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 in Year 3 (FY 2025-26) Value-Based Incentives.Package: Invoice: Electronic Submission Form:
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.
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 Workforce Development- Employee Benefits Package How to Guide (2-A)
- Employee Benefits Package Resource Document (2-A)
- Employee Benefits Package Provider Agency Checklist (2-A) (Revised - August 2025)
- SUD Registered Counselor Minimum Wage Submission Form (New Providers Only) (2-B)
- Bilingual Bonus Training Presentation (New- August 2025)
- Bilingual Bonus Submission Guide (Revised - August 2025)
- Bilingual Bonus - Frequently Asked Questions (New- August 2025)
- Bilingual Bonus Submission Form (2-C) (Revised - August 2025)
- Bilingual Bonus Differential Supplemental Form (2-C)
- LPHA Sign-On/Loyalty Bonus supplemental form
- Instructions for MAT Prescribing Clinician Start-Up Cost Sharing (2-E) (Revised - August 2025)
- MAT Prescribing Clinician Start-Up Cost Sharing Implementation Plan (Non-OTP) (2-E) (Revised - August 2025)
- MAT Prescribing Clinician Start-Up Cost Sharing Implementation Plan (OTP only) (2-E) (Revised - August 2025)
- MAT Prescribing Clinician Start-Up Cost Sharing Addendum (Non-OTP) (2-E) (Revised - August 2025)
- MAT Prescribing Clinician Start-Up Cost Sharing Addendum (OTP only) (2-E) (Revised - August 2025)
- R95 Champion Guide (3-F)
- R95 Policies and Client-Facing Agreements Guide (3-G) (pdf)
- R95 Admission Agreement (3-G) (pdf)
- R95 Admission Agreement (3-G) (word)
- R95 Toxicology Agreement Required Language (3-G) (pdf)
- R95 Toxicology Agreement Required Language (3-G) (word)
- R95 Admission Policy Required Language (3-G) (pdf)
- R95 Admission Policy Required Language (3-G) (word)
- R95 Discharge Policy Required Language (3-G) (pdf)
- R95 Discharge Policy Required Language (3-G) (word)
- R95 Toxicology Policy Required Language (3-G) (pdf)
- R95 Toxicology Policy Required Language (3-G) (word)
- Service Design Follow-up Implementation Plan Change Project Plan (3-H)
