Quarterly Contract Monitoring Forms (QCMR) and Annex A

Contracting

Vendors receiving payment(s) from the state of New Jersey must revise or correct remittance information using the "NJSTART" website.
N.J. Department of Treasury NJSTART

Forms, publications and instructional material related to the DMHAS community services contracting program are made available on this website for your easy reference and download. If you encounter any difficulty with your selections, or have additional questions, please contact the DMHAS Bureau of Contract Administration at (609) 438-4230.

Cash Advance Policy - Administrative Bulletin
Cash Flow Worksheet Advance Payment Request
Advance Payment Request Narrative
DHS Contract Manuals (CRM & CPIM)
Standard Language Document (contract "boilerplate" agreement) and Contracted State Agency Agreement
DOH Business Associate Agreement
Standardized Board Resolution Form (P1.06)
Executive Order 129 Certification:  Source Disclosure Certification Form


 

 

 

Public Law 2005, Chapter 51 (McGreevey Executive Order 134) Forms

(No longer applicable for non-profit agencies - February 2008)

Click here to download Chapter 51 information

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Affirmative Action AA302 Forms and Instructions

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Agreement Form and Instructions for Electronic (ACH) Payments

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Vendor Payment Inquiry System

For more information and to sign up, please click here.

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Addictions Contract Information Management System (CIMS)

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Manual Addictions Post-Award Contract Documents

This file includes:

1. Budget Revision and Instructions (DAS-57)

2. Report of Contract Expenditures and Instructions (DAS-20a)

3. Contract Progress Report (DAS-45)

4. Report of Expenditures and Request for Reimbursement for Construction Contracts and Certification

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FY19 Mental Health Fee for Service

Addendum to DHS SLD for Mental Health Fee for Service (MH FFS) (Revised 04/10/18)
Annex B-2 (Revised 04/20/18)
FFS Rates Chart (Revised 04/20/18)
DOH DMHAS MH FFS Agency Administrative Information Form, FY19 (Revised 04/18/18)
Community Residences for Adults with Mental Illness Annex A (Revised 06/01/17)
Community Support Services (CSS) FFS Annex A (Revised 03/28/2018)
Integrated Case Management (ICMS) Annex A (Revised 11/09/17)
Outpatient Annex A (Revised 06/01/17)
Partial Care Annex A (Revised 06/01/17)
Partial Hospitalization Annex A (Revised 06/01/17)
Programs for Assertive Community Treatment (PACT) Annex A (Revised 04/30/18)
Supported Education (SEd) Annex A (Revised 05/01/18) 
Supported Employment (SE) Annex A (Revised 04/16/17)

Last Reviewed: 5/24/2018