Billing Instructions

Title XX Social Services (DFI)
Program Manual FY23

  1. Unit of Service Reimbursement
  2. Cost of Service Reimbursement

Providers request monthly reimbursement using the Donated Funds Initiative Request for Reimbursement Form, or the Form C-13 Invoice Voucher or the Verification of Donation (IL 444-2715.pdf).  The Verification of Donation form is not applicable for public agencies.  Reimbursement is through either of two methods: unit rate or cost of service. The only providers that are reimbursed on the unit rate are those that provide approved residential service. All other providers are reimbursed on the basis of cost of service.

Funding under the Title XX DFI program is contingent upon a provider having a commitment from donor(s) for 25% of the amount of the total award (100%) or certifying 25% of expenditures if a public agency. A provider may also be their own donor. A minimum 10% (of the total award or 100% amount) cash match is required. In-kind contributions may be up to a maximum of 15% (of the total award or 100% amount). Request for Reimbursement forms may only be submitted after the provider receives the 25% match amount from the donor. The Donated Funds Initiative Request for Reimbursement form or the Verification of Donation form are the documents used to verify the 25% donation.

A. Unit of Service Reimbursement - Approved Residential Service providers only.

When billing using this method, two forms should be completed; the C-13 Invoice Voucher and the Verification of Donation (IL 444-2715) (This form is not applicable for public agencies). The following guidelines should be followed when preparing the C-13 Invoice Voucher.

  1. Prepare the voucher for 100% of the monthly requested amount, i.e., 1000 units @ $5 each = $5,000 (100%).
  2. The amount of donation required is equal to or greater than 25% of the requested amount rounded to the nearest dollar, i.e.:
    • $5,000 x 25% = $1,250 - or -
    • $1,000 x 25% = $250 - or -
    • $307.75 x 25% = $77 - or -
    • $161.31 x 25% = $40
  3. The donation must be received by the provider agency prior to submitting the monthly C-13 Invoice-Voucher.
  4. A properly completed Verification of Donation form must be attached to each C-13 Invoice-Voucher submitted for payment. If no verification is included with the voucher, payment cannot be made unless expenditures are being certified by a public agency.

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B. Cost of Service Reimbursement

When billing using this method, complete the Donated Funds Initiative Request for Reimbursement form following these instructions:

  1. Prepare the Donated Funds Initiative Request for Reimbursement form for 100% of the requested amount using the total of the program costs.
  2. The amount of donation required is equal to or greater than 25% of the requested amount rounded to the nearest dollar, i.e.:
      • $5,000 x 25% = $1,250 - or -
      • $1,000 x 25% = $250 - or -
      • $307.75 x 25% = $77 - or -
      • $161.31 x 25% = $40
  3. The donation must be received by the provider agency prior to submitting the monthly voucher.

  4. In-kind contributions should be verifiable and documented in the provider's records, not be included as contributions or expenditures for any other federal program, and be necessary and reasonable. It is preferred that in-kind contributions are related to direct services. Examples of in-kind contributions are direct services provided by volunteers, donated program supplies, and facilities and equipment to be used in service provision.

    Volunteer services furnished by professional and technical personnel, consultants, and other skilled and unskilled labor may be counted if the services are an integral and necessary part of the service. Rates for volunteer services should be consistent with those paid for similar work in the agency. In instances in which the required skills are not found in the agency, rates should be consistent with those paid for similar work in the labor market. Fringe benefits that are reasonable, allowable, and allocable may be included.

    When an employer other than the Title XX DFI provider furnishes the services of an employee, the services should be valued at the employee's regular rate of pay and fringe benefits provided these services are the same skill for which the employee is normally paid. Donated supplies, such as expendable equipment, office supplies, workshop and classroom supplies, shall be reasonable (i.e., cost basis) and not exceed the fair market value at time of donation. The value of donated space should not exceed the fair rental value of comparable space. The basis for determining the valuation for personal service, material, equipment, and facilities should be documented in the provider's records.

    For in-kind contributions not addressed by these guidelines, it is recommended that the provider contact Bureau of Basic Supports - Title XX staff for clarification.

  5. The Donated Funds Initiative Request for Reimbursement form must be signed by an authorized representative of the Provider and dated. The form includes a certification that the 25% match requirement has been met by the provider. Failure to sign the form will result in non-payment. Supplemental information may also be requested to support program performance.

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