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HCCBG Budget <br />NAME AND ADDRESS Home and Community Care Block Grant for Older Adults <br />COMMUNITY SERVICE PROVIDER DOA -732 (Rev. 2115) <br />Cabarrus County Department of Human Services County Funding Plan County Cabarrus <br />1303 S Cannon Blvd July 1, 2015 through June 30, 2016 <br />Kannapoll NC 28083 Provider Services Summary <br />Services <br />Ser. Delivery <br />A <br />B <br />C <br />D <br />E <br />F <br />G <br />H <br />I <br />Block Grant Funding <br />Required <br />Local Match <br />Net' <br />Sery Cost <br />USDA <br />Subsidy <br />Total <br />Funding <br />Projected <br />HCCBG <br />Units <br />Projected <br />Reimburse. <br />gate <br />Projected <br />HCCBG <br />Clients <br />Projected <br />Total <br />Units <br />(Check One) <br />Direct <br />Purch. <br />Access <br />In-Home <br />Other <br />Total <br />Trans 250 <br />L <br />141250 <br />11111111111111 <br />11111111111N1 <br />11111111111111 <br />15694 <br />156944 <br />0 <br />156944 <br />9149 <br />17.154 <br />8247 <br />99800 <br />In -Home 11- Personal Care 042 <br />135287 <br />15032 <br />150319 <br />0 <br />150319 <br />7705 <br />19.5082 <br />15 <br />7708 <br />In -Home 111- Personal Care 045 <br />45095 <br />5011 <br />50106 <br />0 <br />50106 <br />2442 <br />20.5184 <br />6 <br />2444 <br />Congregate 180 <br />97293 <br />11111/11111111 <br />10810 <br />108103 <br />37500 <br />145603 <br />17236 <br />6.2719 <br />250 <br />45000 <br />Home Delivered 020 <br />62802 <br />11111111111111 <br />6978 <br />69780 <br />52500 <br />122280 <br />16623 <br />4.1978 <br />13000 <br />100000 <br />Housing/ Home Repair 140 <br />35081 <br />H111111111111 <br />3898 <br />38979 <br />0 <br />38979 <br />#DIV /O! <br />#DIV /O! <br />#DIV /DI <br />Adult Day Care 030 <br />19361 <br />11111111111111 <br />2151 <br />21512 <br />0 <br />21512 <br />648 <br />33.1723 <br />6 <br />650 <br />Adult Day Health 155 <br />109707 <br />11111111111111 <br />12190 <br />121897 <br />0 <br />121897 <br />2947 <br />41.3631 <br />20 <br />2948 <br />Senior Center Operation 170 <br />76123 <br />11111111111111 <br />8458 <br />84581 <br />0 <br />0 <br />84581 <br />#DIVIO! <br />#DIV /0? <br />#DIV/Ol <br />11111111111111 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />IIIN111111111 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />11111111111111 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />- 0 <br />11111111111111 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />11111111111111 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />0 <br />Total <br />1111111 <br />1111111 <br />141250 <br />180382 <br />400,3671 <br />721,9991 <br />80222 <br />802221 <br />90000 <br />892221 <br />11111111111111 <br />11111111111111 <br />21544 <br />#DIV/O! <br />'Adult Day Care & Adult Day Health Care Net Service Cask <br />ADC ADHC <br />Daily Care 3107 40 <br />Transportation <br />Administrative <br />Net Ser. Cost Total 3107 40 <br />Certification of required minimum local match <br />availability. Required local match will he expended <br />simultaneously with Block Grant Funding. <br />Signature, County Finance Officer Date <br />�l�� l/�/1 A� <br />Authorized Signature, Title Date <br />Community Service Provider <br />Signature, Chairman, Board of Commissioners Date <br />Attachment number 1 <br />F -3 Page 77 <br />