Managing Entities FY20-21 Templates

Overview

Unless otherwise indicated, these documents are effective July 1, 2021.

Comments questions or suggestions should be directed to: HQW.SAMH.Central@myflfamilies.com.

ME Standard Contract

Standard Contract Part 1

Exhibits

Exhibit A - Special Provisions (Revised 7/24/20)

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 7/24/20

Exhibit C1 - Additional Region-Specific Tasks *

Exhibit C2 - Region-Specific Appropriations *

Exhibit C3 - ME Required Reports, Plans, and Functional Tasks, Revised 7/24/20

Exhibit D - Deliverables

Exhibit E - Minimum Performance Measures

Exhibit F - Method of Payment

Exhibit F1 - ME Schedule of Funds *

Exhibit F2 - Schedule of Payments *

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

Guidance Documents

Guidance 1 - Evidence-Based Guidelines, Revised 11/16/20

Guidance 2 - Tangible Property Requirements

Guidance 3 - Managing Entity Expiration, Termination and Transition Planning Requirements

Guidance 4 - Care Coordination, Revised 4/21/2021

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

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, Revised

Guidance 27 - Central Receiving Systems Grant

Guidance 28 - Forensic Multidisciplinary Team

Guidance 29 - Transitional Voucher

Guidance 30 - Partnership for Success Grant

Guidance 31 - Children’s Mental Health System of Care (CMHSOC) Grant

Guidance 32 - Community Action Treatment (CAT) Team, Revised 3/26/2021

Guidance 33 - HIV Early Intervention Services

Guidance 34 - Mobile Response Team (MRT), Effective 10/12/20

Reporting Templates

Template 1 - Provider Tangible Property Inventory Form

Template 2 - SAMH Block Grant Reporting Template, Revised 2/25/21

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 8 - Discontinued 11/3/2016

Template 9 - Local Match Calculation Form

Template 10 - Managing Entity Monthly Fixed Payment Invoice

Template 11 - Managing Entity Monthly Progress Report, Revised 8/21/20

Template 12 - Managing Entity Monthly Expenditure Report, Revised 5/6/21

Template 13 - Managing Entity Monthly Carry Forward Expenditure Report, Revised 8/6/20

Template 14 - Cost Allocation Plan, Revised 9/9/20

Template 14 - Addendum 1 - Cost Allocation Plan, Effective 11/12/20

Template 14 - Addendum 2 - Cost Allocation Plan, Effective 2/10/21

Template 14 - Addendum 3 - Cost Allocation Plan, Effective 5/6/21

Template 15 - Managing Entity Spending Plan for Carry Forward Report, Revised 8/6/20