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DocuSign Envelope ID: E8DFACF7 -45BE- 435E- 9B5A- BB177E968F07 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />rFr IS'-19 Application <br />Page 5 — 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 />(f) 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 />