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pdfMFP_Budget_Workbook (005) / WFPB Instructions
Section A. Instructions for Completing the MFP Worksheet for Proposed Budget (WFPB) Revised 12/09/2020. Instructions for
completing the Budget Narrative are located on each spreadsheet with the Budget Narrative Workbook.
Please refer to the most recent ABCD Forms for Actual Expenditures.
Please fill in the cells highlighted in YELLOW. All other cells will auto populate.
** Note: This WFPB will be used for FY 2020 – FY 2023. For FY 2021, you will use the same version of the report submitted for
FY 2020, and only update new fields.
Step 1 – Fill in the following yellow highlighted cells about your program and report: (1) Date of Report, (2) State, (3) Award
Number (your award number is located on the most recent Notice of Award (NoA), (4) Reporting Year, (5) Preparer Name (person
who completed the form and can be contacted for questions), (6) Preparer phone number, and (7) Preparer email address.
Note: Each time the form is revised and resubmitted in Grants Solutions, please enter revised information.
Step 2 –
- In the FMAP Table, enter your Original State FMAP rate for each quarter in column C through the next Calendar Year (You do not
need to enter rates until 2023, until your 2022 report). Original State FMAP rates may be found in previous WFPB reports or at
the links below:
FFY 2007 - 2017: http://aspe.hhs.gov/federal-medical-assistance-percentages-or-federal-financial-participation-stateassistance-expenditures
FFY 2018: https://www.gpo.gov/fdsys/pkg/FR-2016-11-15/pdf/2016-27424.pdf
FFY 2019: https://www.gpo.gov/fdsys/pkg/FR-2017-11-21/pdf/2017-24953.pdf
FFY 2020: https://www.govinfo.gov/content/pkg/FR-2018-11-28/pdf/2018-25944.pdf
FFY 2021: https://www.govinfo.gov/content/pkg/FR-2019-12-03/pdf/2019-26207.pdf
For future years , refer to the Federal Register or consult your CMS Project Officer.
- For states participating in the MFP demonstration from October 2008 through June 2011, enter the ARRA Enhanced FMAP
percentage for each quarter in column E. Please use the appropriate rate for each year as published in the Federal Register. (After
you have pasted in these values once, you will not need to update them again as ARRA expired in 2011.)
For January 2020 - TBD, enter the FFCRA Enhanced FMAP percentage for each quarter in column E. The rates are included
in a separate tab within this workbook. When the FFCRA enhancement ends, the state should enter their regular FMAP in Column
E of the FMAP table for future quarters where there is a FFCRA cell. If the cell is left blank, it will default to 0.50.
- Rates for all services (qualified, demonstration, and supplemental) will calculate for each CY when State FMAP rates are
entered in columns C & E of the FMAP table. (See definitions in Section C. of the instructions below for more information on
each of these services.)
Step 3 – Fill in/update the Population Transitions Chart. For prior years, enter (or update) actual transitions for each population,
which should be consistent with the numbers entered in your semi-annual progress reports submitted. For the next calendar
year, enter projected future transitions for each population. The "Other" column includes any populations that do not fit one of
the listed target populations.
The Total Expenditures table, Estimated MFP Enhanced FMAP Calculations, and Benchmarks Achieved Percentage will auto
populate after you fill in actual and projected expenditures for all calendar years.
Step 4 – The Total Expenditures table beginning on Row 110 and the Estimated MFP Enhanced FMAP Calculation table beginning
on Row 124 will automatically populate once the next two tabs are completed.
Step 5 – On the WFPB CY 2007 – 2015 tab, enter actual expenditures for all prior years in the yellow highlighted cells. The
expenditures should reflect the sum of the year's quarterly MFP Financial Reporting Forms (ABCD forms) submitted to CMS and
match prior WFPB reports.
Step 6 – On the WFPB CY 2016 – 2025 tab, enter actual expenditures for all prior years in the yellow highlighted cells. The
expenditures should reflect the sum of the year's quarterly MFP Financial Reporting Forms (ABCD forms) submitted to CMS and
match prior WFPB reports. The MFP Project Officers are aware that for the last quarter of the prior year, actual expenditures may
not be available. If this is the case, please provide best estimates and add a note in the comments section to indicate this. CMS
expects that any estimated expenditures will be updated with actual expenditures with the next year's budget submission. You
may also use the comments section to provide an explanation of an expenditure or note for preparing next year's budget.
Step 7 – For the current year, enter projected expenditures in the yellow highlighted cells.
Page 1 of 37
MFP_Budget_Workbook (005) / WFPB Instructions
Step 8 – For the next calendar year, enter projected future expenditures in the yellow highlighted cells. CMS requests best
estimates for this year and expects that projections will adjust as it gets closer to the final year. (Only enter future expenditures
for the next calendar year. Other future years may be left blank.)
Page 2 of 37
MFP_Budget_Workbook (005) / WFPB Instructions
Section B. Data Validations to Check
Please make sure to check that these values match after completing data entry on all tabs (including the budget narrative tabs).
Validation 1 – Cell B10 (Total Cost) in the tab G. Other-Services Dollars should equal the summed total of the "Qualified HCBS"
rows for the "Total Costs" column (D) in the WFPB tab. Make sure to look at the correct year, and note that values may be slightly
off due to rounding differences.
Example: If you are filling this form out for year 2019 then you would look at the WFPB CY 2016-2025 tab. Using the "Qualified
HCBS" rows, you should be summing rows D75, D76, D77, and D78 and checking that this summed value equals cell B10 in the G.
Other-Services Dollars tab.
Validation 2 – For the year you are filling this out, the Administrative Total Costs value in the WFPB tab should equal the sum of
CY [year] Federal Costs (column B), rows 4, 5, 6, 7, 8, 9, and 12, in the Budget Summary tab. Make sure to look at the correct year,
the correct Administrative cell, and note that values may be slightly off due to rounding differences.
Example: If you are filling this form out for year 2019 and used the Administrative (Other) - 100 % row, then you would look at cell
D91 in the WFPB CY 2016-2025 tab and checking that this value equals the sum of B4, B5, B6, B7, B8, B9, and B12 from the
Budget Summary tab.
Section C. Definition of Line Items
Qualified HCBS Services. Section 6071 of the Deficit Reduction Act (DRA) of 2005 established the Money Follows the Person
(MFP) rebalancing demonstration. MFP demonstrations can provide up to three categories of services: (1) qualified home and
community-based LTSS, (2) demonstration services, and (3) supplemental services. Pursuant to section 6071(b)(1) of the DRA, the
“term “home and community-based long-term care services” means, with respect to a State Medicaid program, home and
community-based services (including home health and personal care services) that are provided under the State’s qualified HCB
program or that could be provided under such a program but are otherwise provided under the Medicaid program.” The term
“Medicaid” means, with respect to a State, the State program under title XIX of the Social Security Act (including any waiver or
demonstration under such title or under section 1115 of such Act relating to such title). “Qualified HCBS” are made available to
demonstration participants when they move to a community-based residence. States are permitted to claim an MFP-enhanced
match rate for the first 365-day post-transition period for qualified HCBS for demonstration participants who transition from an
institutional setting into the community. States are also required to continue the qualified HCBS service provision after the
conclusion of the demonstration program.
Demonstration HCBS Services. Demonstration services are either allowable Medicaid services not currently included in the state’s
array of home and community-based LTSS (such as assistive technologies) or qualified services above what would be available to
non-MFP Medicaid beneficiaries (such as 24-hour personal care, 7 days a week). Demonstration services are eligible for an MFP
enhanced match rate, but are different from the qualified HCBS program services in that they are not required to continue after
the conclusion of the demonstration program or for the participant, at the end of the 365-day enrollment period.
Supplemental Services. In addition to qualified HCBS and unique demonstration services, a State may choose to offer
“supplemental demonstration services” reimbursed through grant funds at a rate based on the state’s standard FMAP. The State
may propose these services because they are essential for successful transition to the community. These services should only be
required during the transition period, or be a one-time cost to the program. These services are not expected to be continued after
the demonstration period.
MFP Enhanced FMAP. States receive an MFP Federal Medical Assistance Percentage (FMAP) through the grant for either qualified
or demonstration home and community based LTSS. The MFP-enhanced FMAP, as defined in section 6071(e)(5) of the DRA, is
equal to the Federal medical assistance percentage (as defined in the first sentence of section 1905(b) of the Social Security Act)
for the State increased by a number of percentage points equal to 50 percent of the number of percentage points by which (A)
such Federal medical assistance percentage for the State, is less than (B) 100 percent; but in no case shall the MFP-enhanced
FMAP for a State exceed 90 percent. It is the State's responsibility to track this fund calculation.
Page 3 of 37
MFP_Budget_Workbook (005) / WFPB Instructions
Administrative costs. States may consider multiple claiming rates to fund administrative activities under the MFP demonstration
grant. States may request reimbursement for administrative costs such as key personnel, MFP travel, in state and out-of-state,
training, outreach and marketing, IT infrastructure to accommodate the MFP reporting requirements, and other administrative
project costs that can be justified to enhance the transition, rebalancing, and MFP sustainability effort, to meet or exceed
benchmarks, to build infrastructure and/or to increase the use of HCBS and decrease the use of institutional services.
Additionally, MFP grant administrative costs may include activities that are represented under certain Line Items:
Quality Improvement-100% Costs related to administering and reporting on individual quality and satisfaction surveys (reimbursed @
about $100-$150 per survey).
State Evaluation (if approved) - 50% . If the state wishes to conduct an independent evaluation, then the Operational Protocol must
include detailed information on the evaluator, evaluation design, variables, and process evaluation. Costs allocated to this
independent evaluation are reported here.
ADRC Funding -100%. This funding is used to facilitate and strengthen the roles of Aging and Disability Resource Centers (ADRCs) in
supporting the rebalancing the delivery of long-term services and supports by coordinating transitions from nursing homes (and other
MFP qualified institutional settings) to community based settings for older adults and people with disabilities or chronic conditions.
American Indians and Alaska Natives (AI/AN Funding) - 100%. Administrative costs may be used for developing and implementing
long term services and supports programs under the MFP Tribal Initiative.
Capacity Building Funding - 100%. This funding is for planning and capacity building activities to accelerate long-term care system
transformation design and implementation, and to expand HCB capacity.
All requested reimbursement for administrative expenses must be presented in the Worksheet for Proposed Budget and described in detail in
the Budget Narrative. For each item/project requested, there should be a justification with a detailed description and a Line Item Budget and
Budget Narrative for each year requested.
Page 4 of 37
MFP_Budget_Workbook (005)
State
United States
Alabama
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Vermont
Virginia
Washington
West Virginia
Wisconsin
Original State FMAP
FY20 *
MFP Enhanced FMAP
(1.00 - Reg FMAP /
2 + Reg FMAP)
0.5000
0.7197
0.7142
0.5000
0.5000
0.5000
0.5786
0.7000
0.6730
0.5347
0.7034
0.5014
0.6584
0.6120
0.5916
0.7182
0.6686
0.6380
0.5000
0.5000
0.6406
0.5000
0.7698
0.6565
0.6478
0.5472
0.6393
0.5000
0.5000
0.5000
0.6703
0.5005
0.6302
0.6602
0.5225
0.5295
0.7070
0.5762
0.6521
0.6089
0.5386
0.5000
0.5000
0.7494
0.5936
0.7500
0.8599
0.8571
0.7500
0.7500
0.7500
0.7893
0.8500
0.8365
0.7674
0.8517
0.7507
0.8292
0.8060
0.7958
0.8591
0.8343
0.8190
0.7500
0.7500
0.8203
0.7500
0.8849
0.8283
0.8239
0.7736
0.8197
0.7500
0.7500
0.7500
0.8352
0.7503
0.8151
0.8301
0.7613
0.7648
0.8535
0.7881
0.8261
0.8045
0.7693
0.7500
0.7500
0.8747
0.7968
MFP FMAP
with
FFCRA Increase
(Jan 2020 - TBD)
0.5620
0.7817
0.7762
0.5620
0.5620
0.5620
0.6406
0.7620
0.7350
0.5967
0.7654
0.5634
0.7204
0.6740
0.6536
0.7802
0.7306
0.7000
0.5620
0.5620
0.7026
0.5620
0.8318
0.7185
0.7098
0.6092
0.7013
0.5620
0.5620
0.5620
0.7323
0.5625
0.6922
0.7222
0.5845
0.5915
0.7690
0.6382
0.7141
0.6709
0.6006
0.5620
0.5620
0.8114
0.6556
MFP Enhanced FMAP
with FFCRA and MFP
(for Jan 2020 - TBD)
Not to Exceed 90%
0.7810
0.8909
0.8881
0.7810
0.7810
0.7810
0.8203
0.8810
0.8675
0.7984
0.8827
0.7817
0.8602
0.8370
0.8268
0.8901
0.8653
0.8500
0.7810
0.7810
0.8513
0.7810
0.9000
0.8593
0.8549
0.8046
0.8507
0.7810
0.7810
0.7810
0.8662
0.7813
0.8461
0.8611
0.7923
0.7958
0.8845
0.8191
0.8571
0.8355
0.8003
0.7810
0.7810
0.9000
0.8278
Calculated MFP
Enhanced FMAP
(Jan 2020 - TBD)
0.7810
0.8909
0.8881
0.7810
0.7810
0.7810
0.8203
0.8810
0.8675
0.7984
0.8827
0.7817
0.8602
0.8370
0.8268
0.8901
0.8653
0.8500
0.7810
0.7810
0.8513
0.7810
0.9159
0.8593
0.8549
0.8046
0.8507
0.7810
0.7810
0.7810
0.8662
0.7813
0.8461
0.8611
0.7923
0.7958
0.8845
0.8191
0.8571
0.8355
0.8003
0.7810
0.7810
0.9057
0.8278
MFP_Budget_Workbook (005) / WFPB
2007 - 2025 Money Follows the Person Demonstration
Worksheet for Proposed Budget (Rev. 12/09/2020)
Instructions: Please fill in only the cells highlighted in YELLOW. All other cells will auto populate and are locked.
Date of Report:
Preparer Name:
State:
Preparer Phone:
Grant Number:
Preparer Email:
2021
Current Year
Please express FMAP
as a decimal
(example: 68.32%=0.6832)
Original State FMAP
Calendar Year Quarters through
2025
Oct - Dec 2008
Jan - Mar 2009
Apr - Jun 2009
Jul - Sept 2009
Oct - Dec 2009
Jan - Mar 2010
Apr - Jun 2010
Jul - Sept 2010
Oct - Dec 2010
Jan - Mar 2011
Apr - Jun 2011
Jul - Sept 2011
Oct - Dec 2011
Jan - Mar 2012
Apr - Jun 2012
Jul - Sept 2012
Oct - Dec 2012
Jan - Mar 2013
Apr - Jun 2013
Jul - Sept 2013
Oct - Dec 2013
Jan - Mar 2014
Apr - Jun 2014
Jul - Sept 2014
Oct - Dec 2014
Jan - Mar 2015
Apr - Jun 2015
Jul - Sept 2015
Oct - Dec 2015
Jan - Mar 2016
Apr - Jun 2016
Jul - Sept 2016
Oct - Dec 2016
Jan - Mar 2017
Apr - Jun 2017
Jul - Sept 2017
Oct - Dec 2017
Jan - Mar 2018
Apr - Jun 2018
Jul - Sept 2018
Oct - Dec 2018
Jan - Mar 2019
Apr - Jun 2019
Jul - Sept 2019
Oct - Dec 2019
Jan - Mar 2020
Apr - Jun 2020
Jul - Sept 2020
Oct - Dec 2020
Jan - Mar 2021
Apr - Jun 2021
Jul - Sept 2021
Oct - Dec 2021
Jan - Mar 2022
Apr - Jun 2022
Jul - Sept 2022
Oct - Dec 2022
Jan - Mar 2023
Apr - Jun 2023
Jul - Sept 2023
Oct - Dec 2023
Jan - Mar 2024
Apr - Jun 2024
Jul - Sept 2024
Oct - Dec 2024
Jan - Mar 2025
Apr - Jun 2025
Jul - Sept 2025
Oct - Dec 2025
FFY 2007
FFY 2008
FFY 2009 Q1
FFY 2009 Q2
FFY 2009 Q3
FFY 2009 Q4
FFY 2010 Q1
FFY 2010 Q2
FFY 2010 Q3
FFY 2010 Q4
FFY 2011 Q1
FFY 2011 Q2
FFY 2011 Q3
FFY 2011 Q4
FFY 2012 Q1
FFY 2012 Q2
FFY 2012 Q3
FFY 2012 Q4
FFY 2013 Q1
FFY 2013 Q2
FFY 2013 Q3
FFY 2013 Q4
FFY 2014 Q1
FFY 2014 Q2
FFY 2014 Q3
FFY 2014 Q4
FFY 2015 Q1
FFY 2015 Q2
FFY 2015 Q3
FFY 2015 Q4
FFY 2016 Q1
FFY 2016 Q2
FFY 2016 Q3
FFY 2016 Q4
FFY 2017 Q1
FFY 2017 Q2
FFY 2017 Q3
FFY 2017 Q4
FFY 2018 Q1
FFY 2018 Q2
FFY 2018 Q3
FFY 2018 Q4
FFY 2019 Q1
FFY 2019 Q2
FFY 2019 Q3
FFY 2019 Q4
FFY 2020 Q1
FFY 2020 Q2
FFY 2020 Q3
FFY 2020 Q4
FFY 2021 Q1
FFY 2021 Q2
FFY 2021 Q3
FFY 2021 Q4
FFY 2022 Q1
FFY 2022 Q2
FFY 2022 Q3
FFY 2022 Q4
FFY 2023 Q1
FFY 2023 Q2
FFY 2023 Q3
FFY 2023 Q4
FFY 2024 Q1
FFY 2024 Q2
FFY 2024 Q3
FFY 2024 Q4
FFY 2025 Q1
FFY 2025 Q2
FFY 2025 Q3
FFY 2025 Q4
FFY 2026 Q1
MFP Enhanced FMAP
(1.00 - Reg FMAP /
2 + Reg FMAP)
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
MFP FMAP with
ARRA Increase
(Oct 2008 - Jun 2011)
FFCRA Increase
(Jan 2020 - TBD)
MFP Enhanced FMAP with
ARRA Increase
(Oct 2008 - Jun 2011)
FFCRA Increase
(Jan 2020 - TBD)
Not to Exceed 90%
Calculated MFP
Enhanced FMAP
ARRA Increase
(Oct 2008 - Jun 2011)
FFCRA Increase
(Jan 2020 - TBD)
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
Populations Transitions Chart (unduplicated count)
Unduplicated Count - Each individual is only counted once in the year that they physically transition.
All population counts and budget estimates are based on the Calendar Year (CY) .
The State is held accountable for the current year populations to be transitioned and actual numbers should be consistent with semi-annual reports submitted in Jan/Feb for the previous calendar year.
All prior year actuals must be updated accordingly to match what is reported on the semi-annual reports.
Elderly
ID/DD
Physical Disability
Mental Illness
Other
CY 2007
CY 2008
CY 2009
CY 2010
CY 2011
CY 2012
CY 2013
CY 2014
CY 2015
CY 2016
CY 2017
CY 2018
CY 2019
CY 2020
CY 2021
CY 2022
Page 6 of 37
Total per CY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
MFP_Budget_Workbook (005) / WFPB
CY 2023
CY 2024
CY 2025
Total Count
0
0
0
0
If a Grantee achieves less than the 85% of the established benchmark, an Action Plan will be required.
See Policy Guidance Achieving and Amending Transition Benchmarks, July 2014
Page 7 of 37
0
0
0
0
0
MFP_Budget_Workbook (005) / WFPB
Demonstration Budget Summary-All Years
Total Expenditures (2007 - 2025)
Qualified HCBS
Demonstration HCBS
Supplemental
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation - 50%
ADRC Funding - 100%
AIAN Funding (Tribal) - 100%
Capacity Building Funding - 100%
Total
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs (Fed & State)
-
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
-
$
$
$
$
$
$
$
$
$
$
$
$
$
State
-
-
Estimated MFP Enhanced FMAP Calculation
CY 2007
CY 2008
CY 2009
CY 2010
CY 2011
CY 2012
CY 2013
CY 2014
CY 2015
CY 2016
CY 2017
CY 2018
CY 2019
CY 2020
CY 2021
CY 2022
CY 2023
CY 2024
CY 2025
Estimated Total
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
Estimated Total
Page 8 of 37
MFP_Budget_Workbook (005) / WFPB CY 2007-2015
Please update expenditures for all past years.
Rates for all services (qualified, demonstration, and supplemental) will calculate
for each CY when State FMAP rates are entered in the FMAP table.
CY 2007
Qualified HCBS
Demonstration HCBS
Supplemental
Administrative - Normal
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports
Administrative (Other) - 100%
State Evaluation (if approved)
ADRC Funding
CY 2007 Total
Rate
0.5000
0.5000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
CY 2008 (including Partial Year Increased FMAP)
Rate
Qualified HCBS (Jan - Sept)
Qualified HCBS (Oct - Dec increased FMAP)
Demonstration HCBS (Jan - Sept)
Demonstration HCBS (Oct - Dec increased FMAP)
Supplemental (Jan - Sept)
Supplemental (Oct - Dec increased FMAP)
Administrative - Normal
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports
Administrative (Other) - 100%
State Evaluation (if approved)
ADRC Funding
CY 2008 Total
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
CY 2009 (using Increased FMAP)
Qualified HCBS (Jan-Mar increased FMAP)
Qualified HCBS (Apr-Jun increased FMAP)
Qualified HCBS (Jul- Sep increased FMAP)
Qualified HCBS (Oct - Dec increased FMAP)
Demonstration HCBS (Jan-Mar increased FMAP)
Demonstration HCBS (Apr-Jun increased FMAP)
Demonstration HCBS (Jul- Sep increased FMAP)
Demonstration HCBS (Oct - Dec increased FMAP)
Supplemental (Jan-Mar increased FMAP)
Supplemental (Apr-Jun increased FMAP)
Supplemental (Jul- Sep increased FMAP)
Supplemental (Oct - Dec increased FMAP)
Administrative - Normal
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports
Administrative (Other) - 100%
State Evaluation (if approved)
ADRC Funding
CY 2009 Total
CY 2010 (using increased FMAP)
Qualified HCBS (Jan-Mar increased FMAP)
Qualified HCBS (Apr-Jun increased FMAP)
Qualified HCBS (Jul- Sep increased FMAP)
Qualified HCBS (Oct - Dec increased FMAP)
Demonstration HCBS (Jan-Mar increased FMAP)
Demonstration HCBS (Apr-Jun increased FMAP)
Demonstration HCBS (Jul- Sep increased FMAP)
Demonstration HCBS (Oct - Dec increased FMAP)
Supplemental (Jan-Mar increased FMAP)
Supplemental (Apr-Jun increased FMAP)
Supplemental (Jul- Sep increased FMAP)
Supplemental (Oct - Dec increased FMAP)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding
CY 2010 Total
Total Costs
$
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Page 9 of 37
-
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
State
-
State
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
Total Costs
$
Federal
Federal
Total Costs
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
-
$
$
$
$
$
$
$
$
$
$
$
Enter CY 2007
Comments Here
-
State
Federal
-
State
-
Enter CY 2008
Comments Here
Enter CY 2009
Comments Here
Enter CY 2010
Comments Here
MFP_Budget_Workbook (005) / WFPB CY 2007-2015
CY 2011 (using partial year increased FMAP)
Qualified HCBS (Jan-Mar increased FMAP)
Qualified HCBS (Apr-Jun increased FMAP)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar increased FMAP)
Demonstration HCBS (Apr-Jun increased FMAP)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar increased FMAP)
Supplemental (Apr-Jun increased FMAP)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding - 100%
CY 2011 Total
CY 2012
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding - 100%
CY 2012 Total
CY 2013
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding - 100%
CY 2013 Total
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
Federal
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
State
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
-
Page 10 of 37
-
Federal
-
$
State
-
State
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
Enter CY 2011
Comments Here
Enter CY 2012
Comments Here
Enter CY 2013
Comments Here
MFP_Budget_Workbook (005) / WFPB CY 2007-2015
CY 2014
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding - 100%
AIAN Funding (Tribal) - 100%
CY 2014 Total
CY 2015
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
CY 2015 Total
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
Federal
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
$
Page 11 of 37
State
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
-
State
-
Enter CY 2014
Comments Here
Enter CY 2015
Comments Here
MFP_Budget_Workbook (005) / WFPB CY 2016-2025
Please update expenditures for all past years.
Rates for all services (qualified, demonstration, and supplemental) will calculate
for each CY when State FMAP rates are entered in the FMAP table.
CY 2016 Total
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
CY 2016 Total
CY 2017
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
CY 2017 Total
CY 2018
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
CY 2018 Total
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
Federal
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
State
Federal
-
Page 12 of 37
State
-
Federal
Total Costs
$
Enter CY 2016
Comments Here
-
State
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
Enter CY 2017
Comments Here
Enter CY 2018
Comments Here
MFP_Budget_Workbook (005) / WFPB CY 2016-2025
CY 2019
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal- 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
CY 2019 Total
CY 2020
Qualified HCBS (Jan-Mar increased FMAP)
Qualified HCBS (Apr-Jun increased FMAP)
Qualified HCBS (Jul- Sep increased FMAP)
Qualified HCBS (Oct - Dec increased FMAP)
Demonstration HCBS (Jan-Mar increased FMAP)
Demonstration HCBS (Apr-Jun increased FMAP)
Demonstration HCBS (Jul- Sep increased FMAP)
Demonstration HCBS (Oct - Dec increased FMAP)
Supplemental (Jan-Mar increased FMAP)
Supplemental (Apr-Jun increased FMAP)
Supplemental (Jul- Sep increased FMAP)
Supplemental (Oct - Dec increased FMAP)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
CY 2020 Total
CY 2021
Qualified HCBS (Jan-Mar increased FMAP)
Qualified HCBS (Apr-Jun increased FMAP)
Qualified HCBS (Jul- Sep increased FMAP)
Qualified HCBS (Oct - Dec increased FMAP)
Demonstration HCBS (Jan-Mar increased FMAP)
Demonstration HCBS (Apr-Jun increased FMAP)
Demonstration HCBS (Jul- Sep increased FMAP)
Demonstration HCBS (Oct - Dec increased FMAP)
Supplemental (Jan-Mar increased FMAP)
Supplemental (Apr-Jun increased FMAP)
Supplemental (Jul- Sep increased FMAP)
Supplemental (Oct - Dec increased FMAP)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
Capacity Building Funding - 100%
CY 2021 Total
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
1.0000
Federal
Page 13 of 37
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
Total Costs
$
State
-
State
Federal
-
State
-
Enter CY 2019
Comments Here
Enter CY 2020
Comments Here
Enter CY 2021
Comments Here
MFP_Budget_Workbook (005) / WFPB CY 2016-2025
CY 2022
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
Capacity Building Funding - 100%
CY 2022 Total
CY 2023
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
Capacity Building Funding - 100%
CY 2023 Total
CY 2024
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
AIAN Funding - 100%
Capacity Building Funding - 100%
CY 2024 Total
CY 2025
Qualified HCBS (Jan-Mar)
Qualified HCBS (Apr-Jun)
Qualified HCBS (Jul-Sept)
Qualified HCBS (Oct-Dec)
Demonstration HCBS (Jan-Mar)
Demonstration HCBS (Apr-Jun)
Demonstration HCBS (Jul-Sept)
Demonstration HCBS (Oct-Dec)
Supplemental (Jan-Mar)
Supplemental (Apr-Jun)
Supplemental (Jul-Sept)
Supplemental (Oct-Dec)
Administrative - Normal - 50%
Administrative - 75%
Administrative - 90%
Federal Evaluation Supports - 100%
Administrative (Other) - 100%
State Evaluation (if approved) - 50%
ADRC Funding -100%
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
1.0000
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
1.0000
Rate
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
$
Rate
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
1.0000
1.0000
Federal
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Total Costs
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
State
-
State
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Page 14 of 37
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Federal
-
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.5000
0.0000
0.0000
0.0000
0.0000
0.5000
0.7500
0.9000
1.0000
1.0000
0.5000
1.0000
-
Federal
Total Costs
$
State
-
State
-
Enter CY 2022
Comments Here
Enter CY 2023
Comments Here
Enter CY 2024
Comments Here
Enter CY 2025
Comments Here
MFP_Budget_Workbook (005) / WFPB CY 2016-2025
AIAN Funding - 100%
Capacity Building Funding - 100%
CY 2025 Total
1.0000
1.0000
$
-
Page 15 of 37
$
$
$
-
$
$
$
-
MFP_Budget_Workbook (005)
MFP Multi-Year Budget Projection
Object Class Categories
a. Personnel
b. Fringe Benefits
c. Travel
d. Equipment
e. Supplies
f. Sub Recipient
g. Services - Other
Total Direct Costs
h. Indirect Costs
Total Project Costs (Direct + Indirect)
CY 2020
(Unobligated Balance)
$
$
$
$
$
$
$
$
$
$
-
CY 2021
$
$
$
$
$
$
$
$
$
$
CY 2022
-
$
$
$
$
$
$
$
$
$
$
CY 2023
-
Page 16 of 37
$
$
$
$
$
$
$
$
$
$
CY 2024
-
$
$
$
$
$
$
$
$
$
$
CY 2025
-
$
$
$
$
$
$
$
$
$
$
Total
-
$
$
$
$
$
$
$
$
$
$
-
MFP_Budget_Workbook (005) / Budget Summary
Budget Summary
Object Class Categories
a. Personnel
b. Fringe Benefits
c. Travel
d. Equipment
e. Supplies
f. Sub Recipient
g. Services - Other
Total Direct Costs
h. Indirect Costs
Total Project Costs (Direct + Indirect)
$
$
$
$
$
$
$
$
$
$
CY 2021
Federal Cost
-
$
$
$
$
$
$
$
$
$
$
CY 2020
Unobligated Balance
-
$
$
$
$
$
$
$
$
$
$
CY 2021
Supplemental
-
$
$
$
$
$
$
$
$
$
CY 2021
Non-Federal Match
-
Total
(sum of columns B and E)
$
$
$
$
$
$
$
$
$
$
-
Additional Detail
For this table, you must manually complete column C (CY 2020 Unobligated Balance) and E (CY 2021 Non-Federal Match). Column B will have information on the unobligated balances for the
different categories and column E will have information on the state share of the budget for the different categories. The CY 2021 Federal Cost column (column B) will be auto-filled when all the
categorical tabs in red are completed.
Page 17 of 37
MFP_Budget_Workbook (005) / A. Personnel
A. Personnel
Unobligated Balance:
Supplement:
Position Title
Total
$
$
$
-
Name
To Section B-SF-424A
Position
Status
Filled
Vacant
Filled
Filled
Filled
Vacant
Vacant
Filled
Filled
Filled
Filled
Annual Salary/Rate
NTE $192,300
$
Level of Effort
Non-Federal
Match
Federal
Federal
$
$
$
$
$
$
$
$
$
$
$
$
-
-
Costs
Non-Federal
Match
$
$
$
$
$
$
$
$
$
$
$
-
Role & Responsibilities
Additional Detail
What Personnel are absolutely necessary for this specific activity? Identify each staff member and provide: the title; time commitment to the project in months; time commitment to the project as a percentage of full-time equivalent; annual salary; wage
rates; etc. Be sure to explain how the use of personnel funds will support the purpose and goals of this proposal. Describe the role, responsibilities and unique qualifications of each position. You may choose to upload or embed a more detailed
explanation.
Page 18 of 37
MFP_Budget_Workbook (005) / B. Fringe Benefits
B. Fringe Benefits
Unobligated Balance:
Supplement:
Component
Retirement
Social Security & Medicare
Group Life
Health Insurance
Retiree Health Credit
Disability
Total
$
$
$
Benefit Rate
To Section B-SF-424A
Salaries/Wages
$
$
$
$
$
$
-
Federal
$
$
$
$
$
$
$
-
Non-Federal Match
$
$
$
$
$
$
-
Narrative/Comment
Additional Detail
Apply the appropriate fringe benefit rate to each salary amount determined in the personnel section. Fringe benefits may include contributions for social security,
employee insurance, pension plans, etc. Only those benefits not included in an organization's indirect cost pool may be shown as direct costs. List all components of
fringe benefit rate. Enter a description of the Fringe funds requested, how the rate was determined, and how their use will support the purpose and goals of this
proposal.
Page 19 of 37
MFP_Budget_Workbook (005) / C. Travel
C. Travel
Unobligated Balance:
Supplement:
Purpose of Travel
MFP P/D Conference
Housing Conference
State Travel
Local Travel
$
$
$
-
Location
Section B-SF-424A
Item
Airfare
Hotel
Per Diem ( Meals )
Cab
Airfare
Hotel
Per Diem ( Meals )
Airfare
Hotel
Per Diem ( Meals )
Mileage
Estimated Staff Eligible
for Travel
Number of Days
Grand Total
Rate
$
$
$
$
$
$
$
$
$
$
$
Federal Cost
-
$
$
$
$
$
$
$
$
$
$
$
Non-Federal Match
-
$
-
$
-
Additional Detail
What travel is associated with this specific activity? The lowest available commercial fares for coach or equivalent accommodations must be used. If state or local policy is
being used, please attach policies as justification. It may also be necessary to attach previous year’s actual budget as part of your justification. Include airfare, mileage, or
rental car and fuel expense. Apply the appropriate reimbursement rate for mileage where appropriate (current IRS allowed rate is available at http://www.irs.gov. Then,
include ground transportation after arrival (train, subway, taxi, rental car). Use the US General Services Administration’s (www.gsa.gov) per diem rates to calculate per diem for
all domestic travel. Include lodging and meals. If the specific travel location is not available in the GSA information, use the county or state rates assigned. Note that meals for
the first and last day of travel can only be charged at 75%. Including this level of detail and information in your budget calculations and budget narrative indicates that you
have carefully evaluated the costs associated with proposed activities rather than randomly assigning an amount.
Page 20 of 37
MFP_Budget_Workbook (005) / D. Equipment
D. Equipment
Unobligated Balance:
Supplement:
Item
Equipment Total
$
$
$
-
To Section B-SF-424A
Rate
$
$
$
$
$
$
$
$
$
Total Cost
-
Federal Cost
$
$
$
$
$
$
$
$
$
$
-
Non-Federal Cost
$
$
$
$
$
$
$
$
$
-
Description
Additional Detail
Permanent equipment is defined as nonexpendable personal property having a useful life of more than one year and an acquisition cost of $5,000 or more. If applicant agency
defines “equipment” at lower rate then, follow the applying agency’s policy. In some instances, the grantor agency may require equipment documentation at a lower rate also.
Enter a description of the equipment and how its purchase will support the purpose and goals of this project. As with other budget categories, if the equipment is used for other
projects or across other departments, please only allocate the appropriate percentage to your project.
Page 21 of 37
MFP_Budget_Workbook (005) / E. Supplies
E. Supplies
Unobligated Balance:
Supplement:
Item(s)
Supplies Total
$
$
$
-
To Section B-SF-424A
Rate
Cost
$
$
$
$
$
$
$
$
Federal
-
$
$
$
$
$
$
$
$
-
Non-Federal Match
$
$
$
$
$
$
$
$
-
Explanation
Additional Detail
Under this category, document materials costing less than $5,000 per unit and often having one-time use. Enter a description of the supplies requested and how their
purchase will support the purpose and goals of this proposal.
Page 22 of 37
MFP_Budget_Workbook (005) / F. Subrecipient
F. Subrecipient Cost
Unobligated Balance:
Supplement:
$
$
$
Item #
Subrecipient
1
2
3
4
5
6
7
8
9
10
To Section B-SF-424A
Statement of Work
Cost
$
$
$
$
$
$
$
$
$
$
$
Total
Federal
-
-
$
$
$
$
$
$
$
$
$
$
$
-
-
Non-Federal Match
$
$
$
$
$
$
$
$
$
$
$
-
Additional Detail
The costs of project activities to be undertaken by a subrecipient should be included in this category as a single line item charge. A complete itemization of the cost comprising the charge should be attached to the budget. If there is more than one contractor, each must be
budgeted separately and must have an attached itemization. Explain the need for each agreement and how their use will support the purpose and goals of this proposal. For those subrecipients already arranged, please provide the proposed detailed categorical budgets. For
those subrecipients that have not been arranged, please provide the expected Statement of Work, Period of Performance and how the proposed costs were estimated. Where there are sub awards covering more than one department or project, please attach either interagency
agreement (IAAs) that clearly shows the cost to your project or in the absence of an IAA, a budget that clearly explains and itemizes the cost to your project is required. (All line items on this tab must be itemized using the subrecipient and 2nd tier subrecipient tab).
Page 23 of 37
MFP_Budget_Workbook (005) / G. Other - Services Dollars
H. Other
Total Federal HCBS Cost:
Unobligated Balance:
Supplement:
$
$
$
Services
-
Rate used for Qualified and Demonstration HCBS Services:
Rate used for Supplemental Services:
Cost
Non-Federal Match
Federal
Qualified HCBS Services
(State Enhanced FMAP Rate)
$
-
$
-
Demonstration HCBS Services
(State Enhanced FMAP Rate)
$
-
$
-
$
-
Supplemental Services
(Original State FMAP)
Total
$
$
-
$
$
-
$
$
-
Cost Methodology
Clearly explain how your Qualified
HCBS Sevices Cost was derived.
See example
Clearly explain how your
Demonstration HCBS Sevices Cost
was derived
Clearly explain how your
Supplemental Sevices Cost was
derived
Additional Detail
For the qualified HCBS, the demonstration HCBS and supplemental costs, please clearly show the methodology used to determine the cost. Based on the number of enrollees
projected to be transitioned, how was the cost determined? Please see the Service Detail Worksheet Example below. You may use this if you please or provide your own detail
worksheet.
Example of the Services Detail Worksheet
Monthly Average Per Transition
Demonstration Services
$950.00
Qualified Services
$2,100.00
Month
January
February
March
April
May
June
July
August
September
October
November
December
Estimated Enrollment
Qualified Services
Estimated Enrollment
Demonstration Services
6
12
12
28
39
40
50
63
70
79
86
99
Supplemental Services
$525.00
Estimated Enrollment
Supplemental Services
7
9
16
20
14
24
32
35
40
45
50
53
Totals
Federal Match Rate
Federal Request
Non-Federal Match
Page 24 of 37
4
10
13
17
20
26
34
39
41
46
52
58
$
$
$
$
Qualified Services Cost
$12,600.00
$25,200.00
$25,200.00
$58,800.00
$81,900.00
$84,000.00
$105,000.00
$132,300.00
$147,000.00
$165,900.00
$180,600.00
$207,900.00
1,226,400.00
1,226,400.00
Demonstration Services Cost
Supplemental Services Cost
$6,650.00
$2,100.00
$8,550.00
$5,250.00
$15,200.00
$6,825.00
$19,000.00
$8,925.00
$13,300.00
$10,500.00
$22,800.00
$13,650.00
$30,400.00
$17,850.00
$33,250.00
$20,475.00
$38,000.00
$21,525.00
$42,750.00
$24,150.00
$47,500.00
$27,300.00
$50,350.00
$30,450.00
$
327,750.00 $
189,000.00
$
$
$
$
$
327,750.00
$
189,000.00
MFP_Budget_Workbook (005) / H. Indirect Charges
H. Indirect Charges
Unobligated Balance:
Supplement:
$
$
$
BUDGET NARRATIVE:
Object Class Category by Line
-
Total Costs
Non-Federal
Match
Federal
DCA/CMS-Approved Cost Allocation
$
-
$
Total
$
-
$
-
-
$
$
$
$
$
-
BUDGET NARRATIVE:
Justification
Please attach approved IDC rate or Cost allocation
plan and explain calculation
-
Additional Detail
How was the cost calculated? Is it a reasonable rate for the project? Do you have a federally approved indirect rate agreement or cost allocation
plan. Has the rate been applied to appropriate base? Remember that those cost that are already in your indirect cost pool cannot be charged to
your direct cost category.
Note:
Policy Reform, Section 200.414 Indirect Costs - Provides a de minimis indirect cost rate of 10% of MTDC to those non-Federal entities who have
never had a negotiated indirect cost rate, thereby eliminating a potential administrative barrier to receiving and effectively implementing
Federal financial assistance.
§200.68 Modified Total Direct Cost (MTDC) - MTDC means all direct salaries and wages, applicable fringe benefits, materials and supplies,
services, travel, and up to the first $25,000 of each subaward (regardless of the period of performance of the subawards under the award).
MTDC excludes equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships,
participant support costs and the portion of each subaward in excess of $25,000. Other items may only be excluded when necessary to avoid a
serious inequity in the distribution of indirect costs, and with the approval of the cognizant agency for indirect costs.
Page 25 of 37
MFP_Budget_Workbook (005) / I.Subrecipient Detailed Budget
Provide narrative justification for each subrecipient and show calculations for each line item: how the subrecipient was selected, vendor quotes, period of performance, description of
the scope of the work, personnel/salary, fringe, travel costs, level of effort (LOE) and how the cost rates were determined. Itemize budget with calculations and describe how each
subrecipient relates to furthering the objectives of the program. Add rows and additional tables as necessary to accurately reflect proposed budget.
If applicable, show the indirect cost rate (ICR) and calculated modified total direct costs (MTDC) in narrative. MTDC consists of total direct costs minus the following exclusions:
equipment over $5,000, capital expenditures, charges for patient care, tuition remission, rental costs of offsite facilities, scholarships, fellowships, and the portion of each subrecipient in
excess of $25,00.
Subrecipients – Provide same detailed information, as provided for “subrecipients”, on the 2nd Tier subrecipient budgets tab. Include vendor quotes/itemized cost build-ups, period of
performance, description of the scope of the work, personnel, salary (level of effort), fringe, supplies, travel costs, how base cost rates and user rates were determined. Show
calculations and describe how each subrecipient relates to furthering the objectives of the program.
#1 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #1:
Narrative Descriptions
-
Page 26 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / I.Subrecipient Detailed Budget
#2 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #2:
#3 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #3:
Narrative Descriptions
-
Narrative Descriptions
-
Page 27 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / I.Subrecipient Detailed Budget
#4 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #4:
#5 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #5:
Narrative Descriptions
-
Narrative Descriptions
-
Page 28 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / I.Subrecipient Detailed Budget
#6 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #6:
#7 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #7:
Narrative Descriptions
-
Narrative Descriptions
-
Page 29 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / I.Subrecipient Detailed Budget
#8 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #8:
#9 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #9:
Narrative Descriptions
-
Narrative Descriptions
-
Page 30 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / I.Subrecipient Detailed Budget
#10 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #10:
Narrative Descriptions
-
Page 31 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / J.2nd Tier Sub-Recipient Detail
Provide narrative justification for each subrecipient and show calculations for each line item: how the subrecipient was selected, vendor quotes, period of performance, description of
the scope of the work, personnel/salary, fringe, travel costs, level of effort (LOE) and how the cost rates were determined. Itemize budget with calculations and describe how each
subrecipient relates to furthering the objectives of the program. Add rows and additional tables as necessary to accurately reflect proposed budget.
If applicable, show the indirect cost rate (ICR) and calculated modified total direct costs (MTDC) in narrative. MTDC consists of total direct costs minus the following exclusions:
equipment over $5,000, capital expenditures, charges for patient care, tuition remission, rental costs of offsite facilities, scholarships, fellowships, and the portion of each subrecipient in
excess of $25,00.
Subrecipients – Provide same detailed information, as provided for “subrecipients”, on the 2nd Tier subrecipient Budgets tab. Include vendor quotes/itemized cost build-ups, period of
performance, description of the scope of the work, personnel, salary (level of effort), fringe, supplies, travel costs, how base cost rates and user rates were determined. Show
calculations and describe how each subrecipient relates to furthering the objectives of the program.
#1 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #1:
Narrative Descriptions
-
Page 32 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / J.2nd Tier Sub-Recipient Detail
#2 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #2:
#3 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #3:
Narrative Descriptions
-
Narrative Descriptions
-
Page 33 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / J.2nd Tier Sub-Recipient Detail
#4 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #4:
#5 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #5:
Narrative Descriptions
-
Narrative Descriptions
-
Page 34 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / J.2nd Tier Sub-Recipient Detail
#6 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #6:
#7 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #7:
Narrative Descriptions
-
Narrative Descriptions
-
Page 35 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / J.2nd Tier Sub-Recipient Detail
#8 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #8:
#9 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #9:
Narrative Descriptions
-
Narrative Descriptions
-
Page 36 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
MFP_Budget_Workbook (005) / J.2nd Tier Sub-Recipient Detail
#10 Subrecipient or Consultant:
Budget Category
Cost
Personnel
Fringe Benefit
Travel
Equipment
Supplies
Subrecipient
Services - Other
Indirect Costs
Totals
$
Narrative Justification Subrecipient #10:
Narrative Descriptions
-
Page 37 of 37
Note: Provide narrative justification for
each subrecipient and show calculations
for each line item: how the subrecipient
was selected, vendor quotes, period of
performance, description of the scope of
the work, personnel/salary, fringe, travel
costs, level of effort (LOE) and how the
cost rates were determined. Itemize
budget with calculations and describe
how each subrecipient relates to
furthering the objectives of the program.
Add rows and additional tables as
necessary to accurately reflect proposed
budget.
| File Type | application/pdf |
| File Title | MFP Budget Workbook |
| Author | Lauren E. Johnson |
| File Modified | 2021-04-22 |
| File Created | 2021-04-22 |