Organizational Provider Agreement Sample Contracts

ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTY
Organizational Provider Agreement • July 19th, 2012 • California

This Contract is entered into on between the Mental Health Plan of Mendocino County hereinafter referred to as MHP and St. Vincent’s School for Boys, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of San Francisco and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.

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ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTY
Organizational Provider Agreement • April 14th, 2022

This Contract is entered into on __________________ “Contract Date” between the Mental Health Plan of _____________ hereinafter referred to as MHP and ______________________, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of ________________ and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.

ORGANIZATIONAL PROVIDER AGREEMENT WITH
Organizational Provider Agreement • April 11th, 2024

This Contract is entered into on October 1, 2023 “Contract Date” between the Mental Health Plan of Merced County (hereinafter referred to as “MHP”) and Aspiranet dba Aspira Foster and Family Services(hereinafter referred to as “Contractor”) for access to Medi-Cal Specialty Mental Health Services for Youth Beneficiaries of Merced County. Contractor is located in the County of Merced, and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.

ORGANIZATIONAL PROVIDER AGREEMENT FOR YOUTH BENIFICIARIES OF MERCED COUNTY
Organizational Provider Agreement • November 27th, 2024

This Contract is entered into between the County of Merced, on behalf of the Mental Health Plan of Merced County hereinafter referred to as “MHP” and Creative Alternatives, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for youth beneficiaries of Merced County, targeting Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) youth, at risk youth or Foster Youth. Contractor is located in the County of Merced and is certified by the MHP to provide Medi-Cal services, as evidenced by the attached Certification.

ORGANIZATIONAL PROVIDER AGREEMENT FOR FOSTER CHILDREN PLACED OUT OF COUNTY
Organizational Provider Agreement • January 5th, 2012

This Contract is entered into on between the Mental Health Plan of Mendocino hereinafter referred to as MHP and St. Vincent’s School for Boys, hereinafter referred to as “Contractor” for access to Medi-Cal Specialty Mental Health Services for Foster Children placed out-of-county. Contractor is located in the County of Marin and is certified by an MHP to provide Medi-Cal services, as evidenced by the attached Certification.

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