Provider Contracts

Provider Contracts

Below is a list of the various documents associated with the current grant agreement between the SCA and the Contractors. 

DDAP Manuals

• Fiscal Manual 
• Operations Manual
• Prevention Manual
• Case Management and Clinical Services (formerly Treatment Manual)
• Client Liability Determination Form (Excel)
• Outpatient Client Liability Table
• Intensive Outpatient/Partial Hospitalization Client Liability Table
• Inpatient Residential Client Liability Table

Appendix E 

• Blair Case Management and Clinical Service Policies 4/1/2022
  • Policy Bulletin No. 21-01 12/1/2021
  • Policy Bulletin No. 22-01 4/1/2022
  • Policy Bulletin No. 23-01 3/1/2023
• Attachment 01 County – CPOC Contact List 4/1/2022
• Attachment 02 Network of Care Chart 4/1/2022
• Attachment 03 Liability Procedure 7/1/2020
• Attachment 03A Drug and Alcohol Client Liability Determination Form 7/1/2020
• Attachment 03B Request for Liability Reduction or Elimination Form 7/1/2020
• Attachment 03C Request for Reduction-Elimination Checklist 7/1/2020
• Attachment 04 SCA-BHMCO Medical Assistance Interface 7/1/2020
• Attachment 05 Care Coordination-Case Management-CRS Service Guideline 7/1/2020
• Attachment 05Ca ICM-RD Referral Form 7/1/2020
• Attachment 05Cb Non Treatment Needs Screening Tool 7/1/2020
• Attachment 05Da CRS Referral Form 7/1/2020
• Attachment 06 Interim Service Policy 7/1/2020
• Attachment 06A Interim Service Brochure 7/1/2020
• Attachment 07A Ancillary Service Tool 7/1/2020
• Attachment 07B Blair Ancillary Service Brochure 4/1/2022
• Attachment 08A TB Screen 4/1/2022
• Attachment 08B HepC-HIV Screen 7/1/2020
• Attachment 09 MAT Consideration 7/1/2020
• Attachment 09A CCBHO Alert #7 7/1/2020
• Attachment 09B MAT Consideration Form 7/1/2020
• Attachment 10 Vivitrol Policy 7/1/2020
• Attachment 11 Buprenorphine Policy 7/1/2020
• Attachment 12 TX Brochure-Benefits 7/1/2020
• Attachment 13 Grievance/TX Limitations/Interim Service Client Choice Notification Form 4/1/2020
• Attachment 14 Network of Care Choice Form 4/1/2022
• Attachment 15 Waiting List – Funding 7/1/2020
• Attachment 16 Release of Information 3/1/2023
• Attachment 17 Client Registration 7/1/2020
• Attachment 18 Admission-Re-Admission Notification Form 7/1/2020
• Attachment 19 Authorization Guidelines 7/1/2020
• Attachment 20 Blair SCA Funding Transfer Form 7/1/2020
• Attachment 21 Grievance and Appeals Policy Brochure 7/1/2020
• Attachment 22 Blair County Drug and Alcohol Complaint Form 7/1/2020