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{"sheet":"Validation Tab","index":0,"n_rows":45,"n_cols":4,"rows_kept":45,"cut":false,"hidden":true,"merged":[]}
[]
["STANDARD POSITION TITLE\n(Use drop-down)","CREDENTIAL\n(Use drop-down)","SPECIALTY\n(Use drop-down)","Modifiers\n(Use drop-down)"]
["Accountant/Bookkeeper ","Licensed ","Billing ","Bilingual "]
["Aide/Assistant ","License Eligible ","Caregiver ","Overnight "]
["Analyst – Evaluations/Data ","Certified SUD Counselor ","Community Organizing ","On-call  "]
["Analyst – Fiscal/Grants ","Registered SUD Counselor ","Data-entry ","Crisis Response "]
["Assistant Program Manager ","Medical Doctor ","Education ","Other"]
["BH Clinician","Peer Support Certification ","Employment ","N/A "]
["Billing Clerk","Master's Level/Not Registered ","Family "]
["Care Coordinator ","Other","Geriatric "]
["Case Manager ","N/A ","Homeless/Housing "]
["Childcare Worker ",null,"MAT "]
["Clinical Supervisor ",null,"Media Advocacy "]
["Direct Support Staff ",null,"Parent "]
["Director /Executive/Asst Director",null,"Peri-Child "]
["Driver ",null,"Prevention "]
["Food Services (Director, Cook, Nutrition, etc.)",null,"TAY "]
["Intake Coordinator",null,"Youth Development "]
["IT Specialist/Technician ",null,"Youth "]
["Licensed Vocational Nurse (LVN) ",null,"Other"]
["Maintenance ",null,"N/A "]
["Medical Director (MD)/Assistant MD "]
["Nurse Practitioner- Family (FNP) "]
["Nurse Practitioner- Psychiatric (PNP) "]
["Occupation Therapist (OT)"]
["Office Assistant "]
["Office Manager "]
["Outreach Worker"]
["Patient Advocate"]
["Patient Advocate Attorney"]
["Peer Support Specialist"]
["Physician’s Assistant (PA) "]
["Program Manager "]
["Psychiatric Technician "]
["Psychiatrist (MD) "]
["Psychologist "]
["Quality Assurance "]
["Registered Nurse (RN) "]
["Rehab Specialist/Qualified Mental Health Professional "]
["Security Guard "]
["Specialist"]
["Student Trainee"]
["SUD Counselor"]
["Team Lead/Supervisor/Other Management"]
["Trainer "]

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["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["BUDGET PREPARATION INSTRUCTIONS"]
[]
["GENERAL INSTRUCTIONS"]
["The template has 13 colored tabs:"]
[null,"Yellow tabs - to be filled by both Substance Use Disorder (SUD) and Mental Health Services (MHS) providers"]
[null,"Blue tabs - for MHS providers only"]
[null,"Purple tab - for SUD providers only"]
["Use one file/template per contract. Multiple programs/funding sources under one contract number can be listed in one file but do not include information \non more than one contracts. "]
[]
["When requesting for administrative adjustment, please include all pages with the Administrative Adjustment Request (AAR) Form in your submission package. Once you have an executed budget, please refrain from altering it without obtaining prior COR approval.  Changing your budget without first consulting with the COR may result in related payments being delayed and/or disallowed."]
[]
["Yellow shaded cells are for data entry.  Do not enter on the non-shaded cells."]
[]
["START WITH BUDGET SUMM AMT tab: "]
["1.     Complete the header data: Contractor Name, Budget Period, Contract #, Amendment #"]
[]
["SCHEDULE I - Salaries and Benefits (Sch I S&B Final tab)"]
["1.    Enter the program name."]
["2.     Complete the staffing information.  When feasible, please list each individual staff position separately.  Alternatively, you may group a class of \n        employees together on one line.  For example, if you employ five social workers for this program, all with different salaries, you may list them all on \n        one line using an average salary if space doesn’t permit you to list them separately."]
[null,"   Use the drop-down selection to enter the Standard Position Title, Credential, Specialty & Modifiers. See Instructions 2 S&B \n   tab for the list and example."]
[null,"2.1     Enter the Proposed Budget and Prior Approved Budget data"]
[null,"2.2     1 FTE is defined as a full time staff member working 40 hours per week.  If staff works only part time, reduce the FTE number accordingly, \n          using 40 hours as a base.  For example, if staff works 30 hours per week, this should be represented as 0.75 FTE (30/40=0.75)."]
[null,"2.3   For beginning of the fiscal year budget, use the latest known budget from prior fiscal year."]
["SCHEDULE II - Operating Expense (Sch II OE FINAL tab)"]
["1.  Enter the program name and Funding Source info in Rows 8 and 9."]
["3.     Complete the operating expense information - Proposed Budget and Prior Approved Budget columns.   Asterisked items are line items that can not be \n        exceeded without written prior COR approval.  Double asterisked item can be exceeded up to $1,000 and will require written prior COR approval in \n        excess more than $1,000.     "]
[null,"3.1     Columns E to G are roll up amounts. Columns H to J is for Program 1, columns K to M for Program 2 and so on. If there are two funding \n          sources in Program 1, fill out two sections for Program 1 so they can be tracked separately."]
[null,"3.2     Lines 33 to 41 \"Other\" - list the specific expense on this line.  This is used if the expense will not fall in any of the categories on the above \n          lines.  If blank, you may hide those rows when printing for submission.  "]
[null,"3.3     Follow the County's flex funds and gift card guidelines."]
[]
["SCHEDULE III - Indirect Cost (Sch III Indirect Final tab)"]
["4.     Complete the following information needed for indirect cost rate calculation: "]
[null,"4.1     Row 13:  If you have any subcontract agreement above $25,000 annually that fall under the subaward determination , please enter the total amount\n           in excess of $25,000 per individual subaward."]
[null,"4.2     Row 14: Enter any distorting items or items exempt from indirect cost allocation.  This may include fixed assets purchases and any \n          unallowable expenses, such as penalties and fines, entertainment/alcoholic beverage, lobbying and fund raising."]
[null,"4.3     Row 16:  Enter the allocated indirect cost"]
[]
["SUPPLEMENTAL A - Fixed Assets (Suppl A Fixed Assets tab - use only with Purchased of Fixed Assets above $5,000)"]
["5.     Only complete this tab if you have any fixed asset purchases (above $5,000 and with life over 1 year)."]
[null,"5.1     Complete the description of fixed asset to be purchased, the rate and the number of units to be purchased."]
[null,"5.2     Enter the amount allocated to each program."]
[]
["SUPPLEMENTAL B - Subcontract (Suppl B Subcontract tab - use only with Subcontract or Consultant line item budget)"]
["6.     Use  this schedule to document your Consultant and Subcontract budget:"]
[null,"6.1    Subcontractor definition under Federal Acquisition Regulation: FAR 3.502-1: Subcontractor (1) means any person, other than the prime \n         contractor, who offers to furnish or furnishes any supplies, materials, equipment or services of any kind under a prime contract or a \n         subcontract entered into in connection with such prime contract and (2) includes any person who offers to furnish or furnishes general supplies \n         to the prime contractor or a higher tier subcontractor.   FAR 3.1001: Subcontractor means any supplier, distributor, vendor, or firm that \n         furnished supplies or services to or for a prime contractor or another subcontractor."]
[null,"6.2    Consultant definition:  FAR 31.205-33: Professional and consultant services ... means those services rendered by persons who are members \n         of a particular profession or possess a special skill and who are not officers or employees of the contractor. Examples include those services \n         acquired by a contractor or subcontractor in order to enhance their legal, economic, financial, or technical positions. Professional and \n         consultant services are generally acquired to obtain information, advice, opinions, alternatives, conclusions  recommendations, training or \n         direct assistance, such as studies, analyses, evaluations, liaison with Government officials, or other forms or representation."]
[null,"6.3   Direct hours refer to the number of hours that the subcontractor or consultant will spend to provide the services to clients stated in the Statement \n         of Work."]
[null,"6.4   Admin hours refer to the number of hours that the subcontractor or consultant will spend providing administration, training, or consultation to \n        staff. "]
[]
["SUPPLEMENTAL C - Gift Card Preapproval (Suppl C Gift Card Preapproval tab - use only with Gift Card line item in the budget)"]
["7.     Complete the gift card information per program/funding source and the checklist on this page if gift cards are budgeted on the Sch II OE FINAL page. \n        The form has to submitted to the COR for pre-approval as the signed budget does not serve as written pre-approval. Refer to BHS Guidelines for \n        Contractors Using Gift Cards for compliance. "]
[]
["LINE ITEM JUSTIFICATION"]
["8.     Complete this page with a brief description and justification for each line item in the budget for budget adjustments and new contracts."]
[]
["MH ADULT PRODUCTIVITY"]
["9.     For Adult/Older Adult Mental  Health programs, use tab labeled MH Adult Productivity.  Fill out the billing units reported in MH Units Data tab.  Input the \n        direct staff FTE reported under Sch I S&B Final tab.  Enter the direct Contract Consultant staff FTE found in Suppl B Subcontract tab by converting the \n        direct hours to direct FTE (Number of hours divide by 1,800 hrs) "]
[null,"9.1  Enter any direct staff that would like to be excluded from the productivity calculation and provide justification why they should be excluded."]
[]
["MH CHILD PRODUCTIVITY"]
["10.    For Children, Youth and Family programs, use the tab labeled MH Child Productivity.  "]
["       ","10.1   Check Statement of Work (SOW) to find specific productivity requirement for your program.  Ensure that minimum productivity standard are \n          met."]
[null,"10.2   Unless otherwise stated in SOW, the following minimum productivity standard must be met:\n         Clinicians - 50%\n         Paraprofessional - 30%\n         Medication management - 75%\n         RNs - 55%"]
[null,"10.3  Enter all required boxes obtained from MH Units Data tab for billing units info, from Sch I S&B Final for direct staff FTE info and from Suppl B \n        Subcontract for subcontract/consultant hours."]
[]
[]
[]
["BUDGET SUMMARY AMOUNT"]
["Complete the top portion (Line 1 Salaries and Benefits) splitting this line item per program/funding source. If there are two funding sources in one program, fill out two columns so the costs can be tracked separately. Refer to the contract allocation letter to complete the bottom portion on Funding Sources (Line 13-24)."]
[]
["Complete Lines 7 to 23 splitting the costs/revenues per program/funding source. Line 12 must equal to the allocation letter or budgeted amounts provided."]
[]
["MH UNITS DATA"]
["Complete one section (Line 10-25) for each program/funding source ensuring services are in line with the Statement of Work and meet the productivity requirement. List Pharmaceuticals, Flex Funds, Ancillary and Housing Cost in a separate cost center/column. If the program does not have cost centers and units of service, this page does not have to be filled out. "]
[]
["Per refer to DMH Letter No. 06-08 dated November 7, 2006 for further definition of the use of the following cost centers for housing and flex funds:  Mode 60 Service Function 70: Client Housing Support Expendtures; Mode 60 Service Function 71: Client Housing Operating Expenditures; Mode 60 Service Function 72: Client Flexible Support Expenditures."]
[]
["SUD Units & Cost Center Data"]
["Complete all yellow shaded cells, splitting the costs and units of service amount cost centers/funding source/modalities and service function codes. For example, GP would have GP DCH, GP Group and GP Individual. "]
[]
["SUBMITTAL REQUIREMENTS"]
["Submit the completed budgets in Excel form to your assigned Contracting Officer's Representative (COR) together with the signed pdf form of the Budget Summ Amt tab only no later than the set due date. Do not put shading on emailed scanned copy of signed budgets."]
["Use the file naming convention for submitted budget:  Budget FY [YY-YY] [contractor name] Contract #"]

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["Standard Budget Position Titles | FY 2025-2026"]
[]
["Position Title ","Credential ","Specialty ","Modifiers "]
["Accountant/Bookkeeper","Licensed","Billing","Bilingual "]
["Aide/Assistant","License Eligible","Caregiver","Overnight "]
["Analyst – Evaluations/Data","Certified SUD Counselor","Community Organizing","On-call  "]
["Analyst – Fiscal/Grants","Registered SUD Counselor","Data-entry","Crisis Response "]
["Assistant Program Manager","Medical Doctor","Education","Other (list in working title) "]
["BH Clinician - indicate Credential (Column F) and if applicable Specialty (Column D)","Peer Support Certification","Employment","N/A "]
["Billing Clerk- Indicate if Billing or Data-Entry (Col D)","Master's Level/Not Registered","Family"]
["Care Coordinator","Other (list in working title)","Geriatric"]
["Case Manager","N/A","Homeless/Housing"]
["Childcare Worker",null,"MAT"]
["Clinical Supervisor",null,"Media Advocacy"]
["Direct Support Staff",null,"Parent"]
["Director/Executive/Asst Director",null,"Peri-Child"]
["Driver",null,"Prevention"]
["Food Services (Director, Cook, Nutrition, etc.)",null,"TAY"]
["Intake Coordinator",null,"Youth Development"]
["IT Specialist/Technician",null,"Youth"]
["Licensed Vocational Nurse (LVN)",null,"Other (list in working title)"]
["Maintenance",null,"N/A"]
["Medical Director (MD)/Assistant MD"]
["Nurse Practitioner- Family (FNP)"]
["Nurse Practitioner- Psychiatric (PNP)"]
["Occupational Therapist (OT)"]
["Office Assistant"]
["Office Manager"]
["Outreach Worker – indicate Specialty (Column D)"]
["Patient Advocate"]
["Patient Advocate Attorney"]
["Peer Support Specialist- indicate Credential (Column F) and if applicable Specialty (Column D)"]
["Physician’s Assistant (PA)"]
["Program Manager"]
["Psychiatric Technician"]
["Psychiatrist (MD)"]
["Psychologist"]
["Quality Assurance"]
["Registered Nurse (RN)"]
["Rehab Specialist/Qualified Mental Health Professional"]
["Security Guard"]
["Specialist- indicate Specialty (Column D)"]
["Student Trainee- Indicate MFT, PCC, CSW in working title"]
["SUD Counselor- indicate Credential (Column F)"]
["Team Lead/Supervisor/Other Management"]
["Trainer"]
[]
[]
[]
["Examples: "]
[]
["Standard Position Title ","Working Title ","Credential ","Specialty ","Modifier "]
["(drop-down) ","(Free-form entry) ","(drop-down) ","(drop-down) ","(drop-down) "]
["BH Clinician ","Peri-Child Clinician ","Licensed ","Peri-Child ","N/A "]
["Billing Clerk ","Clerk ","N/A ","Data-Entry ","N/A "]
["Peer Support Specialist ","TAY Peer Partner ","Peer Support Certification ","TAY ","Bilingual "]
["SUD Counselor ","Overnight Staff ","Registered SUD Counselor ","N/A ","Overnight "]

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[]
["HEALTH AND HUMAN SERVICES AGENCY"]
["BEHAVIORAL HEALTH SERVICES."]
[]
["ADMINISTRATIVE ADJUSTMENT REQUEST"]
["(With Supporting Documentation Attached)"]
["AAR# _______________"]
[]
[]
[null,"CONTRACTOR:",null,null,{"$f":"+'Budget Summ Amt'!D6","v":0},null,null,null,null,null,null,"CONTRACT NO.:",null,null,null,{"$f":"+'Budget Summ Amt'!L6","v":0}]
[null,"ADDRESS:",null,null,null,null,null,null,null,null,null,"BUDGET PERIOD",null,null,null,{"$f":"+'Budget Summ Amt'!I6","v":0}]
[]
[null,"PROGRAM:",null,null,null,null,null,null,null,null,null,"FUNDING SOURCE"]
[null,"REQUESTED BY:",null,null,null,null,null,null,null,null,null,"TELEPHONE NO:"]
[null,null,null,null,"(Name and Title)"]
[]
[null,"NATURE OF REQUEST:",null,null,null,null,null,null,null,null,null,null,null," "]
[null,"REQUEST EFFECTIVE DATE:"]
[]
[null,"DESCRIPTION OF REQUEST (Be specific):"]
[]
[]
[]
[]
[null,"REASON FOR REQUEST (Be specific.  Justify reason and ability to increase/decrease previously budgeted amounts):"]
[]
[]
[]
[]
[null,"NOTE:  Mid-year Budget Adjustments to reduce S&B due to vacancies/delayed hiring shall not impact productivity expectations set at the beginning of the fiscal year."]
[]
[]
[null,"(Authorized Contractor Staff: Print name, designation and sign)",null,null,null,null,null,null,null,null,"Date"]
[]
[]
[]
[null,"COUNTY USE ONLY"]
[]
[null,null,"Recommended",null,null,null,"Not Recommended",null,null,null,"Comments:"]
[]
[]
[]
[null,null,"Program/Contract Analyst (Print and Sign)",null,null,null,null,null,null,null,"Date"]
[]
[]
[]
[]
[null," ","APPROVED",null,null,null,"DENIED",null,null,null,"Comments:"]
[]
[]
[]
[null,null,"COR (Print and Sign)",null,null,null,null,null,null,null,"Date"]
[]
["CC: COR, Contractor, CSU, Contract File"]
[]
["Revised 5/8/24 v1.2"]

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["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Budget Summary Page "]
["This budget will remain in effect throughout the entire contract term unless amended or revised through AAR."]
[]
[]
[null,null,"Contractor:  ",null,null,null,null,"Budget Period:  ",null,null,"Contract #:  ",null,null,"Amendment #:"]
[]
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[null,"Funding Source/Population",null,null,{"$f":"+'Sch II OE FINAL'!H9","v":"FUNDING SOURCE 1"},{"$f":"+'Sch II OE FINAL'!K9","v":"FUNDING SOURCE 2"},{"$f":"+'Sch II OE FINAL'!N9","v":"FUNDING SOURCE 3"},{"$f":"+'Sch II OE FINAL'!Q9","v":"FUNDING SOURCE 4"},{"$f":"+'Sch II OE FINAL'!T9","v":"FUNDING SOURCE 5"},{"$f":"'Sch II OE FINAL'!W9","v":"FUNDING SOURCE 6"},{"$f":"'Sch II OE FINAL'!Z9","v":"FUNDING SOURCE 7"},{"$f":"+'Sch II OE FINAL'!AC9","v":"FUNDING SOURCE 8"},{"$f":"+'Sch II OE FINAL'!AF9","v":"FUNDING SOURCE 9"},{"$f":"'Sch II OE FINAL'!AI9","v":"FUNDING SOURCE 10"},{"$f":"'Sch II OE FINAL'!AL9","v":"FUNDING SOURCE 11"},{"$f":"'Sch II OE FINAL'!AO9","v":"FUNDING SOURCE 12"},{"$f":"'Sch II OE FINAL'!AR9","v":"FUNDING SOURCE 13"},{"$f":"'Sch II OE FINAL'!AU9","v":"FUNDING SOURCE 14"},{"$f":"'Sch II OE FINAL'!AX9","v":"FUNDING SOURCE 15"},{"$f":"'Sch II OE FINAL'!BA9","v":"FUNDING SOURCE 16"},{"$f":"'Sch II OE FINAL'!BD9","v":"FUNDING SOURCE 17"},{"$f":"'Sch II OE FINAL'!BG9","v":"FUNDING SOURCE 18"},{"$f":"'Sch II OE FINAL'!BJ9","v":"FUNDING SOURCE 19"},{"$f":"'Sch II OE FINAL'!BM9","v":"FUNDING SOURCE 20"},{"$f":"'Sch II OE FINAL'!BP9","v":"FUNDING SOURCE 21"},{"$f":"'Sch II OE FINAL'!BS9","v":"FUNDING SOURCE 22"},{"$f":"'Sch II OE FINAL'!BV9","v":"FUNDING SOURCE 23"},{"$f":"'Sch II OE FINAL'!BY9","v":"FUNDING SOURCE 24"},{"$f":"'Sch II OE FINAL'!CB9","v":"FUNDING SOURCE 25"},{"$f":"'Sch II OE FINAL'!CE9","v":"FUNDING SOURCE 26"},{"$f":"'Sch II OE FINAL'!CH9","v":"FUNDING SOURCE 27"},{"$f":"'Sch II OE FINAL'!CK9","v":"FUNDING SOURCE 28"},{"$f":"'Sch II OE FINAL'!CN9","v":"FUNDING SOURCE 29"},{"$f":"'Sch II OE FINAL'!CQ9","v":"FUNDING SOURCE 30"}]
[1,"Salaries and Benefits (Schedule I)",null,{"$f":"SUM(E10:AH10)","v":0},null,null,null,null,null,null,null,null,0]
[2,"Operating Expense (Schedule II)",null,{"$f":"SUM(E11:AH11)","v":0},{"$f":"+'Sch II OE FINAL'!H59","v":0},{"$f":"+'Sch II OE FINAL'!K59","v":0},{"$f":"+'Sch II OE FINAL'!N59","v":0},{"$f":"+'Sch II OE FINAL'!Q59","v":0},{"$f":"+'Sch II OE FINAL'!T59","v":0},{"$f":"+'Sch II OE FINAL'!W59","v":0},{"$f":"+'Sch II OE FINAL'!Z59","v":0},{"$f":"+'Sch II OE FINAL'!AC59","v":0},{"$f":"+'Sch II OE FINAL'!AF59","v":0},{"$f":"+'Sch II OE FINAL'!AI59","v":0},{"$f":"+'Sch II OE FINAL'!AL59","v":0},{"$f":"'Sch II OE FINAL'!AO59","v":0},{"$f":"'Sch II OE FINAL'!AR59","v":0},{"$f":"'Sch II OE FINAL'!AU59","v":0},{"$f":"'Sch II OE FINAL'!AX59","v":0},{"$f":"'Sch II OE FINAL'!BA59","v":0},{"$f":"'Sch II OE FINAL'!BD59","v":0},{"$f":"'Sch II OE FINAL'!BG59","v":0},{"$f":"'Sch II OE FINAL'!BJ59","v":0},{"$f":"'Sch II OE FINAL'!BM59","v":0},{"$f":"'Sch II OE FINAL'!BP59","v":0},{"$f":"'Sch II OE FINAL'!BS59","v":0},{"$f":"'Sch II OE FINAL'!BV59","v":0},{"$f":"'Sch II OE FINAL'!BY59","v":0},{"$f":"'Sch II OE FINAL'!CB59","v":0},{"$f":"'Sch II OE FINAL'!CE59","v":0},{"$f":"'Sch II OE FINAL'!CH59","v":0},{"$f":"'Sch II OE FINAL'!CK59","v":0},{"$f":"'Sch II OE FINAL'!CN59","v":0},{"$f":"'Sch II OE FINAL'!CQ59","v":0}]
[3,"*Fixed Assets (Supplemental A)",null,{"$f":"SUM(E12:AH12)","v":0},{"$f":"+'Suppl A Fixed Assets'!I27","v":0},{"$f":"+'Suppl A Fixed Assets'!J27","v":0},{"$f":"+'Suppl A Fixed Assets'!K27","v":0},{"$f":"+'Suppl A Fixed Assets'!L27","v":0},{"$f":"+'Suppl A Fixed Assets'!M27","v":0},{"$f":"+'Suppl A Fixed Assets'!N27","v":0},{"$f":"+'Suppl A Fixed Assets'!O27","v":0},{"$f":"+'Suppl A Fixed Assets'!P27","v":0},{"$f":"+'Suppl A Fixed Assets'!Q27","v":0},{"$f":"+'Suppl A Fixed Assets'!R27","v":0},{"$f":"+'Suppl A Fixed Assets'!S27","v":0},{"$f":"+'Suppl A Fixed Assets'!T27","v":0},{"$f":"+'Suppl A Fixed Assets'!U27","v":0},{"$f":"+'Suppl A Fixed Assets'!V27","v":0},{"$f":"+'Suppl A Fixed Assets'!W27","v":0},{"$f":"+'Suppl A Fixed Assets'!X27","v":0},{"$f":"+'Suppl A Fixed Assets'!Y27","v":0},{"$f":"+'Suppl A Fixed Assets'!Z27","v":0},{"$f":"+'Suppl A Fixed Assets'!AA27","v":0},{"$f":"+'Suppl A Fixed Assets'!AB27","v":0},{"$f":"+'Suppl A Fixed Assets'!AC27","v":0},{"$f":"+'Suppl A Fixed Assets'!AD27","v":0},{"$f":"+'Suppl A Fixed Assets'!AE27","v":0},{"$f":"+'Suppl A Fixed Assets'!AF27","v":0},{"$f":"+'Suppl A Fixed Assets'!AG27","v":0},{"$f":"+'Suppl A Fixed Assets'!AH27","v":0},{"$f":"+'Suppl A Fixed Assets'!AI27","v":0},{"$f":"+'Suppl A Fixed Assets'!AJ27","v":0},{"$f":"+'Suppl A Fixed Assets'!AK27","v":0},{"$f":"+'Suppl A Fixed Assets'!AL27","v":0}]
[4,"*Indirect Cost (Schedule III)",null,{"$f":"SUM(E13:AH13)","v":0},{"$f":"+'Sch III Indirect FINAL'!E16","v":0},{"$f":"+'Sch III Indirect FINAL'!F16","v":0},{"$f":"+'Sch III Indirect FINAL'!G16","v":0},{"$f":"+'Sch III Indirect FINAL'!H16","v":0},{"$f":"+'Sch III Indirect FINAL'!I16","v":0},{"$f":"+'Sch III Indirect FINAL'!J16","v":0},{"$f":"+'Sch III Indirect FINAL'!K16","v":0},{"$f":"+'Sch III Indirect FINAL'!L16","v":0},{"$f":"+'Sch III Indirect FINAL'!M16","v":0},{"$f":"+'Sch III Indirect FINAL'!N16","v":0},{"$f":"+'Sch III Indirect FINAL'!O16","v":0},{"$f":"'Sch III Indirect FINAL'!P16","v":0},{"$f":"+'Sch III Indirect FINAL'!Q16","v":0},{"$f":"+'Sch III Indirect FINAL'!R16","v":0},{"$f":"+'Sch III Indirect FINAL'!S16","v":0},{"$f":"'Sch III Indirect FINAL'!T16","v":0},{"$f":"+'Sch III Indirect FINAL'!U16","v":0},{"$f":"+'Sch III Indirect FINAL'!V16","v":0},{"$f":"+'Sch III Indirect FINAL'!W16","v":0},{"$f":"'Sch III Indirect FINAL'!X16","v":0},{"$f":"'Sch III Indirect FINAL'!Y16","v":0},{"$f":"'Sch III Indirect FINAL'!Z16","v":0},{"$f":"'Sch III Indirect FINAL'!AA16","v":0},{"$f":"'Sch III Indirect FINAL'!AB16","v":0},{"$f":"'Sch III Indirect FINAL'!AC16","v":0},{"$f":"'Sch III Indirect FINAL'!AD16","v":0},{"$f":"'Sch III Indirect FINAL'!AE16","v":0},{"$f":"'Sch III Indirect FINAL'!AF16","v":0},{"$f":"'Sch III Indirect FINAL'!AG16","v":0},{"$f":"+'Sch III Indirect FINAL'!AH16","v":0}]
[5,"GROSS COST",null,{"$f":"SUM(D10:D13)","v":0},{"$f":"SUM(E10:E13)","v":0},{"$f":"SUM(F10:F13)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(AH10:AH13)","v":0}]
[]
[6,"Less: Contract Revenues"]
[7,"Participant Fees",null,{"$f":"SUM(E17:AH17)","v":0}]
[8,"Other Patient Insurance",null,{"$f":"SUM(E18:AH18)","v":0}]
[9,"Medicare",null,{"$f":"SUM(E19:AH19)","v":0}]
[10,"Other Revenues: (Specify)",null,{"$f":"SUM(E20:AH20)","v":0}]
[11,"TOTAL CONTRACT REVENUES",null,{"$f":"SUM(D16:D20)","v":0},{"$f":"SUM(E16:E20)","v":0},{"$f":"SUM(F16:F20)","v":0},0,0,0,0,0,0,0,0,0,{"$f":"SUM(P16:P20)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
[]
[12,"NET COST (CONTRACT MAX)",null,{"$f":"+D14-D21","v":0},{"$f":"+E14-E21","v":0},{"$f":"+F14-F21","v":0},0,0,0,0,0,0,0,0,0,{"$f":"+P14-P21","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
[]
[]
[null,"I certify that the deliverables and/or services were budgeted specifically for this contract in accordance with the terms and conditions set forth therein and the budgeted costs reported align with the current Cost Allocation Plan on file."]
[]
[]
[]
[null,null,"Contractor's Authorized Signature",null,null,null,null,null,null,null,"  Date:"]
[]
[null,null,"Type Name and Title"]
[]
[]
[null,null,"Approved By:",null,null,null,null,null,null,null,"  Date:"]
[null,null,"(For County Use Only)","COR Approval"]
[]
[]
["ANALYSIS OF COST PERCENTAGES"]
[null,"Program Name",null,"TOTAL",{"$f":"E8","v":"PROGRAM NAME"},"PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ",{"$f":"P8","v":"PROGRAM NAME "},"PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ",{"$f":"Z8","v":"PROGRAM NAME "},{"$f":"AA8","v":"PROGRAM NAME "},"PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME ","PROGRAM NAME "]
[null,"Funding Source/Population",null,null,{"$f":"E9","v":"FUNDING SOURCE 1"},"FUNDING SOURCE 2","FUNDING SOURCE 3","FUNDING SOURCE 4","FUNDING SOURCE 5","FUNDING SOURCE 6","FUNDING SOURCE 7","FUNDING SOURCE 8","FUNDING SOURCE 9","FUNDING SOURCE 10","FUNDING SOURCE 11",{"$f":"P9","v":"FUNDING SOURCE 12"},"FUNDING SOURCE 13","FUNDING SOURCE 14","FUNDING SOURCE 15","FUNDING SOURCE 16","FUNDING SOURCE 17","FUNDING SOURCE 18","FUNDING SOURCE 19","FUNDING SOURCE 20","FUNDING SOURCE 21","FUNDING SOURCE 22","FUNDING SOURCE 23","FUNDING SOURCE 24","FUNDING SOURCE 25","FUNDING SOURCE 26","FUNDING SOURCE 27","FUNDING SOURCE 28","FUNDING SOURCE 29","FUNDING SOURCE 30"]
[25,"Salaries and Benefits (Schedule I)",null,{"$f":"IF(ISERROR(D10/D$14),\"\",D10/D$14)","v":""},"","","","","","","","","",{"$f":"IF(ISERROR(N10/N$14),\"\",N10/N$14)","v":""},"","",{"$f":"IF(ISERROR(Q10/Q$14),\"\",Q10/Q$14)","v":""},"","","","","","","","",{"$f":"IF(ISERROR(Z10/Z$14),\"\",Z10/Z$14)","v":""},"","","","","","","",""]
[26,"Operating Expense (Schedule II)",null,{"$f":"IF(ISERROR(D11/D$14),\"\",D11/D$14)","v":""},"","","","","","","","","",{"$f":"IF(ISERROR(N11/N$14),\"\",N11/N$14)","v":""},"","",{"$f":"IF(ISERROR(Q11/Q$14),\"\",Q11/Q$14)","v":""},"","","","","","","","",{"$f":"IF(ISERROR(Z11/Z$14),\"\",Z11/Z$14)","v":""},"","","","","","","",""]
[27,"Fixed Assets (Supplemental A)",null,{"$f":"IF(ISERROR(D12/D$14),\"\",D12/D$14)","v":""},"","","","","","","","","",{"$f":"IF(ISERROR(N12/N$14),\"\",N12/N$14)","v":""},"","",{"$f":"IF(ISERROR(Q12/Q$14),\"\",Q12/Q$14)","v":""},"","","","","","","","",{"$f":"IF(ISERROR(Z12/Z$14),\"\",Z12/Z$14)","v":""},"","","","","","","",""]
[28,"Indirect Cost (Schedule III)",null,{"$f":"IF(ISERROR(D13/D$14),\"\",D13/D$14)","v":""},"","","","","","","","","",{"$f":"IF(ISERROR(N13/N$14),\"\",N13/N$14)","v":""},"","",{"$f":"IF(ISERROR(Q13/Q$14),\"\",Q13/Q$14)","v":""},"","","","","","","","",{"$f":"IF(ISERROR(Z13/Z$14),\"\",Z13/Z$14)","v":""},"","","","","","","",""]
[29,"GROSS COST",null,{"$f":"SUM(D42:D45)","v":0},{"$f":"SUM(E42:E45)","v":0},{"$f":"SUM(F42:F45)","v":0},{"$f":"SUM(G42:G45)","v":0},0,0,0,0,0,0,{"$f":"SUM(N42:N45)","v":0},0,0,{"$f":"SUM(Q42:Q45)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0]
[]
[null,"FTE COUNT"]
[30,"Direct FTE (Sch I productivity FTE)",null,{"$f":"'Sch I S&B'!AE304","v":0}]
[31,"Admin FTE (Sch I producitivity FTE)",null,{"$f":"'Sch I S&B'!AF304","v":0}]
[32,"Estimated Indirect FTE",null,{"$f":"'Sch III Indirect FINAL'!G21","v":0}]
[33,"Consultant FTE"]
[null,"TOTAL FTE",null,{"$f":"SUM(D49:D52)","v":0}]

{"sheet":"MH Units & Cost Center Data","index":5,"n_rows":549,"n_cols":13,"rows_kept":549,"cut":false,"hidden":false,"merged":[[2,0,2,12]]}
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Budget Summary Page - Mental Health Projected Units Data"]
["Note:  Data on this tab is for internal projections only and does not represent limitations per funding source."]
[]
[]
["Contractor:  ",{"$f":"+'Budget Summ Amt'!D6","v":0},null,null,"Budget Period:  ",{"$f":"+'Budget Summ Amt'!I6","v":0},null,"Contract #:  ",{"$f":"+'Budget Summ Amt'!L6","v":0},null,"Amendment #:",{"$f":"+'Budget Summ Amt'!O6","v":0}]
[]
["Service Function Code",null,"TOTAL","SFC1","SFC2","SFC3","SFC4","SFC5","SFC6","SFC7","SFC8","SFC9","SFC10"]
["Service Function Description"]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!E8","v":"PROGRAM NAME"},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!E9","v":"FUNDING SOURCE 1"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D11:M11)","v":0}]
["Other Revenues",null,{"$f":"SUM(D12:M12)","v":0}]
["Net Cost   ",null,{"$f":"+C11-C12","v":0},{"$f":"+D11-D12","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D14:M14)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D11/D14),\"\",+D11/D14)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D16:M16)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D11/D16),\"\",+D11/D16)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D19:M19)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D20:M20)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D21:M21)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C19:C21)","v":0},{"$f":"SUM(D19:D21)","v":0},0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C22/C16),\"\", +C22/C16)","v":""},{"$f":"IF(ISERROR(+D22/D16),\"\", +D22/D16)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D24:M24)","v":0},{"$f":"IF(ISERROR(+D19*D17*0.5),\"\",ROUND((+D19*D17*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D25:M25)","v":0},{"$f":"IF(ISERROR(+D20*D17*0.65),\"\",ROUND((+D20*D17*0.65),2))","v":""},{"$f":"IF(ISERROR(+E20*E17*0.65),\"\",ROUND((+E20*E17*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D26:M26)","v":0},{"$f":"IF(ISERROR(+D21*D17*0.9),\"\",ROUND((+D21*D17*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C24:C26)","v":0},0,0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!F8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!F9","v":"FUNDING SOURCE 2"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D29:M29)","v":0}]
["Other Revenues",null,{"$f":"SUM(D30:M30)","v":0}]
["Net Cost   ",null,{"$f":"+C29-C30","v":0},{"$f":"+D29-D30","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D32:M32)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D29/D32),\"\",+D29/D32)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D34:M34)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D29/D34),\"\",+D29/D34)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D37:M37)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D38:M38)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D39:M39)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C37:C39)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C40/C34),\"\", +C40/C34)","v":""},{"$f":"IF(ISERROR(+D40/D34),\"\", +D40/D34)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D42:M42)","v":0},{"$f":"IF(ISERROR(+D37*D35*0.5),\"\",ROUND((+D37*D35*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D43:M43)","v":0},{"$f":"IF(ISERROR(+D38*D35*0.65),\"\",ROUND((+D38*D35*0.65),2))","v":""},{"$f":"IF(ISERROR(+E38*E35*0.65),\"\",ROUND((+E38*E35*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D44:M44)","v":0},{"$f":"IF(ISERROR(+D39*D35*0.9),\"\",ROUND((+D39*D35*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C42:C44)","v":0},{"$f":"SUM(D42:D44)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!G8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!G9","v":"FUNDING SOURCE 3"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D47:M47)","v":0}]
["Other Revenues",null,{"$f":"SUM(D48:M48)","v":0}]
["Net Cost   ",null,{"$f":"+C47-C48","v":0},{"$f":"+D47-D48","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D50:M50)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D47/D50),\"\",+D47/D50)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D52:M52)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D47/D52),\"\",+D47/D52)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D55:M55)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D56:M56)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D57:M57)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C55:C57)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C58/C52),\"\", +C58/C52)","v":""},{"$f":"IF(ISERROR(+D58/D52),\"\", +D58/D52)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D60:M60)","v":0},{"$f":"IF(ISERROR(+D55*D53*0.5),\"\",ROUND((+D55*D53*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D61:M61)","v":0},{"$f":"IF(ISERROR(+D56*D53*0.65),\"\",ROUND((+D56*D53*0.65),2))","v":""},{"$f":"IF(ISERROR(+E56*E53*0.65),\"\",ROUND((+E56*E53*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D62:M62)","v":0},{"$f":"IF(ISERROR(+D57*D53*0.9),\"\",ROUND((+D57*D53*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C60:C62)","v":0},{"$f":"SUM(D60:D62)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!H8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!H9","v":"FUNDING SOURCE 4"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D65:M65)","v":0}]
["Other Revenues",null,{"$f":"SUM(D66:M66)","v":0}]
["Net Cost   ",null,{"$f":"+C65-C66","v":0},{"$f":"+D65-D66","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D68:M68)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D65/D68),\"\",+D65/D68)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D70:M70)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D65/D70),\"\",+D65/D70)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D73:M73)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D74:M74)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D75:M75)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C73:C75)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C76/C70),\"\", +C76/C70)","v":""},{"$f":"IF(ISERROR(+D76/D70),\"\", +D76/D70)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D78:M78)","v":0},{"$f":"IF(ISERROR(+D73*D71*0.5),\"\",ROUND((+D73*D71*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D79:M79)","v":0},{"$f":"IF(ISERROR(+D74*D71*0.65),\"\",ROUND((+D74*D71*0.65),2))","v":""},{"$f":"IF(ISERROR(+E74*E71*0.65),\"\",ROUND((+E74*E71*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D80:M80)","v":0},{"$f":"IF(ISERROR(+D75*D71*0.9),\"\",ROUND((+D75*D71*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C78:C80)","v":0},{"$f":"SUM(D78:D80)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!I8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!I9","v":"FUNDING SOURCE 5"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D83:M83)","v":0}]
["Other Revenues",null,{"$f":"SUM(D84:M84)","v":0}]
["Net Cost   ",null,{"$f":"+C83-C84","v":0},{"$f":"+D83-D84","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D86:M86)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D83/D86),\"\",+D83/D86)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D88:M88)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D83/D88),\"\",+D83/D88)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D91:M91)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D92:M92)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D93:M93)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C91:C93)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C94/C88),\"\", +C94/C88)","v":""},{"$f":"IF(ISERROR(+D94/D88),\"\", +D94/D88)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D96:M96)","v":0},{"$f":"IF(ISERROR(+D91*D89*0.5),\"\",ROUND((+D91*D89*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D97:M97)","v":0},{"$f":"IF(ISERROR(+D92*D89*0.65),\"\",ROUND((+D92*D89*0.65),2))","v":""},{"$f":"IF(ISERROR(+E92*E89*0.65),\"\",ROUND((+E92*E89*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D98:M98)","v":0},{"$f":"IF(ISERROR(+D93*D89*0.9),\"\",ROUND((+D93*D89*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C96:C98)","v":0},{"$f":"SUM(D96:D98)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!J8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!J9","v":"FUNDING SOURCE 6"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D101:M101)","v":0}]
["Other Revenues",null,{"$f":"SUM(D102:M102)","v":0}]
["Net Cost   ",null,{"$f":"+C101-C102","v":0},{"$f":"+D101-D102","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D104:M104)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D101/D104),\"\",+D101/D104)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D106:M106)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D101/D106),\"\",+D101/D106)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D109:M109)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D110:M110)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D111:M111)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C109:C111)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C112/C106),\"\", +C112/C106)","v":""},{"$f":"IF(ISERROR(+D112/D106),\"\", +D112/D106)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D114:M114)","v":0},{"$f":"IF(ISERROR(+D109*D107*0.5),\"\",ROUND((+D109*D107*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D115:M115)","v":0},{"$f":"IF(ISERROR(+D110*D107*0.65),\"\",ROUND((+D110*D107*0.65),2))","v":""},{"$f":"IF(ISERROR(+E110*E107*0.65),\"\",ROUND((+E110*E107*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D116:M116)","v":0},{"$f":"IF(ISERROR(+D111*D107*0.9),\"\",ROUND((+D111*D107*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C114:C116)","v":0},{"$f":"SUM(D114:D116)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!K8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!K9","v":"FUNDING SOURCE 7"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D119:M119)","v":0}]
["Other Revenues",null,{"$f":"SUM(D120:M120)","v":0}]
["Net Cost   ",null,{"$f":"+C119-C120","v":0},{"$f":"+D119-D120","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D122:M122)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D119/D122),\"\",+D119/D122)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D124:M124)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D119/D124),\"\",+D119/D124)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D127:M127)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D128:M128)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D129:M129)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C127:C129)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C130/C124),\"\", +C130/C124)","v":""},{"$f":"IF(ISERROR(+D130/D124),\"\", +D130/D124)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D132:M132)","v":0},{"$f":"IF(ISERROR(+D127*D125*0.5),\"\",ROUND((+D127*D125*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D133:M133)","v":0},{"$f":"IF(ISERROR(+D128*D125*0.65),\"\",ROUND((+D128*D125*0.65),2))","v":""},{"$f":"IF(ISERROR(+E128*E125*0.65),\"\",ROUND((+E128*E125*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D134:M134)","v":0},{"$f":"IF(ISERROR(+D129*D125*0.9),\"\",ROUND((+D129*D125*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C132:C134)","v":0},{"$f":"SUM(D132:D134)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!L8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!L9","v":"FUNDING SOURCE 8"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D137:M137)","v":0}]
["Other Revenues",null,{"$f":"SUM(D138:M138)","v":0}]
["Net Cost   ",null,{"$f":"+C137-C138","v":0},{"$f":"+D137-D138","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D140:M140)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D137/D140),\"\",+D137/D140)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D142:M142)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D137/D142),\"\",+D137/D142)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D145:M145)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D146:M146)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D147:M147)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C145:C147)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C148/C142),\"\", +C148/C142)","v":""},{"$f":"IF(ISERROR(+D148/D142),\"\", +D148/D142)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D150:M150)","v":0},{"$f":"IF(ISERROR(+D145*D143*0.5),\"\",ROUND((+D145*D143*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D151:M151)","v":0},{"$f":"IF(ISERROR(+D146*D143*0.65),\"\",ROUND((+D146*D143*0.65),2))","v":""},{"$f":"IF(ISERROR(+E146*E143*0.65),\"\",ROUND((+E146*E143*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D152:M152)","v":0},{"$f":"IF(ISERROR(+D147*D143*0.9),\"\",ROUND((+D147*D143*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C150:C152)","v":0},{"$f":"SUM(D150:D152)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!M8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!M9","v":"FUNDING SOURCE 9"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D155:M155)","v":0}]
["Other Revenues",null,{"$f":"SUM(D156:M156)","v":0}]
["Net Cost   ",null,{"$f":"+C155-C156","v":0},{"$f":"+D155-D156","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D158:M158)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D155/D158),\"\",+D155/D158)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D160:M160)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D155/D160),\"\",+D155/D160)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D163:M163)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D164:M164)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D165:M165)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C163:C165)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C166/C160),\"\", +C166/C160)","v":""},{"$f":"IF(ISERROR(+D166/D160),\"\", +D166/D160)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D168:M168)","v":0},{"$f":"IF(ISERROR(+D163*D161*0.5),\"\",ROUND((+D163*D161*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D169:M169)","v":0},{"$f":"IF(ISERROR(+D164*D161*0.65),\"\",ROUND((+D164*D161*0.65),2))","v":""},{"$f":"IF(ISERROR(+E164*E161*0.65),\"\",ROUND((+E164*E161*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D170:M170)","v":0},{"$f":"IF(ISERROR(+D165*D161*0.9),\"\",ROUND((+D165*D161*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C168:C170)","v":0},{"$f":"SUM(D168:D170)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!N8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!N9","v":"FUNDING SOURCE 10"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D173:M173)","v":0}]
["Other Revenues",null,{"$f":"SUM(D174:M174)","v":0}]
["Net Cost   ",null,{"$f":"+C173-C174","v":0},{"$f":"+D173-D174","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D176:M176)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D173/D176),\"\",+D173/D176)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D178:M178)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D173/D178),\"\",+D173/D178)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D181:M181)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D182:M182)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D183:M183)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C181:C183)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C184/C178),\"\", +C184/C178)","v":""},{"$f":"IF(ISERROR(+D184/D178),\"\", +D184/D178)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D186:M186)","v":0},{"$f":"IF(ISERROR(+D181*D179*0.5),\"\",ROUND((+D181*D179*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D187:M187)","v":0},{"$f":"IF(ISERROR(+D182*D179*0.65),\"\",ROUND((+D182*D179*0.65),2))","v":""},{"$f":"IF(ISERROR(+E182*E179*0.65),\"\",ROUND((+E182*E179*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D188:M188)","v":0},{"$f":"IF(ISERROR(+D183*D179*0.9),\"\",ROUND((+D183*D179*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C186:C188)","v":0},{"$f":"SUM(D186:D188)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!O8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!O9","v":"FUNDING SOURCE 11"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D191:M191)","v":0}]
["Other Revenues",null,{"$f":"SUM(D192:M192)","v":0}]
["Net Cost   ",null,{"$f":"+C191-C192","v":0},{"$f":"+D191-D192","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D194:M194)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D191/D194),\"\",+D191/D194)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D196:M196)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D191/D196),\"\",+D191/D196)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D199:M199)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D200:M200)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D201:M201)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C199:C201)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C202/C196),\"\", +C202/C196)","v":""},{"$f":"IF(ISERROR(+D202/D196),\"\", +D202/D196)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D204:M204)","v":0},{"$f":"IF(ISERROR(+D199*D197*0.5),\"\",ROUND((+D199*D197*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D205:M205)","v":0},{"$f":"IF(ISERROR(+D200*D197*0.65),\"\",ROUND((+D200*D197*0.65),2))","v":""},{"$f":"IF(ISERROR(+E200*E197*0.65),\"\",ROUND((+E200*E197*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D206:M206)","v":0},{"$f":"IF(ISERROR(+D201*D197*0.9),\"\",ROUND((+D201*D197*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C204:C206)","v":0},{"$f":"SUM(D204:D206)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!P8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!P9","v":"FUNDING SOURCE 12"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D209:M209)","v":0}]
["Other Revenues",null,{"$f":"SUM(D210:M210)","v":0}]
["Net Cost   ",null,{"$f":"+C209-C210","v":0},{"$f":"+D209-D210","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D212:M212)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D209/D212),\"\",+D209/D212)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D214:M214)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D209/D214),\"\",+D209/D214)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D217:M217)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D218:M218)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D219:M219)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C217:C219)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C220/C214),\"\", +C220/C214)","v":""},{"$f":"IF(ISERROR(+D220/D214),\"\", +D220/D214)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D222:M222)","v":0},{"$f":"IF(ISERROR(+D217*D215*0.5),\"\",ROUND((+D217*D215*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D223:M223)","v":0},{"$f":"IF(ISERROR(+D218*D215*0.65),\"\",ROUND((+D218*D215*0.65),2))","v":""},{"$f":"IF(ISERROR(+E218*E215*0.65),\"\",ROUND((+E218*E215*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D224:M224)","v":0},{"$f":"IF(ISERROR(+D219*D215*0.9),\"\",ROUND((+D219*D215*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C222:C224)","v":0},{"$f":"SUM(D222:D224)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!Q8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!Q9","v":"FUNDING SOURCE 13"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D227:M227)","v":0}]
["Other Revenues",null,{"$f":"SUM(D228:M228)","v":0}]
["Net Cost   ",null,{"$f":"+C227-C228","v":0},{"$f":"+D227-D228","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D230:M230)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D227/D230),\"\",+D227/D230)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D232:M232)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D227/D232),\"\",+D227/D232)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D235:M235)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D236:M236)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D237:M237)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C235:C237)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C238/C232),\"\", +C238/C232)","v":""},{"$f":"IF(ISERROR(+D238/D232),\"\", +D238/D232)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D240:M240)","v":0},{"$f":"IF(ISERROR(+D235*D233*0.5),\"\",ROUND((+D235*D233*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D241:M241)","v":0},{"$f":"IF(ISERROR(+D236*D233*0.65),\"\",ROUND((+D236*D233*0.65),2))","v":""},{"$f":"IF(ISERROR(+E236*E233*0.65),\"\",ROUND((+E236*E233*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D242:M242)","v":0},{"$f":"IF(ISERROR(+D237*D233*0.9),\"\",ROUND((+D237*D233*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C240:C242)","v":0},{"$f":"SUM(D240:D242)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!R8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!R9","v":"FUNDING SOURCE 14"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D245:M245)","v":0}]
["Other Revenues",null,{"$f":"SUM(D246:M246)","v":0}]
["Net Cost   ",null,{"$f":"+C245-C246","v":0},{"$f":"+D245-D246","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D248:M248)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D245/D248),\"\",+D245/D248)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D250:M250)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D245/D250),\"\",+D245/D250)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D253:M253)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D254:M254)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D255:M255)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C253:C255)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C256/C250),\"\", +C256/C250)","v":""},{"$f":"IF(ISERROR(+D256/D250),\"\", +D256/D250)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D258:M258)","v":0},{"$f":"IF(ISERROR(+D253*D251*0.5),\"\",ROUND((+D253*D251*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D259:M259)","v":0},{"$f":"IF(ISERROR(+D254*D251*0.65),\"\",ROUND((+D254*D251*0.65),2))","v":""},{"$f":"IF(ISERROR(+E254*E251*0.65),\"\",ROUND((+E254*E251*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D260:M260)","v":0},{"$f":"IF(ISERROR(+D255*D251*0.9),\"\",ROUND((+D255*D251*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C258:C260)","v":0},{"$f":"SUM(D258:D260)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!S8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!S9","v":"FUNDING SOURCE 15"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D263:M263)","v":0}]
["Other Revenues",null,{"$f":"SUM(D264:M264)","v":0}]
["Net Cost   ",null,{"$f":"+C263-C264","v":0},{"$f":"+D263-D264","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D266:M266)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D263/D266),\"\",+D263/D266)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D268:M268)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D263/D268),\"\",+D263/D268)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D271:M271)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D272:M272)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D273:M273)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C271:C273)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C274/C268),\"\", +C274/C268)","v":""},{"$f":"IF(ISERROR(+D274/D268),\"\", +D274/D268)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D276:M276)","v":0},{"$f":"IF(ISERROR(+D271*D269*0.5),\"\",ROUND((+D271*D269*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D277:M277)","v":0},{"$f":"IF(ISERROR(+D272*D269*0.65),\"\",ROUND((+D272*D269*0.65),2))","v":""},{"$f":"IF(ISERROR(+E272*E269*0.65),\"\",ROUND((+E272*E269*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D278:M278)","v":0},{"$f":"IF(ISERROR(+D273*D269*0.9),\"\",ROUND((+D273*D269*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C276:C278)","v":0},{"$f":"SUM(D276:D278)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!T8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!T9","v":"FUNDING SOURCE 16"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D281:M281)","v":0}]
["Other Revenues",null,{"$f":"SUM(D282:M282)","v":0}]
["Net Cost   ",null,{"$f":"+C281-C282","v":0},{"$f":"+D281-D282","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D284:M284)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D281/D284),\"\",+D281/D284)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D286:M286)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D281/D286),\"\",+D281/D286)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D289:M289)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D290:M290)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D291:M291)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C289:C291)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C292/C286),\"\", +C292/C286)","v":""},{"$f":"IF(ISERROR(+D292/D286),\"\", +D292/D286)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D294:M294)","v":0},{"$f":"IF(ISERROR(+D289*D287*0.5),\"\",ROUND((+D289*D287*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D295:M295)","v":0},{"$f":"IF(ISERROR(+D290*D287*0.65),\"\",ROUND((+D290*D287*0.65),2))","v":""},{"$f":"IF(ISERROR(+E290*E287*0.65),\"\",ROUND((+E290*E287*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D296:M296)","v":0},{"$f":"IF(ISERROR(+D291*D287*0.9),\"\",ROUND((+D291*D287*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C294:C296)","v":0},{"$f":"SUM(D294:D296)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!U8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!U9","v":"FUNDING SOURCE 17"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D299:M299)","v":0}]
["Other Revenues",null,{"$f":"SUM(D300:M300)","v":0}]
["Net Cost   ",null,{"$f":"+C299-C300","v":0},{"$f":"+D299-D300","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D302:M302)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D299/D302),\"\",+D299/D302)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D304:M304)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D299/D304),\"\",+D299/D304)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D307:M307)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D308:M308)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D309:M309)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C307:C309)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C310/C304),\"\", +C310/C304)","v":""},{"$f":"IF(ISERROR(+D310/D304),\"\", +D310/D304)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D312:M312)","v":0},{"$f":"IF(ISERROR(+D307*D305*0.5),\"\",ROUND((+D307*D305*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D313:M313)","v":0},{"$f":"IF(ISERROR(+D308*D305*0.65),\"\",ROUND((+D308*D305*0.65),2))","v":""},{"$f":"IF(ISERROR(+E308*E305*0.65),\"\",ROUND((+E308*E305*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D314:M314)","v":0},{"$f":"IF(ISERROR(+D309*D305*0.9),\"\",ROUND((+D309*D305*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C312:C314)","v":0},{"$f":"SUM(D312:D314)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!V8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!V9","v":"FUNDING SOURCE 18"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D317:M317)","v":0}]
["Other Revenues",null,{"$f":"SUM(D318:M318)","v":0}]
["Net Cost   ",null,{"$f":"+C317-C318","v":0},{"$f":"+D317-D318","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D320:M320)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D317/D320),\"\",+D317/D320)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D322:M322)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D317/D322),\"\",+D317/D322)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D325:M325)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D326:M326)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D327:M327)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C325:C327)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C328/C322),\"\", +C328/C322)","v":""},{"$f":"IF(ISERROR(+D328/D322),\"\", +D328/D322)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D330:M330)","v":0},{"$f":"IF(ISERROR(+D325*D323*0.5),\"\",ROUND((+D325*D323*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D331:M331)","v":0},{"$f":"IF(ISERROR(+D326*D323*0.65),\"\",ROUND((+D326*D323*0.65),2))","v":""},{"$f":"IF(ISERROR(+E326*E323*0.65),\"\",ROUND((+E326*E323*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D332:M332)","v":0},{"$f":"IF(ISERROR(+D327*D323*0.9),\"\",ROUND((+D327*D323*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C330:C332)","v":0},{"$f":"SUM(D330:D332)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!W8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!W9","v":"FUNDING SOURCE 19"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D335:M335)","v":0}]
["Other Revenues",null,{"$f":"SUM(D336:M336)","v":0}]
["Net Cost   ",null,{"$f":"+C335-C336","v":0},{"$f":"+D335-D336","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D338:M338)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D335/D338),\"\",+D335/D338)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D340:M340)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D335/D340),\"\",+D335/D340)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D343:M343)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D344:M344)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D345:M345)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C343:C345)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C346/C340),\"\", +C346/C340)","v":""},{"$f":"IF(ISERROR(+D346/D340),\"\", +D346/D340)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D348:M348)","v":0},{"$f":"IF(ISERROR(+D343*D341*0.5),\"\",ROUND((+D343*D341*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D349:M349)","v":0},{"$f":"IF(ISERROR(+D344*D341*0.65),\"\",ROUND((+D344*D341*0.65),2))","v":""},{"$f":"IF(ISERROR(+E344*E341*0.65),\"\",ROUND((+E344*E341*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D350:M350)","v":0},{"$f":"IF(ISERROR(+D345*D341*0.9),\"\",ROUND((+D345*D341*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C348:C350)","v":0},{"$f":"SUM(D348:D350)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!X8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!X9","v":"FUNDING SOURCE 20"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D353:M353)","v":0}]
["Other Revenues",null,{"$f":"SUM(D354:M354)","v":0}]
["Net Cost   ",null,{"$f":"+C353-C354","v":0},{"$f":"+D353-D354","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D356:M356)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D353/D356),\"\",+D353/D356)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D358:M358)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D353/D358),\"\",+D353/D358)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D361:M361)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D362:M362)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D363:M363)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C361:C363)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C364/C358),\"\", +C364/C358)","v":""},{"$f":"IF(ISERROR(+D364/D358),\"\", +D364/D358)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D366:M366)","v":0},{"$f":"IF(ISERROR(+D361*D359*0.5),\"\",ROUND((+D361*D359*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D367:M367)","v":0},{"$f":"IF(ISERROR(+D362*D359*0.65),\"\",ROUND((+D362*D359*0.65),2))","v":""},{"$f":"IF(ISERROR(+E362*E359*0.65),\"\",ROUND((+E362*E359*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D368:M368)","v":0},{"$f":"IF(ISERROR(+D363*D359*0.9),\"\",ROUND((+D363*D359*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C366:C368)","v":0},{"$f":"SUM(D366:D368)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!Y8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!Y9","v":"FUNDING SOURCE 21"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D371:M371)","v":0}]
["Other Revenues",null,{"$f":"SUM(D372:M372)","v":0}]
["Net Cost   ",null,{"$f":"+C371-C372","v":0},{"$f":"+D371-D372","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D374:M374)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D371/D374),\"\",+D371/D374)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D376:M376)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D371/D376),\"\",+D371/D376)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D379:M379)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D380:M380)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D381:M381)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C379:C381)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C382/C376),\"\", +C382/C376)","v":""},{"$f":"IF(ISERROR(+D382/D376),\"\", +D382/D376)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D384:M384)","v":0},{"$f":"IF(ISERROR(+D379*D377*0.5),\"\",ROUND((+D379*D377*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D385:M385)","v":0},{"$f":"IF(ISERROR(+D380*D377*0.65),\"\",ROUND((+D380*D377*0.65),2))","v":""},{"$f":"IF(ISERROR(+E380*E377*0.65),\"\",ROUND((+E380*E377*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D386:M386)","v":0},{"$f":"IF(ISERROR(+D381*D377*0.9),\"\",ROUND((+D381*D377*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C384:C386)","v":0},{"$f":"SUM(D384:D386)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!Z8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!Z9","v":"FUNDING SOURCE 22"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D389:M389)","v":0}]
["Other Revenues",null,{"$f":"SUM(D390:M390)","v":0}]
["Net Cost   ",null,{"$f":"+C389-C390","v":0},{"$f":"+D389-D390","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D392:M392)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D389/D392),\"\",+D389/D392)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D394:M394)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D389/D394),\"\",+D389/D394)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D397:M397)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D398:M398)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D399:M399)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C397:C399)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C400/C394),\"\", +C400/C394)","v":""},{"$f":"IF(ISERROR(+D400/D394),\"\", +D400/D394)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D402:M402)","v":0},{"$f":"IF(ISERROR(+D397*D395*0.5),\"\",ROUND((+D397*D395*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D403:M403)","v":0},{"$f":"IF(ISERROR(+D398*D395*0.65),\"\",ROUND((+D398*D395*0.65),2))","v":""},{"$f":"IF(ISERROR(+E398*E395*0.65),\"\",ROUND((+E398*E395*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D404:M404)","v":0},{"$f":"IF(ISERROR(+D399*D395*0.9),\"\",ROUND((+D399*D395*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C402:C404)","v":0},{"$f":"SUM(D402:D404)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AA8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AA9","v":"FUNDING SOURCE 23"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D407:M407)","v":0}]
["Other Revenues",null,{"$f":"SUM(D408:M408)","v":0}]
["Net Cost   ",null,{"$f":"+C407-C408","v":0},{"$f":"+D407-D408","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D410:M410)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D407/D410),\"\",+D407/D410)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D412:M412)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D407/D412),\"\",+D407/D412)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D415:M415)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D416:M416)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D417:M417)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C415:C417)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C418/C412),\"\", +C418/C412)","v":""},{"$f":"IF(ISERROR(+D418/D412),\"\", +D418/D412)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D420:M420)","v":0},{"$f":"IF(ISERROR(+D415*D413*0.5),\"\",ROUND((+D415*D413*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D421:M421)","v":0},{"$f":"IF(ISERROR(+D416*D413*0.65),\"\",ROUND((+D416*D413*0.65),2))","v":""},{"$f":"IF(ISERROR(+E416*E413*0.65),\"\",ROUND((+E416*E413*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D422:M422)","v":0},{"$f":"IF(ISERROR(+D417*D413*0.9),\"\",ROUND((+D417*D413*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C420:C422)","v":0},{"$f":"SUM(D420:D422)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AB8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AB9","v":"FUNDING SOURCE 24"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D425:M425)","v":0}]
["Other Revenues",null,{"$f":"SUM(D426:M426)","v":0}]
["Net Cost   ",null,{"$f":"+C425-C426","v":0},{"$f":"+D425-D426","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D428:M428)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D425/D428),\"\",+D425/D428)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D430:M430)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D425/D430),\"\",+D425/D430)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D433:M433)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D434:M434)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D435:M435)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C433:C435)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C436/C430),\"\", +C436/C430)","v":""},{"$f":"IF(ISERROR(+D436/D430),\"\", +D436/D430)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D438:M438)","v":0},{"$f":"IF(ISERROR(+D433*D431*0.5),\"\",ROUND((+D433*D431*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D439:M439)","v":0},{"$f":"IF(ISERROR(+D434*D431*0.65),\"\",ROUND((+D434*D431*0.65),2))","v":""},{"$f":"IF(ISERROR(+E434*E431*0.65),\"\",ROUND((+E434*E431*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D440:M440)","v":0},{"$f":"IF(ISERROR(+D435*D431*0.9),\"\",ROUND((+D435*D431*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C438:C440)","v":0},{"$f":"SUM(D438:D440)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AC8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AC9","v":"FUNDING SOURCE 25"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D443:M443)","v":0}]
["Other Revenues",null,{"$f":"SUM(D444:M444)","v":0}]
["Net Cost   ",null,{"$f":"+C443-C444","v":0},{"$f":"+D443-D444","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D446:M446)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D443/D446),\"\",+D443/D446)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D448:M448)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D443/D448),\"\",+D443/D448)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D451:M451)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D452:M452)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D453:M453)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C451:C453)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C454/C448),\"\", +C454/C448)","v":""},{"$f":"IF(ISERROR(+D454/D448),\"\", +D454/D448)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D456:M456)","v":0},{"$f":"IF(ISERROR(+D451*D449*0.5),\"\",ROUND((+D451*D449*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D457:M457)","v":0},{"$f":"IF(ISERROR(+D452*D449*0.65),\"\",ROUND((+D452*D449*0.65),2))","v":""},{"$f":"IF(ISERROR(+E452*E449*0.65),\"\",ROUND((+E452*E449*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D458:M458)","v":0},{"$f":"IF(ISERROR(+D453*D449*0.9),\"\",ROUND((+D453*D449*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C456:C458)","v":0},{"$f":"SUM(D456:D458)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AD8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AD9","v":"FUNDING SOURCE 26"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D461:M461)","v":0}]
["Other Revenues",null,{"$f":"SUM(D462:M462)","v":0}]
["Net Cost   ",null,{"$f":"+C461-C462","v":0},{"$f":"+D461-D462","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D464:M464)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D461/D464),\"\",+D461/D464)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D466:M466)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D461/D466),\"\",+D461/D466)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D469:M469)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D470:M470)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D471:M471)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C469:C471)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C472/C466),\"\", +C472/C466)","v":""},{"$f":"IF(ISERROR(+D472/D466),\"\", +D472/D466)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D474:M474)","v":0},{"$f":"IF(ISERROR(+D469*D467*0.5),\"\",ROUND((+D469*D467*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D475:M475)","v":0},{"$f":"IF(ISERROR(+D470*D467*0.65),\"\",ROUND((+D470*D467*0.65),2))","v":""},{"$f":"IF(ISERROR(+E470*E467*0.65),\"\",ROUND((+E470*E467*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D476:M476)","v":0},{"$f":"IF(ISERROR(+D471*D467*0.9),\"\",ROUND((+D471*D467*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C474:C476)","v":0},{"$f":"SUM(D474:D476)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AE8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AE9","v":"FUNDING SOURCE 27"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D479:M479)","v":0}]
["Other Revenues",null,{"$f":"SUM(D480:M480)","v":0}]
["Net Cost   ",null,{"$f":"+C479-C480","v":0},{"$f":"+D479-D480","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D482:M482)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D479/D482),\"\",+D479/D482)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D484:M484)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D479/D484),\"\",+D479/D484)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D487:M487)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D488:M488)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D489:M489)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C487:C489)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C490/C484),\"\", +C490/C484)","v":""},{"$f":"IF(ISERROR(+D490/D484),\"\", +D490/D484)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D492:M492)","v":0},{"$f":"IF(ISERROR(+D487*D485*0.5),\"\",ROUND((+D487*D485*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D493:M493)","v":0},{"$f":"IF(ISERROR(+D488*D485*0.65),\"\",ROUND((+D488*D485*0.65),2))","v":""},{"$f":"IF(ISERROR(+E488*E485*0.65),\"\",ROUND((+E488*E485*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D494:M494)","v":0},{"$f":"IF(ISERROR(+D489*D485*0.9),\"\",ROUND((+D489*D485*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C492:C494)","v":0},{"$f":"SUM(D492:D494)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AF8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AF9","v":"FUNDING SOURCE 28"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D497:M497)","v":0}]
["Other Revenues",null,{"$f":"SUM(D498:M498)","v":0}]
["Net Cost   ",null,{"$f":"+C497-C498","v":0},{"$f":"+D497-D498","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D500:M500)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D497/D500),\"\",+D497/D500)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D502:M502)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D497/D502),\"\",+D497/D502)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D505:M505)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D506:M506)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D507:M507)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C505:C507)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C508/C502),\"\", +C508/C502)","v":""},{"$f":"IF(ISERROR(+D508/D502),\"\", +D508/D502)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D510:M510)","v":0},{"$f":"IF(ISERROR(+D505*D503*0.5),\"\",ROUND((+D505*D503*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D511:M511)","v":0},{"$f":"IF(ISERROR(+D506*D503*0.65),\"\",ROUND((+D506*D503*0.65),2))","v":""},{"$f":"IF(ISERROR(+E506*E503*0.65),\"\",ROUND((+E506*E503*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D512:M512)","v":0},{"$f":"IF(ISERROR(+D507*D503*0.9),\"\",ROUND((+D507*D503*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C510:C512)","v":0},{"$f":"SUM(D510:D512)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AG8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AG9","v":"FUNDING SOURCE 29"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D515:M515)","v":0}]
["Other Revenues",null,{"$f":"SUM(D516:M516)","v":0}]
["Net Cost   ",null,{"$f":"+C515-C516","v":0},{"$f":"+D515-D516","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D518:M518)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D515/D518),\"\",+D515/D518)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D520:M520)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D515/D520),\"\",+D515/D520)","v":""},"","","","","","","","",""]
[]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D523:M523)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D524:M524)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D525:M525)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C523:C525)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C526/C520),\"\", +C526/C520)","v":""},{"$f":"IF(ISERROR(+D526/D520),\"\", +D526/D520)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D528:M528)","v":0},{"$f":"IF(ISERROR(+D523*D521*0.5),\"\",ROUND((+D523*D521*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D529:M529)","v":0},{"$f":"IF(ISERROR(+D524*D521*0.65),\"\",ROUND((+D524*D521*0.65),2))","v":""},{"$f":"IF(ISERROR(+E524*E521*0.65),\"\",ROUND((+E524*E521*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D530:M530)","v":0},{"$f":"IF(ISERROR(+D525*D521*0.9),\"\",ROUND((+D525*D521*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C528:C530)","v":0},{"$f":"SUM(D528:D530)","v":0},0,0,0,0,0,0,0,0,0]
["PROGRAM NAME:",{"$f":"'Budget Summ Amt'!AH8","v":"PROGRAM NAME "},null,null,"FUNDING SOURCE:",null,{"$f":"'Budget Summ Amt'!AH9","v":"FUNDING SOURCE 30"}]
["Gross Cost (Line 5 Budget Summ Amt)",null,{"$f":"SUM(D533:M533)","v":0}]
["Other Revenues",null,{"$f":"SUM(D534:M534)","v":0}]
["Net Cost   ",null,{"$f":"+C533-C534","v":0},{"$f":"+D533-D534","v":0},0,0,0,0,0,0,0,0,0]
["Total Units of Service ",null,{"$f":"SUM(D536:M536)","v":0}]
["Cost per Units of Service",null,null,{"$f":"IF(ISERROR(+D533/D536),\"\",+D533/D536)","v":""},"","","","","","","","",""]
["Total Billing Units",null,{"$f":"SUM(D538:M538)","v":0}]
["Cost per Billing Units",null,null,{"$f":"IF(ISERROR(+D533/D538),\"\",+D533/D538)","v":""},"","","","","","","","",""]
["Standard Rate or CMA"]
["Total SD/MC Billing Units-Traditional (50% FFP)",null,{"$f":"SUM(D541:M541)","v":0}]
["Total SD/MC Billing Units-PPACA (65% FFP)",null,{"$f":"SUM(D542:M542)","v":0}]
["Total SD/MC Billing Units-PPACA (90% FFP)",null,{"$f":"SUM(D543:M543)","v":0}]
["Total SD/MC Billing Units",null,{"$f":"SUM(C541:C543)","v":0},0,0,0,0,0,0,0,0,0,0]
["Percentage of total SD/MC to total billing units",null,{"$f":"IF(ISERROR(+C544/C538),\"\", +C544/C538)","v":""},{"$f":"IF(ISERROR(+D544/D538),\"\", +D544/D538)","v":""},"","","","","","","","",""]
["FFP revenue - traditional (50% FFP)",null,{"$f":"SUM(D546:M546)","v":0},{"$f":"IF(ISERROR(+D541*D539*0.5),\"\",ROUND((+D541*D539*0.5),2))","v":""},"","","","","","","","",""]
["FFP revenue - PPACA, etc (65% FFP)",null,{"$f":"SUM(D547:M547)","v":0},{"$f":"IF(ISERROR(+D542*D539*0.65),\"\",ROUND((+D542*D539*0.65),2))","v":""},{"$f":"IF(ISERROR(+E542*E539*0.65),\"\",ROUND((+E542*E539*0.65),2))","v":""},"","","","","","","",""]
["FFP revenue - PPACA, etc (90% FFP) ",null,{"$f":"SUM(D548:M548)","v":0},{"$f":"IF(ISERROR(+D543*D539*0.9),\"\",ROUND((+D543*D539*0.9),2))","v":""},"","","","","","","","",""]
["TOTAL FFP Revenue",null,{"$f":"SUM(C546:C548)","v":0},{"$f":"SUM(D546:D548)","v":0},0,0,0,0,0,0,0,0,0]

{"sheet":"SUD Units & Cost Center Data","index":6,"n_rows":222,"n_cols":20,"rows_kept":222,"cut":false,"hidden":false,"merged":[[0,0,0,5],[1,0,1,5],[2,0,2,11]]}
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit C - Substance Use Disorder Projected Units Data"]
["Note:  Data on this tab is for internal projections only and does not represent limitations per funding source."]
[]
[null,null,"Contractor: ",{"$f":"'Budget Summ Amt'!D6","v":0},null,"Contract #: ",{"$f":"'Budget Summ Amt'!L6","v":0},null,null,"Amendment #:",{"$f":"'Budget Summ Amt'!O6","v":0}]
[null,null,"Budget Period: ",{"$f":"'Budget Summ Amt'!I6","v":"00:00:00"},null,"State Provider Code: 37- ",null,null,null,"D/M-C Provider Code:"]
[]
["Line","Funding Source","Level of Care","Service","Gross Cost $","Other Revenues $","Net Cost $","Proposed: Total Units of Service","Proposed: DMC Units","Proposed: DMC %","Interim Rate (Rate Cap) $","Gross Cost per Unit $","Net Cost per Unit $","DMC $","Non-DMC $","Prior Approved: Total Units of Service","Prior Approved: DMC Units","Prior Approved: Billing %","Net Increase (Decrease): Total Units of Service","Net Increase (Decrease): Billing Units"]
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[2,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
[3,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
[4,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
[5,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
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[7,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
[8,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
[9,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
[10,null,null,null,null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]-SUD_UOS[[#This Row],[Other Revenues $]],0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],\"\")","v":""},null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Gross Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Net Cost $]]/SUD_UOS[[#This Row],[Proposed: Total Units of Service]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*SUD_UOS[[#This Row],[Proposed: DMC Units]],0)","v":0},{"$f":"IFERROR(MIN(SUD_UOS[[#This Row],[Interim Rate (Rate Cap) $]:[Net Cost per Unit $]])*(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Proposed: DMC Units]]),0)","v":0},null,null,{"$f":"IFERROR(SUD_UOS[[#This Row],[Prior Approved: DMC Units]]/SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],\"\")","v":""},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: Total Units of Service]]-SUD_UOS[[#This Row],[Prior Approved: Total Units of Service]],0)","v":0},{"$f":"IFERROR(SUD_UOS[[#This Row],[Proposed: DMC Units]]-SUD_UOS[[#This Row],[Prior Approved: DMC Units]],0)","v":0}]
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[]
["LOC","Sort",null,"Service"]
["Res 3.5",1,null,"Assessed Delayed Admission (Non-DMC Unit)"]
["Res 3.3",2,null,"Assessed Not Admitted (Non-DMC Unit)"]
["Res 3.1",3,null,"Case Management"]
["IOS",4,null,"Group"]
["OS",5,null,"Individual"]
["WM",6,null,"Patient Education"]
["OTP",7,null,"Recovery Res Bed Day Months 1-3 (Non-DMC Unit)"]
[null,null,null,"Recovery Res Bed Day Months 4-9 (Non-DMC Unit)"]
[null,null,null,"Recovery Services"]
[null,null,null,"Residential Bed Day (Tx)"]
[null,null,null,"Room & Board (Non-DMC Unit)"]

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["SCHEDULE I - SALARIES & BENEFITS",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PROPOSED BUDGET",null,"PRIOR APPROVED BUDGET",null,"NET CHANGE"]
["Line","Contract #","Contractor","Program Name","STANDARD POSITION TITLE\n(Use drop-down)","WORKING TITLE\n(Free-form entry)","CREDENTIAL\n(Use drop-down)","SPECIALTY\n(Use drop-down)","Modifiers\n(Use drop-down)","Salary Range\n(Max may not exceed above 5% w/o COR approval)","Proposed: Direct FTE","Proposed: Admin FTE","Proposed: Annual FTE salary $","Proposed: Number of months","Proposed: Total salary expense $","Proposed: Benefits Rate %","Proposed: Benefits $","Proposed: Total S&B $","Prior Approved: Direct FTE","Prior Approved: Admin FTE","Prior Approved: Annual FTE salary $","Prior Approved: Number of months","Prior Approved: Total salary expense $","Prior Approved: Benefits Rate %","Prior Approved: Benefits $","Prior Approved: Total S&B $","Net Increase (Decrease): Direct FTE","Net Increase (Decrease): Admin FTE","Net Increase (Decrease): Total S&B",null,"Productivity FTE Direct","Productivity FTE Admin","Productivity FTE Direct","Productivity FTE Admin","Productivity FTE Direct","Productivity FTE Admin"]
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[3,"*Gift Cards",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,{"$f":"+CK13-CL13","v":0},null,null,0,null,null,{"$f":"+CQ13-CR13","v":0},null,null,null,null,0,0,{"$f":"+CX13-CY13","v":0}]
[4,"*Interest Expense",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[5,"*Leasehold Improvements",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
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[7,"Building & Facility Cost",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[8,"Equipment Use Cost",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[9,"Telecommunications & Utilities",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[10,"Minor Equipment/Furniture/Fixtures (per BHS Policy)",null,null,null,null,{"$f":"+E20-F20","v":0},null,null,{"$f":"+H20-I20","v":0},null,null,{"$f":"+K20-L20","v":0},null,null,{"$f":"+N20-O20","v":0},null,null,{"$f":"+Q20-R20","v":0},null,null,{"$f":"+T20-U20","v":0},null,null,{"$f":"+W20-X20","v":0},null,null,{"$f":"+Z20-AA20","v":0},null,null,{"$f":"+AC20-AD20","v":0},null,null,{"$f":"+AF20-AG20","v":0},null,null,{"$f":"+AI20-AJ20","v":0},null,null,{"$f":"+AL20-AM20","v":0},null,null,{"$f":"+AO20-AP20","v":0},null,null,{"$f":"+AR20-AS20","v":0},null,null,{"$f":"+AU20-AV20","v":0},null,null,{"$f":"+AX20-AY20","v":0},null,null,{"$f":"+BA20-BB20","v":0},null,null,{"$f":"+BD20-BE20","v":0},null,null,{"$f":"+BG20-BH20","v":0},null,null,{"$f":"+BJ20-BK20","v":0},null,null,{"$f":"+BM20-BN20","v":0},null,null,{"$f":"+BP20-BQ20","v":0},null,null,{"$f":"+BS20-BT20","v":0},null,null,{"$f":"+BV20-BW20","v":0},null,null,{"$f":"+BY20-BZ20","v":0},null,null,{"$f":"+CB20-CC20","v":0},null,null,{"$f":"+CE20-CF20","v":0},null,null,{"$f":"+CH20-CI20","v":0},null,null,0,null,null,{"$f":"+CN20-CO20","v":0},null,null,0,null,null,null,null,0,0,0]
[11,"Supplies (Medical, Office, Printing & Other Supplies)",null,null,null,null,{"$f":"+E21-F21","v":0},null,null,{"$f":"+H21-I21","v":0},null,null,{"$f":"+K21-L21","v":0},null,null,{"$f":"+N21-O21","v":0},null,null,{"$f":"+Q21-R21","v":0},null,null,{"$f":"+T21-U21","v":0},null,null,{"$f":"+W21-X21","v":0},null,null,{"$f":"+Z21-AA21","v":0},null,null,{"$f":"+AC21-AD21","v":0},null,null,{"$f":"+AF21-AG21","v":0},null,null,{"$f":"+AI21-AJ21","v":0},null,null,{"$f":"+AL21-AM21","v":0},null,null,{"$f":"+AO21-AP21","v":0},null,null,{"$f":"+AR21-AS21","v":0},null,null,{"$f":"+AU21-AV21","v":0},null,null,{"$f":"+AX21-AY21","v":0},null,null,{"$f":"+BA21-BB21","v":0},null,null,{"$f":"+BD21-BE21","v":0},null,null,{"$f":"+BG21-BH21","v":0},null,null,{"$f":"+BJ21-BK21","v":0},null,null,{"$f":"+BM21-BN21","v":0},null,null,{"$f":"+BP21-BQ21","v":0},null,null,{"$f":"+BS21-BT21","v":0},null,null,{"$f":"+BV21-BW21","v":0},null,null,{"$f":"+BY21-BZ21","v":0},null,null,{"$f":"+CB21-CC21","v":0},null,null,{"$f":"+CE21-CF21","v":0},null,null,{"$f":"+CH21-CI21","v":0},null,null,0,null,null,{"$f":"+CN21-CO21","v":0},null,null,0,null,null,null,null,0,0,0]
[12,"Drug Testing",null,null,null,null,{"$f":"+E22-F22","v":0},null,null,{"$f":"+H22-I22","v":0},null,null,{"$f":"+K22-L22","v":0},null,null,{"$f":"+N22-O22","v":0},null,null,{"$f":"+Q22-R22","v":0},null,null,{"$f":"+T22-U22","v":0},null,null,{"$f":"+W22-X22","v":0},null,null,{"$f":"+Z22-AA22","v":0},null,null,{"$f":"+AC22-AD22","v":0},null,null,{"$f":"+AF22-AG22","v":0},null,null,{"$f":"+AI22-AJ22","v":0},null,null,{"$f":"+AL22-AM22","v":0},null,null,{"$f":"+AO22-AP22","v":0},null,null,{"$f":"+AR22-AS22","v":0},null,null,{"$f":"+AU22-AV22","v":0},null,null,{"$f":"+AX22-AY22","v":0},null,null,{"$f":"+BA22-BB22","v":0},null,null,{"$f":"+BD22-BE22","v":0},null,null,{"$f":"+BG22-BH22","v":0},null,null,{"$f":"+BJ22-BK22","v":0},null,null,{"$f":"+BM22-BN22","v":0},null,null,{"$f":"+BP22-BQ22","v":0},null,null,{"$f":"+BS22-BT22","v":0},null,null,{"$f":"+BV22-BW22","v":0},null,null,{"$f":"+BY22-BZ22","v":0},null,null,{"$f":"+CB22-CC22","v":0},null,null,{"$f":"+CE22-CF22","v":0},null,null,{"$f":"+CH22-CI22","v":0},null,null,0,null,null,{"$f":"+CN22-CO22","v":0},null,null,0,null,null,null,null,0,0,0]
[13,"Laboratory Services/non-drug testing",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[14,"Pharmaceutical",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[15,"24 Hour Program:  Food & Personal Need Items",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,{"$f":"E25","v":0},{"$f":"H25+K25+N25+Q25+T25+W25+Z25+AC25+AF25+AI25+AL25+AO25+AR25+AU25+AX25+BA25+BD25+BG25+BJ25+BM25+CH25+CQ25+BP25+BS25+BV25+BY25+CB25+CE25+CK25+CN25","v":0},0]
[16,"Client Transportation",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,{"$f":"H26+K26+N26+Q26+T26+W26+Z26+AC26+AF26+AI26+AL26+AO26+AR26+AU26+AX26+BA26+BD26+BG26+BJ26+BM26+CH26+CQ26+BP26+BS26+BV26+BY26+CB26+CE26+CK26+CN26","v":0},0]
[17,"Travel",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[18,"Office Costs (Finance/Legal/Fees/Taxes/Insurance)",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[19,"Staff Development/Training/Education",null,null,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,0,null,null,null,null,0,0,0]
[20,"Other Business Services",null,null,null,null,{"$f":"+E30-F30","v":0},null,null,{"$f":"+H30-I30","v":0},null,null,{"$f":"+K30-L30","v":0},null,null,{"$f":"+N30-O30","v":0},null,null,{"$f":"+Q30-R30","v":0},null,null,{"$f":"+T30-U30","v":0},null,null,{"$f":"+W30-X30","v":0},null,null,{"$f":"+Z30-AA30","v":0},null,null,{"$f":"+AC30-AD30","v":0},null,null,{"$f":"+AF30-AG30","v":0},null,null,{"$f":"+AI30-AJ30","v":0},null,null,{"$f":"+AL30-AM30","v":0},null,null,{"$f":"+AO30-AP30","v":0},null,null,{"$f":"+AR30-AS30","v":0},null,null,{"$f":"+AU30-AV30","v":0},null,null,{"$f":"+AX30-AY30","v":0},null,null,{"$f":"+BA30-BB30","v":0},null,null,{"$f":"+BD30-BE30","v":0},null,null,{"$f":"+BG30-BH30","v":0},null,null,{"$f":"+BJ30-BK30","v":0},null,null,{"$f":"+BM30-BN30","v":0},null,null,{"$f":"+BP30-BQ30","v":0},null,null,{"$f":"+BS30-BT30","v":0},null,null,{"$f":"+BV30-BW30","v":0},null,null,{"$f":"+BY30-BZ30","v":0},null,null,{"$f":"+CB30-CC30","v":0},null,null,{"$f":"+CE30-CF30","v":0},null,null,{"$f":"+CH30-CI30","v":0},null,null,0,null,null,{"$f":"+CN30-CO30","v":0},null,null,0,null,null,null,null,0,0,0]
[21,"Interpreter Services",null,null,null,null,{"$f":"+E31-F31","v":0},null,null,{"$f":"+H31-I31","v":0},null,null,{"$f":"+K31-L31","v":0},null,null,{"$f":"+N31-O31","v":0},null,null,{"$f":"+Q31-R31","v":0},null,null,{"$f":"+T31-U31","v":0},null,null,{"$f":"+W31-X31","v":0},null,null,{"$f":"+Z31-AA31","v":0},null,null,{"$f":"+AC31-AD31","v":0},null,null,{"$f":"+AF31-AG31","v":0},null,null,{"$f":"+AI31-AJ31","v":0},null,null,{"$f":"+AL31-AM31","v":0},null,null,{"$f":"+AO31-AP31","v":0},null,null,{"$f":"+AR31-AS31","v":0},null,null,{"$f":"+AU31-AV31","v":0},null,null,{"$f":"+AX31-AY31","v":0},null,null,{"$f":"+BA31-BB31","v":0},null,null,{"$f":"+BD31-BE31","v":0},null,null,{"$f":"+BG31-BH31","v":0},null,null,{"$f":"+BJ31-BK31","v":0},null,null,{"$f":"+BM31-BN31","v":0},null,null,{"$f":"+BP31-BQ31","v":0},null,null,{"$f":"+BS31-BT31","v":0},null,null,{"$f":"+BV31-BW31","v":0},null,null,{"$f":"+BY31-BZ31","v":0},null,null,{"$f":"+CB31-CC31","v":0},null,null,{"$f":"+CE31-CF31","v":0},null,null,{"$f":"+CH31-CI31","v":0},null,null,0,null,null,{"$f":"+CN31-CO31","v":0},null,null,0,null,null,null,null,0,0,0]
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[null,"Operating Expenses Total",null,null,{"$f":"SUM(E11:E58)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(AK11:AK58)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(BQ11:BQ58)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,null,{"$f":"SUM(CN11:CN58)","v":0},0,0,{"$f":"SUM(CQ11:CQ58)","v":0},0,null,null,null,null,null,0,0,0]
[null,null,null,null,"* May not be exceeded without prior HHSA approval."]
[null,null,null,null,"** Funded line item maybe exceeded up to $1,000.  Excess more than $1,000 will require COR preapproval"]

{"sheet":"Sch III Indirect FINAL","index":9,"n_rows":35,"n_cols":34,"rows_kept":35,"cut":false,"hidden":false,"merged":[[34,9,34,12],[35,9,35,12],[32,9,32,12],[6,0,6,2],[7,0,7,2],[34,3,34,7],[35,3,35,7]]}
[null,null,null,"HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
[null,null,null,"Exhibit  C Schedule III- Indirect Cost"]
[]
[null,null,null,"Contractor:  ",{"$f":"+'Sch II OE FINAL'!F4","v":0},null,null,null,null,null,"Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L4","v":"00:00:00"}]
[null,null,null,"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F5","v":0},null,null,null,null,null,"Amendment #:",{"$f":"+'Sch II OE FINAL'!L5","v":0}]
[]
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["Funding Source/Population",null,null,null,{"$f":"'Budget Summ Amt'!E9","v":"FUNDING SOURCE 1"},{"$f":"'Budget Summ Amt'!F9","v":"FUNDING SOURCE 2"},{"$f":"'Budget Summ Amt'!G9","v":"FUNDING SOURCE 3"},{"$f":"'Budget Summ Amt'!H9","v":"FUNDING SOURCE 4"},{"$f":"'Budget Summ Amt'!I9","v":"FUNDING SOURCE 5"},{"$f":"'Budget Summ Amt'!J9","v":"FUNDING SOURCE 6"},{"$f":"'Budget Summ Amt'!K9","v":"FUNDING SOURCE 7"},{"$f":"'Budget Summ Amt'!L9","v":"FUNDING SOURCE 8"},{"$f":"'Budget Summ Amt'!M9","v":"FUNDING SOURCE 9"},{"$f":"'Budget Summ Amt'!N9","v":"FUNDING SOURCE 10"},{"$f":"'Budget Summ Amt'!O9","v":"FUNDING SOURCE 11"},{"$f":"'Budget Summ Amt'!P9","v":"FUNDING SOURCE 12"},{"$f":"'Budget Summ Amt'!Q9","v":"FUNDING SOURCE 13"},{"$f":"'Budget Summ Amt'!R9","v":"FUNDING SOURCE 14"},{"$f":"'Budget Summ Amt'!S9","v":"FUNDING SOURCE 15"},{"$f":"'Budget Summ Amt'!T9","v":"FUNDING SOURCE 16"},{"$f":"'Budget Summ Amt'!U9","v":"FUNDING SOURCE 17"},{"$f":"'Budget Summ Amt'!V9","v":"FUNDING SOURCE 18"},{"$f":"'Budget Summ Amt'!W9","v":"FUNDING SOURCE 19"},{"$f":"'Budget Summ Amt'!X9","v":"FUNDING SOURCE 20"},{"$f":"'Budget Summ Amt'!Y9","v":"FUNDING SOURCE 21"},{"$f":"'Budget Summ Amt'!Z9","v":"FUNDING SOURCE 22"},{"$f":"'Budget Summ Amt'!AA9","v":"FUNDING SOURCE 23"},{"$f":"'Budget Summ Amt'!AB9","v":"FUNDING SOURCE 24"},{"$f":"'Budget Summ Amt'!AC9","v":"FUNDING SOURCE 25"},{"$f":"'Budget Summ Amt'!AD9","v":"FUNDING SOURCE 26"},{"$f":"'Budget Summ Amt'!AE9","v":"FUNDING SOURCE 27"},{"$f":"'Budget Summ Amt'!AF9","v":"FUNDING SOURCE 28"},{"$f":"'Budget Summ Amt'!AG9","v":"FUNDING SOURCE 29"},{"$f":"'Budget Summ Amt'!AH9","v":"FUNDING SOURCE 30"}]
["Salaries and Benefits",null,null,{"$f":"SUM(E9:P9)","v":0},{"$f":"+'Budget Summ Amt'!E10","v":0},{"$f":"+'Budget Summ Amt'!F10","v":0},{"$f":"+'Budget Summ Amt'!G10","v":0},{"$f":"+'Budget Summ Amt'!H10","v":0},{"$f":"+'Budget Summ Amt'!I10","v":0},{"$f":"+'Budget Summ Amt'!J10","v":0},{"$f":"+'Budget Summ Amt'!K10","v":0},{"$f":"+'Budget Summ Amt'!L10","v":0},{"$f":"+'Budget Summ Amt'!M10","v":0},{"$f":"+'Budget Summ Amt'!N10","v":0},{"$f":"+'Budget Summ Amt'!O10","v":0},{"$f":"+'Budget Summ Amt'!P10","v":0},{"$f":"+'Budget Summ Amt'!Q10","v":0},{"$f":"+'Budget Summ Amt'!R10","v":0},{"$f":"+'Budget Summ Amt'!S10","v":0},{"$f":"+'Budget Summ Amt'!T10","v":0},{"$f":"+'Budget Summ Amt'!U10","v":0},{"$f":"+'Budget Summ Amt'!V10","v":0},{"$f":"+'Budget Summ Amt'!W10","v":0},{"$f":"+'Budget Summ Amt'!X10","v":0},{"$f":"+'Budget Summ Amt'!Y10","v":0},{"$f":"+'Budget Summ Amt'!Z10","v":0},{"$f":"+'Budget Summ Amt'!AA10","v":0},{"$f":"+'Budget Summ Amt'!AB10","v":0},{"$f":"+'Budget Summ Amt'!AC10","v":0},{"$f":"+'Budget Summ Amt'!AD10","v":0},{"$f":"+'Budget Summ Amt'!AE10","v":0},{"$f":"+'Budget Summ Amt'!AF10","v":0},{"$f":"+'Budget Summ Amt'!AG10","v":0},{"$f":"+'Budget Summ Amt'!AH10","v":0}]
["Operating Expense",null,null,{"$f":"SUM(E10:P10)","v":0},{"$f":"+'Budget Summ Amt'!E11","v":0},{"$f":"+'Budget Summ Amt'!F11","v":0},{"$f":"+'Budget Summ Amt'!G11","v":0},{"$f":"+'Budget Summ Amt'!H11","v":0},{"$f":"+'Budget Summ Amt'!I11","v":0},{"$f":"+'Budget Summ Amt'!J11","v":0},{"$f":"+'Budget Summ Amt'!K11","v":0},{"$f":"+'Budget Summ Amt'!L11","v":0},{"$f":"+'Budget Summ Amt'!M11","v":0},{"$f":"+'Budget Summ Amt'!N11","v":0},{"$f":"+'Budget Summ Amt'!O11","v":0},{"$f":"+'Budget Summ Amt'!P11","v":0},{"$f":"+'Budget Summ Amt'!Q11","v":0},{"$f":"+'Budget Summ Amt'!R11","v":0},{"$f":"+'Budget Summ Amt'!S11","v":0},{"$f":"+'Budget Summ Amt'!T11","v":0},{"$f":"+'Budget Summ Amt'!U11","v":0},{"$f":"+'Budget Summ Amt'!V11","v":0},{"$f":"+'Budget Summ Amt'!W11","v":0},{"$f":"+'Budget Summ Amt'!X11","v":0},{"$f":"+'Budget Summ Amt'!Y11","v":0},{"$f":"+'Budget Summ Amt'!Z11","v":0},{"$f":"+'Budget Summ Amt'!AA11","v":0},{"$f":"+'Budget Summ Amt'!AB11","v":0},{"$f":"+'Budget Summ Amt'!AC11","v":0},{"$f":"+'Budget Summ Amt'!AD11","v":0},{"$f":"+'Budget Summ Amt'!AE11","v":0},{"$f":"+'Budget Summ Amt'!AF11","v":0},{"$f":"+'Budget Summ Amt'!AG11","v":0},{"$f":"+'Budget Summ Amt'!AH11","v":0}]
["Fixed Asset",null,null,{"$f":"SUM(E11:P11)","v":0},{"$f":"+'Budget Summ Amt'!E12","v":0},{"$f":"+'Budget Summ Amt'!F12","v":0},{"$f":"+'Budget Summ Amt'!G12","v":0},{"$f":"+'Budget Summ Amt'!H12","v":0},{"$f":"+'Budget Summ Amt'!I12","v":0},{"$f":"+'Budget Summ Amt'!J12","v":0},{"$f":"+'Budget Summ Amt'!K12","v":0},{"$f":"+'Budget Summ Amt'!L12","v":0},{"$f":"+'Budget Summ Amt'!M12","v":0},{"$f":"+'Budget Summ Amt'!N12","v":0},{"$f":"+'Budget Summ Amt'!O12","v":0},{"$f":"+'Budget Summ Amt'!P12","v":0},{"$f":"+'Budget Summ Amt'!Q12","v":0},{"$f":"+'Budget Summ Amt'!R12","v":0},{"$f":"+'Budget Summ Amt'!S12","v":0},{"$f":"+'Budget Summ Amt'!T12","v":0},{"$f":"+'Budget Summ Amt'!U12","v":0},{"$f":"+'Budget Summ Amt'!V12","v":0},{"$f":"+'Budget Summ Amt'!W12","v":0},{"$f":"+'Budget Summ Amt'!X12","v":0},{"$f":"+'Budget Summ Amt'!Y12","v":0},{"$f":"+'Budget Summ Amt'!Z12","v":0},{"$f":"+'Budget Summ Amt'!AA12","v":0},{"$f":"+'Budget Summ Amt'!AB12","v":0},{"$f":"+'Budget Summ Amt'!AC12","v":0},{"$f":"+'Budget Summ Amt'!AD12","v":0},{"$f":"+'Budget Summ Amt'!AE12","v":0},{"$f":"+'Budget Summ Amt'!AF12","v":0},{"$f":"+'Budget Summ Amt'!AG12","v":0},{"$f":"+'Budget Summ Amt'!AH12","v":0}]
["Total Direct Cost (S&B, Operating Expense & Fixed Assets)",null,null,{"$f":"SUM(D9:D11)","v":0},{"$f":"SUM(E9:E11)","v":0},0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(Q9:Q11)","v":0},0,0,0,0,0,0,0,0,{"$f":"SUM(Z9:Z11)","v":0},0,0,0,0,0,0,{"$f":"SUM(AG9:AG11)","v":0},{"$f":"+'Budget Summ Amt'!AH13","v":0}]
["Less: Subaward over $50,000",null,null,{"$f":"SUM(E13:P13)","v":0}]
["Less: Other Distorting Items",null,null,{"$f":"SUM(E14:P14)","v":0}]
["Gross Direct Cost Net of Distorting Items",null,null,{"$f":"+D12-D14-D13","v":0},{"$f":"+E12-E14-E13","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"+Z12-Z14-Z13","v":0},0,0,0,0,0,0,{"$f":"+AG12-AG14-AG13","v":0},0]
["Indirect Cost",null,null,{"$f":"SUM(E16:P16)","v":0}]
["Indirect Cost Rate (based on Net Direct Cost)",null,null,{"$f":"IF(ISERROR(+D16/D15),\"\",+D16/D15)","v":""},{"$f":"IF(ISERROR(+E16/E15),\"\",+E16/E15)","v":""},"","","","","","","","","","","","","","","","","","","","",{"$f":"IF(ISERROR(+Z16/Z15),\"\",+Z16/Z15)","v":""},"","","","","","",{"$f":"IF(ISERROR(+AG16/AG15),\"\",+AG16/AG15)","v":""},{"$f":"IF(ISERROR(+AH16/AH15),\"\",+AH16/AH15)","v":""}]
["Indirect Cost Rate (based on Salaries and Benefits)",null,null,{"$f":"IF(ISERROR(+D16/D9),\"\",+D16/D9)","v":""},{"$f":"IF(ISERROR(+E16/E9),\"\",+E16/E9)","v":""},"","","","","","","","","","","","","","","","","","","","",{"$f":"IF(ISERROR(+Z16/Z9),\"\",+Z16/Z9)","v":""},"","","","","","",{"$f":"IF(ISERROR(+AG16/AG9),\"\",+AG16/AG9)","v":""},{"$f":"IF(ISERROR(+AH16/AH9),\"\",+AH16/AH9)","v":""}]
["Indirect Cost Rate (based on Operating Expenses)",null,null,{"$f":"IF(ISERROR(+D16/D10),\"\",+D16/D10)","v":""},{"$f":"IF(ISERROR(+E16/E10),\"\",+E16/E10)","v":""},"","","","","","","","","","","","","","","","","","","","",{"$f":"IF(ISERROR(+Z16/Z10),\"\",+Z16/Z10)","v":""},"","","","","","",{"$f":"IF(ISERROR(+AG16/AG10),\"\",+AG16/AG10)","v":""},{"$f":"IF(ISERROR(+AH16/AH10),\"\",+AH16/AH10)","v":""}]
[]
[null,null,null,"Number of Estimated Indirect FTE"]
[null,null,null,"Have Federal Approved Indirect Rate?  "]
[]
[null,null,null,"If YES, indicate Rate"]
[]
[]
[null,null,null,"INDIRECT COST METHODOLOGY (Please check one)"]
[]
[]
[]
[null,null,null,"             NOTE: Proposed indirect rate cannot exceed the federal approved indirect rate."]
[]
[]
[]
[null,null,null,"OTHER INDIRECT COST METHODOLOGY",null,null,null,null,null,"Describe departments/functions included in indirect costs (e.g. HR, IT, QA, etc.)"]

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["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",null,"Contract #:  ",null,"Amendment #:"]
["Program Name:  ",null,"Funding Source:  ",null,"State Provider Code: 37-                                          "]
["Budget Period:  ",null,"Address:",null,"D/M-C Provider Code:"]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Agreement Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Agreement Amount ","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
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[null,null,null,null,null,{"$f":"SUM(F25:F36)","v":0}]
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["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F59","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F60","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L60","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H63","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H64","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G61","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L59","v":"00:00:00"},"Address:",{"$f":"+AAR!E66","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K61","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
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[null,null,null,null,null,{"$f":"SUM(F80:F91)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F114","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F115","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L115","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H118","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H119","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G116","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L114","v":"00:00:00"},"Address:",{"$f":"+AAR!E121","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K116","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F135:F146)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F169","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F170","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L170","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H173","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H174","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G171","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L169","v":"00:00:00"},"Address:",{"$f":"+AAR!E176","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K171","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F190:F201)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F224","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F225","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L225","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H228","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H229","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G226","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L224","v":"00:00:00"},"Address:",{"$f":"+AAR!E231","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K226","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F245:F256)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F279","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F280","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L280","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H283","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H284","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G281","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L279","v":"00:00:00"},"Address:",{"$f":"+AAR!E286","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K281","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
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[]
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["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
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[null,null,null,null,null,{"$f":"SUM(F300:F311)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F334","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F335","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L335","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H338","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H339","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G336","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L334","v":"00:00:00"},"Address:",{"$f":"+AAR!E341","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K336","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F355:F366)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F389","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F390","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L390","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H393","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H394","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G391","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L389","v":"00:00:00"},"Address:",{"$f":"+AAR!E396","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K391","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F410:F421)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F444","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F445","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L445","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H448","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H449","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G446","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L444","v":"00:00:00"},"Address:",{"$f":"+AAR!E451","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K446","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F465:F476)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F499","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F500","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L500","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H503","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H504","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G501","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L499","v":"00:00:00"},"Address:",{"$f":"+AAR!E506","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K501","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F520:F531)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F554","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F555","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L555","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H558","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H559","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G556","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L554","v":"00:00:00"},"Address:",{"$f":"+AAR!E561","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K556","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F575:F586)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F609","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F610","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L610","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H613","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H614","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G611","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L609","v":"00:00:00"},"Address:",{"$f":"+AAR!E616","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K611","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F630:F641)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F664","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F665","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L665","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H668","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H669","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G666","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L664","v":"00:00:00"},"Address:",{"$f":"+AAR!E671","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K666","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F685:F696)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F719","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F720","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L720","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H723","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H724","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G721","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L719","v":"00:00:00"},"Address:",{"$f":"+AAR!E726","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K721","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F740:F751)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F774","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F775","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L775","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H778","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H779","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G776","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L774","v":"00:00:00"},"Address:",{"$f":"+AAR!E781","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K776","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F795:F806)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F829","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F830","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L830","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H833","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H834","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G831","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L829","v":"00:00:00"},"Address:",{"$f":"+AAR!E836","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K831","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F850:F861)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F884","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F885","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L885","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H888","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H889","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G886","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L884","v":"00:00:00"},"Address:",{"$f":"+AAR!E891","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K886","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F905:F916)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F939","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F940","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L940","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H943","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H944","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G941","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L939","v":"00:00:00"},"Address:",{"$f":"+AAR!E946","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K941","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F960:F971)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F994","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F995","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L995","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H998","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H999","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G996","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L994","v":"00:00:00"},"Address:",{"$f":"+AAR!E1001","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K996","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1015:F1026)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1049","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1050","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1050","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1053","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1054","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1051","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1049","v":"00:00:00"},"Address:",{"$f":"+AAR!E1056","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1051","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1070:F1081)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1104","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1105","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1105","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1108","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1109","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1106","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1104","v":"00:00:00"},"Address:",{"$f":"+AAR!E1111","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1106","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1125:F1136)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1159","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1160","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1160","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1163","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1164","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1161","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1159","v":"00:00:00"},"Address:",{"$f":"+AAR!E1166","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1161","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1180:F1191)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1214","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1215","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1215","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1218","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1219","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1216","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1214","v":"00:00:00"},"Address:",{"$f":"+AAR!E1221","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1216","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1235:F1246)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1269","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1270","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1270","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1273","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1274","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1271","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1269","v":"00:00:00"},"Address:",{"$f":"+AAR!E1276","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1271","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1290:F1301)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1324","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1325","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1325","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1328","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1329","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1326","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1324","v":"00:00:00"},"Address:",{"$f":"+AAR!E1331","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1326","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1345:F1356)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1379","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1380","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1380","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1383","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1384","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1381","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1379","v":"00:00:00"},"Address:",{"$f":"+AAR!E1386","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1381","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1400:F1411)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1434","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1435","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1435","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1438","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1439","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1436","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1434","v":"00:00:00"},"Address:",{"$f":"+AAR!E1441","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1436","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1455:F1466)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1489","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1490","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1490","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1493","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1494","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1491","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1489","v":"00:00:00"},"Address:",{"$f":"+AAR!E1496","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1491","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1510:F1521)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1544","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1545","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1545","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1548","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1549","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1546","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1544","v":"00:00:00"},"Address:",{"$f":"+AAR!E1551","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1546","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1565:F1576)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit  C Supplemental B - Subcontract Agreements"]
[]
["Contractor:  ",{"$f":"+'Sch II OE FINAL'!F1599","v":0},"Contract #:  ",{"$f":"+'Sch II OE FINAL'!F1600","v":0},"Amendment #:",{"$f":"+'Sch II OE FINAL'!L1600","v":0}]
["Program Name:  ",{"$f":"+'Sch II OE FINAL'!H1603","v":0},"Funding Source:  ",{"$f":"+'Sch II OE FINAL'!H1604","v":0},"State Provider Code: 37-                                          ",{"$f":"+'SUD Units & Cost Center Data'!G1601","v":0}]
["Budget Period:  ",{"$f":"+'Sch II OE FINAL'!L1599","v":"00:00:00"},"Address:",{"$f":"+AAR!E1606","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K1601","v":0}]
[]
[]
[]
[]
["CONSULTANTS ",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["SUBCONTRACT",null,null,null,null,"Contract Rate or Amount","FOR COR USE ONLY"]
["AGENCY","INDIVIDUAL","SCOPE of WORK","POSITION / CLASS","AGREEMENT TERM",null,"Approved","Not Approved"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,{"$f":"SUM(F1620:F1631)","v":0}]
[]
["SUBCONTRACT/CONSULTANT AGREEMENT PRIOR CONCURRENCE / PRE-APPROVAL "]
["Complete, sign and submit this form for prior concurrence / pre-approval of subcontract and/or consultant agreements per Article 1, §1.4. Do NOT send unsigned agreements to COR. "]
["Provide copies of SIGNED subcontract/consultant agreements to COR within 30 days after the effective date of the subcontract/consultant agreement. "]
[]
[]
[]
[]
["NOTE: Expenses related to subcontracts or consultant agreements are subject to denial if there is no written COR pre-approval or if all mandated clauses are not represented in the final, signed agreement."]
[]
["Contractor Authorized Signature",null,null,null,null,null,null,"Date"]
[]
["Print Name & Title"]
[]
["COR: Place a check mark in either the Approved or Not Approved column for each Consultant Agreement or Subcontract and then sign and date below.  "]
[]
[]
["COR Signature",null,null,null,null,null,null,"Date"]

{"sheet":"Suppl A Fixed Assets","index":11,"n_rows":27,"n_cols":38,"rows_kept":27,"cut":false,"hidden":false,"merged":[]}
["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit C Supplemental A - Fixed Asset (over $5,000) "]
[]
["Contractor:  ",null,{"$f":"+'Budget Summ Amt'!D6","v":0},null,"Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!I6:J6","v":0},0]
["Contract #:  ",null,{"$f":"+'Budget Summ Amt'!L6","v":0},null,"Amendment #:",null,null,{"$f":"+'Budget Summ Amt'!O6","v":0}]
[]
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["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit C Supplemental I - Gift Card Preapproval "]
[]
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["Contract #:  ",null,{"$f":"+'Budget Summ Amt'!L6","v":0},"Amendment #:",{"$f":"+'Budget Summ Amt'!O6","v":0}]
[]
[null,"GIFT CARD: Anticipated item description and purpose  ",null,null,null,"TOTAL",null,{"$f":"'Budget Summ Amt'!E8","v":"PROGRAM NAME"},null,{"$f":"'Budget Summ Amt'!F8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!G8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!H8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!I8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!J8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!K8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!L8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!M8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!N8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!O8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!P8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!Q8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!R8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!S8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!T8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!U8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!V8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!W8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!X8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!Y8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!Z8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AA8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AB8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AC8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AD8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AE8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AF8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AG8","v":"PROGRAM NAME "},null,{"$f":"'Budget Summ Amt'!AH8","v":"PROGRAM NAME "}]
[null,null,null,null,null,"ROLL UP",null,{"$f":"'Budget Summ Amt'!E9","v":"FUNDING SOURCE 1"},null,{"$f":"'Budget Summ Amt'!F9","v":"FUNDING SOURCE 2"},null,{"$f":"'Budget Summ Amt'!G9","v":"FUNDING SOURCE 3"},null,{"$f":"'Budget Summ Amt'!H9","v":"FUNDING SOURCE 4"},null,{"$f":"'Budget Summ Amt'!I9","v":"FUNDING SOURCE 5"},null,{"$f":"'Budget Summ Amt'!J9","v":"FUNDING SOURCE 6"},null,{"$f":"'Budget Summ Amt'!K9","v":"FUNDING SOURCE 7"},null,{"$f":"'Budget Summ Amt'!L9","v":"FUNDING SOURCE 8"},null,{"$f":"'Budget Summ Amt'!M9","v":"FUNDING SOURCE 9"},null,{"$f":"'Budget Summ Amt'!N9","v":"FUNDING SOURCE 10"},null,{"$f":"'Budget Summ Amt'!O9","v":"FUNDING SOURCE 11"},null,{"$f":"'Budget Summ Amt'!P9","v":"FUNDING SOURCE 12"},null,{"$f":"'Budget Summ Amt'!Q9","v":"FUNDING SOURCE 13"},null,{"$f":"'Budget Summ Amt'!R9","v":"FUNDING SOURCE 14"},null,{"$f":"'Budget Summ Amt'!S9","v":"FUNDING SOURCE 15"},null,{"$f":"'Budget Summ Amt'!T9","v":"FUNDING SOURCE 16"},null,{"$f":"'Budget Summ Amt'!U9","v":"FUNDING SOURCE 17"},null,{"$f":"'Budget Summ Amt'!V9","v":"FUNDING SOURCE 18"},null,{"$f":"'Budget Summ Amt'!W9","v":"FUNDING SOURCE 19"},null,{"$f":"'Budget Summ Amt'!X9","v":"FUNDING SOURCE 20"},null,{"$f":"'Budget Summ Amt'!Y9","v":"FUNDING SOURCE 21"},null,{"$f":"'Budget Summ Amt'!Z9","v":"FUNDING SOURCE 22"},null,{"$f":"'Budget Summ Amt'!AA9","v":"FUNDING SOURCE 23"},null,{"$f":"'Budget Summ Amt'!AB9","v":"FUNDING SOURCE 24"},null,{"$f":"'Budget Summ Amt'!AC9","v":"FUNDING SOURCE 25"},null,{"$f":"'Budget Summ Amt'!AD9","v":"FUNDING SOURCE 26"},null,{"$f":"'Budget Summ Amt'!AE9","v":"FUNDING SOURCE 27"},null,{"$f":"'Budget Summ Amt'!AF9","v":"FUNDING SOURCE 28"},null,{"$f":"'Budget Summ Amt'!AG9","v":"FUNDING SOURCE 29"},null,{"$f":"'Budget Summ Amt'!AH9","v":"FUNDING SOURCE 30"}]
[null,null,null,null,null,"Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount","Quantity","Amount"]
[1,"for client needs in an emergency to cover….",null,null,null,{"$f":"+H10+J10+L10+N10+P10+R10+T10+V10+X10+Z10+AB10+BN10+AD10+AF10+AH10+AJ10+AL10+AN10+AP10+AR10+AT10+AV10+AX10+AZ10+BB10+BD10+BF10+BH10+BJ10+BL10","v":0},{"$f":"+I10+K10+M10+O10+Q10+S10+U10+W10+Y10+AA10+AC10+BO10+AE10+AG10+AI10+AK10+AM10+AO10+AQ10+AS10+AU10+AW10+AY10+BA10+BC10+BE10+BG10+BI10+BK10+BM10","v":0}]
[2,null,null,null,null,{"$f":"+H11+J11+L11+N11+P11+R11+T11+V11+X11+Z11+AB11+BN11+AD11+AF11+AH11+AJ11+AL11+AN11+AP11+AR11+AT11+AV11+AX11+AZ11+BB11+BD11+BF11+BH11+BJ11+BL11","v":0},{"$f":"+I11+K11+M11+O11+Q11+S11+U11+W11+Y11+AA11+AC11+BO11+AE11+AG11+AI11+AK11+AM11+AO11+AQ11+AS11+AU11+AW11+AY11+BA11+BC11+BE11+BG11+BI11+BK11+BM11","v":0}]
[3,null,null,null,null,0,0]
[4,null,null,null,null,0,0]
[5,null,null,null,null,0,0]
[6,null,null,null,null,0,0]
[7,null,null,null,null,0,0]
[8,null,null,null,null,0,0]
[9]
[10]
[11]
[12]
[null,"TOTAL",null,null,null,{"$f":"SUM(F10:F21)","v":0},{"$f":"SUM(G10:G21)","v":0},{"$f":"SUM(H10:H21)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(AD10:AD21)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(AV10:AV21)","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,{"$f":"SUM(BL10:BL21)","v":0},0,{"$f":"SUM(BN10:BN21)","v":0},{"$f":"SUM(BO10:BO21)","v":0}]
[]
["Checklist"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["Prepared By (Sign & Date)"]
["Type Name & Title",null,null,null,"Date Submitted"]
["Phone number: "]
[]
["COR APPROVAL (Sign & Date)"]
[null,null,null,null,"Date Approved"]
["Note: If any revisions to this form are needed, re-submit the form (by email) to COR with requested changes."]

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["HEALTH AND HUMAN SERVICES AGENCY - BEHAVIORAL HEALTH SERVICES"]
["Exhibit C - Contract Budget - Line Item Justification"]
[]
["Contractor:  ",{"$f":"+'Budget Summ Amt'!D6","v":0},null,null,"Contract #:  ",{"$f":"+'Budget Summ Amt'!L6","v":0},null,"Amendment #:",{"$f":"+'Budget Summ Amt'!O6","v":0}]
["Budget Period:  ",{"$f":"+'Budget Summ Amt'!I6","v":0},null,null,"State Provider Code: 37-                                          ",null,{"$f":"+'SUD Units & Cost Center Data'!G6","v":0},"D/M-C Provider Code:",{"$f":"+'SUD Units & Cost Center Data'!K6","v":0}]
[]
["Background & Instructions:  The following information is required of Contractor when submitting contract budgets adjustments and with new contracts.  "]
[]
["LINE ITEM: Consultants (Services rendered by persons who are members of a particular profession or possess a special skill and who are not officers or employees of the contractor)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"'Sch II OE FINAL'!E11","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Flex Funds ***For Client Use Only***",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E12","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Gift Cards. Includes bus passes, tokens, etc.  ***For Client Use Only. Must also complete Exhibit C Supplemental I - Gift Card Preapproval form***",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E13","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Interest Expense  (e.g., mortgage interest, etc.)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E14","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Leasehold Improvements",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E15","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Subcontracts (Any supplier, distributor, vendor, or firm that furnished supplies or services to or for a prime contractor's Statement of Work)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"'Sch II OE FINAL'!E16","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Building & Facility Costs (Rent, Lease, Repair, Maintenance, Depreciation ) \n**Rent cannot be claimed if you own the building**Depreciation for contractor owned building",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E17","v":0}]
["(Provide a Brief Description & Justification): "]
[null,"Building Rent & Leases (Description)"]
[null,"Building Repair & Maintenance (Description)"]
[null,"Depreciation (Description)"]
["LINE ITEM: Equipment Use Costs (Rent, Lease, Repair and Maintenance (e.g., copiers, fax machines, vehicles, point-of-sale equipment, etc.)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E18","v":0}]
["(Provide a Brief Description/Justification):"]
[]
[]
["LINE ITEM: Telecommunications & Utilities (e.g., internet, telephone, long distance, cell phones, cable or satellite TV, gas, electricity, water, sewer, burglar alarm, etc.)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E19","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Minor Equipment (Per BHS Policy)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E20","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Supplies (Medical, Office, Printing and Other Supplies - Medical Supplies for Client Use Only ***No food, beverages or food supplies***)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E21","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Drug Testing",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E22","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Laboratory Services (e.g., non-drug testing for Clients, etc.)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E23","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Pharmaceutical Cost (for clients only)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E24","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: 24 Hour Program: Food & Personal Need Items\n***For 24 hour program -  Client Use Only.  For non-24 hour program, please use \"Other\" Line Item.  Specify, justify and provide details under \"Other\" line item. ***",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E25","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Client Transportation (e.g., Day Trippers, etc.)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E26","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Travel (includes mileage reimbursement)   ***Must adhere to GSA and IRS limits***",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E27","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Office Mgnt Costs (Accounting, Auditing, Legal Fees, Dues/Subscription,  Insurance (Worker's Comp, Professional Liability), Tax/License/Fees (Professional Licenses, Memberships)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E28","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Staff Development/Training/Education  ***Must benefit Contract/Program/Cost Center***\n                                                                      ",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E29","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other Business Services (e.g., printing, background check for employees/volunteers, recruitment, advertising, professional subscriptions, FedEx, UPS, US Postal Service, etc.)  \n***No staff business meals, food, beverages or food supplies. Drinking water for staff and clients is allowable when no potable water is available***",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E30","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Interpreter Services",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E31","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: *Member Housing",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E32","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: * Augmented Member Housing (blank at start of FY and only filled with COR approval)",null,null,null,null,null,null,null,"Total Amount"]
[null,null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E33","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B34","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E34","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B35","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E35","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B36","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E36","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B37","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E37","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B38","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E38","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B39","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E39","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B40","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E40","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B41","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E41","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B42","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E42","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B43","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E43","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B44","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E44","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B45","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E45","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B46","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E46","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B47","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E47","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B48","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E48","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B49","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E49","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B50","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E50","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B51","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E51","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B52","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E52","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B53","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E53","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B54","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E54","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B55","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E55","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B56","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E56","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B57","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E57","v":0}]
["(Provide a Brief Description & Justification): "]
[]
[]
["LINE ITEM: Other:  (list)",null,null,null,null,null,null,null,"Total Amount"]
[{"$f":"+'Sch II OE FINAL'!B58","v":"Other:  (list)"},null,null,null,null,null,null,null,{"$f":"+'Sch II OE FINAL'!E58","v":0}]
["(Provide a Brief Description & Justification): "]

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["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!D6","v":0},null,null,null,null,null,null,"State Provider Number:"]
["Program Name:",null,null,"PROGRAM 1",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Sch II OE FINAL'!BZ5","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!I6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Sch II OE FINAL'!CF5","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F32=\"YES\",IF(ISERROR(+F26/((F28+F30-F46)*94500)),\"\",+F26/((F28+F30-F46)*94500)),IF(ISERROR(+F26/((F28+F30-F46)*108000)),\"\",+F26/((F28+F30-F46)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F16:F24)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E40:E45)","v":0},{"$f":"SUM(F40:F45)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F50/F52),\"\",+F50/F52)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 2",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F89=\"YES\",IF(ISERROR(+F83/((F85+F87-F103)*94500)),\"\",+F83/((F85+F87-F103)*94500)),IF(ISERROR(+F83/((F85+F87-F103)*108000)),\"\",+F83/((F85+F87-F103)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F73:F81)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E97:E102)","v":0},{"$f":"SUM(F97:F102)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F107/F109),\"\",+F107/F109)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 3",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F146=\"YES\",IF(ISERROR(+F140/((F142+F144-F160)*94500)),\"\",+F140/((F142+F144-F160)*94500)),IF(ISERROR(+F140/((F142+F144-F160)*108000)),\"\",+F140/((F142+F144-F160)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F130:F138)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E154:E159)","v":0},{"$f":"SUM(F154:F159)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F164/F166),\"\",+F164/F166)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 4",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F203=\"YES\",IF(ISERROR(+F197/((F199+F201-F217)*94500)),\"\",+F197/((F199+F201-F217)*94500)),IF(ISERROR(+F197/((F199+F201-F217)*108000)),\"\",+F197/((F199+F201-F217)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F187:F195)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E211:E216)","v":0},{"$f":"SUM(F211:F216)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F221/F223),\"\",+F221/F223)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 5",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F260=\"YES\",IF(ISERROR(+F254/((F256+F258-F274)*94500)),\"\",+F254/((F256+F258-F274)*94500)),IF(ISERROR(+F254/((F256+F258-F274)*108000)),\"\",+F254/((F256+F258-F274)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F244:F252)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E268:E273)","v":0},{"$f":"SUM(F268:F273)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F278/F280),\"\",+F278/F280)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 6",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F317=\"YES\",IF(ISERROR(+F311/((F313+F315-F331)*94500)),\"\",+F311/((F313+F315-F331)*94500)),IF(ISERROR(+F311/((F313+F315-F331)*108000)),\"\",+F311/((F313+F315-F331)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F301:F309)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E325:E330)","v":0},{"$f":"SUM(F325:F330)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F335/F337),\"\",+F335/F337)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 7",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F374=\"YES\",IF(ISERROR(+F368/((F370+F372-F388)*94500)),\"\",+F368/((F370+F372-F388)*94500)),IF(ISERROR(+F368/((F370+F372-F388)*108000)),\"\",+F368/((F370+F372-F388)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F358:F366)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E382:E387)","v":0},{"$f":"SUM(F382:F387)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F392/F394),\"\",+F392/F394)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 8",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F431=\"YES\",IF(ISERROR(+F425/((F427+F429-F445)*94500)),\"\",+F425/((F427+F429-F445)*94500)),IF(ISERROR(+F425/((F427+F429-F445)*108000)),\"\",+F425/((F427+F429-F445)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F415:F423)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E439:E444)","v":0},{"$f":"SUM(F439:F444)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F449/F451),\"\",+F449/F451)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 9",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F488=\"YES\",IF(ISERROR(+F482/((F484+F486-F502)*94500)),\"\",+F482/((F484+F486-F502)*94500)),IF(ISERROR(+F482/((F484+F486-F502)*108000)),\"\",+F482/((F484+F486-F502)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F472:F480)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E496:E501)","v":0},{"$f":"SUM(F496:F501)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F506/F508),\"\",+F506/F508)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 10",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F545=\"YES\",IF(ISERROR(+F539/((F541+F543-F559)*94500)),\"\",+F539/((F541+F543-F559)*94500)),IF(ISERROR(+F539/((F541+F543-F559)*108000)),\"\",+F539/((F541+F543-F559)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F529:F537)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E553:E558)","v":0},{"$f":"SUM(F553:F558)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F563/F565),\"\",+F563/F565)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 11",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F602=\"YES\",IF(ISERROR(+F596/((F598+F600-F616)*94500)),\"\",+F596/((F598+F600-F616)*94500)),IF(ISERROR(+F596/((F598+F600-F616)*108000)),\"\",+F596/((F598+F600-F616)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F586:F594)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E610:E615)","v":0},{"$f":"SUM(F610:F615)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F620/F622),\"\",+F620/F622)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]
[]
[]
[]
[]
["County of San Diego – Health and Human Services Agency"]
["Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health ADULT Contract Productivity "]
["Contractor Name:",null,null,{"$f":"+D$4","v":0},null,null,null,null,null,null,"State Provider Number:",{"$f":"+L$4","v":0}]
["Program Name:",null,null,"PROGRAM 12",null,null,null,null,null,null,"Contract Number:",{"$f":"+L$5","v":0}]
["Budget Period:",null,null,{"$f":"+D$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+L$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES only  - IF APPLICABLE"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY:  Minimal required Annual Productivity is 60% of 1800 work hours (per each FTE, which factors in                                        expected time off), using the following formulae:  "]
[null,"Non-ACT Programs:  64,800 minutes per FTE (determined by 108,000 minutes available per year per FTE multiplied by 60% = 64,800 minutes)"]
[null,null,"ACT Programs:  56,700 minutes per FTE (determined by 94,500 minutes available per year per FTE multiplied by 60% = 56,700 minutes)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(F659=\"YES\",IF(ISERROR(+F653/((F655+F657-F673)*94500)),\"\",+F653/((F655+F657-F673)*94500)),IF(ISERROR(+F653/((F655+F657-F673)*108000)),\"\",+F653/((F655+F657-F673)*108000)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 60%) -"]
[null,null,"Crisis Intervention"]
[]
[null,null,"Medication Support"]
[]
[null,null,"Non-billable activity (SFC 5, 65 and 800s)"]
[]
[null,null,"TOTAL BILLING UNITS",null,null,{"$f":"SUM(F643:F651)","v":0}]
[]
[null,"Direct Staff FTE "]
[]
[null,"Contract Consultant Staff FTEs"]
[null,"(Include all subcontractor staff or consultants who provide direct service to clients)",null,null,null,null,null,null,null,null,null,null,null,"YES"]
[null,"Is this a high-fidelity ACT program?",null,null,null,null,null,null,null,null,null,null,null,"NO"]
[]
[null,null,null,"Non-ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*108000)"]
[null,null,null,"ACT Productivity Formula=","Total Billing Units/((Direct FTE + Contract FTE - Exclude FTE)*94500)"]
[]
[null,"Direct Staff to Exclude from Productivity Calculations"]
[null,"As approved by COR"]
[null,null,"Position",null,"Total direct FTE","FTE to be excluded",null,"Narrative justifying the exclusion of staff from productivity calculation"]
[]
[]
[]
[]
[]
[]
[null,null,"TOTAL",null,{"$f":"SUM(E667:E672)","v":0},{"$f":"SUM(F667:F672)","v":0}]
[]
["B.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF:  "]
[null,"If ratio of Direct Service Staff to Admin Staff is less than 200%, COR approval Is required."]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F677/F679),\"\",+F677/F679)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation or notes here) "]

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["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 1",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F20/(F22*108000)),\"\",+F20/(F22*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F14:F18)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F31/(F33*108000)),\"\",+F31/(F33*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F27:F29)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F44/(F46*108000)),\"\",+F44/(F46*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F40:F42)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F51/(F57*60)),\"\",(F51/(F57*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F62/(F68*1800*60)),\"\",+F62/(F68*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F75*F77*F79","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F86/F88),\"\",+F86/F88)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F96/F98),\"\",+F96/F98)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 2",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F126/(F128*108000)),\"\",+F126/(F128*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F120:F124)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F137/(F139*108000)),\"\",+F137/(F139*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F133:F135)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F150/(F152*108000)),\"\",+F150/(F152*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F146:F148)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F157/(F163*60)),\"\",(F157/(F163*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F168/(F174*1800*60)),\"\",+F168/(F174*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F181*F183*F185","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F192/F194),\"\",+F192/F194)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F202/F204),\"\",+F202/F204)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 3",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F232/(F234*108000)),\"\",+F232/(F234*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F226:F230)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F243/(F245*108000)),\"\",+F243/(F245*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F239:F241)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F256/(F258*108000)),\"\",+F256/(F258*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F252:F254)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F263/(F269*60)),\"\",(F263/(F269*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F274/(F280*1800*60)),\"\",+F274/(F280*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F287*F289*F291","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F298/F300),\"\",+F298/F300)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F308/F310),\"\",+F308/F310)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 4",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F338/(F340*108000)),\"\",+F338/(F340*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F332:F336)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F349/(F351*108000)),\"\",+F349/(F351*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F345:F347)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F362/(F364*108000)),\"\",+F362/(F364*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F358:F360)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F369/(F375*60)),\"\",(F369/(F375*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F380/(F386*1800*60)),\"\",+F380/(F386*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F393*F395*F397","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F404/F406),\"\",+F404/F406)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F414/F416),\"\",+F414/F416)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 5",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F444/(F446*108000)),\"\",+F444/(F446*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F438:F442)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F455/(F457*108000)),\"\",+F455/(F457*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F451:F453)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F468/(F470*108000)),\"\",+F468/(F470*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F464:F466)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F475/(F481*60)),\"\",(F475/(F481*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F486/(F492*1800*60)),\"\",+F486/(F492*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F499*F501*F503","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F510/F512),\"\",+F510/F512)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F520/F522),\"\",+F520/F522)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 6",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F550/(F552*108000)),\"\",+F550/(F552*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F544:F548)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F561/(F563*108000)),\"\",+F561/(F563*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F557:F559)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F574/(F576*108000)),\"\",+F574/(F576*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F570:F572)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F581/(F587*60)),\"\",(F581/(F587*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F592/(F598*1800*60)),\"\",+F592/(F598*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F605*F607*F609","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F616/F618),\"\",+F616/F618)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F626/F628),\"\",+F626/F628)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 7",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F656/(F658*108000)),\"\",+F656/(F658*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F650:F654)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F667/(F669*108000)),\"\",+F667/(F669*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F663:F665)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F680/(F682*108000)),\"\",+F680/(F682*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F676:F678)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F687/(F693*60)),\"\",(F687/(F693*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F698/(F704*1800*60)),\"\",+F698/(F704*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F711*F713*F715","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F722/F724),\"\",+F722/F724)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F732/F734),\"\",+F732/F734)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 8",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F762/(F764*108000)),\"\",+F762/(F764*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F756:F760)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F773/(F775*108000)),\"\",+F773/(F775*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F769:F771)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F786/(F788*108000)),\"\",+F786/(F788*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F782:F784)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F793/(F799*60)),\"\",(F793/(F799*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F804/(F810*1800*60)),\"\",+F804/(F810*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F817*F819*F821","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F828/F830),\"\",+F828/F830)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F838/F840),\"\",+F838/F840)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 9",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F868/(F870*108000)),\"\",+F868/(F870*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F862:F866)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F879/(F881*108000)),\"\",+F879/(F881*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F875:F877)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F892/(F894*108000)),\"\",+F892/(F894*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F888:F890)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F899/(F905*60)),\"\",(F899/(F905*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F910/(F916*1800*60)),\"\",+F910/(F916*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F923*F925*F927","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F934/F936),\"\",+F934/F936)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F944/F946),\"\",+F944/F946)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 10",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F974/(F976*108000)),\"\",+F974/(F976*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F968:F972)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F985/(F987*108000)),\"\",+F985/(F987*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F981:F983)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F998/(F1000*108000)),\"\",+F998/(F1000*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F994:F996)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F1005/(F1011*60)),\"\",(F1005/(F1011*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F1016/(F1022*1800*60)),\"\",+F1016/(F1022*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F1029*F1031*F1033","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F1040/F1042),\"\",+F1040/F1042)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F1050/F1052),\"\",+F1050/F1052)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 11",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F1080/(F1082*108000)),\"\",+F1080/(F1082*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F1074:F1078)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F1091/(F1093*108000)),\"\",+F1091/(F1093*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F1087:F1089)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F1104/(F1106*108000)),\"\",+F1104/(F1106*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F1100:F1102)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F1111/(F1117*60)),\"\",(F1111/(F1117*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F1122/(F1128*1800*60)),\"\",+F1122/(F1128*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F1135*F1137*F1139","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F1146/F1148),\"\",+F1146/F1148)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F1156/F1158),\"\",+F1156/F1158)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]
[]
[]
[]
["                                   County of San Diego – Health and Human Services Agency"]
["                                                        Behavioral Health Services - Mental Health Services"]
["                                                                   Mental Health Children Contract Productivity"]
["Contractor Name:",null,null,{"$f":"+'Budget Summ Amt'!$D$6","v":0},null,null,null,null,null,null,"Provider Number:",{"$f":"+'[5]SUD Units & Cost Center Data'!$G$6","v":0}]
["Program Name:",null,null,"PROGRAM 12",null,null,null,null,null,null,"Contract Number:",{"$f":"+'Budget Summ Amt'!$L$6","v":0}]
["Budget Period:",null,null,{"$f":"+'Budget Summ Amt'!$I$6","v":"00:00:00"},null,null,null,null,null,null,"Amendment #:",{"$f":"+'Budget Summ Amt'!$O$6","v":0}]
[null,null,null,null,null,null,null,null,null,null,"Sub-unit #:"]
[]
["FOR OUTPATIENT SERVICES Only"]
[]
["A.   DIRECT STAFF FTE PRODUCTIVITY "]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (Including MHS Rehab)",null,null,null,null,"Direct Staff FTE Productivity Computation:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F1186/(F1188*108000)),\"\",+F1186/(F1188*108000))","v":""}]
[]
[null,null,"Crisis Intervention"]
[]
[null,null,"TOTAL",null,null,{"$f":"SUM(F1180:F1184)","v":0}]
[]
[null,"Direct Staff FTE"]
[]
["B.   CLINICAL STAFF PRODUCTIVITY (REQUIRED:  50% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (excluding MHS Rehab)",null,null,null,null,"Clinical Staff Productivity Computation:"]
[]
[null,null,"Crisis Intervention",null,null,null,null,{"$f":"IF(ISERROR(+F1197/(F1199*108000)),\"\",+F1197/(F1199*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 50%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F1193:F1195)","v":0}]
[]
[null,"Clinical FTE"]
[]
[]
[]
["C.   CASE MANAGERS AND PARA PROFESSIONAL PRODUCTIVITY (REQUIRED:  30% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Mental Health Services (MHS) Rehab only",null,null,null,null,"Case Managers & Para Professional Productivity Comp:"]
[]
[null,null,"Case Management Brokerage",null,null,null,null,{"$f":"IF(ISERROR(+F1210/(F1212*108000)),\"\",+F1210/(F1212*108000))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 30%) -"]
[null,null,"TOTAL",null,null,{"$f":"SUM(F1206:F1208)","v":0}]
[]
[null,"Case Manager/Paraprofessionals FTE"]
[]
["D.   CONSULTANT(PSYCHIATRIST) PRODUCTIVITY (REQUIRED:  75% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Consultant/Pschiatrist Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(F1217/(F1223*60)),\"\",(F1217/(F1223*60)))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 75%) -"]
[]
[]
[null,"Psychiatrist Hours"]
[]
["E.   NURSES PRODUCTIVITY (REQUIRED:  55% required minimum productivity rate)"]
[]
[null,"Billing Units (from Budget Summary page)"]
[null,null,"Medication Support Services",null,null,null,null,"Nurses Productivity Computation:"]
[]
[null,null,"(Note: If a program has RN as direct staff and Psychiatrist as consultant, estimated Med Supp billing units must be allocated between the two out of the total budgeted Med Supp billing units)",null,null,null,null,{"$f":"IF(ISERROR(+F1228/(F1234*1800*60)),\"\",+F1228/(F1234*1800*60))","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if below 55%) -"]
[]
[]
[null,"RN FTE"]
[]
[]
["FOR DAY TREATMENT SERVICES only"]
[]
["F.   REQUIRED NUMBER OF DAY TREATMENT DAYS (computed number should be the minimum on Budget Summary page)"]
[]
[null,"Program Capacity (stated on SOW)",null,null,null,null,null,"Required Number of Day Treatment Services"]
[]
[null," # of days of Operation (as stated on SOW)",null,null,null,null,null,{"$f":"+F1241*F1243*F1245","v":0}]
[]
[null," % of Required Productivity (as stated on SOW)"]
[null,"(Standard Productivity rate is 90% on SOW)",null,null,null,null,null,"Note: Above is the minimum number of bed days budgeted"]
[]
["OTHERS"]
[]
["G.   RATIO OF DIRECT SERVICE STAFF TO ADMIN STAFF (REQUIRED: 2:1 or 200% minimum)"]
[]
[null,"Direct Service Staff",null,null,null,null,null,"Ratio of Direct Service Staff to Admin Staff"]
[]
[null,"Admin Staff",null,null,null,null,null,{"$f":"IF(ISERROR(+F1252/F1254),\"\",+F1252/F1254)","v":""}]
[null,null,null,null,null,null,null,"(Provide narrative explanation if ratio is below 200%) - "]
[]
[]
[]
[]
["H.   BUDGETED COST PER CLIENT"]
[]
[null,"Program Budget",null,null,null,null,null,"BUDGETED COST PER CLIENT"]
[]
[null,"Number of Unduplicated Client",null,null,null,null,null,{"$f":"IF(ISERROR(+F1262/F1264),\"\",+F1262/F1264)","v":""}]
[null,"(Standard number of clients per Clinical FTE is minimum 40 per year)",null,null,null,null,null,"(Provide narrative explanation if cost per client is above standard cost/client) - "]
[null,null,"Standard Cost Per Client:"]
[null,null,"Outpatient Services",null,"Up to $3,000.00 per client"]
[null,null,"FSP",null,"Up to $4,000.00 per client"]
[null,null,"TBS",null,"$ 5,000.00 up to $7,000.00 per client"]