1-Cost Allocation-Attachment A - Budget Template.xlsx

XLSX spreadsheet 37 KB Posted

Attached to
Cost Allocation Software RFP
Solicitation number
231827
Issued by
Ventura County, California

About this file

This is a Cost Allocation Budget Template document prepared for Ventura County Behavioral Health (VCBH), a division of the County of Ventura Health Care Agency, in response to a Cost Allocation Software RFP. The template provides budget schedules for salary and benefits allocation across three fiscal years, beginning September 1, 2026 through August 31, 2029. The template was prepared by Dan Idell on October 22, 2015, and includes detailed salary and benefits schedules for the first, second, and third contract years. The staffing structure identified includes a Program Director allocated at 10 percent FTE with $1,500 salary and $500 benefits, and two Licensed Clinician positions each allocated at 20 percent FTE with $3,200 salary and $400 benefits per position. The contract period spans three 12-month fiscal years from September 1, 2026 to August 31, 2029.

The template is designed for providers to detail revenue sources, direct operational expenses, indirect expenditures, and census reporting information. The document indicates that all revenue and expense line items are currently populated with zero values and require data entry by responding vendors in the highlighted green sections. The salary and benefits total across all three years is consistent at $9,200 annually ($7,900 in salaries plus $1,300 in benefits). Additional budget categories include direct operational expenses such as drugs and medications, food, professional medical services, utilities, office supplies, and travel, as well as indirect expenditures capped at 15 percent of direct expenses. The template also requires vendors to provide census data including average daily census, monthly encounters, average length of stay, and billable hours for each contract year.

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Other files

File Type Posted
3-Cost Allocation-Attachment C-References.docx DOCX document
2-Cost Allocation-Attachment B-Non-Collusion Affidavit.docx DOCX document
4-Cost Allocation RFP Final.docx DOCX document

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Text version

1-Salaries 1st year

Schedule 1Prepared by: Dan Idell
Provider Name: Cost Allocation Software RFP ProposalDate Prepared: 10/22/2015
Salary and Benefits Schedule 1st Year (12 month period)
Year 1- September 1st 2026- August 31, 2027
BudgetBudget
TotalTotal PayrollVentura County BH Cost Allocation Software RFPVentura County BH Prog C
RefPositionHoursFTESalaryBenefitsTotal S&B%Total FTESalaryBenefits%Total FTEBillable FTESalaryBenefits
1Sample-- 0- 0-0%--
2Program Director-- 0- 0-10%1,500500
3Clinician - Licensed-- 0- 0-20%3,200400
4-- 0- 0-20%3,200400
5-- 0- 0-
6-- 0- 0-
7-- 0- 0-
8-- 0- 0-
9-- 0- 0-
10-- 0- 0---
11-- 0- 0---
12-- 0- 0---
13-- 0- 0---
14-- 0- 0---
15-- 0- 0---
16-- 0- 0---
17-- 0- 0---
18- 0- 0---
--0--- 0- 0- 0--7,9001,300
Total Should tie to Schedule 20
Variance (Error - PLS Correct)0

&Z&F

1-Salaries 2nd year

Schedule 1Prepared by: Dan Idell
Provider Name: Cost Allocation Software RFP ProposalDate Prepared: 10/22/2015
Salary and Benefits Schedule 2ndYear (12 month period)
Year 2- September 1st 2027- August 31, 2028
ProjectionBudgetBudget
TotalTotal PayrollVentura County BH Cost Allocation Software RFPVentura County BH Prog C
RefPositionHoursFTESalaryBenefitsTotal S&B%Total FTESalaryBenefits%Total FTEBillable FTESalaryBenefits
1Sample-- 0- 0-0%--
2Program Director-- 0- 0-10%1,500500
3Clinician - Licensed-- 0- 0-20%3,200400
4-- 0- 0-20%3,200400
5-- 0- 0-
6-- 0- 0-
7-- 0- 0-
8-- 0- 0-
9-- 0- 0-
10-- 0- 0---
11-- 0- 0---
12-- 0- 0---
13-- 0- 0---
14-- 0- 0---
15-- 0- 0---
16-- 0- 0---
17-- 0- 0---
18- 0- 0---
--0--- 0- 0- 0--7,9001,300
Total Should tie to Schedule 20
Variance (Error - PLS Correct)0

&Z&F

1-Salaries 3rd year

Schedule 1Prepared by: Dan Idell
Provider Name: Cost Allocation Software RFP ProposalDate Prepared: 10/22/2015
Salary and Benefits Schedule 3rd Year (12 month period)
Year 3- September 1st 2028- August 31, 2029
ProjectionBudgetBudget
TotalTotal PayrollVentura County BH Cost Allocation Software RFPVentura County BH Prog C
RefPositionHoursFTESalaryBenefitsTotal S&B%Total FTESalaryBenefits%Total FTEBillable FTESalaryBenefits
1Sample-- 0- 0-0%--
2Program Director-- 0- 0-10%1,500500
3Clinician - Licensed-- 0- 0-20%3,200400
4-- 0- 0-20%3,200400
5-- 0- 0-
6-- 0- 0-
7-- 0- 0-
8-- 0- 0-
9-- 0- 0-
10-- 0- 0---
11-- 0- 0---
12-- 0- 0---
13-- 0- 0---
14-- 0- 0---
15-- 0- 0---
16-- 0- 0---
17-- 0- 0---
18- 0- 0---
--0--- 0- 0- 0--7,9001,300
Total Should tie to Schedule 20
Variance (Error - PLS Correct)0

&Z&F

Budget

SCHEDULE 2
Prepared by:
Date Prepared:

Provider Name: Cost Allocation Software RFP Proposal

REVENUE Year 1- September 1, 2026- August 31, 2027 Year 2- September 1, 2027- August 31, 2028 Year 3- September 1, 2028- August 31, 2029 Total 1st Year Budget -Detailed Explanation 2nd Year Budget -Detailed Explanation 3rd Year Budget -Detailed Explanation

Net Patient Service Revenue$0
Total Operating Grants and Contracts
Contributions/Fundraising Income
Donated Goods and Services
Net Assets Released from Restriction
Other Operating Revenue (Realignment/NCC)$0$0$0$0
Total Operating Revenue$0$0$0$0
EXPENSES
Salaries & Benefits$0
Salaries Wages$0
Benefits$0
Total Salarues & Benefits$0$0$0$0
Direct Operational Expenses$0
Drugs, Medication$0
Food, Personal$0
Professional Medical services$0
Registries$0
Recruitment Incentive$0
Housekeeping - Contract$0
Security - Contract$0
Vehicle Expenses$0
Utilities$0
Equipment Maintenance$0
Office Supplies$0
Communication$0
Travel/mileage$0
Other (Specify)$0
TOTAL DIRECT OPERATING EXPENSES$0$0$0$0
Indirect Expenditures: Paid By Provider
Salaries$0
Benefits$0
Accounting, Audit, and Legal$0
Vehicle Expense$0
Staff Expenses$0
Other Indirect Expenditures:$0
Total Indirect Expenditures$0$0$0$0

Total Expenditure $0 $0 $0 $0

Notes:
1) Area highlighted in green for data entry.
2) Explain basis of projection for salaries & benefits and other significant services & supplies such as lease, other professional expenses, etc.
3) Insert lines as needed.
4)Maximum total Indirect expenses is 15% of direct expenses.

Census Report

SCHEDULE 3Provider Name: Cost Allocation Software RFP Proposal
Y1Y2Y3
September 1, 2026 to August 31,2027September 1, 2027 to August 31,2028September 1, 2028 to August 31, 2029
Average Daily Census
Monthly Number of Encounters
Average Length of Stay - Hours
Billable - Hours

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