2018-751-E Finance - The Art Therapy Institute performance agreement

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DocuSign Envelope ID:4FF28E49-EE56-4A40-9331-F55AA8A05998 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Work Statement e) Complete the Work Statement Chart to describe the work to be performed. This chart is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the projected information. Every program is required to have AT LEAST 1 Program Activity, which should be SMART(�jpecific, Measurable, Achievable, Relevant, and_Time-bound. Click on SMART Goals to learn more. • Program Activities should outline major activities the agency implements to accomplish its program goals. (i.e. Deliver meals to elderly/disabled residents.) • Program Goal should explain what the program is trying to achieve/accomplish. Goals are statements about what the program should accomplish. (i.e. Deliver 100 meals per day, Monday-Friday.) • Performance Measures describe how you will evaluate the degree in which you achieved the stated goals. (i.e. Will track the number of meals delivered each day.) • Actual Program Results use program results to indicate the actual measureable achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of 105 meals per day.) Work Statement Chart for Program: Newcomer Art Therapy Program 1. Program Activity Name Reach and Retention Program Goal By follow-up of the Newcomer Art Therapy Project,ATI staff will have delivered art therapy sessions to 275 children and adult newcomers as evidenced by#of clients reported in clinical progress notes. Performance Measures Art therapy records of attendance Previous Year Program Results ATI clinicians delivered sessions to 235 newcomers in FY 2016- 2017. Current Year Estimated Results Despite major CHCCS budget cuts to our program, ATI is on track to deliver art therapy services to 245 newcomers (adults and children) in both Orange and Durham Counties this year. Next Year Projected Results With full funding, ATI would be able to provide art therapy services to 275 child and adult newcomers across the Triangle in FY 18-19. 2. Program Activity Name Self-Esteem and Self-Concept Program Goal From baseline to follow-up, 60% of newcomer clients will report improved self-esteem and self-concept, as indicated by total number of improved items on the Piers-Harris Self-Concept Scale. Performance Measures Piers-Harris Self-Concept Scale Previous Year Program Results 53%of sampled students reported greater self-esteem/self-concept. Current Year Estimated Results Post-intervention data has not yet been collected, but it is estimated that 55% of clients assessed will show increased self-esteem/self- concept. 28 individual students out of the 50 assessed for this Next Year Projected Results 60% of clients assessed will report improved self-esteem and self- concept between pre- and post-data collection. (45 students out of the 75 individuals assessed for this.) 3. Program Activity Name Emotional Difficulties Program Goal From baseline to follow-up, 60% of newcomer clients will experience fewer emotional difficulties, as measured by total number of emotional difficulties on the Strengths and Difficulties Questionnaire. Performance Measures Strengths and Difficulties Questionnaire PROGRAM INFORMATION 3/14/2018 11:53:33 AM Page 19 of 24