Medicaid Policy                                                                 

 

Table XVII Targeted Adult Medicaid (TAM) Agencies

Updated: September 19, 2023

The following agencies may complete the TAM referral forms (42A, 43A and 44A) for a TAM coverage group.  

 

An '*' denotes which agencies can complete the 45A for the General Assistance sub-group.

 

This list is not all inclusive.  If a form is completed by an agency who is not listed below, please contact a DWS Medical Program Specialist for further guidance.

 

Column 1: Approved Providers

Column 2: Indicates the questions they are approved to answer (do not need all questions answered, one is sufficient)

Chronically Homeless

Form 42A

7th Street Treatment*

All questions

Bear River Mental Health*

All questions

Central Utah Counseling*

All questions

Clinical Consultants*

All questions

Community Connection Center

All questions

Crossover Recovery Center

All questions

Davis Behavioral Health*

All questions

Division of Child and Family Services (DCFS)

All questions

First Step House - SLC*

All questions

Four Corners Community Behavioral Health*

All questions

Fourth Street Clinic – SLC*

All questions

Grace Mary Manor - SLC

All questions

Haven*

All questions

Horizon House - Cedar City*

All questions

House of Hope*

All questions

Housing Authority of Salt Lake City (HASLC)

All questions

Housing Connect

All questions

INN-Between

All questions

Iron County Care and Share

All questions

Lantern House (St. Anne’s) - Ogden

All questions

Limitless Recovery All questions 

MATR*

All questions

Midtown Community Health Center – Ogden*

All questions

Mountainlands Community Health Center/Mountainlands Family Health Center*

All questions

Next Level Recovery

All questions

Northeastern Counseling Center*

All questions

Odyssey House - SLC*

All questions

Ogden Police Department

All questions

Optum Salt Lake County*

All questions

Palmer Court - SLC

All questions

Papilion Intergrated Recovery Center

All questions

Rescue Mission – SLC and Ogden

All questions

Road Home - SLC

All questions

Safe Harbor Crisis Center

Question 3

SAIL

All questions

Salt Lake County Criminal Justice Services

All questions

Salt Lake County Division of Behavioral Health*

All questions

Salt Lake Legal Defender Association

All questions

San Juan Counseling Services*

All questions

Southwest Behavioral Health Center*

All questions

Switch Point - St. George*

All questions

Switch Point - Tooele Community Resource Center

All questions

Turning Point - Vernal*

Questions 1, 2 and 4

Urban Indian Center - SLC

All questions

Utah County Dept. of Drug and Alcohol Prevention and Treatment*

All questions

Utah Harm Reduction Coalition (UHRC)

All questions

Utah Naloxone*

Question 4 (Only question 1 on 45A)

Valley Behavioral Health*

All questions

Volunteers of America (VOA)*

All questions

Wasatch Behavioral Health*

All questions

Weber Housing Authority

All questions

Weber Human Services*

All questions

Weigand Homeless Resource Center

All questions

YWCA - SLC*

All questions

 

Justice Involved

Form 43A

Adult Parole and Probation (AP&P) 

All questions

Alpha Counseling

All questions

Atherton Community Treatment Center

All questions

Bear River Health Department

All questions

Bear River Mental Health

All questions

Beecon Recovery

All questions

Bonneville Community Correctional Center

All questions

Box Elder County Sheriff's Office

All questions

Building Beginnings

All questions

Cache County Sheriff's Office

All questions

Cache Valley Recovery (CVR)

All questions

Central Utah Counseling

All questions

Clinical Consultants

All questions

Collective Recovery Center

All questions

Community Connection Center

All questions

Crossover Recovery Center

All questions

Courts - Any federal, state, county, city or tribal mental health/drug court throughout the state.  Defenders office with any court.

Questions 2, 3 and 4

Davis Behavioral Health

All questions

Division of Child and Family Services

All questions

Division of Juvenile Justice and Youth Services (JJYS)

All questions

First Step House - SLC

All questions

Four Corners Community Behavioral Health

All questions

Fortitude Treatment Center

All questions

Horizon House

Question 2

House of Hope

All questions

Huntsman Mental Health Institute - all locations

All questions

J Walker Sober Living & IOP

All questions

Jails – By County: Beaver, Cache, Davis, Garfield, Kane, Millard, SLC, Tooele, Utah, Weber.   Includes county agencies working with the jails.

Question 1

Judicial Supervision Services

All questions

Liberty Addiction Recovery Centers

All questions

Limitless Recovery All questions

MATR

All questions

Next Level Recovery

All questions

New Season Treatment Center - Bountiful

All questions

Northeastern Counseling Center

All questions

Northern Utah Community Correctional Center

All questions

Odyssey House – SLC

All questions

Optum Salt Lake County

All questions

Orange Street Community Correctional Center

All questions

Papilion Integrated Recovery Center

All questions

Pomarri

All questions

Psychiatric and Behavioral Solutions (PBS)

All questions

Recovery Innovations International (RI) All questions
Renaissance Ranch Treatment Centers All questions
Riverton Family Life Center (Also known as Foundation for Family Life and MentorWorks) All questions
Salt Lake County Criminal Justice Services All questions
Salt Lake County Division of Behavioral Health All questions
Salt Lake Legal Defender Association All questions
San Juan Counseling Center All questions
Sanpete County Sheriff's Office All questions
Southwest Behavioral Health Center All questions

State Prison (Department of Corrections) - Draper

All questions

Steps Recovery Centers*

All questions

The Other Side Academy (TOSA) Question 4

True North Recovery

All questions

Urban Indian Center - SLC

All questions
U.S. Probation All questions
Utah County Dept. of Drug and Alcohol Prevention and Treatment All questions
Utah County Public Defender Association All questions
Valley Behavioral Health All questions
Wasatch Behavioral Health All questions

Washington County Court Support Services

All questions

Weber County Correctional Facility (WCCF)

All questions

Weber County Sheriffs Kiesel Facility

All questions

Weber Human Services

All questions

 

State Hospital

Form 44A

State Hospital - Provo

All questions