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.

Adoption support team (AST)
AST service code directory
AST service activity log
AST monthly statistical report
AST quarterly performance measures report
AST monthly statement of cash match and assurances
AST cash match in kind template
AST monthly invoice
AST provider PSSF template

Residential
Procedure on runaways and extended visits
Residential group care monthly and quarterly report
Emergency shelter group care monthly and quarterly

Family visitation centers
Monthly statistical report
Quarterly performance measures report
Monthly statement of cash match and assurances
Cash match in kind template
Monthly invoice

Foster home development/Child placing agency
Invoice template
FHD traditional invoice template
FHD behavioral invoice template
Behavioral FH monthly and quarterly report
Justification for re-licensure
FHD monthly and quarterly report
Respite care agreement
Respite protocol
Working agreement
CIC sibling foster care program report
Procedure on runaways and extended visits

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
IHSS RFP question and answer board

Intensive family preservation and reunification
Monthly statement of cash match and assurances
Monthly invoice
Provider PSSF template

University of West Florida
Quarterly report
Training and consultation monthly statistical report

All providers
Affidavit on disqualifying conditions
E-verify affidavit
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
Provider self-evaluation
RFA provider application – annual
FFN sub-provider incident reporting protocol
LCI incident reporting system quick reference guide

Therapeutic services for children
Monthly invoice

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

Flexible spending
Monthly invoice

Intensive family preservation and reunification
Monthly invoice

In-home safety support
Monthly invoice