VT HMIS PSHA Medicaid Program Forms - Clarity

Here you can find forms with all the HMIS fields that are needed for your PSHA Medicaid Program.

Please click on the link to access document:

• FY25 PSHA Medicaid Program Enrollment - (Word Doc) 
• FY25 PSHA Medicaid Program Status and Services - (Word Doc) 
• FY25 PSHA Medicaid Program Exit - (Word Doc)

If you have questions or concerns, please reach out to your System Administrators at vthmis@icalliances.org

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