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LACKAWANNA-SUSQUEHANNA-WAYNE MENTAL HEALTH AND MENTAL RETARDATION PROGRAM v. COMMONWEALTH PENNSYLVANIA (06/21/89)

decided: June 21, 1989.

LACKAWANNA-SUSQUEHANNA-WAYNE MENTAL HEALTH AND MENTAL RETARDATION PROGRAM, PETITIONER,
v.
COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF PUBLIC WELFARE, RESPONDENT



PETITION FOR REVIEW (ENVIRONMENTAL HEARING BOARD)

COUNSEL

Jonathan Vipond, III, Judith P. Musselman, Baskin, Flaherty, Elliott-Mannino & Beren, P.C., Harrisburg, for petitioner.

John Kane, Chief Counsel, Howard Ulan, Asst. Counsel, Harrisburg, for respondent.

Craig and Barry, JJ., and Kalish, Senior Judge. Kalish, Senior Judge, concurs in the result only.

Author: Craig

[ 127 Pa. Commw. Page 46]

The Lackawanna-Susquehanna-Wayne Mental Health and Mental Retardation Program (Program) appeals an order of the Director of the Office of Hearings and Appeals of the Department of Public Welfare (DPW) holding that (1)

[ 127 Pa. Commw. Page 47]

    the requirement that a minimum occupancy rate of 85 percent be used to calculate reimbursement units for fee-for-service (per diem) funding of Community Residential Rehabilitation (CRR) programs applies to the Program; (2) money donated to the county in response to the Program administrator's letter of solicitation, and given to the Program by the county, is income to the Program; and (3) reimbursement for expenditures related to the administrator's enrollment in a doctoral program is not authorized.

The Program is a provider of mental health and mental retardation services in the three-county area. In 1984, DPW's Office of Operations Review conducted an audit of the Program for a four-year period ending on June 30, 1984.

Three of the findings contained in the Operational Audit Report are the subject of the Program's appeal. Those findings are: (1) $18,726 (reduced by stipulation to $10,499) in CRR expenditures for the 1981-82 fiscal year are not eligible for DPW financial participation; (2) the Program failed to report donations and gifts totaling $30,152 as income; and (3) a $19,327 reimbursement, received by the Program from DPW and the participating counties for the administrator's post-graduate education, is not authorized by DPW regulations or Program policies. The effect of implementing these findings is that a greater amount of local county funds will be required by the Program to provide services.

On November 20, 1986, an Attorney Examiner conducted a formal hearing on the Program's appeal, and recommended a decision holding that DPW properly disallowed $10,499 of reimbursement based on a published 85 percent occupancy rate factor, but that DPW erred in disallowing both the $30,152 in donations, which DPW characterized as contributions to the Program, and the $19,327 in expenditures related to the administrator's enrollment in a doctoral program.

The Program's appeal to DPW's Office of Hearings and Appeals followed. On July 14, 1988, the director of the Office issued an order adopting the examiner's recommendation

[ 127 Pa. Commw. Page 48]

    as to the reimbursement, but rejecting the donation and education recommendations, thereby affirming all three disallowances in the audit findings. The Program now appeals the same three findings to this court.

1.

The first issue is whether DPW properly disallowed $10,499 in reimbursements as a result of adhering to an 85 percent minimum occupancy rate, published in a Mental Health Bulletin, to calculate reimbursement unit amounts for CRR programs. If reimbursement unit amounts are calculated by assuming that at least 85 percent of service units are occupied, the unit amounts are necessarily lower than they would be if a lower occupancy rate were used as the cost devisor. The Program had used an actual occupancy rate (81% in this case) to calculate per diem ...


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