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Application for Operating Assistance <br />Elderly & Handicapped Transportation Assistance Program <br />And <br />Medicaid Transportation Assistance Program <br />FY1991 -92 <br />I. General Information <br />Applicant County: ocarpe 0bunt <br />County Contact Person: JerEX Passmore Title: C. A. T. Coordi <br />Address: -_P-O- Box 8181 City: Hj11SL=Q11gh Zip: 27278 <br />Telephone Number: (914 - FAX Number: (91J 644 -3005 <br />The local government department responsible for program administration: <br />E &HTAP Dept. on A2inciZL.A.T. az=wMedicaid Dept- on Aging /C.A.T. Program <br />The Transportation Development Plan which supports this application was adopted on 110-191 <br />by the Board of County Commissioners. MO DAY YEAR <br />II. Project Descriptions <br />A. Appendix A - Complete "Elderly and Handicapped Transportation Assistance Program <br />Participating Agencies." <br />Describe in narrative form on the back of Appendix A: <br />1. how the Elderly and Handicapped Program transportation will be provided (i.e. lead agency, <br />private operator, volunteer, staff reimbursement, bus passes, etc.) for each agency named on <br />the front of Appendix A; <br />2. how the Elderly and Handicapped Program will be administered locally; <br />3. when interagency meetings will be held to discuss total allocation of Elderly and Handicapped <br />Transportation Assistance Program funds; and <br />4. how certification of Elderly and Handicapped Program participants occurs. <br />Prioritize the types of transportation needed by elderly and handicapped citizens in your <br />county. (1 being the highest priority, 7 being the lowest priority) <br />1 Medical 3 Nutrition <br />6 Employment 4 Education <br />5 Social/Recreational 2 Shopping /Personal Business <br />7 Multipurpose <br />B. Appendix 6- Complete "Medicaid Program Participating Agencies and Description" <br />Describe in narrative form on the back of Appendix B: <br />1- how the Medicaid transportation will be provided (i.e. lead agency, private operator, volunteer, <br />staff reimbursement, bus passes, etc.) for each agency named on the front of Appendix B; <br />2. how the Medicaid transportation will be administered locally; <br />3. when interagency meetings will be held to discuss total allocation of Medicaid Transportation <br />Assistance Program funds. <br />III. Certified Statement <br />