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CSA Provider Tracking: Entering a FY14 Year

1. This information should be pre populated for you Review the information to ensure it is correct Please pay particular attention to the Fiscal Year Begin date for your entity The CFR must be reported Date 09 30 2014 Page 10 CSA Provider Tracking Entering a FY14 Year End CFR in CSA on the same time period as your entity s fiscal year end date so amounts can be traced through to the audited financial statements Step 4 Create a FY2014 Actual Year End CFR Shell To create a Year End actual click Actuals found on the main menu toolbar DE Illinois s ANN Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Click on the Actuals Tab to bring up the Actual List Since 2014 is the first year that you have submitted for your year end data using the CSA system you will see the following message rm Illinois ANAN Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Actuals Actual List Instruction Manual Actual List Your agency has not entered any actuals T Click Add Actual found at the bottom of the screen to add an actual record The system will display the Year End screen Step 5 Complete the 2014 Year End Registration All fields with a red asterisk are required Date 09 30 2014 Page 11 CSA Provider Tracking Entering a FY14 Year End CFR in CSA re Ill
2. Actual List Fiscal Year 2014 Form Type Year End Standard Weekly Hours 40 0 Status In work Back Delete Print Actual Add Program History Status Note By Bob In work Year End Created Smith 10 7 14 11 49 52 AM Date 09 30 2014 Page 13 CSA Provider Tracking Entering a FY14 Year End CFR in CSA ry Illinois p ANN Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Actuals Instruction Manual Ad d Ed it Prog ram Actual List Program Name Program Code Funding Agency DHS ha Description Save amp Add Another Program Cancel Enter the Program Name Required If this is a DHS agreement the Program Name is listed on your CSA agreement and also on the Supplemental listing of Programs to Be Reported on the FY14 CFR mailed to you in May 2014 If this is not a DHS agreement but one of the State of Illinois Health and Human Service agencies enter the associated program name Enter the Program Code Required If this isa DHS agreement the Program Code is listed on your CSA agreement and also on the Supplemental listing of Programs to Be Reported on the FY14 CFR mailed to in May 2014 If this is not a DHS agreement but one of the State of Illinois Health and Human Service agencies enter the associated program code if applicable Select a Funding Agency from the drop down menu that is associated
3. LPN Report Registered Licensed Practical Nurses on this line Occupational Therapist Report Registered Credentialed Occupational Therapist on this line Physical Therapist Report Registered Credentialed Physical Therapist on this line Physician Report Registered Credentialed Physician on this line Principal Report the Chief administrator of the education program on this line Program Director Overall program director Depending on size and structure of the agency this person may function only as an administrator or may also have direct programmatic duties such as counselors supervisor utilization review case review and may carry a clinical case load Costs may therefore be split between program and administration lines in the expense Date 09 30 2014 Page 33 CSA Provider Tracking Entering a FY14 Year End CFR in CSA 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 reports If there is a programmatic function performed by this person then the associated hours and wages allocated to program functions are to be reported here Program Clerical Staff Clerical staff who perform clinical record keeping client appointment tracking case note typing and filing Psychiatrist Report Registered Credentialed Psychiatrist on this line Psychologist Report Registered Credentialed Psychologist on this line Recreation Staff Report Recreation Director and Staff on this
4. 7 ClassifiCatlOMiOt esstteeee ses kesine Dinaar aSa nia e EEE EEEN 7 De COSTS a a E E OCEA 8 indirect F amp A COStsS 8 PAV ON COSTS sree cece cece cece cece te ce NAANA AEE T 9 Personnel Activity Reports PARS cccccccccccceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeess 9 Step 1 Login to the CSA Web Portal wn cssecesssscoceecsaceveeadecece vencedecadeceshevenerceenctcodeevencecoeactcocbveeueecdcbcececbeeeacks 9 Step 2 Check to see if a FY14 Year End CFR is still needed ccssscccccceseessssneeeeeeeessssssnnaeeeeeeesssesnaaes 10 Step 3 Ensure your year end entity date is correct 10 Step 4 Create a FY2014 Actual Year End CFR Shell ccccccccccccccccecceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeas 11 Step 5 Complete the 2014 Year End Registration 11 Step 6 Add orot eeeee 13 Step 7 Review Your Actual Program Listing 14 Step 8 Enter the Schedule of Program Costs cccscsssssecceceeeesseesnneeeeeecesseessneeeeeeseeseeesneeeeeeeesssesnaaaes 16 Step 9 Enter the Schedule of Program REVENUE ccssssccccccesssesssneeeeecesseeesneeeeeeeeeseeessaeeeeeeeesseenaaaes 26 Step 10 Enter the Report of Service Units 29 Step 11 Enter the Program ersoyn eeee 31 Step 12 Enter the Program Consultant and Contractual Expenses ccccccccccccceceececeeeeeeeeeeeeeeeeeeeeeeeess 37 St
5. 0 00 0 00 0 00 0 00 0 00 250 00 0 00 0 00 2600 00 4000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 2 600 00 4 250 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 13720 00 259000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 13 720 00 259 000 00 99 420 00 1 868 750 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 99 420 00 1 868 750 00 Date 09 30 2014 Page 18 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Program Expenses Direct program expenses 1 Program Staff Salaries Report the total expense of the wages of program staff here Including any anticipated accruals Salaries and wages should include vacation holiday or sick pay Do not report contracted staff or consultants on this line Contracted program staff including contracted temporaries should be reported on line 4 Do not report the cost of program clerical staff salaries on line 1 Clerical staff salaries are reported either on line 2 or 36 see instructions for line 2 The amount reported on lines 1 and 2 must match the total amount of costs reported on the Personnel Schedule Schedule F otherwise the CSA system will not allow you to submit the report 2 Program Clerical Staff Salaries The cost of clerical staff to type case notes or otherwise maintains specific client files which are directly attributable to the grant as a direct expense should be repo
6. 0 00 0 00 38 Rent Income 144000 00 0 00 0 00 144000 00 0 00 39 Gain on Sale of Asst 0 00 0 00 0 00 0 00 0 00 40 Cafe amp Vending Mach 0 00 0 00 0 00 0 00 0 00 41 1 Fundraising Events 1500000 00 649 410 00 0 00 848976 00 1614 00 41 2 0 00 0 00 0 00 0 00 0 00 41 3 0 00 0 00 0 00 0 00 0 00 41 4 0 00 0 00 0 00 0 00 0 00 42 Total Contributions amp Other 2 514 628 00 1 517 467 00 101 00 993 276 00 1 614 00 Investment Income 43 Restr Asst Inv Inc 0 00 0 00 0 00 0 00 0 00 44 Unrestr Asst Inv Inc 0 00 0 00 0 00 0 00 0 00 45 Total Investment Income 0 00 0 00 0 00 0 00 0 00 46 Total Revenues 9 271 971 00 1 559 467 00 57 949 00 5 303 276 00 383 109 00 Year End Main Page Jump To Revenue FC EMERGENCY SASS SHELTER soc FCS Show this Program only Show this Program only 0 00 0 00 98000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 1850000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 98 000 00 1 850 000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 18000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 18 000 00 0 00 0 00 0 00 0 00 1420 00 750 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 1 420 00 750 00 0 00 0 00 0 00 0 00 0 00 0 00 99 420 00 1 868 750 00 Date 09 3
7. 09 30 2014 Page 22 CSA Provider Tracking Entering a FY14 Year End CFR in CSA 31 Equipment Under 500 Expensed Building Equipment and Furnishings Assets costing more than 500 must be capitalized 32 Mortgage and Installment Interest Mortgage and installment interest is the cost of borrowing money for long term building needs Note that the interest costs on funds borrowed for construction incurred during the construction period must be capitalized as a part of the building cost and depreciated over the life of the building Operating interest is reported on line 33 below 33 Operating Interest Operating interest is the cost of money borrowed to meet short term recurring spending needs such as payroll telephone bills etc Non operating interest is reported on line 32 above 34 Other specify This line includes all ownership costs not identified above This would include but is not limited to Contracted security staff contracted facility maintenance and related services as well as required mortgage insurance These contractors make repairs and generally keep the physical plant in operating condition including contracted engineers Other specify can be typed over to identify the expense category 35 Total Occupancy Expense The total of lines 24 through 34 Administrative Expenses Note If you do not have an indirect rate established with either the Federal Government or DHS you will need to allocate the administrat
8. Abuse 29 Case Manager 30 Case Mar Ast 31 Health Educator 32 1 Fat 32 2 Job Coach 132 3 32 4 32 5 33 Total All Positions 1 Standard Weeky Howrn 40 0 25 QM 26 QMRP 22 RSA 38 Total All Positions 2 totals mest equal bee 1 bine 2 of the Schedule wf Program Casts were included in th of Une 33 Year End Main Page Provider Info Pring SavesRacaiculate Cancel My Into Total Agency 2040 00 0 00 0 00 4080 00 126600 00 42840 00 20400 00 20400 00 0 00 0 00 2040 00 4080 00 2040 00 6120 00 0 00 0 00 0 00 20400 00 142800 00 0 00 2040 00 Total Agency Ti Total Hours A t 50000 00 0 00 0 00 100000 00 1750000 00 131600 00 800000 00 495000 00 0 00 0 00 80000 00 140000 00 35000 00 255000 00 0 00 0 00 65000 00 500000 00 322000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 813400 00 35000 00 Facilities Budgets otal Head Count 1 00 0 00 0 00 2 00 67 00 21 00 10 00 10 00 0 00 0 00 1 00 2 00 10 00 7 00 Actuals Amount Not Allocated Logout Shaw thes Freatem pohy SEP INDIVIDUAL W 08 COACH sou Total Allocated Program Amount Total Head Count DD CILA 24 HOURS 600 100 00 Total Allocated Program Amount 50000 00 0 00 0 00 50000 00 1500000 00 121600 00 0 00 613400 00 0 00 0 00 0 00 0 00 3 300 000 00 0 00 0 00 0 00 0 0
9. Diagnostic Svc Fees 0 00 0 00 0 00 0 00 0 00 15 1 Other Specify 0 00 0 00 0 00 0 00 0 00 15 2 0 00 0 00 0 00 0 00 0 00 15 3 0 00 0 00 0 00 0 00 0 00 15 4 0 00 0 00 0 00 0 00 0 00 16 Total Fees Purchase of Services 6 198 000 00 0 00 0 00 4 250 000 00 0 00 Grant Revenues 17 Dept of Aging 0 00 0 00 0 00 0 00 0 00 18 Dept of Ch amp Fam Svc 0 00 0 00 0 00 0 00 0 00 19 Dept of Corrections 0 00 0 00 0 00 0 00 0 00 20 DFI CFI 0 00 0 00 0 00 0 00 0 00 21 Dept of Human Svcs 439343 00 0 00 57848 00 0 00 381495 00 22 Dept of Public Aid 0 00 0 00 0 00 0 00 0 00 23 Dept of Pub Health 0 00 0 00 0 00 0 00 0 00 24 Loc Edu Agcy Sch Dis 0 00 0 00 0 00 0 00 0 00 25 Local Gov Awards 0 00 0 00 0 00 0 00 0 00 26 Federal Gov Awards 0 00 0 00 0 00 0 00 0 00 27 Other Gov Awards 0 00 0 00 0 00 0 00 0 00 28 JTPA CETA 0 00 0 00 0 00 0 00 0 00 29 1 Private Foundation 120000 00 42 000 00 0 00 60000 00 0 00 29 2 0 00 0 00 0 00 0 00 0 00 29 3 0 00 0 00 0 00 0 00 0 00 29 4 0 00 0 00 0 00 0 00 0 00 30 Total Grant Revenues 559 343 00 42 000 00 57 848 00 60 000 00 381 495 00 Contribution amp Other 31 Restricted to Oper 840628 00 840 628 00 0 00 0 00 0 00 32 Restricted to Cap 0 00 0 00 0 00 0 00 0 00 33 Unrestricted 30000 00 27 429 00 101 00 300 00 0 00 34 Cont Goods amp Svcs 0 00 0 00 0 00 0 00 0 00 35 Ch amp Adult Food Prog 0 00 0 00 0 00 0 00 0 00 36 Sch Trans Payments 0 00 0 00 0 00 0 00 0 00 37 Sales of Goods amp Svcs 0 00 0 00 0 00
10. End Main Page You will notice that by entering in your program name one time the program name will appear on all subsidiarity schedules The CFR Summary Program and Schedules Go to Table Jump To The Go to Table Jump To drop down menu found in the upper right hand portion of your screen is used to display the various report schedules The following report schedules are available from the drop down menu Summary Programs Schedule of Program Costs Schedule of Program Revenue Report of Service Units Program Personnel and Program Consultant and Contractual Summary The Summary table draws data from the various schedules and is information only There is not data entry needed on this page Select the Summary option from the Go to Table Jump to drop down menu to access the Summary screen All information on the Summary is calculated from subsidiary schedules Click Print to display a printable copy of the Year End Summary Click the Year End Main Page link to display the Year End screen Date 09 30 2014 Page 15 CSA Provider Tracking Entering a FY14 Year End CFR in CSA res Illinois ANP Department of Human Services Home Contracts Provider Info Summary Expenses Revenues Total Program Expenses Total Support Expenses Total Occupancy Expenses Total Administrative Expenses Total Expenses Total Non Reimburseable Expenses Net Expenses Total Fees Purchases of Services Total Grant Revenues Tota
11. Functional Expenses Program Total This should not include any general and administrative indirect expense Start by entering in your total Total Agency Column from your audited financial Statement of Functional Expense Program Total Note If you need to add additional lines or different descriptions you can do so by typing in the white area labeled as other Moving from left to right allocate your costs to the appropriate program Please remember that this form is to be completed on your fiscal year end basis For each program enter in all relevant cost whether allowable or nonallowable This will capture the program s total cost not just those costs paid by DHS Total costs are reported on lines 1 44 This also includes non reimburseable expenses The non reimburseable expenses are reported seperately on lines 45 48 where they are deducted from the total expenses to result in the net expense calculated on line 49 Use the other specify line for items not readily defined When entering please use a positive amount in these fields Be sure to include all costs related to the other State of Illinois Department of Health and Human Sister agencies including Department of Aging Department of Healthcare and Family Services Department of Children and Family Services and Department of Public Health The system will automatically calculate the other costs in the other not allocated column for you The user must be sur
12. cstonesupport com Date 09 30 2014 Page 4 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Relationship of the CFR to the Audited Statement of Functional Expenses The Statement of Functional Expenses is a required part of the financial statements for a non profit entity The CFR when completed will be able to be traced into your Statement of Functional Expenses A B c D E F G H I J 1 CSA Training 3 Inc 2 Statement of Function Expenses 3 For the Year Ended June 30 2014 4 Programs 5 Individ Total Services in 6 With Job DDCila24 Mental Health Spec FC Research For Mgmt amp Expenses 7 Coaching Hours Ctr Standardized SASS Longevity Total General 2014 8 Salaries and Wages 35 000 3 300 000 240 000 22 000 1 100 000 875 000 5 572 000 860 000 6 432 000 9 Employee Health amp Retirement Benefits 41 000 12 000 1 100 75 000 70 000 199 100 147 000 346 100 10 Payroll Taxes 8 500 710 000 72 000 9 000 410 000 238 250 1 447 750 72 000 1 519 750 11 Total Salaries amp Related Benefits 43 500 4 051 000 324 000 32 100 1 585 000 1 183 250 7 218 850 1 079 000 8 297 850 12 13 Professional Fees Contract Services 80 000 80 000 100 000 180 000 14 Supplies 313 000 1 500 20 500 85 000 420 000 25 750 445 750 15 Telephone 1 400 4 200 4 500 10 100 12 000 22 100 16 Postage and Shipping 2 500 2 500 17 Occupancy 65 000 65 000 5 500 70 500 18 Equipment Rental amp Maintenance 30 000 2 600
13. following costs e Janitorial and Other Maintenance Supplies e Building and Grounds Maintenance Supplies e Equipment Maintenance e Electricity and Utilities e Property Building Insurance 27 Vehicle Depreciation List here the cost of vehicle purchases less applicable salvage value over their established useful lives Usually over a 3 year period If you used an accelerated depreciation method the dollar amount of the accelerated depreciation which exceeds the amount that would be calculated using the straight line method should be reported on line 47 in the non allowable cost section 28 All other Depreciation and Amortization List here the allocation of the cost of physical assets over their established useful lives Note that vehicle depreciation is reported separately on line 27 above Provision for depreciation is intended to spread the cost of such assets over the period their use benefits the program or supporting activities of the agency If you used an accelerated depreciation method the dollar amount of the accelerated depreciation which exceeds the amount that would be calculated using the straight line method should be reported on line 47 in the non allowable cost section 29 Vehicle Rent The cost of rented or leased vehicles 30 All other Lease Rent Taxes The cost of leasing property and equipment excluding vehicle rent expenditures reported on line 29 above Property taxes are also reported on this line Date
14. holidays and sick time are included in the sum of amounts paid and accrued For example assume the following caseworker staffing history for an agency with a standard eight hour day and 260 working days in a year Caseworker of Working Hours Paid Wages Paid Name Period on Staff Working Days Hours Paid and Wages Paid and Days Accrued Accrued Craig 7 1 95 6 30 96 260 2 080 24 960 Tom 7 1 95 6 30 96 260 2 080 24 960 Andy 4 1 96 6 30 96 65 520 6 240 Roger 7 1 95 10 31 96 87 696 8 352 Nyle 7 1 95 5 30 96 239 1 912 22 944 Totals 7 288 87 456 In this example 7 288 hours were paid and accrued The 7 288 would be reported in the Total Hours column 87 456 would be reported in the Total Amount Paid column Total Head Count Record the end of year head count in that salary position Allocated This column is calculated by the software for you based on the proportion of salaries entered across programs Date 09 30 2014 Page 32 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Salaries and Wages Under the Program Headings Enter the dollars allocated to each program for salary and wage costs under the proper program headings and within the appropriate position description lines Standard Weekly Hours Identify the number hours in a normal work week For example if the work day begins at 8 30 and ends at 5 00 with a one hour lunch between the w
15. individual clients with special needs where the items purchased become the property of the individual rather than the agency Client allowances are also reported here Clothing and allowances must also be reported on Line 47 14 Telecommunications Costs Assigned to Program List here the portion of the total telephone expense that is associated with utilization by either client in their living quarters or by direct service staff The remaining portion of the total telephone costs is reported in the Date 09 30 2014 Page 20 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Administrative Expense section 15 Foster Care Payments Payments made from the provider agency to the foster parent for foster care services This is commonly referred to as the Board Payment 16 Other specify Other program costs not logically reported in the above lines Other specify can be typed over to identify the expense category 17 Total Program Expenses The total of lines 1 through 16 Support Expense Support expenses have been historically defined for the DD and DMH divisions as those costs that are associated with providing meals and housekeeping services that are direct expenses to the grant 18 Support Salaries List here the accrued salary cost associated with dietary laundry and housekeeping Salaries and wages should include vacation holiday or sick pay Do not report contracted staff or consultants on this line Contract
16. with this program Note all State of Illinois Department of Health and Human Service agencies should be reported on your 2014 CFR Enter a program Description For DHS agreements enter the applicable contract number here This will not appear on the subsidiary schedules Click Save amp Add another Program to save the screen and to add another Program to the Actual The system will clear the Add Edit Program screen Click Save when all programs have been added The system will display the Actual Programs screen with list of all added programs Click Cancel to cancel the screen and return to the Actual Programs screen Step 7 Review Your Actual Program Listing Actual Programs The table will display the following information Program Name Program Code and Funding Agency Click the Program Name link found in the Actual Programs table to view edit an existing Program The system will display the Add Edit Program screen The Jump to drop down menu is used to display the various other schedules Date 09 30 2014 Page 14 CSA Provider Tracking Entering a FY14 Year End CFR in CSA re Illinois Suse Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Programs Jump To Program i Program Name Code Funding Agency SEP INDIVIDUAL W JOB COACH 39U DHS DD CILA 24 HOURS 60D DHS PSYCHIATRIST SERVICE IN MENTAL 350 DHS FC EMERGENCY SHELTER FCS DCFS SASS soc DHFS Print Year
17. your login information with anyone No representative of DHS will ever ask for your password Enter the User ID and Enter the Password first time users will receive a temporary password from DHS Click Login Date 09 30 2014 Page 9 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 2 Check to see if a FY14 Year End CFR is still needed Illinois Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout CSA Tracking Provider Access Actual s needing your attention FY2014 Year End Add Actual Click on Home Tab If you have not submitted a FY14 Year End Report you will receive a reminder on this page that the report is still needed Once you have submitted your report for FY14 this alert will drop off from your home screen Step 3 Ensure your year end entity date is correct Click on Provider Info Tab re Illinois Aw Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Provider Info Name CSA TRAINING 3 FEIN 333333333 Administrative Office D U N S Number 999999999 Administrative Office Address Address is auto filled updated after a valid DUNS is entered and saved Ownership Type Not For Profit z Basis of Maintaining Accounting Records Accrual Fiscal Year Begin Month Day 7 1 By checking this box I certify that all information provided above is correct and complete
18. 0 0 00 Total Head Count 1 00 0 00 0 00 1 00 64 00 20 00 0 00 0 00 0 00 0 00 0 00 1 00 1 00 2 00 0 00 0 00 0 00 10 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 25 00 0 00 0 00 0 00 0 00 125 00 0 00 0 00 0 00 0 00 aso Show thin Program asly Total Allocated Program Amount 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 15 20 20000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 100 00 20000 00 0 00 0 00 0 00 0 00 29 41 75000 00 0 00 0 00 0 00 0 00 100 00 65000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 240 000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 PSYCHIATRIST SERVICE IN MENTAL HEALTH CENTER Total Head Count 0 0C 0 0C 6 0C o oc o oc 1 0c o oc ooc 0 0c 1 0C o oc o oc 1 0c 0 07 0 07 1 00 0 0C 0 0c o oc o oc 0 0c 0 07 0 0C 0 0c 0 0c o oc o oc 0 0c 0 0c 0 0C 0 0C o oc 0 0c 0 0c 0 0C 4 00 o oc 0 0c 0 0C 0 0c Enter the entity s total personnel costs based upon your entity s fiscal year Additional descriptions can be created by using the other rows in white and then specifying position titles All DHS and funding associated with the State of Illinois Sister Health and Human Service Agency programs should be listed her
19. 0 0 0C 33 Total All Positions 1 2 040 00 80 000 00 1 00 0 00 0 00 0 00 80 000 00 1 00 0 00 o oc 34 MHP 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 08 35 QMHP 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 26 QMRP 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c a2 RSA 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 38 Total All Positions 0 00 9 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C C2yTetats must equal Boe 4 of the 4 Schedule of Program Costs nto the following MHP QMMP QM cus Unes 34 3 ware inchuds Prnt Cancel Year End Main Page 9 22 Date 09 30 2014 Page 37 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 13 Review the Summary Page and Submit the Report e Goto the Summary Page Review for accuracy Make any edits if needed e Click Submit to submit an actual found on the Actual screen The system will update the Actual History and Status e If after submitting a report you determine that a new report is needed click Unsubmit to confirm the un submission of the Actual for approval The Unsubmit button will only be available after the Actual has been submitted for Approval e Once this action is taken your Year End CFR will be automatically migrated for you to the CRV re Illinois AS Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Hel
20. 0 00 0 00 0 00 0 00 17 Total Program Expenses 7 531 051 00 1 121 901 00 49 850 00 4 343 000 00 328 200 00 Support Expenses 18 Support Salaries 0 00 0 00 0 00 0 00 0 00 19 Payl Tax amp Fringe Ben 0 00 0 00 0 00 0 00 0 00 20 Dietary Supplies 241500 00 0 00 0 00 240000 00 1000 00 21 Housekeeping amp Laundry 11500 00 0 00 0 00 11000 00 500 00 22 1 Other Specify 0 00 0 00 0 00 0 00 0 00 22 2 0 00 0 00 0 00 0 00 0 00 22 3 0 00 0 00 0 00 0 00 0 00 22 4 0 00 0 00 0 00 0 00 0 00 23 Total Support Expenses 253 000 00 0 00 0 00 251 000 00 1 500 00 Occupancy Expenses 24 Occupancy Salaries 0 00 0 00 0 00 0 00 0 00 25 Payl Tax amp Fringe Ben 0 00 0 00 0 00 0 00 0 00 26 Building amp Eqmt Oper 90000 00 0 00 0 00 90000 00 0 00 27 Vehicle Depreciation 65250 00 65 000 00 0 00 0 00 0 00 28 All Oth Depre amp Amort 0 00 0 00 0 00 0 00 0 00 29 Vehicle Rent 6600 00 0 00 0 00 0 00 0 00 30 Other Lease Rent Tax 30000 00 0 00 0 00 30000 00 0 00 31 Equipment lt 500 0 00 0 00 0 00 0 00 0 00 32 Mortgage amp Interest 0 00 0 00 0 00 0 00 0 00 33 Operating Interest 0 00 0 00 0 00 0 00 0 00 34 1 Misc 1200 00 0 00 0 00 1200 00 0 00 4 0 00 0 00 0 00 0 00 0 00 34 3 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 35 Total Occupancy Expenses 193 050 00 65 000 00 0 00 121 200 00 0 00 Admin amp Office Expenses 36 Admin Salaries 0 00 0 00 0 00 0 00 0 00 37 Payl Tax amp Fringe Ben 0 00 0 00 0 00 0 00 0 00 38 Consultants 0 00 0 00 0 00 0 00 0 00
21. 0 2014 Page 27 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Enter the entity s total revenues based upon your entity s end date Enter the applicable sources and amounts of revenues for each reported program This should include all DHS agreements as well as revenue pertaining to the other State of Illinois Health and Human Service Sister agencies Any differences will be automatically calculated in the all other not allocated column Svc Fee for Ind Cl Line 13 is for reporting special service fees for individual client revenues Fees amp Purchase of Service List here payments made for specific individuals for a specific program service Usually for service provided at a specific date and time or continuously over a period of enrollment Payments may be from a public or private source including units of government education individuals or third party payers This includes payments assessed to an individual or family receiving the service such as fees sliding fees and assessments against pensions Social Security Supplemental Security food stamps survivor benefits insurance etc Also includes specific fees for add on services provided within a larger program context e g add on fees for one on one aide Grant Revenues Funding awarded toward full or partial support of a specific program service or agency or facility serving an identified or targeted population Funding may be provided by a public o
22. 39 Telecom Costs 0 00 0 00 0 00 0 00 0 00 40 Office Supp amp Equip 0 00 0 00 0 00 0 00 0 00 41 Alloc of Mmt and Gen 1294870 00 372 566 00 8099 00 588076 00 53409 00 42 1 Other Specify 0 00 0 00 0 00 0 00 0 00 42 2 0 00 0 00 0 00 0 00 0 00 42 3 0 00 0 00 0 00 0 00 0 00 42 4 0 00 0 00 0 00 0 00 0 00 43 Total Administrative Expenses 1 294 870 00 372 566 00 8 099 00 588 076 00 53 409 00 44 Total Expenses 9 271 971 00 1 559 467 00 57 949 00 5 303 276 00 383 109 00 Non Reimburseable Expenses 45 Depr on DMHDD 30000 00 0 00 0 00 30000 00 0 00 46 Prod Cst amp Wrksh Cl Wg 0 00 0 00 0 00 0 00 0 00 47 1 Non Reimburseable 1301 00 0 00 101 00 1200 00 0 00 47 2 0 00 0 00 0 00 0 00 0 00 47 3 0 00 0 00 0 00 0 00 0 00 47 4 0 00 0 00 0 00 0 00 0 00 48 Total Non Reimburseable Exp 31 301 00 0 00 101 00 31 200 00 0 00 49 Net Expenses 9 240 670 00 1 559 467 00 57 848 00 5 272 076 00 383 109 00 Save amp Recalculate Year End Main Page Jump To Cost X FC EMERGENCY SASS SHELTER soc Fes Show this Program only Show this Program only 22 000 00 1 100 000 00 22000 00 1100000 00 0 00 0 00 10100 00 485000 00 0 00 0 00 0 00 0 00 0 00 20000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 51000 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 83 100 00 1 605 000 00 0 00 0 00 0 00 0 00 0 00 500 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 500 00 0 00 0 00
23. 4 000 36 600 25 000 61 600 19 Outside Printing 14 500 14 500 20 Local Transportation 4 000 4 000 4 000 21 Educational conferences 4 000 4 000 22 Subscriptions amp Reference publications 120 120 23 Special Assistance to Individuals 51 000 51 000 51 000 24 Membership dues 25 Miscellaneous 101 1 200 1 301 1 500 2 801 26 Total Expenses before Depreciation 1 501 424 200 5 700 53 600 24 500 158 500 668 001 190 870 d 858 871 27 28 Depreciation 90 000 250 90 250 25 000 115 250 29 Total Expenses 45 001 4 565 200 329 700 85 700 1 609 750 1 341 750 7 977 101 1 294 870 9 271 971 w A quick refresher 2 CFR Part 200 Guidance for Direct Costs and Indirect Cost Classification As mentioned previously this template and associated definitions included in this manual were initially developed to capture Medicaid costs As we continue to streamline and standardize cost elements for all DHS agreements and rules are promulgated by the Federal HHS agency as well as the State of Illinois Grant Accountability and Transparency Unit these definitions for this manual will continue to be updated Caution should be exercised to accurately report direct indirect allowable and unallowable costs related to your program cost objective A quick refresher of those definitions is found in 2 CFR Part 200 which is sometimes referred to as the new Federal Super bill There are pr
24. 8 Date 09 30 2014 Page 30 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 11 Enter the Program Personnel The user must be sure that line 33 on the Program Personnel table is equal to the sum of lines 1 and 2 on the Schedule of Program Cost table or a actuals submission will result in an input error Select the Personnel option from the Go to Table Jump to drop down menu to access the Program Personnel screen e Click Print to display a printable copy of the Program Personnel Click Save amp Recalculate to save the table and recalculate the newly entered figures Click Cancel to cancel the screen and return to the Actuals List screen Click the Year End Main Page link to display the Year End screen res Mlinois AY Department of Human Services Home Contracts Program Personnel Program Staff Positions J Audologist 2 Behavior Therapist 3 Dietary Technician 4 Dietitian S Habil Aide CC aide G Haba Prof Sup Staff 2 LPN Q Occup Therapist 9 Physical Therapist 39 Physician 11 Principal 12 Program Director 13 Prog Clerical Staff 14 Psychiatrist 15 Psychologist AG Recreation Staff 12 Registered Nurse 18 Social Worker 119 Speech Therapist 20 Subs Abuse Counselor 21 Subs Abuse Paraprof 22 Teacher 22 Teacher Aide 24 Vocational Staff 25 Other Academic Inst 26 Other Medical Care 27 Other Habil Rehab 28 Other Subs
25. CSA Provider Tracking Entering a FY14 Year End CFR in CSA E A G DHS Mission To assist our customers to achieve maximum self sufficiency independence and health through the provision of seamless integrated services for individuals families and communities Illinois Department of Human Services FY 14 DHS Provider Year End Consolidated Financial Report CFR User Manual Version 1 9 12v4 Effective Date 10 9 2014 Date 09 30 2014 Page 1 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Table of Contents Background About DHS Year End Cost Reporting Using the Consolidated Financial Report CFR 3 Why does DHS Require the Collection of Year End Cost Data 3 Where are your requirements outlined and when are the reports due P 4 Where is the information entered and how are reports submitted 4 Who do you call if you have issues with the CRV or need a CSA password reset ccssscccceeeessessseees 4 Relationship of the CFR to the Audited Statement of Functional Expenses ccccccccccccceeeeeeeeeeeeeeeeees 5 A quick refresher 2 CFR Part 200 Guidance for Direct Costs and Indirect Cost Classification 5 COMPOSITION Of COSTS ccccessssccccceeessesnnnneeeeeeesseesnnaaeeeeeeessseeenaaeeeeeesesseeenaaseeeeesssseesaaseeeeeesssseennaaeeeeegs 6 Factors Affectine looeostttee 6 Reasonable Costs 6 All Cable
26. R soc 39U Fcs 350 Unit Type Hours Days x Days x Nights Days x of Clients Served 0 0 0 0 0 Client Units of Enrollment 0 0 0 0 0 Client Units Delivered Provided 2759 20951 614 10950 84500 Number of Days Program Operated 240 366 185 365 365 License Capacity Beginning of Report Period 1 18 58 0 0 0 License Capacity End of Report Period 1 18 58 0 0 0 Date of Change 1 Report Maximum Approved Program Capacity for Programs that do not require a license Year End Main Page Date 09 30 2014 Page 29 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Unit Type A unit of service is a method of measuring the volume of care that has been rendered ina given program Select the appropriate unit type from the drop down menu Refer to the CSA Attachments and Program Manuals or the appropriate Department Program Division personnel for assistance in determining Service Unit Type For DHS agreements starting with 43 DASA contact Rick Nance at 217 557 6706 For DHS agreements starting with 44 DDD contact Dan Blair at 217 524 8489 For DHS agreements starting with 45 DMH contact Cheri Wehmhoff at 217 557 8571 For DHS agreements starting with 46 DRS contact Cassie Laird at 217 557 7764 For DHS agreements starting with FCS contact Cynthia Ragusa at 217 782 5901 or Barb Payne at 217 785 0480 Of Clients Served This should be an unduplicated client count of the clients served durin
27. Year End CFR was included in that mailing In addition in the Spirit of the Management Improvement Initiative forum all revenues and costs associated with the other four State of Illinois Sister Health and Human Service Agencies should also be reflected on the CFR One of the primarily goals of the data collection is to be able to provide the legislature with a true and accurate picture of how much it costs to run the various programs and how the programs are currently being funded Where is the information entered and how are reports submitted Beginning with the FY14 CFR reports all data should be entered into the CSA Community Service Agreement Portal available on the Internet at https grants dhs illinois gov gpsecure gtp This user manual provides instruction on how to navigate and enter data into the CSA system Once you finish your report and click on submit report it will automatically be posted and filed in the Central Repository Vault CRV for you You can also print this report out in pdf format for your accountant Who do you call if you have issues with the CRV or need a CSA password reset If you have trouble registering for the Central Repository Vault contact Aaliyah Bannister Batie at 312 793 4094 or email the CRV Support team at DHS CRV Support illinois gov If you need to register for the CSA or need a password reset to CSA please contact the help desk at 1 866 791 4554 or email the help desk at customerservice
28. al requirements Date 09 30 2014 Page 3 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Where are your requirements outlined and when are the reports due As outlined in Article XVII of the FY14 Community Services Agreement Consolidated Financial Reports CFR a Applies to all Providers unless exempted by program rules regulations or policies b Providers shall submit Consolidated Financial reports within 180 days after the Provider s fiscal year ending on or after June 30 2014 a Inthe discretion of the DHS Chief Financial Officer this deadline may be extended up to nine 9 months after the end of Provider s fiscal year without approval from the cognizant Federal Agency b This deadline may be extended longer than nine 9 months after the end of the Provider s fiscal year continengent upon approval by the Cognizant Federal agency c The Consolidated Financial Report must cover the same period as the Audited Financial Statements cover d Consolidated Financial Reports must include an opinion from the report issuer on the Cost and Revenue Schedules included in the Consolidated Financial Report e Consolidated Financial Reports shall follow a format prescribed by DHS As required by Administrative Rule Section 507 all providers were sent a notice of FY14 Year End Financial Reporting requirements in May 2014 A supplemental listing of the DHS programs that would need to be reported on the FY14
29. e Date 09 30 2014 Page 31 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Position Column Not all positions at an agency are listed here The only positions listed are those that are necessary to support rate computations federal claiming calculations or other data collection needs Positions not listed should be reported on line 32 only if they are classified as program staff The totals of all positions reported here should match the total on line 1 and 2 of the Cost schedule The position column lists staff positions for which there are a set of uniform job descriptions The position descriptions are intended to be functional in nature Therefore staff reasonably fitting into job descriptions should be reported under the associated position title The position descriptions are largely based on those used by the United Way A description of each position is included at the end of these instructions Total Hours Record the total number of hours paid and accrued including overtime hours for each position title filled during the year or any portion thereof Paid vacation holidays and sick time are included in the sum of hours paid and accrued Because salaried positions are not paid for overtime record only the non overtime hours worked Total Amount Paid Record the total dollars paid and accrued including overtime hours for each position title filled during the year or any portion thereof Paid vacation
30. e that the sum of lines 1 and 2 on the Schedule of Program Costs table equals line 33 on the Program Personnel table or an actuals submission will result in an input error Select the Costs option from the Go to Table Jump to drop down menu to access the Schedule of Programs Costs screen Click Print to display a printable copy of the Schedule of Program Costs Click Save amp Recalculate to save the table and recalculate the newly entered figures Click Cancel to cancel the screen and return to the Actuals List screen Click the Year End Main Page link to display the Year End screen Total Agency and Program Totals are based on the entity s fiscal year Note The definitions presented below are from the historical definitions that have been developed and used by our DDD and DMH divisions so the definition represented below for support costs occupancy and general and administrative or indirect expenses might not capture your standard definition of those costs The definitions are intended to guide completion of the report only Those costs clearly identifiable to a cost objective should be classified as direct Those costs that cannot be easily traced to a cost objective should be considered an indirect cost See more explanation in 2 CFR Part 200 Date 09 30 2014 Page 17 CSA Provider Tracking Entering a FY14 Year End CFR in CSA re Illinois Sse Department of Human Services Home Con
31. ed staff and consultants are reported on line 22 19 Support Staff Payroll Taxes and Fringe Benefits List here the portion of the cost of payroll taxes and fringe benefits allocated to Support Staff reported in line 18 These costs include e Employee Health and Retirement Benefits paid by an agency under its own or other employee health and retirement benefit plan e Payroll Taxes are the sum of the social security and other taxes payable by the employer under federal state or local law e Worker s Compensation Insurance e Other Employee Benefits provided to the employee at employer expense 20 Dietary Supplies Costs included here would be those supplies related to food and beverages and other kitchen supplies Non capitalized kitchen equipment expenses within the guidelines should also be included here 21 Housekeeping and Laundry Supplies Costs included here would be housekeeping supplies and laundry and linen supplies 22 Other specify Include contracted support services This could typically include contracted food services or contracted housekeeping staff Include other support costs not logically reported in the above lines 23 Total Support Expense The total of lines 18 through 22 Occupancy Expenses Occupancy expenses have been historically defined for the DD and DMH divisions as all costs arising from an agency s occupancy and use of land buildings and offices This includes maintenance salaries depreciation
32. education they are included in the facilities category Major nonprofit organizations are those which receive more than 10 million dollars in direct Federal funding Date 09 30 2014 Page 8 CSA Provider Tracking Entering a FY14 Year End CFR in CSA b Diversity of nonprofit organizations Because of the diverse characteristics and accounting practices of nonprofit organizations it is not possible to specify the types of cost which may be classified as indirect cost in all situations Identification with a Federal award rather than the nature of the goods and services involved is the determining factor in distinguishing direct from indirect costs of Federal awards However typical examples of indirect F amp A cost for many nonprofit organizations may include depreciation on buildings and equipment the costs of operating and maintaining facilities and general administration and general expenses such as the salaries and expenses of executive officers personnel administration and accounting Section 414 Payroll Costs In regards to Payroll costs charges to awards for salaries and wages whether treated as direct cost or indirect costs will be based on documented payrolls approved by a responsible official s of the organization subparagraph 8 m 1 of Appendix B to 2 CFR Part 230 Personnel Activity Reports PARS The distribution of salaries and wages to awards must be supported by personnel activity reports PARS ref
33. ep 13 Review the Summary Page and Submit the REport ccccecsssssssseseeeseeeeeeeeeeeeeeeesaeaeaaaaaaaaaaees 38 Date 09 30 2014 Page 2 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Background About DHS Year End Cost Reporting Using the Consolidated Financial Report CFR The Consolidated Financial Report CFR is a standardized cost reporting template The use of this template to collect year end costs was agreed to by the five State of Illinois Health and Human Services Agencies during a collective effort known as the Management Improvement Initiative MIIC The template was voted on to be able to serve both as a standardized budget and year end cost reporting form and actually the first version was created close to twenty years ago in an effort to standardize cost data collection primarily in the Medicaid arena The Management Improvement Initiative was signed into law on August 25 2011 as Public Act 97 0558 and mandates that State of Illinois Health and Human Service agencies continue to streamline and reduce financial reporting redundancy that is placed upon providers so that more of their time can be spent in delivering front line services The MIIC committee modified the template so that it met minimum federal reporting requirements The FY14 Year End CFR template utilizes the same format and the same schedules as the Budget CFR which has been used in the DHS FY14 and FY15 budget cycles Also as noted earli
34. er many of the DHS providers have also historically reported year end cost data using this CFR template for many years primarily in the Division of Mental Health and Division of Developmental Disability On July 16 2014 Public Act 98 706 was signed into law by Governor Quinn This law is also referred to as the Grant Accountability and Transparency Act The purpose of this act is to develop a coordinated non redundant process for the provision of effective and efficient oversight of the selection and monitoring of grant recipients It is intended to continue with the efforts of the Management Improvement Initiative and to increase the accountability and transparency in the use of grant funds from whatever source and to reduce administrative burdens on both State agencies and grantees by adopting uniform rules The timeline for implementation of those rules is July 1 2015 The FY14 DHS Year End CFR template is composed of seven schedules o The Year End CFR Summary The Schedule of Reported Programs The Schedule of Program Revenue The Schedule of Program Costs The Report of Service Units Program Personnel Program Consultant and Contractual O OO O O Q Why does DHS Require the Collection of Year End Cost Data Federal administrative requirements issued via OMB Circulars require year end cost reporting data to be submitted by our providers Please reference 2 CFR 200 Code of Federal Regulations Section 200 201 for specific feder
35. es Costs of production include staff salaries Date 09 30 2014 Page 24 CSA Provider Tracking Entering a FY14 Year End CFR in CSA and wages staff fringe benefits client salaries and wages client fringe benefits consultants contractual workers consumable supplies occupancy transportation expensed equipment purchases lease rent interest depreciation and other miscellaneous expenses Cost of production may be reported in Regular Work Vocational Development and Developmental Training The portion of expenses that have already been reported that fall within this classification should also be reported here For State funded vocational programs or developmental training DT programs the expense of clients wages is not reimbursable when the product or service is salable Client wages and fringe benefits if any which are not related to the salable products and services may be reported on line 16 Program Expenses Other 47 Other specify For costs that are Non Reimbursable 48 Total Non Reimbursable Expenses This is the sum of lines 45 47 49 Total Net Expenses is line 44 Total Expenses Sum Lines 17 23 35 43 minus line 48 Total Non Reimbursable Expenses Date 09 30 2014 Page 25 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 9 Enter the Schedule of Program Revenue Select the Revenue option from the Go to Table Jump to drop down menu to access the Schedule of Program Re
36. esented below for your reference Cost objective A program function activity award organizational subdivision contract or work unit for which cost data are desired and for which provision is made to accumulate and measure the cost of processes products jobs capital projects etc A cost objective may be a major function of the non Federal entity a particular service or project a Federal award or an indirect facilities and administrative F amp A cost activity Section 200 28 Date 09 30 2014 Page 5 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Composition of Costs Total cost The total cost of a Federal award is the sum of the allowable direct and allocable indirect costs less any applicable credits Section 200 402 Factors affecting allowability of costs Except where otherwise authorized by statute costs must meet the following general criteria in order to be allowable under Federal awards a Benecessary and reasonable for the performance of the Federal award and be allocable thereto under these principles Conform to any limitations or exclusions set forth in these principles or in the Federal award as to types or amount of cost items c Be consistent with policies and procedures that apply uniformly to both federally financed and other activities of the non Federal entity Be accorded consistent treatment A cost may not be assigned as a direct cost if any other cost incurred fo
37. for which it was originally required See also Section 200 310 insurance coverage through 200 316 property trust relationship and 200 439 Equipment and other capital expenditures iv If the contract is subject to CAS costs must be allocated to the contract pursuant to the Costs Accounting Standards To the extent that CAS is applicable the allocation of costs in accordance with CAS takes precedence over the allocation provisions in this part Section 200 405 Classification of costs There is no universal rule for classifying certain costs as either direct or indirect F amp A under every accounting system A cost may be direct with respect to some specific service or function but indirect with respect to the Federal award or other final cost objective Therefore it is essential that each item of cost incurred for the same purpose be treated consistently in like circumstances either as direct or an indirect F amp A cost in order to avoid possible double charging of Federal awards Guidelines for determining direct and indirect F amp A are provided in subpart 2 CFR Part 200 413 and 200 414 Section 200 412 Date 09 30 2014 Page 7 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Direct Costs a General Direct costs are those costs that can be identified specifically with a particular final cost objective such as a Federal award or other internally or externally funded activity or that can be internally
38. g the reporting period Unduplicated clients are those that are counted once per program regardless of the number of repeat admissions Client Units of Enrollment The number of admissions to the program the process of initiating services to an individual through specified protocols e g screening assessment and processing entrance to service Client Units delivered provided Report the number of actual service units measured in the defined service unit rendered in the program during the reporting period Number or Days Program Operated The number of days the program operated is then reported For example a program that was in operation for a full year and is reporting a full year of operations would report 365 days For reporting purposes here count holidays and weekends as working days License Capacity Beginning of Report Period If the program is licensed and has a licensed capacity identify the licensed capacity at the beginning of the reporting period License Capacity End of Report Period If the program is licensed and has a licensed capacity identify the licensed capacity at the end of the reporting period Date of Change If a change has occurred in the capacity the date of the change should be reported The date of change should be formatted as mm dd yyyy The dashes between the month day and year are important for the date to be properly formatted Also note that the year is formatted for 4 digits 199
39. gist with specialized training in mental health services A licensed social worker possessing a master s or doctoral degree in social work with specialized training in mental health services A licensed registered nurse with at least 1 year of clinical experience ina mental health setting or a Master s Degree in psychiatric nursing A registered occupational therapist with at least 1 year of clinical experience in a mental health setting An individual possessing a master s or doctoral degree in counseling and guidance rehabilitation counseling or family therapy or related field who has successfully completed a practicum and or internship which includes a minimum of 1 000 hours or who has one year of clinical experience under the supervision of a qualified mental health professional or who is a licensed social worker holding a master s degree with 2 years of experience in mental health services 32 Qualified Mental Retardation Professional QMRP A QMRP must have at least 1 year of experience working directly with individuals with mental retardation or other developmental disabilities and be one of the following A licensed doctor of medicine or osteopathy A licensed registered nurse A certified occupational therapist or occupational therapist assistant A certified physical therapist Date 09 30 2014 Page 35 CSA Provider Tracking Entering a FY14 Year End CFR in CSA e A registered physical therapist assistant or a g
40. her laws and regulations and terms and conditions of the Federal award c Market prices for comparable goods or services for the geographic area d Whether the individuals concerned acted with prudence in the circumstances considering their responsibilities to the non Federal entity its employees where applicable it students or membership the public at large and the Federal government Whether the non Federal entity significant deviates from its established practices and policies regarding the incurrence of costs which may unjustifiably increase the Federal awards costs Section 200 404 lt e Date 09 30 2014 Page 6 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Allocable Costs a A cost is allocable to a particular Federal award or other cost objectives if the goods or services involved are chargeable or assignable to that Federal award or cost objective in accordance with relative benefits received This standard is met if the cost a Is incurred specifically for the Federal award b Benefits both the Federal award and other work of the non Federal entity and can be distributed in proportions that may be approximated using reasonable methods and c Is necessary to the overall operation of the non Federal entity and is assignable in part to the Federal award in accordance with the principles in this subpart i All activities which benefit from the non Federal entity s indirect F amp A cos
41. ial Worker 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 19 Speech Therapist 0 00 9 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 20 Subs Abuse Counselor 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 2 Subs Abuse Paraprof 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 22 Teacher 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 23 Teacher Aida 0 00 0 00 0 00 0 00 0 00 0 00 0 00 9 00 0 00 0 00 0 00 0 00 0 0c 24 Vocational Staff 0 00 0 00 0 00 9 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 25 Other Academic Inst 9 00 0 00 0 00 9 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0 28 Other Medical Care 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 06 27 Other Habl Rehab 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 28 Other Subs Abuse 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 29 Case Manager 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 30 Case Mar Ast 9 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 31 Health Educator 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0 32 1 All Oth Not Req Spec 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 o oc 32 2 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 32 3 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 32 4 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0
42. inois ANN Department of Human Services Home Contracts Provider Info My Info Actuals Instruction Manual Yea r En d Actual List Fiscal Year Form Type Standard Weekly Hours Status Cancel Select the Fiscal Year of 2014 Required The Form Type is auto generated Year End Enter the Standard Weekly Hours you use Req here Facilities Budgets Actuals Help Logout 2014 Year End 0 0 uired If a standard weekly work week is 40 insert 40 You do not need to input into anything in the Status field Click Save The system will display the Year End History table You can see that the status of the report is now In Work and a Year End Shell has been created res Illinois ANP Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Actuals Instruction Manual Year End Actual List Fiscal Year Form Type Standard Weekly Hours Status Back Delete Print Actual Add Program Status In work Year End Created Go to Table 7 2014 Year End 40 0 In work History Note By Bob Smith 10 7 14 11 49 52 AM Date 09 30 2014 Page 12 CSA Provider Tracking Entering a FY14 Year End CFR in CSA This Year End screen is the main page for managing viewing and inputting 2014 reporting data All options and tables are available from this screen The system will display the History table and will date and time s
43. ive expenses based on your cost allocation plan If you do have an approved indirect cost rate total administrative expenses should be calculated and allocated on page 41 Administrative expenses generally include those costs that are not directly attributable to specific cost objectives 36 Administrative Salaries The accrued salaries and wages earned by all administrative managerial office and clerical employees except for those that can be directly associated with a grant Typical positions include the administrator assistant administrator accountants bookkeepers and administrative clerical titles Do NOT report contracted staff or consultants on this line Contracted staff including contracted temporaries should be reported on line 38 37 Administrative Payroll Taxes and Fringe Benefits The portion of the cost of payroll taxes and fringe benefits allocated to Administrative Staff reported in line 36 These costs include e Employee Health and Retirement Benefits paid by an agency under its own or other employee health and retirement benefit plan e Payroll Taxes are the sum of the social security and other taxes payable by the employee under federal state or local law e Worker s Compensation Insurance e Other Employee Benefits provided to the employee at employer expense Date 09 30 2014 Page 23 CSA Provider Tracking Entering a FY14 Year End CFR in CSA 38 Administrative Consultants List here the costs of admini
44. l Contributions amp Other Total Investment Income Total Revenues Year End Main Page My Info Facilities Total Agency 7 531 051 00 253 000 00 193 050 00 1 294 870 00 9 271 971 00 31 301 00 9 240 670 00 6 198 000 00 559 343 00 2 514 628 00 0 00 9 271 971 00 Budgets Actuals Help Logout PSYCHIATRIST All Other R DD CILA 24 HOURS SERVICE IN MENTAL Not Allocated pte 60D HEALTH CENTER 350 1 121 901 00 49 850 00 4 343 000 00 328 200 00 0 00 0 00 251 000 00 1 500 00 65 000 00 0 00 121 200 00 0 00 372 566 00 8 099 00 588 076 00 53 409 00 1 559 467 00 57 949 00 5 303 276 00 383 109 00 0 00 101 00 31 200 00 0 00 1 559 467 00 57 848 00 5 272 076 00 383 109 00 0 00 0 00 4 250 000 00 0 00 42 000 00 57 848 00 60 000 00 381 495 00 1 517 467 00 101 00 993 276 00 1 614 00 0 00 0 00 0 00 0 00 1 559 467 00 57 949 00 5 303 276 00 383 109 00 Jump To Summary FC EMERGENCY SHELTER Fcs 83 100 00 0 00 2 600 00 13 720 00 99 420 00 0 00 99 420 00 98 000 00 0 00 1 420 00 0 00 99 420 00 SASS soc 1 605 000 00 500 00 4 250 00 259 000 00 1 868 750 00 0 00 1 868 750 00 1 850 000 00 18 000 00 750 00 0 00 1 868 750 00 Date 09 30 2014 Page 16 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 8 Enter the Schedule of Program Costs The total agency column should reflect the total costs contained in your FY14 Audited Financial Statements Statement of
45. lecting the distribution of activity of each employee must be maintained for all staff members professional and nonprofessional whose compensation is charged in whole or in part directly to awards PARS must also be maintained for other employees whose work involves two or more functions or activities in order to support the allocation of indirect costs Step 1 Login to the CSA Web Portal By entering a valid User ID and Password the user gains access to the CSA Provider Tracking system The user s User ID and Password must be assigned by DHS prior to first login Go to https grants dhs illinois gov gpsecure gt PES inos Department of Human Services System Login Login Illinois Statutes and DHS policy prohibit unauthorized access or disclosure of DHS client employee or any other confidential information Any unauthorized use of DHS computers or disclosure of confidential client or Password employee information may be cause for disciplinary action including termination of employment and or Clear criminal prosecution Do not attempt to login unless you are an authorized user By logging into any Illinois Department of Human Services System using your assigned user ID you acknowledge that you are an authorized user and agree to abide by all rules and regulations of the Illinois Department of Human Services System It is your responsibility to ensure that your user ID and password are kept private Do NOT share
46. line Registered Nurse RN Report Registered Credentialed Nurse on this line Social Worker A licensed social worker possessing a master s or doctoral degree in social work with responsibility for application of social work skills Speech Therapist Report Registered Credentialed Speech Therapist on this line Substance Abuse Counselor Professional Holds clinical certification as a Certified Alcohol and Drug Counselor and meets the requirements of Rule 2060 309 et seq Substance Abuse Paraprofessional Direct service worker e g counselor trainee intake worker night coverage in residential rehabilitation under supervision of the Substance Abuse Professional defined above Teacher Teaches and works with children in an appropriate setting designed for the educational social and emotional development of children Teacher Aide Staff working under the direct supervision of the teacher s Performs duties related to the care of children and operation of classrooms A teacher s aide may have limited responsibility for instruction Vocational Staff Staff working in vocational training and education areas not producing goods or services for sale Other Academic Education or academic positions that cannot be better classified under a different category Other Medical Care Medical positions that cannot be better classified under a different category Other Habilitation Rehabilitation Habilitation or rehabilitation positions
47. nd artwork conferences conventions and meetings not reported in line 11 moving and recruiting and office supplies 43 Total Administrative Expenses The total of lines 36 through 42 44 Total Expenses Sum Lines 17 23 35 43 The total reported expenses to run your program Please note that these are the total costs This includes non reimbursable expense The non reimbursable expenses are again reported on lines 45 through 48 where they are deducted from the total expenses to result in the net expenses calculated on line 49 Non Reimbursable Expenses This section describes those items that are classified as non reimbursable by the State of Illinois or unallowable per Federal regulations These costs are included on lines 1 through 44 They should again be reported in the non reimbursable costs section 45 Depreciation on DMH DD Funded Capital Assets Included Above The portions of the depreciation cost of capital assets reported on lines 27 and 28 that are funded by DMH DD are also reported here For these purposes this reference to funded does not include reimbursements through purchase of service fees or ordinary grant funding Rather only the depreciation costs of assets purchased using special DMH DD funding directed to the purchase of the capital assets should be reported here 46 Costs of Production and Workshop Client Wages Included Above Costs of production include any costs incurred for the sale of goods and servic
48. not be confused with Specific Assistance costs which are reported elsewhere 6 Medicine and Drugs List here the costs of medicine and drug supplies Included among these expenditures would be the object costs of complying with OSHA regulations pertaining to book borne pathogens Date 09 30 2014 Page 19 CSA Provider Tracking Entering a FY14 Year End CFR in CSA The costs of supplies which are later separately reimbursed by the Department of Human Services or other State agency also should be reported on Line 47 Non reimbursable Expenses Other 7 All Other Direct Service Equipment and Supplies List here the cost of program related materials and other supplies used by an agency Items costing more than 500 with a useful life of more than one year must be capitalized and depreciated Such depreciation costs would be reported on lines 27 and 28 8 Staff Transportation List here the object cost of operating vehicles associated with the travel of staff to or from client visits court appearances collateral contacts offsite counseling homemaker sessions or other similar activities The costs may include vehicle insurance license plates gasoline and repairs and maintenance or mileage reimbursement for use of personal cars 9 Client Transportation The object cost of operating vehicles associated with transporting clients to parental visits court Appearances counseling therapy sessions or other similar activities The cos
49. ogram Total Head a allocated program 1 Audiologist 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 o 0c 2 Behavior Therapist 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 3 Dietary Technician 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 4 Dietitian 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 5 Habil Aide CC Aida 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 o oc 6 Habi Prof Sup Statt 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 7 UPN 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 o oc 4 Occup Therapist 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 2 Physical Therapist 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 10 Physician 2040 00 80000 00 1 00 0 00 0 00 0 00 0 00 100 00 80000 00 1 00 0 00 0 00 0 0C JJ Principal 9 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 o oc J2 Program Director 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 1 Prog Gencal Steff 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 14 Psychiatrist 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 15 Psychologist 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 16 Recreation Staff 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0c 12 Registered Nurse 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0C 39 Soc
50. on buildings interest and lease costs that are directly charged to the grant Date 09 30 2014 Page 21 CSA Provider Tracking Entering a FY14 Year End CFR in CSA 24 Occupancy Salaries The salaries and wages earned by an agency s regular employees full or part time temporary employees providing facility maintenance and related services These are employees who make repairs and generally keep the physical plant in operating condition including engineers Salaries for security staff should also be reported here Salaries and wages should include vacation holiday or sick pay Do NOT report contracted staff or consultants on this line Contracted maintenance staff should be reported on line 34 below 25 Occupancy Payroll Taxes and Fringe Benefits List here the portion of the cost of payroll taxes and fringe benefits allocated to Maintenance and security staff These costs include e Employee Health and Retirement Benefits that is the amount paid by an agency under its own or other employee health and retirement benefit plan e Payroll Taxes are the sum of the social security and other taxes payable by the employer under federal state or local law e Worker s Compensation Insurance Other Employee Benefits including any other benefits provided to the employee at employer expense 26 Building and Equipment Operations and Maintenance List here the general physical plant operation and maintenance costs Typically this would include the
51. or externally funded activity or that can be directly assigned to such activities relatively easily with a high degree of accuracy Cost incurred for the same purpose in like circumstance must be treated consistently as either direct or indirect cost b Application to Federal Awards Identification with the Federal award rather than the nature for the goods and services involved is the determining factor in distinguishing direct from indirect costs so include extraordinary utility consumption the cost of materials supplied from stock or services rendered by specialized facilities or other institutional service operations c The salaries of administrative and clerical staff should normally be treated as indirect costs Direct charging of these costs may be appropriate only if all of the following conditions are met a papo Administrative or clerical services are integral to a project or activity Individuals involved can be specifically identified with the project of activity Such costs are explicitly induded in the budget or have the prior written approval The costs are not also recovered as indirect costs Minor items Any direct cost minor amount may be treated as indirect cost for reasons of practicality where such account treatment for that item of cost is consistently applied to all Federal and on Federal costs objecbecives The costs of certain activities are not allowable as charged to Federal awards However even though these cos
52. ork day is 7 1 2 hours long Therefore the normal work week consists of 37 1 2 hours Record 37 5 in this box Program Staff Positions 10 11 12 Audiologist Report credentialed audiologists on this line Behavior Therapist Worker who develops behavioral therapies and programs usually for direct care workers to carry out Position may be credentialed Licensed certified and registered Dietary Technician A worker who carries out special dietary programs and recommendations of dietician may include food preparation Does not include direct care workers classified elsewhere Dietician Credentialed worker who assesses dietary needs of individuals and makes dietary and feeding recommendations designs diets and dietary programs monitors dietary programs and their delivery participates in annual individual habilitation or rehabilitation planning Habilitation Aid Child Care Worker Workers whose primary functions include the provision of hands on face to face contact with the clients This includes both day residential live in sleepover staff and respite care workers It excludes foster parents managers supervisors and administrative staff professional staff that is credentialed licensed and production oriented workers Habilitation Professional or Supervisory Staff Workers not classified elsewhere who are credentialed Licensed registered and certified or whose responsibilities are direct service supervisory
53. p Logout Actuals Instruction Manual Yea r E nd CFR Actual List Fiscal Year 2014 Form Type Year End Standard Weekly Hours 40 0 Status In work Cancel Submit Delete Print Actual Programs History Status Note By Year End Created Bud In work VanDerWal 9 15 14 12 05 12 PM Date 09 30 2014 Page 38
54. r private source including units of government education individuals or foundations Contributions amp Other e Contributions contributions gifts endowments transfer of assets donations of monies goods or services Contributions may be specifically restricted by the donor or unrestricted e Revenue sales of goods and services or assets income from rental of property to others income from cafeteria and vending machines Investment Income Interest earnings on assets and investments including those that are donor restricted as well as those which are restricted Date 09 30 2014 Page 28 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 10 Enter the Report of Service Units Select the Unit option from the Go to Table Jump to drop down menu to access the Report of Service Units screen e Click Print to display a printable copy of the Report of Service Units Click Save to save the newly entered figures entered in the table Click Cancel to cancel the screen and return to the Actuals List screen Click the Year End Main Page link to display the Year End screen re Illinois ANP Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Report of Service Units Jump To Unit x PSYCHIATRIST Description DD CILA 24 HOURS SERVICE IN MENTAL Fe SASS p 60D HEALTH CENTE
55. r the same purpose in like circumstances has been allocated to the Federal award as an indirect cost Be determined in accordance with generally accepted accounting principles GAAP except for state and local governments and Indian tribes only as otherwise provided for in this part f Not be included as a cost or used to meet cost sharing or matching requirements of any other federally financed program in either the current or a prior period See also 200 306 cost sharing or matching paragraph b Be adequately documented See also 200 300 Statutory and national policy requirements through 200 309 Period of performance of this part Section 200 403 b d lt e lt g Reasonable Costs A cost is reasonable if in its nature and amount it does not exceed that which would be incurred by a prudent person under the circumstances prevailing at the time the decision was made to incur the cost The question of reasonableness is particularly important when the non Federal entity is predominately federally funded In determining reasonableness of a given cost consideration must be given to a Whether the cost is of a type generally recognized as ordinary and necessary for the operation of the non Federal entity or the proper and efficient performance of the Federal award b The restraints or requirements imposed by such factors as sound business practices arm s length bargaining Federal state and ot
56. raduate of a 2 year college level program approved by the American Physical Therapy Association or comparable body e A psychologist with at least a master s degree in psychology from an accredited school e Asocial worker with a bachelor s degree from a college or university or graduate degree from a school of social work accredited or approved by the Council on Social Work Education or other comparable body e A speech language pathologist or audiologist with a certificate of Clinical Competence in Speech Language Pathology or Audiology granted by the American Speech Language Hearing Association or comparable body or meeting the education requirements of licensure and be in the process of accumulating the supervised experience required for licensure e A professional recreation staff person with a bachelor s degree in recreation or ina specialty area such as art dance music or physical therapy e A professional dietician registered by the American Dietetic Association e A human services professional with a bachelor s degree in human services field including but not limited to sociology special education rehabilitation counseling or psychology 33 Rehabilitative Services Associate RSA Assists in provision of services in accordance with MRO Rules Sections 132 155 and 132 170 Must be at least 21 years old have demonstrated skills in the field of services to children have demonstrated ability to work within agency structure and accep
57. rted here General clerical duties not specifically performed for a grant should be reported in the administrative cost section Contracted staff including contracted temporaries should be reported on line 3 3 Program Staff Payroll Taxes and Fringe Benefits This is the portion of the cost of payroll taxes and fringe benefits allocated to Program Staff reported in line 1 and 2 These costs include e Employee Health and Retirement Benefits paid by an agency under its own or other employee health and retirement benefit plan e Payroll taxes are the sum of the social security and other taxes payable by the employer under federal state or local law e Worker s Compensation Insurance e Other Employee Benefits provided to the employee at employer expense 4 Program Consultants Program consultants are those that are contracted to provide direct program services and can include the following Vocational Services Academic Instruction Speech and Language Services Occupational and Physical Therapy Psycho Social Services Medical Care Recreational Services and Habilitation Personal Care The amount reported on Line 4 must match the total amount of costs reported on the Program Consultant and Contractual worksheet No entry is needed here as the data is pulled from the Consultant schedule automatically 5 Consumer Wages and Fringe Benefits This represents the cost of paying wages and benefits to clients enrolled in the program This should
58. strative consultants Administrative consultants would include those fulfilling the following administrative functions administrator assistant administrator accountants bookkeepers and administrative clerical titles 39 Telecommunications Costs Not Assigned to Program List here the administrative telecommunications costs This would include all telephone expenses that are not associated with utilization by either client in their living quarters or by direct service staff The portion of the total telephone expense that is associated with utilization by either clients in their living quarters or by direct service staff is reported on line 14 in the program cost section 40 Office Supplies amp Equipment The costs of administrative office supplies and expensed equipment The cost associated with staff recruiting activities should be reported on this line 41 Allocation of Management and General G amp A Management and general expenses must be allocated to programs in proportion to the management and general services received by each program For the majority of our providers this allocation is done by establishing an indirect cost rate Use this line if you have a rate established with either the Department of Human Services or the Federal government 42 Other specify List here all other administrative costs not already reported Included here would be subscriptions and reference materials postage and shipping outside printing a
59. t including unallowable activities and donated services by the non Federal entity or third parties will receive an appropriate allocation of indirect costs ii Any cost allocable to a particular Federal award under the principles provided for in this part may not be charged to other Federal awards to overcome fund deficiencies to avoid restrictions imposed by Federal awards or for other reasons However this prohibition would not preclude the non Federal entity from shifting costs that are allowable under two or more Federal subawards in accordance with existing Federal statutes regulations or the terms and conditions of the Federal awards iii Direct cost allocation principles If a cost benefits two or more projects or activities in proportions that can be determined without undue effort or cost the cost should be allocated to the projects based on the proportional benefit If a cost benefits two or more projects or activities in proportions that cannot be determined because of the interrelationship of the work involved then notwithstanding paragraph ii of this section the costs may be allocated or transferred to benefitted projects on any reasonable documented basis Where the purchase of equipment or other capital asset is specifically authorized under a Federal award the cost are assignable to the Federal award regardless of the use that may be made of the equipment or other capital asset involved when no longer needed for the purpose
60. t supervision have demonstrated ability to work constructively with clients other providers and the community 34 Total All Positions Date 09 30 2014 Page 36 CSA Provider Tracking Entering a FY14 Year End CFR in CSA Step 12 Enter the Program Consultant and Contractual Expenses Total costs are based on the entity s fiscal year All agreements associated with DHS and the State of Illinois Health and Human Service Sister Agencies should be listed All other costs will automatically calculate in the all other not allocated column Select the Contractual option from the Go to Table Jump To drop down menu to access the Program Consultant and Contractual screen e Click Print to display a printable copy of the Program Consultant and Contractual e Click Save amp Recalculate to save the table and recalculate the newly entered figures e Click Cancel to cancel the screen and return to the Actuals List screen e Click the Year End Main Page link to display the Year End screen res Illinois Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Program Consultant and Contractual SEP INDIVIDUAL W J08 COACH DD CILA 24 HOURS PSYCHIATRIST SERVICE IN MENTAL 39u 600 HEALTH CENTER Total Agency a a Shere thts remem wale 350 Program Contract Positions Senta Perse etx Total Total Total Total Hours 0t Agency Total Head Me Allocated Program Toral Head a allocated Pr
61. tamp the form s history It also displays the Year End Status history notes about the report and who has worked on the report as well as the date time of the data entry Step 6 Add Your Programs Using the supplemental listing you received In May 2014 you will need to add programs for all of DHS funding You will also need to add additional programs for other funding received from the other State of Illinois Health and Human Service Agencies These include Department of Aging Department of Healthcare and Family Services Department of Public Health and Department of Children and Family Services Note If you use other funding sources outside the State of Illinois Health and Human Service Agencies such as United Way funding as part of your revenue streams associated with those 5 agencies those will be included in the cost and revenue build up and will not need a separate program code established In addition if there are other programs your entity performs not associated with the 5 State of Illinois Health and Human Service Agencies those will also not need a program code established To add a Program click Add Program found on the Year End screen They system will display the Add Edit Program screen All fields with a red asterisk are required rm Illinois ANN Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Actuals Instruction Manual Yea r End co to Tabie
62. that cannot be better classified under a different category Other Substance Abuse Substance abuse positions that cannot be better classified under a different category Date 09 30 2014 Page 34 CSA Provider Tracking Entering a FY14 Year End CFR in CSA 29 Total All Positions Medicaid Reporting All Medicaid programs that are required to report all substitute care contract positions salaries into the following categories MHP QMHP QMRP and RSA Lines 34 37 The expenses reported in Lines 34 through 37 are from the salaries that were included in the totals of Line 33 30 Mental Health Professional MHP Provides services under the supervision of a qualified mental health professional The mental health professional must possess a bachelor s degree a practical nurse license or have a minimum of five years of experience in mental health or human services 31 Qualified Mental Health Professional QMHP A physician licensed to practice medicine or osteopathy with training in mental health services or 1 year of clinical experience under supervision in treating problems related to mental illness or specialized training in the treatment of children and adolescents A psychiatrist who has successfully completed a training program in psychiatry approved by the American Medical Association the American Osteopathic Association or other training program identified as equivalent by the State of Illinois A licensed psycholo
63. tracts Provider Info My Info Facilities Budgets Actuals Help Logout Schedule of Program Costs All Other SEP INDIVIDUAL DD CILA 24 HOURS PSYCHIATRIST Not Allocated W JOB COACH 60D SERVICE IN MENTAL Account Title Total Agency 39U Show this Program only HEALTH CENTER Show this Program only 350 Show this Program only lt Program Expenses Position Totals Line 33 on Personnel 5 572 000 00 875 000 00 35 000 00 3 300 000 00 240 000 00 1 Staff Salaries 5572000 00 875 000 00 35000 00 3300000 00 240000 00 2 Clerical Staff Sal 0 00 0 00 0 00 0 00 0 00 3 Payl Tax amp Fringe Ben 1646850 00 308 250 00 8500 00 751000 00 84000 00 4 Program Consultants 80 000 00 0 00 0 00 80 000 00 0 00 5 Cons Wage amp Fringe Ben 0 00 0 00 0 00 0 00 0 00 6 Medicine and Drugs 157000 00 85 000 00 0 00 52000 00 0 00 Z Oth Prog Eqmt amp Sup 10000 00 0 00 0 00 10000 00 0 00 8 Staff Transportation 0 00 0 00 0 00 0 00 0 00 9 Client Trans 4000 00 146 000 00 0 00 150000 00 0 00 10 Trans To From Sch 0 00 0 00 0 00 0 00 0 00 11 Svc Staff Conf amp Conv 0 00 0 00 0 00 0 00 0 00 12 Program Insurance 0 00 0 00 0 00 0 00 0 00 13 Direct Cl Spcfc Asst 51000 00 0 00 0 00 0 00 0 00 14 Telecom Costs 10100 00 4 500 00 1400 00 0 00 4200 00 15 Foster Care Payments 0 00 0 00 0 00 0 00 0 00 16 1 Alcohol at Conference 101 00 0 00 101 00 0 00 0 00 16 2 Training Supplies 0 00 4 849 00 4849 00 0 00 0 00 16 3 0 00 0 00 0 00 0 00 0 00 16 4 0 00 0 00 0 00 0 00 0 00 16 5 0 00
64. ts are unallowable for purposes of computing charges to Federal awards they nonetheless must be treated as direct costs for purposes of determining indirect cost rates and be allocated their equitable share of the Federal entity s indirect costs For nonprofit organizations the costs of activities performed by the non Federal entity primarily as a service to members clients or the general public when significant and necessary to the non Federal entity s mission must be treated as direct costs whether or not allowable and be allocated an equitable share of indirect costs Section 200 413 Indirect F amp A Costs a Facilities and Administration Classification For major IHEs and major nonprofit organizations indirect F amp A costs must be classified within two broad categories Facilities and Administration Facilities is defined as depreciation on building equipment and capital improvement interest on debt associated with certain buildings equipment and capital improvements and operations and maintenances expenses Administration is defined as general administration and general expense such as the director s office accounting personnel and all other types of expenditures not listed specifically less than one of the subcategories of facilities including cross allocation from other pools where applicable For nonprofit organizations library expenses are included in the Administration category for institutions of higher
65. ts may include vehicle insurance license plates gasoline and repairs and maintenance or mileage reimbursement for use of personal cars Transportation costs which could be reasonably reported on either line 8 or 9 should be reported on line 9 10 Transportation To From School This line is to be used solely the cost of transporting children to or from school This line would typically be completed only for programs operating a day or boarding school On the previous version of the CFR this cost was not reported separately except to the Purchased Care Review Board 11 Direct Service Staff Conferences and Conventions The costs incurred through participation of program staff in training programs The cost of Conferences and conventions may be included here if agency program staff were participating 12 Program Insurance List here the costs of all liability malpractice personal injury and other types of insurance not reported as property insurance or as employee benefits The expense of malpractice insurance covering employees consultants and members of the board of directors while working in funded programs is allowable Amounts paid for key man life insurance and unallowable malpractice Unallowable malpractice Insurance costs are those costs for covering individuals when working outside the funded Program should be reported here They should also be reported on line 47 13 Direct Client Specific Assistance The object cost of providing
66. venue screen Click Print to display a printable copy of the Schedule of Program Revenue Click Save amp Recalculate to save the table and recalculate the newly entered figures Click Cancel to cancel the screen and return to the Actuals List screen Click the Year End Main Page link to display the Year End screen Date 09 30 2014 Page 26 CSA Provider Tracking Entering a FY14 Year End CFR in CSA re Illinois y ANP Department of Human Services Home Contracts Provider Info My Info Facilities Budgets Actuals Help Logout Schedule of Program Revenue All Other SEP INDIVIDUAL DDCILA24HOURS PSYCHIATRIST Not Allocated W JOB COACH 60D SERVICE IN MENTAL Account Title Total Agency 39U Show this Program only HEALTH CENTER Show this Program only 350 Show this Program only Fees Purchase of Service 1 Dept of Aging 0 00 0 00 0 00 0 00 0 00 2 Dept of Ch amp Fam Svc 98000 00 0 00 0 00 0 00 0 00 3 Dept of Corrections 0 00 0 00 0 00 0 00 0 00 4 Medicaid Rehab Pmt 0 00 0 00 0 00 0 00 0 00 5 Dept of Human Svcs 4200000 00 0 00 0 00 4200000 00 0 00 6 Dept of Public Aid 1850000 00 0 00 0 00 0 00 0 00 7 Dept of Pub Health 0 00 0 00 0 00 0 00 0 00 8 Loc Edu Agcy Sch Dis 0 00 0 00 0 00 0 00 0 00 9 Local Government 0 00 0 00 0 00 0 00 0 00 10 Federal Government 0 00 0 00 0 00 0 00 0 00 11 Oth Gov Agencies 0 00 0 00 0 00 0 00 0 00 12 Client Fam Prog Fees 0 00 0 00 0 00 0 00 0 00 13 Svc Fee for Ind Cl 50000 00 0 00 0 00 50000 00 0 00 14

CSA Provider Tracking: Entering a FY14 Year

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