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DocuSign Envelope ID:8E4BA2A0-F8F0-406A-A380-E6C66CCD78B4 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> O Chapel Hill Transit E-Z Rider—collaboration on transportation <br /> Orange County Animal Shelter—collaboration on community service projects for sheltered <br /> animals. <br /> O Chapel Hill Library—collaboration on community service projects for children's library <br /> O Chapel Hill Service League—collaboration on community service projects for the League's <br /> Christmas House. <br /> • IFC's HomeStart Homeless Shelter---collaboration on community service projects, including <br /> flower arrangements for the HomeStart shelter. <br /> O Carol Woods Retirement Community—collaboration on community outreach and service to <br /> residents. <br /> O Carolina Meadows—collaboration through Carolina Meadows community agency funding <br /> program and service to residents. <br /> Various home health agencies; area assisted living and nursing care facilities—collaboration <br /> on service coordination, client referrals, etc. <br /> Various area schools—student groups, including music groups, volunteer at Charles House. <br /> • Area civic groups, churches—community outreach, church and group members often <br /> volunteer at Charles House. <br /> Program Description (3 pages OR LESS) <br /> Please provide the following information about the proposed program: <br /> c) Summarize the program services proposed and how the program will address a <br /> Town/County priority/goal? <br /> The Charles House Daytime Eldercare Program is a significant support to caregiving families in <br /> our community, families carrying the burdens of caring for aging and frail family members. The <br /> Daytime Program enriches the wellbeing of elders who participate in the program and provides <br /> significant support and respite to family caregivers. <br /> The Chapel Hill Human Human Service Needs Assessment identified priorities: <br /> Affordable Healthcare and in the priority of Education and Family Resources a sub-priority <br /> identified is Family supports and resources— <br /> The Charles House Daytime Eldercare Program addresses both these priority areas. Charles <br /> House is a primary support for families dealing with the challenges of caring for a frail elder <br /> family member. The Daytime Eldercare Program is an affordable care option for families and <br /> supports their caregiving. <br /> The Orange County BOCC Goal 1: Ensure a community network of basic human services and <br /> infrastructure that maintains, protects, and promotes the well-being of all county residents. <br /> The Charles House Daytime Eldercare Program provides significant support to the health <br /> and wellbeing of some of the most frail citizens in our community and supports the wellbeing <br /> of their family caregivers. <br /> The Carrboro Board Priorities include: Create public/private partnerships for various special <br /> programs..., Offer diversified programs reflective of citizen needs and promotes sensitivity to <br /> cultural diversity., and <br /> The Charles House Daytime Eldercare Program provides significant support to the health <br /> and wellbeing of some of the most frail citizens in our community and supports the wellbeing <br /> of their family caregivers. <br /> d) Describe the community need or problem to be addressed in relation to the Chapel Hill <br /> PROGRAM INFORMATION 1/27/2017 4:52:00 PM Page 8 of 16 <br />