HomeMy WebLinkAboutMHIDDEI-414 Program Funded RequirementsFRANKLIN/FULTON COUNTY
MENTAL HEALTH/INTELLECTUAL & DEVELOPMENTAL
DISABILITIES/EARLY INTERVENTION
425 Franklin Farm Lane
Chambersburg, PA 17202
(717) 264-5387
MH/IDD/EI PROCEDURE STATEMENT
PROCEDURE SUBJECT: Program Funded Requirements
PROCEDURE NUMBER: MHIDDEI-414
Effective Date: August 1, 2010
Date Revised: November 2, 2022
Reference: Title 55 – Human Services. Chapter 4300, County Mental Health and Intellectual
Disability Fiscal Manual (revised 2016)
INTRODUCTION:
Program funded services are paid based on total actual expenses less other program income
(Medical Assistance, Perform Care, individual fees, fundraising, contributions, etc.). This policy
establishes the billing and other requirements for program funded Providers. The program
funded contract amount is established as part of the annual budgeting process.
PROCEDURE:
1. Providers must submit a monthly invoice to include the authorized approver’s signature
and the Program Funded Reconciliation (Exhibit A) along with general ledger detail.
2. The monthly invoice and supporting documentation, as stated above, should be submitted
by the 20th of the following month in which services were rendered for program funded
billing. (Monthly invoice and supporting documentation should be submitted by the 15th
of the following month in which services were rendered for Fee-for-Service billing.)
Requests for other billing arrangements need to be approved by the Program Specialist in
consultation with the respective Fiscal Officer.
Program Funded Reconciliation Instructions
1. Fiscal Officers will supply Providers with the Program Funded Reconciliation worksheet.
2. Steps to complete the reconciliation are as follows:
a. Enter the approved budget as well as any changes in encumbrance on the first tab.
b. Enter actual expenses for the appropriate month on that month’s tab. Totals
should equal the general ledger detail.
c. Enter the units/percentage by County.
ATTACHMENT:
Exhibit A: Program Funded Reconciliation
Exhibit A
FRANKLIN/FULTON MH/IDD/EI – PROGRAM FUNDED RECONCILIATION
Provider:
Address:
For Month/Year of:
Program:
Current
Expense
YTD Actual
Expense
YTD Budget
Expense
Remaining
Budget
PROGRAM EXPENSES:
100 Personnel Services
110 Wages & Salaries 4,200.00$ 4,200.00$ 4,166.67$ 45,800.00$
120 Employee Benefits 1,300.00 1,300.00 1,250.00 13,700.00
130 Misc. Personnel Exp.- - 166.67 2,000.00
Sub-total 5,500.00 5,500.00 5,583.33 61,500.00
300 Operating Expenses
310 Occupancy 450.00 450.00 416.67 4,550.00
320 Communications 200.00 200.00 166.67 1,800.00
330 Office Expenses 50.00 50.00 83.33 950.00
340 Supportive Svcs 250.00 250.00 250.00 2,750.00
350 Transportation 400.00 400.00 416.67 4,600.00
360 Purchased Services - - - -
370 Misc. Expenses 100.00 100.00 166.67 1,900.00
Sub-total 1,450.00 1,450.00 1,500.00 16,550.00
400 Equipment & Other Fixed Assets
410 Purchase of Assets *500.00 500.00 250.00 2,500.00
420 Repair & Improvements - - - -
430 Depreciation - - - -
Sub-total 500.00 500.00 250.00 2,500.00
TOTAL PROGRAM EXPENSE 7,450.00 7,450.00 7,333.33 80,550.00
ADMINISTRATIVE EXPENSES:
A110 Wages & Salaries 600.00 600.00 583.33 6,400.00
A120 Employee Benefits 200.00 200.00 175.00 1,900.00
A130 Misc. Personnel Exp.40.00 40.00 41.67 460.00
A150 Professional Svcs 150.00 150.00 166.67 1,850.00
A310 Office Expenses 40.00 40.00 41.67 460.00
A370 Other Admin Expenses - - - -
TOTAL ADMIN EXPENSE 1,030.00 1,030.00 1,008.33 11,070.00
TOTAL EXPENSES 8,480.00$ 8,480.00$ 8,341.67$ 91,620.00$
REVENUE:
510 Room & Board -$ -$ 1,666.67$ 20,000.00$
530 Medical Assistance 1,500.00 1,500.00 - (1,500.00)
540 Federal Soc Svcs Grants - - - -
550 Federal Staffing Grant - - - -
560 Other Fed Funds - - - -
570 Program Service Fees - - - -
580 Private Ins Payments - - - -
590 Charities & Other Income 1,000.00 1,000.00 841.67 9,100.00
600 Provider Cash Resources - - - -
TOTAL NON-COUNTY REVENUE 2,500.00$ 2,500.00$ 2,508.33$ 27,600.00$
FRANKLIN/FULTON FUNDING 5,980.00$ 5,980.00$ 5,833.33$ 64,020.00$
Franklin County Units/Funding 1,200 4,485.00$ 1,200 4,485.00$ 1,250 4,375.00$ 13,800 48,015.00$
Fulton County Units/Funding 400 1,495.00$ 400 1,495.00$ 417 1,458.33$ 4,600 16,005.00$
* Attach list of assets showing description, purchase date and cost.
Mental Health
FRANKLIN/FULTON MH/ID/EI - PROGRAM FUNDED RECONCILATION
July 2016
ABC Provider
123 Main Street
Chambersburg, PA 17201