Appendix E - Spending Plan Forms and Instructions

APPENDIX E
Spending Plan Forms and Instructions

The webversion of these forms is for ADA purposes. Please fill out the Official Forms: Spending Plan Forms and Instructions (pdf)

  1. Instructions: Completing the Program Spending Plan
    1. Spending Plan, Summary
      1. Instruction: Spending Plan Summary General Spending Plan Information
    2. Spending Plan Section, Personal Services
      1. Instructions: Personal Services Spending Plan Personal Services
    3. Spending Plan, Contractual Services
      1. Instructions: Spending Plan Contractual Services
    4. Spending Plan, Supplies and Travel Spending Plan
      1. Instructions: Supplies and Travel Spending Plan
    5. Spending Plan, Equipment
      1. Instructions: Equipment
    6. Application and Plan for Human Services Program
    7. Allowable Costs for Reimbursementunder Grant Agreement

INSTRUCTIONS FOR COMPLETING THE PROGRAM SPENDING PLAN

a. Complete the Spending Plan summary page; this page should show the total cost from all sources of providing the product or service; this total is then allocated to "Applicant and Other" fund sources and the amount "Awarded from IDHS." The lower part of this page will identify the source and amounts of the funds shown in the "Applicant and Other" column above; this amount is further broken down to required "match or cost participation" and "Other".

b. Personal Services - instructions are printed on the back of the page. Please pay close attention to the formula for calculating the Personal Services amount for each position. The proper procedure for calculating this amount is:

  1. Multiply the monthly salary in column (2) times the number of months this position will work on this product/service. The number of months as shown in column (3)
  2. Then multiply this amount times the percent of time this position spends on this product/service. The percent of time this position spends on this product/service as shown in column (4).
  3. The result of this calculation will provide the total Spending Plan amount applicable to this product/service.

This total is then allocated among funds from this grant (Amount Assistance Awarded from IDHS) and all other fund sources (Grantee and Other). Insert proper codes to identify source(s) of other funds.

Fringe Benefits - a total percentage rate is acceptable for this Spending Plan process; however, actual individual expenditure amounts must be reported when requesting reimbursement from the Department. It is desirable to indicate the items and applicable rates that are included in the applicant's fringe benefits claim.

c. Contractual services - itemize and be as specific as possible. All Personal service contracts and sub-grants must be identified and explained. Registration fees, repairs and maintenance costs are shown here.

d. Supplies - itemize and be as specific as possible. Show all printing and paper costs in this line.

e. Travel - Indicate mileage rates for used by the agency; show estimated cost for mileage, lodging, etc. as indicated.

f. Equipment - itemize and be as specific as possible. All equipment purchases require approval either approval through this program Spending Plan and approval process or specific approval during the award period. Equipment purchases should be completed during the early months of the award period.

Spending Plan justification - as instructed, provide additional information or justification for specific items listed in the detailed Spending Plan for which the need is not self-evident. Personal Services contracts and all sub-grants are to be explained and justified in this section.

APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM
FY2010
SPENDING PLAN, Summary

APPLICANT AGENCY:

Tin #:

PROGRAM:

FOR THE PERIOD:

THROUGH:

SPENDING PLAN SUMMARY SOURCES OF FUNDS IDHS Components (specify)
LINE ITEM (Category) Total for the Program Applicant and Other Requested from IDHS Administrative Cost Direct Service Cost _
Personal Services
Contractual Services
Supplies
Travel
Equipment
TOTAL, Direct Costs
SOURCES OF FUNDS - Applicant and Other Sources Required Match Other Support Total
_
_
_
_
_
TOTAL, Applicant and Other Sources

Section 1.01 USE ADDITIONAL SHEETS IF NECESSARY

Spending Plan, Page 1

INSTRUCTION TO APPLICANT
SPENDING PLAN SUMMARY
GENERAL SPENDING PLAN INFORMATION

The Spending Plan for this proposal is to reflect the total cost of the project from all sources. The Spending Plan Summary provides a one-page compilation of these costs. Individual line items are to be itemized in detail on the following pages. Additional information and justification are to be shown on the Spending Plan Justification page(s).

The Spending Plan must comply with the allowable costs for the program, the applicable Administrative Rules and Regulations, the laws of the State of Illinois and any applicable federal guidelines or requirements.

All amounts are to be expressed in whole dollars; each line item is to be rounded to the nearest one hundred-dollar amount.

If additional pages are required, please note applicant agency name and program name on each additional page and number all additional pages as appropriate using the following sequence: Page 1a, Page 1b, Page 2a, Page 2b, and so on. Applications are disassembled and copied by the Department and these page number references will assist reassembly and help to ensure all copies are complete.

SPENDING PLAN SUMMARY

Enter the totals from each detail line-item section and sum these amounts to show the TOTAL, Direct Costs for the program.

SOURCES OF FUNDS columns: The total estimated cost for each line item of the program is to be broken out by funds to be provided from sources other than this RFP (Applicant and Other) and by the amount requested in this proposal (Requested from IDHS).

IDHS Components (specify): The amount requested in this proposal (Requested from IDHS) is to be further broken out by program component(s) as instructed in the Program Description section of the RFP.

SOURCES OF FUNDS - Applicant and Other

Identify the source and amount of all funds shown in the Applicant and Other column of the Spending Plan Summary. Enter the amounts proposed to meet the program's matching or cost participation requirements, if any, in the Required Match column; enter all other program support costs in the Other Support column. The total of the Required Match and Other Support columns must equal the total of the Applicant and Other column of the Spending Plan Summary.

Examples of Applicant and Other fund sources include Applicant funds such as tax revenues; fees or other program income; donations; other corporate funds; and other program support such as other state and or federal grant awards (i.e. WIC, Title X, Title XIX, and Title XX) both from the IDHS and from other agencies.)

ILLINOIS DEPARTMENT OF HUMAN SERVICES
APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM
SPENDING PLAN SECTION, Personal Services

APPLICANT AGENCY:

Tin #:

PROGRAM:

FOR THE PERIOD:

THROUGH:

PERSONAL SERVICES Sources of Funds IDHS Components (specify)
(Position title and Name of Incumbent) Monthly Salary Number of Months Spending Planed Percent of time on Program Total for the Program Applicant and Other Requested from IDHS Administrative Cost Direct Service Cost _
_
_
_
_
_
_
_
PERSONAL SERVICES, Subtotal
FRINGE BENEFITS (Rate: %) Components and rates must be itemized in Spending Plan justification section.
PERSONAL SERVICES AND FRINGE TOTAL

Section 1.01 USE ADDITIONAL SHEETS IF NECESSARY

Spending Plan, Page 2

INSTRUCTIONS TO APPLICANT
PERSONAL SERVICES SPENDING PLAN
PERSONAL SERVICES

Enter the position title and name of the current incumbent; if the position is new or currently not filled, enter "Vacant".

Example: Nurse -Mary Jones

Sally Smith

Vacant

Program Coordinator -Joyce Johnson

Vacant

Enter the monthly salary for each position that will be filled for all or any part of the period. Enter the number of months the position will be filled by an incumbent working on the program. Enter the percent of time the incumbent will devote to the program during the months shown. Enter the total amount of support to be provided for the program, as computed from the information shown, using the following formula:

[Monthly Salary] times [Number of Months Spending Planned] times [Percent of time on Program] = [Total for the Program].

The Total for the Program is then broken out by the amount to be provided from sources other than this application (Applicant and Other) and the amount requested as part of this proposal (Requested from IDHS). The amount Requested from IDHS is further broken out by the various program components (IDHS Components) if the Program Description section of the RFP requests that program components be identified separately.

FRINGE BENEFITS

The components included in the applicant agency's fringe benefit rate are to be itemized (listed by component and rate) in the Spending Plan Justification section. The total fringe benefits rate is entered on the Fringe Benefits line; this rate is then applied to the Personal Services, Subtotal shown as Total for the Program. If the applicant agency includes fringe benefits in the amount Requested from IDHS and the various IDHS Components, the amounts for fringe benefits may not exceed the fringe benefits rate times the Personal Services, Subtotal for those columns.

ILLINOIS DEPARTMENT OF HUMAN SERVICES
APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM
SPENDING PLAN, Contractual Services

APPLICANT AGENCY:

Tin #:

PROGRAM:

FOR THE PERIOD:

THROUGH:

CONTRACTUAL SERVICES Sources of Funds IDHS Components (specify)
(Itemize) Total for the Program Applicant and Other Requested from IDHS Administrative Cost Direct Service Cost _
_
_
_
_
_
_
TOTAL, Contractual Services

Section 1.03 USE ADDITIONAL SHEETS IF NECESSARY

Spending Plan, Page 3

INSTRUCTIONS TO APPLICANT
SPENDING PLAN, Supplies and Travel

List the costs directly attributable the program estimated to be incurred during the period covered by this application. Examples of Contractual Services include conference registration fees; repair and maintenance of furniture and equipment; postage; UPS or other carrier costs; software; subscriptions; training and education costs; and telecommunications costs. See also the Allowable Costs section of the Spending Plan.

Payments (or pass-through) to subcontractors or subgrantees are to be listed here. All subcontracts or subgrants require an attached detailed line-item Spending Plan supporting this contractual amount. The Department must approve, in writing, all subcontracts or subgrants.

ILLINOIS DEPARTMENT OF HUMAN SERVICES
APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM
SPENDING PLAN, Supplies and Travel

APPLICANT AGENCY:

Tin #:

PROGRAM:

FOR THE PERIOD:

THROUGH:

SUPPLIES Sources of Funds IDHS Components (specify)
(Itemize) Total for the Program Applicant and Other Requested from IDHS Administrative Cost Direct Service Cost _
_
_
_
_
_
_
TOTAL, Supplies
TRAVEL Sources of Funds IDHS Components (specify)
(Itemize) Total for the Program Applicant and Other Requested from IDHS Administrative Cost Direct Service Cost _
Mileage (Rate per mile: $ )
Lodging
Meals/PerDiem
Commercial Transportation
Other:
_
TOTAL, Travel

USE ADDITIONAL SHEETS IF NECESSARY

Spending Plan, Page 4

INSTRUCTIONS TO APPLICANT
SUPPLIES AND TRAVEL SPENDING PLAN

SUPPLIES

List the costs, directly attributable to the program, estimated to be incurred during the period covered by this proposal. Examples of Supplies include office supplies; medical supplies (consumable items such as syringes, tape and gauze, other than drugs); educational and instructional materials; cleaning supplies; copy paper and other paper supplies; and letterpress, offset printing, and other printing services. See also the Allowable Costs section of the Spending Plan.

TRAVEL

List the costs, directly attributable to the program, of applicant agency's employees' transportation, mileage, per diem, meals, etc. necessary for carrying out the activities described in the proposal. Unless specifically stated in the Spending Plan, the mileage rate will be assumed to be the same as that authorized for state employees by the Governor's Travel Control Board. See also the Allowable Costs section of the Spending Plan.

Travel costs for contractual consultants are to be included in the Contractual Services line.

ILLINOIS DEPARTMENT OF HUMAN SERVICES
APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM
SPENDING PLAN, Equipment

APPLICANT AGENCY:

Tin #:

PROGRAM:

FOR THE PERIOD:

THROUGH:

EQUIPMENT Sources of Funds IDHS Components (specify)
(Itemize) Total for the Program Applicant and Other Requested from IDHS Administrative Cost Direct Service Cost _
_
_
_
_
_
_
TOTAL, Equipment

USE ADDITIONAL SHEETS IF NECESSARY

Spending Plan, Page 5

INSTRUCTIONS TO APPLICANT
EQUIPMENT

EQUIPMENT

List those items costing over $100.00 each, with a useful life of more than one year, that are required for the successful completion of the activities described in the application. Equipment costs shall include all freight and installation charges. Equipment may include office furniture and equipment, such as desks, chairs, computers, printers and calculators; training materials; reference books; and films. All Equipment purchases must be either approved by the Department, through this Spending Plan or via specific request for items not included in the Spending Plan as submitted. See also the Allowable Costs section of the Spending Plan.

ILLINOIS DEPARTMENT OF HUMAN SERVICES
APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

APPLICANT AGENCY:

Tin #:

PROGRAM:

FOR THE PERIOD:

THROUGH:

Show justification for specific items listed in the detailed Spending Plan for which the need is not self-evident. Justifications should clearly indicate the items being requested are essential to the achievement of the state program objectives.

Fringe Benefits - %
FICA (Social Security) %
Pension/Retirement %
Group Health Insurance %
Group Life Insurance %
Unemployment Insurance %
Workmen's Compensation %
Other:
%
%
%
%
TOTAL, Fringe Benefits Rate %

Other Spending Plan Justification -

ALLOWABLE COSTS FOR REIMBURSEMENT
UNDER GRANT AGREEMENT

To be reimbursable under DHS/CHP Grant Agreement, expenditures must meet the following general criteria:

  1. Be necessary and reasonable for proper and efficient administration of the program and not be a general expense required to carry out the overall responsibilities of the agency.
  2. Be authorized or not prohibited under federal, state or local laws or regulations.
  3. Conform to any limitations or exclusions set forth in the applicable rules, program description or grant agreement.
  4. Be accorded consistent treatment through application of generally accepted accounting principles appropriate to the circumstances.
  5. Not be allocable to or included as a cost of any other state or federally financed program in either the current or a prior period.
  6. Be net of all applicable credits.
  7. Be specifically identified with the provision of a direct service or program activity.
  8. Be an actual expenditure of funds in support of program activities, documented by check number and/or internal ledger transfer of funds.

Examples of allowable costs include the following. This is not meant to be a complete list, but rather specific examples of items within each line item category.

Personal Services:

Gross salary paid to agency employees directly involved in the provision of program services.

Employer's portion of fringe benefits actually paid on behalf of direct services employees; examples include FICA (Social Security), life/health insurance, workers compensation insurance, unemployment insurance and pension/retirement benefits.

Contractual Services:

Conference registration fees

Contractual employees (require prior program approval)

Repair & maintenance of furniture and equipment

  • Postage, postal services, UPS or other carrier costs
  • Software for support of program objectives
  • Subscriptions
  • Training and education costs

Payments (or pass-through) to subcontractors or subgrantees are to be shown in the Contractual Services section - all subcontracts or subgrants require an attached detailed line-item Spending Plan supporting this contractual amount.

Allocation of the applicable portion of the following costs are allowable only if approved by the program and the allocation methodology is approved as part of the application process:

  • Rent or lease of space or facilities
  • Utility costs
  • Insurance
  • Copy machine rental or lease
  • Costs of improvements to real property

Travel:

  • Mileage (at state rate unless specifically noted otherwise)
  • Airline or rail transportation expense
  • Lodging
  • Per diem or meal costs
  • Operation costs of agency owned vehicles

Commodities (Supplies):

  • Office supplies
  • Medical supplies
  • Educational and instructional materials and supplies, including booklets and preprinted pamphlets
  • Household, laundry and cleaning supplies
  • Parts for furniture and office equipment
  • Equipment items costing less than $100.00 each

Printing (include in Supplies):

  • Letterpress, offset printing, binding, lithographing services
  • Photocopy paper, other paper supplies
  • Envelopes, letterhead, etc.

Equipment (requires prior written program approval when items are over $1,000):

  • Equipment is defined as items costing over $100.00 each, with useful life of more than one year. Costs shall include all freight and installation charges.
  • Office equipment and furniture
  • Allowable medical equipment
  • Reference and training materials and exhibits
  • Books and films

Telecommunications (include in Contractual Services):

  • Telephone services
  • Answering services
  • Repair, parts and maintenance of telephones and other communication equipment

Unallowable costs include, but are not limited to:

  • Bad debts
  • Contingencies or provision for unforeseen events
  • Contributions and donations
  • Entertainment, alcoholic beverages, gratuities
  • Fines and penalties
  • Interest and financial costs
  • Legislative and lobbying expenses
  • Real property payments or purchases
  • Indirect cost plan allocations