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' Centralina Area Agency on Aging Home and Community Care Block Grant Process Form: 3 ' APPOINTMENT OF ADVISORY COMMITTEE FOR THE HOME AND. COMMUNITY CARE BLOCK GRANT FOR OLDER ADULTS ' In order to implement-the Home and Community Care Block Grant for Older Adults, the Board. of Count Y Commissioners mtast have appointed an Advisory Committee to assist the designated Lead Agency in the development of the County Aging Funding Plan. This committee must be composed of potential public and private providers of aging services, elected county officials, older adults and other aging interests in the .county. Please complete the remainder of this form to indicate the appointment and membership of this committee.. County Cabarrus ' Date of Board Action May 18. 2009 Board of Commissioners Chairperson Signature County Manager- ' Signature Lead Agency Representative Signa re ' (Check One) X An .existing. on-going committee has responsibility for the Home and ..Community .Block Grant. Membership consists of Board of Commissioner appointments made on a rotating .basis. This committee. will maintain responsibility for the Home and Community Block Grant. until further notice. Name of Committee:.. HCCBG Advisory Committee Length of Terms of Office: 3 years Committee Year Is: January 1 2009 -December 31.2011 (Calendar Year, Fiscal Year, or other) The. Board of Commissioners appoints a special committee each year to fulfill the responsibility for the Home and Community Block Grant Committee. Complete and :attach the Membership List (Form 4) for the Committee assigned responsibility for the Home and Community Care Block Grant. Please mail this form to Gayla S. Woody, Aging Program Administrator, Centralina Council of Govei~tunents, P. O. Box 35008, Charlotte, NC 28235. 0605 (blue) Attachment number 1 Page 165 of 199 H-3