United Behavioral Health

April 23, 2004

United Health Care Attn: Barbara Williamson 2000 West Loop South, Ste. 900 Houston, TX 77027

Dear Ms. Williamson:

The purpose of this letter is to express the need for additional behavioral health care providers in the southeast Nebraska area, specifically in Nebraska City, Nebraska. As the Director of the Behavioral Health Outreach Clinics for the Munroe-Meyer Institute at the University of Nebraska Medical Center, I have experienced first hand the lack of providers in rural Nebraska specializing in children’s mental health services.

You are probably aware of the mental health crisis in Nebraska. The majority of the state’s 96 counties have been identified by the Governor as “Mental Health Shortage Areas,” including Otoe County and its surrounding counties. In a letter dated September 15, 2003, the Governor stated that “Behavioral health issues are a serious problem in Nebraska” and recent legislation has called for a statewide initiative to reform a “broken” system.

Recognizing the need, our department recently extended services to the Nebraska City, Nebraska area. We quickly learned that a significant portion of the community’s population is covered by United Health Care and we contacted UHC to receive out-of-network approval to begin immediately providing treatment to your patients. Unfortunately, we were unable to receive out-of-network authorization and were given the name of two professionals in the area who could provide services, Bob Kohles and Dr. Brenda Glunz.

We conducted a telephone survey with local mental health professionals, as well as the physicians who refer patients to our clinics, and learned that there is a significant shortage of services for children in the Nebraska City area. Dr. Glunz stated that she does not provide therapy services and asked to refer a patient to our clinic. Additionally, Mr. Kohles requested a meeting to discuss our services and establish a process to make referrals. We also learned that other clinicians (Dr. Carol Thurman and the professionals at Blue Valley Mental Health Agency) provide services on a part-time basis in the Nebraska City area and a small portion of their practice includes children’s services. In addition, J. Fish and Associates has relocated their practice to Lincoln and is no longer a presence in Nebraska City.

The Behavioral Health Clinic we have established in Nebraska City fills an overwhelming need in the community. We are a division of the Department of Psychology at the University of Nebraska Medical Center, and our providers are dedicated to the provision of children’s behavioral health services. As a division of the University of Nebraska, we have access to and contribute to cutting edge research in the area of children’s behavioral health care. We are the ONLY provider in the area specializing in behavioral pediatric psychology. Not only do we see referrals common to any child psychologist, we also take pediatric specialty referrals including toileting, feeding, and compliance with medical regimen. Working in the primary care practice, we are able to consult with the child’s primary care physician on a regular basis regarding medication dosages and medical concerns relevant to treatment. We hope this information will be helpful as you negotiate a contract with us. Karen Mruz is our contact person and she recently mailed application materials so that I might become a paneled provider. Thank you for your time and consideration.

Best Regards,

Jodi Polaha, Ph.D. Licensed Psychologist Assistant Professor, Pediatrics Director, Behavioral Health Clinics UNMC, Munroe-Meyer Institute