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Managing Entities FY20-21 Templates

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

Comments questions or suggestions should be directed to: @email.

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
Template 16 - Women's Special Funding Report
Template 17 - Discontinued Effective 7/1/2020
Template 18 - Discontinued Effective 5/18/2017
Template 19 - PFS Drug Epidemiology Network (DEN) Report
Template 20 - CMHSOC Reporting Template
Template 21 - Care Coordination Monthly Report, Revised 7/24/20
Template 22 - Conditional Release Report
Template 23 - Forensic Diversion Report
Template 24 - DBH Supplemental Invoice and Expenditure Report
Template 25 - Forensic Multidisciplinary Team Report
Template 26 - Discontinued Effective 2/23/21
Template 27 - PFS School-Based Prevention Quarterly Report
Template 28 - Mobile Response Team Report
Template 29 - FACT Report
Template 30 - Proviso Project Return on Investment Report, Effective 7/24/20