Provider Service Agreement
Attachment A- ACT
Attachment A- Assessments
Attachment A- Behavior Treatment Review
Attachment A- BHT Services ABA
Attachment A- Children’s Waiver
Attachment A- Clinical Services (OT, PT, SHL)
Attachment A- CLS
Attachment A- Clubhouse
Attachment A- Crisis Intervention
Attachment A- Crisis Residential
Attachment A- Direct Prevention
Attachment A- Enhanced Pharmacy Services
Attachment A- Family Support and Training
Attachment A- Fiscal Intermediary
Attachment A- Health Services
Attachment A- Home-Based Services
Attachment A- Housing Assistance
Attachment A- Individual-Group Therapy (Child, Adult, Family)
Attachment A- Intensive Crisis Stabilization
Attachment A- Nursing Facility Mental Health Monitoring
Attachment A- OBRA PAS-ARR
Attachment A- Peer-Delivered or Peer-Operated Support Services
Attachment A- Personal Care-Residential Setting
Attachment A- Private Duty Nursing
Attachment A- Psychiatric Services
Attachment A- Respite Services
Attachment A- SED Waiver
Attachment A- Skill Building-Nonvocational-Prevocational
Attachment A- SUD Community-Based Treatment
Attachment A- SUD Medication-Assisted Treatment
Attachment A- SUD Outpatient Treatment PIHP
Attachment A- SUD Residential Treatment and Recovery Residences
Attachment A- SUD Residential Withdrawal Management Revised
Attachment A- Supported Employment
Attachment A- Supports Coordination
Attachment A- Targeted Case Management
Attachment A- Transportation
Attachment A- Treatment Planning
Attachment A- Wraparound Services
Attachment A1- Specialized Residential Service Requirements
Attachment B - Reimbursement Terms
Attachment C- Insurance Requirements
Attachment D- Contract Monitoring
Attachment E1- Recipient Rights Inpatient and MH
Attachment E2- Recipient Rights
Attachment E3 - CEU Requirements for Recipient Rights Staff
Attachment F- Performance Indicators
Attachment G- Disclosure of Ownership Form
Attachment H- Delegated Functions
Attachment I- Training Requirements
Attachment J- Conflict of Interest
Attachment K- Designated Collaborating Organization