CTR048044_Contract_Amendment_12.pdf
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- Attached to
- Master Agreement AZ|CTR048044
- Contract number
- CTR048044
- Issued by
- Arizona
About this file
This document is a Contract Amendment issued by the Arizona Department of Economic Security for Contract Number CTR048044, involving the Western Arizona Council of Governments (WACOG) as the contractor. The amendment specifically relates to Area Agencies on Aging (AAA) services and covers the contract period from July 1, 2022, through June 30, 2023.
The amendment increases the contract's reimbursement ceiling from $8,988,517 to $9,472,390.77, reflecting a total increase of $483,873.77. The revised Service Budget encompasses multiple funding sources including State Admin, OAA Admin, SSBG Admin, Title III programs, State Independent Living Supports, and various special funding streams such as CARES Act, ARPA, and COVID-related allocations. The budget covers direct services across multiple program categories including administration, caregiver support, transportation, home-delivered meals, case management, and various specialized services for seniors and vulnerable populations. The amendment appears to be part of a routine adjustment to align funding with current service needs and potential expanded program requirements.
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CONTRACT AMENDMENT
Arizona Department of Economic Security
1789 W Jefferson Street, Mail Drop 1541, Phoenix, AZ 85007
CONTRACT NUMBER: AMENDMENT NUMBER:
CTR048044 Twelve (12)
DESCRIPTION/ LABEL: Area Agencies on Aging (AAA)
CONTRACTOR NAME: Western Arizona Council of Governments
THE ABOVE REFERENCED CONTRACT IS HEREBY MODIFIED AS FOLLOWS:
Pursuant to the Special Terms and Conditions Section 28.0 Levels of Service, and in accordance with the Alert issued on February 28, 2023, the Contract reimbursement ceiling for the period July 1, 2022 through June 30, 2023 is revised from $8,988,517 to $9,472,390.77.
Therefore, the revised Service Budget for the period of July 1, 2022 through June 30, 2023 is attached.
ALL OTHER REQUIREMENTS, SPECIFICATIONS, AND TERMS AND CONDITIONS REMAIN UNCHANGED
ACKNOWLEDGEMENT AND AUTHORIZATION
This Amendment shall be fully executed by means of electronic approval in APP.
Organization Region 4 Contract No. CTR048044 Period 07/01/22 - 06/30/23 Alert 2.28.23
EPHW EPHW CRRSA VACCINE VACCINE
ADM ADM ADM ADM ADM ADM PGD ADM LTC CMG CEI
HCB HCB HCB HCB FCS FCS HCB HCB OMB HCB HCB
C19 C20 C21 C20 PHW PHW CRR VAC VAC
ADM AM5
Ln Fund Source 1 State Admin 59,370.00 8,890.00 2 OAA Admin (III C-1) 290,190.28 3 OAA Admin (III E) 46,430.78 4 SSBG Admin 58,389.00 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 37,360.67 6,587.00 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin. 9,474.00 23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin - 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE 89,840.00
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling 454,783.95 - - - 61,907.78 - 89,840.00 - - - -
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total - - - - - - - - - - -
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total - - - - - - - - - - -
Grand Total 454,783.95 - - - 61,907.78 - 89,840.00 - - - -
EXPENSES (DIRECT)
Personnel - Direct 228,000.00 40,340.00 55,000.00 ERE - Direct 99,783.95 15,731.78 16,500.00 Professional/Out Direct 1,000.00 225.00 Sub-Contracted Travel - Direct 18,000.00 175.00 500.00 Space - Direct 16,000.00 2,300.00 2,000.00 Equipment - Direct One Time On Going 27,000.00 1,544.00 Material/Supplies - Direct 7,000.00 500.00 3,000.00 Operating Svcs - Direct 58,000.00 1,092.00 12,840.00 Allocated Indirect - Direct SubTotal DIRECT 454,783.95 - - - 61,907.78 - 89,840.00 - - - - SubTotal PURCH - - - - - - - - - - -
TOTAL SERVICE 454,783.95 - - - 61,907.78 - 89,840.00 - - - -
Units/Direct Units/Purchased Units Total - - - - - - - - - - -
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total - - - - - - - - - - - Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a state match Required State Match 96,730.09 - - - 15,476.93 - - - - - - State Admin 59,370.00 - - - 8,890.00 - - - - - -l State ILS 37,360.67 - - - 6,587.00 - - - - - - Additional match required - - - - - - - - - - -
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
Admin
Organization Region 4
Ln Fund Source 1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
Amendment 12
VACCINE VACCINE VACCINE Legal ADRC Tran Senior Patrol Senior Patrol MIPPA SHIP MIPPA AAA MIPPA ADRC
ADM CEI ADM LGL INR SHI SHI SHI SHI SHI TSP TR5
HCB HCB HCB LSA HCB SMP SMP SHP SHP SHP HCB FCS
VAC VA1 VA1 CRT VOL OTP MSM MAM MDM
LGL AOC SMV TSP TR5
90,763.00 90,848.00
8,000.00
9,717.53 55,667.13
42,470.00
19,495.00 14,010.00
6,250.00
- - - 100,480.53 - - - 19,495.00 14,010.00 6,250.00 188,985.13 8,000.00
232.00 16,000.00 3,148.00 3,111.00 2,389.00
9,810.00 20,000.00
- - - 3,380.00 - - - - - - 48,921.00 2,389.00
- - - 103,860.53 - - - 19,495.00 14,010.00 6,250.00 237,906.13 10,389.00
8,360.00 7,043.50 2,246.00 3,176.80 2,676.50 854.00
120.00 115.00 100.00 103,860.53 203,446.00 10,389.00
80.00 60.00 50.00 16,000.00 1,800.00 1,500.00 1,200.00
300.00 275.00 200.00 1,000.00 915.00 600.00 18,460.13 4,658.20 1,425.00 1,000.00
- - - - - - - 19,495.00 14,010.00 6,250.00 34,460.13 -
- - - 103,860.53 - - - - - - 203,446.00 10,389.00
- - - 103,860.53 - - - 19,495.00 14,010.00 6,250.00 237,906.13 10,389.00
- - - 5,339.05 - - - - - - 5,344.05 -
- - - 9,717.53 - - - - - - 55,667.13 -
Transportaion
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
Home D Meals Home D Meals Home D Meals Home D Meals Home D Meals HDM FCSP
CNG CNG CNG CNG HDM HDM HDM HDM HDM SUP HED
HCB HCB HCB HCB HCB HCB HCB HCB HCB FCS HCB
C19 C20 C21 C19 C20 C21 BOC
CNG HDM IM5 HPR
816,914.80 713,882.00
119,327.94
26,467.00 162,445.00
54,766.11 76,533.36
254,004.00
898,147.91 - - - 1,206,864.36 - - - - - 119,327.94
114,551.00 135,382.00 81,787.00 115,046.00 200,751.00 131,162.00 169,206.00
11,600.00 58,668.00 393,190.00 - - - 624,963.00 - - - - - -
1,291,337.91 - - - 1,831,827.36 - - - - - 119,327.94
58,914.94 19,904.00
642.00 1,291,337.91 - 1,831,827.36
10,612.00 5,257.00
2,396.00 13,747.00
- - 7,855.00
- - - - - - - - - - 119,327.94 1,291,337.91 - - - 1,831,827.36 - - - - - - 1,291,337.91 - - - 1,831,827.36 - - - - - 119,327.94
48,054.22 - - - 41,993.41 - - - - - -
54,766.11 - - - 76,533.36 - - - - - -
Congregate
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
Caregiver Out Ombudsman Ombudsman Advocacy Advocacy Home Care
HED OTR CMG CMG CMG CMG CMG LTC LTC ADV ADV HSK
HCB FCS FCS FCS HCB HCB HCB OMB OMB HCB HCB HCB
C20 C20 C20 BOC C20 C20
IR5 CM5 CMG LTC ADV HSK
304,130.45 2,608.00 126,798.00
25,748.00 163,672.12
14,418.97 78,293.00
2,775.00 9,214.00 69,412.70 10,108.00 10,462.90 43,095.00
131,952.00
85,268.00
- 28,523.00 172,886.12 - 590,763.15 - - 148,522.97 - 137,260.90 - -
7,203.00 5,728.00 9,190.00 4,475.00
- - 7,203.00 - 5,728.00 - - 9,190.00 - 4,475.00 - -
- 28,523.00 180,089.12 - 596,491.15 - - 157,712.97 - 141,735.90 - -
8,698.00 110,000.00 378,300.00 - - 96,324.90 77,817.25 3,715.00 43,286.12 151,320.00 - - 37,663.07 30,426.65
14,515.00 300.00 865.00 - 287.00 206.00
217.00 850.00 5,000.00 - 3,490.00 9,937.00
776.00 10,000.00 26,200.00 - 5,048.00 3,440.00
80.00 700.00 978.15 - 330.00 750.00
22.00 3,250.00 13,700.00 - - 3,028.00 8,550.00
500.00 4,500.00 14,400.00 - 2,352.00 6,134.00 7,203.00 5,728.00 9,190.00 4,475.00
- 28,523.00 180,089.12 - 596,491.15 - - 157,712.97 - 141,735.90 - -
- 28,523.00 180,089.12 - 596,491.15 - - 157,712.97 - 141,735.90 - -
- - - - 17,890.18 - - 153.41 - 7,458.77 - -
- 2,775.00 9,214.00 - 69,412.70 - - 10,108.00 - 10,462.90 - -
Case Management
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
I & R Care Transitions Home Repair Home Repair Respite Respite Respite
HSK ATT ATT INR INR INR RPR RPR RSP RSP RSP
HCB HCB HCB HCB HCB HCB FCS FCS FCS FCS FCS
C20 C20 C20 BOC C20 ADH C20
ATT IR2 RSP RSP
150,123.00 156,255.16 40,000.00
155,957.60
61,178.88 9,325.43 2,500.00
34,743.00 107,949.72 2,700.00 11,145.28
92,726.42
- 319,251.60 - 168,280.59 - 135,226.42 - - 201,845.88 - -
- 319,251.60 - 168,280.59 - 135,226.42 - - 201,845.88 - -
106,770.50 79,253.00 43,883.09 30,988.42
397.00 1,050.00 319,251.60 201,845.88
204.00 2,200.00 6,250.00 8,000.00
349.00 1,210.00 2,975.00 6,625.00 7,452.00 5,900.00
- - - 168,280.59 - 135,226.42 - - - - -
- 319,251.60 - - - - - - 201,845.88 - -
- 319,251.60 - 168,280.59 - 135,226.42 - - 201,845.88 - -
- 8,830.84 - 9,191.56 - 2,352.96 - - - - -
- 61,178.88 - 9,325.43 - 2,500.00 - - - - -
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
SHIP I&R
ADC ADC CGT CGT CEI INR PCS ADP ADP ADP ADP SHI
FCS FCS FCS FCS FCS FCS FCS FCS FCS HCB HCB SHP
C20 C20 C20 C20 OTR
AC5 CT5 EI5 IN5 PC5 ADP IR1
1,000.00 37,500.00
55,535.00 41,911.00 3,757.00 6,000.00 16,055.00
100.00 4,022.00
80,829.00 59,790.00
136,364.00 - 41,911.00 - 3,757.00 6,000.00 16,055.00 - - 1,100.00 - 101,312.00
1,074.00 220.00 220.00 1,000.00 750.00
- - 1,074.00 - 220.00 220.00 1,000.00 - - - - 750.00
791.00 -
791.00 - - - - - - - - - - -
137,155.00 - 42,985.00 - 3,977.00 6,220.00 17,055.00 - - 1,100.00 - 102,062.00
9,200.00 2,124.00 3,544.00 4,935.00 65,350.00 4,100.00 907.00 1,514.00 2,067.00 25,559.00
24,300.00 25.00 28.00 5,113.00 1,100.00 - 355.00 137,155.00
30.00 47.00 96.00 20.00 310.00
916.00 155.00 223.00 325.00 3,750.00
40.00 142.00 150.00 40.00 288.00
325.00 111.00 139.00 80.00 - 2,800.00
3,000.00 246.00 306.00 3,475.00 2,900.00 1,074.00 220.00 220.00 1,000.00 750.00
- - 42,985.00 - 3,977.00 6,220.00 17,055.00 - - 1,100.00 - 102,062.00 137,155.00 - - - - - - - - - - - 137,155.00 - 42,985.00 - 3,977.00 6,220.00 17,055.00 - - 1,100.00 - 102,062.00
- - - - - - - - - 58.82 - 2,205.90
- - - - - - - - - 100.00 - 4,022.00
Title III-E/Caregiger
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
SMP Out Vol Pr Senior Patrol Volunteer Mgt Volunteer Mgt Adult Day Adult Day Prog Developm Prog Developm Lifespn Voucher Ombudsman Direct Care Worker Direct Care Worker
SHI SHI VOS VOS ADC ADC PGD PGD RSP LTC ATT PRC
SMP SMP HCB HCB HCB HCB HCB HCB FCS OMB HCB HCB
OVP VMS C20 C20 C20 VCH FTE DCW DCW
OVP SMP VMS ADC PGD RSV
59,502.00 273,230.33
3,501.00 16,975.44
59,646.00
17,267.00
111,991.00
68,905.00
- 17,267.00 122,649.00 - - - 290,205.77 - - 68,905.00 111,991.00 -
4,800.00 3,950.00
- 4,800.00 3,950.00 - - - - - - - - -
- 22,067.00 126,599.00 - - - 290,205.77 - - 68,905.00 111,991.00 -
10,486.00 72,827.75 145,000.00 49,000.00 3,776.00 31,316.25 63,800.00 15,000.00
175.00 225.00 750.00 111,991.00
110.00 2,400.00 4,200.00 1,200.00 4,700.00 9,095.77 1,500.00
50,000.00
120.00 255.00 9,500.00
800.00 3,725.00 5,960.00 600.00
600.00 7,200.00 1,900.00 2,805.00
4,800.00 3,950.00
- 22,067.00 126,599.00 - - - 290,205.77 - - 68,905.00 - -
- - - - - - - - - - 111,991.00 -
- 22,067.00 126,599.00 - - - 290,205.77 - - 68,905.00 111,991.00 -
- - 3,500.15 - - - 16,072.51 - - - - -
- - 3,501.00 - - - 16,975.44 - - - - -
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
Direct Care Worker Direct Care Worker Direct Care Worker Direct Care Worker Direct Care Incentive Direct Care Incentive Direct Care Incentive Direct Care Incentive ARPA ARPA ARPA
HSK RSP ADC NRH ATT PRC HSK RSP ADM ADM TSP
HCB FCS HCB HCB HCB HCB HCB FCS HCB FCS HCB
DCW DCW DCW DCW DCI DCI DCI DCI ARP ARP ARP
37,652.00 3,274.00 5,294.48
90,000.00
112,956.00
9,820.00
82,297.00 112,702.00 81,586.00
- 82,297.00 - - 112,702.00 - - 81,586.00 150,608.00 13,094.00 95,294.48
- 82,297.00 - - 112,702.00 - - 81,586.00 150,608.00 13,094.00 95,294.48
80,000.00 6,274.00 30,400.00 2,000.00
500.00 52,353.00 82,297.00 112,702.00 81,586.00 42,941.48
7,020.00 5,825.00 500.00
6,000.00 1,500.00 4,000.00 4,000.00
15,363.00 320.00
- - - - - - - - 150,608.00 13,094.00 52,353.00
- 82,297.00 - - 112,702.00 - - 81,586.00 - - 42,941.48
- 82,297.00 - - 112,702.00 - - 81,586.00 150,608.00 13,094.00 95,294.48
- - - - - - - - 37,652.00 3,273.33 5,294.16
- - - - - - - - 37,652.00 3,274.00 5,294.48
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
ARPA ARPA ARPA ARPA ARPA ARPA ARPA ARPA ARPA ARPA ARPA ARPA
ADP RPR CMG CMG CNG HDM HED LTC PGD RSP ATT PRC
FCS FCS HCB HCB HCB HCB HCB OMB HCB FCS HCB HCB
ARP ARP ARP ARP ARP ARP ARP ARP ARP ARP ARP ARP
5,882.95 9,296.29 17,980.00 16,912.13
100,000.00 287,500.00 158,035.00
305,656.00
76,812.28
- - - 105,882.95 167,331.29 323,636.00 - - - 76,812.28 304,412.13 -
- - - 105,882.95 167,331.29 323,636.00 - - - 76,812.28 304,412.13 -
59,400.00 24,972.95
185.00 167,331.29 323,636.00 76,812.28 304,412.13
1,290.00 9,465.00
410.00 4,960.00 5,200.00
- - - 105,882.95 - - - - - - - -
- - - - 167,331.29 323,636.00 - - - 76,812.28 304,412.13 -
- - - 105,882.95 167,331.29 323,636.00 - - - 76,812.28 304,412.13 -
- - - 5,882.40 9,296.26 17,979.92 - - - - 16,911.91 -
- - - 5,882.95 9,296.29 17,980.00 - - - - 16,912.13 -
1 State Admin 2 OAA Admin (III C-1) 3 OAA Admin (III E) 4 SSBG Admin 5 Title III-B 6 Title III-C1 7 Title III-C2 8 Title III-D 9 Title III-E Caregiver
10 NSIP
11 Title VII Elder Abuse 12 Title VII FED OMB 13 State Ind Living Supports 14 State Ombudsman 15 State Respite 16 SSBG (Services)
17 SHIP
18 Senior Medicare Patrol 19 HB2695 Lottery 20 SCSEP (Title V) 21 SSBG - HCB Wait List 22 SSBG - One-Time Admin.
23 SSBG - One-Time (Services)
24 MIPPA - SHIP
25 MIPPA - AAA
26 MIPPA - ADRC
27 Adult Day Health
28 FFCRA - C1
29 FFCRA - C1 Admin
30 FFCRA - C2
31 CARES Act - III-B 32 CARES Act - III-C2 Admin 33 CARES Act - III-C2 34 CARES Act - III-E 35 CARES Act - III-E Admin 36 CARES Act - III-VII - FED. OMB.
37 Cares Act ADRC 38 Title III-C2 COVID Supplemental 39 OAA Admin. III-C2 COVID Supp.
40 ACCESS VACCINES
41 ACCESS VACCINES ADMIN
42 CRRSA LTC OMB.
43 ADRC ACCESS VACCINES
44 ADRC ACCESS VACCINES ADMIN
45 ARPA - III-B
46 ARPA - III-C1
47 ARPA - III-C1 ADMIN
48 ARPA - III-C2
49 ARPA - III-D
50 ARPA - III-E
51 ARPA - III-E ADMIN
52 ARPA - VII FED OMBUDSMAN
53 STATE DIRECT CARE WORKER
54 STATE DIRECT CARE INCENTIVE
55 EXPANDING PH WORKFORCE
56 STATE LTC OMBUDSMAN
Reimbursement Ceiling
DIRECT SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
PURCHASED SERVICES
ALTCS
Program Income Non-Fed In-kind Non-Fed Cash Other Federal Total
Grand Total
EXPENSES (DIRECT)
Personnel - Direct ERE - Direct Professional/Out Direct Sub-Contracted Travel - Direct Space - Direct Equipment - Direct One Time On Going Material/Supplies - Direct Operating Svcs - Direct Allocated Indirect - Direct SubTotal DIRECT SubTotal PURCH
TOTAL SERVICE
Units/Direct Units/Purchased Units Total
Unit Rate/Direct Unit Rate/Purch Unit Rate/Total Note: Title III-B, III-C1, III-C2, III-D, III-E (Admin) require a s Required State Match State Admin l State ILS Additional match required
DAARS Codes
AIMS Codes
SERVICE DETAIL
PROGRAM Codes
ARPA ARPA ARPA ARPA
CGT PC5 HSK HOLD HDM ATT CMG EHS RSP
FCS FCS HCB HOLD HCB HCB HCB HCB HCB
ARP ARP ARP HOLD WTL WTL WTL LCA LCA
EHL RSA
TOTAL
68,260.00 290,190.28
46,430.78 58,389.00
1,332,757.94 816,914.80 713,882.00 119,327.94 476,635.72 188,912.00
14,418.97 78,293.00
536,499.00 43,095.00 34,743.00
690,696.00 59,790.00 17,267.00
225,405.00 80,000.00 100,000.00 405,405.00 9,474.00
85,268.00 19,495.00 14,010.00
6,250.00
92,726.42
414,744.77 892,244.77 171,963.30 329,998.30 126,912.00 239,868.00 581,097.38 886,753.38
89,659.00 89,659.00 7,000.00 5,872.86 127,892.33 217,577.47
19,641.00 29,461.00 20,377.00 20,377.00
194,288.00 194,288.00
89,840.00 68,905.00
7,000.00 5,872.86 - 1,552,286.78 225,405.00 80,000.00 100,000.00 - - 9,472,390.77
38,610.00
- - - - - - - - - 38,610.00
114,551.00 233,401.00
- - 325,236.00 310,178.00
90,268.00
- - - - - - - 1,073,634.00
7,000.00 5,872.86 - 1,552,286.78 225,405.00 80,000.00 100,000.00 - - 10,584,634.77
62,543.00 1,827,751.84 26,718.00 732,039.58
7,000.00 5,872.86 1,552,286.78 200.00 1,670,290.64 225,405.00 80,000.00 5,708,227.46
832.00 83,730.00 3,389.00 130,814.77
56,000.00
805.00 49,362.15 1,963.00 112,835.13 3,550.00 174,973.20
38,610.00 7,000.00 5,872.86 - 1,552,286.78 - - 100,000.00 - - 4,876,407.31
- - - - 225,405.00 80,000.00 - - - 5,708,227.46 7,000.00 5,872.86 - 1,552,286.78 225,405.00 80,000.00 100,000.00 - - 10,584,634.77
- - - - - - - - 376,942.82
- - - - - - - - 68,260.00
- - - - - - - - 536,499.00
LTC Assisted livingSSBG Wait List
| Region 4 Amendment 12.pdf |
| FINAL RIV COB Amend 12 SFY23.pdf |
| COB |
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