ESBD_383500_1732791533102_2025_Budget Allocation Form_Ryan White.xlsx

35 KB Posted

Attached to
STDC Far West Texas RFP No 25-01. 02. 03.
Solicitation number
STDC_FARWEST-TEXAS_RFP-NO_25-01.02.03.
Issued by
Comal County, Texas

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Written by GovTribe AI ·

This is a blank Ryan White Budget Allocation Form template that outlines the budget structure for Ryan White program services. The form is organized into core medical services and support services categories, with specific line items for Early Intervention Services, Health Insurance Premium and Cost Sharing, Home and Community Based Health Services, Medical Case Management, Mental Health Services, Oral Health Care, and various other medical and support service categories.

The budget template is structured into seven main cost categories: Personnel, Fringe Benefits, Travel, Equipment, Supplies, Contractual, and Other, with provisions for indirect cost calculations. The personnel section allows for detailed staff allocation calculations based on monthly rates and time percentages over a 5-month period. All sections include spaces for allocation across different service categories, with automatic calculation of totals and percentage distributions, though the template is currently unpopulated with no actual budget figures entered.

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RW Budget Allocation

LEGAL BUSINESS NAMERYAN WHITE BUDGETEarly Intervention ServicesHealth Insurance Premium and Cost SharingHome and Community Based Health ServicesHome Health CareHospice ServicesLocal AIDS Pharmaceutical Assistance/CSAMedical Nutrition TherapyMedical Case MgmtMental Health ServicesOral Health CareOutpatient Ambulatory Health ServicesSubstance Abuse Outpatient CareChild Care ServicesEmergency Financial AssistanceFood Bank/Home-Delivered MealsHealth Education/Risk Reduction (HE/RR)Housing ServicesLinguistics ServicesMedical Transportation ServicesNon-Medical Case MgmtOther Professional ServicesOutreach ServicesPsychosocial Support ServicesReferral for Health Care/ Supportive ServicesRehabilitation ServicesRespite CareSubstance Abuse Services (Residential)Treatment Adherence (Non-Medical)Other ServicesAdmin/
OperatingDifference
DESCRIPTIONTotal
A. PERSONNEL
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
Job Title (Name of Staff) $/month x % time charged to funding source x 5 months =$ - 0- 0- 0
PERSONNEL TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
B. FRINGE BENEFITS
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
FRINGE BENEFITS TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
C. TRAVEL
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
TRAVEL TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
D. EQUIPMENT
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
EQUIPMENT TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
E. 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
SUPPLIES TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
F. CONTRACTUAL
Description/Justification:$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
CONTRACTUAL TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
G. OTHER
Description/Justification:$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
$ - 0- 0- 0
OTHER TOTAL$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
Indirect Cost Rate%%
Total Indirect Cost$ - 0- 0- 0- 0
- 0
TOTAL BUDGET$ - 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0- 0
% of Total BudgetERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!ERROR:#DIV/0!

TOTAL OF CORE MEDICAL SERVICES $ - 0 %

TOTAL OF SUPPORT SERVICES $ - 0 %

&"Arial,Bold"

BUDGET ALLOCATION FORM

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