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DocuSign Envelope ID: C5305795- 2DF5- 4A04- B090- 9F458AA520CB <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />The Carrboro Board Priorities include: Create publicfprivate partnerships for various special <br />programs..., Offer diversified programs reflective of citizen needs and promotes sensitivity to <br />cultural diversity., and <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 />f) Who is your target population of individuals to benefit from this program and how will <br />they be identified and connected with the program? <br />The target population for Charles House services is families and individuals who are dealing <br />with challenges of aging, including cognitive decline, dementia, Alzheimer's, Parkinson's, <br />neuro - muscular disorders, stroke, vision and hearing loss, ambulation and balance concerns, <br />social engagement decline, etc. <br />gj Describe the credentials of the program manager and other key staff. (Ex. Identify <br />,Program Manager and credentials, describe training provided to volunteers, etc.) <br />Staff credentials: <br />Paul Klever, Executive Director, BSW, MHA <br />Amanda Borer, Associate Director, MHA <br />Chuck Fleming, Program Administrator, MSW, experience in aging services. <br />Dean Fox, Program Director, MSW, 5 years Charles House experience. <br />Brianna Baker, Program Director, Masters Recreation Therapy. <br />The Program Team of Directors and Facilitators bring varying levels of experience, working <br />as a collaborative team. Training is an ongoing process of orientation, peer instruction and <br />in- service training. Volunteers who are part of the Program Team also receive orientation, <br />peer instruction and will participate in in- service training. <br />h) Describe the specific period over which the activities will be carried out and include <br />an implementation timeline. <br />The Charles House Daytime Program is an ongoing service. The program operates Monday <br />through Friday, 7;30 -5:30. <br />i) Why is funding this program a good investment for the community? How does funding <br />this program add value to the community? (250 words OR LESS) <br />As stated in above, Charles House is an exceptional community resource addressing the <br />challenging issues caregiving families face with aging family members. The resources <br />and support services provided to these families is vital to our community being a <br />welcoming and attractive place to live, work, and age. <br />j) Describe what would happen if requested funding is not awarded at all or if a reduced <br />allocation is recommended. <br />The Human Services Funding is critical to the Charles House Scholarship Fund, which <br />allows services to be made available to families across the socio- economic spectrum, <br />families of need and to accommodate the significant agency discounts for the Orange <br />County Department on Aging and Dept, of Social Services. <br />Without this funding, there would be severe reduction in the level of services available to <br />Orange County agencies' clients and other families of need. <br />k) What percentage of your target population is low- moderate income? <br />Charles House does not collect verified income information from client families. However, <br />the elders who are part of Charles House are all on a fixed retirement income. Some of <br />PROGRAM INFORMATION 1/2212018 2:17:04 PM P a g e 9 of 15 <br />