HomeMy WebLinkAbout20062388 RESOLUTION
RE: APPROVE SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT FOR CHILD
WELFARE CLIENTS AND AUTHORIZE CHAIR TO SIGN - SIGNAL BEHAVIORAL
HEALTH NETWORK
WHEREAS,the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with a Substance Abuse Treatment Service
Agreement for Child Welfare Clients between the County of Weld,State of Colorado,by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Social
Services, and Signal Behavioral Health Network, commencing July 1, 2006, and ending June 30,
2007, with further terms and conditions being as stated in said agreement, and
WHEREAS,after review,the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
NOW,THEREFORE,BE IT RESOLVED by the Board of County Commissioners of Weld
County,Colorado,ex-officio Board of Social Services,that the Substance Abuse Treatment Service
Agreement for Child Welfare Clients between the County of Weld,State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Social
Services, and Signal Behavioral Health Network be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 30th day of August, A.D., 2006, nunc pro tunc July 1, 2006.
..C< c `i BOARD OF COUNTY COMMISSIONERS
} VELD COU , COLORADO
ATTEST: LIMb*: ile, Chair
Weld County Clerk to the Borrs,c,� ,, ;j O
_.- _ David E. Long, Pro-Tem,ilutBY: � �
De ty Cleo the Board
WI ' H. Jerke 4 (�p
APP AST • �VV
Robert D. Mas en
ounty Attorney EXCUSED
Glenn Vaad
Date of signature: 42-1o(c
2006-2388
SS0033
; CC � -i9-oe
‘444.1/44.4%Njti DEPARTMENT OF SOCIAL SERVICES
P.O. BOX A
GREELEY, CO. 80632
IDWebsite:www.co.weld.co.us
Administration and Public Assistance(970)352-1551
Child Support(970)352-6933
OFax(970)346-7663
•
COLORADO MEMORANDUM
TO: M.J. Geile, Chair Date: August 28, 2006
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services(41,01
RE: Substance Abuse Treatment Service AgreCfnent under AFS Service Funding
between Signal Behavioral Health Network and the Weld County Department of
Social Services
Enclosed for Board approval is a Substance Abuse Treatment Service Agreement under AFS
Service Funding between Signal Behavioral Health Network(Signal) and the Weld County
Department of Social Services (Department). This Agreement was reviewed at the Board's Work
Session held on August 28,2006.
The major provisions of the Agreement are as follows:
1. The term of the Agreement is July 1, 2006 through June 30, 2007.
2. Signal will contribute $89,707.20 from designated ADAD Additional Family Service
(AFS) funds on behalf of families and adolescents receiving child welfare services
through the Department. Signal will retain $4,485.36 in administrative fees.
3. Signal will provide assessments, monitored sobriety services, and treatment according to
Signal's fee schedule and through their provider, Island Grove Regional Treatment
Center.
4. The Department will refer to Signal those families and adolescents involved in the child
welfare system and who are in need of substance abuse services.
If you have any questions,please telephone me at extension 6510.
2006-2388
AFS-06-07
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
Fiscal Year July 1St 2006 through June 30th 2007
This Agreement is between the Weld County Department of Social Services, hereinafter referred
to as "WCDSS" and Signal Behavioral Health Network, hereinafter referred to as "Signal".
WHEREAS,the Weld County Department of Social Services requires the services of a substance
abuse treatment provider to assist the County in delivering substance abuse treatment services to child
welfare clients, and Signal is willing and able to provide such services; and
WHEREAS, Signal is a Colorado non-profit corporation organized for the purpose of managing
and coordinating high quality, cost efficient, integrated chemical dependency and related behavioral
health care services in the State of Colorado.
NOW, THEREFORE, it is mutually agreed as follows:
SERVICES:
A. Responsibilities of Signal:
1. Signal agrees and desires to participate as the service coordinator for WCDSS qualified
child welfare clients under the definition set forth in the Child Welfare Lawsuit
Settlement Agreement(David Littman vs. State of Colorado).
2. Signal will maintain a high quality of clinical care to clients in a delivery system of
limited resources and public funding. The full continuum of care(Outpatient, Intensive
Outpatient, Transitional Residential,Intensive Residential,Therapeutic Community, or
comparable alternatives as mutually agreed upon)will be available to clients. The
client's clinical needs will determine the level of care Signal is to provide.
3. Signal will assure that all eligible child welfare clients referred by WCDSS in need of
treatment will receive such in accordance with ASAM PPC-II R level of care,as
reimbursed by the State of Colorado, Alcohol and Drug Abuse Division.
4. Signal will serve child welfare clients (parents and children)on a priority basis who
comply with the following criteria as WCDSS refers:
• Case is active on TRAILS, and
• Case meets the State DHS program category criteria 4, 5, or 6, and
• Case meets the definition of"imminent risk for out-of-home placement/reunification"
set forth by the State of Colorado.
5. Signal will include the following provisions in all subcontracts with providers:
• The Provider shall submit a treatment plan to WCDSS within 30 days
• The Provider shall enter monthly progress reports into the Signal system no later than
the 8th calendar day of the month following the month during which the services were
rendered. Complete and accurate AFS claims for payment must be entered into the
Signal system within 120 days from the date of service or such claims will be denied.
Signal will be responsive to WCDSS in crediting denied AFS charges as appropriate.
• Any failure of Signal to credit AFS, as appropriate,will result in a debit of Core
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AFS-06-07
funds in the identical dollar amount. Said deduction will be identified on the
remittance generated by the Core Services Caseworker and Core Payroll Clerk.
• Signal, or their designee, agrees to provide Social Services monitoring results(UA,
BA, patch,tox trap)by emailing said results to the Core Services Caseworker at
Social Services no later than 72 hours after the day of service. Signal agrees to
include all AFS Utilization Reports with the Core Services invoice.
• Signal will resolve any duplicated fees and/or errors identified by the WCDSS billing
review process within 30 days of identification of such errors. Those requests will be
submitted in writing or email to: Accounting Department 1391 Speer Blvd., Ste 300,
Denver CO 80204.
6. Signal will utilize AFS monies only for TRT clients, including room& board,therapies and
monitoring, and as specifically requested by WCDSS in writing as evidenced by authorizing
such services in the Signal system. Any requests by WCDSS to transfer charges to be paid
by AFS will be addressed within 30 days of the written request by mail or email.
7. Signal will assure that the providers in its network give timely notice of cancelled
appointments to the clients and will reschedule such appointments as soon as practical.
8. Signal will provide,by accessibility to download off the Signal database monthly progress
reports with the WCDSS requested information included (see Attachment"B")for each
WCDSS client in treatment.
9. Signal will provide up to 4 hours of training, if requested by WCDSS staff, for WCDSS staff
in accessing data reports and on the use of the child welfare referral system.
10. Signal will provide technical support,as necessary, for WCDSS staff in accessing data
reports and on the use of the child welfare referral system.
11. Signal shall reconcile all treatment providers' complete claims to AFS funds within 120
days from the date the service was rendered.
B. Responsibilities of WCDSS:
1. WCDSS will work cooperatively with Signal and its Providers to deliver quality, efficient
and cost-effective substance abuse treatment services to WCDSS qualified clients.
2. WCDSS will make every effort to inform Signal and its Providers in a timely manner of
system issues,developments, and complications so that Signal and the Provider can make
informed choices in its role as the managed service organization and treatment agency
respectively.
3. WCDSS will assure that all referrals under this contract meet the eligibility criteria
expressed in Section 1(A)(4)above.
4. WCDSS agrees to provide Signal with the name of a primary contact person who will be
responsible for interacting with Signal's accounting and information systems
departments.
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5. WCDSS, or its authorized designee(s),will be responsible for electronically authorizing
services to various providers.
6. WCDSS will review monthly AFS Actual reports and determine any duplicate charges
pursuant to Core or other previously paid services. WCDSS will report monthly any
discrepancies in duplication and/or errors to Signal, and in cooperation with Signal,work
with Signal to resolve any conflicts of billed services or fees.
7. WCDSS will complete the Signal remittance advice and return to Signal within 15
business days of completion of the applicable month's TRAILS payroll date. Each
remittance advice shall detail reasons for denial of any and all services. WCDSS shall
reimburse Signal for all completed services invoiced with all necessary and accurate
information included within 45 calendar days from the date of receipt of Signal's invoice.
8. The Core Services Caseworker shall be the primary contact for receipt of Signal invoices
and the Core Payroll Clerk shall be responsible for generating the Signal remittance
advice.
IL PERIOD OF PERFORMANCE
The Signal Additional Family Service period of performance under this Agreement shall be for
the 12-month period beginning July 1, 2006 through June 30, 2007, unless sooner terminated.
As a condition of continuing to render services under this Agreement, it is understood that Signal
will report any limitation or restriction of their license or insurance or the ability to perform the
services covered by this Agreement under any condition of impairment.
Either party may terminate this Agreement or any part herein at any time by giving not less than
45 days advance written notice to the other party.
In the absence of any formal agreement beyond the term of this Agreement, Signal agrees to
continue providing treatment, under the terms of this Agreement, for clients that are in treatment
or referred by WCDSS for treatment. This is with the further understanding that service delivery
and payment are subject to the termination terms mentioned above.
Signal reserves the right to suspend services to clients if funding is no longer available. WCDSS
acknowledges financial responsibility for all services authorized and performed before the
effective date of termination.
III. COMPENSATION
Signal agrees to contribute a maximum of eighty-nine thousand seven hundred seven dollars and
twenty cents($89,707.20) annually from designated ADAD Additional Family Service (AFS)
funds to serve eligible clients in accordance with the terms herein. Of this amount, Signal shall
retain four thousand four hundred eighty-five dollars and thirty-six cents($4,485.36)or five
percent of the service fees, salaries, and other authorized costs that are actually incurred in the
delivery of the treatment services authorized in this Agreement.
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AFS-06-07
IV. CLIENT FEES OR CO-PAYS
Neither Signal nor their network providers shall assess a client fee or co-pay to child welfare
clients served under this contract, unless the client is required to pay for any positive urine screen
as a condition of their treatment plan or through court order for monitored sobriety and/or
treatment as a condition of their treatment plan. Any such client fees or co-pays shall be outside
the scope of this contract, and Signal shall have no responsibility for accounting for such fees and
co-pays.
V. ATTACHMENTS
Signal and WCDSS agree to adopt herein the attached fee-for-service Attachment A.
VI. INDEPENDENT CONTRACTOR
Signal and its providers shall be providing services hereunder as an independent contractor and
the relationship of employer and employee does not exist between WCDSS and Signal.
VII. NON-DISCRIMINATION
It is the policy of Signal to provide equal opportunity without discrimination based on race, color,
sex, religion, age, sexual orientation, national origin,veteran status,or individual handicap in any
aspect of employment,training or services offered. All Signal programs, activities, and services
are administered on a non-discriminatory basis subject to the provisions of:
Title VI and VII of the Civil Rights Act of 1964
Executive Order 11246, as amended
Title VII and VIII of the Public Health Services Act
Rehabilitation Act of 1973 (Section 503 and 504)
Equal Pay Act of 1963, as amended
Title IX of the Education Amendments of 1972
Vietnam Era Veteran's Readjustment Assistance Act of 1974
Age Discrimination in Employment Act of 1967
Age Discrimination Act of 1975
Non-Discrimination Laws of the State of Colorado.
VIII. ACCESS TO RECORDS
Signal and WCDSS agree to make available in a timely manner all books,documents, and
records pertinent to this contract for the purpose of billing for services, audit, and compliance
with requirements and regulations of federal and state agencies and commercial insurance
carriers.
Signal acknowledges that in reviewing, storing,processing, or otherwise dealing with any client
records dealing with any client seen by a Signal provider or the on-site substance abuse counselor
is bound by the confidentiality provisions of 42 CFR Part 2. If necessary, Signal shall resist in
judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR
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AFS-06-07
Part 2. WCDSS and Signal shall sign a Qualified Service Organization Agreement in compliance
with 42 CFR, Part 2.
IX. OBLIGATIONS
Obligations of WCDSS and Signal are contingent upon funds for that purpose being appropriated,
budgeted and otherwise made available.
X. PROVISIONS
This Agreement may be amended only by written agreement signed by each of the parties hereto.
This Agreement shall be binding upon, and shall inure to the benefit of the respective parties
hereto and shall not be assigned without the consent of all parties hereto.
XI. NOTICES
Any notice required to be given pursuant to the terms and provisions hereof, shall be in writing
and shall be sent by certified mail, return receipt requested:
To Signal at: To Weld County at:
Bill Wendt, Chief Executive Officer Judy A. Griego, Director
Signal Behavioral Health Network Weld County Department of Social Services
1391 Speer Blvd., Suite 300 P.O. Box A
Denver, CO 80204 Greeley, CO 80632
XII. DISPUTE RESOLUTION
It is the desire of all parties to resolve disputes at the Signal/County level through shared
decision making. The County and Signal shall attempt to resolve all disputes at the lowest
level possible within each organization. If the parties fail to reach an agreement,the
issue shall be documented and submitted to Signal's Chief Executive Officer and the
WCDSS Director(or their designee). Such documentation shall include a statement of the
issue(s), position of both parties, and each party's specific request(s). If Signal and the
WCDSS are unable to resolve the dispute, either party may submit the dispute to the
Colorado Department of Human Services, Child Welfare and Alcohol and Drug Abuse
Division.
The State shall review all documentation regarding the dispute and provide written
findings to the parties. If either party disagrees with the State's findings,the aggrieved
party may pursue additional dispute resolution processes. In this event, Signal and the
WCDSS agree to submit unresolved disputes arising out of the contract to non-binding
mediation/arbitration in Denver, Colorado, in accordance with the commercial rules and
practices of the American Arbitration Association then in force or pursuant to such other
rules and procedures as to which the parties may agree. Notwithstanding the above,
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AFS-06-07
nothing herein shall be construed to limit either party's right to resolve any dispute in
court if mediation/arbitration is unsuccessful.
Nothing herein shall be construed as a waiver of any defense or affirmative defense to
any claim.
This Agreement shall be governed by and construed in accordance with the laws of the State of
Colorado.
XIII MISCELLANEOUS PROVISIONS
13.1 Headings. The headings of the sections and subsections of this Agreement are inserted
solely for ease of reference and shall not in any way affect the meaning or interpretation
of this Agreement.
13.2 Non-Assignment. None of the parties shall have the right to assign the benefits or
delegate the obligations in this Agreement without prior written consent of the other
parties. Subject to the foregoing,this Agreement shall be binding upon and inure to the
benefit of the parties and their respective heirs, successors, legal or personal
representatives and permitted assigns.
13.3 Waiver of Breach. The waiver of any party of a breach or violation of any provision of
this Agreement shall not operate as, or be construed to be, a waiver of any subsequent
breach of the same or any other provision thereof.
13.4 Gender and Number. Whenever the context of this Agreement requires,the gender of all
words shall include the masculine, feminine and neuter, and the number of all words shall
include singular and plural.
13.5 Severability. If any provision of this Agreement is held to be unenforceable for any
reason,the unenforceability thereof shall not affect the remainder of this Agreement,
which shall remain in full force and effect and be enforceable in accordance with its
terms.
13.6 Counterparts. This Agreement may be executed in duplicate originals, each of which
shall be an original instrument but both of which taken together shall constitute one and
the same instrument.
13.7 Entire Agreement. This Agreement constitutes the entire understanding and agreement
between the parties with respect to its subject matter and supersedes all prior agreements
or understandings, whether written or unwritten, with respect to the same subject matter.
13.8 Hold Harmless. To the extent authorized by law each party shall indemnify, save and
hold harmless the other and the Colorado Department of Human Services, against any
and all claims, damages, liability and court awards including costs, expenses, and
attorney fees incurred as a result of any act or omission by the party's employees, agents,
subcontractors, or assignees, or arising out of any dispute between the WCDSS, Signal,
Network Providers and the State Department of Human Services in connection with the
Agreement.
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AFS-06-07
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
APPROVED BY:
SIGNAL BEHAVIORAL HEALTH NETWORK
2'Lc;:rc-kAr:yr,n) S (2/ nt,
John TAwster,Board President Dai
Signal's Federal tax ID Number: 84-1362495
WELD COUNTY
oe,b) AUG 3 0 2006
By: M. Geile Date AUG 3 0 2006
Board of County Commissioners
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
aI?kla/0(09
By: J A.eiego, Di fort Date
ATTESTING TO BOARD OF COUNTY
COMMISSIONER SIGNATURES ONLY
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$a
ATTEST: aul,,no WE UNTY CLERK TO. HE BOARD J c�woe
Fr
BY: TOCLE O �p HE BOARD O W%
7
07006-g.11-96fce
AFS-06-07
SIGNAL BEHAVIORAL HEALTH NETWORK and
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE
Attachment A
Fee-For-Service Reimbursement(for services not provided by the on-site counselor):
Amounts are not to exceed the following:
Base Admin Payer
Service HIPAA Code HIPAA Unit Rate Fee Rate
Antabuse Monitoring H0033 each $2.00 $0.10 $2.10
Antabuse Physical - Existing Client 99214 each $60.00 $3.00 $63.00
Antabuse Physical - New Client 99203 each $60.00 $3.00 $63.00
Breathalyzer 82075 each $2.00 $0.10 $2.10
15 minute
Case Management H0006 session(s) N/A N/A N/A
Day Treatment:Adolescent H2012:HA hour(s) $9.87 $0.49 $10.36
Day Treatment:Adult H2012:HB hour(s) $6.90 $0.35 $7.25
Detox-OP H0012 day(s) N/A N/A N/A
Detoxification H0011 day(s) $185.00 $9.25 $194.25
Drug Patch Confirmation H0048 each N/A N/A N/A
Drug Patch Monitoring H0048:HF each $50.00 $2.50 $52.50
15 minute
Evaluation H0002 session(s) $11.67 $0.58 $12.25
15 minute
Evaluation:Out of Area H0002:TN session(s) $16.67 $0.83 $17.50
15 minute
Family Counseling T1006 session(s) $25.00 $1.25 $26.25
15 minute
Group Counseling H0005 session(s) $6.75 $0.34 $7.09
Hair Testing 84999 each N/A N/A N/A
15 minute
Individual Counseling H0004 session(s) $15.00 $0.75 $15.75
Intake T2010 each N/A N/A N/A
Intensive Short-Term
Residential:Adolescent H0018:HA day(s) $228.00 $11.40 $239.40
Intensive Short-Term Residential:Adult H0018:HB day(s) $170.00 $8.50 $178.50
15 minute
Medical testimony 99075 session(s) $18.75 $0.94 $19.69
15 minute
Multisystemic therapy for juveniles H2033 session(s) N/A N/A N/A
Opioid Replacement(Buprenorphine) J0592 month(s) N/A N/A N/A
Opioid Replacement(Methadone) H0020 month(s) $415.00 $20.75 $435.75
15 minute
Prevention Information Dissemination H0024 session(s) N/A N/A N/A
Psychiatric Diagnostic Interview Exam 90801 15 minute N/A N/A N/A
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session(s)
15 minute
Skills Training and Development H2014 session(s) N/A N/A N/A
Therapeutic Behavioral
Srvc:Preq/Parent H2020:HD day(s) $99.50 $4.98 $104.48
Therapeutic Behavioral
Srvcs:Adolescent H2020:HA day(s) $125.00 $6.25 $131.25
Therapeutic Behavioral Srvcs:Adult
w/o I H2020:HB day(s) $59.00 $2.95 $61.95
Transitional Long-Term Residential H0019 day(s) $93.00 $4.65 $97.65
Transitional Long-Term
Residential:Preg/Parent(NDF) H0019:HD day(s) $175.00 $8.75 $183.75
UA-Oral Swab 82055 each $15.00 $0.75 $15.75
UA-GCMS per substance 82542 per drug $18.00 $0.90 $18.90
UA—Soma 81099 each N/A N/A N/A
UAw/TX H0003:HF each $12.00 $0.60 $12.60
UA w/o TX H0003 each $12.00 $0.60 $12.60
Vapor inhalations evaluation 94664 each $40.00 $2.00 $42.00
UA- Dip Stick 81002 each N/A N/A N/A
A GC/MS will automatically be completed without additional WCDSS authorization for all substances that test
positive at initial urine drug screening.
The following services are available exclusively through AFS funds and must be purchased in
conjunction with the residential treatment services described in the fee-for-service schedule above for
both Core and AFS funded residential treatment services:
T2048:HB: Room and Board: Adult
Addition Research and Treatment Services Daily $16.88 $0.84 $17.72
(ARTS)
Arapahoe House Daily $45.23 $2.26 $47.49
Crossroads Daily $50.00 $2.50 $52.50
Island Grove Daily $35.00 $1.75 $36.75
Sobriety House Daily $22.00 $1.10 $23.10
T2048:HA: Room and Board: Adolescent
Addition Research and Treatment Services Daily $38.12 $1.91 $40.03
(ARTS)
Arapahoe House Daily $36.30 $1.82 $38.12
Crossroads Daily N/A N/A N/A
Island Grove Daily $33.00 $1.65 $34.65
Sobriety House Daily N/A N/A N/A
T2048:HD: Room and Board: Preg/Parent
Addition Research and Treatment Services Daily $16.88 $0.84 $17.72
(ARTS)
Arapahoe House Daily $50.17 $2.51 $52.68
Crossroads Daily $75.00 $3.75 $78.75
Island Grove Daily N/A N/A N/A
Sobriety House Daily N/A N/A N/A
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ATTACHMENT "B"
Island Grove Regional Treatment Center, Inc.
[address]
Phone: Fax:
WELD COUNTY DSS AFS/CORE SERVICES MONTHLY REPORT FORM
To: DSS FAX: (970) 353-5215
(Caseworker's Name)
From: Telephone: (970) 313-
(Therapist's Name)
Date: Fax: (970)
Provider Name: Island Grove Regional Treatment Center Modality:
Client Name: HH#:
Month of: Year: Treatment Type:
Attitude: 1 2 3 4 5 (1 =very poor; 5=excellent)
Progress: 1 2 3 4 5
Participation: 1 2 3 4 5
Narration:
Groups Attended:
Date: Topic: Date: Topic:
Date: Topic: Date: Topic:
Date: Topic: Date: Topic:
Date: Topic: Date: Topic:
Date: Topic: Date: Topic:
Date: Topic: Date: Topic:
Date: Topic: Date: Topic:
Monitored Sobriety:
Date: Type/Result: Date: Type/Result:
Date:_ Type/Result: Date: Type/Result:
Date:_ Type/Result: Date: Type/Result:
Date: Type/Result: Date: Type/Result:
Date: Type/Result: Date: Type/Result:
Date: Type/Result: Date:_ Type/Result:
Date: Type/Result: Date:_ Type/Result:
Authorization for services valid: through ; requesting renewal? Yes
**Therapist affirms that the above information is true and correct:
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