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DocuSign Envelope ID:4D553CF7-2BBD-4F4E-B84E-E6B8B077A9AB <br /> EXHIBIT A <br /> PROVIDER'S OUTSIDE AGENCY APPLICATION <br /> than the state average (University of Wisconsin Population Health Institute). North <br /> Carolina has a goal to reduce the number of poor mental health days to 2.8 per <br /> month by 2020 (Healthy NC 2020). <br /> The Affordable Care Act has improved access to mental health services for many; <br /> however, since Medicaid was not expanded in NC, a large proportion of people <br /> remain uninsured and without access to these services. Or, if they have some health <br /> insurance, the co-pay or deductible amount, coupled with their income, prevents <br /> them from seeking mental health care. <br /> Current mental health service delivery in NC is inadequate. In the wake of NC's <br /> mental health reform and the country's economic downturn, many individuals who <br /> need mental health services are unable to access care because they either do not <br /> meet certain diagnostic criteria, or they are unable to get past established financial <br /> barriers. The Kaiser Foundation estimates this population to be 357,000. Studies <br /> show that mental illness is significantly higher among the uninsured, and that <br /> currently 182,000 uninsured adults in our state have a mental illness. Untreated <br /> mental illness has many consequences, both for individuals suffering and for the <br /> larger community. <br /> Substance use disorders and untreated mental illness are directly connected with <br /> indigence, unemployment, adolescent pregnancy, school dropout, crime, chronic <br /> illness and death. Freedom House has developed community partnerships and <br /> programs that build the necessary skills and connections to employment, education <br /> and housing clients will need when they reenter the community. Their recovery can <br /> diminish the societal and economic costs to their families and communities. <br /> Understanding of the challenges Orange County residents who suffer from mental <br /> illness and/or substance use disorder, the Orange County Board of Commissioners <br /> established this goal as their top priority in 2016: Ensure a community network of <br /> basic human services and infrastructure that maintains, protects and promotes the <br /> well-being of all county residents. This goal specifically notes mental health as an <br /> area of focus. <br /> r) Who is your target population of individuals to benefit from this program and how will they be <br /> identified and connected with the program? <br /> The population to be served is men and women who suffer from mental illness and/or <br /> substance use disorders, and who often have chronic medical conditions related to <br /> their mental illness, addiction or medication used to treat illness. Our programs will <br /> serve the low-income, uninsured, indigent and homeless populations in Orange <br /> County. Clients come to Freedom House most often by referral from hospitals, clinics, <br /> physicians, local social service agencies, law enforcement or the court system. <br /> Clients also come to Freedom House on their own accord, without referral. We <br /> gather necessary demographic data during the intake process. <br /> s) Describe the credentials of the program manager and other key staff. (Ex. Identify Program <br /> Manager and credentials, describe training provided to volunteers, etc.) <br /> DO NOT SUBMIT THIS PAGE 1/31/2017 11:11:58 AM Page 20 of <br />