable to complete such documentation, then a notation in theprogress notes should be made, along with follow-up attempts to get the client's signature.• A Monthly statements by Case Manager must be prepared to account for the cash and voucher expendituresmade during the monthInstructions:• Any use of service dollars must have clear supporting documentation in the service plan (except in emergencysituations) and progress notes.• The amount of service dollars used, why the service dollars are used and how the use of service dollars are insupport of the service plan must be noted in the progress note.• Receipts, sales, slips, etc., must be obtained by the case manager and signed by the client accessing the servicedollars.• Individual transactions in excess of $100 will require the approval of the supervisor.• Once the service has been acquired and paid for, all excess funds must be returned to the applicable supervisorwith the weekly report.Budgets and Claims:• Providers should be instructed to complete their budgets (CBR) per the fiscal model that pertains to their programand year. Instruct providers to budget the Net Deficit** based on contracted number of allocated managers orteams and the current model configurations.• The total Net Deficit Funding for a county must be budgeted at the totals of the Case Management Report.Exceeding the Net Deficit will cause an error during the Group CBR validation process on ALFS.• Net Deficit Funding designated as “ICM Service Dollars” may be used to support the ICM Service DollarManagement program (2810). Costs associated with service dollar management may only be budgeted andclaimed against program code 2810.Note: Refer to Case Management Models procedure for more informationResources:

1. Spending Plan Guidelines :http://www.omh.state.ny.us/omhweb/spguidelines/case_mngmt_models/2010_nyc_model.html2. Mental Health Medicaid Case Management Manual: Hard copy only-contact Adult Services Program StaffDate: May 1, 2011OMH Review: 9/23/10

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALPERSONALIZED RECOVERY ORIENTED SERVICES (PROS)Personalized Recovery Oriented Services (PROS) is a comprehensive recovery oriented program for individuals withsevere and persistent mental illness. The goal of the program is to integrate treatment, support, and rehabilitation in amanner that facilitates the individual's recovery. Goals for individuals in the program are to: improve functioning, reduceinpatient utilization, reduce emergency services, reduce contact with the criminal justice system, increase employment,attain higher levels of education, and secure preferred housing.Brief Description of Process: (how does it work?)The PROS license gives counties and providers the ability to integrate multiple programs into a comprehensiverehabilitation service. There are four Components in the PROS program: Community Rehabilitation and Support (CRS);Intensive Rehabilitation (IR); Ongoing Rehabilitation and Support (ORS); and Clinical Treatment, an optional componentof a PROS program. A program can be fully licensed to operate a comprehensive program which includes all components(with or without clinical treatment) or have a limited license to provide only employment support and IntensiveRehabilitation.Frequency:Starting in the 3 rd year of the PROS programs, State Aid is recalculated annually based on CAIRS data. (Please seedetail regarding this determination in the Spending Plan Guideline link below)Instructions:County Specific Steps for PROS Conversion:1. Considerations for PROS Conversion:a. PROS conversion is a county plan. Planning discussions must occur with the LGU. PROS conversionrequires LGU sign off.b. PROS conversion programsi. There are several programs eligible to be converted to PROS. Planning discussions between theLGU, providers and OMH determine which programs will be phased out when converting toPROS.ii. State Aid associated with the agreed upon conversion programs will be removed from the CountyState Aid Letter and/or Direct Contract and supplanted by the Medicaid reimbursement plus theabove modeled State Aid per 100 clients.iii. COPS/CSP attached to a conversion program is supplanted by the Medicaid reimbursement forPROS.iv. Conversion programs may have different phase out requirements upon establishment of a PROS.Refer to Spending Plan Guidelines for a list of conversion programs and phase out details.c. Refer to Spending Plan Guidelines for formulas for State Aid for Start-up/Cash Flow. Discuss theavailability of Start-up funds with the local Field Office.d. County Steps for PROS conversioni. Interested providers should discuss possible conversion with County LGUii. The LGU should communicate interest to the OMH Field Officeiii. All interested providers must complete and submit a preliminary version of the PROS Fiscal Tool.The LGU and OMH will review the tool before additional planning conversations occur.iv. The LGU should coordinate conversations between impacted agencies and with the OMH FieldOffice to identify the county-wide impact of a PROS conversion.1. A call or meeting between interested providers, the LGU and OMH will occur to discussthe PAR process, time frames and county plan.v. The LGU will verify with OMH, using an OMH Fiscal Implication Form, whichagencies/programs/funding will be converted.vi. The LGU reviews and responds to the provider’s submitted PROS PAR.

PROS Reimbursement:PROS is primarily a Medicaid reimbursed program, with State Aid and Medicare as additional funding sources.The base Medicaid rate payment for PROS billing is an accumulation of each day’s PROS units within a calendar month(please see PROS program design link below on the description of a PROS Unit). The PROS monthly base rate paymentis provided at 5 different levels (tiers). The total number of units in the calendar month determines which of the 5 tiers youare able to bill, for that individual in that month (please see PROS program design link below on the detail of PROS tiers).Additional Medicaid payments are available for Medicaid individuals receiving the three components of the PROSprograms (IR, ORS, and Clinic Treatment). (Please see the Finance Chapter of the PROS handbook for all rates).Resources:1. NYS OMH PROS Summaryhttp://www.omh.ny.gov/omhweb/pros/2. PROS Handbook (main site)http://www.omh.ny.gov/omhweb/pros/Handbook.htma. PROS Provider Handbook – Finance Chapter:http://www.omh.ny.gov/omhweb/pros/finance.htmlb. PROS Provider Handbook – Overview of Program Design:http://www.omh.ny.gov/omhweb/pros/program_design.html3. Aid to Localities Spending Plan Guidelines (2010-2011)http://www.omh.state.ny.us/omhweb/spguidelines/PDF/10PKT34_PROS.pdf4. Title 14 of the New York Codes, Rules and Regulations Chapter XIII Part 512http://www.dos.state.ny.us/info/nycrr.html5. Part 512 PROS Regulations – OMH Text:http://www.omh.ny.gov/omhweb/policy_and_regulations/Adoption/Part_512_20100127.html6. NYAPRS PROS Ticket to Work/Employment Network Resourceshttp://www.nyaprs.org/community-economic-development/PROS-works/Date: May 1, 2011OMH Review: 3/8/11

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALCHILD AND FAMILY CLINIC-PLUSThe Child and Family Clinic-Plus program was an initiative of the Office of Mental Health designed to systematicallyaddress the mental health needs of underserved children and their families through early intervention activities andincreased use of evidenced based practices by mental health providers. Under Child and Family Clinic-Plus , OMH andits community partners sought to provide more aggressive community education, improved access, training and clinicaldevelopment in effective treatment models, and short term in-home skill building and support. OMH licensed clinicproviders designated as Clinic-Plus providers were to receive State Aid advancements and Medicaid clinic rateenhancements for providing Clinic-Plus program components. Note: OMH sought federal approval to receive a Medicaidfee enhancement for two distinct service components; however, to date, federal approval has not been received. In theinterim, OMH provided State Aid for the fee enhancement service components.It is anticipated that in January 2012, the current Clinic-Plus program will transition into a new programmatic and fiscalmodel.Brief Description of Process: (how does it work?)Each Child and Family Clinic-Plus provider is expected to: collaborate with the local mental health government agencyto conduct systematic early recognition activities for identified priority populations; demonstrate skill in engaging families intreatment; offer a range of evidence-based treatments that are individually determined and family focused; and provide aconstellation of support services in the home and community that lead to skill mastery for the child and family.Child and Family Clinic-Plus providers provide the following:Broad-based screening in natural environmentsComprehensive assessmentExpanded clinic capacityIn-home servicesEvidence Based TreatmentAll Clinic-Plus providers must be a part of the Clinic Quality Improvement Initiative under the OMH.Frequency:Annual PlanEach year, Child and Family Clinic-Plus providers are required to submit an Annual Plan to their local mental healthdepartment. The mental health department combines all annual plans for a county-wide submission to the NYS Office ofMental Health. The annual plan details providers’ intentions for implementing Clinic-Plus services from screening to inhomeservices. Annual Plans include the following elements:Target population to be screened;Community Education Plan and Community Education;Plan for addressing language and sensory needs of children and families;Screening instrument(s) that will be used;Annual Projected # Screened;Screening plan (personnel, location, coordination with other Clinic-Plus providers, etc.);Child and Family Engagement Strategies;Annual Projected # of Comprehensive Assessments (Medicaid and Non-Medicaid);Comprehensive Assessment plan (staff conducting assessments, approaches, etc.);Diagnostic and psychometric assessments to be used;Annual Projected Increase in Admissions;Plan for ensuring cultural congruence;

Plan for use of Evidenced-Based Treatments;Staff Development Plan;Annual Projected In-home services (Medicaid and Non-Medicaid);Plan for providing In-home services; andBudget and budget narrative.Annual plans include not only the anticipated data elements, but also describe how Clinic-Plus will be implemented andhow providers plan to uphold the values and treatment expectations of a Child and Family Clinic-Plus Program.Instructions:Designating Child and Family Clinic-Plus ProgramsEach local mental health department identified the number of Clinic-Plus programs that were designated in their area. Thenumber and size of the Clinic-Plus program drives the financial model that helps to determine: numbers of screenings,numbers of comprehensive assessments, the anticipated increase in clinic admissions capacity, and in-home services.Generally, screening goals (initial number of screenings allocated) for each county/borough are based on local populationdata; the larger the county, the more screenings they will be able to conduct. For the purposes of Clinic-Plus designationand funding distribution, screenings are defined in terms of "units." One unit of screening is approximately 1,000screenings. The minimum size for a Clinic- Plus program is 1 screening unit.Clinic Plus ReimbursementClinic-Plus financing is broken into three components: Screening and Outreach, Comprehensive Assessments and In-Homes Services. The Screening component is funded 100% by State Aid. A fixed amount of State Aid was allocated to acounty/provider for each estimated screening unit. OMH sought federal approval for a $50 Medicaid fee enhancement tothe base clinic visit for the Comprehensive Assessment and In-Home Services. The enhanced rate was to be received forup to 3 comprehensive assessments per client per admission, and 9 in-home services per client per year. While waitingfor federal approval, OMH provided State Aid advancements to the county/provider for these fee enhancements. For Non-Medicaid eligible clients, comprehensive assessments and in-home services were funded 100% by State Aid.The State Aid advancements to the county/provider for the three components were based on estimates from an OMHapproved Clinic-Plus Calculator. The Clinic-Plus Calculator determined the base allocation based on a series ofassumptions such as admission rates, payer mix, etc. A provider’s original approved Clinic-Plus Calculator was includedwith the agency’s Clinic-Plus PAR acceptance letter and was to serve as the benchmark for budget and service reporting.To track the delivery of services, providers are required to bill for Comprehensive Assessment and In-Home Treatmentservices provided to Medicaid clients at a rate of $.01. The following Medicaid Rate Codes are used:4669 = Comprehensive Assessment4670 = In-Home TreatmentThe Medicaid billing codes and procedures apply to any base clinic visit. This enhancement-only rate code is billed forchildren who are fee-for-service Medicaid or are in Medicaid Managed Care who receive a Comprehensive Assessmentor In-Home Treatment Visit. Billing for Medicaid managed care eligible children is sent directly to CSC as is done for feefor service Medicaid. The Medicaid managed care carrier is not billed for the rate enhancements.It is anticipated that OMH will use the annual billing for these rate codes to reconcile State Aid that a Clinic Plus providerhas been advanced for these enhancements. These billings are also important in the event that OMH obtains federalapproval that will allow the retroactive billing of the fee enhancements for Medicaid reimbursement.Reporting RequirementsChild and Family Clinic-Plus providers are required to report program level data to their Local Mental HealthDepartment Director and to the Office of Mental Health (OMH) on a quarterly basis. Providers submit aggregate data onall screening activities, comprehensive assessments, Clinic-Plus utilization, and in-home services through a QuarterlyService Report. Program service reporting requirements are outlined in Appendix G of the Clinic-Plus Guidancedocument.

Fiscal activity related to Clinic-Plus screenings must be reported under program code 0790 (Clinic-Plus Outreach andScreening) and funding code 046N.Fiscal activity related to the rate enhancements associated with Comprehensive Assessments and In-Home Servicesmust be reported under program code 2100 (Clinic Treatment) and funding code 046N.The State Aid budgeted for Clinic-Plus Outreach and Screening, Comprehensive Assessments and In-Home Servicesshould be based on the allocations identified in the original Clinic-Plus Calculator that have been modified for Cost ofLiving Adjustments (COLA) in applicable years.Resources:1. Clinic Plus Website:http://clinicplus.org/2. OMH Spending Plan Guidelines for Clinic-Plus at:http://www.omh.ny.gov/omhweb/spguidelines/3. Child and Family Clinic Plus Support Network for Providers:http://www.omh.ny.gov/omhweb/clinicplus/support_network/index.html4. Clinic Plus Service Statistics:http://bi.omh.ny.gov/clinicplus/indexDate: May 1, 2011OMH Review: 3/28/11

FISCAL OFFICER TRAINING MANUALCLINIC RESTRUCTURING OVERVIEWBusiness Process: (what is it?)The New York State Office of Mental Health (OMH) has undertaken a multi-year initiative to restructure the way the Statedelivers and reimburses publicly supported mental health services. The goal is to develop a system of quality care thatresponds to the individual needs of adults and children and delivers care in appropriate settings.Clinic restructuring represents the first phase of this transformation process. The plan is a redesigned clinic program; anew payment system; and a multi-year implementation plan. To implement this plan, new clinic treatment regulations –Part 599 – were promulgated to establish standards for the certification, operation and reimbursement of clinic treatmentprograms.Brief Description of Process: (how does it work?)The restructuring plan introduces a new billable rate and weighting system. The transition to APG reimbursement will bea phased in process. During the transition, some procedures will be paid at the full APG rate and others will receive aExisting Operating Component (Legacy) rate. The Legacy rate is based on the historical provider specific Medicaidpayment.The APG portion of the Legacy rate will increase in each phase according to the following schedule:Freestanding Article 31 clinics and D&TCs have a 4 year transition plan which began on October 1, 2010.Existing OperatingComponent (Legacy)New rates(APG)YEAR110/1/10 – 9/30/11YEAR 210/1/11 – 9/30/12YEAR 310/1/12 – 9/30/13YEAR 410/1/13 – On75% 25%50% 50%25% 75%0% 100%Hospital Based Article 31 Mental Health Clinics and D&TCs entered the transition period for hospital APGs on October 1,2010 during the Year 2 phase-in.Existing OperatingComponent (Legacy)New rates(APG)YEAR 212/1/09 – 12/31/10YEAR 31/1/11 – 12/31/11YEAR 41/1/12 – On50% 50%25% 75%0% 100%

At this time, CMS has not yet approved the amendment to NYS’s Medicaid Plan for OMH licensed mental health clinics.As a result, while Part 599 program regulations went into effect on October 1, mental health clinics will not transition toAPG claiming until CMS approval has been received. Once federal approval is received, claims for services deliveredafter October 1 will be automatically reprocessed under APGs.Instructions:OverviewThe plan contains six key elements for reform:1. A redefined and more responsive set of clinic treatment services and greater accountability for outcomes.Clinic is defined as a level of care with specific services. These services will enhance consumer engagement and supportquality assessment and treatment. Clinic treatment will be part of a coordinated and accountable system of recovery andresiliency, which includes other Medicaid reimbursable and non-Medicaid specialty services, such as case management,day and vocational services.2. Redesigned Medicaid clinic rates and phase out of COPs. Medicaid payment rates will be based on the efficientand economical provision of services to Medicaid clients. OMH has established peer groups for payment. Payments willbe comparable for similar services delivered by similar providers across service systems. Payments will also includeadjustments for factors which influence the cost of providing services. The new system will phase out the COPS add-onrate, but clinics will continue to receive CSP. OMH is committed to integrating clinic restructuring with the NYSDepartment of Health’s (DOH) new outpatient reimbursement methodology called APGs (Ambulatory Patient Groups).APGs will replace New York’s current “threshold visit” methodology for reimbursement.3. HIPAA compliant procedure based payment systems with modifiers to reflect variations in cost. The FederalHIPAA Administrative Simplification Act requires the use of a HIPAA compliant billing system. Billing codes for clinicservices will be HIPAA compliant with modifiers to reflect differences in resources and related costs (e.g., early morning,evening and weekend hours; languages other than English; and select services provided by a physician). Additionally, thestate is funding select offsite children’s services and crisis-brief for both adults and children. Claiming for children’s offsiteand crisis-brief offsite will not be done using a modifier; instead a separate rate code will be used. More information willfollow shortly.4. Provisions for indigent care. Article XVII of New York’s Constitution gives the State a special responsibility to care for“persons suffering from mental disorder or defect and [for] the protection of the mental health of the inhabitants”. Assuringaccess to outpatient clinic services is essential to meeting this objective and reducing the demand for other high costservices such as inpatient care. Currently, OMH clinics receiving COPs are required to serve all clients regardless ofability to pay. As part of restructuring, OMH will work to develop a comprehensive strategy for funding mental healthoutpatient services to the uninsured.5. Address Medicaid HMOs/State insurance plan underpayments. Medicaid managed care and, Family Health Plusand underpay for mental health clinic services. To ensure continued access to clinic services, OMH will address Medicaidmanaged care underpayments.6. Standards of Care. OMH recently released standards of care for clinic treatment for adults and children. Theseguidelines are a first step in articulating the basic tenets of good clinical care and accountability. While these have beenlongstanding expectations, they have not been consistently communicated or met.

Resources:1. NYS OMH Clinic Restructuring: https://www.omh.state.ny.us/omhweb/clinic_restructuring/default.html2. NYS OASAS Clinic Restructuring: http://www.oasas.state.ny.us/admin/hcf/APG/Index.cfmDate: May 1, 2011OMH Review: 4/4/11

Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALAID TO LOCALITIES FISCAL SYSTEM (ALFS) ACCESSThe Aid to Localities Fiscal System (ALFS) allows the Office of Mental Health (OMH), Bureau of Community Budget andFinancial Management (CBFM) to develop a budget, allocate funds, disburse payments and ensure that funds areexpended in compliance with existing laws, regulations and guidelines. From LGU perspective, the ALFS is an importantsource for County related fiscal information.Brief Description of Process: (how does it work?)The ALFS system is the mechanism for the LGU’s oversight, monitoring and management of the OMH State Aid fundingcycle. The LGU receives funding information from the OMH on the State Aid Letter Authorization, which is generated outof ALFS and then prepares and submits OMH fiscal reporting documents via the Consolidated Fiscal Reporting (CFR)Software, which then subsequently flows into ALFS overnight. The ALFS system is built on the Spending Plans, which areused to track individual funding sources within a funding type and to specify allocations to counties, direct contracts ormiscellaneous recipients (ex. software consultants) and also incorporates the Consolidated Fiscal Manual rules of theNYS OMH.Note: In 2011, OMH began the transition of the ALFS system (aka “ALFS Classic”) to ALFS-Web, a web-basedapplication.The ALFS systems are accessed through a user name which is assigned by the OMH, a password chosen by theindividual, a 4-digit “pin” number chosen by the individual and a token which is provided by the OMH. An ALFS user cancontact the OMH Help Desk (1-800-HELP-NYS or 1-800-435-7697) with ALFS related problems. A user with County-levelaccess can view the names, user IDs and status of other ALFS users in the county in the “User Administration” screen inALFS web.Frequency:Request for access is made once for each individual. For users requiring access to multiple counties, a request needs tobe made for each county. For any change to the access rights, the request needs to be submitted again.Instructions:1. Complete ‘Request for Access’ form and sign it.2. Have Director of Community Services approve and submit the form with a cover letter on the County letter head,to NYS OMH.3. Receive user name, pin and token from the Office of Mental Health through mail in approximately 2 – 4 weeks.4. Tokens have an expiration date listed on the back; NYS OMH will send new tokens prior to expiration date and toreturn expired tokens.5. Annually, NYS OMH validates county user access to ALFS.6. Return the ALFS token to the OMH for users who no longer require access.

Resources:The OMH Help Desk: 1-800-HELP-NYS or helpdesk@omh.state.ny.usDate: May 1, 2011OMH Review: 3/8/11

FISCAL OFFICER TRAINING MANUALMENTAL HEALTH PROVIDER DATABASE (MHPD)Business Process: (what is it?)The Mental Health Provider Data exchange (MHPD) is a OMH-only web-based application which is used to supportCONCERTS, a master provider directory of the New York State public mental health system. The MHPD enables localmental health authorities and providers to use the ease of the Internet to verify or request changes to program informationthey are required to submit to the OMH. The CONCERTS database lists all providers, programs and site information, CFRsite code (necessary for the input on the CBR and CFR), agency staff contact information, etc.Brief Description of Process: (how does it work?)As is the case for the ALFS system, a user name and password are required to enter the MHPD system (see instructionsbelow for directions). Providers can add, close, and make corrections or updates to OMH programs via the MHPD internetbased system. All programs reported on an agency’s Consolidated Budget & Claim Reports are required to be in thedatabase. Failure to register the correct program or site information will result in Error/Exception reports from OMH andcan lead to possible funding/claiming issues. Registering programs in MHPD not only provides a state wide list ofprograms for each county, but also generates a unique site code for each program entry and is required for the Budgetand Claiming Reports.As new entries and requests for changes are made in MHPD, they are reviewed by the providers local Field Office. TheField Office then makes recommendations for approval or denial prior to Central Office approval. The Field Office oftentimes communicates with the LGU for verification of the information in the request. This keeps information current for allparties involved.Frequency:As needed for:Viewing and updating descriptive, contact and other program and administrative information for Facilities,Programs and SitesRequest minor changes to licensed programs via Administrative ActionsCreate / Close unlicensed mental health programsBy November 2010, to a limited extent for existing programs, providers will be able to open, close or resizelicense programsCompleting surveys that collect program-level informationInstructions:As of January 19, 2011 the external MHPD Self Registration application has been removed. Agencies or Facilities mustself-register for the Security Management System (SMS) and an agency-appointed Security Manager will use the SMSapplication to grant MHPD access to appropriate agency staff. For assistance locating the agency Security Manager,check with the agency’s Director, or call the OMH Help Desk at 1-800-HELP-NYS.In order to access MHPD, the user must be assigned a security group (provider user, provider admin, county user, orcounty admin), user ID and password. This can be accomplished by having the agency’s Security Manager enter theuser’s information into the Security Management System. Changes to a user’s access level, name, title, email, and phonenumber in MHPD must be made by the agency’s Security Manager.

Once access has been granted, the agency user then monitors program information in MHPD and makes changes toprograms as needed. OMH also uses MHPD as a vehicle to collecting data (i.e. Uncompensated Care, CaseManagement, etc.).LGU staff that is registered as ‘County Users’ can view information and submit requests for all providers and programslocated within their county. The LGU designated staff person receives e-mail notification of any provider change requestsand approvals.All providers should have at least 1 representative MHPD user to monitor their programs information and submitinformation as requested (i.e. Uncompensated Care, Case Management, etc.).All provider program information listed in MHPD is used in various ways. It allows OMH to take an inventory of theservices and programs being provided across the state and well as connect programs across multiple databases andsources of information. OMH also uses the information to populate their website for those looking to “Find a MentalHealth Program in Your Community”. It allows people to find services across NYS and includes provider programlocations and phone numbers as listed in MHPD.MHPD is a rapidly changing application that has expanded in purpose since its inception. For the most updated MHPDinformation please refer to the OMH website.Resources:1. MHPD Data Base Link: http://www.omh.state.ny.us/omhweb/mhpd/2. Mental Health Program Directory: “Find a Mental Health Program” - http://bi.omh.state.ny.us/bridges/indexDate: May 1, 2011OMH Review: 1/19/11

FISCAL OFFICER TRAINING MANUALADDITIONAL RESOURCESAdditional ResourcesDescriptions and Linksa. Acronyms This list of Acronyms was compiled from a variety of sources. Anacronym is a pronounceable word formed from each of the first letters ofa descriptive phrase or by combining the initial letters or parts of wordsfrom the phrase.For a list Acronyms related to Mental Health:http://www.omh.ny.gov/omhweb/resources/acronyms.htmlb. CBR and Claiming Manual CBR - Consolidated Budget Reporting Manual documents provideprocedures and step-by-step instructions for fulfilling fiscal reportingrequirements related to the receipt of State Aid. (NYC and Upstate).To view the CBR and Claiming Manual:http://www.omh.ny.gov/omhweb/cbrc. CFR Manual The Consolidated Fiscal Reporting (CFR) site provides information onfiling CFR documents and resources including contact listings,schedules, frequently asked questions, (FAQ's) and links to relatedsites.To view the CFR Manual and download the CFR software:http://www.omh.ny.gov/omhweb/finance/main.htmd. Aid to Localities Spending Plan The Spending Plan Guidelines site provides the Aid To LocalitiesSpending Plan Allocation Guidelines and Instruction manualsTo view the Spending Plan Guidelines:http://www.omh.ny.gov/omhweb/spguidelines/selectletter.aspFunding Source Codee. NYS OMH / OPWDD / OASASWebsitesi. CFRS Mailing ListALFSOMH Website: http://www.omh.ny.gov/index.htmlOPWDD Website: http://www.omr.state.ny.us/OASAS Website: http://www.oasas.state.ny.us/CFRS Mailing List: will keep you informed on the CFRS Softwareincluding new versions and software updates.To put your email address on the CFRS mailing list:http://www.omh.ny.gov/omhweb/listserv/cfr.htmf. Fiscal Officer Meetings County-organized Fiscal Officer meetings occur throughout the year todiscuss various topics, share concerns, issues, solutions, information,etc. Contact your local NYS Field Office or nearest County FiscalOfficer for schedule and location.g. NYS Field Offices The Field Office, as an intermediary between NYS and Counties,oversees the fiscal reporting of a particular region of the state and canbe a valuable resource for county Fiscal Officers. Comments orquestions about the Aid to Localities Spending Plan AllocationGuidelines may be addressed to the Field Office.OMH Field Offices:http://www.omh.ny.gov/omhweb/aboutomh/FieldOffices.html

OPWDD Field Offices (DDSO):http://www.omr.state.ny.us/ws/ws_linemap.jspOASAS Field Offices:http://www.oasas.state.ny.us/pio/regdir.cfmh. What is?-Form AC-1171Form AC-1171 is the State Aid Voucher form for OPWDD. See theCBR and Claiming Manual for more information:http://www.omh.ny.gov/omhweb/cbr-NPI-Patient Characteristicsi. Program Changes – What do you do?-PARNPI stands for National Provider Identifier and is related to the HealthInsurance Portability and Accountability Act (HIPAA). For moreinformation: http://www.emedny.org/hipaa/NPI/index.htmlThe Patient Characteristics Survey is required for all programslicensed or funded by NYS OMH. Patient Characteristics Survey (PCS)Portal - The PCS provides a comprehensive one–week "snapshot" ofthe population served by New York State's public mental health system.View demographic, clinical, and service-related information for eachperson who receives a mental health service during the specified one–week period using the dynamic Portal Summary or Planning ReportsPatient Characteristics webpage:http://bi.omh.state.ny.us/pcs/indexPAR refers to the Prior Approval Review process for obtaining programcertification. The Application for Prior Approval Review (OMH-165 3/99)is available in Portable Document Format (PDF) and as an on-line formand should be used for projects subject to prior approval by the Office ofMental Health as defined under NYCRR Part 551.PAR webpage: http://www.omh.ny.gov/omhweb/par-MHPDThe Mental Health Provider Data exchange (MHPD) is a Web-basedapplication designed to support an accurate and timely master directoryof providers in the New York State public mental health system. TheMHPD enables local mental health authorities and providers to use theease of the Internet to verify or request changes to program informationthey are required to submit to OMH.MHPD webpage: http://www.omh.ny.gov/omhweb/mhpdj. OMH Statistics and Reports OMH collects Residential, Children, Patient Characteristics, Medicaid,and other data for use in planning and analysis. A variety of reports areavailable.Statistics and Reports:https://www.omh.state.ny.us/omhweb/statistics/Date Review: 5/1/11