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DocuSign Envelope ID: 5D25D6E0-716B-4244-AEA3-02E6A45FD852 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Work Statement <br /> m) Complete the Work Statement Chart to describe the work to be performed. <br /> This chart 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. Every program is required to have AT LEAST 1 <br /> Program Activity, which should be SMART (Specific, Measurable, Achievable, Relevant, <br /> and Time-bound. Click on SMART Goals to learn more. <br /> • Program Activities should outline major activities the agency implements to accomplish its <br /> program goals. (i.e. Deliver meals to elderly/disabled residents.) <br /> • Program Goal should explain what the program is trying to achieve/accomplish. Goals are <br /> statements about what the program should accomplish. (i.e. Deliver 100 meals per day, <br /> Monday-Friday.) <br /> • Performance Measures describe how you will evaluate the degree in which you achieved <br /> the stated goals. (i.e. Will track the number of meals delivered each day.) <br /> • Actual Program Results use program results to indicate the actual measureable <br /> achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of <br /> 105 meals per day.) <br /> Work Statement Chart for Program Advocate Program <br /> 1. Program Activity Name Assisting homeless and near-homeless individuals to gain jobs <br /> Program Goal CEF Advocates will assist 140 homeless or near-homeless <br /> individuals to gain employment, through one-on-one support in <br /> resumes, job applications, interview preparation, employer <br /> relationships, and connections to supportive community resources <br /> Performance Measures Assess employment status upon intake and document changes in <br /> employment status through weekly meetings and regular follow-up <br /> with members. <br /> Previous Year Program Results 126 members gained employment <br /> Current Year Estimated Results 140 members will gain employment <br /> Next Year Projected Results 140 members will gain employment <br /> 2. Program Activity Name Enabling homeless and near-homeless individuals to secure stable <br /> housing <br /> Program Goal CEF Advocates will assist at least 80 homeless or near-homeless <br /> individuals to secure housing, through assistance with searching for <br /> housing, negotiating with landlords, navigating affordable housing <br /> resources, accessing Rapid Rehousing assistance, and securing <br /> support for move-in costs. <br /> Performance Measures Assess the housing status upon intake and document changes in <br /> housing status, determined through regular updates and continued <br /> follow-up with members <br /> Previous Year Program Results 65 members secured housing <br /> Current Year Estimated Results 73 members will secure housing <br /> Next Year Projected Results 80 members will secure housing <br /> 3. Program Activity Name Supporting homeless and low-income individuals in successfully <br /> reaching personal savings goals <br /> Program Goal At least 90 members will achieve 25% of their personal savings <br /> goal or greater. Savings goals are often long-term goals, and 25% <br /> represents a significant step for low-resource households towards <br /> PROGRAM INFORMATION 1/31/2017 11:04:24 AM Page 2 .f 2 <br />