Summary Information

1. Awarding Agency Name: Illinois Department of Human Services
2. Agency Contact:

Joseph Tracy

joseph.tracy@illinois.gov

(312) 814-6359

3. Announcement Type: Initial announcement
4. Type of Assistance Instrument: Grant
5. Funding Opportunity Number: 19-444-26-1746-01
6. Funding Opportunity Title: Service Enhancement for Pregnant and Postpartum Women with OUD
7. CSFA Number: 444-26-1746
8. CSFA Popular Name: PPW-OUD
9. CFDA Number(s): 93.788
10. Anticipated Number of Awards: 2
11. Estimated Total Program Funding: $542,000
12. Award Range Minimum and maximum award amount
If not applicable, indicate"not applicable"
13. Source of Funding: Federal
14. Cost Sharing or Matching Requirement: No
15. Indirect Costs Allowed Yes
Restrictions on Indirect Costs 2 CFR 200 and 45 CFR Part 75
16. Posted Date: October 10, 2018
17.Application Range: 10/10/2018 - 11/26/2018
18. Technical Assistance Session: Session Offered: No

NOFO

A. Program Description

Illinois State Opioid Response (SOR) Grant - Service Enhancement for Pregnant and Postpartum Women with OUD (PPW-OUD)

The purpose of this Notice of Funding Opportunity (NOFO), referred to as Service Enhancement for Pregnant and Postpartum Women with OUD (PPW-OUD), is to pilot family-based services to pregnant and postpartum women with a primary, secondary, or tertiary diagnosis of opioid use disorder (OUD). Pilot programs will include the use of specialized screening, referral, family-based treatment interventions, and recovery support services, for pregnant and postpartum women with OUD and their families.

Definitions:

Certified Peer Recovery Specialist (CPRS)- A credential for individuals who share the experience of recovering from a substance use or mental health disorder, either directly or as family members or significant others. Persons served by a CPRS include persons with substance use disorders, mental illnesses, persons dually diagnosed with mental illness and substance use disorder, family members/significant others and/or staff of organizations seeking consultation on the recovery model. The CPRS assists individuals in becoming involved in their own recovery process so they might develop personalized action plans for their own behavioral, emotional, physical and social health. They provide experience, education and professional services to assist and support individuals in developing and/or maintaining recovery-oriented, wellness-focused lifestyles.

Cultural Competence Plan - A strategic plan that outlines a systematic organizational approach to providing culturally responsive services to individuals and increasing cultural competence among staff at each level of the organization.

Doula - A trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible. A doula's role is not the same as a midwife's and is not required to have medical training. *The Doula Services Network outlines the certification requirements and various doula training organizations. http://doula-services.com/category/become-a-doula/ 

Doula Certified Peer Recovery Specialist- A person in active recovery who obtains dual certification as both a birth and a postpartum doula to assist the recovering mother through all phases of obstetrics and the CPRS to assist in recovery from her addiction.

Family-based services - At a minimum, family-based services acknowledge the influence and importance of family, provide for family involvement, and address family issues in individual treatment plans.

Neonatal Abstinence Syndrome (NAS) - Group of physiologic and neurobehavioral signs of withdrawal that may occur in a newborn who was exposed to psychotropic substances in utero. The syndrome may be managed with non-pharmacologic interventions but may require pharmacotherapy. Symptoms may include excessive crying, poor feeding or sucking, fever, vomiting and diarrhea, tremors and irritability, and/or low birthweight.

Post-partum - the period after childbirth up to 12 months.

Trauma-Informed Approach - A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization.

Background

In June 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued Funding Opportunity Announcement (FOA) # TI-18-015, State Opioid Response Grants (SOR). This SAMHSA grant program expands upon the federal funds made available to states and territories to address the opioid crisis in this country. This grant program's stated aim is "to address the opioid crisis by increasing access to medication-assisted treatment (MAT) using the three FDA-approved medications for the treatment of opioid use disorder (OUD), reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder (OUD) (including prescription opioids, heroin, and illicit fentanyl and fentanyl analogs)." To be considered MAT in Illinois, with the exception of services provided in a hospital setting, patients must be receiving one of the three FDA-approved medications for OUD in combination with participation in IDHS/SUPR-licensed treatment services. The grants awarded to states and territories are formula-based. Illinois is targeted to receive $28,569,209 in each of two years through this Grant program. The service initiatives included in the Illinois SOR grant application are designed to expand upon the services supported through the SAMHSA-STR grant that was awarded to Illinois in May 2017.

While various population groups and areas of the State of Illinois have been differentially impacted by opioid use-related problems, virtually all communities and residents of our state have in some way been impacted by the opioid crisis. Perhaps none of the problems that are associated with the national opioid crisis has heightened the awareness of the general public as the dramatic increase in opioid overdose deaths. From 1999 to 2016, more than 350,000 Americans died from an overdose involving any opioid. In 2016, there were about 42,000 opioid-related overdose deaths in this country which was about five times higher than the comparable number in 1999 (Centers for Disease Control and Prevention (CDC), 2018). Like most states, Illinois has experienced a notable increase in drug overdose deaths that can primarily be attributed to an increase in opioid overdose deaths. Death records obtained from the Illinois Department of Public Health (IDPH) showed 2,110 drug-related overdose deaths during 2017. The majority of these were heroin-related fatalities either alone or in combination with a synthetic opioid, primarily fentanyl. From 1999 to 2016, the population rate of opioid overdose deaths in Illinois increased from 3.9 to 15.3 per 100,000 persons (National Institute on Drug Abuse). The 1,947 opioid-related overdose deaths among Illinois residents in 2016 represented an over 300% increase in the number of such deaths that were reported in 1999. Based on their review of multiple national databases, the CDC has concluded that for every opioid overdose death it can be concluded that there are 130 individuals who have some form of OUD. If this estimation factor is applied to Illinois, it can be estimated that there are over 250,000 persons in our state with an OUD.

Need for Enhanced Services for Pregnant and Postpartum Women with OUD

According to the SAMHSA released document, "A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders", the use of MAT during pregnancy is a recommended best practice for the care of pregnant women with opioid use disorders (American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women, & American Society of Addiction Medicine, 2012). MAT is the use of medications in combination with counseling and behavioral therapies to provide a whole-patient approach to the treatment of substance use disorders (SAMHSA, 2014a). Research shows that a combination of medication and behavioral therapies is most successful for substance use disorder treatment. MAT is clinically driven and focuses on individualized patient care. Further, this document states that a coordinated, multi-system approach best serves the needs of pregnant women with opioid use disorders and their infants. (Substance Abuse and Mental Health Services Administration. A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders. HHS Publication No. (SMA) 16-4978. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2016. Available at: http://store.samhsa.gov/).

Additionally, this report states that "During the intrapartum and postpartum period, special considerations are needed for women who are opioid dependent to ensure appropriate pain management, to prevent postpartum relapse and a risk of overdose, and to ensure adequate contraception to prevent unintended pregnancies. Patient stabilization with opioid-assisted therapy is compatible with breastfeeding. Neonatal abstinence syndrome is an expected and treatable condition that follows prenatal exposure to opioid agonists. All infants born to women who use opioids during pregnancy should be monitored for neonatal abstinence syndrome and be treated if indicated."

Medication Assisted Therapy (MAT) is the use of one of three FDA-approved medications coupled with behavioral therapy and supportive services and is a highly effective way of treating opioid use disorder. Each of the three medications - buprenorphine, methadone and naltrexone - is covered by Medicaid in Illinois. The use of MAT with pregnant women is narrowed to methadone and buprenorphine as supported by the opinion of The American College of Obstetricians and Gynecologists (ACOG). https://www.acog.org/ 

Illinois Adverse Pregnancy Outcomes Reporting System (APORS) is the Illinois Department of Public Health's (IDPH) surveillance system for adverse outcome in infants, including birth defects, very low birth weight, positive drug screens, and drug withdrawal symptoms. According to APORS data, 3,026 infants were reported as drug exposed, and the majority were exposed to a combination of drugs (52%) and to opioids (48%). In SUPR's 2018 Needs Assessment Study, estimates indicate that as many as 44.8% (n = 5,669) of Illinois pregnant women with past-year AUD/SUD misused pain relievers in 2015.

The number of pregnant women who were admitted to substance use treatment in fiscal year 2017, as reported in DARTS, was 303 with an average age of 28 years old. 83% of the pregnant women were never married; 71% had children under the age of 25 and 28% were involved with DCFS. Pregnant women with OUD made up 51% of these admissions during SFY2017. 45% of the admitted pregnant women indicated that they were not part of the labor force and another 41% were not employed/looking for work in the past 30 days. Over 80% of the admissions were either self-referred or from the criminal justice system which could be suggestive that stronger connections and collaborations to healthcare, such as Federally Qualified Health Centers, birthing hospitals, obstetricians and gynecologists need to be encouraged.

In October 2017, the United States Government Accountability Office released a report to Congress entitled Newborn Health, Federal Action Needed to Address Neonatal Abstinence Syndrome (NAS). The report indicates that "NAS is a withdrawal condition within infants that can result from the prenatal use of opioids by pregnant women. Prenatal opioid use occurs when a woman, during the course of her pregnancy, uses an opioid-based medication or substance. Prenatal opioid use can take various forms, including (1) the use of prescriptions for pain management, such as fentanyl and oxycodone; (2) medication-assisted treatment for opioid addiction, such as methadone and buprenorphine; (3) prescription drug misuse or use disorder (such as using an opioid without a prescription, using a different dosage than prescribed, or continuing to use an opioid when it is no longer needed for pain); and (4) illicit opioid use, such as heroin use."

According to the 2017 Illinois Neonatal Abstinence Syndrome Advisory Committee Annual Report since 2011, the rate of NAS in Illinois has trended upward. In fact, from 2011 to 2016, there was a 53% increase in the NAS rate in Illinois, according to hospital discharge data for all Illinois hospitals. In 2011, the statewide NAS rate was 1.77, per 1,000 deliveries; in 2016 the NAS rate was 2.70 per 1000 deliveries. IDPH reports that infants born in Illinois with NAS have longer hospital stays and higher hospital charges than infants without NAS. In 2016, the median length of hospital stay after birth was 11 days longer for infants with NAS compared to infants without NAS. In 2016, the median charges for the birth hospitalization of infants with NAS were approximately $33,700, compared to approximately $4,400 for infants without NAS. In 2016, the total charges for the hospital care of infants born with NAS were nearly $18 million higher than what would have been expected if they had been born without NAS. Further in 2016, the rate of NAS in Illinois was about 2.7 NAS cases per 1,000 live births, affecting 391 infants born in Illinois that year. The NAS rate is highest among: Non-Hispanic White infants, infants covered by public insurance (Medicaid) or who are uninsured, and infants residing in urban counties outside the Chicago metropolitan area. http://www.dph.illinois.gov/sites/default/files/publications/publicationsowhnas-annual-report.pdf 

Inclusion of Service Enhancement for PPW-OUD in Illinois SOR Grant Goals and Objectives

Illinois SOR Project Goal 2 aims to increase the availability of evidence-based information, outreach, linkage/referral, medication-assisted treatment (MAT), recovery support, and prevention services that are available for Illinois residents with opioid use disorders (OUD). Specifically, this goal calls for providing funding for implementation of evidence-based recovery support services for pregnant and post-partum women with OUD.

Within the projected total amount of $542,000 that will be allocated towards supporting expanded MAT services, there is a maximum funding award of $271,000 for a single application.

Over the course of the two years of the project, 100 pregnant and post-partum women with OUD will be served at 50 per year. Each funded provider will be responsible for serving 25 pregnant and post-partum women with OUD per year or 50 over the course of the project.

IDHS/SUPR is committed to supporting the development of programs that enhance services through implementation of evidence-based recovery support services. Key in the development of these enhanced services will be the use of Doula Certified Peer Recovery Specialists. The Peer Recovery Specialist will be a person in active recovery who will obtain dual certification as both a birth and a postpartum doula to assist the recovering mom through all phases of obstetrics and of recovery from her addiction. Certification options can be found at http://doula-services.com/category/become-a-doula/.

Further, it has been well documented the importance of treating a woman while taking into consideration the needs of her family and significant others. According to SAMHSA's Family-Centered Treatment for Women with Substance Use Disorders: History, Key Elements and Challenges, there are two primary reasons why family-centered treatment for parental substance use disorders makes sense. First, research on women's substance use, dependence, and treatment shows that relationships, especially with family and children, play an important role in women's substance use, treatment, and relapse. Second, 70 percent of women entering treatment have children. These children are at high risk of child abuse and neglect, developmental problems, and adolescent substance use. (Werner, D., Young, N.K., Dennis, K, & Amatetti, S., 2007). It is also noted that the family-centered model includes a continuum of family-based clinical and community support services that address many factors for women and their families, such as substance misuse; mental health; physical health; developmental health; and social, economic, and environmental needs. Because women place high values on their relationships and families, treatment should focus on promoting and supporting healthy attachment and relationships between parents and children and on women's relationships with others. Family-centered treatment helps not only the woman dealing with adverse outcomes of drug use - it also helps her family and their needs.

Therefore, successful applicants will also include evidence-based practices in the following areas in the development of their enhanced PPW-OUD services:

1) Family-support

2) Trauma-Informed Care

3) Counseling

4) Screening tools

5) Parenting

6) Employment

7) Assessment of children

Please refer to SAMHSA's new Evidence Based-Practices Resource Center which contains scientifically-based resources for a broad range of audiences, including Treatment Improvement Protocols, toolkits, resource guides, clinical practice guidelines, and other science-based resources. https://www.samhsa.gov/ebp-resource-center.

Key program components

  • Ability to enhance OUD services to pregnant and post-partum women either directly as an OTP or with a strong relationship with an OTP. Develop a plan for access to methadone and buprenorphine for the targeted population.
  • Facilitate the availability of family-based treatment and recovery support services. This includes the provision of services for pregnant and postpartum women, their minor children, age 17 and under, and other family member of the women and children as deemed necessary.
  • Strong collaborative relationship with a hospital and/or or FQHC and ob/gyn's. Evidence provided through a letter of support or MOU.
  • Trauma-informed system of assessments, interventions, and social-emotional skill building services; and
  • Certified Doula Peer Recovery Specialist requires certification as a CPRS as well as obtaining both the birth and post-partum doula certifications
  • Care coordination and case management to ensure Medicaid benefits and other mainstream benefits are assessed and coordinated.
  • Promote effective and efficient coordination and delivery of services across multiple systems and providers (e.g., behavioral health, primary care, housing, child and family services).
  • Recovery support services (e.g., child care, vocational, educational, and transportation services)
  • Outreach, engagement, screening, and assessment
  • Provide developmentally appropriate screenings and activities
  • Ensure culturally appropriate services
  • Ability to serve 25 PPW and their families annually during the project period.

Other components (not required but encouraged):

* Staff with the Gender Competency Endorsement (GCE). Information about the endorsement can be found at the Illinois Certification website: http://www.iaodapca.org/credentialing/womens-endorsement/ 

Performance

Successful applicants will be responsible for providing enhanced family-based services to pregnant and postpartum women with a primary, secondary, or tertiary diagnosis of opioid use disorder (OUD). Programs will include the use of evidence-based screening, referral, family -based treatment interventions, and recovery support services, for pregnant and postpartum women with OUD and their families. Programs will also be in compliance with the programmatic and reporting requirements specified in the current IDHS/SUPR Contractual Policy Manual, and Title 77, Illinois Administrative Code Rule 2060. Successful applicants will also be responsible for collecting and reporting data that will allow IDHS/SUPR to be in compliance with SAMHSA SOR grantee expectations. This data will also assist IDHS/SUPR in evaluating the client outcomes that are associated with these enhanced pregnant and post-partum women with OUD services.

Deliverables

Successful applicants will be responsible for the following deliverables and associated timelines.

  1. Development of an approved project implementation plan within 30 days of award that will enable the delivery of services within the first 60 days of receiving the award. This must include approved staffing, timeline for staff obtaining Certified Peer Recovery Specialist (CPRS) status, dual certification as both a birth and a postpartum doula, other chosen evidence-based practices and development of partnerships with hospitals, obstetricians and gynecologists.
  2. Submit the agency's cultural competence plan within 90 days of award.
  3. Submit copies of current referral linkage agreements and Memoranda of Understanding (MOU's) within 30 days of award.
  4. Submit evidence of staff obtaining the CPRS and dual (birth and post-partum) doula certifications by 6/30/19.
  5. Achieve 100% of their target for admission of NEW patients to the enhanced PPW-OUD services for the SFY2019 funding period.
  6. Ensure that an IDHS Recipient Identification Number (RIN) has been assigned to each person admitted to PPW-OUD services. The IDHS RIN will be used as the unique non-identifying number that will be used for all baseline and follow-up data collection tools.
  7. Enter required PPW-OUD client descriptive and service delivery data in the IDHS/SUPR DARTS system in accordance with established timelines.
  8. Submission of monthly reports of quantitative service delivery data and narrative information detailing the development of the network. The report format will be developed by IDHS/SUPR to be compliant with SAMHSA SOR grantee reporting requirements as stated in the federal FOA, and which may be communicated to state grantees by SAMHSA post-award. IDHS/SUPR will provide directions for the completion of these reports and their submission. The monthly reports will be due within 15 calendar days of the end of the reporting month.
  9. Administration of the baseline version of the SAMHSA/CSAT GPRA data collection to each person admitted to the enhanced PPW-OUD services. The baseline version of this tool shall be administered within 7 calendar days of admission or opening date in DARTS. The funded organization will be responsible for completion of the version of the CSAT/GPRA tool that is completed at time of discharge from the enhanced PPW-OUD services. IDHS/SUPR will provide training on the administration and completion of these SAMHSA/CSAT GPRA tool versions, along with instructions for the submission of completed tools.
  10. Collaboration with an IDHS/SUPR external evaluator that will be responsible for administration of the CSAT/GPRA tool to participating women at three-month and six-month post-admission follow-up. This collaboration will include assistance in obtaining and updating information that will be used to contact admitted women for these follow-up interviews.
  11. Participate in additional information and data collection activities that will be associated with documentation of these expanded and enhanced Women's OUD services.
  12. Participate in site visits by IDHS/SUPR and/or contractor staff that will include sample reviews of PPW-OUD patient records.
  13. Submit quarterly progress reports by the 30th of each month for the preceding quarter.
  14. Present progress to the Illinois Advisory Council and/or Women's Committee
  15. Submit monthly Contract Expenditures Payment Voucher no later than the 15th day of each month for the preceding month by e-mail.

B. Funding Information

  1. This grant program is 100% Federally-funded. Funding for this award will come from the SAMHSA Opioid SOR grant award to IDHS/SUPR and does not have a match requirement. This NOFO is considered a new application.
  2. In SFY2019, IDHS anticipates the availability of approximately $542,000 for eligible applicants.
  3. There is a maximum amount of $271,000 for an award to a qualified organization within the limit of available funding.
  4. Subject to appropriation, the grant period will begin upon the execution of the grant agreement and will continue through September 29, 2020 contingent on the availability of federal funding.
  5. Pre-award costs for services in anticipation of an award are not allowable.
  6. Grant funds are to be used to support non-Medicaid eligible services.
  7. Budgets may include costs for the doula certifications (birth and postpartum) and CPRS certification, including training.
  8. Applicants may submit only one proposal.
  9. Subcontractor Agreement(s) and budgets must be pre-approved by and on file with IDHS. Subcontractors are subject to all provisions of the Agreement(s). The successful applicant agency shall retain sole responsibility for the performance of the subcontractor.

NOTE: The release of this NOFO does not obligate IDHS to make an award.

C. Eligibility Information

Eligible Applicants. This competitive funding opportunity requires licensure by IDHS/SUPR in order to start services.

To be eligible to receive funding under this Notice of Funding Opportunity (NOFO) the applicant must have completed the following Pre-award Requirements:

  1. Authentication- entities must create an account in the Illinois.gov Authentication Portal.
  2. Grantee Registration - Grantees must be registered with the State of Illinois. Grantee Registration is completed by going to https://grants.illinois.gov/ portal and linking the Illinois.gov account to the organization.
  3. Grantee Pre-qualification - Providers should be directed to become prequalified if not, update state and federal registrations. Language should also be included in the competitive NOFO and any communications pertaining to the NOFO. If this is for a Non-competitive NOFO or "Non-NOFO" and the provider is not prequalified, they should not be included in the application.
    1. Valid DUNS number
    2. Current SAM.gov account
    3. Not be on the Federal Excluded Parties List
    4. Good Standing with the Illinois Secretary of State
    5. Not be on the Illinois Stop Payment list
    6. Not be on the Illinois Department of Healthcare and Family Services Provider Sanctions list
  4. Fiscal and Administrative Risk Assessment (ICQ)
  5. Programmatic Risk Assessment (PRA)

Cost Sharing or Matching.

Not applicable.

Indirect and Direct Administrative Costs.

Federally Negotiated Indirect Cost Rate Agreement (NICRA) - Organizations that receive direct federal funding may have an indirect cost rate that was negotiated with the Federal Cognizant Agency. Illinois will accept the federally negotiated rate. The organization must provide a copy of the Federal NICRA letter.

State Negotiated Rate - The organization must negotiate an indirect cost rate with the State of Illinois if it does not have a Federally Negotiated Indirect Cost Rate or the organization may elect to use a de minimis rate. The indirect cost rate proposal must be submitted to the State of Illinois within 90 days of the notice of award.

An organization that has never received a Federally Negotiated Indirect Cost Rate may:

1. Elect a de minimis rate of 10% of modified total direct costs (MTDC). Once established, the de minimis rate may be used indefinitely. The State of Illinois must verify the calculation of the MTDC annually in order to accept the de minimis rate,

OR

2. Choose to not charge an indirect rate to the award at all.

Training and Technical Assistance:

Programs must agree to receive consultation technical assistance from authorized representatives of the Department. This technical assistance will include training on the administration and submission of SAMHSA/CSAT Government Performance and Results Act (GPRA) required for any program staff involved in the enrollment of clients into the project. The program and collaborating partners will be required to be in attendance at any site visits by IDHS/SUPR staff. Programs will be required to attend regular meetings and trainings as provided by IDHS or a subcontractor of IDHS. This will include team participation in a learning collaborative.

Sectarian Issue:

Applicant organizations may not expend federal or state funds for sectarian instruction, worship, prayer, or to proselytize. If the applicant organization is a faith-based or a religious organization that offers such activities, these activities shall be voluntary for the individuals receiving services and offered separately from the program.

Background Checks:

Background checks are required for all program staff and volunteers who have the potential for one-on-one contact with children and youth. Funded programs will be required to have a written protocol on file requiring background checks, as well as evidence of their completion.

Other: In NO case will more than one proposal be funded within the same geographic area or in overlapping geographic areas. Applicants may be asked to revise their originally proposed catchment area to ensure that this is the case.

D. Application and Submission Information

  1. Proposal Container and Format Requirements: All applications must be typed on 8 1/2 x 11-inch paper using 12-point type and at 100% magnification. Tables may be used to present information with a 10-point type.
  2. The program narrative must be typed single-spaced, on one side of the page, with 1-inch margins on all sides. The program narrative must not exceed the page totals specified in Section D: Application and Submission Information, #2 - Content and Form of Application Submission.
  3. The entire application, including appendices, must be sequentially page numbered (hand written page numbers are acceptable). Items included in other than the program narrative NOT included in the page limitations. The program narrative has a maximum of 10 pages.
  4. Applicants must submit the proposal via an email. Submit the proposal to DHS.GrantApp@Illinois.Gov. The Department is under no obligation to review applications that do not comply with the above requirements.
  5. The Agency Opportunity Number and the program contact must be in the subject line. Specifically, the subject line must be:
    • Your Organization Name, 19-444-26-1746-01, Joseph Tracy
  6. Successful applicants will be required to submit a complete electronic version of their approved application and budget.
  7. Uniform Grant Budget Template and Uniform Grant Budget Template Instructions can be found at http://www.dhs.state.il.us/page.aspx?item=85366
  8. Applicants must submit a single proposal in pdf format. All items, including attachments and appendices, must be scanned or "pdf'd" into a single file.
  9. ALL Applications MUST include the following mandatory attachments sent as three separate pdf files in a single email corresponding to the sections below and labeled according to the following conventions:
    • Uniform State Grant Application: Your Organization Name, 19-444-26-1746-01, Uniform State Grant Application
    • Grant Expense-Based Budget Template (pdf): Your Organization Name, 19-444-26-1746-01, Grant Expense-Based Budget
    • Proposal Narrative (following the headings in Section E): Your Organization Name, 19-444-26-1746-01, Proposal Narrative

Please use your organization's full legal name on all forms and documents. (An abbreviation in the filename and subject line is allowed as long as it is consistent throughout.)

Materials are provided throughout the announcement. Appendices will be made available in user/printer friendly format and may be found on the Illinois Department of Human Services web site at: http://www.dhs.state.il.us/page.aspx?item=101591. Please click on the corresponding link to the right. Additional copies may be obtained by contacting the contact person listed below.

Contact:

Joseph Tracy

Illinois Department of Human Services

Division of Substance Use Prevention and Recovery

401 South Clinton, 2nd Floor

Chicago, IL 60607

email: Joseph.Tracy@illinois.gov

phone: 312.814.6359

Each applicant must have access to the internet. The IDHS website will contain information regarding the NOFO and materials necessary for submission. Questions and answers will also be posted on the Department's website as described later in this announcement. It is the responsibility of each applicant to monitor that website and comply with any instructions or requirements relating to the NOFO.

Letter of Intent Requested

A letter of intent is requested to allow SUPR staff to estimate the potential review workload and plan the review. The letter is not required, is not binding, and does not enter into the review of a subsequent application.

Applicants are requested to submit a letter of intent on or before 11/13/2018 and should include the following:

  • Number and title of this funding opportunity
  • A few sentences describing the proposed project
  • Agency Name and a contact name, email address and telephone number(s)

The letter of intent should be sent to: Joseph.Tracy@illinois.gov

The Agency, Opportunity Number and the label "LOI" (letter of intent) must be in the subject line. Specifically, the subject line must be:

* Your Organization Name, 19-444-26-1746-01, LOI

E. Application Review Information

Proposal Narrative Content:

Applicants must submit a proposal that contains the information outlined below. Each section must have a heading that corresponds to the headings in bold type listed below. Within each section, you must indicate the Section letter and number in your response, i.e., type "A-1", "A-2", etc., before your response to each narrative item. If the applicant believes that the subject has been adequately addressed in another part of the application narrative, then provide the cross-reference to the appropriate part of the narrative. The narrative portion must follow the page guidelines set for each section and must be in the order requested.

Formatting:

The Proposal Narrative text must be legible. Pages must be typed in black on letter-size (81/2 x 11) paper, single-spaced, using a font of Times New Roman 12, with all margins (left, right, top, bottom) at least one inch each. You may use Times New Roman 10 only for charts, tables, and footnotes. Pages must be numbered consecutively from beginning to end of the Proposal Narrative. The page limit for the Proposal Narrative is 10 pages. Any narrative information that exceeds the 10-page limit will be discarded and excluded from the review process.

Applicant organizations must provide the following information.

A. Organization Qualifications (20 points). The purpose of this section is for the applicant to provide a description of the organization's experience and qualifications generally, and specific to the provision of PPW-OUD services.

  1. Provide a brief description of the full array of services provided by your organization. Include numbers of persons served annually in your service programs, and the general demographics of service program participants.
  2. Describe the PPW services currently provided by your organization, to include the site locations of these services, the number of persons served during SFY2017 or SFY2018 (please indicate which year you choose), and the demographic characteristics of these women (race, average age, Hispanic/Latino ethnicity, and sexual identity). Provide information regarding the number of women served through your program during the selected year. Describe any focus on special populations, particularly co-occurring, families involved with DCFS, involvement with the criminal justice system and homelessness.
  3. Provide a brief description of the staff members that will be responsible for the delivery of the PPW services, including their educational background, organizational affiliation, years of experience and other relevant information. Identify whether you currently have a doula, a doula peer recovery specialist or a peer recovery specialist interested in becoming a doula already on staff. Describe how the agency will support the identified individual with lived experience obtain or maintain the required certifications (CPRS and dual doula certifications) as well as provide ongoing supervision.
  4. Provide a summary of existing linkages between the key partners and with external community resources and services, particularly with organizations addressing employment, human and health services not provided by the applicant organization. Highlight linkages with healthcare providers i.e. hospitals, FQHC's, obstetricians and gynecologists.

B. Population of Focus and Statement of Need (20 points). The purpose of this section is to describe the characteristics of the persons who will be served through the enhanced PPW services.

  1. Provide a comprehensive demographic profile of the PPW population in your identified geographic area in terms of race, ethnicity, language, gender identity, sexual orientation, age, housing and socioeconomic status. (Socioeconomic status (SES) is an economic and sociological combined total measure of a person's work experience and of an individual's or family's economic and social position in relation to others, based on income, education, and occupation.)
  2. Provide evidence of the need for enhanced PPW services by describing the nature of the problem and any service gaps identified in the targeted geographic area for the population. Include the source of the data provided.
  3. Provide a summary of the impacts of the opioid crisis among residents of the proposed geographic service area(s). Include mention of your organization's involvement in local activities and strategies in response to the opioid crisis.
  4. Describe how your application addresses the shortage of family-based addiction treatment in your area(s) of service.

C. Description of Plan and Scope (40 points). Provide the following information regarding the proposed enhanced PPW services that will be delivered in the identified geographic service area(s).

  1. Provide an overview of your plan to implement all identified evidence-based practices and timeframes for staff trainings and/or certifications to be completed.
  2. Describe how you will identify, recruit and retain the target populations. Include specific strategies for identifying and engaging women early in their pregnancies (e.g., the first trimester).
  3. Describe how the enhanced PPW services will coordinate with existing programming and specifically any current programming for the PPW population within your organization.
  4. Identify and describe any collaborating partners. Describe their roles and responsibilities. (Linkages and MOU submission guidelines are outlined in the Deliverable Section. They should not be included as part of this application.)
  5. Describe the clinical and care management approaches that you will use to ensure coordination of care for patients and with partners.

i. Provide a summary of how of each of the evidence-based screenings and practices will be documented.

ii. Describe your approach for managing induction and stabilization for new patients.

iii. Explain assessment protocols including how you determine needs for counseling and recovery support services.

iv. Describe the coordination of MAT services with the enhanced PPW services and collaborating team members.

v. Describe your plan for monitoring PPW patients' health status, treatment progress, and services use to improve care and address gaps in care.

vi. Describe how you will deliver co-existing medical and support services needed by your clients. This can include health services, recovery support services and adjunct services such as transportation and child care.

vii. Describe how the doula peer recovery specialist will build a relationship with the patient and family prior to the birth.

viii. Describe your agency's medication diversion protocols.

6. Describe your use of the Illinois Prescription Monitoring Program in patient monitoring.

D. Performance Reporting (20 points). To ensure accountability at all levels of service provision, IDHS is implementing the practice of performance-based contracting with its grantee agencies. The articulation and achievement of measurable outcomes help to ensure that we are carrying out the most effective programming possible. At a minimum, applicants will be expected to collect and report data indicators and measures as described in this NOFO. The applicant agency must address the following items in regard to performance data collection and reporting.

  1. Describe your experience with in the collection and reporting of program service and performance data. Include mention of your organization's record of submitting the DARTS patient and service data that is required as part of your IDHS/SUPR contract. Make mention of any experience that your organization has with administration of the SAMHSA/CSAT GPRA tool.
  2. Describe your experience in utilizing the identified evidence-based screenings services and practices for the enhanced PPW services. Include mechanisms for ensuring fidelity to the screenings and practices.
  3. Describe your organizational procedures for collection, maintenance, and reporting of PPW client demographic and service data.
  4. Describe your capacity and commitment to collect and report the service and performance data specified in this PPW-OUD NOFO.
  5. Describe how you have shared program information (client data and results) with community stakeholders, institutions, and community representatives for planning and evaluation purposes.

E. Budget and Budget Narrative (No page limit-include as Attachment A) (Not scored)

The SFY2019 Service Enhancement for Pregnant and Postpartum Women with OUD contracts of successful applicants will contain expense-based budgets. Monthly invoices will be submitted that will detail expenditures per the approved IDHS/SUPR. Quarterly performance reports are required with shall summarize services/activities delivered, goals and objectives accomplished, challenges encountered for the quarter, as well as other information specified for project evaluation. The reports submitted will need to demonstrate compliance with the components of the contact.

Dun and Bradstreet Universal Numbering System (DUNS) Number and System for Award Management (SAM)

Each applicant is required to:

  • Be registered in SAM before submitting the application. The following link provides a connection for SAM registration: www.sam.gov
  • Provide a valid DUNS number in its application.
  • Continue to maintain an active SAM registration with current information at all times in which the applicant has an active Federal, Federal pass-through or State award or an application or plan under consideration by a Federal or State awarding agency.

IDHS may not make a Federal pass-through or State award to an applicant until the applicant has complied with all applicable DUNS and SAM requirements and, if an applicant has not fully complied with the requirements by the time IDHS is ready to make the award, IDHS may determine that the applicant is not qualified to receive the award and use that determination as a basis for making the award to another applicant.

Submission Dates and Times:

Applications must be received no later than 12:00 p.m. on 11/26/2018. The application container will be date and time-stamped upon receipt via email. The Department will not accept applications submitted by mail, overnight mail, diskette, or by fax machine.

Submit the completed grant proposal to DHS.GrantApp@Illinois.gov electronically on 11/26/2018 at 12:00 p.m. Applications must be emailed.

If you have trouble emailing the document due to the file size, please utilize the CMS File Transfer Utility located at https://filet.illinois.gov/filet/PIMupload.asp. Please follow the instructions to attach your application. Remember to include the subject line above.

To be considered, proposals must be emailed by the designated date and time listed above. For your records, please keep a copy of your email submission with the date and time the application was submitted along with the email address to which it was sent. The deadline will be strictly enforced. In the event of a dispute, the applicant bears the burden of proof that the proposal was received on date and time and to the email address listed above.

Intergovernmental Review --Not Applicable

Funding Restrictions:

A. The grant program is subject to the cost principles found in Subpart E 2 CFR 200.

B. Examples of unallowable costs include, but are not limited to:

  • Bad debts
  • Contingencies or provision for unforeseen events
  • Contributions and donations
  • Entertainment, food, alcoholic beverages, gratuities
  • Cash incentives to participate in treatment/recovery support sessions
  • Housing costs
  • Fines and penalties
  • Interest and financial costs
  • Legislative and lobbying expenses
  • Real property payments or purchases

C. Grant funds cannot be used for existing services provided by the applicant organization; the use of these funds to supplant existing resources is not allowed

D. The use of a federally-approved indirect cost rate for research is not allowable.

F. Award Administration Information

Criteria: Funding is not guaranteed. All applicants must demonstrate that they meet all requirements under this NOFO as described throughout. Applications that fail to meet the criteria described in "Eligible Applicants" as identified in Section C "Eligibility Information" will not be scored and considered for funding.

  • Review teams comprised of three individuals in IDHS serving in the Division of Substance Use Prevention and Recovery will be assigned to review applications. Applications will first be reviewed and scored individually. Scores will be sent to the application Review Coordinator to be compiled and averaged to produce the final application score.
  • Proposal Scoring: Application Narratives will be evaluated on the following criteria:
    • Lead Organization Qualifications- 20 points*
    • Population of Focus and Statement of Need -20 points
    • Description of Plan and Scope - 40 points
    • Performance Reporting - 20 points
    • Budget and Budget Narrative - Not scored
    • TOTAL 100 POINTS

Review and Selection Process:

Proposals will be reviewed by a panel established by staff from IDHS. Panel members will read and evaluate applications independently using guidelines furnished by IDHS. Scoring will be on a 100-point scale. Scoring will not be the sole award criterion. While recommendations of the review panel will be a key factor in the funding decisions, IDHS considers the findings of the review panel to be non-binding recommendations. IDHS maintains final authority over funding decisions and reserves the right to consider additional factors, such as geographical distribution of proposed service areas and patient population characteristics, when making final award decisions.

  • Final award decisions will be made by the Secretary, at the recommendation of the Director of the Division of Substance Use Prevention and Recovery. IDHS reserves the right to negotiate with successful applicants to cover under-served areas that may result from this process.
  • In NO case will more than one proposal be funded for the same provider organization. IDHS may contact applicants to obtain clarification regarding any aspects of an application prior to making any awards. IDHS is not obligated to make any State award as a result of the announcement.

Merit-Based Evaluation Appeal Process

Competitive grant appeals are limited to the evaluation process. Evaluation scores may not be protested. Only the evaluation process is subject to appeal and shall be reviewed by the IDHS' Appeal Review Officer (ARO).

Submission of Appeal.

Competitive grant appeals are limited to the evaluation process. Evaluation scores may not be protested. Only the evaluation process is subject to appeal and shall be reviewed by the IDHS' Appeal Review Officer (ARO).

Submission of Appeal.

An appeal must be submitted in writing to Danielle Kirby of IDHS/SUPR who will send to the ARO for consideration.

An appeal must be received within 14 calendar days after the date that the grant award notice has been published.

The written appeal shall include at a minimum the following:

i. The name and address of the appealing party.

ii. identification of the grant.

iii. A statement of reasons for the appeal.

Response to Appeal.

IDHS will acknowledge receipt of an appeal within 14 calendar days from the date the appeal was received.

IDHS will respond to the appeal within 60 days or supply a written explanation to the appealing party as to why additional time is required.

The appealing party must supply any additional information requested by IDHS within the time period set in the request.

Resolution

a. The ARO shall make a recommendation to the Agency Head or designee as expeditiously as possible after receiving all relevant, requested information.

b. In determining the appropriate recommendation, the ARO shall consider the integrity of the competitive grant process and the impact of the recommendation on the State Agency.

c. The Agency will resolve the appeal by means of written determination.

d. The determination shall include, but not be limited to:

e. Review of the appeal;

f. Appeal determination; and

g. Rationale for the determination.

G. State Awarding Agency Contact(s)

  1. State Award Notices: Applicants recommended for funding under this NOFO following the above review and selection process will receive a "Notice of State Award Finalist." This notice will identify additional grant award requirements that must be met before a grant award can be executed. These will include one or more of the following:
    • Grantee Pre-Qualification Process
    • Financial and Administrative Risk Assessment - Internal Control Questionnaire
    • Conflict of Interest and Mandatory Disclosures
  2. A Notice of State Award (NOSA): A NOSA will be issued to the review finalists that have successfully completed all grant award requirement. Based on the NOSA, the review finalist is positioned to make an informed decision to accept the grant award. The NOSA shall include:
    • The terms and condition of the award.
    • Specific conditions assigned to the grantee based on the fiscal and administrative and programmatic risk assessments.
    • Upon acceptance of the grant award, announcement of the grant award shall be published by the awarding agency to Grants.Illinois.gov.
    • A Notice of Non-Selection as a State Award Finalist shall be sent to the applicants not receiving awards.
    • The NOSA must be signed by the grants officer (or equivalent). This signature effectively accepts the state award and all conditions set forth within the notice. This signed NOSA is the authorizing document. The Agency signed NOSA must be remitted to the Department as instructed in the notice.
  3. Administrative and National Policy Requirements: The agency awarded funds shall provide services as set forth in the IDHS grant agreement and shall act in accordance with all state and federal statutes and administrative rules applicable to the provision of the services.
    • To review a sample of the FY2019 IDHS contract/grant agreement, please visit the IDHS website at http://www.dhs.state.il.us/page.aspx?item=29741.
    • The agency awarded funds through this NOFO must further agree to comply with all applicable provisions of state and federal laws and regulations pertaining to nondiscrimination, sexual harassment and equal employment opportunity including, but not limited to: The Illinois Human Rights Act (775 ILCS 5/1-101 et seq.), The Public Works Employment Discrimination Act (775 ILCS 10/1 et seq.), The United States Civil Rights Act of 1964 (as amended) (42 USC 2000a-and 2000H-6), Section 504 of the Rehabilitation Act of 1973 (29 USC 794), The Americans with Disabilities Act of 1990 (42 USC 12101 et seq.), and The Age Discrimination Act (42 USC 6101 et
  4. Indirect Cost Rate Requirements:

Federally Negotiated Indirect Cost Rate Agreement (NICRA) - Organizations that receive direct federal funding may have an indirect cost rate that was negotiated with the Federal Cognizant Agency. Illinois will accept the federally negotiated rate. The organization must provide a copy of the Federal NICRA letter which confirms a valid federal rate for the SFY2019 time period.

State Negotiated Rate - The organization must negotiate an indirect cost rate with the State of Illinois if it does not have a Federally Negotiated Indirect Cost Rate or the organization may elect to use a de minimis rate. The indirect cost rate proposal must be submitted to the State of Illinois within 90 days of the notice of award.

De Minimis Rate - An organization that has never received a Federally Negotiated Indirect Cost Rate may elect a de minimis rate of 10% of modified total direct costs (MTDC). Once established, the de minimis rate may be used indefinitely. The State of Illinois must verify the calculation of the MTDC annually in order to accept the de minimis rate.

5. Reporting:

a. The Provider will submit Contracts Expenditures Payment Vouchers in the format prescribed by IDHS SUPR. The CEPVs must be submitted no later than the 15th day of each month for the preceding month by email.

b. The Provider will be responsible for the deliverables and data collection and reporting expectations listed in Section A of this NOFO.

c. The Provider will submit audits and/or Financial Reports in a format provided by the Department and by the established deadlines.

H. Other Information, if applicable

Questions and Answers: If you have questions related to this NOFO, please send them via email to: Joseph.Tracy@illinois.gov with "PPW-OUD - NOFO" in the subject line of the email. NOTE: The final deadline to submit any written questions regarding the PPW-OUD - NOFO is 11/13/2018.

Mandatory Forms -- Required for All Agencies

  1. GA-19-444-26-1746-01 (pdf)
  2. Uniform Grant Budget Template | Instructions

Important Dates for this NOFO

What? When? Who?/Where? Subject of Email
Letter of Intent 11/13/2018 Joseph.Tracy@illinois.gov Your Organization Name, 19-444-26-1746-01, LOI
Questions Submitted 11/13/2018 Joseph.Tracy@illinois.gov PPW-OUD - NOFO
Proposals Due 11/26/2018 DHS.GrantApp@Illinois.Gov Your Organization Name, 19-444-26-1746-01, LOI

Attachments:

Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants: https://store.samhsa.gov/shin/content//SMA18-5054c/SMA18-5054.pdf 

Websites:

SAMHSA Publications: http://store.samhsa.gov/

American College of Obstetricians and Gynecologists: https://www.acog.org/

Illinois Department of Public Health: http://www.dph.illinois.gov/sites/default/files/publications/publicationsowhnas-annual-report.pdf 

The Doula Services Network: http://doula-services.com/category/become-a-doula/

Evidence-Based Practices Resource Center: https://www.samhsa.gov/ebp-resource-center

Illinois Certification Board/CPRS: http://www.iaodapca.org/credentialing/certified-peer-recovery-specialist-cprs/ 

Illinois Certification Board/Women's Endorsement: http://www.iaodapca.org/credentialing/womens-endorsement/