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DocuSign Envelope ID:E522BFFC-A634-4A11-A162-195A3BE957A4 <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Page 12 — Program / Project Description <br /> (c) Bulleted list of other agencies: <br /> • Chapel Hill-Carrboro and Orange County School System <br /> • Triangle Consortium for Suicide Prevention <br /> • Perinatal Loss Education Consortium <br /> • A Helping Hand <br /> • UNC Health System <br /> • Durham Coalition on Grief <br /> • S.O.S <br /> • Compassionate Friends <br /> • Other local non-profit organizations to meet the unmet needs of patients with limited <br /> resources. <br /> (d) Programs: <br /> Duke Hospice Bereavement Services has a vibrant and active children's bereavement program <br /> which emphasizes the importance of recognizing the developmental consequences of death and <br /> grief during the early years. We have developed a workshop which targeted all school personnel <br /> who may have contact with children. The goal of this workshop was to provide education and <br /> resources to assist school personnel to better understand the impact of grief and loss on the <br /> cognitive, physical and emotional well-being of children. The Bereavement Center is located in <br /> Hillsborough and serves as a primary resource for grief support and education for both the <br /> Chapel Hill/Carrboro and Orange County School system. We receive regular calls from school <br /> personnel in both districts requesting support, resources, education and intervention for the <br /> children in their districts. <br /> (e) Town/county priority: Protect and Provide for a safe community <br /> (0 Population to be served. <br /> Duke Hospice Bereavement Services has been a leader in providing grief support and education <br /> in the Triangle Area and has partnered with local school systems to address the needs of grieving <br /> students in the school setting. For over 15 years we have consulted with and responded to <br /> requests for support in the local school systems and in the communities we serve. <br /> (g) Who specifically will carry out? <br /> The Bereavement Center staff consisting of 2.88 full time staff will provide the services <br /> indicated. The staff provides training to student interns who will also be available on a limited <br /> basis to provide these services. The primary location will be the Unicorn Bereavement Center <br /> located in Hillsborough. Additional sites will include any school in the districts serving student <br />