Request for Reimbursement October 2019 Major Form Changes Form is - PowerPoint PPT Presentation

Request for Reimbursement October 2019

Major Form Changes • Form is now one document with multiple tabs • Form must be submitted in Excel format to information@pdcom.in.gov • Previous “Form IV” (non-reimbursable calculator) has been eliminated; all calculations are done by embedded formulas • New non-reimbursable expense lines have been added • “Full-time” and “part-time” designations eliminated; all positions are a percentage of a full-time equivalent (FTE) • Expanded case types on case assignment worksheet

Request for Reimbursement Email completed form to: information@pdcom.in.gov COUNTY: Year Quarter 2 PREPARER'S NAME: PREPARER'S EMAIL ADDRESS: PREPARER'S CONTACT NUMBER: Quarter designation drives non- reimbursable calculations for attorney caseload

Check all boxes that apply to your county: Office Self Insurance for health insurance Chief Deputy Chief Public Defender

Enter the total number of full time equivalents (FTE) for each category below. See instructions for more information. Paralegals Investigators Social Workers Administrative Assistants Office Administrators Interns Other Non-Litigation Support Staff This area is to show the number of support staff for adequate/inadequate staffing determinations

I. FINANCIAL INFORMATION Total Expenditures (for indigent defense during the period covere $0.00 Actual Non-Reimbursable Non-Reimbursable Expenditures $ - 0 Expenses (see Instructions) Reimbursable Expenditures $0.00 $0.00 40% Reimbursement Amount Nothing is entered into the white boxes. The teal box may be used for actual non- reimbursable expenses.

A. PERSONAL SERVICES (Employees and Contractors) 1. Paralegals (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 2. Investigators (incl benefits) Percentage of time spent on non-reimbursable case support 3. Social Workers (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 0% 4. Administrative Assistants, Office Administrators, Interns, & Non-Litigation Support Staff (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 0% 5. Attorneys with no caseload (incl benefits) Percentage of time spent on non-reimbursable case support 0% 6. Total Attorney Salaries $0.00 7. Total Attorney Benefits $0.00 TOTAL PERSONAL SERVICES $0.00

Enter the total number of full time equivalents (FTE) for each category below. See instructions for more information. Paralegals 1 Investigators 1 Social Workers 1 A. PERSONAL SERVICES (Employees and Contractors) 1. Paralegals (incl benefits) $15,000.00 Percentage of time spent on non-reimbursable case support 25% 2. Investigators (incl benefits) $20,000.00 Percentage of time spent on non-reimbursable case support 0% 3. Social Workers (incl benefits) $22,500.00 Percentage of time spent on non-reimbursable case support 10% 4. Administrative Assistants, Office Administrators, Interns, & Non-Litigation Support Staff (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 0% 5. Attorneys with no caseload (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 0% 6. Total Attorney Salaries $0.00 7. Total Attorney Benefits $0.00 I. FINANCIAL INFORMATION Total Expenditures (for indigent defense during the period covere $57,500.00 Non-Reimbursable Expenditures $ 6,000.00 Reimbursable Expenditures $51,500.00 $20,600.00 40% Reimbursement Amount

Investigators Social Workers Paralegals Non- Non- Non- Reimbursable Reimbursable Reimbursable Time Time Time Worksheet Worksheet Worksheet % of time % of time % of time spent on spent on spent on Non- Non- Non- Reimburs Reimburs Reimburs Name Compensation Fringe ables Name Compensation Fringe ables Name Compensation Fringe ables Katy Hudson $ 7,500.00 $ 1,000.00 10% Amanda Rogers $ 11,000.00 $ 2,000.00 1% Ramon Estevez $ 7,000.00 $ 5,000.00 20% Peter Hernandez $ 4,500.00 $ 2,000.00 2% Caryn Johnson $ 4,500.00 $ 1,000.00 5% Margaret Hyra $ 8,000.00 $ 2,500.00 4% Terry Bollette $ 1,000.00 $ 500.00 2% Totals $ 12,000.00 $ 3,000.00 7% Totals $ 16,500.00 $ 3,500.00 2% Totals $ 15,000.00 $ 7,500.00 13%

A. PERSONAL SERVICES (Employees and Contractors) 1. Paralegals (incl benefits) $15,000.00 Percentage of time spent on non-reimbursable case support 7% 2. Investigators (incl benefits) $20,000.00 Percentage of time spent on non-reimbursable case support 2% 3. Social Workers (incl benefits) $22,500.00 Percentage of time spent on non-reimbursable case support 13% 4. Administrative Assistants, Office Administrators, Interns, & Non-Litigation Support Staff (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 0% 5. Attorneys with no caseload (incl benefits) $0.00 Percentage of time spent on non-reimbursable case support 0% I. FINANCIAL INFORMATION Total Expenditures (for indigent defense during the period covere $57,500.00 Non-Reimbursable Expenditures $ 4,375.00 Reimbursable Expenditures $53,125.00 $21,250.00 40% Reimbursement Amount

6. Total Attorney Salaries $0.00 7. Total Attorney Benefits $0.00

B. SUPPLIES & EQUIPMENT 1. Office Supplies $0.00 2. Equipment Repair and Maintenance 3. Equipment Rentals 4. Other Supplies TOTAL SUPPLIES $0.00

1.Professional Services: $5,500.00 a. Total Expert Consultant/Witness Expenses $5,000.00 Amount spent on non-reimbursable cases $1,500.00 b. Total Interpreter Expenses $500.00 Amount spent on non-reimbursable cases $90.00 2.Total Defense Requested Depositions $6,000.00 Amount spent on non-reimbursable cases $0.00 3. Total Defense Requested Transcripts $4,000.00 Amount spent on non-reimbursable cases $700.00 4. Travel Expenses $0.00 5. Printing, Copying, Postage $0.00 6. Utility Services (including telephone service) $0.00 7. Building Rental/Lease $0.00 8. Facility Repair and Maintenance 9. Building Related Expense Proration (see instructions) 10. Continuing Legal Education (CLE) $0.00 11. Other non-listed Services and Charges (describe) $0.00 $0.00

I. FINANCIAL INFORMATION Total Expenditures (for indigent defense during the period covere $15,500.00 Non-Reimbursable Expenditures $ 2,290.00 Reimbursable Expenditures $13,210.00 $5,284.00 40% Reimbursement Amount

Tab 1 Review • ☐ Preparer’s contact information listed • ☐ Proper quarter selected from the dropdown menu • ☐ All non-reimbursable expenses are accounted for: • Depositions • Transcripts • Experts • Interpreters • percentage of time spent on non-reimbursable case types for support staff, attorneys with no caseload, etc.

To enter the next set of information, select the “Form II” tab at the bottom of the screen

Attorney Information Qualified Qualified for Qualifie for Qualifie Juvenile Qualifie Qualifie d for Appeals d for Qualifie Waiver or d for d for Qualified Appeals Level 5 Attorney First Title (Chief, Benefits Qualified for Levels 1- d for Murder Juvenile Juvenile for Qualified L4 and and Attorney Last Name Name Deputy, etc) Status Salary/Contract/Hourly FTE Max Compensation pd Murder? 4 Level 5? Level? 1-4? Other? CHINS? for TPR? up? below? Smith John DEPUTY Adequate Contract 1.00 $ - $ - no no yes no yes yes no yes yes yes

Example 1: Standard format Last name (column A), First Name (column B) Attorney First Attorney Last Name Name Smith John Example 2: Contract with a firm County contracts with a firm. Enter the attorney name and the firm’s name (where the payments are made) in parentheses next Attorney First Attorney Last Name Name to the last name Smith (Firth, Wynn, & Meyer) John Example 3: Paid under more than one status Attorney is paid in multiple ways such as a .75 contract and additional hourly work up to .25 FTE. Enter “c” or “h” after their Attorney First Attorney Last Name Name last name Smith ( C ) John Smith ( H ) John Example 4: Worked under another name If they attorney worked under another name during the previous four quarters, enter the previous name in parentheses Attorney First Attorney Last Name Name Smith John (Jeff)

Please make sure the names are spelled correctly!

Title (Chief, Deputy, etc) Status Salary/Contract/Hourly DEPUTY Adequate Contract Titles generally include The only options Chief, Chief Deputy, are salary, Deputy contract or hourly

Benefits FTE Max Compensation pd 1.00 $ - $ - • We are no longer using “full-time” or “part-time”. All positions are now a percentage of a full-time equivalent (FTE). Anything other than .5 and 1.00 FTE designations must be approved by the commission. • Enter the direct-paid compensation during the quarter, again using multiple lines if necessary for attorneys paid under more than one status. • Enter the benefits paid on the attorney’s behalf during the quarter. If your county is self-insured, please use the self-insurance worksheet (or similar methodology to stay below the cap). Benefits may include health insurance, PERF, dental insurance, FICA, etc.