Tennessee Housing Development Agency
Supportive Services Value Calculation WorksheetUse this form to calculate the value of supportive services used as match. Refer to the Supportive Services Value Calculation Guide for detailed instructions. Applicant: _________________________________________________________Length of compliance period: ___5 Years ___10 Years ___15 YearsSupportive Services provided by applicant’s own staff. Complete the table below-Type of ServiceService Hours per Month Total Hours Worked Per Month % of Service HoursTotal Monthly SalariesMonthly Service ValueAnnual Service ValueCompliance Period Total Service ValueHrs provided to THTF residents(Svc Hrs ÷ Total Hrs)(Total Monthly Salaries ÷ % of Svc Hrs)(Monthly Svc Value x 12)(Annual Svc Value x Compliance Period)Case ManagementIntensive Day Treatment/TherapyBehavioral TherapyHealth ServicesAlcohol and Drug Abuse Recovery Support ServicesAnger ManagementEmployment Counseling/Job Placement AssistanceFinancial Literacy/ EducationLife Skills TrainingJob Skills TrainingGED TrainingOther: __________________ Other:__________________Total Supportive Services ValueSupportive Services paid for by the applicant. Complete the table below.Type of Service and Name of vendorPer-unit CostNumber of THTF residents servedTotal CostFrequency(i.e. weekly)Annual CostCompliance Period Total Value(Annual Cost x Compliance Period)Total Supportive Services ValueContracts or agreements with other organizations to provide services. Complete the fields below.Name of organization providing services: ___________________________________________Length of contract/agreement: ___________________Total contract value: ______________________Number of residents receiving services under the contract: _____THTF-funded housing residents receiving services under the contract: _____Total value of supportive services provided to THTF residents: _______________________ ................
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