HICAP BUDGET - SUMMARY (All Years)

Transcription

1 BUDGET CDA 229 (REV 4/217) Attachment 1 ' California PIIHSTMENTO EXHIBIT B Page 1 of 19 BUDGET - SUMMARY (All Years) BUDGET PERIOD: 7/1/217-6/3/2 [ ] ORIGINAL [X] REVISION #1 SUBMISSION DATE: 1/3/18 PSA No: 25 COST CATEGORY State Funds FUNDS Income / AAA ADMINISTRATION Federal Admin Reimb. Admin Fund Admin Other Funds Personnel 71,328 35,643 16,971 Operating Expenses Indirect Admin ADMINISTRATION 71, ,9/1 PROGRAM Federal Reimb. Income / Other Funds FUNDS Direct Services Subcontractor Subrecipient Services PROGRAM 576, ,313 1,784,12 5/6,968 84,839 42,313 1, BUDGET 576, , ,956 1,891,91 Legal Representation Services are provided: [W&l Code, Section 9541 (c) (3)] Payment Method: Reimbursement [ x ] Request for Funds [ ] HHS Approved Indirect Cost Rate(s): [ x ] Yes Amount Budgeted: $ FOR STATE USE ONLY AAA-BASED TEAM / FISCAL SPECIALIST DATE TEAM COACH DATE For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aoino ca.aov.

2 STATE OF CALIFORNIA..Cauforma I II FA KTMFNT nr BUDGET CDA 229 (REV 4/217) EXHIBIT B Page 3 of 19 AAA ADMINISTRATION BUDGET - STATE & LOCAL FUNDS (12 MONTH) BUDGET PERIOD: 7/1/217 /3/2 IB ORIGINAL PERSONNEL X ] REVISION # 1 Monthly Wage Rate FTE Position Classification: Total Annual FTE % of Time Worked SUBMISSION DATE: 1/3/218 PSA No: Reimb. Fund 25 Senior Management Analyst I 9,873 7.% 8, 1, 9, Management Analyst 8, % 13, 9, 22. Accountant II 6,558 5.% 2,776 1, SALARIES & WAGES STAFF BENEFITS PERSONNEL OPERATING EXPENSES Rent: Equipment (List Item below) Reimb. Sqft: Fund Sq ft Rate (mo.): Quantity Travel: Other Operating Expenses (List): OPERATING EXPENSES INDIRECT COSTS STATE & LOCAL ADMINISTRATION * Equipment exceeding $5 must be reported on Property page For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aaing.ca.oov.

3 BUDGET CDA 229 (REV 4/217) * ^CAI JrOKXIA A DlTAKTMrNTClF Aging EXHIBIT B Page 6 of 19 SUBCONTRACTOR SUBRECIPIENT SERVICES SCHEDULE -12 Month BUDGET PERIOD: 7/1/21/ - 6/3/218 l ] ORIGINAL [ X ) REVISION # 1 SUBMISSION DATE: 1/3/218 PSA No: 25 Subcontractors Subrecipients Name: Center for Health Care Rights (213) S. La Fayette Park PI.,LA,CA Ms. Aileen Harper 9 Month 3 Month Reimbursement Fund Income and Other CONTRACTED SERVICES 153,751 52, , ,15 68,657 Name: Name: Name: CONTRACTED SERVICES Budget Contracted expenses from all funding sources 9 MONTH FED. 3 MONTH FED. REIMB. FUND LOCAL FUNDS For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aaina.ca.Qov. 153,751 52, , ,15 68,657

4 STATE OF CALIFORNIA < ". Cautosckia A Otf ABTMCN'T fh ING BUDGET CDA 229 (REV 4/217) EXHIBIT B Page 9 of 19 AAA ADMINISTRATION BUDGET - STATE & LOCAL FUNDS (12 MONTH) BUDGET PERIOD: 7/1/218-6/3/219 PERSONNEL Position Classification: [ ] ORIGINAL [ X REVISION # 1 SUBMISSION DATE: 1/3/218 Monthly Total Annual FTE Reimb. Fund Wage Rate FTE % of Time Worked Senior Management Analyst I PSA No: 25 1,96 7.% 8, 1, 9, Management Analyst 8, % 13, 9, 22, Accountant II 6,76 5.% 2,776 1,881 4,657 SALARIES & WAGES STAFF BENEFITS PERSONNEL OPERATING EXPENSES Rent: "Equipment (List Item below) Reimb. Sq ft: Fund Sq ft Rate (mo.): Quantity u I) Travel: Other Operating Expenses (List): I) OPERATING EXPENSES INDIRECT COSTS STATE & LOCAL ADMINISTRATION * Equipment exceeding $5 must be reported on Property page For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aoino.ca.oov.

5 BUDGET CDA 229 (REV 4/217) -CAUKWNIA Rffaktwxtof EXHIBIT B Page 12 of 19 SUBCONTRACTOR SUBRECIPIENT SERVICES SCHEDULE -12 Month BUDGET PERIOD: 7/1/218-6/3/219 [ ORIGINAL [X] REVISION #1 SUBMISSION DATE 1/3/218 PSA No: 25 Subcontractors Subrecipients 9 Month 3 Month Reimbursement Fund Income and Other CONTRACTED SERVICES Name: Center for Health Care Rights 157,564 53, ,28 134,14 613,231 (213) S. La Fayette Park PI., LA.CA Ms. Aileen Harper Name: Name: Name: CONTRACTED SERVICES Budget Contracted expenses from all funding sources 9 MONTH FED. 3 MONTH FED. REIMB. FUND LOCAL FUNDS For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aainQ.ca.aov. 157,564 53, ,28 134,14 613,231

6 STATE OF CALIFORNIA -CAUFOSKIA DlT AKTMrNTOI BUDGET CDA 229 (REV 4/217) EXHIBIT B Page 15 of 19 AAA ADMINISTRATION BUDGET - STATE & LOCAL FUNDS (12 MONTH) BUDGET PERIOD: 7/1/219-6/3/22 PERSONNEL Position Classification: l ORIGINAL [X] REVISION# 1 SUBMISSION DATE 1/3/218 Monthly Total Annual FTE Reimb. Fund Wage Rate FTE % of Time Worked Senior Management Analyst I PSA No: 25 1,96 7.% 8. 1, 9. Management Analyst 8, % 13, 9, 22, Accountant II 6,76 5.% 2,776 1,881 4,657 SALARIES & WAGES STAFF BENEFITS PERSONNEL OPERATING EXPENSES Rent: Equipment (List Item below) Reimb. Sqft'T Fund Sq ft Rate (mo.): Quantity Travel: Other Operating Expenses (List): OPERATING EXPENSES INDIRECT COSTS STATE & LOCAL ADMINISTRATION * Equipment exceeding $5 must be reported on Property page For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aaino.ca.gov.

7 BUDGET CDA229 (REV 4/217) ; -Caupokxia Dir ictmintol' EXHIBIT B Page 18 of 19 SUBCONTRACTOR SUBRECIPIENT SERVICES SCHEDULE -12 Month BUDGET PERIOD: 7/1/219-6/3/22 [ ] ORIGINAL. [X] REVISION # 1 SUBMISSION DATE: 1/3/218 PSA No: 25 Subcontractors Subrecipients 9 Month 3 Month Reimbursement Fund Income and Other CONTRACTED SERVICES Name: Center for Health Care Rights 119,886 39, ,28 134,14 562, S. La Fayette Park PI., LA,CA (213) Ms. Aileen Harper Name: Name: Name: 9 MONTH FED. 3 MONTH FED. REIMB. FUND LOCAL FUNDS FOTAL CONTRACTED SERVICES 119,886 39, ,28 134,14 562,232 Budget Contracted expenses from all funding sources For questions or accessibility assistance with this financial document, please contact CDAFiscalTeam@aQino.ca.aov.