(a) Targeted case management (TCM), pursuant to Section 1915(g) of the Social Security Act as amended by Public Law 99-272 (42 U.S.C. Sec. 1396n(g)), shall be covered as a benefit, effective January 1, 1995. Nothing in this section shall be construed to require any local governmental agency to implement TCM. (b) A local governmental agency may contract with the department to provide TCM services. The department shall not contract with local education agencies to provide case management services under this section. (c) A local governmental agency may contract with any private or public entity to provide TCM services on its behalf under the conditions specified by the department in regulations. (d) Each local governmental agency that provides TCM services shall have all of the following: (1) Established procedures for performance monitoring. (2) A countywide system to prevent duplication of services and to ensure coordination and continuity of care among providers of case management services provided to beneficiaries who are eligible to receive case management services from two or more programs. (3) A fee mechanism effective January 1, 1995, specific to TCM services provided, which may vary by program. (e) Subject to the requirements of federal law and regulations, a local governmental agency or an entity under contract with a local governmental agency may provide TCM services to one or all of the following groups of Medi-Cal beneficiaries, which shall be defined in regulation: (1) High-risk persons. (2) Persons who have language or other comprehension barriers. (3) Persons on probation. (4) Persons who have exhibited an inability to handle personal, medical, or other affairs. (5) Persons abusing alcohol or drugs, or both. (6) Adults at risk of institutionalization. (7) Adults at risk of abuse or neglect. (f) (1) A local governmental agency that elects to provide TCM services to the groups specified in subdivision (e) shall, for each fiscal year, for the purpose of obtaining federal Medicaid reimbursement, submit an annual cost report as prescribed by the department that certifies all of the following: (A) The expenditure of 100 percent of the costs incurred for the provision of TCM services from the local governmental agencyâs general fund or from any other funds allowed under federal law and regulation. (B) The amount of funds expended on allowable TCM services. (C) Its expenditures represent costs that are eligible for federal financial participation. (D) The costs reflected in the annual cost reports used to determine TCM rates are developed in compliance with the definitions contained in the Office of Management and Budget (OMB) Circular A-87. (E) Case management services provided in accordance with Section 1396n(g) of Title 42 of the United States Code will not duplicate case management services provided under any home- and community-based services waiver. (F) Claims for providing case management services pursuant to this section will not duplicate claims made to public agencies or private entities under other program authorities for the same purposes. (G) The requirements of subdivision (d) have been met. (2) The department shall deny any claim if it determines that any certification required by this subdivision is not adequately supported for purposes of federal financial participation. (3) (A) A city that is not a local governmental agency, or any other local public entity that contracts with a local governmental agency pursuant to subdivision (c) and that is located within a county that is a participating local governmental agency pursuant to this section, may submit certification to the local governmental agency of amounts expended for TCM services in accordance with Section 433.51 of Title 42 of the Code of Federal Regulations. (B) A city or other local public entity that submits certification pursuant to this paragraph shall comply with the requirements of paragraph (1), with other requirements applicable to local
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