PCSAO is gathering information about costs incurred by PCSAs for health care services provided to kids in custody and their parents.  Our goals are to:
(1) Try to help PCSAs obtain reimbursement for the costs they incurred
(2) Track cost-shifting over time, particularly as behavioral health care services are moved into managed care. If we see evidence of additional cost-shifting over time, we will use de-identified data collected through this survey to advocate for change. 

What service(s) did your PCSA pay for?

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* 2. What service(s) did your PCSA pay for?

What cost did your PCSA incur for the service(s)?

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* 3. What cost did your PCSA incur for the service(s)?

Who received the service(s)?

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* 4. Who received the service(s)?

When did this incident occur?

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* 5. When did this incident occur?

Is there anything else about this cost-shift incident you think we should know?

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* 6. Is there anything else about this cost-shift incident you think we should know?

If you'd like us to contact you about any of the information above, and/or if you'd like us to try to help you obtain reimbursement for the service(s) you described, please leave your contact information below.

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* 7. If you'd like us to contact you about any of the information above, and/or if you'd like us to try to help you obtain reimbursement for the service(s) you described, please leave your contact information below.

Thank you very much for your feedback and time!

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