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  5. BHSE Sample Budget Narrative and Personnel Justification Tables

BHSE Sample Budget Narrative and Personnel Justification Tables

You must upload your 2-year budget narrative in the HRSA Electronic Handbooks (EHBs). This will include your proposed federal and non-federal funds for year 1 and year 2. It should include a table of personnel you will pay with federal funds for each year. 

See Section IV.2.iv in the fiscal year (FY) 2024 Behavioral Health Service Expansion (BHSE) notice of funding opportunity (NOFO) for guidance. 

The incomplete samples are for reference. 

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Sample budget narrative

Personnel

Include budget details for each staff position in the personnel justification tables. 

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
Nurse Practitioner to provide mental health services        
Peer Support Specialist        
Social Worker to provide substance use disorder (SUD) services – will increase from 0.5 to 1.0 FTE in Year 2        
TOTAL PERSONNEL        

Fringe Benefits

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
FICA @ X.XX%        
Medical @ X%        
Retirement @ X%        
Unemployment & Workers Compensation @ X%        
Disability @ X%        
Dental @ X %        
TOTAL FRINGE @ X%        

Travel

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request

Integrated Care Conference 

  • 1 staff: Nurse Practitioner

Total cost of $X, which includes the following costs per person:

  •  Airfare @ $X
  • Conference fees @ $X
  • Lodging @ $X
  • Per diem @ $X
        

Local travel for Peer Support Specialist to travel to provide recovery support services at the sites where we propose to provide Medications for Opioid Use Disorder (MOUD) treatment

  • $X mileage rate @ X miles for X trips per week x XX weeks
        
TOTAL TRAVEL        

Equipment 

Provide the total cost for moveable equipment costing $5,000 or more. 

Your year 1 funding request for minor alteration and renovation (A/R) and equipment combined cannot exceed $250,000. 

You cannot request BHSE funds for equipment costs in year 2.

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
XXX item to support YYY        
TOTAL EQUIPMENT        

Supplies

Include items that cost less than $5,000 per unit separated into three categories: office supplies, medical supplies, and educational supplies.

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
Tablets for providers to connect with EHR system (4 tablets @ $X each)        
Office Supplies ($X per month x 12 months)        
Medical Supplies ($X per visit x X,XXX visits)        
TOTAL SUPPLIES        

Contractual

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
Psychiatric Services to provide mental health care and treatment (Contracted at 0.20 FTE)        
Mental Health First Aid Training for Personnel (30 hours @ $X per hour)        
TOTAL CONTRACTUAL        

Construction

Provide the total cost for each A/R project. Include line-item costs in the A/R Project Budget Justification. 

Year 1 funding request for minor A/R and equipment combined may not exceed $250,000. 

You may not request BHSE funds for minor A/R costs in year 2.

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
Conversion of storage space and removal of wall to create a counseling space for mental health services        
TOTAL CONSTRUCTION        

Other

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
EHR Provider Licenses (4 @ $X per license)        
Staff Recruitment (Internet advertisements)        
Gasoline (Mobile unit travel to X sites)        
TOTAL OTHER        

Total costs

Object Class Category Year 1 
Federal Request		 Year 1 
Non-Federal Request		 Year 2
Federal Request		 Year 2
Non-Federal Request
TOTAL DIRECT CHARGES 
(Enter the sum of TOTAL from the tables above: Personnel, Fringe Benefits, Travel, Equipment, Supplies, Contractual, Construction, and Other)		        
TOTAL INDIRECT CHARGES 
(X.XX% Indirect Rate)
Note: If applicable, you must provide your indirect cost rate agreement under Attachment 1: Other Relevant Documents.		        
TOTAL COSTS $600,000 or less   $500,000 or less  

Sample personnel justification tables

List the personnel costs for all direct hire staff and contractors you will support with BHSE funding. 

You may not use funds to pay an individual at a rate in excess of Federal Executive Level II of the Federal Executive Pay Scale ($221,900 as of January 2024).

Year 1: Personnel justification table

Staff Name Position Title % FTE Full-Time Base Salary Adjusted Annual Salary* Federal Amount Requested
R. Brown Nurse Practitioner 1.00  $95,000 No adjustment $95,000
A. Ruiz Psychiatrist (contracted) 0.20 $245,000 $221,900 $44,380
S. Lee Peer Support Specialist 0.50 $45,000 No adjustment $22,500
T. White Social Worker 0.50 $55,000 No adjustment $27,500

*Use this column only when the salary is over the limitation of $221,900.

Year 2: Personnel justification table

Staff Name Position Title % FTE Full-Time Base Salary Adjusted Annual Salary* Federal Amount Requested
R. Brown Nurse Practitioner 1.00 $95,000 No adjustment $95,000
A. Ruiz Psychiatrist (contracted) 0.20 $245,000 $221,900 $44,380
S. Lee Peer Support Specialist 0.50 $45,000 No adjustment $22,500
T. White Social Worker 1.00 $55,000 No adjustment $55,000
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