Unit Cost Calculation PART IV. A. 3. (Page 1 of 3) Applicant________________________________ Older Americans Act Unit Cost Calculation SERVICE CATEGORIES TOTAL UNITS OF SERVICE TOTAL UNDUPLICATED PERSONS TOTAL OAA TITLE III FUNDING TOTAL LOCAL FUNDING TOTAL ALL FUNDING Add 3 & 4 OAA III COST PER UNIT Divide 3 by 1 TOTAL LOCAL COST PER UNIT Divide 4 by 1 TOTAL COST PER UNIT Add 6 & 7 TOTAL OAA TITLE III COST PER PERSON Divide 3 by 2 TOTAL LOCAL COST PER PERSON Divide 4 by 2 COST PER PERSON Add 9 &10 Registered Services: ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) ( 7 ) ( 8 ) ( 9 ) ( 10 ) ( 11 ) 1. Personal care 2. Homemaker 3. Chore 4. Home-delivered meals 5. Adult day care/ health 6. Case management 7. Congregate meals 8. Nutrition counseling 9. Assisted transportation Non-Registered "Other" Services: 10. Transportation 11. Legal assistance 12. Nutrition education 13. Information & assistance 14. Outreach Unit Cost Calculation PART IV. A. 3. (Page 2 of 3) Older Americans Act Unit Cost Calculation SERVICE CATEGORIES UNITS OF SERVICE TOTAL UNDUPLICATED PERSONS OAA TITLE III FUNDING TOTAL LOCAL FUNDING TOTAL ALL FUNDING Add 3 & 4 OAA TITLE III TOTAL LOCAL COST PER UNIT Divide 4 COST PER UNIT Add 6 & 7 TOTAL OAA TITLE III COST PER PERSON TOTAL LOCAL COST PER PERSON Divide 4 by 2 TOTAL COST PER PERSON Add 9 &10
COST PER UNIT Divide 3 by 1 by 1 Divide 3 by 2 15. Funded ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) ( 7 ) ( 8 ) ( 9 ) ( 10 ) ( 11 ) Advocacy/representation Education/training Education/information and assistance Education/outreach Health promotion Medication management Home repair Coordination of services Information services Information services-GRRC Access assistance Access assistance-GRRC Counseling Counseling-GRRC Support groups Support groups-GRRC Training Training-GRRC Respite care Respite care-GRRC Supplemental services Supplemental services-GRRC Unit Cost Calculation PART IV. A. 3. (Page 3 of 3) Non-Older Americans Act Unit Cost Calculation SERVICE CATEGORIES TOTAL UNITS OF SERVICE TOTAL UNDUPLICATED PERSONS TOTAL NON-OAA FUNDING TOTAL NON-OAA COST PER UNIT Divide Col.3 by .1 TOTAL NON-OAA COST PER PERSON Divide .3 by 2 16. Non-OAA Services ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) Non-OAA - Contract Services
Non-OAA - Contract Meals Non-OAA - Advantage Meals Non-OAA - Head Start Meals PART IV. A. 4. (Page 1 of 2) Summary Program Budget Applicant _____________________________________ III-B SOCIAL SERVICES III-C1 CONGREGATE MEALS III-C2 HOME DELIVERED MEALS III-D HEALTH PROMOTION/ MED MGMT III-E CAREGIVER SUPPORT TOTALS BUDGET CATEGORIES Transp OR Home Maker Home Repair Meals Cost Project Mgmt. Other Costs Meals Cost Project Mgmt Delivery Costs Other Costs Out Nut Educ Nut Transp Out Nut Educ HDM Assess /
Total Personnel Costs Supporting Budget Schedule PART IV. A. 5. (page 2 of 8 pages) Applicant _____________________________________ III-B SOCIAL SERVICES III-C1 CONGREGATE MEALS III-C2 HOME DELIVERED MEALS III-D HP/MM III-E CAREGIVER SUPPORT TOTALS BUDGET CATEGORIES Trans OR Home Home Repair Meals Cost Project Mgmt. Other Costs Meals Cost Project Mgmt Delivery Costs Other Costs Out Nut Educ Nut Transp Out Reach Nut Educ HDM Assess / 2. STAFF TRAVEL Total Travel Costs 3. FOOD
Total Food Costs Supporting Budget Schedule PART IV. A. 5. (page 3 of 8 Applicant _____________________________________ III-B SOCIAL SERVICES III-C1 CONGREGATE MEALS III-C2 HOME DELIVERED MEALS III-D HP/MM III-E CAREGIVER SUPPORT TOTALS BUDGET CATEGORIES Trans OR Home Maker Home Repair Meals Cost Project Mgmt. Costs Meals Cost Project Mgmt Delivery Costs Other Costs Out Reach Nut Educ Nut Transp Out Nut Educ HDM Assess / 4. NUTRITION CONSULTANT Total Nutrition Consultant Costs 5. EQUIPMENT
Total Equipment Costs Supporting Budget Schedule PART IV. A. 5. (page 4 of 8 pages) Applicant _____________________________________ III-B SOCIAL SERVICES III-C1 CONGREGATE III-C2 HOME DELIVERED III-D HP/MM III-E CAREGIVER SUPPORT TOTALS BUDGET CATEGORIES Trans OR Home Home Repair Meals Cost Project Mgmt. Costs Meals Cost Project Mgmt Delivery Costs Other Costs / Out Reach Nut Educ Nut Transp Out Reach Nut Educ HDM Assess 6. RENT/UTILITIES Total Rent/Utilities Costs 7. OTHER COSTS
Supporting Budget Schedule PART IV. A. 5. (page 5 of 8 Applicant _____________________________________ Non-Older Americans Act Contract Services Non-Older Americans Act Contract Meals Non-Older Americans Act Advantage Meals TOTALS BUDGET CATEGORIES Meals Cost Project Mgmt Delivery Costs Other Costs Meals Cost Project Mgmt Delivery Other Costs 1. PERSONNEL (Itemized By Title) Total Personnel Costs