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Home | Services | Substance Abuse and Mental Health | Resources for Providers | Managing Entities | FY22-23 Templates

Unless otherwise indicated, these documents are effective July 1, 2022. Comments questions or suggestions should be directed to: @email

CONTRACT DOCUMENTS

ME Standard Contract

* Exhibits C1, C2, F1 and F2 are unique documents for each Managing Entity and will be distributed separately.

Exhibits
Exhibit A - Special Provisions Revised 1/1/2023
Exhibit A1 - Program and Service Specific Terms
Exhibit A2 - SAMH Programmatic State and Federal Laws, Rules, and Regulations
Exhibit B - Scope of Work
Exhibit B1 - Federal Block Grant Requirements
Exhibit C - Task List Revised 1/1/2023
Exhibit C1 - Additional Region-Specific Tasks *
Exhibit C2 - Region-Specific Appropriations *
Exhibit C3 - ME Required Reports, Plans, and Functional Tasks Revised 1/1/2023
Exhibit D - Deliverables
Exhibit E - Minimum Performance Measures Revised 1/1/2023
Exhibit F - Method of Payment
Exhibit F1 - ME Schedule of Funds *
Exhibit F2 - Schedule of Payments *

 

Guidance Documents
Guidance 1 Evidence Based Guidelines
Guidance 2 Tangible Property Requirements
Guidance 3 Managing Entity Expiration, Termination and Transition Planning Requirements
Guidance 4 Care Coordination Revised 8/1/2022
Guidance 5 Residential Mental Health Treatment for Children and Adolescents
Guidance 6 Outpatient Forensic Mental Health Services
Guidance 7 State Mental Heath Treatment Facility Admission and Discharge Processes
Guidance 8 Assisted Living Facilities with Limited Mental Health (ALF LMH) Licensure
Guidance 9 Supplemental Security Income/Social Security Disability Insurance (SSI/SSDI) Outreach Access, and Recovery (SOAR)
Guidance 10 Prevention Services
Guidance 11 Juvenile Incompetent to Proceed (JITP)
Guidance 12 Behavioral Health Network (BNet) Guidelines and Requirements
Guidance 13 Indigent Drug Program (IDP)
Guidance 14 Prevention Partnership Grants (PPG)
Guidance 15 Projects for Assistance to Transition from Homelessness (PATH)
Guidance 16 Florida Assertive Community Treatment (FACT) Handbook Revised 8/1/2022
Guidance 17 Temporary Assistance for Needy Families (TANF) Funding Guidance
Guidance 18 Family Intensive Treatment (FIT) Model Guidelines and Requirements
Guidance 19 Child Welfare Integration
Guidance 20 Local Review Team
Guidance 21 Housing Coordination
Guidance 22 Federal Grant Financial Management Requirements
Guidance 23 Crisis Counseling Program
Guidance 24 Performance Outcomes Measurement Manual
Guidance 25 National Voter Registration Act Guidance
Guidance 26 Women's Special Funding, Substance Abuse Services for Pregnant Women and Mothers
Guidance 27 Central Receiving Systems Grant
Guidance 28 Forensic Multidisciplinary Team
Guidance 29 Transitional Voucher
Guidance 32 Community Action Treatment (CAT) Team Revised 8/1/2022
Guidance 33 HIV Early Intervention Services
Guidance 34 Mobile Response Team (MRT) Revised 8/1/2022
Guidance 35 Recovery Management Practices
Guidance 36 LATTERS Teams Effective 1/1/2023
Guidance 37 Family First Prevention Services Act (FFPSA) Teams Effective 1/1/2023
Guidance 38 CAT Team for Ages 0 10 Effective 1/1/2023
Guidance 39 Multidisciplinary Child Welfare Teams Effective 1/1/2023

 

Reporting Templates
Template 1 - Provider Tangible Property Inventory Form
Template 2 - SAMH Block Grant Reporting Template - Revised 3/10/2023
Template 3 - Narrative Report for the Substance Abuse and Mental Health Block Grant
Template 4 - Managing Entity Annual Business Operations Plan
Template 5 - ALF-LMH Forms
Template 6 - Behavioral Health Network Participant Forms
Template 7 - BNet Alternative Service Forms
Template 9 - Local Match Calculation Form
Template 10 - Managing Entity Monthly Fixed Payment Invoice
Template 11 - Managing Entity Monthly Progress Report
Template 12 - Managing Entity Monthly Expenditure Report - Revised 3/10/2023
Template 13 - Managing Entity Monthly Carry Forward Expenditure Report - Revised 10/10/2022

Template 14 Cost Allocation Plan 2022 07 01

Template 15 - Managing Entity Spending Plan for Carry Forward Report - Revised 8/9/2022
Template 16 - Women's Special Funding Report
Template 21 - Care Coordination Monthly Report Revised 8/1/2022
Template 22 - Conditional Release Report
Template 23 - Forensic Diversion Report
Template 24 - CCP Supplemental Invoice and Expenditure Report
Template 25 - Forensic Multidisciplinary Team Report
Template 28 - Mobile Response Team Report
Template 29 - FACT Report Revised 8/1/2022
Template 30 - Proviso Project Return on Investment Report
Template 31 - Clubhouse Supported Employment Report
Template 32 - Transitional Voucher Incidental Report

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