Cardinal Innovations Healthcare 2017 Needs and Gaps Analysis

Transcription

1 2017 Community Mental Health, Substance Use and Developmental Disabilities Services Needs and Gaps Analysis for the Triad Region (Formerly known as CenterPoint Human Services) This study assesses the community to determine needs and capacity of providers to deliver services. This evaluation will aid in the development of organizational strategic plans, such as local business plans, network development plans and strategic initiatives, as needed to incorporate results from the service needs assessment and gaps analysis.

2 Table of Contents Section One... 3 Executive Summary... 3 Progress and Achievements... 4 Demographic Data... 4 CenterPoint Human Services General Population Demographics... 4 Member Served Population... 5 Members Served by Diagnosis and Benefit Plan... 6 Racial Demographics... 7 Special Populations... 8 Needs Assessment... 9 Section Two: Access and Choice Standards Data... 9 Outpatient Services... 9 Location-Based Services Community / Mobile Services Crisis Services Inpatient Services Specialized Services C-Waiver Services Service-Related Items Section Three: Service Needs and Gaps Identified by Members, Family Members and Other Stakeholders Section Four: Strategies for Addressing Service Gaps Section Five: Geo Maps Section Six: Departmental Priorities Appendix A Geo Maps Location-based Services Psychosocial Rehabilitation Child & Adolescent Day Treatment Substance Abuse Comprehensive Outpatient Therapy (SACOT) Substance Abuse Intensive Outpatient Treatment Program (SAIOP) Opioid Treatment Community / Mobile Services Assertive Community Treatment Team (ACTT) Community Support Team (CST) Intensive In-Home Service (IIHS) Mobile Crisis P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

3 Multi-Systemic Therapy (MST) (b)(3) MH Supported Employment Service (b)(3) IDD Supported Employment Service (b)(3) Wavier Community Guide (b)(3) Waiver Individual Support (Personal Care) (b)(3) Waiver Peer Support (b)(3) Waiver Respite Crisis Services Facility-based Respite Crisis Detox (Non-Hospital) Inpatient Services Inpatient / Hospital (Adult) Inpatient / Hospital (Child) Specialized Services Partial Hospital Psychiatric Residential Treatment Facility (PRTF) Residential Treatment Level Residential Treatment Level Residential Treatment Level 2 (Therapeutic Foster Care) Residential Treatment Level Residential Treatment Level (b)(3) Out of Home Respite (b)(3) IDD Facility-based Respite (b)(3) IDD Residential Supports Intermediate Care Facility (IDD) C-Waiver services Day Supports Residential Supports Residential Supports Residential Supports Residential Supports P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

4 Section One Executive Summary On July 1, 2016, Cardinal Innovations and CenterPoint Human Services consolidated, adding 4 counties (Forsyth, Stokes, Davies, and Rockingham) to the Cardinal Innovations service area. These four counties are referred to as the Triad Region within the Cardinal Innovations service area. The for the Triad Region describes identified behavioral needs within its service area for the fiscal year of July 2015 June Because the 2017 Community Needs and Gaps Analysis requires an analysis of the demographics, access and choice data, and mapping from the period July 2015 June 2016 (prior to consolidation), the data in these sections were not included in the 2017 Cardinal Innovations Community Needs and Gaps Analysis submitted on June 1, For this reason, this document serves as a supplement to the document submitted on June 1. The Needs Assessment Survey, Progress and Achievements, and Departmental Priorities, however, are included in the document submitted on June 1, This document incorporates data, reports, and input from the following sources: CenterPoint Human Services internal data bases North Carolina State Budget Office Medicaid Global Eligibility File (GEF) United States Census Bureau NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS) NC Division of Medical Assistance (DMA) Department of Health Service Regulation (DHSR) Licensed Facilities The data in this document utilizes geo access analysis to determine if choice and access standards as set by NC Department of Health and Human Services are met. GeoNetworks GeoAccess GIS application was used to analyze the proximity or distance of contracted Network providers to member locations. Based on the Geo Access data, the following location-based services did not meet the access and choice standards. For Medicaid funded services, 100% of eligible individuals must have a choice of two different provider agencies for each location-based service within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. For non-medicaid funded services, 100% of eligible individuals must have access to at least one provider agency for each location-based service within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. With the consolidation, the following services remain as a gap and exceptions were requested in the document submitted on June 1. Psychosocial Rehabilitation (non-medicaid funded) Child and Adolescent Day Treatment (Medicaid and non-medicaid funded) Substance Abuse Comprehensive Outpatient Treatment Program (SACOT) (Medicaid and non-medicaid funded) Opioid Treatment (Medicaid and non-medicaid funded) For Specialized Services, the following service did not meet the access and choice standard. For Medicaid funded services, 100% of eligible individuals must have access to at least one provider agency for each specialized service. For non- Medicaid funded services, 100% of eligible individuals must have access to at least one provider agency for each specialized service. With the consolidation, the following services remain as a gap and exceptions were requested in the document submitted on June 1. SA non-medical Community Residential Treatment (Medicaid) Cardinal Innovations will conduct a more detailed analysis of the needs and gaps identified in this report, and will develop appropriate strategies. 3 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

5 Progress and Achievements Please see the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis for a detailed description of the progress and achievements. Demographic Data CenterPoint Human Services General Population Demographics Stokes Rockingham Forsyth Davie According to the 2015 North Carolina Office and State Budget estimates (most current), there are approximately 547,133 people living in the Triad service area which includes Forsyth, Stokes, Davie and Rockingham Counties. Fifty-two percent (52%) are female and forty-eight percent (48%) are male with the average median age per county of County Female Male Total Forsyth 193,031 53% 173,512 47% 366,543 Rockingham 47,665 52% 44,419 48% 92,084 Stokes 24,042 51% 22,721 49% 46,763 Davie 21,441 51% 20,302 49% 41,743 Total 286,179 52% 260,954 48% 547,133 4 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

6 Member Served Population For Fiscal Year 2016 (FY16), the Triad service area consisted of 70,761 Medicaid eligible individuals. Of this population, 14,268 received at least one Medicaid service. In addition to the Medicaid eligible population, 6,255 individuals or members received at least one non-medicaid funded service. The largest percentage of the Medicaid served population was in Forsyth at 64% followed by Rockingham, Stokes and Davie. Note: Members may be counted in more than one county due to relocation For non-medicaid funded services, the highest percentage of members served was in Forsyth at 68% followed by Rockingham, Stokes and Davie. Note: Members may be counted in more than one county due to relocation For all service areas, the total number of members with Medicaid receiving at least one service per the total number of the Medicaid eligible population for the fiscal year is 20%. 5 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

7 Members Served by Diagnosis and Benefit Plan Child/Adolescent members with a Mental Health (MH) diagnosis comprised the highest number of members served for Medicaid and/or State-funding compared to Intellectual and Developmental Disabilities (I/DD) and Substance Use Disorder (SUD) members. Medicaid State Geographic Area I/DD MH SUD Other Total I/DD MH SUD Other Total Forsyth Stokes Davie Rockingham Total Adult members with a MH diagnosis comprised the highest number of members served for Medicaid and/or State funding compared to I/DD and SUD members. Geographic Area Medicaid State I/DD MH SUD Other Total I/DD MH SUD Other Total Forsyth Stokes Davie Rockingham Total P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

8 Racial Demographics The racial demographics for the Triad service area by county are described below. Racial demographics vary greatly between counties and aggregated community areas. U.S. Census Bureau, American Community Survey 5-Year Estimates 7 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

9 Special Populations Ethnic Groups Communities in America are becoming more culturally diverse. Current projections suggest that by 2025, racial and ethnic minorities will account for more than 40 percent of all Americans. Lack of awareness of cultural differences can affect the prevention, identification, and treatment of many mental health problems. 1 The five most recognized racial and ethnic minority groups according to United States Federal classifications are African-American, American Indian/Alaska Natives, Asian-Americans/Pacific Islanders, White American and Hispanic-American. Latino is tracked in our data as an ethnicity designation, and may apply to a person of any race. 2 The graph below represents the percentage of population in the given ethnic group within the Triad Region. U.S. Census Bureau, American Community Survey 5-Year Estimates Civilian Veterans 18 Years and Over The Triad Region is committed to providing information and services for civilian veterans and their family members, as well as providing support to our partners who provide services to these members. Below is the percentage of civilian veterans with a service-connected disability based on total population of each county. U.S. Census Bureau, American Community Survey 5-Year Estimates 1 New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA Rockville, MD: U.S. Office of Management and Budget, OMB, P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

10 Pregnant Women The Triad Region participated in the Managing Substance Use in Pregnancy Collaborative that is a partnership with providers, stakeholders, physicians and Northwest Community Care Center (NWCCC) to address the needs of this priority population. NWCCC serves Davidson, Davie, Forsyth, Stokes, Surry, Wilkes and Yadkin Counties. With the consolidation between Cardinal Innovations and CenterPoint, this effort has continued. Needs Assessment Please see the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis for a detailed description of the needs assessment. Section Two: Access and Choice Standards Data Outpatient Services Medicaid-funded services standard 100% of eligible individuals must have a choice of two different outpatient services provider agencies within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. Non-Medicaid-funded services standard 100% of eligible individuals have a choice of two different outpatient services provider agencies within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. Categories # of enrollees with choice of two providers within 30/45 miles/ minutes* Medicaid # of Medicaid Enrollees % Non-Medicaid Funded # of consumers with choice of two providers within 30/45 miles/minutes* # of Consumers % Reside in urban counties 70,761 70,761 6,255 6,255 Reside in rural counties Total (standard = 100%) 70,761 70, % 6,255 6, % Adults (age 18+) 26,387 26,387 5,953 5,953 Children (age 17 and younger) 44,374 44, Total (standard = 100%) 70,761 70, % 6,255 6, % * 30/45 miles/minutes is the abbreviated term used in this document for individuals having choice and/or access within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. Medicaid-funded services exceptions Is an exception for Medicaid-funded outpatient services in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes No If the access and choice data is not at 100%, is an exception request included with the 2017 gaps report? Yes No If no, please explain. Non-Medicaid-funded services exceptions Is an exception for non-medicaid-funded outpatient services in place as of the date of the 2017 gaps report 9 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

11 submission, 5/1/2017? Yes No If the access and choice data is not at 100%, is an exception request included with the 2017 gaps report? Yes No If no, please explain. Location-Based Services Medicaid-funded services standard 100% of eligible individuals must have a choice of two different provider agencies for each location-based service within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. Non-Medicaid-funded services standard 100% of eligible individuals have access to at least one provider agency for each location-based service within 30 miles or 30 minutes (45 miles or 45 minutes in rural counties) of their residences. Location-based Services Medicaid # and % of enrollees with choice of two providers within 30/45 miles/minutes of their residences Total # of Medicaid Non-Medicaid Funded # and % of consumers with at least one provider within 30/45 miles/minutes of their residences # % Enrollees # % Total # of Consumers Psychosocial Rehabilitation 26, % 26,387 3,987 99% 4,035 Child and Adolescent Day 42,732 96% 44, % 261 Treatment SA Comprehensive Outpatient Treatment Program SA Intensive Outpatient Program 56,113 79% 70,761 1,369 82% 1,668 65,312 92% 70,761 1,369 82% 1,668 Opioid Treatment 12,692 48% 26,387 1,327 81% 1,633 Day Supports % 326 Medicaid-funded services exceptions Are exceptions for any Medicaid-funded location-based service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o Child and Adolescent Day Treatment analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. o SACOT analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. o SAIOP with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. o Opioid analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. If the access and choice data is not at 100% for any Medicaid-funded location-based service, are exception requests included with the 2017 gaps report? 10 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

12 Yes, please list. No, please explain. o Child and Adolescent Day Treatment analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. o SACOT analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. o Opioid analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. Non-Medicaid-funded services exceptions Are exceptions for any non-medicaid-funded location-based service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o Child and Adolescent Day Treatment analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. o SACOT analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. o SAIOP with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. o Opioid analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions are in place and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. If the access and choice data is not at 100% for any non-medicaid-funded location-based service, are exception requests included with the 2017 gaps report? Yes, please list. No, please explain. o o o o PSR analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions have been requested and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. Child and Adolescent Day Treatment analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions have been requested and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. SACOT analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions have been requested and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. Opioid analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. Exceptions have been requested and are listed on the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. 11 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

13 Community / Mobile Services Medicaid-funded standard 100% of eligible individuals must have a choice of two provider agencies within the LME/MCO service area for each community/ mobile service. Non-Medicaid-funded services standard 100% of eligible individuals have access within the LME/MCO service area to at least one provider agency for each community/ mobile service. Community/Mobile Service Assertive Community Treatment Team Medicaid # and % of enrollees with choice of two provider agencies within the LME-MCO catchment area Total # of Medicaid Non-Medicaid-Funded # and % of consumers with access to at least one provider agency within the LME-MCO catchment area # % Enrollees # % Total # of Consumers 26, % 26,387 4, % 4,035 Community Support Team 26, % 26,387 5, % 5,668 Intensive In-Home 44, % 44, % 261 Mobile Crisis *0 0% 70,761 6, % 6,255 Multi-systemic Therapy *0 0% 44, % 261 (b)(3) MH Supported 70, % 70,761 Employment Services (b)(3) I/DD Supported Employment Services (b)(3) Waiver Community Guide (b)(3) Waiver Individual Support (Personal Care) 7, % 70,761 70, % 70,761 70, % 70,761 (b)(3) Waiver Peer Support 70, % 70,761 (b)(3) Waiver Respite 70, % 70,761 I/DD Supported Employment Services (non- Medicaid-funded) Long-term Vocational Supports (non-medicaidfunded) MH/SA Supported Employment Services (IPS- SE) (non-medicaid-funded) I/DD Non-Medicaid-funded Personal Care Services I/DD Non-Medicaid-funded Respite Community Services I/DD Non-Medicaid-funded Respite Hourly Services not in a licensed facility Developmental Therapies (non-medicaid-funded) % % 285 5, % 5, % % % % P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

14 Medicaid-funded services exceptions Are exceptions for any Medicaid-funded community/mobile service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o o Mobile Crisis - with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. Multi-systemic Therapy - with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. If the access and choice data is not at 100% for any Medicaid-funded community/mobile service, are exception requests included with the 2017 gaps report? Yes, please list. No, please explain. o o Mobile Crisis - with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. Multi-systemic Therapy - with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. Non-Medicaid-funded services exceptions Are exceptions for any non-medicaid-funded community/mobile service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No If the access and choice data is not at 100% for any non-medicaid-funded community/mobile service, are exception requests included with the 2017 gaps report? Yes, please list. No, please explain. Crisis Services Medicaid-funded services standard 100% of eligible individuals must have access within the LME/MCO service area to at least one provider agency for each crisis service. Non-Medicaid-funded services standard 100% of eligible individuals must have access within the LME/MCO service area to at least one provider agency for each crisis service. Crisis Service Facility-Based Crisis - adults Medicaid # and % of enrollees with access within the LME-MCO catchment area to at least one provider agency Total # of Medicaid Non-Medicaid Funded # and % of consumers with access within the LME-MCO catchment area to at least one provider agency # % Enrollees # % Total # of Consumers 0 0% 26,387 5, % 5,953 Facility-Based Respite 70, % 70,761 6, % 6,255 Detoxification (non- 70, % 70, % 1,668 hospital) FOR INFORMATION PURPOSES ONLY: Facility-Based Crisis children 0 0% 44, % P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

15 Medicaid-funded services exceptions Are exceptions for any Medicaid-funded crisis service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o Facility-based Crisis with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. If the access and choice data is not at 100% for any Medicaid-funded crisis service, are exception requests included with the 2017 gaps report? Yes, please list. No, please explain. o Facility-based Crisis with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standards have been met. No exception needed. Non-Medicaid-funded services exceptions Are exceptions for any non-medicaid-funded crisis services in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No If the access and choice data is not at 100% for any non-medicaid-funded crisis service, are exception requests included with the 2017 gaps report? Yes, please list. No, please explain. Inpatient Services Medicaid-funded services standard 100% of eligible individuals must have access within the LME/MCO service area to at least one provider agency for each inpatient service. Non-Medicaid-funded services standard 100% of eligible individuals must have access within the LME/MCO service area to at least one provider agency for each inpatient service. Service Inpatient Hospital Adult Inpatient Hospital Adolescent/Child Medicaid Non-Medicaid-Funded # and % of enrollees with access # and % of consumers with access within the LME-MCO catchment Total # of within the LME-MCO catchment area to at least one provider agency Medicaid area to at least one provider agency Total # of # % Enrollees # % Consumers 26, % 26,387 5, % 5,668 44, % 44, % 261 Medicaid-funded services exceptions Are exceptions for any Medicaid-funded inpatient service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No If the access and choice data is not at 100% for any Medicaid-funded inpatient service, are exception requests included with the 2017 gaps report? 14 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

16 Yes, please list. No, please explain. Non-Medicaid-funded services exceptions Are exceptions for any non-medicaid-funded inpatient service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No If the access and choice data is not at 100% for any non-medicaid-funded inpatient service, are exception requests included with the 2017 gaps report? Yes, please list. Specialized Services Medicaid-funded services standard No, please explain. 100% of eligible individuals must have access to at least one provider agency for each specialized service. Non-Medicaid-funded services standard 100% of eligible individuals must have access to at least one provider agency for each specialized service. Number Parent Agencies with Number Parent Agencies with Current Contract Service Current Medicaid Contract for Non-Medicaid Funded Services Partial Hospitalization 2 2 MH Group Homes 16 Psychiatric Residential Treatment Facility 20 Residential Treatment Level 1 2 Residential Treatment Level 2: 22 Therapeutic Foster Care Residential Treatment Level 2: other 13 than Therapeutic Foster Care Residential Treatment Level 3 21 Residential Treatment Level 4 1 Child MH Out-of-home respite 2 SA Non-Medical Community Residential 0 0 Treatment SA Medically Monitored Community 0 0 Residential Treatment SA Halfway Houses 1 I/DD Out-of-home respite (non- 9 Medicaid-funded) I/DD Facility-based respite (non- 5 Medicaid-funded) I/DD Supported Living (non-medicaidfunded) 2 (b)(3) I/DD Out-of-home respite 52 (b)(3) I/DD Facility-based respite 8 (b)(3) I/DD Residential supports 4 Intermediate Care Facility/IDD 76 Medicaid-funded services exceptions Are exceptions for any Medicaid-funded specialized services in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o SA Non-Medical Community Residential Treatment analysis of the data after the consolidation of 15 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

17 o Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. An exception request was made with the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. SA Medically Monitored Community Residential Treatment with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standard for this service has been met. No exception needed. If there is a Medicaid-funded specialized service without a current (5/1/2017) contract with the LME/MCO, is an exception request included with the 2017 gaps report? Yes, please list. No, please explain. o SA Non-Medical Community Residential Treatment analysis of the data after the consolidation of Cardinal Innovations and CenterPoint show the access and choice standard for this service have not been met. An exception request was made with the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis. Non-Medicaid-funded services exceptions Are exceptions for any non-medicaid-funded specialized services in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o SA Non-Medical Community Residential Treatment with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standard for this service has been met. No exception needed. o SA Medically Monitored Community Residential Treatment with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standard for this service has been met. No exception needed. If there is a non-medicaid-funded specialized service without a current (5/1/2017) contract with the LME/MCO, is an exception request included with the 2017 gaps report? Yes, please list. No, please explain. o o SA Non-Medical Community Residential Treatment with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standard for this service has been met. No exception needed. SA Medically Monitored Community Residential Treatment with the consolidation of Cardinal Innovations and CenterPoint, the access and choice standard for this service has been met. No exception needed. C-Waiver Services A. C-Waiver Services Requiring Choice of At Least Two Providers within the Service Area. Standard: 100% of eligible individuals must have a choice of two provider agencies within the LME/MCO service area for each service. C-Waiver Services-Choice of two providers Services Adult Child # and % of enrollees with choice of two provider agencies within the LME/MCO catchment area # % Total # of C- Waiver Enrollees Community Living and Supports % 698 Community Navigator % 698 Community Navigator Training for % 698 Employer of Record Community Networking % P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

18 C-Waiver Services-Choice of two providers Services Adult Child # and % of enrollees with choice of two provider agencies within the LME/MCO catchment area # % Total # of C- Waiver Enrollees Crisis Behavioral Consultation % 698 In Home Intensive % 698 In Home Skill Building % 698 Personal Care % 698 Crisis Consultation % 698 Crisis Intervention & Stabilization % 698 Supports Residential Supports % 698 Residential Supports % 698 Residential Supports % 698 Residential Supports % 698 Respite Care - Community % 698 Respite Care Nursing LPN & RN % 698 Supported Employment 16 & older % 632 Supported Employment Long Term 16 & older % 632 Follow-up Supported Living 18 & older 0 0% 595 B. C-Waiver Services Requiring Access within the Service Area to At Least One Provider Standard: 100% of eligible individuals must have access within the LME/MCO service area to at least one provider agency for each service. Services Adult Child C-Waiver Services Access to at least one provider # and % of enrollees with access within the LME-MCO catchment area to at least one provider agency # % Total # of C-Waiver Enrollees Day Supports % 698 Out of Home Crisis % 698 Respite Care - Community % 698 Facility Financial Supports 0 0% % 698 Specialized Consultative Services (at least one provider of one of multiple services) Medicaid-funded C-Waiver services exceptions Are exceptions for any Medicaid-funded C-Waiver service in place as of the date of the 2017 gaps report submission, 5/1/2017? Yes, please list. No o Supported Living this service definition was not in place prior to the consolidation of Cardinal Innovations and CenterPoint. The access and choice standards are currently met by Cardinal Innovations. No exception needed. o Financial Supports - this service definition was not in place prior to the consolidation of Cardinal Innovations and CenterPoint. The access and choice standards are currently met by Cardinal Innovations. No exception needed. 17 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

19 If the access and choice data is not at 100% for any Medicaid-funded C-Waiver service, are exception requests included with the 2017 gaps report? Yes, please list. No, please explain. o o Supported Living this service definition was not in place prior to the consolidation of Cardinal Innovations and CenterPoint. The access and choice standards are currently met by Cardinal Innovations. No exception needed. Financial Supports - this service definition was not in place prior to the consolidation of Cardinal Innovations and CenterPoint. The access and choice standards are currently met by Cardinal Innovations. No exception needed. Service-Related Items A. Medicaid-funded In Lieu of Services Please see the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis for a detailed description of the In Lieu of services. B. Non-Medicaid funded (State-funded) Services Please see the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis for a detailed description of the non-medicaid funded services. Section Three: Service Needs and Gaps Identified by Members, Family Members and Other Stakeholders Please see the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis for a detailed description of the service needs and gaps identified by members, family members and other stakeholders. Section Four: Strategies for Addressing Service Gaps Please see the 2017 Network Development Plan submitted by Cardinal Innovations. Section Five: Geo Maps Separate geo maps for all Medicaid-funded services listed in this document, except for outpatient services can be found in Appendix A. Section Six: Departmental Priorities Please see the 2017 Cardinal Innovations Needs Assessment and Gaps Analysis for a detailed description of the departmental priorities. 18 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

20 Appendix A Geo Maps Location-based Services One geo map for each Medicaid location-based service. Maps show provider locations with a radius of 30 miles for providers located in urban counties and 45 miles for providers located in rural counties for the Cardinal Innovations service area. Psychosocial Rehabilitation 19 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

21 Child & Adolescent Day Treatment 20 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

22 Substance Abuse Comprehensive Outpatient Therapy (SACOT) 21 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

23 Substance Abuse Intensive Outpatient Treatment Program (SAIOP) 22 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

24 Opioid Treatment 23 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

25 Community / Mobile Services One geo map for each Medicaid community/mobile service. Blue shaded area indicates provider coverage in the Cardinal Innovations service area. Assertive Community Treatment Team (ACTT) 24 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

26 Community Support Team (CST) 25 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

27 Intensive In-Home Service (IIHS) 26 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

28 Mobile Crisis 27 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

29 Multi-Systemic Therapy (MST) 28 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

30 (b)(3) MH Supported Employment Service 29 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

31 (b)(3) IDD Supported Employment Service 30 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

32 (b)(3) Wavier Community Guide 31 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

33 (b)(3) Waiver Individual Support (Personal Care) 32 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

34 (b)(3) Waiver Peer Support 33 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

35 (b)(3) Waiver Respite 34 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

36 Crisis Services One geo map for each Medicaid crisis service that shows provider locations within the Cardinal Innovations service area. Facility-based Respite 35 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

37 Crisis Detox (Non-Hospital) 36 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

38 Inpatient Services One geo map for each Medicaid inpatient service that shows provider locations within Cardinal Innovations Service area. Inpatient / Hospital (Adult) 37 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

39 Inpatient / Hospital (Child) 38 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

40 Specialized Services One geo map for each Medicaid specialized service that shows Cardinal Innovations contracted provider locations within North Carolina. Partial Hospital 39 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

41 Psychiatric Residential Treatment Facility (PRTF) 40 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

42 Residential Treatment Level 1 41 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

43 Residential Treatment Level 2 42 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

44 Residential Treatment Level 2 (Therapeutic Foster Care) 43 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

45 Residential Treatment Level 3 44 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

46 Residential Treatment Level 4 45 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

47 (b)(3) Out of Home Respite 46 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

48 (b)(3) IDD Facility-based Respite 47 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

49 (b)(3) IDD Residential Supports 48 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

50 Intermediate Care Facility (IDD) 49 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

51 C-Waiver services One geo map for each C-Waiver residential and day supports service contracted with Cardinal Innovations. Day Supports 50 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

52 Residential Supports 1 51 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

53 Residential Supports 2 52 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

54 Residential Supports 3 53 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e

55 Residential Supports 4 54 P a g e C a r d i n a l I n n o v a t i o n s H e a l t h c a r e