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DocuSign Envelope ID: EA54395E-EA79-461 B-8A4A-AODF56E9A02D <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) <br /> Program Name: Caregivinq Collaborative <br /> Program Primary Contact and Title: Jennifer Ashley, Executive Director <br /> Telephone Number: 919-403-5555 E-Mail: jennifer.ashley(a�ahelpinghandnc.orq <br /> a) Indicate the type of Human Service Needs Priority, if program applicable: <br /> ® Priority Area #1: safety-net services for disadvantaged residents <br /> ® Priority Area #2: education, mentorship, and afterschool programming for <br /> youth facing a variety of challenges <br /> ® Priority Area #3: programs aimed at improving health and nutrition of needy residents <br /> b) Indicate the type of program for which you are requesting funding <br /> (Check all that apply to this program) <br /> Program Category Youth Adult Elderly Disabled Public Housing <br /> Neighborhoods/Residents <br /> Affordable Housing <br /> Affordable Healthcare <br /> Education X <br /> Family Resources <br /> Jobs/Jobs Training X <br /> Food X X X <br /> Transportation X X X <br /> Other: Please specify X <br /> Access to healthcare X X <br /> c) Provide a bulleted list of other agencies, if any, with which your agency <br /> coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) <br /> to be funded. For each, briefly describe the coordinated/collaborative efforts. <br /> Community collaborations and partnerships are instrumental to meeting the needs of our <br /> community's seniors. A Helping Hand is actively engaged in collaborative efforts to make <br /> Orange County the premier place to grow older and participates in a number of partnerships, <br /> committees and initiatives, including: <br /> • Orange County Department on Aging: In addition to having a companion care contract with <br /> OCDOA, A Helping Hand collaborates on mutual clients. Additionally, AHH participates in <br /> many initiatives and programs sponsored by OCDOA, including their Music in my Mind <br /> program and The Sharp Caregiver Awards. This year we have been asked to serve as a <br /> resource for the upcoming Master Aging Plan. <br /> PROGRAM INFORMATION 1/31/2017 3:19:07 PM <br />