Instructions for Using the Extended Services

Monthly Report Spreadsheet

for Reporting VESID and OMRDD Extended Services

to VESID Central Office

The Extended Services monthly report spreadsheet is for the reporting of both VESID and OMRDD Extended services to VESID Central Office for reimbursement purposes. This spreadsheet automatically calculates the allowable reimbursement for Extended services for each month. The monthly totals generated by each report are to be transferred to the New York State Standard Voucher that is submitted quarterly to VESID Central Office for reimbursement.

Please be sure to use the correct form for VESID Extended and OMRDD Extended Services as the rates for each are different. The tabs at the bottom of the spreadsheet are labeled. There are the VESID Extended and OMRDD Extended forms and also a sample form for each. Feel free to look through the sample forms to get an understanding of how the forms work.

Directions for filling in the forms:

1. Please enter your agency name, contract number and the month and year that services are to be reimbursed for at the top of the form.

2. For each consumer in Extended Services, enter their CaMS ID number, their name and the date they entered into Extended services. Also, check with an “X” the 2 or more contacts box if the individual received such services or check the zero contacts box if contacts have not been provided during the month. The reimbursement totals automatically update as individuals are entered with 2 contacts or more.

3. When all consumers are entered for a month, print the report out. Unused rows can be hidden to reduce the number of pages that print. The Executive Director or comparable authority for the agency must sign the certification at the bottom of the form. Transfer the totals from each monthly report for the quarter to the NYS Standard Voucher for reimbursement. Attach these forms with the signed certifications to the Standard Voucher to be mailed into the VESID Contracts and Grants Unit at Central Office. If your agency has both VESID and OMRDD Extended Services, a total of 6 forms should be attached to the quarterly voucher. If you only provide VESID Extended, then there should be 3 forms attached to the voucher.

A sample of the forms is attached. Blanks may be downloaded from http://www.vesid.nysed.gov/supportedemployment/reimbursement.htm.