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Outside Agencies/Human Services <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 />☐ Behavior Health ☐ Public Health & Health Education <br />☐ Food & Nutritional Service ☐ Recreational <br />☐ Housing ☐ Senior Services <br />X Human Rights & Community Services ☐ Youth Services <br />☐ Juvenile & Adult Justice Services ☐ Other <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 />Program Goal # 1 Members are able to access the community services and <br />resources they need to increase their security and health <br />Performance Measure <br />(How will you accomplish <br />your goal?) <br />Members receive referrals and are provided language <br />accompaniment to attend and meaningfully participate in <br />appointments with service providers (medical, social <br />services, school, etc) <br />Actual Results <br />(Outcome) <br />Ending FY2022 <br />458 Members, 38 of whom live in Orange County outside of <br />Chapel Hill and Carrboro, attend and meaningfully participate <br />in critical appointments, and complete referrals. <br />Projected Results <br />(Outcome) <br />Ending FY2023 <br />640 Members, 37 of whom live in Orange County outside of <br />Chapel Hill and Carrboro, attend and meaningfully participate <br />in critical appointments, and complete referrals. <br />Projected Results <br />(Outcome) <br />Ending FY2024 <br />641 Members, 29 of whom live in Orange County outside of <br />Chapel Hill and Carrboro, attend and meaningfully participate <br />in critical appointments, and complete referrals. <br />1621 <br />DocuSign Envelope ID: C7E9E35D-4294-4C57-9D16-FD34B7245AA8