Managing Entities

FY19-20 ME Templates

These draft documents are published for initial stakeholder comment through March 22, 2019. Additional documents and revised drafts based on stakeholder feedback will be published and announced as needed. Final versions of the documents will be published in late May 2019 for amendment into all current Managing Entity contracts to be effective July 1, 2019. Comments questions or suggestions should be directed to: jimmers.micallef@myflfamilies.com.

CONTRACT DOCUMENTS

ME Standard Contract

Exhibits

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

INCORPORATED DOCUMENTS

Guidance Documents

Reporting Templates

  • Template 1 - Provider Tangible Property Inventory Form - No proposed revisions
  • Template 2 - SAMH Block Grant Reporting Template - No proposed revisions
  • Template 3 - Narrative Report for the Substance Abuse and Mental Health Block Grant - No proposed revisions
  • Template 4 - Managing Entity Annual Business Operations Plan
    • Template 4 - Supplement - Behavioral Health Catalog of Care 
  • Template 5 - ALF-LMH Forms - No proposed revisions
  • Template 6 - Behavioral Health Network Participant Forms - No proposed revisions
  • Template 7 - BNet Alternative Service Forms - No proposed revisions
  • Template 8 - Discontinued 11/3/2016
  • Template 9 - Local Match Calculation Form - No proposed revisions
  • Template 10 - Managing Entity Monthly Fixed Payment Invoice - No proposed revisions
  • Template 11 - Managing Entity Monthly Progress Report
  • Template 12 - Managing Entity Monthly Expenditure Report
  • Template 13 - Managing Entity Monthly Carry Forward Expenditure Report
  • Template 14 - Cost Allocation Plan - No proposed revisions
  • Template 15 - Managing Entity Spending Plan for Carry Forward Report - No proposed revisions
  • Template 16 - Women's Special Funding Data Reporting Template Instructions - No proposed revisions
  • Template 17 - FIT Reporting Template - No proposed revisions
  • 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 - No proposed revisions
  • Template 22 - Conditional Release Report
  • Template 23 - Forensic Diversion Report
  • Template 24 - DBH Supplemental Invoice and Expenditure Report - No proposed revisions
  • Template 25 - Forensic Multidisciplinary Team Report - No proposed revisions
  • Template 26 - Regional Action Steps to Forensic Goals - No proposed revisions
  • Template 27 - PFS School-Based Prevention Quarterly Report