Exhibit_E-BHFOperatingBudgetTemplate.xlsx
XLSX spreadsheet 15 KB Posted
- Solicitation number
- 2024HCA8
- Issued by
- Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Raft Island CDP, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington
About this file
This document is a template for an operating budget for an Opioid Treatment Program (OTP) facility. The Washington State Health Care Authority and the Department of Commerce have initiated a Request for Application (RFA) to solicit applications from Opioid Treatment Providers interested in building or retrofitting an existing building for an OTP facility. The RFA covers projects in multiple jurisdictions within Washington state, including counties and cities. Applicants must complete the provided operating budget template, which includes columns for actual operating costs in the year before the capital project and projected operations for the twelve-month period after project completion.
The operating budget template covers revenue sources such as grants, contracts, Medicaid, and fee-for-service, as well as staffing and operating expenses. Applicants must provide detailed projections for various staffing positions and operating expense categories. The template also requires applicants to calculate net income. The RFA does not provide any details on pricing terms, set-asides, incumbents, funding requirements or sources, or other salient financial information.
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Other files
| File | Type | Posted |
|---|---|---|
| 2024HCA8-OTPFacilityBuildRetrofit-Final.pdf | ||
| 2024HCA8_Q&A_Pre-Application_Conference.xlsx | XLSX spreadsheet | |
| Exhibit_B-1_Draft_Contract.docx | DOCX document | |
| 2024HCA8-Amendment_1.pdf | ||
| Exhibit_A-Applicant_Forms_and_Certifications.docx | DOCX document | |
| Exhibit_B-2-Draft_INA.docx | DOCX document |
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Text version
Sheet1 INSTRUCTIONS: If your organization already has an operating budget formatted similar to the template below, you may upload your document into the ZoomGrants application. Submitting paragraphs of text (narrative description) is not an acceptable format for your operating budget.
If your organization does not have an operating budget format similar to the template below, please complete the template provided by Commerce and upload into the ZoomGrants application.
There are two columns to this operating budget that reflect the time period for which information is being requested.
Column 1: Column 1 should be completed by applicants who are proposing a capital project in a facility that is already operational (e.g facility expansions or rehabs). We want to see actual operating costs for six to twelve months of operations in the year before the capital project was started. If your proposed project is not in a facility that is already operational, you do not need to complete column 1.
Column 2: All applicants must complete column 2. This colum represents the time period starting after completion of the proposed capital project and must show projected operations for a twelve month period of time.
| OPERATING REVENUES | ||
| Column 1 | Column 2 | |
| Start Date of Operating Budget: | MM/DD/YY | MM/DD/YY |
| End Date of Operating Budget: | MM/DD/YY | MM/DD/YY |
| Grants and Contracts | $ - | $ - |
| Medicaid | $ - | $ - |
| Fee-for-service | $ - | $ - |
| Other -Specify | $ - | $ - |
| TOTAL OPERATING REVENUES | $ - | $ - |
| *Add additional lines as needed. Edit types of Operative Revenues to match your organization. |
| STAFFING | |||||
| Column 1 | Column 2 | ||||
| POSITION | Total FTEs | TOTAL Salaries/Benefits/ | |||
| Taxes | Total FTEs | TOTAL Salaries/Benefits/ |
Taxes
| Program Director | $ - | $ - | ||
| Supervisor/ RN | $ - | $ - | ||
| Licensed Staff | $ - | $ - | ||
| Caregivers | $ - | $ - | ||
| Administration | $ - | $ - | ||
| Maintenance | $ - | $ - | ||
| Housekeeping & Janitorial | $ - | $ - | ||
| Other - Specify | $ - | $ - | ||
| TOTAL STAFFING | 0 | $ - | 0 | $ - |
| *Adjust staffing position titles to match your organization |
| OPERATING EXPENSES | ||
| Column 1 | Column 2 | |
| Salaries, Benefits & Taxes | $ - | $ - |
| Rent | $ - | $ - |
| Utilities | $ - | $ - |
| Office Supplies | $ - | $ - |
| Administrative (telephone, security services, dues/subscriptions, etc.) | $ - | $ - |
| Insurance | $ - | $ - |
| Taxes | $ - | |
| Training | $ - | $ - |
| Travel/Transportation | $ - | $ - |
| Marketing | $ - | $ - |
| IT/IS Costs (software, maintenance, etc.) | $ - | $ - |
| Contracted Services | $ - | $ - |
| Building Service and Maintenance | $ - | $ - |
| Client Related Expenses | ||
| Patient Essentials | $ - | $ - |
| Janitorial Costs | $ - | $ - |
| Misc. Costs | $ - | $ - |
| Other - Specify | $ - | $ - |
| TOTAL OPERATING EXPENSES | $ - | $ - |
| *Add additional lines as needed. Edit types of Operating Expenses to match your organization. |
| Total Operating Revenues | $ - | $ - |
| Total Staffing & Operating Expenses | $ - | $ - |
| Net Income | $ - | $ - |
Operating Budget Template
File details come from the government source that posted it. Updated .