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fblm $.ocMroasun Coop <br />21i <br />Gettonnected GetAnswvrs. <br />LETTER OF SUPPORT FOR IMPLEMENTATION OF A <br />LOCAL HELP ME GROW SYSTEM <br />Agency Name: 211 Palm Beach / Treasure Coast <br />Counties Served: Palm Beach County, Martin County, St. Lucie County, Indian River County, <br />Okeechobee County <br />Address: P.O. Box 3588, Lantana, FL 33465 <br />Executive Directoy Susan K. Buz <br />Signature: <br />)C Date: <br />cm,_aw <br />This letter is in support of 211 Palm Be. h / TreasurL Coast's applicati n to become the Help Me <br />Grow Affiliate/Lead Agency for its five county region. <br />By signing this letter of support, the below named organization commits to ongoing collaboration <br />with the lead agency to fully implement Help Me Grow in the counties served, with fidelity to the <br />model which includes: <br />• Three structural requirements including an organizing entity, plans for universal county -wide <br />access and continuous quality improvement <br />• Four core program components: <br />o Outreach to health care providers <br />o Centralized telephone access point <br />o Community outreach <br />o Data collection and analysis <br />This formally signifies our support for our county's implementation of a Help Me Grow system for <br />effective, universal, early surveillance and screening for all children, and connection to existing <br />programs and services and affirms our willingness to participate. <br />Organization Name: <br />Name of Authorized Representative: <br />Title: <br />Signature: <br />Email and Phone Contact: <br />County Served: <br />4 <br />