Residential Budget Template.xlsx

XLSX spreadsheet 30 KB Posted

Attached to
RFP 25 134 SUDRS Withdrawal Management and Residential Treatment Services
Solicitation number
DBHE26-ADMN-6449
Issued by
San Bernardino County, San Francisco City, California

About this file

Written by GovTribe AI ·

This is a residential budget template document from the San Bernardino County Department of Behavioral Health for Substance Use Disorder and Recovery Services contracts. The template covers three fiscal years: FY26/27 (February 1, 2027 to June 30, 2027, 5 months), FY27/28 (July 1, 2027 to June 30, 2028, 12 months), and FY28/29 (July 1, 2028 to December 31, 2028, 6 months). The RFP 25-134 for Withdrawal Management and Residential Treatment Services requires questions to be submitted by noon on Thursday, August 6, 2026, with proposals due by 4:00 PM on Thursday, August 20, 2026, to DBH Administration at 550 Hospitality Lane, 1st Floor, San Bernardino, CA 92415-0026.

The budget template establishes contracted rates for multiple service categories including Residential Withdrawal Management at $380.16 per bed day, Standard Residential services at $207.49 per bed day, Enhanced Residential services at $286.59 per bed day, Specialized Residential services at $277.73 per bed day, Childcare at $78.00 per unit, and Room & Board at $60.00 per unit. Additionally, the contract covers stand-alone services for Medications for Addiction Treatment (MAT), Care Coordination, Peer Support Services, and Recovery Services. Funding sources include Medi-Cal, Block Grant, Opioid Settlement Realignment, and CalWORKs. Federal funding includes the Substance Abuse Prevention & Treatment Block Grant (CFDA 93.959) and the Medi-Cal Assistance Program (CFDA 93.778), both administered through the State DHCS.

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Other files

File Type Posted
Addendum No. 2 RFP 25 134 Floor Plan.pdf PDF
RFP DBH - 25-134 Residential Treatment Fillable Forms FINAL.docx DOCX document
RFP DBH - 25-134 Residential Treatment FINAL~1.pdf PDF
Addendum No. 1 RFP 25 134 Q and A FINAL.pdf PDF

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FY2627

SAN BERNARDINO COUNTY
DEPARTMENT OF BEHAVIORAL HEALTH
Substance Use Disorder and Recovery Services - Residential Contract
SCHEDULE A - Proposed Budget
BUDGET PERIOD:FY26/27 February 1, 2027 to June 30, 2027 (5 Months)
Contractor Name:Prepared by:
Facility Address: 1Title:
Facility Address: 2Date Prepared:
Facility Address: 3
Provider Number (36xx/86xx):
Maximum Annual Obilgation:$ - 0

FUNDING SOURCE Medi-Cal Block Grant Opioid Settlement Realignment CalWORKs TOTAL

3.2 Residential Withdrawal Management
Cost of Services$ - 0
Bed Days0
Contracted Rate$380.16$380.16$380.16$380.16$380.16
3.1 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$207.49$207.49$207.49$207.49$207.49
3.3 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$286.59$286.59$286.59$286.59$286.59
3.5 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$277.73$277.73$277.73$277.73$277.73
Childcare
Cost of Services$ - 0
Units0000
Contracted Rate$78.00$78.00$78.00
Room & Board
Cost of Services$ - 0
R&B Units0000
Contracted Rate$60.00$60.00$60.00
Stand Alone Services
Medications for Addiction
Treatment (MAT)$ - 0
Care Coordination$ - 0
Peer Support Services$ - 0
Recovery Services$ - 0
SUMMARY OF ALL SERVICES
Total Bed Days000000
R&B Units0000
Total Cost of Services$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
* Round Costs to nearest dollar

APPROVED BY:

PROVIDER AUTHORIZED SIGNATURE PRINTED NAME DATE

DBH PROVIDER SUPPORT AUTHORIZED SIGNATURE PRINTED NAME DATE

DBH PROGRAM MANAGER or DESIGNEE SIGNATURE PRINTED NAME DATE

Federal funds include:
CFDA TitleCFDA No.Award NameFederal AgencyPass-through

Agency

Substance Abuse Prevention & Treatment Block Grant93.959SABGSAMHSAState DHCS
Medi-Cal Assistance Program93.778DMC-ODSDHHSState DHCS

FY2728

SAN BERNARDINO COUNTY
DEPARTMENT OF BEHAVIORAL HEALTH
Substance Use Disorder and Recovery Services - Residential Contract
SCHEDULE A - Proposed Budget
BUDGET PERIOD:FY27/28 July 1, 2027 to June 1, 2028
Contractor Name:Prepared by:
Facility Address: 1Title:
Facility Address: 2Date Prepared:
Facility Address: 3
Provider Number (36xx/86xx):
Maximum Annual Obilgation:$ - 0

FUNDING SOURCE Medi-Cal Block Grant Opioid Settlement Realignment CalWORKs TOTAL

3.2 Residential Withdrawal Management
Cost of Services$ - 0
Bed Days0
Contracted Rate$380.16$380.16$380.16$380.16$380.16
3.1 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$207.49$207.49$207.49$207.49$207.49
3.3 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$286.59$286.59$286.59$286.59$286.59
3.5 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$277.73$277.73$277.73$277.73$277.73
Childcare
Cost of Services$ - 0
Units0000
Contracted Rate$78.00$78.00$78.00
Room & Board
Cost of Services$ - 0
R&B Units0000
Contracted Rate$60.00$60.00$60.00
Stand Alone Services
Medications for Addiction
Treatment (MAT)$ - 0
Care Coordination$ - 0
Peer Support Services$ - 0
Recovery Services$ - 0
SUMMARY OF ALL SERVICES
Total Bed Days000000
R&B Units0000
Total Cost of Services$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
* Round Costs to nearest dollar

APPROVED BY:

PROVIDER AUTHORIZED SIGNATURE PRINTED NAME DATE

DBH PROVIDER SUPPORT AUTHORIZED SIGNATURE PRINTED NAME DATE

DBH PROGRAM MANAGER or DESIGNEE SIGNATURE PRINTED NAME DATE

Federal funds include:
CFDA TitleCFDA No.Award NameFederal AgencyPass-through

Agency

Substance Abuse Prevention & Treatment Block Grant93.959SABGSAMHSAState DHCS
Medi-Cal Assistance Program93.778DMC-ODSDHHSState DHCS

FY2829

SAN BERNARDINO COUNTY
DEPARTMENT OF BEHAVIORAL HEALTH
Substance Use Disorder and Recovery Services - Residential Contract
SCHEDULE A - Proposed Budget
BUDGET PERIOD:FY28/29 July 1, 2028 to December 31, 2028 (6 Months)
Contractor Name:Prepared by:
Facility Address: 1Title:
Facility Address: 2Date Prepared:
Facility Address: 3
Provider Number (36xx/86xx):
Maximum Annual Obilgation:$ - 0

FUNDING SOURCE Medi-Cal Block Grant Opioid Settlement Realignment CalWORKs TOTAL

3.2 Residential Withdrawal Management
Cost of Services$ - 0
Bed Days0
Contracted Rate$380.16$380.16$380.16$380.16$380.16
3.1 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$207.49$207.49$207.49$207.49$207.49
3.3 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$286.59$286.59$286.59$286.59$286.59
3.5 Residential
Cost of Services$ - 0
Bed Days0
Contracted Rate$277.73$277.73$277.73$277.73$277.73
Childcare
Cost of Services$ - 0
Units0000
Contracted Rate$78.00$78.00$78.00
Room & Board
Cost of Services$ - 0
R&B Units0000
Contracted Rate$60.00$60.00$60.00
Stand Alone Services
Medications for Addiction
Treatment (MAT)$ - 0
Care Coordination$ - 0
Peer Support Services$ - 0
Recovery Services$ - 0
SUMMARY OF ALL SERVICES
Total Bed Days000000
R&B Units0000
Total Cost of Services$ - 0$ - 0$ - 0$ - 0$ - 0$ - 0
* Round Costs to nearest dollar

APPROVED BY:

PROVIDER AUTHORIZED SIGNATURE PRINTED NAME DATE

DBH PROVIDER SUPPORT AUTHORIZED SIGNATURE PRINTED NAME DATE

DBH PROGRAM MANAGER or DESIGNEE SIGNATURE PRINTED NAME DATE

Federal funds include:
CFDA TitleCFDA No.Award NameFederal AgencyPass-through

Agency

Substance Abuse Prevention & Treatment Block Grant93.959SABGSAMHSAState DHCS
Medi-Cal Assistance Program93.778DMC-ODSDHHSState DHCS

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