19-444-26-1747-01 NOFO SOR Hospital Screening and Warm Handoff

Helping Families. Supporting Communities. Empowering Individuals.

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: 19-444-26-1747-01
6. Funding Opportunity Title: SOR Hospital Screening and Warm Handoff
7. CSFA Number: 19-444-26-1747-01
8. CSFA Popular Name: SOR Hospital Screening and Warm Handoff
9. CFDA Number(s): 93.788
10. Anticipated Number of Awards: 5-7
11. Estimated Total Program Funding: $5 million per year for two years
12. Award Range $500,000-$1,000,000 per year
13. Source of Funding: Federal
14. Cost Sharing or Matching Requirement: No
15. Indirect Costs Allowed Yes
Restrictions on Indirect Costs

Yes

2 CFR 200 /45 CFR Part 75

16. Posted Date: 10/10/2018 - 12/3/2018
17.Application Range: Due December 3, 2018
18. Technical Assistance Session:

Session Offered: Yes
Session Mandatory: No
Thu, Oct 18, 2018 2:00 PM - 4:00 PM CDT

Copy of the TA Session (pptx)

NOFO

A. Program Description

Purpose

This funding opportunity is intended to support the creation of hospital-based programs that provide robust, evidence-based screening, brief intervention, and referral to treatment (SBIRT) and warm handoff services to persons with opioid use disorder(OUD) and/or other substance use disorders (SUD).

Definitions

Certified Peer Recovery Specialist (CPRS): Individuals trained to incorporate their unique personal experience in their own recovery with a distinct knowledge base and human service skills. Additional information about CPRS professionals can be found at http://www.iaodapca.org/credentialing/certified-peer-recovery-specialist-cprs/.

DATA Waivered Provider: A physician, nurse practitioner, or physician assistant authorized by the federal government to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000). Additional information can be found at

https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/training-materials-resources/buprenorphine-waiver.

Medication-Assisted Treatment (MAT): The use of one of three FDA-approved medications - buprenorphine, methadone, and naltrexone - coupled with a comprehensive treatment plan that is delivered in a manner that is consistent with IDHS/SUPR licensure standards. When delivered in a non-hospital setting the provider organization must be licensed by IDHS/SUPR.

Motivational Interviewing: A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.

Recovery Support: Culturally and linguistically appropriate services that assist individuals and families working toward recovery from substance use problems. They incorporate a full range of social, legal, and other services that facilitate recovery, wellness, and linkage to and coordination among service providers, and other supports shown to improve quality of life for people in and seeking recovery and their families.

Screening, Brief Intervention, and Referral to Treatment (SBIRT): An evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. The SBIRT model was cited by an Institute of Medicine recommendation that called for community-based screening for health risk behaviors, including substance use.

Warm Handoff: A referral to treatment in which the patient receives support and motivation sufficient to engage in and adhere to ongoing treatment. A warm handoff goes beyond providing a written referral or scheduling an appointment. It involves establishing a collaborative relationship with the patient, providing practical, personalized support for entering and adhering to treatment, and, in coordination with treatment providers, delivering ongoing recovery support services based upon patient needs.

Background

In June 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued Funding Opportunity Announcement #TI-18-015, State Opioid Response Grants (SOR). This SAMHSA grant program aims 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, 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).

On August 14, 2018, the Illinois Department of Human Services, Division of Substance Use Prevention and Recovery (IDHS/SUPR) submitted an application in response to SAMHSA FOA #TI-18-015. This application proposed a comprehensive continuum of OUD outreach, referral to MAT, recovery support, and prevention services in response to the critical nature of the opioid crisis in Illinois. Decisions regarding the service components of this continuum were based on input from the strategic plan developed during Year 1 of Illinois's Opioid - State Targeted Response (STR) grant, and on learnings and experience gained from implementation of Opioid-STR services. IDHS/SUPR received notice of an SOR grant award on September 20,2018.

Need for Hospital-Based SBIRT and Warm-Handoff Services

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.

Inclusion of Hospital-Based Services in Illinois' SOR Grant Goals and Objectives

The grants that will be funded through this NOFO are consistent with the below SAMHSA-funded Illinois SOR award goal and objective:

  • Project Goal 2: Increase the availability of evidence-based information, outreach, linkage/referral, MAT, recovery support, and prevention services that are available for Illinois residents with OUD.
  • Project Objective 2.3: Increase OUD screening and "warm handoff" services in multiple general hospital emergency departments and inpatient units.

$5M per year of the total SOR grant funds received from SAMHSA are designated for the expansion of hospital-based screening, brief intervention, and referral to treatment (SBIRT) services that are targeted toward persons with OUD. It is anticipated that five to seven hospitals will be selected as subrecipients. IDHS/SUPR has a target of delivering SBIRT and warm handoff services to 500 unduplicated clients throughout the state during each of the two years of SAMHSA SOR grant funding.

Program Requirements

Successful applicants will be responsible for implementing a robust SBIRT program to identify hospital patients with OUD and facilitate their engagement in treatment through an intensive discharge planning process. Eligible applicants will be general hospitals licensed by the State of Illinois, with the intent that these services will be provided by hospital personnel and not through contractual agreements with external organizations. Hospitals partnering with external organizations that have been funded to provide screening and warm handoff services through the Opioid-STR grant to IDHS/SUPR are not eligible for funding under this opportunity.

Successful grantees will develop their model for providing SBIRT and warm handoff according to the specific needs and resources of their patients with OUD, their hospitals, and the communities they serve. While these models must address how patients with OUD will be identified and engaged during their time in the hospital emergency department and/or inpatient units, this funding opportunity is particularly focused on the warm handoff process. Successful grantees will demonstrate how SOR grant funds and hospital resources will be leveraged to ensure that patients with OUD are discharged with the personal motivation, practical plans, and skilled support needed to transition successfully into ongoing treatment.

Performance

Successful applicants will be responsible for collecting and reporting data that will allow IDHS/SUPR to comply with SAMHSA SOR grantee expectations. This data will also assist IDHS/SUPR in evaluating the patient outcomes associated with this approach. Required data collection will include administration of the baseline version of an interview tool to each patient who receives warm handoff services. (The follow-up version of this tool will be administered by an IDHS/SUPR-contracted SOR evaluator and will not be the grantee's responsibility). SUPR will provide training on administration of this tool as well as instructions regarding the submission of completed baseline interview tools. The development of applicant staffing patterns should take into account consideration of this data collection and reporting requirement. SUPR also anticipates supporting a process evaluation of the development, implementation, and functioning of the hospital screening and warm handoff projects. Successful applicants will be expected to cooperate with the information and additional data collection requirements that will be associated with this process evaluation. This NOFO's program narrative must include a statement that the applicant agrees to comply with these data collection and reporting expectations.

As noted above, successful grantees will propose a model for providing SBIRT and warm handoff that addresses the specific needs and resources of their patients with OUD, their hospitals, and the communities they serve. At a minimum, the models must include a number of key components related to program design and organizational capacity:

Program Design

  • Use of evidence-based approaches, including SBIRT and motivational interviewing techniques, to identify patients with OUD and facilitate entry to treatment. Grantees will be expected to provide 24-hour coverage for screening and brief intervention.
  • Primary reliance on Certified Peer Recovery Specialists (CPRS) to engage patients with OUD and facilitate warm handoffs.
  • Assessment for most appropriate type of MAT prior to discharge. Induction of buprenorphine, if clinically appropriate, in consultation with intended SUD treatment provider(s) and with clear plan for subsequent administration. If another type of MAT is indicated, is should be addressed in the intensive discharge planning described below.
  • Intensive discharge planning that addresses each patient's unique treatment needs, including ongoing MAT and adjunct support through counseling, and additional social concerns such as housing and employment. Grantees will be expected to maintain staffing patterns to ensure this service is readily available prior to discharge. This process should include pre-discharge telephone call(s) or visit(s) between patient, CPRS professionals, and service providers to schedule intake appointment(s) to occur promptly upon discharge.
  • Consultation with patient, family (if appropriate), insurance provider (if the patient has coverage), and treatment provider(s) to confirm that the recommended course of treatment is covered and/or affordable.
  • In consultation with the IDHS/SUPR learning collaborative, distribution of Naloxone prior to discharge to all patients with a positive screen for OUD.
  • Provision of transportation to and from the intake appointment to ensure that the patient arrives and is engaged by intake staff.
  • Provision of ongoing case management and recovery support to ensure that patients remain engaged in treatment over time. This may include continuing to help patients navigate stages of change and addressing practical considerations such as transportation and scheduling.

Organizational Capacity

  • Designation of a member of the hospital's senior leadership team who will champion the program, ensure rapid integration with hospital operations, and participate in monthly IDHS/SUPR SOR Hospital Warm Handoff grantee meetings.
  • Designation of a project director who will oversee the day-to-day operations of the program, serve as a point person for communications with IDHS/SUPR, and attend required meetings and learning collaborative sessions, including monthly IDHS/SUPR SOR Hospital Warm Handoff grantee meetings.
  • Maintenance or establishment of a referral network of IDHS/SUPR-licensed outpatient MAT and other SUD treatment providers sufficient to serve the patients referred through this program. It is expected that the hospital will establish linkage agreements and routine communications with providers in this network to monitor capacity and ensure smooth, timely transitions.
  • Maintenance or establishment of a referral network of other health and human services providers who can address a broad spectrum of patient needs, including mental health treatment, pain management, housing, family supports, life skills, job development, and peer recovery supports.
  • Participation in a learning collaborative addressing SBIRT, naloxone distribution, and other issues relevant to SOR grant goals and objectives.
  • Commitment to achieving and/or maintaining a sufficient number of DATA-waivered physicians, physician assistants, and nurse practitioners to meet the induction needs of patients identified through this project.

Technical Assistance

Various technical assistance opportunities will be available to grantees, including webinars and learning collaborative sessions designed to assist hospitals launching and expanding screening and warm-handoff services.

B. Funding Information

  • * This grant program is 100% federally-funded. Funding for this award will come from the Substance Abuse and Mental Health Services Administration, State Opioid Response (SOR) Grant (TI010018) award to IDHS/SUPR and does not have a match requirement. The federal funding period for this award is expected to run from September 30, 2018-September 29, 2020.
  • This NOFO is considered a new application.
  • Contracts will be awarded on a State Fiscal Year basis, anticipated to begin in the second quarter of SFY2019 and conclude in the second quarter of SFY2021. During this 24-month period, IDHS anticipates the availability of approximately $10,000,000 for eligible applicants.
  • 5-7 grants will be awarded, ranging from $500,000-$1,000,000 per year for two years.
  • Subject to appropriation, the grant period will begin upon the execution of the grant agreement and will continue for 24-months. It is expected that all deliverables will be completed during the grant period.
  • Pre-award costs for services in anticipation of an award are not allowable.
  • Each hospital may submit only one application. A hospital system seeking funding for screening and warm handoff services in multiple hospitals must submit separate applications for each hospital.
  • Unexecuted (not signed) Subcontractor Agreement(s) and budgets must be pre-approved by and on file with IDHS, in accordance with the "Subawards" section of the current Contractual Policy Manual. Subcontractors are subject to all provisions of the Agreement(s). The successful applicant agency shall retain sole responsibility for the performance of the subcontractor.

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 November 26, 2018 at 5:00pm 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, 19-444-26-1747-01, LOI

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

C. Eligibility Information

To be eligible to receive funding under this Notice of Funding Opportunity (NOFO) the applicant must be in good standing with all State and federal tax entities and be certified as a vendor with the Illinois Office of the Comptroller.

All applicants are required to provide the requested information as outlined in this NOFO to be considered for funding in SFY2019. Successful proposals will serve as the applicant's program plan and budget for the SFY2019 grant period. Funding will continue through September 2020, dependent upon continued federal funding and successful provider performance.

Applicant agencies will not be eligible for a grant award until they have pre-qualified through the Grant Accountability and Transparency Act (GATA) Grantee Portal, www.grants.illinois.gov.

During pre-qualification, Dun and Bradstreet verifications are performed including a check of Debarred and Suspended status and good standing with the Secretary of State. The pre-qualification process also includes a financial and administrative risk assessment utilizing an Internal Controls Questionnaire (ICQ).

If applicable, the agency will be notified that it is ineligible for award as a result of the Dun and Bradstreet verification, and if corrective action is needed to become eligible for a grant award.

There are no cost sharing or matching requirements for this funding opportunity.

Indirect costs are allowed.

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.

Other:

Agencies awarded funds through this NOFO must have a computer and system supports that meet the following minimum specifications for the purpose of utilizing the required IDHS reporting forms and the receipt/submission of electronic program and fiscal information:

Internet access, preferably high-speed

Scanning and Email capabilities

Microsoft Excel

Microsoft Word

Training and Technical Assistance:

Programs must agree to receive consultation technical assistance from authorized representatives of the Department. 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.

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, 19-444-26-1747-01, 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" and sent in a single e-mail.
  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, 19-444-26-1747-01, Uniform State Grant Application
    • Grant Expense-Based Budget Template (pdf): Your Organization Name, 19-444-26-1747-01, Grant Expense-Based Budget
    • Proposal Narrative (following the headings in Section E): Your Organization Name, 19-444-26-1747-01, 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 Alcoholism and Substance Abuse

401 South Clinton, 2nd Floor

Chicago, IL 60607

email: Joseph.Tracy@illinois.gov (note that this is not the application submission email address)

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.

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. Lead Organization Qualifications (20 points).

  1. Provide a brief description of the full array of services provided by your hospital. Include the number and demographic characteristics (e.g., race, gender, age, Hispanic/Latino ethnicity, sexual identity, and area of residence) of persons services annually by the hospital, with specific figures for departments where you propose to implement SBIRT and warm handoff services (e.g., emergency department, medical/surgical unit, labor and delivery).
  2. What is your hospital's capacity to implement the proposed program? Include in your response:

a. Experience with SBIRT and motivational interviewing;

b. Capacity to add CPRS professionals to staffing array;

c. Capacity to establish a sufficient number of DATA-waivered providers to initiate treatment for patients with OUD identified under this program;

d. Service and referral networks relevant to substance use disorders.

  1. Provide the name of the member of your senior leadership team who will serve as champion for the proposed program and briefly describe their background, including education, years of experience, years of tenure in your organization, and ability to mobilize staff support for this project.
  2. Provide the name of the proposed project director who will be responsible for the day-to-day management of the project and briefly describe their background, including education, years of experience, experience managing comparable initiatives, and other relevant information.
  3. Describe the network of MAT service providers to which you currently refer patients for MAT services. Is it sufficient to serve the referrals your proposed program will generate, and if not, how will you expand this network? Describe additional linkages with external community resources including non-MAT SUD providers and agencies addressing employment and housing. Highlight any linkages with state or local human services or correctional organizations.

B. Population of Focus and Statement of Need (20 points).

In this section, identify and describe the population and communities that will gain access to hospital-based SBIRT and warm handoff services through this project, and discuss the impact that OUD has had on these groups.

  1. Define the geographic area(s) served by the hospital and provide a demographic profile of the area in terms of race, ethnicity, language, gender, age, rural/urban population, and socioeconomic (including insurance) status. Explain whether this demographic profile is consistent with the demographic characteristics of your hospital's patient population.
  2. Using the Illinois Department of Public Health's Opioid Data Dashboard (http://idph.illinois.gov/opioiddatadashboard/) and your hospital's own data, provide a summary of the impact of OUD among residents of the area served by your hospital and among patients of the hospital. Include the number of overdose deaths.
  3. Provide evidence of the need to develop hospital-based screening and warm handoff services.

C. Description of Plan and Scope (40 points).

Provide the following information regarding the plan to provide hospital-based OUD screening and warm handoff services.

1. Detailed description of the proposed program design - this should be a comprehensive description of how the program will work and include specific discussion of the following key components:

a. Describe how patients will be screened for OUD: how will evidence-based approaches such as SBIRT and motivational interviewing inform the screening protocol? Will patients in targeted departments be universally screened, or will screening be targeted based on certain indicators or risk factor? How will the hospital ensure that screening and brief intervention are available 24-hours per day in targeted departments?

b. Describe the role of Certified Peer Recovery Specialists (CPRS) relative to screening, patient engagement, and facilitating warm handoffs to treatment providers. How will the hospital recruit individuals with lived experience and support them in the process of becoming certified? How will the hospital ensure that CPRS professionals are introduced and integrated as a core member of the health care team?

c. Once a patient has had a positive screening for OUD and has been engaged by a CPRS professional, how will the patient be assessed for most appropriate type of MAT prior to discharge? How will induction of buprenorphine, if clinically appropriate, be handled? If another type of MAT is indicated, how will that be arranged?

d. What is the discharge planning process? How will the patient and various members of the health care team work with the CPRS professional to develop an ongoing treatment plan? How will patient be engaged to build enthusiasm for and ownership of the plan? Will staffing for intensive discharge planning be in place 24-hours a day? If not, how will the hospital ensure that the patient's discharge is not unduly delayed due to staff scheduling?

e. How will the program work with patient, family (if appropriate), insurance provider (if the patient has coverage), and treatment provider(s) to confirm that the recommended course of treatment is covered and/or affordable? It is expected that the CPRF professional will play a role in this process; patient financial services may also be involved.

f. Describe the process that the hospital will follow to dispense Naloxone prior to discharge to all patients with a positive screening for OUD. Applicants who have encountered barriers to dispensing Naloxone should describe those barriers and indicate their willingness to work with the learning collaborative to identify strategies for making the antidote available to patients with a positive screen for OUD.

g. How will patient transportation to and from the intake appointment be provided. How will the CPRS professional ensure that the patient arrives and is engaged by intake staff?

h. How will CPRS professionals remain available to patients after discharge to deliver case management and recovery support as needed? Hospitals are not expected to become outpatient service providers, but some ability for discharged patients to remain connected to the CPRS professionals is desirable.

2. Detailed description of how the hospital will establish, maintain, and sustain the organizational capacity to deliver OUD screening and warm handoff services, including:

a. How will the senior leader champion the proposed program to ensure that managers at all levels of the hospital are aware of this initiative and supportive of changes that may be required to accommodate screening and intensive discharge planning?

b. How will the project director interact with all hospital staff, including senior leadership, clinical and business managers, and CPRS professionals to ensure efficient operations?

c. How will the applicant establish and maintain a robust referral network of DHS/SUPR-licensed outpatient MAT and other SUD treatment providers sufficient to serve the patients referred through this program? Who will be responsible to forming relationships, monitoring capacity, and addressing care coordination concerns?

d. How will the applicant establish and maintain a referral network of other health and human services providers who can address a broad spectrum of patient needs, including mental health treatment, pain management, housing, family supports, life skills, job development, and peer recovery supports?

e. How will the applicant bring lessons from the learning collaborative (such as Naloxone dispensing) to bear on day-to-day operations?

f. How will the hospital ensure that its pool of DATA-waivered physicians, physician assistants, and nurse practitioners is sufficient to meet the induction needs of patients identified through this project?

3. State the unduplicated numbers of patients to whom you propose to deliver SBIRT warm handoff services to during the 24-month duration of funding. Indicate the expected numbers of persons who receive screening only, brief intervention, and referral to treatment services on an annual basis. State the total funds being requested and the estimated average cost per patient during this funding period. It is expected that the total number of persons screened will be substantially larger than the number who receive a referral to treatment.

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 lead agency must address the following items regarding performance data collection and reporting.

  1. Describe your experience with the reporting associated with SUD and OUD. What types of data are available?
  2. Describe your experience with the collection and reporting of program service and performance data to external funders. Make mention of any experience that your organization has with administration of the SAMHSA/CSAT GPRA tool.
  3. Describe your organization's capacity and commitment to collect and report the service and performance data specified in this NOFO.
  4. Describe your experience developing and using data to assess use of care guidelines in practice settings, patient outcomes, and patient experience of care.
  5. Describe your experience in designing and implementing quality improvement activities to improve the provision of care (e.g., learning collaboratives, PDSA cycles).
  6. Describe how you have shared information (measures 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 SFY 2019 SOR Hospital Screening and Warm Handoff 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 12/3/2018. 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 12/3/2018 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.

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
      1. 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).

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.

  1. 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).
  2. Submission of Appeal.
  3. An appeal must be submitted in writing to Danielle Kirby of IDHS/SUPR who will send to the ARO for consideration.
  4. An appeal must be received within 14 calendar days after the date that the grant award notice has been published.
  5. The written appeal shall include at a minimum the following:

a) The name and address of the appealing party.

b) identification of the grant.

c) A statement of reasons for the appeal.

Response to Appeal.

  1. IDHS will acknowledge receipt of an appeal within 14 calendar days from the date the appeal was received.
  2. 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.
  3. The appealing party must supply any additional information requested by IDHS within the time period set in the request.
  4. Resolution
    1. The ARO shall make a recommendation to the Agency Head or designee as expeditiously as possible after receiving all relevant, requested information.
    2. 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.
    3. The Agency will resolve the appeal by means of written determination.
    4. The determination shall include, but not be limited to:
      1. Review of the appeal;
      2. Appeal determination; and
      3. 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 seq.). Additional terms and conditions may apply.
  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:
    1. 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.
    2. The Provider will be responsible for the deliverables and data collection and reporting expectations listed in Section A of this NOFO.
    3. 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 "SOR Hospital Screening and Warm Handoff

- NOFO" in the subject line of the email. NOTE: The final deadline to submit any written questions regarding the SOR Hospital Screening and Warm Handoff- NOFO is 11/26/2018.

11-2-2018 Modified D. Performance Reporting (20 points). Item 3 Second sentence was a duplicate of Item 6, so the duplicate sentence was removed from Item 3. 

Mandatory Forms -- Required for All Agencies

  1. GA-19-444-26-1747-01 (pdf)
  2. Uniform Grant Budget Template | Instructions

Important Dates For this NOFO

What? When? Who?/Where? Subject of Email
Bidders' Conference 10/18/2018 Webinar N/A
Letter of Intent 11/26/2018 Joseph.Tracy@illinois.gov Your Organization Name, 19-444-26-1747-01, LOI
Questions Submitted 11/26/2018 Joseph.Tracy@illinois.gov SOR Hospital Screening and Warm Handoff- NOFO
Proposals Due 12/3/2018 DHS.GrantApp@Illinois.Gov Your Organization Name, 19-444-26-1747-01, Joseph Tracy