Iv E Foster Care Billing Forms - Excel

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Iv E Foster Care Billing Forms - Excel Powered By Docstoc
					County:                                           Example
Billing Period:

                                                                                                            Administration          Training
I. Participant / Administrative Cost Pool Costs                              Total Dollars     FFP RATE =           50.00%               75.00%
The cost pool is based on actual costs for the following:
         Salaries, Wages, and Fringe:
         Salaries                                                                86,684.06
         Finge                                                                   14,238.34
           Subtotal, Salaries, Wages and Fringe                                 100,922.40                       12,701.08               362.31

         Travel:
         Travel                                                                   1,511.83

           Subtotal, Travel                                                       1,511.83                         190.26                  5.43

         Overhead:
         Rent                                                                    10,553.58
         Utilities                                                                  565.89
         Supplies                                                                   388.58
         Other                                                                      580.81
         Reg. Fees                                                                    0.00
         Use Allowance                                                              395.55

           Subtotal, Overhead                                                    12,484.41                        1,571.16                44.82

I. TOTAL, Administrative Cost Pool                                              114,918.64                       14,462.50               412.56



II. Administrative Support Costs based on FTE's
         Salaries, Wages, and Fringe:
         Salaries                                                                15,405.93
         Fringe                                                                   2,530.51
           Subtotal, Salaries, Wages and Fringe                                  17,936.44                        2,257.30                64.39

         Travel:
         Travel                                                                     268.69

           Subtotal, Travel                                                         268.69                          33.81                  0.96

         Overhead:
         Rent                                                                     1,875.63
         Utilities                                                                  100.57
         Supplies                                                                    69.06
         Other                                                                      103.22
         Reg. Fees                                                                    0.00
         Use Allowance                                                               70.30

           Subtotal, Overhead                                                     2,218.78                         279.23                  7.97

II. TOTAL, Administrative Indirect Costs based on FTE's                          20,423.91                        2,570.34               73.32



                                                                                                                        Allocated
                                                                                                                       IV-E Share
                                                                                                                 17,032.84              485.88

III. Indirect Cost Rate Calculation: (Salaries, Wages & Fringe)
         Salaries, Wages, and Fringe - Direct                                                  13,063.00
         Salaries, Wages, and Fringe - Administrative Support                                   2,321.69
         Total                                                                                 15,384.69


         County's Approved Indirect Cost Rate                                                    40.34%
                                                                                                6,206.18          6,206.18


TOTAL REIMBURSABLE COSTS TO TITLE IV-E FOSTER CARE ASSISTANCE:                                                   23,239.02              485.88

                                                        IV-E REIMBURSABLE:                                       11,619.51              364.41

                                                        INVOICED AMOUNT:                                                              11,983.92




                                                                              TJPC-FIS-08-11
County:                                              Example
Billing Period:                                         0



     TITLE IV-E-1 REPORTING CATEGORIES and                                  Total                                                                                               Federal
        DFPS CODING BLOCK INFORMATION                     RMTS Results    Computable   Organization     Program      Account      Total Computable   Less Certified Match   Reimbursement
                                           Admin. CP =>   $ 17,032.84
5.       State and Local Administration
5a.      Case Planning & Management                             0.17733     3,020.42              510        27200       797160         3,020.42            (1,510.21)         1,510.21
5b.      Pre-placement Activities                               0.53542     9,119.72              510        27200       797161         9,119.72            (4,559.86)         4,559.86
5c.      Eligibility Determinations                                   0          -                510        27200       797162             0.00                 0.00              0.00
5e.      Other Administration                                   0.28725     4,892.68              510        27200       797163         4,892.68            (2,446.34)         2,446.34
                                                               1.00000     17,032.82                                                                                           8,516.41

         Indirect Administration (included in 5e.)                          6,206.18              510        27200       797101         6,206.18            (3,103.09)         3,103.09

7.       State and Local Training                                             485.88              510        27200       797102           485.88             (121.46)            364.42
                                                                                                                                       23,724.88          (11,740.96)         11,983.92




                                                                                       TJPC-FIS-08-11
County:                                                                                          Example
Billing Period:                                                                                     0

                                                                                 TIME STUDY WORKSHEET


                                                                          JUVENILE PROBATION POPULATIONS
                                                                                                                                                                                    COURT-ORDERED
                                                                                                       IV-E ELIGIBILITY                                                            PROBATION - YOUTH       REASONABLE
                                                                                                            RATE                                                                     IN OWN HOME           CANDIDATE %
                                                                                     IV-E CERTIFIED
                                                                                (In IV-E Placements)          17.38240%                                              CANDIDATE                      50            45.455%
                                                                                            NOT-IV-E          82.61760%                                          NOT CANDIDATE                      60            54.545%
                                                                                              TOTAL          100.00000%                                                  TOTAL                     110           100.000%



                                                                                        IV-E                   IV-E            COUNTY
                                                                                       Adm .50               Trng .75           FUNDS            TOTAL
                                                                       TIME STUDY
                               ACTIVITY CODES                           Responses

1. Facilitating IV-E Eligibility Determination/Redetermination                    0          0.00000                                                0.00000
2. Case Management                                                              753
      Reasonable Candidates (RC)                                 680                      118.20032                               561.79968       680.00000
      Foster Care (FC)                                            58                       10.08179                                47.91821        58.00000
      Other (O)                                                   15                                                               15.00000        15.00000
3. Court-Related                                                                569
      Reasonable Candidates (RC)                                 250                       43.45600                               206.54400       250.00000
      Foster Care (FC)                                           250                       43.45600                               206.54400       250.00000
      Other (O)                                                   69                                                               69.00000        69.00000
4. Training - IV-E Allowable Topics                                              21
      Reasonable Candidates Training (RC)                        15                                               2.60736          12.39264        15.00000
      Foster Care Training (FC) (Direct-charge approved)          6                                               6.00000           0.00000         6.00000
5. Counseling and Social Services                                                 7                                                 7.00000         7.00000
6. Other Activities                                                            379                                                379.00000       379.00000

7. General Administration & Training                                           218         28.21788                     N/A       189.78212       218.00000
   4. General Training                                                         117         15.14446                     N/A       101.85554       117.00000
8. Leave and Breaks                                                            335         43.36234                     N/A       291.63766       335.00000


(SUBTOT 1-6)                                                                  1,729       215.19411               8.60736        1,505.19853     1,729.00000



TOTAL 1-8:                                                                    2,399       301.91879              8.60736         2,088.47385     2,399.00000



                                                                                        IV-E                   IV-E            COUNTY                                                COMBINED IV-E
                                                                                       Adm .50               Trng .75           FUNDS            TOTAL                             Adm. @ .50 (Indirect)
                                                                                          0.12585                0.00359           0.87056         1.00000 <--must add to 1.0000                 0.12944


TIME STUDY RESULTS



CONVERTED                                                                              GR - IVE           GR - IVE               IVE               IVE            COUNTY
                                                                                      FC Adm .50         FC Trng .25          FC Adm .50       FC Trng .75         FUNDS
                                                                                      CERTIFIED          CERTIFIED               220               221           CERTIFIED               TOTAL

METHOD OF FINANCE ==>                                                                  6.29300%           0.09000%             6.29300%        0.26900%             87.05600%           100.00100%         <--must add to 100%




                                                                                            TJPC-FIS-08-11
County:                                                                    Example
Billing Period:                                                               0




                                     %            Salaries              Fringe              Travel            Supplies             Reg. Fees           Utilities           Rentals           Other            Use Allowances
Total Costs                                   $        114,885.27   $       18,870.55   $      2,003.68   $          515.00   $                -   $          750.00   $     13,987.00   $       769.76   $            524.24

Allocable Costs                               $       114,885.27    $       18,870.55   $      2,003.68   $         515.00    $                -   $         750.00    $     13,987.00   $       769.76   $            524.24

Indirect Joint Costs (Box1)         15.0905% $         (17,336.81) $        (2,847.67) $        (302.37) $           (77.72) $                 -   $        (113.18) $       (2,110.71) $       (116.16) $             (79.11)
Unallowable Joint Costs (Box1)       9.4567% $         (10,864.40) $        (1,784.54) $        (189.48) $           (48.70) $                 -   $         (70.93) $       (1,322.71) $        (72.79) $             (49.58)

Direct Costs                                  $         86,684.06   $       14,238.34   $      1,511.83   $         388.58    $                -   $         565.89    $     10,553.58   $       580.81   $            395.55

Program Portion (Box3)              100.0000% $         86,684.06   $       14,238.34   $      1,511.83   $         388.58    $                -   $         565.89    $     10,553.58   $       580.81   $            395.55
                                              $         86,684.06   $       14,238.34   $      1,511.83   $         388.58    $                -   $         565.89    $     10,553.58   $       580.81   $            395.55



Allocable Indirect Joint Costs                $         17,336.81   $        2,847.67   $       302.37    $           77.72   $                -   $         113.18    $      2,110.71   $       116.16   $             79.11

Unallowable Indirect Costs (Box2)   11.1374% $          (1,930.88) $          (317.16) $         (33.68) $            (8.66) $                 -   $         (12.61) $         (235.08) $        (12.94) $              (8.81)

Direct Indirect Costs                         $         15,405.93   $        2,530.51   $       268.69    $           69.06   $                -   $         100.57    $      1,875.63   $       103.22   $             70.30

Program Portion (Box3)              100.0000% $         15,405.93   $        2,530.51   $       268.69    $           69.06   $                -   $         100.57    $      1,875.63   $       103.22   $             70.30
                                              $         15,405.93   $        2,530.51   $       268.69    $           69.06   $                -   $         100.57    $      1,875.63   $       103.22   $             70.30




                                                                                                                                  TJPC-FIS-08-11
County:                                                        Example
Billing Period:                                                   0
Source of Funding       Expenditures            Salaries     Fringe     Travel    Supplies   Reg. Fees     Utilities      Rental   Other    Unallowable        Total
General Funds           Salaries               42,177.55                                                                                                   42,177.55
General Funds           FICA                                3,013.46                                                                                        3,013.46
General Funds           Retirement                          4,110.11                                                                                        4,110.11
General Funds           Mileage                                         545.68                                                                                545.68
General Funds           Electronic Monitoring                                                                                                  1,539.87     1,539.87
General Funds           Placement Expense                                                                                                     68,887.95    68,887.95
General Funds           Travel over State Rate                                                                                                   450.00       450.00
General Funds           Case Plan Development                           337.00                                                                                337.00
General Funds           Title IV-E Basic                                262.00                                                                                262.00
General Funds           Capital Outlay                                                                                                         4,050.00     4,050.00
State Aid               Probation Supplies                                          458.00                                                                    458.00
State Aid               Postage                                                      57.00                                                                     57.00
State Aid               Training Materials                                                                                         769.76                     769.76
State Aid               Pager Rental                                                                        750.00                                            750.00
State Aid               Rent                                                                                           13,987.00                           13,987.00
State Aid               Vehicle Maintenance                                                                                                      974.87       974.87
State Aid               Travel Expense                                  859.00                                                                                859.00
Progressive Sanctions   Salaries               36,611.91                                                                                                   36,611.91
Progressive Sanctions   FICA                                2,428.05                                                                                        2,428.05
Progressive Sanctions   Retirement                          3,485.06                                                                                        3,485.06
Salary Adj. Fund        Salaries               36,095.81                                                                                                   36,095.81
Salary Adj. Fund        FICA                                2,435.00                                                                                        2,435.00
Salary Adj. Fund        Retirement                          3,398.87                                                                                        3,398.87
                                  GRAND TOTAL 114,885.27   18,870.55   2,003.68     515.00        0.00      750.00     13,987.00   769.76     75,902.69   227,683.95




Source of Documentation:




                                                                                                         TJPC-FIS-08-11
County:                                                                 Example
Billing Period:                                                            0
                                                                        SALARY PAGE

                                                            Structure          Number of pay   Possible hours   Actual hours
                                             Class      (Direct, Indirect,      periods per     worked per       worked per
    Name or Emp. #             Title        (A, P, U)     Unallowable)            quarter         quarter         quarter      FTE        Salary
         236         Chief                      A            Indirect                6              480            480.00      1.00   $     18,759.00
         862         Asst CJPO                  A             Direct                 6              480            240.00      0.50   $     15,687.27
         248         Receptionist               A            Indirect                6              480            240.00      0.50   $      2,062.27
         159         Sec                        A             Direct                 6              480            480.00      1.00   $     11,234.55
         357         JPO                        P             Direct                 6              480            480.00      1.00   $     11,234.55
         753         JPO                        P             Direct                 6              480            480.00      1.00   $     11,234.55
         951         JPO                        P             Direct                 6              480            480.00      1.00   $     11,234.55
         789         JPO                        P             Direct                 6              480            480.00      1.00   $     10,863.40
         456         JPO                        P             Direct                 6              480            480.00      1.00   $     10,757.46
         123         JPO                        P             Direct                 6              480            480.00      1.00   $      8,675.20
         852         Transport                  U          Unallowable               6              480            120.00      0.25   $        948.67
         741         Community Service          U          Unallowable               6              480            240.00      0.50   $      1,867.31
         963         Community Service          U          Unallowable               6              480            90.00       0.19   $        326.49




                                   TOTAL:                                                                                      9.94   $    114,885.27




                                                                             TJPC-FIS-08-11
County:                                                    Example
Billing Period:                                               0
            Sum of FTE                                                                Click in this box.
                                   Class(A, P, U)
            Structure(Direct, Indirect, Unallowable)   Total                          Go to Data Menu (top of screen)
            Direct                 A                     1.5                          Select / Click "Refresh Data" or "Refresh All"
                                   P                       6                          Go to next tab/page
                                   U                       0
            Direct Total                                 7.5
            Indirect               A                     1.5
            Indirect Total                               1.5
            Unallowable            U                    0.94
            Unallowable Total                           0.94
            (blank)                (blank)                 0
            (blank) Total                                  0
            Grand Total                                 9.94

            DETERMINATION OF JOINT COSTS
            Indirect                    1.5                               15.0905%
    1       Direct
            Unallowable
                                        7.5
                                       0.94
                                                                          75.4527%
                                                                           9.4567%
            **Based on FTE             9.94                              100.0000%

            DETERMINATION OF DIRECT PORTION OF INDIRECT COSTS
            Direct                      7.5               88.8626%
    2       Unallowable
            **Based on FTE
                                       0.94
                                       8.44
                                                          11.1374%
                                                         100.0000%

            DETERMINATION OF PROGRAM PORTION OF DIRECT COSTS
            A                          1.5 reallocated
    3       P
            U
                                         6
                                         0
                                                6
                                                0
                                                       100.0000%
                                                         0.0000%
            **Based on FTE             7.5      6      100.0000%


            This box groups together the FTEs by structure and is then used to
     1      break out the different cost pools on the formulas page.

            This box is used to allocate the indirect FTEs over direct and
     2      unallowable FTEs.

            This box looks at the direct structure and breaks down the allowability
     3      between the participants and unallowable employees.




                                                                                          TJPC-FIS-08-11
County:                                 Example
Billing Period:                             0
                   Eligibility Determination Summary

                    Month:

                    PID #         Facility Name                         Date Placed
          1         a             Gulf Coast                                  18-Sep-07
          2         b             Pegasus                                      7-Jun-08
          3         c             Have Heaven                                  21-Jul-08
          4         d             Incentives                                   7-Mar-08
          5         e             Brookhaven                                   9-Feb-08
          6         f             Smith, John                                 16-Apr-08




          Total               6          Certified (provided by DFPS)                 2


          Eligibility Rate:                             33.3330%




Quarterly Eligibility Rate:                             30.7690%




                                                                                   TJPC-FIS-08-11
County:                               Example
Billing Period:                          0
                  Eligibility Determination Summary

                  Month:

                  PID #        Facility Name                         Date Placed
     1            a            Gulf Coast                                  18-Sep-07
     2            b            Pegasus                                      7-Jun-08
     3            c            Have Heaven                                  21-Jul-08




     Total                 3          Certified (provided by DFPS)                 1


     Eligibility Rate:                               33.3330%




                                                                                    TJPC-FIS-08-11
County:                              Example
Billing Period:                          0
                  Eligibility Determination Summary

                  Month:

                  PID #        Facility Name                         Date Placed
    1             a            Gulf Coast                                  18-Sep-07
    2             b            Pegasus                                      7-Jun-08
    3             c            Have Heaven                                  21-Jul-08
    4             d            Incentives                                   7-Mar-08




    Total                  4          Certified (provided by DFPS)                 1


    Eligibility Rate:                                25.0000%




                                                                                        TJPC-FIS-08-11
County:                                                 Example
Billing Period:                                            0

                                  Use Allowance
Equipment:            $ 19,454.00
Buildings:            $ 40,000.00

Data obtained from : 2007 Depreciation Schedule provided by Auditor's Office

                                        Annual       Quarterly
6 2/3% Equipment Use Allowance:     $    1,296.94   $   324.24
2% Buildings Use Allowance:         $      800.00   $   200.00

                                                    $    524.24




                                                                               TJPC-FIS-08-11

				
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Description: Iv E Foster Care Billing Forms document sample