Return
to Services
|
Personal
Special Needs Budget
September,
2000
Client:
Mr. E
Age:
59
| Expenses |
Monthly
Amount |
Annual
Amount |
| |
| Monthly
Housing Expenses |
|
| Laundry
Costs |
$
20.00 |
$
240.00 |
| Clothing
Costs |
50.00 |
600.00 |
| Cleaning
Supplies |
20.00 |
240.00 |
| |
| Caregiver
Services |
|
| LPN: |
|
| 40
hours/week @$21 |
3,640.00 |
43,680.00 |
| (Camille
E) |
|
| 80
hours/week @$10 |
|
| (Jennifer) |
1,733.00 |
20,800.00 |
| (Amelia) |
1,733.00 |
20,800.00 |
| Physical
Therapy |
480.00 |
5,760.00 |
| Physician
Visits |
100.00 |
1,200.00 |
| Case
Management |
400.00 |
4,800.00 |
| Nutritional
Supplement (Peritive) 6 cans/day |
664.00 |
7,968.00 |
| Dietary
Needs (juice / water) |
25.00 |
300.00 |
| Hygiene
Needs (shaving cream, soap, |
20.00 |
240.00 |
| deodorant,
etc.) |
|
| Vehicle
Expenses (gas, oil change, maintenance) |
200.00 |
2,400.00 |
| Utility
Bills (telephone, electric, gas) |
200.00 |
2,400.00 |
| |
| Medical
Supplies |
|
| Foley
Catheter (2 / month) |
4.00 |
48.00 |
| Urinary
drainage bag (2 / month) |
6.00 |
72.00 |
| Trach
(1 / month) |
80.00 |
960.00 |
| Trach
collars (1 box / month) |
5.00 |
60.00 |
| Trach
mask (1 / month) |
3.00 |
36.00 |
| G-Tube
- 18" French (6 / year) $77 / each |
39.00 |
468.00 |
| Drain
sponges 4x4 (130 / month) |
135.00 |
1,620.00 |
| Gauze
pads 4x4 (80 / month) |
11.00 |
132.00 |
| Dressings
5x4 (70 / month) |
8.00 |
96.00 |
| Syringes
- 60 cc (4 / month) |
9.00 |
108.00 |
| Cara
Klenz (2 bottles / month) |
20.00 |
240.00 |
| 3M
Paper Tape (2 rolls / month) |
2.00 |
25.00 |
| Diapers
(130/month) |
172.00 |
2,064.00 |
| Chux
Pads (60 / month) |
50.00 |
600.00 |
| Saline
(4 bottles / month) |
28.00 |
336.00 |
| Rubber
Disposable Gloves |
22.00 |
264.00 |
| (2
boxes/month) |
|
| Cotton
tipped applicators |
4.00 |
48.00 |
| (1/2
box/month) |
|
| Swab
sticks (1/2 box / month) |
18.00 |
216.00 |
| |
| Total |
$
XXXXXX |
$
XXXXXXXX |
| |
| Expenses |
Total
Amount |
| Special
One-Time Equipment Purchases |
|
| Accessible
Van - (Purchased by Mrs. E) |
$
55,000 |
| Accessible
Housing (Projection) |
300,000
- 350,000 |
| Furniture
/ Appliances for home |
5,000
- 10,000 |
| Wheelchair |
3,500
- 5,000 |
| Wheelchair
Cushion |
350-
500 |
| Back-up
Generator |
3,000
- 5,000 |
| Suction
Machine / and tubing |
850 |
| Feeding
Pump |
2,200 |
| IV
Pole |
25 |
| Humidified
Air Compressor & Reservoir |
710 |
| Electric
Hospital Bed with Side Rails / Mattress |
1,750-
2,000 |
| Hoyer
Lift with sling |
1,500-
3,000 |
| Air
Mattress for hospital bed |
110-
250 |
| Sheep
skin heel protectors (bunny boots) |
30/pair |
| |
| |
| *Medical
Discretionary Fund |
10,000 |
| |
| Total |
$XXXXXX-$XXXXXX |
| |
| *Mrs.
E has requested reimbursement for expenses paid toward
an accessible van for Mr. E. |
Download
a PDF version of this case study:
Personal Special Needs Budget
You
will need Adobe Acrobat reader to print this document.
Click
here for a free download.
|
