PROVIDER RESOURCES
We strive to work together to build stronger and healthier communities through an integrated system of care, and that starts with ensuring our providers have all the resources they need. We are proud to offer the following resources and tools to our service provider network and partners. Service providers can find all the necessary documents and forms to fulfill their contractual obligations and ensure they are able to effectively serve people in need.
988-211
Adult Family Care Homes Records
Attachment I Compliance
BNet Clinical 1
BNet
CAT Team
CAT Clinical Performance Measure Analysis Monitoring Tool
CFS FSPT
Children Residential
Civil State Hospital
Clinical Records ID 62
CORE
Cost Reimbursement
CQI IRAS
CQI Suicide Prevention Best Practices
Crisis Respite Service
Crisis Stabilization Unit Services
DHoH Services – Client
DHoH Services – Organization
DHoH Services – Personnel
Employee Eligibility – Organization
Employee Eligibility – Personnel Tool rev.1.16.2026
FACT Clinical Records
Family First Prevention Services Act (FFPSA) Teams Monitoring Tool
Family Services Treatment Team (FSTT)
First Episode Psychosis
FMT
Forensic State Hospital
Financial 65E-14 Audit
Financial Contract Audit
Financial Data Validation rev. 031425
Financial Desk Audits
Financial Fiscal Mgmt Audit
Financial CMHBG Audit
Financial-SAPTBG-Audit-Revised080320
Family Treatment Coordinator (FTC)
FIT Services Monitoring Tool
Fixed Rate Monitoring Tool
HIPAA Notice of Privacy Practices
HIPAA Privacy Data Security – Organization
HIPAA Privacy-Data Security – Personnel rev. 021926
HIV Early Intervention
Indigent Psychiatric Medication Program -Client
Indigent Psychiatric Medication Program -Org
Incidental Expenditures – Organizational
Level 2 Background Screening rev. 01.21.26
LMH-ALF
MAT Clinical Tool (All MAT)
MH Clubhouse
MH Outpatient and Case Management
Mobile Response Team – MOU Check
Mobile Response Team Tool
MRT Clinical Performance Measure Analysis Monitoring Tool
National Voter Registration Act
NSP Care Coordination Monitoring Tool
PATH COMPLIANCE NEW SEPT 2021
PATH RECORDS NEW SEPT 2021
PATH Interview Tool Oct 2024
Prevention Specialists
Recovery Support Services (RSS) Tool
Recovery Support Services
ROSC Training
SA Aftercare Tool
SA Detoxification
SA Intervention Clinical Tool
SA Outpatient & Case Management
SANDR Reporting
SBIRT Services
SOAR COMPLIANCE NEW Sept 2024
SOAR RECORDS NEW 2024
Standard Contract
Standard Financial Audit
Subcontract Monitoring
Substance Abuse and Block Grant HIV
Substance Use Outpatient Treatment
Substance Use Residential Treatment
Supportive Employment Records NEW Oct 2024
Supportive Housing Records NEW Sept 2021
TANF SAMH Checklist
(Required)
LSF Standard Contract – FY 26-27
Network Service Provider Attachment I – Financial Compliance – FY 26-27
Network Service Provider Attachment II – FY 26-27
Network Service Provider Exhibit A – Special Provisions – FY 26 -27
Network Service Provider Exhibit A1 – Program and Service Specific Terms – FY 26-27
Network Service Provider Exhibit A2 – SAMH Programmatic Laws FY 26-27
Network Service Provider Exhibit B – Scope of Work – FY 26-27
Network Service Provider Exhibit B1 – Federal Block Grant Requirements – FY 26-27
Network Service Provider Exhibit C – FY 26-27
Network Service Provider Exhibit C1 – FY 26-27
Network Service Provider Exhibit C2 – Required Reports – FY 26-27
Network Service Provider Exhibit C2 – Required Reports -POs Only – FY 26-27
Network Service Provider Exhibit D – Deliverables – FY 26-27
Network Service Provider Exhibit E – Minimum Performance Measures – FY 26-27
Network Service Provider Exhibit F – Method of Payment – FY 26-27
Network Service Provider Exhibit F1 – Funding Detail – FY 26-27
Network Service Provider Exhibit F2 – Covered Service Rates – FY 26-27
Template A – Required Reports – FY 26-27
Template B – Performance Outcome Measures – FY 26-27
Template C and D – Projected Operating and Capital Budget – FY 26-27
Template E – Agency Capacity Report – FY 26-27
Template F – Program Descriptions – FY 26-27
Template G – Submission of Information – Fillable – FY 26-27
Template H – Funding Detail – FY 26-27
Template I – Invoice FY 26-27
Template J – Local Match Calculation Form FY 26-27
Template K – Federal Block Grant Requirements – FY 26-27
Template L – Covered Service Rates by Program – FY 26-27
Template M – Bed Hold Request Form – Fillable – FY 26-27
Template M2 – Forensic Bed Hold Form – FY 26-27
Template M3 – Continued Stay Request Form – FY 26-27
Template N – Incidental Expenses Request Approval Form – Fillable – FY 26-27
Template O – Expenditure Reconciliation Report – FY 26-27
Template O – Expenditure Reconciliation Reports – Multi-OCA – FY 26-27
Template P – Cost Reimbursement Template – Part 1 – FY 26-27
Template P – Cost Reimbursement Template – Part 2 – FY 26-27
Template Q – Network Development Template – FY 26-27
Template R- Respite Extension Request Form – FY 26-27
Incorporated Document 1 – LSF Glossary of Contract Terms – FY 26-27
Incorporated Document 2 – Evidence Based Practice Guidelines – FY 26-27
Incorporated Document 3 – State and Federal Laws, Rules, Regulations – FY 26-27
Incorporated Document 4 – Auxiliary Aids for Deaf and Hard of Hearing – FY 26-27
Incorporated Document 5 – SAMH Funding Resource Guide – FY 26-27
Incorporated Document 6 – SIPP – FY 26-27
Incorporated Document 7 – Outpatient Forensic MH Services – FY 26-27
Incorporated Document 8 – SMHTF Admission and Discharge Processes – FY 26-27
Incorporated Document 9 – LMH-ALF Monitoring – FY 26-27
Incorporated Document 10 – SOAR – FY 26-27
Incorporated Document 11 – Expiration Termination Transition Planning – FY 26-27
Incorporated Document 12 – Crisis Counseling Program – FY 26-27
Incorporated Document 13 – Tangible Property Reqs – FY 26-27
Incorporated Document 14 – Performance Outcomes Manual – FY 26-27
Incorporated Document 15 – Prevention Services and PPG – FY 26-27
Incorporated Document 16 – Integration with Family and Child Well-Being – FY 26-27
Incorporated Document 16 – CW Integration Manual – FY 26-27
Incorporated Document 16 – Integration with Child Welfare – FTC Report FY 26-27
Incorporated Document 17 – SDC – FY 26-27
Incorporated Document 18 – BNet – FY 26-27
Incorporated Document 18 – BNet – DCF Template 7
Incorporated Document 19 – Financial Management Requirements – FY 26-27
Incorporated Document 20 – FACT – FY 26-27
Incorporated Document 20 – Outcome Measure Data Collection Tool
Incorporated Document 20 – Transitional Voucher – FACT Monthly Report
Incorporated Document 20 – FACT Monthly Vacancy Report FY 26-27
Incorporated Document 20 – FACT Monthly Referral Report – FY 26-27
Incorporated Document 21 – TANF – FY 26-27
Incorporated Document 21 – TANF – One-time Payment Form Exhibit A
Incorporated Document 22 – Adult Respite Services – FY 26-27
Incorporated Document 22- Adult Respite Report – FY 26-27
Incorporated Document 23 – Women’s Special Funding Substance Abuse Services for Pregnant Women and Mothers – FY 26-27
Incorporated Document 24 – PATH – FY 26-27
Incorporated Document 24 – PATH – PATH Incidental Expenses Summary Report
Incorporated Document 24 – PATH – PATH Quarterly Housed Report
Incorporated Document 25 – IDP FY 26-27
Incorporated Document 25 – IDP – IDP Report
Incorporated Document 26 – HIV Early Intervention Services – FY 26-27
Incorporated Document 27 – National Voter Registration Act – FY 26-27
Incorporated Document 28 – FIT – FY 26-27
Incorporated Document 28 – FIT Client Information Form
Incorporated Document 29 – Seclusion and Restraint Reporting – FY 26-27
Incorporated Document 30 – Family Service Planning Team – FY 26-27
Incorporated Document 30 – FSPT Monthly POS Template-Appendix K
Incorporated Document 30 – FSPT – Appendix L- FY 26-27
Incorporated Document 31 – Care Coordination – FY 26-27
Incorporated Document 31 – Care Coordination Spreadsheet – FY 26-27
Incorporated Document 31 – Children’s Care Coordination Report
Incorporated Document 32 – Suicide Prevention Best Practices – FY 26-27
Incorporated Document 33 – Central Receiving System – CRS Performance Measures Report – FY 26-27
Incorporated Document 33 – Central Receiving System – FY 26-27
Incorporated Document 33 – Central Receiving System – Supplementary Guidance
Incorporated Document 34 – Transitional Voucher – FY 26-27
Incorporated Document 34 – Transitional Voucher – EXH A – Trans Vouch Pur Req (Fillable) – FY 26-27
Incorporated Document 34 – Housing Checklist
Incorporated Document 35 – State Opioid Response (SOR) FY 26-27
Incorporated Document 35 – Template 34 – DCF Template FY 26-27
Incorporated Document 35 – SOR – Paramedicine Report
Florida SOR Resource Guide
Incorporated Document 36 – Recovery Management Practices – FY 26-27
Incorporated Document 36 – Recovery Management Practices – ROSC Modules Employee Attestation
Incorporated Document 37 – Supported Employment – FY 26-27
Incorporated Document 37 – Supported Employment – Supp Emp Tracking Sheet
Incorporated Document 38 – Juvenile Incompetent to Proceed (JITP) – FY 26-27
Incorporated Document 38 – Juvenile Incompetent to Proceed (JITP) – JITP Tracker
Incorporated Document 39 – Co-Responder Program (CoR) – FY 26-27
Incorporated Document 39 – Co-Responder Program (CoR) Report FY 26-27
Incorporated Document 40 – Community Action Treatment (CAT) Team for Ages 0-10 FY 26-27
Incorporated Document 40 – CAT Program Staffing Report
Incorporated Document 41 – School Telehealth Proviso FY 26-27
Incorporated Document 42 – Community Action Treatment (CAT) Team – FY 26-27
Incorporated Document 42 – Community Action Treatment (CAT) Team – Appendix 1-3 – FY 25-26
Incorporated Document 42 – Community Action Treatment (CAT) Team – Exhibit A
Incorporated Document 42 – Community Action Treatment Monthly Census Report FY 26-27
Incorporated Document 42 – Community Action Treatment (CAT) Team Program Staffing Report
Incorporated Document 43 – Mobile Response Team (MRT) – FY 26-27
Incorporated Document 43 – Mobile Response Team (MRT) Data Report FY 26-27
Incorporated Document 43 – Mobile Response Outreach Report FY 26-27
Incorporated Document 43 – Mobile Response Team (MRT) Program Staffing Report
Incorporated Document 44 – Forensic Multi-Disciplinary Team (FMT) FY 26-27
Incorporated Document 44 – Forensic Multi-Disciplinary Team (FMT) – Template 25 FMT – LSFHS Version
Incorporated Document 44 – Forensic Multi-Disciplinary Team (FMT) Monthly Vacancy Report
Incorporated Document 45 – Supported Housing FY 26-27
Incorporated Document 46 – First Episode Psychosis FY 26-27
Incorporated Document 46 – Coordinated Specialty Care for ESMI-FEP-Monthly-Report
Incorporated Document 47 – Clubhouse FY 26-27
Incorporated Document 48 – Family Well-being Treatment Team FY 26-27
Incorporated Document 48 – Family Well-being Treatment Team – FIT Lite Report
Incorporated Document 49 – FACT-IL – FY 26-27
Incorporated Document 49 – Intermediate Level FACT (FACT-IL) Team Model Outcome Measures Report FY 26-27
Incorporated Document 49 – Intermediate Level FACT (FACT-IL) Team Model Report FY 26-27
Incorporated Document 50 – Family First Prevention Services Act (FFPSA) FY 26-27
Incorporated Document 51 – 988 Florida Lifeline (988 FL) FY 26-27
Incorporated Document 52 – Coordinated Opioid Recovery (CORE) Network of Addiction Care FY 26-27
Template 37 – Coordinated Opioid Recovery (CORE) Network Quarterly Narrative Report
Template 38 – Coordinated Opioid Recovery (CORE) Network Quarterly Data Report
Incorporated Document 54 – Opioid Settlement FY 26-27
Incorporated Document 55 – Children Respite FY 26-27
Incorporated Document 55 – Children Respite Persons Served and Perf Report
Incorporated Document 56- Bridge Programs FY 26-27
Incorporated Document 57 – Incident Reporting Analysis System (IRAS) and Continuous Quality Improvement FY 26-27
Incorporated Document 58 – Children’s Short-term Residential Treatment (SRT) Program FY 26-27
Incorporated Document 58 – Short-term Residential Treatment – Outreach Report
Incorporated Document 58 – Short-term Residential Treatment – Performance Metrics Report
Incorporated Document 59 – First Responder Program FY 26-27
Incorporated Document 59 – First Responder Report – Peer Support Referral Report FY 26-27
Incorporated Document 60 – Treatment Alternative for Safer Communities (TASC) FY 26-27
Incorporated Document 61 – Behavioral Health Consultants FY 26-27
Incorporated Document 62 – Provider Documentation Standards – Mental Health
Incorporated Document 63 – Medication for Opioid Use Disorder (MOUD) and Medication-Assisted Treatment (MAT) Provider Guidance: Expectations and Responsibilities
Incorporated Document 64-Documentation Standards for Non-Clinical Recovery Support Services FY 26-27
Incorporated Document 65-Daily Living Activities-20 FY 26-27
*Network Service Provider Attachments for specific/special programs are incorporated in the appropriate contracts and not included here. Requests to view the Attachments can be made to LSF Health Systems.
Reporting Templates:
Forensic RTF Report
SMHTF Transitional Program Report FY 26-27
Template 33 – DSV ALF
Transitional Program Report FY 26-27 – Meridian Williams Manor
Transitional Beds – Exhibit A-C
Vacant Position Report
Wraparound Monthly Performance Measure Report
Monthly Narrative Report – Marion Senior Services
COACHES Monthly Performance Measures Report
MANAGING ENTITY (ME) AND THE FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES (DCF) CONTRACT:
The components of the contract between the ME, Lutheran Services Florida, and DCF can be found here for the appropriate fiscal year:
https://www.myflfamilies.com/services/substance-abuse-and-mental-health/samh-providers/managing-entities
The executed contract between the ME, Lutheran Services Florida, and DCF can be found here:
https://facts.fldfs.com/Search/ContractDetail.aspx?AgencyId=600000&ContractId=EHME2
The requirements of the Data System are located here:
https://www.myflfamilies.com/services/samh/providers/FASAMS
Request Access to KIS Express, OneDrive or WITS – SOR Program’s Web Infrastructure for Treatment Services:
Technical Assistance (TA) is provided to Network Service Providers as needed. The documents presented in the TA sessions can be found here.
CF-MH 1037: FY 2022-23-Reconciliation Workshop: MH1037 Instructions for 22-23 Revised
CF-MH 1037: FY 2022-23-Reconciliation Workshop (RCOs): MH1037 Instructions for 22-23 RCOs
Exhibit C and D – Proj Operating and Capital Budget: FY 2024-2025 Exhibit C and D Workshop: Exhibit C and D Instructions for 24-25
Exhibit E – Agency Capacity Report: FY 2024-2025 Exhibit E Workshop: Exhibit E Instructions for 24-25
