CMHPSM Regional Mental Health Provider Manual
Overview
Organizational service providers contracted by a CMHPSM Regional CMHSP partner to deliver services to individuals with a serious mental illness and/or intellectual/developmental disability should refer to this webpage for important information.
Organizational Credentialing / Re-Credentialing
General Information
Application Forms
Microsoft Word Versions of Attachment Forms
Attachment A: Administrative Staff Requirements
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Attachment B1: Aide Level / DSP Staff Criminal Background Check Form
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Attachment B2: Aide Level / DSP Staff General Background Check Form
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Attachment C: Aide Level / DSP Staff Training Requirements Form
Attachment D1: Licensed Staff Criminal Background Check Form
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Attachment D2: Licensed Staff General Background Check Form​
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Attachment E: Licensed Staff Training Requirements Form
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Attachment F: Licensed Staff Credentialing Information Form
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Microsoft Excel Versions of Attachment Forms
Attachment A: Administrative Staff Requirements
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Attachment B1: Aide Level / DSP Staff Criminal Background Check Form
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Attachment B2: Aide Level / DSP Staff General Background Check Form
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Attachment C: Aide Level / DSP Staff Training Requirements Form
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Attachment D1: Licensed Staff Criminal Background Check Form
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Attachment D2: Licensed Staff General Background Check Form
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Attachment E: Licensed Staff Training Requirements Form
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Federal Debarment & Exclusion Requirements
Debarment Information Submission Form
Debarment / Exclusion Information and Resources
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