10-26053 Form 5 Region Selection.docx

This is a Region Selection Form (Form 5) for the Utah Department of Health and Human Services, Division of Services for People with Disabilities (DHHS), related to a peer support services contract opportunity for persons on the DSPD wait list. The form allows providers to indicate which geographic regions they wish to serve for the delivery of in-person peer support services. Providers may select one or more of four defined regions: Northern (Box Elder, Cache, and Rich counties), Wasatch Front (Davis, Morgan, Salt Lake, Summit, Tooele, Utah, Wasatch, and Weber counties), Central/Eastern (Carbon, Daggett, Duchesne, Emery, Grand, Juab, San Juan, Sanpete, Sevier, and Uintah counties), and Southern (Beaver, Garfield, Iron, Kane, Millard, Piute, Washington, and Wayne counties). The peer support services are intended to assist persons with disabilities and their families to remain in home and community-based settings while awaiting Home and Community Based Services (HCBS), with services to be provided by individuals with lived experience to identify needs, offer support and guidance, navigate systems, and connect persons and families to resources.

The document does not contain information regarding pricing terms, contract term duration, renewal options, response or due dates, award dates, set asides, incumbent information, or funding amounts and sources. These details would be contained in the primary solicitation documents or related contract opportunity materials.