Budget_Forms_6_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

Budget Forms Summary

This is a budget proposal template and narrative guide for the Orange County, California Office of Care Coordination's Rapid Rehousing Services contract. The document establishes budget structure and narrative requirements for a six-month contract period running January 1, 2027 through June 30, 2027, with a due date of October 5, 2026. The budget template includes worksheets for tracking administrative costs, program costs, staffing allocations, services and supplies, startup costs, revenue projections, and facility expenses. The proposal requires detailed narratives addressing indirect/administrative cost justification (capped at 10% of program costs or as directed by funding source), cost allocation plans, salaries and benefits details including leave accrual policies, staffing and services descriptions with variance explanations, program organization charts, job descriptions, program goals and evaluation methods, and staffing patterns with productivity metrics. All budget inputs must be hard-coded without formulas or links, and all narratives must be clearly written to align with the organization's strategic program plan and goals.

The template is designed for an actual cost reimbursement contract model and includes sections for administrative and program costs separated into salaries, benefits, services and supplies, professional services, indirect costs, subcontractor expenses, and flexible funds. Revenue sources are tracked separately, including Medi-Cal funding (Federal Financial Participation and State Match), Medicare, insurance, client fees, donations, and other county discretionary or Mental Health Services Act funding. The budget requires explanation of all variances between proposed and revised budgets, with specific guidance provided for common variance types such as staffing increases, merit increases, position changes, and cost allocation modifications. Equipment and facility costs must include detailed descriptions with original purchase dates, useful life, lease terms, square footage allocations, mortgage/rent information, and depreciation methods. The document includes an internal comment thread indicating that Eric Uxeda, Contract Administrator, has made several edits and requires amounts to match the original proposal and changes to reflect "Approved" status following budget negotiations and finalization.

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Other files

File Type Posted
Rapid_Rehousing_Services_(Addendum_#4_Revision).pdf PDF
Budget_Forms_12_month.xlsx XLSX spreadsheet
Rapid_Rehousing_Services_(Addendum_#2_Revision).pdf PDF
2._RRH_Budget_Form.xlsx XLSX spreadsheet
1._Homeless_Service_System_Pillars_Attestation.pdf PDF
3._Standards_of_Care.pdf PDF
4._Model_Contract.pdf 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 NarrativeAre 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 PlanNarrative 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/DetailsInclude 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 ChartChart should be Program specific and include Title, Staff Name (if known), FTE.
Job DescriptionsJob 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/GoalsProvide 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 PatternsStaffing should include items such as FTEs and productivity levels for each position.
Proposal Reminders
NarrativesNarratives need to be clearly written and well thought out; they should explain and mirror your strategic program plan and goals.
Inputting InformationAll inputs must be hard coded. Do not use any links or formulas to input any information into the budget package.
Questions/ClarificationsIf you have any questions or need clarification regarding completing your budget package and documents, please contact the Procurement Administrator for clarification.
Final Review and CompletionHave 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
BUDGETBUDGETVS.Increase/
FYFYPROPOSEDDecrease
ADMINISTRATIVE COSTS
Salaries$0$0$00.0%
Benefits$0$0$00.0%
Services & Supplies$0$0$00.0%
Professional Services$0$0$00.0%
Indirect Costs$0$0$00.0%
SUBTOTAL ADMIN COSTS$0$0$00.0%
Percent Administrative Cost to Program Cost0.0%0.0%0.0%
PROGRAM COSTS
Salaries$0$0$00.0%
Benefits$0$0$00.0%
Services & Supplies$0$0$00.0%
Subcontractors$0$0$00.0%
Flexible Funds$0$0$00.0%
SUBTOTAL PROGRAM COSTS$0$0$00.0%
Start-Up Costs$0$0$00.0%
TOTAL GROSS COSTS$0$0$00.0%

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$00.0%FFP %0.00%0.00%
Medi-Cal Match$0$00.0%State %0.00%0.00%
SubTotal Medi-Cal$0$0$00.0%
% Medi-Cal Offset0.0%0.0%
Other Revenue (Patient Fees/Insurance)$00.0%
Other Revenue (MHSA)$00.0%
Other Revenue (County Discretionary)$00.0%
Other Revenue_______________$00.0%
Other Revenue_______________$00.0%
SubTotal Other Revenue$0$0$00.0%
Total Revenue$0$0$00.0%
0.0%0.0%
State Funds$0$0$00.0%
(Total Cost - Total Revenue)0.0%0.0%
Maximum Obligation$0$0$00.0%
(Total Revenue + State Funds)0.0%0.0%
PROPOSEDREVISEDVARIANCE
BUDGETBUDGETREVISED
Cost/Minute CalculationFYFYVS. PROPOSED
Total Contract DSH000
Total Gross Cost$0$0$0
Total Minutes000
Cost/Min$0.00$0.00$0.00
DSH Workload Standards
MH Services000
Medication Services000
TOTAL000

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.REVISEDVARIANCE
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.REVISEDVARIANCEVARIANCE
FTEFTEvs. PROPOSEDSALARYSALARYvs. PROPOSEDVARIANCE 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.BENEFITSBENEFITSPROPOSEDREVISEDREVISEDPROPOSEDREVISEDREVISED
POSITION TITLE, IF AVAILABLE NAME, LICENSE/DEGREEFYFYFTEFYFYSALARY(FTE, Salary, DSH, and Caseload)FYFYMONTHLY DSHMONTHLY DSHvs. PROPOSEDCASELOADCASELOADvs. PROPOSED
DIRECT ADMINISTRATION
10.0000.000.00$0.00$0.00$0.00
20.0000.000.00$0.00$0.00$0.00
30.0000.000.00$0.00$0.00$0.00
40.0000.000.00$0.00$0.00$0.00
50.0000.000.00$0.00$0.00$0.00
60.0000.000.00$0.00$0.00$0.00
70.0000.000.00$0.00$0.00$0.00
80.0000.000.00$0.00$0.00$0.00
90.0000.000.00$0.00$0.00$0.00
100.0000.000.00$0.00$0.00$0.00
110.0000.000.00$0.00$0.00$0.00
120.0000.000.00$0.00$0.00$0.00
130.0000.000.00$0.00$0.00$0.00
140.0000.000.00$0.00$0.00$0.00
150.0000.000.00$0.00$0.00$0.00
160.0000.000.00$0.00$0.00$0.00
170.0000.000.00$0.00$0.00$0.00
180.0000.000.00$0.00$0.00$0.00
190.0000.000.00$0.00$0.00$0.00
200.0000.000.00$0.00$0.00$0.00
Subtotals Direct Administration0.000.000.00$0.00$0.00$0.00$0.00$0.00
PROGRAM ADMINISTRATION
10.0000.000.00$0.00$0.00$0.00
20.0000.000.00$0.00$0.00$0.00
30.0000.000.00$0.00$0.00$0.00
40.0000.000.00$0.00$0.00$0.00
50.0000.000.00$0.00$0.00$0.00
60.0000.000.00$0.00$0.00$0.00
70.0000.000.00$0.00$0.00$0.00
80.0000.000.00$0.00$0.00$0.00
90.0000.000.00$0.00$0.00$0.00
100.0000.000.00$0.00$0.00$0.00
110.0000.000.00$0.00$0.00$0.00
120.0000.000.00$0.00$0.00$0.00
130.0000.000.00$0.00$0.00$0.00
140.0000.000.00$0.00$0.00$0.00
150.0000.000.00$0.00$0.00$0.00
160.0000.000.00$0.00$0.00$0.00
170.0000.000.00$0.00$0.00$0.00
180.0000.000.00$0.00$0.00$0.00
190.0000.000.00$0.00$0.00$0.00
200.0000.000.00$0.00$0.00$0.00
Subtotals Program Admininstration0.000.000.00$0.00$0.00$0.00$0.00$0.00
DIRECT NON-DSH PROGRAM
10.0000.000.00$0.00$0.00$0.0000
20.0000.000.00$0.00$0.00$0.0000
30.0000.000.00$0.00$0.00$0.0000
40.0000.000.00$0.00$0.00$0.0000
50.0000.000.00$0.00$0.00$0.0000
60.0000.000.00$0.00$0.00$0.0000
70.0000.000.00$0.00$0.00$0.0000
80.0000.000.00$0.00$0.00$0.0000
90.0000.000.00$0.00$0.00$0.0000
100.0000.000.00$0.00$0.00$0.0000
110.0000.000.00$0.00$0.00$0.0000
120.0000.000.00$0.00$0.00$0.0000
130.0000.000.00$0.00$0.00$0.0000
140.0000.000.00$0.00$0.00$0.0000
150.0000.000.00$0.00$0.00$0.0000
160.0000.000.00$0.00$0.00$0.0000
170.0000.000.00$0.00$0.00$0.0000
180.0000.000.00$0.00$0.00$0.0000
190.0000.000.00$0.00$0.00$0.0000
200.0000.000.00$0.00$0.00$0.0000
210.0000.000.00$0.00$0.00$0.0000
220.0000.000.00$0.00$0.00$0.0000
230.0000.000.00$0.00$0.00$0.0000
240.0000.000.00$0.00$0.00$0.0000
250.0000.000.00$0.00$0.00$0.0000
260.0000.000.00$0.00$0.00$0.0000
270.0000.000.00$0.00$0.00$0.0000
280.0000.000.00$0.00$0.00$0.0000
290.0000.000.00$0.00$0.00$0.0000
300.0000.000.00$0.00$0.00$0.0000
310.0000.000.00$0.00$0.00$0.0000
320.0000.000.00$0.00$0.00$0.0000
330.0000.000.00$0.00$0.00$0.0000
340.0000.000.00$0.00$0.00$0.0000
350.0000.000.00$0.00$0.00$0.0000
360.0000.000.00$0.00$0.00$0.0000
370.0000.000.00$0.00$0.00$0.0000
380.0000.000.00$0.00$0.00$0.0000
390.0000.000.00$0.00$0.00$0.0000
400.0000.000.00$0.00$0.00$0.0000
Subtotals Direct Non-DSH Program0.000.000.00$0.00$0.00$0.00$0.00$0.00000
DIRECT DSH PROGRAM (NON-MEDICATION SUPPORT SERVICES)
10.0000.000.00$0.00$0.00$0.0000000
20.0000.000.00$0.00$0.00$0.0000000
30.0000.000.00$0.00$0.00$0.0000000
40.0000.000.00$0.00$0.00$0.0000000
50.0000.000.00$0.00$0.00$0.0000000
60.0000.000.00$0.00$0.00$0.0000000
70.0000.000.00$0.00$0.00$0.0000000
80.0000.000.00$0.00$0.00$0.0000000
90.0000.000.00$0.00$0.00$0.0000000
100.0000.000.00$0.00$0.00$0.0000000
110.0000.000.00$0.00$0.00$0.0000000
120.0000.000.00$0.00$0.00$0.0000000
130.0000.000.00$0.00$0.00$0.0000000
140.0000.000.00$0.00$0.00$0.0000000
150.0000.000.00$0.00$0.00$0.0000000
160.0000.000.00$0.00$0.00$0.0000000
170.0000.000.00$0.00$0.00$0.0000000
180.0000.000.00$0.00$0.00$0.0000000
190.0000.000.00$0.00$0.00$0.0000000
200.0000.000.00$0.00$0.00$0.0000000
210.0000.000.00$0.00$0.00$0.0000000
220.0000.000.00$0.00$0.00$0.0000000
230.0000.000.00$0.00$0.00$0.0000000
240.0000.000.00$0.00$0.00$0.0000000
250.0000.000.00$0.00$0.00$0.0000000
260.0000.000.00$0.00$0.00$0.0000000
270.0000.000.00$0.00$0.00$0.0000000
280.0000.000.00$0.00$0.00$0.0000000
290.0000.000.00$0.00$0.00$0.0000000
300.0000.000.00$0.00$0.00$0.0000000
310.0000.000.00$0.00$0.00$0.0000000
320.0000.000.00$0.00$0.00$0.0000000
330.0000.000.00$0.00$0.00$0.0000000
340.0000.000.00$0.00$0.00$0.0000000
350.0000.000.00$0.00$0.00$0.0000000
360.0000.000.00$0.00$0.00$0.0000000
370.0000.000.00$0.00$0.00$0.0000000
380.0000.000.00$0.00$0.00$0.0000000
390.0000.000.00$0.00$0.00$0.0000000
400.000.000.00$0.00$0.00$0.0000000
Subtotals Direct DSH Program0.000.000.00$0.00$0.00$0.00$0.00$0.00000000
(Non-Medication Support Services)
DIRECT DSH PROGRAM (MEDICATION SUPPORT SERVICES*)
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
0.0000.000.00$0.00$0.00$0.0000000
Subtotal Direct DSH Program0.000.000.00$0.00$0.00$0.00$0.00$0.00000000
(Medication Support Services)
PROGRAM SUBCONTRACTORS
10.0000.000.00$0.00$0.00$0.00
20.0000.000.00$0.00$0.00$0.00
30.0000.000.00$0.00$0.00$0.00
40.0000.000.00$0.00$0.00$0.00
50.0000.000.00$0.00$0.00$0.00
60.0000.000.00$0.00$0.00$0.00
70.0000.000.00$0.00$0.00$0.00
80.0000.000.00$0.00$0.00$0.00
90.0000.000.00$0.00$0.00$0.00
100.0000.000.00$0.00$0.00$0.00
110.0000.000.00$0.00$0.00$0.00
120.0000.000.00$0.00$0.00$0.00
130.0000.000.00$0.00$0.00$0.00
140.0000.000.00$0.00$0.00$0.00
Subtotals Non-DSH Subcontractors0.000.000.00$0.00$0.00$0.00
DSH Subcontractors (Non-Medication Support Services)
150.0000.000.00$0.00$0.00000
160.0000.000.00$0.00$0.00000
170.0000.000.00$0.00$0.00000
180.0000.000.00$0.00$0.00000
190.0000.000.00$0.00$0.00000
200.0000.000.00$0.00$0.00000
210.0000.000.00$0.00$0.00000
220.0000.000.00$0.00$0.00000
230.0000.000.00$0.00$0.00000
240.0000.000.00$0.00$0.00000
250.0000.000.00$0.00$0.00000
260.0000.000.00$0.00$0.00000
Subtotal DSH Subcontractors0.000.000.00$0.00$0.00$0.00000
(Non-Medication Support Services)
DSH Subcontractors (Medication Support Services)
280.0000.000.00$0.00$0.0000
290.0000.000.00$0.00$0.0000
300.0000.000.00$0.00$0.0000
310.0000.000.00$0.00$0.0000
320.0000.000.00$0.00$0.0000
330.0000.000.00$0.00$0.0000
340.0000.000.00$0.00$0.0000
350.0000.000.00$0.00$0.0000
360.0000.000.00$0.00$0.0000
370.0000.000.00$0.00$0.0000
380.0000.000.00$0.00$0.0000
390.0000.000.00$0.00$0.0000
Subtotal DSH Subcontractors0.000.000.00$0.00$0.00$0.00000
(Medication Support Services)
SUMMARY
ADMINISTRATION
Direct Administration0.000.000.00$0.00$0.00$0.00000000
Program Administration0.000.000.00$0.00$0.00$0.00000000
TOTAL ADMINISTRATION0.000.000.00$0.00$0.00$0.00000000
PROGRAM
Direct Non-DSH Program0.000.000.00$0.00$0.00$0.00000000
Direct DSH Program (Non-Medication Support Services)0.000.000.00$0.00$0.00$0.00000000
*Direct DSH Program (Medication Support Services)0.000.000.00$0.00$0.00$0.00000000
TOTAL PROGRAM0.000.000.00$0.00$0.00$0.00000000
SUBCONTRACTORS
Non-DSH Subcontractors0.000.000.00$0.00$0.00$0.00000000
DSH Subcontractors (Non-Medication Support Services)0.000.000.00$0.00$0.00$0.00000000
*DSH Subcontractors (Medication Support Services)0.000.000.00$0.00$0.00$0.00000000
TOTAL SUBCONTRACTORS:0.000.000.00$0.00$0.00$0.00000000

TOTAL CONTRACT 0.00 0.00 0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0

DSH STAFF CALCULATION
FTEANNUAL DSHModified DSHIf modified please provide supporting documentation:
Mental Health Services0.000
*Medication Support Services0.000
Total Contract DSH Staff0.0000

*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.REVISEDREVISED
BUDGETBUDGETVS.
FYFYPROPOSEDVARIANCE 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.REVISEDREVISED
BUDGETBUDGETVS.
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
January 1, 2027 - June 30, 2027
PROGRAM SUMMARY
TO:ERIC AXEFROM:
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

PROGRAMADMINFYFY
FTEFTETOTAL PROPOSEDTOTAL REVISED
NAME AND LOCATIONServices(*)STAFFSTAFFBUDGETCOSTS
0
Rapid Rehousing Services for Individuals, Families and Transitional Youth8) Other (Specify below)0.000.00$0$0
Orange County, California

GRAND TOTALS: 0.00 0.00 $0 $0

SERVICES (*)SelectBEHAVIORAL_HEALTHPUBLIC_HEALTHCORRECTIONAL_HEALTHMEDICAL_SERVICESSUBSTANCE_USE_DISORDER
Area:1) Outpatient1) ADEPT1) Radiology1) MSI1) PSN
AUTHORIZED SIGNATURE2) Full Service Partnership2) TUPP2) EMSF2) Post Custody
Program:3) Wraparound3) HIV Care Srvs (Specify below)3) HDM3) Sober Living
8) Other (Specify below)The undersigned hereby acknowledges: "I have read and understand the contents of the4) In-Home Crisis Stabilization4) HIV Prevention (Specify below)4) Ambulance4) AB 109
Rapid Rehousing Services for Individuals, Families and Transitional Youthattached budget request for County funding for the contract period specified above.5) Crisis Residential5) HIV Specialty Srv. (Specify below)5) CCS5) Narcotic Repl.
It is correct to the best of my knowledge and represents the organization's proposal for6) Outreach & Engagement6) Communicable Disease Services6) Straight Talk
the provision of services to the County. I also hereby certify that I have the authority to submit7) Prevention & Intervention7) Nutrition Services7) Res. Recovery
this information on behalf of the organization".8) Supported Employment8) Other (Specify below)8) Res Recov. & Detox
9) Multi-Service Center9) Outpatient Services
10) Training10) CalWORKS
Authorized RepresentativeDate11) 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
January 1, 2027 - June 30, 2027
TO:ERIC AXEFROM:0
COUNTY PROCUREMENT OFFICE(Corporate Name as Listed on Articles of Incorporation)
OFFICE OF CARE COORDINATION0
400 W. CIVIC CENTER DR. 3RD FL(Street Address of Admin. Offices)
SANTA ANA, CA 9270100
(City, State, Zip Code)(Telephone)
UEI# by Location

Daniel Vu: Daniel Vu:

UNIQUE ENTITY IDENTIFIER

Tax ID#
NPI #
NOTE: This document contains automatic links.FYFY
*Enter values/information into the GREEN SHADED areas only*
PROGRAMADMINCONTRACTCONTRACT
PROGRAM NAMEFTE STAFFFTE STAFFTOTAL PROPOSEDTOTAL REVISED
AND LOCATIONSERVICESPROPOSEDPROPOSEDBUDGETCOSTS

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
January 1, 2027 - June 30, 2027
PROVIDER:0
(Corporate Name as Listed on Articles of Incorporation)
0
(Street Address of Admin. Offices)
00
(City, State, Zip Code)(Telephone)
PROPOSED
I. ADMINISTRATION COSTSTOTAL
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 AMOUNTGross 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 SUPPLIESBUDGET
1Equipment( Lease) (from page 5)$ - 0
2Equipment (Owned) (from page 5)$ - 0
3Office 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 SUPPLIESBUDGET
1Equipment( Lease) (from page 5)$ - 0
2Equipment (Owned) (from page 5)$ - 0
3Office 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
1Housing
2Transportation
3Food
4Education
5Employment
6Health
7Clothing
8Enrichment Activities
9Residential Treatment
10Miscellaneous/Other
11Other __________________
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 DetailsBUDGET
Administration
1Salaries-
2Benefits
3Indirect
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
1Salaries-
2Benefits
3Indirect
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
FYFYof
BudgetedProposedIncrease%
RevenueRevenue(Decrease)Change
CLIENT FEES$ -$ - 0$ - 00.0%
RESIDENTIAL/PARTICIPANT FEES$ -$ - 0$ - 00.0%
INSURANCE$ -$ - 0$ - 00.0%
MEDI-CAL (FFP and State Match)CalAIM (TBD)$ -$ - 0$ - 00.0%
MEDICARE$ -$ - 0$ - 00.0%
FOOD STAMPS$ -$ - 0$ - 00.0%
DONATIONS$ -$ - 0$ - 00.0%
SDI$ -$ - 0$ - 00.0%
OTHER (County Discretionary)$ -$ - 0$ - 00.0%
OTHER (MHSA)$ -$ - 0$ - 00.0%
TOTAL REVENUE$0$0$ - 00.0%
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
TotalProposed
LocationFacilityAllocation
GROSS SQUARE FOOTAGEMORTGAGE INTEREST
LEASE/RENT EXPENSEPROPERTY TAXES
GROSS SQUARE FOOTAGEMORTGAGE INTEREST
LEASE/RENT EXPENSEPROPERTY TAXES
GROSS SQUARE FOOTAGEMORTGAGE INTEREST
LEASE/RENT EXPENSEPROPERTY TAXES
GROSS SQUARE FOOTAGEMORTGAGE INTEREST
LEASE/RENT EXPENSEPROPERTY 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
OWNEDto be
PurchaseorORIGINALUSEFULCharged
ITEMDateLEASEDCOSTLIFEFY
--
--
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 YouthSelectSelect
LOCATION:Orange County, CaliforniaCashYes
Describe your accounting method (select one from drop down box):AccrualNo
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, CaliforniaTOTALTOTAL
TITLE OF POSITION,HRs PerFTEMonthlyMonthlyMonthlyHourlyMonthlyPercent ofMonthlyAnnualPercent ofMonthly
(IF AVAILABLE NAME OF EMPLOYEE)WeekpercentProposedSalary forBenefits forRate forSalary forThese Srvc.Benefits forBenefits forBenefits toProposed
(IF AVAILABLE LICENSE/DEGREE)This ProgramequivalentDSHThis ProgramThis ProgramThis ProgramAll Prgrms.All Prgrms.All Prgrms.All Prgrms.Annual SalaryCaseload
DIRECT ADMINISTRATION
0.00N/A$0.00$0.000%$0.000.0%N/A
1
0.00N/A$0.00$0.000%$0.000.0%N/A
2
0.00N/A$0.00$0.000%$0.000.0%N/A
3
0.00N/A$0.00$0.000%$0.000.0%N/A
4
0.00N/A$0.00$0.000%$0.000.0%N/A
5
0.00N/A$0.00$0.000%$0.000.0%N/A
6
0.00N/A$0.00$0.000%$0.000.0%N/A
7
0.00N/A$0.00$0.000%$0.000.0%N/A
8
0.00N/A$0.00$0.000%$0.000.0%N/A
9
0.00N/A$0.00$0.000%$0.000.0%N/A
10
0.00N/A$0.00$0.000%$0.000.0%N/A
11
0.00N/A$0.00$0.000%$0.000.0%N/A
12
0.00N/A$0.00$0.000%$0.000.0%N/A
13
0.00N/A$0.00$0.000%$0.000.0%N/A
14
0.00N/A$0.00$0.000%$0.000.0%N/A
15
0.00N/A$0.00$0.000%$0.000.0%N/A
16
0.00N/A$0.00$0.000%$0.000.0%N/A
17
0.00N/A$0.00$0.000%$0.000.0%N/A
18
0.00N/A$0.00$0.000%$0.000.0%N/A
19
0.00N/A$0.00$0.000%$0.000.0%N/A
20
Subtotals0.000.000.00$0.00$0.00N/A$0.000%N/A$0.000.0%
Monthly
Proposed
PROGRAM ADMINISTRATIONCaseload
0.00N/A$0.00$0.000%$0.000.0%N/A
1
0.00N/A$0.00$0.000%$0.000.0%N/A
2
0.00N/A$0.00$0.000%$0.000.0%N/A
3
0.00N/A$0.00$0.000%$0.000.0%N/A
4
0.00N/A$0.00$0.000%$0.000.0%N/A
5
0.00N/A$0.00$0.000%$0.000.0%N/A
6
0.00N/A$0.00$0.000%$0.000.0%N/A
7
0.00N/A$0.00$0.000%$0.000.0%N/A
8
0.00N/A$0.00$0.000%$0.000.0%N/A
9
0.00N/A$0.00$0.000%$0.000.0%N/A
10
0.00N/A$0.00$0.000%$0.000.0%N/A
11
0.00N/A$0.00$0.000%$0.000.0%N/A
12
0.00N/A$0.00$0.000%$0.000.0%N/A
13
0.00N/A$0.00$0.000%$0.000.0%N/A
14
0.00N/A$0.00$0.000%$0.000.0%N/A
15
0.00N/A$0.00$0.000%$0.000.0%N/A
16
0.00N/A$0.00$0.000%$0.000.0%N/A
17
0.00N/A$0.00$0.000%$0.000.0%N/A
18
0.00N/A$0.00$0.000%$0.000.0%N/A
19
0.00N/A$0.00$0.000%$0.000.0%N/A
20
Subtotals0.000.000.00$0.00$0.00N/A$0.000%N/A$0.000.0%
Monthly
Proposed
Direct PROGRAM:Caseload
0.00N/A$0.00$0.000%$0.000.0%0.00
1
0.00N/A$0.00$0.000%$0.000.0%0.00
2
0.00N/A$0.00$0.000%$0.000.0%0.00
3
0.00N/A$0.00$0.000%$0.000.0%0.00
4
0.00N/A$0.00$0.000%$0.000.0%0.00
5
0.00N/A$0.00$0.000%$0.000.0%0.00
6
0.00N/A$0.00$0.000%$0.000.0%0.00
7
0.00N/A$0.00$0.000%$0.000.0%0.00
8
0.00N/A$0.00$0.000%$0.000.0%0.00
9
0.00N/A$0.00$0.000%$0.000.0%0.00
10
0.00N/A$0.00$0.000%$0.000.0%0.00
11
0.00N/A$0.00$0.000%$0.000.0%0.00
12
0.00N/A$0.00$0.000%$0.000.0%0.00
13
0.00N/A$0.00$0.000%$0.000.0%0.00
14
0.00N/A$0.00$0.000%$0.000.0%0.00
15
0.00N/A$0.00$0.000%$0.000.0%0.00
16
0.00N/A$0.00$0.000%$0.000.0%0.00
17
0.00N/A$0.00$0.000%$0.000.0%0.00
18
0.00N/A$0.00$0.000%$0.000.0%0.00
19
0.00N/A$0.00$0.000%$0.000.0%0.00
20
0.00N/A$0.00$0.000%$0.000.0%0.00
21
0.00N/A$0.00$0.000%$0.000.0%0.00
22
0.00N/A$0.00$0.000%$0.000.0%0.00
23
0.00N/A$0.00$0.000%$0.000.0%0.00
24
0.00N/A$0.00$0.000%$0.000.0%0.00
25
0.00N/A$0.00$0.000%$0.000.0%0.00
26
0.00N/A$0.00$0.000%$0.000.0%0.00
27
0.00N/A$0.00$0.000%$0.000.0%0.00
28
0.00N/A$0.00$0.000%$0.000.0%0.00
29
0.00N/A$0.00$0.000%$0.000.0%0.00
30
0.00N/A$0.00$0.000%$0.000.0%0.00
31
0.00N/A$0.00$0.000%$0.000.0%0.00
32
0.00N/A$0.00$0.000%$0.000.0%0.00
33
0.00N/A$0.00$0.000%$0.000.0%0.00
34
0.00N/A$0.00$0.000%$0.000.0%0.00
35
0.00N/A$0.00$0.000%$0.000.0%0.00
36
0.00N/A$0.00$0.000%$0.000.0%0.00
37
0.00N/A$0.00$0.000%$0.000.0%0.00
38
0.00N/A$0.00$0.000%$0.000.0%0.00
39
0.00N/A$0.00$0.000%$0.000.0%0.00
40
Subtotals0.000.000$0.00$0.00N/A$0.000%N/A$0.000.0%0.00
Monthly
DIRECT DSH PROGRAM (NON-MEDICATION SUPPORT SERVICES)Proposed Caseload
0.00$0.00$0.00- 00%$0.000.0%0.00
1
0.00$0.00$0.000%$0.000.0%0.00
2
0.00$0.00$0.000%$0.000.0%0.00
3
0.00$0.00$0.000%$0.000.0%0.00
4
0.00$0.00$0.000%$0.000.0%0.00
5
0.00$0.00$0.000%$0.000.0%0.00
6
0.00$0.00$0.000%$0.000.0%0.00
7
0.00$0.00$0.000%$0.000.0%0.00
8
0.00$0.00$0.000%$0.000.0%0.00
9
0.00$0.00$0.000%$0.000.0%0.00
10
0.00$0.00$0.000%$0.000.0%0.00
11
0.00$0.00$0.000%$0.000.0%0.00
12
0.00$0.00$0.000%$0.000.0%0.00
13
0.00$0.00$0.000%$0.000.0%0.00
14
0.00$0.00$0.000%$0.000.0%0.00
15
0.00$0.00$0.000%$0.000.0%0.00
16
0.00$0.00$0.000%$0.000.0%0.00
17
0.00$0.00$0.000%$0.000.0%0.00
18
0.00$0.00$0.000%$0.000.0%0.00
19
0.00$0.00$0.000%$0.000.0%0.00
20
0.00$0.00$0.000%$0.000.0%0.00
21
0.00$0.00$0.000%$0.000.0%0.00
22
0.00$0.00$0.000%$0.000.0%0.00
23
0.00$0.00$0.000%$0.000.0%0.00
24
0.00$0.00$0.000%$0.000.0%0.00
25
0.00$0.00$0.000%$0.000.0%0.00
26
0.00$0.00$0.000%$0.000.0%0.00
27
0.00$0.00$0.000%$0.000.0%0.00
28
0.00$0.00$0.000%$0.000.0%0.00
29
0.00$0.00$0.000%$0.000.0%0.00
30
0.00$0.00$0.000%$0.000.0%0.00
31
0.00$0.00$0.000%$0.000.0%0.00
32
0.00$0.00$0.000%$0.000.0%0.00
33
0.00$0.00$0.000%$0.000.0%0.00
34
0.00$0.00$0.000%$0.000.0%0.00
35
0.00$0.00$0.000%$0.000.0%0.00
36
0.00$0.00$0.000%$0.000.0%0.00
37
0.00$0.00$0.000%$0.000.0%0.00
38
0.00$0.00$0.000%$0.000.0%0.00
39
0.00$0.00$0.000%$0.000.0%0.00
40
Subtotals0.000.000$0.00$0.00N/A$0.000%N/A$0.000.0%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$0.000%$0.000.0%0.00
1
0.00$0.00$0.000%$ - 0$0.000.0%0.00
2
0.00$0.00$0.000%$ - 0$0.000.0%0.00
3
0.00$0.00$0.000%$ - 0$0.000.0%0.00
4
0.00$0.00$0.000%$ - 0$0.000.0%0.00
5
0.00$0.00$0.000%$ - 0$0.000.0%0.00
6
0.00$0.00$0.000%$ - 0$0.000.0%0.00
7
0.00$0.00$0.000%$ - 0$0.000.0%0.00
8
0.00$0.00$0.000%$ - 0$0.000.0%0.00
9
0.00$0.00$0.000%$ - 0$0.000.0%0.00
10
0.00$0.00$0.000%$ - 0$0.000.0%0.00
11
0.00$0.00$0.000%$ - 0$0.000.0%0.00
12
0.00$0.00$0.000%$ - 0$0.000.0%0.00
13
0.00$0.00$0.000%$ - 0$0.000.0%0.00
14
Subtotals0.000.000$0.00$0.00N/A$0.000%N/A$0.000.0%0
SUBCONTRACTS:
SubcontractorsPOSITION OR AGENCY:Total Annual HoursFTERate Per Hr.Annual CostMonthly CostMonthly DSH
100.00$$0.00$0.00N/A
200.00$$0.00$0.00N/A
300.00$$0.00$0.00N/A
400.00$$0.00$0.00N/A
500.00$$0.00$0.00N/A
600.00$$0.00$0.00N/A
700.00$ - 0$0.00$0.00N/A
800.00$ - 0$0.00$0.00N/A
900.00$ - 0$0.00$0.00N/A
1000.00$ - 0$0.00$0.00N/A
1100.00$ - 0$0.00$0.00N/A
1200.00$ - 0$0.00$0.00N/A
1300.00$ - 0$0.00$0.00N/A
1400.00$ - 0$0.00$0.00N/A
Subtotals Subcontractors00.00N/A$0.00$0.00N/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 HoursFTERate Per Hr.Annual CostMonthly CostMonthly DSH
1700.00$ - 0$0.00$0.000
1800.00$ - 0$0.00$0.000
1900.00$ - 0$0.00$0.000
2000.00$ - 0$0.00$0.000
2100.00$ - 0$0.00$0.000
2200.00$ - 0$0.00$0.000
2300.00$ - 0$0.00$0.000
2400.00$ - 0$0.00$0.000
2500.00$ - 0$0.00$0.000
2600.00$ - 0$0.00$0.000
2700.00$ - 0$0.00$0.000
2800.00$ - 0$0.00$0.000
Subtotals DSH Subcontractors (Non-Medication Support Services)00.00N/A$0.00$0.000

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 HoursFTERate Per Hr.Annual CostMonthly CostMonthly DSH
3100.00$ - 0$0.00$0.000
3200.00$ - 0$0.00$0.000
3300.00$ - 0$0.00$0.000
3400.00$ - 0$0.00$0.000
3500.00$ - 0$0.00$0.000
3600.00$ - 0$0.00$0.000
3700.00$ - 0$0.00$0.000
3800.00$ - 0$0.00$0.000
4000.00$ - 0$0.00$0.000
4100.00$ - 0$0.00$0.000
4200.00$ - 0$0.00$0.000
4300.00$ - 0$0.00$0.000
Subtotals DSH Subcontractors (Medication Support)00.00N/A$0.00$0.000
Total Subcontractors0.000.00N/A$0.00$0.000
DIRECT ADMINISTRATION TOTALS:0.000.000.00$0.00$0.00
DIRECT PROGRAM TOTALS:0.000.000.00$0.00$0.00
INDIRECT COSTS:N/AN/AN/AN/AN/A
SUBCONTRACTS:N/A0.000.00$0.00N/A
TOTALS:0.000.000.00$0.00$0.00
HRs PerFTEMonthlyMonthlyMonthly
WeekpercentProposedSalary forBenefits for
This ProgramequivalentDSHThis ProgramThis 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 NarrativeAre 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 PlanNarrative 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/DetailsInclude 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 ChartChart should be Program specific and include Title, Staff Name (if known), FTE.
Please see attached Organization Chart.
Job DescriptionsJob 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/GoalsProvide 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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