Guidelines | Templates | Forms

Central Florida Cares funds a services network comprised of many organizations offering various levels of treatment options.

Guidelines | Templates | Forms

Block Grant Manuals

The Block Grant Requirements Manual released by the Department of Children and Families for Managing Entities and Providers is to offer direction as to the requirements for the Substance Use Prevention and Treatment Grant (Grant) administered by the U.S. Substance Use and Mental Health Services Administration (SAMHSA). The elements in this document are requirements that the Federal government has imposed on recipients of the Grant.
Block Grant Manual for ME’s v2.0
Block Grant Manual for Providers v2.0

DCF Chart 8 System

The Chart 8’s are issued by the Department of Children and Families Revenue Management Department. A Chart 8 is issued for each funding Other Cost Accumulator (OCA). It provides the budget entity, purpose of the funding, funding restrictions, type of funds and CFDA/CFSA category. Chart 8’s are useful in understanding how funding can be utilized as well as creating cost allocation plans.
MH0TB – MH TANF
MH0PG – MH PATH Grant
MH0FH – Community Forensic Multidisciplinary Teams
MH0CN – MH Care Coordination Direct Client Services
MH0BN – MH BNET
MH000 – MH Services & Support
MSTRV – Transitions Vouchers Substance Use
MSOPM – FL Response To The Opioid Crisis Mat
MSOPH – FL Targeted Response Opioid Crisis-Hospital
MSOCN – SA Care Coordination Direct Client Services
MS091 – SA Family Intensive Treatment (FIT)
MS081 – ME Expand SA Services For Pregnant Women & their Family
MS025 – SA Prevention Services
MS023 – SA HIV Services
MS0TB – ME SA TANF
MS0PP – SA Prevention Partnership Program
MS000 – SA Services & Support
MHTRV – MH Transitions Vouchers
MHSHG – Housing Coordination
MHSFP – MH State Funded For Profit Sub-Recipients
MHSCR – Centralized Receiving Systems
MHSCD – Care Coordination
MHS55 – Circles of Care – Geropsychiatric Care
MHS52 – Circles of Care-Crisis Stabilization
MHS51 – Circles of Care-Cedar Village
MHS00 – ME Administration
MHHIP – Hurricane Irma Immediate Services Program
MHCAT – ME MH Community Action Teams (CAT)
MH076 – MH Indig Psych Meds Program
MH073 – MH Fact Program Admin
MH072 – MH Comm Forensic Beds
MH071 – MH PRTS Emot Disturb Child/Youth
MS917 – ME STEPS Women’s Residential Treatment
MS911 – ME Phoenix Affiliates-Family Stabiliz For Opioid
MH028 – ME Osceola Mental Health –Park Place
MSSOR – ME State Opioid Response Services-MAT
MSSOP – ME State Opioid Response Disc Grant Services-Prevent
MSCBS – ME SA Community Based Services
MHC0V – ME Emergency COVID-19 Grant
MHFMH – ME MH Forensic Transitional Beds
MS917 – ME STEPS Women’s Residential Treatment
MSCS0 – ME SA Seminole Co Sheriff Opioid ARC Partnership
MSRC2 – ME State Opioid Response Disc-Rec Comm Org-Yr-2
MSSGP- ME State Opioid Response Disc Grant-GPRA

Policy Memos

CFCHS strives to ensure our subcontractors as well as community stakeholders are informed of new or revised policies. These policy memos from Department of Children and Families Substance Use and Mental Health office include decisions, guidance and/or policy stance on various topics.
Repeal of Prohibition on Use of CMHS BG funds in Prisons or Jails (2/26/2020)
Opioid STR Funds to For-Profits OTPs Memo (2/20/2018)
Clarification of Language in HB 1121: re: Initiation of Involuntary Examination of Minors (11/3/2017)
Policy Memo Regarding Mental Health First Aid and Block Grant Funding (10/16/2017)
STR MAT Service Period Memo (5/11/2017)
Ensuring Forensic Case Managers are Attending Court (9/9/2016)
Policy memo to clarify scope of svcs funded by BG HIV EIS funding (12/31/2015)
Housing Choice Memo (10/9/2015)
CSU-SRT Designated Smoking Area Guidance (8/12/2015)
Performance Based Prevention System (7/1/2015)
SAMH-funded services to persons pending admission to non-SAMH benefits programs (4/8/2015)
Family Intensive Treatment Service Areas Signed Memo (4/2/2015)
Memo Regarding Primary Prevention Block Grant Funding for Parenting Classes (3/13/2015)
Revised Definition of Psychiatric Nurse (1/30/2015)

Program Description and Organizational Profile Templates

Per 65E-14 F.A.C. subcontractors must provide a program description to include an organizational profile. The program description is provided for each program funded under the Managing Entity and provides important information explaining the structure, population served, covered services, staffing levels and admission/discharge criteria within the program. The organizational profile provides an overview of the organization, populations served as a whole and performance measures pertinent to the funded programs.
Network Program Description Template (rev 3/2019)
Organization Profile Template (revised 3/2019)

Exception Report Guidance

CFCHS: Exception Report Guide (10-8-2024)
CFCHS: Exception Reports and Payment (11-1-16)
Provider Attestation (11-1-16)

FASAMS

FASAMS is the Financial and Services Accountability Management System, developed for the Department of Children and Families, to track data specific to State and Federal reporting requirements.
Frequently Asked Questions
Videos Tutorials
System Training
Mod 4 to Expenditure OCA Crosswalk

Fiscal Report Templates and Instructions

Provider Fiscal Reports template
Personnel Detail Record Instructions
Projected Cost Center Revenue and Operating Budget Instructions
Agency Capacity Report Instructions

Incidental Pre-Authorization Requests

Incidental expenses are temporary expenses incurred to facilitate the continuation of treatment and stabilization in the community when no other resources are available. All incidental expenses higher than $500 shall be authorized by CFCHS only to the extent that they are reasonable, allowable, and necessary as determined through the individual’s treatment plan. CFCHS will only authorize expenses for individuals admitted under CFCHS funded programs. This does not include outreach specific programs; these must be programs where the individual is receiving person specific services. CFCHS will approve up to (3) three months in advance housing costs per request. Please complete and submit all requests using the following form:

Incidental/Residential Pre-Authorization Request Form
The following links are form field descriptions and the incidental procedure codes when completing the form above:
Descriptions of Required Fields in Pre-Authorization Request Form
Incidental Procedure Codes
For any questions or concerns on the pre-authorization process, you may contact:
Incidental Expenses, Transitional Vouchers – Miralys Martinez, Risk Management Specialist, email: mmartinez@cfchs.org
Forensic Residential – Michelle Arroyo, Forensic Coordinator, email: marroyo@cfchs.org
Civil State Hospital – Stephanie Smith, System of Care Manager, email: ssmith@cfchs.org
PRTS
Rachel Bishop, Children’s Care Coordinator – For Orange and Osceola counties (Circuit 9), email: rbishop@cfchs.org
Incidental Expense Pre-Authorization Policy

Network Monitoring

Current Network Training

CFCHS has a responsibility to the community and to the people it serves to ensure that all Subcontractors are knowledgeable of the system of care services, how to navigate those services, proper referral and transfer procedures throughout the system of care, contract requirements, and offering technical assistance on an as-needed basis.
CFCHS Incidentals Training
CFCHS Contracts Onboard Training (rev 1-27-25)
Exhibit B Required Reports (rev 2-16-24)
Report Tracking System (RTS)
ROSC 101
Incident Report Training

Archived Network Trainings

Incident Report Training (Archive 4-27-2021)
FY 1213 CFCHS Provider New Contract Webinar 2-7-2013
FY1314 CFCHS Funding and Program Change Requests July 2013
FY1314 CFCHS Funding Distribution by Provider 1-14-14
FY1314 CFCHS Network Budget Allocation presentation with notes 3-7-14
FY1415 CFCHS Sanctions and Penalties 12-18-14
FY1415 CFCHS The Importance of Block Grant Reporting 01-14-2015
FY1415 CFCHS Performance Measures 2-25-2015
FY1415 Eligibility Documentation and Sliding Fee Scale 3-11-2015
FY1516 cfchsdata.org Financial 3.0 Training July 2015
FY1516 Bed Count Module Webinar September 2015
FY1516 Incidentals Pre-Authorization Process 12-10-2015
FY1617 Transitional Voucher Process 12-1-2016
Sanctions and Penalties webinar 12-18-2014
Performance Measures webinar 02-25-2015
Eligibility Documentation and Sliding Fee Scale 3-11-2015
Bed Count Module Webinar September 2015
Incidentals Pre-authorization Process 12-10-2015

Current

Access to Care, Waiting List, and Capacity Management

Behavioral Health Service Procurement

Children’s Mental Health-Residential Treatment

Contract Review

Incidental Expense Pre-Authorization Policy

Network Complaints and Grievances

Payer of Last Resort and Financial Eligibility

Priority Population Eligibility

Pro-Children Act of 1994

Procurement

Rights of Individuals Served

Sliding Fee Scale

Specified Programs Performance Measure Analysis Monitoring and Validation

Sponsorship

Subcontractor Compliance and Performance Improvement

Subcontractor Dispute Resolution

Subcontractor Files

Subcontractor Incident Reporting to CFCHS’ Reporting and Management System

Subcontractor Invoice Validation and Approval

Subcontractor Match

Subcontractor Monitoring

Subcontractor Risk Assessment

Subcontractor Training

Community Persons Served Satisfaction Survey

Central Florida Cares Health Systems, Inc.’s (CFCHS) goal is to ensure quality services are rendered to all individuals receiving services and closely works with its subcontracted network to make improvements and support best practices. To achieve this, CFCHS Subcontractors obtain feedback on service provision through the Department of Children and Families Community Person Served Satisfaction Survey (CPSSS).

The CPSSS assess the individual’s level of satisfaction in seven (7) domains, which include, general satisfaction, access to care, appropriateness and quality of care, outcomes of care, involvement in treatment, social connectedness, and functional satisfaction; and consists of 14 questions for adults and 8 questions for children.

Please refer to Pamphlet 155-2, Appendix 4, Community Person Served Satisfaction Survey (CPSSS) for additional details.

You can share your experience about the services you, or a loved one, are receiving by accessing the CPSSS at the following link and QR code:
https://floridadcf.iad1.qualtrics.com/jfe/form/SV_2mmcxrBueRZjw6W

Provision of services must never be based upon individuals completing the survey.
If you have additional questions, please contact:
Jerrymar Foster
Quality Improvement Specialist
jfoster@cfchs.org
407-985-3571

National Voter Registration Act

ALF-LMHL Resources

Cooperative Agreement & Community living & support plan
Resident Health Assessment for ALF

AHCA’s website for directory:
https://ahca.myflorida.com/mchq/health_facility_regulation/assisted_living/alf.shtml

Care Coordination

Children’s Coordinated System Of Care Plan – House Bill 945
CFCHS Care Coordination Guidelines (Rev 9-2021)
Care Coordination Weekly Report Template (Rev 7-15-2022)
Guidance Doc (Rev 8-2022)

Community Action Team (CAT)

CAT – Community Action Treatment (CAT) teams provide community-based services to children ages 11 to 21 with a mental health or co-occurring substance Use diagnosis with any accompanying characteristics such as being at-risk for out-of-home placement as demonstrated by repeated failures at less intensive levels of care; having two or more hospitalizations or repeated failures; involvement with the Department of Juvenile Justice or multiple episodes involving law enforcement; or poor academic performance or suspensions. Children younger than 11 may be candidates if they display two or more of the aforementioned characteristics.
CAT Monthly Census Template (Rev. July 2, 2024)
CAT Provider YTD Total- Appendix I & II
CAT COC Vacant Position Template
CAT Aspire Vacant Position Template
CAT Example ROI Formula
Guidance 32 CAT

Child Welfare Integration

Central Florida Health Care System (CFCHS), Department of Children and Families (DCF), Embrace Families and Brevard Family Partnership have agreed to work together to coordinate services and supports for the adult parents and caregivers involved in both the child welfare system and behavioral health system. The Integration Protocols outlines the guiding principles and goals in assisting parents/caregivers in ongoing coordination and collaboration of behavioral health services to ensure engagement and retention in treatment.
DCF CFCHS CBCCF Integration Protocol
DCF CFCHS BFP Integration Protocol
Integration Protocol Flow Chart for Providers – Brevard
Integration Protocol Flow Chart for Providers – C9 Seminole

Civil And Forensic Resources

Civil – CFCHS contracts with Community Mental Health Treatment Centers in each of its covered counties to provide a Community Case Manager for individuals residing in State Mental Health Treatment Facilities. The Community Case Manager coordinates admission and discharge planning for the civil system. They track individuals during their state mental health treatment stay and post-discharge to ensure treatment engagement, stable housing, resumption or acquisition of benefits, and meaningful involvement in the community.

Forensic – CFCHS contracts with Community Mental Health Treatment Centers in each of its covered counties to provide forensic case management services for individuals charged with or at-risk of being charged with a felony offense. These are individuals who have been court ordered for an evaluation or who have been committed to the Department of Children and Families (DCF) under the provisions of Chapter 916, F.S. Specifically, these are individuals who have received an Order for Evaluation of Competency or Sanity or have been adjudicated as Incompetent to Proceed (ITP) or Not Guilty by Reason of Insanity (NGI) due to mental illness.
State Mental Health Reintegration Plan
Civil Client Info Template (rev 10-2023)
Circuit Transfer Request (rev 7-2017)
CFCHS FMT Guide (Jan 2023)
FMT Monthly Census
Forensic Census Template
Guidance 6 – Outpatient Forensic Mental Health Services
Guidance 7 – Forensic and Civil Treatment Facility Admission and Discharge Processes
Guidance 28 – Forensic Multidisciplinary Team
CFCHS Forensic Specialist Guide
SMHTF Meetings Report Template

Florida Assertive Community Treatment (FACT)

FACT – In an effort to promote independent, integrated living for individuals with serious psychiatric disabilities, Florida Assertive Community Treatment (FACT) teams provide a 24-hour-a-day, seven-days-a week, multidisciplinary approach to deliver comprehensive care to people where they live, work or go to school, and spend their leisure time. The programmatic goals are to prevent recurrent hospitalization and incarceration and improve community involvement and overall quality of life for program participants.
Aspire Orange FACT Team Referral
MHRC Osceola FACT Referral
MHRC Brevard FACT Referral
FACT Quarterly AdHoc Report
FACT Monthly Reports
FACT Monthly Census – Template
Guidance 16 – Florida Assertive Community Treatment (FACT) Handbook

Medication Assisted Treatment Service Providers

Medication Assisted Treatment (MAT) services include assessments, case management, peer support services, recovery planning, residential and detoxification services and medication management. The delivery of medications for the treatment of substance use disorder which are prescribed by a licensed health care professional. Service is in conjunction with a clinical assessment and substance Use treatment.

BREVARD COUNTY
Aspire Health Partners (407) 245-0014
Central Florida Treatment Center (321) 951-9750
Circles of Care (321) 722-5261
RASE Project (321) 305-4397
Specialized Treatment Education and Prevention Services, Inc./S.T.E.P.S. (407) 522-2144

ORANGE COUNTY
Aspire Health Partners (407) 245-0014
Central Florida Treatment Center (407) 843-0041
LifeStream Behavioral Center (866) 355-9394 or (352) 315-7800
RASE Project (407) 518-1094
Specialized Treatment Education and Prevention Services, Inc./S.T.E.P.S. (407) 522-2144

OSCEOLA COUNTY
House of Freedom (407) 957-9077 ext. 204
Park Place Behavioral Healthcare (407) 846-0023
RASE Project (407) 518-1094
The Transition House (407) 892-4202, ext. 169 or ext.164

SEMINOLE COUNTY
Advent Health Hope and Healing Center (407) 303-2200
Aspire Health Partners (407) 323-2036
Longwood Comprehensive Treatment Center (321) 999-9617
RASE Project (407) 518-1094
Specialized Treatment Education and Prevention Services, Inc./S.T.E.P.S. (407) 522-2144

Mobile Response Team (MRT)

CFCHS MRT Guide (July 2019)
MRT Monthly Report Template (Rev. July 28, 2023)

Short-Term Residential Treatment

Short Term Residential – The Short Term Residential Treatment Facility (SRT) is a co-ed adult inpatient unit providing services to individuals with a mental health diagnosis and/or co-occurring substance Use diagnosis. SRT provides a high level of care for individuals who are no longer experiencing a psychiatric emergency but who are still in need of additional inpatient treatment prior to community placement. SRT also serves clients waiting for placement at the state hospital. The length of stay on SRT varies but the average is usually 3 months.
SRT Waitlist Template (Rev. August 9, 2019)

SOAR

SSI/SSDI Outreach, Access, and Recovery (SOAR) is a model designed to increase access to Social Security Administration (SSA) disability benefits for eligible individuals who are experiencing or at risk of homelessness and have a mental illness, medical impairment, and/or a co-occurring substance use disorder.

Online training: https://soarworks.prainc.com/content/soar-online-course-catalog
Online Application Tracking: https://soartrack.samhsa.gov/

TANF

TANF – Temporary Assistance to Needy Families (TANF) is a federal block grant program which provides funding to states to help move recipients into work and turn welfare into a program of temporary assistance. Central Florida Cares Health System, Inc. oversees the portion of TANF funding used to provide services to families receiving welfare benefits and families at-risk of receiving welfare benefits who may suffer from substance Use and/or mental health illnesses.

TANF Forms
TANF EZ-1 Form (Rev January 2025) | Download
TANF EZ-1 Form – Spanish (Rev January 2025) | Download
TANF Contingency Funding Request Form (Rev January 2016) | Download
TANF Financial Information Form (Rev February 2017) | Download
TANF Non-Custodial Parent Form | Download
TANF Participant Log | Download
TANF Monthly Income Verification Form (Rev February 2017) | Download

TANF Guidelines
CFCHS TANF Guide (rev February 2020)
TANF Flowchart (rev November 2018)
2024 Federal Poverty Guidelines | Download

WITS

FL SOR 3 Resource Guide
FL SOR 3 User Guide
FL SOR 3 Smart Guide
New GPRA Tool QxQ without Section H
WITS Staff Management User Guide