Grant and Fiscal Reporting Forms and Templates

Legend:

  = Grants
  = Fiscal

 

SFY 2020

Drug Court Reports
  

Probate Court Billing Reimbursement
  

Section 5122.43 of the Ohio Revised Code authorizes that certain county probate court costs and expenses of proceedings held under Chapter 5122 may be reimbursed by the Ohio Department of Mental Health and Addiction Services (OhioMHAS).

Probate Courts are again required to enter and submit an online Allocation Application within the OhioMHAS Grant and Funding Management System (GFMS) in order for OhioMHAS to process the reimbursement billings. Please continue to submit monthly requests for reimbursement in the same manner in which you have in the past.

Section 5122.43 defines the costs and expenses of proceedings eligible for reimbursement, and in accordance, probate courts will be reimbursed for allowable costs and expenses for those cases related to mental health commitments or involving mental health clients. The following are the FY2020 Probate Court Allocation letter, FY2020 Probate Court Allocations, instructions, and forms necessary in submitting those monthly billings to OhioMHAS; and the User Guide with instructions for registering with the OhioMHAS Grant and Funding Management System (GFMS).

MHA-Board Level Budget Report
  

Title XX
  

Title XX Annual Plan

Title XX Invoice:

Title XX Annual Expenditure Report 

Title XX Social Services Allocations

Treatment Alternatives to Street Crime (TASC) Reports
  

Women's Treatment and Recovery Reporting Forms
 

Strong Families Safe Communities Bi-Annual Report Form
 

SFY 2019

Drug Court Reports
  

Probate Court Billing Reimbursement
  

Section 5122.43 of the Ohio Revised Code authorizes that certain county probate court costs and expenses of proceedings held under Chapter 5122 may be reimbursed by the Ohio Department of Mental Health and Addiction Services (OhioMHAS). 

Probate Courts are again required to enter and submit an online Allocation Application within the OhioMHAS Grant and Funding Management System (GFMS) in order for OhioMHAS to process the reimbursement billings.  Please continue to submit monthly requests for reimbursement in the same manner in which you have in the past. 

Section 5122.43 defines the costs and expenses of proceedings eligible for reimbursement, and in accordance, probate courts will be reimbursed for allowable costs and expenses for those cases related to mental health commitments or involving mental health clients. The following are the FY2019 Probate Court Allocation letter, FY2019 Probate Court Allocations, instructions, and forms necessary in submitting those monthly billings to OhioMHAS; and the User Guide with instructions for registering with the OhioMHAS Grant and Funding Management System (GFMS).

Title XX
  

Title XX Annual Plan

Title XX Invoice:

Title XX Annual Expenditure Report 

Title XX Social Services Allocations

Treatment Alternatives to Street Crime (TASC) Reports
  

  

SFY 2018

Drug Court Reports
  

MHA-Board Level Budget Report
  

The MHA-Board Level Budget Report report is completed annually by each Alcohol, Drug Addiction and Mental Health board, Community Mental Health board, and Alcohol & Drug Addiction Services board (ADAMH, CMH, and ADAS) and submitted to OhioMHAS. The data provides a complete picture of the types of services provided by the contracted mental health and addiction serving agencies and the corresponding expenditures and revenue in the mental health and addiction system.

Specialized Dockets Payroll Subsidy Reports
  

Title XX
  

Title XX Annual Plan

Title XX Invoice:

Title XX Annual Expenditure Report 

Title XX Social Services Allocations

Treatment Alternatives to Street Crime (TASC) Reports
  

  

  

SFY 2016

Addiction Grant Funded Projects
  

  • SFY 2016 POPS Reporting Requirements (Word)

MHA-Board Level Budget Report
  

The MHA-Board Level Budget Report report is completed annually by each Alcohol, Drug Addiction and Mental Health board, Community Mental Health board, and Alcohol & Drug Addiction Services board (ADAMH, CMH, and ADAS) and submitted to OhioMHAS. The data provides a complete picture of the types of services provided by the contracted mental health and addiction serving agencies and the corresponding expenditures and revenue in the mental health and addiction system.

  

SFY 2015

Mental Health Grant Funded Projects
  

  • SFY 2015 Performance Measure Worksheet (Word | PDF)
  • SFY 2015 PMW Quarterly Reporting Forms (Word | PDF)

Addiction Grant Funded Projects
  

SFY 2015 Addiction Grant Funded Projects

SFY 2015 Treatment Reporting Requirements

  • SFY 2015 Treatment and Recovery Reporting Requirements_TASC_Drug Court_CFRO_TC_MOMS (Word I PDF)
  • SFY 2015 Juvenile TASC Programmatic Report Form and Instructions (Word | PDF)                 
  • SFY 2015 Adult TASC Programmatic Report Form and Instructions (Word I PDF)   
  • SFY 2015 Juvenile Drug Court Programmatic Report Form and Instructions (Word I PDF)
  • SFY 2015 Adult Drug Court Programmatic Report Form and Instructions (Word I PDF)
  • SFY 2015 Family Drug Court Programmatic Report Form and Instructions (Word I PDF)
  • SFY 2015 Circle for Recovery (CFRO) Programmatic Report Form and Instructions (Word I PDF)
  • SFY 2015 Therapeutic Communities/TC Expansion Programmatic Report Form and Instructions (Word I PDF)
  • SFY 2015 Problem Gambling Programmatic Report Form and Instructions (Word I PDF)
  • SFY 2015 Reporting Requirements SAMI (Word I PDF)

SFY 2015 Women’s Grant Reporting Requirements

  • SFY 2015 Women’s Treatment Reporting Requirements (Word I PDF)
  • SFY 2015 Women's Report Template (Word I PDF)
  • SFY 2015 Women's Demographics Chart (Word I PDF)

SFY 2015 Prevention Reporting Requirements

  • SFY 2015 Prevention Reporting Requirements (Word I PDF)

SFY 2015 SBIRT Reporting Requirements/strong

  • SFY 2015 SBIRT Provider Reporting Requirements (Word I PDF)
  • SFY 2015 SBIRT WSU Reporting Requirements (Word I PDF)
  • SFY 2015 SBIRT Face Sheet (Word I PDF)

SFY 2015 Conference and Training Reporting Requirements

  • SFY 2015 Conference and Training Reporting Requirements (Word I PDF)
  • SFY 2015 Conference and Training Face Sheet (Word I PDF)

SFY 2015 Goals and Objectives Reporting Requirements

  • SFY 2015 Goals and Objectives Reporting Requirements (Word I PDF)
  • SFY 2015 Goals and Objectives Face Sheet (Word I PDF)

SFY 2015 Budget/Expenditure Form

  • SFY 2015 Budget/Expenditure Form (Excel)

SFY 2014 Furniture/Equipment Form

  • SFY 2015 Furniture/Equipment Form (Excel)

  

SFY 2014

TASC, Drug Court, CFRO, Therapeutic Communities, and TC Expansion Forms
  

  • SFY 2014 Treatment and Recovery Reporting Requirements TASC_Drug Court_CFRO_TC  (Word | PDF)
  • SFY 2014 Juvenile TASC Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2014 Adult TASC Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2014 Juvenile Drug Court Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2014 Adult Drug Court Programmatic Report Form and Instructions (Word | PDF)
  •  SFY 2014 Family Drug Court Programmatic Report Form and Instructions (Word | PDF)
  •  SFY 2014 Circle for Recovery (CFRO) Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2014 Therapeutic Communities/TC Expansion Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2014 Problem Gambling Programmatic Report Form and Instructions (Word | PDF)
  •  SFY 2014 Reporting Requirements SAMI (Word | PDF)

Women's Treatment Reporting Requirements
  

  • SFY 2014 Women’s Treatment Reporting Requirements (Word | PDF)
  • SFY 2014 Women's Report Template (Word | PDF)
  • SFY 2014 Women's Demographics Chart (Word | PDF)

Women's Prevention Reporting Requirements
  

  • SFY 2014 Women's Report Template (Word | PDF)

Prevention GFA Reporting Requirements
  

  • SFY 2014 Prevention GFA Reporting Requirements (Word | PDF)

SPF SIG Reporting Forms
  

  • SFY 2014 SPF SIG Face (Word | PDF)
  • SFY 2014 SPF SIG Grantee Reporting Requirements (Word | PDF)

SBIRT Reporting Requirements
  

  • SFY 2014 SBIRT Provider Reporting Requirements (Word | PDF)
  • SFY 2014 SBIRT WSU Reporting Requirements (Word | PDF)
  • SFY 2014 SBIRT Face Sheet (Word | PDF)

Conference and Training Reporting Requirements
  

  • SFY 2014 Conference and Training Reporting Requirements (Word | PDF)
  • SFY 2014 Conference and Training Face Sheet (Word | PDF)

Goals and Objectives Reporting Requirements
  

  • SFY 2014 Goals and Objectives Reporting Requirements (Word | PDF)
  • SFY 2014 Direct-Funded Goals and Objectives Face Sheet (Word | PDF)
  • SFY 2014 Board-Funded Goals and Objectives Face Sheet (Word | PDF)

Budget/Expenditure Form
  

  • SFY 2014 Budget/Expenditure Form (Excel)

Furniture/Equipment Form
  

  •  SFY 2014 Furniture/Equipment Form (Excel)

  

SFY 2013

Treatment
  

  • SFY 2013 Treatment and Recovery Reporting Requirements_TASC_Drug Court_CFRO_TC (Word)
  • SFY 2013 Reporting Requirements SAMI (Word)

TASC, Drug Court, CFRO, Therapeutic Communities and TC Expansion Attachment by Program Area
  

  • SFY 2013 Juvenile TASC Programmatic Report Form and Instructions (Word)
  • SFY 2013 Adult TASC Programmatic Report Form and Instructions (Word)
  • SFY 2013 Juvenile Drug Court Programmatic Report Form and Instructions (Word)
  • SFY 2013 Adult Drug Court Programmatic Report Form and Instructions (Word)
  • SFY 2013 Family Drug Court Programmatic Report Form and Instructions (Word)
  • SFY 2013 Circle for Recovery (CFRO) Programmatic Report Form and Instructions (Word)
  • SFY 2013 Therapeutic Communities/TC Expansion Programmatic Report Form and Instructions (Word)
  • SFY 2013 Problem Gambling Programmatic Report Form and Instructions (Word)

Women's Treatment Reporting Requirements
  

  • SFY 2013 Women’s Treatment Reporting Requirements (Word)
  • SFY 2013 Women's Report Template (Word)

Women's Prevention Reporting Requirements
  

  • SFY 2013 Womens Prevention Reporting Requirements (Word)
  • SFY 2013 Women's Report Template (Word)

Prevention GFA Reporting Requirements
  

  • SFY 2013 Prevention GFA Reporting Requirements (Word)

Budget Expenditure Form
  

  • SFY 2013 Budget/Expenditure Form (Excel)

SPF SIG Reporting Forms
  

  • SFY 2013 SPF SIG Face Sheet (Word | PDF)
  • SFY 2013 SPF SIG Final Expenditure Form (Excel)
  • SFY 2013 SPF SIG Grantee Reporting Requirements (Word | PDF)

  

SFY 2012

Treatment and Recovery Reporting Requirements for TASC, Drug Court, CFRO, Therapeutic Communities and TC Expansion
  

  • SFY 2012 Treatment and Recovery Reporting Requirements_TASC_Drug Court_CFRO_TC (Word | PDF)
  • SFY 2012 Reporting Requirements SAMI (Word | PDF)

TASC, Drug Court, CFRO, Therapeutic Communities and TC Expansion Attachment 2 by Program Area
  

  • SFY 2012 Juvenile TASC Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2012 Adult TASC Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2012 Juvenile Drug Court Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2012 Adult Drug Court Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2012 Family Drug Court Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2012 Circle for Recovery (CFRO) Programmatic Report Form and Instructions (Word | PDF)
  • SFY 2012 Therapeutic Communities/TC Expansion Programmatic Report Form and Instructions (Word)
  • SFY 2012 Problem Gambling Programmatic Report Form and Instructions Attachment 2 (PDF)

Women's Treatment Reporting Requirements
  

  • SFY 2012 Women’s Treatment Reporting Requirements (Word | PDF)
  • SFY 2012 Women's Report Template (Word | PDF)

Prevention GFA Reporting Requirements
  

  • Final SFY 2012 Prevention GFA Reporting Requirements (Word | PDF)
  • SFY 2012 Women's Prevention Reporting Requirements (Word | PDF)
  • SFY 2012 SPF SIG Reporting Requirements (Word | PDF)
  • SFY 2012 Women's Report Template (Word | PDF)
  • Equipment Furniture Itemization Form (Excel | PDF)

Conference and Training Reporting Requirements
  

  • SFY 2012 Conference and Training Reporting Requirements (PDF)
  • SFY 2012 Conference and Training Face Sheet (PDF)

Goals and Objectives Reporting Requirements
  

  • SFY 2012 Direct/Board Funded Goals and Objectives Reporting Requirements (WordPDF)
  • SFY 2012 Board Funded Goals and Objectives Face Sheet (Word | PDF)

Budget/Expenditure Form
  

  • SFY 2012 Budget/Expenditure Form (Excel | PDF)