Substance Abuse Prevention and Control
Guidance Documents, Invoice, and Forms
The following is an at-a-glance review of all guidance documents, invoice, and forms prepared by the SAPC team to support the provider network with Year 4 (FY 2026-27) Value-Based Incentives.Package: Invoice: Payments:
- Project Codes and Descriptions (document forthcoming)
Please review the VBI Electronic Submission Form Guide above for detailed instructions on accessing and completing the form. When ready to submit, access the VBI Electronic Submission Form also linked above. This link is new and specific to Fiscal Year 2026-27.
Please note: All VBI invoices and deliverables must be submitted via the electronic form. Email submissions will not be accepted. If you encounter any issues completing the electronic form, please contact DPH-SAPC-VBI@ph.lacounty.gov.
Program-Specific Documents for Provider Agency Use:
Finance and Business Operations- Building Performance and Risk Metrics (1-C) – Data Aggregation (program documents forthcoming)
- Instructions for MAT Prescribing Clinician Start-Up Cost Sharing (2-C)
- MAT Prescribing Clinician Start-Up Cost Sharing Implementation Plan (Non-OTP) (2-C)
- MAT Prescribing Clinician Start-Up Cost Sharing Implementation Plan (OTP only) (2-C
- MAT Prescribing Clinician Start-Up Cost Sharing Addendum (Non-OTP) (2-C)
- MAT Prescribing Clinician Start-Up Cost Sharing Addendum (OTP only) (2-C)
- R95 Unique Clients Served Activity Guide (3-H)
- R95 Unique Clients Served Submission Checklist (3-H)
- R95 Policies and Client-Facing Agreements Submission Checklist (3-I)
- R95 Admission Agreement (3-I) (pdf)
- R95 Admission Agreement (3-I) (word)
- R95 Toxicology Agreement Required Language (3-I) (pdf)
- R95 Toxicology Agreement Required Language (3-I) (word)
- R95 Admission Policy Required Language (3-I) (pdf)
- R95 Admission Policy Required Language (3-I) (word)
- R95 Discharge Policy Required Language (3-I) (pdf)
- R95 Discharge Policy Required Language (3-I) (word)
- R95 Toxicology Policy Required Language (3-I) (pdf)
- R95 Toxicology Policy Required Language (3-I) (word)
