TITLE
Recommendation to authorize the refund of $86,236 to the State of California Department of Health Care Services, for the Targeted Case Management Program interim reconciliation process, tentative settlement for Fiscal Year 2018-2019. (Citywide)
DISCUSSION
The City of Long Beach Department of Health and Human Services (Health Department) participates in the Targeted Case Management (TCM) Program with the State of California Department of Health Care Services (DHCS). The Health Department has participated in the TCM program since the early 1990s. Reimbursement revenue received from the program totals approximately $120,000 annually. As of May 30, 2020, the Heath Department received $3,066,533 in revenue reimbursement.
The TCM Program assists defined targeted groups in accessing medical, social, educational, and other needed services. TCM service components include comprehensive assessment and periodic reassessment of client status, development of individual services plans for each beneficiary, referral and related activities, and monitoring with follow up activities. There are five defined targeted groups for the TCM program: children under the age of 14, medically fragile individuals, individuals at risk of institutionalization, individuals in jeopardy of negative health or psycho-social outcomes, and individuals with communicable diseases.
The Health Department submitted its annual TCM Program cost report to DHCS on November 1, 2019. In May 2020, the DHCS Audit and Investigation Branch (DHCS A & I) completed an interim reconciliation for the City for the Fiscal Year (FY) 2018-2019 TCM Program and determined that the City was overpaid in the amount of $86,236. The refund of $86,236 is a tentative settlement for the FY 2018-2019 TCM Program interim reconciliation process for the cost report time period of July 1,2018 to June 30,2019.
This matter was reviewed by Deputy City Attorney, Taylor M. Anderson on August 31, 2020 and by Revenue Management Of...
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