2018-550-E DSS - OCIM outside agency agreement

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DocuSign Envelope ID: EBOFBDBE -FD15- 4428 - 8998- 19A867F94OCC 3. PROGRAM INFORMATION (submit a separate Section 3 for each program) Program Name: Samaritan Relief Ministry Program Primary Contact and Title: Kay Stagner, Manager of Client Services Telephone Number. 919 - 732 -6194 ext. 12 E -Mail: ocimsrm@embaMmaii.com a) Indicate the type of Human Service Needs Priority, if program applicable: ✓ ❑ Priority Area #1: safety -net services for disadvantaged residents ❑ Priority Area #2: education, mentorship, and afierschool programming for youth facing a variety of challenges ✓ ❑ Priority Area #3: programs aimed at improving health and nutrition of needy residents b) Indicate the type of program for which you are requesting funding (Check all that apply to this program) Program Category Youth Adult Elderly Disabled Public Housing - Neigh b o rh o o dsMesiden is Affordable Housing Affordable Healthcare -- Education Family Resources JobslJobs Training Food Transportation x x x x x Other. Financial assistance for rent, utility, prescription medication x x x x x c) Provide a bulleted list of other agencies, if any, with which your agency coordinatesl'collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinatedTcollaborative efforts. • Orange County Department of Social Services: The Samaritan Relief Ministry receives referrals for individuals and families needing food and emergency financial assistance_ • Orange County Health Department: "WIC" and other matemitylyoung children related programs make referrals for food, baby formula, and diapers. • Lutheran Family Services and other mental health case management programs: social workers and case managers refer clients to the Samaritan Relief Ministry for food. PPr)r RA AA IAIP r -?AAA TinN ❑ AA p a" ra 'I C; n f 7J;