Question Title

* 1. Please provide your name, affiliation, role, and contact information.

Question Title

* 2. Do you feel your organization has a sufficient number of residential behavioral health beds to meet the needs of youth in the communities you serve?

Question Title

* 3. Please indicate how many additional beds you need in each of the below settings—if any—to sufficiently meet the needs of the communities you serve. Please consider your organization's waitlists, and the number of youth screened as appropriate for receipt of services, but denied due to bed shortages.

Question Title

* 4. Based on your experience, what do you think is driving the bed shortage in your facility/facilities?

Question Title

* 5. Please list specific reasons you have denied referrals for placement. For example, if you were unable to support the needs of a youth who was been referred, please describe what those needs are.

Question Title

* 6. What is your current licensed bed capacity for youth in each of the following settings?

Question Title

* 7. Do you have an excess of licensed beds in any of your residential behavioral health facilities for children/adolescents that you are unable to fill? If so, please indicate below how many, by setting, and why you feel you are unable to fill the beds (e.g., lack of staffing, youth are too acute, too few referrals).

Question Title

* 8. Would you or a colleague be willing to speak with NC Medicaid about information you’ve provided here if we have follow-up questions?

T