IHS Contract Support Costs Policy Updates

 
Contract
Support
 
Costs
 
Tribal Self Governance
Conference
April 2019
 
IHS Business
 
Principles
&
 
Goals
 
 
Comply 
with 
requirement to 
pay
 
full
CSC
 
need
Improve 
communication
 and
understanding
Improve
 and simplify
 business
 
practices
o 
consistency and fairness 
for 
all
 
Tribes
Implement IHS 
CSC
 
Policy
 
2
 
IHS CSC
 
Policy
 
o
O
ctober 
2016
 - a
nnounc
e
 the 
updated CSC 
P
olicy
o
The 
P
olicy 
can 
be 
found 
in 
the
 
Indian  Health
Manual
 
online
 -
https://www.ihs.gov/IHM/index.cfm?module=dsp_ih
m_pc_p6c3#6-3.2E
o
Includes a
 new template
 to calculate CSC
o
December 2017 – temporary suspension of part of
the CSC Policy
o
April 2018 - Tribal Consultation on suspended portion
of Policy
o
Final decision pending with IHS
 
3
 
IHS CSC 
Policy 
Changes/Updates
 
Overall 
goal 
is 
to 
simplify and streamline 
the
 
process
Includes Guiding
 
Principles
Expanded 
on 
definitions 
to 
assure and support
broad 
understanding 
and 
consistent
 
application
Startup and Pre-Award 
o
Paid one time to support the assumption of new program, functions,
services and activities
o
Within 90 
days 
after 
the 
initial
 
12 
month
 period of operation
, the Awardee
will 
certify 
that all 
funds 
were
 
spent
 on the negotiated activities
(certification only applies to startup costs)
o
Pre-award are paid for costs incurred prior to the assumption of PFSA’s
 
IHS CSC 
Policy 
Changes/Updates
 
Direct
 
CSC
 
o
Medical 
Inflation
 
Rate
o
Apply the 
inflation rate by 
the end of the first 
quarter (final percent issued
in 
November)
 
Indirect
 
CSC
 
o
Determine if prior year 
funds 
were expended; 
verify that 
the 
total 
health
care
 costs are at least equal to the amount IHS funded
.
 If 
the
expenditures
 
do 
not exceed the 
IHS 
funding 
provided
,
 
the CSC
calculation is subject 
to 
calculations outlined in 6-3.2.E.1.a
.i.b
.
o
90 day 
closeout 
after 
contract term 
available at 
option of 
the
 
Tribe
 if rate
is current
o
Use of
 
Rates
Fixed 
w/ Carry Forward 
– current or one 
year 
old
 
rate
Provisional final – 2 
year 
– final
 
rate
Allow
ed 
for grace 
period 
for 
2014 
-
 
2017
 
What
is
CSC?
 
 
106(a)(1)
funds 
(Secreta
r
ial
Amount)
 
 
106(a)(2)
F
unds
 -
(CSC)
 
Service Unit
Shares
 
Contract Support
 
Costs
o
The full 
amount of 
CSC funding for 
new, expanded, and ongoing contracts
or  compacts, as determined under 
this 
chapter pursuant 
to 
25 U.S.C. 
§
5325(a).
o
An 
amount 
for the reasonable costs for 
activities which 
must 
be carried 
out to
ensure 
compliance 
with 
the 
terms 
of the contract 
and prudent management
but which:
Normally 
are not 
carried out 
by 
the respective 
Secretary in 
his 
[her] direct
operation of the 
program; 
or
Are 
provided by 
the 
Secretary in 
support of the contracted 
program
 
from
resources 
other than those 
under
 
contract.
o
CSC that 
are 
eligible 
include 
the costs of 
reimbursing 
tribal contractors for
reasonable and allowable costs 
of
 
Direct program expenses 
for the operation of the 
federal program 
that 
is
the 
subject 
of the
 
contract
any additional administrative 
or 
other 
expense 
related 
to the 
overhead
incurred 
by the tribal contractor 
in connection with 
the 
operation 
of the
Federal program, function, service, 
or 
activity pursuant 
to the
 
contract
 
Key Definitions
 
Key 
Definitions
 
Direct 
Contract 
Support
 
Costs
o
Direct program expenses for 
the 
operation of 
the ISDEAA 
Programs 
that
are 
the subject 
of the award, 
that 
otherwise 
meet the 
definition of 
CSC
in  
25 U.S.C. 
§
 
5325(a)
(2)
.
o
Pays for activities that are not funded in the Secretarial amount or
contained in the IDC pool
.
o
See 
Policy for
 
examples
Duplication
o
The Agency is required to account for activities that may have already
been funded in the Secretarial amount with the original transfer of the
program.
Reasonable
 
Costs
o
A cost 
is 
reasonable 
if, in its nature and amount, if it does 
not exceed that
which would be incurred by 
a 
prudent person 
under the 
circumstances
prevailing at 
the 
time 
the 
decision was made 
to 
incur 
the
 
cost.
 
Key 
Definitions
 
Allowable
 
Costs
 
o
N
ecessary and 
reasonable for the 
performance 
of 
the 
Federal 
award;
consistent with policies and procedures; accorded 
consistent 
treatment
(a 
cost cannot 
be 
a 
direct 
cost 
if any 
costs 
incurred 
for the 
same purpose
are 
treated 
as indirect 
costs 
to 
a 
different 
federal 
award); consistent with
generally accepted accounting
 
principles
 
Indirect 
Cost
 
Rate
 
o
Negotiated 
with 
the Cognizant Agency
 
(IBC/DCA)
o
Identifies indirect 
cost need, not 
indirect 
contract 
support 
cost
 
need
 
Indirect Costs
o
Costs 
that have been incurred 
for 
common or 
joint 
purposes. 
These 
costs
benefit 
more than 
one cost objective and cannot be 
readily identified
with a 
particular 
final 
cost objective 
without 
effort disproportionate 
to 
the
results achieved.
 
Key 
Definitions
 
Indirect Contract Support
 
Costs
o
Administrative 
or other expenses 
related to the 
overhead 
incurred 
by 
a
contractor 
in 
connection 
with the 
operation of 
ISDEAA 
programs pursuant 
to the
contract and 
that 
otherwise 
meet the 
definition of 
CSC in 
25 U.S.C. 
§ 
5325(a)(2)-
(3).
o
Based 
on a 
Tribe’s 
d
irect 
c
ost 
b
ase 
times
 IDC
 rate, 
and accounts 
for
reasonableness and duplication 
of 
activities 
that 
are included in 
the
Tribe’s106(a)(1)
 
amount.
 
Exclusion
o
Direct expenditures excluded 
from the 
direct costs 
in 
order 
to 
calculate 
the
direct cost base 
to which the IDC rate 
is applied. 
These types 
of expenditures
vary by awardee and are defined 
in the IDC rate
 
agreement.
 
Key 
Definitions
 
Passthrough
 
Expenditure
o
Similar 
to 
exclusions 
in that 
pass-through expenditures 
may 
be excluded 
from
the 
direct cost base 
to which the IDC rate is typically 
applied, 
though such
expenditures also 
may 
be assigned 
a lower 
nominal 
IDC rate. The IDC rate(s)
should 
be applied 
to such 
expenditures consistent 
with the IDC rate
agreement.
Indirect
-T
ype
 
C
osts
o
Negotiated when a Tribe does not have an IDC rate agreement with their
cognizant agency or requests such a negotiation, even if they have a
negotiated rate
.
o
IHS 
and the contractor/compactor will negotiate 
a lump-sum 
amount 
for
indirect-type costs 
that 
consists of 
those 
categories of costs 
that 
normally are
found in IDC 
pools of contractors 
with rates 
and 
that 
are consistent 
with the
requirements 
of 25 U.S.C. 
§ 
5325(a)(2)-(3).Categories 
of 
typical 
costs 
are
outlined in the
 
policy.
Retained
 
Service
o
Funding which is 
eligible 
to 
be contracted but 
for which the 
awardee has
chosen not 
to 
contract, and 
thus, for which the IHS 
has 
retained
associated  
funding.
 
15
 
Direct Contract
 
Support
Costs
 
Negotiating
 
DCSC
 
- 
IHS 
CSC
 
Policy
o 
Manual
 
Exhibit 6-3-G, Section 
C
 
Steps:
1.
The 
Tribe 
must submit 
a
 
proposal
The 
policy 
identifies what 
the 
proposal should typically include.
2.
The IHS verifies 
the amounts 
in 
the
 
proposal
Reasonableness
Verify fringe 
rates that 
are
 
identified
May
 require requesting 
further documentation from
 
Tribe
3.
To compute the 
DCSC 
requirement, the 
awardee and 
the 
IHS 
must
negotiate 
the 
total 
cost 
to 
the 
awardee 
of the 
activities 
to 
be supported
with
 
CSC.
4.
The 
IHS 
reviews for 
duplication 
of costs, 
identify any activities
 that
are already included in 
the 
Secretarial amount.
 
Indirect
-
Type
 
Costs
 
Awardees 
without 
negotiated
 
rates
o
Or 
Awardee has 
an outdated
 
rate
o
The CSC policy also provides that Tribes can request such a negotiation
even if they have a negotiated rate
Annual 
lump sum
 
amount
O
verhead” or “indirect
-
type”
 
costs
Cannot 
be for activities funded in the
Secretarial amount 
or costs funded through
direct 
CSC.
 
CSC
 
Reconciliation
 
Data
 
updates
o
Rate
 
changes
o
Pass 
throughs and
 
exclusions
o
Changes 
in base
 
funding
o
Review for reasonableness 
and
 
duplication
Communication
o
Overpayments 
- Notice 
to
 
Tribe
o
Share documentation 
used 
to calculate
 
overpayment
o
Follow 
up 
with appropriate amendments 
or
 
modifications
Communication 
with
 
Tribes
o
Use of CSC Negotiations
 
template
o
Agreement on CSC need 
and
 
payment
 
Use of Indirect Cost Rate
 
o
Commitment to comply with Tribal Rate
o
Rate
 Year
o
Pass 
throughs and
 
exclusions
o
Changes 
in base
 
funding
o
Review for reasonableness 
and
duplication
 
CSC Fund Status
FY 2014 - 2019
 
Questions?
 
Contact Information:
 
Roselyn Tso, Director
Office of Direct Service and
Contracting Tribes
Phone:  301-443-1104
Cell: 971-506-1928
Email: Roselyn.Tso@IHS.gov
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Explore the latest updates in the IHS Contract Support Costs (CSC) policy, focusing on simplification, streamlining processes, and ensuring fair practices for all tribes. Learn about changes in the calculation methods, guidelines for startup and pre-award costs, medical inflation rate adjustments, and key definitions related to CSC funding. Stay informed on the evolving policies impacting tribal self-governance and contract support costs.


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  1. Contract Support Costs Tribal Self Governance Conference April 2019

  2. IHS Business Principles & Goals Comply with requirement to pay full CSC need Improve communication and understanding Improve and simplify business practices o consistency and fairness for all Tribes Implement IHS CSC Policy 2

  3. IHS CSC Policy o October 2016 - announce the updated CSC Policy o The Policy can be found in the Indian Health Manual online - https://www.ihs.gov/IHM/index.cfm?module=dsp_ih m_pc_p6c3#6-3.2E o Includes a new template to calculate CSC o December 2017 temporary suspension of part of the CSC Policy o April 2018 - Tribal Consultation on suspended portion of Policy o Final decision pending with IHS 3

  4. IHS CSC Policy Changes/Updates Overall goal is to simplify and streamline the process Includes Guiding Principles Expanded on definitions to assure and support broad understanding and consistent application Startup and Pre-Award o Paid one time to support the assumption of new program, functions, services and activities o Within 90 days after the initial 12 month period of operation, the Awardee will certify that all funds were spent on the negotiated activities (certification only applies to startup costs) o Pre-award are paid for costs incurred prior to the assumption of PFSA s

  5. IHS CSC Policy Changes/Updates Direct CSC o Medical Inflation Rate o Apply the inflation rate by the end of the first quarter (final percent issued in November) Indirect CSC o Determine if prior year funds were expended; verify that the total health care costs are at least equal to the amount IHS funded. If the expendituresdo not exceed the IHS funding provided, the CSC calculation is subject to calculations outlined in 6-3.2.E.1.a.i.b. o 90 day closeout after contract term available at option of theTribe if rate is current o Use of Rates Fixed w/ Carry Forward current or one year old rate Provisional final 2 year final rate Allowed for grace period for 2014 - 2017

  6. Service Unit Shares 106(a)(1) funds (Secretarial Amount) What is CSC? 106(a)(2) Funds - (CSC)

  7. Key Definitions Contract Support Costs o The full amount of CSC funding for new, expanded, and ongoing contracts or compacts, as determined under this chapter pursuant to 25 U.S.C. 5325(a). o An amount for the reasonable costs for activities which must be carried out to ensure compliance with the terms of the contract and prudent management but which: Normally are not carried out by the respective Secretary in his [her] direct operation of the program; or Are provided by the Secretary in support of the contracted program from resources other than those under contract. o CSC that are eligible include the costs of reimbursing tribal contractors for reasonable and allowable costs of Direct program expenses for the operation of the federal program that is the subject of the contract any additional administrative or other expense related to the overhead incurred by the tribal contractor in connection with the operation of the Federal program, function, service, or activity pursuant to the contract

  8. Key Definitions Direct Contract Support Costs o Direct program expenses for the operation of the ISDEAA Programs that are the subject of the award, that otherwise meet the definition of CSC in 25 U.S.C. 5325(a)(2). o Pays for activities that are not funded in the Secretarial amount or contained in the IDC pool. o See Policy for examples Duplication o The Agency is required to account for activities that may have already been funded in the Secretarial amount with the original transfer of the program. Reasonable Costs o A cost is reasonable if, in its nature and amount, if it does not exceed that which would be incurred by a prudent person under the circumstances prevailing at the time the decision was made to incur the cost.

  9. Key Definitions Allowable Costs o Necessary and reasonable for the performance of the Federal award; consistent with policies and procedures; accorded consistent treatment (a cost cannot be a direct cost if any costs incurred for the same purpose are treated as indirect costs to a different federal award); consistent with generally accepted accounting principles Indirect Cost Rate o Negotiated with the Cognizant Agency (IBC/DCA) o Identifies indirect cost need, not indirect contract support cost need Indirect Costs o Costs that have been incurred for common or joint purposes. These costs benefit more than one cost objective and cannot be readily identified with a particular final cost objective without effort disproportionate to the results achieved.

  10. Key Definitions Indirect Contract Support Costs o Administrative or other expenses related to the overhead incurred by a contractor in connection with the operation of ISDEAA programs pursuant to the contract and that otherwise meet the definition of CSC in 25 U.S.C. 5325(a)(2)- (3). o Based on a Tribe s direct cost base times IDC rate, and accounts for reasonableness and duplication of activities that are included in the Tribe s106(a)(1) amount. Exclusion o Direct expenditures excluded from the direct costs in order to calculate the direct cost base to which the IDC rate is applied. These types of expenditures vary by awardee and are defined in the IDC rate agreement.

  11. Key Definitions Passthrough Expenditure o Similar to exclusions in that pass-through expenditures may be excluded from the direct cost base to which the IDC rate is typically applied, though such expenditures also may be assigned a lower nominal IDC rate. The IDC rate(s) should be applied to such expenditures consistent with the IDC rate agreement. Indirect-Type Costs o Negotiated when a Tribe does not have an IDC rate agreement with their cognizant agency or requests such a negotiation, even if they have a negotiated rate. o IHS and the contractor/compactor will negotiate a lump-sum amount for indirect-type costs that consists of those categories of costs that normally are found in IDC pools of contractors with rates and that are consistent with the requirements of 25 U.S.C. 5325(a)(2)-(3).Categories of typical costs are outlined in the policy. Retained Service o Funding which is eligible to be contracted but for which the awardee has chosen not to contract, and thus, for which the IHS has retained associated funding.

  12. Contract Support Costs (CSC) Negotiation Template (FY 20XX) C h e c k o n e b o x: E s timate o f C S C n e e d Final C S C R e conciliatio n C h e c k o n e b o x: F A A m e n d m e nt F A C u mu l at i v e F u n d i n g R e port ( C F R ) D at e C o m p l e te d: Tribe /Tribal O r g an i zat i o n ( T / T O ) : Nu mb er # # Example T/TO Subtotals T o t al s S o u r c e o f I n p u t s Recurring a nd Non-Recu r ri ng Eligible Funding for the T / T O 's P r ogr a ms, Functions, Services, or Activities ( P F S A ) at the Service Unit Level. Dependi ng on the structure of a n a wa r dee's indirect cost ( I D C ) rate, this m a y include buy- backs. $655,943.00 A P r o g r a m (Service Unit) F u n d i n g E x p e n d i tu r es fr o m carryover fu n d s (for w h i c h C S C w a s n o t fu n d e d previously), N e t of pass- th r o u g hs a n d exclusions Pursuant to Section 6-3.2.E.1.b.1.b.i. This is determi ned by whet her the parties included the funds in the C S C calculation in the year a wa r de d a nd not by h o w the T / T O allocates funding in its accounting records. $0.00 A . 1 Recurring a nd Non-Recu r ri ng Eligible Funding for the T / T O 's P F S A at the Ar ea L evel ( Ar ea Office Tribal Shares, or A O T S ) . $75,000.00 B Total A r e a Tribal S h a r e s Recurring a nd Non-Recu r ri ng Eligible Funding for the T / T O 's P F S A at the Headquarter s L evel (Headquarter s Tribal Shares, or H Q T S ) . $30,000.00 C Total H e a d q u a rte rs Tribal S h a r e s $760,943.00 Items A + B + C (T otal Recurring a nd Non-Recu r ri ng eligible funding a wa r de d under the Secretarial Amou nt D Total Secretarial A m o u n t I D C A s s o c i a te d W i t h Recurring Service U n i t S h a r e s $0.00 Negotiated a nd calculated pursuant to Section 6-3.2.E.3 either: (a) case-by- case analysis, or (b) 97-3 method. E.1 $21,000.00 Negotiated a nd calculated pursuant to Section 6-3.2.E.4, either: (a) case-by-ca se analysis, or (b) 80-20 method. E.2 I D C A s s o c i a te d W i t h Tribal S h a r e s Total I D C Identified A s A s s o c i a te d W i t h th e Secretarial A m o u n t $21,000.00 This represent s P F S A funded in the Secretarial a mou nt determi ned to be duplicative of T / T O I D C Pool. E.3 $739,943.00 I t em D - E . 3 F Direct Co s ts F u n d e d th r o u gh Secretarial A m o u n t $76,390.00 P er prior-year agreement . T o be provided by I H S w h e n final inflation rate for previous year becomes available (usually in N ovember ) . Final rate would be u sed to update this amount, a nd a wa r d T / T O inflation on D C S C at the end of I H S 's first quarter. S ee Section 6-3.2.D.3. G Prior Y e a r Direct C S C ( D CS C) N e e d 1 . 6 % H Inflation Factor $77,612.24 I.1 D 2 1 -2 2 will automatically incorporate either the prior-year D C S C need (reflected in D 2 1 ) or, if there is a current- year renegotiation, the renegotiated a mou nt (reflected in D22). $0.00 Cu r r e n t Y e a r D C S C N e e d I.2 $77,612.24 Summarizes the negotiation for Nonrecur ri ng P r e - A w a r d a nd Startup costs for n e w or expa nded P F S A s in the upcoming year. $450.00 I.3 Startup a n d P r e - A w a r d N e e d Items F + I , but s ubject to Section 6-3.2, Paragraph E.1.a, Es timate of Indirect C S C N e e d a n d F undi n g Prior to t he Contract Year a n d E.1.b, Determination of Final A m o u n t for Indirect C S C N e e d a n d F undi n g. $818,005.24 J Total Direct Co s ts $14,262.29 T he a mou nt of passthrou ghs a nd exclusions funded by I H S . K Less: P a s s th r o u g h s a n d Exclusions $803,742.95 I t em J - K Current I D C rate. If T / T O has multiple I D C rates, enter blended rate a nd submit detailed calculation of the blended rate. L Direct Co s t B a s e 1 5 . 0 0 % M M o s t current I D C rate I t em L * M Equals I t em E . 3 if the T / T O has higher than a 2 5 . 0 0 % I D C rate; if T / T O has a rate of 2 5 . 0 0 % or lower the credit in I t em O is ba sed on the total I D C need for Tribal Shares generated by the T / T O 's rate plus the I D C Associat ed with Recurring Service Unit Shares ( I t em E.1) (Direct C ost B a se x I D C R a t e) $ 1 2 0 , 5 6 1 . 4 4 N I D C N e e d (Non-Recurring) B a s e d o n I D C Rate Credit for I D C A s s o c i a te d w i th th e Secretarial A m o u n t $12,600.00 O I t em N - O (T otal I D C need less credit for I D C associated with the Secretarial a mou nt $ 1 0 7 , 9 6 1 . 4 4 P Cu r r e n t - Y e a r Indirect C S C N e e d A s negotiated, pursuant to Section 6-3.2E.2; see also Exhibit G, footnote 10. Enter $ 0 if the T / T O negotiates indirect C S C solely ba sed on its I D C rate. $ 0 . 0 0 Q I D C- T y p e Co s ts $ 1 8 6 , 0 2 3 . 6 8 Items I.2 + I.3 + P + Q (T otal need for D C S C , indirect C S C , a nd P r e - A w a r d a nd Startup) R Cu r r e n t - Y e a r Total C S C N e e d I t em I.2 $ 7 7 , 6 1 2 . 2 4 S Cu r r e n t - Y e a r D C S C N e e d T otal D C S C funding paid to the T / T O year-to-date. $ 0 . 0 0 T Total D C S C P a i d Year-to-Date $ 1 0 7 , 9 6 1 . 4 4 Items P + Q U Cu r r e n t - Y e a r Indirect C S C N e e d $ 1 0 0 , 0 0 0 . 0 0 T otal indirect C S C funding paid to the T / T O year-to-date. Total Indirect C S C P a i d Year-to-Date V I t em I.3 $ 4 5 0 . 0 0 W Cu r r e n t - Y e a r Startup a n d P r e - A w a r d N e e d Total Startup a n d P r e - A w a r d C S C P a i d Year-to- D a te $ 0 . 0 0 T otal Startup a nd P r e - A w a r d C S C funding paid to the T / T O year-to-date. X N o te R e g a r d i ng S u b - A w a r d s : T h e te m p l a te a w a r d s C S C o n th e direct cost b a s e incurred b y th e T/TO. C S C n e e d of th e T / T O A N D th e T / T O treats s u b - a w a r d s as a p a s s th r o u g h cost w h e n d e te r m i n i n g its direct cost base, th e total C S C n e g o ti a te d can b e a d ju s te d to incorporate eligible costs specifically identified for e a c h s u b - a w a r d e e ( w h i l e recognizing s u b - a w a r d e e p a s s th r o u g hs a n d exclusions a n d th e s u b - a w a r d e e ' s indirect cost rate). If th e T / T O h a s a n a g r e e m e n t( s ) w i th a s u b - a w a r d e e w h o s e costs are eligible to b e c o n s i d e red in th e 15 F o o tn o te : This T e m p l a te is a tool u s e d b y th e Indian H e a l th Service (IHS) for calculating a n d negotiating CS C. N e i th e r this T e m p l a te n o r a n y o th e r negotiation d o c u m e n ts creates a contractual obligation o n b e h a l f of either IHS o r a T/TO. T h e C S C a m o u n t that th e parties a g r e e is r e q u i re d u n d e r a n y Indian S e l f - D e te rm i na ti o n a n d Education Assistance Act ( I S D E A A ) a g r e e m e n t will b e identified in th e a g r e e m e n t itself.

  13. Direct Contract Support Costs Negotiating DCSC - IHS CSC Policy o Manual Exhibit 6-3-G, Section C Steps: 1. The Tribe must submit a proposal The policy identifies what the proposal should typically include. The IHS verifies the amounts in the proposal Reasonableness Verify fringe rates that are identified May require requesting further documentation from Tribe 3. To compute the DCSC requirement, the awardee and the IHS must negotiate the total cost to the awardee of the activities to be supported with CSC. 4. The IHS reviews for duplication of costs, identify any activities that are already included in the Secretarial amount. 2.

  14. Indirect-Type Costs Awardees without negotiated rates o Or Awardee has an outdated rate o The CSC policy also provides that Tribes can request such a negotiation even if they have a negotiated rate Annual lump sum amount Overhead or indirect-type costs Cannot be for activities funded in the Secretarial amount or costs funded through direct CSC.

  15. CSC Reconciliation Data updates o Rate changes o Pass throughs and exclusions o Changes in base funding o Review for reasonableness and duplication Communication o Overpayments - Notice to Tribe o Share documentation used to calculate overpayment o Follow up with appropriate amendments or modifications Communication with Tribes o Use of CSC Negotiations template o Agreement on CSC need and payment

  16. Use of Indirect Cost Rate o Commitment to comply with Tribal Rate o Rate Year o Pass throughs and exclusions o Changes in base funding o Review for reasonableness and duplication

  17. CSC Fund Status FY 2014 - 2019 Fiscal Year FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 FY 2019 Appropriations $612,483,901 $662,970,000 $686,859,423 $714,596,372 $762,642,272 $822,227,000 Disbursed $611,282,992 $639,125,541 $675,328,915 $705,355,391 $754,253,926 $304,976,365 Balance $1,200,909 $23,844,459 $11,530,508 $9,240,981 $8,388,346 $517,250,635 Reconciliation remains open for all years

  18. Questions? Contact Information: Roselyn Tso, Director Office of Direct Service and Contracting Tribes Phone: 301-443-1104 Cell: 971-506-1928 Email: Roselyn.Tso@IHS.gov

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