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SPOA for Adults
 
 
     Instructions for submitting a SPOA application for:

  Mental Health Residential Programs
  • Mental Health Independent Housing Programs
  • Forensic Case Management (FCM) for people incarcerated
  • Case Management for individuals who are not Medicaid eligible
  • Assertive Community Treatment (ACT) if HHCM has been tried and ruled out
Click here to download the SPOA application.

You will also need to take the following steps:

  • The SPOA consent form needs to be printed out, signed by the applicant, and faxed to OCMS at 315.472.0084. For the consent form, click here.  To obtain a Spanish version of the consent form, click here.


  • Also, please fax the most recent psychosocial and history, or combined assessment to OCMS at 315.472.0084.


  • Applications to residential providers cannot be submitted to them electronically. You will need to print out the completed application and fax it with the signed SPOA consent and residential attachments, directly to the residential providers of choice.


  • Residential and housing referrals will continue to need the additional forms required by their licensure, such as Physician's Authorization for Restorative Services, Physical, TB test, for OMH programs, or DSS 3122, TB test, and/or Mental Health Evaluation for Adult Homes. (A list, and copies of these will be made available on the ongov and OCMS websites.)


  • Supported Housing (independent housing) programs will continue to need to know facts like number and ages of household, rental/landlord history, and utility and financial statements common to finding rental housing. A concise format to gather this information is being developed by Supported Housing Providers, until it is available; please note such information on your fax cover sheet.
    
 
 
 
 
 
 
 
 
 

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