1. Therap Services eLTSS Pilot Presentation November 12, 2015 © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

2. Therap Contact Information NameRoleEmail Peter O’MearaGovernment Relationspeter.omeara@therapservices.net Stephen FlaniganSenior Product Specialist Stephen.flanigan@therapservices.net Ken SlavinBusiness Development ken.slavin@therapse rvices.net © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

3. Background: Therap is a National Leader in LTSS: Over 1780 Providers including ID/DD, Employment, Birth to 3, Early Intervention, Schools, etc. Organizations in 49 states use Therap. Statewide Contracts in 7 states (AR, SC, NE, ND, MT, ID, & NM) Other State Contracts, Counties, MCOs and Multi-State Providers Over 400,000 individual users (staff) Over 302,000 individual records © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

4. Agenda Introduction Goal of Pilot Tier Piloting Activity to Pilot Role of Therap Services in the pilot Standards and Technologies Under Consideration Logistics Ecosystem Defining Success Resources/References © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

5. Therap’s Off-the- Shelf system is designed to support a system from LTSS eligibility determination to plan development. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790. Therap has implemented User Story 1 in Nebraska and supports about 5,000 people.

6. Therap has implemented User Story 2 in Nebraska and supports about 5,000 people. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790. Again Therap’s Off-the-Shelf system provides communication opportunities for the Beneficiary, Advocates, and other concerned parties to participate in the service design, delivery, and assessment process.

7. Use Case workflow currently implemented in Nebraska Assessments for eligibility and level of need. Establish Service plans and funding levels. Submit Automated Referrals to services providers. Develop preliminary service delivery plans with Oversight Agency, Beneficiary, and Advocate involvement. Oversight Agency reviews beneficiary and advocates input and approves final. Oversight Agency authorizes payment for services. Service delivery is documented with participation of Oversight Agency, Beneficiary, and Advocates. Payment for services in processed. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

8. Use Case Functional Breakdown State Manages: Eligibility determination. Level of Need Assessment. Care Plan Development and Budgeting. Referrals. Service Authorizations. Claims. Tracking Outcomes. Quality Assurance. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

9. Use Case Functional Breakdown Beneficiaries and Advocates. Participate in care planning and selection of service providers. Manage day to day service selection based on individual budget. Participate in real time communication with service providers. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

10. Features of Use Case Personal Health Records are fully interoperable and are built with data from state, service providers, beneficiary, and advocates. System structure allows PHRs to be moved to providers as needed. Documentation is available in real time at local and aggregate levels. Beneficiaries and advocates are partners in choice and delivery of service delivery. Beneficiaries and advocates provide feedback on service satisfaction. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

11. Tier Piloting © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790. Therap is currently operating Tier 3 systems in a number of states. Those systems are primarily self-contained. Therap developed a Long Term & Post Acute Care EHR with an exportable HL7 CCD health summary we believe that system will assist with expansion of Tier 3 technology to a broad group in LTSS. Therap’s goal over the life of this pilot is to expand the Tier 3 functionally in its system to a larger ecosystem and to expand expertise in person centered planning on an interoperable system to a greater number of LTSS populations.

12. Activity of the Pilot The development of a portable Personal Health Record is the goal of the pilot and an appropriate functional next step for Therap. The Therap system was developed as a person-centered system and has successfully expanded to serve other populations. To expand further Therap will focus on the development of a widely portable PHR. Therap is a secure inclusive system and will use this opportunity to enhance a system that supports organizational communication, increases the value of support staff, and encourages participation of families and guardians. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

13. Activity of the Pilot The focus of the service model has and continues to be driven by the needs of individuals and their families in concert with a circle of support as they create an integrated and Individualized Plan of Service. The preceding values have created a real time system of communication and documentation that is currently operationalized for hundreds of thousands of individuals and their caregivers. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

14. Role of Therap In the Pilot The development of a portable Personal Health Record is an appropriate expansion of Therap’s person centered structure. Therap is designed to use technology as a component not a barrier to person entered support. Therap is committed to the development of innovative and secure technology including six patents for secure interoperable documentation technology. Therap has developed an oversight system that links different organizations in a secure interoperable structure and this program will expand the reach of that effort and improve the quality of care. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

15. Standards and Technologies Therap has already developed a certified LT&PAC system. LT&PAC has been discontinued but Therap Users at 1800 locations are using system features developed for that effort including an HL7 CCD XML Export. Therap is committed to supporting providers in all states receiving TEFT grants and is committed to providing interoperable support of PHRs in whatever format and consistent with standards as they are established. The team supporting Therap’s Self-Advocate and Family Support programs have determined that PHR development is an essential component of that project and will aid in the development and testing of interfaces. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

16. Logistics Therap works with providers in every state that has a TEFT grant and our hope is that as a state develops their grant a pilot that involves a LTSS provider who utilizes Therap will be considered. Therap is capable of interfacing in Tiers 1, 2 and 3. We are committed to supporting the TEFT eLTSS goals. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

17. Ecosystem Partners: Designated DD Provider selected by the TEFT Grant and Therap. A pilot group of individuals and families served by the provider willing to participate and be active users of the system. All relevant health care providers who support the individuals in the pilot including primary care physician groups, in home health care providers and all allied health providers including specialists and pharmacies. All relevant state agencies with either funding,oversight or licensing authority. MMIS or State legacy client information system. © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

18. Defining Success Implement Pilot by April 2016 Move the Pilot Group from Tier I to 3 Truly implement interoperability for Circle of Support including health providers. Establish a pilot network and set group of users within a defined geographic area Demonstrate that Families/Guardians and Individuals are succesfully accessing and utilizing eLTSS © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

19. Summary Proposal Therap’s Role in the Pilot: Provide technology to enable all eLTSS Plan components: create a plan, approve/authorize plan/services, access, view review plan, update plan. Current Service Providers: Our solution is currently implemented in ID, MT, ND, NE, SC, NM, AR What Domains does Therap Address: Based on the population we serve and the scope of the Therap platform, all domains will be addressed Current Ecosystem and Who Therap would Add: Our solution serves different populations in different states with different programmatic goals and practices than the person-centered planning ones identified through the eLTSS Initiative. We want to work with eLTSS pilot participants to test person-centered planning with other populations such as aging and TBI Tier Piloted: We have already demonstrated Tiers 1 and 2; we are looking to validate Tier 3 © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.

20. Thank you © Copyright Therap Services, LLC. 2003 – 2015 US Patents #8819785, #8739253, #8281370, #8528056, #8613054, #8615790.