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DocuSign Envelope ID:871596FB-EB3F4768-BC79-A5D9ADF74E87 <br /> Attachment B <br /> Statement of Work <br /> Subcontractor: Oranae:County, North'Carolina <br /> This statement should be short summary describing what the Subcontractor does and how the <br /> Subcontractor will use these funds. The terms of the contract between TJAAAA and the <br /> Subcontractor requires that these goals are met for the stated period. The uses of these funds <br /> are not limited to but MUST include the following activities. <br /> 1) Conduct a minimum of two outreach activities in each county. A minimum of one <br /> outreach activity must be planned in collaboration with a community partner(s)that <br /> serves individuals with mental illness, and a minimum of one outreach activity must be <br /> held that focuses on people who are aging and/or have disabilities other than mental <br /> illness. <br /> 2) All outreach activities must include Relay for Extra Help materials provided by the Senor <br /> Health Insurance Information (SHIIP) office. <br /> 3) Coordinate with local SHIIP sites and refer individuals who are likely eligible for LIS and <br /> MSP. <br /> 4) Submit Client Counseling Contact forms for individual counseling and Public& Media <br /> Outreach forms fro outreach events monthly to the TJAAA office for entering in the <br /> national SHIPtalk reporting system. <br /> 5) Develop new partnerships for planning and conducting successful outreach events. <br /> 6) Encourage Medicare beneficiaries to participate in local disease prevention and wellness <br /> activities. <br /> 7) Monthly reporting forms for contracted activities and expenses incurred are to be <br /> submitted to electronically by the 1 Oth of each month for the month prior to Susan Reed <br /> at susan.reed wake ov.com. A final report of expenses incurred is due on or before <br /> EMBINOM <br /> The following Scope of Work should address the ways the Subcontractor will accomplish the <br /> above expectations and/or willingness to comply. <br /> SCOPE OF WORK: <br /> (maximum 2 pages) <br /> 1) Orange County SHIIP (OC SHIIP)will conduct a minimum of two outreach <br /> activities including collaborating with at least one community partner that serves <br /> individuals with mental illness to conduct an outreach event, and at least one <br /> Page 7 of 12 <br />