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{"sheet":"Vendor Worksheet Instructions","index":0,"n_rows":97,"n_cols":2,"rows_kept":97,"cut":false,"hidden":false,"merged":[[39,1,43,8],[34,1,35,8],[3,0,7,8],[27,1,28,8],[23,1,25,8],[37,0,38,8],[45,1,48,8],[50,1,50,8],[96,0,97,8],[91,0,94,8],[52,1,53,8],[67,1,68,8],[70,1,70,8],[85,1,87,8],[79,1,79,8],[81,1,81,8],[89,1,89,8],[83,1,83,8],[59,1,63,8],[71,1,71,8]]}
["AB 1522 - EMPLOYEE SICK LEAVE 2015 RATE ADJUSTMENT"]
["WORKSHEET INSTRUCTIONS"]
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["These instructions are for the Vendor Worksheet.  After you read these instructions, please go to the “Vendor Worksheet” tab to begin.  You will ONLY be able to fill-in and select from the shaded fields on this worksheet.  The information you submit on this worksheet will be reviewed by FDLRC.  If additional information is needed FDLRC will contact you.  After the review, you will receive written approval or denial of the requested rate adjustment."]
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["SECTION A:  PROGRAM INFORMATION"]
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["Row 1","Please enter the Service Provider Name."]
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["Row 2","Please enter the six-digit Vendor Number."]
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["Row 3","Please enter the three-digit Service Code."]
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["Row 4","Please enter the Subcode if applicable."]
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["Row 5","Please enter the Staffing Ratio."]
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["Row 6","Please enter the number of Enrolled Clients."]
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["Row 7","Please enter the dates for the beginning and end of a review period of 3 consecutive months.  If you have been recently vendored and have less that 3 months of payroll and billing data, please enter the dates for an applicable review period of up to 3 months."]
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["Row 8","Please enter the current rate as established by FDLRC and select the Unit Type, either Daily or Hourly, from the drop-down list."]
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["Rows 9 & 10","Rate information will populate automatically here."]
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["Row 11","Select the Vendoring Regional Center from the drop-down list."]
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["Row 12-14","Select the User Regional Center(s), if applicable, from the drop-down list.  If you need to list additional user regional centers, please click the designated button. "]
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["SECTION B:  EMPLOYEE WAGE INFORMATION - Applicable to only those employed staff not currently receiving a paid leave benefit of at least 3 days or 24 hours annually as described in AB 1522."]
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["Column A","Please enter the name or initials of the employed staff who were paid during the review period, followed by their position title.  For any employee/position who received two or more different hourly wages during the review period being reported, please list only the most current wage paid with the requested information in columns B through G.  If additional rows are needed, please click on the designated button."]
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[null,"DO NOT include staff who are providing these services that are funded by another source, such as through a contract with a school district.  Also, DO NOT include wages paid to clients while receiving these services or any worker who is paid through other sources such as contract funding."]
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["Column B","Please enter the Position Title of the Employee."]
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["Column C","Please enter the current Hourly Wage paid to the employee(s) reported during the Review Period."]
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["Columns D & E","Wage information will calculate automatically here."]
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["Column F","Please enter the Workers' Compensation Insurance Employer Rate as a percentage."]
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["Column G","Please enter your Total Unemployment Insurance contribution rate as a percentage,  including the net Federal and State rates, and the Employment Training Tax of 0.1%.  (Refer to your Form DE-2088 that you receive from the State of California Employment Development Department (EDD) for your contribution rates for Unemployment Insurance and Employment Training Tax.) "]
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["Column H","Wage information will calculate automatically here."]
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["Column I","Please enter the actual Total Hours Worked During the Review Period by each of the reported employee(s)."]
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["Column J","Annualized hourly information will calculate automatically here."]
[null,"If less than a 3 month period, Section A Row 7,  FDLRC will adjust the calculation as needed."]
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["Column K","Earned Sick Leave totals will calculate automatically here."]
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["Column L","Total Cost of Sick Leave Benefits will calculate automatically here."]
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["SECTION C:  RATE ADJUSTMENT CALCULATION"]
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["Row 1","Total wages, payroll taxes, workers' compensation, and other mandated employer costs will calculate automatically here."]
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["Row 2","Total Actual Number of Units of Services Billed to all Regional Centers during the \n3 month period will calculate automatically here."]
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["Row 3","Total Annualized Number of Units of Services Billed to all Regional Centers will calculate automatically here."]
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["Rows 4 - 8","Please select the individual regional center(s) billed in the Review Period and enter the total units billed in the Review Period for the selected regional center(s).  If you need to list additional regional centers, please click the designated button."]
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["Row 9","The rate change will calculate automatically here and populate Row 9 in Section A, Program Information."]
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["Please review ALL the information you have entered on the worksheet, and specifically rows 8 - 10 in Section A, and row 8 in Section C.  These rows should have calculated rate information based on the data you have entered.  If there is an error message in these rows, you may need to re-enter the information in Sections B, and/or C."]
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["Before submitting, please save your workbook using the vendor number in the title of the file.  Failure to do so results in the submission of an empty workbook."]

{"sheet":"Vendor Worksheet","index":1,"n_rows":114,"n_cols":13,"rows_kept":114,"cut":false,"hidden":false,"merged":[[26,11,29,11],[26,12,29,12],[26,10,29,10],[28,1,29,1],[18,2,18,6],[20,2,20,6],[26,3,29,3],[26,4,29,4],[26,6,29,6],[26,9,29,9],[26,5,29,5],[26,2,29,2],[26,8,29,8],[26,7,29,7],[19,2,19,6],[17,2,17,6],[10,2,10,6],[10,7,10,9],[11,3,11,5],[12,3,12,5],[12,7,12,9],[13,3,13,5],[13,7,13,9],[14,2,14,6],[15,2,15,6],[16,2,16,6],[4,2,4,6],[5,2,5,6],[6,2,6,6],[8,2,8,6],[9,2,9,6]]}
["AB 1522 - Employee Sick Leave Rate Adjustment Calculation Worksheet"]
["Effective July 1, 2015"]
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["SECTION A:  PROGRAM INFORMATION"]
[1,"Service Provider Name"]
[2,"Vendor Number"]
[3,"Service Code"]
[4,"Sub-code (if applicable)"]
[5,"Staffing Ratio"]
[6,"Number of Enrolled Consumers"]
[7,"Review Period: (Enter Beginning & End)"]
[8,"Current Rate:",null,"Select Unit Type: Daily or Hourly",null,null,"Daily"]
[9,"Rate Adjustment:",{"$f":"G57","v":{"$error":"#DIV/0!"}}]
[10,"New Rate:",{"$f":"C12+G57","v":{"$error":"#DIV/0!"}}]
[11,"Select Vendoring Regional Center from Drop Down Menu"]
[12,"Select User Regional Centers from Drop Down Menu"]
[13,"Select User Regional Centers"]
[14,"Select User Regional Centers"]
[13,"Select User Regional Centers"]
[{"$f":"A19+1","v":14},"Select User Regional Centers"]
[{"$f":"A20+1","v":15},"Select User Regional Centers"]
[]
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["SECTION B:  EMPLOYEE WAGE INFORMATION"]
[null,"A","B","C","D","E ","F","G","H","I","J","K","L"]
[null,"Name or Initials of Staff Employee(s)","Position Title","Hourly Wage","Employer Social Security Tax @ 6.2%","Employer Medicare Tax @1.45%","Workers Compensation as a %","Total Unemploy. Insurance as a %","Total Hourly Wage plus Mandate Payroll Costs","Total Hours Worked during the 3 Months Review Period","Annualized Hours","Earned Sick Leave (1:30) up to 24 Hrs. ","Cost of the Employee Sick Leave Benefit"]
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[null,"(Please See Instructions for Listing Employees Receiving more than One Wage)"]
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[1,"Staff 1",null,null,{"$f":"D31*0.062","v":0},{"$f":"D31*0.0145","v":0},null,null,{"$f":"SUM(D31+E31+F31)+(D31*G31)+(D31*H31)","v":0},null,{"$f":"J31*4","v":0},{"$f":"IF(K31/30<24,K31/30,24)","v":0},{"$f":"L31*I31","v":0}]
[2,"Staff 2 ",null,null,{"$f":"D32*0.062","v":0},{"$f":"D32*0.0145","v":0},null,null,{"$f":"SUM(D32+E32+F32)+(D32*G32)+(D32*H32)","v":0},null,{"$f":"J32*4","v":0},0,0]
[3,"Staff 3",null,null,0,0,null,null,0,null,0,0,0]
[4,null,null,null,0,0,null,null,0,null,0,0,0]
[5,null,null,null,0,0,null,null,0,null,0,0,0]
[6,null,null,null,0,0,null,null,0,null,0,0,0]
[7,null,null,null,0,0,null,null,0,null,0,0,0]
[8,null,null,null,0,0,null,null,0,null,0,0,0]
[9,null,null,null,0,0,null,null,0,null,0,0,0]
[10,null,null,null,0,0,null,null,0,null,0,0,0]
[" ",null,null,null,null,null,null,null,"Totals",{"$f":"SUM(J31:J40)","v":0},{"$f":"SUM(K31:K40)","v":0},{"$f":"SUM(L31:L40)","v":0}]
[null," ",null,null,null,null,null,null,null,null,null,"Total Cost of Sick Leave Benefit",{"$f":"SUM(M31:M41)","v":0}]
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["SECTION C:  RATE ADJUSTMENT CALCULATION"]
[1,null,null,null,null,"Total Cost of the Earned Sick Leave Benefit:",{"$f":"M42","v":0}]
[2,null,null,null,null,"Actual Number of Units of Services Billed to all Regional Centers for the Review Period:",{"$f":"SUM(G52:G56)","v":0}]
[3,null,null,null,null,"Annualized Number of Units of Service:",{"$f":"G49*4","v":0}]
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[4,"Select Regional Center from Drop Down Menu:",null,null,null,"Enter Total No. of Units for Review Period"]
[5,"Select Regional Center:",null,null,null,"Enter Total No. of Units for Review Period"]
[6,"Select Regional Center:",null,null,null,"Enter Total No. of Units for Review Period"]
[7,"Select Regional Center:",null,null,null,"Enter Total No. of Units for Review Period"]
[8,"Select Regional Center:",null,null,null,"Enter Total No. of Units for Review Period"]
[9,"Rate Change (Q x R)",null,null,null,null,{"$f":"ROUND(G48/G50,2)","v":{"$error":"#DIV/0!"}}]
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["Daily","Daily"]
["Hourly","Hourly"]
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["ACRC","ACRC"]
["CVRC","CVRC"]
["ELARC","ELARC"]
["FDLRC","FDLRC"]
["FNRC","FNRC"]
["GGRC","GGRC"]
["HRC","HRC"]
["IRC","IRC"]
["KRC","KRC"]
["NBRC","NBRC"]
["NLACRC","NLACRC"]
["RCEB","RCEB"]
["RCOC","RCOC"]
["RCRC","RCRC"]
["SARC","SARC"]
["SCLARC","SCLARC"]
["SDRC","SDRC"]
["SGPRC","SGPRC"]
["TCRC","TCRC"]
["VMRC","VMRC"]
["WRC","WRC"]

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["AB 1522 - EMPLOYEE SICK LEAVE 2015 RATE ADJUSTMENT"]
["SUMMARY & CERTIFICATION INSTRUCTIONS"]
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["These instructions are for the Vendor Summary & Certification.   After you read these instructions, please go to the “Vendor Summary & Certification” tab.  Please review the Program Information and enter the service address associated with the information submitted on this workbook.  If your program has a different mailing address than the service address, please enter this information."]
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["Please enter the requested Contact Information for the individual responsible for completing this workbook.  This information will include Contact Name, Contact Phone Number, Email Address, and Executive Director/Owner."]
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["Please review the current rate, proposed rate change, and the proposed new rate, which are calculated based on the information you have entered on the worksheet.  If there is an error message in the rate information, go back and review the information in the worksheet. "]
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["Please ensure you click on the \"I AGREE\" checkbox prior to saving or sending the workbook."]
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["We ask that you save this workbook using your vendor number and service code in the title of the file name.  For example, \"H12345 510.xlsm\", then email the workbook to FDLRC at \"serviceprovider@lanterman,org\" by hitting the “SUBMIT” button on the bottom of the Vendor Summary & Certification worksheet.  Please ensure you submit a copy to the vendoring regional center and to keep copies for your records."]
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["PLEASE NOTE:  By hitting the “SUBMIT” button on the bottom of the “Vendor Summary & Certification” worksheet, you certify that the information provided to FDLRC is specific to payroll costs necessary to meet the requirements of AB 1522, that went into effect on July 1, 2015.  You additionally certify to the best of your knowledge and belief that the information submitted is true and correct, and subject to verification by all record keeping and audit processes, procedures, and guidelines under the Lanterman Act and Title 17 of the California Code of Regulations (CCR)."]
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["You must retain ALL backup documentation which supports the information being submitted in this workbook.  The backup information for the information provided on this workbook is subject to all record keeping and audit processes, procedures, and guidelines under the Lanterman Act and Title 17, CCR.  "]
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[" "]
["EMAIL ADDRESS:"]
["bmcneal@altaregional.org"]
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["MAILING ADDRESS:"]
["Alta California Regional Center"]
["Attention:  Beverly McNeal"]
["2241 Harvard Street,  Suite 100"]
["Sacramento, CA 95815"]

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["AB 1522 - EMPLOYEE SICK LEAVE 2015 RATE ADJUSTMENT"]
["SUMMARY & CERTIFICATION SHEET"]
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["PROGRAM INFORMATION"]
[]
["Service Provider Name:",null,{"$f":"'Vendor Worksheet'!C5:G5","v":0}]
["Vendor Number:",null,{"$f":"'Vendor Worksheet'!C6:G6","v":0}]
["Service Code:",null,{"$f":"'Vendor Worksheet'!C7:G7","v":0}]
["Subcode (if applicable):",null,{"$f":"'Vendor Worksheet'!C8","v":0}]
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["Service Address:"]
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["Mailing Address:"]
["(if different than service address)"]
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["CONTACT INFORMATION"]
[null,null,"Individual Responsible for Completing Worksheet:"]
["Contact Name:"]
["Contact Phone Number:"]
["Email Address:"]
["Executive Director/Owner:"]
[]
["Current Rate:",null,{"$f":"'Vendor Worksheet'!C12","v":0}]
["Proposed Rate Change:",null,{"$f":"'Vendor Worksheet'!C13","v":{"$error":"#DIV/0!"}}]
["Proposed New Rate:",null,{"$f":"'Vendor Worksheet'!C14","v":{"$error":"#DIV/0!"}}]
["Unit Type:",null,{"$f":"'Vendor Worksheet'!G12","v":"Daily"}]
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["By checking the box below, I certify that the information provided to the FDLRC is specific to payroll costs necessary to meet the requirements of AB 1522, which went into effect on July 1, 2015, and that this vendor does not currently offer a sick leave benefit as required by AB 1522.  I additionally certify to the best of my knowledge and belief the information submitted is true and correct, and subject to verification by all record keeping and audit processes, procedures, and guidelines under the Lanterman Act and Title 17 of the California Code of Regulations.  "]
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[null,null,null,"I AGREE"]
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["To submit this completed 'Vendor Summary & Certification' and 'Vendor Worksheet' electronically please save the document as instructed on the Certification Instructions, then click on the following 'SUBMIT' button."]
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["Before submitting please save your workbook using your vendor number!"]
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["Please submit your workbook to bmcneal@altaregional.org"]
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["Please keep a copy for your records and submit a copy to the vendoring regional center."]