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California Family Health Council, Inc.

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Samples File: Fiscal

The Fiscal Samples provide assistance to delegate agencies in updating their finance files as they relate to the Title X program. The list currently reflects some of the more common findings from site evaluations, such as the need for specific policies and procedures, cost allocation methodologies, time and activity reporting, and schedule of discounts. These documents are intended to provide agencies a starting point in complying with the regulations.

  • Cost Allocation Definitions - PDF
  • Cost Allocation Plan - Word
  • Equipment Inventory Form - Word
  • 2009 Federal Poverty Guidelines - PDF
  • Sample CHC Denial Analysis - Excel
    Removed for editing January 2010. Please check back for the updated version.
  • 2009 Sliding Fee Scale - Excel

Accounting Policies & Procedures from Planned Parenthood Los Angeles

Download the entire Manual:

  • PPLA Acounting Policies & Procedures Manual - Zip file

You will need a program that can extract ("unzip") the compressed files; your IT department should be able to help you.

Or download the individual section you need:

All files are in Microsoft Word.

Federal Reporting Forms

Internal Control Documents

Time & Activity Reporting

  • Hourly Attestation - Excel
  • Salaried Attestation - Word

Time Study Procedures and Templates

Download the entire package as a zip file, or only the file you need.

  • Time Study Package - Zip file
  • Time Study Procedures - Word
  • Time Study Template - Protected Fields - Excel
    Data can be entered, but calculations are locked and cannot be edited
  • Time Study Template - Fully Editable - Excel
    All fields are open and can be edited

Want to help out?

CFHC invites agencies to make their materials available to others throughout the Title X system. For Fiscal and Financial items, this can be arranged by contacting Stephanie Ceponis, Site Financial Analyst, Finance Division at 510-486-0412 x4534, email ceponiss@cfhc.org.

Resources for Title X Clinics

Visit the FPCPP websiteVisit Healthed.org for more trainings and conferencesJoin a research study at testmethods.orgSee resources just for our Title X clinics.

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