Preparation of State Agency Budget List of Positions, Form

4612 - Preparation of State Agency Budget List of Positions, Form CMS-1465a (Exhibit 47) (Rev. 1, 05-21-04) A - Usage This form is applicable for both LTC and non-LTC budgeted positions. The SA prepares a separate Form CMS-1465A of staff years and salaries for title XVIII non-LTC, title XVIII LTC, and title XIX positions. The SA prepares three Forms CMS-1465A with its annual budget request. B - Heading The SA verifies the pre-filled official name of the agency and inserts the period for which funds are requested. NOTE: The SA includes overtime needs for all categories of positions listed, and provides detail justification explanations for the estimated costs. The SA must not enter positions on Form CMS-1465A, which represents consultants (i.e., personnel who perform services on a fee basis and are not employees of the State). The SA shows funds for such services in Other Direct Costs, line 12 of Form CMS-435. The SA must not enter positions on Form CMS-1465A, which represents personnel related to NAR or NATCEP. The SA shows funds for such services in Other Direct Costs, as a separate line item in Miscellaneous of Form CMS-435. (See §4543 for instructions pertaining to costs incurred for NAR/NATCEP.) C - Positions - Column Entries 1. Column (A), Position Title/Name The SA lists each position and person’s name. A full-time incumbent position: ● Will work full-time on the State survey program on a continuing basis; ● Whose time will be subject to cost allocation between State and Federal programs. Where applicable, the SA indicates after the position title whether part-time (PT) or temporary (T) and subdivides positions into three classifications (surveyor, nonsurveyor professional and clerical) to simplify preparation of totals and for CMS review. 2. Column (B), City Where Located The SA shows the city where the incumbent is located. If all positions are located in the same city, the SA shows the city on the first line followed by: (all). 3. Column (C), Number of Positions The SA enters the total number of positions planned for the FY shown on the corresponding line of column (A). 4. Column (D), Staff-Years The SA enters the total staff-years to be worked during the FY by the incumbent(s) for the position shown on corresponding line of column (C). For full-time positions whose incumbents are on duty at the beginning of the fiscal year, this is the same number as shown in column (C). The time shown in staff years for full-time positions should be the time that it is anticipated will be spent in that program for which the budget request applies. The SA determines staff-years for new full-time positions based on the quarter the incumbent is expected to enter on duty, as follows: Entrance Quarters Staff Years October-December 1.00 January-March .75 April-June .50 July-September .25 The staff-years shown for part-time or temporary positions are derived by multiplying the percentage of time to be applied by the number shown in column (C). 5. Column (E), Funds Required The automated system calculates the total funds required by multiplying column (D) Staff Years and column (F) Annual Salary. 6. Column (F), Annual Salary The SA enters the annual salary for each full-time position presented in column (A) including part-time and/or temporary positions. D - Totals After completion of column entries, the automated system tallies the salaries of all positions. These salaries should then be entered into the appropriate section on Form CMS-435, Salaries; line l and 2. E - Certification: Date, Signature, and Title The automated system dates the Form CMS-1465A. The SA certifying official enters their name and title.