Managing Entities FY23-24 Templates

Unless otherwise indicated, these documents are effective July 1, 2023. Comments questions or suggestions should be directed to: @email.

CONTRACT DOCUMENTS

ME Standard Contract

Standard Contract Part 1

EXHIBITS
Exhibit A - Special Provisions - Revised 11/1/2023
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 11/1/2023
Exhibit C1 - Additional Region-Specific Tasks *
Exhibit C2 - Region-Specific Appropriations *
Exhibit C3 - ME Required Reports, Plans, and Functional Tasks - Revised 11/01/2023
Exhibit D – Deliverables
Exhibit E - Minimum Performance Measures
Exhibit F - Method of Payment - Revised 11/1/2023
Exhibit F1 - ME Schedule of Funds *
Exhibit F2 – Sample Schedule of Payments

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

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
Guidance 5 – Residential Mental Health Treatment for Children and Adolescents
Guidance 6 – Outpatient Forensic Mental Health Services
Guidance 7 – State Mental Health 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 in 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 – Integration with Child Welfare
Guidance 20 – Local, Regional, and State Review Teams
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 (CRS)
Guidance 28 – Forensic Multidisciplinary Team
Guidance 29 – Transitional Voucher
Guidance 30 – Deleted – effective 9/29/2021
Guidance 31 – Deleted – effective 7/1/2021
Guidance 32 – Community Action Treatment (CAT) Team - Revised 2/6/2024
Guidance 33 – HIV Early Intervention Services
Guidance 34 – Mobile Response Team (MRT)
Guidance 35 – Recovery Management Practices
Guidance 36 – Linking, Advocating, Treating, Transitioning, Empowering and Recovery Support (LATTERS); Florida Assertive Community Treatment (FACT) Tier 2 Variation
Guidance 37 – Family First Prevention Services Act (FFPSA) Teams, Community Action Treatment (CAT) Tier 2 Variation - Revised 9/18/2023
Guidance 38 – Community Action Treatment (CAT) Team for Ages 0-10, (CAT Tier 3 Variation) - Revised 9/18.2023
Guidance 39 – Multidisciplinary Child Welfare Teams
Guidance 40 – Family Support Teams (FST) Community Action Treatment (CAT) Team, Tier 4 Variation - Revised 9/18/2023
Guidance 41 –Coordinated Opioid Recovery Network of Addiction Care (CORE Network) - Effective 10/1/2023
Guidance 42 – State Opioid Response (SOR) Project - Revised 11/1/2023

Reporting Templates
Template 1 – Provider Tangible Property Inventory Form
Template 2 – SAMH Block Grant Reporting Template Overview and Instructions
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 – BNet Participant Forms
Template 7 – BNet Alternative Service Forms
Template 8 – Deleted, effective 11/29/2016
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 11/6/2023
Template 13 – Managing Entity Monthly Carry Forward Expenditure Report - Revised 9/21/2023
Template 14 – Cost Allocation Plan
Template 15 – Managing Entity Spending Plan for Carry Forward Report - Revised 9/21/2023
Template 16 – Deleted, effective 7/1/2023
Template 17 – Deleted, effective 7/1/2020
Template 18 – Deleted, effective 5/18/2017
Template 19 – Deleted – effective 9/29/2021
Template 20 – Deleted, effective 7/1/2021
Template 21 – Monthly Care Coordination Report - Revised 9/18/2023
Template 22 – Forensic Mental Health Services Report - Revised 10/12/2023
Template 23 – Forensic Diversion Report - Revised 10/12/2023
Template 24 – CCP Supplemental Invoice and Expenditure Report
Template 25 – Forensic Multidisciplinary Team Report - Revised 10/12/2023
Template 26 – Deleted, effective 7/1/21
Template 27 – Deleted – effective 9/29/2021
Template 28 – Mobile Response Team Report - Revised 8/7/2023
Template 29 – FACT Quarterly Report - Revised 9/18/2023
Template 30 – Proviso Project Return on Investment Report
Template 31 – Deleted, effective 7/1/2023
Template 32 – Transitional Voucher Incidental Report - Revised 9/18/2023
Template 33 –Community Forensic Beds Report - Revised 10/12/2023
Template 34 – SOR Reports - Revised 11/1/2023
Template 35 – FY 2023-24 $126M Tracking Tool - Revised 11/1/2023

Managing Entities FY23-24 Templates

CONTRACT DOCUMENTS

ME Standard Contract

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