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附錄 A 和 B 說明和模板
制定附錄 A 和 B 所需的文件
歡迎參與與舊金山公共衛生部 (DPH) 的簽約流程。以下文件將為您的機構提供必要的信息，以完成 DPH 合約程序。發現要填寫的模板，以使您的合約獲得認證，並獲得透過 RFP/Q 選擇分配的資金。收到資助通知後，必須在指定的截止日期前透過附錄 A 和附錄 B 範本提交服務的簡要說明和相應的預算。下面也提供了有關如何完成附錄的詳細說明。此外，還將指派一名合約開發和技術援助專案經理 (CDTA PM) 來回答問題並指導您完成合約開發流程。
文件
附錄 A - 計劃敘述
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.
附錄 B - 預算
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.
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