Self-Determination Agreement between Sanilac County Community Mental Health Authority (SCCMH) and____________________________________________ (Recipient) Case# ____________Self-Determination Agreement • May 4th, 2021
The purpose of this agreement is to define the roles and responsibilities of the above-mentioned parties, in order to assure the provision of the specific services and/or service providers identified below, as desired by the Recipient, documented in the Recipient's Person Centered Individual Plan of Service (IPOS), and agreed to by all parties through a signed/approved SCCMH Funding Request or Voucher Budget, and by the signatures on this agreement.
