(a.k.a. 711 Form)
Some service programs may be required to complete a 711 form rather than a 600/610 form. The specific form used is based on what SPC code is identified for the specific service provided. The State has determined which SPCs require a 711 form and which require a 600/610 form. The County Contract Manager will communicate which reporting process is required for each program through its annual contracts. Note that the Contract Manager may require a 600/610 form despite the program being one that has a 711 form-appropriate SPC code.
The 711 Form may be used only for these types of services.
|SPC Code||Description||Reporting Units|
|107||Specialized Transportation & Escort Trips||One-Way Trip|
|403||Recreation & Alternative Activities||Staff Hours|
|408||Community Prevention||Staff Hours|
|501||Crisis Intervention||Staff Hours|
|602||Information & Referral||Contacts|
|605||Advocacy & Defense Resources||Staff Hours|
|606||Health Screening & Accessibility||Staff Hours|
|701||Training & Development||Staff Hours|
|702||Agency / Systems Management||Staff Hours|
If you have questions about this report, please call your designated data entry contact.