Financial Support Unit
Aid to Counties Toolkit
- Abbreviated Instructions for Staff Entering Expenditures on ATC Website (PDF) Updated 10/23
- New ATC Website
- Aid to County "ATC" Change Request Form (electronic document)
- Aid to County Payment Schedule 2025 (PDF) - Updated 1/7/25
Administrative Monitoring
- DPH Administrative Monitoring Assessment Tool (PDF) Updated 01/2025
- DPH Financial Checklist (PDF)
- Billing Review Tool (PDF)
- 2025 - 2027 LTATB/OCPHN Joint Monitoring Schedule (PDF)
Budget Preparation Maintenance of Effort and Reports
- Agency Reports and Considerations for Health Directors
- Revenue Tracking
- Expenditure
- Payroll
Consolidated Agreement and Program Agreement Addenda
- Consolidated Agreement FY 24-25 (PDF) - Added 7/23/24
- Links to Agreement Addenda
Sample Forms and Tools for Registration and Financial Eligibility
- Brief Form Bill or Not Bill Insurance (DOCX)
- Sample Registration Checklist
- Sample Abbreviated Registration Checklist
- Sample Third Party Income Confirmation Letter
- Sample Third Party Release of Information Form (English/Spanish)
- Approved Income Documents - Sources of Income - Updated 02/2025
- Terms and Conditions/Receipt of Notice of Privacy Practices
Fee Development and Fee Setting
Billing and Collection of Revenue
- Collecting Co-Payments and Applying Sliding Fee Scales - Job Aid for Front Desk Staff
- Sample Fee, Eligibility, and Billing Policy - Under revision - 8/2024
- Sliding Fee Scales
- Bad Debt Set-Off Clearinghouse
LHD Credentialing Resources
Training
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