Budget Justification HRSA-21-140 SAMPLE.pdf

ATTACHMENT 2: BUDGET JUSTIFICATION - HRSA-21-140

XYZ Northern Medical (SAMPLE) Total Requested - $1,000,000

Category Budget (1-Year)

Salaries & Wages $286,500 Fringe Benefits $100,275 Total Personnel: $386,775 Travel $5,200 Equipment $75,000 Supplies $1,000 Contractual $462,257 Other $6,800 Total Direct Costs: $937,032 Indirect Costs (14% of MTDC)* $62,968 Totals: $1,000,000

APPLICANT Organization: XYZ Northern Medical - $1,000,000

PERSONNEL: $386,775

Project Director (1.0 FTE): Ms. Martinez will be responsible for establishing the Community-based Vaccine Outreach Project in local counties. She will oversee daily operations, leverage existing partnerships in high-need communities, provide overall project monitoring ensuring timelines are met, and meet all federal reporting requirements. Salary of $99,000 is requested. Fringe requested is $34,650.

Co-Project Director (.5 FTE): Mr. Duo, MSW will mobilize, supervise and monitor the progress of community health workers and social support specialists. Salary is requested $39,000. Fringe request is $13,650.

Evaluator (.10 FTE): Dr. Amal, PhD will lead this activity to develop and track survey results, monitor progress and make adjustments as needed. Salary request is $12,500. Fringe requested is $4,375.

TBA, Community Health Workers (4 FTEs): The CHW/case managers will do door-to-door outreach directly in low-vaccine rate neighborhoods to educate them about the vaccine, assist them in making a vaccine appointment, provide them with resources to find convenient vaccine locations, and provide community member with transportation or other needs to get to a vaccination site. Total requested is for 4 CHW @ $34,000 each. Total salaries requested for 4 CHW = $136,000. Total fringe requested for 4 CHWs is $47,600.

Total Salaries: $286,500

Fringe benefits are calculated at 35% for all XYZ personnel and comprise of Social Security and Medicare taxes, health insurance, life insurance, and retirement plan. Total Fringe Benefits: $100,275.

Total Personnel (Salaries & Fringe): $386,775

CONTRACTUAL: $462,257

We will subcontract with two partner organizations – Northwest County Services and The Wellness Consortium – to provide trainings, data collection and modeling, targeted outreach, and other grassroots public health activities to support vaccination efforts. This covers the partner personnel, supplies, travel and materials. (See sub contractual details). Total Contractual: $462,257.

EQUIPMENT: $75,000

Multi-use Vehicle: We will purchase a handicap/delivery vehicle with wheelchair conversion to take community members without transportation to vaccine sites. $50,000.

Van: General use by community health and outreach workers to travel to hard-to-reach communities. $25,000. Total Equipment: $75,000.

TRAVEL: Approximately $5,200 will be used for local and regional travel. This funding will support travel for the Project Director and 2 staff to travel to various outreach sites throughout the project area. Travel is calculated at the federally reimbursed rate. Total Travel: $5,200

SUPPLIES: General office supplies, $1,000 based on 10 staff and $100 per staff person. Our department provides basic office supplies (printer paper, pens, paper clips, binder clips, staplers) to each employee at a cost of $100/employee.

Total Supplies: $1,000.

OTHER: Approximately $1,000 will be spent for purchasing of Zoom or similar online conference services for teleconferences, in order to ensure that each site can have communication outlets for meetings (10 licenses with $100/license).

Incentives: Approximately $5,800 will be used to purchase and distribute gift cards ($15-20 increments) to incentivize community members to get both vaccinations. Appropriate cards will be purchased for grocery stores, Target, or similar.

Total Other: $6,800.

INDIRECT COSTS/OVERHEAD: An indirect cost rate of 14% is applied to modified total direct costs (MTDC) for XYZ Northern. MTDC include all salaries and wages, fringe benefits, supplies, travel, other and up to the first $25,000 of each subcontract. XYZ Northern Medical has a negotiated indirect cost rate with DCA. Total Modified Direct Costs = $449,775. *Indirect Costs at 14% of MTDC =$62,968.

Subcontracts:

Subcontract: Partner A: NORTHWEST County Service - $318,320

Co-Project Director (1.0 FTE): Dr Warbler, PhD will direct As Co-Project Director, she will be responsible for the overall delivery of all activities under objectives 1-5 and requested and required reports. Salary requested: $86,000.

TBA, Community Outreach Workers (5 FTEs): Case managers and social workers will do door-to-door outreach directly in low-vaccine rate neighborhoods, assist them in making a vaccine appointments, providing information and resources to find convenient vaccine locations, and provide community member with transportation or other needs to get to a vaccination site. Total requested is for 5 Outreach workers @ approximately $43,309. Total requested = $216,545.

TBA, 2 Students in the Center for Education (CE): Students at hourly Rate $15 for 625 hours will be recruited. These positions will be filled by healthcare IT students to collect data for Objectives 2-4. Total requested for these students will be $9,375.

Total Subcontract Partner A Personnel: $311,920.

TRAVEL: A total of $4,000 is requested for local and regional travel including mileage to required site meetings and regional travel to partner locations for meetings. Local travel is estimated reimbursed at the Federal rate. Total Partner A Travel: $4,000

SUPPLIES: It is anticipated that $2,400 will be spent for general disposable supplies at $200.00 a month for 12 months to support meetings across the target communities. Total Partner A Supplies: $2,400.

EQUIPMENT: No equipment costs are requested.

INDIRECT COSTS/OVERHEAD: None requested.

Subcontract: Partner B: THE WELLNESS CONSORTIUM - $143,937

Co-Project Director (1.0 FTE): Mr. Cade will direct the data mapping and predictive modeling. He will coordinate all meetings and reports with partners on health data and predicting community spread of COVID-19. The salary amount of $50,537 will support this effort for a minimum of 700 hours.

Administrative Support Staff (3 FTEs): Staff will support scheduling and coordinating events, including travel for collecting data and meeting. They will distribute and manage supplies and assist with monitoring and planning and assist students and interns. 3 FTEs x $25,000 = $75,000 requested.

TBA, 2 Students @ Hourly Rate $15 for 900 hours. These positions will be filled by healthcare IT students to collect data for Objectives 2-4. Total requested for these students will be $13,500.

Total Subcontract Partner B Personnel: $135,000

TRAVEL: It is anticipated that approximately $3,700 will be used for local and regional travel. This funding will support travel for the Project Director and 1 staff to travel to partnership meetings, and for the purposes of collecting data in the region regarding COVID-19 affects and community spread. ($1,850 per person x 2 workers = $2,700). Travel is calculated at the federally reimbursed rate. Total Partner B Travel: $3,700.

SUPPLIES: It is anticipated that $1,200 will be spent for general disposable supplies at $100 a month for 12 months to support meetings across the target communities. Total Partner B Supplies: $1,200.

EQUIPMENT: No equipment costs are requested.

INDIRECT COSTS/OVERHEAD: None Requested.

Total Sub contractual: $462,257