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DocuSign Envelope ID:4D553CF7-2BBD-4F4E-B84E-E6B8B077A9AB <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> needs. Based on this intake interview, PBCN staff <br /> identifies an available volunteer therapist who <br /> specializes in treatment modalities that best match the <br /> client's needs. <br /> Program Goal 75% of clients will have improved mental health status <br /> and functioning during and/or at completion of PBCN <br /> services, as reported by PBCN therapists. <br /> Performance Measures PBCN volunteer therapists provide information <br /> regarding whether their client experienced improved <br /> mental health status and functioning during and/or at <br /> completion of services. <br /> Previous Year Program Results Of the therapists who respond to the request to <br /> complete the report forms, 75% of clients experienced <br /> improved mental health status and functioning. <br /> Current Year Estimated Results Of the therapists who respond to the request to <br /> complete the report forms, 75% of clients experienced <br /> improved mental health status and functioning. <br /> Next Year Projected Results Of the therapists who respond to the request to <br /> complete the report forms, 75% of clients experienced <br /> improved mental health status and functioning. <br /> 9. Program Activity Name Compeer staff promotes the program with therapists, <br /> coordinates and facilitates match meetings and <br /> supports both the Compeer friends and volunteers as <br /> needed throughout the course of the relationship. <br /> Program Goal 75% of individuals living with severe and persistent <br /> mental illness referred to Compeer will be matched with <br /> a trained volunteer for weekly social activities. <br /> Performance Measures The number of current, new and terminated Compeer <br /> matches on a monthly basis; monthly records of <br /> volunteer hours and activities. <br /> Previous Year Program Results Of the 23 matched Compeer friends and volunteers, <br /> 60% remained engaged in weekly social outings leading <br /> to improved socialization skills, reduced isolation and <br /> reduced frequency of noncompliance with treatment. <br /> The program hosted 2 cook-outs with social activities for <br /> compeer friends and volunteers. <br /> Current Year Estimated Results Of the 28 matched Compeer friends and volunteers, <br /> 65% remained engaged in weekly social outings leading <br /> to improved socialization skills, reduced isolation and <br /> reduced frequency of noncompliance with treatment. <br /> The program hosted 2 cook-outs with social activities for <br /> compeer friends and volunteers. <br /> Next Year Projected Results Of the 28 matched Compeer friends and volunteers, <br /> 65% remained engaged in weekly social outings leading <br /> to improved socialization skills, reduced isolation and <br /> reduced frequency of noncompliance with treatment. <br /> The program hosted 2 cook-outs with social activities for <br /> compeer friends and volunteers. <br /> DO NOT SUBMIT THIS PAGE 1/31/2017 11:11:58 AM Page 34 of <br />