AGENCY: Department of Health and Human Services. Healthcare Administration. Division of Integrated Healthcare. Office of Eligibility Policy

SERIES: 7971
TITLE: Budget reports
DATES: 1975-
ARRANGEMENT: Chronological

DESCRIPTION: These budget reports are submitted to the federal government to request medicaid funds and to document the spending of medicaid funds.

Included in this record are State Survey Agency Certification Budget/Expenditure Report Form, State Agency Budget List of Positions, State Survey Agency Budget Request-Long Term Care Facility Workload Form, State Survey Agency Budget Request Form

and State Agency Schedule for Equipment Purchases. Information contained within this record includes: department name and address; period covered by form; description of equipment purchased and cost; breakdown of expenses for salaries and other expenses; listing of positions, or groups of positions and funding requested for each; and breakdowns of funds needed and funds requested.

RETENTION

Retain for 3 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Paper: Retain in Office for 3 years after the date of submission of expenditure report and then destroy.

APPRAISAL

Administrative Fiscal

This record has administrative and fiscal values. Retention of this record is based on 42 Code of Federal Regulations 433.32.

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