Orange County NC Website
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~d y n o., <br />~~Eo- <br />~~ <br />V~~~~~ <br />Michael F. Easley, Governor <br />Dempsey Benton, Secretary <br />Organization Name: <br />North Carolina Department of Health and Human Services <br />Office of Research, Demonstrations, and <br />Rural Health Development <br />2009 Mail Service Center • Raleigh, North Carolina 27699-2009 <br />Tel: 919-733-2040 • Fax: 919-733.8300 <br />John Price, Director <br />_Orange County Health Department <br />FY 2009 Community Health Center Grants <br />YEAR 3 CONTINUATION GRANT <br />Budget Template <br />Budget Time Period: July 2008 -June 2009 <br />PROJECT REVENUE (add additional rows as needed) <br />Year 3 Community Health Continuation Grant Request $44,769 <br />Estimated Carryover of SFY 2008 Community Health Grant Funds $0 <br />Other Revenue <br />Patient fees $1180 <br />Insurance receipts (Medicare, Medicaid, etc.) $1206 <br />Other grant (define) <br />Other rant (define) <br />Other revenue (define) <br />Other revenue (define) <br /> <br />Total Project Revenue $47,155 <br />PROJECT EXPENSES (add additional rows as needed) <br />Staff n~ <br />Staff salaries (List by position type -example: MD, nurse, therapist, etc.) <br />(1) <br />(2) <br />(3) <br />(4) <br />(5) <br />Staff fringe benefits (Report as lump sum) <br />Temporary or contract staff (List by position type) <br />(1) Family Nurse Practitioner (.3 FTE) -12 hrs x $28.97/hr x 48 weeks $16,687 <br />(2) RN (.3 FTE) -12 hrs x $25.50/hr x 48 weeks $14,688 <br />(3) Lab Tech (.3 FTE) -12 hrs x $14.25 x 48 weeks $8,208 <br />Location: 311 Ashe Avenue • Cooke Building • Governor Morehead Campus • Raleigh, NC 27606 <br />An Equal Opportunity/ Affirmative Action Employer <br />