2018-441-E Finance - Charles House Association outside agency agreement

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DocuSign Envelope ID: C5305795- 2DF5- 4A04- B090- 9F458AA520CB EXHIBIT "I3" Scope of Services 1,Y 2018-19 Outside Agency Performance Agreement Agency Name: CHARLES HOUSE ASSOCIATION Program Name: DAYTIME ELDERCARE PROGRAM Funding Award: $23,250 Outline how the agency will spend Orange County's landing award. Expense Description Amount Personnel Fx ease $23,250 Program Services Outline [lie critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019. • The Daytime Eldercare Program provides therapeutic social engagernetn, care and activity for elders and respite for family caregivers. • family Caregiver Support: The Daytime Program supports family caregivers by offering respite from the ongoing concerns of caring for a loved one and by supporting the best functioning of their loved ones through participation in the therapeutic program. • Enriching the lives of elders, enhancing well-being and supporting functionin : the relationship Charles House establishes with enrolled families is the basis for the collaboration in caring. The Daytime Program works to support a variety of functioning abilities for participants— including self - esteem, gross and fine motor skills, social skills, verbal skills, ambulation, memory and reminiscence, activities of daily living. • Maintaining Program Standards: Program administration assures that all aspects of the Program are in compliance with the state rules for annual certification. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons /units served within Oran e County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results •50 %0 of enrolled families in the funding year will have the capacity to 33 of 66 families enrolled continue providing care in the home and not require, or delay, residential care in July, 2018 will continue placement for their participant /enrollee caregiving at end of gaunt period. -Over 50% of families will report in the annual evaluation survey satisfaction More than 25 of the 50 with the Charles House program and will report positive effects of the families responding to the program for their enrolled family members, such as improvement in their annual evaluation survey participant/enrolice's behavior, emotional status, physical and /or cognitive will report positive effects functioning fi-om enrollment. •Charles House Association will continue to surpass the NC Standards and State Certification occurs maintain state certification to operate as an adult day care program in June /July annually — r� DocuSigned by: r01� kt�kw Executive Director 8/16/2018 SF2816385FSG466... Certified by: O;r �'�dn> -�� Title: X tiy r1t�� Date: 3 (Provider's Signature)