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Outside Agencies/Human Services <br /> <br />Program information  P a g e  18 of 31  <br />Please select which function area best aligns with your agency and program(s) in which you are  <br />requesting funding.  Please select only one from the list below:   <br /> <br />☐  Behavior Health ☐ Public Health & Health Education  <br />☒ Food & Nutritional Service ☐ Recreational <br />☐ Housing ☐ Senior Services <br />☐ Human Rights & Community Services ☐ Youth Services <br />☐ Juvenile & Adult Justice Services ☐ Other <br />   <br /> <br />If you selected other, please tell us what function area best aligns with your organization:   <br />  <br />  <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 /> <br />Program Goal # 1 Homebound seniors and disabled adults will improve <br />nutrition and reduce social isolation <br />Performance Measure <br />(How will you accomplish your goal?) <br /># Individuals will receive Meals on Wheels <br />Actual Results <br />(Outcome) <br />Ending FY2022 <br />53 individuals received Meals on Wheels <br /> Projected Results <br />(Outcome) <br />Ending FY2023 <br />63 individuals will receive Meals on Wheels <br />Projected Results <br />(Outcome) <br />Ending FY2024 <br />63 individuals will receive Meals on Wheels <br /> <br /> <br />  <br />  <br />DocuSign Envelope ID: 876F9864-87DD-492C-B615-80555A87A4F0