DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1850

CENTER FOR MEDICARE

TO: All Part D Plan Sponsors

FROM: Cynthia G. Tudor, Ph.D., Director, Medicare Drug Benefit and C & D Data Group Cheri Rice, Director, Medicare Plan Payment Group

SUBJECT: Reminder of the Waiver for Short-Cycle Dispensing by Pharmacies Servicing ICF/MRs and IMDs and for I/T/U Pharmacies and Clarification of the Reporting for New Prescription Drug Event Fields

DATE: February 7, 2013

Waiver of Short-Cycle Dispensing Requirements

In our 4144 Final Rule (76 FR 21432) published April 15, 2011, we added a new regulation at §423.120(c) to require effective January 1, 2013 that all pharmacies servicing long-term care facilities to dispense solid oral doses of brand-name drugs in no greater than 14-day increments at a time. With this memorandum we remind Part D sponsors that, in accordance with § 423.154 (c), these requirements are waived for pharmacies when they service intermediate care facilities for the mentally retarded (ICFs/MR) and institutes for mental disease (IMDs) as defined in § 435.1010, and for I/T/U pharmacies as defined in § 423.100. To assist sponsors in identifying the IMD facilities, we have attached a list of IMDs. Please note this is not a comprehensive list of all licensed IMDs, but includes those in State . Note as well that both Greil and Searcy Hospital in recently closed.

Clarification of PDE Reporting for Claims for Beneficiaries in an ICF/MR or IMD

With this memorandum we also clarify certain PDE reporting requirements when the beneficiary resides in an ICF/MR or IMD. In our memorandum dated October 1, 2012, entitled “Revised Reporting Requirements for Prescriber Identifiers and Other Prescription Drug Event Fields,” we announced that beginning February 28, 2013 we will revise the PDE detail record layout to include the Patient Residence, Pharmacy Service Type, and Submission Clarification Code (SCC) fields. We will require Patient Residence and Pharmacy Service Type to be included on all PDE records with dates of service of February 28, 2013 or later. In those instances when short cycle dispensing is required (that is, for claims where the Patient Residence code is 03- Nursing Facility,) the SCC must be included on the PDE and must be a valid value If the Patient Residence is other than ‘03”, the SCC must be blank. Thus, should an ICF/MR or IMD elect to implement short cycle dispensing, the PDE could not be used to report information on the dispensing methodology used. Should we determine that these facilities are adopting short-cycle dispensing, we will request a future systems change to permit the information to be reported in the PDE.

Alabama Alabama Susan Chambers Beverly White Facility Director F aci Iity Director Greil Memorial Mary Starke Harper Geriatric Center 2140 Upper Wetumpka Road P.O. Box 21231 Montgomery, Alabama 36107 Tuscaloosa, Alabama 35402 Phone: (334) 262-0363 Phone: (205) 759-0929 Fax: (334) 834-4562 Fax: (205) 759-0931 E-mail: [email protected] E-mail: Beverly. [email protected]

Alabama Alabama Randy Phillips Beatrice McLean Facility Director Facility Director North Alabama Regional Hospital Searcy Hospital 4218 Highway 31 South PO Box 1090 Decatur, Alabama 35603-5039 Mt. Vemon, Alabama 36560 Phone: (256) 560-220 I Phone: (251) 662-6768 Fax: (256) 560-2203 Fax: (251) 829-5588 E-mail: [email protected] E-mail: [email protected]

Alabama Alabama Roxanna Bender Sheila Taylor Director Facility Director Taylor Hardin Secure Medical Facility 1301 Jack Warner Pkwy, N.E. 200 University Boulevard Tuscaloosa, Alabama 35404 Tuscaloosa, Alabama 35401 Phone: (205) 556-7060 Phone: (205) 759-0750 Fax: (205) 556-1198 Fax: (205) 759-0890 E-mail: [email protected] E-mail: [email protected]

Alabama Alaska Beverly Be/1-Shambley, Ph.D. Ron Adler Director of Ml Facilities CEO Division of Mental Illness Alaska Psychiatric Institute Alabama Department of 2800 Providence Drive 100 North Union Street Anchorage, Alaska 99508 P.O. Box 301410 Phone: (907) 269-71 00 Montgomery, Alabama 36130-1410 Fax: (907) 269-7251 Phone: (334) 242-3952 E-mail: [email protected] Fax: (334) 242-0759 E-mail: [email protected]

Alaska Arizona li1arianne Holman, Ph.D. C01y Nelson Clinical Director CEO Alaska Psychiatric Institute Arizona State Hospital 2900 Providence Drive Arizona Department of Health Services Anchorage, Alaska 99508 2500 E. Van Buren Phone: (907) 269-7168 Phoenix, Arizona 85034 Fax: (907) 269-7128 Phone: (602) 220-6000 E-mail: [email protected] Fax: E-mail: [email protected] Arkansas Arkansas Steven Henson Jay Hill Facility Administrator Facility Administrator Arkansas Health Center Department of Human Services, Division of Behavioral Health Services Department of Human Services, Division of Behavioral Health Services 305 South Palm Street 6701 Hwy. 67 Little Rock, Arkansas 72205-5432 Benton, Arkansas 72015 Phone: (501) 686-9826 Phone: (50 I) 860-0526 Fax: (50!) 686-9483 Fax: E-mail: [email protected] E-mail: [email protected]

California Audrey King Linda Persons Acting Executive Director Acting Executive Director Coalinga State Hospital Atascadero State Hospital P.O. Box 5000 10333 El Camino Real Coalinga, Califomia 93210-5000 PO Box 7001 Phone: (559) 935-4303 Atascadero, Califomia 93423 Fax: (559) 935-7118 Phone: (805) 468-200 I E-mail: [email protected] Fax: (805) 468-0103 E-mail: [email protected]

California California Cynthia Lusch Dolly Matteucci Acting Executive Director Executive Director Salinas Valley Psychiatric Program P.O. Box 1080 2100 Napa Vallejo Highway Soledad, California 93960 Napa, California 94558 Phone: (831) 678-5654 Phone: (707) 253-5454 Fax: (831) 678-5666 Fax: (707) 253-5411 E-mail: [email protected] E-mail: [email protected]

California California Jvfichael Barsom Carlos Luna Acting Executive Director Executive Director Metropolitan State Hospital 11401 South Bloomfield Avenue 3102 East Highland A venue Norwalk, Califomia 90650 Patton, Califomia 92369 Phone: (562) 651-2245 Phone: (909) 425-7321 Fax: (562) 929-3131 Fax: (909) 425-6169 E-mail: [email protected] E-mail: [email protected]

Colorado Colorado Keith LaGrenade. MD. Teresa Bernal, RN Superintendent Interim Superintendent Colorado Mental Health Institute- Fort Logan Mental Health Institute at Pueblo 3520 W. Oxford Ave Colorado Department of Human Services Denver, Colorado 80236 1600 West 24th Street Phone: (303) 866-7094 Pueblo, Colorado 81003 Fax: (303) 866-7088 Phone: (719) 546-4147 E-mail: [email protected] Fax: (719) 546-4484 E-mail: [email protected] Colorado Connecticut Kenneth Cole Jim Pisciotta Director, Mental Health Institute Division CEO Department of Human Services Southwest CT Mental Health System Colorado Department of Human Services 97 Middle Street 3520 West Oxford Avenue, #A-216 Bridgeport, Connecticut 06604 Denver, Colorado 80236 Phone: (203) 579-7368 Phone: (303) 866-7091 Fax: (203) 579-6305 Fax: E-mail: [email protected] E-mail: [email protected]

Connecticut Connecticut Helene Vartelas Michael Sernyak, M.D. CEO CEO Connecticut Valley Hospital Connecticut Mental Health Center PO Box 351 P.O. Box 1842 Middletown, Connecticut 06457 34 Park Street Phone: (860) 262-5887 New Haven, Connecticut 06519 Fax: (860) 262-5989 Phone: (203) 974-7144 E-mail: [email protected] Fax: (203) 974-7091 E-mail: [email protected]

Delaware Delaware Greg Valentine Kevin Huckshorn, R.N., MS.N., C.A.D.C., I.C.R.C. Chief Executive Officer Director Delaware Psychiatric Center Division of and Mental Health 1901 N. DuPont Highway Delaware Health and Social Services New Castle, Delaware I 9720 1901 North Dupont Highway Phone: (302) 255-2710 Main Administration Bldg., Room 187 Fax: (302) 255-4422 New Castle, Delaware I 9720 E-mail: [email protected] Phone: (302) 255-9398 Fax: (302) 255-4427 E-mail: [email protected]

District of Columbia Florida Dr. Patrick Canavan Bob Quam Chief Executive Officer Hospital Administrator Saint Elizabeths Hospital Treasure Coast Forensic Treatment Facility/ GEO Care, Inc Department of Mental Health 96 Southwest Allapattah Road 2700 Martin Luther King Jr. Avenue, SE Indiantown, Florida 34956 Washington, District of Columbia 20032 Phone: (772) 597-9400 Phone: (202) 299-5500 Fax: (772) 597-9498 Fax: (202) 561-6957 E-mail: [email protected] E-mail: [email protected]

Florida Florida Lee Packer Carmen Paroby Hospital Administrator Hospital Administrator So. Florida Evaluation & Treatment Center/ GEO Care, Inc. West Florida Community Care Center 18680 SW 376th Street 5500 Stewart St. Florida City, Florida 33034 Milton, Florida 32570 Phone: (786) 349-600 l Phone: (850) 983-5500 Fax: (786) 349-6082 Fax: (850) 983-5530 E-mail: [email protected] E-mail: [email protected] Florida Florida Joe Infantino Diane James Hospital Administrator Hospital Administrator Northeast Florida State Hospital Florida State Hospital 7487 S. State Road 121 PO Box 1000 Macclenny, Florida 32063 Chattahoochee, Florida 32324 Phone: (904) 259-6211 Phone: (850) 663-7536 Fax: (904) 259-710 I Fax: (850) 663-7303 E-mail: [email protected] E-mail: [email protected]

Florida Florida Bill Baxter Diane Funston Hospital Administrator Hospital Administrator No. Florida Evaluation & Treatment Center GEO Care Inc. 1200 NE 55th Blvd. South Florida State Hospital Gainesville, Florida 3260 I 800 East Cypress Drive Phone: (352) 375-8484 Pembroke Pines, Florida 33025 Fax: (352) 264-8305 Phone: (954) 392-3050 E-mail: [email protected] Fax: (954) 392-3499 E-mail: [email protected]

Georgia Georgia Nan Lewis Charles Li, M.D. Regional Hospital Administrator Regional Hospital Administrator East Central Regional Hospital Georgia Regional Hospital at Savannah I 00 My11le Boulevard 1915 Eisenhower Drive Gracewood, Georgia 30812 Savannah, Georgia 31406 Phone: (706) 790-2030 Phone: (912) 356-2045 Fax: (706) 790-2025 Fax: (912) 351-3550 E-mail: [email protected] E-mail: [email protected]

Georgia Georgia John Robertson Rick Gray Regional Hospital Administrator Regional Hospital Administrator West Central Georgia Regional Hospital Georgia Regional Hospital/Atlanta 3000 Schatulga Rei 3073 Panthersville Road PO Box 12435 Decatur, Georgia 30034 Columbus, Georgia 31917 Phone: ( 404) 243-2110 Phone: (706) 568-5203 Fax: (404) 212-4621 Fax: (706) 568-2257 E-mail: [email protected] E-mail: [email protected]

Georgia Georgia Randall Hines Eric Carpenter Regional Hospital Administrator Regional Hospital Administrator Central State Hospital Southwestem State Hospital Powell Building Division of Mental Health, Developmental Disabilities 620 Broad Street 400 S. Pinetree Boulevard Milleclgeville, Georgia 31062 Thomasville, Georgia 31799 Phone: ( 4 7 8) 445-412 8 Phone: (229) 227-3020 Fax: (478) 445-6034 Fax: (229) 227-2883 E-mail: [email protected] E-mail: [email protected] Hawaii Idaho lvfark Fridovich, Ph.D. Tracey Sessions Administrator Administrative Director Hawaii State Hospital Idaho State Hospital South Department of Health 700 East Alice Street 45-710 Keaahala Road PO Box400 Kaneohe, Hawaii 96744 Blackfoot, Idaho 83221 Phone: (808) 236-8275 Phone: (208) 785-8402 Fax: (808) 247-7335 Fax: (208) 785-8459 E-mail: mark.fridovich@doh .hawaii.gov E-mail: [email protected]

Idaho Idaho Susan Broetje Ken Krqji Administrative Director Administrative Director Idaho State School and Hospital State Hospital North 3 I 00 11th Ave N 300 Hospital Drive Nampa, Idaho 83687 Orofino, Idaho 83544 Phone: (208) 442-2812 Phone: (208) 476-81 I 7 Fax: (208) 467-0965 Fax: (208) 476-7898 E-mail: [email protected] E-mail: [email protected]

Illinois Illinois Donna A1urray Karen Schweighart Interim Hospital Administrator Hospital Administrator Choate Mental Health Center McFarland Mental Health Center 1000 North Main Street IL Dept of Human Services/Div of Mental Health Anna, Illinois 62906 90 I Southwind Road Phone: (618) 833-5I61 Springfield, Illinois 62703-5125 Fax: (6 I 8) 833-4191 Phone: (217) 786-6836 E-mail: [email protected] Fax: (2I7) 786-7167 E-mail: [email protected]

Illinois Illinois Edith (Edie) Newman Tom Monahan Interim Hospital Administrator Hospital Administrator John J. Madden Mental Health Center Tinley Park Mental Health Center 1200 South 1st Avenue 7400 West 183rd Street P.O. Box 7000 Tinley Park, Illinois 604 77 Hines, Illinois 60140 Phone: (708) 614-404 7 Phone: (708) 338-7249 Fax: (708) 614-4495 Fax: (708) 338-7057 E-mail: [email protected] E-mail: [email protected]

Illinois Illinois A(ji·eda Kibby Ellen Otomo Hospital Administrator Interim Hospital Administrator I-I. Douglass Singer Mental Health Chicago-Read Mental Health Center 4402 North Main Street 4200 North Oak Park Avenue Rockford, Illinois 61103 Chicago, Illinois 60634 Phone: (815) 987-7032 Phone: (773) 794-40IO Fax: (815) 987-7670 Fax: (773) 794-4046 E-mail: [email protected] E-mail: [email protected] Illinois Illinois Paul Brock Melissa Gross Hospital Administrator Hospital Administrator Elgin Mental Health Center Chester Mental Health Center 750 South State Street 13 15 Lehman Drive Elgin, Illinois 60123 P.O. Box 31 Phone: (847) 742-1040 Chester, Illinois 62233 Fax: (847) 429-4910 Phone: (618) 826-4571 E-mail: [email protected] Fax: (618) 826-3229 E-mail: [email protected]

Illinois Indiana Brian E. Thomas Lottie Cook Interim Hospital Administrator Superintendent Alton Mental Health Center Evansville Psychiatric Children's Center 4500 College A venue 3400 East Morgan A v Alton, Illinois 62002 Evansville, Indiana 4 7714 Phone: (618) 474-3861 Phone: (812) 477-6436 Fax: (618) 474-3213 Fax: (812) 474-4247 E-mail: [email protected] E-mail: [email protected]

Indiana Indiana LanyLisak Peggy Stephens Superintendent Superintendent and Medical Director Larue D. Carter Memorial Hospital Madison State Hospital 2601 Cold Spring Road 71 l Green Road Indianapolis, Indiana 46222 Madison, Indiana 47250 Phone: (317) 941-4350 Phone: 812-265-2611 Fax: (317) 941-4308 Fax: (812) 273-7377 E-mail: [email protected] E-mail: [email protected]

Indiana Indiana Cathe Fulcher Robert Clover Superintendent Superintendent Evansville State Hospital Logansport State Hospital 3400 Lincoln Avenue l 098 South State Road 25 Evansville, Indiana 4 7714 Logansport, Indiana 46947 Phone: (812) 469-6800 Phone: (574) 737-3611 Fax: (812) 469-6868 Fax: (574) 737-3900 E-mail: [email protected] E-mail: [email protected]

Indiana Iowa JejfButler Bhasker Dave, MD. Superintendent Superintendent Richmond State Hospital Independence Mental Health Instih1te 498 NW 18th Street 2277 Iowa Avenue Richmond, Indiana 47374 Independence, Iowa 50644 Phone: (765) 935-9200 Phone: (319) 334-2583 Fax: (765) 966-4593 Fax: (319) 334-5252 E-mail: [email protected] E-mail: [email protected] Iowa Iowa Mark Lund, M.A. Vacant Superintendent Hospital Administrator Clarinda Mental Health Institute Cherokee Mental Health Institute 1800 North 16th Street I 25 I West Cedar Loop P.O. Box 338 Cherokee, Iowa 5 I 0 I 2 Clarinda, Iowa 51632 Phone: (712) 225- I 685 Phone: (7 I 2) 542-2 I 6 I Fax: (712) 225-6934 Fax: (712) 542-6113 E-mail: E-mail: [email protected]

Iowa Iowa Ron Mullen Jason Smith, Ph.D. Superintendent Administrator Mount Pleasant Mental Health Institute Civil Commitment Unit for Sexual Offenders 1200 East Washington Street c/o Cherokee Mental Health Institute Mount Pleasant, Iowa 52641 1251 W. Cedar Loop, Box 6 Phone: (319)385-6804 Cherokee, Iowa 51012 Fax: (319) 385-8465 Phone: (712) 225-6948 E-mail: [email protected] Fax: (712) 225-6933 E-mail: [email protected]

Kansas Kansas Christopher Burke Steven F. Ashcraji Superintendent Superintendent Lamed State Hospital Rainbow Mental Health Facility 130 I Kansas Hwy, 264 2205 W. 36th Avenue Lamed, Kansas 67550 Kansas City, Kansas 66103-2198 Phone: (620) 285-4360 Phone: (913) 755-7073 Fax: (620) 285-4357 Fax: (913) 755-263 7 E-mail: [email protected] E-mail: [email protected]

Kansas Kansas John Worley, Ph.D. Thomas J. Kin/en, Ph.D Clinical Program Director Superintendent Osawatomie State Hospital & Rainbow Mental Health Facility Larned State Hospital 500 State Hospital Drive 1301 KS Hwy 264 Osawatomie, Kansas 66064 Lamed, Kansas 67550 Phone: (913) 755-7230 Phone: (620) 285-4360 Fax: Fax: (620) 285-4357 E-mail: [email protected] E-mail: [email protected]

Kansas Kentucky Steven F. Ashcraji Kel/ie Wallace Superintendent Hospital Director Osawatomie State Hospital Eastem State Hospital 500 State Hospital Drive 627 W. 4th Street Osawatomie, Kansas 66064-0500 Lexington, Kentucky 40508 Phone: (913) 755-7073 Phone: (859) 246-7030 Fax: (913) 755-2637 Fax: (859) 246-7018 E-mail: [email protected] E-mail: [email protected] Kentucky Kentucky Wenc(y Morris Dr. Vital Shah Executive Director Director ARH Psychiatric Center Central State Hospital I 02 Medical Center Drive I 05 I 0 LaGrange Road Hazard, Kentucky 4 I 70 I Louisville, Kentucky 40223 Phone: (606) 487-74 I 0 Phone: (502) 253-7060 Fax: (606) 439-670 I Fax: (502) 253-7049 E-mail: [email protected] E-mail: [email protected]

Kentucky Louisiana Stephen Wiggins Wayne Hallford Director CEO Western State Hospital Central Louisiana State Hospital 2400 Russellville Road P.O. Box 503 I P.O. Box 2200 Pineville, Louisiana 71361 Hopkinsville, Kentucky 42240 Phone: (318) 484-6202 Phone: (270) 797-3771 Fax: (318) 484-650 I Fax: (270) 886-4487 E-mail: [email protected] E-mail: [email protected]

Louisiana Louisiana Richard Kramer, FACHE, SPHR Kanc(v Collins, APRN, lv!SN CEO Acting CEO Southeast Louisiana Hospital Eastern Louisiana Mental Health System P.O. Box 3850 P.O. Box498 Mandeville, Louisiana 70470 Jackson, Louisiana 70748 Phone: (985) 626-6560 Phone: (225) 634-20 I 6 Fax: (985) 626-6559 Fax: (225) 634-4345 E-mail: [email protected] E-mail: [email protected]

Maine Maine Jv!mylouise ~McEwen Linda Abernethy Superintendent Superintendent Riverview Psychiatric Center Psychiatric Center 250 Arsenal Street II SHS- 656 State Street I I State House Station P.O. Box 926 Augusta, Maine 04330 Bangor, Maine 04402 Phone: (207) 624-467 4 Phone: (207) 941-4035 Fax: (207) 287-6123 Fax: (207) 941-4062 E-mail: [email protected] E-mail: [email protected]

Maryland Maryland Ken Basler Paula Langmead CEO CEO JLG RICA Springfield Hospital Center 15000 Broschart Road 6655 Sykesville Road Rockville, Maryland 20850 Sykesville, Maryland 2 I 784 Phone: (30 I) 251-6820 Phone: (4 I 0) 970-700 I Fax: (30 I) 309-9004 Fax: (4 I 0) 970-7005 E-mail: [email protected] E-mail: [email protected] Maryland Maryland Judy Hott David Helsel, M.D. CEO CEO Thomas B. Finan Center Clifton T. Perkins Hospital Center 10102 Country Club Rd. SE 8450 Dorsey Run Road Cumberland, Maryland 21502 Jessup, Maryland 20794 Phone: (301) 777-2240 Phone: (410) 724-3001 Fax: (301) 777-2364 Fax: (410) 724-3009 E-mail: [email protected] E-mail: [email protected]

Maryland Maryland Penny ll1akris Cheryl Heilman CEO Acting CEO RICA- Baltimore Spring Grove Hospital Center 605 S. Chapel Gate Lane 55 Wade Avenue Baltimore, Ma1yland 21229 Catonsville, Maryland 21228 Phone: 410-368-780 I Phone: (410) 402-7455 Fax: 410-368-7886 Fax: ( 41 0) 402-7094 E-mail: [email protected] E-mail: [email protected]

Maryland Massachusetts Randy Bradford Marilyn Feitelberg Acting CEO Chief Operating Officer Eastern Shore Hospital Center Tewksbury Hospital P.O. Box 800 DMH Hathorne Units Cambridge, Maryland 21613 365 East Street Phone: ( 41 0) 221-2525 Tewksbury, Massachusetts 01876 Fax: (410) 221-2534 Phone: (978) 851-7321 E-mail: [email protected] Fax: (978) 851-8675 E-mail: [email protected]

Massachusetts Massachusetts Anthony Riccitelli Roberta Guez Chief Operating Officer Chief Operating Officer 305 Belmont Street PO Box 4007 Worcester, Massachusetts 01604 Taunton, Massachusetts 02780 Phone: (508) 368-3461 Phone: (508) 977-3110 Fax: (508) 363-1515 Fax: (508) 977-3751 E-mail: [email protected] E-mail: [email protected]

Michigan Rose Laskowski James J. Coleman Hospital Director Hospital Administrator Caro Center Kalamazoo Psychiatric Hospital 2000 Chambers Road 13 12 Oakland Drive Caro, Michigan 48723 P.O. Box A Phone: (989) 673-3191 Kalamazoo, Michigan 49008 Fax: (989) 673-6749 Phone: (269) 337-3000 E-mail: [email protected] Fax: (269) 33 7-3350 E-mail: [email protected] Michigan Minnesota Carol E. Holden, M.D. Patricia L. Carlson Hospital Administrator CEO Center for Forensic Psychiat1y MN-State Operated Services Box 2060 444 Lafayette Road Ann Arbor, Michigan 48106 PO Box 64980 Phone: (734) 429-2531 St. Paul, Minnesota 55164-0980 Fax: (734) 944-0802 Phone: 651-431-2369 E-mail: [email protected] Fax: 651-431-7456 E-mail: [email protected]

Mississippi Mississippi Paul Callens James Chastain Director Director North Mississippi State Hospital Mississippi State Hospital 193 7 Briar Ridge Road P.O. Box !57-A Tupelo, Mississippi 38804 Whitfield, Mississippi 39193 Phone: (662) 290-4200 Phone: (601) 351-8001 Fax: (662) 290-4261 Fax: (601) 351-8228 E-mail: [email protected] E-mail: [email protected]

Mississippi Mississippi Debbie Ferguson Stacy Miller Director Director Central Mississippi Residential Center Specialized Treatment Facility for the Emotionally P.O. Box 470 14426 James Bond Road Newton, Mississippi 39345 Gulport, Mississippi 39503 Phone: (60 1) 683-2061 Phone: (228) 328-6000 Fax: (601) 683-9484 Fax: (228) 865-9364 E-mail: [email protected] E-mail: [email protected]

Mississippi Mississippi Charles Carlisle Clint Ashley Director Director East Mississippi State Hospital South Mississippi State Hospital 4555 Highland Park Drive 823 Highway 589 P.O. Box 4128, West Station Pnrvis, Mississippi 39475 Meridian, Mississippi 39304-4128 Phone: ( 60 I) 794-0 I 00 Phone: (601) 482-6186 Fax: (601) 794-0100 Fax: (601) 481-1246 E-mail: [email protected] E-mail: [email protected]

Missouri Bob Reit::., Ph.D. Anthony Cuneo Director of Psychiatric Facilities coo Division of Comprehensive Psychiatric Services Metropolitan St. Louis Psychiatric Center Missouri Department of Mental Health 5351 Delmar 1706 East Elm St. Louis, Missouri 63112 P.O. Box 687 Phone: (314) 877-0500 Jefferson City, Missouri 65102 Fax: (314) 877-0937 Phone: (573) 751-3662 E-mail: [email protected] Fax: (573) 751-7815 E-mail: [email protected] Missouri Missouri Felix Vincenz, Ph.D. Laurent Javois coo Eastern Regional Executive Officer St. Louis Psychiatric Rehabilitation Center St. Louis Psychiatric Rehabilitation Center 5300 Arsenal Street 5300 Arsenal St. Louis, Missouri 63139 St. Louis, Missouri 63139 Phone: (314) 877-6500 Phone: (314) 877-5987 Fax: (314) 877-5982 Fax: (314) 877-6106 E-mail: [email protected] E-mail: [email protected]

Missouri Missouri Mmy Attebury Denise Norbwy coo West/Southwest Regional Executive Officer Nmihwest Missouri Psychiatric Rehabilitation Center Southwest Missouri Psychiatric Rehabilitation Center 3505 Frederick 1301 Industrial Parkway East St. Joseph, Missouri 64506 El Dorado Springs, Missouri 64744 Phone: (816) 387-2300 Phone: (417) 876-1002 Fax: (816) 387-2329 Fax: (417) 876-1004 E-mail: [email protected] E-mail: [email protected]

Missouri Missouri Marty A1artin-Forman Melissa Ring, Ph.D., MHA coo coo Fulton Sate Hospital Southeast Missouri Mental Health Center 600 East Fifth Street 1010 West Columbia Fulton, Missouri 65251-1796 Farmington, Missouri 63640 Phone: (573) 592-3000 Phone: (573) 218-6792 Fax: (573) 592-2330 Fax: (573) 218-6703 E-mail: [email protected] E-mail: [email protected]

Missouri Missouri Julie Inman Martha Cassel Southeast Regional Executive Officer coo Southeast Missouri Mental Health Center Cottonwood Residential Treatment Center 1010 West Columbia I 025 North Sprigg Street Fam1ington, Missouri 63640 Gape Girardeau, Missouri 63701 Phone: (573) 218-6792 Phone: (573) 290-5888 Fax: (573) 218-6703 Fax: (573) 290-5895 E-mail: [email protected] E-mail: [email protected]

Missouri Montana Marcia Ford John Glueckert coo CEO Hawthorn Children's Psychiatric Hospital Montana State Hospital 190 I Pennsylvania Avenue 300 Gamet Way St. Louis, Missouri 63 13 3 Wann Springs, Montana 59756 Phone: (314) 512-7800 Phone: ( 406) 693-70 I 0 Fax: (314) 512-7812 Fax: (406) 693-7023 E-mail: [email protected] E-mail: [email protected] Montana Nebraska Joan Da~v William Gibson Associate Administrator CEO Montana State Hospital Lincoln Regional Center Warm Springs, Montana 59756 Lincoln Regional Center Phone: (406) 693-7149 P.O. Box 94949 Fax: ( 406) 693-7007 Lincoln, Nebraska 68509 E-mail: [email protected] Phone: (402) 479-5388 Fax: (402) 479-5591 E-mail: [email protected]

Nevada Nevada Vacant Rosa!yne Reynolds Director/Administrator Agency Director Rawson-Neal Psychiatric Hospital Northem Nevada Adult Mental Health Services 1650 Community College Drive 480 Galletti Way Las Vegas, Nevada 89146 Sparks, Nevada 89431 Phone: (702) 486-4400 Phone: (775) 688-2010 Fax: (702) 486-4541 Fax: (775) 688-2052 E-mail: E-mail: [email protected]

New Hampshire Robert.!. Macleod John Whitenack CEO Assistant Director, Office of State Hospital Management New Hampshire Hospital Division of Mental Health Services 36 Clinton Street Department of Human Services Concord, New Hampshire 03301 50 E. State Street, 3rd Floor Phone: (603) 271-5200 PO Box 727 Fax: (603) 271-5395 Trenton, New Jersey 08625 E-mail: [email protected] Phone: (609)777-0757 Fax: (609) 777-0662 E-mail: [email protected]

New Jersey New Jersey John E. Main Teresa A. McQuaide ChiefExecutive Officer Chief Executive Officer Ann Klein Forensic Center Trenton Psychiatric Hospital Department of Human Services Sullivan Way, P.O. Box 7500 P.O. Box 7717 West Trenton, New Jersey 08628 Stuyvesant A venue Phone: (609) 633-1588 West Trenton, New Jersey 08628 Fax: (609) 396-5701 Phone: (609) 633-0892 E-mai I: teresa. mcquaide@dhs .state.nj. us Fax: (609) 633-0971 E-mail: [email protected]

New Jersey New Jersey Allan Boyer Rosita M Cornejo, M.P.H., R.D., C.P.R.? Chief Executive Officer Director of Quality Management Ancora Psychiatric Hospital Division of Mental Health and Addiction Services 301 Spring Garden Road Department of Human Services Ancora, New Jersey 08037 P.O. Box 727 Phone: (609) 567-7365 Trenton, New Jersey 08625 Fax: (609) 561-1858 Phone: ( 609) 777-072 7 E-mail: [email protected] Fax: (609) 777-0657 E-mail: [email protected] New Jersey New Mexico Janet Monroe W.He111J' Gardner CEO Director Greystone Park Psychiatric Hospital Sequoyah Adolescent Treatment Center 59 Koch Avenue 3405 W. Pan American Freeway, NE Morris Plains, New Jersey 07050 Albuquerque, New Mexico 87107 Phone: (973) 889-4570 Phone: (505) 222-0375 Fax: (973) 889-8793 Fax: (505) 222-030 I E-mail: [email protected] .us E-mail: [email protected]

New York Elizabeth Suhre Jejji·ey Lieberman, MD. Acting Executive Director Executive Director Rochester Psychiatric Center New York State Psychiatric Institute Ill Elmwood A venue 1051 Riverside Drive Rochester, New York 14620-3965 New York, New York 10032 Phone: (585) 241-1594 Phone: (212) 543-5000 Fax: (585) 241-1424 Fax: (212) 543-5200 E-mail: [email protected] E-mail: [email protected]

New York New York Christopher Tavel/a, Ph.D. A!ark Stephany Executive Director Director Rockland Psychiatric Center Elmira Psychiatric Center !40 Old Orangeburg Road 100 Washington Street Orangeburg, New York I 0962-!!96 Elmira, New York 14902 Phone: (845) 359-1000 Phone: (607) 737-4738 Fax: (845) 359-1744 Fax: (607) 73 7-9080 E-mail: [email protected] E-mail: [email protected]

New York New York Ann Marie Barbaro/la !11aureen Bosco Acting Executive Director Executive Director Creedmoor Psychiatric Center Central New York Psychiatric Center 80-45 Winchester Boulevard P.O. Box 300 Bldg. 40, 17th Floor Marcy, New York 13403 Queens Village, New York 11427 Phone: (315) 765-3600 Phone: (718) 264-3600 Fax: (315) 765-3629 Fax: (718) 264-3635 E-mail: [email protected] E-mail: [email protected]

New York New York June DaCosta KatheHayes Acting Executive Director Executive Director Bronx Children's Psychiatric Center Western New York Children's Psychiatric Center 100 Waters Place I 0 I 0 East and West Road Bronx, New York 10461-2799 West Seneca, New York 14224 Phone: (718) 239-3600 Phone: (716) 677-7000 Fax: (718) 239-3669 Fax: (716) 675-6455 E-mail: [email protected] E-mail: [email protected] New York New York Thomas Dodson Pamela Turner Executive Director Executive Director Buffalo Psychiatric Center Bronx Psychiatric Center 400 Forest Avenue 1500 Waters Place Buffalo, New York 14213 Bronx, New York I 0461 Phone: (716) 816-200 I Phone: (718) 862-3300 Fax: (716) 885-0710 Fax: (718) 862-4858 E-mail: [email protected] E-mail: [email protected]

New York New York Rosanne Gaylor Dr. Donald C. Goff Executive Director Executive Director South Beach Psychiatric Center Nathan S. Kline Institute for Psychiatric Research 777 Seaview A venue 140 Old Orangeburg Road Staten Island, New York 10305 Orangeburg, New York 10962 Phone: (71 8) 667-2709 Phone: (845) 398-5500 Fax: (7 I 8) 667-2344 Fax: (845) 398-5510 E-mail: [email protected] E-mail: [email protected]

New York New York Anita Daniels Carol Stevens Executive Director Acting Executive Director Rockland Children's Psychiatric Center Kingsboro Psychiatric Center 2 First A venue 68 I Clarkson A venue Orangeburg, New York I 0962 Brooklyn, New York I 1203 Phone: (845) 680-5700 Phone: (718) 221-7395 Fax: (845) 680-5580 Fax: (7 I 8) 22 I -7206 E-mail: [email protected] E-mail: [email protected]

New York New York Tom fYallace Vincent Miccoli Acting Executive Director Acting Executive Director Greater Binghamton Health Center Manhattan Psychiatric Center, Kirby Forensic Psychiatric Center 425 Robinson Street 600 East I 25th Street Binghamton, New York 13904-1775 Wards Island, New York 10035 Phone: (607) 773-4082 Phone: (646) 672-5858 Fax: (607) 773-4387 Fax: (646) 672-6893 E-mail: [email protected] E-mail: [email protected]

New York New York Colleen SalVyer, RN,MSN Colleen Sa11yer Executive Director Executive Director Hutchings Psychiatric Center Mohawk Valley Psychiatric Center 620 Madison Street 1400 Noyes Street Syracuse, New York 13210 Utica, New York 13502 Phone: (3 I 5) 426-3632 Phone: (3 I 5) 738-4404 Fax: (315) 426-3603 Fax: (315) 738-4414 E-mail: [email protected] .gov E-mail: [email protected] New York New York Lewis Campbell Peggi Healy Executive Director Executive Director Capital District Psychiatric Center Mid-Hudson Forensic Psychiatry Center 75 New Scotland Avenue 2834 Route 17-M Albany, New York 12208 New Hampton, New York 1095 8 Phone: (518) 447-9611 Phone: (845) 374-8700 Fax: (518) 434-0041 Fax: (845) 374-8861 E-mail: [email protected] E-mail: [email protected]

New York New York TomMcOivin Kathy O'Keefe Executive Director Executive Director Sagamore Children's Psychiatric Center Pilgrim Psychiatric Institute 197 Half Hollow Road 998 Crooked Hill Road Dix Hills, New York 11746 WestBrentwood, NewYork 11717 Phone: (631) 370-1701 Phone: (631) 761-2616 Fax: (631) 370-1714 Fax: (631) 761-2194 E-mail: [email protected] E-mail: [email protected]

New York New York Sam Bastien June DaCosta Executive Director Acting Executive Director St. Lawrence Psychiatric Center Queens Children's Psychiatric Center One Chimney Point Drive 74-03 Commonwealth Boulevard Ogdensburg, New York 13669 Bellerose, New York 11426 Phone: (315) 541-200 I Phone: (718) 264-4500 Fax: (315) 541-2041 Fax: (718) 740-0968 E-mail: [email protected] E-mail: [email protected]

North Carolina J Mike He1mike Tom Mahle Hospital Director Director Central Regional Hospital- Raleigh and Butner I 003 12th Street 1000 South Sterling Street Butner, North Carolina 27509 Morganton, North Carolina 28655 Phone: (919) 575-7211 Phone: (828) 433-2324 Fax: (919) 575-7229 Fax: (828) 433-2292 E-mail: [email protected] E-mail: [email protected]

North Carolina North Dakota J. Luckey Welsh, Jr. Alex Schweitzer Acting Hospital Director Superintendent of Institutions Cheny Hospital North Dakota State Hospital 20 I Stevens Hill Road 2605 Circle Drive Goldsboro, North Carolina 27530 Jamestown, North Dakota 58401-6905 Phone: (919) 731-3204 Phone: (70 1) 253-3964 Fax: (919) 731-3785 Fax: (70 1) 253-3999 E-mail: [email protected] E-mail: [email protected] Ohio Jane Krason Dr. A;fvchail Scheramic CEO CEO Appalachian Behavioral Healthcare Northwest Ohio Psychiatric Hospital I 00 Hospital Drive 930 Detroit Avenue Athens, Ohio 45701 Toledo, Ohio 43614-2701 Phone: (740) 594-5000 Phone: (419)381-1881 Fax: (740) 592-5392 Fax: (419) 389-1361 E-mail: [email protected] E-mail: [email protected]

Ohio Ohio Liz Banks, MSW David Colletti CEO CEO Summit Behavioral Healthcare Northcoast Behavioral I-Iealthcare System II 0 I Summit Road 1756 Sagamore Road Cincinnati, Ohio 45237 P.O. Box 305 Phone: (513) 948-3600 Northfield, Ohio 44067 Fax: (513) 948-3080 Phone: (330) 467-7131 E-mail: [email protected] Fax: (330) 467-2420 E-mail: [email protected]

Ohio Ohio Jeff Sims Karen Woods-Nyce CEO CEO Heartland Behavioral H ealthcare Twin Valley Behavioral Healthcare 3000 Erie Street 2200 West Broad Street P.O. Box 540 Columbus, Ohio 43223 Massillon, Ohio 44646 Phone: (614) 752-0333 Phone: (330) 833-3135 Fax: (614) 752-0087 Fax: (330) 833-6564 E-mail: [email protected] E-mail: [email protected]

Oklahoma Oklahoma Jeff Smith Stan Ardoin, MD. Executive Director State Medical Director Children's Recovery Center of Oklahoma Griffin Memorial Hospital 320 12th Avenue, N.E. Oklahoma Department of Mental Health and Substance Abuse Services Nom1an, Oklahoma 73071 P.O. Box 151 Phone: ( 405) 364-9004 Nom1an, Oklahoma 73070-0151 Fax: (405) 573-3804 Phone: ( 405) 573-6684 E-mail: [email protected] Fax: (405)321-4514 E-mail: [email protected]

Oklahoma Oklahoma Truc~v Hojjinan Debbie Moran Executive Director Executive Director Nmthwest Center for Behavioral Health Jim Taliaferro Community Mental Health Center 1222 Tenth Street, Suite 211 602 S.W. 38th Woodward, Oklahoma 73801 Lawton, Oklahoma 73505-6999 Phone: (580) 571-3233 Phone: (580) 248-5780 Fax: (580) 254-2985 Fax: (580) 248-3610 E-mail: [email protected] E-mail: [email protected] Oklahoma Oklahoma Debbie Moran Lany Gross Executive Director Executive Director Carl Albert Community Mental Health Center Griffin Memorial Hospital 1101 E. Monroe 900 East Main Street P.O. Box 579 P.O. Box 151 McAlester, Oklahoma 74502 Norman, Oklahoma 73070 Phone: (918) 426-780 I Phone: ( 405) 573-6600 Fax: (918) 426-5526 Fax: (405) 321-4514 E-mail: [email protected] E-mail: [email protected]

Oklahoma Lori Jordan, MBA Greg Roberts Executive Director Superintendent Oklahoma Forensic Center P.O. Box 69 2600 Center Street, N.E. Vinita, Oklahoma 74301 Salem, Oregon 97301 Phone: (918)256-7841 Phone: (503) 945-2850 Fax: (918) 256-3730 Fax: (503) 945-2867 E-mail: [email protected] E-mail: [email protected]

Oregon Pennsylvania Keny Kelly, RN Theresa Long Superintendent CEO Blue Mountain Recovery Center 2600 Westgate 200 State Hospital Drive Pendleton, Oregon 97801 Danville, Pennsylvania 17821 Phone: (541) 276-0810 Phone: 570-271-4510 Fax: (54!) 278-2209 Fax: 570-271-4514 E-mail: kerry [email protected] E-mail: [email protected]

Pennsylvania Pennsylvania Charlotte Uber Philip Mader CEO Director, Bureau of Hospital Community Operations Office of Mental Health and Substance Abuse Services 33 Main Drive PA Department of Public Welfare Warren, Pennsylvania 16365 PO Box 2675 Phone: (814) 726-4257 Admin Building, DOS Complex Annex Fax: (814) 726-4378 Harrisburg, Pennsylvania 17105-2675 E-mail: [email protected] Phone: (717) 772-7676 Fax: (717) 78 7-2866 E-mail: [email protected]

Pennsylvania Pennsylvania Constance Swan Andrea Kepler CEO CEO South Mountain Restoration Center Wernersville State Hospital I 0058 South Mountain Road P.O. Box 300 South Mountain, Pennsylvania 17261 Wernersville, Pennsylvania 19565 Phone: (717) 749-3121 Phone: ( 61 0) 670-4111 Fax: (717) 749-4071 Fax: (610) 670-4101 E-mail: [email protected] E-mail: [email protected] Pennsylvania Pennsylvania Geny Kent Edna A1cCutcheon CEO CEO Norristown State Hospital I 001 Sterigere Street State Route 1014 Norristown, Pennsylvania 1940 I Torrance, Pennsylvania 15779 Phone: (610) 313-1015 Phone: (724) 459-4511 Fax: (61 0) 313-1013 Fax: (724) 459-4498 E-mail: [email protected] E-mail: [email protected]

Pennsylvania Puerto Rico Monica Bradbzuy Felix Maldonado, M.D. CEO Medical Director Clarks Summit State Hospital Ponce Forensic Psychiatric Hospital 1451 Hillside Drive P.O. Box 7321 Clarks Summit, Pennsylvania 18411 Ponce, Puerto Rico 00732 Phone: (570) 586-2011 Phone: (787) 844-5554 Fax: (570) 587-7415 Fax: (787) 842-7111 E-mail: [email protected] E-mail:

Puerto Rico Puerto Rico Rene Rivera Molina, MHSA Manuel Pubi//ones, Jvf.D. Administrator Medical Director Ponce Forensic Psychiatric Hospital Dr. Ramon Fernandez Marina Psychiatric Hospital G.P.O. Box 7321 P.O. Box 2100 Ponce, Puerto Rico 00732 San Juan, Puerto Rico 00922 Phone: (787) 844-0 I 01 Phone: (787) 766-4646 Fax: (787) 842-7111 Fax: (787) 296-2409 E-mail: E-mail:

Rhode Island Rhode Island Lori Mota Paul Despres Supervisor Patient Resources CEO Rlwde Island Department of Behavioral Healthcare, Developmental Disabilities Eleanor Slater Hospital & Hospitals RI -Department of Behavioral Healthcare, Developmental Disabilities & P.O. Box 8293 Hospitals Cranston, Rhode Island 02920 Ill Howard Avenue-Reagan Building Phone: ( 40 I) 462-1795 Cranston, Rhode Island 02920 Fax: (40 I) 462-3555 Phone: ( 40 I) 462-3666 E-mail: [email protected] Fax: (401) 462-3679 E-mail: [email protected]

South Carolina Tennessee Jahn Fletcher William L. Ventress Director Chief Officer Patrick B. Ha!Tis Psychiatric Hospital Moccasin Bend Mental Health Institute P.O. Box 2907 I 00 Moccasin Bend Road Anderson, 29622 Chattanooga, Tennessee 3 7405-4496 Phone: (864) 231-2673 Phone: ( 423) 785-340 I Fax: (864) 225-3297 Fax: (423) 785-3347 E-mail: [email protected] E-mail: [email protected] Tennessee Tennessee Roger P. Pursley Candace Gilligan Chief Officer Chief Officer Western Mental Health Institute Middle Tennessee Mental Health Institute TN. Dept. Mental Health 22 I Stewarts Ferry Pike II 100 Highway 64 West Nashville, Tennessee 37214 Bolivar, Tennessee 38008 Phone: (615) 902-7536 Phone: (731) 228-2016 Fax: (615) 902-7541 Fax: (731) 658-2783 E-mail: [email protected] E-mail: [email protected]

Tennessee Texas Lisa Daniel Sonia Hernandez-Keeble CEO, Interim Superintendent Memphis Mental Health Institute Rio Grande State Center/ South Texas Health Care System 951 Court Ave Mental Retardation Memphis, Tennessee 38103 1401 Rangerville Road Phone: (901) 577-1801 Harlingen, Texas 78550 Fax: (901) 577-1434 Phone: (956) 364-840 I E-mail: [email protected] Fax: (956) 430-2496 E-mail: [email protected]

Texas Texas Free/Hale Ted Debbs CEO Superintendent/CEO Rusk State Hospital P.O. Box 70 P.O. Box 318 Terrell, Texas 75160 Rusk, Texas 75785 Phone: (972) 55 I -8560 Phone: (903) 683-7297 Fax: (972) 551-8053 Fax: (903) 683-710 I E-mail: [email protected] E-mail: [email protected]

Texas Texas Stephen Anfinson Robert Arizpe Superintendent Superintendent/CEO Kerrville State Hospital San Antonio State Hospital 72 I Thompson Drive 671 I S. New Braunfels Avenue, Suite I 00 Kerrville, Texas 78028 San Antonio, Texas 78223 Phone: (830) 896-2211/ 6200 Phone: (210) 531-771 I Fax: (830) 792-4926 Fax: (210) 531-7876 E-mail: [email protected] E-mail: [email protected]

Texas Texas Lois Moore Ed Maughan Harris County Psychiatric Center Superintendent 2800 South MacGregor Way Big Spring State Hospital Houston, Texas 77021 No1th Highway 87 Phone: (713) 741-5000 Big Spring, Texas 79721 Fax: (713) 741-7832 Phone: (432) 267-8216 E-mail: [email protected] Fax: (432) 267-7263 E-mail: [email protected] Texas Texas James E. Smith, L.C.S.W., D.C.S.W Zu/ema Carrillo Superintendent Superintendent North Texas State Hospital El Paso Psychiatric Center Department of Mental Health & Mental Retardation Administration P.O. Box 2231 4615 Alameda Avenue 4730 College Drive El Paso, Texas 79905 Vernon, Texas 76385 Phone: (915) 534-5412 Phone: (940) 552-4000 Fax: (915) 534-5587 Fax: (940) 553-2500 E-mail: [email protected] E-mail: [email protected]

Texas Texas Eddie Gree11field Carl Schock Director Superintendent Waco Center for Youth 3501 North 19th Street 4110 Guadalupe Street Waco, Texas 76708 Austin, Texas 78751 Phone: (254) 745-5101 Phone: (512) 419-2100 Fax: (254) 745-5398 Fax: (512) 419-2163 E-mail: [email protected]. us E-mail: [email protected]

Utah Vermont Dallas Earnshaw, A.P.R.N, C.NS., B.C. Frank Reed Superintendent Interim Operations Director Utah State Hospital State of Vermont Division of Substance Abuse and Mental Health Department of Mental Health 1300 East Center Street Redstone Building Provo, Utah 84603 26 Terrace Street Phone: (801) 344-4200 Montpelier, Vermont 05609-1101 Fax: (80 I) 344-4291 Phone: (802) 828-3809 E-mail: [email protected] Fax: (802) 828-1717 E-mail: [email protected]

Virginia Virginia Robin Crews Vicki Montgomel)' Acting Director Director/CEO Southern Virginia Mental Health Institute Central State Hospital 382 Taylor Drive 26317 W. Washington Street Danville, Virginia 24541 P.O. Box 4030 Phone: (434) 773-4230 Petersburg, Virginia 23803 Fax: (434) 773-4274 Phone: (804) 524-7373 E-mail: [email protected] Fax: (804) 524-4571 E-mail: [email protected]

Virginia Virginia Kim Runion William J. Tuell Director Director Virginia Center for Behavioral Rehabilitation Commonwealth Center for Children and Adolescent P.O. Box 548 PO Box 4000 4901 E. Patrick Hemy Highway Staunton, Virginia 24401-9124 Burkville, Virginia 23922 Phone: (540) 332-2102 Phone: 434-767-7803 Fax: (540) 332-2201 Fax: 434-767-5526 E-mail: [email protected] E-mail: [email protected] Virginia Virginia David lvf. Lyon Jack Wood Acting Director Director Northern Virginia Mental Health Institute Eastern State Hospital 3302 Gallows Road 460 1 Ironbound Road Falls Church, Virginia 22042 P.O. Box 8791 Phone: (703) 207-7111 Williamsburg, Virginia 08791 Fax: (703) 207-7146 Phone: 757-253-5241 E-mail: [email protected] Fax: 757-253-5065 E-mail: [email protected]

Virginia Virginia Cynthia L. McClaskey Jack Barber, M.D. Director Director Southwestern Virginia Mental Health Institute Western State Hospital 340 Bagley Circle 1301 Richmond Road Marion, Virginia 24354 Staunton, Virginia 24401 Phone: (276) 783-1201 Phone: (540) 332-8200 Fax: (276) 783-9712 Fax: (540) 332-8197 E-mail: [email protected] E-mail: [email protected]

Virginia Virginia Steve Herrick Jack Barber, M.D. Director Director Piedmont Geriactric Hospital Western State Hospital PO Box427 1301 Richmond Road Burkeville, Virginia 23922 Staunton, Virginia 24401 Phone: (434) 767-4568 Phone: (540) 332-8200 Fax: (434) 767-4500 Fax: (540) 375-4394 E-mail: [email protected] E-mail: jack.barber@dbhds. virginia.gov

Washington Washington Jess Jamieson Connie Wilmot CEO CEO Western State Hospital Eastern State Hospital 9601 Steilacoom Boulevard, S.W. P.O. Box 800 Lakewood, Washington 98498-7213 Medical Lake, Washington 99022 Phone: (253) 756-2350 Phone: (509) 565-4351 Fax: (253) 756-2963 Fax: (509) 299-7015 E-mail: [email protected] E-mail: [email protected]

Washington West Virginia Rick Mehlman, Ph.D. D. Parker Haddix CEO CEO Child Sh1dy and Treatment Center William R. Sharpe, Jr. Hospital 8805 Steilacoom Boulevard, S.W. 936 Sharpe Hospital Road Tacoma, Washington 98498 Weston, West Virginia 26452 Phone: (253)756-2830 Phone: (304) 269-1210 Fax: (253) 756-3911 Fax: (304) 269-6235 E-mail: [email protected] E-mail: [email protected] Wisconsin Wisconsin Debra McCulloch Tom Speech, Ph.D. Director Director Sand Ridge Secure Treatment Center Winnebago Mental Health Institute Department of Health Services P.O. Box 9 Ill North Road Winnebago, Wisconsin 54985 P.O. Box 700 Phone: (920) 235-4910 Mauston, Wisconsin 53948-0700 Fax: (920) 235-3807 Phone: ( 608) 84 7-1720 E-mail: [email protected] Fax: (608) 847-1793 E-mail: [email protected]

Wisconsin Wisconsin Byran Barto·w Greg01y J. Van Rybroek, Ph.D., J.D. Director Director Wisconsin Resource Center Mendota Mental Health Department of Health Services Mendota Mental Health Institute 1505 North Drive 301 Troy Drive Winnebago, Wisconsin 54985 Madison, Wisconsin 53704 Phone: (920) 236-4180 Phone: ( 608) 301-1 042 Fax: (920) 236-4199 Fax: (608) 301-1390 E-mail: byran. [email protected] E-mail: Gregory. [email protected]

Wyoming Bill Sexton Administrator Wyoming State Hospital Wyoming Department of Health, Behavioral Health Division P.O. Box 177 831 South Highway 150 Evanston, Wyoming 82931-0177 Phone: (307) 789-3464 Fax: (307) 789-5277 E-mail: [email protected]