The file's text, extracted by GovTribe without its formatting.
Department of Mental Health – Division of Child, Youth, and Family Services Flexible Support Services Request For Response DMH Document Number: DMH #2019-FLEX-3066-02
AMENDED AND RESTATED LIST OF PERMITTED RESPONSE ATTACHMENTS
| Attachment |
| Response Requirement |
| 1 |
| Organizational Chart with Privacy and Security Officers |
| I2b |
| 2 |
| Human Rights Policies and Procedures |
| I4a |
| 4 |
| Restraint and Seclusion Prevention Policies and Procedures |
| I5a |
| 5 |
| Organizational CLAS Self-assessment |
| I6b |
| 6 |
| Job Descriptions for Flex Support Services Staff |
| I8a |
| 7 |
| Resumes-Management or Supervisory with current Candidate |
| I8a |
| 8 |
| Implementation Timeline |
| I9b |
| 9 |
| Executed original Commonwealth Terms and Conditions for Human and Social Services |
| I10a |
| 10 |
| Executed original Massachusetts Form W-9 |
| I10b |
| 11 |
| Contractor Authorized Signatory Listing (1 original), both pages with second page notarized |
| I10c |
| 12 |
| Two Original executed Standard Contract Forms |
| I10d |
| 13 |
| Original Authorized for Electric Funds Payment Form |
| I10e |
| 14 |
| Sample Group agenda(s)/curriculum |
| II4b |
| 15 |
| Clinician Assessment and screening tools |
| III2b |
| 16 |
| Clinician Progress Monitoring and Transition Indicator Tool |
| III2c |
| 17 |
| Clinicians Training Plan |
| III4b |
| 18 |
| Family Partner Progress Monitoring and Transition Indicator Tool |
| IV2d |
| 19 |
| Family Partners/Senior Family Partners Training Plan |
| IV3b |
| 20 |
| Young Adult Peer Mentor Training Plan |
| V3b |
| 21 |
| Therapeutic Support Specialist Progress Monitoring and Transition Indicator Tool |
| VI2b |
| 22 |
| Therapeutic Support Specialist Training Plan |
| VI3b |
| 23 |
| Clinical Services Vignette |
| III5 |
| 24 |
| Parent/Caregiver Peer Support Vignette |
| IV6 |
| 25 |
| Young Adult Peer Mentoring Vignette |
| V6 |
| 26 |
| Therapeutic Support Services Vignette |
| VI5 |