2019 Community Mental Health, Substance Use and Developmental Disabilities Services Network Adequacy and Accessibility Analysis July 1, 2019 Partners Behavioral Health Management 901 S. New Hope Road Gastonia, NC 28054 Partners 2019 Network Adequacy and Accessibility Analysis Table of Contents i Table of Contents Section One: Network Availability & Accessibility ....................................................................................... 1 Section 1.1 Access & Choice Standard Tables ........................................................................................... 1 1.1.1 Outpatient Services ...................................................................................................................... 1 1.1.2 Location-Based Services ............................................................................................................... 2 1.1.3 Community/Mobile Services ........................................................................................................ 3 1.1.4 Crisis Services ............................................................................................................................... 4 1.1.5 Inpatient Services ......................................................................................................................... 4 1.1.6 Specialized Services ...................................................................................................................... 5 1.1.7 C-Waiver Services ......................................................................................................................... 6 Section 1.2 Geo Maps ............................................................................................................................... 7 Section 1.3 Access to Care ........................................................................................................................ 7 Section Two: Accommodation .................................................................................................................... 10 Section 2.1 Catchment area demographics & special populations ........................................................ 10 Section 2.2 Obstacles and barriers to serving specific populations ....................................................... 17 Section 2.3 Social Determinants of Health ............................................................................................. 18 Section 3: Acceptability ............................................................................................................................... 21 Section 3.1 Methods to get input from consumers and family members .............................................. 21 Section 3.3 Methods to get input from other stakeholders ................................................................... 26 Section 3.4 Service Gaps and Barriers to Service – Other Stakeholders................................................. 27 Section 3.5 Using Survey Data ................................................................................................................ 29 Section Four: Special Populations .............................................................................................................. 30 Section 4.1 Transitions to Community Living Initiative (TCLI) ................................................................ 30 Section 4.2 Children with Complex Needs .............................................................................................. 34 Section 5: Network Access Plan .................................................................................................................. 35 Appendix A: Geo Maps ............................................................................................................................... 36 Location Based Services .......................................................................................................................... 36 Community Mobile Services ................................................................................................................... 43 Crisis Services .......................................................................................................................................... 55 Specialized Services ................................................................................................................................ 60 C-Waiver Services ................................................................................................................................... 76 Additional Opioid Services ...................................................................................................................... 79 Appendix B: Registry of Unmet Needs ........................................................................................................ 83 Partners 2019 Network Adequacy and Accessibility Analysis Table of Contents ii Appendix C: Provider Ratios........................................................................................................................ 86 Appendix D1: Demographic & Special Population Data ............................................................................. 88 Appendix D2: Social Determinants of Health Data ................................................................................... 101 Appendix E1: Community Assessment Survey Response Index ............................................................... 106 Appendix E2: Community Assessment Blank Surveys .............................................................................. 165 Appendix F: Network Access Plan ............................................................................................................. 192 Section 5.1 Executive Summary ............................................................................................................ 192 Section 5.2 Access Plan ......................................................................................................................... 196 Section 5.3 In Lieu of and Alternative Services ..................................................................................... 196 Appendix G: Impact of NC 1115 Medicaid Waiver ................................................................................... 204 Appendix H: Network Development Plan ................................................................................................. 205 Appendix I: Request for Exception ............................................................................................................ 213 Partners 2019 Network Adequacy and Accessibility Analysis Section One: Network Availability & Accessibility 1 Section One: Network Availability & Accessibility ∗ The total number of unique individuals receiving at least one state funded/non-Medicaid funded service is different than the numbers reported in the tables. Not all the individuals who received a service had addresses within the catchment area. Total number receiving services was 11,257. ∗ The number of Medicaid enrollees was 188,185. However, not all had addresses within the Catchment Area. Therefore, the numbers reflected in the tables are different than 188,185. Section 1.1 Access & Choice Standard Tables 1.1.1 Outpatient Services Medicaid Non-Medicaid Funded Categories # of providers # of enrollees # of Medicaid % (# of # of providers # of consumers # of % (# of accepting new with choice of enrollees enrollees with accepting new with choice of consumers consumers Medicaid two providers choice/# of non-Medicaid two providers with choice/# consumers within 30/45 enrollees) funded within 30/45 of consumers) miles/ minutes consumers miles/minutes Reside in urban counties 343 132,763 132,763 27 8,546 8,546 Reside in rural counties 343 39,890 39,890 27 2,002 2,002 Total (standard = 100%) 343 172,653 172,653 100% 27 10,548 10,548 100% Adults (age 18+) 197 87,132 87,132 18 10,346 10,346 Children (age 17 and younger) 184 85,521 85,521 8 204 204 Total (standard = 100%) 343 172,653 172,653 100% 27 10,550 10,550 100% *The number of providers accepting new consumers for adult and children outpatient services was calculated using encounter data. This means the number may be underreported due to some of the contracted outpatient providers not serving the specific age group during FY18 or becoming a contracted agency after the fiscal year, but before 1/1/19. ** The number of providers may not equal the Total when simply added together because some providers serve both adults and children. These providers were counted in both the adult and children lines but not double counted in the total. The total is the unique, unduplicated count. Partners 2019 Network Adequacy and Accessibility Analysis Section One: Network Availability & Accessibility 2 1.1.2 Location-Based Services Medicaid Non-Medicaid Funded # of providers # and % of enrollees with Total # of # of providers # and % of consumers with at Total # of accepting new choice of two providers within Medicaid accepting new least one provider within 30/45 consumers Medicaid 30/45 miles/minutes of their enrollees non-Medicaid miles/minutes of their consumers residences funded residences Location-based Services # % consumers # % Psychosocial Rehabilitation 23 87,132 100% 87,132 8 6,627 100% 6,627 Child and Adolescent Day 28 85,521 100% 85,521 5 167 100% 167 Treatment SA Comprehensive Outpatient Treatment 16 171,405 99% 172,653 6 3,947 90% 4,397 Program SA Intensive Outpatient 31 172,653 100% 172,653 10 4,397 100%