Health 3450000. Part 1 of 2 J
FORMB osc Usa Only: Category Code: Report Period: April 1, 2013 to March 31 ' 2014 ing State Agency Name: NYS Dept. of Health Agency Code: 12000 Number: C001214 Term: 01/01/2013 to 12/31/2013 or Name: The Research Foundation for SUNY at Binghamton University or Address: PO Box 6000, Binghamton, NY 13902 Description of Services Being Provided: Early Outcomes (ECO) Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research [gj Training D Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Arch itect Services 0 Surveying 0 Environmental Services D Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal D Other Consulting 0 Employment Category NUmber of Employees Number of Hours Worked Amount Payable Under the Business Operations Specialist, All Others 1 456.75 14168.39 Computer Occupations, All Other 1 259.00 11064.00 Graduate Teaching Assistant 5 149,75 1575.77 Teachers and Instructors, All Other 1 494.25 17874.69 Natural Sciences Managers 1 68.75 12700,89 Total this page 9 1428,50 57383.74 Grand Total 9 1428.50 57383.74 Name of person who prep~~ ~ort~. drienne S. Mason Preparer's Signature: ~ ~ Title: Sponsored Proqrarns Assistant, Phone #: 607-777-6752 Date Pre arad: 05/13/2014 Use additional pages if necessary) Page 1 of 1
MRY-15-2014 10:24 GRRNTS RND CONTRRCTS 716 645 2760 P.07 FORMS OSC Use Only: Category Code: or'a Annual Employment Report Reporting Period: April 1I 2013 to March 31I 2014 ing Agency Code: Number: State Agency Name: C001214 Term: 1/1/2013 to 12131/2013 NYS Department of Health or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Organized Research Scope Of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental ServiO Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Employment Category Number of Employeee Number of Hours Worked Amount Payable Under the Data Manager/Statistician 2 1057.10 $54,255.54 Administrative Assistant II 1 738.75 $16,499.45 Principle Investigator 1 57.52 $10,207.11 Total this page 4 1853.37 $80,962.10 Grand Total 4 1853.37 $80,962.10 Name of person who prep red thi report: Karrie Mrowczynski Preparer's Signature: -. Title: AR Financial Reporting Coo 716-645-4406 Date Pre ared: 5/14/2014 (Use additional pages if necessary) Page 1 of 1 RF63260
May-15-2014 03:28pm From-IPRO ADMIN. 516 326 7791 T-676 P.008/024 F-572 FORM B OSC Use Only category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C020995 Start Date: 01/01 /2006 End Date: 8/31/2014 or Name: Island Peer Review Organization or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 Description of Services Being Provided: ACF Hotline Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services X Mental Health Services Accountmq Auditing Paralegal teoal Other Consultinq Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 29-1111-00 RegisteredNurses 3 2,521.4 125546 11-9199.99 Managers All Others 1 71.5 7585 I Totals this page 4 2,592.9 133,131 Grand Total:. 4 2592.9 133)31.\ Name of person who prepared this report: Title: Senior Director of Finance Daniel A. Schweitzer Phone #: 515-326-7767 Preparer's signature: ~ ~ Date Prepared: 5/13 /14 go~~ lsage 1 of 1 (use additional pages if necessary)
AC3272-S (Effective 4/12) FORMB New York or's Planned Employment Report Period: April 1,2013 to March 31,2014 ing State Agency Name: 'Dep+--. -0+ Heal+h Number: C - o;l / I I 8 - Agency Business Unit:. Term/Ol 11/3 to 3/3/liJ Agency Department ID: 3Ll SDOOO or Name: Cmf'r Conc;:,u.l-t--Voq Sev\J\C..es R.J L~I N.i, lj. uo or Address: 1100 \YO,-\ s.~.. Description of Services Being Provided:... Con<;,u...l ~ ~ex-\ilc<3 Scope of (Choose one that best fits): D Analysis D Evaluatioy, D Research D Training D Data Processing [lrtomputer Programming DOther IT consulting D Engineering D Architect Services D Surveying D Environmental Services D Health Services D Mental Health Services D Accounting D Auditing D Paralegal D Legal D Other Consulting Employment Category Number of Number of hours to Amount Payable Employees be worked Under the Comoukr- P romxmmra ;(0.21, 151'], "1.S /,9otJ ID9 Q:; -J U I Total this page 0 0 $ 0.00 Grand Total I, q ()LJ. I Irf1.qJ, Name of person who prepared this report: be:..tic\.. j c.-ke.v--f'i'cll7 Title: A \R.d~ Preparer's Signature: ~ Date Prepared: S If t.\.t \ Y (Use additional pages, if necessary) Page 1 of -1-
May-15-2014 03:28pm From-IPRO ADMIN. 516 326 7791 T-676 P.007/024 F-572 FORM B OSC Use Only category Code: Report Period: April L, 2013 to March 31, 2014 Office of the Medicaid Inspector General Agency Code 12000 Number: C021393 Start Date: 01/01/2006 End Date: 8/31/2014 or Name: Island Peer Review Organization, Inc. or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 Description of Services Being Provided: Surveillance & Hotline Complaints Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services X. Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 29-1111.00 Reqlstered Nurses 23 23709.6 1,382,952 43-6014.00 Secretaries 2 1672.0 59649 11-9199.99 Managers AllOthers 1 830.1 88,765 29-1111.00 Registered Nurses 14 11,244.0 633,236 {temps) 31-9099.99 Health Care Support 4 2,483.1 125,449 Workers - All Other Totals this page: 44 39,938.8 2,290051 Grand Total: 44 39,938.8 2,290051 Name of person who prepared Title: Senior Director of Finance Preparer's signature: Date Prepared: 5 /13 /14 'U ';.J" this report: A~ Daniel A. Schweitzer Phone #: 516-326-7767 Page 1 of 1 (use ~dditlonal pages if necessmy)
FORMB ose Use Only: Cateaorv Code: ors Annual Employment Report. Report Period: April 1 2013 to March 31. 2014 ing State Agency Name: NYS Developmental Disabilities Planning Council I 2.. 0() 0 Agency Code: Number: C022123 Term: 09/01/2012 to 11/30/2013 or Name: The Research Foundation for SUNY at.binghamton University or Address: PO Box 6000, Binghamton, NY 13902 Description of Services Being Provided: Nurse Practitioner Training Program Scope of (Choose One that best fits): Analysis 0 Evaluation 0 Research ~ Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering D Architect Services 0 Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Managers, All Other 1 24.00 1986.20 - Physical Scientists, All Other 1 109.75 7586.84 Total this page 2 133.75 9573.04 Grand Total 2 133.75 9573.04 Name of person who prep Preparsr's Signature:._...l~~~~'--.L.I.j~~ Title: Sponsored Programs Assistant I Date Pre ared: 05/13/2014 Phone #: 607-777~6752 Use additional pages if necessary) Page 1 of 1 _
May-15-2014 03:27pm From-IPRO ADMIN. 516 326 7791 T-676 P.005/024 F-572 State Consultant Services FORM B QSC U!Se Only ReportingCode: category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: (024581 Start Date: 4/01/2013 End Date: 03/31/2014 or Name: Island Peer Review Organization or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 Description of Services Being Provided: AIDS Institute - AIMS Base Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Enqineering Architect Services Surveying Environmental Services Health Services X Mental Health Services Accounting Auditing paralegal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 29-1111.00 Registered Nurses 6 7,692.6 494,568 15-1051.00 Computer Systems 12 2,416.9 170,126 29-1069-99 Physicians and 1 571.0 136,202 Surgeons 43-9111-00 Statistical Assist 2 2712.0 146,819 43-9199,99 Office & Admin 9 7 101.0 260,251 11-9199.99 Managers 6 6885.4 603,257 Totals this page: 36 27/378.9 1811 223 Grand Total: Name of person who prepared this report: Daniel A. Schweitzer Title: Senior Director of Finance Phone #: 516-326-7767 ~\-J_ I Preparer s signature: /\ "" Date Prepared: 5 /13/14 ~~ I. page~ Of 2 (use additional pages if necessary)
May-15-2014 03:28pm From-IPRO ADMIN. 516 326 7791 T-676 P.006/024 F-572 FORM B OSC Use OoJy Category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C024581 Start Date: 4/01/2013 End Date: 03/31/2014 or Name: Island Peer Review Organization or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 Description of Services Being Provided: AIDS Institute - AIMS Base Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processino Computer Proqrammtno Other IT ConsultinQ Enqineerinq Architect Services Surveying Environmental Services Health Services X Mental Health Services Accounting Auditing Paraleqal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be. Under the Worked 29-1111.00 RegistereoNurses 3 4,759.5 301,043 (temp) 29-1069-99 Consultants 15 120.6 14527 Totals this page: 18 4,880.1 315,570 Grand Total: 54 32,259.0 2 126,793 Name of person who prepared this report: Daniel A. Schweitzer Title: Senior Director of Finance Phone #:. 516-326-7767 Preparer's signature: ~ ':.-R. 6 ~ ~<==y Date Prepared: 5 /13/14 Page 2 of 2 (use additional pages if necessary)
FORM B OSC Use Only: Cate 0 Code: Re ort Period: A ril1, 2013 to March 31, 2014 ing State Agency Name: Department of Health Agency Code: 12000 Number: C024666 Term: 4/1/2009 to 3/31/2014 or Name: Millennium Plastic Surgery, PC or Address: 28 Wensley Drive, Great Neck, NY 11021 Description of Services Being Provided: Medical Coordinators provide professional medical consultation for the Office of Professional Medical Conduct. Duties include reviewing professional medical conduct cases and patient records and conducting interviews with physicians either under investigation or on probation. Scope of (Choose one that best fits): Analysis 0 Evaluation ~ Research0 Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Physicians and Surgeons, All Others 1 755.00 $45,300.00 Total this paqe 1 755.00 $45,300.00 Grand Total / ) ----. / / //d 1 755.00 $45,300.00 Name of person who prej?f~barek, MD Preparer's Signature: Lf/:J1//r/ Title: President u:~v Phone #: Date Prepared: Use additional pagesifnecess~ ry) / I Page 1 of 1
AC3272-S (Effective 4/12) FORMB New York or's Planned Employment Report Period: April 1, 2013 to March 31, 2014 "" J ing State Agency Name: ~ ~. 61 J-/-eaJ CfJ) I U Agency Business Unit: ' Tenn:'l 1')..110 to /1311 t/p, Agency Department ID:345DOO 0 Number: co a.tfc/3'7 or Name: Cmf\ QOYl'Su..l ~ SeY \j\<...6 or Address:,{oo \voq s.~. RJ, Description of Services Being Provided:... Cons,LLl ~ Scope of (Choose one that best fits): SQX"\I\c~3 D Analysis D Evaluat~n D Research D Training L~I D Data Processing ijz'computer Programming DOther IT consulting N.{ [:t uo D Engineering D Architect Services D Surveying D Environmental Services D Health Services D Mental Health Services D Accounting D Auditing D Paralegal D Legal D Other Consulting Employment Category Number of Number of hours to Amount Payable Employees be worked Under the. rj&nfl l1u- Pro~. I~~ lsd, ~q~. (it::, $ 31/ds/', 374,5, 0 Total this page 0 0 $ 0.00 Grand Total / ;) G:. l50, ~ '/'7. 7S ~37,c 5G., 314-, 5~ Name of person who prepared this report: be:.tlc\.. J ~fy'o-1j Title: A \R.d~ /} I Preparer's Signature: ~ ~ Date Prepared: S I( t..\; l l-\ (Use additional pages, if necessary) Page 1 of --1-
AC 3272-S (Effective 4/12) FORMB New York Report Period: April 1,2013 to March 31,2014 ing State Agency Name: New York State Department of Health Number: C025147 Agency Business Unit DOH01 Term: 08/20/2010 to 08/19/2017 Agency Department ID: 12000 or Name: MAXIMUS, Inc. or Address: 11419 Sunset Hills Road, Reston VA 20190 Description of Services Being Provided: Operate the Enrollment Center and NYS of Health for NYS Health Insurance Programs Scope of (Choose one that best fits): D Analysis DEvaluation D Research D Training D Data Processing D Computer Programming D Other IT consulting D Engineering D Architect Services D Surveying D Environmental Services D Health Services D Mental Health Services D Accounting D Auditing D Paralegal D Legal [83 Other Consulting Number of Number of Amount Payable Employment Category Employees Hours Worked Under the Administrative Services Managers 11-3011.00 Business Intelligence Analysts 15-1199.08 1.79 3,589.50 $237,795.00 14.97 30,051.25 $1,930,902.00 Chief Executives 11-1011.00 0.79 1,587.00 $480,760.00 Compliance Officers 13-1041.00 1.70 3,408.00 $190,439.00 Computer and Information Systems Managers 11-3021.00 Computer Network Architects 15-1143.00 Computer Systems Analysts 15-1121.00 Computer Systems Engineers/Architects 15-1199.02 Computer User Support Specialists 15-1151.00 Customer Service Representatives 43-4051.00 3.24 6,498.75 $635,245.00 4.32 8,672.63 $939,719.00 25.59 51,386.76 $4,241,701.00 32.56 65,382.77 $8,257,854.00 14.27 28,646.75 $1,172,536.00 562.69 1,129,885.25 $33,540,771.00 Data Entry Keyers 43-9021.00 28.02 56,262.66 $1,381,594.00 Database Administrators 0.92 1,841.60 $228,825.00 Database Architects 15-1199.06 1.06 2,136.75 $225,570.00 Total this Page 691.92 1,389,349.67 $53,463,711.00 Grand Total 892.35 1,791,802 $80,014,186.00 Name of person who prepared this report: Ferdinand Morales Title: Vice-President, Health;~ion Phone #: 518-649-8471 Preparer's Signature: --P-,".-r-----7---J-------
New York Report Period: April 1, 2013 to March 31,2014 ing State Agency Name: New York State Department of Health Number: C025147 Agency Business Unit: DOH01 Term: 08/20/2010 to 08/19/2017 Agency Department 10: 12000 or Name: MAXIMUS, Inc. or Address: 11419 Sunset Hills Road, Reston VA 20190 Description of Services Being Provided: Operate the Enrollment Center and NYS of Health for NYS Health Insurance Programs Scope of (Choose one that best fits): Analysis DEvaluation o Research o Training Data Processing o Computer Programming o Other IT consulting o Engineering o Architect Services o Surveying o Environmental Services o Health Services o Mental Health Services o Accounting o Auditing o Paralegal o Legal.. [gi Other Consulting - Number of Numl;lerof Amount Payable Employment Category Employees Hours Worked Under the Executive Secretaries and Executive Admin. Assistants 43-6011.00 1.67 3,363.00 $129,479.00 Financial Analysts 13-2051.00 4.16 8,353.50 $476,561.00 Financial Managers 11-3031.00 0.93 1,858.50 $212,834.00 General and Operations Managers 11-1021.00 Human Resources Managers 11-3121.00 Human Resources Specialists 13-1071.00 Information Technology Project Managers 15-1199.09 Interpreters and Translators 27-3091.00 30.94 62,133.00 $6,017,855.00 2.63 5,285.75 $491,084.00 7.28 14,610.00 $793,431.00 4.05 8,137.50 $1,590,353.00, 0.08 150.68 $11,920.00 Managers- All Other 11-9199.00 2.80 5,614.50 $425,977.00 Market Research Analysts and Marketing Specialists 13-1161.00 Office and Administrative Support Workers, All Other 43-9199.00 1.14 2,286.50 $116,117.00 4.34 8,718.75 $437,176.00 Office Clerks, General 43-9061.00 1.62 3,256.85 $86,463.00 Postal Service Mail Sorters, Processors and Processing Machine 26.90 54,015.75 $1,422,435.00 Operators 43-5053.00 Total this Page 88.54 177,784.28 $12,211,685.00 Grand Total 892.35 1,791,802 $80,014,186.00 Name of person who prepared this report: Ferdinand Morales Title: Vice-President, Health East Division Phone #: 518-649-8471 AC 3272-S (Effective 4/12) Preparer's Signature: ----<i3r...sc==:::-r--------
AC 3272-S (Effective 4/12) FORMS New York Report Period: April 1, 2013 to March 31, 2014 ing State Agency Name: New York State Department of Health Number: C025147 Agency Business Unit: DOH01 Term: 08/20/2010 to 08/19/2017 Agency Department 10: 12000 '0 or Name: MAXIMUS, Inc. 3 t.f (' 0 () 0 or Address: 11419 Sunset Hills Road, Reston VA 20190 Description of Services Being Provided: Operate the Enrollment Center and NYS of Health for NYS Health Insurance Programs Scope of (Choose one that best fits): D Analysis DEvaluation D Research D Training D Data Processing D Computer Programming D Other IT consulting D Engineering D Architect Services D Surveying D Environmental Services D Health Services D Mental Health Services D Accounting D Auditing D Paralegal D Legal r8j Other Consulting Number of Number of Amount Payable Employment Category Employees Hours Worked Under the Quality Control Analysts 19-4099.01 71.74 144,047.99 $5,202,773.00 Software Developers, Systems Software 15-1133.00 Software Quality Assurance Engineers and Testers 15-1199.01 Telecommunications Engineering Specialists 15-1143.01 Training and Development Managers 11-3131.00 Training and Development Specialists 13-1151.00 11.91 23,919.27 $5,521,381.00 4.78 9,597.25 $1,041,643.00 1.86 3,741.25 $260,857.00 2.81 5,633.75 $447,956.00 18.79 37,728.75 $1,864,180.00 Total this Page 111.89 224,668.26 $14,338,790.00 Grand Total 892.35 1,791,802 $80,014,186.00 Name of person who prepared this report: Ferdi Title: Vice-President, Health East Division Preparer's Signature: -----~::::::c.::::::::=,...:;.----- Date Prepared: 05/15/2014 Phone #: 518-649-8471
MAY-14-2014 17:29 GRANTS AND CONTRACTS 716 645 2760 P.07 FORMe OSC Use Only; Reporting Code: Category Code: Reporting Period: 4/1113 3/31/14 ing State Agency Name: NYS Department of Health Agency Code: Number: C026429 Term: 9/1/2010 to 8/31/2014 or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Organized Research Scope of (Choose one that best fits): Analysis 0 Evah.Jatian G Research 0 Training 0 Data Processing 0 Computer Programming D other IT consulting 0 Engineering 0 Architect Services 0 Surveyil")g 0 Environmental Servic3D Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Research Scientist 1 1370.25 $117,114.85 Research Technician I 1 307.50 $10,405.80 Research Project Assistant 1 153.75 $5,440.45 Principle Investigator 1 212.08 $31,022.10 Total this page 4 2043.58 $163,983.20 Grand Total 4 2043.58 $163,983.20 Name of person who prepared this report: =t0u=ias-myszka Preparer's signature:~ :;&:---"'-11;..;::;...::l;.&,"--::dy::.,... _ Title: AR Financial Reporting Coordinator II Phone #: 716-645-4391 Date Pre ared: 5/14/2014 (Use additional pages if necessary) Page 1 of 1
MAY-14-2014 17:29 GRANTS AND CONTRACTS 716 645 2760 P.06 FORMB osc U~e Only: Reporting Code: Category Code: state Consultant Services Reporting Period: 4/1/13-3/31/14 ing Agency Code: State Agency Name: NYS Department Number: C026714 Term: 8/1/2013 to 7/31/2014 or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Organized Research of Health Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research [] Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental Servic~D Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Research Project Assistant 5 3683.78 $65,361.06 Postdoctoral Associate 2 2595.00 $92,318.22 Research Scientist 1 1297.50 $2,230.21 Senior Research Scientist 1 460.00 $14,196.98 Research Technician III 1 1297.50 $41,399.87 Principal Investigator 1 133.00 $20,151.47 Co-Principal lnvestiqator 8 1684.08 $151,327.19 Total this page 19 11170.86 $386,985.00 Grand Total 19 11170.86 $386,985.00 *..,., ;r:as Name of person who prepared this report: M &zka Preparer's Signature: Title: AR Financial Reporting Coordinator II Phone #: 716-645-4391 Date Prepared: 5/14/2014 (Use additional pages if necessary) Page 1 of 1
May-15-2014 03:29pm From-IPRO ADMIN, 516 326 7791 T-676 P,010/024 F-572 FORM B OSC Use Onjy category Code; ors Annual Employment Report Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C026723 Start Date: 08/01 /2010 End Date: 07 /31 /2015 or Name: Island Peer Review Organization or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 Description of Services Being Provided: Infection Control ' Scope of (Chose one that best fits): Analysis Evaluation Research Traininq Data Processing Computer Proqrarnrnlnq Other IT Consultinq Enoineerinc Architect Services Survevinc Environmental Services Health Services X Mental Health Services Accountinq Auditinq Paralegal Lecal Other Consultinq Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 29-1111-00 Registered Nurses 2 2580.9 177 042.00 11-9199.99ManagersAll Others 1 105.60 11,578.00 Totals this page: 3 2,686.50 188,620.00 Grand Total: 3 2,686.50 188,620.00 Name of person who prepared this report: Title: Senior Director of Finance Preparer's signature: c-o ).(, 0 A ~ Daniel A. Schweitzer Phone #: 516-326-7767 Date Prepared: 5 /13/14 Page 1 of 1 (use additional pages if necessary)
May-15-2014 03:29pm From-IPRO ADMIN. 516 326 7791. T-676 P 011/024 F-572 State Consultant Services FORM B OSC Use Only category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C026782. Start Date: 12/31/10 End Date:12/31/2015 or Name: Island Peer Review Organization, Inc. or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 Description of Services Being Provided: Pre-Admission Screening and Resident Review (PASRR) Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consultlnc Engineering Architect Services Survevinn Environmental Services Health Services X Mental Health Services Accounting Auditing paralegal Leqal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 29-1111.00 Reqistered Nurses 9 3,549.2 269,436 43-9021.00 Data Entry 4 3481.6 104 L 569 11-9199.99 Managers All Others 1 1,337.5 104,129 15-1051.00 Computer Systems 3 362.9 27,516 Ana~sts 29-1069.99 Physicians & 35 2/119.1 157,159 Surgeons (temps) 11-9111.00 Medical and Health Services Manager 10 401.5 47,046 Totals this page: 62 111251.8 709,855 -Grand Total: 62 111251.8 709855 Name of person who prepared this report: Title: Senior Director of Finance Preparer's signature: ~.~. A~ Daniel A. Schweitzer Phone 516-326-7767 D~te Prepared; 5 113/14 Page 1 of 1 (use additional pages if necessary
MRY-15-2014 15:45 GRRNTS RND CONTRRCTS 715 545 2750 P.0V01 FORMS OSC Use Only: Reporting Code: Calegol)' Code: Reporting Period: April 1, 2013 March 31, 2014 ing Agency Code: Number: Term: State Agency Name: 7/1/2013 to NYS Department of Health C-026952 6/30/2014 or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: NYS Department of Health Alzheimer's Disease Assistance Centers (ADAC) Public Services RF Award 6764816 Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research.D Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect ServicesO Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 AuditingD ParalegalD Legal 0 OtherConsulting 0 Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Project Staff Assistant 1 1489.6 $ 50,767.87 Principal Investigator 1 391.5 s 17,728.18 Total this page 2 1881.1 $ 68,496-05 Grand Total 2 1881.1 $ 68,496_05 Name of per~on who prepare~thi$ M ~e Preparer's SIgnature: ~'./1JjC_ "- abe Title: AR Financial report Coord Phone #: 716.645.4404 Date Pre ared: 5/15/2012 rosemary.mccabe@buffalo.edu (Use additional pages if necessary) Page 1 of 1 TOTRL P.01
MRY-15-2014 15:48 GRRNTS RND CONTRRCTS 716 645 2760 P.01/01 FORMS OSC U$& Only: Reporting Code; Category Code: or's Annual Employment Report Reporting Period: April 1, 2013 - March 31, 2014 ing State Agency Name: Agency Code: Number: Term: 71112013 to NYS Department C-026952 6/30/2014 or Name: Research F~undation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Centers (ADACs) - COLA Su of Health NYS Department of Health Alzheimer's Disease Assistance lement Scope of (Choose One that best fits): Analysis 0 EValuation 0 Research 0 Training 121 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Arch itect ServicesD Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 ParalegalD Legal 0 Other Consulting 0 Public Services RF Award 67114 Amount Payable Under the Employment Category Number of Employees Number of Hours Worked Project Staff Assistant 1 204 $ 6,964.46 Total this page 1 204 $ 6,964.46 Grand Total 1 204 $ 6,964.46 Name of per~on who pr~~~se McCabe rosemaly.mccabe@buffalo.edll Preparer's Slgnature:_l:t1&~.:;.~.r...I.~,IfI.~~_""';;;' ~_~ Title: AR Financial report Coord Phone #: 716.645.4404 Date Prepared: 5/15/2012 (Use additional pages if necessary) Page 1 of 1 TOTRL P.01
May 13 14 03:20p PHPG 84743314 61 p.2 FORM B OSC Use Only Reporti 9 Code: Category Code: Date Approved: Report Period April 1, 2013 to March 31,2014 New York State Department of Health Agency Code 12000 Number: C026961 Start Date: 3/15/11 End Date: 9/14/16 or Name: Westport Health Care Management Inc. Idba The Pacific Health Contact Address: 1725 McGovern SI. Suite 201, Highland Park, IL 60035 Description of Services Being Provided: Eligibility verification and program integrity Policy Group services Scope of the (Chose one that best fits): Paralegal Auditin Research Computer Pro lrammirlq Architect Servic es Health Services Auditin Other Consultin 9 Employment Category General and Operations Managers Regulatory Affairs Managers Regutatory Affairs Specialists Auditors Database Administrators Office Clerks, General Number of Employees Number of Hours Worked 2 1,134 1 1,653 2 1,286 15 15,794 2 1,g27 1,808 Amount Payable Under the $ $ s s s $ 79,021.80 123,071.52 57,084.80 616,008.82 68,108.04 52,986.36 Totals this page: Grand Total: 23 23,602 $ 23 23,602 s 996,283.35 996,283.35 Name of person who prepared this report: Scott Wittman Title: Director Phone #: 2241765-4422 Preparer's signature: ~~ Date Prepared: 5/13/14 Page 1 of1 (use additional pages if necessary)
FORM B OSC Use Only Category Code: Report Period: April 1, to March 31, New York State Department of Health Agency Code 12000 Number: C027077 Start Date: 4/4/11 End Date: 3/ 31 /16 or Name:GCOM Software Inc or Address: 24 Madison Avenue Ext., Albany NY 12203 Description of Services Being Provided: Consultants Long Term Care Restructuring project Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting X Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 15-1511.00 6 5178.85 311872.75 Totals this page: 6 5178.85 311872.75 Grand Total: 6 5178.85 311872.75 Name of person who prepared this report: Holly Savarese Title: VP of Operations Phone #:518-869-1671 Preparer's Signature:W~ ~ Date Prepared: 5 / 13 /2104 Page 1 of 1 (use additional pages if necessary) Page 1 of 2
May-15-2014 03:27pm From-IPRO ADMIN. 516 326 7791 T-676 P.002/024 F-572 FORM B OSC Use Only Category Code: Report Period: April 1, 2013 to March 3~, 2014 New York State Department of Health Agency Code 12000 Number: C027080 Start Date: 10 / 01 /2011 End Date: 9 /30/2016 or Name: Island Peer Review Organization or Address: 1979 Marcus Avenue, Lake Success, NY 11042-1002 D.escription of Services Being Provided: Hospital Complaint Intake (Hotline) On Site Investigations and Diagnostic Treatment Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processinq Computer Proqramming Other IT Consultmo Enqineerinq Architect Services survevmo Environmental Services Health Services X Mental Health Services Accounting Auditing Paralegal Leqal Other Consultinq Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 29-1111-00 Reqistered Nurses 7 5,274.6 294703.43-9061.00 Office Clerk General 2 3365.0 133638 11-9199.99 Manaqers All Others 1 213.0 21 722. 29-1111-00 Registered Nurses- Temp Help 1 11755.0 102 131 Totals this page 11 10,607,60 552,194 Grand Total; 11 106'07.60 552,194 Name of person who prepared Title: Senior Director of Finance Preparer's signature: '0 Date Prepared: 5 /13/14 this report: ~~A~. Daniel A. Schweitzer Phone #: 516-326-7767. Page 1 of 1 (use /1dditional pages If necessary)
'l. FORM B OSC Use Only Category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number:C027328 Start Date: 6/1 /2011 End Date: 5/31/2015 or Name: Medical Answering Services, LLC or Address: PO Box 12000, Syracuse, NY 13218 Description of Services Being Provided: Medicaid Transportation Management Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services C Health Services--=:> Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 11-1021.00 2 4,700 $190,000 43-1011.00 26 50,300 $773,000 43-4051.00 108 225,000 $2,448,000 43-9022.00 5 8,100 $102,000 43-30993.00 6 12,600 $156,000 11-2031.00 4 6,300 $148,000 13-1111.00 1 3,000 $32,000 11-9199.02 1 1,500 $49,000 19-3022.00 3 6,200 $79,000 13-1151.00 2 5,100 $96,000 Totals this page: 158 322,800 $4,073,000.00 Grand Total: 0 0 $ 0.00 Name of person who prepared this report: Wayne Freeman Title: COO Phone #: 315-701-7009 Preparer's signature: Date Prepared: 5/29/14 Page 1 of 2 (use additional pages if necessary) Page 1 of 3
.. State Consultant FORM B Services OSC Use Only Category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number:C027328 Start Date: 6/1 /2011 End Date: 5/31/2015 or Name: Medical Answering Services, LLC or Address: PO Box 12000, Syracuse, NY 13218 Description of Services Being Provided: Medicaid Transportation Management Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services C _Health Services-=:::> Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 15-1151.00 1 2,800 $75000 49-9071.00 1 1,500 $28000 13-2011.01 2 4,700 $158,000 43-3051.00 1 3,100 $61,000 11-3121.00 1 1,600 $45,000 13-1071.00 1 3,100 $45,000 43-9051.00 1 1,400 $16,000 Totals this page: 8 18,200 $ 428,000.00 Grand Total: 166 341,000 $ 4,501,000.00 Name of person who prepared this report: Wayne Freeman Title: COO. /J Phone #:315-701-7110 ~fa fre.f1~ U Preparer's signature: Date Prepared: 5/ 29 /14 Page 2 of 2 (use additional pages if necessary) Page 2 of 3
MRY-15-2014 10:25 GRRNTS RND CONTRRCTS 716 645 2760 P.09 FORMB OSC Use Only: Reporting Code: Category Code: Reporting Period: April 1, 2013 to March 31, 2014 ing Agency Code: Number: State Agency Name: C027431 Term: 4/1/2013 to 3/31/2014 NYS Department of Health or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Public Services Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing D Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental Servic:[J Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 ParalegalD Legal 0 Other Consulting D Employment Category Number 01 Employees Number of Hours Worked Amount Payable Under the contract Principle Investigator 1 490.58 $26,089.79 Senior Research Support Specialist 1 97.88 $14,936.49 Co Principle Investigator 1 53.25 $4,259.84 Total this page 3 641.71 $45.286.12 Grand Total 3 641.71 $45,286.12 Name of person who prepared this report: Karrie Mrowczynski Pre parer's Signature: cw.. ~ h 0.;;::' Title: AR Financial Reporting CO~ina Phone #: 716-645-4406 Date Pre ared: 5114/2014 (Use additional pages if necessary) Page 1 of 1 RF64416
MRY-15-2014 10:24 GRRNTS RND CONTRRCTS 716 645 2760 P.04 FORMS OSC Use Only! Category Code: Reporting Period: April 1, 2013 to March 31, 2014 ing State Agency Name: Agency Code: Number: C027431 NYS Department Term: 10/1/2011 to 3131/2013 or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Public Services of Health Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training [2] Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental Servic[J Health SelYices 0 Mental Health Services 0 Accounting 0 Auditing 0 ParalegalD Legal 0 Other Consulting 0 Amount Payable Under (hi! Employment Category Number of Employees Number of Hours Worked Co-Principle Investigator NEX, 71.25 $7,078.48. Fetal this page 1 71.25 $7,078.48 Grand Total 1 71.25 $7,078.48 Name of person who p~ed. this report: K.arrie Mrowczynski Preparer's Signature: J",;v.., n. 4<=' Title: AR Financial Reporting coo'%fna Phone #: 716-645-4406 Date Prepared: 5/14/2014 (Use additional pages if necessary) Page 1 of 1 RF60212
APR. 5. 2014 3: 4 PM FORMS 9172289200...-- NO.5 57-P. 2 OSCUse Only: ReportingCode: Cate 0 Code: Re ort Period: April 1, 2013 to March 31, 2014 ing State Agency Name: NYS Department of Health- Office of Managed Care Agency Coda: 12000 Number: C027557 -=6i50ooo Term: 10/1/2011 to 9/30/2015 or Name: MAXIMUS INC. or Address: 30 Broad Street, New York, NY 10004 Description of Services Being Provided: Managed cars benefits counseling and enrollment broker services. Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing LJ Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting ~ EmploymentCOitegory Numberof Employees Numberof HoursWorked AmountPaYOIbieUnder the General and Operations Managers 11-'1021.00 13 25684.75 $2602,217.72 Customer Service Representatives 43-4051.00 237 474,544.62 $15640,241.34 Computer and Information Systems Manager 11-3021.00 2 3,156.50 $363,053.05 Computer Systems Analysts 15-1051.00 13 26,806.75 $2172,651.49 Statisticians 15"2041.00 2 4,700.QO $271,006.92 In~ectors 51-90tH.OO 10 20,907.50 $1,096,293.83 Postal Service Mail Sorters, Processors and Processing Machine Operators 43 5053.00 8 15382.83 $703304.31 Financial Mana9.ers 11-3031.00 1 1,679.00 $206,393.19 Financial Analysts 13-2051.00 1 1,161.00 $70,754.47 Administrative Services Managers 11-3011.00 1 1,504.00 $149,707.44 Office Clerks GeneraI43-9061.00 1 1,273.50 $45,959.17 Human Resource Managers 11-3040.00 1 1 187.00 $152,953.10 Human Resources, Training and Labor Relations Specialist 13-1079.99 2 3,6BO.75 $177,267.87 Total this page 292 581.668.19 $23,651,803.90 Grand Total 292 581,66B.19 $23,651,803.90 Name of person who prepared this report: Awilda Martinez p,ep"er'sjg"'tu",;~cg ~ Title: Project Director Phone. 17) 228-5610 Date Pre ared: 4/15/2014 Use additional pages if necessary) Page 1 of 1
FORM B OSC Use Only: Cateqorv Code: Report Period: October 1, 2013 to March 31,2014 ing State Agency Name: New York State Department of Health Agency Code: 1200 Number: C #027566 / 3~{)OO Term: 10/1/2013 to 9130/2014 or Name: National Center for Healthy Housing or Address: 10320 Little Patuxent Parkway, Suite 500, Columbia, MD 21044 Description of Services Being Provided: Other consulting <, o Scope of (Choose one that best fits): Analysis D Evaluation D Research D Training D Data Processing D Computer Programming D Other IT consulting D Engineering D Architect Services D Surveying 0 Environmental Services 0 Health Services D Mental Health Services 0 Accounting 0 Auditing D Paralegal 0 Legal 0 Other Consulting [8J Number of Employment Category Number of Hours Worked I Employees.- NCHH Staff ;, ": ;. "'j.", t '", 1".,~ Amount Payable Under the 15-2041.01 - Biostatisticians Sherry Dixon, Ph.D., NCHH Biostatistician 1 49.7 $6,150.48* 19-2041.00 - Environmental Scientists and Specialists, Including Health Amanda Reddy, MS,Proqram Manaqer 1 327.1 $29,973.31 * 11-9151.00 - Social and Community Service Managers Jane Malone, BA, NCHH Policy Analyst and Field Investigator 1 56 $5,018.32* 11-1011.00 - Chief Executives Rebecca Morley, MSPP, NCHH Executive Director, Project Director and Field Investigator Jonathan Wilson, MPP, NCHH Deputy Director 2 105.5 $17,128.55* 19-4061.00 - Social Science Research Assistants Judith Akoto, MPH, NCHH Project Coordinator Christopher Bloom, NCHH, Project Coordinator 2 10 $558.35*, Amy Murphy Consulting, LLC (NCHH contractor),. ~:,:~ -..; 19-2041.00 - Environmental Scientists and Specialists, Including Health Amy Murphy, MPH, Project Field Investiqator - Consultant 1 195 $28,000** Total this page 8 743.3 $86,829.01 Page 1 of 2
TBD (NCHH contractor) 19-2041.00 - Environmental Scientists and Specialists, Including Health TBD - Primary Prevention Specialist 1 0 $0 Other Consultants/ors 27-1024.00 - Graphic Designers Ann Gardner, Graphic Designer, Consultant 19-2041.00 - Environmental Scientists and Specialists, Including Health Amanda Reddy, MS, Healthy Housing Solutions, consultant (prior to 11/1/2013) 2 2.6 $280.80 Total this page 3 2.0 $280.80 Grand Total 11 745.9 $87,109.81 Preparer's Signatur Title: Program Manage..,L-\!c...:...I<:..L~IL."..,..~.d6...E.1:..q..4-------------- Phone #: 443.539.4152 Date Pre ared: 05/02/2014 (Use additional pages if necessary) Page 2 of 2 *Fully loaded rate including fringe and indirect rates as approved **Rate changed from $150/hour to $125/hour effective 3/1/2014. under C#027566.
May-15-2014 03:28pm From-IPRO ADMIN. 516 326 7791 T-676 P.009/024 F-572 FORM B osc Use Only category Code; Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C027596 Start Date: 09/01/2011 End Date: 08/ 31/2014 or Name: Island Peer Review Organization or Address: 1979 Marcus Avenue, Lake success, NY 11042-1002 Description of Services Being Provided: Implementation Assistance for Health Home and Patient Centered Medical Homes Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processinq Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services X Mental Health Services Accounting Auditing Paralegal Leqal Other Consulting_ Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 15-1051.00 computer Systems I Analyst 11 11/638.0 547/961 11-9111.00 Medicaland Health 358,673 ServicesManaqer 12 5639/ 43-9061.00 Office Clerk General 14 11 630.9 428,113 11-9199.99 ManagersAllothers 9 3867 333,608 11-9199.99 ManagersAll Others Consultants 1 20 3870 29-111.00 RegisteredNurses 52 35851.6 1,720,564 29-1069.99 Physicians& Surqeons All other' 2 3445.5 489078 Totals this page 101 72/092,0 3,881,867 Grand Total: 101 72,092,0 3,881867 Name of person who prepared this report: Daniel A. Schweitzer Title: Senior Director of Finance Phone #: 516-326-7767 Preparer's signature: CO '";{f X~ Date Prepared: 5/13/14 Page".:'1 of 1 (use additionalpages if necessary)
MRY-15-2014 15:03 GRRNTS RND CONTRRCTS 716 645 2760 P.01/01 FORMS OSC Use Only: Category Code: Reporting Period: April 1, 2013 - March 31; 2014 ing State Agency Name: Agency Code: 12000 Number: C":027968 Term: or Name: 7/1/2013 to NYS Department of Health 6/30f2014 Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: UB Family Medicine Expansion of Ambulatory Care Program Training Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect ServicesD Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services [I Accounting 0 AuditingD ParalegalO Legal 0 Other Consulting D RF Award 62214 Employment Category Number of Employees Number of Hours Worked Amouflt Payable Under the Principal Education Specialist 1 511 s 21,366.24 Total this page 1 511 s 27,366.24 Grand Total 1 511 $ 27,366.24 Name of person who p~~ McCabe rosemary.mccabe@buffalo.edu Preparer's signature:.--t~f'o- ~=--I-J,...l!6.oa.u/~:...lI.."=: _ Title: AR Financial report Coord Phone #: 716.645.4404 Date Pre ared: 5f15/2012 (Use additional pages if necessary) Page 1 of 1 TOTRL P. 01
FORMB OSC Use Only: Category Code: State Consultant Services Report Period: April 1, 2013 to March 31, 2014 ing State Agency Name: Department of Health Agency Code: Number: C028085 Term: 5/14/2012 to 5/13/2013 or Name: GENESYS Consulting Services, Inc. or Address: 2 Computer Drive West, Suite 101, Albany, NY 12205 Description of Services Being Provided: Oracle Data Base Administration Services 12000 d 3 cf S()60 Scope of (Choose one that best fits): Analysis D Evaluation D Research D Training D Data Processing D Computer Programming [gj Other IT consulting D Engineering D Architect Services D Surveying D Environmental Services D Health Services D Mental Health Services D Accounting D Auditing D Paralegal D Legal D Other Consulting D Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Specialist III 1 225 $24,300.00 Total this page 1 225 $24,300.00 Grand Total 1 225 $24,300.00 Name of person who prepawd this rep.ort:. G.rista Maiello Preparer's Signature: l:m4tu/!11tueth Title: Business Office Manager Phone #: 518-459-9500 Date Pre ared: 5/2/2014 Use additional pages if necessary) Page 1 of 1
MRY-15-2014 14:45 GRRNTS Rl'-lD CONTRRCTS 716 645 2760 P.0V01 FORMB ose Use Only: Reporting COde: Category Code: Reporting Period: April 1, 2013 - March 31, 2014 ing Agency Code: Number: Term: State Agency Name: 7/1/2013 to NYS Department of health 3450000 C028108 6/30/2014 or Name: Research Foundation of SUNY, Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Directed Reprogramming of Human Fibroblasts to Oligodenrocyte Progenitors Organized Research RF Award 63737 Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect ServicesD Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services (2) Accounting 0 Auditin9D ParalegalD Legal 0 Other Consulting 0, Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Principoallnvestigator 1 290 $ 25,115.69 Research Scientist 1 375 $ 65,986.10 Resarch Project Assistant 1 290 s 12,439.82 Total this page '3 955 $ 103,541.62 Grand Total 3 955 $ 103,541.62 Name of per~on who pres Preparer's SIgnature: 2,;,.1" this..m.. rt {jt!ju rosemary.mccabe@buffalo.edu Title: AR Financial report Coord Phone #: 716.645.4404 Date Prepared: 5/15/2012 (Use additional pages if necessary) Page 1 of 1 TOTRL P.01
MRY-15-2014 10:25 GRRNTS RND CONTRRCTS 716 645 2760 P.08 FORMB osc US8 Only: CEitegori Code: ReportIng Period: April 1, 2013 to March 31, 2014 ing Agency Code: Number: State Agency Name: C028129 Term: 3/1/2013 to 2/28/2016 NYS Department of Health or Name: Research Foundation of SUNY. Buffalo or Address: 402 Crofts Hall, Buffalo, NY 14260 Description of Services Being Provided: Organized Research Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research [2] Training 0 Data Processing 0 Computer Programming 0 Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental SerYiO Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 employment Category Number of Employees Number of Hours Worked Amount Payable Under the Research Scientist 3 4702.00 $163,876.42 Research Technician I 1 114.00 $3,443.05 Principle Investigator 1 418.00 $63,708.34 Total this page 5 5234.00 $231,027.81 Grand Total 5 5234.00 $231.027.81 Name of person who pre at 9 this report: Karrie Mrowczynski Preparer's Signature:-=.~~~--,-...lL.~~~::"'- ~ _ Title: AR Financial Reporting Coor 716-6454406 Date Pre ared: 5/14/2014 (Use additional pages if necessary) Page 1 of 1 RF64202
FORM B OSC Use Only Category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C028340 Start Date: 10/01/2012 End Date: 09/30/2013 or Name: United Hospital Fund of New York, Inc. or Address: 1411 Broadway, 1th Floor, New York, NY 10018 Description of Services Being Provided: Medicaid - Medicaid Collaborative Studies Scope of (Chose one that best fits): Analysis., Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked Chief Executives 11-1011.00 1 52 $ 10,595.00 Political Scientist 19-3094.00 3 2,212 $ 157,391.00 Public Relations Manager 11-2031.00 1 134 $ 10,438.00 Social ScienceResearch Asst 19-4061.00 1 909 $ 22,471.00 Editor 27-3041.00 1 138 $ 10353.00 Executive Secretaries & Administrative Assistants 43-6011.00 1 209 $ 6,655.00 Totals this page: 8 3,654 $ 217,903.00 Grand Total: 8 3654 $217,903.00 Name of person who prepared this report: Sheila M. Abrams Title: Senior VP for Administration and Finance Phone #: 212-494-0717 Preparer's signature: h~ m {\Wfluns, svp, luff" Date Prepared: 05/13/2014 Page 1 of 1 (use additional pages if necessary) Page 1 of 2
FORM B OSC Use Only category Code: Report Period: April 1, 2013 to March 31, 2014 New York State Department of Health Agency Code 12000 Number: C028340 Start Date: 10/01/2013 End Date: 09/30/2014 or Name: United Hospital Fund of New York, Inc. or Address: 1411 Broadway, 1ih Floor, New York, NY 10018 Description of Services Being Provided: Medicaid - Medicaid Collaborative Studies Scope of (Chose one that best fits): Analysis.., Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked Chief Executives 11-1011.00 1 46 $ 9,358.00 Political Scientist 19-3094.00 3 1,951 $ 142,580.00 PublicRelationsManager11-2031.00 1 46 $ 3,593.00 Social ScienceResearch Asst 19-4061.00 1 616 $ 15,218.00 Editor 27-3041.00 2 129 $ 7,112.00 ExecutiveSecretaries & Administrative 1 92 $ 2,950.00 Assistants 43-6011.00 Totals this page: 9 2,880 $ 180,811.00 Grand Total: 9 2,880 $ 180,811.00 Name of person who prepared this report: Sheila M. Abrams Title: Senior VP for Administration and Finance Phone #: 212-494-0717 Preparer's signature: ~~ m. ~m--cu"ka, 5iff u..ttf Date Prepared: 05/13/2014 Page 1 of 1 (use additional pages if necessary) Page 1 of 2
FORM B OSC Use Only Category Code: or's Annual Employment Report Report Period: April 1, 13 to March 31, 14 New York State Department of Health Number: C028363 Start Date: 11 / 1 /12 End Date: 3/31/14 or Name:GCOM Software Inc or Address: 24 Madison Avenue Ext., Albany NY 12203 Agency Code 12000 3 5 o 6 a 0 Description of Services Being Provided: Consultants NYPORTS Staff Aug Scope of (Chose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT Consulting Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting X Employment Category Number of Number of Amount Payable Employees Hours to be Under the Worked 15-1131.00 2 1277 90709.50 Totals this page: 2 1277 90709.50 Grand Total: 2 1277 90709.50 Name of person who prepared this report: Holly Savarese Title: VP of Operations Phone #:518-869-1671 Preparer's signatureqj:>lol.j,~ Date Prepared: 5 i 13-j1104 r Page 1 of 1 (use additional pages if necessary) Page 1 of 2
1 FORMS OSC Use Only: Reporting COde: catsaorv Code: State Consultant Se~ices or's Annual Employ~ent Report R~~ort Period: April 1, 2013 to March 31,2014 ing State Agency Name: NYS Dept of Health Agency Code: 12000 Number: C028621 Term: 10/01/2013 to 09/30/201.8 I. " or Name: The Research Foundation for SUNY at Binghamton University or Address: PO Box 6000, Binghamton, NY 13~02 Description of Services Being Provided: Lesbian and Gay Family Building Project Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research: t:8j Training 0 i Data Processing 0 Computer Programming 0 Other Il[ consulting 0 Engineering 0 Architect Services 0 SurveYing 0 8nvironmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 i Employment Category Number of Employees tjumber of Hours Worked Executive Secretaries and I Amount Payable Under the Administrative Assistants 1 i 348.75 5701.37 Graduate Teaching ASSistants 1 465.00 8021.31 Natural Sciences Managers 1 623.00 21520.20 : ; i,, : -!, Total this page 3 ; 1436.75 35242.88 Grand Total 3, 1436.75 35242.88 Name of person who Pre~PO~drienne s. ~son. Preparer's Signature:. ~ I Title: Sponsored Programs Assistant I Phon~ #: 607-777-6752. Date Pre ared: 05/13/2014! Use additional pages if necessary) Page 1 of 1
FORM B OSC Use Only: Category Code: Report Period: April 1, 2013 to March 31, 2014 ing State Agency Name: Department of Health Number: C028665 Agency Code: 12000 Term: 4/1/2013 to 9/30/2013 or Name: GENESYS Consulting Services, Inc. or Address: 2 Computer Drive West, Suite 101, Albany, NY 12205 Description of Services Being Provided: Home Care Services Worker Registry Enhancements Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing 0 Computer Programming I:8l Other IT consulting 0 Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Employment Category Number of Employees Number of Hours Worked Amount Payable Under the Project Manager" 1 492.5 $61,562.50 Programmer /Analyst " 3 2485.5 $223,783.50 Specialist" 2 1660.5 $203,270.00 Total this page 6 4638.5 $488,616.00 Grand Total 6 4638.5 $488,616.00 Name of person who prepn~is rt}?~rt: Crista Maiello Preparer's Signature: (2j~14ttU J./.p Title: Business Office Manager Phone #: 518-459-9500 Date Pre ared: 5/2/2014 Use additional pages if necessary) Page 1 of 1
FORMB OSC Use Only: Category Code: Report Period: April 1, 2013 to March 31, 2014 ing State Agency Name: Department of Health Agency Code: 12000 Number: C028666 Term: 4/1/2013 to 3/31/2014 or Name: GENESYS Consulting Services, Inc. or Address: 2 Computer Drive West, Suite 101, Albany, NY 12205 Description of Services Being Provided: DB Programmer/Administrator for Child Health Plus Scope of (Choose one that best fits): Analysis D Evaluation D Research D Training D Data Processing D Computer Programming [8J Other IT consulting D Engineering D Architect Services D Surveying D Environmental Services D Health Services D Mental Health Services D Accounting D Auditing D Paralegal D Legal D Other Consulting D Employment Category Number of Employees Number of Hours Worked Amount Payable Under the DB Programmer/Administrator 1 1178 $141,360.00 Total this page 1 1178 $ $141,360.00 Grand Total 1 1178 $141,360.00 Name of person who prepar~d t~is rep!mcrista Maiello Preparer's Signature: (!/liai:4dgti,jl~ Title: Business Office Manager Phone #: 518-459-9500 Date Pre ared: 5/2/2014 Use additional pages if necessary) Page 1 of
FORMB OSC Use Only: Category Code: Report Period: April 1, 2013 to March 31, 2014 ing State Agency Name: Department of Health Number: C029244 Term: 01/01/14 to 03/31/14 Agency Code: ~ <.{ S-Obb\ or Name: Unisys Corporation or Address: 10B Madison Ave Ext. Albany, NY 12203 Description of Services Being Provided: Information Technology Consulting Services Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing 0 Computer Programming 0 Other IT consulting ~ Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0 Health Services 0 Mental Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 O'Net Employment Category Number of Employees Number of Hours Worked Amount Payable Under (see Q"Net on-line at online.onetcenter.org) the Computer Systems Analysts 2 931 $151,082.68 Computer and Information System 1 450 $102,231.00 Managers Computer Software Engineer, 7 3308 $394,893.84 Application Software Quality Assurance 1 479 $49,226.83 Engineer and Tester Total this page 11 5168 $697,434.35 Grand Total 11 Name of person who prepared tljjs-yeport: Thomas P. Mannix Preparer's Signature: ~--p/~ Title: s Manager, Unisys Corporation Phone #: 908-445-7560 Date Pre ared: 5/9/2014 (Use additional pages if necessary) Page 1 of 1
FORM B OSC Use Only: Repo ing Code: Category Code: Report Period: April 1, 2013 to March 31, 2014 ing State Agency Name: Department of Health Number: C029381 Term: 04/01/2013 to 03/31/2014 or Name: Patricia A. Lynch Associates, Inc. or Address: 712 Route gp, Saratoga Springs, NY 12866 Description of Services Being Provided: IT Project Management Services Agency Code: 12000 3 'i ~oc>/) Scope of (Choose one that best fits): Analysis 0 Evaluation 0 Research 0 Training 0 Data Processing 0 Computer Programming 0 Other IT consulting X Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0 Health Services 0 Men al Health Services 0 Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0 Amount Payable Under Employment Category Number of Employees umber of Hours Worked the Project Manager 01 1880 S197,400 I Total this page 01 1880 $197,400 Grand Total 01 1880 $197,400 Name of person who prepare Preparer's Signature: Title: President Date Prepared: 05/15/2014 ~~w.2 ;;;::...---':::~~;;~~~====:::::::_ Use additional pages if necessary) Page 01 of 01
From: 05/13/2014 15:47 #237 P.0301033 FORM B OSC Use Only: Category Code: Report Period: April 1,2013 to March 31, 2014 ing State Agency Name: '1)6 +1 Number: C\"(),(2..$"J(1 D -- 8""3 19 T erm: IJ iij-o II - IJ-/ 31/ Jt; I,) Agency Code: /ugio or Name: New York State Technology Enterprise Corporation (NYSTEC) or Address: 500 Avery Lane, Suite A Rome, NY 13441 Description of Services Being Provided: Technology Consulting Scope of (Choose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT consulting. Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Amount Payable Under the Employment Category Number of Employees Number of Hours Worked 11-3021.00 Computer and Information Systems Managers 18 IQ, &.r-/ J r )'{ 5, 3S',el1J Total this page /"0,,q{f,l.(7,JSi3 3.5(C Grand Total If). I "tip'f1 f(j '3.1.<')(/') Preparer's Signature: -".q..."..l-..:<==<:"""-~.!. === Title: General Counsel & Phone #: 518.431.7031 Date Prepared: 5/9/2014 Use additional pages if necessary) Page 1 of 1
From: 05/13/2014 15:47 #237 P.029/033 FORM B osc Use Only: Category Code: Report Period: April 1,2013 to March 31, 2014 ing State Agency Name: Number: ~ W) YC.S)J-/ f- - G 33/ T erm: LI/ Lj / ;).\) {/~ L//3()/}o I 3 Agency Code: IZGrzSb or Name: New York State Technology Enterprise Corporation (NYSTEC) or Address: 500 Avery Lane, Suite A Rome, NY 13441 Descriptionof Services Being Provided: Technology Consulting Scope of (Choose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT consulting Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Amount Payable Under the Employment Category Number of Employees Number of Hours Worked 11-3021.00 Computer and Information Systems Managers 1 /03+ (~_)2 < ad Total this page <.j ics 7 IJD <;::;S (;'i) Grand Total L{ /fi?-,t 12() <2S:"~ Name of person who prepared~ report: Jana S. Behe Preparer's Signature: \ja ~ Title: General Counsel & CC~ Phone#: 518.431.7031 Date Prepared: 5/9/2014 Use additional pages if necessary) Page 1 of 1
From: 05/13/2014 15:47 #237 P,028/033 FORM B OSC Use Only: Calegory Code: Report Period: April 1,2013 to March 31, 2014 ing State Agency Name: Number: c.}vi!)12 ~:2C(G-- ~ 500 Term: 1/ l] M' 2- {//J-lrj)tJlL( Agency Code: or Name: New York State Technology Enterprise Corporation (NYSTEC) or Address: 500 Avery Lane, Suite A Rome, NY 13441 Description of Services Being Provided: Technology Consulting Scope of (Choose one that best fits): Analysis Evaluation Research Training Data Processing Computer Programming Other IT consulting Engineering Architect Services Surveying Environmental Services Health Services Mental Health Services Accounting Auditing Paralegal Legal Other Consulting Amount Payable Under the Employment Category Number of Employees Number of Hours Worked 11-3021.00 Computer and Information Systems Managers t ~7()7~0 ~~/{3 2 '1 Total this page x In ') IJ '7,.5(j (. r; I sl 'I Grand Total <i< /..')67, ')'0 In'ifl '( 2 tl Name of person who prepared this repo Preparer's Siqnature: ---,- :_----r1-'---l-=::::::...----------- Title: General Counsel & CCO 518.431.7031 Date Prepared: 5/9/2014 Use additional pages if necessary) Page 1 of 1