FORMS FOR ADULTS
Behavioral Health Forms
Substance Use Treatment Support Forms
Buprenorphine Coordinator Program
Recovery Support Services Program
York/Adams Recovery House/Bridge Support Subsidy
- The Bridge Support/Recovery House Program is a Reinvestment Plan for recovery house room and board subsidies for York and Adams HealthChoices Members. This subsidy has been established to assist HealthChoices Members in need of financial assistance with limited income and assets, and to:
- Continue to support members in their recovery
- Reduce the number of non-hospital drug and alcohol rehabilitation readmissions.
- Increase the individuals’ ability to be employed and/or participate in volunteer activities.
- The reinvestment funds for this project provide subsidies in two distinct ways for approved applicants, and the amounts are determined by the York/Adams HealthChoices Management Unit.
- Applications can only be submitted by a case manager with SAM or MH/IDD, Probation Officer (Adult or Juvenile), Children and Youth Case Worker, Drug and Alcohol Commission, RASE Buprenorphine Coordinator, and/or other social worker from a higher level of care.
- Basic Eligibility Criteria includes but is not limited to:
- Individuals (18) years or older; Enrolled in Medical Assistance, and/or be likely eligible for Medical Assistance
- Those with a current documented substance use disorder
- Current residents of either York or Adams County for at least six (6) months
- Individuals with income or assets below 138% of the Federal Poverty Limit and have limited savings and assets
- Individuals able to sustain Recovery House Room and Board with temporary assistance
- Meet the eligibility criteria and be accepted at an approved recovery house
- Individuals connected with a case manager with SAM or MH/IDD, Probation Officer (Adult or Juvenile), Children and Youth Case Worker, Drug and Alcohol Commission, RASE Buprenorphine Coordinator, and/or other social worker from a higher level of care
- Applicant has had a Drug and Alcohol Assessment and a recommendation
- Individuals with limited income and assets
Approved Preferred Provider Recovery House(s)
| Recovery House Provider | Location | Gender Served | Security Deposit | Weekly Room and Board | Total Due at Admission |
|
Just 4 Today Sober Living
|
Stewartstown, PA |
Male (19) Female (5) |
$155.00 (Refundable Security Deposit) $100.00 (Intake/1st Month Transportation Fee - Non Refundable) |
$133.00 | $388.00 |
|
Safe Haven Transitional Living
|
York, PA |
Male (42) Female (22) |
$0.00 (Security Deposit) $250.00 (Initial two weeks rent) $40.00 (Intial two weeks house food) $150.00 (Intake Fee- Non Refundable |
$145.00 (Weekly Rent and Food) $10.00 (Window Air Conditioner May to September) |
$440.00 |
|
Sees The Day
|
York, PA |
Male (36) Female (44) |
$200.00 (Refundable Security Deposit) $250.00 (Initial two weeks rent) $40.00 (Initial two weeks food) |
$145.00 (Weekly Rent and Food) | $490.00 |
|
Choices Recovery House
|
York, PA |
Male (11) Female (27) |
$100.00 (Refundable Security Deposit) $200.00 Administrative Fee $250.00 (Initial Two Weeks Rent) $40.00 (Initial Two Weeks Food) |
$145.00 (Weekly Rent and Food) | $590.00 |
|
Keep It Green (Contract Pending)
|
York, PA |
Male (71) Female (11) |
$50.00 (Refundable Security Deposit) $150.00 Processing Fee $115.00 (Initial Two Weeks Rent) $25.00 (Initial Two Weeks Food) |
$140.00 (Weekly Rent and Food) | $340.00 |
Subsidy Applications for this program have been provided to System Partners, and they have the ability to submit applications with the HealthChoices Member. To request a subsidy application for a HealthChoices Member, email AEHampson@old.yorkcountypa.gov.
CHILD AND ADOLESCENT FORMS
Behavioral Health Forms
CRR(Community Residential Rehabilitation) Room and Board: This subsidy provides room and board payment only for children who are placed out of the home in a CRR and meet eligibility criteria.
Release of Information for CRR Room and Board
CRR Room and Board Application
To Learn More About the Subsidy and the Parents/Guardian's Financial Responsibility Click Here
Joint Planning Team: The goal for this process is to ensure that the youth and family are able to independently plan and access the resources they need in the community in order to have the least restrictive placement for youth.
Announcing the Joint Planning Team for Truancy: This pilot project will be accepting referrals from the Office of Children, Youth and Families of York County to work with youth and family to plan for youth to reduce the amount of truant days. The process will utilize the family voice and choice, to identify natural and community supports to address the truant behaviors.
Please see the program announcement: Click Here