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<br />Program information P a g e 23 o f 55 <br />lifestyle behaviors (improved <br />nutrition, conflict resolution <br />skills, stress reduction <br />practices, exercise at least <br />30min 3x a week, annual <br />check-ups, etc.) <br />105 out of <br />105 <br /> <br />100% <br />124 out of <br />124 <br />Performance <br />Indicators <br />% and # of program <br />participants with new, <br />sustained, improved, or <br />restored social skills <br />100% <br />105 out of <br />105 <br /> <br />100% <br />124 out of <br />124 <br />100% or 117 100% or 128 <br />Performance <br />Indicators <br />% and # of program <br />participants with new, <br />sustained, improved, or <br />restored social connections <br />(social activities, outreach <br />calls and visits, community <br />involvement) <br />100% <br />105 out of <br />105 <br /> <br />100% <br />124 out of <br />124 <br />100% or 117 100% or 128 <br />Performance <br />Indicators <br />% and # of program <br />participants who meet one <br />wellness goal <br />100% <br />105 out of <br />105 <br /> <br />100% <br />124 out of <br />124 <br />100% or 117 100% or 128 <br />Performance <br />Indicators <br />% and # of hospitalization <br />rates among program <br />participants with substance <br />abuse and/or psychiatric <br />disorders <br />15% <br />16 out of <br />105 <br /> <br />16% <br />20 out of <br />124 <br />10% or 12 9% or 12 <br />Performance <br />Indicators <br />% and # of participants who <br />engage in activities that <br />100% 100% or 117 100% or 128 <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION <br />DocuSign Envelope ID: 11DA72B8-CC83-439E-A25C-F64DE607C614