SHEET 2: AGENCY AND SERVICES INFORMATION
Agency Name:  
   
Unit Cost Year: 1 July 2000 to 30 June 2001
HACC Services Provided The Unit For Costing Your Service Total Units of Service Delivered in the Unit Cost Year[1] Number of Jobs  
1. Allied Health Care - Centre Hours      
2. Allied Health Care - Home Hours      
3. Assessment Hours      
4. Case Management Hours      
5. Case Plan, Review & Coord Hours      
6. Centre-based Day Care Hours      
7. Counselling/Info/Advocacy Hours      
8. Domestic Assistance Hours      
9. Formal Linen Service Collections      
10. Home Maintenance Hours      
11. Home Modification $      
12. Meals - Centre Meals      
13. Meals - Home Meals      
14. Nursing Care - Centre Hours      
15. Nursing Care - Home Hours      
16. Other Food Services Hours      
17. Prov. Goods & Equipment Pieces      
18. Personal Care Hours      
19. Respite Care Hours      
20. Social Support Hours      
21. Transport One way trips      

[1]
Enter the total units of service delivered in the last year.  Include services delivered by paid staff and volunteers.