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DocuSign Envelope ID: 134C4810- 3CA5- 4008- 9E74- 2A07D3AECED8 <br />EXHIBIT A - PROVIDER'S OUTSIDE AGENCY APPLICATION <br />o Through participating and contributing, members regain skills, a sense of <br />purpose, self - worth, and confidence working in the Clubhouse <br />• The Basic Components of Clubhouse: The Employment Programs <br />• People with SMI have the lowest employment rates of any disability. <br />• Returning to paid employment is a right of membership and a priority at the <br />Clubhouse <br />• We provide members opportunities to return to paid employment in integrated <br />work settings. <br />• Three types of employment programs: Transitional, Supported, and Independent <br />• Employment is at the employer's place of business and pays the prevailing wage <br />for the required work. <br />• The Basic Components of Clubhouse: Education <br />• Often education has been interrupted by SMI. Our Supported Education assists <br />with admissions, financial aid, and utilization of disability offices. <br />• The Clubhouse provides opportunities and assistance helping members <br />complete or start their certificate or degree programs at colleges and universities. <br />• The Basic Components of Clubhouse: Evening, Weekend, Holiday Program <br />• Many people with SMI live in isolation. <br />• Our Evening, Weekend, Holiday Program reduces isolation and gives members a <br />sense of social connectedness and belonging. <br />• The Basic Components of Clubhouse: Transportation <br />• Access to Club Nova is essential for our members to participate in our full range <br />of opportunities. <br />• Transportation operates a morning and an evening route throughout Orange <br />County. <br />d) Agency's History with Providing These Services: <br />Club Nova offers solutions to the challenges our members and our community face on a daily basis. For <br />almost 30 years, Club Nova has been saving and changing lives and making a positive impact on the health of <br />our community. <br />We have over 29 years of experience in providing the full range of supports and opportunities that define <br />the Model and are in our funding request. The Model operates on proven standards and has been replicated <br />effectively with over 300 Clubhouses worldwide. A rigorous accreditation process assures fidelity to the <br />standards of the Model. Club Nova holds a 3 Year Accreditation and is one of six accredited Clubhouses in <br />North Carolina. The Clubhouse Model is included in the Substance Abuse and Mental Health Services <br />Administration (SAMHSA) registry for Evidence -Based Practices. In 2017 the Conrad N. Hilton Foundation, of <br />the world's most prestigious humanitarian prizes, chose the Clubhouse International /Fountain House <br />Clubhouse Model as the answer to alleviating worldwide human suffering for individuals living with mental <br />illness. Our dedication to our members and this community have earned Club Nova the 2016 <br />GlaxoSmithKline Impact Award and Employee Choice Award, 2016 Chamber of Commerce Business <br />Excellence Award for Community Impact, 2016 Faith Connections Community Servant Award and <br />recognition by Towns of Carrboro and Chapel Hill for being a Model of Excellence in mental Health. With <br />Club Nova's current plans for expansion, we look forward to the next 30 years. <br />Agency Information 2/9/2017 1:51:06 PM Page 5 of 26 <br />