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ADAMH reimbursement counties

If your business is in one of the counties listed as one of the ADAMH reimbursement counties on the SURWSP overview page, you will be reimbursed directly through your county Alcohol, Drug Addiction and Mental Health (ADAMH) board.

To enroll, complete the SURWSP Enrollment Form (SUR-1). Employers meeting the eligibility requirements will receive additional information on program participation. Enrollment in the program does not obligate you to perform any duties or requirements. Program requirements and obligations only apply if you decide to seek reimbursement.

Reimbursement *
Contact the ADAMH board that serves your county before submitting your SUR-2 Request for Reimbursement 

County ADAMH board contact information

Your county ADAMH board will provide details on how to submit requests, including any county-specific forms which must be completed before the county ADAMH board can reimburse you. 

You must provide a W-9 to the ADAMH board. 

When you are ready to submit a reimbursement request to your ADAMH board, complete the SURWSP Request for Reimbursement (SUR-2) and submit it along with the supporting documentation listed on the form to your ADAMH board. You are not required to include the State of Ohio supplier ID number of your company on the form you submit to the ADAMH board.


Reimbursement is available on a first come, first served basis while funding and BWC resources are available. Both the program and funding may be modified or suspended at any time.