RESOURCE COLLECTION
Appendix A and B instructions and templates
Required documents for developing Appendix A and B
Welcome to the contracting process with the San Francisco Department of Public Health (DPH). The following documents will equip your agency with essential information to navigate through DPH contracting procedures. Discover templates to fill out to get your contract certified and gain access to the allocated funds awarded through the RFP/Q selection. Upon receiving a funding notification, a brief description of services and a corresponding budget must be submitted on Appendix A and Appendix B templates by a specified due date. Detailed instructions on how to complete the appendices are also provided below. Additionally, a Contract Development and Technical Assistance Program Manager (CDTA PM) will be assigned to answer questions and guide you through the contract development process.
Documents
Appendix A - Program Narrative
Go through this list to make sure all contract development requirements have been completed before submitting the Appendix A and B.
Follow the Appendix A instructions based on the system of care (SOC) solicitation.
A description of services for each program must be submitted on the designated system of care Appendix A template. Select the correct template based on the mode of service(s) in the RFP/Q solicitation.
Comprehending the details of your funding notification is crucial for accurately filling out the Appendix A and B template.
Use this Appendix A template for CHEP programs only.
Appendix B - Budget
This Appendix B - Non-BHS Budget template and instructions should be used only for the following Systems of Care (SOC): Primary Care, HIV Health Services (HHS), Community Health Equity and Promotions (CHEP), Maternal, Child and Adolescent Health (MCAH), and Fiscal Intermediary and or Program Management
This Appendix B - Budget Template should be used for Community Health Equity and Promotions (CHEP) Health Access Programs (HAP) Only.
The updated Appendix B and instructions has the following main updates:
- CalAIM efforts/ Blended Rate for Outpatient programs – Steam line App B by removing CalAIM LOE Tab and instead collects practitioner type through revised “Salaries and Benefits” tab.
- Two-year budgets – Instructions on how to complete and submit two-year budgets
- Units of Services/Unduplicated Clients (UOS/UDC) allocation table from App A to App B – UOS/UDC allocation tab now in App B IF SOC requires agency to complete
Please carefully review the revised Appendix B instructions before completing your FY2024-25 Appendix B and only use this template for the following Systems of Care (SOC) program services: Adult and Older Adult (AOA), Children Youth and Families (CYF), Mental Health Services Act (MHSA), Residential Programs, Substance Use Disorder Services (SUD), Transitional Aged Youth (TAY) If you have any questions, please contact your CDTA Program Manager.
This template is a tool to help providers determine their FY 24/25 Blended Rate and Units of Service for their Outpatient SMH/SUD Programs.
Resources
Other CDTA Resources