MOU Example
MEMORANDUM OF UNDERSTANDING (MOU) BETWEEN W-2 AGENCIES, SUBSTANCE ABUSE SERVICE PROVIDERS, MENTAL HEALTH PROVIDERS, CHILD WELFARE AGENCIES, MANAGED CARE PROVIDERS, AND PROBATION AND PAROLE AGENCIES
This memorandum of understanding is established in order to facilitate the delivery of services to assist families to gain mastery of their lives, eliminate barriers between and within the services and to reduce the resulting confusion for the families we serve. We the undersigned agree to the following Memorandum of Understanding.
MOU GOALS
- The alcohol and other drug abuse (AODA) treatment provider will be the case coordinator, or HUB, using a comprehensive case management approach with W-2, Child Welfare, Mental Health and all other agencies supporting the family.
- All impact agencies must work together to identify issues, barriers, goals, and coordinate service plans so activities do not conflict with one another.
- Inter-agency cross training will occur by all agencies involved in the case. It is imperative to the success of the participant and their service plan that agency representatives are educated on the requirements and policies of all coordinating agencies.
- The case HUB agency will develop, make referrals, and monitor a needs assessment and universal service plan for the case.
- All changes or deviations from the universal service plan will be discussed in a case coordination meeting with all the agencies prior to the action being instituted.
- The coordination of funding sources will be an integral part of the delivery of services.
- The HUB agency's responsibility may change depending on case needs.
- If there is a change of the HUB agency, the changes in the universal service plan need to be re-addressed.
- The confidentiality requirements of every agency involved with the case plan will be upheld.
- Specific releases will be obtained and signed by the primary person in the case on an as-needed basis to coordinate communication, ensure confidence of sensitive information, coordinate inter-agency meetings and service plans, and establish protocol for crisis or emergency situations.
| Signature | Title | Date Signed |
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W-2 Agency Representative's Signature |
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AODA Treatment Provider Representative's Signature |
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Child Welfare Agency Representative's Signature |
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Mental Health Provider Representative's Signature |
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Managed Care Representative's Signature |
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Probation/Parole Representative's Signature |
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This MOU will remain in effect throughout the duration of participant's universal service plan.