Financial Assessment. Annual UMDAP (Uniform Method of Determining Ability to Pay) To determine family’s UMDAP liability, please list any other family members currently being seen by Mental Health: Gross Monthly Income (include all in the Household) A. Self $ B. Parents/Spouse/Domestic Partner ….$ C. Other $ Number of Persons Dependent on Income Allowable Expenses A. Court Ordered Monthly Obligation $ B. Monthly Child Care Payments(Only if Necessary for Employment) $ C. Monthly Dependent Support Payments $ D. Monthly Medical Expense Payments $ E. Monthly Mandated Deductions for Retirement Plan (Do not include Social Security)… $ F. Housing Cost (Mortgage/Rent) $ Asset Amount (List all liquid assets) A. Savings… $ B. Checking… $ C. Stocks… $ Health Plan or Insurance Company (Not employer) Name of Company Street Address City State Zip Insurance Co. phone number Policy Number Group Number Name of Insured Person Relationship to Client Social Security Number of Insured Person (if other than client) Does this Client have Healthy Families Insurance? □ Yes □ No If Yes, complete San Mateo County Mental Health SED form. Does this Client have Healthy Kids Insurance? □ Yes □ No Does this Client have HealthWorx Insurance.? □ Yes □ No CLIENT AUTHORIZATION –This section is not required for Full scope Medi-Cal Clients I affirm that the statements made herein are true and correct. I understand that I am responsible for paying the UMDAP liability amount or cost of treatment received by myself or by members of my household during each 1-year period. If the cost of service is more than the UMDAP liability amount, I pay the lesser amount. It is my responsibility and I agree to provide verification of income, assets and expenses. If I do not, I will be billed in full for services received. I authorize San Mateo County Mental Health to xxxx all applicable mental health services to Medi-Care and/or my insurance plan, including any services provided under 26.5. I authorize payment of healthcare benefits to San Mateo County Mental Health. Signature of Client or Authorized Person Date Reason if client is unable to sign Client Refused to Sign Authorization: □ (Please check if applicable) Date Reason Name of Interviewer Phone Number Best Time to Contact FAX COMPLETED COPY TO: MIS/BILLING UNIT (000)-000-0000 San Mateo County Mental Health Services Use Only ENTERED BY CLIENT ACCOUNT # DATA ENTRY DATE Below are instructions for accessing the State’s MEDS (Medi-Cal Eligibility Determination System) to determine...
Financial Assessment. Activities re- lated to determining a noncustodial parent’s ability to provide support.
Financial Assessment. 12.3.1 CONTRACTOR must inform and include in all client service contracts that the client may request CONTRACTOR to conduct a financial assessment in accordance with these standards to determine his/her ability to pay program fees.
12.3.2 A sliding fee scale shall be utilized. CONTRACTOR must assess the client program fee and set the payment schedule based on the client’s documentation of income.
12.3.3 CONTRACTOR must maintain in the client records a copy of all financial assessments and documentation of income provided by the client.
Financial Assessment. 14.3.1 CONTRACTOR shall conduct a Financial Assessment with PARENTS using a sliding fee schedule provided by ADMINISTRATOR to determine fees that PARENTS may be able to pay, for services received.
Financial Assessment. 7.14.1 CONTRACTOR shall conduct a Financial Assessment with adult CLIENTS, using a sliding fee schedule provided by ADMINISTRATOR to determine fees that adult CLIENTS may be able to pay for services received.
Financial Assessment. 11.1 Initial approval of a request for flexible or early retirement is at the discretion of the management team in your service area. They will consider the business benefit to and/or impact on the service, the savings to the Council and whether there are any costs to the Council. These could be pension strain costs, the cost of replacing you or the cost of re-grading the post and reallocating the work. Any costs must be met by savings in the Service budget within 2 years of your leaving.
11.2 Each request for flexible/early retirement needs to have a financial assessment done and approved by Finance. The assessment will show:
a) the business benefit to the service resulting from your flexible or early retirement;
b) any reduction in your salary costs that will result from your retirement. In the case of flexible retirement requests the reduction must be a minimum of 20% of your basic annual salary;
c) how much the change will cost the Council (e.g. pension strain costs, replacement cost); and
d) whether the costs are affordable and can be paid back in 2 years or less. If the assessment does not meet all of these criteria, your request will not be approved.
11.3 Final approval of your request by the Council must be obtained before any decision can be sent to you. Final approval involves:
a) where your full-time equivalent salary and/or the costs to the Council are each £50,000 or less, the case must be approved by the Director of Corporate Governance and the Head of Finance on the Council’s behalf;
b) where your full-time equivalent salary and/or the costs to the Council each exceed £50,000, the case must be approved by the Directors of Corporate Governance and the Head of Finance, in consultation with the Convener of the Finance and Resources Committee; and
c) a request involving the Chief Executive, a Director or Chief Officer must be submitted for consideration and approval through a formal committee process.
11.4 Where a case is approved, the Service Director (or nominee) will notify the employee in writing of the decision. People and Organisation will then initiate the retirement arrangements.
11.5 Where a case is refused, the Service Director (or nominee) will notify the employee of the decision and the reasons in writing. There is no right of appeal against this decision.
11.6 All approved cases will be reported to the Council Management Team as part of the regular monitoring reports on Workforce Management and included in an annual report to the Fi...
Financial Assessment. The product values and harvest costs were provided by licensees in a planning meeting in December of 2008. Some of this information was taken from the previous Type I Silviculture Investment Strategy and some numbers, such as harvest costs were updated since harvest costs were not provided in the Type I analysis. The product values are listed in Table 51. Table 51. Product Values Premium ($/m3) Sawlog ($/m3) Pulp ($/m3) Base 70 45 28 Site Prep (Mounding & Disc Trenching) 550 1.7 Apply to all harvest blocks in same period of harvest Planting Non-GW seedlings 864 1.5 Apply to all harvest blocks in same period of harvest, for Basecase/Fert and rehab runs Planting GW seedlings 896 1.5 Apply to all harvest blocks in same period of harvest, for GW run Rehabilitation 1200 3.2 Apply to all rehab blocks in same period of harvest, for GW run Aeral Fertilization 395 10 Apply to Fertilized Blocks in Fert run The harvesting costs used was an average harvest cost for the TSA of $37.73/m3 and came from the BC bioenergy website7.
Financial Assessment. CONTRACTOR shall conduct a 24 Financial Assessment with adult CLIENTS using a Sliding Fee Schedule provided 25 by ADMINISTRATOR, to determine fees for services that adult CLIENTS may be 26 able to pay, for services received. However, CONTRACTOR shall not refuse 27 services to CLIENTS referred by ADMINISTRATOR because of inability or 28 unwillingness to pay. CDA1018-00 Page 10 of 24 April 20, 2018
Financial Assessment. Medical schools teach how to take a patient history and physical exam- ination; they don’t teach how to read a profit and loss statement. There- fore, the best advice for this part of the employment process is to enlist the support of an accountant. A good accountant acts like a pathology lab— you send off information and you get back a usable interpretation of that information. The timing for requesting xxxxx- cial data from a potential employer is critical. Do not expect a practice or hospital to provide such material until both parties have expressed mu- tual, serious interest in pursuing an employment relationship. Once both parties’ interest has been established, items as possible. If you foresee diffi- culties obtaining the information, ask your accountant to contact the prac- xxxx or hospital’s accountant (or other appropriate financial manager) to re- quest or discuss these items. Often, more information will be divulged if a recruit asks his or her advisor to have the conversation directly,
Financial Assessment. The project promoters have presented separately calculated financial performance indicators for Estonia and Finland with several assumptions. The concerned NRA notes that financial performance calculation is carried out in line with the current regulatory framework and the methodology makes appropriate assumptions. However, the analysis submitted by the project promoters is dependent on many assumptions for example the Balticconnector’s average annual capacity bookings and tariffs.
