ESBD_383500_1732791555417_2025_Budget Allocation Form_State Services.xlsx

XLSX spreadsheet 35 KB Posted Nov 28, 2024

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

About this file

Written by GovTribe AI · Nov 28, 2024

This is a State Services Budget Allocation Form template for AIDS/HIV services, containing sections for various medical and support services including Early Intervention, Health Insurance Premium Sharing, Home Health Care, Medical Case Management, and multiple other healthcare and support programs. The form is structured for a 5-month budget period and includes detailed line items for personnel, fringe benefits, travel, equipment, supplies, contractual services, and other expenses.

The budget template includes calculation fields for core medical services and support services percentages, with an indirect cost rate section. The form is currently blank with all monetary fields showing zero values, intended to be completed by service providers. The document includes 31 different service categories spread across both medical and support services, with built-in formulas to calculate budget allocations and percentages of total budget for each service category.

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ESBD_383500_1732791774966_Appendix C - General Provisions.docx	DOCX document	Dec 9, 2024
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ESBD_383500_1732791868465_Appendix G - Priority Setting and Resource Allocation Determination.docx	DOCX document	Dec 9, 2024
ESBD_383500_1733770663509_STDC_Competitive_Far West Texas RFP No 25-01.02.03._RW-SS-HOPWA Funds_Addendum 2.pdf	PDF	Dec 9, 2024
ESBD_383500_1732791815964_Appendix F - Assurances.docx	DOCX document	Dec 9, 2024
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ESBD_383500_1732791906028_Appendix I - Letter of Intent.doc	DOC document	Dec 9, 2024
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ESBD_383500_1734130742992_Far West Texas RFP No. 25-01.02.03 Question and Answers Publication.pdf	PDF	Dec 9, 2024
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ESBD_383500_1732791555417_2025_Budget Allocation Form_State Services.xlsx	XLSX spreadsheet	Dec 9, 2024
ESBD_383500_1732791775452_Appendix D - Program Requirements for HIV Contracts.docx	DOCX document	Dec 9, 2024
ESBD_383500_1732791906643_Appendix J - STDC RFP Review and Score Tool.xlsx	XLSX spreadsheet	Dec 9, 2024
ESBD_383500_1732791718095_Appendix A - Funding Available 25-26.docx	DOCX document	Dec 9, 2024
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ESBD_383500_1732791718095_Appendix A - Funding Available 25-26.docx	DOCX document	Nov 28, 2024
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ESBD_383500_1732791450490_2025_Categorical Budget Form_Ryan White.xls	XLS spreadsheet	Nov 28, 2024
ESBD_383500_1732791869067_Appendix H - RFP Priorities and Allocations.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791815964_Appendix F - Assurances.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791533102_2025_Budget Allocation Form_Ryan White.xlsx	XLSX spreadsheet	Nov 28, 2024
ESBD_383500_1732791906643_Appendix J - STDC RFP Review and Score Tool.xlsx	XLSX spreadsheet	Nov 28, 2024
ESBD_383500_1732791162051_RFP Narrative Forms.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791815455_Appendix E - DSHS TB-HIV-STD Security and Database Account Management and TCT.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791868465_Appendix G - Priority Setting and Resource Allocation Determination.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791132499_RFP Instructions and Guidance.pdf	PDF	Nov 28, 2024
ESBD_383500_1732791774966_Appendix C - General Provisions.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791775452_Appendix D - Program Requirements for HIV Contracts.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791051145_STDC_Competitive_Far West Texas RFP No 25-01.02.03._RW-SS-HOPWA Funds.pdf	PDF	Nov 28, 2024
ESBD_383500_1732791718649_Appendix B - HIV-STD Policies and Procedures including Resources.docx	DOCX document	Nov 28, 2024
ESBD_383500_1732791489407_2025_Categorical Budget Form_HOPWA.xls	XLS spreadsheet	Nov 28, 2024
ESBD_383500_1732791906028_Appendix I - Letter of Intent.doc	DOC document	Nov 28, 2024
ESBD_383500_1732791601147_2025_Subcontractor Data Sheet_State Services.xlsx	XLSX spreadsheet	Nov 28, 2024

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SS Budget Allocation

	LEGAL BUSINESS NAME	STATE SERVICES BUDGET	Early Intervention Services	Health Insurance Premium and Cost Sharing	Home and Community Based Health Services	Home Health Care	Hospice Services	Local AIDS Pharmaceutical Assistance/CSA	Medical Nutrition Therapy	Medical Case Mgmt	Mental Health Services	Oral Health Care	Outpatient Ambulatory Health Services	Substance Abuse Outpatient Care	Child Care Services	Emergency Financial Assistance	Food Bank/Home-Delivered Meals	Health Education/Risk Reduction (HE/RR)	Housing Services	Linguistics Services	Medical Transportation Services	Non-Medical Case Mgmt	Other Professional Services	Outreach Services	Psychosocial Support Services	Referral for Health Care/ Supportive Services	Rehabilitation Services	Respite Care	Substance Abuse Services (Residential)	Treatment Adherence (Non-Medical)	Other Services	Admin/
Operating		Difference
	DESCRIPTION																																Total
	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 Budget	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!	ERROR:#DIV/0!

TOTAL OF CORE MEDICAL SERVICES $ - 0 %

TOTAL OF SUPPORT SERVICES $ - 0 %

&"Arial,Bold"

BUDGET ALLOCATION FORM

File details come from the government source that posted it. Updated Nov 28, 2024.