You must include a budget narrative and a personnel justification table when you apply for Quality Improvement Fund – Transitions in Care for Justice Involved Populations (QIF-TJI) funding. Your budget narrative shows how you will use the funds you request. Your personnel justification table(s) show how much staff and contractors will be paid from the federal funds.
These samples are for reference only. You may use them to help you write your application.
The Budget Narrative section of the Notice of Funding Opportunity (NOFO) will tell you what to include. Find the NOFO on QIF-TJI Technical Assistance webpage.
On this page:
Sample budget narrative
Personnel
Include budget details for each staff position in the Personnel Justification table(s).
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| Administration | ||||||
| Medical staff | ||||||
| Enabling staff | ||||||
| IT staff | ||||||
| TOTAL PERSONNEL |
Fringe benefits
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| FICA @ X.XX% | ||||||
| Health Insurance Coverage @ X% | ||||||
| Dental @ X% | ||||||
| Unemployment Insurance @ X% | ||||||
| Workers Compensation @ X% | ||||||
| Disability @ X% | ||||||
| TOTAL FRINGE @ X% |
Travel
Include details for both local and long-distance travel.
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| Local travel for Community Health Workers to provide in-person case management services at partner jail as part of our project (XXX miles @ $0.XX per mile) | ||||||
| TOTAL TRAVEL |
Equipment
Include items of movable equipment that cost $5,000 or more and will last one year or more.
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| EHR upgrade to add new clinical workflows and clinical decision supports, and facilitate information exchange with partner jail to facilitate linkage to care activities (1 @ $XX,XXX) | ||||||
| TOTAL EQUIPMENT (see Equipment List for details) |
Supplies
Include items that cost less than $5,000 each per unit and other supplies.
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| Overdose prevention kits containing naloxone 100 @ $XXX | ||||||
| Portable Wifi hotspot device 2 @ $XXX | ||||||
| Printed educational materials to promote prevention and treatment of HCV, HIV, other infectious disease, reducing risk of drug overdose, and promote ongoing primary care: 2,000 color pages at @ $0.XX each | ||||||
| TOTAL SUPPLIES |
Contractual
Clearly explain the purpose of each contract/subaward, how you estimated the costs, and the specific contract/subaward deliverables.
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| Consultant for health center personnel training (XX hours @ $XX per hour) | ||||||
| Consultant to design and oversee EHR updates to integrate new clinical workflows (XX hours @ $XX per hour) | ||||||
| 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.
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| Client transportation assistance (XX bus tokens @ $X.XX each) | ||||||
| TOTAL OTHER |
Total Costs
| Budget Line Item | Year 1 Federal | Year 1 Non-Federal | Year 2 Federal | Year 2 Non-Federal | Category Total Federal | Category Total Non-Federal |
|---|---|---|---|---|---|---|
| TOTAL DIRECT CHARGES Sum of TOTAL Expenses tables above (e.g., Personnel, Fringe Benefits, Travel, Equipment, Supplies, Contractual, and Other) | ||||||
|
TOTAL INDIRECT CHARGES (X.XX% Indirect Rate) 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. Include approved indirect cost agreement in Attachment 2: Other Relevant Documents. |
||||||
| TOTALS (Total of Total Direct Charges and Indirect Charges) |
Sample personnel justification tables
Provide information for all personnel paid with federal funds.
Do not use federal funds to pay anyone more than Federal Executive Level II of the Federal Executive Pay scale (PDF - 3 KB). This amount may change annually ($221,900, as of January 2024). This applies to the base salary. It does not include fringe benefits or outside income.
Refer to the NOFO for further guidance.
Table 1: Year 1 personnel justification table
| Staff Name | Position Title | Base Salary | Adjusted Annual Salary* | FTE to Support QIF-TJI Project | Federal Amount Requested |
|---|---|---|---|---|---|
| J. Smith | Physician | $275,000 | $221,900 | 0.10 | $22,190 |
| L. Taylor | Physician | $251,000 | $221,900 | 0.10 | $22,190 |
| R. Doe | Community Health Worker | $45,550 | N/A | 1.00 | $45,550 |
| TBD | Community Health Worker | $45,550 | N/A | 1.00 | $45,550 |
| TBD | Community Health Worker | $45,550 | N/A | 0.50 | $22,775 |
| E. Chambers | Patient Care Coordinator | $47,750 | N/A | 0.50 | $23,875 |
| B. Jackson | Medical Assistant | $32,000 | N/A | 0.50 | $16,000 |
| M. Liu | QI Analyst | $75,500 | N/A | 0.50 | $37,750 |
| F. Martinez | Director of Quality | $103,000 | N/A | 0.10 | $10,300 |
| N. Grey | IT Specialist | $75,000 | N/A | 0.25 | $18,750 |
| E. Reyes | Data Specialist | $48,000 | N/A | 1.00 | $48,000 |
| M. Moore | Nurse | $79,000 | N/A | 1.00 | $79,000 |
| Total | 6.55 FTE | $391,930 |
Total: $391,930
*Use this column only when the salary is over the $221,900 limit.
Table 2: Year 2 personnel justification table
| Staff Name | Position Title | Base Salary | Adjusted Annual Salary* | FTE to Support QIF-TJI Project | Federal Amount Requested |
|---|---|---|---|---|---|
| J. Smith | Physician | $275,000 | $221,900 | 0.10 | $22,190 |
| L. Taylor | Physician | $251,000 | $221,900 | 0.10 | $22,190 |
| R. Doe | Community Health Worker | $45,550 | N/A | 1.00 | $45,550 |
| TBD | Community Health Worker | $45,550 | N/A | 1.00 | $45,550 |
| TBD | Community Health Worker | $45,550 | N/A | 0.50 | $22,775 |
| E. Chambers | Patient Care Coordinator | $47,750 | N/A | 0.50 | $23,875 |
| B. Jackson | Medical Assistant | $32,000 | N/A | 0.25 | $8,000 |
| M. Liu | QI Analyst | $75,500 | N/A | 0.50 | $37,750 |
| F. Martinez | Director of Quality | $103,000 | N/A | 0.10 | $10,300 |
| N. Grey | IT Specialist | $75,000 | N/A | 0.20 | $15,000 |
| E. Reyes | Data Specialist | $48,000 | N/A | 1.00 | $48,000 |
| M. Moore | Nurse | $79,000 | N/A | 0.50 | $39,500 |
| Total | 5.75 FTE | $340,680 |
Total: $340,680
*Use this column only when the salary is over the $221,900 limit.