FY 2014 Performance Contract



Date Revised (if Applicable)

FY 2014 Performance Contract Documents

Executive Overview (PDF)


General Provisions (MS Word) 

April 4, 2014

Performance Contract Notebook Program Attachment (MS Word)

April 17, 2014


Report I.A Service Performance Report (MS Excel)


Report III-IV (MS Excel)



Form A Affidavit of Board Member (MS Word)


Form B Affidavit of Executive Director (MS Word)


Form C MHD Quarterly Reporting Form (MS Excel)


Form D Voter Registration (MS Word)


Form E Rural Border Intervention Project (MS Excel)


Form F PESC Service Delivery Report (MS Excel)

June 2014

Form G Financial Statement Certification (MS Word)


Form H Supportive Housing Report (MS Excel)

March 26, 2014

Form I OCR Annual Budget Expenditures (MS Excel)

April 8, 2014

Form J Disaster Behavioral Health Conference Expenditures (MS Word)

February 18, 2014

Form K Security Administrator Attestation (MS Word)


Form L Expenditures for Title XX (MS Excel)


Form M PESC Expenditure Summary (MS Excel)

June 2014

Form N Consumer Operated Services Program Report (MS Excel)


Form O - Rider 75 (MS Excel)


Form S Contact List (MS Excel)

January 6, 2014

Form T Disaster Contact List (MS Word)


Form V New Generation Medication Report (MS Word)


Form V-Vet Electronic Assessment (MS Word)


Form V-Vet Hard Copy (MS Word)


Form V-Vet Expenditures (MS Excel)


Form V-Vet JDTR Expenditures (MS Excel)


Form V-Vet Service Delivery (MS Excel)


Form X Community Hospital Report (MS Excel)


Form Z Forensic Clearinghouse Monthly Report (MS Excel)

June 2014

Information Items

Information Item A Cognitive Behavioral Therapy Competency Policy (MS Word)

April 4, 2014

Information Item B Procedures for Title XX (MS Word) 


Information Item C Service Targets, Outcomes, and Performance Measures (MS Word)

June 2014

Information Item D Instructions for Report III (MS Word)


Information Item E Instructions for Report IV (MS Word)


Information Item F TCM and Rehab Payment Method (MS Word)


Information Item G Service Definitions (MS Word)


Information Item H Client Benefits Plan (MS Word)


Information Item I Local Planning (MS Word)


Information Item M CRCG MOU (MS Word)


Information Item Q Fair Hearing Procedures (MS Word)


Information Item R RDM Waiting List Maintenance Manual (MS Word)


Information Item S Submission Calendar (MS Excel) Please note: This document does not have macros enabled. Should you need a macros-enabled copy of this document, please contact your contract manager.

April 4, 2014

Information Item T Data Exchange and COC Guidelines (MS Word)


Information Item V Crisis Service Standards (MS Word)


Information Item W Urban and Rural ACT Designation (MS Excel)


Last updated June 24, 2014