{"text_format":"3","workbook":"xlsx","n_sheets":1,"sheets":["DAAS-732 In Home Suppliment"],"read":"whole","date_system":"1900"}

{"sheet":"DAAS-732 In Home Suppliment","index":0,"n_rows":33,"n_cols":7,"rows_kept":33}
[]
[{"$nulls":6},"Supplement to Provider Services Summary"]
[{"$nulls":6},"In-Home Services Detail"]
["Name of Community Service Provider",{"$nulls":5},"DAAS-732 Supplement (Effective: 7/08)"]
[{"$nulls":6},"July 1,2022 through June 30, 2023"]
["Revision # _____________"]
[]
[null,"                 A","B","C","F","G","H"]
[null,"HCCBG","Required","Net","Projected","Projected","Projected "]
[null,"In-Home","Local","Service","HCCBG","Reimbursement","HCCBG "]
["In-Home Services","Funding","Match","Cost","Units","Rate","Clients"]
["Level I - 235 Respite",null,{"$f":"ROUND((B12)/0.9*0.1,0)","v":0},{"$f":"SUM(B12)+C12","v":0}]
["Level I - 041 H Mgmt ",null,{"$f":"ROUND((B13)/0.9*0.1,0)","v":0},{"$f":"SUM(B13:B13)+C13","v":0}]
["Subtotal Level I ",{"$f":"SUM(B12:B13)","v":0},{"$f":"SUM(C12:C13)","v":0},{"$f":"SUM(D12:D13)","v":0},{"$f":"SUM(E12:E13)","v":0},null,{"$f":"SUM(G12:G13)","v":0}]
["Level II - 236 Respite",null,0,{"$f":"SUM(B15:B15)+C15","v":0}]
["Level II - 042 PC",null,0,{"$f":"SUM(B16:B16)+C16","v":0}]
["Level II - 043 H Mgmt",null,0,{"$f":"SUM(B17:B17)+C17","v":0}]
["Subtotal Level II",{"$f":"SUM(B15:B17)","v":0},{"$f":"SUM(C15:C17)","v":0},{"$f":"SUM(D15:D17)","v":0},{"$f":"SUM(E15:E17)","v":0},null,{"$f":"SUM(G15:G17)","v":0}]
["Level III - 237 Respite",null,0,{"$f":"SUM(B19:B19)+C19","v":0}]
["Level III - 044 H Mgmt",null,0,{"$f":"SUM(B20:B20)+C20","v":0}]
["Level III - 045 PC",null,0,{"$f":"SUM(B21:B21)+C21","v":0}]
["Subtotal Level III",{"$f":"SUM(B19:B21)","v":0},{"$f":"SUM(C19:C21)","v":0},{"$f":"SUM(D19:D21)","v":0},{"$f":"SUM(E19:E21)","v":0},null,{"$f":"SUM(G19:G21)","v":0}]
["Level IV - 238 Respite",null,0,{"$f":"SUM(B23:B23)+C23","v":0}]
["Level IV - 046 H Mgmt",null,0,{"$f":"SUM(B24:B24)+C24","v":0}]
["Subtotal Level IV",{"$f":"SUM(B23:B24)","v":0},{"$f":"SUM(C23:C24)","v":0},{"$f":"SUM(D23:D24)","v":0},{"$f":"SUM(E23:E24)","v":0},null,{"$f":"SUM(G23:G24)","v":0}]
["Total",{"$f":"SUM(B25+B22+B18+B14)","v":0},{"$f":"SUM(C25+C22+C18+C14)","v":0},{"$f":"SUM(D25+D22+D18+D14)","v":0},{"$f":"SUM(E25+E22+E18+E14)","v":0}]
[]
[]
[]
[]
[]
[null,"Authorized Signature",null,null,"Title",null,"Date"]
[null,"Community Service Provider"]