CFDA Number(s. When applicable, the Grantee shall inform its licensed independent public accountant of the federal regulations that are to be complied with in the performance of an audit. This information shall consist of the following Catalog of Federal Domestic Assistance Numbers: 93.387 Tennessee State-Based Tobacco Prevention and Control Program IN WITNESS WHEREOF, GRANTEE LEGAL ENTITY NAME: GRANTEE SIGNATURE DATE PRINTED NAME AND TITLE OF GRANTEE SIGNATORY (above) DEPARTMENT OF HEALTH: XXXX XXXXXXX, MD, MBA, FAAP, COMMISSIONER DATE Attachment 1 Grantee’s Application 00-00-00 XX XXXXXXXXXX 2 Federal Award Identification Worksheet Subrecipient’s name (must match registered name in DUNS) Subrecipient’s DUNS number Federal Award Identification Number (XXXX) Federal award date CFDA number and name Grant contract’s begin date Grant contract’s end date Amount of federal funds obligated by this grant contract Total amount of federal funds obligated to the subrecipient Total amount of the federal award to the pass-through entity (Grantor State Agency) Name of federal awarding agency Name and contact information for the federal awarding official Is the federal award for research and development? Indirect cost rate for the federal award (See 2 C.F.R. §200.331 for information on type of indirect cost rate) GRANT BUDGET (BUDGET PAGE 1) ADDITIONAL IDENTIFICATION INFORMATION AS NECESSARY APPLICABLE PERIOD: The grant budget line-item amounts below shall be applicable only to expense incurred during the period beginning DATE, and ending DATE. POLICY 03 Object Line-item Reference EXPENSE OBJECT LINE-ITEM CATEGORY 1 (detail schedule(s) attached as applicable) GRANT CONTRACT GRANTEE PARTICIPATION TOTAL PROJECT 1 Salaries2 $0.00 $0.00 $0.00 2 Benefits & Taxes $0.00 $0.00 $0.00 4, 15 Professional Fee/ Grant & Award 2 $0.00 $0.00 $0.00 5 Supplies $0.00 $0.00 $0.00 6 Telephone $0.00 $0.00 $0.00 7 Postage & Shipping $0.00 $0.00 $0.00 8 Occupancy $0.00 $0.00 $0.00 9 Equipment Rental & Maintenance $0.00 $0.00 $0.00 10 Printing & Publications $0.00 $0.00 $0.00 11, 12 Travel/ Conferences & Meetings2 $0.00 $0.00 $0.00 13 Interest 2 $0.00 $0.00 $0.00 14 Insurance $0.00 $0.00 $0.00 16 Specific Assistance To Individuals2 $0.00 $0.00 $0.00 17 Depreciation 2 $0.00 $0.00 $0.00 18 Other Non-Personnel 2 $0.00 $0.00 $0.00 20 Capital Purchase 2 $0.00 $0.00 $0.00 22 Indirect Cost (% and method) $0.00 $0.00 $0.00 24 In-Kind Expense $0.00 $0.00 $0.00 25 GRAND TOTAL $0.00 $0.00 $0.00 1 Each expense object lin...
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 45 Standards and Procedures Effective Date: October 1, 2017 Service Name: Nursing Facility Specialized Services Service ID Code: DD 45 1. Overview. Nursing Facility Specialized Services (DD 45 Services) are individualized habilitation services for Individuals with Intellectual or Developmental Disabilities (I/DD) residing in a Nursing Facility, as defined in OAR 411-070-0005 (32). These DD 45 Services are to be integrated with, but are in addition to and not duplicative of, care the Nursing Facility is required to provide.
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 48 Standards and Procedures Effective Date: October 1, 2017 Service Name: Case Management Service ID Code: DD 48 1. Overview. Case Management Services (DD 48 Services) are delivered to Individuals who are eligible for Intellectual or Developmental Disability Services (I/DD Services) funded by DHS in an identified CDDP’s geographic Program Area.
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 49 Standards and Procedures Effective Date: October 1, 2017 Service Name: Comprehensive In-Home Support Services for Adults Service ID Code: DD 49
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. Catalog of Federal Domestic Assistance (CFDA) #(s) of federal funds to be paid through the Agreement: 93-778. Service Element DD 50 Standards and Procedures Effective Date: October 1, 2017 Service Name: Residential Facilities Service ID Code: DD 50 1. Overview. Residential Facilities Services (DD 50 Services) consist of 24-hour residential care and supervision to eligible Individuals in community licensed service settings.
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 51 Standards and Procedures Effective Date: October 1, 2017 Service Name: Supported Living Services Service ID Code: DD 51 1. Overview. Supported Living Services (DD 51 Services) consist of individual support, delivered in a personalized manner, to adults with Developmental Disabilities based on the Individual’s needs and preferences. These DD 51 Services include attendant care, training, and support that promote opportunities for Individuals to live in their own home or apartment or in their family home and to be part of and participate in the communities in which they live.
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 53 Standards and Procedures Effective Date: October 1, 2017 Service Name: Transportation Services Non-Transit Districts Service ID Code: DD 53 1. Overview. Transportation Services (DD 53 Services) are public or private transportation supports provided to individuals with Intellectual/Developmental Disabilities (I/DD) receiving services from a Community Developmental Disabilities Program (CDDP) for the individual to gain access to community-based state plan (K-plan) and waiver services, activities and resources. Transportation services are not used 1) to replace natural supports, volunteer transportation and other transportation services available to the individual; 2) to compensate the service provider for travel to or from the service provider’s home; 3) for medical needs; or 4) to benefit others in the household. DD 53 Services are to be related to an individual’s service plan needs and are to be provided in the most cost-effective manner that will meet those needs. Individuals receiving DD 49 Comprehensive In-Home Support (DD 49), DD 50 24-Hour Residential Services (DD 50), DD 51 Supported Living Services (DD 51) or DD 58 Adult Xxxxxx Care Services (DD 58) are to access DD 53 Services for transportation for Individual Supported Employment (OR401), Small Group Supported Employment (OR543), Discovery (OR539), Employment Path Services (OR541), Day Support Activity (OR542). Other transportation, not including medical transportation, is inclusive of the service payment rate for DD 50, DD 51 and DD 58. Community Transportation for DD 49 is accessed in Plan of Care (POC).
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that Contractor is a subrecipient. Catalog of Federal Domestic Assistance (CFDA) #(s) of federal funds to be paid through this Contract: 93-778.
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 55 Standards and Procedures Effective Date: October 1, 2017 Service Name: Abuse Investigation Services Service ID Code: DD 55 1. Overview. Abuse Investigation Services (DD 55 Services) for adults include responding to abuse allegations and assuring that the abuse allegations are appropriately reported, screened and investigated. County must operate a Community Developmental Disability Program (CDDP) or have a service agreement with another CDDP to perform abuse investigation activities included in the DD 55 Services.
CFDA Number(s. In accordance with the State Controller’s Oregon Accounting Manual, policy 30.40.00.102, and DHS procedure “Contractual Governance”, DHS’ determination is that County is a subrecipient. The Catalog of Federal Domestic Assistance (CFDA) #(s) of Federal Funds to be paid through the Agreement: 93-778. Service Element DD 58 Adult Xxxxxx Home Services Standards and Procedures Effective Date: October 1, 2017 Service Name: Adult Xxxxxx Homes Service ID Code: DD 58 Adults 1. Overview. DD 58 Adult Xxxxxx Home Services governs the delivery of residential care and services to Individuals who are 18 years or older with an Intellectual or Developmental Disability (I/DD) in adult xxxxxx homes. DD 58 Adult Xxxxxx Home Services include 24-hour supervision, room and board, and assistance with the activities of daily living, instrumental activities of daily living and other activities, including recreation, socialization and access to services which help the Individuals develop appropriate skills to increase or maintain their level of functioning in accordance with each Individual’s person-centered plan.
