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5 <br />• • • •J ■D. • v •J •••: -.• r .• • - <br />� �' }• �• `•� • 'JAI r'J }• <br />150 <br />100$ <br />$8, 750 <br />1.20 <br />1.12 <br />8Cf$ <br />Y7 /000 <br />90 <br />75% <br />$6,563 <br />75 <br />60$ <br />$5,250 <br />60 <br />50$ <br />$4,375 <br />37 <br />40% <br />$3'500 <br />30 <br />25� <br />$2,188 <br />20% <br />$1,750 <br />Local applicant agencies are to use this formula in preparing their funding <br />requests. <br />in counties with more than one maternity care coordination agency, each may submit <br />a separate request for funds. However, if both agencies indicate that they intend <br />to extend maternity cane coordination services to Medicaid recipients served by <br />private physicians, then their applications must also include a signed letter of <br />agreement. The letter of agreement must detail the client assignment arrangements <br />that have been agreed to by the two agencies. <br />-$ - r •: •:r• At " VI <br />The sulnnission deadline for is December 14 1990. <br />must either be received or Applications_ <br />ked that date. arts that fail to meet <br />the submission deadline or that are fete will not be a-----, <br />Applications should be mailed to: <br />Ms. Marcia Roth <br />Division of Maternal and Auld Health <br />Rost Office Box 27687 <br />Raleigh, North Carolina 27611 -7687 <br />Applications should be delivered to: <br />Ms. Marcia Roth <br />Room ;302 <br />1330 St. Mazy /s Street <br />Raleigh, North Carolina <br />■ • ..� a- �- ■ r• .• -Ja.� <br />— Applications may be Med to: <br />Ms. Marcia Roth <br />FAX # (919) 733 -0488 <br />r • r:y • r i •:• ell r ••a . ;� ti <br />'• r ar <br />