Home and Community Based Services
Forms and Information

• Federal OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit Organizations

Quarterly reports are due 30 days after each quarter ending:

1st quarter - July 1 - September 30

2nd quarter - October 1 - December 31

3rd quarter - January 1 - March 31

4th quarter - April 1 - June 30

Quarterly reports may be mailed, faxed or emailed to the grant administrator listed below. Please mail, fax or scan original signature pages.

Grants and Contracts Support Team
P.O. Box 110650
Juneau, AK
99811-0650
Fax: (907) 465-3419

• SIH and NFCSP:
  Marlyn Carrillo, Grants Administrator
  Phone: (907)465-3026
• Adult Day:
  Stephen Bower,Grants Administrator
  Phone: (907)465-6924

Adult Day Services

• Adult Day Services Grant Program Manual (PDF)
• SAMS HCB Registration Form (Word)(PDF)
• FY13 ADS Biannual Report Narrative (Word)(PDF)

Senior In–Home Services

• SIH Grant Program Manual (PDF)
• SAMS HCB Registration Form (Word)(PDF)
• FY13 SIH Biannual Report Narrative (Word)(PDF)
• FY13 SIH CFR 2 - Expenditures by Service Category (Excel)
• SIH Case Management Assessment Form (Word)
• SIH Plan of Care Form (Word)
• SIH Supplemental Services Request Form (Word)
  

National Family Caregiver Support Program

• NFCSP SAMS Registration Form (Word)(PDF)
• FY13 NFCSP Biannual Narrative (Word)(PDF)
• FY13 NFCSP CFR 2 – Expenditures by Service Category (Excel)

SAMS (Social Assistance Management Software)

• SAMS Security Agreement Form (Word) (PDF)
• 2013 HCB Senior Grants Data Entry Manual (PDF)

   

  Program Manager

  Adult Day, Senior In-Home Services, National Family Caregiver Support:
  Cyndee Simpson-Sugar
  Program Manager
  Division of Senior and Disabilities Services
  PO Box 110680,
  Juneau, Alaska 99811-0680
  Phone: (907) 465-4798
  Fax: (907) 465-1170