Skip to navigation Skip to content Skip to footer

Program Modification

REQUEST AN INQUIRY FOR CONTRACT MODIFICATION CONSIDERATION

Submissions are excepted from June to January of the current fiscal year starting July 1st.

Potential Program Modification requests should be discussed first with your Contract Managers. Once they have been discussed and vetted, your Contract Manager will initiate the Program Modification request on your behalf via DocuSign. Formal Program Modifications will be accepted from June through to January starting of the current fiscal year stating July 1st. Program Modification must be received no later than the following dates to correspond with respective quarterly changes:

  •  By July 1st (for updates executed in October)
  • By August 14th (for updates executed in December)
  • By November 13th (for updates executed in March)
  • By January 29th (for updates executed for the new fiscal year renewels)

Outline of the Program Modification Workflow:
•  BHSD’s program staff and agency’s program staff work together to identify programs needing a modification.
•  BHSD’s program staff will email agency a link to begin the  modification process.


Read the two sections following the entry form area, titled Program Modifications and Rate Changes before proceeding with a request to modify a program. 

Program Modifications

Given the requirements of network adequacy - including timeliness and access, the Behavioral Health Services Department (BHSD) will be expanding Program Modification submissions to all those issues related to contract capacity. Contract capacity will refer to the ability or the potential ability to take on or limit additional clients within a singular program (e.g., Outpatient, etc.) or a series of related programs (e.g., School Linked Services, etc.).

The Department requests that Agencies closely monitor and manage their own operational capacity -based on available reports and discussions with their Contract Managers to ensure that they do not exceed current contracted capacity. Once an Agency nears their contractual obligations, the Agency should immediately contact the Division Director to discuss and develop a plan to ensure that the Agency does not exceed contracted capacity (without first approval from the Department). Such plans might include a “step down” of clients who are appropriate for lower levels of care, closing out client cases for those who have been 90 days without service, implementing a temporary cessation of referrals, etc.

Finance offers a Program Modification template for use in the submission of a program modification. A program modification requires that the submitter have a good knowledge of their program’s average active slot capacity. The template’s tab labeled “Modification Requirements” outlines the requirements for submission. < MH Program Modification >  Program Modifications should be submitted and will be accepted between July and January of the current fiscal year.

Rate Changes

The Behavioral Health Services Department (BHSD) annually offers mid-fiscal year all contracted agencies an opportunity to propose a justification for an increase or decrease in their interim negotiated rates and to change their contracted Medi-Cal expenses. All rate changes are applied retroactively to the beginning of the current fiscal year. All requested changes in rates will be evaluated on the bases of the agency’s performance, the agency’s costs to provide services, and the BHSD’s goals and needs.  Rate Change requests should be submitted, and will be accepted between July and January of the current fiscal year. All rate changes are retro-active to the beginning of the current fiscal year.

Actual Costs

If the initial current fiscal year interim contract rates were the same as the prior fiscal year interim contract rates and current circumstances have resulted in costs that are not in line with interim rates, then contractors may request increases or decreases that better align rates with cost.

Rate adjustment requests should be based on prior fiscal year’s cost report information and supporting documentation and the first three to six months of the current fiscal year by creating a mock cost report including your agency’s financial statements.  

New Costs

Rate adjustment requests should be based on prior fiscal year’s cost report information and supporting documentation and the first three to six months of the current fiscal year by creating a mock cost report including your agency’s financial statements.  

 Finance offers a “MH Mode 15 Rate Change Mod” template for use in the request of a modification to the interim rates for mode 15 services. For mode 05 and mode 10 rate change, requests for the “Program Modification” template can be used. The template’s tab labeled “Submission Requirements” outlines the requirements for submission. <MH Mode 15 Rate Change Modification template and  MH Program Modification template spreadsheets> Rate Change requests will be accepted between July and January of the current fiscal year. All rate changes are retro-active to the beginning of the current fiscal year.






Last updated: 6/26/2020 3:10 PM