MDCH - Substance Abuse Contract Agreement Reports

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Substance Abuse Contract Agreement Reports

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OFFICE OF DRUG CONTROL POLICY

Required Reports & Data Submissions – Schedule, Forms, & Instructions:

Fiscal Year 2008 Fiscal Year 2007

FY08 (Oct. 1, 2007 – Sep. 30, 2008)

Report Title/Data Submission	Period Covered	Due Date	Send To	Instructions & Specifications
Administration Expenditures Report	Fiscal Year 2008	Jan. 31, 09 mandatory submission	EGrAMS Statistical Report	Contract Attachment B: Administration Expenditures Report Instructions OMB Circular A-87 OMB Circular A-122
Audit Report	Fiscal Year 2008	9 months after close of Contractor's fiscal year	Office of Audit and EGrAMS Attachment Report	Contract Part II: Section I, G Audit Status Notification Letter template Audit Requirements How to Report (OMB) Circular A-133
Certificate of Cost Allocation Plan Only if agency uses Central Cost Allocation (CCA)	Fiscal Year 2008	When CCA is introduced, is revised, or every 2 yrs., whichever comes first	BFA/ Accounting and EGrAMS Attachment Report	Contract Attachment B: pages 1-3 OMB Circular A-87
Communicable Disease Provider Information Plan/Report	Semi-annual: Oct.-Mar. Apr.-Sep.	Apr. 31, 08 and Jan. 31, 09	EGrAMS Statistical Report	Contract Attachment E: (Instructions contained in the report form.)
Health Insurance Portability & Accountability Act (HIPAA) 837 Encounter Data	Records are completed as services are provided, and then submitted monthly for each quarter.	Monthly (minimum 12 submissions per year), 30 days post adjudication of a claim	via DEG to MDCH/MIS-Operations	Contract Attachment E: Supplemental Instructions to SA CAs for 837 Encounter Data Submission MDCH Electronic Submission Manual Data Clarification Documents
HIV Data Reporting HIV providers must utilize MDCH/HAPIS data collection methods, including: Uniform Reporting System (URS) CareWare for case management; and HIV Event System (HES) - HIV/AIDS Prevention and Intervention Section (HAPIS) for Counseling, Testing and Referral (CTR), and other prevention/risk reduction activities.	In real time	As event occurs	Submit via web-based HAPIS system: www.hapis.org	Contract Attachment E: Prevention Policy #02: Communicable Disease, Reporting Requirements
Legislative Report -Section 408	Fiscal Year 2008	Jan. 31, 09	EGrAMS Statistical Report	Instructions will be issued by Dec. 10, 08
Notice of Excess or Insufficient Funds	Fiscal Year 2008	May 1, 08	EGrAMS Attachment Report	Contract Attachment A, Administrative and Financial section, #13
Performance Indicators for Substance Abuse Services	Quarterly: Oct.-Dec., Jan.-Mar., Apr.-Jun., and Jul.-Sep.	Two months following the quarter: Feb. 28, May 31, Aug. 31, and Nov. 30	EGrAMS Statistical Report	Contract Attachment E: Data Collection/Recording & Reporting Requirements
Preliminary Closeout Schedule To be sent to contractors Aug. 08	Fiscal Year 2008	Sep. 2008, date to be determined by DMB at year-end closing	BFA/ Accounting	Contract Part II: Section IV, E Preliminary Closeout Schedule Instructions To be sent to contractors Aug. 08
Prevention Data Set to be determined	Fiscal Year 2008	If not using State System: upload monthly by (to be decided).	state system or upload monthly to ??	Contract Attachment E: Prevention Data Set instructions to be determined
Prevention Expenditures by Strategy Report	Fiscal Year 2008	Jan. 31, 09	EGrAMS Statistical Report	Contract Attachment E: Prevention Expenditures by Strategy Report Instructions
Prevention Report for SAPT Block Grant: Tables 1 to 4 to be determined	Fiscal Year 2006 (required) Fiscal Year 2007 (optional)	Jun. 30, 08	EGrAMS Attachment Report	Contract Attachment E: Prevention Report for SAPT Block Grant instructions to be determined
Prevention Services Population Report to be determined	Fiscal Year 2007	Jan. 31, 08	EGrAMS Statistical Report	Contract Attachment E: Prevention Services Population Report Instructions to be determined
Priority Populations Waiting List Deficiencies Report	Monthly	End of the month following the month in which the exceptions occurred.	EGrAMS Statistical Report	Contract Attachment E: Instructions for Completing the Federal Priority Populations Waiting List Certification Form
Problem Gambling Screening & Referral Project Report (SEMCA only)	Monthly	End of the month following the month in which the activity occurred.	EGrAMS Attachment Report	Contract Attachment A –SEMCA, Services Section, # 2 k Contract Attachment E: (Instructions contained in the report.)
Revenues and Expenditures Report (RER) –Quarterly NOTE: The 4th quarter RER is not required to be submitted.	Quarterly: Oct.-Dec., Jan.-Mar., and Apr.-Jun. –– First 3 qtrs only.	Last day of the month, following the end of the quarter: Jan. 31, Apr. 30, and Jul. 31.	BFA/ Accounting and EGrAMS Expenditure Report	Contract Attachment B: RER Instructions
Revenues and Expenditures Report (RER) –Final	Fiscal Year 2008	Jan. 31, 09	BFA/ Accounting and EGrAMS Expenditure Report	Contract Attachment B: RER Instructions
Sentinel Events Data Report (residential treatment only)	Semi-annual: Oct.-Mar. Apr.-Sep.	Last day of the month following the end of the 2nd & 4th quarters: Apr. 30, 07 and Oct. 31, 07	EGrAMS Statistical Report	Contract Attachment E: Sentinel Events Reporting Guide Data Collection/Recording & Reporting Requirements
State Prevention Framework/State Incentive Grant (SPF/SIG) Requirements Report to be determined	Fiscal Year 2008	to be decided	EGrAMS Attachment Report	Contract Attachment E: State Prevention Framework/State Incentive Grant (SPF/SIG) Requirements to be determined
Tobacco/Formal Synar Compliance Inspection Surveys	Jul. 1-31, 08	Aug. 15, 08	EGrAMS Attachment Report	Instructions to be issued in June 08 by Prevention Section
Tobacco Retailer Master List – Improvement and Clarification Process (Forms are transmitted to individual CAs)	Annual	Mar. 31, 08	EGrAMS Attachment Report	Contract Attachment E: Instructions for the Synar Tobacco Retailer Master List – Improvement and Clarification Process
Treatment Episode Data Set (TEDS)	Monthly	Last day of each month	via DEG to MDCH/MIS-Operations	Contract Attachment E: Instructions for Treatment Episode Data Set (TEDS) Submission for SA CAs to be revised Data Collection/Recording & Reporting Requirements Substance Abuse Encounter Reporting: HCPCS and Revenue Codes Supplemental Instructions to SA CAs for 837 Encounter Data Submission
Underage Drinking Prevention Project Narrative Report, Bay County (no form) (Riverhaven only)	Quarterly: Oct.-Dec., Jan.-Mar., Apr.-Jun., and Jul.-Sep.	Last day of the month following the quarter: Jan. 31, Apr. 30, Jul. 31, and Oct. 31	EGrAMS Attachment Report	Contract Attachment A –Riverhaven, Services section, # 3 c
Women, Pregnant Women, and Women with Dependent Children Progress Report to be revised AKA: Women's Specialty Services Report	Fiscal Year 2008	Jan. 31, 09	EGrAMS Attachment Report	Contract Attachment E: Guidelines for Completing the Women, Pregnant Women, and Women with Dependent Children Progress Report to be revised
Youth Access to Tobacco Activity Report	Fiscal Year 2008	Oct. 31, 08	EGrAMS Statistical Report	Contract Attachment E: (Instructions contained in the report.)

FY07 (Oct. 1, 2006 – Sep. 30, 2007)

Report Title/Data Submission	Period Covered	Due Date	Send To	Instructions & Specifications
Audit Report	Fiscal Year 2007	9 months after close of Contractor's fiscal year	Office of Audit and SACM	Contract Part II: Section I, G Audit Status Notification Letter template Audit Requirements How to Report (OMB) Circular A-133

Reports that do not conform to instructions may not be determined as "received."

Reports that require an original signature should be mailed to the appropriate area as listed, with the document date determined by postmark or commercial carrier receipt.

Send to SACM:

Send electronically to:
murrayden@michigan.gov

The received date is determined by the date of transmission.
Mail only those requiring an original signature to:
Office of Drug Control Policy
Substance Abuse Contract Management
Michigan Dept. of Community Health
Lewis Cass Building, 5th Floor
320 S. Walnut Street
Lansing, MI 48913

Send to BFA/Accounting:

U.S. mail: Bureau of Finance/Accounting Division
Expenditure Operations Section
Michigan Dept. of Community Health
P.O. Box 30720
Lansing, MI 48909
Overnight services (UPS, Fed. Ex.):
Bureau of Finance/Accounting Division
Expenditure Operations Section
Michigan Dept. of Community Health
Lewis Cass Building, 4th Floor
320 W. Walnut Street
Lansing, MI 48913

Send to Office of Audit:

U.S. mail: Office of Audit
Quality Assurance and Review Section
Michigan Dept. of Community Health
P.O. Box 30479
Lansing, MI 48909-7979
Overnight services (UPS, Fed. Ex.):
Office of Audit
Quality Assurance and Review Section
Michigan Dept. of Community Health
Capitol Commons Center
400 S. Pine Street
Lansing, MI 48913

Send via DEG to MDCH/MIS-Operations:

Data Exchange Gateway (DEG)
Michigan Department of Community Health
Michigan Department of Information Technology

For client admissions: put c:4823 4823@dchbull
For client discharges: put c:4824 4824@dchbull

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