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<br />Program information P a g e 15 o f 32 <br />Total 1148 1750 1751 1979 <br />Income <br />Low-income (80% of the Area Median Income and Below) <br />Please see income table in the attachments 100% 100% 100% 100% <br />Total 1148 1750 1751 1979 <br /> <br /> <br /> <br />12. Cost Per Individual <br /> <br />This cost per individual must reflect the total program budget divided by the total number of program <br />individuals in this application. <br /> <br /> Actual 2021-2022 Projected 2022-2023 Projected 2023-2024 <br />Total Cost of Program 118,035 118,867 168,768 <br />Total # of Individuals 1750 1751 1979 <br />Cost Per Individual $67 $67 $85 <br /> <br />13. Performance Indicators <br />For Chapel Hill and Carrboro applicants: <br />Please complete the following chart with information about the Strategic Objective, Intermediate Result, and <br />the Agency Performance Indicator for each program for which you are applying for funding. Please select one <br />strategic objective per program. If you would like to provide additional information on how your program <br />aligns with additional strategic objectives, please include that information in Question 10 – Program <br />Description. See the Results Framework in the Attachments section as a reference. <br /> <br />Program Name: Healthy Food Access Program <br /> <br />Strategic <br />Objective <br />(please choose one from <br />the Results Framework) <br /> Children improve their educational outcomes <br /> Residents Increase their livelihood security <br />X Residents improve their health outcomes <br /> <br />Intermediate <br />Result <br />3.2: Residents demonstrate new healthy lifestyle behaviors <br /> <br />RESULTS Actual <br /> 2021-2022 <br />Projected <br /> 2022-2023 <br />Projected <br /> 2023-2024 <br />Performance <br />Indicators <br /> <br /># of people reporting healthier <br />functionality and lifestyle behaviors <br />(improved nutrition and access to <br />healthy food, stress reduction <br />practices, exercise at least 30min 3x <br />a week.). <br />100% of 12 <br />heads of <br />household <br />reporting on <br />behalf of 57 <br />total household <br />participants, <br />report that all <br />household <br />member, or 57 <br />people total, <br />improve their <br />100% of 12 <br />heads of <br />household <br />reporting on <br />behalf of 57 <br />total household <br />participants, <br />report that all <br />household <br />member, or 57 <br />people total, <br />improve their <br />100% of 23 <br />heads of <br />household <br />reporting on <br />behalf of 109 <br />total household <br />participants, <br />report that all <br />household <br />member, or 109 <br />people total, <br />improve their <br />EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATIONDocuSign Envelope ID: D2C31311-1A1A-4A30-9007-2F17D64E6227