1. Great Plains Area 2014 GPRA Results

2. 2014 TargetABR 2014 4th Qtr BelcrtEBFtTomFt TottFtYtsLBPR DIABETES GROUP Diabetes Dx Ever 13.9%14.5%14.1%13.7%11.3%14.8%10.2%13.7% Documented A 1 C 81.3%82.5%85.2%87.9%88%84.5%89.4%74.6% Good Glycemic Control 48.3%44.3%49.6%39.3%49.1%45.3%41.5%55%38.7% Controlled BP <140/90 64.6%59.6%73.7%59%66.2%67.9%46.3%68.1%60.5% LDL Assessed 73.9%73.7%74%80.6%77.5%80.2%57.4%80%83.5% Nephropathy Assessed Baseline54.4%69.4%70.4%40.2%69.9%51.6%27.5%52.1% Retinopathy Exam 58.6%49.2%67.9%37.8%71.4%44.3%69.8%12.5%46.7% DENTAL Access to Services 29.2%26.7%29.2%25.7%31.4%21.8%31.8%6.2%28% Sealants 13.9%17.9%24.9%6.1%17.2%9.7%29.7%019.3% Topical Fluoride 26.7%29.9%42.9%14.9%35.6%24.7%41.7%.10%36% IMMUNIZATIONS Influenza (Adult) 65+ 69.1%61.2%66.6%54.8%72.3%72.1%57.8%66.2%52.4% Pneumovax (Adult) 65+ Baseline81.4%85.6%83.1%92.4%90.5%75.3%81.8%79.2% Childhood Immunizations 74.8%77.6%81.5%75.4%100%75.3%69.6%78%81.9% PREVENTION CANCER SCREENING Pap Screening Baseline46.5%59.9%53.1%68.2%53.5%33.2%36.9%44.5% Mammography Screening 54.7%46.4%47.3%68.9%56.6%68.5%31.7%58.7%43.9% Colorectal Ca Screening 35%26.3%31.5%21.2%39.8%38.5%9.7%71.4%23% Tobacco Cessation 45.7%47.6%75.5%50.8%74.6%69%32.2%49.4%38.8% BEHAVIORAL HEALTH Alcohol Screening (FAS Prevention) 65.9%67.7%75.2%84.8%75%68.4%61.5%72.4%72.1% DV/IPV Screen 16-24 64.1%65.3%73.2%83.6%72.6%65%58.4%72.8%70% Depression Screening 66.9%68.5%78.6%82.4%74.2%72.8%56.8%72.7%67.8% CVD RELATED CVD Comprehensive 51%51.7%65.8%60%80.7%73.5%38.4%62.8%45.9% OTHER CLINICAL Prenatal HIV Screening 89.1%86.6%90.6%82.1%100%94.4%87.7%96.6%92.4% Breastfeeding Rates 29%26.9%29%50%44.4%0050%25.6%

3. 2014 TargetABR 2014 4th Qtr RCRsbdKeebleWagrWinnCarl TFlandPoncaSanteeTrent DIABETES GROUP Diabetes Dx Ever 13.9%10.7%14.6%15.7%14.2%16.6%19%11.7%12.9%14.2%15.5% Documented A 1 C 81.3%82.3%80%89.1%86.8%75.6%75.7%74.6%79.9%83.6%71.8% Good Glycemic Control 48.3%44.3%47.2%43.8%54.6%45.6%42.4%41.2%42.9%45.7%35.3%44.8% Controlled BP <140/90 64.6%59.6%53.4%54.5%63.5%59.5%58.2%57.4%54.8%58.3%56%46.4% LDL Assessed 73.9%73.7% 64.4%81.9%75.5%71.6%56%64.3%76%64.7%60.8% Nephropathy Assessed Baseline54.4%48.6%50.9%69.7%91.4%2.8%55.5%24.6%60.2%67.2%23.8% Retinopathy Exam 58.6%49.2%62.1%35.1%44.3%64.8%39.8%19%38.1%27.2%44.8%21% DENTAL Access to Services 29.2%26.7%13.9%25.9%36.1%37.6%26.3%23.9%38.3%36.6%28.4%39% Sealants 13.9%17.9%3.9%20%39.1%12.5%16.3%9.9%14.9%21.8%12.8%32.9% Topical Fluoride 26.7%29.9%7.8%35.1%42.6%27.8%17.8%22.4%34.9%32.2%27.7%41.6% IMMUNIZATIONS Influenza (Adult) 65+ 69.1%61.2%69.7%53.6%73.4%75.2%57.6%54.7%53.7%72.8%50%45.1% Pneumovax (Adult) 65+ Baseline81.4%87.8%79.3%87.6%89.9%79.7% 75.5%55.6%71.6%73.8%39.8% Childhood Immunizations 74.8%77.6%76.7%76.1%72.4%91.7%77.1%76.6%12.5%40.5%74.2%63.6% PREVENTION CANCER SCREENING Pap Screening Baseline46.5%30.7%45.2%49.4%53.1%25.3%54.5%15.9%50.3%36.1%63.8% Mammography Screening 54.7%46.4%54.8%39.4%56.1%55%46.8%24.1%6.4%18.2%41.8%4.5% Colorectal Ca Screening 35%26.3%40.6%20.9%45.6%29.6%20.1%2.8%3.8%5.9%10.3%1.9% Tobacco Cessation 45.7%47.6%43.5%45.4%77%45%24.3%5.1%12.5%17%35.1%7% BEHAVIORAL HEALTH Alcohol Screening (FAS Prevention) 65.9%67.7%62.6%81.4%68.3% 74.7%26.4%28.3%35.3%47.4%2.2% DV/IPV Screen 16-24 64.1%65.3%61.2%81.1%64.1%64%73.5%22.8%.5%35.2%42.2%1.6% Depression Screening 66.9%68.5%70.9%81.2%71.9%67.6%71.6%22.2%18.1%44.5%56.8%17.7% CVD RELATED CVD Comprehensive 51%51.7%61.7%21.2%65.8%66.7%53.5%1.3%29.3%24%28.9%9.8% OTHER CLINICAL Prenatal HIV Screening 89.1%86.6%89.8%89.6%92.4%97.3%83.9%014.3%54.8%20%76.9% Breastfeeding Rates 29%26.9%36.4%31%21.7%8.3%17.8%00100%00

4. GPRA DashboardGREAT PLAINS AREADate:10/8/2014 Quarterly ReportGY2014 Q4 National Great Plains Area Great Plains Area IHS 2014 Goals Met/Not Met I/T/U GPRA Quarterly Report Quarter 3-2014 2014 2014 GPRA Target 2013 Final Q1Q2Q3Q4 ↑ or ↓ from 2014 Target DIABETES GROUP Diabetes Dx Ever N/A Documented A1c N/A Good Glycemic Control48.3% 44.9% 37.5%41.90%44.50%-3.8% Controlled BP <140/9064.6%64.60%61.7% 46.3%53.80%60.10%-4.5% LDL Assessed73.9% 68.6% 51.5%64.50%74.70%0.8% Nephropathy AssessedBaseline 73.8% 34.5%44.60%54.90%Baseline Retinopathy Exam58.6% 48.5% 29.5%39.60%51.60%-7.0% 0.0% Access to Services29.2% 25.7% 16.8%22%26.20%-3.0% Sealants13.9% 14.7% 8.2%14.70%18.00%4.1% Topical Flouride26.7% 24.4% 18.1%25.20%29.90%3.2% IMMUNIZATIONS0.0% Influenza 65+69.1% 60.1% 55.5%60.50%61.80%-7.3% Pneumovax 65+Baseline 85.8% 80.4%81.20%83.20%Baseline Childhood Immunizations74.8% 72.8% 57.2%68.70%78.80%4.0% PREVENTION0.0% Pap Smear ScreeningBaseline 53.8% 44.2%45.40%46.20%Baseline Mammogram Screening54.7% 47.6% 41.1%43.30%49.50%-5.2% Colorectal Ca Screen35.0% 24.5% 21.7%24.10%28.60%-6.4% Tobacco Cessation45.7% 44.9% 35.0%42.20%50.30%4.6% Alcohol Screening (FAS Prev)65.9% 67.4% 51.0%60.90%71.90%6.0% DV/IPV Screen 16-2464.1% 65.5% 48.7%58.40%69.90%5.8% Depression Screen66.9% 68.7% 52.3%61.90%72.20%5.3% Comp. CVD Assessment51.0% 40.3% 23.6%38.20%54.70%3.7% Prenatal HIV Screening89.1% 82.7% 82.3%83.30%90.40%1.3% Breastfeeding Rates29.0% NA 26.5%27%26.70%-2.3%