Network Service Provider contract documents:

(Required)

LSF Standard Contract: LSF Standard Contract – FY 20-21

Attachment I: Network Service Provider Attachment I – FY 20-21 rev. 7.15.2020

Attachment II (Lobbying): Network Service Provider Attachment II CF 1123_Lobbying – FY 20-21

Attachment III (Audit): Network Service Provider Attachment III CF 1120_Audit – FY 20-21

Attachment IV (HIPAA): Network Service Provider Attachment IV – HIPAA – FY 20-21

Other Network Service Provider Attachments:

(As Needed)

Community Action Teams (CAT):

Network Service Provider Attachment – CAT – FY 20-21 8.1.2020

CAT Extension-Readmission Authorization Form rev 10.14.19

CAT Exhibit A- Statewide Wraparound Training & Certification

Incidental Expenses Request Form 04.20.20

Expenditure Reconciliation Report – Incidentals CAT

APPENDIX 1 Update – September 2018

APPENDIX 2 – July 1 2018

CAT ROI Template Appendix 3 – as of 1.22.20

Mobile Response Teams (MRT):

Network Service Provider Attachment – MRT – FY 20-21

Mobile Response Team Monthly Data Report – Revised 11.13.19

Mobile Response Framework

Expenditure Reconciliation Report – Incidentals

Exhibit A – Required Reports – FY 20-21 rev. 8.1.2020

Exhibit B – Performance Outcome Measures – FY 20-21

Exhibit C and D – Projected Operating and Capital Budget – FY 20-21

Exhibit C-1 and D-1 – Statement of Revenue and Expense – FY 20-21

Exhibit E – Agency Capacity Report – FY 20-21

Exhibit F – Program Descriptions – FY 20-21

Exhibit G – Submission of Information – Fillable – FY 20-21

Exhibit H – Funding Detail – FY 20-21

Exhibit I – Invoice FY 20-21

Exhibit J – Local Match Calculation Form – FY 20-21

Exhibit K – Federal Block Grant Requirements – FY 20-21

Exhibit L – Covered Service Rates by Program – FY 20-21

Exhibit M – Bed Hold Request Form – Fillable – FY 20-21

Incorporated Document 1 – LSF Glossary of Contract Terms – FY 20-21

Incorporated Document 2 – Evidence Based Practice Guidelines – FY 20-21

Incorporated Document 3 – State and Federal Laws, Rules, Regulations – FY 20-21

Incorporated Document 4 – Auxilliary Aids for Deaf and Hard of Hearing – FY 20-21

Incorporated Document 5 – SAMH Funding Resource Guide – FY 20-21

Incorporated Document 6 – SIPP – FY 20-21

Incorporated Document 7 – Outpatient Forensic MH Services – FY 20-21

Incorporated Document 8 – SMHTF Admission and Discharge Processes – FY 20-21

Incorporated Document 9 – LMH-ALF Monitoring – FY 20-21

Incorporated Document 10 – SOAR – FY 20-21

Incorporated Document 11 – Expiration Termination Transition Planning – FY 20-21

Incorporated Document 12 – Crisis Counseling Program – FY 20-21

Incorporated Document 13 – Tangible Property Reqs – FY 20-21

Incorporated Document 14 – Performance Outcomes Manual – FY 20-21

Incorporated Document 15 – Prevention Services – FY 20-21

Incorporated Document 16 – Integration Planning and Position- FY 20-21

Incorporated Document 16 – IPP- CW Integration Manual – FY 20-21

Incorporated Document 17 – SDC – FY 20-21

Incorporated Document 18 – BNET – FY 20-21

Incorporated Document 19 – Financial Managment Requirements – FY 20-21

Incorporated Document 20 – FACT – FY 20-21

Incorporated Document 20 – FACT Monthly Referral Report – FY 20-21

Incorporated Document 20 – Outcome Measure Data Collection Tool – FY 20-21

Incorporated Document 20 – Transitional Voucher – FACT Monthly Report FY 20-21

Incorporated Document 21 – TANF – FY 20-21

Incorporated Document 22 – Crisis Respite Services – FY 20-21

Incorporated Document 23 – Womens Special Funding SA Services for PWM – FY 20-21

Incorporated Document 24 – PATH – FY 20-21 – Monthly LSF Homeless HU Search and Update List

Incorporated Document 24 – PATH – FY 20-21 – PATH Incidental Expenses Summary Rep

Incorporated Document 24 – PATH – FY 20-21 – PATH Quarterly Housed Report

Incorporated Document 24 – PATH – FY 20-21

Incorporated Document 25 – IDP – FY 20-21

Incorporated Document 25 – IDP – IDP Report – FY 20-21

Incorporated Document 26 – HIV Early Intervention Services – FY 20-21

Incorporated Document 27 – National Voter Registration Act – FY 20-21

Incorporated Document 28 – FIT – FY 20-21

Incorporated Document 29 – Seclusion and Restraint Reporting – FY 20-21

Incorporated Document 30 – Children’s Mental Health Care Coordination Program – FY 20-21

Incorporated Document 30 – FSPT Montly POS Template-Appendix K – FY 20-21

Incorporated Document 31 – Care Coordination – FY 20-21

Incorporated Document 31 – Care Coordination Spreadsheet – FY 20-21

Incorporated Document 32 – Suicide Prevention Best Practices – formerly STR – FY 20-21

Incorporated Document 33 – Central Receiving System – FY 20-21

Incorporated Document 33 – Central Receiving System – CRS Performance Measures Report – FY 20-21

Incorporated Document 34 – Transitional Voucher – Appendix 1 -Transitional Voucher Incidental Expenses

Incorporated Document 34 – Transitional Voucher – EXH A – Trans Vouch Pur Req (Fillable) – FY 20-21

Incorporated Document 34 – Transitional Voucher – EXH B – Grad Asses Scale (Fillable) – FY 20-21

Incorporated Document 34 – Transitional Voucher – FY 20-21

Incorporated Document 35 – State Opioid Response (SOR) – FY 20-21

Incorporated Document 36 – Recovery Support Services – FY 20-21

Incorporated Document 37 – Supported Employment – FY 20-21

Incorporated Document 37 – Supported Employment – Supp Emp Tracking Sheet – FY 20-21

Incorporated Document 38 – Juvenile Incompetent to Proceed (JITP) – FY 20-21

Incorporated Document 38 – Juvenile Incompetent to Proceed (JITP) – JITP Tracker – FY 20-21

Incorporated Document 39 – Co-Responder Program (CoR) – FY 20-21

Incorporated Document 39 – Co-Responder Program (CoR) – Report – FY 20-21