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Professional Services Agreement <br />Page 17 <br /> AGENCY NAME: Central Washington University Psychology Department <br />SALARIES AND WAGES <br />STAFF NAME POSITION/TITLE HOURLY RATE TOTAL HOURS COST <br />Clinic Director Clinic Director $46-$48/hr 1920/yr*2yrs $182,700 <br />Graduate Student Assistant Graduate Student Assistant $18/hr 960/yr*2yrs $34,560 <br />TOTAL SALARIES/WAGES: $217,260 <br />BENEFITS <br />BENEFIT RATE (%): 33% (Director) 3% (Student) TOTAL BENEFITS: $61,328 <br />DIRECT CLIENT SERVICES <br />CLIENT SERVICE COST <br />Counseling materials (MATCH-ADTC manuals, 20*$100*2yrs) $4,000 <br />Counseling questionaires and risk surveys and manuals (10*$100*2yrs) $2,000 <br />HIPPA compliant healthcare portal (doxy.me or similar, $600*2yrs) $1,200 <br />State counseling supervision training (director only) $500 <br />TOTAL DIRECT CLIENT SERVICES COST: $7,700 <br />HEALTH PROMOTION AND OUTREACH <br />PROMOTION/OUTREACH ACTIVITY COST <br />Recruitment and marketing materials $200 <br />TOTAL HEALTH PROMOTION AND OUTREACH COSTS: $200 <br />EQUIPMENT <br />ITEM QUANTITY UNIT COST COST <br />Electronic medical record system 1 $720 annually $1440 <br />TOTAL EQUIPMENT COSTS: $1440 <br />SUB CONTRACTS <br />CONTRACT PURPOSE CONTRACTOR NAME COST <br />Psychologist or Psychiatrist Consultation Psychologist or Psychiatrist $2,500 <br />TOTAL SUBCONTRACT COSTS: $2,500 <br />INDIRECT COSTS INFORMATION <br />APPROVED INDIRECT COST RATE (ICR) 15% <br />ICR BASED ON: OTHER <br />TOTAL ESTIMATED INDIRECT COSTS: $43,564 <br />TOTAL BUDGET PROPOSAL: $333,992 <br />BUDGET PROPOSAL <br />EXHIBIT “D”