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DocuSign Envelope ID:C70973D3-D989-4F31-A95E-3BCC099C95E7 XHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Performance Measures Strengths and Difficulties Questionnaire (total number of emotional <br /> difficulties) <br /> Previous Year Program Results By follow-up, 45% of newcomer clients experienced fewer <br /> emotional difficulties <br /> Current Year Estimated Results From baseline to follow-up, we have estimated that 50% of <br /> newcomer clients will experience fewer emotional difficulties. <br /> Next Year Projected Results By follow-up, 50% of newcomer clients will have experienced fewer <br /> emotional difficulties. <br /> 4. Program Activity Name Newcomer's Art Therapy Program <br /> Program Goal Self-esteem <br /> Performance Measures Piers-Harris Self-Concept Scale (total number of happiness items) <br /> Previous Year Program Results By follow-up, 52% of newcomer clients experienced greater <br /> happiness. <br /> Current Year Estimated Results We have estimated that from baseline to follow-up, 50% of <br /> newcomer clients will report greater happiness. However, since our <br /> results rely on baseline and follow-up data (collected in Spring <br /> 2017), we do not yet have current estimated results for this year. <br /> Next Year Projected Results By follow-up, 50% of newcomer clients will have experienced <br /> greater happiness. <br /> Program Activity Name Newcomer's Art Therapy Program <br /> Program Goal Anxiety <br /> Performance Measures Hopkins Symptoms Checklist-25 (total number of anxiety <br /> Symptoms) <br /> Previous Year Program Results By follow-up, 57% of participating clients experienced fewer total <br /> anxiety symptoms. <br /> Current Year Estimated Results We have estimated that from baseline to follow-up, 60% of <br /> newcomer clients will suffer fewer symptoms of anxiety. However, <br /> since our results rely on baseline and follow-up data (collected in <br /> Spring 2017), we do not yet have current estimated results for this <br /> year. <br /> Next Year Projected Results By follow-up, 60% of newcomer clients will have experienced fewer <br /> total anxiety symptoms. <br /> Newcomer'sArt TherapyProgram <br /> Program Activity Name Newcomer's Art Therapy Program <br /> Program Goal Community-based /strengths based goals <br /> Performance Measures Session notes indicating the number of students participating in the <br /> individual and group art therapy sessions delivered. <br /> Previous Year Program Results This activity was not assessed as a goal in previous years. <br /> Current Year Estimated Results ATI partnered with CWS and FMF, two community agencies, to <br /> increase our collaborative programming and offer art therapy in <br /> community settings where we can provide additional supports in <br /> partnership. These have been very well attended, and the <br /> partnership between agencies has strengthened our work as well. <br /> Next Year Projected Results We plan to continue to do community outreach and offer art therapy <br /> groups through partnerships throughout the community. <br /> PROGRAM INFORMATION 2/8/2017 3:01:12 PM P a g e 17 of 2 0 <br />