providing mental health &
substance abuse  services for
the people of Alameda County ...  

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2000 Embarcadero Cove, Suite 400, Oakland, CA  94606
Phone: (510) 567-8100    Driving Directions

Forms & Documents By Category


Contract Renewal Documents  

Standard Documents for FY 21-22

  • Standard Exhibit A Attachments
  • Standard Exhibit B: Payment Terms and Conditions
    • MH Exhibit B: Terms and Conditions of Payment – Pending
    • SUD Exhibit B: Terms and Conditions of Payment – Pending
    • Exhibit B-4: MH Cost Report Submission Timeline
    • Exhibit B-5: MH Mental Health Cost Settlement Appeal Procedures
  • Standard Exhibit C: Insurance Requirements
  • Other Exhibits
    • Exhibit D: Audit Requirements
    • Exhibit E: Business Associate Provisions (HIPAA)
    • Exhibit F: Debarment and Suspension Certification
    • Exhibit G: Lobbying Restrictions and Disclosure Certification (Services-As-Needed Contracts Only - See Exhibit A-2 for Master Contracts)
    • Exhibit H: SUD Qualified Service Organization Agreement (Services-As-Needed Contracts Only - See Exhibit A-3 for Master Contracts)
    • Exhibit O: The Iran Contract Act (ICA) of 2010
  • Reference Only

Mental Health  

Housing/Homeless Criteria and Definition of Terms
EveryOne Home Alameda County Continuum of Care (CoC) Council Prioritization for Permanent Supportive Housing Opportunities

Shift of Funds Request Family Engagement and Group Services Reminder

Provider Resources  

MHP FFS Provider Forms  

Substance Use Disorder  

Coming soon



Organizational and/or Program Changes Forms

Other Standard Forms