2RSOBudget.htm

Instructions for Completing the BUDGET REPORT for a July/August Component Program providing RELATED SERVICES ONLY (9015)

INTRODUCTION

This packet includes instructions and forms to complete a Budget for the July/August component for a Related Services Only (9015) school age program applying for approval under Section 4408 of the Education Law. This Budget is to be used for programs providing Related Services Only to students with disabilities.

These instructions reference the most current Reimbursable Cost Manual. This manual defines items included in specific expense accounts listed on the attached State Education Department (SED) forms and is the basis for determining reimbursable costs on desk audits and field audits. Please refer any questions to:

New York State Education Department
Rate Setting Unit
Room 304, Education Building
Albany, NY 12234

Telephone: (518) 474-3227
Fax: (518) 486-3606

Website: http://www.oms.nysed.gov/rsu

I. GENERAL INSTRUCTIONS

All information should pertain to the July/August component of a Related Services Only (9015) program for school age students.
Report expenses in whole dollar amounts.
Reported expenses must be reasonable, necessary and directly related to this education program.
Submit two (3) copies of each Budget.

THE UNIVERSITY OF THE STATE OF NEW YORK
New York State Education Department
Rate Setting Unit
Albany, New York 12234

RELATED SERVICES ONLY (9015)
BUDGET REPORT

SED SCHOOL CODE:	________________________________________________
AGENCY NAME:	________________________________________________
PROGRAM NAME:	________RELATED SERVICES ONLY__ (9015) ______
SERVICE DATES:	From:_______________	To:___________________


FISCAL CONTACT:	________________________________________________ Name
	________________________________________________ Title
	________________________________________________ Telephone Number

DO NOT FORGET TO SUBMIT THIS BUDGET REPORT TOGETHER WITH THE PROGRAM APPLICATION (J/A 03)

INSTRUCTIONS FOR COMPLETING
THE BUDGET FORMS FOR JULY/AUGUST
PROGRAMS PROVIDING RELATED SERVICES ONLY

SPECIFIC INSTRUCTION

I. General Information

Please indicate whether the information supplied in the Budget is based on estimated expenditures or actual financial data. If the session is over for which a rate is being set, the Budget must include only actual costs.

II. Program Data

Report the number of students placed in the Related Services Only program, not a full-time equivalent (FTE) number of students.

Total Number of Related Services Only 1/2 Hour Sessions Delivered - Report the total number of related services only 1/2 hour sessions actually provided. The actual sessions provided must be in accordance with the services required by the student’s IEP. Upon audit, the cost of sessions in excess of those required by the student’s IEP will be adjusted. Also, should it be determined that the student(s) did not receive the total required IEP services, SED program staff will be informed. The situation will jeopardize the program’s approvability in future years.

III. Program Expenses

Include only expenses that pertain to students placed in a Related Services Only program.

Identify expenses for both Nondirect Care (Administration/Facility) and Direct Care (Related Services).

If actual expenses are reported, nondirect care costs reported for the Related Services Only program cannot also be reported on a financial report for a governmental agency for any other program (i.e., at a charge to the general fund or another cost center).

The Reimbursable Cost Manual (RCM) requires that allocation methods be fair, reasonable and documented. If providers complete the Consolidated Fiscal Report (CFR), agency administration must be allocated using ratio value. Please refer to the RCM available on Website: http://www.nysed.gov/psru/psruhome.htm for information about standards of reimbursement.

IV. Personal Services

Report salaries of Nondirect Care and Direct Care by job classification.

Allocate administrative expenses to the Related Services Only Budget report as necessary. Note instructions in Section III relating to nondirect care cost allocations.

FTE: Report employee FTE to two (2) decimal places. Use the following as a basis for reporting employee FTE:

Staff Position	District Organizations/ Retirement FTE	ConversionFactor*	EmployeeFTE
July/August	1.00	x .12	= .12

* 6 Weeks/52 Weeks = .12 (2 Month Positions)

Note: The numerator in the conversion factor calculation must equal the number of weeks the particular program runs.

Travel time should be considered when calculating a Related Service provider’s employee FTE. A provider’s travel time from his/her home to the student’s service delivery site does not apply. However, travel time from a school/office to the student’s service delivery site during regular school hours should be included in the calculation of the provider’s employee FTE.
Following are job titles that should be used when reporting positions in each category:

Nondirect Care Positions	Direct Care Positions
District Superintendent/Executive Director	Nurse
Business Manager/Finance Director	Speech Therapist
Principal/Program Administrator	Physical Therapist
Accountant/Bookkeeper	Occupational Therapist
Office Related Worker	Therapy Aide
Maintenance Worker	School Psychologist
Other (Specify):	School Social Worker

V. Contracted Services

Provide information relating to consultants or contractors costs reported in Section III under "Program Expenses", Line 3, Total OTPS.

VI. Certification Statement

The District Superintendent and the Comptroller must verify that the information contained in the Related Services Only Budget Report is true and complete.

I. General Information

Mailing Address	.
.	.
.	.
.	.
School Telephone
Facsimile Number
District Superintendent
Contact Person

The following information is based on:

Estimated Data:	From ________________	To _______________
Actual Data:	From ________________	To _______________

II. Program Data

1.	Number of Students Enrolled (NOT FTE)	.
2.	Total Number of Related Services Only 1/2 Hour Sessions Provided	.

III. Program Expenses

Account	Nondirect Care	Direct Care
Personal Services:	..	.
1. Total Salaries	.	.
2. Total Fringe Benefits	.	.
3. Total Other Than Personal Services (OTPS)	.	.
4. Total Equipment	.	.
5. Total Property	.	.
Grand Total: (Lines 1-5)	..	.

IV. Personal Services

Nondirect Care - Administration/Facility

Job Title	Salary	FTE
.	.	.
.	.	.
.	.	.
.	.	.
.	.	.
Nondirect Care Total:	.	.

Direct Care - Related Services

Job Title	Salary	FTE
.	.	.
.	.	.
.	.	.
.	.	.
.	.	.
Direct Care Total:	.	.

V. Contracted Services

Type of Service/Name of Provider Hours of Service Total Paid NDC Total Paid DC

.. . . .

. . . .

. . .. .

. . . ..

. . . .

.. . . .

TOTAL: . . .

. . .

VI. Certification Statement

______________________________________________________________ is the Comptroller, and

______________________________________________________________ is the District Superintendent

We declare that we have examined the attached Budget report for July/August Component Programs Providing Related Services Only and the information contained therein is true and complete.

Section 200.7(b)(1) of the Regulations of the Commissioner of Education contains the following statement:

"Parents of students attending schools governed by this section shall not be asked to make any payments…for allowable costs for students placed according to New York State procedures."

This certifies that the _______________________________________________________
Name of School

is in compliance with the aforementioned statement and all applicable Regulations of the Commissioner of Education.

__________________________________________
Signature (Comptroller)

__________________________________________
Signature (District Superintendent)

__________________________________________
Date

Type of Service/Name of Provider	Hours of Service	Total Paid NDC	Total Paid DC
..	.	.	.
.	.	.	.
.	.	..	.
.	.	.	..
.	.	.	.
..	.	.	.
TOTAL:	.	.	.
TOTAL:	.	.	.