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DocuSign Envelope ID: 134C4810- 3CA5- 4008- 9E74- 2A07D3AECED8 <br />EXHIBIT A - PROVIDER'S OUTSIDE AGENCY APPLICATION <br />e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes <br />in the past year? Is there a new Executive Director? Are there new initiatives ?) <br />While Club Nova has not experienced any major changes in the past year, we have continued to provide <br />employment services despite elimination of state funds - as well as retaining members who receive other <br />services which Club Nova cannot be reimbursed for (ACTT services) despite the two services' being <br />complementary of each other. While no major changes have occurred, we are always aware the Medicaid <br />state funds could shift without much notice. <br />f) Schedule of Positions (For Entire Agency) <br />• Full Time Equivalent (FTE) staff will be noted as 1.00; half time as .50; quarter time as .25, etc. <br />• Calculate a Full Time Equivalent for all recorded volunteer hours using the following: <br />Total Volunteer Hours = Volunteer FTE <br />2,080 <br /># of FTE-Full-Time Paid Positions: 10 <br /># of FTE - Paid Part -Time Positions: 4 (these are quarter time positions) <br /># of Volunteers: 127 # of FTE - Volunteers:0 <br />g) Living Wage <br />Does this agency pay permanent employees a minimum living wage? (Yes /No) Yes <br />If yes, is this agency an Orange County Living Wage Certified Employer? No <br />If no, please explain. <br />Club Nova Community has strived to give our employees living wages, but still fall short with four of our <br />quarter time employees for transportation. With the low Medicaid reimbursement rates and exclusions of <br />services we cannot be reimbursed for, our budget cannot currently handle the increase to Living Wage for <br />all employees. We are working on a gradual, yearly, increase and hope to be in line with Living Wage in <br />Orange County and be an Orange County Living Wage Certified Employer in the upcoming year. <br />Agency Information 2/9/2017 1:51:06 PM Page 6 of 26 <br />