Contract Exhibits
The following documents are available on this website for subproviders within our Community-Based Care contract. In the event these documents are updated, current subcontractors will be notified of updates. Please consider this website your primary reference source for contractual exhibits.
Programs
- Family Support Team (FST)
- Adoption Support Team (AST)
- Home Option for Medically Exceptional (HOME)
- Residential
- Family Visitation Center
- Foster Home Development
- Child Protection Professional Training
- Family Care Unit
- All Providers
- Sexual and Physical Abuse Treatment Services (SPATS)
- Wraparound
Adoption Support Team
- AST Service Code Directory
- AST Service Activity Log
- AST Monthly Statistical Report
- AST Quarterly Performance Measures Report
- Monthly Statement of Cash Match and Assurances
- Cash Match In Kind template
- Monthly Invoice
- Provider PSSF Template
Residential
- Residential Monthly Statistical Report
- Procedure on Runaways and Extended Visits
- Residential Quarterly Performance Measures Report
- Standardized Placement Request Form
Family Visitation Centers
- Visitation Center Monthly Statistical Report
- Visitation Center Quarterly Performance Measures Report
- Monthly Statement of Cash Match and Assurances
- Cash Match In Kind Template
- Monthly Invoice
- Invoice template-Family Visitation Center
Foster Home Development
- Behavioral Foster Home Monthly and Quarterly Reports
- Justification for Re-Licensure
- FHD Monthly Statistical Report
- FHD Quarterly Performance Measures Report
- Respite Care Agreement
- Respite Protocol
- Working Agreement
- Standardized Placement Request Form
- Procedure on Runaways and Extended Visits
- Monthly Invoice
Family Care Unit
- FCU Service Code Directory
- FCU Monthly Statistical Report
- FCU Monthly Activity Report
- Unit Cost Invoice
- Monthly Invoice
In-Home Support Services
- IHSS Monthly and Quarterly Report
- IHSS Service Code Directory
- Monthly Invoice
- Provider PSSF Template
Intensive Family Preservation and Reunification
University of West Florida
All Providers
- Affidavit of Compliance Background Screening
- Affidavit of Screening Requirements
- Attachment I - Standard Contract
- Attachment II - Financial and Compliance Audit
- Attachment III -Business Associate Agreement
- Certification Regarding Debarment
- Certification Regarding Lobbying
- Civil Rights Compliance Checklist
- DCF Security Agreement
- STARS Quick Reference Guide
- Subprovider Incident Reporting Protocol
- Provider Self Evaluation
- RFA - Provider Application - Annual
Therapeutic Services for Children
Sexual and Physical Abuse Treatment Services (SPATS)
- Monthly Invoice
- Quarterly Performance Measure Report
- Client Eligibility Attestation Form
- SPATS Service Code Directory
Wraparound Contract
- Wraparound Monthly and Quarterly Report
- Family Support Services FSFN Guide
- Wraparound Service Code Directory
- Monthly Statement of Cash Match and Assurances
- Monthly Invoice
- Provider PSSF Template