You must submit a budget narrative with personnel justification table as a required attachment in your fiscal year (FY) 2023 Expanding COVID-19 Vaccination (ECV) Post-Award Application Submission in the HRSA Electronic Handbooks (EHBs). Refer to the ECV Post-Award Application Submission Guidance.
Upload a 6-month budget narrative (December 1, 2022 – May 31, 2023) that clearly explains and justifies your proposed federal and non-federal expenditures. The budget narrative must align with your Activity List and the SF-424A Budget Information form, Section B, completed in EHBs.
| PERSONNEL | 6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
| Medical Staff | |||
| Enabling Staff | |||
| TOTAL PERSONNEL |
| FRINGE BENEFITS | 6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
| FICA @ X.XX% | |||
| Health Insurance @ X% | |||
| Dental @ X% | |||
| Unemployment Insurance @ X% | |||
| Workers Compensation @ X% | |||
| Disability @ X% | |||
| TOTAL FRINGE BENEFITS |
| TRAVEL (Include details for both local and long distance travel.) |
6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
| Local travel for staff to provide COVID-19 vaccinations, outreach, and education at X community locations (XXX miles @ $0.XX per mile) | |||
| Local travel to transport patients to and from COVID-19 vaccination sites (XXX miles @ $0.XX per mile) | |||
| TOTAL TRAVEL |
| SUPPLIES (Include equipment items that cost less than $5,000 each and other supplies.) |
6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
COVID-19 Vaccination Supplies
|
|||
| Portable generator for outdoor COVID-19 vaccination events | |||
| TOTAL SUPPLIES |
| CONTRACTUAL (Provide a clear explanation as to the purpose of each contract/subaward, how the costs were estimated, and the specific contract/subaward deliverables.) |
6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
| Consultant to work with community- and faith-based organizations to coordinate collaboration for COVID-19 vaccination events and amplify education and outreach efforts | |||
| Consultant for COVID-19 vaccination education materials tailored for specific populations (XX hours @ $XX per hour) | |||
| Consultant to make COVID-19 vaccination updates to health center’s online education materials in multiple languages | |||
| Consultant to provide training to health center staff on patient-centered, culturally affirming strategies to increase COVID-19 vaccination, vaccine confidence, and address social and other barriers to COVID-19 vaccination access | |||
| TOTAL CONTRACTUAL |
| OTHER (Include justification of costs that do not fit into any other category. In some cases, rent, utilities, and insurance may fall under this category if they are not included in an approved indirect cost rate.) |
6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
| Staff recruitment – newspaper and Internet posting | |||
| Gas for mobile unit to travel throughout the service area to support COVID-19 vaccine events | |||
| TOTAL OTHER | |||
| Total Direct Charges (Sum of TOTAL Expenses) |
| INDIRECT COSTS (Include only if your organization has a negotiated indirect cost rate or has previously claimed a de minimus rate of 10% of modified total direct costs. Upload your approved indirect cost agreement in the ECV Post-Award Application Submission, if applicable.) |
6-Month Federal Costs | 6-Month Non-Federal Costs | Total 6-Month Costs (Federal and Non-Federal) |
|---|---|---|---|
| X.XX% indirect rate | |||
| TOTALS (Total of Total Direct Charges and Indirect Charges) |
Example Personnel Justification Table
Provide personnel costs for all direct hire staff and contractors to be supported by ECV funding. If you use federal funding from more than one award to pay an individual’s salary, you may not pay that individual more than 1.0 FTE from all award sources.
| Name | Position Title | Base Salary | Adjusted Annual Salary* | FTE to Support ECV Project | Federal Amount Requested (6 months) |
|---|---|---|---|---|---|
| J. Smith | Physician | $235,000 | $212,100 | 0.05 | $5,303 |
| P. Jones | Patient/Community Education Specialist | $50,000 | N/A | 0.50 | $12,500 |
| A. Martinez | Community Health Worker | $55,000 | N/A | 1.00 | $27,500 |
| M. Moore | Nurse | $71,000 | N/A | 1.00 | $35,500 |
| unknown | Community Collaboration Coordinator (contractor) | $60,000 | N/A | 0.50 | $15,000 |
| unknown | Trainer | $105/hour ($218,400 annually) | $101.97/hour ($212,100) |
50 hours | $5,099 |
Total: FTE to Support ECV Project 3.05 FTE, Federal Amount Requested (6 months) $100,902
* If the salary is over the federal limitation of $212,100, include the adjusted annual salary. This amount reflects an individual’s base salary including bonuses and overtime, but not including fringe and any income that an individual may be permitted to earn outside of the duties to your organization.