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DocuSign Envelope ID: F807B28A-EF75-498C-9EC8-5863109A5978 <br /> R COUNTY <br /> i IM11`111; CAWIANA <br /> Outside Agencies/Human Services <br /> Please use the drop down menu below to select which function area best aligns with your agency <br /> and program(s) in which you are requesting funding. Please select only one from the drop-down <br /> menu below. <br /> Public Health and Health Education <br /> If you selected other, please tell us what function area best aligns with your organization: <br /> Please indicate three program goals/performance measures below. <br /> A few notes: <br /> • If you use percentages, please put the actual number equivalence. <br /> • Please ensure your performance measures are outcome based and not outputs. <br /> Information and Referral Service <br /> Connects community members with local resources <br /> and services after assessment of need. Resource <br /> Program Goal#1 database maintained for a multitude of services. <br /> Follow-up conducted to ensure connection was made <br /> and additional resources provided as needed. <br /> Distributes diapers for residents from Diaper Bank of <br /> NC. <br /> At the end of the contact,,clients are asked whether <br /> Per#brmance Measure they received the information or help they needed. <br /> (How will you accomplish your goal?) <br /> These results are tracked. <br /> Actual,Results Of 1,337 clients, 95.5% reported knowledge of <br /> (Outcome), appropriate social services in FY 19-20. <br /> Ending FYI9 20 <br /> projected Results Of at least 1,200 clients, 85% will report knowledge of <br /> (Outcome) appropriate social services in FY 20-21, <br /> Ending' FY202 <br /> Projected Results Of at least 1,200 clients, 85% will report knowledge of <br /> (Outcome); appropriate social services in FY 21-22. <br /> Endri:' FY2022 <br /> Youth Interpersonal Violence Preyerition Education' <br /> Provides age appropriate datin violence prevention <br /> Program Goal#2 education sessions in 6th and 8 ' grade health <br /> education classes.' <br /> Program information P a g e 2 4 o f 3 4 <br />