Fiscal Year 2021 SUD (Non-Medicaid) Reporting Instructions and Forms

For additional information, contact SUD Contracts staff at mdhhs-bhdda-contracts-mgmt@michigan.gov.

 

Reports / Forms

Software 

Instructions (PDF)

 1

Charitable Choice

Excel

Instructions

 2

Child Referral

Excel

Instructions

 3   

Communicable Disease

Excel

Instructions

 4

Injecting Drug Users 90% Capacity Treatment

Excel

Instructions

 5

Legislative Report - due 2/28/2022

Excel

Instructions

 6

Maintenance of Effort (MOE)

Excel

Instructions

 7

Notice of Excess or Insufficient Funds (NEIF)

Excel

Instructions

 8 PDS Outcomes Survey Data Excel Instructions

 9

Primary Prevention Expenditures by Strategy - due 2/28/2022

Excel

Instructions

 10

Priority Populations Waiting List Deficiencies

Excel

Instructions

11 SAHL DHH Report Excel Instructions

12  

Sentinel Events Data

Word

Instructions

13

Special Projects - Earmark Funded - No longer required

Excel

Instructions

14   

SOR Monthly Budget Report

Excel

Instructions

15   

SORII Monthly Budget Report

Excel

Instructions

16   

Synar Coverage Study Canvassing - not due until FY22

Excel

Instructions

17  

Tobacco/Formal Synar - Youth Access to Tobacco Compliance Checks

Excel

Instructions

18

Tobacco Retailer Master List - OROSC will provide customized form

Excel

Instructions

19 

Women's Specialty Services - Annual Report

Word

Instructions

20  

Women's Specialty Services (WSS) Mid-Year Status Report

Excel

Instructions

21  

Youth Access to Tobacco Activity Report

Word

Instructions