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Division of Aging <br />Service Cost Computation Worksheet 1/98 <br /> In-Home Service Service Service Service Service Service <br /> Grand Aide <br />IlL Computation of Rates Total Level II <br /> A. ComputaUon of Unit Cost Rate: IIIIIIIIIIIIIIII II/1111111111111 IIIIIIIIIIIIIIII IIIIIIIIIIIII1~ IIIIIIIIIIIIIII IIIIIIIIIIIIIII IIIIIIIIIIII/11 IIIIIIIIIIIIIII IIIIIIIIIIIIIII <br /> 1. Total Expenses (equals line II.J) 108,614 ~//I/I/11/11/11 108,614 0.0~ a 0 0 0 0 <br /> 2. Total Projected Units IIIIIIIIIIIII1# tllllllllllllll 8,816 <br /> 3. Total Unit Cost Rate IIIIIIIIIIIIIIII IIIIIIIIIIIIIII 12.32 #DIVlO! #DIVlOI #DlVl0! #DIV/O! #DIV/O! #DIV/0! <br /> B. Computation of Ralmbumament Rate: IIIIIIIIIIIIIIII ~111111111111111 IIIIIIIIIIIIIIII IIIIIIIIIIIIII1~IIIIIIIIIIIII1~ IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII <br /> 1. Total Revenues (equals ~ine I.J) 108,614 IIIIIIIIIIIIIII 108,614 O.0C C 0 0 0 0 <br /> 2. Less: USDA (equals line I.D) ii IIIIIIIIIIII/11 0 0.00 0 a 0 0 0 <br /> Title V (equals line I.E and II.D) IIIIII/11111111 0 0.00 0 a 0 0 0 <br /> Non Match In-Kind (equals line I.H and Il,C) I~ IIIIIIIIIIIIIII 0 0.00 0 a 0 0 0 <br /> 3. Revenues Subject to Unit Reimbursement 108,614 IIIIIIIII/11111 108,614 0.00 0 a 0 0 0 <br /> 4. Total Projected Units (equals line III.A.2) /11111111111111 IIIII/11/111111 8,816 0.00 0 O 0 0 0 <br /> 5. Total Reimbursement Rate IIIIIIIIIIIIIIII IIIIIIIIIIIIIII 12.32 #DIVlO! #DIV/0! #DIV/0! #DIV/0! #DIVI0! #DIV/0! <br /> C. Units Reimbursed Through HCCBG IIIIIIIIIIIIIIII IIIIIIIIIIIIIII 8,7~6 #DIVI01 #DIVI01 #DIVIOI #DIVI01 #DIVI01 #DIVI01 <br /> D. Units Reimbursed Through Program Income' IIIIIIIIIIIIIIII 1/1111111111/I/ 8t #DlVl01 #DIVlOI #DlVl01 #DlVl01 #DlVl01 #DlVl01 <br /> E. Units Relmburae~ Through Remaining Revenues IIIIIIIIIIIIIIII IIIIIIIIIIIIIII 0.~ #DIVI01 #.DIV/OI #OlVl0! #DIVIOI #DIVIOI #OlVlOI <br /> F. Total Units Relmbumed/Total Projected Units IIIIIIIIIIIIIIII IIIII/111/11111 8,8t6.00 #DIV/01 #DIV#)I JDIVl01 #DlVl01 #DlVl01 ~lV/OI <br /> · The Division of Agiog ARMS deducts reported program <br /> income from reimbursement paid to providers. Line III.D <br /> i~licates ~ 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 111.8.5 Col. G <br /> Projected Total Service Units Line III.F CoL I <br /> 3 <br /> <br /> <br />