Budget_Forms_12_month.xlsx
XLSX spreadsheet 404 KB Posted
- Attached to
- Rapid Rehousing Services
- Solicitation number
- RFP-017-3080101-EA
- Issued by
- Orange County, San Francisco City, California
About this file
This budget forms document is associated with Orange County, California's Office of Care Coordination solicitation for Rapid Rehousing Services for Individuals, Families and Transitional Youth. The budget package is designed as a 12-month template for fiscal year July 1, 2027 through June 30, 2028, requiring contractors to provide detailed cost breakdowns across administrative and program components. The document requires hard-coded numerical entries only—no formulas or links—and mandates comprehensive supporting narratives including indirect/administrative cost justifications, cost allocation plans, detailed staffing and benefits information, services and supplies analyses, equipment and facility expense details, revenue projections, and program descriptions with organizational charts and job descriptions. All budget submissions must be completed and submitted by October 5, 2026, with final review and approval contingent upon negotiations and finalization by the Contract Administrator.
The budget structure separates administrative costs from program costs, with administrative costs capped at a maximum of 10% of total program costs unless otherwise directed by the funding source. The template accommodates multiple cost categories including salaries, benefits, services and supplies, subcontractors, flexible funds, and start-up costs. Contractors must document their accounting methodology (cash, accrual, or modified accrual), facility expenses including lease and mortgage information, equipment ownership and lease details, licenses and permits, and specific revenue sources such as Medi-Cal, insurance, client fees, and other funding streams. The package is structured to support actual cost reimbursement contracts and requires detailed staffing worksheets specifying position titles, FTE allocations, monthly salaries, benefits percentages, and caseloads or direct service hours where applicable. Orange County United Way's submission demonstrates the expected level of detail, including leveraged funding contributions and collaborative service delivery through five district-specific subcontracting agencies.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Rapid_Rehousing_Services_(Addendum_#4_Revision).pdf | ||
| Budget_Forms_6_month.xlsx | XLSX spreadsheet | |
| Rapid_Rehousing_Services_(Addendum_#2_Revision).pdf | ||
| 2._RRH_Budget_Form.xlsx | XLSX spreadsheet | |
| 1._Homeless_Service_System_Pillars_Attestation.pdf | ||
| 3._Standards_of_Care.pdf | ||
| 4._Model_Contract.pdf |
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Procurement Budget Guide Proposal and Budget Guide tc={E02103C8-D01F-48DF-B26F-2CC792621004}: [Threaded comment]
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Comment:
@Axe, Eric I updated this page with the changes we discussed.
| Indirect/Administrative Costs Narrative | Are those costs: (a) incurred for a common or joint purpose of benefiting more than one cost objective (i.e. more than one program or contract), and (b) not directly attributable to the cost of providing direct services (i.e. supportive services such as administrative management, fiscal, human resources, etc.). The Indirect/Administrative Costs cannot exceed a maximum percentage (%) of the program costs or as directed in the RFP and/or by Funding Source for the total program costs. |
| Cost Allocation Plan | Narrative that details all costs, including a key for cost centers to distinguish costs that are to be allocated under the proposal.. |
| Salaries & Benefits Narrative/Details (Including Leave Accrual) | Explain in detail who in your organization is paid under this contract and provide detailed information and percentages for employee benefits and taxes. Leave Accrual: Explain the vacation/other leave accrual and charging process that your organization uses. |
| Budget Narrative/Details | Include Staffing and Services & Supplies (S&S) narrative. Staffing: Narrative must describe each position in the contract (Administrative & Program) and their function(s). S&S: Give specific details on each budget line requested (Administrative & Program). Any variances from your current agreement needs to be explained for both the staffing and S&S. |
| Program Description Documents | ||
| Program Organization Chart | Chart should be Program specific and include Title, Staff Name (if known), FTE. | |
| Job Descriptions | Job Descriptions need to be specific to the program being proposed and their function in the program. If you propose subcontracts include information on their job function; including term, hourly rate, total cost, and scope of work. Remember: Job Descriptions need to match the titles and details provided in the Staffing S&EB section. | |
| Program Narrative/Goals | Provide a brief description of your program (including philosophy, rationale and staffing narrative). The what and why of your program. What are your objectives and goals? Provide information on structured activities. How do you evaluate your program's success and improve any barriers/failures? | |
| Staffing Patterns | Staffing should include items such as FTEs and productivity levels for each position. |
| Proposal Reminders | |
| Narratives | Narratives need to be clearly written and well thought out; they should explain and mirror your strategic program plan and goals. |
| Inputting Information | All inputs must be hard coded. Do not use any links or formulas to input any information into the budget package. |
| Questions/Clarifications | If you have any questions or need clarification regarding completing your budget package and documents, please contact the Procurement Administrator for clarification. |
| Final Review and Completion | Have your team conduct a final review/edit of the Proposed Budget package prior to submission. |
@Axe, Eric I updated this page with the changes we discussed.
P1 Budget
| BUDGET AND MAXIMUM OBLIGATION WORKSHEET |
| 0 |
| Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| Orange County, California |
| FY |
| VARIANCE | |
| PROPOSED |
Uyeda, Brian: Contract Administrator:
Amounts must match the original proposal. REVISED Uyeda, Brian: Contract Administrator:
Change to read "Approved" following negotiations and finalizing the budget and staffing. REVISED Uyeda, Brian: Contract Administrator:
| Change to read "Approved" following negotiations and finalizing the budget and staffing. | Percentage | ||||
| BUDGET | BUDGET | VS. | Increase/ | ||
| FY | FY | PROPOSED | Decrease | ||
| ADMINISTRATIVE COSTS | |||||
| Salaries | $0 | $0 | $0 | 0.0% | |
| Benefits | $0 | $0 | $0 | 0.0% | |
| Services & Supplies | $0 | $0 | $0 | 0.0% | |
| Professional Services | $0 | $0 | $0 | 0.0% | |
| Indirect Costs | $0 | $0 | $0 | 0.0% | |
| SUBTOTAL ADMIN COSTS | $0 | $0 | $0 | 0.0% | |
| Percent Administrative Cost to Program Cost | 0.0% | 0.0% | 0.0% |
| PROGRAM COSTS | ||||
| Salaries | $0 | $0 | $0 | 0.0% |
| Benefits | $0 | $0 | $0 | 0.0% |
| Services & Supplies | $0 | $0 | $0 | 0.0% |
| Subcontractors | $0 | $0 | $0 | 0.0% |
| Flexible Funds | $0 | $0 | $0 | 0.0% |
| SUBTOTAL PROGRAM COSTS | $0 | $0 | $0 | 0.0% |
| Start-Up Costs | $0 | $0 | $0 | 0.0% |
| TOTAL GROSS COSTS | $0 | $0 | $0 | 0.0% |
REVENUES
Uyeda, Brian: Contract Administrator: All Requested Revenue funding amounts are obtained from the Approved NOE and subject to modification pending negotiations.
Uyeda, Brian: Contract Administrator:
Amounts must match the original proposal.
Uyeda, Brian: Contract Administrator:
Change to read "Approved" following negotiations and finalizing the budget and staffing.
Uyeda, Brian: Contract Administrator:
| Change to read "Approved" following negotiations and finalizing the budget and staffing. | ERROR:#REF! | ERROR:#REF! | ||||||
| Federal Medi-Cal (FFP) | $0 | $0 | 0.0% | FFP % | 0.00% | 0.00% | ||
| Medi-Cal Match | $0 | $0 | 0.0% | State % | 0.00% | 0.00% | ||
| SubTotal Medi-Cal | $0 | $0 | $0 | 0.0% | ||||
| % Medi-Cal Offset | 0.0% | 0.0% |
| Other Revenue (Patient Fees/Insurance) | $0 | 0.0% | ||
| Other Revenue (MHSA) | $0 | 0.0% | ||
| Other Revenue (County Discretionary) | $0 | 0.0% | ||
| Other Revenue_______________ | $0 | 0.0% | ||
| Other Revenue_______________ | $0 | 0.0% | ||
| SubTotal Other Revenue | $0 | $0 | $0 | 0.0% |
| Total Revenue | $0 | $0 | $0 | 0.0% |
| 0.0% | 0.0% | |||
| State Funds | $0 | $0 | $0 | 0.0% |
| (Total Cost - Total Revenue) | 0.0% | 0.0% |
| Maximum Obligation | $0 | $0 | $0 | 0.0% |
| (Total Revenue + State Funds) | 0.0% | 0.0% |
| PROPOSED | REVISED | VARIANCE | |
| BUDGET | BUDGET | REVISED | |
| Cost/Minute Calculation | FY | FY | VS. PROPOSED |
| Total Contract DSH | 0 | 0 | 0 |
| Total Gross Cost | $0 | $0 | $0 |
| Total Minutes | 0 | 0 | 0 |
| Cost/Min | $0.00 | $0.00 | $0.00 |
| DSH Workload Standards | |||
| MH Services | 0 | 0 | 0 |
| Medication Services | 0 | 0 | 0 |
| TOTAL | 0 | 0 | 0 |
Caseload Standard 0.00 0.00 0.00
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator Draft: Date &A
P1 Staffing
| STAFFING WORKSHEET |
| 0 |
| Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| Orange County, California |
| FY |
VARIANCE PROPOSED
Uyeda, Brian: Contract Administrator:
Amounts must match the
| original proposal. | REVISED | VARIANCE | |
| PROPOSED |
Uyeda, Brian: Contract Administrator:
Amounts must match the original proposal. REVISED REVISED MONTHLY MONTHLY REVISED PROPOSED Uyeda, Brian: Contract Administrator:
Amounts must match the
| original proposal. | REVISED | VARIANCE | VARIANCE | |||||
| FTE | FTE | vs. PROPOSED | SALARY | SALARY | vs. PROPOSED | VARIANCE EXPLANATION |
Uyeda, Brian: All variances must be explained and included in this column. Please do not reference line-item variance explanations as being addressed in your narratives.
Variance explanations should be clear and concise. Some examples are as follows:
FTE
"Increased staffing required to serve an additional _____ clients/slots."
"New proposed position due to _____."
S&EB
"Proposed merit increase of ___%."
"New position due to _____."
S&S "Historic usage shows increase/decrease of funds required."
"Allocation cost for this line increased/decreased due to proposed increase/decrease in FTE."
DSH & Caseload "Reduced DSH and caseload due to ______."
"New proposed DSH producing position due to_____."
Uyeda, Brian: Contract Administrator:
Amounts must match the original proposal.
Uyeda, Brian: Contract Administrator:
Amounts must match the
| original proposal. | BENEFITS | BENEFITS | PROPOSED | REVISED | REVISED | PROPOSED | REVISED | REVISED | |||||||||
| POSITION TITLE, IF AVAILABLE NAME, LICENSE/DEGREE | FY | FY | FTE | FY | FY | SALARY | (FTE, Salary, DSH, and Caseload) | FY | FY | MONTHLY DSH | MONTHLY DSH | vs. PROPOSED | CASELOAD | CASELOAD | vs. PROPOSED | ||
| DIRECT ADMINISTRATION | |||||||||||||||||
| 1 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 2 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 3 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 4 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 5 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 6 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 7 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 8 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 9 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 10 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 11 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 12 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 13 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 14 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 15 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 16 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 17 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 18 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 19 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| 20 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||||||||||
| Subtotals Direct Administration | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| PROGRAM ADMINISTRATION | |||||||||
| 1 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 2 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 3 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 4 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 5 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 6 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 7 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 8 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 9 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 10 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 11 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 12 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 13 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 14 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 15 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 16 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 17 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 18 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 19 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| 20 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |||
| Subtotals Program Admininstration | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| DIRECT NON-DSH PROGRAM | ||||||||||||
| 1 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 2 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 3 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 4 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 5 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 6 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 7 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 8 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 9 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 10 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 11 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 12 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 13 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 14 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 15 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 16 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 17 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 18 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 19 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 20 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 21 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 22 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 23 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 24 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 25 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 26 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 27 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 28 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 29 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 30 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 31 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 32 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 33 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 34 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 35 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 36 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 37 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 38 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 39 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| 40 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | ||||
| Subtotals Direct Non-DSH Program | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 |
| DIRECT DSH PROGRAM (NON-MEDICATION SUPPORT SERVICES) | |||||||||||||||
| 1 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 2 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 3 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 4 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 5 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 6 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 7 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 8 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 9 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 10 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 11 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 12 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 13 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 14 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 15 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 16 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 17 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 18 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 19 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 20 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 21 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 22 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 23 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 24 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 25 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 26 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 27 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 28 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 29 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 30 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 31 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 32 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 33 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 34 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 35 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 36 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 37 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 38 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 39 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 40 | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| Subtotals Direct DSH Program | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 | |
| (Non-Medication Support Services) |
| DIRECT DSH PROGRAM (MEDICATION SUPPORT SERVICES*) | ||||||||||||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | ||||
| Subtotal Direct DSH Program | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| (Medication Support Services) |
| PROGRAM SUBCONTRACTORS | |||||||
| 1 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 2 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 3 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 4 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 5 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 6 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 7 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 8 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 9 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 10 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 11 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 12 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 13 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| 14 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | |
| Subtotals Non-DSH Subcontractors | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 |
| DSH Subcontractors (Non-Medication Support Services) | ||||||||||
| 15 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 16 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 17 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 18 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 19 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 20 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 21 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 22 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 23 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 24 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 25 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| 26 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | 0 | ||
| Subtotal DSH Subcontractors | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | |
| (Non-Medication Support Services) |
| DSH Subcontractors (Medication Support Services) | ||||||||||
| 28 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 29 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 30 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 31 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 32 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 33 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 34 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 35 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 36 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 37 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 38 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| 39 | 0.000 | 0.00 | 0.00 | $0.00 | $0.00 | 0 | 0 | |||
| Subtotal DSH Subcontractors | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | |
| (Medication Support Services) |
| SUMMARY | ||||||||||||
| ADMINISTRATION | ||||||||||||
| Direct Administration | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| Program Administration | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| TOTAL ADMINISTRATION | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| PROGRAM | ||||||||||||
| Direct Non-DSH Program | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| Direct DSH Program (Non-Medication Support Services) | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| *Direct DSH Program (Medication Support Services) | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| TOTAL PROGRAM | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| SUBCONTRACTORS | ||||||||||||
| Non-DSH Subcontractors | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| DSH Subcontractors (Non-Medication Support Services) | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| *DSH Subcontractors (Medication Support Services) | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
| TOTAL SUBCONTRACTORS: | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | $0.00 | 0 | 0 | 0 | 0 | 0 | 0 |
TOTAL CONTRACT 0.00 0.00 0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0
| DSH STAFF CALCULATION | ||||
| FTE | ANNUAL DSH | Modified DSH | If modified please provide supporting documentation: | |
| Mental Health Services | 0.00 | 0 | ||
| *Medication Support Services | 0.00 | 0 | ||
| Total Contract DSH Staff | 0.00 | 0 | 0 |
*Should only include MD's (Psychiatrists) and Licensed Nurse Practioners.
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator
P1 S&S
| SERVICES AND SUPPLIES ANALYSIS |
| 0 |
| Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| Orange County, California |
| FY |
| VARIANCE | |
| PROPOSED |
Uyeda, Brian: Contract Administrator:
Amounts must match the
| original proposal. | REVISED | REVISED | |||
| BUDGET | BUDGET | VS. | |||
| FY | FY | PROPOSED | VARIANCE EXPLANATION |
Uyeda, Brian: All variances must be explained and included in this column. Please do not reference line-item variance explanations as being addressed in your narratives.
Variance explanations should be clear and concise. Some examples are as follows:
Office Space - "Increased due to renegotiated lease agreement."
Equipment - "Increased due to 3 new laptop computers for new proposed program staff."
Program Supplies - "Reduced due to historical usage and savings reallocated to Equipment."
Uyeda, Brian: Contract Administrator:
Amounts must match the original proposal. ADMINISTRATIVE SERVICES AND SUPPLIES
| Equipment( Lease) (from page 5) | $0 | $0 | $0 |
| Equipment (Owned) (from page 5) | $0 | $0 | $0 |
| Office Space (from page 5) | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| 0 | $0 | $0 | $0 |
| Subtotal Admin. Services & Supplies | $0 | $0 | $0 |
PROGRAM SERIVCES AND SUPPLIES
| Equipment( Lease) (from page 5) | $ - 0 | $0 | $0 |
| Equipment (Owned) (from page 5) | $ - 0 | $0 | $0 |
| Office Space (from page 5) | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| 0 | $ - 0 | $0 | $0 |
| Subtotal Program Services & Supplies | $0 | $0 | $0 |
| Flex Fund Detail (For MHSA Agreements only) | |||
| Housing | $ - | $0 | $0 |
| Transportation | $ - | $0 | $0 |
| Food | $ - | $0 | $0 |
| Education | $ - | $0 | $0 |
| Employment | $ - | $0 | $0 |
| Health | $ - | $0 | $0 |
| Clothing | $ - | $0 | $0 |
| Enrichment Activities | $ - | $0 | $0 |
| Residential Treatment | $ - | $0 | $0 |
| Miscellaneous/Other | $ - | $0 | $0 |
| Other __________________ | $ - | $0 | $0 |
| Flex Fund Totals | $0 | $0 | $0 |
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator
P1 Start-Up
| Start-Up Costs |
| 0 |
| Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| Orange County, California |
| FY |
| VARIANCE | |
| PROPOSED |
Uyeda, Brian: Contract Administrator:
| Amounts must match the original proposal. | REVISED | REVISED | ||||
| BUDGET | BUDGET | VS. | ||||
| ADMINISTRATIVE COSTS |
Uyeda, Brian: Contract Administrator:
Titles must match the original proposal. FY FY PROPOSED VARIANCE EXPLANATION Uyeda, Brian: All variances must be explained and included in this column.
Variance explanations should be clear and concise. Some examples are as follows:
Office Space - "Increased due to renegotiated lease agreement since proposal was submitted."
Equipment - "Increased due to 3 new laptop computers for additional proposed 3.0 FTE program staff."
Program Supplies - "Increased due to additional proposed 3.0 FTE program staff."
Uyeda, Brian: Contract Administrator:
Titles must match the original proposal.
Uyeda, Brian: Contract Administrator:
| Amounts must match the original proposal. | Salaries | - | $0 | $0 |
| Benefits | - | $0 | $0 | |
| Indirect | - | $0 | $0 | |
| Sub Total Administration | $0 | $0 | $0 |
| Services and Supplies | |||
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| Sub Total Admin. Services & Supplies | $0 | $0 | $0 |
Subtotals Admininistrative Start-up Costs $0 $0 $0
| PROGRAM COSTS | |||
| Salaries | - | $0 | $0 |
| Benefits | - | $0 | $0 |
| Indirect | - | $0 | $0 |
| Sub Total Program | $0 | $0 | $0 |
| Services and Supplies | |||
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| 0 | - | $0 | $0 |
| Sub Total Program Services and Supplies | $0 | $0 | $0 |
| Subtotals Program Start-up Costs | $0 | $0 | $0 |
Grand Total Start-up Costs $0 $0 $0
CA Analysis Notes
| 0 |
| Orange County, California |
| CA Analysis Renewal Notes |
1.
2.
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator
Proposed Summary
| DUE DATE: | October 5, 2026 | ||
| CONTRACT BUDGET PROPOSAL PACKAGE | |||
| July 1, 2027 - June 30, 2028 |
| PROGRAM SUMMARY | |||||
| TO: | ERIC AXE | FROM: | |||
| COUNTY PROCUREMENT OFFICE | (Contractor's Corporate Name as Listed on Articles of Incorporation) | ||||
| OFFICE OF CARE COORDINATION | |||||
| 400 W. CIVIC CENTER DR. 3RD FL | (Street Address of Admin. Offices) | ||||
| SANTA ANA, CA 92701 | |||||
| (City, State, Zip Code) | (Telephone) | ||||
| NOTE: This document contains automatic links. | |||||
| *Enter values/information only into the GREEN SHADED areas* | (Profit/Non-Profit/Other) |
TYPE OF CONTRACT: Actual Cost Reimbursement
| PROGRAM | ADMIN | FY | FY | ||
| FTE | FTE | TOTAL PROPOSED | TOTAL REVISED | ||
| NAME AND LOCATION | Services(*) | STAFF | STAFF | BUDGET | COSTS |
| 0 | |||||
| Rapid Rehousing Services for Individuals, Families and Transitional Youth | 8) Other (Specify below) | 0.00 | 0.00 | $0 | $0 |
| Orange County, California |
GRAND TOTALS: 0.00 0.00 $0 $0
| SERVICES (*) | Select | BEHAVIORAL_HEALTH | PUBLIC_HEALTH | CORRECTIONAL_HEALTH | MEDICAL_SERVICES | SUBSTANCE_USE_DISORDER | |
| Area: | 1) Outpatient | 1) ADEPT | 1) Radiology | 1) MSI | 1) PSN | ||
| AUTHORIZED SIGNATURE | 2) Full Service Partnership | 2) TUPP | 2) EMSF | 2) Post Custody | |||
| Program: | 3) Wraparound | 3) HIV Care Srvs (Specify below) | 3) HDM | 3) Sober Living | |||
| 8) Other (Specify below) | The undersigned hereby acknowledges: "I have read and understand the contents of the | 4) In-Home Crisis Stabilization | 4) HIV Prevention (Specify below) | 4) Ambulance | 4) AB 109 | ||
| Rapid Rehousing Services for Individuals, Families and Transitional Youth | attached budget request for County funding for the contract period specified above. | 5) Crisis Residential | 5) HIV Specialty Srv. (Specify below) | 5) CCS | 5) Narcotic Repl. | ||
| It is correct to the best of my knowledge and represents the organization's proposal for | 6) Outreach & Engagement | 6) Communicable Disease Services | 6) Straight Talk | ||||
| the provision of services to the County. I also hereby certify that I have the authority to submit | 7) Prevention & Intervention | 7) Nutrition Services | 7) Res. Recovery | ||||
| this information on behalf of the organization". | 8) Supported Employment | 8) Other (Specify below) | 8) Res Recov. & Detox | ||||
| 9) Multi-Service Center | 9) Outpatient Services |
| 10) Training | 10) CalWORKS | ||
| Authorized Representative | Date | 11) Mentoring | |
| 12) CalWorks | |||
| 13) SSI Outreach | |||
| 14) Representative Payee | |||
| 15) Patient Advocate | |||
| 16) Other (specify below) |
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator
Proposed Budget
| Due Date: | October 5, 2026 | |
| CONTRACT BUDGET PACKAGE | ||
| July 1, 2027 - June 30, 2028 |
| TO: | ERIC AXE | FROM: | 0 | |
| COUNTY PROCUREMENT OFFICE | (Corporate Name as Listed on Articles of Incorporation) | |||
| OFFICE OF CARE COORDINATION | 0 | |||
| 400 W. CIVIC CENTER DR. 3RD FL | (Street Address of Admin. Offices) | |||
| SANTA ANA, CA 92701 | 0 | 0 | ||
| (City, State, Zip Code) | (Telephone) | |||
| UEI# by Location |
Daniel Vu: Daniel Vu:
UNIQUE ENTITY IDENTIFIER
| Tax ID# |
| NPI # |
| NOTE: This document contains automatic links. | FY | FY | ||||
| *Enter values/information into the GREEN SHADED areas only* | ||||||
| PROGRAM | ADMIN | CONTRACT | CONTRACT | |||
| PROGRAM NAME | FTE STAFF | FTE STAFF | TOTAL PROPOSED | TOTAL REVISED | ||
| AND LOCATION | SERVICES | PROPOSED | PROPOSED | BUDGET | COSTS |
0 8) Other (Specify below) 0.00 0.00 $0 $0
| Rapid Rehousing Services for Individuals, Families and Transitional Youth | |||||
| Orange County, California | |||||
| N/A | |||||
| BUDGET SUMMARY | |||||
| 6 MONTH REQUESTED BUDGET | |||||
| July 1, 2027 - June 30, 2028 | |||||
| PROVIDER: | 0 | ||||
| (Corporate Name as Listed on Articles of Incorporation) | |||||
| 0 | |||||
| (Street Address of Admin. Offices) | |||||
| 0 | 0 | ||||
| (City, State, Zip Code) | (Telephone) | ||||
| PROPOSED | |||||
| I. ADMINISTRATION COSTS | TOTAL | ||||
| A. Salaries | $0 | ||||
| B. Benefits | $0 | ||||
| C. Services and Supplies | $0 | ||||
| D. Professional Services Costs | $0 | ||||
| E. Indirect Costs | $0 | ||||
| F. Subtotal (I.A. thru E.) ** | $0 |
** (Administration Costs cannot exceed a maximum of 10%, or as directed by Funding Source of total Program costs)
| II. PROGRAM COSTS | |||
| A. Salaries | $0 | ||
| B. Benefits | $0 | ||
| C. Services and Supplies | $0 | ||
| D. Subcontractor Costs | $0 | ||
| E. Flexible Funds | $0 | ||
| F. Start-Up Funds | $0 | ||
| G. Subtotal (II.A. thru F.) | $0 |
III. TOTAL COSTS (I.F. + II.F.) $0
IV. REVENUE FUNDING $0
V. NET COST (III. - IV.) $0
| VI. CONTRACT AMOUNT | Gross Cost | $0 |
| Net Cost | $0 |
ADMINISTRATIVE SERVICES AND SUPPLIES DETAIL
| PROVIDER: | 0 |
| PROGRAM NAME: | Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| LOCATION: | Orange County, California |
NOTE: INCLUDE ADMINISTRATION COSTS ONLY. DO NOT INCLUDE DIRECT PROGRAM COSTS.
| FY | |
| TOTAL PROPOSED | |
| SERVICES AND SUPPLIES | BUDGET |
| 1 | Equipment( Lease) (from page 5) | $ - 0 | |
| 2 | Equipment (Owned) (from page 5) | $ - 0 | |
| 3 | Office Space (from page 5) | $ - 0 | |
| 4 | |||
| 5 | |||
| 6 | |||
| 7 | |||
| 8 | |||
| 9 | |||
| 10 | |||
| 11 | |||
| 12 | |||
| 13 | |||
| 14 | |||
| 15 | |||
| 16 | |||
| 17 | |||
| 18 | |||
| 19 | |||
| 20 | |||
| 21 | |||
| 22 | |||
| 23 | |||
| 24 | |||
| 25 | |||
| 26 | |||
| 27 | |||
| 28 | |||
| 29 | |||
| 30 | |||
| 31 | |||
| SERVICES AND SUPPLIES SUBTOTAL | $ - 0 |
* Indicate your food cost per client per day if applicable:
** Indicate your reimbursement rate per mile:
PROGRAM SERVICES AND SUPPLIES DETAIL
| PROVIDER: | 0 | |
| PROGRAM NAME: | Rapid Rehousing Services for Individuals, Families and Transitional Youth | |
| LOCATION: | Orange County, California | |
| NOTE: DO NOT INCLUDE ADMINISTRATION COSTS. INCLUDE DIRECT PROGRAM COSTS ONLY. |
| FY | |
| TOTAL PROPOSED | |
| SERVICES AND SUPPLIES | BUDGET |
| 1 | Equipment( Lease) (from page 5) | $ - 0 | |
| 2 | Equipment (Owned) (from page 5) | $ - 0 | |
| 3 | Office Space (from page 5) | $ - 0 | |
| 4 | |||
| 5 | |||
| 6 | |||
| 7 | |||
| 8 | |||
| 9 | |||
| 10 | |||
| 11 | |||
| 12 | |||
| 13 | |||
| 14 | |||
| 15 | |||
| 16 | |||
| 17 | |||
| 18 | |||
| 19 | |||
| 20 | |||
| 21 | |||
| 22 | |||
| 23 | |||
| 24 | |||
| 25 | |||
| 26 | |||
| 27 | |||
| 28 | |||
| 29 | |||
| 30 | |||
| SERVICES AND SUPPLIES SUBTOTAL | $ - 0 |
* Indicate your food cost per client per day if applicable:
** Indicate your reimbursement rate per mile:
| FY | ||
| REQUESTED | ||
| *** | Flex Fund Detail (For MHSA Agreements only) | BUDGET |
| 1 | Housing | |
| 2 | Transportation | |
| 3 | Food | |
| 4 | Education | |
| 5 | Employment | |
| 6 | Health | |
| 7 | Clothing | |
| 8 | Enrichment Activities | |
| 9 | Residential Treatment | |
| 10 | Miscellaneous/Other | |
| 11 | Other __________________ | |
| Flex Fund Totals | $0 |
*** Discuss with Contract Administrator if you have any questions.
FY
Wheeler, Vicki: Wheeler, Vicki:
| If Proposed Services will not have Start-Up Funding Lines 195 thru 249 should be hid. | REQUESTED | ||
| Start-Up Details | BUDGET |
| Administration | ||
| 1 | Salaries | - |
| 2 | Benefits | |
| 3 | Indirect | |
| Sub Total Administration | $0 |
| Services and Supplies | ||
| 4 | - | |
| 5 | ||
| 6 | ||
| 7 | ||
| 8 | ||
| 9 | ||
| 10 | ||
| 11 | ||
| 12 | ||
| 13 | ||
| Sub Total Admin. Services & Supplies | $0 | |
| Total Administration Start-up | $0 |
| Program | ||
| 1 | Salaries | - |
| 2 | Benefits | |
| 3 | Indirect | |
| Sub Total Program | $0 |
| Services and Supplies | ||
| 4 | - | |
| 5 | ||
| 6 | - | |
| 7 | ||
| 8 | ||
| 9 | ||
| 10 | ||
| 11 | ||
| 12 | ||
| 13 | ||
| 14 | ||
| 15 | ||
| 16 | ||
| 17 | ||
| 18 | ||
| 19 | ||
| 20 | ||
| 21 | ||
| 22 | ||
| Sub Total Program Services & Supplies Start-up | $0 | |
| Subtotals Program Start-up Costs | $0 |
Grand Total Start-up Costs $0
REVENUE DETAIL
INDICATE BUDGETED REVENUE AND EXPLAIN THE BASIS FOR THESE PROJECTIONS.
| Amount | |||||
| FY | FY | of | |||
| Budgeted | Proposed | Increase | % | ||
| Revenue | Revenue | (Decrease) | Change | ||
| CLIENT FEES | $ - | $ - 0 | $ - 0 | 0.0% | |
| RESIDENTIAL/PARTICIPANT FEES | $ - | $ - 0 | $ - 0 | 0.0% | |
| INSURANCE | $ - | $ - 0 | $ - 0 | 0.0% | |
| MEDI-CAL (FFP and State Match) | CalAIM (TBD) | $ - | $ - 0 | $ - 0 | 0.0% |
| MEDICARE | $ - | $ - 0 | $ - 0 | 0.0% | |
| FOOD STAMPS | $ - | $ - 0 | $ - 0 | 0.0% | |
| DONATIONS | $ - | $ - 0 | $ - 0 | 0.0% | |
| SDI | $ - | $ - 0 | $ - 0 | 0.0% | |
| OTHER (County Discretionary) | $ - | $ - 0 | $ - 0 | 0.0% | |
| OTHER (MHSA) | $ - | $ - 0 | $ - 0 | 0.0% | |
| TOTAL REVENUE | $0 | $0 | $ - 0 | 0.0% |
| UNRESTRICTED DONATIONS: | $ - | $ - 0 | $ - 0 |
| % CLIENTS MEDI-CAL ELIGIBLE: | 0.0% | 0.0% | 0.0% |
REMARKS:
FACILITY EXPENSE DETAIL
| PROVIDER: | 0 |
| PROGRAM NAME: | Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| LOCATION: | Orange County, California |
OFFICE SPACE
| In the space below, describe the basis for budgeting costs of program facilities and office space. Include leases, mortgages, and |
| property tax as applicable. If an allocation is made between the program(s) applied for herein and another program, indicate |
| the basis for this allocation. Costs should reflect annualized amounts. |
| FY | ||||
| Total | Proposed | |||
| Location | Facility | Allocation | ||
| GROSS SQUARE FOOTAGE | MORTGAGE INTEREST | |||
| LEASE/RENT EXPENSE | PROPERTY TAXES | |||
| GROSS SQUARE FOOTAGE | MORTGAGE INTEREST | |||
| LEASE/RENT EXPENSE | PROPERTY TAXES | |||
| GROSS SQUARE FOOTAGE | MORTGAGE INTEREST | |||
| LEASE/RENT EXPENSE | PROPERTY TAXES | |||
| GROSS SQUARE FOOTAGE | MORTGAGE INTEREST | |||
| LEASE/RENT EXPENSE | PROPERTY TAXES | |||
| FY | ||||
| Total Contract Cost | $0 |
| Administrative Costs | $0 |
| Program Costs | $0 |
| Other_______ | $0 |
| Total Cost | $0 |
EQUIPMENT OWNED & LEASE DETAIL
| List the item description, original cost, and useful life of any item purchased for $2,000 or more that you will be depreciating or |
| charging to the County contract. |
| Amount | |||||
| OWNED | to be | ||||
| Purchase | or | ORIGINAL | USEFUL | Charged | |
| ITEM | Date | LEASED | COST | LIFE | FY |
| - | - | ||||
| - | - |
| FY | |
| Administrative Amount Owned to be Charged | |
| Administrative Amount of Leased Equipment Expense | |
| Program Amount Owned to be or Charged | |
| Program Amount of Leased Equipment Expense | |
| Total Contract Cost | $0 |
FINANCIAL/ACCOUNTING INFORMATION
| PROVIDER: | 0 | ||
| PROGRAM NAME: | Rapid Rehousing Services for Individuals, Families and Transitional Youth | Select | Select |
| LOCATION: | Orange County, California | Cash | Yes |
| Describe your accounting method (select one from drop down box): | Accrual | No | |
| Modified Accrual | |||
| Accrual |
| NOTE: Any change in your accounting method over the past year or since last renewal must be carefully considered and requires notification be sent to Contract Administrator. | |
| Please use remark section below. |
LICENSES, PERMITS, APPROVALS
| PROVIDER: | 0 |
| PROGRAM NAME: | Rapid Rehousing Services for Individuals, Families and Transitional Youth |
| LOCATION: | Orange County, California |
| Does your program require a Conditional Use Permit (CUP)? (check one): | No |
| Expiration Date: |
REMARKS:
Facility is located in a zone.
Do you plan to provide services at any new locations? If so, explain where and give zone and CUP or variance information.
State Certification Expiration Date:
Provisional: Unconditional:
If Residential Facility:
Type of License: Expiration Date:
| Food Stamp Certification |
| Expiration Date: |
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator
Proposed Staffing
| 0 | |||||||||||||
| Rapid Rehousing Services for Individuals, Families and Transitional Youth | |||||||||||||
| Orange County, California | TOTAL | TOTAL | |||||||||||
| TITLE OF POSITION, | HRs Per | FTE | Monthly | Monthly | Monthly | Hourly | Monthly | Percent of | Monthly | Annual | Percent of | Monthly | |
| (IF AVAILABLE NAME OF EMPLOYEE) | Week | percent | Proposed | Salary for | Benefits for | Rate for | Salary for | These Srvc. | Benefits for | Benefits for | Benefits to | Proposed | |
| (IF AVAILABLE LICENSE/DEGREE) | This Program | equivalent | DSH | This Program | This Program | This Program | All Prgrms. | All Prgrms. | All Prgrms. | All Prgrms. | Annual Salary | Caseload | |
| DIRECT ADMINISTRATION | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 1 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 2 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 3 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 4 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 5 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 6 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 7 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 8 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 9 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 10 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 11 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 12 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 13 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 14 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 15 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 16 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 17 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 18 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 19 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 20 | |||||||||||||
| Subtotals | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | N/A | $0.00 | 0% | N/A | $0.00 | 0.0% |
| Monthly | |||||||||||||
| Proposed | |||||||||||||
| PROGRAM ADMINISTRATION | Caseload | ||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 1 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 2 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 3 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 4 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 5 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 6 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 7 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 8 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 9 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 10 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 11 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 12 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 13 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 14 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 15 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 16 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 17 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 18 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 19 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | N/A | ||||||
| 20 | |||||||||||||
| Subtotals | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 | N/A | $0.00 | 0% | N/A | $0.00 | 0.0% |
| Monthly | |||||||||||||
| Proposed | |||||||||||||
| Direct PROGRAM: | Caseload | ||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 1 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 2 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 3 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 4 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 5 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 6 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 7 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 8 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 9 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 10 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 11 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 12 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 13 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 14 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 15 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 16 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 17 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 18 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 19 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 20 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 21 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 22 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 23 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 24 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 25 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 26 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 27 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 28 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 29 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 30 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 31 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 32 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 33 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 34 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 35 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 36 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 37 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 38 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 39 | |||||||||||||
| 0.00 | N/A | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 40 | |||||||||||||
| Subtotals | 0.00 | 0.00 | 0 | $0.00 | $0.00 | N/A | $0.00 | 0% | N/A | $0.00 | 0.0% | 0.00 |
| Monthly | |||||||||||||
| DIRECT DSH PROGRAM (NON-MEDICATION SUPPORT SERVICES) | Proposed Caseload | ||||||||||||
| 0.00 | $0.00 | $0.00 | - 0 | 0% | $0.00 | 0.0% | 0.00 | ||||||
| 1 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 2 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 3 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 4 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 5 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 6 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 7 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 8 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 9 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 10 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 11 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 12 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 13 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 14 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 15 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 16 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 17 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 18 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 19 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 20 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 21 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 22 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 23 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 24 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 25 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 26 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 27 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 28 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 29 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 30 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 31 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 32 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 33 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 34 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 35 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 36 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 37 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 38 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 39 | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | |||||||
| 40 | |||||||||||||
| Subtotals | 0.00 | 0.00 | 0 | $0.00 | $0.00 | N/A | $0.00 | 0% | N/A | $0.00 | 0.0% | 0.00 |
| Monthly | ||||||||||||||
| DIRECT DSH PROGRAM (MEDICATION SUPPORT SERVICES) | ||||||||||||||
| Uyeda, Brian: This section is only for Non-Subcontract Psychiatrists and Licensed Nurse Practioners providing Medication Support Services. | Proposed Caseload | |||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $0.00 | 0.0% | 0.00 | ||||||||
| 1 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 2 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 3 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 4 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 5 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 6 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 7 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 8 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 9 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 10 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 11 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 12 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 13 | ||||||||||||||
| 0.00 | $0.00 | $0.00 | 0% | $ - 0 | $0.00 | 0.0% | 0.00 | |||||||
| 14 | ||||||||||||||
| Subtotals | 0.00 | 0.00 | 0 | $0.00 | $0.00 | N/A | $0.00 | 0% | N/A | $0.00 | 0.0% | 0 |
| SUBCONTRACTS: | ||||||||
| Subcontractors | POSITION OR AGENCY: | Total Annual Hours | FTE | Rate Per Hr. | Annual Cost | Monthly Cost | Monthly DSH | |
| 1 | 0 | 0.00 | $ | $0.00 | $0.00 | N/A | ||
| 2 | 0 | 0.00 | $ | $0.00 | $0.00 | N/A | ||
| 3 | 0 | 0.00 | $ | $0.00 | $0.00 | N/A | ||
| 4 | 0 | 0.00 | $ | $0.00 | $0.00 | N/A | ||
| 5 | 0 | 0.00 | $ | $0.00 | $0.00 | N/A | ||
| 6 | 0 | 0.00 | $ | $0.00 | $0.00 | N/A | ||
| 7 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 8 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 9 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 10 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 11 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 12 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 13 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| 14 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | N/A | ||
| Subtotals Subcontractors | 0 | 0.00 | N/A | $0.00 | $0.00 | N/A |
DSH Subcontractors (Non-Medication Support Services) Uyeda, Brian: This section is for all DSH producing subcontractors, excluding subcontractors providing Medication Support Services.
| POSITION OR AGENCY: | Total Annual Hours | FTE | Rate Per Hr. | Annual Cost | Monthly Cost | Monthly DSH | |||
| 17 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 18 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 19 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 20 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 21 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 22 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 23 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 24 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 25 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 26 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 27 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 28 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| Subtotals DSH Subcontractors (Non-Medication Support Services) | 0 | 0.00 | N/A | $0.00 | $0.00 | 0 |
DSH Subcontractors (Medication Support Services) Uyeda, Brian: This section is only for subcontractors providing Medication Support Services (i.e., Psychiatrists and Licensed Nurse Practioners).
Uyeda, Brian: This section is for all DSH producing subcontractors, excluding subcontractors providing Medication Support Services.
| POSITION OR AGENCY: | Total Annual Hours | FTE | Rate Per Hr. | Annual Cost | Monthly Cost | Monthly DSH | |||
| 31 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 32 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 33 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 34 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 35 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 36 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 37 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 38 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 40 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 41 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 42 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| 43 | 0 | 0.00 | $ - 0 | $0.00 | $0.00 | 0 | |||
| Subtotals DSH Subcontractors (Medication Support) | 0 | 0.00 | N/A | $0.00 | $0.00 | 0 | |||
| Total Subcontractors | 0.00 | 0.00 | N/A | $0.00 | $0.00 | 0 |
| DIRECT ADMINISTRATION TOTALS: | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 |
| DIRECT PROGRAM TOTALS: | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 |
| INDIRECT COSTS: | N/A | N/A | N/A | N/A | N/A |
| SUBCONTRACTS: | N/A | 0.00 | 0.00 | $0.00 | N/A |
| TOTALS: | 0.00 | 0.00 | 0.00 | $0.00 | $0.00 |
| HRs Per | FTE | Monthly | Monthly | Monthly |
| Week | percent | Proposed | Salary for | Benefits for |
| This Program | equivalent | DSH | This Program | This Program |
&"Times,Bold"&8&F &"Times,Bold"&8&P of &N &"Times,Bold"&8Prepared By: Contract Administrator
Narrative
| Proposal and Budget Guide | ||
| Indirect/Administrative Costs Narrative | Are those costs: (a) incurred for a common or joint purpose of benefiting more than one cost objective (i.e. more than one program or contract), and (b) not directly attributable to the cost of providing direct services (i.e. supportive services such as administrative management, fiscal, human resources, etc.). The Indirect/Administrative Costs cannot exceed a maximum percentage (%) of the program costs or as directed in the RFP and/or by Funding Source for the total program costs. | |
| Yes, indirect costs are both (a) incurred for a common or joint purpose of benefiting more than one cost objective, and (b) not directly attributable to the cost of providing direct services. We are using the 10% de minimis rate to set our indirect costs | ||
| Cost Allocation Plan | Narrative that details all costs, including a key for cost centers to distinguish costs that are to be allocated under the proposal. | |
| The Cost Center for this program will be "HPSP Program," ensuring direct program costs charged to the County contract are segregated within our accounting system to ensure contract compliance. Costs under this program include: |
- Staffing (Program Manager, I&R Specialist)
- Direct Financial Assistance
- Stabilization Payments
- Subcontractors - 4.5 FTE District Specific Case Managers
Leveraged funding in support of this program will be tracked separately.
| Salaries & Benefits Narrative/Details (Including Leave Accrual) | Explain in detail who in your organization is paid under this contract and provide detailed information and percentages for employee benefits and taxes. Leave Accrual: Explain the vacation/other leave accrual and charging process that your organization uses. |
| Two Orange County United Way staff person will be paid under this contract, the HPSP Program Manager and Information & Referral Specialist. United Way estimates a 20% benefits rate for staff, which includes FICA, workers compensation, EPLI, health benefits, and our PEO Insperity. Employees receive ten holidays per year, as well as one personal floating holiday. Paid Time Off is accrued at a rate of 0.05769 hours per one hour worked, for a maximum annual accrual of 15 days for years 0-5 with the company; 0.07692 hours per one hour worked, for a maximum annual accrual of 20 days for years 6-9; and 0.09615 hours per one hour worked, for a maximum annual accrual of 25 days for years 10+. | |
| Budget Narrative/Details | Include Staffing and Services & Supplies (S&S) narrative. Staffing: Narrative must describe each position in the contract (Administrative & Program) and their function(s). S&S: Give specific details on each budget line requested (Administrative & Program). Any variances from your current agreement needs to be explained for both the staffing and S&S. |
| The HPSP program funds two Orange County United Way staff persons: (1) HPSP Program Manager -funded at 0.25 FTE, with an additional 0.25 FTE dedicated to the program through leveraged funds. This position will report directly to the Executive Director of United to End Homelessness, and will oversee the program's activity. They will work closely with 211OC and our partnering district-specific service providers to ensure streamlined referrals and connections to services, and will also be responsible for receiving, reviewing, approving, and submitting requests for financial assistance through the Whatever it Takes portal. (2) 211OC Information & Referral Specialist - funded at 0.5 FTE with an additional 0.5 FTE funded through leveraged funds. This FTE will be allocated to perform initial assessments for the HPSP program. |
This program also funds district-specific case managers at our five subcontracting service providers. This includes Abrazar (1.0 FTE, serving Districts 1&2), Families Forward (1.0 FTE, serving Districts 2&3), Mercy House (1.0 FTE, serving District 2), Pathways of Hope (1.0 FTE, serving Districts 2&4), and South County Outreach (0.50 FTE, serving District 5).
Also included in this budget is Direct Financial Assistance and Stabilization Payments in the amount of $1,979,872 across the two year contract period.
United Way will additionally contribute leveraged funding to support this program, which will include the following/year:
- HPSP Program Manager - 0.25 FTE
- 211OC Information & Referral Specialist - 0.5 FTE
- District Specific Case Management Supervisors - 0.9 FTE
- Stabilization Payments - $56,264 (year 1) and $61,933 (year 2)
- Childcare Costs - $5,000
- Transportation - $18,170
- Technology Enhancements - $25,000
- Impact Management User Fees - $15,000
- Financial Payment Processing and Management - $15,000
| Program Description Documents | ||
| Program Organization Chart | Chart should be Program specific and include Title, Staff Name (if known), FTE. | |
| Please see attached Organization Chart. | ||
| Job Descriptions | Job Descriptions need to be specific to the program being proposed and their function in the program. If you propose subcontracts include information on their job function; including term, hourly rate, total cost, and scope of work. Remember: Job Descriptions need to match the titles and details provided in the Staffing S&EB section. | |
| Please see attached job descriptions for HPSP Program Manager and positions subcontracted through five district-specific service providers (Abrazar, Families Forward, Mercy House, Pathways of Hope, South County Outreach). | ||
| Program Narrative/Goals | Provide a brief description of your program (including philosophy and rationale). The what and why of your program. What are your objectives and goals. Provide information on structured activities. How you evaluate your program's success and improve any barriers/failures. |
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