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DocuSign Envelope ID: 6818677A -D518- 4750- B391- F6169FB2A4C4 <br />Exhibit A: Provider's Outside Agency Application <br />Work Statement Chart for Program Caregivinp Collaborative <br />1. Program Activity Name <br />Volunteer Companion Care <br />Program Goal <br />Provide companionship, escorted medical transportation, in home <br />assistance, meal preparation and respite care to a minimum of 160 <br />Orange County low income seniors. <br />Performance Measures <br />We will track the number of scheduled visits along with tasks <br />erformed in each visit. <br />Previous Year Program Results <br />Over 150 clients were provided these companion care services. <br />Current Year Estimated Results <br />160 or more clients will be provided these companion care services. <br />Next Year Projected Results <br />180 clients will be provided these companion care services. <br />2. Program Activity Name <br />Pre Health Internship <br />Program Goal <br />Train and assign 40 pre health interns to Orange Count7future <br />need of companion services, with the goal of enhanpractitioner's <br />understanding of the realities of aging in . <br />Additionally, working to connect these interns to the greater <br />community and impact their long term views on aging and service. <br />Performance Measures <br />We will be conducting a pre and post test to gauge the understanding <br />and empathy levels of participating interns. <br />Previous Year Program Results <br />35 pre health interns participated in this program last year. <br />Current Year Estimated Results <br />40 pre health interns will participate in this program. <br />Next Year Projected Results <br />40 pre health interns will participate in this program. <br />3. Program Activity Name <br />Programs Goal <br />Performance Measures <br />Previous Year Program Results <br />Current Year Estimated Results <br />Next Year Projected Results <br />4. Program Activity Name <br />Program Goal <br />Performance Measures <br />Previous Year Program Results <br />Current Year Estimated Results <br />Next Year Projected Results <br />PROGRAM INFORMATION 1/23/2018 11:40:33 AM Page B of" 21 <br />