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HCCBG Budget <br />NAME AND ADDRESS Home and Community Care Block Grant for <br />COMMUNITY SERVICE PROVIDER <br />Cabarrus Meals on Wheels County Funding Plan <br />Provider Services Summary <br />Services <br />Ser. Delivery <br />A <br />B <br />C <br />Block Grant Funding <br />Required <br />Local Match <br />Net* <br />Sery Cost <br />(Check One) <br />Direct <br />Purch. <br />Access <br />In -Home <br />Other <br />Total <br />Home Delivered 020 <br />0 <br />31257 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />3473 <br />34730 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \\ <br />0 <br />0 <br />Total <br />\ \ \ \ \ \\ <br />\ \ \ \ \ \\ <br />1 01 <br />31257 <br />1 01 <br />31,257 <br />3473 <br />34730 <br />*Adult Day Care & Adult Day Health Care Net Service Cost <br />ADC ADHC <br />Daily Care Certification of required minimum local match <br />Transportation availability. Required local match will be expended <br />Administrative simultaneously with Block Grant Funding. <br />Net Ser. Cost Total <br />Signature, County Finance Officer Date <br />Attachment number 1 <br />F -3 Page 91 <br />