Presentation on Easter Seals UCP's experience with implementing the CABHA concept over the past 15 months.

1. Critical Access Behavioral Healthcare AgencyOne Year Later Richard Edwards Erica Arrington, MD Easter Seals UCP

2. Serves 17,000 people annually across NC and VA Certified as a CABHA providing child-specific mental health services, but also provide MH services to adults Certified as a CABHA in Wake County, but meet the service array qualifications in six NC communities Erica Arrington, MD—Medical Director Jill Hinton, PhD—Clinical Director Easter Seals UCP

3. Enhanced clinical and medical support for programs Enhanced engagement among physicians and nurses Stronger clinical and medical engagement at senior leadership level of the organization Enhanced clinical and medical support for individuals with urgent needs Grant funding to support reverse co-location of behavioral health and medical services in two NC communities CABHA Successes

4. Medicaid rate reductions in 2009 of 9.5% Required CABHA services (Outpatient Therapy & Psychiatric Services) have rates below private market Targeted Case Management – MH/SA has not covered costs as originally intended Significantly increased travel time for key personnel—taking away from primary duties No additional funding to support increased personnel costs for Medical & Clinical Directors CABHA Challenges

5. CABHA implementation began for us in January, 2010 with the official transition date of January 1, 2011 CABHA transition has significantly reduced the number of providers of specific services However, January 1 implementation did not result in large numbers of referrals Questions remain about stability given large number of CABHAs (~200) and insufficient funding CABHA Transition

6. Easter Seals UCP has clearly seen a positive impact the CABHA concept has had on our agency and our services However, without additional support, the CABHA model is not sustainable We appreciate Sec. Cansler’s commitment to finding a solution to assure continuity and availability of services that are clinically sound and create positive impact for the individuals, families and communities we serve CABHA transition is still in process CABHA—One Year Later