Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC CONTRACT NO. HHS000663700277 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12, 2020 Date of execution: August 12, 2020 THE FOLLOWING ATTACHMENTS TO HHSC CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning. 1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI0830546 NU58DP006501-01-01 Federal Award Date: 10/01/2019 01/31/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse Centers for Disease Control and Mental Health Services Administration (SAMHSA) Prevention CFDA Name and Number: 93.959 93.439 Awarding Official Contact Information: ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ at ▇▇▇▇@▇▇▇.▇▇▇ DUNS: 196616478 And, Federal Award Identification Number (▇▇▇▇): 6 B04MC32573-01-01 Federal Award Date: 01/08/2019 Name of Federal Awarding Agency: U.S. Department of Health and Human Services Health Resources and Services Administration CFDA Name and Number: 93.994 Awarding Official Contact Information: ▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: at ▇▇▇▇▇.▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ DUNS: 196616478 VIII, MODIFICATIONS TO UNIFORM TERMS AND CONDITIONS SIGNATURE PAGE FOLLOWS SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000455600001 DEPARTMENT OF STATE HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: ▇GRANTEE ▇▇▇▇ ▇. ▇▇▇▇▇▇▇ Name: Chief Operating Officer ▇.▇. ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO City Manager Date of execution: _August 1231, 2020 2019 Date of execution: August 1230, 2020 2019 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000455600001 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A - STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ACTIVITY PLAN ATTACHMENT B PROGRAM SERVICES & UNIT RATES - BUDGET ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D - UNIFORM TERMS AND CONDITIONS-GRANTEE CONDITIONS ATTACHMENT D - CONTRACT AFFIRMATIONS ATTACHMENT E - SUPPLEMENTAL & SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F - FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population- FFATA CERTIFICATION
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC CONTRACT NO. HHS000663700277 HHS000663700130 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASSOUTH TEXAS RURAL HEALTH SERVICES, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ CEO Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC CONTRACT NO. HHS000663700277 HHS000663700130 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI0830546 B04MC33869-01-01 Federal Award Date: 10/01/2019 12/17/2019 Name of Federal Awarding Agency: U.S. Department of Health and Human Services (HHS)Services, Substance Abuse Health Resources and Mental Health Services Administration (SAMHSAHRSA) CFDA Name and Number: 93.959 93.994 Awarding Official Contact Information: ▇Program Contact: ▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇ ▇▇▇▇/DSCH/Dallas ▇▇▇▇ ▇▇▇▇▇ ▇▇. Dallas, Grants Specialist, Contact NumberTX 75202-5433 Email: ▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇ Phone: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile▇ Fax: (▇▇▇) ▇▇▇-▇▇▇▇, Email▇ Division of Grants Management Operations: ▇▇▇▇▇.▇▇ ▇▇▇▇▇▇ MailStop Code: 10N 176D OFAM 5600 Fishers Ln. Rockville, MD 20852-1750 Email: ▇▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇ Phone: (▇.▇▇) ▇▇▇-▇▇▇▇ Fax: (▇▇▇) ▇▇▇-▇▇▇▇ SIGNATURE PAGE FOLLOWS SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000790300001 DEPARTMENT OF STATE HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES THE UNIVERSITY OF TEXAS, INC. TEXAS AT AUSTIN S g S g Printed Name: ▇▇▇▇▇ ▇▇▇▇▇▇ , M.D Printed Name: ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Title: _Associate Commissioner, Community HealthTIimtlep: rAosvseimsteant Director, OSP Date of executionsignature: _August 1224, 2020 Date of executionsignature: August 1224, 2020 THE FOLLOWING ATTACHMENTS DOCUMENTS ARE ATTACHED TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000790300001 AND ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A -- STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES -- BUDGET ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D -- UNIFORM TERMS AND CONDITIONS-CONDITIONS – GRANTEE VERSION 2.16.1, MARCH 26, 2019 ATTACHMENT D – UT SYSTEM SUPPLEMENTAL CONDITIONS V.1.1 MARCH 2020 ATTACHMENT E – UT SYSTEM SPECIAL CONDITIONS VERSION 1.2 V.03.2017 ATTACHMENT F -- FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ G-- FFATA ATTACHMENTS FOLLOW I. PURPOSE ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more ▇ will lead efforts as the external system evaluator of the following service types/levels Help Me Grow Texas Cohort and Help Me Grow North Texas initiative, with the goal of caredeveloping a three-year strategic plan to guide state efforts to support the expansion of effective early childhood systems in Texas communities. The below service types/levels Help Me Grow is an evidence-based national system model that promotes collaboration among child-serving sectors to build a more efficient and effective system that promotes the optimal health development of care are based on Texas Administrative Code (TAC) requirementsyoung children. Effective early childhood state systems ensure that state policies align with effective community practices, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelinespromote and provide implementation support for evidence-base practices, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providerscreate funding mechanisms that reduce inefficiencies, work to identify system gaps, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇develop or revise programs that enhance access and outcomes.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: Substance Abuse and Prevention Treatment (SAPT), 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ Federal Award Identification Number (▇▇▇▇): H79TI081729 Federal Award Date: 09/30/2018 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: State Opioid Response, 93.788 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇▇▇▇ ▇. Browne, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700161 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: EL DORADO TEXAS COMMUNITY SERVICE CENTER ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Title: Administrative Director Date of execution: _August 12July 17, 2020 Date of execution: August 12July 17, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700161 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE VERSION 2.16.1 ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationA MEDICATION ASSISTED TREATMENT
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700176 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES VOLUNTEERS OF TEXAS, INC. AMERICA TEXAS ▇▇▇▇▇ Ita Associate Commissioner Name: ▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 20, 2020 Date of execution: August 12July 17, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700176 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationFOLLOW
Appears in 1 contract
Sources: Health and Human Services Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 H79TI081729 Federal Award Date: 10/01/2019 09/30/2018 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 State Opioid Response, 93.788 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇ ▇. Browne, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700084 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASADDICTION SERVICES, INC. Name: LLC ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Clinical Director Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700084 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE VERSION 2.16.1 ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationA MEDICATION ASSISTED TREATMENT
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700079 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: TEXAS COMMUNITY SUPERVISION ALTERNATIVES LLC ▇▇▇▇▇ Ita Associate Commissioner ▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Managing Partner Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700079 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. FEMALES Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700190 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASCENTER FOR HEALTH CARE SERVICES, INCBEXAR CO. NameMHMR By: By: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & Date of execution: July 28, 2020 ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ President/CEO Date of execution: _August 12, 2020 Date of execution: August 12July 28, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700190 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT GOV’T ENTITY VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700059 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASALPHA HOME, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700059 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700197 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASCHRISTIAN FARMS-TREEHOUSE, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO ▇▇▇▇▇ ▇▇▇▇▇▇▇ Executive Director Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700197 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. FEMALES Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700099 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASTHE TURNING POINT, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Executive Director Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700099 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. FEMALES Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 H79TI081729 Federal Award Date: 10/01/2019 09/30/2018 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 State Opioid Response, 93.788 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇ ▇. Browne, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700001 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASTEXAS AMERICAN MEDICAL CONSULTANTS, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 20, 2020 ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Administrative Director Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700001 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE VERSION 2.16.1 ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationA MEDICATION ASSISTED TREATMENT
Appears in 1 contract
Sources: Health and Human Services Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700120 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, TURTLE CREEK MANOR INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ Pres./CEO Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700120 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC CONTRACT NO. HHS000663700277 HHS000663700254 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: CENIKOR FOUNDATION ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & Date of execution: July 24, 2020 ▇▇▇▇ ▇▇▇▇▇▇ President/CEO Date of execution: _August 12, 2020 Date of execution: August 12July 24, 2020 THE FOLLOWING ATTACHMENTS TO HHSC CONTRACT NO. HHS000663700277 HHS000663700254 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Health and Human Services Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 H79TI081729 Federal Award Date: 10/01/2019 09/30/2018 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 State Opioid Response, 93.788 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇ ▇. Browne, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700018 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES WEST TEXAS COUNSELING AND REHABILITATION OF TEXASTEMPLE, INC. Name: DBA WTCR TEMPLE, INC. ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 21, 2020 ▇▇▇▇ ▇▇▇▇▇▇ MD President Date of execution: August 12July 21, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700018 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE VERSION 2.16.1 ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationA MEDICATION ASSISTED TREATMENT
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054B08TI08354-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700211 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. BLUEBONNET TRAILS COMMUNITY MHMR CENTER Name: ▇▇▇▇▇ Ita Name: ▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Associate Commissioner IDD/BH President & CEO Executive Director Date of execution: _August 12July 20, 2020 Date of execution: August 12July 17, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700211 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 GOVERNMENT ENTITY ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationFOLLOW
Appears in 1 contract
Sources: Health and Human Services Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000779500002 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES CITY OF TEXAS, INC. Name: LUBBOCK ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Name: ▇▇▇▇▇▇ ▇▇▇▇ Title: Mayor Date of execution: _August 128, 2020 Date of execution: August 125, 2020 THE FOLLOWING ATTACHMENTS DOCUMENTS ARE HEREBY ATTACHED TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL CONTRACT AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) 448 Title 25 Part 1 located at the following link: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇▇.▇▇▇▇▇.▇▇.▇▇/public/readtac$ext.ViewTAC?tac_view=4&ti=25&pt=1&ch=448 requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-provider- portals/behavioral- behavioral-health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 H79TI081729 Federal Award Date: 10/01/2019 09/30/2018 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 State Opioid Response, 93.788 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇ ▇. Browne, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700003 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES CROSSROADS TREATMENT CENTERS OF TEXASFORT WORTH, INC. Name: PLLC ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Title: CFO Date of execution: _August 1214, 2020 Date of execution: August 1214, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700003 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE VERSION 2.16.1 ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationA MEDICATION ASSISTED TREATMENT
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700041 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES VOLUNTEERS OF TEXAS, INC. Name: AMERICA TEXAS ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Ita Ange1a King Associate Commissioner IDD/BH President & CEO Date of execution: _August 12July 20, 2020 Date of execution: August 12Ju1y 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700041 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationFOLLOW
Appears in 1 contract
Sources: Health and Human Services Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700148 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: THE COUNCIL ON RECOVERY ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH Date of execution: _July 20, 2020 Name: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Title:President & and CEO Date of execution: _August 12, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700148 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700251 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: CENIKOR FOUNDATION ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & Name: ▇▇▇▇ ▇▇▇▇▇▇ Title: President/CEO Date of execution: _August 12July 23, 2020 Date of execution: August 12July 23, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700251 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. FEMALES Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700210 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES VOLUNTEERS OF TEXAS, INC. AMERICA TEXAS Name: ▇▇▇▇▇ Ita Name: ▇▇▇▇▇▇ ▇▇▇▇▇▇ NameTitle: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Associate Commissioner IDD/BH President & Title: CEO Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700210 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationFOLLOW
Appears in 1 contract
Sources: Health and Human Services Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC CONTRACT NO. HHS000663700277 HHS000663700043 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇, INC. ▇▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 22, 2020 ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ Executive Director Date of execution: August 12July 22, 2020 THE FOLLOWING ATTACHMENTS TO HHSC CONTRACT NO. HHS000663700277 HHS000663700043 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054B08TI08354-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC CONTRACT NO. HHS000663700277 HHS000663700245 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASALIVIANE, INC. Name▇▇▇▇▇ Ita Associate Commissioner Date of execution: _July 20, 2020 ▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: Title: ▇▇▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC CONTRACT NO. HHS000663700277 HHS000663700245 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700158 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASCHRISTIAN FARMS-TREEHOUSE, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO ▇▇▇▇▇ ▇▇▇▇▇▇▇ Executive Director Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700158 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700221 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. ▇▇▇▇▇▇ ▇▇▇▇▇▇ COUNTY MHMR CENTER Name: ▇▇▇▇▇ Ita Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Associate Commissioner IDD/BH President & CEO Date of execution: _August 12July 22, 2020 Date of execution: August 12July 22, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700221 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700202 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASNORTH TEXAS ADDICTION COUNSELING & EDUCATION, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 20, 2020 ▇▇▇▇▇ ▇▇▇▇▇▇ Name: Title:Executive Director Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700202 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700203 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASPLAINVIEW SERENITY CENTER, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: Dr. ▇▇▇▇ ▇▇▇▇▇▇ Title: Assoc. Commissioner IDD/BH President & Date of execution: July 20, 2020 Title: CEO Date of execution: _August 12, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700203 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. FEMALES Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700012 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS▇▇▇▇ ▇▇▇▇ HOME, INC. INC ▇▇▇▇▇ Ita Associate Commissioner Name: Title: ▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Chief Executive Officer Date of execution: _August 12July 22, 2020 Date of execution: August 12July 22, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700012 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC CONTRACT NO. HHS000663700277 HHS000663700028 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASAZLEWAY, INC. Name: ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12July 21, 2020 ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Executive Director Date of execution: August 12July 21, 2020 THE FOLLOWING ATTACHMENTS TO HHSC CONTRACT NO. HHS000663700277 HHS000663700028 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700131 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXASFORT BEND REGIONAL COUNCIL ON SUBSTANCE ABUSE, INC. Name▇▇▇▇▇ Ita Associate Commissioner Date of execution: ▇July 20, 2020 ▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 12, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700131 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- health-services-providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target PopulationFOLLOW
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700232 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: THE WOMEN’S HOME ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Date of execution: _August 1215, 2020 ▇▇▇▇ ▇▇▇▇▇▇ CEO Date of execution: August 127, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700232 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700218 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES HEART OF TEXAS, INC. Name: TEXAS REGION MHMR CENTER ▇▇▇▇▇ Ita Associate Commissioner ▇▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Chief Executive Officer Date of execution: _August 12July 20, 2020 Date of execution: August 12July 20, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 ARE HEREBY INCORPORATED BY REFERENCE: HHS000663700218 ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. FEMALES Grantee shall provide Substance Use Disorder Treatment Services for one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Contract
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700169 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: SABINE VALLEY REGIONAL MHMR CENTER ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & CEO Name: ▇▇▇▇▇ ▇▇▇▇▇ Title: Executive Director Date of execution: _August 124, 2020 Date of execution: August 124, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700169 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT GOV’T ENTITY VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement
Additional Grant Information. Federal Award Identification Number (▇▇▇▇): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, Grants Management Officer, Point of Contact is ▇▇▇▇▇ ▇▇▇▇, Grants Specialist, Contact Number: (▇▇▇) ▇▇▇-▇▇▇▇, Facsimile: (▇▇▇) ▇▇▇-▇▇▇▇, Email: ▇▇▇▇▇.▇▇▇▇@▇▇▇▇▇▇.▇▇▇.▇▇▇ SIGNATURE PAGE FOR HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700246 HEALTH AND HUMAN SERVICES COMMISSION PHOENIX HOUSES OF TEXAS, INC. Name: CENIKOR FOUNDATION ▇▇▇▇▇ ▇▇▇▇▇▇ Name: ▇▇▇▇ ▇▇▇▇▇▇ Assoc. Commissioner IDD/BH President & Title: President/CEO Date of execution: _August 1213, 2020 Date of execution: August 1213, 2020 THE FOLLOWING ATTACHMENTS TO HHSC SYSTEM AGENCY CONTRACT NO. HHS000663700277 HHS000663700246 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I HHSC SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT ▇ ▇▇▇▇▇▇▇’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR YOUTH
A. ADULTS Grantee shall provide Substance Use Disorder Treatment Services for substance use disorder treatment services to the target population at one (1) or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: ▇▇▇▇▇://▇▇▇.▇▇▇▇▇.▇▇▇/doing-business-hhs/provider-portals/behavioral- behavioral-health-services-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: ▇▇▇.▇▇▇▇.▇▇▇, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
1. Outpatient Treatment Services 2. Supportive Residential Treatment Services 3. Intensive Residential Treatment Services
B. TREATMENT FOR YOUTH (TRY) Program Target Population
Appears in 1 contract
Sources: Grant Agreement