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NAM~ AND ADDRESS llome and Community Care Block Grant for Older Adulta <br />COMMUNITY SERVICE PROVIDER DOA-732 (Rev. 1/98} <br />Cabarms County Department of Social Services County Funding Plan County Cabarrus <br />1303 S. Cannon Blvd. July I, 2000 through June 30, 2001 <br />Kannapolis, NC 28083 Provider Services Summary <br /> <br /> B C D 1'] F G H ! <br /> A <br /> $ef. D~livce/ Projected Projected Projected Projected <br /> (C~ck One) Block Grant Funding Required Net* USDA Total tlCCBG Reimburse. tlCCBG Total <br />Services Direct eu~h. Access ln-Itome Other Total Local Match Serv Cost Subsidy Funding Units Rate Clients Units <br />IHA Services x $103,330 \\\\\\\\\\\\\\\\\\ $11,481 $114,811 $114,811 9,026 $12.72 3(~ 9,100 <br /> <br /> Total \\\\\\\ \\\\\\\ 0 $103,33~ $0 $103,330 $11,481 $114,811 0- $114,811 9,026 ~\\\\\\\\\\\\\ 30 9,10C <br />*Adult Day Care & Adult Day Health Care Net Service Cost <br />ADC ADIIC~/"~~ ~"--~--~.~._._~ ~ <br />Daily Care Certification ofrequired minimum local match availability. .~. ~ '- ~_'9 ~, ~ <br />Transporlation Required local match will b~ expended simultaneously A~"~ature, Title Date <br />Administrative with Block Grnnt Funding. Comh~nity Service Provider <br /> <br /> Signature, County ~ina~ce Officer t , Date Signature, Chairman, Board of Commissioners Date <br /> <br /> <br />