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DocuSign Envelope ID: 17COF518- 9238 - 480E- 96E6- 77F FCC C2626B <br />iv. <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />® Orange County Other (DO NOT Include HOME funding here) <br />o Other Government Grants <br />• Triangle United Way <br />• State Government <br />• Federal Government (CDBG /HOME /etc.) <br />• Private Foundation Grants <br />o Other Revenue <br />Expenditures <br />• Compensation <br />• Rent & Utilities <br />• Supplies & Equipment <br />• Travel & Training <br />• Other Expenses <br />Does your agency budget show a Surplus or Deficit? Deficit <br />Is there a significant change? Yes /No Yes <br />Please provide a brief explanation for Surplus or Deficit, and significant changes. <br />Senior Care of Orange County continues to deal with a significant change within the past <br />fiscal year. The Florence Gray Soltys Adult Day Health Program has various third party <br />payer sources which includes the Veterans Administration providing limited funding days <br />of service for eligible Veterans. In the past, Veterans qualified for attendance in the <br />program for up to five days per week, where now its three days. The increase in the cost <br />of living wage, where the program cost per day of service has remain constant. Also, staff <br />turnover remains a major issue due to limited wages and employees needing benefits. <br />What is your agency's fiscal year? July 1, 2018 - June 30, 2019 <br />Agency Information 1/23/2018 4:21:18 PM Page 14 of 25 <br />