Chapter 5 – Administrative

Policy

• California Correctional Health Care Services (CCHCS) and Division of Health Care Services (DHCS) shall pay undisputed claims timely for which payment is appropriate under a settlement agreement, an Order of a court or administrative tribunal that is final or that CCHCS/DHCS chooses not to appeal, or for other reasons (hereinafter referred to as non-contract claims).

Purpose

• Establish a consistent approach for CCHCS/DHCS internal review and approval of non-contract claims to ensure payment of non-contract claims is legally appropriate, is approved by any impacted CCHCS/DHCS programs and/or California Department of Corrections and Rehabilitation (CDCR) institutions, and is within CCHCS/DHCS budget.

Applicability

• This policy sets forth the process for CCHCS/DHCS internal approval of payment for certain types of claims, including, but not limited to, the following:

  • Claims filed with the Department of General Services’ Office of Risk and Insurance Management, such as claims by contractors related to invoices that CCHCS/DHCS has deemed are not properly payable under contract and claims by employees or others.

  • Claims before the Labor Commissioner, such as claims by subcontractors that have not been paid by a contractor for goods or services that CCHCS/DHCS received.

  • Appeals filed with the State Personnel Board or California Department of Human Resources by CCHCS/DHCS employees that result in reinstatements, back pay settlements, or other resolution that involves monetary payment.

  • Settlement of court or other administrative litigation, including commercial litigation, the assessment of fines against CCHCS/DHCS, and incarcerated person claims.

  • Other matters that are within the CCHCS/DHCS authority.

• This policy is not applicable to the following:

  • Processes that are external to CCHCS/DHCS.

  • Payment of invoices that are payable pursuant to contract.

  • Payment of invoices that are payable pursuant to the Plata Court Orders dated March 30, 2006, and November 8, 2006.

  • Payment of invoices that are payable pursuant to Penal Code Section 5023.5.

  • Action on out-of-class grievances.

Responsibility

• Responsibility for review and approval of non-contract claims pertaining to the Mental Health and Dental Services programs shall reside with the Undersecretary, Health Care Services.  Responsibility for review and approval of non-contract claims pertaining to Medical Services and all other areas within CCHCS shall reside with the Receiver, who hereby delegates review and approval to the Undersecretary, Health Care Services.  The Undersecretary, Health Care Services, hereby delegates review and approval, except as noted in (e)(2)(B), below, to the Director of Health Care Policy and Administration, the Chief Counsel of the CCHCS Office of Legal Affairs (COLA), the Associate Director of Fiscal Management or designee, the Deputy Director of any CCHCS program area, and the Chief Executive Officer of any CDCR institution impacted by the non-contract claim.  The appropriate level of review shall be determined by the value of the non-contract claim that is proposed to be paid, following the procedure set forth below.

Procedure

• Requests for settlement or payment of claims, including requests for settlement authority for upcoming hearings in any judicial or administrative forum, shall be directed to the attention of the Chief Counsel, COLA.  The Chief Counsel shall seek recommendations from the assigned COLA Attorney, the Deputy Director of any CCHCS/DHCS program area, and the Chief Executive Officer of any CDCR institution that is impacted by the claim.

  • The COLA Attorney shall indicate the time within which reply to the request is needed, to ensure timely response to the request for settlement or payment of the claim.

  • The COLA Attorney shall secure a budget line item for funding from the Associate Director of Fiscal Management or designee, if the recommendation proposes payment of CCHCS/DHCS funds.

• The COLA Attorney shall ensure preparation of a memorandum containing the recommendation(s) of persons within CCHCS/DHCS who have responded to the COLA Attorney’s request.  This memorandum shall be routed for the following approvals:

  • Recommendations for settlement or payment of claims of under $100,000:  Approvals are required by the Chief Counsel, the Deputy Director of any impacted CCHCS/DHCS program area, the Chief Executive Officer of any impacted CDCR institution, and the Director of Health Care Policy and Administration.

  • Recommendations for settlement or payment of claims of $100,000 or more:  Approvals are required by the Undersecretary, Health Care Services, for their respective areas of responsibility, in addition to the approvals required in (e)(2)(A).

• Upon receipt of the required approvals or a decision not to approve the requested settlement or payment, the Chief Counsel shall arrange for appropriate response to the party requesting settlement or payment of the claim.

• The original approval package shall be retained by COLA, which shall serve as CCHCS/DHCS custodian of records regarding these claims.

Contact

• For questions regarding this policy and procedure, please contact the Associate Director, Fiscal Management, or the Chief Counsel, COLA.

Policy

• California Correctional Health Care Services (CCHCS) out-of-state travel (OST) requests shall be approved in advance by the Undersecretary, Health Care Services; Secretary; and the Governor’s Office, as applicable, prior to traveling outside of California on official business only.

Purpose

• Out-of-state travel is defined as any travel outside the State of California for the purpose of conducting state business.

Procedure

• OST Blanket Request

  • OST Blanket Travel provides state agencies the authority, in advance, to approve travel listed in their department’s travel plan. The OST Blanket Travel requests are classified as either mission-critical or non-mission critical (discretionary) travel, based on the Out of State Blanket request form submitted by the requesting program.

  • The Fiscal Management Section (FMS) Technical Unit shall issue an OST Blanket Call Letter and OST Request form on an annual basis, generally issued between December and April, to inform all CCHCS program areas to submit a request for advanced approval. OST Request forms are due to FMS Technical Unit.

  • To be considered for OST Blanket, each program shall prepare and submit the OST request package one-year in advance, including all necessary forms and supporting documentation (with required signatures), as identified in the Call Letter, to the FMS OST mailbox: m_OutOfStateTravel@cdcr.ca.gov.

  • Upon approval, FMS shall forward the OST request package to CDCR’s Accounting Services Branch (ASB).

    • Medical Requests: ASB shall retain the OST request package for record keeping only. FMS shall forward a copy of the request package to the CDCR Agency Secretary.

    • Dental and Mental Health Requests: ASB shall route the OST request packages to the Secretary and the Governor’s Office, as applicable, for approval.

• Individual Trip Requests

  • Individual OST requests are submitted when travel was not originally known or requested through the OST Blanket Request process.

  • To be considered for an Individual OST, the requester shall prepare an Individual Trip Request package to include the following:

    • A request memorandum (refer to the CCHCS and CDCR Individual OST Memorandum template);

    • Completed CDCR 3060, Out of State Individual Trip Request, and STD 257, Out-of-State Travel, which are available on the CDCR Out-of-State Travel page; and

    • Relevant event documentation (e.g., brochure, flyer, invitation and agenda).

  • Individual OST requests shall be submitted to FMS at least eight weeks in advance of the travel date to provide sufficient time to obtain the required approvals, as indicated in the steps below.

    • Medical Services Request

      • Medical Services requests are under the authority of the Receiver, or designee. Upon the end of the Receivership, Medical Services requests will align with Section (c)(2)(C)2.

      • The program shall submit a completed Individual OST request package, including an Individual OST Memorandum addressed to the Director of Health Care Policy and Administration, CDCR 3060, STD 257, and supporting documentation (e.g., brochure, flyer, invitation, and agenda) to support the trip to the FMS OST mailbox: m_OutOfStateTravel@cdcr.ca.gov.

      • The FMS analyst shall review the Individual Trip Request package and provide any feedback to the program.

      • The program shall complete necessary revisions and route the Individual Trip Request package to the program director and applicable program leadership for approval.

      • All levels of the traveler’s supervisory chain of command between the traveler and program director shall also review and approve the Individual OST request package.

      • Approvers shall indicate their approval by initialing in the memorandum’s Via field.

      • The program director shall sign the memorandum to indicate their approval of the costs, purpose of travel, and content of the presentation, if available.

      • The program shall submit the completed Individual Trip Request package to the FMS OST mailbox: m_OutOfStateTravel@cdcr.ca.gov.

      • The FMS analyst shall review and route the completed Individual Trip Request package to the following: 

        • Director, Health Care Policy and Administration, for approval and signature on the memorandum.

        • Program director and Undersecretary, Health Care Services, for approval and signature on the     STD 257.

      • Upon approval by the Director, Health Care Policy and Administration, Receiver, and Undersecretary, Health Care Services, the FMS analyst shall forward a copy of the Individual Trip Request package to ASB and the CDCR Agency Secretary and notify the program of their trip number once assigned by ASB.

    • Dental and Mental Health Services Requests

      • The program shall submit a completed Individual Trip Request package, including a memorandum addressed to the Associate Director of ASB, CDCR 3060, STD 257, and backup documentation (e.g., brochure, flyer, invitation, and agenda) to support the trip to the FMS OST mailbox: m_OutOfStateTravel@cdcr.ca.gov.

      • The FMS analyst shall review the OST request package and provide any feedback to the program.

      • The program shall complete necessary revisions and route the Individual Trip Request package to the program director and applicable program leadership for approval.

      • All levels of the traveler’s supervisory chain of command between the traveler and program director shall also review and approve the Individual OST request package.

      • Approvers shall indicate their approval on a route slip or by attaching an email indicating their approval.

      • The program director shall sign the memorandum to indicate their approval of the costs, purpose of travel, and content of the presentation, if available.

      • The program shall submit the completed Individual Trip Request package with all required signatures to the FMS OST mailbox: m_OutOfStateTravel@cdcr.ca.gov.

      • The FMS analyst shall review and route the completed Individual Trip Request package to the following:

        • Undersecretary, Health Care Services, for approval and signature on the STD 257.

        • ASB Associate Director for review and approval.

      • Upon approval, ASB shall forward the Individual Trip request to the CDCR Agency Secretary for approval.

      • ASB shall notify FMS of the outcome, and FMS shall notify the traveler and requester of the approval and ASB-assigned trip number or denial.

Policy

• California Correctional Health Care Services (CCHCS) is responsible for developing and distributing staffing allocations. Staffing allocations are based on factors that include an institution’s mission, physical plant, clinic considerations, and population by risk level acuity. Staffing allocations are adjusted during the Fall Population and May Revision processes, and these allocations are distributed based on factors that include approved Budget Change Proposals (BCPs), Spring Finance Letters (SFLs), mission changes, program initiatives, and operational needs.

Responsibility

• The Fiscal Management Section is responsible for collaborating with applicable program areas to conduct a comprehensive review of staffing allocations to determine adjustments in accordance with this policy.

• Program areas are responsible for reviewing pending and approved legislation and court orders to determine the impact on operational needs and identifying required adjustments based on changes within an institution’s mission, physical plant, clinic considerations, patient volume, and population by risk level acuity.

• The CCHCS Office of Legal Affairs and the Director, Health Care Services, shall review all program area assessments of impact of pending and approved legislation, and court orders.

Procedure

• Staffing Model Ratios and Allocations

  • Staffing model ratio allocations by classification are determined and adjusted based on the following:

    • Risk level acuity that consists of High Risk 1, High Risk 2, Medium Risk, and Low Risk.

      • Special risk factors that increase the acuity level by one, include Female Factor, Age 50 and older, and Americans with Disabilities Act low and medium.

    • Licensed bed counts that consist of Correctional Treatment Center, Hospice, Mental Health Crisis Bed, Outpatient Housing Unit, Psychiatric Inpatient Program (PIP), and Skilled Nursing Facility designations.

      • For the purposes of this policy, PIPs are specific to those located at the California Health Care Facility (CHCF), California Medical Facility, Salinas Valley State Prison, San Quentin Rehabilitation Center, and California Institution for Women.

    • Integrated Substance Use Disorder Treatment Program population changes.

    • Approved new or augmented BCPs/SFLs.

    • Mission changes.

    • Program or operational adjustments that do not exceed the total authority determined through the Fall Population and May Revision processes.

• CHCF Staffing

  • CHCF staffing allocations are determined by applicable BCPs, except where defined otherwise and based upon population risk level acuity.