Page 1 of 16
Cancer Prevention and Early
Detection Program
Health System/Government Organization
Budget Guidance
Table of Contents
OVERALL GUIDANCE (All Strategies) 3
Budget with Justification Form 3
General Budget Categories and Descriptions 4
Personal Services 4
Supplies & Operating Expenses 4
Travel 5
Contractual 5
Indirect (F&A) Cost Rate: 6
Tips for Completing the Budget 7
Recommended and Required Budget Items 8
Unallowable Budget Items 8
HEALTH NAVIGATION AND CLINICAL SERVICES (HNCS) STRATEGY 8
General 8
Personal Services 9
Supplies and Operating Expenses 10
Travel 11
Contractual 11
Indirect Costs 11
Budget for Health Navigation and Clinical Services to Individual Clients (based on
data entered into eCaST) - eCaST Budget (included for information only) 11
THE COMMUNITY OUTREACH (TCO) STRATEGY 12
General 12
Personal Services 13
Supplies and Operating Expenses 13
Travel 14
Contractual 14
Indirect Costs 14
CLINIC QUALITY IMPROVEMENT (CQI) STRATEGY 14
General 14
OVERALL GUIDANCE (All Strategies) 3
Page 2 of 16
Health System/Government Organization Budget Guidance
Personal Services 15
Supplies and Operating Expenses 15
Travel 16
Indirect Costs 16
Additional Guidance Specific to the B&C CQI Sub-Strategy 16
Additional Guidance Specific to the CRC CQI Sub-Strategy 16
Updated January 2024 2|
Personal Services 15
Page 3 of 16
Health System/Government Organization Budget Guidance
OVERALL GUIDANCE (All Strategies)
Budget with Justification Form
● The budget period will be June 30 - June 29, annually.
● A Health System/Government Organization Budget with Justification Template
is provided.
● All dollar amounts and descriptions are entered in the Budget Template tab for
that strategy’s respective funding source:
○ The Community Outreach and Health Navigation and Clinical Services
Strategies and Breast and Cervical (B&C) Clinic Quality Improvement
(CQI) Sub-Strategy on one tab.
■ NOTE: When organizations first apply for the B&C CQI
Sub-Strategy, it will also be on a separate tab, but these costs
will be merged with the Community Outreach and Health
Navigation and Clinical Services Strategies budget in the final
contracting documents.
○ Colorectal (CRC) CQI Sub-Strategy on its own tab.
● Enter your organization’s name and program and fiscal staff names and contact
information in the cells on the budget form.
● Include the costs for all strategies (The Community Outreach, Clinic Quality
Improvement, and Health Navigation and Clinical Services [program
administration and management costs only], as applicable) for which your
organization is funded (or applying to add).
● The budget template has some common budget items pre-populated, however
you may modify or delete these items and descriptions if needed.
● In the “Description” column, indicate to which strategy(ies) the cost(s) applies.
● If your organization is not funded for the Community Outreach (TCO) or Clinic
Quality Improvement (CQI) strategies, delete the references to TCO or CQI that
have been pre-populated in the Budget with Justification Form.
● Organizations that are only funded for the Health Navigation and Clinical
Services (HNCS) strategy may decline all program administration and
management funding. If an organization chooses to decline all program
administration and management funding, the organization is not required to
submit a draft budget.
Updated January 2024 3|
Page 4 of 16
Health System/Government Organization Budget Guidance
General Budget Categories and Descriptions
See budget guidance under each strategy below for additional guidance within the
strategy.
Personal Services
List all employees who will perform work for the strategy (HNCS, TCO, CQI).
Include salaries, and time and effort percentage (full-time equivalent, hourly
or FTE). Each position listed must include a fringe rate. In the justification cell,
include the role and expected work of the position. Include a description of
how fringe benefits are determined and what is included in the calculation
(insurance, paid time off, etc.).
Some Health System staff may have time in the budget that is shared for HNCS
program administration and management, TCO and CQI strategies. The
proportion budgeted and charged to each strategy must be reasonable. This
person may also have some of their time covered by the budget for HNCS to
Individual Clients (i.e., eCaST Budget). The time covered by the budget for
HNCS to Individual Clients will not be listed in the budget.
Non-employee contractual staff should not be listed in the Personal Services
section of the budget. Include these personnel in the Contractual section of the
budget.
Examples of allowable personal services costs (not exhaustive)
o Programmatic staff
o Management staff
o Fiscal staff
o Data/evaluation staff
o Contracting staff
o Fringe benefits
Supplies & Operating Expenses
Include all operating expenses. The justification should describe the rationale,
necessity and reasonableness of operation costs. If rent is claimed as a direct
cost, provide a narrative justification. What specific supplies will you purchase
with the requested funds, and an estimate how much each costs?
Participant support costs such as the following are allowable costs, but MUST
be billed separately on the invoice as they may be subject to a different
indirect rate for organizations which use modified total direct costs (MTDC) as
a basis for their indirect rate:
○ Gift cards to reduce the barrier of adult or child care costs so eligible
Updated January 2024 4|
Page 5 of 16
Health System/Government Organization Budget Guidance
clients can attend screening appointment
○ Food or grocery gift cards to reduce the barrier of food insecurity
Travel
Include all travel and indicate whether in-state or out-of-state. Include costs
for attendance at any mandatory meetings if not offered remotely. Include
appropriate per diem, lodging, mileage, and vehicle rental or airfare rates or
include a link to current approved rates. How did you arrive at your travel
expenses—how many trips, how many people, what rates for rental car, per
diem, lodging?
Examples of allowable travel costs (not exhaustive)
o Mileage, per diem and lodging costs for staff travel to the in-person
meeting, training, and conferences
Participant travel costs such as the following may be allowable costs, but MUST
be billed separately on the invoice as they may be subject to a different
indirect rate for organizations which use modified total direct costs (MTDC) as
a basis for their indirect rate
o Taxi, Uber and Lyft vouchers or gas cards to assist participants in
traveling to health system for screening or follow-up
Contractual
Include all subcontractors needed to complete the work. This includes, but is
not limited to, consulting and personal services subcontracts. Restrictions
outlined in the budget guidelines, including cost reimbursement terms, also
apply to subcontracts. No subcontractor may be pre-paid for services. If you
hire subcontractors, what specific tasks will they perform, how many hours will
each take, and at what rate?
Examples of allowable contractual costs (not exhaustive)
o Note: At some organizations the items below may instead fit into the
Personal Services or Supplies & Operating category, depending on how
the organization makes these purchases)
o Graphic designer
o Interpretation
o Translation
o Printing
o Transportation
Updated January 2024 5|
Page 6 of 16
Health System/Government Organization Budget Guidance
Indirect (F&A) Cost Rate:
Definition: Indirect costs are those that have been incurred for common or
joint objectives and cannot be readily identified with a particular final cost
objective or grant account. Indirect costs may be called Facilities and
Administration costs (F&A) at some organizations. Indirect costs are different
from administrative costs in most cases. For example, a program employee can
be considered administrative and not be included in an organization’s indirect
costs. Costs classified as indirect can differ depending upon your organizational
structure and accounting practices but some common examples include
depreciation on buildings and equipment, operating and maintenance costs of
facilities, and general administrative expenses such as the salaries and
expenses of executive officers and accounting or legal staff.
If the organization/business maintains an indirect or F&A rate and the
organization chooses to include this cost on the budget, it is expected that the
amount budgeted will reflect the organization’s/business’s approved rate. Be
prepared to submit one of the following if requested:
a. Federally Negotiated Indirect Rate Agreement – An entity that receives
funding directly from the federal government is eligible to recover
indirect costs by using a federally negotiated indirect cost rate from
their Federal cognizant agency.
b. CDPHE Negotiated Indirect Rate Agreement – An entity that does not
have a current negotiated indirect cost rate with a federal agency AND
does not receive federal funds directly from a federal agency can
negotiate an indirect cost rate with the internal audit unit at CDPHE.
Alternatives to a negotiated indirect cost rate:
a. de minimis indirect cost rate – The de minimis rate of 10 percent of
modified total direct costs (MTDC) is available to all non-Federal entities
(2 CFR 200.414(f)). MTDC excludes equipment, capital expenditures,
charges for patient care, rental costs, tuition reimbursement,
scholarships and fellowships participant support costs and the portion of
each subaward in excess of $25,000.
b. Direct Charge All Expenses - Organizations may elect to direct charge all
allowable expenses on their billings for each contract, grant or award.
Billed costs will be subject to field review by the CDPHE.
If your organization opts to waive indirects, CDPHE will need written approval
of the request to waive the indirect rate by your organization’s Controller or
other official that understands the impact of not taking indirects.
Updated January 2024 6|
Page 7 of 16
Health System/Government Organization Budget Guidance
Tips for Completing the Budget
● Involve the correct people (usually fiscal staff) in completing the budget.
● Contact your organization’s fiscal staff early in the process.
● Certain cells have been locked to ensure formulas do not get changed in error.
Please contact cdphe_cancer@state.co.us if there is a cell that must be
unlocked.
● Rate and Quantity fields must match the description. Provide a detailed
description that explains expenses fully.
● In the “Description of Work” cells, be clear on how the expense will fulfill the
goals of the project and strategy activities. Indicate to which strategies the
cost applies. For example HNCS, TCO. Do not write “Translation of materials.”
Instead, say why: “Translation of materials needed for culturally and
linguistically appropriate materials to be distributed at outreach and
educational events.”
● Include budget for support staff (including fiscal staff), copying charges,
postage, memberships, telephone charges, meeting costs, and all the other
"hidden" expenses.
● Describe the need for budget totals/items in the description to assist the
reviewer to determine the reasonableness of the proposed budget.
● Ensure that requested funding aligns with the range of funding available.
● Remember that the budget should not raise any red flags. Review the budget
through the eyes of the individuals who do not know your organization.
○ What might not be clear?
○ Where would more explanation be helpful?
○ Can your organization accomplish the intended goals and activities with
the proposed budget?
○ Is the budget consistent with the statement of work?
○ Are costs necessary? Reasonable? Allocated to the project appropriately?
○ Are there unallowable costs? Food for meetings with internal staff or
external partners is not an allowable expense - do not include it in your
Updated January 2024 7|
Please contact cdphe_cancer@state.co.us if there is
Page 8 of 16
Health System/Government Organization Budget Guidance
budget.
● Consider adding costs into each major budget category so that you have
flexibility to move funds into that category later, if needed.
● Check your math.
● Avoid using acronyms. Spell out the terms.
Recommended and Required Budget Items
● Organizations should budget personnel for program management of strategies
(i.e., progress reports, invoicing, evaluation, webinars, manage sub-contracts,
etc.).
● Organizations should budget personnel time and costs for staff to
learn/understand program requirements and to participate in training.
Unallowable Budget Items
● Fundraising events or lobbying.
● In-kind/match contributions.
● Equipment costing more than $5,000 (Equipment is defined as a purchase
greater than or equal to $5,000 for an article of nonexpendable, tangible
personal property having a useful life of more than one year).
● Capital projects.
● Research.
● Food for meetings with internal staff or external partners. NOTE: Food may be
allowable under the TCO and/or HNCS strategies as a tool for barrier reduction
(i.e. to address food insecurity issues).
HEALTH NAVIGATION AND CLINICAL SERVICES (HNCS)
STRATEGY
General
● Organizations that are also funded for the Community Outreach (TCO) and/or
Clinic Quality Improvement (CQI) strategies must indicate in the description
which items relate to the Health Navigation and Clinical Services (HNCS)
strategy.
Updated January 2024 8|
Page 9 of 16
Health System/Government Organization Budget Guidance
● Organizations are paid for health navigation and clinical services to individual
clients based on data entered into the eCaST data system and according to the
Cancer Prevention and Early Detection Bundled Payment System (BPS). These
costs should not be included in the budget. Please see the “Budget for Health
Navigation and Clinical Services to Individual Clients” section below for more
information.
● All costs must be directly related to the provision of the following services for
eligible clients:
o Health navigation for breast and cervical cancer screening services, or
o Breast and cervical cancer screening and diagnostic services procedures
● Organizations may budget for costs to conduct marketing in communities to
identify clients who may be eligible for and in need of CDPHE-funded Clinical
Services and connect these clients to services at their clinic.
● Organizations must not budget for treatment or treatment support services for
breast or cervical cancer (navigation into the initiation of breast and cervical
treatment services is allowable).
o Make sure that services such as translation, interpretation, graphic design, etc.
are included in the budget category that reflects how your organization pays
for these services. For example, in some organizations these might be
employees, in others they may be contractors.
Personal Services
● Organizations should budget for personnel time and costs for staff to:
o Manage the HNCS strategy (i.e, progress reports, invoicing, evaluation,
webinars, site visits and chart audits,etc.).
o Manage subcontracts (i.e., billing tracking and resolution, subcontractor
training about WWC, communication with subcontractors, staff and
clients, etc.)
o Identify potential eligible clients (i.e. looking through EHRs, basic
outreach) and determining eligibility.
o Enroll clients into HNCS, including verifying eligibility and completion of
forms.
o Assist clients to enroll in insurance.
o Navigate individual clients to completion of breast and cervical
screening office visits.
Updated January 2024 9|
Cancer Prevention and Early Detection Bundled Payment System (BPS)
Page 10 of 16
Health System/Government Organization Budget Guidance
o Learn/understand the expectations of the HNCS strategies and
participate in training.
o Participate in recommended health navigation training.
o Enter data into the eCaST data system.
o Coordinate with the CQI team to support evidence-based intervention
(EBI) implementation. (Organizations that are also funded for B&C CQI
Sub-strategy only)
● Organizations must not budget for personnel time for navigation provided to
individual clients who need mammograms and breast and cervical cancer
diagnostic services (which is included in the separate budget amount for
services to individual clients and is paid based on data entered into eCaST [i.e.,
herein referred to as “eCaST Budget”). Examples of personnel tasks which are
already included in the eCaST Budget include health navigation of individual
clients, notifying clients of results, and helping clients schedule appointments.
● Organizations must not budget for personnel time for providing breast and
cervical cancer and diagnostic screening procedures to individual clients (which
is paid by insurance or included in the eCaST Budget). Examples of personnel
tasks which are paid by insurance or already included in the eCaST Budget
include providing Paps and mammograms, providing follow-up procedures by
the health system or subcontractors/referral providers, notifying clients of
results, and helping clients schedule appointments.
● Some Health System staff may have time that is both in the budget for program
administration and management and covered by the budget for HNCS to
Individual Clients (i.e., eCaST Budget). The time that is covered by the budget
for HNCS to Individual Clients (i.e., eCaST Budget) must not be listed in the
budget.
● Examples of additional allowable HNCS personal services costs (not exhaustive)
o Health Navigator (for time not spent navigating an individual client, such
as when attending training)
o Clinical staff time (for time not spent providing procedures/navigation
to an individual client, such as when attending training)
Supplies and Operating Expenses
● Allowable purchase of supplies/operating line item:
o CDPHE has a list of allowable purchases for HNCS supplies and operating
and the Budget with Justification Form uses this generic line item which
references that list. Additional justification is not required for items on
Updated January 2024 10|
Page 11 of 16
Health System/Government Organization Budget Guidance
the Health Navigation and Clinical Services Allowable Purchases List.
o Organizations should enter a flat amount into the rate column. The
quantity has been pre-populated at “1” for this line item in the budget.
o The Health Navigation and Clinical Services Allowable Purchases List is
posted on the Health Navigation and Clinical Services: Reimbursement
and Fiscal Management webpage.
Travel
● Organizations should consider budgeting for travel costs for staff to participate
in recommended training.
● Organizations should consider budgeting for client travel costs that may include
bus, cab, taxi or Uber/Lyft vouchers to assist clients with reducing
transportation barriers to get to a screening, diagnostic or initial treatment
appointment.
o Budget requests for client travel expenses should be tailored to your
organization (i.e., Uber and Lyft should not be included if the
organization is only doing taxi vouchers; taxi, Uber and Lyft should not
be included if the organization is only purchasing gas cards) and listed in
a separate line item called Participant Travel Expenses.
Contractual
● Organizations must not subcontract health navigation services for individual
clients.
● Organizations must not budget for the contractual cost for referral procedures
(which are included in the separate eCaST Budget).
Indirect Costs
● Organizations should budget for indirect costs according to the guidance found
on page 6.
Budget for Health Navigation and Clinical Services to Individual Clients
(based on data entered into eCaST) - eCaST Budget (included for
information only)
● Organizations are paid for health navigation and clinical services to individual
clients based on data entered in the eCaST data system and according to the
Cancer Prevention and Early Detection Bundled Payment System (BPS), herein
referred to as eCaST Budget. CDPHE has classified the eCaST Budget awards as
Updated January 2024 11|
Health Navigation and Clinical Services: Reimbursement and Fiscal Management webpage
Page 12 of 16
Health System/Government Organization Budget Guidance
fixed amount awards. Additional guidance about eCaST fixed awards can be
found in the Health Navigation and Clinical Services Administrative Program
Manual and on the Health Navigation and Clinical Services: Reimbursement and
Fiscal Management webpage.
● eCaST Budgets are not part of the contract budget and instead charged to a
single General Accounting Encumbrance (GAE). A GAE is where funding for
multiple Awardees is grouped together instead of being held separately for
each Awardee. The eCaST GAE will be referenced in the additional provisions of
the contract, however eCaST Budgets are managed outside of the contract and
no specific eCaST dollar amount will be referenced in the contract.
● Each organization’s proposed screening goals and eCaST Budget for the budget
period will be included in the Action Plan template. The Budget and Goals can
be negotiated as part of the Action Planning process.
● Reimbursement through the eCaST Budget is expected to cover costs associated
with:
o Breast and cervical cancer screening procedures as outlined in the CPT
Code List1 (Eligible uninsured/underinsured clients only).
o Health navigation services to individual clients to complete
mammograms and breast and cervical diagnostic procedures.
o Notification to clients of procedure results.
o Assistance scheduling appointments.
o Navigation to initiation of treatment services for persons diagnosed with
cancer.
o Health First Colorado Breast and Cervical Cancer Treatment Program
(BCCP) enrollment (Eligible uninsured/underinsured clients only).
o Personnel time to provide the above items.
o Indirect costs.
THE COMMUNITY OUTREACH (TCO) STRATEGY
General
● Indicate in the description which items relate to the Community Outreach
strategy.
● All costs must be directly related to the Community Outreach strategy.
● Organizations must not budget for payment of breast and cervical cancer
1 The current CPT Code List can be found on the Health Navigation and Clinical Services: Reimbursement and Fiscal Management
webpage.
Updated January 2024 12|
Health Navigation and Clinical Services: Reimbursement and Fiscal Management webpage
Page 13 of 16
Health System/Government Organization Budget Guidance
screenings.
● Organizations should budget for costs associated with reducing TCO participant
barriers (i.e, transportation, language assistance or reduction of food
insecurity)
● Make sure that services such as translation, interpretation, graphic design, etc.
are included in the budget category that reflects how your organization pays
for these services. For example, in some organizations these might be
employees, in others they may be contractors.
Personal Services
● Organizations must budget for:
o A person (or sub-contractor) to serve in a health navigator or community
health worker (CHW)/promotora role for community outreach. This
person should be at least 0.5 FTE on this strategy.
o Personnel time and costs for staff to manage and implement the
Community Outreach strategy (i.e, progress reports,
invoicing, evaluation, webinars, site visits, manage sub-contracts, etc.).
o Personnel time and costs for staff to learn/understand the expectations
of the Community Outreach strategy and to participate in required
training.
o Personnel time and costs for assisting participants to enroll in insurance.
● Examples of additional allowable TCO personal services costs (not
exhaustive)
o Community Health Worker (CHW)/Promotora or Health Navigator
o Interpreter staff (if employees)
Supplies and Operating Expenses
● Examples of allowable supplies and operating expenses (not exhaustive)
o Registration for relevant training or conference
o Translation costs (if not considered an employee or contractor)
o Office supplies for conducting Community Outreach
o Printing costs (if not done by a contractor)
o Outreach and educational materials
o Postage
o Program costs
Updated January 2024 13|
Page 14 of 16
Health System/Government Organization Budget Guidance
o Reimbursement of participant support costs for child or adult day care
o Computers, laptops, or tablets to input client data during community
outreach (CDPHE prior authorization is mandatory)
Travel
● Organizations should consider budgeting for travel costs to participate in
recommended training.
● Organizations should consider budgeting for travel costs to support participants
receiving direct assistance. This may include bus, cab, taxi or Uber/Lyft
vouchers to assist participants with reducing transportation barriers to get to a
clinic for their initial screening.
o Budget requests for participant travel expenses must be tailored to your
organization (i.e., Uber and Lyft should not be included if the
organization is only doing taxi vouchers; taxi, Uber and Lyft should not
be included if the organization is only purchasing gas cards) and listed in
a separate line item called Participant Travel Expenses.
Contractual
● Organizations may choose to sub-contract with one or more community-based
organizations to assist with implementation of this strategy.
● Examples of additional allowable TCO contractual costs (not exhaustive)
Note: At some organizations the items below may instead fit into the Personal
Services or Supplies & Operating category, depending on how the organization
makes these purchases
o Reimbursement of participant support costs for child or adult day care
o Contracted community-health worker/promotora
Indirect Costs
● Organizations should budget for indirect costs according to the guidance found
on page 6.
CLINIC QUALITY IMPROVEMENT (CQI) STRATEGY
General
● Indicate in the description which items relate to the B&C or CRC CQI
Updated January 2024 14|
Page 15 of 16
Health System/Government Organization Budget Guidance
sub-strategy.
● All costs must be directly related to the CQI strategy and the evidence-based
interventions (EBI) selected for implementation.
● Breast and cervical CQI and colorectal CQI funding must be accounted for
separately and cannot be intermingled. Breast and cervical funding can only be
used for breast and cervical CQI activities. Colorectal funding can only be used
for colorectal CQI activities.
● Organizations must not budget for treatment or treatment support services.
● Make sure that services such as translation, interpretation, graphic design, etc.
are included in the budget category that reflects how your organization pays
for these services. For example, in some organizations these might be
employees, in others they may be contractors.
Personal Services
● Organizations should budget for personnel time and costs for staff to:
o Manage the CQI strategy (i.e, progress reports, invoicing, evaluation,
webinars, and site visits, etc.).
o Identify potential eligible clients (i.e. looking through EHRs) and
determining eligibility.
o Learn/understand the expectations of the CQI strategy, how it intersects
with Health Navigation and Clinical Services, and to participate in
required training.
o Participate in EBI implementation activities.
o Clinical staff time (for time not spent providing procedures/navigation
to an individual client, such as when attending training, receiving
technical assistance or coordinating with HNCS staff)
Supplies and Operating Expenses
● Examples of allowable supplies and operating expenses (not exhaustive)
○ Registration for relevant training or conference
○ Translation costs (if not considered an employee or contractor)
○ Office supplies for conducting CQI
○ Printing costs (if not done by a contractor)
○ Educational materials
○ Program costs
Updated January 2024 15|
Page 16 of 16
Health System/Government Organization Budget Guidance
○ EHR enhancements (one-time expenses under the $5,000 threshold)
Travel
● Organizations should consider budgeting for travel costs to participate in
recommended training.
Indirect Costs
● Organizations should budget for indirect costs according to the guidance found
on page 6.
Additional Guidance Specific to the B&C CQI Sub-Strategy
● Organizations must not budget for payment of breast and cervical cancer
screenings.
● Budget personnel time to coordinate with the Health Navigation and Clinical
Services team to support evidence-based intervention (EBI) implementation.
● Organizations must not budget for the contractual cost for referral breast and
cervical procedures (which are included in the separate eCaST Budget).
Additional Guidance Specific to the CRC CQI Sub-Strategy
● Organizations must not budget the purchase of stool-based tests or payment of
direct clinical services with the exception of CDPHE approved follow-up
colonoscopies after a positive stool test.
● Organizations who are implementing the Reducing Structural Barriers EBI should
consider budgeting for travel costs to support eligible clients. This may include
bus, cab, taxi or Uber/Lyft vouchers to assist clients with reducing
transportation barriers to get to a clinic for their follow-up colonoscopy.
o Budget requests for participant travel expenses must be tailored to your
organization (i.e., Uber and Lyft should not be included if the
organization is only doing taxi vouchers; taxi, Uber and Lyft should not
be included if the organization is only purchasing gas cards) and listed in
a separate line item called Participant Travel Expenses.
o Organizations funded for follow-up colonoscopies may have additional funds
added as a contractual cost once they have determined a payment
method/process with colonoscopy referral partner(s).
Updated January 2024 16|