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NAME AND ADDRESS <br />COMMUNITY SERVICE PROVIDER <br />Joint Orange Chatham Community Action <br />Post Office, Box 27 <br />Pittsboro, NC 27312 <br />Home and Community Care Block Grant for Older Adults <br />County Funding Plan <br />Provider Services Summary <br />DOA-732 (Rev. 2/07) <br />County of Orange <br />July 1, 2007 throush June 30.2008 <br /> A B C D E F G H I <br /> Ser. Delivery <br />(Check one) Block Grant Fundin <br />Required <br />Net* <br />USDA <br />Total Projected <br />HCCBG Projected <br />eimburse Projected <br />HCCBG Projected <br />Total <br />Services Dirxt torch. Access In-Home Other Total Local Matc Serv Cost Subsid Fundin Units Rate Clients Units <br />Con ate Nutrition X 97295 \\\\1\\\\\\\\\\\1\ 10811 108106 21029 129135 28568 4.3879 375 35047 <br /> \\\\1\\\\\\\\\\\\ 0 0 0 <br /> \\1\\\\\\\\\\\\\\\ 0 0 0 <br /> \\\1\\\1\\\\\\\\\\ 0 0 0 <br /> \\\\1\\\\\\\\\\\\1 0 0 0 <br /> \\\\\\1\\\\\\\\\\\ 0 0 0 <br /> \\\\\\\\1\\\\\\\1 0 0 0 <br /> \\\\\\\\\\\\\\\\1\ 0 0 0 <br /> \\1\1\\\\\\\\\\\\\ 0 0 0 <br /> \\\\1\1\\\\\\\\\\\ 0 0 0 <br /> \\\1\\\\\\\\\\\\\\ 0 0 0 <br /> \\\\\\\\\\\\\\\\\\ 0 0 0 <br /> \\\\\\\\\\\\\\\\\\ 0 0 0 <br /> \\\\\\\\\\\\\\1\\\ 0 0 0 <br />Total \\1\\\\ \\\\\\\ 0 0 97295 97295 10811 108106 21029 129135 28568 \\\\\\\\\\\\\\ 375 35047 <br />*Adult Day Care & Adult Day Hea1W Care Net Service Cost <br />ADC ADHC ~ (Q~~~ ,/ <br />Daily Care Certification of required minimum local match availability. T ~ d <br />Transportation Required local match will be expended simultaneously Autho afore, Title Date <br />Administrative with Block Grant Funding. Co~ty ervice Pro <br />Net Ser. Cost Total ~,~~/~f ~ , ~ _l , ~~~// / .r..t . _ ~ . _ _ns .. / _. I _ <br />Signature, County Finance Officer Date <br />• • 1 <br />