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DocuSign Envelope ID:6CD4A528-52AE-410E-B18B-BA619068A9AB t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> 3. PROJECT/PROGRAM INFORMATION <br /> Agency & Program Name: Dispute Settlement Center: Mediation <br /> As you complete your application, complete only those sections that pertain to the type of <br /> application you are submitting. The application is divided into several sections and not all sections <br /> apply to every project. Every applicant MUST complete the main application. <br /> a) Check the type of funding request for this application package submittal and complete the <br /> application and supplemental application sections as specified below: <br /> x Human Services (Main Application Only) <br /> ❑ AH Non-Construction (Main Application Only) <br /> ❑ AH Construction — (Main Application AND Part B) <br /> ❑ AHDR Non-Construction (Main Application Only) <br /> ❑ AHDR Construction — (Main Application AND Part B) <br /> ❑ CDBG Non-Construction — (Main Application AND Part A) <br /> ❑ CDBG Construction — (Main Application AND Part A AND Part B) <br /> ❑ HOME CHDO Set-aside — (Main Application AND Part A) <br /> ❑ HOME Other — (Main Application AND Parts A AND Part B) <br /> Indicate the type of program for which you are requesting funding: <br /> Program Category Youth Adult Elderly Disabled Public Housing <br /> (not elderly) Neighborhoods/Residents <br /> Education <br /> Health and Nutrition <br /> Job Training <br /> Sports and Arts <br /> Activities <br /> Pre-School Activities <br /> After-School Activities <br /> Mentoring <br /> Transportation <br /> Housing <br /> Other: Please specify X–could be <br /> MEDIATION X X X <br /> Program/Project Description (Label your responses as outlined below; not to exceed 3 pages.) <br /> Please provide the following information about the proposed program/project: <br /> b) Summarize the program services proposed and how the program will address the chosen <br /> County priority? <br /> Dispute Settlement Center, through mediation, offers a forum for the resolution of interpersonal <br /> disputes. We propose to offer mediation in 1) Orange County Criminal District Court; 2) for families <br /> in separation and divorce and eldercare disputes; and 3)for Medicaid Appeals. Unresolved conflict <br /> can lead to public health problems and even threats to public safety. The local court system needs <br /> help with appropriate handling of a large volume of cases from civilian-generated warrants. <br /> c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or <br /> Main Application 5/24/2016 9:47:14 AM .. g 6 of 23 <br />