MENTAL HEALTH: Alabama County and County Equivalent Listing

Autauga County Population Group: Low Income-Mental Health Catchment Area 14 Baldwin County (Entire County HPSA) Barbour County Population Group: Low Income - Barbour/Dale/Geneva/Henry/Houston Facility: Easterling Correctional Facility Facility: Ventress Correctional Facility Bibb County Population Group: Low Income-Bibb/Pickens/Tuscaloosa - Mental Health Catchment Area 8 Facility: Bibb Correctional Facility Facility: Cahaba Medical Care Foundation Blount County Population Group: Low Income - Catchment Area M-5 Bullock County Service Area: Mental Health Catchment Area 15 Butler County Service Area: Catchment Area M-18 Calhoun County Service Area: Calhoun/Cleburne - Mental Health Catchment Area 7 Chambers County Service Area: Chambers/Lee/Russell/Tallapoosa - Mental Health Catchment Area 12 Cherokee County Population Group: Low Income - Mental Health Catchment Area 6 Chilton County Service Area: Catchment Area M 11 Choctaw County Service Area: Catchment Area M-10 Clarke County Service Area: Mental Health Catchment Area 17 Clay County Service Area: Clay/Coosa/Randolph/Talladega Mental Health Catchment Area 9 Cleburne County Service Area: Calhoun/Cleburne - Mental Health Catchment Area 7 Coffee County Service Area: Catchment Area M-18 Colbert County Service Area: Colbert/Franklin/Lauderdale - Mental Health Catchment Area 1 Conecuh County Service Area: Mental Health Catchment Area 17 Facility: Tri-County Medical Center

Page 1 of 208 Pages MENTAL HEALTH: Alabama County and County Equivalent Listing

Coosa County Service Area: Clay/Coosa/Randolph/Talladega Mental Health Catchment Area 9 Covington County Service Area: Catchment Area M-18 Crenshaw County Service Area: Catchment Area M-18 Cullman County (Entire County HPSA) Dale County Population Group: Low Income - Barbour/Dale/Geneva/Henry/Houston Dallas County Service Area: Mental Health Catchment Area 13 Facility: Rural Health Medical Program DeKalb County Population Group: Low Income - Mental Health Catchment Area 6 Elmore County Population Group: Low Income-Mental Health Catchment Area 14 Facility: Draper Correctional Facility Facility: Julia Tutwiler Prison for Women Facility: Staton Correctional Facility Escambia County Service Area: Mental Health Catchment Area 17 Facility: Fountain Correctional Facility Etowah County Population Group: Low Income - Mental Health Catchment Area 6 Facility: Quality of Life Health Services Fayette County Service Area: Catchment Area M-4 Franklin County Service Area: Colbert/Franklin/Lauderdale - Mental Health Catchment Area 1 Geneva County Population Group: Low Income - Barbour/Dale/Geneva/Henry/Houston Greene County Service Area: Catchment Area M-10 Hale County Service Area: Catchment Area M-10 Henry County Population Group: Low Income - Barbour/Dale/Geneva/Henry/Houston Houston County Population Group: Low Income - Barbour/Dale/Geneva/Henry/Houston Jackson County Service Area: Jackson/Marshall - Mental Health Catchment Area 20 Facility: Northeast Alabama Health Services, Inc.

Page 2 of 208 Pages MENTAL HEALTH: Alabama County and County Equivalent Listing

Jefferson County Population Group: Low Income - Catchment Area M-5 Facility: Birmingham Healthcare Lamar County Service Area: Catchment Area M-4 Lauderdale County Service Area: Colbert/Franklin/Lauderdale - Mental Health Catchment Area 1 Lawrence County Population Group: Low Income - Lawrence/Limestone/Morgan - Mental Health Catchment Area 2 Lee County Service Area: Chambers/Lee/Russell/Tallapoosa - Mental Health Catchment Area 12 Limestone County Population Group: Low Income - Lawrence/Limestone/Morgan - Mental Health Catchment Area 2 Facility: Limestone Correctional Facility Lowndes County Population Group: Low Income-Mental Health Catchment Area 14 Macon County Service Area: Mental Health Catchment Area 15 Facility: Central Alabama Comprehensive Health, Inc. Madison County Facility: Central North Alabama Health Services Marengo County Service Area: Catchment Area M-10 Marion County Service Area: Catchment Area M-4 Facility: Hamilton Correctional Facility Marshall County Service Area: Jackson/Marshall - Mental Health Catchment Area 20 Facility: Marshall Family Health Clinic Mobile County Population Group: Low Income-Mobile/Washington - Mental Health Catchment Area 16 Facility: Bayou La Batre Area Health Development Facility: Family Oriented Primary Health Care Facility: Franklin Primary Health Center Facility: The Bayou Clinic Monroe County Service Area: Mental Health Catchment Area 17 Montgomery County Population Group: Low Income-Mental Health Catchment Area 14 Facility: Health Services, Inc. Facility: Kilby Correctional Facility

Page 3 of 208 Pages MENTAL HEALTH: Alabama County and County Equivalent Listing

Morgan County Population Group: Low Income - Lawrence/Limestone/Morgan - Mental Health Catchment Area 2 Perry County Service Area: Mental Health Catchment Area 13 Pickens County Population Group: Low Income-Bibb/Pickens/Tuscaloosa - Mental Health Catchment Area 8 Pike County Service Area: Mental Health Catchment Area 15 Facility: Southeast Alabama Rural Health Association Randolph County Service Area: Clay/Coosa/Randolph/Talladega Mental Health Catchment Area 9 Russell County Service Area: Chambers/Lee/Russell/Tallapoosa - Mental Health Catchment Area 12 Shelby County Service Area: Catchment Area M 11 St. Clair County Population Group: Low Income - Catchment Area M-5 Facility: St. Clair Correctional Facility Sumter County Service Area: Catchment Area M-10 Talladega County Service Area: Clay/Coosa/Randolph/Talladega Mental Health Catchment Area 9 Facility: Federal Correctional Institution - Talladega Tallapoosa County Service Area: Chambers/Lee/Russell/Tallapoosa - Mental Health Catchment Area 12 Tuscaloosa County Population Group: Low Income-Bibb/Pickens/Tuscaloosa - Mental Health Catchment Area 8 Facility: Whatley Health Service Walker County Service Area: Catchment Area M-4 Facility: Capstone Rural Health Center Washington County Population Group: Low Income-Mobile/Washington - Mental Health Catchment Area 16 Wilcox County Service Area: Mental Health Catchment Area 13 Winston County Service Area: Catchment Area M-4

Page 4 of 208 Pages MENTAL HEALTH: Alaska County and County Equivalent Listing

Aleutians East Borough (Entire County HPSA) Aleutians West Census Area Facility: Iliuliuk Family Health Center Anchorage Borough Facility: Alaska Women's Resource Center Facility: Aleutians/Pribilof Islands Association Facility: Anchorage Community Mental Health Services Facility: Anchorage Neighborhood Health Center Facility: Eastern Aleutian Tribe, Inc. Facility: Ninilchik Traditional Council Facility: Southcentral Foundation Bethel Census Area Facility: Bethel Family Clinic Facility: Yukon-Kuskokwim Health Corporation Bristol Bay Borough Service Area: Bristol Bay, Lake and Peninsulan and Dil Facility: Bristol Bay Borough Dillingham Census Area Service Area: Bristol Bay, Lake and Peninsulan and Dil Facility: Bristol Bay Area Health Corporation Facility: Eklutna Health Clinic Facility: Kanakanak Hospital Fairbanks North Star Borough Population Group: Low Income - Fairbanks North Star Facility: Chief Andrew Issac Health Center Facility: Dena' Nena' Henash Facility: Interior Community Health Center Hoonah-Angoon Census Area (Entire County HPSA) Kenai Peninsula Borough (Entire County HPSA) Facility: Peninsula Community Health Services of Alaska, Inc. Facility: Seldovia Village Health Center Facility: Spring Creek Correctional Center Ketchikan Gateway Borough Service Area: Southern Southeast Alaska Facility: Ketchikan Indian Corporation Kodiak Island Borough Facility: Kodiak Area Native Association Facility: Kodiak Island Health Care Foundation Lake and Peninsula Borough Service Area: Bristol Bay, Lake and Peninsulan and Dil Matanuska-Susitna Borough (Entire County HPSA) Facility: Mat-Su Health Services

Page 5 of 208 Pages MENTAL HEALTH: Alaska County and County Equivalent Listing

Matanuska-Susitna Borough (Entire County HPSA) Facility: Scf Valley Native Primary Care Center Facility: Sunshine Community Health Center Nome Census Area Facility: Norton Sound Health Corporation North Slope Borough (Entire County HPSA) Facility: Samuel Simmonds Memorial Hospital Northwest Arctic Borough (Entire County HPSA) Facility: Maniilaq Association Petersburg Census Area Service Area: Southern Southeast Alaska Prince of Wales-Hyder Census Area Service Area: Southern Southeast Alaska Sitka Borough Facility: Searhc/MT. Edgecumbe Hospital Facility: Southeast Alaska Regional Health Consortium Skagway Municipality (Entire County HPSA) Skagway-Hoonah-Angoon Census Area Facility: Dahl Memorial Clinc Valdez-Cordova Census Area (Entire County HPSA) Facility: Cross Roads Medical Center Facility: Native Village of Eyak Wrangell City and Borough Service Area: Southern Southeast Alaska Wrangell-Petersburg Census Area Facility: Alaska Island Community Services Yakutat Borough Facility: Yakutat Community Health Center Yukon-Koyukuk Census Area Facility: Council of Athabascan Tribal Governments

Page 6 of 208 Pages MENTAL HEALTH: Arizona County and County Equivalent Listing

Apache County Service Area: Northern Arizona Mental Health Catchment Area Facility: Chinle Comprehensive Health Center Facility: Fort Defiance PHS Indian Hospital Facility: Navajo Division of Emergency Medical Services Facility: Navajo Division of Health Facility: Navajo Division of Social Services Facility: Navajo Health Foundation Dba Sage Memorial Hospita Facility: Sage Memorial Hospital Facility: Tsaile Indian Health Center Cochise County Service Area: Southeast Arizona Catchment Area Facility: Arizona State Prison - Douglas Facility: Chiricahua Community Health Center Facility: Copper Queen Medical Associates-Bisbee Facility: Copper Queen Medical Associates-Douglas Facility: Palominas/Hereford Rural Health Clinics Coconino County Service Area: Northern Arizona Mental Health Catchment Area Facility: Canyonlands Community Health Center Facility: Inscription House Health Center Facility: Kaibab-Paiute Tribe Facility: Naca Family Health Center Facility: Native Americans for Community Action Facility: North Country Community Health Center Facility: Sacred Peaks Health Center Facility: San Juan Southern Paiute Tribe Facility: Tuba City Regional Health Care Corporation Gila County Service Area: Pinal/Gila Catchment Area Facility: Bylas Health Center Facility: Pleasant Valley Community Medical Center Facility: Tonto Apache Tribe Graham County Service Area: Southeast Arizona Catchment Area Facility: Arizona State Prison - Safford Facility: San Carlos Apache Tribe Facility: San Carlos PHS Indian Hospital Greenlee County Service Area: Southeast Arizona Catchment Area La Paz County Service Area: Southwest Arizona Catchment Area

Page 7 of 208 Pages MENTAL HEALTH: Arizona County and County Equivalent Listing

La Paz County Facility: Colorado River Indian Community Facility: Parker PHS Indian Hospital Maricopa County (Entire County HPSA) Facility: Arizona State Prison - Lewis Facility: Arizona State Prison - Perryville Facility: Arizona State Prison - Phoenix Facility: Clinica Adelante, Inc. Facility: Community Hospital Clinic Facility: Federal Correctional Institution - Phoenix Facility: Fort McDowell Yavapai Nation Facility: Gila River Health Care Corporation Facility: Maricopa County Community Health Center Facility: Maricopa County Special Health Care District Facility: Mountain Park Health Center Facility: Native American Community Health Center - Dunlap Facility: Native American Community Health Center, I Facility: Neighborhood Outreach Access to Health Facility: Phoenix Indian Medical Center Facility: Salt River Clinic Facility: Wesley Community Center Inc. Mohave County Service Area: Northern Arizona Mental Health Catchment Area Facility: Hualapai Tribe Facility: Peach Springs PHS Indian Health Center Navajo County Service Area: Northern Arizona Mental Health Catchment Area Facility: Arizona State Prison - Winslow Facility: Cibecue PHS Indian Health Center Facility: Health and Social Services Committee Facility: Hopi Health Care Center Facility: Kayenta PHS Indian Health Center Facility: Pinon Health Center Facility: White Mountain Apache Tribe Facility: Whiteriver Indian Health Services Hospital Facility: Winslow Indian Health Care Center Pima County Population Group: Low Income - Pima County Facility: Ajo Community Health Center Facility: Arizona State Prison - Tucson Facility: El Rio Health Center Facility: Federal Correctional Complex - Tucson

Page 8 of 208 Pages MENTAL HEALTH: Arizona County and County Equivalent Listing

Pima County Facility: Marana Health Center Facility: Pascua Yaqui Tribe Health Programs Facility: San Xavier PHS Indian Health Center Facility: Sells PHS Indian Hospital Facility: Sells PHS Indian Hospital-Santa Rosa Clinic Facility: Tohono O'Odham Nation Facility: Tucson Indian Center Facility: United Community Health Center Pinal County Service Area: Pinal/Gila Catchment Area Facility: Ak-Chin Indian Community Facility: Arizona State Prison - Eyman Facility: Arizona State Prison - Florence Facility: Desert Visions Wellness Center Facility: Hu Hu Kam Memorial Hospital Facility: Immigration and Customs Enforcement - Eloy Facility: Immigration and Customs Enforcement - Florence Facility: Immigration and Customs Enforcement - Pinal County Facility: Kearny Clinic Facility: Rightway Healthcare LLC Facility: Sun Life Family Health Center Facility: Superior Clinic Santa Cruz County Service Area: Southeast Arizona Catchment Area Facility: Mariposa Community Health Center Yavapai County Service Area: Northern Arizona Mental Health Catchment Area Facility: Yavapai County Health Department Facility: Yavapai-Apache Nation Facility: Yavapai-Prescott Tribe Yuma County Service Area: Southwest Arizona Catchment Area Facility: Arizona State Prison - Yuma Facility: Cocopah Tribe Facility: Sunset Community Health

Page 9 of 208 Pages MENTAL HEALTH: Arkansas County and County Equivalent Listing

Arkansas County Service Area: Pine Bluff Catchment Area Ashley County Service Area: Monticello Catchment Area Facility: Mainline Health Systems Baxter County Service Area: Mountain Home Catchment Area Benton County Facility: Decatur Medi Clinic Boone County Service Area: Mountain Home Catchment Area Bradley County Service Area: Monticello Catchment Area Calhoun County Service Area: El Dorado Catchment Area Facility: Cabun Rural Health Services Carroll County Service Area: Carroll/Madison Catchment Area Chicot County Service Area: Monticello Catchment Area Facility: Lake Village Clinic, P.A. Clark County Service Area: Hot Springs Catchment Area Clay County Service Area: Jonesboro Catchment Area Facility: Corning Area Health Care Cleburne County Service Area: Batesville Catchment Area Cleveland County Service Area: Pine Bluff Catchment Area Columbia County Service Area: El Dorado Catchment Area Conway County Service Area: Russellville Catchment Area Craighead County Service Area: Jonesboro Catchment Area Crawford County Service Area: Fort Smith Catchment Area Crittenden County Facility: East Arkansas Family Health Cross County Service Area: Helena Catchment Area

Page 10 of 208 Pages MENTAL HEALTH: Arkansas County and County Equivalent Listing

Dallas County Service Area: El Dorado Catchment Area Desha County Service Area: Monticello Catchment Area Drew County Service Area: Monticello Catchment Area Franklin County Service Area: Fort Smith Catchment Area Fulton County Service Area: Batesville Catchment Area Garland County Service Area: Hot Springs Catchment Area Grant County Service Area: Pine Bluff Catchment Area Greene County Service Area: Jonesboro Catchment Area Hempstead County Service Area: Texarkana Catchment Area Hot Spring County Service Area: Hot Springs Catchment Area Facility: Ouachita River Correctional Unit Howard County Service Area: Texarkana Catchment Area Independence County Service Area: Batesville Catchment Area Izard County Service Area: Batesville Catchment Area Facility: North Central Correctional Unit Jackson County Service Area: Batesville Catchment Area Facility: Grimes Correctional Unit Facility: McPherson Correctional Unit Jefferson County Service Area: Pine Bluff Catchment Area Facility: Jefferson Comprehensive Facility: Pine Bluff Correctional Unit Facility: Randall Williams Unit Facility: Tucker Maximum Security Unit Facility: Tucker Prison Unit Johnson County Service Area: Russellville Catchment Area

Page 11 of 208 Pages MENTAL HEALTH: Arkansas County and County Equivalent Listing

Lafayette County Service Area: Texarkana Catchment Area Lawrence County Service Area: Jonesboro Catchment Area Lee County Service Area: Helena Catchment Area Facility: East Arkansas Regional Unit at Brickeys Facility: Lee County Cooperative Lincoln County Service Area: Pine Bluff Catchment Area Facility: Cummins Unit Facility: Varner Supermax Unit Little River County Service Area: Texarkana Catchment Area Logan County Service Area: Fort Smith Catchment Area Facility: Booneville Community and Fam Medical Clinic Facility: River Valley Primary Care Services Madison County Service Area: Carroll/Madison Catchment Area Marion County Service Area: Mountain Home Catchment Area Miller County Service Area: Texarkana Catchment Area Mississippi County Service Area: Jonesboro Catchment Area Monroe County Service Area: Helena Catchment Area Facility: Mid-Delta Health Systems, Inc. Montgomery County Service Area: Hot Springs Catchment Area Nevada County Service Area: El Dorado Catchment Area Newton County Service Area: Mountain Home Catchment Area Ouachita County Service Area: El Dorado Catchment Area Perry County Service Area: Russellville Catchment Area Phillips County Service Area: Helena Catchment Area

Page 12 of 208 Pages MENTAL HEALTH: Arkansas County and County Equivalent Listing

Pike County Service Area: Hot Springs Catchment Area Poinsett County Service Area: Jonesboro Catchment Area Polk County Service Area: Fort Smith Catchment Area Facility: Healthy Connections Pope County Service Area: Russellville Catchment Area Prairie County (Entire County HPSA) Pulaski County Facility: Wrightsville Unit Randolph County Service Area: Jonesboro Catchment Area Scott County Service Area: Fort Smith Catchment Area Searcy County Service Area: Mountain Home Catchment Area Facility: Boston Mountain Rural Facility: Marshall Family Practice Clinic Sebastian County Service Area: Fort Smith Catchment Area Sevier County Service Area: Texarkana Catchment Area Sharp County Service Area: Batesville Catchment Area St. Francis County Service Area: Helena Catchment Area Facility: Federal Correctional Complex - Forrest City Stone County Service Area: Batesville Catchment Area Union County Service Area: El Dorado Catchment Area Van Buren County Service Area: Batesville Catchment Area Washington County Facility: St. Francis House NWA, Inc. White County Service Area: Batesville Catchment Area Woodruff County Service Area: Batesville Catchment Area Facility: White River Rural Health Center

Page 13 of 208 Pages MENTAL HEALTH: Arkansas County and County Equivalent Listing

Yell County Service Area: Russellville Catchment Area

Page 14 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Alameda County Population Group: Low Income - MSSA 2h/Ashland Facility: Alameda County Health Department Facility: Asian Health Services Facility: Axis Community Health Facility: Childrens Hospital Facility: La Clinica De La Raza Facility: Lifelong Medical Care Facility: Native American Health Center Facility: Tiburcio Vasquez Health Center Facility: Tri-City Health Center Facility: West Oakland Health Council Butte County (Entire County HPSA) Facility: Chuk Ndule Medical Center-Gridley Facility: Dr. Ndulue Medical Practice-Oroville Facility: Feather River Hospital Family Health Center Facility: Northen Valley Indian Health - Chico Facility: Northern Valley Indian Health-Cohasset Calaveras County (Entire County HPSA) Colusa County (Entire County HPSA) Facility: Colusa Indian Community Council Contra Costa County Service Area: MSSA 17/Byron Service Area: MSSA 18D/Antioch North and West Service Area: MSSA 18F/Richmond Central Facility: Contra Costa County Health Del Norte County (Entire County HPSA) Facility: Sutter Coast Community Clinic El Dorado County Facility: El Dorado County Community Health Center Facility: Shingle Springs Tribal Health Program Fresno County Service Area: MSSA 25, 26, 27, 28/Western Fresno Service Area: MSSA 31 and 32 - Sanger/Reedley Service Area: MSSA 35B and D Clovis West/Fresno East Population Group: Low Income/MFW - MSSA 30/Caruthers-Raisin City Population Group: Low Income/Migrant Farmworker/Homeless - MSSA 35F (Fresno North Central) Facility: Adventist Health Community Care Caruthers Facility: Adventist Health Community Care-Coalinga Facility: Adventist Health Community Care-Huron Facility: Central Valley Indian Health Inc.

Page 15 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Fresno County Facility: Coalinga State Mental Hospital Facility: Federal Correctional Institution - Mendota Facility: Greater Fresno Health Organization Facility: United American Involvement-Fresno Facility: United Health Centers of San Joaquin Valley Facility: Valley Family Health Cntr/Maternal and Child Care-CA Facility: Valley Health Team Glenn County (Entire County HPSA) Facility: Northern Valley Indian Health Humboldt County Population Group: Low Income - Humboldt County Facility: Hoopa Valley Tribe Facility: Open Door Community Health Centers Facility: Redwoods Rural Health Center Facility: United Indian Health Service - Potowat Imperial County (Entire County HPSA) Facility: Calexico Health Center Facility: California State Prison - Calipatria Facility: Centinela State Prison Facility: Clinicas De Salud Del Pueblo Facility: Fort Yuma Inyo County Facility: Toiyabe Indian Health Project Kern County Service Area: MSSA 61/Arvin Service Area: MSSAs 57.1, 57.2, and 59 (Taft/Frazier Park/Buttonwi Service Area: MSSAs 58.1. 58.2, 60 Shafter/Lost Hills/Wasco Service Area: MSSAs 62,63,64 - Tehachapi/Lake Isabella/Ridgecres Facility: Beverly Medical Center II Facility: California Correctional Institution Facility: Clinica Sierra Vista Facility: Kern Valley State Prison Facility: National Health Services, Inc. Facility: Sage Community Health Center Facility: United American Indian Involvement-Bakersfield Kings County (Entire County HPSA) Facility: Avenal Community Health Center Facility: Avenal State Prison Facility: California State Prison - Corcoran Facility: Central Valley Family Facility: Health Valley Medical Group, Inc.

Page 16 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Kings County (Entire County HPSA) Facility: Substance Abuse Treatment Facility Lake County Population Group: Low Income - Lake County Facility: Lake County Tribal Health Consortium Facility: Middletown Medical Clinic Lassen County Facility: California Correction Center Facility: Federal Correctional Institution - Herlong Facility: High Desert State Prison Facility: Lassen Indian Health Center Facility: Mountain Valleys Health Centers, Inc. Facility: Northeastern Rural Health Los Angeles County Service Area: MSSA 78.1/Avalon Service Area: MSSA 78.2C/Bell Northeast Service Area: MSSA 78.2D/City Terrace/East Los Angeles/Maravilla Service Area: MSSAs 78.2III,78.2BBB/North Long Beach/Compton Ea Population Group: Low Income/Homeless-MSSA 78.2Z/Santa Monica South/Venice Facility: All for Health, Health for All Facility: All-Inclusive Community Health Center Facility: Alta Medical Health Services Corporation Facility: American Indian Healing Center Facility: Antelope Valley Community Clinic Facility: Arroyo Vista Family Health Facility: Asian/Pacific Health Care Venture Facility: Bartz-Altadonna Community Health Center Facility: Benevolence Industries Facility: Bienvenidos Community Health Center Facility: Central Neighborhood Health Foundation Facility: Children's Clinic Facility: Chinatown Service Center Facility: Clinica Monsenor Oscar a. Romero Facility: Community Health Alliance of Pasadena Facility: Comprehensive Community Health Centers, Inc. Facility: Desert AIDS Project Facility: East Valley Community Health Center Facility: Eisner Pediatric and Family Facility: El Proyecto Del Barrio-Arleta Facility: Family Health Care Centers of Gtr La Facility: Federal Correctional Institution - Terminal Islan Facility: Garfield Health Center

Page 17 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Los Angeles County Facility: Harbor Free Clinic Facility: JWCH/Clinic Institute Facility: Korean Health, Educ., Info and Research (Kheir) Ce Facility: Los Angeles Christian Health Center Facility: Los Angeles Gay and Lesbian Center Facility: Metropolitan Detention Center - Los Angeles Facility: Mission City Community Network Facility: Northeast Community Clinic (Necc) Facility: Northeast Valley Health Facility: Queenscare Family Clinic Facility: Saint Anthony Medical Facility: Samuel Dixon Family Health Center Facility: Samuel Dixon Family Health Centers Facility: South Bay Family Healthcare Center Facility: South Central Family Health Facility: St. John's Well Child and Family Center Facility: T.H.E. Clinic Facility: The Saban Free Clinic Facility: United American Indian Involvement Facility: Universal Community Health Center Facility: Universal Health Foundation Facility: University Muslim Medical Association Facility: Valley Community Clinic Facility: Venice Family Clinic Facility: Watts Healthcare Corporation Facility: Westside Family Health Center Facility: Wilmington Community Clinic Madera County (Entire County HPSA) Facility: Charlie Mitchell Childrens Clinic Facility: Darin Camarena Health Center Marin County Facility: Coastal Health Alliance Facility: Marin City Health and Wellness Center Facility: Marin Community Clinic Mariposa County (Entire County HPSA) Mendocino County Facility: Anderson Valley Health Facility: Anderson Valley Health Center, Inc. Facility: Consolidated Tribal Health Project, Inc. Facility: Long Valley Health Center Facility: Mendocino Coast Clinics, Inc.

Page 18 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Mendocino County Facility: Mendocino Community Facility: Potter Valley Community Health Center Facility: Redwood Coast Medical Center Facility: Round Valley Indian Health Center Merced County (Entire County HPSA) Service Area: MSSA 25, 26, 27, 28/Western Fresno Facility: Bloss Memorial Hospital District Facility: Castle Family Health Center Facility: Golden Valley Health Center Facility: Livingston Community Health Services Facility: USP Atwater Modoc County (Entire County HPSA) Facility: Canby Family Practice Clinic Facility: Surprise Valley Medical Clinic Mono County (Entire County HPSA) Monterey County Service Area: MSSA 104/Big Sur/Lucia Service Area: MSSA 105 and 106 - King City/San Ardo Service Area: MSSA 107 - Soledad Facility: Clinica De Salud Del Valle Facility: Correctional Training Facility-Soledad Facility: Monterey County Health Department Napa County Facility: Community Health Clinic Ole Nevada County (Entire County HPSA) Facility: Chapa-De Indian Health Program-Grass Valley Facility: Miners Community Clinic Facility: Sierra Family Medical Clinic, Inc. Orange County Facility: Asian Health Center Facility: Casa De Salud Clinic Dba (Ocrm Health Care Facility: Central City Community Health Centers - Anaheim Facility: Mission Hospital's Camino Health Center Facility: North Orange County Regional Health Foundation Facility: Share Our Selves (Sos) Facility: University of California-Irvine Family Health Placer County Service Area: MSSA 117/Dollar Point Facility: Chapa De Indian Health Program, Inc. Plumas County Facility: Plumas Rural Health Center

Page 19 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Riverside County Service Area: MSSA 126/Blythe Service Area: MSSA 127, 128, 130/Desert Center/Coachella/Idyllwi Facility: California Rehabilitation Center Facility: Centro Medico Community Clinic, Inc. Facility: Chuckawalla Valley State Prison Facility: Community Health Systems, Inc. Facility: County of Riverside Facility: County of Riverside Community Health Agency (Crcha) Facility: Ironwood State Prison Facility: Oasis Community Health Center Sacramento County Facility: California Rural Indian Health Board, Inc. Facility: Folsom State Prison Facility: Health for All, Inc. Facility: Sacramento Community Clinic Facility: Sacramento County Department of Health Facility: Sacramento Native American Health Center, Inc. Facility: The Effort San Benito County Facility: San Benito Health Foundation San Bernardino County Service Area: MSSA 142/Argus/Trona Service Area: MSSA 144.2/Yucca Valley/Joshua Tree Service Area: MSSA 145.1A/Hesperia West and MSSA 145.1B/Apple Vall Service Area: MSSA 145.2/Adelanto Service Area: MSSA 145.3/Lucerne Valley Service Area: MSSA 146/Big Bear Lake Service Area: MSSA 147-Crestline/Blue Jay Service Area: MSSA 148/Lytle Creek/Wrightwood Service Area: MSSA 149/Barstow Service Area: MSSA 150/Baker/Harvard/Newberry Springs Population Group: Low Income-MSSAs 143 and 144.3-Needles/Twentynine PA Facility: Federal Correctional Complex - Victorville Facility: Inland Behavioral and Health Services Facility: San Bernardino County Health Center Facility: Sean R. Thomas, MD Facility: Social Action Community Health System San Diego County Service Area: MSSA 159/Buckman Springs Population Group: Low Income - MSSA 161C (Golden Hill/Logan Heights) Population Group: Low Income - MSSA 161J/San Ysidro

Page 20 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

San Diego County Facility: Borrego Community Health Foundation Facility: Campo Clinic Facility: Family Health Centers of San Diego Facility: Immigration and Customs Enforcement - San Diego Facility: Imperial Beach Community Clinic Facility: Indian Health Council Facility: La Maestra Family Clinic Facility: Metropolitan Correctional Center - San Diego Facility: Mountain Health Facility: Neighborhood Healthcare/Escondido Facility: North County Health Services Facility: Operation Samahan, Inc. Facility: San Diego American Indian Health Center Facility: San Diego Family Care Facility: San Ysidro Health Center Facility: Southern Indian Health Council Facility: St. Vincent De Paul Village Facility: Sycuan Band of Mission Indians Facility: Vista Community Clinic San Francisco County Facility: Mission Neighborhood Health Center Facility: North East Medical Services Facility: San Francisco Community Clinic Consort Facility: South of Market Health Center San Joaquin County Service Area: MSSA 164.2 (Banta) Population Group: Low Income - MSSA 165-Farmington/Linden Facility: Community Medical Centers, Inc. San Luis Obispo County Facility: Community Health Centers of the Central Coast, Inc. San Mateo County Facility: San Mateo County Health Services Agency Facility: South County Community Health Center Santa Barbara County Service Area: MSSAs 178.1/178.2/179/180.2-Buellton/Solvang/Lompo Facility: American Indian Health and Services Corporation Facility: Federal Correctional Complex - Lompoc Facility: Santa Barbara County Public Facility: Santa Ynez Band of Mission Indians Santa Clara County Facility: Asian Americans for Community Involvemen

Page 21 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Santa Clara County Facility: Gardner Family Health Facility: Indian Health Center of Santa Clara Facility: Mayview Community Health Center Facility: San Jose Foothills Family Community Clinic Facility: Santa Clara Valley Health and Hospital Facility: School Health Clinics of Santa Clara County Santa Cruz County Facility: County of Santa Cruz Health Services Facility: Salud Para La Gente Facility: Santa Cruz Women's Health Center Shasta County Facility: Hill Country Community Clinic Facility: Shasta Community Health Center Facility: Shingletown Medical Center Sierra County (Entire County HPSA) Facility: Western Sierra Medical Clinic Siskiyou County Facility: Fairchild Medical Group, Inc. Facility: Karuk Tribe of California Facility: McCloud Healthcare Clinic Facility: Mercy Mt. Shasta Community Clinic Facility: Quartz Valley Indian Reservation Solano County Facility: California State Prison - Solano Facility: Solano County Health and Social Services Sonoma County Facility: Alliance Medical Center Facility: Copper Towers Family Medical Care Facility: Petaluma Health Center Facility: Santa Rosa Community Health Centers Facility: Sonoma County Indian Health Facility: Sonoma Valley Community Health Center Facility: West County Health Centers, Inc. Stanislaus County Facility: Stanislaus County Sutter County Facility: Ampla Health (Formerly) Del Norte Clinics, Inc. Tehama County (Entire County HPSA) Facility: Rolling Hills Clinic Trinity County (Entire County HPSA) Facility: Southern Trinity Health Services

Page 22 of 208 Pages MENTAL HEALTH: California County and County Equivalent Listing

Tulare County Facility: Alta Family Health Clinic, Inc. Facility: Family Care/Tulare City Facility: Family Healthcare Network Facility: Tulare Community Health Facility: Tulare County Health Tuolumne County (Entire County HPSA) Facility: Forest Road Health and Wellness Center Facility: Sierra Conservation Center Ventura County Facility: Clinicas Del Camino Facility: Ventura County Public Healthcare Agency Yolo County Population Group: Low Income/Migrant Farmworkers - Yolo County Facility: Communicare Health Center Facility: MMC for Children and Families Facility: Northern Valley Indian Health-Woodland Facility: The Midtown Medical Center for Children and Families Facility: Winters Healthcare Foundation Yuba County Service Area: MSSA 247 (Challenge/Brownsville) Facility: Chuk Ndule, MD Facility: County of Yuba/Peach Tree Clinic

Page 23 of 208 Pages MENTAL HEALTH: Colorado County and County Equivalent Listing

Adams County Facility: Regents of the University of Colorado Alamosa County Service Area: San Luis Valley Facility: Valley-Wide Health Services Arapahoe County Facility: Admhn - Sycamore Clinic Facility: Admhn Inverness Clinic Facility: Metro Community Provider Network Archuleta County Population Group: Low Income - Southwestern Mental Health CA Baca County Service Area: Southeastern Mental Health Catchment Area Bent County Service Area: Southeastern Mental Health Catchment Area Boulder County Facility: Clinica Campesina Facility: Mental Health Center-Bbc Facility: Mental Health Partners - Coffman Clinic Facility: Mental Health Partners - Sherman Clinic Chaffee County Service Area: West Central Mental Health Region Facility: Buena Vista Correctional Facility Cheyenne County Service Area: Northeast/East Central Mental Health Catchment are Conejos County Service Area: San Luis Valley Costilla County Service Area: San Luis Valley Crowley County Service Area: Southeastern Mental Health Catchment Area Facility: Arkansas Valley Correctional Custer County Service Area: West Central Mental Health Region Delta County Service Area: Midwestern Colorado Mental Health Catchment Area Facility: Surface Creek Family Practice Denver County Population Group: Low Income Denver Mental Health Catchment Area Facility: Colorado Coalition for the Homeless Facility: Colorado Mental Health Institute - Fort L Facility: Denver Health and Hospital

Page 24 of 208 Pages MENTAL HEALTH: Colorado County and County Equivalent Listing

Denver County Facility: Denver Indian Health and Family Services Facility: Denver Reception and Diagnostic Center Facility: Denver Womens Correctional Facility Facility: Mhcd - Adult Spectrum of Care Facility: Mhcd - Clermont Wellness Center Dolores County Population Group: Low Income - Southwestern Mental Health CA Facility: Dolores County Health Association Douglas County Facility: Admhn Castle Rock Clinic Facility: Admhn Parker Clinic Eagle County Service Area: Colorado West Regional Mental Health Catchment are El Paso County Service Area: Aspen Pointe Mental Health Catchment Area Facility: Peak Vista Community Health Centers, Inc. Elbert County Service Area: Northeast/East Central Mental Health Catchment are Fremont County Service Area: West Central Mental Health Region Facility: Button Family Practice, P.C. Facility: Colorado Territorial Correctional Facility Facility: Federal Correctional Institution - Florence Facility: Fremont Correctional Facility Garfield County Service Area: Colorado West Regional Mental Health Catchment are Gilpin County Facility: Mountain Family Health Center Grand County Service Area: Colorado West Regional Mental Health Catchment are Gunnison County Service Area: Midwestern Colorado Mental Health Catchment Area Hinsdale County Service Area: Midwestern Colorado Mental Health Catchment Area Huerfano County Service Area: Spanish Peaks Mental Health Catchment Area Jackson County Service Area: Colorado West Regional Mental Health Catchment are Kiowa County Service Area: Southeastern Mental Health Catchment Area

Page 25 of 208 Pages MENTAL HEALTH: Colorado County and County Equivalent Listing

Kit Carson County Service Area: Northeast/East Central Mental Health Catchment are La Plata County Population Group: Low Income - Southwestern Mental Health CA Facility: Southern Ute Health Center (Tribal) Lake County Service Area: West Central Mental Health Region Las Animas County Service Area: Spanish Peaks Mental Health Catchment Area Lincoln County Service Area: Northeast/East Central Mental Health Catchment are Facility: Limon Correctional Facility Facility: Plains Medical Center Logan County Service Area: Northeast/East Central Mental Health Catchment are Facility: Sterling Correctional Facility Mesa County Service Area: Colorado West Regional Mental Health Catchment are Mineral County Service Area: San Luis Valley Moffat County Service Area: Colorado West Regional Mental Health Catchment are Facility: Northwest Colorado Community Health Center Montezuma County Population Group: Low Income - Southwestern Mental Health CA Facility: Towaoc PHS Indian Health Center Montrose County Service Area: Midwestern Colorado Mental Health Catchment Area Facility: Olathe Community Clinic Morgan County Service Area: Northeast/East Central Mental Health Catchment are Otero County Service Area: Southeastern Mental Health Catchment Area Ouray County Service Area: Midwestern Colorado Mental Health Catchment Area Park County Service Area: Aspen Pointe Mental Health Catchment Area Phillips County Service Area: Northeast/East Central Mental Health Catchment are Pitkin County Service Area: Colorado West Regional Mental Health Catchment are

Page 26 of 208 Pages MENTAL HEALTH: Colorado County and County Equivalent Listing

Prowers County Service Area: Southeastern Mental Health Catchment Area Facility: High Plains Community Health Center Pueblo County Service Area: Spanish Peaks Mental Health Catchment Area Facility: Colorado Mental Health Institute Pueblo Facility: Pueblo Community Health Center Rio Blanco County Service Area: Colorado West Regional Mental Health Catchment are Rio Grande County Service Area: San Luis Valley Routt County Service Area: Colorado West Regional Mental Health Catchment are Saguache County Service Area: San Luis Valley San Juan County Population Group: Low Income - Southwestern Mental Health CA San Miguel County Service Area: Midwestern Colorado Mental Health Catchment Area Facility: Uncompahgre Combined Community Health Center Sedgwick County Service Area: Northeast/East Central Mental Health Catchment are Summit County Service Area: Colorado West Regional Mental Health Catchment are Facility: Summit Community Care Clinic Teller County Service Area: Aspen Pointe Mental Health Catchment Area Washington County Service Area: Northeast/East Central Mental Health Catchment are Weld County Population Group: Low Income - Weld County Facility: Plan De Salud Del Valle Facility: Sunrise Community Health Yuma County Service Area: Northeast/East Central Mental Health Catchment are

Page 27 of 208 Pages MENTAL HEALTH: Connecticut County and County Equivalent Listing

Fairfield County Population Group: Low Income - Bridgeport Population Group: Low Income - Danbury Population Group: Low Income - Southend Stamford Facility: Federal Correctional Institution - Danbury Facility: Norwalk Community Health Center Facility: Optimus Health Care, Inc. Facility: Southwest Community Health Center Hartford County Population Group: Low Income - Hartford Population Group: Low Income - New Britain Facility: Charter Oak Health Center, Inc. Facility: Community Health Services Inc. Facility: East Hartford Community Health Center Litchfield County (Entire County HPSA) Facility: Community Health and Wellness of Gtr Torrington Middlesex County (Entire County HPSA) Facility: Community Health Center of Middletown New Haven County Population Group: Low Income - New Haven/West Haven/Hamden Population Group: Low Income - Waterbury Facility: Cheshire Correctional Institution Facility: Cornell Scott-Hill Health Corporation Facility: Fair Haven Community Health Facility: Staywell Health Center, Inc. New London County (Entire County HPSA) Facility: Mashantuckey Pequot Tribal Nation Facility: United Community and Family Services, Inc. Tolland County (Entire County HPSA) Windham County (Entire County HPSA) Facility: Generations Family Health

Page 28 of 208 Pages MENTAL HEALTH: Delaware County and County Equivalent Listing

Kent County Facility: Community Mental Health Clinic (CMHC) – Dover Facility: Milford State Service Center at Riverwalk New Castle County Facility: Community Mental Health Clinic(CMHC)–Wilmington Facility: Delaware Psychiatric Center Facility: Henrietta Johnson Medical Facility: James T. Vaughn Correctional Center Facility: Westside Health Services Sussex County Population Group: Low Income - Sussex County Facility: La Red Health Center, Inc. Facility: Sussex Correctional Institution

Page 29 of 208 Pages MENTAL HEALTH: District of Columbia County and County Equivalent Listing

District of Columbia Service Area: Anacostia Facility: Community of Hope Facility: Elaine Ellis Center of Health Facility: Family and Medical Counseling Services, Inc. Facility: La Clinica Del Pueblo Facility: Mary's Center for Maternal and Child Care Facility: Unity Health Care, Inc. Facility: Whitman Walker Clinic

Page 30 of 208 Pages MENTAL HEALTH: Florida County and County Equivalent Listing

Alachua County Facility: Children's Medical Center @ Alachua Baker County Facility: Children's Medical Center-Glen St. Mary Bay County Service Area: Mental Health Catchment Area 2A Facility: Pancare of Florida, Inc. Bradford County Service Area: Mental Health Catchment Area 3A Brevard County Facility: The Brevard Health Alliance, Inc. Broward County Facility: Broward Community and Family Health Center Facility: North Broward Hospital District/Homeless Facility: Seminole Tribe of Florida-Health Admin Calhoun County Service Area: Mental Health Catchment Area 2A Facility: Calhoun Correctional Institution Citrus County Population Group: Low Income - Citrus County Facility: Citrus County Health Department Collier County Facility: Collier Health Service Facility: Immokalee Health Center Columbia County Service Area: Mental Health Catchment Area 3A Facility: Children's Medical Center-Lake City Facility: Columbia Correctional Institution Facility: Columbia County Health Center DeSoto County (Entire County HPSA) Dixie County (Entire County HPSA) Facility: Cross City Correctional Institution Duval County Facility: Duval County Health Department Facility: I.M. Sulzbacher Center for the Homeless Escambia County Population Group: Low Income-Escambia Facility: Century Correctional Institution Facility: Escambia Community Clinics Inc. Franklin County (Entire County HPSA) Facility: Franklin Correctional Institution Gadsden County (Entire County HPSA)

Page 31 of 208 Pages MENTAL HEALTH: Florida County and County Equivalent Listing

Gilchrist County (Entire County HPSA) Facility: Lancaster Correctional Institution Facility: Trenton Medical Center Glades County Service Area: Glades/Hendry Catchment Area Gulf County Service Area: Mental Health Catchment Area 2A Facility: Gulf Correctional Institution Facility: Gulf County Health Department/St. Joseph Hamilton County Service Area: Mental Health Catchment Area 3A Facility: Hamilton Correctional Institution Hardee County (Entire County HPSA) Hendry County Service Area: Glades/Hendry Catchment Area Facility: Big Cypress Indian Health Service Center Hernando County Population Group: Low Income - Hernando County Facility: Hernando Correctional Institution Facility: Nature Coast Community Health Center Highlands County Population Group: Low Income/Migrant Farmworker - Highlands County Facility: Avon Park Correctional Institution Facility: Central Florida Health Facility: Family Practice Center of Avon Park Hillsborough County Service Area: Southeast Hillsborough Population Group: Low Income - Port of Tampa Population Group: Low Income-Magdalene Lake_Hillsborough Population Group: Low Income-Plant City/Dover_Hillsborough Population Group: Low Income-West Tampa_Hillsborough Facility: Suncoast Community Health Centers Facility: Tampa Community Health Centers Holmes County Service Area: Mental Health Catchment Area 2A Facility: Holmes Correctional Institution Indian River County Population Group: Low Income-Indian River Facility: Treasure Coast Community Health Center Jackson County Service Area: Mental Health Catchment Area 2A Facility: Federal Correctional Institution - Marianna

Page 32 of 208 Pages MENTAL HEALTH: Florida County and County Equivalent Listing

Jackson County Facility: Graceville Correctional Facility Facility: Jackson Correctional Institution Jefferson County (Entire County HPSA) Facility: Jefferson Correctional Institution Lafayette County Service Area: Mental Health Catchment Area 3A Facility: Mayo Correctional Institution Lake County Population Group: Low Income/Migrant Farmworker Lake Facility: Gchn-Umatilla Health Clinic Lee County Facility: Family Health Centers of Southwest Florida Leon County Population Group: Low Income/Migrant Farmworker - Leon County Facility: Bond Community Facility: North Florida Medical Centers, Inc. Levy County Facility: Chiefland Medical Center, Inc. Liberty County (Entire County HPSA) Facility: Liberty Correctional Institution Facility: Liberty County Community Health Center Madison County (Entire County HPSA) Facility: Four Freedoms Health Services Facility: Madison Correctional Institution Manatee County Facility: Manatee County Rural Health Services, Inc. Marion County Population Group: Low Income - Marion County Facility: Heart of Florida Health Center, Inc. Facility: Lowell Correctional Institution Facility: Lowell Correctional Institution - Annex Facility: Lowell Reception Center Facility: Marion Correctional Institution Martin County Service Area: Indiantown Service Area Miami-Dade County Facility: Banyan Community Health Center Facility: Borinquen Healthcare Facility: Camillus Health Concern, Inc. Facility: Citrus Health Network, Inc. Facility: Community AIDS Resource/Dba Care Resours

Page 33 of 208 Pages MENTAL HEALTH: Florida County and County Equivalent Listing

Miami-Dade County Facility: Community Health of South Dade Facility: Dade Correctional Institution Facility: Federal Correctional Institution - Miami Facility: Federal Detention Center - Miami Facility: Immigration and Customs Enforcement - Krome Facility: Jessie Trice Community Health Center, Inc. Facility: Miami Beach Community Monroe County Service Area: Lower Keys - Monroe Service Area: Upper Keys - Monroe Facility: Rural Health Network of Monroe County Florida, Inc. Okaloosa County Facility: Okaloosa Correctional Institution Okeechobee County (Entire County HPSA) Facility: Brighton Health Center Orange County Facility: Central Florida Reception Center Facility: Community Health Centers, Inc. Facility: Health Care Center for the Homeless, Inc. Osceola County Facility: Primary Care Medical Services of Poinciana Palm Beach County Service Area: Belle Glade/Pahokee Facility: C.L. Brumback Health Center Facility: Florida Community Health Centers, Inc. Facility: Foundcare Health Center Facility: Genesis Community Health Facility: South Bay Correctional Facility Pasco County Population Group: Low Income - East Pasco Facility: Premier Community Health Care Group Pinellas County Facility: Community Health Centers of Pinellas Facility: Pinellas County Board of County Commissioners/Huma Polk County Population Group: Low Income/Migrant Farmworker - Polk County Facility: Polk Correctional Institution Putnam County (Entire County HPSA) Facility: Rural Healthcare, Inc. Facility: Sunrise Primary Care

Page 34 of 208 Pages MENTAL HEALTH: Florida County and County Equivalent Listing

Santa Rosa County Facility: Santa Rosa Correctional Institution Sarasota County Facility: Sarasota County Health Department Seminole County Facility: Central Florida Family Health Center St. Johns County (Entire County HPSA) Facility: Northeast Florida Health Services Sumter County Population Group: Low Income - Sumter County Facility: Federal Correctional Institution - Coleman Facility: Sumter Correctional Institution Facility: Thomas Langley Medical Center Facility: Wildwood Medical Center Suwannee County Service Area: Mental Health Catchment Area 3A Facility: Children's Medical Center @ Branford Facility: Children's Medical Center @ Live Oak Facility: Suwannee Correctional Institution-Annex Facility: Suwannee Correctional Institution-Main Taylor County (Entire County HPSA) Union County Service Area: Mental Health Catchment Area 3A Facility: Reception and Medical Center (Rmc) Facility: Union Chd/New River Community Health Care Center Facility: Union County Health Department/New River Community Health Center Wakulla County (Entire County HPSA) Facility: Wakulla Correctional Institution Walton County (Entire County HPSA) Facility: Walton Correctional Institution Washington County Service Area: Mental Health Catchment Area 2A

Page 35 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Appling County Service Area: Pineland Catchment Area Facility: Appling Medical Group Facility: Appling Obstetrics and Gynecology Facility: Appling Pediatrics Facility: South GA Medical Associates Atkinson County Service Area: Satilla Catchment Area 32 Bacon County Service Area: Satilla Catchment Area 32 Baker County Service Area: Albany Catchment Area Baldwin County Service Area: Catchment Area 22 Facility: Baldwin State Prison Facility: Central State Hospital-Baldwin Banks County Service Area: Georgia Mountains Service Area Bartow County Service Area: Highland Rivers Center Catchment Area Ben Hill County Service Area: Behavioral Health Services - South Georgia Berrien County Service Area: Behavioral Health Services - South Georgia Bibb County Facility: First Choice Primary Care, Inc. Brantley County Service Area: Satilla Catchment Area 32 Brooks County Service Area: Behavioral Health Services - South Georgia Bryan County Service Area: Hinesville Bulloch County Service Area: Pineland Catchment Area Burke County Service Area: Ogeechee Catchment Area Butts County Service Area: McIntosh Trail Catchment Area Facility: Georgia Diagnostic Prison Calhoun County Service Area: Albany Catchment Area

Page 36 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Camden County Service Area: Hinesville Candler County Service Area: Pineland Catchment Area Carroll County Service Area: Chattahoochee-Flint Catoosa County Service Area: Lookout Mountain Catchment Area 1 Charlton County Service Area: Satilla Catchment Area 32 Chatham County Facility: Coastal State Prison Facility: Westside-Urban Health Center Chattooga County Service Area: Lookout Mountain Catchment Area 1 Facility: Hays State Prison Clarke County Facility: Athens Neighborhood Health Center, Inc. (Anhc) Clinch County Service Area: Satilla Catchment Area 32 Coffee County Service Area: Satilla Catchment Area 32 Facility: Coffee Regional First Care Colquitt County Service Area: Thomas Trail Facility: Colquitt Regional Medical Center Primary Care Cook County Service Area: Behavioral Health Services - South Georgia Coweta County Service Area: Chattahoochee-Flint Crawford County Population Group: Low Income - Phoenix Catchment Area Crisp County Service Area: Middle Flint Catchment Area 26 Facility: Georgia Department of Community Health Services Dade County Service Area: Lookout Mountain Catchment Area 1 Facility: Primary Health Care Centers of Dade Dawson County Service Area: Georgia Mountains Service Area Decatur County Service Area: Thomas Trail

Page 37 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

DeKalb County Facility: Clifton Springs Mental Health Clinic Facility: Georgia Regional Hospital Facility: Meridian Education Reource Group, Inc. Facility: North Dekalb Mental Health Clinic Facility: Oakhurst Medical Center Facility: Palmetto Health Council, Inc. Facility: The Dekalb Addiction Clinic Facility: The Kirkwood Center Facility: Winn Way Mental Health Clinic Dooly County Service Area: Middle Flint Catchment Area 26 Dougherty County Service Area: Albany Catchment Area Facility: Albany Area Primary Health Care Douglas County (Entire County HPSA) Early County Service Area: Albany Catchment Area Facility: Primary Care of Southwest Georgia, Inc. Echols County Service Area: Behavioral Health Services - South Georgia Effingham County (Entire County HPSA) Elbert County Facility: Medical Center of Elberton, LLC Emanuel County Service Area: Ogeechee Catchment Area Facility: East Georgia Healthcare Facility: Emanuel Prompt Care Evans County Service Area: Pineland Catchment Area Fannin County Service Area: Georgia Highlands Facility: Georgia Mountains Health Services Fayette County Service Area: McIntosh Trail Catchment Area Floyd County Service Area: Highland Rivers Center Catchment Area Forsyth County Service Area: Georgia Mountains Service Area Facility: Georgia Highlands Community Health Center Franklin County Service Area: Georgia Mountains Service Area

Page 38 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Fulton County Service Area: West Fulton Trail Facility: Good Samaritan Health Center, Inc. Facility: Neighborhood Union Health Center Facility: Southside Medical Center Facility: St. Joseph's Mercy Care Services Facility: United States Penitentiary - Atlanta Facility: West End Medical Centers, Inc. Gilmer County Service Area: Georgia Highlands Glascock County Service Area: Ogeechee Catchment Area Glynn County Service Area: Hinesville Gordon County Service Area: Highland Rivers Center Catchment Area Grady County Service Area: Thomas Trail Greene County Facility: Tender Care Clinic Gwinnett County Facility: Cetpa Facility: Gwinnett County Board of Health Facility: Phillips State Prison Habersham County Service Area: Georgia Mountains Service Area Facility: Lee Arrendale State Prison Hall County Service Area: Georgia Mountains Service Area Hancock County Service Area: Catchment Area 22 Haralson County (Entire County HPSA) Hart County Service Area: Georgia Mountains Service Area Heard County Service Area: Chattahoochee-Flint Henry County Service Area: McIntosh Trail Catchment Area Houston County Population Group: Low Income - Phoenix Catchment Area Irwin County Service Area: Behavioral Health Services - South Georgia

Page 39 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Irwin County Facility: South Central Health Center Jasper County Service Area: Catchment Area 22 Jeff Davis County Service Area: Pineland Catchment Area Jefferson County Service Area: Ogeechee Catchment Area Jenkins County Service Area: Ogeechee Catchment Area Facility: Jenkins County Family Medicine Johnson County Facility: Community Health Care Systems, Inc. Facility: Johnson State Prison Lamar County Service Area: McIntosh Trail Catchment Area Lanier County Service Area: Behavioral Health Services - South Georgia Lee County Service Area: Albany Catchment Area Liberty County Service Area: Hinesville Facility: Diversity Health Center, Inc. Long County Service Area: Hinesville Lowndes County Service Area: Behavioral Health Services - South Georgia Lumpkin County Service Area: Georgia Mountains Service Area Macon County Service Area: Middle Flint Catchment Area 26 Madison County Facility: Medlink Georgia, Inc. Marion County Service Area: Middle Flint Catchment Area 26 McIntosh County Service Area: Hinesville Meriwether County Service Area: Chattahoochee-Flint Miller County Service Area: Albany Catchment Area

Page 40 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Mitchell County Service Area: Thomas Trail Facility: Autry State Prison Facility: Phoebe Family Medical Center - Camilla Facility: Phoebe Family Medical Center - Pelham Murray County Service Area: Georgia Highlands Muscogee County Facility: Valley Healthcare System Paulding County Service Area: Highland Rivers Center Catchment Area Peach County Population Group: Low Income - Phoenix Catchment Area Pickens County Service Area: Georgia Highlands Pierce County Service Area: Satilla Catchment Area 32 Pike County Service Area: McIntosh Trail Catchment Area Polk County Service Area: Highland Rivers Center Catchment Area Putnam County Service Area: Catchment Area 22 Rabun County Service Area: Georgia Mountains Service Area Richmond County Facility: Christ Community Health Services Augusta, Inc. Facility: Neighborhood Improvement Project, Inc. Schley County Service Area: Middle Flint Catchment Area 26 Screven County Service Area: Ogeechee Catchment Area Seminole County Service Area: Thomas Trail Spalding County Service Area: McIntosh Trail Catchment Area Stephens County Service Area: Georgia Mountains Service Area Stewart County Facility: Immigration and Customs Enforcement - Stewart Facility: Southwest Georgia Health Care

Page 41 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Sumter County Service Area: Middle Flint Catchment Area 26 Tattnall County Service Area: Pineland Catchment Area Facility: Georgia State Prison Facility: Rogers State Prison Taylor County Service Area: Middle Flint Catchment Area 26 Terrell County Service Area: Albany Catchment Area Thomas County Service Area: Thomas Trail Tift County Service Area: Behavioral Health Services - South Georgia Toombs County Service Area: Pineland Catchment Area Towns County Service Area: Georgia Mountains Service Area Troup County Service Area: Chattahoochee-Flint Turner County Service Area: Behavioral Health Services - South Georgia Union County Service Area: Georgia Mountains Service Area Upson County Service Area: McIntosh Trail Catchment Area Walker County Service Area: Lookout Mountain Catchment Area 1 Ware County Service Area: Satilla Catchment Area 32 Facility: McKinney Community Health Center Warren County Facility: Tricounty Health Systems Washington County Service Area: Catchment Area 22 Facility: Washington State Prison Wayne County Service Area: Pineland Catchment Area Facility: Federal Correctional Institution - Jesup Webster County Service Area: Middle Flint Catchment Area 26

Page 42 of 208 Pages MENTAL HEALTH: Georgia County and County Equivalent Listing

Wheeler County Facility: Accord Family Medicine White County Service Area: Georgia Mountains Service Area Whitfield County Service Area: Georgia Highlands Wilkinson County Service Area: Catchment Area 22 Worth County Service Area: Albany Catchment Area

Page 43 of 208 Pages MENTAL HEALTH: Hawaii County and County Equivalent Listing

Hawaii County Service Area: Kau Catchment Area Service Area: North Hawaii Population Group: Low Income - Puna Facility: Bay Clinic Facility: Hamakua Health Center Facility: West Hawaii Community Health Center Honolulu County Population Group: Low Income - North Shore Facility: Federal Detention Center - Honolulu Facility: Halawa Correctional Facility Facility: Kalihi-Paloma Health Center Facility: Kokua Kalihi Valley Comprehensive Family Facility: Ko'Olauloa Community Health and Wellness Facility: Papa Ola Lokahi Facility: Waianae Coast Community Health Center Facility: Waikiki Health Center Facility: Waimanalo Health Center Kalawao County Service Area: Island of Molokai Kauai County Service Area: Kauai East Service Area: Waimea Service Area Facility: Ho'Ola Lahui - Hawaii Maui County Service Area: Hana East Maui Service Area: Island of Molokai Service Area: Maui Mental Health Service Area Facility: Community Clinic of Maui Facility: Hana Community Health Center Facility: Lana'I Community Health Center Facility: Molokai General Hospital Facility: Molokai Ohana Health Care, Inc.

Page 44 of 208 Pages MENTAL HEALTH: Idaho County and County Equivalent Listing

Ada County Service Area: Mental Health Region IV Facility: Family Practice Residency of ID Facility: Idaho State Correctional Institution Adams County Service Area: Catchment Area #3 Facility: Adams County Health Center Bannock County Service Area: Mental Health Region VI Facility: Health West, Inc. Bear Lake County Service Area: Mental Health Region VI Benewah County Service Area: Mental Health Region I Facility: Benewah Medical/Wellness Center Facility: St Maries Family Medicine Bingham County Service Area: Mental Health Region VI Facility: Not-Tsoo Gah-Nee Indian Health Center Facility: State Hospital South Blaine County Service Area: Mental Health Region V Boise County Service Area: Mental Health Region IV Bonner County Service Area: Mental Health Region I Bonneville County Service Area: Mental Health Region VII Boundary County Service Area: Mental Health Region I Facility: Bonners Ferry Family Medicine Facility: Boundary Regional Community Health Center Butte County Service Area: Mental Health Region VII Camas County Service Area: Mental Health Region V Canyon County Service Area: Catchment Area #3 Facility: Community Council of Idaho, Inc. Facility: Terry Reilly Community Health Center Caribou County Service Area: Mental Health Region VI

Page 45 of 208 Pages MENTAL HEALTH: Idaho County and County Equivalent Listing

Cassia County Service Area: Mental Health Region V Clark County Service Area: Mental Health Region VII Clearwater County Service Area: Mental Health Region II Custer County Service Area: Mental Health Region VII Elmore County Service Area: Mental Health Region IV Facility: Glenns Ferry Health Center Facility: Trinity Mountain Medical Clinic Franklin County Service Area: Mental Health Region VI Fremont County Service Area: Mental Health Region VII Facility: Upper Valley Free Clinic Gem County Service Area: Catchment Area #3 Facility: Emmett Medical Center Gooding County Service Area: Mental Health Region V Idaho County Service Area: Mental Health Region II Jefferson County Service Area: Mental Health Region VII Facility: Upper Valley Family Medicine Jerome County Service Area: Mental Health Region V Kootenai County Service Area: Mental Health Region I Facility: Dirne Community Health Clinic Latah County Service Area: Mental Health Region II Lemhi County Service Area: Mental Health Region VII Lewis County Service Area: Mental Health Region II Lincoln County Service Area: Mental Health Region V Madison County Service Area: Mental Health Region VII

Page 46 of 208 Pages MENTAL HEALTH: Idaho County and County Equivalent Listing

Minidoka County Service Area: Mental Health Region V Nez Perce County Service Area: Mental Health Region II Facility: Nimiipuu Health Center Nez Perce Facility: Nimiipuu Health Center-Kamiah Oneida County Service Area: Mental Health Region VI Owyhee County Service Area: Catchment Area #3 Payette County Service Area: Catchment Area #3 Facility: Valley Family Health Care Power County Service Area: Mental Health Region VI Shoshone County Service Area: Mental Health Region I Teton County Service Area: Mental Health Region VII Twin Falls County Service Area: Mental Health Region V Facility: Family Health Services Valley County Service Area: Mental Health Region IV Washington County Service Area: Catchment Area #3 Facility: Two Rivers Medical Clinic, PA

Page 47 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

Adams County Service Area: Catchment Area 3-01-01 Alexander County Service Area: Catchment Area 25 Facility: Community Health and Emergency Services Facility: Tamms Correctional Facility Bond County Service Area: Catchment Area 04-01-01 Facility: Federal Correctional Institution - Greenville Brown County Service Area: Catchment Area 3-01-01 Facility: Quincy Medical Group-Mt. Sterling Rural Health Facility: Western Illinois Correctional Center Bureau County Service Area: Mental Health Catchment Area 1-07-07 Calhoun County Service Area: Catchment Area 3-02-02 Carroll County Service Area: Whiteside/Lee-Catchment Area 1-03-03 Cass County Service Area: Catchment Area 3-01-01 Facility: Cass County Health Department Christian County Service Area: Catchment Area 03-03-04 Clark County Service Area: Catchment Area 03-07-07 Clay County Service Area: Catchment Area 4-03-33 Clinton County Service Area: Catchment Area 4-03-33 Coles County Service Area: Catchment Area 3 Cook County Service Area: Auburn Gresham/Washington Heights Service Area: Chicago Central Service Area: Cicero/Berwyn Service Area: Roseland/Pullman/Riverdale Service Area: South Chicago Service Area: South Shore/Chatham/Avalon Park/Burnside Service Area: West Englewood/Englewood Population Group: Low Income - Franklin Park Population Group: Low Income Chicago Northeast (1-8, 13-22)

Page 48 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

Cook County Population Group: Low Income-Chicago Near South Facility: Access Community Health Network Facility: Alivio Medical Center Facility: Altgeld Health Center Facility: American Indian Health Service of Chicago, Inc. Facility: Asian Human Services Family Health Center Facility: Aunt Marthas Youth Service Facility: Beloved Community Family Services, Inc. Facility: Centro De Salud Esperanza Facility: Chicago Department of Public Health Facility: Chicago Family Health Facility: Christian Community Health Center Facility: Circle Family Care Facility: City of Chicago Department of Health - Lower Wests Facility: Community Health Partnership of Illinois Facility: Community Nurse Health Association Facility: Erie Family Health Center Facility: Family Christian Health Center Facility: Friend Family Health Center Facility: Heartland Health Outreach Facility: Heartland International Health Center Facility: Howard Brown Health Facility: Lawndale Christian Health Facility: Mercy Hospital and Medical Facility: Metropolitan Correctional Center - Chicago Facility: Mile Square Community Health Center Facility: Near North Health Facility: PCC Community Wellness Center Facility: Primecare Community Health Facility: Sadie Waterford Assessment and Treatment Facility: Sadie Waterford Manor Facility: The Clinic at Altgeld Facility: Turning Point Behavioral Healthcare Center Crawford County Service Area: Catchment Area 4-03-33 Cumberland County Service Area: Catchment Area 3 Facility: Sbl - Neoga Clinic De Witt County Service Area: Catchment Area 3-05-05

Page 49 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

DeKalb County (Entire County HPSA) Facility: Tri-County Community Health Center - Malta Douglas County Service Area: Catchment Area 3 DuPage County Population Group: Low Income - Franklin Park Edgar County Service Area: Catchment Area 03-07-07 Edwards County Service Area: Catchment Area 4-03-33 Effingham County Service Area: Catchment Area 4-03-33 Fayette County Service Area: Catchment Area 4-03-33 Ford County (Entire County HPSA) Franklin County Service Area: Catchment Area 4-04-04 Facility: Rea Clinic/Christopher Greater Fulton County Service Area: Catchment Area 1-08-08 Facility: Illinois River State Correctional Center Gallatin County Service Area: Catchment Area 4-04-04 Greene County Service Area: Catchment Area 3-02-02 Facility: Thomas H. Boyd Rural Health Clinic Hamilton County Service Area: Catchment Area 4-04-04 Hancock County Service Area: Catchment Area 3-01-01 Hardin County Service Area: Catchment Area 25 Henderson County Service Area: Galesburg Catchment Area-1-06-06 Facility: Henderson County Rural Health Henry County Service Area: Galesburg Catchment Area-1-06-06 Iroquois County Service Area: Catchment Area 03-07-07 Jackson County Service Area: Catchment Area 25

Page 50 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

Jasper County Service Area: Catchment Area 4-03-33 Jefferson County Service Area: Catchment Area 4-04-04 Jersey County Service Area: Catchment Area 3-02-02 Jo Daviess County Service Area: Jo Daviess/Stephenson Catchment Area 01-01-01 Johnson County Service Area: Catchment Area 25 Facility: Shawnee Correctional Center Kane County Facility: Greater Elgin Family Care Center Facility: Visiting Nurse Association of Fox Valley Knox County Service Area: Galesburg Catchment Area-1-06-06 Facility: Hill Correctional Center Facility: Knox County Health Department La Salle County (Entire County HPSA) Lake County Facility: Lake County Community Health Department and Commun Lawrence County Service Area: Catchment Area 4-03-33 Facility: Lawrence Correction Center Facility: Lawrence County Health Department Lee County Service Area: Whiteside/Lee-Catchment Area 1-03-03 Livingston County Service Area: Mc Lean/Livingston Facility: Pontiac Correctional Center Logan County Service Area: Mental Health Catchment Area 3-03-03 Facility: Lincoln Correctional Center Facility: Logan Correctional Center Macon County Service Area: Catchment Area 3-05-05 Facility: Community Health Improvement Center Facility: Decatur Correctional Center Macoupin County Service Area: Catchment Area 03-03-04 Facility: Macoupin County Public Health Department

Page 51 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

Madison County Service Area: Catchment Area 04-01-01 Facility: Big Muddy River Correctional Center Marion County Service Area: Catchment Area 4-03-33 Marshall County Service Area: Mental Health Catchment Area 1-07-07 Mason County Service Area: Mental Health Catchment Area 3-03-03 Massac County Service Area: Catchment Area 25 McDonough County Service Area: Catchment Area 1-08-08 McLean County Service Area: Mc Lean/Livingston Facility: Chestnut Family Health Center Menard County Service Area: Mental Health Catchment Area 3-03-03 Monroe County (Entire County HPSA) Montgomery County Service Area: Catchment Area 03-03-04 Facility: Graham Correctional Center Morgan County Service Area: Catchment Area 3-02-02 Moultrie County Service Area: Catchment Area 3-05-05 Ogle County Service Area: Whiteside/Lee-Catchment Area 1-03-03 Peoria County Facility: Heartland Community Health Clinic Perry County Service Area: Catchment Area 25 Facility: Pinckneyville Correction Center Piatt County Service Area: Catchment Area 3-05-05 Pike County Service Area: Catchment Area 3-01-01 Facility: Quincy Medical Group - Pleasant Hill Facility: Quincy Medical Group-Barry Rural Health Facility: Quincy Medical Group-Pike County Family Practice Facility: Quincy Medical Group-Pittsfield Rural Health

Page 52 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

Pope County Service Area: Catchment Area 25 Pulaski County Service Area: Catchment Area 25 Putnam County Service Area: Mental Health Catchment Area 1-07-07 Randolph County Service Area: Catchment Area 25 Facility: Menard Correctional Center Richland County Service Area: Catchment Area 4-03-33 Saline County Service Area: Catchment Area 4-04-04 Sangamon County Population Group: Low Income - Sangamon Facility: Board of Trustees of Southern IL University Facility: Central Counties Health Centers Schuyler County Service Area: Catchment Area 3-01-01 Facility: Idhstreatment and Detention Facility Scott County Service Area: Catchment Area 3-02-02 Facility: Quincy Medical Group-Winchester FP Shelby County Service Area: Catchment Area 3 St. Clair County Service Area: East St. Louis Facility: Southern IL Regional Wellness Center Facility: Southern Illinois Healthcare Foundation Stark County Service Area: Mental Health Catchment Area 1-07-07 Stephenson County Service Area: Jo Daviess/Stephenson Catchment Area 01-01-01 Tazewell County Facility: Federal Correctional Institution - Pekin Union County Service Area: Catchment Area 25 Facility: Rural Health, Inc. Vermilion County Service Area: Catchment Area 03-07-07 Facility: Danville Correctional Center

Page 53 of 208 Pages MENTAL HEALTH: Illinois County and County Equivalent Listing

Wabash County Service Area: Catchment Area 4-03-33 Warren County Service Area: Galesburg Catchment Area-1-06-06 Washington County (Entire County HPSA) Wayne County Service Area: Catchment Area 4-03-33 White County Service Area: Catchment Area 4-04-04 Whiteside County Service Area: Whiteside/Lee-Catchment Area 1-03-03 Facility: Morrison Community Hospital Family Care Facility: Whiteside County Health Department Will County Service Area: East Joliet Facility: Will County Community Williamson County Service Area: Catchment Area 4-04-04 Facility: Shawnee Health Services Corporation Facility: USP Marion Winnebago County Facility: Crusaders Clinic

Page 54 of 208 Pages MENTAL HEALTH: Indiana County and County Equivalent Listing

Adams County (Entire County HPSA) Allen County Facility: Neighborhood Health Clinics, Inc. Facility: Park Center, Inc. Benton County Service Area: Region 30 Mental Health Blackford County Service Area: Grant/Blackford County Mental Health Catchment Area Carroll County Service Area: Region 30 Mental Health Cass County Service Area: Four Counties Catchment Area No. 10 Clark County Facility: Family Health Center of Clark County, Indiana Crawford County Service Area: Southern Indiana Catchment Area De Kalb County Service Area: Northeastern Catchment Area #18 Dearborn County Service Area: Mental Health Service Area #4 Delaware County Population Group: Low Income Mental Health Catchment Area 6 Facility: Meridian Services Corporation Facility: Open Door Health Services, Inc. Dubois County Service Area: Southern Indiana Catchment Area Elkhart County (Entire County HPSA) Facility: Heart City Health Center Facility: Maple City Health Care Center Facility: Maple City Health Care Center, Inc. Fayette County Service Area: East Central Mental Health Catchment Area 8 Fountain County Service Area: Region 30 Mental Health Franklin County Service Area: Mental Health Service Area #4 Fulton County Service Area: Four Counties Catchment Area No. 10 Gibson County Facility: Oakland City Family Practice, LLC Grant County Service Area: Grant/Blackford County Mental Health Catchment Area

Page 55 of 208 Pages MENTAL HEALTH: Indiana County and County Equivalent Listing

Greene County (Entire County HPSA) Facility: Ridge Medical Center Henry County Population Group: Low Income Mental Health Catchment Area 6 Facility: Knightstown Family Health Care Facility: New Castle Pediatrics Huntington County Service Area: Warsaw Mental Health Catchment Area 28 Jasper County Service Area: Region 30 Mental Health Jay County Population Group: Low Income Mental Health Catchment Area 6 Johnson County Facility: Trafalgar Family Health Center Kosciusko County Service Area: Warsaw Mental Health Catchment Area 28 Lagrange County Service Area: Northeastern Catchment Area #18 Lake County Service Area: Gary Population Group: Low Income - Northwest Lake Facility: Community Healthnet, Inc./Dba Gary Community Healt Facility: East Chicago Community Health Center Madison County Facility: Madison County Community Health Center Marion County Population Group: Low Income - Near Northeast Indianapolis Facility: Health and Hospital Corporation of Marion County Facility: Healthnet Facility: Indiana Health Centers Facility: Jane Pauley Community Health Center Facility: Raphael Health Center Facility: Shalom Health Care Center, Inc. Marshall County Service Area: Warsaw Mental Health Catchment Area 28 Miami County Service Area: Four Counties Catchment Area No. 10 Facility: Miami Correctional Facility Montgomery County Service Area: Region 30 Mental Health Newton County Service Area: Region 30 Mental Health

Page 56 of 208 Pages MENTAL HEALTH: Indiana County and County Equivalent Listing

Noble County Service Area: Northeastern Catchment Area #18 Ohio County Service Area: Mental Health Service Area #4 Orange County Service Area: Southern Indiana Catchment Area Parke County Service Area: Vermillion/Parke Perry County Service Area: Southern Indiana Catchment Area Porter County Facility: Healthlinc, Inc. (Formerly Hilltop) Facility: Northshore Health Centers, Inc. Pulaski County Service Area: Four Counties Catchment Area No. 10 Facility: Knox Winamac Community Health Centers (Kwchc) Putnam County (Entire County HPSA) Facility: Putnamville Correctional Facility Randolph County Service Area: East Central Mental Health Catchment Area 8 Ripley County Service Area: Mental Health Service Area #4 Rush County Service Area: East Central Mental Health Catchment Area 8 Spencer County Service Area: Southern Indiana Catchment Area St. Joseph County (Entire County HPSA) Starke County Facility: Knox Family Medical Center Steuben County Service Area: Northeastern Catchment Area #18 Sullivan County Facility: Wabash Valley Correctional Facility Switzerland County Service Area: Mental Health Service Area #4 Tippecanoe County Service Area: Region 30 Mental Health Facility: Purdue University - Family Health Clinics Facility: Tippecanoe Community Health Center Union County Service Area: East Central Mental Health Catchment Area 8

Page 57 of 208 Pages MENTAL HEALTH: Indiana County and County Equivalent Listing

Vanderburgh County Facility: Echo Community Health Care Vermillion County Service Area: Vermillion/Parke Facility: Vermillion-Parke Community Health Center Vigo County Facility: Federal Correctional Complex - Terre Haute Wabash County Service Area: Warsaw Mental Health Catchment Area 28 Warren County Service Area: Region 30 Mental Health Wayne County Service Area: East Central Mental Health Catchment Area 8 Wells County (Entire County HPSA) White County Service Area: Region 30 Mental Health Whitley County Service Area: Warsaw Mental Health Catchment Area 28

Page 58 of 208 Pages MENTAL HEALTH: Iowa County and County Equivalent Listing

Adair County Service Area: Mental Health Catchment Area 9B Adams County Service Area: Mental Health Catchment Area 14 Facility: Alegent Health Rosary Clinic - Corning Allamakee County Service Area: Mental Health Catchment Area-03 Appanoose County Service Area: Mental Health Catchment Area 15 Audubon County Service Area: Mental Health Catchment Area 11 Benton County Service Area: Mental Health Catchment Area 18 Black Hawk County Facility: Peoples Community Health Clinic Boone County Service Area: Catchment Area 10 Bremer County Service Area: Mental Health Catchment Area-03 Facility: Rohlf Memorial Clinic Buchanan County Service Area: Mental Health Catchment Area-03 Buena Vista County Service Area: Mental Health Catchment Area 1 Facility: United Community Health Center Butler County Service Area: Mental Health Catchment Area-03 Facility: Franklin Medical Center-Dumont Calhoun County Service Area: Catchment Area 10 Facility: North Central Correctional Facility Carroll County Service Area: Mental Health Catchment Area 11 Cass County Service Area: Mental Health Catchment Area 13B Facility: Anita Medical Center Facility: Atlantic Medical Center Rural Health Clinic Facility: Griswold Medical Center Facility: Massena Medical Center Cedar County Service Area: Mental Health Catchment Area-17

Page 59 of 208 Pages MENTAL HEALTH: Iowa County and County Equivalent Listing

Cerro Gordo County Service Area: Mental Health Catchment Area-02 Cherokee County Service Area: Mental Health Catchment Area 1 Chickasaw County Service Area: Mental Health Catchment Area-03 Clarke County Service Area: Mental Health Catchment Area 14 Clay County Service Area: Mental Health Catchment Area 1 Clayton County Service Area: Mental Health Catchment Area-03 Facility: Regional Family Health - Strawberry Point Clinton County Service Area: Mental Health Catchment Area-04 Crawford County Service Area: Mental Health Catchment Area 11 Davis County Service Area: Mental Health Catchment Area 15 Decatur County Service Area: Mental Health Catchment Area 14 Facility: Community Health Centers of Southern Iowa Delaware County Service Area: Mental Health Catchment Area-03 Des Moines County Population Group: Low Income - Mental Health Catchment Area-16B Facility: Community Health Centers of Southeastern Iowa Dickinson County Service Area: Mental Health Catchment Area 1 Dubuque County Service Area: Mental Health Catchment Area-04 Facility: Crescent Community Health Center Emmet County Service Area: Mental Health Catchment Area 1 Fayette County Service Area: Mental Health Catchment Area-03 Floyd County Service Area: Mental Health Catchment Area-02 Franklin County Service Area: Mental Health Catchment Area-02 Facility: Franklin Medical Center - Hampton Facility: Franklin Medical Center - Latimer

Page 60 of 208 Pages MENTAL HEALTH: Iowa County and County Equivalent Listing

Fremont County Service Area: Mental Health Catchment Area 13B Facility: Medical Clinic, P.C. Facility: Medical Clinic-Hamburg Facility: Medical Clinic-Sidney Greene County Service Area: Catchment Area 10 Guthrie County Service Area: Mental Health Catchment Area 11 Hamilton County Service Area: Catchment Area 10 Hancock County Service Area: Mental Health Catchment Area-02 Hardin County Service Area: Mental Health Catchment Area-08 Harrison County Service Area: Mental Health Catchment Area 12 Facility: Alegent Health Clinic Logan Facility: Alegent Health Clinic Missouri Valley Facility: Alegent Health-Dunlap Clinic Facility: Alegent Health-Woodbine Clinic Henry County Service Area: Mental Health Catchment Area 16A Facility: Mount Pleasant Correctional Facility Howard County Service Area: Mental Health Catchment Area-03 Facility: Cresco Clinic Humboldt County Service Area: Catchment Area 10 Ida County Service Area: Mental Health Catchment Area 1 Iowa County Service Area: Mental Health Catchment Area 18 Jackson County Service Area: Mental Health Catchment Area-04 Jasper County Service Area: Mental Health Catchment Area-08 Facility: Newton Correctional Facility Jefferson County Service Area: Mental Health Catchment Area 16A Johnson County Facility: Iowa Medical and Classification Center

Page 61 of 208 Pages MENTAL HEALTH: Iowa County and County Equivalent Listing

Jones County Service Area: Mental Health Catchment Area-17 Facility: Monticello Medical Center Keokuk County Service Area: Mental Health Catchment Area-08 Kossuth County Service Area: Mental Health Catchment Area-02 Lee County Population Group: Low Income - Mental Health Catchment Area-16B Facility: Iowa State Penitentiary Linn County Facility: Linn Community Care Louisa County Population Group: Low Income - Mental Health Catchment Area-16B Lucas County Service Area: Mental Health Catchment Area 15 Lyon County Service Area: Mental Health Catchment Area 1 Madison County Service Area: Mental Health Catchment Area 9B Mahaska County Service Area: Mental Health Catchment Area-08 Marion County Service Area: Mental Health Catchment Area-08 Marshall County Service Area: Mental Health Catchment Area-08 Mitchell County Service Area: Mental Health Catchment Area-02 Monona County Service Area: Mental Health Catchment Area 12 Monroe County Service Area: Mental Health Catchment Area 15 Montgomery County Service Area: Mental Health Catchment Area 13B Muscatine County Service Area: Mental Health Catchment Area-17 O'Brien County Service Area: Mental Health Catchment Area 1 Facility: Hartley Mercy Medical Center Facility: Paullina Mercy Medical Center Facility: Primghar Mercy Medical Clinic Facility: Sutherland Mercy Medical Clinic

Page 62 of 208 Pages MENTAL HEALTH: Iowa County and County Equivalent Listing

Osceola County Service Area: Mental Health Catchment Area 1 Page County Service Area: Mental Health Catchment Area 13B Facility: Clarinda Correctional Facility Palo Alto County Service Area: Mental Health Catchment Area 1 Plymouth County Service Area: Mental Health Catchment Area 1 Pocahontas County Service Area: Mental Health Catchment Area 1 Polk County Facility: Primary Health Care, Inc. Facility: Proteus, Inc. Pottawattamie County Facility: Council Bluffs Community Health Center Poweshiek County Service Area: Mental Health Catchment Area-08 Ringgold County Service Area: Mental Health Catchment Area 14 Sac County Service Area: Mental Health Catchment Area 11 Scott County Facility: Community Health Care Shelby County Service Area: Mental Health Catchment Area 11 Sioux County Service Area: Mental Health Catchment Area 1 Facility: Greater Sioux Community Health Center (Gschc) Story County Service Area: Catchment Area 10 Tama County Service Area: Mental Health Catchment Area-08 Facility: Sac and Fox Tribe of the Mississippi in IA Taylor County Service Area: Mental Health Catchment Area 14 Union County Service Area: Mental Health Catchment Area 14 Van Buren County Service Area: Mental Health Catchment Area 16A Facility: Cantril Medical Clinic Facility: Douds Medical Clinic

Page 63 of 208 Pages MENTAL HEALTH: Iowa County and County Equivalent Listing

Van Buren County Facility: Farmington Rural Health Facility: Keosauqua Rural Health Wapello County Service Area: Mental Health Catchment Area 15 Facility: River Hills Community Health Center Washington County Service Area: Mental Health Catchment Area 16A Wayne County Service Area: Mental Health Catchment Area 15 Webster County Service Area: Catchment Area 10 Facility: Community Health Center of Fort Dodge Facility: Fort Dodge Correctional Facility Winnebago County Service Area: Mental Health Catchment Area-02 Winneshiek County Service Area: Mental Health Catchment Area-03 Woodbury County Service Area: Mental Health Catchment Area 12 Facility: Siouxland Community Health Center Worth County Service Area: Mental Health Catchment Area-02 Wright County Service Area: Mental Health Catchment Area-02 Facility: Franklin Medical Center - Dows

Page 64 of 208 Pages MENTAL HEALTH: Kansas County and County Equivalent Listing

Allen County Service Area: Catchment Area #7 Anderson County Service Area: Catchment Area #7 Atchison County Service Area: Mental Health Area 4 Barber County Service Area: Mental Health Catchment Area 21 Barton County Service Area: Mental Health Area 20 Facility: We Care Project Bourbon County Service Area: Catchment Area #7 Brown County Service Area: Mental Health Area 3 Facility: White Cloud Indian Health Station Butler County (Entire County HPSA) Facility: Augusta Family Practice Chase County Service Area: Catchment Area #12 Chautauqua County Service Area: Mental Health Area 13 Cherokee County (Entire County HPSA) Facility: St John's Clinic-Columbus-Family Medicine Cheyenne County Service Area: Mental Health Area 23 Clark County Service Area: Mental Health Area 22 Facility: Ashland Health Center Clay County Service Area: Mental Health Area 14 Facility: Clay Center Family Physicians Cloud County Service Area: Mental Health Area 14 Coffey County Service Area: Catchment Area #12 Comanche County Service Area: Mental Health Area 22 Cowley County (Entire County HPSA) Crawford County (Entire County HPSA) Facility: Community Health Center of Southeast Kansas

Page 65 of 208 Pages MENTAL HEALTH: Kansas County and County Equivalent Listing

Decatur County Service Area: Mental Health Area 23 Dickinson County Service Area: Catchment Area #15 Facility: Herington Area Health Clinic Doniphan County Service Area: Mental Health Area 3 Douglas County Facility: Heartland Medical Clinic, Inc. Edwards County Service Area: Mental Health Area 22 Elk County Service Area: Mental Health Area 13 Ellis County Service Area: Mental Health Area 23 Facility: First Care Clinic, Inc. Ellsworth County Service Area: Catchment Area #15 Finney County Service Area: Mental Health Area 24 Facility: United Methodist Western Kansas Mexican American M Ford County Service Area: Mental Health Area 24 Franklin County Service Area: Mental Health Catchment Area 6 Geary County Service Area: Mental Health Area 14 Facility: Konza Prairie Community Health Gove County Service Area: Mental Health Area 23 Graham County Service Area: Mental Health Area 23 Grant County Service Area: Mental Health Area 24 Gray County Service Area: Mental Health Area 24 Greeley County Service Area: Mental Health Area 24 Facility: Greeley County Family Practice Clinic Greenwood County Service Area: Catchment Area #12

Page 66 of 208 Pages MENTAL HEALTH: Kansas County and County Equivalent Listing

Hamilton County Service Area: Mental Health Area 24 Harper County Service Area: Mental Health Catchment Area 21 Harvey County Population Group: Low Income - Mental Health Catchment Area 16 Facility: Health Ministries Clinic Haskell County Service Area: Mental Health Area 25 Hodgeman County Service Area: Mental Health Area 24 Jackson County Service Area: Mental Health Area 3 Facility: Holton Family Health Clinic Jefferson County Service Area: Mental Health Area 4 Jewell County Service Area: Mental Health Area 14 Johnson County Facility: Health Partnership Clinic of Johnson County Kearny County Service Area: Mental Health Area 24 Kingman County Service Area: Mental Health Catchment Area 21 Kiowa County Service Area: Mental Health Area 22 Labette County (Entire County HPSA) Lane County Service Area: Mental Health Area 24 Leavenworth County Service Area: Mental Health Area 4 Facility: USP Leavenworth Lincoln County Service Area: Catchment Area #15 Linn County Service Area: Catchment Area #7 Logan County Service Area: Mental Health Area 23 Facility: New Frontiers Health Services Lyon County Service Area: Catchment Area #12 Facility: Flint Hills Community Health Center/Lyon

Page 67 of 208 Pages MENTAL HEALTH: Kansas County and County Equivalent Listing

Marion County Population Group: Low Income - Mental Health Catchment Area 16 Marshall County Service Area: Mental Health Area 14 Facility: Downtown Medical Clinic Facility: Marysville Clinic McPherson County Population Group: Low Income - Mental Health Catchment Area 16 Meade County Service Area: Mental Health Area 25 Miami County Service Area: Mental Health Catchment Area 6 Facility: Associates in Family Care - Osawatomie Facility: Associates in Family Care - Paola Facility: Louisburg Family Care Mitchell County Service Area: Mental Health Area 14 Montgomery County Service Area: Mental Health Area 13 Morris County Service Area: Catchment Area #12 Morton County Service Area: Mental Health Area 24 Nemaha County Service Area: Mental Health Area 3 Facility: Centralia Medical Clinic Neosho County Service Area: Catchment Area #7 Facility: Handshy Medical Clinic - Chanute Ness County Service Area: Mental Health Area 23 Norton County Service Area: Mental Health Area 23 Osage County Service Area: Catchment Area #12 Osborne County Service Area: Mental Health Area 23 Ottawa County Service Area: Catchment Area #15 Pawnee County Service Area: Mental Health Area 20

Page 68 of 208 Pages MENTAL HEALTH: Kansas County and County Equivalent Listing

Phillips County Service Area: Mental Health Area 23 Facility: Logan Medical Clinic Facility: Phillips County Medical Clinic Pottawatomie County Service Area: Mental Health Area 14 Facility: Onaga Clinic Facility: St. Mary's Clinic Pratt County Service Area: Mental Health Catchment Area 21 Rawlins County Service Area: Mental Health Area 23 Reno County Service Area: Mental Health Catchment Area 21 Facility: Prairie Star Health Center Republic County Service Area: Mental Health Area 14 Rice County Service Area: Mental Health Area 20 Riley County Service Area: Mental Health Area 14 Rooks County Service Area: Mental Health Area 23 Rush County Service Area: Mental Health Area 23 Russell County Service Area: Mental Health Area 23 Saline County Service Area: Catchment Area #15 Facility: Salina Family Healthcare Center Scott County Service Area: Mental Health Area 24 Sedgwick County Facility: Center for Health and Wellness Facility: Gracemed Health Clinic, Inc. Facility: Hunter Health Clinic Seward County Service Area: Mental Health Area 25 Shawnee County Facility: Kansas Department of Health Facility: Shawnee County Health Agency

Page 69 of 208 Pages MENTAL HEALTH: Kansas County and County Equivalent Listing

Sheridan County Service Area: Mental Health Area 23 Sherman County Service Area: Mental Health Area 23 Smith County Service Area: Mental Health Area 23 Stafford County Service Area: Mental Health Area 20 Stanton County Service Area: Mental Health Area 24 Stevens County Service Area: Mental Health Area 25 Sumner County (Entire County HPSA) Facility: Bass Memorial Baptist Hospital Dba Caldwell Family Cli Thomas County Service Area: Mental Health Area 23 Trego County Service Area: Mental Health Area 23 Wabaunsee County Service Area: Catchment Area #12 Wallace County Service Area: Mental Health Area 23 Washington County Service Area: Mental Health Area 14 Wichita County Service Area: Mental Health Area 24 Wilson County Service Area: Mental Health Area 13 Woodson County Service Area: Catchment Area #7

Page 70 of 208 Pages MENTAL HEALTH: Kentucky County and County Equivalent Listing

Adair County (Entire County HPSA) Allen County (Entire County HPSA) Ballard County Service Area: Western Kentucky Barren County (Entire County HPSA) Bath County Service Area: Gateway Mental Health Catchment Facility: Bath County Medical Clinic Bell County Service Area: Cumberland River Mental Health Catchment Facility: Red Bird Clinic Boyd County Service Area: Fivco Mental Health Catchment Area #10 Boyle County Population Group: Low Income - Danville Catchment Area Bracken County Service Area: Buffalo Trace Mental Health Catchment Area Breathitt County Service Area: Upper Kentucky River Facility: Aaron K. Jonan Memorial Clinic, Inc. Facility: Juniper Health, Inc. Breckinridge County (Entire County HPSA) Butler County (Entire County HPSA) Caldwell County Service Area: Pennyroyal Mental Health Catchment Area Calloway County Service Area: Western Kentucky Campbell County Facility: Health Point Family Care Carlisle County Service Area: Western Kentucky Carroll County Service Area: Carroll/Gallatin Counties Carter County Service Area: Fivco Mental Health Catchment Area #10 Facility: Carter County Medical Clinic Casey County (Entire County HPSA) Christian County Service Area: Pennyroyal Mental Health Catchment Area Clark County Facility: Clark Family Care Facility: Winchester Family Practice

Page 71 of 208 Pages MENTAL HEALTH: Kentucky County and County Equivalent Listing

Clay County Service Area: Cumberland River Mental Health Catchment Facility: Community Health Center-Clay County Facility: Federal Correctional Institution - Manchester Facility: Kate Ireland Health Center Clinton County (Entire County HPSA) Crittenden County Service Area: Pennyroyal Mental Health Catchment Area Cumberland County (Entire County HPSA) Facility: Cumberland Family Medical Center Daviess County Facility: Daviess County/River Valley Behavioral Health Edmonson County (Entire County HPSA) Elliott County Service Area: Fivco Mental Health Catchment Area #10 Estill County (Entire County HPSA) Fayette County Facility: Bluegrass Farmworker Health Center Facility: Federal Medical Center - Lexington Facility: Lexington-Fayette County Health Department Fleming County Service Area: Buffalo Trace Mental Health Catchment Area Floyd County Service Area: Mountain Facility: Big Sandy Healthcare, Inc. Facility: Eastern Kentucky Tender Care Pediatrics Fulton County Service Area: Western Kentucky Gallatin County Service Area: Carroll/Gallatin Counties Garrard County Population Group: Low Income - Danville Catchment Area Grant County Service Area: Grant/Pendleton Graves County Service Area: Western Kentucky Grayson County (Entire County HPSA) Greenup County Service Area: Fivco Mental Health Catchment Area #10 Hancock County (Entire County HPSA) Harlan County Service Area: Cumberland River Mental Health Catchment

Page 72 of 208 Pages MENTAL HEALTH: Kentucky County and County Equivalent Listing

Harlan County Facility: Clover Fork Outpatient Medical Project Hart County (Entire County HPSA) Henderson County (Entire County HPSA) Henry County (Entire County HPSA) Hickman County Service Area: Western Kentucky Facility: Clinton Family Care Clinic Hopkins County Service Area: Pennyroyal Mental Health Catchment Area Jackson County Service Area: Cumberland River Mental Health Catchment Facility: Health Help, Inc. Jefferson County Facility: Family Health Center, Inc. Facility: Park Duvalle Community Johnson County Service Area: Mountain Knott County Service Area: Upper Kentucky River Facility: Primary Care Centers of Eastern KY-Hindman Knox County Service Area: Cumberland River Mental Health Catchment Facility: Barbourville Family Health Center Facility: Grace Community Health Center, Inc. Laurel County Service Area: Cumberland River Mental Health Catchment Facility: Corbin Pediatric Associates Lawrence County Service Area: Fivco Mental Health Catchment Area #10 Lee County Service Area: Upper Kentucky River Leslie County Service Area: Upper Kentucky River Facility: Appalachian Clinic-Wooton Facility: Primary Care Centers of Eastern KY-Hyden Letcher County Service Area: Upper Kentucky River Facility: Mountain Comprehensive Health Corporation Lewis County Service Area: Buffalo Trace Mental Health Catchment Area Facility: Lewis County Primary Care Center

Page 73 of 208 Pages MENTAL HEALTH: Kentucky County and County Equivalent Listing

Lincoln County Population Group: Low Income - Danville Catchment Area Livingston County Service Area: Pennyroyal Mental Health Catchment Area Logan County (Entire County HPSA) Lyon County Service Area: Pennyroyal Mental Health Catchment Area Madison County Facility: Berea Health Ministry, Inc. Facility: Jon M. Strauss Facility: Kentucky River Foothills Development Council Facility: Madison Family Clinic Facility: Strauss Family Practice Magoffin County Service Area: Mountain Facility: Salyersville Medical Center, LLC Marion County Facility: Lebanon Clinic - Communicare Marshall County Service Area: Western Kentucky Martin County Service Area: Mountain Facility: USP Big Sandy Mason County Service Area: Buffalo Trace Mental Health Catchment Area McCracken County Service Area: Western Kentucky McCreary County (Entire County HPSA) Facility: USP McCreary McLean County (Entire County HPSA) Menifee County Service Area: Gateway Mental Health Catchment Mercer County Population Group: Low Income - Danville Catchment Area Facility: Pathfinders Metcalfe County (Entire County HPSA) Monroe County (Entire County HPSA) Montgomery County Service Area: Gateway Mental Health Catchment Facility: Sterling Health Solutiions, Inc. Morgan County Service Area: Gateway Mental Health Catchment

Page 74 of 208 Pages MENTAL HEALTH: Kentucky County and County Equivalent Listing

Muhlenberg County Service Area: Pennyroyal Mental Health Catchment Area Facility: Community Health Centers of Western Kentucky Nelson County Facility: Flaget Immediate Care Clinic Ohio County (Entire County HPSA) Oldham County Facility: Kentucky Correctional Institute for Women Facility: Kentucky State Reformatory Owen County (Entire County HPSA) Facility: Triad Health Systems, Inc. Owsley County Service Area: Upper Kentucky River Pendleton County Service Area: Grant/Pendleton Perry County Service Area: Upper Kentucky River Facility: Appalachian Physicians, PSC Facility: Kentucky Mountain Health Alliance Facility: Mountain After-Hours Clinic Facility: Pediatric Associates of Hazard, LLC Facility: Primary Care Centers of Eastern KY-Hazard Facility: Primary Care Centers of Eastern KY-Vicco Facility: University of Kentucky College of Medicine/North F Pike County Service Area: Mountain Facility: Pediatric Associates of Pikesville, LLC Powell County (Entire County HPSA) Robertson County Service Area: Buffalo Trace Mental Health Catchment Area Rockcastle County Service Area: Cumberland River Mental Health Catchment Rowan County Service Area: Gateway Mental Health Catchment Russell County (Entire County HPSA) Todd County Service Area: Pennyroyal Mental Health Catchment Area Trigg County Service Area: Pennyroyal Mental Health Catchment Area Trimble County (Entire County HPSA) Union County (Entire County HPSA) Washington County (Entire County HPSA)

Page 75 of 208 Pages MENTAL HEALTH: Kentucky County and County Equivalent Listing

Wayne County (Entire County HPSA) Webster County (Entire County HPSA) Facility: Regional Health Care Affilates, Inc. Whitley County Service Area: Cumberland River Mental Health Catchment Facility: Atienze-Acob Medical Clinic Wolfe County Service Area: Upper Kentucky River

Page 76 of 208 Pages MENTAL HEALTH: Louisiana County and County Equivalent Listing

Acadia Parish (Entire County HPSA) Allen Parish (Entire County HPSA) Facility: Federal Correctional Complex - Oakdale Ascension Parish (Entire County HPSA) Facility: Elayn Hunt Correctional Center Assumption Parish (Entire County HPSA) Facility: Reddy Family Medical Clinic Facility: Reddy Family Medical Clinic Pierre Part Avoyelles Parish (Entire County HPSA) Facility: Tunica-Biolxi Indian Tribe of Louisiana Beauregard Parish (Entire County HPSA) Bienville Parish (Entire County HPSA) Bossier Parish (Entire County HPSA) Caddo Parish Facility: David Raines Community Health Center Calcasieu Parish (Entire County HPSA) Facility: Southwest Louisiana Center for Health Services Caldwell Parish (Entire County HPSA) Cameron Parish (Entire County HPSA) Catahoula Parish (Entire County HPSA) Facility: Catahoula Parish Hospital Service District Claiborne Parish (Entire County HPSA) Concordia Parish (Entire County HPSA) De Soto Parish Facility: Casse/Community Health Institute East Baton Rouge Parish Population Group: Low Income - East Baton Rouge Parish Facility: Baton Rouge Primary Care Collabrative Facility: Capitol City Family Health Center East Carroll Parish (Entire County HPSA) East Feliciana Parish (Entire County HPSA) Facility: Primary Care Providers for a Health Feliciana Evangeline Parish (Entire County HPSA) Franklin Parish (Entire County HPSA) Facility: Chitimacha Health Clinic Facility: Tensas Community Health Center Grant Parish (Entire County HPSA) Facility: Federal Correctional Complex - Pollock Iberia Parish (Entire County HPSA) Facility: Iberia Comprehensive Community Health Center Iberville Parish Population Group: Low Income - Iberville Parish

Page 77 of 208 Pages MENTAL HEALTH: Louisiana County and County Equivalent Listing

Iberville Parish Facility: Reddy Family Medical Clinic-Plaquemine Facility: Reddy Family Medical Clinic-White Castle Facility: St. Gabriel Health Clinic Jackson Parish (Entire County HPSA) Jefferson Davis Parish (Entire County HPSA) Facility: Elton Rural Health Clinic Jefferson Parish Facility: East Jefferson Community Health Center Facility: Jefferson Community Health Centers, Inc. Facility: St. Charles Community Health Center - Kenner Pedia La Salle Parish (Entire County HPSA) Facility: Immigration and Customs Enforcement - Jena Lafayette Parish (Entire County HPSA) Lafourche Parish (Entire County HPSA) Lincoln Parish (Entire County HPSA) Livingston Parish (Entire County HPSA) Madison Parish (Entire County HPSA) Facility: Madison Parish Hospital Rural Health Morehouse Parish (Entire County HPSA) Facility: Morehouse Community Medical Center Natchitoches Parish (Entire County HPSA) Facility: Natchitoches Out Patient Orleans Parish Population Group: Low Income - Orleans Parish Facility: Common Ground Health Clinic Facility: Excelth, Inc. Health Care Facility: Healthcare for the Homeless Facility: Marillac Community Health Centers Facility: Mary Queen of Viet Nam Community Development Corporation Facility: Mqvn Community Development Corporation/Noela Community Health Center Facility: St. Thomas Community Health Center, Inc. Ouachita Parish (Entire County HPSA) Facility: Primary Health Service Plaquemines Parish (Entire County HPSA) Pointe Coupee Parish (Entire County HPSA) Facility: Innis Community Health Rapides Parish (Entire County HPSA) Facility: Rapides Primary Health Care Center Red River Parish (Entire County HPSA) Richland Parish (Entire County HPSA) Facility: Delhi Rural Health Clinic

Page 78 of 208 Pages MENTAL HEALTH: Louisiana County and County Equivalent Listing

Richland Parish (Entire County HPSA) Facility: Northeast Louisana Health Center Facility: Parish of Richland/Dba Delhi Community Health Cent Sabine Parish (Entire County HPSA) St. Bernard Parish (Entire County HPSA) St. Charles Parish Facility: St. Charles Community Health Center, Inc. St. Helena Parish (Entire County HPSA) Facility: St. Helena Community Health Center St. James Parish (Entire County HPSA) St. John the Baptist Parish Population Group: Low Income - St. John the Baptist Parish St. Landry Parish (Entire County HPSA) Facility: Southwest Louisianna Primary St. Martin Parish (Entire County HPSA) St. Mary Parish (Entire County HPSA) Facility: Teche Action Clinic St. Tammany Parish (Entire County HPSA) Tangipahoa Parish (Entire County HPSA) Facility: Multipractice Clinic, Inc. Tensas Parish (Entire County HPSA) Terrebonne Parish (Entire County HPSA) Union Parish (Entire County HPSA) Vermilion Parish (Entire County HPSA) Vernon Parish (Entire County HPSA) Washington Parish (Entire County HPSA) Facility: Rayburn Correctional Center West Baton Rouge Parish (Entire County HPSA) West Carroll Parish (Entire County HPSA) West Feliciana Parish (Entire County HPSA) Facility: Louisiana State Penitentiary Winn Parish (Entire County HPSA) Facility: Winn Community Health Center, Inc.

Page 79 of 208 Pages MENTAL HEALTH: Maine County and County Equivalent Listing

Androscoggin County Service Area: Rumford-Mental Health Analysis Area 14 Facility: Community Clinical Services Facility: DFD Russell Medical Center Aroostook County Service Area: Ft Kent/Madawaska Service Area: Houlton - Mental Health Analysis Area #30 Service Area: Lincoln/Millinocket Service Area: Mental Health Analysis Area 31-32 Facility: Fish River Rural Health Facility: Pines Health Services Cumberland County Service Area: Bridgton Facility: Health Care for Portland's Homeless Franklin County Service Area: Farmington Service Area: Rumford-Mental Health Analysis Area 14 Hancock County Facility: Bucksport Regional Kennebec County Service Area: Farmington Service Area: Rumford-Mental Health Analysis Area 14 Facility: Rural Health Centers of Maine, Inc. Knox County Facility: Islands Community Medical Center Facility: Maine State Prison Lincoln County Facility: John F. Andrews Family Care Center Facility: Lincoln Medical Partners-Damariscotta Facility: Lincoln Medical Partners-Waldoboro Oxford County Service Area: Bridgton Service Area: Farmington Service Area: Rumford-Mental Health Analysis Area 14 Penobscot County Service Area: Dover-Foxcroft Service Area: Houlton - Mental Health Analysis Area #30 Service Area: Lincoln/Millinocket Facility: Corinna Family Practice Facility: Dexter Family Practice Facility: Dexter Internal Medicine Facility: Health Access Network

Page 80 of 208 Pages MENTAL HEALTH: Maine County and County Equivalent Listing

Penobscot County Facility: Katahdin Valley Health Facility: Newport Family Practice Facility: Penobscot Community Health Center Facility: Penobscot Indian Nation Facility: Penobscot Valley Primary Care Piscataquis County Service Area: Dover-Foxcroft Facility: Dover-Foxcroft Family Medicine Facility: Guilford Medical Associates Facility: Milo Family Practice Somerset County Service Area: Dover-Foxcroft Service Area: Farmington Facility: Healthreach Community Health Centers Facility: Sebasticook Family Doctors Facility: Sebasticook Regional Family Care (Rural Health Cli Waldo County Facility: Arthur Jewell Community Health Center Facility: Stockton Springs Regional Health Center Facility: The Islesboro Health Center Washington County Service Area: Calais Service Area: Houlton - Mental Health Analysis Area #30 Service Area: Machias Facility: Calais Regional Medical Services Facility: Eastport Healthcare Facility: Harrington Family Health Facility: Passamaquoddy Pleasant Point Health Center Facility: Passamaquoddy Tribe Indian Township Facility: Regional Medical Center Facility: St. Croix Regional Family Health York County Facility: Sacopee Valley Health Facility: York County Community Action Corporation

Page 81 of 208 Pages MENTAL HEALTH: Maryland County and County Equivalent Listing

Allegany County Population Group: Medicaid Eligible - Allegany Facility: Federal Correctional Institution - Cumberland Facility: North Branch Correctional Institution Facility: Western Correctional Institution Anne Arundel County Facility: Anne Arundel County Detention Center Facility: Maryland Correctional Institution - Jessup Facility: Owensville Primary Care Baltimore City Population Group: Medicaid Eligible - Arlington Population Group: Medicaid Eligible - East Baltimore City Population Group: Medicaid Eligible - North Central Baltimore City Population Group: Medicaid Eligible - South Baltimore Population Group: Medicaid Eligible - West Central Baltimore City Facility: Baltimore City Detention Center Facility: Baltimore City Health Department/Northwest High Sc Facility: Baltimore Medical Systems Facility: Central Booking and Intake Facility Facility: Chase Brexton Health Services Facility: Chesapeake Detention Facility Facility: Family Health Center of Baltimore Facility: Health Care for the Homeless, Inc. Facility: Lifeline Foundation, Inc. Facility: Maryland Reception and Diagnostic Center Facility: Metro Transition Center Facility: Park West Medical Center Facility: People's Community Health Center Facility: Total Health Care Calvert County (Entire County HPSA) Caroline County (Entire County HPSA) Facility: Choptank Community Health Cecil County (Entire County HPSA) Facility: West Cecil Health Center, Inc. Charles County (Entire County HPSA) Dorchester County Population Group: Medicaid Eligible - Dorchester County Garrett County (Entire County HPSA) Facility: Western Maryland Health Care Corporation Harford County Service Area: North Harford Population Group: Medicaid Eligible - Southern Harford County

Page 82 of 208 Pages MENTAL HEALTH: Maryland County and County Equivalent Listing

Kent County Population Group: Medicaid Eligible - Kent County Montgomery County Facility: Community Clinic, Inc. (Cci) Prince George's County Facility: Greater Baden Medical Services Queen Anne's County (Entire County HPSA) Somerset County Service Area: Lower Eastern Shore Facility: Three Lower Counties Community Services St. Mary's County (Entire County HPSA) Washington County (Entire County HPSA) Facility: Roxbury Correctional Institution Facility: Tri-State Community Health Center, Inc. Facility: Walnut Street Community Health Center Wicomico County Service Area: Lower Eastern Shore Worcester County Service Area: Lower Eastern Shore

Page 83 of 208 Pages MENTAL HEALTH: Massachusetts County and County Equivalent Listing

Barnstable County Service Area: Lower Outer Cape Service Area: Upper Cape Mhhpsa Facility: Cape Cod Free Clinic and Community Health Center Facility: Duffy Health Center, Inc. Facility: Mashpee Wampanoag Tribe Facility: Outer Cape Health Berkshire County Facility: Community Health Program Bristol County Facility: Bristol County House of Corrections Facility: Greater New Bedford Facility: Healthfirst Family Care Center Essex County Population Group: Lawrence-Low Income Mental Health Facility: Greater Lawrence Family Health Facility: Lowell Community Health Center Facility: Lynn Community Health Center Facility: North Shore Community Health Franklin County Population Group: Low Income - Greenfield/Montague/Sunderland Facility: Community Health Centers of Franklin County Hampden County Population Group: Holyoke Low Income Mental Health Population Group: Springfield Low Income Mental Health Health Professional Shortage Area Facility: Caring Health Center, Inc. Facility: Holyoke Health Center Facility: Springfield Public Health Department Facility: Springfield Southwest Hampshire County Facility: Hilltown Community Health Center, Inc. Middlesex County Population Group: Lowell Low Income Mental Health Facility: Federal Medical Center Devens Facility: Massachusetts Correctional Institution Concord Facility: Massachusetts Correctional Institution Shirley - Sbcc Norfolk County Facility: Manet Community Health Center Facility: Massachusetts Correctional Institution Cedar Junction Facility: Massachusetts Correctional Institution Norfolk

Page 84 of 208 Pages MENTAL HEALTH: Massachusetts County and County Equivalent Listing

Plymouth County Facility: Brockton Neighborhood Facility: Massachusetts Treatment Center Facility: Old Colony Correctional Facility Suffolk County Facility: Boston Healthcare for the Homeless Facility: Codman Square Health Center Facility: Connecticut River Valley Farmworkers/Massachusetts Facility: Dimock Community Health Center Facility: Dorchester House Multi-Service Center Facility: East Boston Facility: Fenway Community Health Center Facility: Harbor Health Services Facility: Harvard Street Neighborhood Health Center Facility: Joseph M. Smith Community Health Facility: Mattapan Community Health Facility: North End Community Facility: Roxbury Comprehensive Facility: South Boston Community Health Facility: South Cove Community Facility: South End Community Health Center Facility: Upham's Corner Health Center Facility: Whittier Street Health Worcester County Facility: Community Health Connections Facility: Community Healthlink Facility: Edward M. Kennedy Community Health Center Facility: Family Health Center of Worcester, Inc. Facility: North Central Correctional Institution-Gardner

Page 85 of 208 Pages MENTAL HEALTH: Michigan County and County Equivalent Listing

Alcona County (Entire County HPSA) Facility: Alcona Health Center Alger County (Entire County HPSA) Facility: Alger Maximum Correctional Facility Allegan County Service Area: South Haven Service Area Facility: Match-East-Be-Nash-She-Wish Pottawatomi Alpena County Facility: Alpena Medical Arts, Primary Care Antrim County Service Area: North Country Catchment Area Facility: Kalkaska Family Practice Primary Care-Mancelona Arenac County Service Area: Bay-Arenac Facility: Augres St. Joseph Family Clinic Facility: Sterling Area Health Baraga County (Entire County HPSA) Barry County (Entire County HPSA) Bay County Service Area: Bay-Arenac Facility: Pinconning Medical Care, Inc. Benzie County Service Area: Manistee Berrien County (Entire County HPSA) Facility: Coloma Medical Center Facility: Community Medical Center Branch County Service Area: Coldwater-Hillsdale Service Area Calhoun County Facility: Family Health Center - Battle Creek Facility: Nottawaseppi Huron Band of Potawatomi Southern Hea Cass County (Entire County HPSA) Facility: Borgess Lee Medical Group - Dowagiac Clinic Facility: Borgess Lee Medical Group-Cassopolis Clinic Facility: Borgess Lee Medical Group-Division Street Clinic Facility: Bronson Lakeview Family Care-Marcellus Facility: Lakeland Immediate Care Center Charlevoix County Service Area: North Country Catchment Area Facility: East Jordan Family Health Cheboygan County Service Area: North Country Catchment Area

Page 86 of 208 Pages MENTAL HEALTH: Michigan County and County Equivalent Listing

Chippewa County Service Area: Eastern Upper Peninsula Facility: Bay Mills Indian Community Facility: Chippewa Correctional Facility Facility: Riverside Medical Associates Primary Care Clare County Service Area: Central Michigan Service Area Crawford County Service Area: North Central Delta County (Entire County HPSA) Facility: Osf Medical Group-Escanaba Facility: Osf Medical Group-Gladstone Dickinson County Service Area: Iron Mountain Facility: Dickinson Family and Geriatric Clinic Facility: Dickinson Family Practice Facility: Dickinson Pediatric Clinic Facility: MMC-Kingsford Clinic Facility: Nordic Medical Center Eaton County Facility: Riverside Family Practice Emmet County Service Area: North Country Catchment Area Genesee County Facility: Genesee County Community Mental Health Facility: Hamilton Community Health Network, Inc. Gladwin County Service Area: Central Michigan Service Area Gogebic County (Entire County HPSA) Gratiot County Facility: Ashley Family Care Center Facility: Ithaca Family Care Center Facility: St. Louis Correctional Facility Hillsdale County Service Area: Coldwater-Hillsdale Service Area Facility: Primary Care Associates of Jonesville, LLC Houghton County Service Area: Houghton-Keweenaw Huron County (Entire County HPSA) Ingham County Facility: Ingham County Health Department

Page 87 of 208 Pages MENTAL HEALTH: Michigan County and County Equivalent Listing

Ionia County (Entire County HPSA) Facility: Charles R. Barker Facility: The Family Health Center Portland Iosco County Service Area: Au Sable Valley Iron County Service Area: Iron Mountain Isabella County Service Area: Central Michigan Service Area Facility: Nimkee Memorial Wellness Center Jackson County Facility: Center for Family Health, Inc. Facility: Charles Egeler Reception and Guidance Center Facility: Springport Medical Clinic Kalamazoo County Facility: Family Health Center, Inc. Kalkaska County Service Area: North Country Catchment Area Kent County Facility: Cherry Street Services Facility: Nottawaseppi Huron Band of the Potawatomi-Grand Ra Facility: St. Marys Health Services Keweenaw County Service Area: Houghton-Keweenaw Lake County Facility: Baldwin Family Health Leelanau County Facility: Northwest Michigan Health Services, Inc. Facility: Tawas Bay Family Practice Lenawee County (Entire County HPSA) Facility: Health Specialists of Lenawee, P.C. Luce County (Entire County HPSA) Facility: Newberry Correctional Facility Mackinac County Service Area: Eastern Upper Peninsula Facility: Lambert Tribal Clinic Manistee County Service Area: Manistee Facility: Wellston Medical Center Marquette County Facility: Upper Great Lakes Family Health Center Facility: Upper Peninsula Association of Rural Health

Page 88 of 208 Pages MENTAL HEALTH: Michigan County and County Equivalent Listing

Mason County Facility: Primary Health Services Mecosta County Service Area: Central Michigan Service Area Menominee County (Entire County HPSA) Midland County Service Area: Central Michigan Service Area Missaukee County Service Area: North Central Monroe County Facility: Family Medical Center Montcalm County (Entire County HPSA) Facility: Carson Family Care Center Montmorency County (Entire County HPSA) Facility: Thunder Bay Community Health Services Muskegon County (Entire County HPSA) Facility: Hackley Community Care Center Facility: Lakeshore Medical Center Facility: Muskegon Family Care Center Newaygo County (Entire County HPSA) Facility: Pine Medical Croup Primary Care Oakland County Facility: Oakland Integrated Health Network (Oihn) Facility: Oakland Primary Health Services Oceana County Facility: Lakeshore Medical Group Facility: Shelby Family Care Ogemaw County Service Area: Au Sable Valley Facility: Primary Care Practice - Alger Facility: Primary Care Practice - West Branch Ontonagon County (Entire County HPSA) Osceola County Service Area: Central Michigan Service Area Facility: Spectrum Health Evart Family Practice Facility: Spectrum Health Reed City Family Practice Facility: Spectrum Health Tustin Family Practice Oscoda County Service Area: Au Sable Valley Otsego County Service Area: North Country Catchment Area Facility: Ostego Memorial Hospital Medicare Rural Health Clinic-Gaylord

Page 89 of 208 Pages MENTAL HEALTH: Michigan County and County Equivalent Listing

Otsego County Facility: Otsego Memorial Hospital Rural Health Clinic-Center Ave Presque Isle County (Entire County HPSA) Roscommon County Service Area: North Central Facility: Midmichigan Health Services Saginaw County Facility: Health Delivery, Inc. Facility: Neighborhood Outreach Access to Health Facility: Saginaw Correctional Facility Sanilac County (Entire County HPSA) Schoolcraft County Facility: Manistique Tribal Health Clinic Shiawassee County Facility: Arnold Medical Clinic C/O Memorial Healthcare Facility: Dba Ionia Family Practice/Ionia Associates, LLC Facility: Durand Family Health Center St. Clair County Facility: Downriver Community Service St. Joseph County (Entire County HPSA) Facility: Centreville Medical Care Facility: Primary Care White Pigeon Facility: Three Rivers Health Tuscola County (Entire County HPSA) Van Buren County Service Area: South Haven Service Area Facility: Bronson Lakeview Family Care-Decatur Facility: Bronson Lakeview Family Care-Lawton Facility: Bronson Lakeview Family Care-Mattawan Facility: Bronson Lakeview Family Care-Paw Paw Facility: Hartford Medical Center Facility: Intercare Community Health Facility: Lakeview Medical Center Facility: South Haven Community Hospital Cooper Rural Health Clinic Facility: South Haven Community Hospital Rural Health Clinic Wayne County Service Area: Hamtramck Service Area Service Area: Northwest Detroit Service Area: South Detroit Service Area Facility: American Indian Health and Family Svs of Southeast MI Facility: Charter County of Wayne Facility: Community Health and Social Services

Page 90 of 208 Pages MENTAL HEALTH: Michigan County and County Equivalent Listing

Wayne County Facility: Covenant Community Care, Inc. Facility: Detroit Community Health Network Facility: Detroit Health Care for the Homeless Facility: Health Centers Detroit Medical Group, P.C. Facility: The Wellness Plan Facility: Western Wayne Family Health Center Wexford County Service Area: North Central

Page 91 of 208 Pages MENTAL HEALTH: Minnesota County and County Equivalent Listing

Aitkin County Service Area: Region 3 Anoka County Facility: Anoka Metro Regional Treatment Center Facility: Minnesota Correctional Facility - Lino Lakes Becker County Service Area: Mental Health Region 4 Facility: White Earth PHS Indian Hospital Facility: White Earth Tribal Mental Health Beltrami County Service Area: Mental Health Service Area Region 2 Facility: PHS Indian Hospital - Red Lake Benton County Service Area: Central Region Big Stone County Service Area: Southwest Central Region Facility: Graceville Health Center Clinic Blue Earth County Service Area: South Central Region Facility: Open Door Health Center Brown County Service Area: South Central Region Facility: Sleepy Eye Medical Center Carlton County Service Area: Region 3 Facility: Fond Du Lac Min-No-Aya-Win Clinic Facility: Minnesota Correctional Facility - Moose Lake Cass County Service Area: Region 5 Mental Health Service Area Facility: Cass Lake Indian Heath Service Hospital Facility: Leech Lake Band of Ojibwe Chippewa County Service Area: Southwest Central Region Chisago County Service Area: Region 7E Facility: Minnesota Correctional Facility - Rush City Clay County Service Area: Mental Health Region 4 Facility: Migrant Health Service Clearwater County Service Area: Mental Health Service Area Region 2

Page 92 of 208 Pages MENTAL HEALTH: Minnesota County and County Equivalent Listing

Cook County Service Area: Region 3 Facility: Sawtooth Mountain Clinic Cottonwood County Service Area: Southwest Central Region Crow Wing County Service Area: Region 5 Mental Health Service Area Douglas County Service Area: Mental Health Region 4 Faribault County Service Area: South Central Region Freeborn County Service Area: South Central Region Grant County Service Area: Mental Health Region 4 Hennepin County Facility: Cedar Riverside People's Center Facility: Community University Health Care Center Facility: Dba Axis Community Health Center Facility: Fremont Community Health Facility: Hennepin County Health Care for the Homeless Facility: Indian Health Board Facility: Native American Community Clinic Facility: Northpoint Health and Wellness Center Facility: Southside Community Hubbard County Service Area: Mental Health Service Area Region 2 Isanti County Service Area: Region 7E Itasca County Service Area: Region 3 Jackson County Service Area: Southwest Central Region Kanabec County Service Area: Region 7E Kandiyohi County Service Area: Southwest Central Region Kittson County Service Area: Mental Health Service Area Region 1 Koochiching County Service Area: Region 3

Page 93 of 208 Pages MENTAL HEALTH: Minnesota County and County Equivalent Listing

Lac qui Parle County Service Area: Southwest Central Region Lake County Service Area: Region 3 Lake of the Woods County Service Area: Mental Health Service Area Region 2 Le Sueur County Service Area: South Central Region Lincoln County Service Area: Southwest Central Region Lyon County Service Area: Southwest Central Region Mahnomen County Service Area: Mental Health Service Area Region 1 Marshall County Service Area: Mental Health Service Area Region 1 Martin County Service Area: South Central Region McLeod County Service Area: Southwest Central Region Meeker County Service Area: Southwest Central Region Mille Lacs County Service Area: Region 7E Facility: Mille Lacs Band of Ojibwe Behavioral Health Facility: Mille Lacs Family Clinic-Onamia Facility: Mille Lacs Health System-Isle Facility: Ne-Ia-Shing Clinic Morrison County Service Area: Region 5 Mental Health Service Area Facility: Mille Lacs Family Clinic-Hillman Murray County Service Area: Southwest Central Region Nicollet County Service Area: South Central Region Nobles County Service Area: Southwest Central Region Norman County Service Area: Mental Health Service Area Region 1 Olmsted County Facility: Federal Medical Center - Rochester

Page 94 of 208 Pages MENTAL HEALTH: Minnesota County and County Equivalent Listing

Otter Tail County Service Area: Mental Health Region 4 Pennington County Service Area: Mental Health Service Area Region 1 Pine County Service Area: Region 7E Pipestone County Service Area: Southwest Central Region Polk County Service Area: Mental Health Service Area Region 1 Pope County Service Area: Mental Health Region 4 Ramsey County Facility: Model Cities Health Center Facility: United Family Practice Health Center Facility: Westside Community Health Center Red Lake County Service Area: Mental Health Service Area Region 1 Redwood County Service Area: Southwest Central Region Renville County Service Area: Southwest Central Region Rice County Service Area: South Central Region Facility: Minnesota Correctional Facility - Faribault Rock County Service Area: Southwest Central Region Roseau County Service Area: Mental Health Service Area Region 1 Scott County Facility: Minnesota Correctional Facility - Shakopee Facility: Shakopee Mdewakanton Sioux Community Sherburne County Service Area: Central Region Facility: Minnesota Correctional Facility - St Cloud Sibley County Service Area: South Central Region Facility: Sibley Medical Clinic St. Louis County Service Area: Region 3 Facility: Bois Forte Tribal Clinic Facility: Cook Area Health Services

Page 95 of 208 Pages MENTAL HEALTH: Minnesota County and County Equivalent Listing

St. Louis County Facility: Lake Superior Community Health Center Stearns County Service Area: Central Region Facility: Albany Medical Center Stevens County Service Area: Mental Health Region 4 Facility: Chokio Medical Center Swift County Service Area: Southwest Central Region Todd County Service Area: Region 5 Mental Health Service Area Facility: Bertha Medical Clinic Traverse County Service Area: Mental Health Region 4 Wadena County Service Area: Region 5 Mental Health Service Area Washington County Facility: Minnesota Correctional Facility - Stillwater Facility: Minnesota Correctional Facility Oak Park Heights Watonwan County Service Area: South Central Region Wilkin County Service Area: Mental Health Region 4 Wright County Service Area: Southwest Central Region Yellow Medicine County Service Area: Southwest Central Region

Page 96 of 208 Pages MENTAL HEALTH: Mississippi County and County Equivalent Listing

Adams County Service Area: Mental Health Catchment Area 11 Alcorn County Service Area: Mental Health Catchment Area 4 Amite County Service Area: Mental Health Catchment Area 11 Facility: Amite County Medical Attala County Service Area: Mental Health Catchment Area 6 Benton County Service Area: Mental Health Catchment Area 3 Facility: North Benton County Health Bolivar County Service Area: Mental Health Catchment Area 5 Facility: Delta Health Center, Inc. Calhoun County Population Group: Low Income - Mental Health Catchment Area 2 Carroll County Service Area: Mental Health Catchment Area 6 Chickasaw County Service Area: Mental Health Catchment Area 3 Choctaw County Service Area: Mental Health Catchment Area 7 Claiborne County Service Area: Mental Health Catchment Area 11 Facility: Claiborne County Family Health Center Clarke County Service Area: Mental Health Catchment Area 10 Facility: Outreach Health Services Clay County Service Area: Mental Health Catchment Area 7 Coahoma County Service Area: Mental Health Catchment Area 1 Facility: Aaron E. Henry Community Health Center Covington County Service Area: Catchment Area 12 DeSoto County Population Group: Low Income - Mental Health Catchment Area 2 Forrest County Service Area: Catchment Area 12 Facility: Southeast Mississippi Rural Health

Page 97 of 208 Pages MENTAL HEALTH: Mississippi County and County Equivalent Listing

Franklin County Service Area: Mental Health Catchment Area 11 George County Service Area: Mental Health Catchment Area 14 Greene County Service Area: Catchment Area 12 Facility: Greene Area Medical Extenders, Inc. Grenada County Service Area: Mental Health Catchment Area 6 Hancock County Service Area: Catchment Area 13 Harrison County Service Area: Catchment Area 13 Facility: Coastal Family Health Center, Inc. Hinds County Facility: Central Mississippi Civic Improvement Facility: Central Mississippi Health Services Holmes County Service Area: Mental Health Catchment Area 6 Facility: Dr. Arelia C. Mallory Community Health Center Humphreys County Service Area: Mental Health Catchment Area 6 Issaquena County Service Area: Mental Health Catchment Area 5 Itawamba County Service Area: Mental Health Catchment Area 3 Facility: Mantachie Rural Health Care, Inc. Jackson County Service Area: Mental Health Catchment Area 14 Jasper County Service Area: Mental Health Catchment Area 10 Jefferson County Service Area: Mental Health Catchment Area 11 Facility: Jefferson Comprehensive Jefferson Davis County Service Area: Catchment Area 12 Jones County Service Area: Catchment Area 12 Facility: Family Health Center, Inc. Kemper County Service Area: Mental Health Catchment Area 10

Page 98 of 208 Pages MENTAL HEALTH: Mississippi County and County Equivalent Listing

Lafayette County Population Group: Low Income - Mental Health Catchment Area 2 Lamar County Service Area: Catchment Area 12 Lauderdale County Service Area: Mental Health Catchment Area 10 Facility: East Mississippi State Hospital Facility: Greater Meridian Health Clinic Lawrence County Service Area: Mental Health Catchment Area 11 Leake County Service Area: Mental Health Catchment Area 10 Lee County Service Area: Mental Health Catchment Area 3 Leflore County Service Area: Mental Health Catchment Area 6 Lincoln County Service Area: Mental Health Catchment Area 11 Lowndes County Service Area: Mental Health Catchment Area 7 Madison County Facility: G. A. Carmichael Family Health Center Marion County Service Area: Catchment Area 12 Marshall County Population Group: Low Income - Mental Health Catchment Area 2 Facility: Northeast Mississippi Monroe County Service Area: Mental Health Catchment Area 3 Facility: Access Family Health Services Facility: Chestnut Medical Clinic Facility: Pioneer Family Medical Montgomery County Service Area: Mental Health Catchment Area 6 Neshoba County Service Area: Mental Health Catchment Area 10 Facility: Choctaw Health Center Facility: Mississipp Band of Choctaw Indians Newton County Service Area: Mental Health Catchment Area 10 Noxubee County Service Area: Mental Health Catchment Area 7

Page 99 of 208 Pages MENTAL HEALTH: Mississippi County and County Equivalent Listing

Oktibbeha County Service Area: Mental Health Catchment Area 7 Panola County Population Group: Low Income - Mental Health Catchment Area 2 Pearl River County Service Area: Catchment Area 13 Perry County Service Area: Catchment Area 12 Pike County Service Area: Mental Health Catchment Area 11 Pontotoc County Service Area: Mental Health Catchment Area 3 Prentiss County Service Area: Mental Health Catchment Area 4 Quitman County Service Area: Mental Health Catchment Area 1 Rankin County Facility: Family Healthcare Clinic Scott County Service Area: Mental Health Catchment Area 10 Facility: East Central Mississippi Health Care, Inc. Sharkey County Service Area: Mental Health Catchment Area 5 Smith County Service Area: Mental Health Catchment Area 10 Stone County Service Area: Catchment Area 13 Sunflower County Service Area: Mental Health Catchment Area 6 Tallahatchie County Service Area: Mental Health Catchment Area 1 Tate County Population Group: Low Income - Mental Health Catchment Area 2 Tippah County Service Area: Mental Health Catchment Area 4 Tishomingo County Service Area: Mental Health Catchment Area 4 Tunica County Service Area: Mental Health Catchment Area 1 Union County Service Area: Mental Health Catchment Area 3

Page 100 of 208 Pages MENTAL HEALTH: Mississippi County and County Equivalent Listing

Walthall County Service Area: Mental Health Catchment Area 11 Warren County Service Area: Mental Health Catchment Area 15 Washington County Service Area: Mental Health Catchment Area 5 Wayne County Service Area: Catchment Area 12 Webster County Service Area: Mental Health Catchment Area 7 Wilkinson County Service Area: Mental Health Catchment Area 11 Winston County Service Area: Mental Health Catchment Area 7 Yalobusha County Population Group: Low Income - Mental Health Catchment Area 2 Yazoo County Service Area: Mental Health Catchment Area 15 Facility: Federal Correctional Complex - Yazoo City

Page 101 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Adair County Service Area: Mental Health Service Area 14/Hannibal Facility: Northeast Missouri Health Council Andrew County Service Area: St. Joseph Catchment Area Atchison County Service Area: St. Joseph Catchment Area Audrain County Service Area: Mental Health Service Area 15/Mexico Barry County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Barton County Population Group: Low Income - Joplin Catchment Area Bates County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Benton County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Bollinger County Service Area: Cape Girardeau Boone County Population Group: Low Income - Columbia Mental Health Catchment Area Facility: Family Health Center of Boone County Buchanan County Service Area: St. Joseph Catchment Area Facility: Northwest Health Services Butler County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Caldwell County Service Area: Chillicothe Catchment Area Callaway County Service Area: Mental Health Service Area 15/Mexico Camden County Service Area: Cole Catchment Area Cape Girardeau County Service Area: Cape Girardeau Facility: Cross Trails Medical Center Carroll County Population Group: Low Income - Columbia Mental Health Catchment Area Carter County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Cass County Facility: Harrisonville Medical Clinic

Page 102 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Cass County Facility: Pleasant Hill Medical Clinic Cedar County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Chariton County Population Group: Low Income - Columbia Mental Health Catchment Area Christian County Population Group: Low Income - Springfield Mental Health Service are Clark County Service Area: Mental Health Service Area 14/Hannibal Clay County Service Area: Mental Health Service Area 06/Tri County Catchment Clinton County Service Area: St. Joseph Catchment Area Cole County Service Area: Cole Catchment Area Facility: Jefferson City Correctional Center Cooper County Population Group: Low Income - Columbia Mental Health Catchment Area Facility: Boonville Correctional Center Crawford County Population Group: Low Income - Rolla Catchment Area Dade County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Dallas County Population Group: Low Income - Springfield Mental Health Service are Daviess County Service Area: Chillicothe Catchment Area DeKalb County Service Area: St. Joseph Catchment Area Dent County Population Group: Low Income - Rolla Catchment Area Douglas County Service Area: West Plains Catchment Area Facility: Douglas County Public Health Center Dunklin County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Gasconade County Population Group: Low Income - Rolla Catchment Area Gentry County Service Area: St. Joseph Catchment Area Facility: Northwest Medical Center (Stanberry)

Page 103 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Greene County Population Group: Low Income - Springfield Mental Health Service are Facility: Advocates for a Healthy Community/Dba Jordan Valle Facility: Medical Center for Federal Prisons - Springfield Grundy County Service Area: Chillicothe Catchment Area Harrison County Service Area: Chillicothe Catchment Area Henry County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Hickory County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Facility: Lake Area Primary Care Clinic Facility: Ozarks Resource Group Holt County Service Area: St. Joseph Catchment Area Howard County Population Group: Low Income - Columbia Mental Health Catchment Area Howell County Service Area: West Plains Catchment Area Facility: Rural Alliance for Better Health Iron County Population Group: Low Income - Rolla Catchment Area Jackson County Population Group: Low Income - Jackson County Facility: Pineville Medical Clinic Facility: Samuel Rogers Health Facility: Swope Health Services Jasper County Population Group: Low Income - Joplin Catchment Area Jefferson County Facility: Community Treatment Inc. Knox County Service Area: Mental Health Service Area 14/Hannibal Laclede County Service Area: Cole Catchment Area Lafayette County Facility: Family Health Medical Practice Lawrence County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Lewis County Service Area: Mental Health Service Area 14/Hannibal

Page 104 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Lewis County Facility: Quincy Medical Group - Canton Facility: Quincy Medical Group - Lewistown Rural Health Facility: Quincy Medical Group-Labelle Rural Health Linn County Service Area: Chillicothe Catchment Area Livingston County Service Area: Chillicothe Catchment Area Macon County Service Area: Mental Health Service Area 14/Hannibal Facility: Moberly Correctional Center Madison County Service Area: Cape Girardeau Maries County Population Group: Low Income - Rolla Catchment Area Marion County Service Area: Mental Health Service Area 14/Hannibal Facility: Salt River Community Health Center McDonald County Population Group: Low Income - Joplin Catchment Area Facility: Anderson Rural Health Clinic Facility: Goodman Family Clinic Facility: Ozark Tricounty Health Center Facility: Southwest City Community Clinic Mercer County Service Area: Chillicothe Catchment Area Miller County Service Area: Cole Catchment Area Mississippi County Service Area: Sikeston Catchment Area Moniteau County Population Group: Low Income - Columbia Mental Health Catchment Area Monroe County Service Area: Mental Health Service Area 15/Mexico Montgomery County Service Area: Mental Health Service Area 15/Mexico Morgan County Population Group: Low Income - Columbia Mental Health Catchment Area New Madrid County Service Area: Sikeston Catchment Area Facility: Southeast Missouri Health Network, Inc.

Page 105 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Newton County Population Group: Low Income - Joplin Catchment Area Facility: Eastern Shawnee Tribe Nodaway County Service Area: St. Joseph Catchment Area Oregon County Service Area: West Plains Catchment Area Osage County Service Area: Cole Catchment Area Facility: Community Health Center of Central Missouri Ozark County Service Area: West Plains Catchment Area Pemiscot County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Perry County Service Area: Cape Girardeau Pettis County Population Group: Low Income - Columbia Mental Health Catchment Area Facility: Regional Health Care Clinic, Inc./Katy Trail Phelps County Population Group: Low Income - Rolla Catchment Area Pike County Service Area: Mental Health Service Area 15/Mexico Platte County Service Area: Mental Health Service Area 06/Tri County Catchment Polk County Population Group: Low Income - Springfield Mental Health Service are Pulaski County Service Area: Cole Catchment Area Facility: Central Ozark Medical Putnam County Service Area: Chillicothe Catchment Area Ralls County Service Area: Mental Health Service Area 15/Mexico Randolph County Population Group: Low Income - Columbia Mental Health Catchment Area Ray County Service Area: Mental Health Service Area 06/Tri County Catchment Reynolds County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Facility: Missouri Highlands Health Care

Page 106 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Ripley County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Saline County Population Group: Low Income - Columbia Mental Health Catchment Area Schuyler County Service Area: Mental Health Service Area 14/Hannibal Scotland County Service Area: Mental Health Service Area 14/Hannibal Scott County Service Area: Sikeston Catchment Area Shannon County Service Area: West Plains Catchment Area Shelby County Service Area: Mental Health Service Area 14/Hannibal St. Charles County Facility: Crider Health Center St. Clair County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Facility: Osceola Rural Health Clinic Facility: Sac-Osage Hospital Tri-County Clinic St. Francois County Population Group: Low Income - Rolla Catchment Area St. Louis City Population Group: Low Income - Catchment Area 24 Population Group: Low Income - St. Louis City Area 24-2 Facility: Family Care Health Centers Facility: Grace Hill Facility: Myrtle Hilliard Davis Comprehensive Heal Facility: People's Health Centers St. Louis County Facility: North Central Community Health Center Facility: The Right Solution Ste. Genevieve County Service Area: Cape Girardeau Stoddard County Service Area: Sikeston Catchment Area Stone County Population Group: Low Income - Springfield Mental Health Service are Sullivan County Service Area: Chillicothe Catchment Area Taney County Population Group: Low Income - Springfield Mental Health Service are

Page 107 of 208 Pages MENTAL HEALTH: Missouri County and County Equivalent Listing

Texas County Service Area: West Plains Catchment Area Facility: South Central Correctional Center Vernon County Population Group: Low Income - Mental Health Service Area #8 (Nevada Catchment Area) Washington County Population Group: Low Income - Rolla Catchment Area Facility: Great Mines Health Center Wayne County Service Area: Poplar Bluff-Mental Health Catchment Area 19 Webster County Population Group: Low Income - Springfield Mental Health Service are Facility: Fordland Clinic Inc. Facility: Ozark Correctional Center Worth County Service Area: St. Joseph Catchment Area Wright County Service Area: West Plains Catchment Area

Page 108 of 208 Pages MENTAL HEALTH: Montana County and County Equivalent Listing

Beaverhead County (Entire County HPSA) Big Horn County (Entire County HPSA) Facility: Big Horn Valley Health Center Blaine County Service Area: North-Central Montana Facility: Fort Belknap PHS Indian Hospital Facility: Harlem PHS Indian Hospital Facility: Hays Clinic/Eagle Child Health Center Facility: Sweet Medical Center, Inc. Broadwater County (Entire County HPSA) Carbon County (Entire County HPSA) Carter County Service Area: Eastern Montana Cascade County Facility: Cascade City County Health Department/Community He Facility: Indian Family Health Clnic Facility: Lodge Grass Health Clinic Chouteau County Service Area: North-Central Montana Custer County Service Area: Eastern Montana Facility: Custer County Community Health Center Daniels County Service Area: Eastern Montana Dawson County Service Area: Eastern Montana Fallon County Service Area: Eastern Montana Fergus County Service Area: Lewistown Facility: Central Montana Community Health Center Flathead County Population Group: Low Income - Flathead County Facility: Flathead City-County Health Department Gallatin County Population Group: Low Income - Gallatin County Garfield County Service Area: Eastern Montana Glacier County Service Area: North-Central Montana Facility: Blackfeet Tribal Health Department Facility: Browning PHS Indian Hospital

Page 109 of 208 Pages MENTAL HEALTH: Montana County and County Equivalent Listing

Glacier County Facility: Glacier Community Health Center Golden Valley County (Entire County HPSA) Granite County (Entire County HPSA) Hill County Service Area: North-Central Montana Facility: Bullhook Community Health Center Facility: Rocky Boy Tribal Health Department Jefferson County (Entire County HPSA) Judith Basin County Service Area: Lewistown Lake County (Entire County HPSA) Facility: Flathead Tribal Health and Human Services Facility: The Confederated Salish and Kootenai Tribal Health D Lewis and Clark County Facility: Helena Indian Alliance Facility: Lewis and Clark City/County Health Department Liberty County Service Area: North-Central Montana Lincoln County (Entire County HPSA) Facility: Lincoln County Community Health Center Madison County (Entire County HPSA) McCone County Service Area: Eastern Montana Meagher County (Entire County HPSA) Mineral County (Entire County HPSA) Facility: Mineral Regional Health Center Missoula County Population Group: Low Income - Missoula County Facility: Missoula City/County Health Department Facility: Missoula Indian Center Musselshell County (Entire County HPSA) Park County (Entire County HPSA) Facility: Community Health Partners Facility: Livingston Health Care Dba Park Clinic Facility: Park Clinic - West Crawford Petroleum County Service Area: Lewistown Phillips County Service Area: Eastern Montana Pondera County Service Area: North-Central Montana

Page 110 of 208 Pages MENTAL HEALTH: Montana County and County Equivalent Listing

Pondera County Facility: Heart Butte Clinic Powder River County Service Area: Eastern Montana Prairie County Service Area: Eastern Montana Ravalli County (Entire County HPSA) Richland County Service Area: Eastern Montana Roosevelt County Service Area: Eastern Montana Facility: Fort Peck Tribal Health Project Facility: Poplar PHS Indian Health Center Rosebud County Service Area: Eastern Montana Facility: Ashland Community Health Center Facility: Lame Deer PHS Indian Health Center Facility: Northern Cheyenne Tribal Health Department Facility: Rosebud Health Care Center Sheridan County Service Area: Eastern Montana Silver Bow County Facility: Butte-Silverbow Primary Health Care Facility: North American Indian Alliance Stillwater County (Entire County HPSA) Teton County Service Area: North-Central Montana Toole County Service Area: North-Central Montana Facility: Marias Healthcare Services, Inc. Treasure County Service Area: Eastern Montana Valley County Service Area: Eastern Montana Wheatland County Service Area: Lewistown Wibaux County Service Area: Eastern Montana Yellowstone County Facility: Indian Health Board of Billings Facility: Montana Migrant Facility: Yellowstone City/County Health Department

Page 111 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

Adams County Service Area: Mental Health Catchment Area 3 Antelope County Service Area: Catchment Area 4 Arthur County Service Area: Catchment Area 2 Banner County Service Area: Catchment Area 1 Blaine County Service Area: Mental Health Catchment Area 3 Boone County Service Area: Catchment Area 4 Box Butte County Service Area: Catchment Area 1 Boyd County Service Area: Catchment Area 4 Brown County Service Area: Catchment Area 4 Buffalo County Service Area: Mental Health Catchment Area 3 Burt County Service Area: Catchment Area 4 Facility: Cottonwood Rural Health Clinic Facility: Oakland Family Practice Butler County Service Area: Mental Health Catchment Area 5 Cass County Facility: Weeping Water Medical Center Cedar County Service Area: Catchment Area 4 Facility: Laurel Mercy Medical Clinic Chase County Service Area: Catchment Area 2 Cherry County Service Area: Catchment Area 4 Facility: Valentine Medical Clinic, LLC Cheyenne County Service Area: Catchment Area 1 Clay County Service Area: Mental Health Catchment Area 3 Facility: Edgar Medical Center

Page 112 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

Colfax County Service Area: Catchment Area 4 Facility: Alegent Health Clarkson Clinic Facility: Alegent Health Howells Clinic Facility: Alegent Health Schuyler Clinic Facility: Howells Family Practice Cuming County Service Area: Catchment Area 4 Facility: Dinklage Medical Clinic Facility: Wisner Family Practice Custer County Service Area: Mental Health Catchment Area 3 Facility: Callaway Medical Clinic Dakota County Service Area: Catchment Area 4 Dawes County Service Area: Catchment Area 1 Facility: Legend Buttes Health Services Center Dawson County Service Area: Catchment Area 2 Facility: Gothenburg Medical Arts Rural Health Clinic Deuel County Service Area: Catchment Area 1 Dixon County Service Area: Catchment Area 4 Dodge County Facility: Scribner Medical Clinic Douglas County Facility: Charles Drew Medical Clinic Facility: Fred Leroy Health and Wellness Clinic Facility: Nebraska Urban Indian Health Coalition Facility: One World Community Health Center Dundy County Service Area: Catchment Area 2 Facility: Quality Healthcare Services Medical Clinic-Benkelm Fillmore County Service Area: Mental Health Catchment Area 5 Facility: Fillmore County Medical Center, P.C. Franklin County Service Area: Mental Health Catchment Area 3 Frontier County Service Area: Catchment Area 2

Page 113 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

Furnas County Service Area: Mental Health Catchment Area 3 Gage County Service Area: Mental Health Catchment Area 5 Facility: Adams Primary Care Facility: Gage County Medical Clinic Facility: Women's Health Center-Beatrice Garden County Service Area: Catchment Area 1 Facility: Garden County Hospital Rural Health Clinic Garfield County Service Area: Mental Health Catchment Area 3 Facility: Burwell Medical Clinic Gosper County Service Area: Catchment Area 2 Grant County Service Area: Catchment Area 2 Greeley County Service Area: Mental Health Catchment Area 3 Hall County Service Area: Mental Health Catchment Area 3 Hamilton County Service Area: Mental Health Catchment Area 3 Harlan County Service Area: Mental Health Catchment Area 3 Hayes County Service Area: Catchment Area 2 Hitchcock County Service Area: Catchment Area 2 Facility: Quality Healthcare Services Medical Clinic-Stratto Holt County Service Area: Catchment Area 4 Facility: Avera Holt County Medical Clinic Facility: Avera O'Neill Family Medicine Facility: Greater Sandhill's Family Healthcare, Primary Care Facility: Grtr Sandhills Family Healthcare-Stuart Facility: West Holt Medical Clinic Hooker County Service Area: Catchment Area 2 Howard County Service Area: Mental Health Catchment Area 3

Page 114 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

Jefferson County Service Area: Mental Health Catchment Area 5 Johnson County Service Area: Mental Health Catchment Area 5 Facility: Tecumseh Family Health Care Kearney County Service Area: Mental Health Catchment Area 3 Keith County Service Area: Catchment Area 2 Keya Paha County Service Area: Catchment Area 4 Kimball County Service Area: Catchment Area 1 Facility: Kimball County Hospital Clinic Knox County Service Area: Catchment Area 4 Facility: Northern Ponca Tribe of Nebraska Facility: Santee Sioux Nation Lancaster County Service Area: Mental Health Catchment Area 5 Facility: Nebraska Urban Indian Medical Center Facility: People's Health Center Facility: Ponca Tribe of Nebraska Lincoln County Service Area: Catchment Area 2 Facility: Brady Rural Health Clinic Logan County Service Area: Catchment Area 2 Loup County Service Area: Mental Health Catchment Area 3 Madison County Service Area: Catchment Area 4 Facility: Norfolk Community Health Care Clinic Facility: Ponca Hills Health and Wellness Center McPherson County Service Area: Catchment Area 2 Merrick County Service Area: Mental Health Catchment Area 3 Facility: Lone Tree Medical Associates, P.C. Morrill County Service Area: Catchment Area 1

Page 115 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

Nance County Service Area: Catchment Area 4 Facility: Lone Tree Medical Associates - Fullerton Facility: Park Street Medical Clinic Nemaha County Service Area: Mental Health Catchment Area 5 Nuckolls County Service Area: Mental Health Catchment Area 3 Facility: Dba Superior Family Medical Center Facility: Superior Family Medical Center Otoe County Service Area: Mental Health Catchment Area 5 Facility: Nebraska City Medical Clinic Facility: Syracuse Medical Center Pawnee County Service Area: Mental Health Catchment Area 5 Facility: Pawnee County Rural Health Clinic Perkins County Service Area: Catchment Area 2 Phelps County Service Area: Mental Health Catchment Area 3 Pierce County Service Area: Catchment Area 4 Platte County Service Area: Catchment Area 4 Facility: Good Neighbor Community Health Center Polk County Service Area: Mental Health Catchment Area 5 Red Willow County Service Area: Catchment Area 2 Richardson County Service Area: Mental Health Catchment Area 5 Facility: Family Medicine Facility: Humboldt Family Medicine Rock County Service Area: Catchment Area 4 Facility: Greater Sandhills Family Healthcare-Bass Saline County Service Area: Mental Health Catchment Area 5 Saunders County Service Area: Mental Health Catchment Area 5

Page 116 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

Scotts Bluff County Service Area: Catchment Area 1 Facility: Panhandle Community Seward County Service Area: Mental Health Catchment Area 5 Sheridan County Service Area: Catchment Area 1 Facility: Gordon Clinic Sherman County Service Area: Mental Health Catchment Area 3 Sioux County Service Area: Catchment Area 1 Stanton County Service Area: Catchment Area 4 Thayer County Service Area: Mental Health Catchment Area 5 Facility: Bruning Medical Clinic Facility: Chester Medical Clinic Facility: Davenport Medical Clinic Facility: Deshler Medical Clinic Facility: Thayer County Health Services Thomas County Service Area: Catchment Area 2 Thurston County Service Area: Catchment Area 4 Facility: Carl T. Curtis Health Center Facility: Winnebago PHS Indian Hospital Valley County Service Area: Mental Health Catchment Area 3 Facility: North Loup Medical Clinic Facility: Vchs Medical Clinic (Formerly Ord Family Health Center) Washington County Facility: Fort Calhoun Clinic Facility: Mch Physicians Wayne County Service Area: Catchment Area 4 Facility: Wayne Mercy Medical Clinic Webster County Service Area: Mental Health Catchment Area 3 Wheeler County Service Area: Mental Health Catchment Area 3

Page 117 of 208 Pages MENTAL HEALTH: Nebraska County and County Equivalent Listing

York County Service Area: Mental Health Catchment Area 5

Page 118 of 208 Pages MENTAL HEALTH: Nevada County and County Equivalent Listing

Carson City Service Area: Northern Nevada Mental Health Catchment Area Facility: Nevada Health Centers Churchill County Service Area: Northern Nevada Mental Health Catchment Area Facility: Fallon Health Center Clark County Service Area: Goodsprings-West Clark County Service Area: Laughlin - Southern Clark County Service Area: Mesquite-North Clark County Facility: High Desert State Prison Facility: Moapa Health Clinic Facility: Southern Desert Correctional Center Facility: Southern Nevada Adult Mental Health Services Douglas County Service Area: Northern Nevada Mental Health Catchment Area Facility: Topaz Ranch Medical Clinic Elko County Service Area: Northern Nevada Mental Health Catchment Area Facility: Elko Health Center Facility: Owyhee Community Hospital Facility: Southern Bands Clan Health Center Esmeralda County (Entire County HPSA) Eureka County Service Area: Northern Nevada Mental Health Catchment Area Humboldt County Service Area: Northern Nevada Mental Health Catchment Area Facility: Fort McDermitt Tribal Health Center Lander County Service Area: Northern Nevada Mental Health Catchment Area Lincoln County (Entire County HPSA) Lyon County Service Area: Northern Nevada Mental Health Catchment Area Facility: Yerington Paiute Tribe Mineral County Service Area: Northern Nevada Mental Health Catchment Area Facility: Walker River Paiute Tribal Health Center Nye County Service Area: Northern Nevada Mental Health Catchment Area Facility: Duckwater Shoshone Tribe Pershing County Service Area: Northern Nevada Mental Health Catchment Area

Page 119 of 208 Pages MENTAL HEALTH: Nevada County and County Equivalent Listing

Pershing County Facility: Lovelock Correctional Center Storey County Service Area: Northern Nevada Mental Health Catchment Area Washoe County Service Area: Northern Nevada Mental Health Catchment Area Facility: Health Access Washoe Facility: Nevada Skies Youth Wellness Center Facility: Nevada Urban Indians, Inc. Facility: Pyramid Lake Tribal Health Center Facility: Reno Sparks Shoshone Paiute Health Center White Pine County Service Area: Northern Nevada Mental Health Catchment Area Facility: Ely Health Station Facility: Newe Medical Clinic\Ely Shoshone Tribe

Page 120 of 208 Pages MENTAL HEALTH: New Hampshire County and County Equivalent Listing

Coos County Service Area: Eastern Coos Service Area: Littleton Service Area Facility: Coos County Family Health Services Facility: Indian Stream Health Center Facility: Weeks Medical Center - Groveton Facility: Weeks Medical Center - Whitefield Grafton County Service Area: Eastern Grafton Service Area: Littleton Service Area Facility: Ammonoosuc Community Health Services Facility: Mid State Health Center Hillsborough County Facility: Harbor Homes, Inc. Facility: Manchester Community Health Center Facility: Manchester Health Department Merrimack County Facility: Health First Family Care Rockingham County Facility: Families First of the Greater Seacoast Facility: Lamprey Healthcare Strafford County Facility: Avis Goodwin Community Health Center Sullivan County Facility: Charlestown Family Medical Facility: Newport Health Center

Page 121 of 208 Pages MENTAL HEALTH: New Jersey County and County Equivalent Listing

Atlantic County Facility: Atlanticare Health Services Facility: Southern Jersey Family Medical Camden County Facility: Camcare Health Corporation Facility: Project H.O.P.E. Inc. Cumberland County Facility: Community Health Care, Inc. Facility: Federal Correctional Institution - Fairton Essex County Facility: Newark City Health and Human Services Facility: Newark Community Health Facility: Northern State Prison Hudson County Facility: Horizon Health Center Facility: Metropolitan Family Health Network Facility: North Hudson Community Action Corporation Mercer County Facility: Henry J. Austin Health Middlesex County Facility: Chandler Health Facility: Jewish Renaissance Medical Center Monmouth County Facility: Monmouth Family Health Center Facility: Visiting Nurse Association of Cent Jersy Community Morris County Facility: Zufall Community Clinic Ocean County Facility: Lakewood Resource and Referral Center Dba Chemed Facility: Ocean Health Initiative Passaic County Facility: Paterson Community Health Center Union County Facility: Immigration and Customs Enforcement - Elizabeth Facility: Plainfield Neighborhood Health Services

Page 122 of 208 Pages MENTAL HEALTH: New Mexico County and County Equivalent Listing

Bernalillo County Service Area: Southwest Valley Population Group: Low Income - North Valley Facility: Albuquerque Healthcare Facility: Albuquerque PHS Indian Hospital Facility: First Choice Community Healthcare, Inc. Facility: First Nations Community Health Facility: Samaritan Counseling Center Facility: University of New Mexico Psychiatric Center Catron County Service Area: Border Catchment Area Chaves County Service Area: Southeastern Catchment Area Cibola County (Entire County HPSA) Facility: Acoma-Canoncito-Laguna PHS Health Center Facility: New Mexico Womens Correctional Facility Facility: New Sunrise Regional Treatment Center Facility: Pine Hill Indian Health Center Facility: Pueblo of Laguna of Community Health and Wellness Colfax County (Entire County HPSA) Curry County Service Area: Plains Mental Health Service Area De Baca County Service Area: Plains Mental Health Service Area Facility: Debaca Hospital/Family Practice Center Dona Ana County (Entire County HPSA) Facility: Ben Archer Community Health Center Facility: La Clinica De Familia Eddy County Service Area: Southeastern Catchment Area Grant County Service Area: Border Catchment Area Guadalupe County Service Area: Plains Mental Health Service Area Harding County Service Area: Plains Mental Health Service Area Hidalgo County Service Area: Border Catchment Area Facility: Hidalgo Medical Service Lea County Service Area: Southeastern Catchment Area

Page 123 of 208 Pages MENTAL HEALTH: New Mexico County and County Equivalent Listing

Lincoln County Service Area: Southeastern Catchment Area Facility: Carrizozo Health Center Luna County Service Area: Border Catchment Area McKinley County Service Area: Catchment Area 1 Facility: Crownpoint Comprehensive Health Center Facility: Gallup Indian Medical Center Facility: Presbyterian Medical Services Facility: Zuni PHS Indian Hospital Mora County (Entire County HPSA) Facility: Mora Valley Community Health Services, Inc. Otero County Service Area: Southeastern Catchment Area Facility: Mescalero PHS Indian Hospital Quay County Service Area: Plains Mental Health Service Area Rio Arriba County (Entire County HPSA) Facility: Circle of Life Behavioral Health Facility: Eight Northern Indian Pueblos, Inc. Facility: El Centro Family Health Facility: Jicarilla PHS Indian Health Center Facility: La Clinca Del Pueblo De Rio Arriba Facility: Las Clinicas Del Norte Roosevelt County Service Area: Plains Mental Health Service Area Facility: Las Casa De Buena Salud San Juan County Service Area: Catchment Area 1 Facility: Northern Navajo Medical Center San Miguel County (Entire County HPSA) Facility: Pecos Valley Medical Sandoval County Service Area: Northern Sandoval Facility: Cochiti Health Clinic Facility: El Pueblo Health Services Facility: Jemez Health and Human Services Facility: Sandia Health Clinic Facility: Zia Health Clinic Facility: Zia Pueblo Health Program

Page 124 of 208 Pages MENTAL HEALTH: New Mexico County and County Equivalent Listing

Santa Fe County Facility: La Familia Medical Center Facility: Santa Fe Recovery Center Facility: Sante Fe PHS Indian Hospital Sierra County Service Area: South Central Catchment Area Socorro County Service Area: South Central Catchment Area Facility: Alamo Navajo Health Center Taos County (Entire County HPSA) Facility: Taos PHS Indian Health Center Torrance County (Entire County HPSA) Union County Service Area: Plains Mental Health Service Area Valencia County (Entire County HPSA) Facility: Central New Mexico Correctional Facility

Page 125 of 208 Pages MENTAL HEALTH: New York County and County Equivalent Listing

Albany County Facility: Whitney Young, Jr. Health Center Allegany County (Entire County HPSA) Bronx County Population Group: Kingsbridge/Riverdale - Medicaid Eligible Population Group: Medicaid Eligible - Fordham/Norwood Population Group: Medicaid Eligible - Hunts Point/Mott Haven Population Group: Medicaid Eligible - Soundview Population Group: Medicaid Eligible - West Central Bronx Population Group: Parkchester/Throgs Neck Medicaid Elgible Facility: Bronx Community Health Network Facility: Bronx Lebanon Integrated Services System Facility: Help/Psi Services Corporation Facility: Hunts Point Multi-Service Center, Inc. Facility: Morris Heights Health Center, Inc. Facility: Union Community Health Center Facility: Urban Health Plan, Inc. Broome County Population Group: Medicaid Eligible-Broome County Cattaraugus County (Entire County HPSA) Facility: Lionel John/Allegany I.R. Health Center Facility: Southern Tier Community Health Center Network D/B/ Cayuga County Facility: Central New York Psychiatric Center - Auburn Correctional Facility: East Hill Family Medical, Inc. Chautauqua County (Entire County HPSA) Facility: Cattaraugus Indian Reservation Health Center Facility: The Chautauqua Center Chemung County Population Group: Medicaid Eligible - Chemung County Facility: Elmira Psychiatric Center Chenango County (Entire County HPSA) Clinton County Population Group: Clinton County - Medicaid Eligible Cortland County Population Group: Medicaid Eligible - Cortland County Facility: Family Health Network of Central New York Delaware County Population Group: Medicaid Eligible-Delaware County Dutchess County Facility: Downstate Correctional Facility

Page 126 of 208 Pages MENTAL HEALTH: New York County and County Equivalent Listing

Erie County Population Group: Medicaid Eligible - Buffalo Service Area Facility: Community Health Center of Buffalo Facility: Gowanda Correctional Facility Facility: Northwest Buffalo Community Health Center Essex County (Entire County HPSA) Facility: Association Community Action of Northeast Adironda Facility: Federal Correctional Institution - Ray Brook Franklin County (Entire County HPSA) Facility: St. Regis Mohawk Health Services Fulton County Population Group: Medicaid Eligible - Fulton County Genesee County (Entire County HPSA) Facility: Immigration and Customs Enforcement - Buffalo Greene County Population Group: Medicaid Eligible - Greene County Hamilton County (Entire County HPSA) Herkimer County (Entire County HPSA) Jefferson County Population Group: Medicaid Eligible - Jefferson County Facility: North Country Children's Clinic Kings County Service Area: Southwest Brooklyn Population Group: Medicaid Eligible - Coney Island/Gravesend Facility: Bedford Stuyvesant Facility: Brooklyn Plaza Medical Center Facility: Brownsville Community Facility: Ezra Medical Center Facility: Housing Works, Inc. Facility: Icl Healthcare Choices, Inc. Facility: Metropolitan Detention Center - Brooklyn Facility: ODA Primary Care Health Facility: Sunset Park Family Health Facility: Woodhull Mental Health Center Lewis County (Entire County HPSA) Livingston County Service Area: Southern Livingston County Madison County (Entire County HPSA) Monroe County Population Group: Medicaid Eligible - Westside Rochester Population Group: Medicaid Population - Jordan Facility: Anthony Jordan Health Center

Page 127 of 208 Pages MENTAL HEALTH: New York County and County Equivalent Listing

Monroe County Facility: Oak Orchard Community Facility: Rochester Primary Care Facility: St. Mary's Hospital of the Sisters Montgomery County (Entire County HPSA) Nassau County Facility: Nassau Health Care Corporation New York County Population Group: Kingsbridge/Riverdale - Medicaid Eligible Population Group: Medicaid Eligible - Lower East Side Population Group: Medicaid Eligible - Upper Manhattan Population Group: Medicaid Eligible - Washington Heights-Inwood Facility: Ahrc Health Care, Inc. Facility: American Indian Community House Facility: Asian and Pacific Islander Coalition on HIV/AIDS, in Facility: Bellevue Hospital Facility: Betances Health Center Facility: Boriken Neighborhood Facility: Charles B. Wang Community Health Center, Inc. Facility: Community Healthcare Network Facility: Covenant House Facility: Health Care for the Homeless Facility: Heritage Health and Housing Facility: Institute for Family Health Facility: Metropolitan Correctional Center - New York Facility: New York Children's Health Project Facility: Project Renewal Facility: Settlement Health Facility: Upper Room AIDS Ministry, Inc. Facility: William F. Ryan Community Health Center Oneida County (Entire County HPSA) Facility: Oneida Correctional Facility Onondaga County (Entire County HPSA) Facility: Hutchings Psychiatric Center Facility: Syracuse Community Health Center Orange County Facility: Ezras Cholim Health Center, Inc. Facility: Federal Correctional Institution - Otisville Facility: Greater Hudson Valley Family Health Center Facility: Middletown Community Health Center Orleans County (Entire County HPSA)

Page 128 of 208 Pages MENTAL HEALTH: New York County and County Equivalent Listing

Oswego County (Entire County HPSA) Facility: Northern Oswego Otsego County Population Group: Medicaid Eligible - Otsego County Queens County Population Group: Medicaid Eligible - Long Island City/Woodside Facility: J. P. Addabbo Family Facility: Project Samaritan Health Services Facility: The Floating Hospital Richmond County Facility: Beacon Christian Community Health Center Facility: Community Health Center of Richmond Rockland County Population Group: Medicaid Eligible - Monsey-New Square Facility: Refuah Health Center Schenectady County Facility: Schenectady Family Health Services/Dba Hometown He Schoharie County (Entire County HPSA) Schuyler County (Entire County HPSA) Seneca County Population Group: Medicaid Eligible-Seneca Facility: Five Points Correctional Facility, Mental Health St. Lawrence County (Entire County HPSA) Facility: Cerebral Palsy Association of North Country Steuben County Population Group: Medicaid Eligible - Steuben County Suffolk County Facility: Shinnecock Indian Nation Sullivan County (Entire County HPSA) Tompkins County Population Group: Medicaid Eligible - Tompkins County Warren County Facility: Hudson Headwaters Health Network Wayne County Population Group: Medicaid Eligible-Wayne Westchester County Population Group: Medicaid Eligible - City of Yonkers Facility: Hudson River Healthcare Facility: Mt. Vernon Neighborhood Health Center Facility: Open Door Family Medical Center Wyoming County (Entire County HPSA)

Page 129 of 208 Pages MENTAL HEALTH: New York County and County Equivalent Listing

Yates County (Entire County HPSA) Facility: Finger Lakes Migrant Health Proj

Page 130 of 208 Pages MENTAL HEALTH: North Carolina County and County Equivalent Listing

Alleghany County (Entire County HPSA) Anson County Facility: Anson Regional Facility: Brown Creek Correctional Institution Facility: Lanesboro Correctional Institution Avery County (Entire County HPSA) Facility: Avery-Mitchell Correctional Institution Facility: Mountain View Correctional Institution Beaufort County Facility: Metropolitan Community Health Bertie County Service Area: Roanoke-Chowan Facility: Bertie County Rural Health Association Bladen County Service Area: Southeast Regional Mental Health Catchment Area Brunswick County (Entire County HPSA) Buncombe County Facility: Craggy Correctional Center Facility: Western North Carolina Community Health Burke County Facility: Foothills Correctional Institution Facility: Western Youth Institution Cabarrus County Facility: Cabarrus Community Health Center Caldwell County Facility: Collettsville Medical Center Facility: West Caldwell Health Council, Inc. Caswell County Facility: Caswell Family Medical Center Cherokee County (Entire County HPSA) Columbus County Service Area: Southeast Regional Mental Health Catchment Area Facility: Chadbourn Family Practice Center Facility: Columbus County Community Health Center Facility: Tabor Correctional Institution Cumberland County Facility: Stedman-Wade Health Services Duplin County Service Area: Duplin-Sampson Durham County Facility: Lincoln Community Health Center

Page 131 of 208 Pages MENTAL HEALTH: North Carolina County and County Equivalent Listing

Edgecombe County Service Area: Edgecombe/Nash Facility: Opportunities Industrialization Center Inc. Facility: Rocky Mount OIC Family Medical Center Forsyth County Facility: Southside United Health Center Gaston County Facility: Gaston Family Health Services, Inc. Gates County Service Area: Roanoke-Chowan Granville County Facility: Federal Correctional Complex - Butner Facility: Granville Internal Medical and Geriatrics Greene County Facility: Greene County Health Care, Inc. Guilford County Facility: Triad Adult and Pediatric Medicine Halifax County Facility: Rural Health Group, Inc. Harnett County Facility: First Choice Community Health Centers Facility: Harnett Correctional Institution Henderson County Facility: Blue Ridge Community Health Services Hertford County Service Area: Roanoke-Chowan Facility: Roanoke-Chowan Community Health Center Iredell County Facility: Harmony Medical Care PA Jackson County (Entire County HPSA) Johnston County Facility: Benson Area Medical Center Lenoir County Facility: Kinston Community Health Center Macon County (Entire County HPSA) Madison County Facility: Hot Springs Health Program Mecklenburg County Facility: C.W. Williams Community Health Center Mitchell County Facility: Bakersville Community Medical Clinic

Page 132 of 208 Pages MENTAL HEALTH: North Carolina County and County Equivalent Listing

Montgomery County Facility: Southern Correctional Institution Nash County Service Area: Edgecombe/Nash New Hanover County Facility: New Hanover Northampton County Service Area: Roanoke-Chowan Onslow County (Entire County HPSA) Orange County Facility: Piedmont Health Services Pender County Facility: Black River Family Practice Facility: Black River Health Center Facility: Maple Hill Medical Center Person County Facility: Person Counseling Center Facility: Person Family Medical Center Randolph County Facility: Merce Medical Resource Center Richmond County (Entire County HPSA) Robeson County Service Area: Southeast Regional Mental Health Catchment Area Facility: Dr. Arthur Jr. Robinson Medical Clinic Facility: Fairmont Medical Clinic Facility: Johnson Medical Clinic Facility: Lumberton Correctional Institution Facility: Maxton Family Practice Center Facility: Riverquest Medical Care Facility: Robeson Healthcare Corporation Facility: Rowland Medical Clinic Rockingham County Facility: RMSA Health Center, Inc. Rutherford County Facility: Community Clinic of Rutherford County Sampson County Service Area: Duplin-Sampson Facility: Goshen Medical Center Facility: Tri-County Community Scotland County Service Area: Southeast Regional Mental Health Catchment Area Facility: Laurel Hill Medical Clinic

Page 133 of 208 Pages MENTAL HEALTH: North Carolina County and County Equivalent Listing

Scotland County Facility: Scotland Correctional Institution Surry County (Entire County HPSA) Swain County (Entire County HPSA) Facility: Analenisigi Center Facility: PHS Indian Hospital-Cherokee Wake County Facility: North Carolina Department of Health and Human Services Facility: Wake Health Services, Inc. Warren County Facility: Warren Correctional Institution Watauga County Facility: High Country Community Health Wilson County Facility: Carolina Family Health Centers, Inc. Yadkin County Facility: New River Behavioral Healthcare

Page 134 of 208 Pages MENTAL HEALTH: North Dakota County and County Equivalent Listing

Adams County Service Area: Dickinson Catchment Area Barnes County Service Area: Jamestown Catchment Area Benson County Service Area: Devils Lake Catchment Area Facility: Fort Totten PHS Indian Health Center Billings County Service Area: Dickinson Catchment Area Bottineau County (Entire County HPSA) Bowman County Service Area: Dickinson Catchment Area Facility: Southwest Medical Clinic Burke County (Entire County HPSA) Burleigh County Facility: West Central Human Service Center Cass County Facility: Family Healthcare Center Facility: Southeast Human Services Center Cavalier County Service Area: Devils Lake Catchment Area Dickey County Service Area: Jamestown Catchment Area Facility: James River Correctional Center Divide County (Entire County HPSA) Dunn County Service Area: Dickinson Catchment Area Eddy County Service Area: Devils Lake Catchment Area Emmons County (Entire County HPSA) Foster County Service Area: Jamestown Catchment Area Golden Valley County Service Area: Dickinson Catchment Area Grand Forks County Facility: Northeast Human Service Center Facility: Valley Community Health Center Grant County (Entire County HPSA) Griggs County Service Area: Jamestown Catchment Area Hettinger County Service Area: Dickinson Catchment Area

Page 135 of 208 Pages MENTAL HEALTH: North Dakota County and County Equivalent Listing

Kidder County (Entire County HPSA) LaMoure County Service Area: Jamestown Catchment Area Facility: Rural Health Kulm Logan County Service Area: Jamestown Catchment Area Facility: Rural Health Gackle Facility: Rural Health Napoleon McIntosh County Service Area: Jamestown Catchment Area Facility: Dba Rural Health Wishek Facility: Rural Health Wishek McKenzie County (Entire County HPSA) McLean County (Entire County HPSA) Facility: Northland Health Partners Community Health Center Mercer County (Entire County HPSA) Facility: Coal Country Community Health Center Facility: Sakakawea Beulah Clinic Facility: Sakakawea Hazen Clinic Mountrail County (Entire County HPSA) Facility: Fort Berthold PHS Indian Health Center Nelson County (Entire County HPSA) Oliver County (Entire County HPSA) Pembina County (Entire County HPSA) Pierce County (Entire County HPSA) Ramsey County Service Area: Devils Lake Catchment Area Ransom County (Entire County HPSA) Renville County (Entire County HPSA) Richland County (Entire County HPSA) Rolette County Service Area: Devils Lake Catchment Area Facility: Belcourt PHS Indian Hospital Sargent County (Entire County HPSA) Sheridan County (Entire County HPSA) Sioux County (Entire County HPSA) Facility: Fort Yates PHS Indian Hospital Slope County Service Area: Dickinson Catchment Area Stark County Service Area: Dickinson Catchment Area Steele County (Entire County HPSA)

Page 136 of 208 Pages MENTAL HEALTH: North Dakota County and County Equivalent Listing

Stutsman County Service Area: Jamestown Catchment Area Facility: North Dakota State Hospital Towner County Service Area: Devils Lake Catchment Area Traill County (Entire County HPSA) Walsh County (Entire County HPSA) Ward County Facility: North Central Human Svc Center Wells County Service Area: Jamestown Catchment Area Williams County (Entire County HPSA) Facility: Northwest Human Services Center

Page 137 of 208 Pages MENTAL HEALTH: Ohio County and County Equivalent Listing

Adams County Service Area: Catchment Area #53 Allen County Population Group: Mental Health Catchment Area 62 Facility: Health Partners of Western Ohio Ashtabula County (Entire County HPSA) Athens County Service Area: Catchment Area 33 Auglaize County Population Group: Mental Health Catchment Area 62 Belmont County Population Group: Low Income - Catchment Area 8 Facility: Belmont Correctional Institution Facility: Ohio Hills Health Brown County (Entire County HPSA) Butler County Facility: Butler County Community Health Carroll County Service Area: Catchment Area 31 Champaign County Service Area: Mental Health Catchment Area 63 Clark County Service Area: Catchment Area #65 Facility: Rocking Horse Children's Health Center Clermont County Facility: Clermont Pediatric Center Facility: Healthsource of Ohio, Inc. Columbiana County Population Group: Medicaid Eligible - Columbiana County Facility: Community Action Agency of Columbiana County Coshocton County Service Area: Catchment Area 32 Crawford County (Entire County HPSA) Cuyahoga County Facility: Care Alliance Facility: Neighborhood Health Care Facility: Northcoast Behavioral Healthcare Facility: Northeast Neighborhood Health Facility: The Free Medical Clinic of Greater Cleveland Darke County Service Area: Catchment Area 64 Facility: Family Health Services of Darke County

Page 138 of 208 Pages MENTAL HEALTH: Ohio County and County Equivalent Listing

Defiance County Service Area: Defiance Fulton Henry Williams Counties Erie County Service Area: Ottawa/Erie Health Professional Shortage Area Facility: Erie County Health Department (Echd) Facility: Family Health Services of Erie County Fairfield County (Entire County HPSA) Facility: Fairfield County Combines General Health Distric Fayette County Population Group: Medicaid Eligible - Catchment Area 52 Franklin County Facility: Capital Park Family Health Center Facility: Columbus Neighborhood Health Center Facility: Lower Lights Christian Health Center Facility: Southeast, Inc. Fulton County Service Area: Defiance Fulton Henry Williams Counties Gallia County Service Area: Catchment Area 35 Greene County Service Area: Catchment Area #65 Guernsey County Service Area: Catchment Area 32 Hamilton County Facility: Christian Community Health Svs/Dba Crossroad Health Facility: Cincinnati Health Network Facility: City of Cincinnati Department of Health Facility: Lincoln Heights Health Care Connection Facility: Neighborhood Health Center Facility: Winton Hills Medical Center Hardin County Population Group: Mental Health Catchment Area 62 Harrison County Population Group: Low Income - Catchment Area 8 Henry County Service Area: Defiance Fulton Henry Williams Counties Highland County Population Group: Medicaid Eligible - Catchment Area 52 Facility: Highland Family Healthcare Hocking County Service Area: Catchment Area 33

Page 139 of 208 Pages MENTAL HEALTH: Ohio County and County Equivalent Listing

Holmes County Service Area: Wayne/Holmes (Catchment Area 27) Huron County (Entire County HPSA) Jackson County Service Area: Catchment Area 35 Lawrence County Service Area: Catchment Area #53 Facility: Ironton-Lawrence County Community Action Organizat Logan County Service Area: Mental Health Catchment Area 63 Lorain County Facility: Lorain Correctional Institution Facility: Lorain County Health and Dentistry Facility: Mercy Allen Rural Health Clinic Lagrange Facility: Mercy Allen Rural Health Clinic Wellington Lucas County Facility: Neighborhood Health Association of Toledo Madison County Service Area: Catchment Area #65 Facility: London Correctional Institution Facility: Madison Correctional Institution Mahoning County Facility: Ohio Northeast Health System, Inc. Marion County Facility: Center Street Community Clinic, Inc. Facility: Marion Correctional Institution Facility: North Central Correctional Institution Meigs County Service Area: Catchment Area 35 Mercer County Service Area: Catchment Area 61 Miami County Service Area: Catchment Area 64 Monroe County Population Group: Low Income - Catchment Area 8 Montgomery County Facility: Community Health Centers of Greater Dayt Facility: Five Rivers Health Centers Family Health Center Facility: Good Samaritan Hospital Homeless Morgan County Service Area: Catchment Area 32 Facility: Muskingum Valley Health Centers

Page 140 of 208 Pages MENTAL HEALTH: Ohio County and County Equivalent Listing

Morrow County (Entire County HPSA) Muskingum County Service Area: Catchment Area 32 Noble County Service Area: Catchment Area 32 Facility: Noble Correctional Institution Ottawa County Service Area: Ottawa/Erie Health Professional Shortage Area Paulding County Service Area: Catchment Area 61 Perry County Service Area: Catchment Area 32 Pickaway County Population Group: Medicaid Eligible - Catchment Area 52 Pike County Population Group: Medicaid Eligible - Catchment Area 52 Facility: Community Action of Pike County Preble County (Entire County HPSA) Putnam County (Entire County HPSA) Richland County Facility: Mansfield Correctional Institution Facility: Richland Correctional Institution Facility: Third Street Community Ross County Population Group: Medicaid Eligible - Catchment Area 52 Facility: Chillicothe Correctional Institution Facility: Family Healthcare Facility: Greenfield Medical Services Facility: Ross Correctional Institution Sandusky County Service Area: Seneca/Sandusky/Wyandot Facility: Community Health Services Scioto County Service Area: Catchment Area #53 Facility: Community Action Organization of Scioto County Hlt Facility: Southern Ohio Correctional Facility Seneca County Service Area: Seneca/Sandusky/Wyandot Shelby County Service Area: Catchment Area 64 Stark County Facility: Canton Community Clinic, Inc.

Page 141 of 208 Pages MENTAL HEALTH: Ohio County and County Equivalent Listing

Summit County Facility: Akron Community Health Trumbull County Facility: Trumbull Correctional Institution Tuscarawas County Service Area: Catchment Area 31 Facility: Tuscarawas County Health Department Union County (Entire County HPSA) Van Wert County Service Area: Catchment Area 61 Facility: Community Health Family Care Clinic Vinton County Service Area: Catchment Area 33 Warren County Facility: Lebanon Correctional Institution Washington County Population Group: Medicaid Eligible - Washington County Wayne County Service Area: Wayne/Holmes (Catchment Area 27) Williams County Service Area: Defiance Fulton Henry Williams Counties Wood County Facility: Wood County Combined General Health District Wyandot County Service Area: Seneca/Sandusky/Wyandot

Page 142 of 208 Pages MENTAL HEALTH: Oklahoma County and County Equivalent Listing

Adair County Service Area: Catchment Area 21 Facility: Neochc-Westville Alfalfa County Service Area: Catchment Area 10 Facility: Great Salt Plains Health Center Facility: James Crabtree Correctional Center Atoka County Service Area: Catchment Area 6 Facility: ABC Medical Clinic, Inc. Facility: Mack Alford Correctional Center Beaver County Service Area: Catchment Area 10 Beckham County Service Area: Catchment Area 9 Blaine County Service Area: Catchment Area 9 Facility: Watonga Indian Heath Service Clinic Bryan County Service Area: Catchment Area 7 Facility: Choctaw Nation of Oklahoma-Durant Facility: Durant Health Center Caddo County Service Area: Catchment Area 8 Service Area: Catchment Area 9 Facility: Anadarko PHS Indian Health Center Facility: Carnegie Indian Health Center Facility: Northeastern Tribal Health System Canadian County Facility: El Reno PHS Indian Health Clinic Facility: Federal Correctional Institution - El Reno Carter County Service Area: Catchment Area 7 Facility: Ardmore Chickasaw Health Clinic Cherokee County Service Area: Catchment Area 21 Facility: Cherokee Nation of Oklahoma Facility: Northeastern Oklahoma Community Health Center Facility: W.W. Hastings Indian Hospital Choctaw County Service Area: Catchment Area 6 Facility: Choctaw Nation Health Clinic-Hugo

Page 143 of 208 Pages MENTAL HEALTH: Oklahoma County and County Equivalent Listing

Cimarron County Service Area: Catchment Area 10 Cleveland County Facility: Joseph Harp Correctional Center Facility: Lexington Correctional Center ( Lark) Coal County Service Area: Catchment Area 6 Comanche County Service Area: Catchment Area 8 Facility: Comanche County Hospital Authority Facility: Comanche Tribe of Oklahoma Facility: Lawton PHS Indian Health Hospital Cotton County Service Area: Catchment Area 8 Craig County Population Group: Low Income - Catchment Area 1 Facility: Cherokee Nation Vinita Health Clinic Creek County Population Group: Low Income - Catchment Area 13 Facility: Cmhi Grant Facility: Sapulpa Behavioral Health Facility: Sapulpa Health Center Custer County Service Area: Catchment Area 9 Facility: Clinton PHS Indian Hospital Delaware County Population Group: Low Income - Catchment Area 1 Facility: Cherokee Nation Sam Hider Health Center Dewey County Service Area: Catchment Area 10 Ellis County Service Area: Catchment Area 10 Garfield County Service Area: Catchment Area 10 Garvin County Service Area: Catchment Area 7 Facility: So. Central Medical and Resource Center (Scmr Grant County Service Area: Catchment Area 10 Greer County Service Area: Catchment Area 9 Facility: Oklahoma State Reformatory

Page 144 of 208 Pages MENTAL HEALTH: Oklahoma County and County Equivalent Listing

Harmon County Service Area: Catchment Area 8 Facility: Shortgrass Community Health Center, Inc. Harper County Service Area: Catchment Area 10 Haskell County Service Area: Catchment Area 6 Facility: Stigler Health and Wellness Center Hughes County Service Area: Catchment Area 6 Facility: East Central Oklahoma Family Health Center, Inc. Facility: Wetumka Behavioral Health Jackson County Service Area: Catchment Area 8 Jefferson County Service Area: Catchment Area 8 Johnston County Service Area: Catchment Area 7 Facility: Family Health Center of Southern Oklahoma Facility: Tishomingo Chickasaw Htlh Center Kay County Service Area: Catchment Area 11 Facility: Kanza Health Clinic Facility: Tonkawa Tribe of Oklahoma Facility: White Eagle Indian Health Center Kingfisher County Service Area: Catchment Area 10 Kiowa County Service Area: Catchment Area 9 Latimer County Service Area: Catchment Area 6 Le Flore County Service Area: Catchment Area 6 Facility: Choctaw Nation Health Care Center-Talihina Facility: Choctaw Nation Indian Health - Poteau Facility: Diabetes Treatment Center Lincoln County Facility: Black Hawk Health Center Logan County Service Area: Catchment Area 10 Facility: Mary Mahoney Health Center @ Langston

Page 145 of 208 Pages MENTAL HEALTH: Oklahoma County and County Equivalent Listing

Love County Service Area: Catchment Area 7 Major County Service Area: Catchment Area 10 Marshall County Service Area: Catchment Area 7 Mayes County Population Group: Low Income - Catchment Area 1 Facility: A-Mo Health Center McClain County Facility: Chickasaw Nation Health Clinic-Purcell McCurtain County Service Area: Catchment Area 6 Facility: Choctaw Nation Indian Health - Broken Bow Facility: Kiamichi Family Medical Center McIntosh County Service Area: Catchment Area 16 Facility: Eufaula Behavioral Health Facility: Eufaula Health Center Murray County Service Area: Catchment Area 7 Muskogee County Service Area: Catchment Area 16 Facility: Muskogee Indian Health Center Noble County Service Area: Catchment Area 11 Facility: Otoe-Missouri Tribe Nowata County Population Group: Low Income - Catchment Area 1 Facility: Cherokee Nation Will Rogers Health Center Okfuskee County Population Group: Low Income - Catchment Area 13 Facility: Okemah Behavioral Health Facility: Okemah Indian Health Center Oklahoma County Facility: Community Health Centers, Inc. Facility: Federal Transfer Center - Oklahoma City Facility: Oklahoma City Indian Clinic Facility: Oklahoma Community Health Services Okmulgee County Population Group: Low Income - Catchment Area 13 Facility: Muscogee (Creek) Nation Div. Of Health a

Page 146 of 208 Pages MENTAL HEALTH: Oklahoma County and County Equivalent Listing

Okmulgee County Facility: Okmulgee Behavioral Health Facility: Okmulgee Health Center Facility: Youth Wellness Program Osage County Service Area: Catchment Area 11 Facility: Dick Conner Correctional Center Facility: Fairfax Medical Facilities, Inc. Facility: Osage Nation Facility: Pawhuska PHS Indian Health Center Ottawa County Population Group: Low Income - Catchment Area 1 Facility: Modoc Tribal Council Facility: Northeastern Tribal Health System - Ottawa Facility: Northeastern Tribal Health System - Peoria Facility: Northeastern Tribal Health System-Miami Facility: Northeastern Tribal Health System-Seneca-Cayuga Facility: Quapaw Tribe of Oklahoma Facility: Wyandotte Nation/Bearskin Health Center Pawnee County Service Area: Catchment Area 11 Facility: Pawnee Nation of Oklahoma Facility: Pawnee PHS Indian Health Center Payne County Service Area: Catchment Area 11 Facility: Iowa Tribe of Oklahoma Pittsburg County Service Area: Catchment Area 6 Facility: Caring Hands Healthcare Centers, Inc. Facility: Choctaw Nation Indian Health - McAlester Pontotoc County Service Area: Catchment Area 7 Facility: Chickasaw Nation Medical Center Pottawatomie County Facility: Absentee Shawnee Tribal Clinic Facility: Citizen Pottawatomie Nation Health Service Facility: Kickapoo Tribal Health Center Facility: Mabel Bassett Correctional Center Pushmataha County Service Area: Catchment Area 6 Facility: Pushmataha Family Medical Center

Page 147 of 208 Pages MENTAL HEALTH: Oklahoma County and County Equivalent Listing

Roger Mills County Service Area: Catchment Area 9 Rogers County Population Group: Low Income - Catchment Area 1 Facility: Claremore Indian Hospital Seminole County Service Area: Catchment Area 7 Facility: Central Oklahoma Family Medical Center Facility: Wewoka Indian Health Center Sequoyah County Service Area: Catchment Area 21 Facility: Cherokee Nation Redbird Smith Health Center Stephens County Service Area: Catchment Area 8 Texas County Service Area: Catchment Area 10 Tillman County Service Area: Catchment Area 8 Tulsa County Facility: Community Health Connection Inc. Facility: Indian Health Care Resource Center of Tulsa Facility: Morton Comprehensive Wagoner County Service Area: Catchment Area 21 Facility: Arkansas Verdigris Valley Health Centers , in Facility: Muskogee-Creek Nation-Koweta Facility Washington County Population Group: Low Income - Catchment Area 1 Facility: Cherokee Nation Bartlesville Health Center Washita County Service Area: Catchment Area 9 Woods County Service Area: Catchment Area 10 Woodward County Service Area: Catchment Area 10

Page 148 of 208 Pages MENTAL HEALTH: Oregon County and County Equivalent Listing

Baker County Service Area: Northeastern Oregon Service Area Benton County Population Group: Linn/Benton County Low Income_Migrant Farmworker Facility: Alsea Rural Health Care, Inc. Facility: Benton County Health Department Clackamas County Facility: Clackamas County Community Health Division Clatsop County (Entire County HPSA) Facility: Coastal Family Health Center Coos County Service Area: Catchment Area 14 Facility: Coos Bay Tribal Clinic Facility: Coquille Community Health Center Facility: Waterfall Clinic, Inc. Crook County Service Area: Central Oregon Facility: Mosaic Medical Curry County Service Area: Catchment Area 14 Deschutes County Facility: Lapine Community Health Center Douglas County (Entire County HPSA) Facility: Adapt Facility: Cow Creek Tribal Clinic Facility: Umpqua Community Health Gilliam County Service Area: East Columbia Grant County Service Area: East Columbia Harney County Service Area: Southeastern Oregon Facility: Burns-Paiute Health Clinic Facility: Wadatika Health Center Hood River County Service Area: Mid Columbia Catchment Area Facility: La Clinica Del Carino Jackson County (Entire County HPSA) Facility: Community Health Center, Inc. Facility: La Clinica Del Valle Jefferson County Service Area: Central Oregon

Page 149 of 208 Pages MENTAL HEALTH: Oregon County and County Equivalent Listing

Jefferson County Facility: Warm Springs PHS Indian Health Center Josephine County (Entire County HPSA) Facility: Siskiyou Community Health Klamath County Service Area: Southcentral Oregon Facility: Klamath Health Partnership Facility: Klamath Tribal Health Center Lake County Service Area: Southcentral Oregon Lane County Service Area: Oakridge Service Area: West Lane County Facility: Community Health Centers of Lane County Facility: Peacehealth Medical Group-Dexter Facility: White Bird Clinic Lincoln County (Entire County HPSA) Facility: Coastal Health Practitioners Facility: Lincoln City Medical Center Facility: Lincoln County Health and Human Services Facility: Siletz Community Health Clinic Linn County Population Group: Linn/Benton County Low Income_Migrant Farmworker Malheur County Service Area: Southeastern Oregon Marion County Population Group: Low Income/Migrant Farmworker/Homeless - Marion/Po Facility: Chemawa Indian Health Center Facility: Northwest Human Services Morrow County Service Area: East Columbia Facility: Columbia River Community Health Services Facility: Pioneer Memorial Clinic Multnomah County Facility: Central City Concern Facility: Multnomah County Health Department Facility: Native American Rehabilitation Association Facility: Neighborhood Health Center Facility: Ohsu-Richmond Clinic Facility: Oregon Health and Science University Richmond Community Health Center Facility: Outside In Facility: Portland Area Office

Page 150 of 208 Pages MENTAL HEALTH: Oregon County and County Equivalent Listing

Multnomah County Facility: The Wallace Medical Concern Polk County Population Group: Low Income/Migrant Farmworker/Homeless - Marion/Po Facility: Grand Ronde Health Center Sherman County Service Area: Mid Columbia Catchment Area Tillamook County (Entire County HPSA) Facility: The Rinehart Clinic Facility: Tillamook County Health Umatilla County Service Area: East Columbia Facility: Confederated Umatilla Tribes Yellowhawk Clinic Union County Service Area: Northeastern Oregon Service Area Wallowa County Service Area: Northeastern Oregon Service Area Wasco County Service Area: Mid Columbia Catchment Area Washington County Facility: Virginia Garcia Memorial Health Center Wheeler County Service Area: East Columbia Facility: Asher Clinic Yamhill County Facility: Federal Correctional Institution - Sheridan

Page 151 of 208 Pages MENTAL HEALTH: Pennsylvania County and County Equivalent Listing

Allegheny County Facility: East Liberty Family Health Care Center Facility: For Sto Rox Facility: Metro Family Practice, Inc. Facility: North Side Christian Health Center Facility: Primary Care Health Services Facility: Squirrel Hill Health Center Facility: University of Pittsburgh - Matilda Theiss Health C Armstrong County (Entire County HPSA) Facility: Armstrong Primary Care Center-Leechburg Facility: Armstrong Primary Care Center-Rural Valley Beaver County (Entire County HPSA) Facility: Urban Health Initiatives Inc. Bedford County Facility: Hyndman Area Health Center, Inc. Berks County Facility: Berks Community Health Center Blair County (Entire County HPSA) Bradford County Population Group: Low Income Bradford/Sullivan Mental Health Catchme Cambria County (Entire County HPSA) Facility: Glendale Area Medical Center Facility: Portage Health Center Facility: State Correctional Institution - Cresson Cameron County Service Area: Elk/Cameron Mental Health Catchment Area Facility: Keystone Ruralhealth Consortia, Inc. Carbon County Facility: St. Luke's Miners Health Center Chester County Facility: La Communidad Hispana Inc. Clarion County (Entire County HPSA) Clearfield County (Entire County HPSA) Facility: State Correctional Institution - Houtzdale Clinton County Service Area: Clinton-Lycoming Mental Health Health Professional Shortage Area Crawford County (Entire County HPSA) Facility: Cambridge Springs Health Center Facility: Conneaut Lake Health Center Facility: Conneaut Valley Health Center Facility: John E. Balmer Do, Spartansburg Medical Center Facility: John E. Balmer Do/Canadohta Health Clinic

Page 152 of 208 Pages MENTAL HEALTH: Pennsylvania County and County Equivalent Listing

Crawford County (Entire County HPSA) Facility: Meadville Community Health Center Cumberland County Facility: Sadler Health Care Corporation Facility: State Correctional Institution Camp Hill Dauphin County Facility: Hamilton Health Center Delaware County Facility: Chespenn Health Services Facility: State Correctional Institution Chester Elk County Service Area: Elk/Cameron Mental Health Catchment Area Erie County Facility: Community Health Net Facility: State Correctional Institution Albion Fayette County (Entire County HPSA) Facility: Community Medical Services Facility: State Correctional Institution Fayette Forest County Service Area: Forest/Warren Facility: State Correctional Institution - Forest Franklin County Facility: Keystone Rural Health Center Fulton County (Entire County HPSA) Greene County Facility: Cornerstone Care, Inc. Facility: State Correctional Institution Greene Huntingdon County Service Area: Huntingdon/Mifflin/Junita Mental Health Catchment Facility: Broadtop Area Medical Center Facility: Mount Union Area Medical Center Facility: Southern Huntingdon County Medical Center Facility: State Correctional Institution - Huntingdon Menta Indiana County (Entire County HPSA) Jefferson County (Entire County HPSA) Facility: Allegheny Health Center Facility: Phillips States MD Family Practice Juniata County Service Area: Huntingdon/Mifflin/Junita Mental Health Catchment Lackawanna County Facility: Scranton Primary Health Care Center

Page 153 of 208 Pages MENTAL HEALTH: Pennsylvania County and County Equivalent Listing

Lancaster County Facility: Southeast Lancaster Health Services Facility: Welsh Mountain Medical and Dental Center Lehigh County Facility: Neighborhood Health Centers (Nhclv) of Lehigh Vall Luzerne County Facility: Rural Health Corporation of Northeast Pennsylvania Facility: State Correctional Institution Dallas Facility: State Correctional Institution Retreat Lycoming County Service Area: Clinton-Lycoming Mental Health Health Professional Shortage Area Facility: State Correctional Institution - Muncy Facility: Susquehanna Community Health and Dental Clinic McKean County (Entire County HPSA) Facility: Federal Correctional Institution - McKean Mercer County Facility: Mercer Family Medicine Center Facility: Primary Health Network, Inc. Facility: Sharon Community Health Center Mifflin County Service Area: Huntingdon/Mifflin/Junita Mental Health Catchment Montgomery County Facility: Community Health and Dental Care Northumberland County Facility: Miller Family Health Center Facility: State Correctional Institution - Coal Township Philadelphia County Facility: Covenant House Health Services Facility: Delaware Valley Community Health, Inc. Facility: Department of Public Health-City of Philadelphia Facility: Esperanza Health Center Facility: Federal Detention Center - Philadelphia Facility: Greater Philadelphia Health Action Facility: Philadelphia Health Management Corporation Facility: Quality Community Health Facility: Resources for Human Development Facility: Sayre Health Center Facility: Spectrum Health Services, Inc. Pike County Service Area: Central Pike County Facility: Pinnacle Health Partners-Tafton Potter County (Entire County HPSA)

Page 154 of 208 Pages MENTAL HEALTH: Pennsylvania County and County Equivalent Listing

Schuylkill County Facility: Federal Correctional Institution - Schuylkill Facility: State Correctional Institution - Frackville Facility: State Correctional Institution - Mahanoy Somerset County Facility: Highlands Family Medicine Facility: State Correctional Institution Somerset Sullivan County Population Group: Low Income Bradford/Sullivan Mental Health Catchme Susquehanna County (Entire County HPSA) Facility: Barnes-Kasson Health Center, Inc. Tioga County (Entire County HPSA) Facility: North Pennsylvania Comprehensive Union County Facility: Federal Correctional Complex - Allenwood Facility: USP Lewisburg Venango County (Entire County HPSA) Warren County Service Area: Forest/Warren Washington County Facility: Centerville Clinics Facility: Wpso/McDonald Family Medicine Wayne County (Entire County HPSA) Facility: Highland Physicians, Ltd. Facility: USP Canaan Facility: Wayne Memorial Community Health Center Westmoreland County Facility: Community Health Clinic Facility: Mon Valley Community Health Services, Inc. York County Service Area: York City Mental Health Facility: Family First Health

Page 155 of 208 Pages MENTAL HEALTH: Rhode Island County and County Equivalent Listing

Newport County Facility: East Bay Community Action Program Providence County Population Group: Low Income City of Woonsocket Facility: Blackstone Valley Community Facility: Chad Brown Health Center Facility: Comprehensive Community Action, Inc. Facility: Northwest Community Health Center Facility: Providence Community Health Center Facility: Thundermist Healthcare Facility: Tri-Town Community Action Program Washington County Facility: Bayside Family Healthcare, Inc. Facility: Narragansett Indian Tribe Health Pgm Facility: Wood River Health Services

Page 156 of 208 Pages MENTAL HEALTH: South Carolina County and County Equivalent Listing

Abbeville County Service Area: Beckman Service Area Aiken County Population Group: Low Income - Aiken/Barnwell Counties Facility: Margaret J. Weston Health Center Allendale County Population Group: Low Income - Coastal Empire Service Area Facility: Low Country Health Anderson County Population Group: Low Income - Anderson/Oconee/Pickens Service Area Facility: Patrick B. Harris Psychiatric Hospital Bamberg County Population Group: Low Income - Orangeburg Service Area Barnwell County Population Group: Low Income - Aiken/Barnwell Counties Beaufort County Population Group: Low Income - Coastal Empire Service Area Calhoun County Population Group: Low Income - Orangeburg Service Area Charleston County Facility: Franklin C. Fetter Family Health Center Facility: St. James-Santee Family Health Center Cherokee County Population Group: Low Income - Spartanburg Service Area Chester County Population Group: Low Income - Catawba Service Area Chesterfield County Service Area: Tri - County Service Area Facility: Sandhills Medical Foundation Clarendon County Service Area: Santee-Wateree Service Area Colleton County Population Group: Low Income - Coastal Empire Service Area Darlington County Population Group: Low Income - Pee Dee Service Area Facility: Caresouth Dillon County Service Area: Tri - County Service Area Edgefield County Service Area: Beckman Service Area Facility: Federal Correctional Institution - Edgefield Fairfield County (Entire County HPSA)

Page 157 of 208 Pages MENTAL HEALTH: South Carolina County and County Equivalent Listing

Florence County Population Group: Low Income - Pee Dee Service Area Facility: Hopehealth, Inc. Georgetown County Service Area: Georgetown-Williamsburg Greenville County Facility: New Horizon Family Health Greenwood County Service Area: Beckman Service Area Facility: Carolina Health Centers, Inc. Hampton County Population Group: Low Income - Coastal Empire Service Area Facility: Dba Harrison Peeples Health Care Center, Inc. Facility: Federal Correctional Institution - Estill Horry County Population Group: Low Income - Horry County Facility: Healthcare Partners Facility: Little River Medical Center Jasper County Population Group: Low Income - Coastal Empire Service Area Facility: Beaufort Jasper Comprehensive Kershaw County Service Area: Santee-Wateree Service Area Lancaster County Population Group: Low Income - Catawba Service Area Facility: Carenet of Lancaster Laurens County Service Area: Beckman Service Area Lee County Service Area: Santee-Wateree Service Area Lexington County Service Area: Batesburg-Leesville Population Group: Low Income - Pelion/Swansea Marion County Population Group: Low Income - Pee Dee Service Area Facility: Fowler Rural Medical Marlboro County Service Area: Tri - County Service Area Facility: Federal Correctional Institution - Bennettsville McCormick County Service Area: Beckman Service Area

Page 158 of 208 Pages MENTAL HEALTH: South Carolina County and County Equivalent Listing

Newberry County Service Area: Beckman Service Area Oconee County Population Group: Low Income - Anderson/Oconee/Pickens Service Area Orangeburg County Population Group: Low Income - Orangeburg Service Area Facility: Family Health Centers Pickens County Population Group: Low Income - Anderson/Oconee/Pickens Service Area Facility: Foothills Community Health Care Richland County Facility: Eau Claire Cooperative Facility: Genesis Health Care, Inc. Facility: South Carolina Migrant Health Program Saluda County Service Area: Beckman Service Area Spartanburg County Population Group: Low Income - Spartanburg Service Area Facility: Regenesis Community Health Center Sumter County Service Area: Santee-Wateree Service Area Facility: Sumter Family Health Center Union County Population Group: Low Income - Spartanburg Service Area Williamsburg County Service Area: Georgetown-Williamsburg Facility: Federal Correctional Institution - Williamsburg York County Population Group: Low Income - Catawba Service Area Facility: Catawba Indian Nation Facility: Community Medicine Foundation

Page 159 of 208 Pages MENTAL HEALTH: South Dakota County and County Equivalent Listing

Aurora County Service Area: Catchment Area 4 Beadle County Service Area: Catchment Area 3 Bennett County Service Area: Catchment Area 11 Bon Homme County Service Area: Catchment Area 12 Facility: Mike Durfee State Prison - Springfield Brookings County Service Area: Catchment Area 1 Brown County Service Area: Catchment Area 7 Brule County Service Area: Catchment Area 4 Buffalo County Service Area: Catchment Area 2 Facility: Crow Creek Sioux Tribe Facility: Fort Thompson PHS Indian Hospital Butte County (Entire County HPSA) Campbell County Service Area: Catchment Area 7 Charles Mix County Service Area: Catchment Area 12 Facility: Wagner PHS Indian Hospital Facility: Yankton Sioux Tribe Clark County Service Area: Catchment Area 5 Clay County Service Area: Catchment Area 12 Codington County Service Area: Catchment Area 5 Corson County Service Area: Catchment Area 8 Facility: McLaughlin Health Center Facility: McLaughlin PHS Indian Hospital Custer County (Entire County HPSA) Davison County Service Area: Catchment Area 4 Day County Service Area: Catchment Area 7

Page 160 of 208 Pages MENTAL HEALTH: South Dakota County and County Equivalent Listing

Deuel County Service Area: Catchment Area 5 Dewey County Service Area: Catchment Area 8 Facility: Eagle Butte PHS Indian Hospital Facility: Isabel Community Clinic Facility: West Dakota Health Center Douglas County Service Area: Catchment Area 12 Edmunds County Service Area: Catchment Area 7 Fall River County (Entire County HPSA) Faulk County Service Area: Catchment Area 7 Grant County Service Area: Catchment Area 5 Gregory County Service Area: Catchment Area 10 Haakon County Service Area: Catchment Area 2 Facility: Philip Clinic Hamlin County Service Area: Catchment Area 5 Hand County Service Area: Catchment Area 3 Hanson County Service Area: Catchment Area 4 Harding County (Entire County HPSA) Hughes County Service Area: Catchment Area 2 Facility: Rural Health Care Hutchinson County Service Area: Catchment Area 12 Hyde County Service Area: Catchment Area 2 Jackson County Service Area: Catchment Area 11 Facility: Wanblee PHS Indian Health Center Jerauld County Service Area: Catchment Area 3 Jones County Service Area: Catchment Area 2

Page 161 of 208 Pages MENTAL HEALTH: South Dakota County and County Equivalent Listing

Kingsbury County Service Area: Catchment Area 5 Lake County Service Area: Catchment Area 3 Lawrence County Service Area: Lawrence and Meade Counties Lyman County Service Area: Catchment Area 2 Facility: Lower Brule Sioux Tribe Marshall County Service Area: Catchment Area 7 McPherson County Service Area: Catchment Area 7 Meade County Service Area: Lawrence and Meade Counties Mellette County Service Area: Catchment Area 10 Miner County Service Area: Catchment Area 3 Facility: Horizon Health Care Minnehaha County Facility: City of Sioux Falls Health Facility: SD State Penitentiary - Minnehaha Facility: South Dakota Urban Indian Health, Inc. Moody County Service Area: Catchment Area 1 Facility: Flandreau Santee Sioux Tribe Pennington County Facility: Community Health Center of Black Hill Facility: Rapid City PHS Indian Health Hospital Perkins County Service Area: Catchment Area 8 Potter County Service Area: Catchment Area 7 Roberts County Service Area: Catchment Area 5 Facility: Sisseton PHS Indian Hospital Facility: Sisseton-Wahpeton Oyate Tribe Sanborn County Service Area: Catchment Area 4 Shannon County Service Area: Catchment Area 11

Page 162 of 208 Pages MENTAL HEALTH: South Dakota County and County Equivalent Listing

Shannon County Facility: Kyle PHS Health Center Facility: Oglala Sioux Tribe Facility: Pine Ridge PHS Indian Hospital Spink County Service Area: Catchment Area 7 Facility: South Dakota Development Center Stanley County Service Area: Catchment Area 2 Sully County Service Area: Catchment Area 2 Todd County Service Area: Catchment Area 10 Facility: Rosebud PHS Indian Hospital Facility: Rosebud Sioux Tribe Tripp County Service Area: Catchment Area 10 Turner County Facility: Parker Medical Clinic Union County Service Area: Catchment Area 12 Facility: Union County Health Walworth County Service Area: Catchment Area 7 Facility: Youth Regional Treatment Center Yankton County Service Area: Catchment Area 12 Facility: South Dakota Human Services Center Ziebach County Service Area: Catchment Area 8 Facility: Cheyenne River Sioux Tribe

Page 163 of 208 Pages MENTAL HEALTH: Tennessee County and County Equivalent Listing

Anderson County Population Group: Low Income - Mental Health Catchment Area #6 Bedford County Service Area: Mental Health Catchment Area 19 Facility: Bedford Urgent Care Facility: Lynette M. Adams, MD Facility: Unionville Family Practice Benton County Service Area: Mental Health Catchment Area 21 Bledsoe County Population Group: Low Income-Mental Health Catchment Area 12 Blount County Population Group: Low Income - Mental Health Catchment Area #8 Bradley County Population Group: Low Income-Mental Health Catchment Area 10 Campbell County Population Group: Low Income - Mental Health Catchment Area #6 Facility: Community Health of East Tennessee Facility: Dayspring Family Health Cannon County Service Area: Mental Health Catchment Area 9 Carroll County Service Area: Mental Health Catchment Area 21 Carter County Service Area: Mental Health Catchment Area # 1. Cheatham County Service Area: Mental Health Catchment Area 14 Chester County Service Area: Mental Health Catchment Area 24 Claiborne County Service Area: Mental Health Catchment Area 5 Clay County Service Area: Mental Health Catchment Area 9 Cocke County Service Area: Mental Health Catchment Area 5 Facility: Rural Medical Services Coffee County Service Area: Mental Health Catchment Area 19 Crockett County Service Area: Mental Health Catchment Area 22 Cumberland County Service Area: Mental Health Catchment Area 9

Page 164 of 208 Pages MENTAL HEALTH: Tennessee County and County Equivalent Listing

Davidson County Facility: Dba Vine Hill/University Community Health Services Facility: Matthew Walker Comprehensive Facility: Tennessee Department of Health - Stewart County Facility: United Neighborhood Health Decatur County Service Area: Mental Health Catchment Area 24 Facility: Jennings Family Medical Clinic DeKalb County Service Area: Mental Health Catchment Area 9 Dickson County Service Area: Mental Health Catchment Area 14 Dyer County Service Area: Mental Health Catchment Area 22 Facility: Dyersburg Family Walk-in Clinic Fayette County Population Group: Low Income - Mental Health Catchment Area 25 Fentress County Service Area: Mental Health Catchment Area 9 Franklin County Service Area: Mental Health Catchment Area 19 Gibson County Service Area: Mental Health Catchment Area 21 Giles County Service Area: Mental Health Catchment Area 20 Grainger County Service Area: Mental Health Catchment Area 5 Greene County Service Area: Mental Health Catchment Area 4 Grundy County Population Group: Low Income-Mental Health Catchment Area 12 Hamblen County Service Area: Mental Health Catchment Area 5 Facility: Cherokee Health Systems Hamilton County Population Group: Low Income-Hamilton County Facility: Chattanooga/Hamilton County Health Department Facility: Erlanger Health Systems Hancock County Service Area: Mental Health Catchment Area 4 Hardeman County Service Area: Mental Health Catchment Area 24

Page 165 of 208 Pages MENTAL HEALTH: Tennessee County and County Equivalent Listing

Hardeman County Facility: Hardeman County Community Health Center Hardin County Service Area: Mental Health Catchment Area 24 Facility: Hardin County Regional Health Center Hawkins County Service Area: Mental Health Catchment Area 4 Facility: Rural Health Services Consortium Haywood County Service Area: Mental Health Catchment Area 23 Henderson County Service Area: Mental Health Catchment Area 23 Henry County Service Area: Mental Health Catchment Area 21 Hickman County Service Area: Mental Health Catchment Area 20 Houston County Service Area: Mental Health Catchment Area 14 Humphreys County Service Area: Mental Health Catchment Area 14 Jackson County Service Area: Mental Health Catchment Area 9 Jefferson County Service Area: Mental Health Catchment Area 5 Johnson County Service Area: Mental Health Catchment Area # 1. Knox County Population Group: Low Income - Knox County Lake County Service Area: Mental Health Catchment Area 22 Facility: Citizens of Lake County for Health Lauderdale County Population Group: Low Income - Mental Health Catchment Area 25 Facility: Christian Family Medicine, Inc. Facility: Rural Health Clinics of West Tennessee-West M Facility: Rural Health Clinics of West TN-Anthony Site Lawrence County Service Area: Mental Health Catchment Area 20 Lewis County Service Area: Mental Health Catchment Area 20 Lincoln County Service Area: Mental Health Catchment Area 19

Page 166 of 208 Pages MENTAL HEALTH: Tennessee County and County Equivalent Listing

Loudon County Population Group: Low Income - Mental Health Catchment Area #8 Macon County Service Area: Mental Health Catchment Area 9 Facility: Hope Family Health Services Madison County Service Area: Mental Health Catchment Area 23 Marion County Population Group: Low Income-Mental Health Catchment Area 12 Marshall County Service Area: Mental Health Catchment Area 20 Maury County Service Area: Mental Health Catchment Area 20 McMinn County Population Group: Low Income-Mental Health Catchment Area 10 McNairy County Service Area: Mental Health Catchment Area 24 Meigs County Population Group: Low Income-Mental Health Catchment Area 10 Monroe County Population Group: Low Income - Mental Health Catchment Area #8 Facility: Chota Community Health Services Facility: Women's Wellness and Maternity Center Montgomery County Service Area: Mental Health Catchment Area 14 Moore County Service Area: Mental Health Catchment Area 19 Morgan County Population Group: Low Income - Mental Health Catchment Area #6 Facility: Morgan County Health Obion County Service Area: Mental Health Catchment Area 22 Overton County Service Area: Mental Health Catchment Area 9 Perry County Service Area: Mental Health Catchment Area 20 Facility: Perry County Medical Pickett County Service Area: Mental Health Catchment Area 9 Polk County Population Group: Low Income-Mental Health Catchment Area 10 Facility: Ocoee Regional Health

Page 167 of 208 Pages MENTAL HEALTH: Tennessee County and County Equivalent Listing

Putnam County Service Area: Mental Health Catchment Area 9 Facility: Upper Cumberland Primary Care Project Rhea County Population Group: Low Income-Mental Health Catchment Area 12 Roane County Population Group: Low Income - Mental Health Catchment Area #6 Robertson County Service Area: Mental Health Catchment Area 14 Rutherford County Facility: Rutherford County Primary Care/Dbaprimary Care and H Scott County Population Group: Low Income - Mental Health Catchment Area #6 Facility: Mountain Peoples Health Sequatchie County Population Group: Low Income-Mental Health Catchment Area 12 Sevier County Population Group: Low Income - Mental Health Catchment Area #8 Shelby County Service Area: Northwest Memphis/Frayser Population Group: Low Income - Millington/Woodstock-Lucy Population Group: Low Income - Parkway Village/Fox Meadows Population Group: Low Income - South Memphis/Whitehaven-Levi Facility: Christ Community Health Services, Inc. Facility: Federal Correctional Institution - Memphis Facility: Memphis Health Center, Inc. Smith County Service Area: Mental Health Catchment Area 9 Stewart County Service Area: Mental Health Catchment Area 14 Sullivan County Service Area: Mental Health Catchment Area # 1. Tipton County Population Group: Low Income - Mental Health Catchment Area 25 Unicoi County Service Area: Mental Health Catchment Area # 1. Union County Service Area: Mental Health Catchment Area 5 Van Buren County Service Area: Mental Health Catchment Area 9 Warren County Service Area: Mental Health Catchment Area 9

Page 168 of 208 Pages MENTAL HEALTH: Tennessee County and County Equivalent Listing

Warren County Facility: Pioneer Pediatrics Washington County Service Area: Mental Health Catchment Area # 1. Facility: East Tennessee State University Wayne County Service Area: Mental Health Catchment Area 20 Weakley County Service Area: Mental Health Catchment Area 22 White County Service Area: Mental Health Catchment Area 9 Williamson County Facility: Mercy Health Services Facility: Prohealth Rural Health Services, Inc.

Page 169 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Anderson County (Entire County HPSA) Andrews County (Entire County HPSA) Angelina County (Entire County HPSA) Aransas County (Entire County HPSA) Armstrong County (Entire County HPSA) Atascosa County (Entire County HPSA) Facility: Atascosa Healthcare Austin County (Entire County HPSA) Bailey County (Entire County HPSA) Bandera County (Entire County HPSA) Bastrop County (Entire County HPSA) Baylor County (Entire County HPSA) Bee County (Entire County HPSA) Facility: La Bahia Clinic Bexar County Service Area: San Antonio South East Service Area: San Antonio South West Facility: Barrio Comprehensive Health Center Facility: El Centro Del Barrio Blanco County (Entire County HPSA) Borden County (Entire County HPSA) Bosque County (Entire County HPSA) Bowie County (Entire County HPSA) Brazoria County Facility: Stephen F. Austin Community Health Center, Brazos County (Entire County HPSA) Facility: Brazos Valley Community Action Brewster County (Entire County HPSA) Briscoe County (Entire County HPSA) Brooks County (Entire County HPSA) Brown County (Entire County HPSA) Burleson County (Entire County HPSA) Burnet County (Entire County HPSA) Facility: Seton Highland Lakes Clinic Marbles Fall Facility: Seton Highland Lakes Dba Marble Falls Health Center Caldwell County (Entire County HPSA) Facility: Children's Care-a-Van Callahan County (Entire County HPSA) Cameron County (Entire County HPSA) Facility: Brownsville Community Health Center Facility: Immigration and Customs Enforcement - Port Isabel Facility: Su Clinica Familia

Page 170 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Camp County (Entire County HPSA) Carson County (Entire County HPSA) Cass County (Entire County HPSA) Castro County (Entire County HPSA) Chambers County (Entire County HPSA) Facility: Chambers County Public Hospital District Cherokee County (Entire County HPSA) Childress County (Entire County HPSA) Cochran County (Entire County HPSA) Coke County (Entire County HPSA) Coleman County (Entire County HPSA) Collingsworth County (Entire County HPSA) Colorado County (Entire County HPSA) Facility: Rice Medical Associates Comanche County (Entire County HPSA) Facility: Cross Timbers Healthcare Concho County (Entire County HPSA) Facility: Frontera Healthcare Network Cooke County (Entire County HPSA) Facility: Gainesville State School Cottle County (Entire County HPSA) Crane County (Entire County HPSA) Crockett County (Entire County HPSA) Crosby County (Entire County HPSA) Culberson County (Entire County HPSA) Dallam County (Entire County HPSA) Dallas County Service Area: South Dallas Service Area: West Dallas Facility: Dallas County Hosptial District Facility: Los Barrios Unidos Community Health Center Facility: Mission East Dallas (Medical) and Metroplex Project Facility: MLK Jr. Family Center Facility: Urban Inter-Tribal Center of Texas Dawson County (Entire County HPSA) Deaf Smith County (Entire County HPSA) Denton County Facility: Health Services of North Texas, Inc. DeWitt County (Entire County HPSA) Dickens County (Entire County HPSA) Dimmit County (Entire County HPSA) Facility: Women's Clinic of Dimmit and Zavala

Page 171 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Donley County (Entire County HPSA) Duval County (Entire County HPSA) Eastland County (Entire County HPSA) Ector County Facility: Ector County Hospital District Edwards County (Entire County HPSA) El Paso County (Entire County HPSA) Facility: Centro De Salud Familia Facility: Centro San Vicente Health Center Facility: Immigration and Customs Enforcement - El Paso Facility: Project Vida Health Center Ellis County Facility: Ellis County Coalition for Health Option Erath County (Entire County HPSA) Falls County (Entire County HPSA) Fannin County (Entire County HPSA) Fayette County (Entire County HPSA) Facility: Tejas Health Care (Thc) Fisher County (Entire County HPSA) Floyd County (Entire County HPSA) Foard County (Entire County HPSA) Fort Bend County Facility: The Access Health Richmond Center Freestone County (Entire County HPSA) Frio County (Entire County HPSA) Facility: Immigration and Customs Enforcement - South Texas/ Gaines County (Entire County HPSA) Galveston County Service Area: Galveston MHMR Facility: Coastal Health and Wellness Garza County (Entire County HPSA) Gillespie County (Entire County HPSA) Glasscock County (Entire County HPSA) Gonzales County (Entire County HPSA) Facility: Community Health Centers of South Central Texas Gray County (Entire County HPSA) Gregg County Facility: Longview Wellness Center Facility: Special Health Resources of Texas Grimes County (Entire County HPSA) Hale County (Entire County HPSA) Facility: Regency Health Network

Page 172 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Hall County (Entire County HPSA) Hamilton County (Entire County HPSA) Hansford County (Entire County HPSA) Hardeman County (Entire County HPSA) Harris County Service Area: Acres Home Service Area: Aldine Service Area: East Central Service Area: Ripley Service Area Service Area: Third Ward Service Area Facility: Asian Am. Health Coalition of Gtr Houston/Dba Hope C Facility: El Centro De Corazon Facility: Federal Detention Center - Houston Facility: Fourth Ward Clinic Dba Good Neighbor Hcc Facility: Harris County Hospital District Facility: Houston Area Community Services, Inc. Facility: Houston Community Health Center Facility: Houston Health Care for the Homeless Facility: Immigration and Customs Enforcement - Houston Facility: Legacy Community Health Systems, Inc. Facility: Pasadena Health Centers Facility: South Central Houston Action Council, Inc. Facility: Spring Branch Community Health Center Harrison County Facility: East Texas Border Health Clinics Hartley County (Entire County HPSA) Facility: Dalhart Family Medicine Clinic Haskell County (Entire County HPSA) Hemphill County (Entire County HPSA) Henderson County (Entire County HPSA) Hidalgo County (Entire County HPSA) Facility: Nuestra Clinica Del Valle Hill County (Entire County HPSA) Hockley County (Entire County HPSA) Facility: South Plains Rural Health Hood County (Entire County HPSA) Houston County (Entire County HPSA) Howard County (Entire County HPSA) Hudspeth County (Entire County HPSA) Hunt County Facility: Community Health Services Agency Hutchinson County (Entire County HPSA)

Page 173 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Jack County (Entire County HPSA) Jasper County (Entire County HPSA) Facility: Christus Jasper Family Practice Clinic Jeff Davis County (Entire County HPSA) Jefferson County Facility: Federal Correctional Complex - Beaumont Facility: Gulf Coast Health Center Jim Hogg County (Entire County HPSA) Jim Wells County (Entire County HPSA) Facility: Community Action Corporation of South Texas Jones County (Entire County HPSA) Facility: Anson Family Wellness Clinic Facility: Kapu Medical Clinic Karnes County (Entire County HPSA) Kaufman County (Entire County HPSA) Kenedy County (Entire County HPSA) Kent County (Entire County HPSA) Kerr County (Entire County HPSA) Kimble County (Entire County HPSA) King County (Entire County HPSA) Kinney County (Entire County HPSA) Kleberg County (Entire County HPSA) Knox County (Entire County HPSA) Facility: Munday Family Clinic La Salle County (Entire County HPSA) Facility: South Texas Rural Health Services Lamb County (Entire County HPSA) Lampasas County (Entire County HPSA) Lee County (Entire County HPSA) Facility: Giddings State School Leon County (Entire County HPSA) Liberty County Facility: Health Center of Southeast Texas Limestone County (Entire County HPSA) Facility: Family Medicine Center Facility: Parkview Rural Health Clinic Lipscomb County (Entire County HPSA) Live Oak County (Entire County HPSA) Facility: Federal Correctional Institution - Three Rivers Llano County (Entire County HPSA) Loving County (Entire County HPSA)

Page 174 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Lubbock County Facility: Community Health Center of Lubbock Facility: Dba Larry Combest Community Health and Wellness Lynn County (Entire County HPSA) Madison County (Entire County HPSA) Marion County (Entire County HPSA) Martin County (Entire County HPSA) Mason County (Entire County HPSA) Matagorda County (Entire County HPSA) Facility: Matagorda Episcopal Health Outreach Prog Maverick County (Entire County HPSA) Facility: United Medical Centers McCulloch County (Entire County HPSA) McLennan County Facility: Heart of Texas Community Health Facility: McLennan County State Juvenile Correctional Facili McMullen County (Entire County HPSA) Medina County (Entire County HPSA) Menard County (Entire County HPSA) Midland County Population Group: Low Income - Midland Facility: Midland Community Healthcare Services, Inc. Milam County (Entire County HPSA) Mills County (Entire County HPSA) Mitchell County (Entire County HPSA) Montague County (Entire County HPSA) Montgomery County (Entire County HPSA) Facility: Lone Star Community Health Center Moore County (Entire County HPSA) Motley County (Entire County HPSA) Nacogdoches County (Entire County HPSA) Facility: East Texas Community Health Services Navarro County (Entire County HPSA) Newton County (Entire County HPSA) Nolan County (Entire County HPSA) Facility: Rolling Plains Rural Health Clinic, LLC Nueces County Population Group: Low Income - Nueces County Facility: Amistad Community Health Center Ochiltree County (Entire County HPSA) Oldham County (Entire County HPSA) Palo Pinto County (Entire County HPSA)

Page 175 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Panola County (Entire County HPSA) Parmer County (Entire County HPSA) Pecos County (Entire County HPSA) Polk County (Entire County HPSA) Presidio County (Entire County HPSA) Facility: Presidio County Health Clinic Rains County (Entire County HPSA) Reagan County (Entire County HPSA) Real County (Entire County HPSA) Red River County (Entire County HPSA) Reeves County (Entire County HPSA) Roberts County (Entire County HPSA) Robertson County (Entire County HPSA) Runnels County (Entire County HPSA) Facility: Ballinger Hospital Clinic Rusk County (Entire County HPSA) Facility: Mt. Enterprise Community Health Center Sabine County (Entire County HPSA) San Augustine County (Entire County HPSA) San Jacinto County (Entire County HPSA) San Patricio County (Entire County HPSA) San Saba County (Entire County HPSA) Schleicher County (Entire County HPSA) Scurry County (Entire County HPSA) Shackelford County (Entire County HPSA) Facility: Shackelford County Community Resource Center Shelby County (Entire County HPSA) Facility: The Hope Project Inc. Sherman County (Entire County HPSA) Smith County Facility: Community Health Clinics of Northeast TX Somervell County (Entire County HPSA) Starr County (Entire County HPSA) Facility: Family Health Center, LLP Facility: Family Medical and Specialty Clinic Stephens County (Entire County HPSA) Stonewall County (Entire County HPSA) Sutton County (Entire County HPSA) Swisher County (Entire County HPSA) Tarrant County Facility: Federal Medical Center - Carswell Facility: North Texas Area Community Health Center, Inc.

Page 176 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Taylor County (Entire County HPSA) Terrell County (Entire County HPSA) Facility: Cactus Health Services, Inc. Terry County (Entire County HPSA) Throckmorton County (Entire County HPSA) Facility: Throckmorton County Rural Health Care Clinic Tom Green County Facility: La Esperanza Clinic, Inc. Travis County Facility: People's Community Clinic Facility: Travis County Healthcare District Trinity County (Entire County HPSA) Tyler County (Entire County HPSA) Upton County (Entire County HPSA) Uvalde County (Entire County HPSA) Facility: Community Health Development, Inc. Val Verde County (Entire County HPSA) Van Zandt County (Entire County HPSA) Victoria County (Entire County HPSA) Waller County (Entire County HPSA) Ward County (Entire County HPSA) Washington County (Entire County HPSA) Webb County (Entire County HPSA) Facility: Gateway Community Health Center Wharton County Facility: Mid Coast Medical Clinic Wheeler County (Entire County HPSA) Wichita County Facility: Northcentral Texas Community Health Center Wilbarger County (Entire County HPSA) Willacy County (Entire County HPSA) Facility: Immigration and Customs Enforcement - Willacy Williamson County Facility: Immigration and Customs Enforcement - Taylor Facility: Lone Star Circle of Care Wilson County (Entire County HPSA) Winkler County (Entire County HPSA) Wise County (Entire County HPSA) Wood County (Entire County HPSA) Facility: Etmc First Physician Health Clinic Yoakum County (Entire County HPSA)

Page 177 of 208 Pages MENTAL HEALTH: Texas County and County Equivalent Listing

Young County (Entire County HPSA) Facility: Lovett-Meredith Rural Health Clinic Zapata County (Entire County HPSA) Zavala County (Entire County HPSA) Facility: Vida Y Salud Health System

Page 178 of 208 Pages MENTAL HEALTH: Utah County and County Equivalent Listing

Beaver County Service Area: Five County Mental Health Catchment Area (Southwes Box Elder County Service Area: Bear River Mental Health Catchment Area Cache County Service Area: Bear River Mental Health Catchment Area Carbon County Service Area: Four Corners Mental Health Catchment Area Facility: Carbon Medical Services Daggett County Service Area: Uintah Basin Duchesne County Service Area: Uintah Basin Emery County Service Area: Four Corners Mental Health Catchment Area Facility: Green River Medical Garfield County Service Area: Five County Mental Health Catchment Area (Southwes Grand County Service Area: Four Corners Mental Health Catchment Area Iron County Service Area: Five County Mental Health Catchment Area (Southwes Facility: Cedar City Paiute Medical Clinic Facility: Paiute Indian Tribe of UT Juab County Service Area: Six County Mental Health Catchment Area Kane County Service Area: Five County Mental Health Catchment Area (Southwes Millard County Service Area: Six County Mental Health Catchment Area Facility: Kanosh Paiute Medical Clinic Piute County Service Area: Six County Mental Health Catchment Area Rich County Service Area: Bear River Mental Health Catchment Area Facility: Bear Lake Community Health Center Inc. Salt Lake County Facility: Community Health Centers, Inc. Facility: Indian Walk-in Center Facility: Midvale Family Health Clinic Facility: Utah State Prison - Draper Facility: Wasatch Homeless

Page 179 of 208 Pages MENTAL HEALTH: Utah County and County Equivalent Listing

San Juan County (Entire County HPSA) Facility: Utah Navajo Health Sanpete County Service Area: Six County Mental Health Catchment Area Facility: Central Utah Correctional Facility Sevier County Service Area: Six County Mental Health Catchment Area Facility: Koosharem Paiute Medical Clinic Summit County (Entire County HPSA) Tooele County (Entire County HPSA) Facility: Goshute Tribe Uintah County Service Area: Uintah Basin Facility: Fort Duchesne PHS Indian Health Center Facility: Ute Indian Tribe Facility: Ute Indian Tribe-Alch/Service Area Utah County (Entire County HPSA) Facility: Mountainlands Community Health Center, Inc. Wasatch County (Entire County HPSA) Washington County Service Area: Five County Mental Health Catchment Area (Southwes Facility: Enterprise Valley Medical Facility: Shivwits Paiute Medical Clinic Facility: Southwest Utah Community Health Center Wayne County Service Area: Six County Mental Health Catchment Area Facility: Wayne Community Health Weber County Facility: Midtown Community Health Center

Page 180 of 208 Pages MENTAL HEALTH: Vermont County and County Equivalent Listing

Bennington County Facility: Michael Welther Dba Arlington Family Practice Caledonia County Facility: Nvrh Corner Medical Facility: Nvrh St. Johnsbury Pediatrics Chittenden County Facility: Community Health Center of Burlington Essex County Facility: Northern Counties Health Care Franklin County Facility: Richford Health Center, Inc. Lamoille County Facility: Copley Professional Services Group Facility: Ryder Brook Pediatrics Orange County Facility: Little Rivers Health Care Orleans County Facility: Community Medical Associates-186 Facility: Community Medical Associates-41 Facility: Family Practice of Newport Facility: Family Practice of Newport-186 Facility: Newport Pediatrics and Adolescent Medicine Facility: North Country OB/GYN Practice Facility: North Country OB/GYN Services Facility: The Barton Clinic Rutland County Facility: Rutland Region Community Health Centers, Inc. Washington County Facility: Northeast Washington County Community Health Cente Windham County Facility: Dba Mountain Valley Medical Clinic Facility: Otis Health Care Dba Grace Cottage Family Health Windsor County Facility: Springfield Medical Care Systems, Inc.

Page 181 of 208 Pages MENTAL HEALTH: Virginia County and County Equivalent Listing

Accomack County Service Area: Eastern Shore Service Area Alexandria City Facility: Alexandria Neighborhood Health Services Alleghany County Service Area: Alleghany Highlands Service Area Amelia County Service Area: Crossroads Service Area Amherst County Population Group: Low Income - Central Virginia Service Area Appomattox County Population Group: Low Income - Central Virginia Service Area Bath County Service Area: Rockbridge Service Area Bedford City Population Group: Low Income - Central Virginia Service Area Bedford County Population Group: Low Income - Central Virginia Service Area Bland County Service Area: Mount Rogers Service Area Facility: Bland County Medical Bristol City Service Area: Highlands Service Area Brunswick County Service Area: Southside Planning District Buchanan County Service Area: Cumberland Mountain Service Area Buckingham County Service Area: Crossroads Service Area Facility: Central Virginia Health Services Buena Vista City Service Area: Rockbridge Service Area Campbell County Population Group: Low Income - Central Virginia Service Area Caroline County Service Area: Rappahannock Service Area Carroll County Service Area: Mount Rogers Service Area Facility: Tri-Area/Laurel Fork Health Clinic Charlotte County Service Area: Crossroads Service Area

Page 182 of 208 Pages MENTAL HEALTH: Virginia County and County Equivalent Listing

Covington City Service Area: Alleghany Highlands Service Area Culpeper County Service Area: Rappahannock/Rapidan Service Area Cumberland County Service Area: Crossroads Service Area Danville City Population Group: Low Income - Danville/Pittsylvania Service Area Facility: Piedmont Access to Health Services (Path) Dickenson County Service Area: Cumberland Mountain Service Area Essex County Service Area: Middle Peninsula/Northern Neck Service Area Fauquier County Service Area: Rappahannock/Rapidan Service Area Floyd County Population Group: Low Income-New River Valley Service Area Franklin City Service Area: Western Tidewater Service Area Franklin County Population Group: Low Income - Piedmont Service Area Fredericksburg City Service Area: Rappahannock Service Area Galax City Service Area: Mount Rogers Service Area Giles County Population Group: Low Income-New River Valley Service Area Gloucester County Service Area: Middle Peninsula/Northern Neck Service Area Grayson County Service Area: Mount Rogers Service Area Halifax County Service Area: Southside Planning District Harrisonburg City Facility: Harrisonburg Community Health Center Henry County Population Group: Low Income - Piedmont Service Area Highland County Facility: Highland Medical Center Isle of Wight County Service Area: Western Tidewater Service Area

Page 183 of 208 Pages MENTAL HEALTH: Virginia County and County Equivalent Listing

James City County Facility: Olde Towne Medical Center King and Queen County Service Area: Middle Peninsula/Northern Neck Service Area King George County Service Area: Rappahannock Service Area King William County Service Area: Middle Peninsula/Northern Neck Service Area Lancaster County Service Area: Middle Peninsula/Northern Neck Service Area Lee County Service Area: Planning District I Mental Health Catchment Area Facility: Stone Mountain Health Services Facility: USP Lee Lexington City Service Area: Rockbridge Service Area Loudoun County Facility: Loudoun Community Health Center Louisa County (Entire County HPSA) Lunenburg County Service Area: Crossroads Service Area Facility: Southern Dominion Health Systems, Inc. Lynchburg City Population Group: Low Income - Central Virginia Service Area Facility: Johnson Health Center Madison County Service Area: Rappahannock/Rapidan Service Area Martinsville City Population Group: Low Income - Piedmont Service Area Facility: Martinsville Henry County Coalition Health and Human Services Mathews County Service Area: Middle Peninsula/Northern Neck Service Area Mecklenburg County Service Area: Southside Planning District Middlesex County Service Area: Middle Peninsula/Northern Neck Service Area Montgomery County Population Group: Low Income-New River Valley Service Area Nelson County (Entire County HPSA) Facility: Blue Ridge Medical Center Newport News City Facility: Peninsula Institute for Community Health

Page 184 of 208 Pages MENTAL HEALTH: Virginia County and County Equivalent Listing

Northampton County Service Area: Eastern Shore Service Area Facility: Eastern Shore Rural Health Northumberland County Service Area: Middle Peninsula/Northern Neck Service Area Norton City Service Area: Planning District I Mental Health Catchment Area Nottoway County Service Area: Crossroads Service Area Orange County Service Area: Rappahannock/Rapidan Service Area Page County Service Area: Shenandoah/Page Patrick County Population Group: Low Income - Piedmont Service Area Pittsylvania County Population Group: Low Income - Danville/Pittsylvania Service Area Portsmouth City Facility: Portsmouth Community Health Center Prince Edward County Service Area: Crossroads Service Area Prince George County Facility: Federal Correctional Complex Petersburg Prince William County Facility: Greater Prince William Community Health Ct Pulaski County Population Group: Low Income-New River Valley Service Area Radford City Population Group: Low Income-New River Valley Service Area Rappahannock County Service Area: Rappahannock/Rapidan Service Area Richmond City Facility: Daily Planet Facility: Vernon J. Harris East End Community Health Center Richmond County Service Area: Middle Peninsula/Northern Neck Service Area Roanoke City Facility: Kuumba Community Health Rockbridge County Service Area: Rockbridge Service Area Russell County Service Area: Cumberland Mountain Service Area

Page 185 of 208 Pages MENTAL HEALTH: Virginia County and County Equivalent Listing

Scott County Service Area: Planning District I Mental Health Catchment Area Facility: Clinch River Health Services Shenandoah County Service Area: Shenandoah/Page Smyth County Service Area: Mount Rogers Service Area Facility: Southwest Virginia Community Health Services Southampton County Service Area: Western Tidewater Service Area Facility: Horizon Health Services Spotsylvania County Service Area: Rappahannock Service Area Stafford County Service Area: Rappahannock Service Area Suffolk City Service Area: Western Tidewater Service Area Sussex County Facility: Stony Creek Community Health Center Tazewell County Service Area: Cumberland Mountain Service Area Washington County Service Area: Highlands Service Area Westmoreland County Service Area: Middle Peninsula/Northern Neck Service Area Wise County Service Area: Planning District I Mental Health Catchment Area Wythe County Service Area: Mount Rogers Service Area

Page 186 of 208 Pages MENTAL HEALTH: Washington County and County Equivalent Listing

Adams County (Entire County HPSA) Facility: Columbia Basin Health Association Asotin County (Entire County HPSA) Benton County Service Area: Tri-Cities Chelan County Service Area: Chelan/Douglas Facility: Columbia Valley Community Health Center Clallam County (Entire County HPSA) Facility: Clallam Bay Corrections Center Facility: Jamestown South'Klallam Tribe Facility: Lower Elwha Klallam Health Clinic Facility: Makah - Sophie Trettevick Indian Health Center Facility: Peninsula Children's Clinic, Inc. Facility: Quileute Clinic Clark County Population Group: Migrant Seasonal Farmworkers - Clark County Columbia County (Entire County HPSA) Cowlitz County Population Group: Low Income - Cowlitz/Wahkiakum Counties Facility: Cowlitz Family Health Facility: Cowlitz Tribe Douglas County Service Area: Chelan/Douglas Ferry County (Entire County HPSA) Facility: Colville Confederated Tribes Facility: Inchelium Health Clinic Franklin County Service Area: Tri-Cities Facility: Coyote Ridge Corrections Center Facility: La Clinica Community Health Center Garfield County (Entire County HPSA) Grant County (Entire County HPSA) Facility: Grant County Public Hospital (Gcphd)Dba Mattawa Communit Facility: Moses Lake Community Health Center Grays Harbor County (Entire County HPSA) Facility: Chehalis Tribal Clinic Facility: Roger Saux Health Center Facility: Stafford Creek Correctional Center Island County (Entire County HPSA) Jefferson County (Entire County HPSA)

Page 187 of 208 Pages MENTAL HEALTH: Washington County and County Equivalent Listing

King County Facility: Country Doctors Community Clinic Facility: Federal Detention Center - Seatac Facility: Healthpoint Facility: International Community Health Services Facility: Muckleshoot Tribal Clinic Facility: Neighborhood Health Facility: Sea Mar Community Health Center Facility: Seattle Indian Health Facility: Seattle/King County Department of Public Health Facility: Snoqualmie-North Bend Family Clnic Facility: Snoqualmie-Tolt Community Clnic Kitsap County (Entire County HPSA) Facility: Peninsula Community Health Facility: Port Gamble South'Klallam Tribal Clinic Facility: Suquamish Tribe Kittitas County (Entire County HPSA) Klickitat County (Entire County HPSA) Lewis County (Entire County HPSA) Facility: Valley View Health Center Lincoln County (Entire County HPSA) Mason County (Entire County HPSA) Facility: Skokomish Tribal Health Clinic Facility: Squaxin Island Health Center Facility: Washington Corrections Center Okanogan County (Entire County HPSA) Facility: Colville PHS Indian Health Center Facility: Family Health Centers Facility: Omak Clinic Pacific County (Entire County HPSA) Facility: Shoalwater Bay Health Clinic Pend Oreille County (Entire County HPSA) Facility: Kalispel Tribe Pierce County Facility: Community Health Care Delivery Facility: Immigration and Customs Enforcement - Tacoma Facility: Metropolitan Development Cooperative Facility: Puyallup Tribal Health Authority Facility: Washington Corrections Center for Women Facility: Western State Hospital San Juan County (Entire County HPSA)

Page 188 of 208 Pages MENTAL HEALTH: Washington County and County Equivalent Listing

Skagit County (Entire County HPSA) Facility: Sauk-Suiattle Health Clinic Facility: Swinomish Health Clinic Facility: Upper Skagit Tribal Clinic Skamania County (Entire County HPSA) Snohomish County Facility: Community Health Center of Snohomish Facility: Monroe Correctional Complex Facility: Stillaguamish Tribal Clinic Facility: Tulalip Clinic Spokane County Service Area: Deer Park Service Area Service Area: Southeast Spokane County Service Area: Southwest Spokane Population Group: Low Income/Homeless - City of Spokane Facility: Airway Heights Corrections Center Facility: Community Health Association of Spokane Facility: Healing Lodge of Seven Nations Facility: N.A.T.I.V.E. Project of Spokane Stevens County (Entire County HPSA) Facility: David C. Wynecoop Memorial Clinic Facility: N.E.W. Health Programs Facility: Spokane Tribe Thurston County (Entire County HPSA) Facility: Nisqually Health Clinic Wahkiakum County Population Group: Low Income - Cowlitz/Wahkiakum Counties Walla Walla County (Entire County HPSA) Facility: Adventist Health/Medical Group Facility: Washington State Penitentiary Whatcom County Population Group: Low Income/Migrant Farmworker - Whatcom Facility: Indian Tribal Consortium Facility: Interfaith Community Health Center Facility: Lummi Tribal Health Center Facility: Nooksack Tribal Health Center Whitman County (Entire County HPSA) Yakima County (Entire County HPSA) Facility: Central Washington Family Medicine Facility: Grandview Medical Center Facility: Lincoln Ave Fam Medical Facility: White Swan Clinic

Page 189 of 208 Pages MENTAL HEALTH: Washington County and County Equivalent Listing

Yakima County (Entire County HPSA) Facility: Yakima Indian Health Center Facility: Yakima Neighborhood Health Services Facility: Yakima Valley Farmworkers Clinic

Page 190 of 208 Pages MENTAL HEALTH: West Virginia County and County Equivalent Listing

Barbour County Service Area: Appalachian (VII) Barbour,Randolph,Tucker, Upshur Facility: Bellington Community Medical Services Facility: Myers Clinic Berkeley County Facility: East Ridge Health Systems - Martinsburg Facility: Shenandoah Valley Medical Center Boone County Facility: Boone County Hospital Medical Clinic Facility: Hygeia Facilities Foundation Facility: Prestera Center Boone County Office Cabell County Facility: Prestera Center 625 Facility: Prestera Center Cabell County Office Facility: Prestera Center Margarette R. Leach Center Facility: Valley Health Systems Calhoun County Service Area: Westbrook Health Services Catchment Area Facility: Minnie Hamilton Health Center Clay County Facility: Prestera Center Clay County Office Fayette County Service Area: Mental Health Catchment Area IV Fmrs Facility: New River Family Health Center Gilmer County Facility: Federal Correctional Institution - Gilmer Grant County Population Group: Low Income - Petersburg (VIII) Greenbrier County Service Area: Seneca (IV) Facility: Northern Greenbrier Health Clinic Facility: Rainelle Medical Center Facility: Rupert Primary Care Hampshire County Population Group: Low Income - Petersburg (VIII) Facility: Hampshire Memorial Hospital Hancock County Facility: Change Inc. , Dba Family Medical Care Hardy County Population Group: Low Income - Petersburg (VIII) Facility: E.A. Hawse Health Center

Page 191 of 208 Pages MENTAL HEALTH: West Virginia County and County Equivalent Listing

Jackson County Service Area: Westbrook Health Services Catchment Area Jefferson County Facility: East Ridge Health Systems - Kearneysville Kanawha County Facility: Cabin Creek Health Center Facility: Prestera Center Kanawha County Office Lewis County Facility: William R. Sharpe Hospital Lincoln County Facility: Lincoln County Primary Care Center Facility: Prestera Center Lincoln County Office Logan County Service Area: Logan/Mingo (II-1) Facility: Rural Health Access Corporation/Dba Coalfield Health Center Marion County Facility: Douglas D. Wolfe Do, Inc. Facility: Monongahela Valley Association of Health Centers Facility: North Marion Medical Associates Mason County Facility: Prestera Center Mason County Office McDowell County Service Area: Southern Highlands Catchment Area Facility: Bradshaw Medical Rural Health Clinic Facility: Federal Correctional Institution - McDowell Facility: Tug River Health Association Facility: Welch Emergency Hospital Rural Health Clinic Facility: Yukon Medical Clinic Mercer County Service Area: Southern Highlands Catchment Area Facility: Bluestone Health Center Facility: Jana Peters, Do Mineral County Population Group: Low Income - Petersburg (VIII) Mingo County Service Area: Logan/Mingo (II-1) Monongalia County Facility: Clay-Battelle Health Services Monroe County Service Area: Mental Health Catchment Area IV Fmrs Facility: Miller Family Practice Facility: Monroe County Health Center

Page 192 of 208 Pages MENTAL HEALTH: West Virginia County and County Equivalent Listing

Morgan County Facility: East Ridge Health Systems - Berkeley Springs Facility: Mountaineer Community Health Center, Inc. Nicholas County Service Area: Seneca (IV) Pendleton County Population Group: Low Income - Petersburg (VIII) Facility: Pendleton Community Center Pleasants County Service Area: Westbrook Health Services Catchment Area Pocahontas County Service Area: Seneca (IV) Facility: Pocahontas Memorial Hospital Medical Practice Preston County Facility: USP Hazelton Putnam County Facility: Family Care, Inc. Facility: Prestera Center Putnam County Office Raleigh County Service Area: Mental Health Catchment Area IV Fmrs Facility: Community Health Systems Facility: Federal Correctional Institution - Beckley Randolph County Service Area: Appalachian (VII) Barbour,Randolph,Tucker, Upshur Facility: Valley Health Care, Inc. Ritchie County Service Area: Westbrook Health Services Catchment Area Facility: Ritchie County Primary Care Association Inc. Roane County Service Area: Westbrook Health Services Catchment Area Facility: Roane County Family Health Center Facility: Roane General Medical Associates Facility: Roane General Medical Clinic Facility: Southern Roane Medical Clinic Summers County Service Area: Mental Health Catchment Area IV Fmrs Facility: Family Care Clinic Facility: S.K. Shammaa, MD Taylor County Facility: Pinewood Medical Center Facility: Preston-Taylor Community Health Center Facility: Tygart Valley Total Care Clinic

Page 193 of 208 Pages MENTAL HEALTH: West Virginia County and County Equivalent Listing

Tucker County Service Area: Appalachian (VII) Barbour,Randolph,Tucker, Upshur Facility: St. George Medical Clinic, Inc. Tyler County Service Area: Westbrook Health Services Catchment Area Upshur County Service Area: Appalachian (VII) Barbour,Randolph,Tucker, Upshur Facility: Community Care of West Virginia Wayne County Facility: Prestera Center Wayne County Office Webster County Service Area: Seneca (IV) Facility: Camden-on-Gauley Medical Center Facility: Webster County Memorial Wetzel County Facility: Pine Grove Health Center Wirt County Service Area: Westbrook Health Services Catchment Area Facility: Wirt County Health Services Association Wood County Service Area: Westbrook Health Services Catchment Area Wyoming County Service Area: Southern Highlands Catchment Area

Page 194 of 208 Pages MENTAL HEALTH: Wisconsin County and County Equivalent Listing

Adams County (Entire County HPSA) Facility: Federal Correctional Institution - Oxford Ashland County Facility: Bad River Health Svs Barron County (Entire County HPSA) Bayfield County (Entire County HPSA) Facility: Red Cliff Health Services Facility: The Lakes Community Health Center, Inc. Brown County Facility: Green Bay Correctional Institution Facility: N.E.W. Community Clinic Burnett County (Entire County HPSA) Facility: St. Croix Tribal Health Dpt Chippewa County Facility: Stanley Correctional Institution Clark County (Entire County HPSA) Columbia County (Entire County HPSA) Facility: Columbia Correctional Facility Crawford County (Entire County HPSA) Facility: Prairie Du Chien Correctional Institution Dane County Facility: Madison Community Health Center Dodge County (Entire County HPSA) Facility: Dodge Correctional Institution Facility: Fox Lake Correctional Institution Facility: Waupun Correctional Institution Door County (Entire County HPSA) Douglas County (Entire County HPSA) Florence County (Entire County HPSA) Forest County (Entire County HPSA) Facility: Potawatomi Health and Wellness Center Facility: Sokaogon Chippewa Indian Community Grant County (Entire County HPSA) Facility: Wisconsin Secure Program Correction Facility Iowa County (Entire County HPSA) Iron County (Entire County HPSA) Jackson County (Entire County HPSA) Facility: Ho-Chunk Nation Health Dpt Facility: Jackson Correctional Institution Jefferson County (Entire County HPSA) Juneau County (Entire County HPSA) Facility: Mile Bluff Clinic, LLP

Page 195 of 208 Pages MENTAL HEALTH: Wisconsin County and County Equivalent Listing

Juneau County (Entire County HPSA) Facility: Necedah Family Medical Center Facility: New Lisbon Clinic Facility: New Lisbon Correctional Institution Kenosha County Facility: Kenosha Community Health Center Kewaunee County (Entire County HPSA) Lafayette County (Entire County HPSA) Langlade County (Entire County HPSA) Lincoln County (Entire County HPSA) Facility: Lincoln Hills School Manitowoc County (Entire County HPSA) Marathon County (Entire County HPSA) Facility: Bridge Community Health Center Marinette County (Entire County HPSA) Marquette County (Entire County HPSA) Menominee County (Entire County HPSA) Facility: Menominee Tribal Clinic-Wolf River Milwaukee County Service Area: Milwaukee Upper North Service Area: Near North Side - Milwaukee Facility: 16th Street Community Health Center Facility: Gerald I. Ignace Health Center Facility: Milwaukee County Behavioral Health Division Facility: Milwaukee Health Services Facility: Outreach Community Health Centers, Inc. Facility: Progressive Community Health Centers, Inc. Facility: Transitional Living Services Monroe County Facility: Scenic Bluffs Health Center Oconto County (Entire County HPSA) Facility: Northern Health Centers, Inc. Outagamie County Facility: Oneida Community Health Center Polk County (Entire County HPSA) Price County (Entire County HPSA) Racine County Facility: Racine Correctional Institution Facility: Racine Youthful Offender Correctional Facility Richland County (Entire County HPSA) Rock County Service Area: Central Beloit

Page 196 of 208 Pages MENTAL HEALTH: Wisconsin County and County Equivalent Listing

Rock County Service Area: Janesville City Facility: Community Health Systems Rusk County (Entire County HPSA) Sauk County (Entire County HPSA) Sawyer County (Entire County HPSA) Facility: Lac Courte Oreilles Community Health Center Shawano County (Entire County HPSA) Facility: Stockbridge-Munsee Tribal Health Center Sheboygan County (Entire County HPSA) Facility: Kettle Moraine Correctional Institution Facility: Sheboygan Area Community Clinics Taylor County (Entire County HPSA) Trempealeau County (Entire County HPSA) Vernon County (Entire County HPSA) Vilas County (Entire County HPSA) Facility: Great Lakes Inter-Tribal Council Facility: Peter Christensen Health Center Walworth County (Entire County HPSA) Washburn County (Entire County HPSA) Facility: Northwoods Community Health Waupaca County (Entire County HPSA) Waushara County (Entire County HPSA) Facility: La Clinica De Los Camesinos Facility: Redgranite Correctional Institution Winnebago County Facility: Fox Cities Community Health Center Facility: Oshkosh Correctional Institution Facility: Wisconsin Resource Center - Men Wood County Facility: Marshfield Family Health

Page 197 of 208 Pages MENTAL HEALTH: Wyoming County and County Equivalent Listing

Albany County Service Area: Southeast Wyoming Big Horn County Service Area: Northwest Wyoming Mental Health Area Campbell County Service Area: Northeast Wyoming Mental Health Catchment Area Carbon County Service Area: Southeast Wyoming Converse County Service Area: Central Wyoming Crook County Service Area: Northeast Wyoming Mental Health Catchment Area Fremont County Service Area: Central Wyoming Facility: Arapaho Clinic Facility: Arapahoe PHS Indian Health Center Facility: Ft. Washakie PHS Indian Health Center Facility: Northern Arapaho Tribal Health Dpt Facility: Shoshone Tribal Health Dpt Goshen County Service Area: Southeast Wyoming Hot Springs County Service Area: Northwest Wyoming Mental Health Area Johnson County Service Area: Northeast Wyoming Mental Health Catchment Area Laramie County Service Area: Southeast Wyoming Facility: Cheyenne Health and Wellness Center Facility: Community Action of Laramie County Facility: Wyoming Migrant Health Lincoln County Service Area: Southwest Wyoming Natrona County Service Area: Central Wyoming Facility: Community Action Partnership of Natrona Facility: Community Health Center Niobrara County Service Area: Central Wyoming Park County Service Area: Northwest Wyoming Mental Health Area Platte County Service Area: Southeast Wyoming

Page 198 of 208 Pages MENTAL HEALTH: Wyoming County and County Equivalent Listing

Sheridan County Service Area: Northeast Wyoming Mental Health Catchment Area Sublette County Service Area: Southwest Wyoming Sweetwater County Service Area: Southwest Wyoming Facility: Sweetwater County Community Health Clinic Teton County Service Area: Southwest Wyoming Uinta County Service Area: Southwest Wyoming Washakie County Service Area: Northwest Wyoming Mental Health Area Weston County Service Area: Northeast Wyoming Mental Health Catchment Area

Page 199 of 208 Pages MENTAL HEALTH: American Samoa County and County Equivalent Listing

Eastern District Service Area: American Samoa Service Area Facility: Tafuna Family Medical Center Manu'a District Service Area: American Samoa Service Area Rose Island Service Area: American Samoa Service Area Swains Island Service Area: American Samoa Service Area Western District Service Area: American Samoa Service Area

Page 200 of 208 Pages MENTAL HEALTH: Federated States of Micronesia County and County Equivalent Listing

Chuuk State (Entire County HPSA) Facility: Pohnpei Community Health Center Kosrae State (Entire County HPSA) Pohnpei State (Entire County HPSA) Yap State (Entire County HPSA) Facility: Wa'Ab Community Health Center

Page 201 of 208 Pages MENTAL HEALTH: Guam County and County Equivalent Listing

Guam Facility: Southern Region Health Center

Page 202 of 208 Pages MENTAL HEALTH: Marshall Islands County and County Equivalent Listing

Kwajalein Facility: Ministry of Health

Page 203 of 208 Pages MENTAL HEALTH: Northern Mariana Islands County and County Equivalent Listing

Northern Islands Municipality Service Area: Commonwealth Northern Mariana Islands Facility: Cnmi Department of Public Health Rota Municipality Service Area: Commonwealth Northern Mariana Islands Saipan Municipality Service Area: Commonwealth Northern Mariana Islands Tinian Municipality Service Area: Commonwealth Northern Mariana Islands

Page 204 of 208 Pages MENTAL HEALTH: Republic of Palau County and County Equivalent Listing

Airai State Facility: Ministry of Health

Page 205 of 208 Pages MENTAL HEALTH: Puerto Rico County and County Equivalent Listing

Arroyo Municipio Facility: Centro De Salud Familia Barceloneta Municipio Facility: Barceloneta Primary Health Caguas Municipio Facility: Sanos Camuy Municipio Facility: Camuy Health Services Ciales Municipio Facility: Ciales Primary Health Cidra Municipio Facility: COSSMA Corporation Florida Municipio Facility: Centro De Servicios Primarios De Salud De Patillas Facility: Centro De Servicios Primarios De Salud Inc. Guaynabo Municipio Facility: Metropolitan Detention Center Guaynabo Gurabo Municipio Facility: Gurabo Community Health Center Hatillo Municipio Facility: Corporation De Services Medicos Puerto Rico Lares Municipio Facility: Castaner General Hospital Facility: Lares Health Center Loiza Municipio Facility: Concilio De Salud Integral De Loiza Mayaguez Municipio Facility: Western Region/Migrant Health Morovis Municipio Facility: Morovis Community Health Naranjito Municipio Facility: Salud Integral En La Montane Ponce Municipio Facility: Consejo De Salud Rincon Municipio Facility: Rincon Rural Health San Juan Municipio Facility: Junta Del Centro De Salud Comunal Facility: San Juan Comprehensive Vieques Municipio (Entire County HPSA)

Page 206 of 208 Pages Page 207 of 208 Pages MENTAL HEALTH: U.S. Virgin Islands County and County Equivalent Listing

St. Croix (Entire County HPSA) Facility: Frederiksted Healthcare St. John (Entire County HPSA) St. Thomas (Entire County HPSA) Facility: East End Family Health Center

Page 208 of 208 Pages