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DocuSign Envelope ID: C5305795- 2DF5- 4A04- B090- 9F458AA520CB <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />* Chapel Hill Transit E -Z Rider— collaboration on transportation <br />Orange County Animal Shelter — collaboration on community service projects for sheltered <br />animals. <br />® Chapel Hill Library — collaboration on community service projects for children's library <br />® Chapel Hill Service League — collaboration on community service projects for the League's <br />Christmas House. <br />® IFC's HomeStart Homeless Shelter — collaboration on community service projects, including <br />flower arrangements for the HomeStart shelter. <br />® Carol Woods Retirement Community — collaboration on community outreach and service to <br />residents. <br />® Carolina Meadows — collaboration through Carolina Meadows community agency funding <br />program and service to residents. <br />Various area assisted living and nursing care facilities — collaboration on service <br />coordination, client referrals, etc. <br />* Numerous in -home care agencies, home health and hospice agencies —work collaboratively <br />with mutual client families <br />• Various area schools— student groups, including music groups, volunteer at Charles <br />House. <br />o Area civic groups, churches — community outreach, church and group members often <br />volunteer at Charles House. <br />Program Description (3 pages OR LESS) <br />Please provide the following information about the proposed program: <br />d) Summarize the program services proposed and how the program will address a <br />Town /County priority /goal? <br />The Charles House Daytime Eldercare Program is a significant support to caregiving families <br />in our community, families carrying the burdens of caring for aging and frail family members. <br />The Daytime Program enriches the wellbeing of elders who participate in the program and <br />provides significant support and respite to family caregivers. <br />e) Describe the community need or problem to be addressed in relation to the Chapel Hill <br />Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of <br />Chapel Hill Council Goals, Carrboro Board Priorities, or other community priorities (i.e. <br />Council /Board Goals). Reference local data (using the provided links, i.e. Chapel Hill Human <br />Services Needs Assessment) to support the need for this program. <br />The Chapel Hill Human Human Service Needs Assessment identified priorities: <br />Affordable Healthcare and in the priority of Education and Family Resources a sub - priority <br />identified is Family supports and resources — <br />The Charles House Daytime Eldercare Program addresses both these priority areas. Charles <br />House is a primary support for families dealing with the challenges of caring for a frail elder <br />family member. The Daytime Eldercare Program is an affordable care option for families and <br />supports their caregiving. <br />The Orange County BOCC Goal 1: Ensure a community network of basic human services and <br />infrastructure that maintains, protects, and promotes the well -being of all county residents. <br />The Charles House Daytime Eldercare Program provides significant support to the health <br />and wellbeing of some of the most frail citizens in our community and supports the wellbeing <br />of their family caregivers. <br />PROGRAM INFORMATION 1/2202018 2:17:04 PM P a g e 8 of 15 <br />