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DocuSign Envelope ID:4D553CF7-2BBD-4F4E-B84E-E6B8B077A9AB <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> Previous Year Program Results Crisis staff provided treatment and discharge planning <br /> for 100% of all clients. <br /> Current Year Estimated Results Crisis staff will provide treatment and discharge <br /> planning for 100% of all clients. <br /> Next Year Projected Results Crisis staff will provide treatment and discharge <br /> planning for 100% of all clients. <br /> 3, Program Activity Name Freedom House Crisis Care Coordinators work with <br /> UNC ER staff, individuals and our doctors and clinicians <br /> to admit difficult cases into the crisis unit, diverting them <br /> from the local or State hospitals. <br /> Program Goal Divert 96% of those referred to the crisis unit from our <br /> local hospital ER and expensive State hospitals. <br /> Performance Measures Care Coordinators track all referrals and their outcomes <br /> using a referral tracking log. <br /> Previous Year Program Results Diverting referrals to our crisis unit instead of high cost <br /> State and local hospitals not only saves money, but it <br /> also provides a stronger continuum of care for <br /> individuals as they discharge from the crisis unit and <br /> into longer term care. Our diversion rate was 90%. <br /> Current Year Estimated Results Diverting referrals to our crisis unit instead of high cost <br /> State and local hospitals not only saves money, but it <br /> also provides a stronger continuum of care for <br /> individuals as they discharge from the crisis unit and <br /> into longer term care. We anticipate a diversion rate of <br /> 96%. <br /> Next Year Projected Results Diverting referrals to our crisis unit instead of high cost <br /> State and local hospitals not only saves money, but it <br /> also provides a stronger continuum of care for <br /> individuals as they discharge from the crisis unit and <br /> into longer term care. We anticipate a diversion rate of <br /> 96%. <br /> DO NOT SUBMIT THIS PAGE 1/31/2017 11:11:58 AM Page 16 of <br />