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Office of Mental Health

New York State Consolidated Budget and Claiming Manual Subject: CQR-1 Agency Quarterly Fiscal Summary Section: 22
For the Periods:
January 1, 2009 to December 31, 2009
July 1, 2009 to June 30, 2010
Issued: September 9, 2009

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The CQR-1 Agency Quarterly Fiscal Summary schedule is used to report intra-year expenses, revenues, net operating costs and funding sources for programs receiving Aid to Localities (State Aid) funding from the NYS Office of Alcoholism and Substance Abuse Services (OASAS), NYS Office of Mental Health (OMH) and NYS Office of Mental Retardation and Developmental Disabilities (OMRDD).

Note: The NYS Office of Mental Health (OMH) does not require the submission of intra-year claims. Accordingly, OMH does not require the submission of CQR-1 claim schedules.

General Instructions

The CQR-1 is only used to report intra-year fiscal information. A final CQR-1 is not required and should not be submitted. For final claim submissions the consolidated Claim Report (CCR) schedules included as part of the year-end Consolidated Fiscal Report (CFR) are used.

  1. Separate OASAS-specific and/or OMRDD-specific CQR-1 schedules must be prepared.
  2. Separate OASAS-specific and/or OMRDD-specific CQR-1 schedules must be prepared for each county in which the service provider operates programs and/or from which the service provider receives State Aid funding.
  3. Additional CQR-1 continuation schedules are required if:
    1. a service provider operates more than four (4) programs and/or
    2. receives State Aid reimbursement from more than four (4) unique funding code and funding code index combinations.
  4. The overall flow of the CQR-1 schedule is as follows:
    • Column 1 displays the service provider's approved budget.
    • Column 2 displays the service provider's cumulative (local fiscal year-to-date) approved expenses, revenues and net operating costs.
    • Column 3 displays the sum of columns 4–7 (or more if required) exclusive of lines 15–19, 23–25, 31–33, 39–41 and 47-49.

Note: OASAS expects all service providers to use approved CFRS Software to complete Intra-year Fiscal Reporting documents and to submit those documents via the Internet. At this time, paper copies are still required to be sent directly to OASAS' Bureau of Financial Management.
Heading Instructions – CQR-1.1 and CQR-1.2

State Agency *

Indicate whether the reported programs are for either OASAS services or OMRDD services.

Fiscal Period *

Enter the beginning and ending dates of the complete 12 month fiscal reporting period (01/01/XX to 12/31/XX, 07/01/XX to 06/31/XY, etc.). Do not enter the dates of the quarter or mid-year period for which expenses and revenues are being reported.

Quarter Reported *

Indicate the specific intra-year claim period the CQR-1 covers (i.e. 1st quarter, 2nd quarter, mid-year, etc.).

Agency Name *

Enter the name of the organization (service provider) operating the reported program(s).

Prepared by *

Enter name of person that prepared the CQR-1 and can answer questions about the information contained in the document.

Telephone *

Enter the preparer's telephone number.

Agency Code *

Enter the five (5) digit code assigned to the organization operating the reported program(s).

County Name and Code *

Enter the name and associated two (2) digit code for the county where the reported programs operated and/or were funded through a local county contract. Please see Appendix C of this manual and the Consolidated Fiscal Reporting and Claiming Manual (CFR Manual) for a list of New York State counties and their associated county codes.

LGU *

Local contract funded service providers: Enter the name of the Local Governmental Unit (LGU) that contracted for the reported programs.

Direct contract funded service providers: Make no entry.

* Complete this at the top of each page of the CQR-1.1 & CQR-1.2.

LGU Approval By *

LGUs: Enter the name of the individual representing the LGU) that has reviewed and approved the expenses, revenues, net operating costs and funding code information reported on the CQR-1.

Local contract funded service providers: Make no entry.

Direct contract funded service providers: Make no entry.

Program Type *

For each reported program, enter the type of program operated using the program names in Appendices E and G of this manual and the CFR Manual.

Program Code & Program Code Index *

For each reported program, enter the applicable OASAS or OMRDD program code and program code index. Please see Appendices E and G of this manual and the CFR Manual for complete listings of valid OASAS and OMRDD program codes. Program code indexes are assigned as follows:

OASAS: Use the same array of program codes and indexes as were used during the prior reporting period unless programs have been combined, added or removed from OASAS funding for this reporting period. If programs have been added or removed from OASAS funding, consult with the OASAS Field Office for the appropriate array of program codes and indexes to be used.

OMRDD: OMRDD programs reported on a program type basis (expenses and revenues aggregated and reported in one (1) column) and programs codes 0053, 0054, 0090, 0091, 0200, 0202, 1090, 1091, 2090, 2091, 3090, 4090, 5090, 5091, 6090 and 6091 use index code “00”. For all other OMRDD programs use “01” for the first occurrence of each program type, “02” for the second occurrence, “03” for the third occurrence, etc (e.g. Family Support).

Accounting Method (CQR-1.1 only) *

For each reported program, enter the method of accounting used i.e., accrual, modified accrual or cash.

* Complete this at the top of each page of the CQR-1.1 & CQR-1.2.

Line Instructions – CQR-1.1 - Expenses (Columns 4-7)

  1. Personal Services

    For each reported program, enter the personal services expenses for the reporting period. Do not include agency administration personal services on this line.

  2. Vacation Leave Accruals

    For each reported program, enter the vacation leave accruals (current quarter or mid-year adjustments) that correspond to the personal services reported on line 1. Do not include agency administration vacation leave accruals on this line.

    OASAS Note: OASAS does not allow service providers to budget for or claim vacation leave accruals for State Aid reimbursement.

  3. Fringe Benefits

    For each reported program, enter the fringe benefits that correspond to the personal services reported on line 1. Include FICA, hospitalization, retirement benefits, group life insurance, etc. Do not include agency administration fringe benefits on this line.

    Note: Fringe benefits expenses are allowable expenses to the extent that they are reasonable and available to all employees.

  4. Other Than Personal Services

    For each reported program, enter the OTPS expenses for the reporting period. Include food, repairs and maintenance, utilities, telephones, minor expensed equipment (equipment costing less than $1,000 per unit and having a useful life of less than two (2) years), supplies, etc. Do not include agency administration OTPS expenses on this line.

  5. Equipment – Provider Paid

    For each reported program, enter the equipment-related expenses for the reporting period. Include the cost of any vehicle and equipment leases on this line. Do not include agency administration equipment expenses on this line. Also, do not include any equipment expenses reported on line 4, OTPS.

    OASAS Note: OASAS does not allow service providers to budget for or claim equipment depreciation for State Aid reimbursement. All equipment must be expensed in the year of purchase.

    OMRDD Note: Equipment costing $1,000 or more and having a useful life of two (2) or more years may be depreciated or expensed in the year of purchase.

  6. Property – Provider Paid

    For each reported program, enter the property-related expenses for the reporting period. Include property lease costs, building depreciation, property casualty insurance, etc. Do not include agency administration property expenses on this line.

    OASAS Note: OASAS does not allow service providers to budget for or claim property depreciation for State Aid reimbursement. Only the actual property-related costs incurred can be claimed.

  7. Agency Administration

    For each applicable program, enter the allocated agency administration expenses for the reporting period. Total county operated and not-for-profit service provider agency administration expenses must be allocated to OASAS, OMRDD and all other funding sources using the ratio value methodology.

    Note: County operated service providers must allocate agency administration expenses to programs other than LGU administration (program code 0890). LGU administration is considered a unique cost center separate and distinct from agency administration expenses incurred by other county operated programs. Agency administration expenses for the management and oversight of all county operated programs other than program code 0890 cannot be included in the expenses reported under program code 0890. Please see Appendix I and Appendix K of this manual and the CFR Manual for more detailed information on agency administration and LGU administration.

  8. Adjustments/Non-Allowable Costs

    For each reported program enter the adjustments to reported expenses and/or non-allowable expenses for the reporting period. The amount(s) entered on line 8 cannot be a negative number. Please refer to Appendix X of this manual and the CFR Manual for descriptions of some, but not all, non-allowable expenses.

  9. Total Expenses

    For each reported program, enter the sum of lines 1-7 minus line 8.

    Line Instructions – CQR-1.1 - Revenues (Columns 4-7)

  10. Please Check (OMRDD Only)

    For each reported program, indicate the type of revenue allocation methodology used (Participant Specific or Non-Participant Specific).

  11. Medicaid Revenue

    For each reported program, enter the actual Medicaid revenue received for the reporting period. (See notes to line 12 below.)

  12. Non-Medicaid Revenue

    For each reported program, enter the revenues received from all sources other than Medicaid for the reporting period. This includes DSH revenue and revenue received from Medicaid MCOs.

    Disproportionate Share (DSH): OASAS service providers should report any DSH revenue received on line 12, Non-Medicaid Revenue.

    Medicaid Managed Care: Revenues received directly from a Medicaid Managed Care Organization (MCO) should be reported on line 12, Non-Medicaid Revenue.

  13. Total Revenues

    For each reported program, enter the sum of lines 11 and 12.

  14. Net Operating Costs

    For each reported program, enter the result of line 9 minus line 13.

    Line Instructions – CQR-1.1 - Miscellaneous (Columns 4-7)

  15. State Contract Number/Local Contract Number

    For each reported program, enter the contract number as follows:

    State Contract Number: For direct contracts with OASAS or OMRDD, enter the State contract number.

    LGU Contract Number: For local contracts with a county, enter the local contract number if one is assigned.

    Note: A State or LGU contract number must be entered. If the funding LGU does not use contract numbers, enter the first seven (7) letters of the county name as a proxy. If the county name is seven (7) letters or less, enter the complete county name.

    Note: OASAS would prefer that all County operated and Not for Profit service providers funded through a local contract with a County use the first seven (7) letters of the County name rather than an LGU contract number.

  16. Total Persons Served (OMH Only)

    For OASAS and OMRDD programs, make no entry.

  17. Total Units of Service

    For each applicable program reported, enter the units of service provided during the reporting period.

    Note: Reporting units of service may not be applicable for certain types of programs. Please see Appendices E and G of this manual and the CFR Manual to determine if units of service should be reported for a specific type of program.

  18. Gross Cost Per Unit

    For each program with reported units of service, enter the gross cost per unit of service for the reporting period. The gross cost per unit of service is calculated by dividing the total program expenses reported on line 9 by the total program units of service reported on line 17. The gross cost per unit of service should be calculated to the nearest hundredth place (XXX.XX).

  19. Net Cost Per Unit

    For each program with reported units of service, enter the net cost per unit of service for the reporting period. The net cost per unit of service is calculated by dividing the total program net operating costs expenses reported on line 14 by the total program units of service reported on line 17. The net cost per unit of service should be calculated to the nearest hundredth place (XXX.XX).

  20. Workshop Contract Sales (Direct)

    OASAS: Make no entry.

    OMRDD: For each reported workshop program, enter the industrial contract sales revenues for the reporting period.

  21. Local Government (OASAS Only)

    OASAS: For each reported program, enter the amount of local government contribution (local county tax) that is being applied against the net deficit for the reporting period. Use this line only if one or more of the funding code and funding code indexes used on the CQR-1.2 reimburses State Aid at 100% of the net expenses reported.

    OMRDD: Make no entry.

  22. Voluntary Contributions

    OASAS: Make no entry. Voluntary contributions are budgeted for and reported as Non-Medicaid Revenue on line 12.

    OMRDD: Make no entry.

Line Instructions – CQR-1.2 – General Funding Source Information

If expenses, revenues and net operating costs need to be distributed between funding codes, there are four ways this can be accomplished:

  1. Expenses, revenues and net operating costs can be direct charged.
  2. Expenses, revenues and net operating costs can be distributed using units of service. When using this method, the ratio of the units of service applied to a funding code or State Agency must be calculated using six decimal place multipliers (i.e. .123456). The sum of all multipliers used must equal 1.000000.
  3. Expenses, revenues and net operating costs can be distributed using a ratio. When using this method, the ratio must be calculated using six decimal place multipliers (i.e. .123456). The sum of all multipliers used must equal 1.000000.
  4. For OMRDD programs using the Participant Specific Revenue Allocation methodology, expenses are distributed between funding codes using units of service (see number 1 above). Revenues are direct charged to the appropriate funding code(s) based on the funding source and the consumers generating the revenues under that funding source.

Please check with the funding State Agency (OASAS or OMRDD) if you have any questions regarding the allocation methodology to be used.

Line Instructions – CQR-1.2 – Funding Code Information (Columns 4-7)

Lines 23, 31, 39 and 47 – Funding Code

For each reported program, enter the applicable three (3) digit funding code(s) used during the reporting period.

OASAS Note: OASAS funded county operated and not-for-profit service providers must also enter the alphabetic funding source index. The funding code and funding code index combinations used must be consistent with those used in the service provider's most recently approved budget.

County operated and local contract funded not-for-profit service providers can find the correct funding code and funding code indexes to use on the most recently issued OASAS Approval Letter for the fiscal reporting period.

Direct contract funded county operated and not-for-profit service providers can find the correct funding code and funding code indexes to use on the most recent Appendix B of their fully executed contract with OASAS.

Only one (1) unique funding code or funding code/funding code index combination can be used on each line.

Lines 24, 32, 40 and 48 – Number of Persons Served (OMH Only)

For OASAS and OMRDD programs, make no entry.

Lines 25, 33, 41 and 49 – Units of Service

For each applicable program, enter the units of service provided during the reporting period.

Note: Reporting units of service may not be applicable for certain types of programs. Please see Appendices E and G of this manual and the CFR Manual to determine if units of service should be reported for a specific type of program.

Lines 26, 34, 42 and 50 – Total Expenses

For each unique funding code and funding code index combination used in a reported program, enter the allocated portion of the expenses entered on CQR-1.1, line 9.

Lines 27, 35, 43 and 51 – Revenue: Medicaid

For each unique funding code and funding code index combination used in a reported program, enter the allocated portion of the expenses entered on CQR-1.1, line 11.

Lines 28, 36, 44 and 52 – Revenue: Other

For each unique funding code and funding code index combination used in a reported program, enter the allocated portion of the expenses entered on CQR-1.1, line 12.

Lines 29, 37, 45 and 53 – Total Revenues

For each unique funding code and funding code index combination used in a reported program, enter the allocated portion of the expenses entered on CQR-1.1, line 13.

Lines 30, 38, 46 and 54 – Net Operating Costs

For each unique funding code and funding code index combination used in a reported program, enter the allocated portion of the expenses entered on CQR-1.1, line 13.

Comments or questions about the information on this page can be directed to the Community Budget & Financial Management (CBFM) Group.