| Note: Donations are money or gifts of things, donated by an individual, family, or trust, that are intended to be used for a charitable purpose. Per the donation regulations applied to healthcare organizations, only 5% of a donation may be used to fund operating expenses on an annual basis. For example, if the Smith family donated $100,000 to a nonprofit healthcare organization, only $5,000 of that donation could be spent annually on whatever purpose the Smith family designated for the gift. However, the full amount of a donation can be used to purchase equipment or to purchase or renovate space, with the donor's consent. Equipment maintenance is an ongoing cost and cannot be funded by donations, except via the 5% rule. People, staff, supplies, and rental costs cannot be funded by donations except through the 5% rule. The rules regarding the use of donations are much more limiting for for-profit organizations vs. nonprofit organizations.
Grants are very specific about what will and will not be covered. They require a written grant request or proposal that specifically states how the money will be used. Once a grant is awarded, the receiving organization must show proof that the money was used as directed by the grantor and as stated in the grant application. Grants are usually time sensitive and often nonrenewable. Most are designed to help initiate a program, not to sustain a program. |
| IHP 670 Proposed Program Budget Template |
| | Complete this template by replacing the bracketed text with the relevant information. |
| | Course |
| | Program Name | Pediatric Fertility Preservation |
| | Program Planner |
| Volume Projections |
| Year | Total visits | Increase | Average increase/year |
| 2021 | 200 | 3100 | 15% |
| 2022 | 200 | 6500 | 20% |
| 2023 | 300 | 9450 | 25% |
| 2024 | 400 | 12620 | 25% |
| 2025 | 500 | 15750 | 25% |
| Projected Total Visits for 2021 | 1600 | 47420 |
| Projected total is Total visits for prior year (2020) increased by Average increase/year |
| Expenses |
| People |
| Staff by position (RN, Biller, Coder, etc.) | Cost | Hours | year | Total annual cost | Benefits | Benefit cost | Total Cost For One Position | Number of Positions Needed | Total Cost |
| Medical Provider | 24 | 8 | 616 | 69,120 | 22% | 35,235 | 69,120 | 1 | 138,240 |
| Nutrionist | 30 | 8 | 280 | 86,400 | 22% | 16,016 | 86,400 | 1 | 172,800 |
| Quality Improvement Coordinator | 20 | 8 | 216 | 57,600 | 22% | 12,355 | 57,600 | 1 | 115,200 |
| Front Desk Clerk | 10 | 8 | 120 | 28,800 | 22% | 6,864 | 28,800 | 1 | 57,600 |
| Medical Assistant | 10 | 8 | 120 | 28,800 | 22% | 6,864 | 28,800 | 1 | 57,600 |
| Equipment |
| Equipment | Cost per item | One-time cost (Yes/No) | Annual cost to operate/maintain equipment |
| Computer | 450 | yes | 720 |
| Screen Projector | 300 | yes | 900 |
| Weight scale | 200 | yes | 600 |
| tables | 350 | no | n/a |
| chairs ( 25 chairs @ $50.00 ) | 1200 | no | n/a |
| Total Cost | $2,500.00 |
| Space |
| Rental cost per year | Renovation cost |
| 6000 | 0 |
| Supplies |
| Item | Annual cost |
| Printing | 1000 |
| File Folders | 100 |
| Educational Materials | 600 |
| Weight Scale | 300 |
| Paper, Pens and pencils | 250 |
| | 2250 |
| Program Expenses |
| Total one-time expenses for equipment | Total annual operating expenses (people, space, annual equipment costs, supplies) |
| [Insert text.] | 355720 |
| Revenue |
| Annual earned revenue from billing | Annual saved revenue | Expected donations for equipment, space renovation | Expected grant income (please note available grants and sponsoring organizations) |
| patient visit | 600 | 600,000 | 600,000 |
| n/a | n/a | n/a | n/a |
| n/a | n/a | n/a | n/a |
| Profitability |
| Note revenue and income total not including donations | Subtract all operating expenses | Is this program sustainable? |
| [Insert text.] | [Insert text.] | [Insert text.] |
veronrcaxe.hwrne
IHP670ProposedProgramBudgetedited21.xlsx
