Fiscal Reporting Forms and Templates
FY 2013 "505 Hot Spot" Collaborative Project
This form is to be completed for each collaborative project and submitted to ODMH by May 25, 2012. The data will be used to provide a detailed description of how 505 project funds will be used to initiate specific activities of the project; and on what timeline 505 funds will be drawn, by fiscal quarter, in order to support the specific project. Additionally, the data will be compiled to report on projects by name, location, target population, or service activity.
DMH-FIS-040 Report
The DMH-FIS-040 report is completed annually by each alcohol, drug addiction and mental health (ADAMH) board and community mental health board and submitted to ODMH. The data provides a complete picture of the types of services provided by mental health agencies and the corresponding expenditures and revenue in the mental health system. This information is used to develop of the Annual Report, which provides the number and types of services available to severely mentally disabled people through state-operated services and community mental health agencies.
- DMH-FIS-040 form template
- Instructions for completing the DMH-FIS-040 form
- Numbered advisory regarding the DMH-FIS-040 form
Request for Advance or Reimbursement Form
This form is used by local alcohol, drug addiction and mental health (ADAMH) boards and community mental health boards to request funds from the Ohio Department of Mental Health (ODMH).
