Forms

Forms for Adults

Behavioral Health Forms

Substance Use Treatment Support Forms

Buprenorphine Coordinator Program

Recovery Support Services Program

York / Adams Recovery House / Bridge Support Subsidy

  • The Bridge Support/Recovery House Program is a Reinvestment Plan for recovery house room and board subsidies for York and Adams HealthChoices Members. This subsidy has been established to assist HealthChoices Members in need of financial assistance with limited income and assets, and to:
    • Continue to support members in their recovery
    • Reduce the number of non-hospital drug and alcohol rehabilitation readmissions.
    • Increase the individuals' ability to be employed and/or participate in volunteer activities.
  • The reinvestment funds for this project provide subsidies in two distinct ways for approved applicants, and the amounts are determined by the York/Adams HealthChoices Management Unit.
  • Applications can only be submitted by a case manager with SAM or MH/IDD, Probation Officer (Adult or Juvenile), Children and Youth Case Worker, Drug and Alcohol Commission, RASE Buprenorphine Coordinator, and/or other social worker from a higher level of care.
  • Basic Eligibility Criteria includes but is not limited to:
    • Individuals (18) years or older; Enrolled in Medical Assistance, and/or be likely eligible for Medical Assistance
    • Those with a current documented substance use disorder
    • Current residents of either York or Adams County for at least six months
    • Individuals with income or assets below 138% of the Federal Poverty Limit and have limited savings and assets
    • Individuals able to sustain Recovery House Room and Board with temporary assistance
    • Meet the eligibility criteria and be accepted at an approved recovery house
    • Individuals connected with a case manager with SAM or MH/IDD, Probation Officer (Adult or Juvenile), Children and Youth Case Worker, Drug and Alcohol Commission, RASE Buprenorphine Coordinator, and/or other social workers from a higher level of care
    • The applicant has had a Drug and Alcohol Assessment and a recommendation
    • Individuals with limited income and assets

Child and Adolescent Forms

Behavioral Health Forms

Community Residential Rehabilitation (CRR) Room and Board: This subsidy provides room and board payment only for children who are placed out of the home in a CRR and meet eligibility criteria.

To Learn More About the Subsidy and the Parents / Guardian's Financial Responsibility view our What is the CRR Room 2015 (PDF)

Joint Planning Team - The goal for this process is to ensure that the youth and family are able to independently plan and access the resources they need in the community in order to have the least restrictive placement for youth.

Announcing the Joint Planning Team for Truancy - This pilot project will be accepting referrals from the Office of Children, Youth and Families of York County to work with youth and family to plan for youth to reduce the amount of truant days. The process will utilize the family voice and choice, to identify natural and community supports to address the truant behaviors.

Please see the program announcement: Joint Truancy Announcement September 2016 (PDF)

Joint Planning Team -Referral Form (PDF)