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Amended Provider Agreement- Complex Behavioral Collaborative Consultation and Training

***This amendment issued 5/14/21 serves to clarify what information may not be submitted as proof of federal tax ID. Please refer to the final page of the provider agreement.***

***This amendment issued on 10/16/20 serves to update the email address on this online public notice. All signed Provider Agreements and documentation demonstrating provider eligibility should be emailed to HSS.FMS.Grants.Provider.Agreements@alaska.gov.***

The Department of Health and Social Services, Division of Behavioral Health, is entering into Agreements under 7 AAC 81 with qualified providers for the State of Alaska's Complex Behavioral Collaborative Consultation and Training program for the purpose of assisting Alaska service providers or population-based projects in meeting the needs of Medicaid clients of all ages with complex behavioral management who exhibit maladaptive behaviors. 
For questions or additional information, please contact:

Val Cummins, Grants Administrator
Grants & Contracts Support Team
Dept. of Health and Social Services
P.O. Box 110650
Juneau, AK 99811-0650
Phone: (907)465-3026 Fax: (907)465-8678
Email: val.cummins@alaska.gov