Exhibit D – Required Reports, Plans, and Functional Tasks All Reports and Plans must be submitted to the Contract Manager electronically and be uploaded to the ME’s secure web-based doc-vault. Required by Frequency Due No Later Than: A. Required Reports & Plans A.1 Regional planning documents Attachment I Section B.1.a.(1)(b) As Needed As Needed A.2 ME Annual Business Operations Plan Template: Incorporated Document 3 Attachment I Section B.1.a.(1)(d) Annually July 15 A.3 Update Network Service Provider Catalogue of Care Template: Incorporated Document 3, Section 3.3 Attachment I Section B.1.a.(1)(e) As Needed As Needed A.4 Plan for Reintegrating Discharge-Ready Individuals Attachment I Section B.1.a.(1)(f) Annually July 15 A.5 Record Transition Plan Guidance: Incorporated Document 4 Attachment I Section B.1.a.(1)(g) Once Within 90 days of execution A.6 Care Coordination Plan Attachment I Section B.1.a.(2)(b) Initial; and Annual Update Initial: within 60 days of execution; and Annual Update: July 15 A.7 Fraud and Abuse Prevention Protocol Attachment I Section B.1.a.(3)(d) Once within 60 days of execution A.8 Quality Assurance Plan Attachment I Section B.1.a.(3)(e)2. Initial; and Annual Update Initial: within 60 days of execution; and Annual Update August 31 A.9 Network Service Provider Management Plan Attachment I Section B.1.a.(4)(a) Initial; and Annual Update Initial: within 30 days of execution; and Annual Update: July 15 A.10 Information Technology Plan Attachment I Section B.1.a.(5)(e) Once Within 60 days of execution (and reviewed annually) A.11 Procurement Policy Attachment I Section B.3.e. Within 90 days of execution A.12 ALF-LMH Plan Incorporated Document 8 Annual December 1 A.13 National Voters Rights Act Quarterly Report Incorporated Document 20 Quarterly January 15; April 15; July 15; October 15
A.14 Contract Provider Property Inventory Template: Incorporated Document 21, Page 3 Incorporated Document 21 Initial; and Annually Initial: within 30 days of contract execution; Annual: July 31 B. Required Financial Forms & Documents B.1 Managing Entity Operating and Capital Budget Template: Form CF-MH 1042, per ch. 65E-14, F.A.C. Attachment I Section B.5.c.(3). As Needed 30 days after any amendment to Exhibit E B.2 Network Service Provider forms required pursuant to ch. 65E-14, F.A.C. Templates available at B.3 Managing Entity Fixed Payment Invoice (Advance Payment) Template: Incorporated Document 25 Attachment 1 Section C.2.a. Annually July 1 B.4 Documentation of interest earned on advanced funds Attachment 1 Section C.2.b. Quarterly As Needed B.5 Managing Entity Monthly Fixed Payment Invoice Template: Incorporated Document 25 Attachment I Section C.2.e. and Section C.3.a Monthly; and FY Final: Annually 20th of month following service delivery and FY Final: August 15 B.6 SAMH Managing Entity Monthly Progress Report Template Incorporated Document 22 B.7 SAMH Managing Entity Monthly Expenditure Report Template Incorporated Document 26 B.8 Cost Allocation Plan Template Incorporated Document 28 Attachment I Section C.4. Initial, and Annual Update, and Revisions as needed Initial: Within 30 days of execution; and Annual Update: July 31; and Revisions: Within 20 days of notifying the Department B.9 Managing Entity Spending Plan for Carry Forward Report Template Incorporated Document 29 Attachment I Section C.5.b. Annually Within 30 days of confirmation of approved amount from the Department B.10 SAMH Managing Entity Monthly Carry Forward Expenditure Report Template Incorporated Document 27 Attachment I Sections C.2.e. & C.3.a.(4) Monthly 20th of month following service delivery; and FY Final: August 15 B.11 BNet Statement of Program Cost Incorporated Document 12 Annually September 1
B.12 Financial and Compliance Audit Attachment III Annually, and As needed 180 days after the end of the provider’s fiscal year; and 30 days after the ME’s receipt of the audit report C. Required Data Submission & Performance Reporting C.1 Monthly Data Submission to SAMH Data System Attachment I Section B.1.a.(5)(c) Monthly 18th of each month C.2 Submission of Corrected Records to SAMH Data System Attachment I Section B.1.a.(5)(m) As needed Within 60 days after initial record submission C.3 Data required by Federal or State Grant Awards Other than Sections C.5 and C.6, below Attachment I Section B.1.a.(5)(n) As needed As established by Grantor timeframes C.4 Quarterly Report Attachment I Section C.10 Quarterly October 20 January 20 April 20 July 31 C.5 Substance Abuse and Mental Health Block Grant Report Template: Incorporated Document 34 Exhibit A Section 4.2 Semi-annually February 15 August 15 C.6 Narrative Report for the Substance Abuse and Mental Health Block Grant Template: Incorporated Document 35 Exhibit A Section 4.3 Annually May 30 C.7 BNet Alternative Services Documentation Incorporated Document 12 Monthly 15th of each month C.8 BNet Auxiliary Aid Service Record Incorporated Document 12 Monthly 5th business day of the month D. Required Contract Forms & Documents D.1 W-9 Form Standard Contract Section C.7.e. Once Upon execution D.2 Proof of Insurance Standard Contract Section 9 Attachment I Section D.4. Annually; and As needed Initial: upon execution; Annual: March 31; and As needed: Within 30 days of a modification of terms D.3 Security Agreement Form Standard Contract Section 28.c. Annually Upon execution; and Updated annually