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Certified by: _______________________ Title: __________________________ Date: ____________ <br /> (Provider’s Signature) <br /> <br /> <br />EXHIBIT “B” <br /> <br />Scope of Services – FY 2021-2022 <br />Outside Agency Performance Agreement <br /> <br />Agency Name: Orange County Rape Crisis Center <br />Program Name: Pro Bono Couneling Network <br />Funding Award: $14,000 <br /> <br />Outline how the agency will spend Orange County’s funding award. <br />Program Services <br />Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2022. <br />• The PBCN provides high-quality counseling services free of charge to underinsured residents and <br />arranges personalized referrals to low-cost, sliding scale, or subsidized services for all those <br />seeking assistance, <br />• <br />• <br /> <br />Anticipated Outcomes <br />The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange <br />County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants <br />within that measure’s description or for an earlier performance measure. <br />Performance Measures Anticipated <br />Results <br />residents who contact the agency for services) will gain access to high quality mental <br />health care free of charge through the PBCN <br /> 45 (85% <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Expense Description Amount <br />PBCN Coordinator Salary + Fringe 12000 <br />Rent 2000 <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: BEA4B8BB-13B7-4322-9698-A424692E9FD4 <br />10/20/2021Executive Director