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Exhibit A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> m.) Work Statement <br /> This form is used to document program activities, program goals, performance measures, <br /> and actual results. (Add more rows as needed) If this is a new program, you will only <br /> document the projected information. <br /> • Program Activities should outline major activities the agency implements to accomplish its <br /> program goals. <br /> • Program Goal should explain what the program is trying to achieve/accomplish. Goals are <br /> statements about what the program should accomplish. SMART Goals <br /> • Performance Measures describe how you will evaluate the degree in which you achieved <br /> the stated goals. <br /> • Actual Program Results use program results to indicate the actual measureable <br /> achievement of goals. If goals were not met, please explain. <br /> Actual Estimated Projected <br /> 20142015 2015-2016 2016-2017 <br /> U' <br /> WINNER. u <br /> Program Activity 1 Crisis Support:Staff and trained volunteers("Companions")respond to walk-in clients and to calls <br /> on the 24-Hour Help Line.Companions provide emotional support;give resources, information,and <br /> referrals;and accompany survivors to medical,legal,and law enforcement appointments.Staff and <br /> trained volunteers facilitate support groups and workshops for survivors. <br /> Program Goal The OCRCC will provide The OCRCC will provide The OCRCC will provide <br /> assistance to approximately assistance to approximately assistance to approximately <br /> 620 individuals. 600 individuals. 600 individuals. <br /> Performance Measures Staff and volunteers keep records of each client contact. <br /> Program Results We served a total of 524 We expect to serve about 590 We expect to serve about 600 <br /> clients. clients. clients. <br /> We estimated client numbers <br /> based on growth rates from <br /> previous years, but service <br /> numbers unexpectedly <br /> declined.Though we saw <br /> fewer clients than anticipated, <br /> we now see each client more <br /> frequently than in the past. In <br /> the past 5 years,we have seen <br /> a 62%increase in the number <br /> of contacts we have per client. <br /> 62 of the 524 clients <br /> participated in 15 support <br /> groups and/or workshops.We <br /> held more groups than the <br /> expected 8,which takes more <br /> staff time for fewer clients. <br /> Main Application 1/25/2016 12:55:42 PM P a g e 14 of 32 <br />