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Provider Resource Library

Tools, forms and resources for Ryan White Provider use are available below. To be notified via email when new information is posted, click here.

collapse Category : CAREWare ‎(2)
CAREWare Agency Agreement.pdfCAREWare Agency Agreement47 KB
CAREWare User Agreement.pdfCAREWare User Agreement63 KB
collapse Category : Forms ‎(12)
Case Management Assessment Form.docCase Management Assessment Form512 KB
Case Management Intake Form.docCase Management Intake Form88 KB
Certified Transportation Referral Form.docCertified Transportation Referral Form201 KB
CertifiedReferralForm.docxCertifiedReferralForm26 KB
Client Eligibility Requirements.pdfClient Eligibility Requirements60 KB
Client Individualized Care Plan.docClient Individualized Care Plan40 KB
Client Level Data Certified Referral Form.xlsClient Level Data Certified Referral Form39 KB
Client Reassessment Form.pdfClient Reassessment Form196 KB
Client Rights and Responsibilities.docClient Rights and Responsibilities41 KB
Federal Poverty Level.xlsFederal Poverty Level32 KB
General Consent Form.docGeneral Consent Form41 KB
Provider General Referral Form.docProvider General Referral Form343 KB
collapse Category : Handbook ‎(1)
Case Management Handbook.pdfCase Management Handbook978 KB
collapse Category : Monitoring Tools ‎(17)
Ambulatory Care.xlsAmbulatory Care74 KB
Case Management.xlsCase Management72 KB
EIS Tool.xlsEIS Tool69 KB
Fiscal Monitoring Tool.xlsFiscal Monitoring Tool95 KB
Food.xlsFood71 KB
General Monitoring Report.xlsGeneral Monitoring Report95 KB
Health Insurance.xlsHealth Insurance70 KB
Housing.xlsHousing66 KB
Legal Services.xlsLegal Services68 KB
Medical Nutritional Therapy.xlsMedical Nutritional Therapy66 KB
Medications Drug Reimbursement Program.xlsMedications Drug Reimbursement Program68 KB
Mental Health.xlsMental Health64 KB
Oral Health Care.xlsOral Health Care63 KB
Outreach.xlsOutreach69 KB
Psychosocial Support.xlsPsychosocial Support71 KB
Substance Abuse.xlsSubstance Abuse64 KB
Transportation - Contracted.xlsTransportation - Contracted68 KB
collapse Category : Procedure/Guidance ‎(7)
2010 Transportation Procedure.pdf2010 Transportation Procedure185 KB
Dental Referrals.pdfDental Referrals461 KB
Establishing an URN.pdfEstablishing an URN67 KB
Eye Care Referral.pdfEye Care Referral231 KB
Formula for Determining Number of Files to Monitor.pdfFormula for Determining Number of Files to Monitor61 KB
Invoice-Billing Proceedure.pdfInvoice-Billing Proceedure29 KB
Undetectable Viral Loads and Visit Requirements.pdfUndetectable Viral Loads and Visit Requirements87 KB
collapse Category : Quality ‎(1)
Quality Management Report.pdf
Checked Out To: Houser, LorraineQuality Management Report.pdf
Checked Out To: Houser, LorraineQuality Management Report104 KB
collapse Category : Reports ‎(2)
MAI Quarterly Report.docMAI Quarterly Report767 KB
Part A Quarterly Report.docPart A Quarterly Report767 KB
collapse Category : Standards of Care ‎(3)
Standard of Care - Case Management.pdfStandard of Care - Case Management331 KB
Standard of Care - Food Service.pdfStandard of Care - Food Service331 KB
Standard of Care - Housing.pdfStandard of Care - Housing326 KB


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