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For Fiscal Year 2003-2004 the Department of Children and Families’ Substance Abuse Program Office has developed an alternative format for data reporting for state-licensed, private providers who are not under contract with the Department.  This new format is designed to reduce the amount of time and resources previously required to enter data into the Department’s data system.

Effective immediately, private providers shall have the option of using the linked format to submit aggregated client data.  Data must be aggregated on a 12-month basis that aligns with the state’s fiscal year of July 1^st through June 30^th  and be submitted to the Department by July 31^st of each year.  Beginning in July 2004 proof of data submission to the Department shall be required prior to the issuance of licenses.  Providers may, in lieu of this new format, continue their use of the state’s MHSA software for data reporting purposes.  Each provider will need to inform the District ADM Office of their choice of reporting format by October 1, 2003.

The second link is a census form to be completed as of June 30^th of each year and submitted to the Department in conjunction with the aggregate data form.  A set of instructions for both forms has been attached to clarify the data requested.  The completed forms should be sent to the following address:

Any questions or concerns may be addressed to Mr. Duchene of my office at (850) 921-8464.

Click here for the Client Service Aggregate Form

Click here for the Client Census Form

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