Orange County NC Website
DocuSign Envelope ID: E546BA93-2CAA-4121-B91A-3F2107563B4D <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Total N/A 100 500 <br /> Work Statement <br /> • 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, and <br /> 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 My Brother's Keeper(MBK) Orange County <br /> Program Activity Name Leadership Summit <br /> Program Goal 1 To build a program and policy agenda <br /> Performance Measures 1. #of partners that accurately describe common agenda <br /> 2. #of partners that publicly discuss/advocate for common <br /> agendaAoals <br /> Previous Year Program Results I N/A <br /> Current Year Estimated Results N/A <br /> Next Year Projected Results 1. 20 partners accurately describe common agenda <br /> 2. 20 partners publicly discuss/advocate for common agenda <br /> oa's <br /> Program Activity Name Establish shared measurement practices <br /> Program Goal j To develop shared data system <br /> Performance Measures 1. #of partners that understand the value of shared data <br /> 2. #of partners that have robust/shared data capacity <br /> 3. #of partners that make decisions based on data <br /> 4. #of partners that utilize data in a meaningful way <br /> rent YYear Program Results N/A <br /> Cur .... �� .... . ..� <br /> Previous ear Estimated Results j N/A <br /> Next Year Projected Results 1. 20 partners n__. the value WoW shared p understand the value of shared data <br /> 2. 20 partners have robust/shared data capacity <br /> 3. 20 partners make decisions based on data <br /> 4. 20 Sartners utilize data in a meaniniful wa <br /> Program Activity Name Scan of current youth-serving and mentoring organizations <br /> Program Goal To increase#of relevant stakeholders engaged in the initiative <br /> Performance Measures 1. <br /> of stakeholders engaged in the initiative <br /> Previous Year Pro g ram Results N/A <br /> mmmm <br /> PROGRAM INFORMATION 1/31/2017 3:24:15 PM i) ago 21 o l'' 2 9 <br />