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Division of Aging <br />Service Cost Computation Worksheet 1/98 <br /> In-Home Service Service Service Se~lce Service Service <br /> Grand Aide <br />III. Computation of Rates Total Level II <br /> <br />1. Total Expenses (equals.line II.J) 115,752 IIIIIIIIIIIIIII 115,752 0.00 0 0 0 0 (~ <br />1. Total Revenues (equals line I.J) 115,752 IIIIIIIIIIIIIII 115,752 0.00 0 0 0 0 (~ <br />2. Less: USDA (equals line I.D) 0 IIIIIIIIIIIIIII 0 0.00 0 0 0 0 0 <br />Title V (equals line I.E and II.D) IIII/11/111//11 0 0.00 0 0 0 0 0 <br />Non Match In-Kind (equals line I.H and Il.C) 0 IIIIIIIIIIIIIII · 0 0.00 0 0 0 0 0 <br />3. Revenues Subject to Unit Reimbursement 115,752 /////////////// 115,752 0.00 0 0 0 0 0 <br />C. Units Reimbursed Through HCCBG IIIIIIIIIIIIIIII //////////////I ! 9,026 #DlVl01 #DIV/01 #DlVl01 #DlVl01 #DIVI01 #DIVI01 <br />D. Units Reimbursed Through Program Income* IIIIIIIIIIIIIIII /////////////// 74 #DlVl01 #DlVl01 #DIVI01 #DlVl01 #DIVI01 #DIVI01 <br />E. Unita Relmbumed Through Remaining Revenues ///////I///11//I //I//I//11///// 0.00 #DIVI01 #DlVl01 #DlVl01 #DlVl01' #DlVl01 #DlVl01 <br />F. Total Units Reimburaed/Total Projected Units I///I/I//11///11 !////////I//I/// 9,100.00 #DIVI01 #DIVI01 #DlVl01 #DIVI01 #DIVI01 #DIVI01 <br />' The Division of Aging ARMS deducts reported program <br />income from reimbursement paid to providers. Line III.D <br />indicates the number of units that will have to be produced <br />in addition to those stated on line III.C in order to earn the <br />net revenues stated on line I,C. <br />Information on this form (DOA-732A) corresponds with <br />information stated on the Provider Services Summary <br />(DOA-732) as follows: <br /> DOA-732A DOA-732 <br /> Block Grant Funding Line I.A Col. A <br /> Required Local Match-Cash & In-Kind Line I.B Col. B <br /> Net Service Cost Line I.C Col. C <br /> USDA Subsidy Line I.D Col. D <br /> Total Funding L.I.C+I.D Col. E <br /> Projected HCCBG Reimbursed Units Line III.C Col. F <br /> Total Reimbursement Rate Line III.B.5 Col. G <br /> Projected Total Service Units Line III.F Col. I <br /> 3 <br /> <br /> <br />