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DocuSign Envelope ID:636AFD33-DA5C-4B55-88DC-03C0863BAFE3 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Actual Estimated Projected <br /> 2014-2015 2015-2016 2016-2017 <br /> Family Consultations/ Family Consultations/ Family Consultations/ <br /> Referrals: FAN Referrals: FAN Referrals: FAN <br /> advocates provided advocates provide advocates will provide <br /> support, advocacy and support, advocacy and support, advocacy and <br /> information/referral information/referral information/referral <br /> assistance for parents assistance for parents assistance for parents <br /> who called MHAT/FAN who call MHAT/FAN for who call MHAT/FAN for <br /> for help with services for help with services for help with services for <br /> their child. FAN their child. FAN their child. FAN <br /> advocates spent advocates spend advocates will spend <br /> approximately 1-4 hours approximately 1-4 hours approximately 1-4 hours <br /> on one or more phone on one or more phone on one or more phone <br /> calls or 1:1 meetings to calls or 1:1 meetings to calls or 1:1 meetings to <br /> identify needs, services, identify needs, services, identify needs, services, <br /> providing service providing service providing service <br /> navigation assistance, navigation assistance, navigation assistance, <br /> supporting and coaching supporting and coaching supporting and coaching <br /> parents on how to parents on how to parents on how to <br /> advocate for needed advocate for needed advocate for needed <br /> services and how and services and how and services and how and <br /> where to connect youth where to connect youth to where to connect youth to <br /> to positive community positive community positive community <br /> Program Activity 2 resources. resources. resources. <br /> Improve access to <br /> services for children Improve access to Improve access to <br /> with mental health services for children with services for children with <br /> needs; improve parents' mental health needs; mental health needs; <br /> ability to advocate improve parents' ability improve parents' ability <br /> effectively and secure to advocate effectively to advocate effectively <br /> needed services for their and secure needed and secure needed <br /> Program Goal children services for their children services for their children <br /> Parent reports of <br /> satisfaction with Parent reports of Parent reports of <br /> information and referral satisfaction with satisfaction with <br /> assistance; feedback information and referral information and referral <br /> from parents and assistance; feedback from assistance; feedback from <br /> community agencies re: parents and community parents and community <br /> effectiveness of parent agencies re: effectiveness agencies re: effectiveness <br /> Performance advocacy to obtain of parent advocacy to of parent advocacy to <br /> Measures needed services obtain needed services obtain needed services <br /> Consultations and <br /> Referrals provided to <br /> Consultations & estimated 225 families Consultations and <br /> Referrals provided for (130 families through Referrals provided to <br /> Program Results 213 families 12/31/15) estimated 240 families <br /> Main Application 5/25/2016 9:20:28 AM P 15 of 2 <br />