HomeMy WebLinkAbout2025-228A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
AMENDMENT # 002
THIS AMENDMENT, entered into between Southeast Florida Behavioral Health
Network, Inc., (SEFBHN) hereinafter referred to as the "Managing Entity" and the Indian
River County Board of County Commissioners, hereinafter referred to as the
"Provider," amends agreement number AGR75.
The purpose of this amendment is to extend the agreement between the Indian River
County Board of County Commissioners (IRCBOCC) and Southeast Florida Behavioral
Health Network, Inc. (SEFBHN) through June 30, 2028 and, clearly define how unspent
funding has rolled from one year to another. As a result, while this contract is being
extended for three years, funding will appear as though it is being reduced - this is
primarily because $1,641,140.00 in FY 23/24 of unused funding was not removed from
the agreement when FY 24/25 funds were initially allocated. Administrative fees for FY
26/27 and 27/28 are calculated based on expected allocations.
FY 23/24 will become $0.00; FY 24/25 will become $81,341.00; FY 25/26 will become
$439,621.00; FY 26/27 will be added as $558,732.00; and, FY 27/28 will be added as
157,386.00. The new agreement value will become $1,237,080.00.
1. Page 1, (Amended and Restated) Service Agreement, B. Tasks, 1. Budget and
Compensation, is hereby amended to read:
1. Budget and Compensation
The fees set by this Agreement are based upon the Scope of Work listed above,
the description of the Scope of Services as detailed in Attachment A: Scope of
Service, herein incorporated by reference. The budget is and are further itemized
on the Attachment C: Line Item Operating Budget and the Statement of
Funding, both herein incorporated by reference.
The Indian River County Board of County Commissioners will receive
$1,237,080.00 ($0.00 for FY 23/24; $81,341.00 for FY 24/25; $439,621.00 for
FY 25/26; $558,732.00 for FY 26/27; and, $157,386.00 for FY 27/28), for
services rendered as described in Attachment A: Scope of Service. These
funds will be released on a cost reimbursement basis as approved and split
between CORE Services funding and for Non -Qualified County Services funding,
as further described below.
To request and receive payment, the Attachment D: Cost Reimbursement
Invoice, herein incorporated by reference, must be submitted and include
purpose and description of the services performed. The Provider shall only
invoice for services delivered during the agreement period. Properly completed
and approved cost reimbursement invoices are due by the 101h of each month.
Payments will be released thereafter.
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RYAN L. BUTLER, CLERK
a. CORE Services
The Indian River County Board of County Commissioners will receive
$1,049,469.00 ($0.00 for FY 23/24; $0.00 for FY 24/25; $393,551.00 for FY
25/26; $524,734.00 for FY 26/27; and, $131,184.00 for FY 27/28), for CORE
services rendered as described in Attachment A, Scope of Service.
b. Non -Qualified Services
The Indian River County Board of County Commissioners will receive
$187,611.00 ($0.00 for FY 23/24; $81,341.00 for FY 24/25; $46,070.00 for
FY 25/26; $33,998.00 for FY 26/27; and, $26,202.00 for FY 27/28), for Non -
Qualified County services rendered as described in Attachment A, Scope of
Service.
Based on the table below, the following 5% administrative fees will be withheld
from the Indian River County Board of County Commissioners by SEFBHN,
at the Indian River County Board of County Commissioners' request. This
administrative fee will support SEFBHN in their oversight of the agencies
specified in Attachment B: List of Non -Qualified County Providers, herein
incorporated by reference.
FY
Allocation to Indian
5% Admin
Notes
River County
Fee
23/24
$1,276,140.00
$63,807.00
Fee to be collected in
FY 24/25.
24/25
$610,674.00
$30,534.00
Fee partially collected.
25/26
$661,398.00
$33,070.00
All fees through FY
25/26 to be caught up.
26/27
$679,958.00
$33,998.00
27/28
$524,043.00
$26,202.00
TOTAL
$3,752,213.00
$187,611.00
This is to be invoiced however, payment will then be withheld to reflect the
collection of the administrative fee by Southeast Florida Behavioral Health
Network, Inc. as agreed.
2. Page 4, (Amended and Restated) Service Agreement, D. General Provisions,
Bullet 4, is hereby amended to read:
The following Attachments are incorporated into this Agreement by reference:
a. Attachment A: Scope of Service
b. Attachment B: List of Non -Qualified County Providers
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RYAN L. BUTLER, CLERK
c. Attachment C: Line Item Operating Budget
d. Attachment D: Cost Reimbursement Invoice
e. Statement of Funding
3. All changes shall begin on July 1, 2025, or when signed by both parties.
IN WITNESS THEREOF, the parties hereto have caused this 3 page amendment to be
executed by their undersigned officials as duly authorized.
Indian River County Board „o�* '0ry ,tir putheast Florida Behavioral Health
County Comm issionerso�.••" Network, Inc.
Signed by: ,
Name:
Title:
h Flescher ��'9��FRcouza
Chairman
Date: October 7, 2025
Ann M. Berner
Chief Executive Officer
The parties agree that any future amendment(s) replacing this page will not affect the
above execution.
Federal Tax ID # (or SSN): 59-6000674
APPROVED AS TO FORM
AND LEGAL SUFFICIENCY
134NIFR1,�.�Sk�&.�
NW. SHULER
COUNTY ATTORNEY
Provider FY Ending Date: 06130
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller
Deputy Clerk
SERVICE AGREEMENT ATRUE COPY
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Attachment A RYAN L. BUTLER, CLERK
Scope of Services
A. Florida Statewide Response for Opioid Abatement
The "Children and Families Operating Procedure on Florida Statewide Response for
Opioid Abatement," is herein incorporated by reference and should be followed as per
the most recent effective date available. At the time of this Agreement's execution, this
document is still in draft form. When available, it will be shared from Southeast Florida
Behavioral Health Network, Inc. staff.
B. Core Strategies
Non -Qualified Counties shall choose from the abatement strategies listed in the Core
Strategies — Abatement Strategies section below. However, priority shall be given to the
following core abatement strategies ("Core Strategies.")
1. Naloxone or another FDA -approved drug to reverse opioid overdoses.
a. Expand training for first responders, schools, community support groups and
families.
b. Increase distribution to individuals who are uninsured or whose insurance does
not cover the needed service.
2. Medication -Assisted Treatment ("MAT") Distribution and other opioid -related
treatment
a. Increase distribution of MAT to non -Medicaid eligible or uninsured individuals.
b. Provide education to school-based and youth -focused programs that discourage
or prevent misuse.
c. Provide MAT education and awareness training to healthcare providers, EMTs,
law enforcement, and other first responders; and
d. Treatment and Recovery Support Services such as residential and inpatient
treatment, intensive outpatient treatment, outpatient therapy or counseling, and
recovery housing that allow or integrate medication with other support services.
3. Pregnant & Postpartum Women
a. Expand Screening, Brief Intervention, and Referral to Treatment ("SBIRT")
services to non -Medicaid eligible or uninsured pregnant women.
Incorporated Document 1 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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b. Expand comprehensive evidence -based treatment and recovery services,
including MAT, for women with co-occurring Opioid Use Disorder ("OUD") and
other Substance Use Disorder ("SUD")/Mental Health disorders for uninsured
individuals for up to 12 months postpartum; and
c. Provide comprehensive wrap-around services to individuals with Opioid Use
Disorder (OUD) including housing, transportation, job placement/training, and
childcare.
4. Expanding Treatment for Neonatal Abstinence Syndrome
a. Expand comprehensive evidence -based and recovery support for NAS babies;
b. Expand services for better continuum of care with infant -need dyad; and
c. Expand long-term treatment and services for medical monitoring of NAS babies
and their families.
5. Expansion of Warm Hand-off Programs and Recovery Services
a. Expand services such as navigators and on-call teams to begin MAT in hospital
emergency departments;
b. Expand warm hand-off services to transition to recovery services;
c. Broaden scope of recovery services to include co-occurring SUD or mental
health conditions.
d. Provide comprehensive wrap-around services to individuals in recovery
including housing, transportation, job placement/training, and childcare; and
e. Hire additional social workers or other behavioral health workers to facilitate
expansions above.
6. Treatment for Incarcerated Population
a. Provide evidence -based treatment and recovery support including MAT for
persons with OUD and co-occurring SUD/MH disorders within and transitioning
out of the criminal justice system; and
b. Increase funding for jails to provide treatment to inmates with OUD.
Incorporated Document 2 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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7. Prevention Programs
a. Funding for media campaigns to prevent opioid use (similar to the FDA's "Real
Cost" campaign to prevent youth from misusing tobacco).
b. Funding for evidence -based prevention programs in schools.;
c. Funding for medical provider education and outreach regarding best prescribing
practices for opioids consistent with the 2016 CDC guidelines, including
providers at hospitals (academic detailing);
d. Funding for community drug disposal programs; and
e. Funding and training for first responders to participate in pre -arrest diversion
programs, post overdose response teams, or similar strategies that connect at -
risk individuals to behavioral health services and supports.
8. Expanding Syringe Service Programs
Provide comprehensive syringe services programs with more wrap-around services
including linkage to OUD treatment, access to sterile syringes, and linkage to care
and treatment of infectious diseases.
9. Evidence -based data collection and research analyzing the effectiveness of
the abatement strategies within the State.
10. Core Strategies — Abatement Strategies
a. Approved Uses — Part One: Treatment
(1) Treat Opioid Use Disorder (OUD)
Support treatment of Opioid Use Disorder (OUD) and any co-occurring
Substance Use Disorder or Mental Health (SUD/MH) conditions through
evidence -based or evidence -informed programs or strategies that may
include, but are not limited to, the following:
(a) Expand availability of treatment for OUD and any co-occurring SUD/MH
conditions, including all forms of Medication -Assisted Treatment (MAT)
approved by the U.S. Food and Drug Administration.
(b) Support and reimburse evidence -based services that adhere to the
American Society of Addiction Medicine (ASAM) continuum of care for
OUD and any co-occurring SUD/MH conditions.
Incorporated Document 3 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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(c) Expand telehealth to increase access to treatment for OUD and any co-
occurring SUD/MH conditions, including MAT, as well as counseling,
psychiatric support, and other treatment and recovery support services.
(d) Improve oversight of Opioid Treatment Programs (OTPs) to assure
evidence -based or evidence informed practices such as adequate
methadone dosing and low threshold approaches to treatment.
(e) Support mobile intervention, treatment, and recovery services, offered by
qualified professionals and service providers, such as peer recovery
coaches, for persons with OUD and any co-occurring SUD/MH conditions
and for persons who have experienced an opioid overdose.
(fl Treatment of trauma for individuals with OUD (e.g., violence, sexual
assault, human trafficking, or adverse childhood experiences) and family
members (e.g., surviving family members after an overdose or overdose
fatality), and training of health care personnel to identify and address
such trauma.
(g) Support evidence -based withdrawal management services for people
with OUD and any cooccurring mental health conditions.
(h) Training on MAT for health care providers, first responders, students, or
other supporting professionals, such as peer recovery coaches or
recovery outreach specialists, including tele mentoring to assist
community-based providers in rural or underserved areas.
(i) Support workforce development for addiction professionals who work
with persons with OUD and any co-occurring SUD/MH conditions.
Ili) Fellowships for addiction medicine specialists for direct patient care,
instructors, and clinical research for treatments.
(k) Scholarships and supports for behavioral health practitioners or workers
involved in addressing OUD and any co-occurring SUD or mental health
conditions, including but not limited to training, scholarships, fellowships,
loan repayment programs, or other incentives for providers to work in
rural or underserved areas.
(1) Provide funding and training for clinicians to obtain a waiver under the
federal Drug Addiction Treatment Act of 2000 (DATA 2000) to prescribe
MAT for OUD and provide technical assistance and professional support
to clinicians who have obtained a DATA 2000 waiver.
Incorporated Document 4 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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I. Dissemination of web -based training curricula, such as the
American Academy of Addiction Psychiatry's Provider Clinical
Support Service -Opioids web -based training curriculum and
motivational interviewing.
II. Development and dissemination of new curricula, such as the
American Academy of Addiction Psychiatry's Provider Clinical
Support Service for Medication -Assisted Treatment.
(2) Support to People in Treatment and Recovery
Support people in treatment for or recovery from OUD and any co-occurring
SUD/MH conditions through evidence -based or evidence -informed programs
or strategies that may include, but are not limited to, the following:
(a) Provide comprehensive wrap-around services to individuals with OUD
and any co-occurring SUD/MH conditions, including housing,
transportation, education, job placement, job training, or childcare.
(b) Provide the full continuum of care of treatment and recovery services for
OUD and any co-occurring SUD/MH conditions, including supportive
housing, peer support services and counseling, community navigators,
case management, and connections to community-based services.
(c) Provide counseling, peer -support, recovery case management and
residential treatment with access to medications for those who need it to
persons with OUD and any co-occurring SUD/MH conditions.
(d) Provide access to housing for people with OUD and any co-occurring
SUD/MH conditions, including supportive housing, recovery housing,
housing assistance programs, training for housing providers, or recovery
housing programs that allow or integrate FDA -approved medication with
other support services.
(e) Provide community support services, including social and legal services,
to assist in deinstitutionalizing persons with OUD and any co-occurring
SUD/MH conditions.
(fl Support or expand peer -recovery centers, which may include support
groups, social events, computer access, or other services for persons
with OUD and any co-occurring SUD/MH conditions.
(g) Provide or support transportation to treatment or recovery programs or
Incorporated Document 5 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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RYAN L. BUTLER, CLERK
SERVICE AGREEMENT
services for persons with OUD and any co-occurring SUD/MH
conditions.
(h) Provide employment training c
treatment for or recovery from
conditions.
educational services for persons in
OUD and any co-occurring SUD/MH
(i) Identify successful recovery programs such as physician, pilot, and
college recovery programs, and provide support and technical assistance
to increase the number and capacity of high-quality programs to help
those in recovery.
Q) Engage non -profits, faith -based communities, and community coalitions
to support people in treatment and recovery and to support family
members in their efforts to support the person with OUD in the family.
(k) Training and development of procedures for government staff to
appropriately interact and provide social and other services to individuals
with or in recovery from OUD, including reducing stigma.
(1) Support stigma reduction efforts regarding treatment and support for
persons with OUD, including reducing the stigma on effective treatment.
(m) Create or support culturally appropriate services and programs for
persons with OUD and any cooccurring SUD/MH conditions, including
new Americans.
(n) Create and/or support recovery high schools.
(o) Hire or train behavioral health workers to provide or expand any of the
services or supports listed above.
(3) Connect People who Need Help to the Help they Need (Connections to
Care)
Provide connections to care for people who have — or at risk of developing —
OUD and any cooccurring SUD/MH conditions through evidence -based or
evidence -informed programs or strategies that may include, but are not
limited to, the following:
(a) Ensure that health care providers are screening for OUD and other risk
factors and know how to appropriately counsel and treat (or refer if
necessary) a patient for OUD treatment.
Incorporated Document 6 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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(b) Fund Screening, Brief Intervention and Referral to Treatment (SBIRT)
programs to reduce the transition from use to disorders, including SBIRT
services to pregnant women who are uninsured or not eligible for
Medicaid.
(c) Provide training and long-term implementation of SBIRT in key systems
(health, schools, colleges, criminal justice, and probation), with a focus
on youth and young adults when transition from misuse to opioid disorder
is common.
(d) Purchase automated versions of SBIRT and support ongoing costs of the
technology.
(e) Expand services such as navigators and on-call teams to begin MAT in
hospital emergency departments.
(f) Training for emergency room personnel treating opioid overdose patients
on post -discharge planning, including community referrals for MAT,
recovery case management or support services.
(g) Support hospital programs that transition persons with OUD and any co-
occurring SUD/MH conditions, or persons who have experienced an
opioid overdose, into clinically appropriate follow-up care through a
bridge clinic or similar approach.
(h) Support crisis stabilization centers that serve as an alternative to hospital
emergency departments for persons with OUD and any co-occurring
SUD/MH conditions or persons that have experienced an opioid
overdose.
(i) Support the work of Emergency Medical Systems, including peer support
specialists, to connect individuals to treatment or other appropriate
services following an opioid overdose or other opioid related adverse
event.
(j) Provide funding for peer support specialists or recovery coaches in
emergency departments, detox facilities, recovery centers, recovery
housing, or similar settings; offer services, supports, or connections to
care to persons with OUD and any co-occurring SUD/MH conditions or
to persons who have experienced an opioid overdose.
(k) Expand warm hand-off services to transition to recovery services.
(1) Create or support school-based contacts that parents can engage with to
Incorporated Document 7 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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seek immediate treatment services for their child; and support prevention,
intervention, treatment, and recovery programs focused on young
people.
(m) Develop and support best practices on addressing OUD in the
workplace.
(n) Support assistance programs for health care providers with OUD.
(o) Engage non -profits and the faith community as a system to support
outreach for treatment.
(p) Support centralized call centers that provide information and connections
to appropriate services and supports for persons with OUD and any co-
occurring SUD/MH conditions.
(4) Address the Needs of Criminal -Justice -Involved Persons
Address the needs of persons with OUD and any co-occurring SUD/MH
conditions who are involved in, are at risk of becoming involved in, or are
transitioning out of the criminal justice system through evidence -based or
evidence -informed programs or strategies that may include, but are not
limited to, the following:
(a) Support pre -arrest or pre -arraignment diversion and deflection strategies
for persons with OUD and any co-occurring SUD/MH conditions,
including established strategies such as:
Self -referral strategies such as the Angel Programs or the Police
Assisted Addiction Recovery
II. Initiative (PAARI).
III. Active outreach strategies such as the Drug Abuse Response
Team (DART) model.
IV. "Naloxone Plus" strategies, which work to ensure that individuals
who have received naloxone to reverse the effects of an overdose
are then linked to treatment programs or other appropriate
services.
V. Officer prevention strategies, such as the Law Enforcement
Assisted Diversion (LEAD) model.
Incorporated Document 8 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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SERVICE AGREEMENT `'AN L. BUTLER, CLERK
VI. Officer intervention strategies such as the Leon County, Florida
Adult Civil Citation Network, or the Chicago Westside Narcotics
Diversion to Treatment Initiative; or
VII. Co -responder and/or alternative responder models to address
OUD-related 911 calls with greater SUD expertise.
(b) Support pre-trial services that connect individuals with OUD and any co-
occurring SUD/MH conditions to evidence -informed treatment, including
MAT, and related services.
(c) Support treatment and recovery courts that provide evidence -based
options for persons with OUD and any co-occurring SUD/MH conditions.
(d) Provide evidence -informed treatment, including MAT, recovery support,
harm reduction, or other appropriate services to individuals with OUD and
any co-occurring SUD/MH conditions who are incarcerated in jail or
prison.
(e) Provide evidence -informed treatment, including MAT, recovery support,
harm reduction, or other appropriate services to individuals with OUD and
any co-occurring SUD/MH conditions who are leaving jail or prison have
recently left jail or prison, are on probation or parole, are under
community corrections supervision, or are in re-entry programs or
facilities.
(f) Support critical time interventions (CTI), particularly for individuals living
with dual -diagnosis OUD/serious mental illness, and services for
individuals who face immediate risks and service needs and risks upon
release from correctional settings.
(g) Provide training on best practices for addressing the needs of criminal -
justice -involved persons with OUD and any co-occurring SLID/MH
conditions to law enforcement, correctional, or judicial personnel or to
providers of treatment, recovery, harm reduction, case management, or
other services offered in connection with any of the strategies described
in this section.
(5) Address the Needs of Pregnant Women and their Families, Including
Babies with Neonatal Abstinence Syndrome
Address the needs of pregnant or parenting women with OUD and any co-
occurring SUD/MH conditions, and the needs of their families, including
babies with neonatal abstinence syndrome (NAS), through evidence -based
Incorporated Document 9 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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SERVICE AGREEMENT RYAN L. BUTLER, CLERK
or evidence -informed programs or strategies that may include, but are not
limited to, the following:
(a) Support evidence -based or evidence -informed treatment, including MAT,
recovery services and supports, and prevention services for pregnant
women — or women who could become pregnant — who have OUD and
any co-occurring SUD/MH conditions, and other measures to educate
and provide support to families affected by Neonatal Abstinence
Syndrome.
(b) Expand comprehensive evidence -based treatment and recovery
services, including MAT, for uninsured women with OUD and any co-
occurring SUD/MH conditions for up to 12 months postpartum.
(c) Training for obstetricians or other healthcare personnel that work with
pregnant women and their families regarding treatment of OUD and any
co-occurring SUD/MH conditions.
(d) Expand comprehensive evidence -based treatment and recovery support
for NAS babies; expand services for better continuum of care with infant -
need dyad; expand long-term treatment and services for medical
monitoring of NAS babies and their families.
(e) Provide training to health care providers who work with pregnant or
parenting women on best practices for compliance with federal
requirements that children born with Neonatal Abstinence Syndrome get
referred to appropriate services and receive a plan of safe care.
(fl Child and family supports for parenting women with OUD and any co-
occurring SUD/MH conditions.
(g) Enhanced family supports and childcare services for parents with OUD
and any co-occurring SUD/MH conditions.
(h) Provide enhanced support for children and family members suffering
trauma as a result of addiction in the family; and offer trauma -informed
behavioral health treatment for adverse childhood events.
(i) Offer home-based wrap-around services to persons with OUD and any
co-occurring SUD/MH conditions, including but not limited to parent skills
training.
(j) Support for Children's Services — Fund additional positions and services,
including supportive housing and other residential services, relating to
Incorporated Document 10 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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SERVICE AGREEMENT RYAN L. BUTLER, CLERK
children being removed from the home and/or placed in foster care due
to custodial opioid use.
b. Approved Uses — Part Two: Prevention
(1) Prevent Over -prescribing and Ensure Appropriate Prescribing and
Dispensing of Opioids
Support efforts to prevent over -prescribing and ensure appropriate
prescribing and dispensing of opioids through evidence -based or evidence -
informed programs or strategies that may include, but are not limited to, the
following:
(a) Fund medical provider education and outreach regarding best prescribing
practices for opioids consistent with Guidelines for Prescribing Opioids
for Chronic Pain from the U.S. Centers for Disease Control and
Prevention, including providers at hospitals (academic detailing).
(b) Training for health care providers regarding safe and responsible opioid
prescribing, dosing, and tapering patients off opioids.
(c) Continuing Medical Education (CME) on appropriate prescribing of
opioids.
(d) Support for non -opioid pain treatment alternatives, including training
providers to offer or refer to multi -modal, evidence -informed treatment of
pain.
(e) Support enhancements or improvements to Prescription Drug Monitoring
Programs (PDMPs), including but not limited to improvements that:
I. Increase the number of prescribers using PDMPs.
II. Improve point -of -care decision-making by increasing the quantity,
quality, or format of data available to prescribers using PDMPs, by
improving the interface that prescribers use to access PDMP data,
or both; or
Ill. Enable states to use PDMP data in support of surveillance or
intervention strategies, including MAT referrals and follow-up for
individuals identified within PDMP data as likely to experience
OUD in a manner that complies with all relevant privacy and
security laws and rules.
Incorporated Document 11 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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SERVICE AGREEMENT RYAN L. BUTLER, CLERK
(f) Ensuring PDMPs incorporate available overdose/naloxone deployment
data, including the United States Department of Transportation's
Emergency Medical Technician overdose database in a manner that
complies with all relevant privacy and security laws and rules.
(g) Increase electronic prescribing to prevent diversion or forgery.
(h) Educate Dispensers on appropriate opioid dispensing.
(2) Prevent Misuse of Opioids
Support efforts to discourage or prevent misuse of opioids through evidence -
based or evidence informed programs or strategies that may include, but are
not limited to, the following:
(a) Fund media campaigns to prevent opioid misuse.
(b) Corrective advertising or affirmative public education campaigns based
on evidence.
(c) Public education relating to drug disposal.
(d) Drug take -back disposal or destruction programs.
(e) Fund community anti-drug coalitions that engage in drug prevention
efforts.
(f) Support community coalitions in implementing evidence -informed
prevention, such as reduced social access and physical access, stigma
reduction — including staffing, educational campaigns, support for people
in treatment or recovery, or training of coalitions in evidence -informed
implementation, including the Strategic Prevention Framework
developed by the U.S. Substance Abuse and Mental Health Services
Administration (SAMHSA).
(g) Engage non -profits and faith -based communities as systems to support
prevention.
(h) Fund evidence -based prevention programs in schools or evidence -
informed school and community education programs and campaigns for
students, families, school employees, school athletic programs, parent -
teacher and student associations, and others.
(i) School-based or youth -focused programs or strategies that have
Incorporated Document 12 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
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demonstrated effectiveness in preventing drug misuse and seem likely to
be effective in preventing the uptake and use of opioids.
(j) Create of support community-based education or intervention services
for families, youth, and adolescents at risk for OUD and any co-occurring
SUD/MH conditions.
Support evidence -informed programs or curricula to address
mental health needs of young people who may be at risk of
misusing opioids or other drugs, including emotional modulation
and resilience skills.
II. Support greater access to mental health services and supports for
young people, including services and supports provided by school
nurses, behavioral health workers or other school staff, to address
mental health needs in young people that (when not properly
addressed) increase the risk of opioid or other drug misuse.
(3) Prevent Overdose Deaths and Other Harms (Harm Reduction)
Support efforts to prevent or reduce overdose deaths or other opioid -related
harms through evidence based or evidence -informed programs or strategies
that may include, but are not limited to, the following:
(a) Increase availability and distribution of naloxone and other drugs that
treat overdoses for first responders, overdose patients, individuals with
OUD and their friends and family members, individuals at high risk of
overdose, schools, community navigators and outreach workers, persons
being released from jail or prison, or other members of the general
public.
(b) Public health entities provide free naloxone to anyone in the community.
(c) Training and education regarding naloxone and other drugs that treat
overdoses for first responders, overdose patients, patients taking opioids,
families, schools, community support groups, and other members of the
general public.
(d) Enable school nurses and other school staff to respond to opioid
overdoses, and provide them with naloxone, training, and support.
(e) Expand, improve, or develop data tracking software and applications for
overdoses/naloxone revivals.
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(f) Public education relating to emergency responses to overdoses.
(g) Public education relating to immunity and Good Samaritan laws.
(h) Educate first responders regarding the existence and operation of
immunity and Good Samaritan laws.
(i) Syringe service programs and other evidence -informed programs to
reduce harms associated with intravenous drug use, including supplies,
staffing, space, peer support services, referrals to treatment, fentanyl
checking, connections to care, and the full range of harm reduction and
treatment services provided by these programs.
Q) Expand access to testing and treatment for infectious diseases such as
HIV and Hepatitis C resulting from intravenous opioid use.
(k) Support mobile units that offer or provide referrals to harm reduction
services, treatment, recovery supports, health care, or other appropriate
services to persons that use opioids or persons with OUD and any co-
occurring SUD/MH conditions.
(1) Provide training in harm reduction strategies to health care providers,
students, peer recovery coaches, recovery outreach specialists, or other
professionals that provide care to persons who use opioids or persons
with OUD and any co-occurring SUD/MH conditions.
(m) Support screening for fentanyl in routine clinical toxicology testing.
c. Approved Uses — Part Three: Other Strategies
(1) First Responders
In addition to items in previous sections relating to first responders, support
the following:
(a) Educate law enforcement or other first responders regarding appropriate
practices and precautions when dealing with fentanyl or other drugs.
(b) Provision of wellness and support services for first responders and others
who experience secondary trauma associated with opioid -related
emergency events.
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(2) Leadership, Planning and Coordination
Support efforts to provide leadership, planning, coordination, facilitation,
training, and technical assistance to abate the opioid epidemic through
activities, programs, or strategies that may include, but are not limited to, the
following:
(a) Statewide, regional, local, or community regional planning to identify root
causes of addiction and overdose, goals for reducing harms related to
the opioid epidemic, and areas and populations with the greatest needs
for treatment intervention services; to support training and technical
assistance; or to support other strategies to abate the opioid epidemic
described in this opioid abatement strategy list.
(b) A dashboard to share reports, recommendations, or plans to spend
opioid settlement funds; to show how opioid settlement funds have been
spent; to report program or strategy outcomes; or to track, share, or
visualize key opioid -related or health-related indicators and supports as
identified through collaborative statewide, regional, local, or community
processes.
(c) Invest in infrastructure or staffing at government or not-for-profit agencies
to support collaborative, cross -system coordination with the purpose of
preventing overprescribing, opioid misuse, or opioid overdoses, treating
those with OUD and any co-occurring SUD/MH conditions, supporting
them in treatment or recovery, connecting them to care, or implementing
other strategies to abate the opioid epidemic described in this opioid
abatement strategy list.
(d) Provide resources to staff government oversight and management of
opioid abatement programs.
(3) Training
In addition to the training referred to throughout this document, support
training to abate the opioid epidemic through activities, programs, or
strategies that may include, but are not limited to, the following:
(a) Provide funding for staff training or networking programs and services to
improve the capability of government, community, and not-for-profit
entities to abate the opioid crisis.
(b) Support infrastructure and staffing for collaborative cross -system
coordination to prevent opioid misuse, prevent overdoses, and treat
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those with OUD and any co-occurring SUD/MH conditions, or implement
other strategies to abate the opioid epidemic described in this opioid
abatement strategy list (e.g., health care, primary care, pharmacies,
PDMPs, etc.).
(4) Research
Support opioid abatement research that may include, but is not limited to, the
following:
(a) Monitoring, surveillance, data collection, and evaluation of programs and
strategies described in this opioid abatement strategy list.
(b) Research non -opioid treatment of chronic pain.
(c) Research on improved service delivery for modalities such as SBIRT that
demonstrate promising but mixed results in populations vulnerable to
opioid use disorders.
(d) Research on novel harm reduction and prevention efforts such as the
provision of fentanyl test strips.
(e) Research on innovative supply-side enforcement efforts such as
improved detection of mail -based delivery of synthetic opioids.
(f) Expanded research on swift/certain/fair models to reduce and deter
opioid misuse within criminal justice populations that build upon
promising approaches used to address other substances (e.g., Hawaii
HOPE and Dakota 24/7).
(g) Epidemiological surveillance of OUD-related behaviors in critical
populations including individuals entering the criminal justice system,
including but not limited to approaches modeled on the Arrestee Drug
Abuse Monitoring (ADAM) system.
(h) Qualitative and quantitative research regarding public health risks and
harm reduction opportunities within illicit drug markets, including surveys
of market participants who sell or distribute illicit opioids.
(i) Geospatial analysis of access barriers to MAT and their association with
treatment engagement and treatment outcomes.
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C. Covered Services as defined in Florida Administrative Code 65E-14.021
The covered services and project codes listed below are based on those eligible to access
MSONQ, MSOCR, and their Carryforward OCAs as per the DCF FASAMS Pamphlet 155-
2 with a last revision date of 12/4/24, herein incorporated by reference. If the OCA
associated with this program changes, or the list of eligible services are changed,
Southeast Florida Behavioral Health Network, Inc. staff will inform the Indian River County
Board of County Commissioners in an email which will include a the DCF FASAMS
Pamphlet 155-2 and a revised Statement of Funding, herein incorporated by reference, if
applicable.
1. Funding is currently available for the Non -Qualified County programs under MSONQ,
the current Other Cost Accumulator (OCA), associated with this Agreement for ME
Opioid TF Non -Qualified Counties funding.
2. Funding is currently available for the CORE programs under MSOCR, the current Other
Cost Accumulator (OCA), associated with this Agreement for ME Opioid TF Coord
Opioid Recovery Care funding.
D. Covered Services as defined in Florida Administrative Code 65E-14.021
For simplicity MSOCR will include MSOCR and MSOCR Carry Forward and, MSONQ will
include MSONQ and MSONQ Carry Forward.
1. 1 — Assessment (Eligible OCAs: MSOCR, MSONQ)
This Covered Service includes the systematic collection and integrated review of
individual -specific data, such as examinations and evaluations. This data is gathered,
analyzed, monitored and documented to develop the person's individualized plan of
care and to monitor recovery. Assessment specifically includes efforts to identify the
person's key medical and psychological needs, competency to consent to treatment,
history of mental illness or substance use and indicators of co-occurring conditions, as
well as clinically significant neurological deficits, traumatic brain injury, organicity,
physical disability, developmental disability, need for assistive devices, physical or
sexual abuse, and trauma.
2. 2 — Case Management (Eligible OCAS: MSOCR)
Case management services consist of activities that identify the recipient's needs, plan
services, link the service system with the person, coordinate the various system
components, monitor service delivery, and evaluate the effect of the services received.
This covered service shall include clinical supervision provided to a service provider's
personnel by a professional qualified by degree, licensure, certification, or specialized
training in the implementation of this service.
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3. 3 — Crisis Stabilization (Eligible OCAs: MSONQ)
These acute care services, offered twenty-four hours per day, seven days per week,
provide brief, intensive mental health residential treatment services. These services
meet the needs of individuals who are experiencing an acute crisis and who, in the
absence of a suitable alternative, would require hospitalization.
4. 4 — Crisis Support/Emergency (Eligible OCAs: MSOCR, MSONQ)
This non-residential care is generally available twenty-four hours per day, seven days
per week, or some other specific time period, to intervene in a crisis or provide
emergency care. Examples include: crisis/emergency screening, mobile response,
telephone or telehealth crisis support, and emergency walk-in.
5. 5 — Day Care (Eligible OCAs: MSONQ)
Day care services, in a non-residential group setting, provide for the care of children of
persons who are participating in mental health or substance use treatment services. In
a residential setting, day care services provide for the residential and care -related costs
of a child living with a parent receiving residential services. This covered service must
be provided in conjunction with another Covered Service provided to a person 18 years
of age or older.
6. 6 — Day Treatment (Eligible OCAs: MSOCR, MSONQ)
Day Treatment services provide a structured schedule of non-residential interventions
to assist individuals to attain skills and behaviors needed to function successfully in
living, learning, work, and social environments. Activities emphasize rehabilitation,
treatment, activities of daily living, and education services, using multidisciplinary
teams to provide integrated programs of academic, therapeutic, and family services.
For mental health programs, day treatment services must be provided for four or more
consecutive hours per day. Substance abuse programs must follow the standards set
forth in Rules 65D-30.0081 and 65D-30.009, F.A.C.
7. 8 — In -Home and On -Site (Eligible OCAs: MSOCR, MSONQ)
Therapeutic services and supports, including early childhood mental health
consultation, are rendered for individuals and their families in non -provider settings
such as nursing homes, assisted living facilities, residences, schools, detention
centers, commitment settings, foster homes, daycare centers, and other community
settings.
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8. 9 — Inpatient (Eligible OCAs: MSONQ)
Inpatient services provided in psychiatric units within hospitals licensed as general
hospitals and psychiatric hospitals under Chapter 395, F.S. They provide intensive
treatment and stabilization to persons exhibiting behaviors that may result in harm to
self or others due to mental illness or co-occurring mental illness and substance use
disorder.
9. 10 — Intensive Case Management (Eligible OCAs: MSOCR)
These services are typically offered to persons who are being discharged from an acute
care setting, and need more professional care, and have contingency needs to remain
in a less restrictive setting. The services include the same components as case
management as described in subparagraph (4)(d)1., of this rule, but are provided at a
higher intensity and frequency, and with lower caseloads per case manager sufficient
to meet the needs of the individuals in treatment.
10.11 — Intervention — Individual and 42 — Intervention — Group (Eligible OCAs:
MSOCR, MSONQ)
Intervention services focus on reducing risk factors generally associated with the
progression of substance misuse and mental health problems. Intervention is
accomplished through early identification of persons at risk, performing basic individual
assessments, and providing supportive services, which emphasize short-term
counseling and referral. These services are targeted toward individuals and families.
This covered service shall include clinical supervision provided to a service provider's
personnel by a professional qualified by degree, licensure, certification, or specialized
training in the implementation of this service.
11.12 — Medical Services (Eligible OCAs: MSOCR, MSONQ)
Medical services provide primary psychiatric care, therapy, and medication
administration provided by an individual licensed under the state of Florida to provide
the specific service rendered. Medical services improve the functioning or prevent
further deterioration of persons with mental health or substance abuse problems,
including mental status assessment. Medical services are usually provided on a regular
schedule, with arrangements for non-scheduled visits during times of increased stress
or crisis.
12.13 — Medication Assisted Treatment (Eligible OCAs: MSOCR, MSONQ)
This Covered Service provides for the delivery of medications for the treatment of
substance use disorders which are prescribed by a licensed health care professional.
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Services must be based upon a clinical assessment, and treatment and support
services must be available for and offered to individuals receiving medications to
support their ongoing recovery.
13.14 — Outpatient — Individual and 35 — Outpatient — Group (Eligible OCAs: MSOCR,
MSONQ)
Outpatient services provide clinical interventions to improve the functioning or prevent
further deterioration of persons with mental health and/or substance abuse use
disorders. These services are usually provided on a regularly scheduled basis by
appointment, with arrangements made for non-scheduled visits during times of
increased stress or crisis. Outpatient services may be provided to an individual or in a
group setting. The maximum number of individuals allowed in a group session is 15.
This covered service shall include clinical supervision provided to a service provider's
personnel by a professional qualified by degree, licensure, certification, or specialized
training in the implementation of this service.
14.15 — Outreach (Eligible OCAs: MSOCR, MSONQ)
Outreach services are provided through a formal program to both individuals and the
community. Community services include education, identification, and linkage with
high-risk groups. Outreach services for individuals: encourage, educate, and engage
prospective individuals who show an indication of substance misuse and mental health
problems or needs. Individual enrollment is not included in Outreach services.
15.18 — Residential Level I (Eligible OCAs: MSONQ)
These licensed services provide a structured, live-in, non -hospital setting with
supervision on a twenty-four hours per day, seven days per week basis. For adult
mental health, Residential Treatment Facilities Level IA and IB, as defined in Rule 65E-
4.016, F.A.C., are reported under this Covered Service. For children with serious
emotional disturbances, Level 1 services are the most intensive and restrictive level of
residential therapeutic intervention provided in a non -hospital or non -crisis stabilization
setting. Residential Treatment Centers, as defined in Rule 65E-9.002, F.A.C. are
reported under this Covered Service. For substance use treatment, Residential Level
1, as defined in Rule 65D-30.007, F.A.C., provides a range of assessment, treatment,
rehabilitation, and ancillary services in an intensive therapeutic environment, with an
emphasis on treatment, and may include formal school and adult education programs.
16.19 — Residential Level II (Eligible OCAs: MSONQ)
Level II facilities are licensed, structured rehabilitation -oriented group facilities that
have twenty-four hours per day, seven days per week, supervision. Level II facilities
house persons who have significant deficits in independent living skills and need
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extensive support and supervision. For adults with a mental illness, Residential
Treatment Facilities Level II, as defined in Rule 65E-4.016, F.A.C., are reported under
this Covered Service. For children with serious emotional disturbances, Level II
services provide intensive therapeutic behavioral and treatment interventions.
Therapeutic Foster Homes are reported under this Covered Service. For substance
use treatment, Level II, as defined in Rule 65D-30.007, F.A.C., services provide a range
of assessment, treatment, rehabilitation, and ancillary services in a less intensive
therapeutic environment with an emphasis on rehabilitation and may include formal
school and adult educational programs.
17.20 — Residential Level III (Eligible OCAs: MSONQ)
These licensed facilities provide twenty-four hours per day, seven days per week
supervised residential alternatives to persons who have developed a moderate
functional capacity for independent living. For adults with a mental illness, Residential
Treatment Facilities Level III, as defined in Rule 65E-4.016, F.A.C., are reported under
this Covered Service. For substance use treatment, Level III, as defined in Rule 65D-
30.007, F.A.C., provides a range of assessment, rehabilitation, treatment and ancillary
services on a long-term, continuing care basis where, depending upon the
characteristics of the individuals served, the emphasis is on rehabilitation or treatment.
18.21 — Residential Level IV (Eligible OCAs: MSONQ)
This type of facility may have less than twenty-four hours per day, seven days per week
on -premise supervision. It is primarily a support service and, as such, treatment
services are not included in this Covered Service, although such treatment services
may be provided as needed through other Covered Services. Level IV includes satellite
apartments, satellite group homes, and therapeutic foster homes. For adults with a
mental illness, Residential Treatment Facilities Level IV, as defined in paragraph 65E-
4.016, F.A.C., are reported under this Covered Service. For substance use treatment,
Level IV, as defined in Rule 65D-30.007, F.A.C., provides a range of assessment,
rehabilitation, treatment, and ancillary services on a long-term, continuing care basis
where, depending upon the characteristics of the individuals served, the emphasis is
on rehabilitation or treatment.
19.22 — Respite Services (Eligible OCAs: MSOCR, MSONQ)
Respite care services support the family or other primary care giver by providing time-
limited, temporary relief, including overnight stays, from the ongoing responsibility of
care giving.
20.24 — Substance Abuse Inpatient Detoxification (Eligible OCAs: MSOCR, MSONQ)
These programs utilize medical and clinical procedures to assist adults, and
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adolescents with substance use disorders in their efforts to withdraw from the physical
effects of substance use. Residential detoxification and addiction receiving facilities
provide emergency screening, evaluation, short-term stabilization, and treatment in a
medically supervised.
21.25 — Supportive Employment (Eligible OCAs: MSOCR, MSONQ)
Supported employment is an evidence -based approach that assists individuals with
gaining competitive integrated employment. Supported employment can be a team -
based approach and focuses on the full range of community jobs that match the job
seeker's strengths and preferences. Job supports are individualized and include: job
development, job placement, and long-term job coaching.
22.26 — Supported Housing/Living (Eligible OCAs: MSOCR, MSONQ)
Supported housing/living is an evidence -based approach to assist persons with
substance use and mental illness in the selection of permanent housing of their choice.
These services also provide the necessary supports to transition into independent
community living and assure continued successful living in the community. For children
with mental health challenges, supported living services are a process which assist
adolescents in selecting and maintaining housing arrangements and provides services,
such as training in independent living skills, to assure successful transition to
independent living or with roommates in the community. For substance use treatment,
services provide for the housing and monitoring of recipients who are participating in
non-residential services, recipients who have completed or are completing substance
use treatment, and those recipients who need assistance and support in independent
or supervised living within a "live-in" environment.
23.27 — Treatment Alternative for Safer Community (Eligible OCAs: MSOCR,
MSONQ)
TASC provides for identification, screening, court liaison, referral and tracking of
persons in the criminal justice system with a history of substance use or addiction.
24.28 — Incidental Expenses (Eligible OCAs: MSOCR, MSONQ)
This Covered Service reports temporary expenses incurred to facilitate continuing
treatment and community stabilization when no other resources are available. All
incidental expenses shall be authorized by the Managing Entity. Allowable purchases
under this Covered Service includes: transportation, childcare, housing assistance
clothing, educational services, vocational services, medical care, housing subsidies,
pharmaceuticals and other incidentals as approved by the Department or Managing
Entity.
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25.29 — Aftercare — Individual and 43 — Aftercare — Group (Eligible OCAs: MSONQ)
Aftercare activities occur after a treatment level of care is completed and include
activities such as supportive counseling, life skills training, and relapse prevention for
individuals with mental illness or substance use disorders to assist in their ongoing
recovery. Aftercare services help individuals, families, and pro -social support systems
reinforce a healthy living environment.
26.30 — Information and Referral (Eligible OCAs: MSOCR, MSONQ)
These services maintain information about resources in the community, link people
who need assistance with appropriate service providers, and provide information about
agencies and organizations that offer services. The information and referral process is
comprised of: being readily available for contact by the individual, assisting the
individual with determining which resources are needed, providing referral to
appropriate resources, and following up to ensure the individual's needs have been
met, where appropriate.
27.32 — Substance Abuse Outpatient Detoxification (Eligible OCAs: MSONQ)
These services utilize medication or a psychosocial counseling regimen that assists
recipients in their efforts to withdraw from the physiological and psychological effects
of addictive substances.
28.36 — Room and Board with Supervision Level I (Eligible OCAs: MSONQ)
This Covered Service solely provides for room and board with supervision on a twenty-
four hours per day, seven days per week basis. It corresponds to Residential Level I
as defined in F.A.C. 65E-14.021.
29.37 — Room and Board with Supervision Level II (Eligible OCAs: MSONQ)
This Covered Service solely provides for room and board with supervision on a twenty-
four hours per day, seven days per week basis. It corresponds to Residential Level II
as defined in F.A.C. 65E-14.021. This Covered Service is not applicable for provider
facilities which meet the definition of an Institute for Mental Disease as defined by Title
42 CFR, Part 435.1010.
30.38 — Room and Board with Supervision Level III (Eligible OCAs: MSONQ)
This Covered Service solely provides for room and board with supervision on a twenty-
four hours per day, seven days per week basis. It corresponds to Residential Level III
as defined in F.A.C. 65E-14.021.
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31.39 — Short-term Residential Treatment (Eligible OCAs: MSONQ)
These individualized, stabilizing acute and immediately sub -acute care services
provide short and intermediate duration intensive mental health residential services on
a twenty-four hours per day, seven days per week basis, as provided for in Rule
Chapter 65E-12, F.A.C. These services shall meet the needs of individuals who are
experiencing an acute or immediately sub -acute crisis and who, in the absence of a
suitable alternative, would require hospitalization.
32.40 — Mental Health Clubhouse Services (Eligible OCAs: MSONQ)
Structured, evidence -based services both strengthen and/or regain the individual's
interpersonal skills, provide psycho -social support, develop the environmental supports
necessary to help the individual thrive in the community and meet employment and
other life goals, and promote recovery from mental illness. Services are typically
provided in a community-based program with trained staff and members working as
teams to address the individual's life goals and to perform the tasks necessary for the
operations of the program. The emphasis is on a holistic approach focusing on the
individual's strengths and abilities while challenging the individual to pursue those life
goals. This service would include, but not be limited to, clubhouses certified under the
International Center for Clubhouse Development. This covered service may not be
provided to a person less than 18 years old.
33.44 — Comprehensive Community Service Team — Individual and 45 —
Comprehensive Community Service Team - Group (Eligible OCAs: MSONQ)
This Covered Service is a bundled service package designed to provide short-term
assistance and guide individuals to rebuild skills in identified roles in their environment
through the engagement of natural supports, treatment services, and assistance of
multiple agencies when indicated. Services provided under Comprehensive
Community Service Teams may not be simultaneously reported to another Covered
Service. Allowable bundled activities include the following Covered Services as defined
in subsection (4) of F.A.C. 65E-14.021: Aftercare, Assessment, Care Coordination,
Case Management, Information and Referral, In-home/Onsite, Intensive Case
Management, Intervention, Outpatient, Outreach, Prevention — Indicated, Recovery
Support, Supported Employment, and Supportive Housing.
34.46 — Recovery Support — Individual and 47 — Recovery Support - Group (Eligible
OCAS: MSOCR, MSONQ)
This Covered Service is comprised of nonclinical activities that assist individuals and
families in recovering from substance use and mental health conditions. Activities
include social support, linkage to and coordination among service providers, life skills
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training, recovery planning, coaching, education on mental illness and substance use
disorders, assisting individuals using digital therapeutics approved by the United States
Food and Drug Administration, and other supports that facilitate increasing recovery
capital and wellness contributing to an improved quality of life. Recovery capital is the
personal, family, social, community resources and natural supports that promote
recovery. These activities may be provided prior to, during, and after treatment. These
services support and coach an adult or child and family to regain or develop skills to
live, work and learn successfully in the community. This Covered Service shall include
supervision provided to a service provider's personnel by a professional qualified by
degree, licensure, certification, or specialized training in the implementation of this
service, or by a certified peer specialist who has at least 2 years of fill -time experience
as a peer specialist at a licensed behavioral health organization. This Covered Service
must be provided by a Certified Recovery Peer Specialist pursuant to Section 397.417,
F.S. These services exclude twelve -step programs such as Alcoholics Anonymous and
Narcotics Anonymous.
35.48 — Prevention - Indicated (Eligible OCAs: MSONQ)
Indicated prevention services are provided to at -risk individuals who are identified as
having minimal but detectable signs or symptoms foreshadowing mental health or
substance use disorders. Target recipients of indicated prevention services are at -risk
individuals who do not meet clinical criteria for mental health or substance use
disorders. Indicated prevention services preclude, forestall, or impede the development
of mental health or substance use disorders. These services shall address the following
specific prevention strategies, as defined in rule 65D-30.013, F.A.C.: education,
alternative and problem identification and referral services.
36.49 — Prevention - Selective (Eligible OCAs: MSONQ)
Selective prevention services are provided to a population subgroup whose risk of
developing mental health or substance use disorders is higher than average. Target
recipients of selective prevention services do not meet clinical criteria for mental health
or substance use disorders. Selective prevention services preclude, forestall, or
impede the development of mental health or substance use disorders. These services
shall address the following specific prevention strategies, as defined in Rule 65D-
30.013, F.A.C.: information dissemination, education, alternatives, and problem
identification and referral services.
37.50 — Prevention — Universal Direct (Eligible OCAs: MSONQ)
Universal direct prevention services are provided to the general public or a whole
population that has not been identified on the basis of individual risk. These services
preclude, forestall, or impede the development of mental health or substance use
disorders. Universal direct services directly serve an identifiable group of participants
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who have not been identified on the basis of individual risk. This includes interventions
involving interpersonal and ongoing or repeated contact such as curricula, programs,
and classes. These services shall address the following specific prevention strategies,
as defined in rule 65D-30.013, F.A.C.: information dissemination, education,
alternatives, or problem identification and referral services.
38.51 — Prevention — Universal Indirect (Eligible OCAs: MSONQ)
Universal indirect prevention services are provided to the general public or a whole
population that has not been identified on the basis of individual risk. These services
preclude, forestall, or impede the development of mental health or substance use
disorders. Universal indirect services support population -based programs and
environmental strategies such as changing laws and policies. These services can
include programs and policies implemented by coalitions. These services can also
include meetings and events related to the design and implementation of components
of the strategic prevention framework, including needs assessments, logic models, and
comprehensive community action plans. These services shall address the following
specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: information
dissemination, education, community-based processes, and environmental strategies.
39.52 — Care Coordination (Eligible OCAs: MSOCR, MSONQ)
Care Coordination is a time-limited service that assists individuals with behavioral
health conditions who are not effectively engaged with case management or other
behavioral health services and supports for a successful transition to appropriate levels
of care. Once engagement in the necessary community-based services is verified, care
coordination services are terminated.
40.53 — HIV Early Intervention Services (Eligible OCAs: MSOCR)
This Covered Service is a bundled service package to provide Human
Immunodeficiency Virus (HIV) Early Intervention Services in accordance with 65D-
30.004, F.A.C. Allowable HIV Early Intervention Services may include one or any
combination of the following activities: pretest counseling; posttest counseling; tests to
confirm the presence of HIV; tests to diagnose the extent of the deficiency in the
immune system; tests to provide information on appropriate therapeutic measures for
preventing and treating the deterioration of the immune system and conditions arising
from HIV, including tests for hepatitis C (when provided to individuals with HIV);
therapeutic measures for preventing and treating the deterioration of the immune
system and conditions arising from HIV; and, linkages to diagnostic tests, therapeutic
measures, and HIV specific support services.
Incorporated Document 26 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
A TRUE COPY
Cs --R T IFICATION ON LAST PAGE
SERVICE AGREEMENT "AN L. BUTLER, CLERK
41.54 — Room and Board with Supervision Level IV (Eligible OCAs: MSONQ)
This Covered Service solely provides for room and board with supervision on a twenty-
four hours per day, seven days per week basis. It corresponds to Respite Services as
defined in F.A.C. 65E-14.021.
E. Project Codes
1. A2 — FIT Team (Eligible OCAs: MSONQ)
Bundled rate expenditures for Family Intensive Treatment teams. Allowable covered
services within the bundled rate must be reported in FASAMS as the actual covered
service (i.e., case management, medical services, etc.)
2. A3 — Central Receiving System (Eligible OCAs: MSONQ)
Bundled rate expenditures for Central Receiving System grants. Allowable covered
services within the bundled rate must be reported in FASAMS as the actual covered
service (i.e., case management, medical services, etc.)
3. A4 — Care Coordination (Eligible OCAs: MSONQ)
Bundled rate expenditures for Care Coordination. Allowable covered services within
the bundled rate must be reported in FASAMS as the actual covered service (i.e., case
management, incidentals, etc.
4. A8 — Local Diversion Forensic Project (Eligible OCAs: MSONQ)
Bundled rate expenditures for Outpatient Forensic Mental Health Services as
described in Guidance 6 of the ME contract. Allowable covered services within the
bundled rate must be reported in FASAMS as the actual covered service (i.e., case
management, medical services, etc.)
5. B1 — Network Evaluation and Development (Eligible OCAs: MSOCR, MSONQ)
Allowable expenditures of network service provider funding necessary to evaluate,
develop, or expand the capacity of the regional network of care. This includes fidelity
monitoring, independent quality assessment, workforce development, training, and
related initiatives
6. B3 — Cost Reimbursement (Eligible OCAs: MSOCR, MSONQ)
Expenditures paid on an actual cost reimbursement method of payment, as defined in
Incorporated Document 27 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
A TRUE COPY
CERTIFICATION ON LAST PAGE
SERVICE AGREEMENT RYAN L. BUTLER, CLERK
rule 65E-14.019, F.A.C., for necessary staffing, supplies and related expenditures to
establish operational start-up capacity for new programs or services. Allowable costs
are limited to those expenditures directly related to new services; to service contracts
when required by statute, grant or funding source; or to specific fixed capital outlay
projects appropriated by the legislature.
7. B7 - Wraparound (Eligible OCAs: MSONQ)
Bundled rate expenditures for Wraparound. This project code should only be used
when implementing the evidence -based Wraparound approach to care management,
as defined by the National Wraparound Initiative (https:Hnwi.pdx.edu/). Expenditures
for Wraparound may be billed as case management, CCST, or a bundled rate to
include allowable covered services of assessment, case management, recovery
support, CCST, medical, incidentals, and in-home/on-site.
8. CO — Other Bundled Projects (Eligible OCAs: MSOCR, MSONQ)
Bundled rate expenditures for local community behavioral health initiatives not
otherwise reportable under other project codes.
9. C1 — Sustainability Payment for Emergency Response (Eligible OCAs: MSONQ)
Lump sum payments to support provider sustainability during declared public
emergencies. This code may only be used once per OCA per Provider each month to
report the difference between the Total YTD ME General Ledger payments to the
provider and the Total YTD Actual Payable reported for all other Covered Service and
Project Codes for that OCA.
Incorporated Document 28 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
A TRUE COPY
CERTIFICATION ON LAST PAGE
SERVICE AGREEMENT RYAN L. BUTLER, CLERK
Attachment B
List of Non -Qualified County Providers
The following providers are to receive Non -Qualified County funding:
A. Indian River County Mental Health Collaborative, Inc.
B. Indian River County Sheriff's Office
C. 19th Judicial Circuit Drug Court
D. Treasure Coast Homeless Council
E. Substance Abuse Council of Indian River County, Inc. (also known as Thrive IRC,
Inc.)
F. If needed, other providers will be added to this list upon approval of the Board of
County Commissioners.
Incorporated Document 1 Agreement No.: AGR75-002
Indian River County Board of County
Commissioners
A TRUE COPY
INCORPORATED DOCUMENT RYANCERTIFICATIONLSLE , C LAST PAGE
RYAM1! L. SUTLER, CLERK
ATTACHMENT C: LINE ITEM OPERATING BUDGET
Agency:
Indian River County Board of County
Commissioners
CIRCUIT 19
CATEGORY: LINE ITEM
DESCRIPTION
FY 23/24
Personnel Services: Salary and
Fringe
Supports Salary for Three Captain
Field Training Officers and Fringe
$
Total by Fiscal Year
$ _
CIRCUIT 19
CATEGORY: LINE ITEM
DESCRIPTION
FY 24/25
Personnel Services: Salary and
Fringe
Supports Salary for Three Captain
Field Training Officers and Fringe
$
Total by Fiscal Year
$ _
CIRCUIT 19
CATEGORY: LINE ITEM
DESCRIPTION
FY 25/26
Personnel Services: Salary and
Supports Salary for Three Captain
$ 524,734.00
Fringe
Field Training Officers and Fringe
$ 393,551.00
as of 10/1/25)
Total by
Fiscal Year 1
$ 393 551.00
CIRCUIT 19
CATEGORY: LINE ITEM
DESCRIPTION
FY 26/27
Personnel Services: Salary and
Fringe
Supports Salary for Three Captain
Field Training Officers and Fringe
$ 524,734.00
Total by Fiscal Year
$ 524,734.00
CIRCUIT 19
CATEGORY: LINE ITEM
DESCRIPTION
FY 27/28
Personnel Services: Salary and
Supports Salary for Three Captain
Fringe
Field Training Officers and Fringe
$ 131,184.00
Prorated three months
Total by
Fiscal Year 1
$ 131,184.00
Total MSOCR and MSOCR Carry Forward in Agreement 1 $1,049,469.001
Agreement No.: AGR75-002
Attachment C Indian River County Board of County Commissioners
A TRUE COPY
INCORPORATED DOCUMENT CERTIFICATION ON LAST PAGE
"YAN L. BUTLER, CLERK
Cost Reimbursement Invoice
PROVIDER NAME:
ADDRESS:
FEDERAL ID #:
AGREEMENT#:
CIRCUIT:
PERIOD COVERED BY THIS REPORT:
TOTAL AGREEMENT
TOTAL EXPEND. EXPENDITURES
FY 24/25 BUDGET SUMMARY AMOUNT FOR C19
THIS REPORT YEAR TO DATE
EXPENSES
Personnel Services: Salary and Fringe $0.00
Withheld Administrative Fee (5% as noted in Agreement) 81,341.00
GRAND TOTAL = $81,341.00
$0.00 $0.00
AMOUNT OF FUNDS REQUESTED
FOR PROVIDER AGENCY USE ONLY:
I CERTIFY THE ABOVE REPORT IS A TRUE AND CORRECT REFLECTION OF THIS PERIOD'S ACTIVITIES
FOR INTERNAL USE ONLY:
AND THAT REPORTED EXPENDITURES HAVE BEEN MADE FOR ALLOWABLE ITEMS RELATED TO THE
PURPOSE OF THIS AGREEMENT
SIGNATURE OF PROVIDER AGENCY OFFICIAL
DATE INVOICE RECEIVED
TITLE
DATE GOODS/SERVICES RECEIVED
DATE
DATE INSPECTED AND APPROVED
PHONE
APPROVED BY
TITLE / DATE
Agreement No.: AGR75-002
Attachment D 1 Indian River County Board of County Commissioners
INCORPORATED DOCUMENT A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
Cost Reimbursement Invoice
PROVIDER NAME:
ADDRESS:
FEDERAL ID #:
AGREEMENT M
CIRCUIT:
PERIOD COVERED BY THIS REPORT:
TOTALAGREEMENT
TOTALEXPEND. EXPENDITURES
FY 25/26 BUDGET SUMMARY AMOUNT FOR C19
THIS REPORT YEAR TO DATE
EXPENSES
Personnel Services: Salary and Fringe $393,551.00
Withheld Administrative Fee (5% as noted in Agreement) $46,070.00
GRAND TOTAL = $439,621.00
$0.00 $0.00
AMOUNT OF FUNDS REQUESTED
FOR PROVIDER AGENCY USE ONLY:
I CERTIFY THE ABOVE REPORT IS A TRUE AND CORRECT REFLECTION OF THIS PERIOD'S ACTIVITIES
FOR INTERNAL USE ONLY:
AND THAT REPORTED EXPENDITURES HAVE BEEN MADE FOR ALLOWABLE ITEMS RELATED TO THE
PURPOSE OF THIS AGREEMENT
SIGNATURE OF PROVIDER AGENCY OFFICIAL
DATE INVOICE RECEIVED
TITLE
DATE GOODS/SERVICES RECEIVED
DATE
DATE INSPECTED AND APPROVED
PHONE
APPROVED BY
TITLE / DATE
Agreement No.: AGR75-002
Attachment D 1 Indian River County Board of County Commissioners
INCORPORATED DOCUMENT A TRUE COPY
CSAR i iFiCATION ON LAST PAGE
— N L. BUTLER, CLERK
Cost Reimbursement Invoice
PROVIDER NAME:
ADDRESS:
FEDERAL ID #:
AGREEMENT #:
CIRCUIT:
PERIOD COVERED BY THIS REPORT:
TOTALAGREEMENT
TOTAL EXPEND. EXPENDITURES
FY 26/27 BUDGET SUMMARY AMOUNT FOR C19
THIS REPORT YEAR TO DATE
EXPENSES
Personnel Services: Salary and Fringe $524,734.00
Withheld Administrative Fee (5% as noted in Agreement) 33,998.00
GRAND TOTAL = $558,732.00
$0.00 $0.00
AMOUNT OF FUNDS REQUESTED
FOR PROVIDER AGENCY USE ONLY:
I CERTIFY THE ABOVE REPORT IS A TRUE AND CORRECT REFLECTION OF THIS PERIOD'S ACTIVITIES
FOR INTERNAL USE ONLY:
AND THAT REPORTED EXPENDITURES HAVE BEEN MADE FOR ALLOWABLE ITEMS RELATED TO THE
PURPOSE OF THIS AGREEMENT
SIGNATURE OF PROVIDER AGENCY OFFICIAL
DATE INVOICE RECEIVED
TITLE
DATE GOODS/SERVICES RECEIVED
DATE
DATE INSPECTED AND APPROVED
PHONE
APPROVED BY
TITLE / DATE
Agreement No.: AGR75-002
Attachment D 1 Indian River County Board of County Commissioners
INCORPORATED DOCUMENT A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
Cost Reimbursement Invoice
PROVIDER NAME:
ADDRESS:
FEDERAL ID #:
AGREEMENT #:
CIRCUIT:
PERIOD COVERED BY THIS REPORT:
TOTAL AGREEMENT
TOTALEXPEND. EXPENDITURES
FY 27/28 BUDGET SUMMARY AMOUNT FOR C19
THIS REPORT YEAR TO DATE
EXPENSES
Personnel Services: Salary and Fringe $131,184.00
Withheld Administrative Fee (5% as noted in Agreement) $26,202.00
GRAND TOTAL = $157,386.00
$0.00 $0.00
AMOUNT OF FUNDS REQUESTED
FOR PROVIDER AGENCY USE ONLY:
I CERTIFY THE ABOVE REPORT IS A TRUE AND CORRECT REFLECTION OF THIS PERIOD'S ACTIVITIES
FOR INTERNAL USE ONLY:
AND THAT REPORTED EXPENDITURES HAVE BEEN MADE FOR ALLOWABLE ITEMS RELATED TO THE
PURPOSE OF THIS AGREEMENT
SIGNATURE OF PROVIDER AGENCY OFFICIAL
DATE INVOICE RECEIVED
TITLE
DATE GOODS/SERVICES RECEIVED
DATE
DATE INSPECTED AND APPROVED
PHONE
APPROVED BY
TITLE / DATE
Agreement No.: AGR75-002
Attachment D 1 Indian River County Board of County Commissioners
A TRUE COPY
Southeast Floridan CERTIFICATION ON LAST PAGE
11-1.0— N� ,,� NIT.Oi RYAN L. BUTLER, CLERK
Certification Regarding Eligibility to Contract
A. The Managing Entity shall not subcontract for Behavioral Health Services with any
person or entity which:
1. Is barred, suspended, or otherwise prohibited from doing business with any
government entity, or has been barred, suspended, or otherwise prohibited from
doing business with any government entity in accordance with s. 287.133, F.S.;
2. Is under investigation or indictment for criminal conduct, or has been convicted of
any crime which would adversely reflect on its ability to provide services, or which
adversely reflects its ability to properly handle public funds;
3. Has had a contract terminated by the Department for failure to satisfactorily
perform or for cause;
4. Has failed to implement a corrective action plan approved by the Department or
any other governmental entity, after having received due notice; or
5. Is ineligible for contracting pursuant to the standards in s. 215.473(2), F.S.
B. Regardless of the amount of the subcontract, the Managing Entity shall immediately
terminate the subcontract for cause, if at any time during the lifetime of the
subcontract, the Provider is:
C«
1. Found to have submitted a false certification under s. 287.135, F.S., or
2. Is placed on the Scrutinized Companies with Activities in Sudan List or
3. Is placed on the Scrutinized Companies with Activities in the Iran Petroleum
Energy Sector List, or
4. Is placed on the Scrutinized Companies that Boycott Israel List or is engaged in a
boycott of Israel.
The undersigned certifies their agency is q=Mewol -aqd
a contract with the Managing Entity an J1
or termination have been met:
Signature ��•
Joseph Flescher •-•'�f� cou��:••'
Name of Authorized Individual
Certification Packet
Attest: Ryan L. Butler, Clerk of
Circuit Court and ComptroNer
By:a� A��
UI
Deputy Clerk
eligible to enter into or maintain
Xiteria listed for disqualification
Ci--tAber 7, 2025
oQ: Date
AGR75-002
Application or Contract
Number
Agreement No.: AGR75-002
Indian River County Board of
County Commissioners
Southeast Florida
eEn�rio��i wcnirn n�rvo�R
A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L.. BUTLER, CLERK
Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion Contracts/Subcontracts
This certification is required by the regulations implementing Executive Order 12549,
Debarment and Suspension, signed February 18, 1986. The guidelines were published
in the May 29, 1987 Federal Register (52 Fed. Reg., pages 20360 - 20369).
A. Instructions
Each provider whose contract/subcontract equals or exceeds $25,000 in federal
moneys must sign this certification prior to execution of each contract/subcontract.
Additionally, providers who audit federal programs must also sign, regardless of
the contract amount. The Southeast Florida Behavioral Health Network ("ME")
cannot contract with these types of providers if they are debarred or suspended by
the federal government.
2. This certification is a material representation of fact upon which reliance is placed
when this contract/subcontract is entered into. If it is later determined that the
signer knowingly rendered an erroneous certification, the Federal Government
may pursue available remedies, including suspension and/or debarment.
3. The provider shall provide immediate written notice to the ME at any time the
provider learns that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
4. The terms "debarred," "suspended," "ineligible," "person," "principal," and
"voluntarily excluded," as used in this certification, have the meanings set out in
the Definitions and Coverage sections of rules implementing Executive Order
12549. You may contact the ME's assigned Compliance Administrator for
assistance in obtaining a copy of those regulations.
5. The provider agrees by submitting this certification that, it shall not knowingly enter
into any subcontract with a person who is debarred, suspended, declared
ineligible, or voluntarily excluded from participation in this contract/subcontract
unless authorized by the Federal Government.
6. The provider further agrees by submitting this certification that it will require each
subcontractor of this contract/subcontract, whose payment will equal or exceed
$25,000 in federal moneys, to submit a signed copy of this certification.
7. The ME may rely upon a certification of a provider that it is not debarred,
suspended, ineligible, or voluntarily excluded from contracting/subcontracting
unless it knows that the certification is erroneous.
Certification Packet 2 Agreement No.: AGR75-002
Indian River County Board of
County Commissioners
SoutheastFlorid
81-110-181-1IOI MIA1IM $IT.I!
A TRUE COPY
GERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
8. This signed certification must be kept in the ME contract file. Subcontractor's
certification must be kept at the provider's business location.
B. Certification
1. The prospective provider certifies, by signing this certification, that neither he
nor his principals is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this
contract/subcontract by any federal department or agency.
2. Where the prospective provider is unable to certify to any of the statements in
this certification, such prospective provider shall attach an explanation to this
certification.
O�tgber 7, 2025
Signa ure:oma; Date
•'meq . � •'p�;:
Indian River County Board of*COUN��
County Commissioners .... Chairman
Company Title
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroliear
By. 1�ato
Deputy Ckwk
Certification Packet 3 Agreement No.: AGR75-002
Indian River County Board of
County Commissioners
Southeast Florid
�[NAv1011A1 MFwIIM NITY'OIIM
A TRUE COPY
CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
Certification Regarding Lobbying for Contracts, Grants, Loans, and
Cooperative Agreements
A. The undersigned certifies, to the best of his or her knowledge and belief, that:
No federal appropriated funds have been paid or will be paid, by or on behalf of
the undersigned, to any person for influencing or attempting to influence an officer
or an employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with the
awarding of any federal contract, the making of any federal grant, the making of
any federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
2. If any funds other than federal appropriated funds have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, a member of congress, an officer or employee of congress, or an
employee of a member of congress in connection with this federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its
instructions.
3. The undersigned shall require that the language of this certification be included in
the award documents for all subawards at all tiers (including subcontracts,
subgrants, and contracts under grants, loans and cooperative agreements) and
that all subrecipients shall certify and disclose accordingly.
INTENTIONALLY LEFT BLANK
Certification Packet 4 Agreement No.: AGR75-002
Indian River County Board of
County Commissioners
Southeast florid
OEM --Al -1,I .-ORR
A TRUE COPY
CER:TIFiCATION ON LAST PAGE
RYAN L. BUTLER, CLERK
B. This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, Title
31, U.S. Code. Any person who fails to 9R;XP?pquired certification shall be subject
to a civil penalty of not less than $10,,@&tQ��rid"rZo'ue than $100,000 for each such
failure.
gnature
h Flescher
C-):
Name of Authorized Individual
Indian River County Board of County
Commissioners
Name of Organization
1801 27th Street, Vero Beach, Florida
32960, United States
Address of Organization
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller
By: A /;)fi 1 4�17
;October 7, 2025
oma: Date
AGR75-002
Application or Contract
Number
Certification Packet 5 Agreement No.: AGR75-002
Indian River County Board of
County Commissioners
STATEMENT OF FUNDING
Provider Name: Indian River County Board of County commissioners
Contract Number: AGR75 (06/01/2024-06/30/2028)
Circuit 19 (Amendment 002)
STATE OF FLORIDA
MEDIAN RNER COUNTY
THIS I CERTIFY THAT TH* IS A TRUE AND CORRECT
COP E ORIGINAL ON fM.E THISjmfME.
n. RYANLAWS&R. ER s1 a I
EON Mr, 011 FUMMWAIJ ►M-RAwVI a
J i
COVERED SERVICE RATES
FUNDING DETAIL
FY23/24
FY24/25
FY25/26
FY26/27
FY27/28
GRANDTOTAL
OCA
Program
Type
Fund
Code
Circuit
Description
Start Dates
End Dates
6/1/2024
6/30/2024
7/1/2024
6/30/2025
7/1/2025
9/30/2025
7/1/2026
6/30/2027
7/1/2027
6/30/2028
Type
MSOCR
SA
DCF
19
ME Opioid TF Coord Opioid Recovery Care
$ -
$
$
$ 524,734.00 $
131,184.00
$ 655,918.00
MSOCR-CF
SA
DCF
19
ME Opioid TF Coord Opioid Recovery Care
CARRY FORWAR
$ -
$
$ 393,551.00 $ $
19
$ 393,551.00
MSONQ-CF
SA
DCF
19
ME Opioid TF Non -Qualified Counties
CARRY FORWAR
$ -
$
$ 46,070.00
MSONQ-CF
$ 46,070.00
MSONQ
SA
DCF
19
ME Opioid TF Non -Qualified Counties
$
$ 81,341.00
$
$ 33,998.00 $
26,202.00
$ 141,541.00
TOTAL
SA
$
$ 81,341.00
$ 439,621.00
$ 558,732.00 $
157,386.00
$ 1,237,080.00
COVERED SERVICE RATES
Covered
Service/Project
Program
Fund
Circuit
Description and Current Year Eligible OCAS
FY23/24
FY24/25
FY25/26
FY26/27
FY27/28
Codes
Type
Code
MSOCR MSONQ
83
SA
OCF
19
Cost Reimbursement MSOCR-CR
$ 1.00
$ 1.00
$ 1.00
$ 1.00
$ 1.00
MSONQ-CF