NAP Sample Budget Narrative

This sample budget narrative shows what your New Access Points (NAP) budget could look like. 

What to do

You must:

• Detail your costs for the 1-year period of performance
• Include a table to show the staff who will be paid with federal funds
• Align with your SF-424A: Budget Information Form and Form 3: Income Analysis

Find guidance

Refer to this sample as you plan your project budget.

See Section 5.1v of the SF-424 Two-Tier Application Guide. (PDF - 704 KB)

Jump to:

• Revenue
• Expenses
• Federal personnel justification table 

Revenue

REVENUE	Federal Request	Non-Federal Resources	Total
NAP FUNDING REQUEST
APPLICANT ORGANIZATION
STATE FUNDS
LOCAL FUNDS
OTHER SUPPORT
PROGRAM INCOME (projected payments for delivery of services)
TOTAL REVENUE

Expenses

Personnel

Include:

• Totals for each staff category as noted on Form 2
• Budget details for each staff position in the personnel justification table

Object Class Category	Federal Request	Non-Federal Resources	Total
MANAGEMENT STAFF
SUPPORT STAFF
MEDICAL STAFF
DENTAL STAFF
MENTAL HEALTH STAFF
SUBSTANCE USE DISORDER STAFF
VISION SERVICES STAFF
PHARMACY STAFF
ENABLING STAFF
OTHER STAFF
TOTAL PERSONNEL

Fringe benefits

Fringe should be a percentage of personnel costs.

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

Travel

Include details for both local and long-distance travel.

Object Class Category	Federal Request	Non-Federal Resources	Total
Local travel to transport patients to and from service sites (XXX miles @ $0.XX per mile)
Telehealth conference in XYZ city  2 staff attending: Physician and Nurse Coordinator   Total price is $XXXX per person, which includes the following costs per person:  Airfare @ $XXX  Conference fees @ $XXX  Lodging @ $XX   Per diem @ $XX
Local travel for street outreach (X,XXX miles @ $0.XX per mile)
TOTAL TRAVEL

Equipment

Include:

• Total cost of equipment purchases with a unit cost of $5,000 or more
• Line-item costs in the Equipment List form

Your funding request cannot exceed $250,000 for minor A/R and equipment combined.

Object Class Category	Federal Request	Non-Federal Resources	Total
TOTAL EQUIPMENT  (See Equipment List for details)

Supplies

Include supplies and equipment that cost less than $5,000 each.

Object Class Category	Federal Request	Non-Federal Resources	Total
Office Supplies ($X per month x 12 months)
Printing Costs ($X.XX per brochure x 4 brochures x X,000 copies)
Medical Supplies ($X.XX per visit x X,XXX visits)
Dental Supplies ($X.XX per visit x X,XXX visits)
Webcams to support telehealth (5 webcams @ $XX each)
Tablets for providers to connect with EHR system (3 tablets @ $XXX each)
TOTAL SUPPLIES

Contractual

Explain the purpose of each contract and include a summary in Attachment 7.

If you have a contract or subaward for a substantive part of the scope of project, attach the contract to Form 8.

Object Class Category	Federal Request	Non-Federal Resources	Total
Pharmacy Services ($X per contract)
Laboratory Services ($X per sample x X,XXX samples)
Substance Use Disorder Specialist (contracted at XXX hours, at $XXX/hour) remote (no travel)
Optometry Services ($X per patient x XXX patients)
Waste Removal ($X per month x 12 months)
TOTAL CONTRACTUAL

Construction

Include:

• Total cost for each minor A/R project
• Line-item costs in the A/R Project Budget Justification

Your funding request cannot exceed $250,000 for minor A/R and equipment combined.

Object Class Category	Federal Request	Non-Federal Resources	Total
Minor A/R costs for ABC Site – renovation of exam rooms
Minor A/R costs for XYZ Site – renovation to create private counseling space for mental health services
TOTAL CONSTRUCTION  (See Minor A/R Budget Justification)

Other

Include justification of costs that do not fit into any other category.

Rent, utilities, and insurance may fall under this category if you do not include them in your indirect cost rate.

Object Class Category	Federal Request	Non-Federal Resources	Total
EHR provider licenses $X each
Staff Recruitment  (# newspaper ads @ $XX and # internet ads @ $XX)
Membership Dues (specify membership organization and cost)
TOTAL OTHER

Total costs

Object Class Category	Federal Request	Non-Federal Resources	Total
TOTAL DIRECT CHARGES (Enter the sum TOTAL for Personnel, Fringe Benefits, Travel, Equipment, Supplies, Contractual, Construction, and Other)
TOTAL INDIRECT CHARGES  XX% indirect cost rate (Include approved indirect cost agreement in Attachment 12: Other Relevant Documents. If you do not have an approved rate, you may charge a 10% de minimis rate of modified total direct costs.)
TOTALS (Total of TOTAL DIRECT CHARGES and INDIRECT CHARGES)

Federal personnel justification table

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

Name	Position Title	% FTE	Base Salary	Adjusted Annual Salary*	Federal Amount Requested
C. Martinez	CEO	0.50	$150,000	No adjustment needed	$75,000
J. Smith	Physician	0.50	$225,000	$221,900	$110,950
R. Doe	Nurse Practitioner	1.00	$75,950	No adjustment needed	$75,950
D. Jones	Data/AP Specialist	0.25	$33,000	No adjustment needed	$8,250
H. Black	Outreach Director	0.50	$65,000	No adjustment needed	$32,500
S. White	Referral Specialist	1.00	$40,000	No adjustment needed	$40,000
M. Green	Substance Use Disorder Specialist (contractor)	0.75	$100,000	No adjustment needed	$75,000
TOTAL					$417,650

*Use this column only when the salary is over the 2024 limit of $221,900.