Awarding Agency Name: Human Services
Agency Contact: Christina Miller (Christina.Miller@illinois.gov)
Announcement Type: Modified
Type of Assistance Instrument: Grant
Funding Opportunity Number: 20-444-24-0829-01
Funding Opportunity Title: Dental Program
CSFA Number 444-24-0829
CSFA Popular Name Dental Program
Anticipated Number of Awards: 1-3
Award Range $79,259.44 to $138,834.60
Source of Funding State

Cost Sharing or Matching

Requirements

No
Indirect Costs Allowed Yes
Restrictions on Indirect Costs No
Posted Date May 20th, 2019
Application Date Range May 20th, 2019 to June 20th, 2019
Grant Application Link Grant Application (pdf)
Technical Assistance Session No

Agency-specific Content for the Notice of Funding Opportunity

Dental Program

GLOSSARY OF TERMS FOR PURPOSE OF THIS NOFO

ADA = American Disability Act

Applicant = Potential Dental applicant

APS = Adult Protective Services

ARO = Appeal Review Officers

CARS = Crowe Activity Review System

CEO = Chief Executive Officer

CFO = Chief Financial Officer

CFR = Code of Federal Regulations

CSA = Community Service Agreement

DCFS = Department of Children and Family Services

DD = Developmental Disabilities

DDD = Division of Developmental Disabilities

DHS = Department of Human Services

DUNS = Data Universal Numbering System

FEIN = Federal Tax Identification Number

GATA = Grants Accountability and Transparency Act

GOMB = Governor's Office of Management and Budget

HBS = Home Based Services

HCBS = Home and Community Based Services

HIPAA = Health Insurance Portability and Accountability Act

IDHS = Illinois Department of Human Services

ILCS = Illinois Compiled Statutes

MTDC = Modified Total Direct Cost

NICRA = Negotiated Indirect Cost Rate Agreement

NLT = Not Later Than

NOFO = Notice of Funding Opportunity

NOSA = Notice of State Award

OMB = Office of Management and Budget

PA = Public Act

PDF = Portable Document Format

PHI = Protected Health Information

ROCS= Reporting of Community Services

RIN = Recipient Information Number

SAM = System for Award Management

SoS = Secretary of State

SSN = Social Security Number

A. Program Description

PURPOSE OF THE PROGRAM:

The Dental Program grant seeks to increase access to comprehensive dental care for individuals who meet the eligibility criteria for Developmental Disability (DD) services (intellectual/developmental disability plus related conditions). This population faces challenges in accessing oral health care. By providing culturally sensitive, accessible care across the State of Illinois, the program serves to a dental home to increase access to oral health care services for individuals with Developmental Disabilities, while at the same time encouraging preventive care and providing oral education to ensure lifelong healthy behaviors. This is achieved through multi-partner collaborations between dental and dental hygiene education and community-based dentists and dental clinics, marked by shared expertise and resources. Only services that are not eligible for reimbursement through Medicare, Medicaid, or Private insurance are qualified to be paid through this grant.

PROGRAM OBJECTIVES:

In providing dental care to children and adults who meet the eligibility criteria for DD services, the Dental Program will include:

  1. A comprehensive array of dental care services to include preventive dental services, dental education, hygiene, and various dental repairs;
  2. Improved dental hygiene through prevention and training (e.g., reducing gum disease, tooth decay, and tooth loss);
  3. Dissemination of educational materials to individuals that promote and improve dental hygiene and reduce dental issues;
  4. Immediate dental care services for the target population who are unable to secure dental care and services in traditional community settings because of their disability; and
  5. Sharing and disseminating program information to others serving individuals with disabilities about the services provided by the grantee.
  6. Utilization of a consent form authorizing the grantee to share Health Insurance Portability and Accountability Act (HIPAA) and Protected Health Information (PHI) information with the Department of Human Services, Division of Developmental Disabilities (DHS/DDD). Use the following link to access the consent form: http://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL462-1214.pdf
  7. Services delivered to individuals and billable through Medicaid, Medicare or Private insurance may not be claimed/charged to/paid/reimbursed through this grant.

AGENCY FUNDING PRIORITIES:

The priority of the grant is to increase access to comprehensive dental care for individuals who meet the eligibility criteria for DD services throughout the State of Illinois by ensuring that dental services are offered in all regions of the state. Priority will be given to providers who agree to provide services in the Northwest region and Southern region as well as the following counties in the Central Region: Adams, Brown, Calhoun, Cass, Christian, Clark, Coles, Cumberland, De Witt, Douglas, Edgar, Ford, Fulton, Greene, Hancock, Henderson, Iroquois, Jersey, Knox, Macon, Macoupin, Mason, Menard, Montgomery, Moultrie, Piatt, Pike, Sangamon, Schuyler, Scott,  Shelby, Stark, Vermillion, Warren and Woodford.

INDICATORS OF SUCCESSFUL PROJECTS:

A successful agency will:

  • Provide a detailed analysis of the needs of the clients in the geographical area and a plan to address those needed.
  • Must be capable of providing services by July 1st, 2019.
  • Would include key personnel including a combination of experience and education of the Dentist, Hygienists, Dental Assistants, Dental Manager, Interns or Residents.
  • Have prior experience serving persons with intellectual developmental disabilities and other specialty populations.
  • Meet all the requirements outlined in the Divisions procedural manuals and applicable legislative rules.
  • Have an overall budget with the cost range allowed in this NOFO.
  • Demonstrate a program that is well articulated and in alignment with the program requirements.
  • Will have one or more office locations in the area of service to limit to travel time of participants.
  • Be able to explain the societal and personal impact that this program would have on the individuals served.
  • Include means to communicate and serve multiple ethnic populations.
  • Demonstrate collaboration with DD providers (i.e. Individual Services Coordination agency and Community, schools, dentists, etc.) in order to bring program awareness to individuals in need of service.
  • Identify and provide needed dental services that are not covered by Medicare, Medicaid or private insurance.

CITATIONS FOR AUTHORIZING STATUTES AND REGULATIONS:

2 CFR 200 : https://www.gpo.gov/fdsys/granule/CFR-2014-title2-vol1/CFR-2014-title2-vol1-part200/content-detail.html

Developmental Disabilities CSA Attachment A: http://www.dhs.state.il.us/page.aspx?item=103251

Developmental Disabilities Program Manual: http://www.dhs.state.il.us/page.aspx?item=103254

Mental Health and Developmental Disabilities Code 405 ILCS 5 (http://www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=1496 )

Adult Protective Services Act 320 ILCS 20: http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1452

Abused and Neglected Child reporting Act: (325 ILCS) 5/1: http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1460&ChapterID=32

DDD Pre-Admission Screening Manual: Intake, Assessment, & Determination Summary:

http://www.dhs.state.il.us/page.aspx?item=53021

PERFORMANCE MEASURES:

  1. Grantee will provide a comprehensive array of dental care services for the target population who are unable to secure dental care and services in traditional community settings because of their disability. These services will include preventive dental services, dental education, hygiene, and various dental repairs. NOTE: Services delivered to individuals and billable through Medicaid, Medicare or Private insurance may not be claimed/charged to/paid/reimbursed through this grant.
    1. The Provider will design a survey to determine the effectiveness of the services provided. Required Survey Information: Survey must collect data from the individual served, or guardian as applicable. Data to be collected includes, but is not limited to:
      1. How did you learn about the services provided by the (add name of grantee)? Options must include but are not limited to:
        • I was referred by another dentist or dental provider;
        • I saw a brochure or pamphlet about the services offered;
        • I learned about (Grantee's Name) services from another person who previously received services from the (Grantee's Name);
        • I learned about (Grantee's Name) services from an agency which provides other services or supports for me or other people with developmental disabilities.
      2. What is the reason for your visit today? Options must include, but are not limited to:
        • I wanted to learn about how to take better care of my teeth and mouth (Oral Hygiene).
        • This was a regular check-up for me.
        • I had a problem with my teeth, gums or mouth which required help from a dentist.
      3. Why did the individual or guardian use the services provided by the grantee? Options must include, but are not limited to:
        • I have never needed a dentist;
        • I use another dentist for regular check-ups;
        • I needed a dentist, but could not afford the cost of a dentist;
        • I needed a dentist, but could not find a dentist who would accept my insurance or Medicaid;
        • I needed a dentist but could not find a dentist who would serve me.
      4. Tell us about your visit today:
        1. How long did you have to wait for an appointment?
          • One day or less
          • Between 1 to 7 days
          • Up to 30 days
          • Over 30 days
        1. Once you arrived for your appointment time, how long did it take for you to be seen?
          • 1 - 5 minutes
          • 5 - 10 minutes
          • 10 - 20 minutes
          • over 20 minutes
        2.  Were your dental needs met?
          • Yes, my dental needs were met today.
          • No, my dental needs were NOT met today.
          • If no, please explain
        3. Would you use this dental service again?
          • Yes, I will use this dental service again
          • No, I will not use this dental service again
          • If no, please explain
  2. The grantee will provide a survey to each indivdual following the delivery of services. The survey can be answered by the individual or guardian as applicable. The survey is to determine the overall satisfaction of all services that were provided.
  3. Hours of services will provide the maximum accessibility to services for the target population as possible.
  4. Implement a marketing strategy that will raise awareness of dental resources available to individuals with a developmental disability.

 PERFORMANCE STANDARDS:

  1. Each dentist full-time equivalent funded by the grant will provide services to at least 125 clients per quarter.
  2. A overall goal of 90% satisfaction with services received as documented by individual satisfactions surveys.
  3. A minimum of 37.5 hours per week of service hours will be provided during prime service periods.
  4. Grantee will disseminate materials to at least 25% of the target populations identified by the applicant in the program plan submission each quarter that promote and improve dental hygiene and reduce dental issues.

DELIVERABLES:

  1. The Provider will provide documentation that details the dental care services provided:
    1. Required data: Documentation regarding individuals served during the reporting period: (Spreadsheet (xlsx) )
    2. Due dates: 1st Quarter Reports are due No Later Than (NLT) October 15th, 2nd Quarter Reports are due NLT January 15th, 3rd Quarter Reports are due NLT April 15th, 4th Quarter Reports are due NLT July 15th.
  2. The Provider will provide a list of clients scheduled to receive services during the next quarter and the schedule of hours of operation.
    1. Required data: Client name, date/time of scheduled appointment, service to be provided, name of dentist.
    2. Schedule of projected hours of operation.
    3. Due dates: 1st Quarter Reports are due NLT October 15th, 2nd Quarter Reports are due NLT January 15th, 3rd Quarter Reports are due NLT April 15th, 4th Quarter Reports are due NLT July 15th.
  3. The Provider will provide a summary of satisfaction survey results and copies of individual surveys.
    1. Required data: Summary of all data collected with the survey each quarter.
    2. Due dates: 1st Quarter Reports are due NLT October 15th, 2nd Quarter Reports are due NLT January 15th, 3rd Quarter Reports are due NLT April 15th, 4th Quarter Reports are due NLT July 15th.
  4. The Grantee will provide a listing documenting what materials are sent to promote, improve dental hygiene, and reduce dental issues and an example of materials.
    1. Name client, RIN, date provided, what materials were provided.
    2. Due dates: 1st Quarter Reports are due NLT October 15th, 2nd Quarter Reports are due NLT January 15th, 3rd Quarter Reports are due NLT April 15th, 4th Quarter Reports are due NLT July 15th.

B. Funding Information

  1. This NOFO is considered a competitive application for funding.
  2. The Dental Program is a Non-Medicaid state funded program. In FY20 the Department will fund 3 geographic areas  for dental services to ensure availability statewide.
  3. In FY20, the Department anticipates the availability of approximately $213,451.57 in total funding.
  4. The Department anticipates funding between 1 and 3 applicants.
  5. The anticipated award areas and ranges are listed as follows:

Map of counties per region of Dental NOFO

Award Range

Minimum:

126,052.47

Maximum:

157,565.59

County Proposed Area

2010 Census

Population

Boone NW 54,165
Bureau NW 34,978
Carroll NW 15,387
Dekalb NW 105,160
Grundy NW 50,063
Henry NW 50,486
Jo Daviess NW 22,678
LaSalle NW 113,924
Lee NW 36,031
Mercer NW 16,434
Ogle NW 53,497
Putnam NW 6,006
Rock Island NW 147,546
Stephenson NW 47,711
Whiteside NW 58,498
Winnebago NW 295,266
Total 1,107,830
Award Range

Minimum:

$124,951.14

Maximum:

$138,834.60

County Proposed Area

2010 Census

Population

Adams C 67,103
Brown C 6,937
Calhoun C 5,089
Cass C 13,642
Champaign C 201,081
Christian C 34,800
Clark C 16,335
Coles C 53,873
Cumberland C 11,048
De Witt C 16,561
Douglas C 19,980
Edgar C 18,576
Ford C 14,081
Fulton C 37,069
Greene C 13,886
Hancock C 19,104
Henderson C 7,331
Iroquois C 29,718
Jersey C 22,985
Knox C 52,919
Livingston C 38,950
Logan C 30,305
McDonough C 32,612
McLean C 169,572
Macon C 110,768
Macoupin C 47,765
Marshall C 12,640
Mason C 14,666
Menard C 12,705
Montgomery C 30,104
Morgan C 35,547
Moultrie C 14,846
Peoria C 186,494
Piatt C 16,729
Pike C 16,430
Sangamon C 197,465
Schuyler C 7,544
Scott C 5,355
Shelby C 22,363
Stark C 5,994
Tazewell C 135,394
Vermillion C 81.625
Warren C 17,707
Woodford C 38,664
Total 1,944,362
Award Range

Minimum:

$79,259.44

Maximum:

$88,066.04

County Proposed Area

2010 Census

Population

Alexander S 8,238
Bond S 17,768
Clay S 13,815
Clinton S 37,762
Crawford S 19,817
Edwards S 6,721
Effingham S 34,242
Fayette S 22,140
Franklin S 39,561
Gallatin S 5,589
Hamilton S 8,457
Hardin S 4,320
Jackson S 60,218
Jasper S 9,698
Jefferson S 38,827
Johnson S 12,582
Lawrence S 16,833
Madison S 269,282
Marion S 39,437
Massac S 15,429
Monroe S 32,957
Perry S 22,350
Pope S 4,470
Pulaski S 6,161
Randolph S 33,476
Richland S 16,233
St. Clair S 270,056
Saline S 24,913
Union S 17,808
Wabash S 11,947
Washington S 14,716
Wayne S 16,760
White S 14,665
Williamson S 66,357
Total 1,233,605
  1. The Department anticipates funding between 1 and 3 applicants to provide Dental services as described in this NOFO for the 2 geographic areas identified Central (C), and Southern (S).
  2. The grant period will begin upon execution of the grant agreement no sooner than July 1, 2019 and will end on June 30, 2020. The release of this Notice of Funding Opportunity (NOFO) does not obligate the Illinois Department of Human Services to make an award. Services many not be provided until a contract is fully executed by the Department.
  3. Allowable and Unallowable expenditures for this award are identified in 2 CFR 200.
  4. This will be a one-year grant award with two (2), one (1) year renewal options.
  5. Type(s) of assistance instrument that may be awarded if applications are successful: Grant
  6. Applicants must submit a program plan which identifies the selected service areas ( NW, C, S geographic areas), supports the level of funding and details service delivery and deliverables. If the applicant is interested in serving multiple areas, they must submit a separate request for each area. The successful applicant will be required to prepare a budget in accordance with the template provided by the Illinois Department of Human Services, Division of Developmental Disabilities, which follows and adheres to all applicable State and Federal guidelines. Applicants must submit a program plan which supports the level of funding and details service delivery.
  7. Program Plan: Providers must include these as part of the Program Plan.
    1. Need - Description of Need
      • Provide a detailed analysis of the needs of individuals in the geographic area you will serve and discuss your agencies plans for meeting those needs.
      • Provide data, facts, and/or evidence detailing underserved populations and any other target populations of clients you will serve and justify why you will target these groups.
    2. Capacity - Agency Qualification/Organizational Capacity Agency readiness:
      • Describe the process your agency will follow to be fully ready to begin providing service by July 1, 2019.
      • Provide your agency's organizational chart and highlight key personnel and their educational background, qualifications, certifications, and licenses, including years of experience serving specialized populations.
      • Describe the agency's prior experience serving persons with a developmental disability.
      • Describe your agency's qualifications as they relate to the requirements outlined in the Division's procedural manuals and applicable legislative rules.
      • Provide estimated budget projections utilizing the Uniform Grant Budget Template in CSA.
      • Address each of the following:
        • Salaries and Wages
        •  Fringe Benefits
        •  Travel
        •  Equipment
        • Supplies
        • Contractual Services & Sub-awards
        • Consultant Services and Expenses
        • Construction
        • Occupancy - Rent and Utilities
        • Research & Development
        • Telecommunications
        • Training and Education
        • Direct Administrative Costs
        • Other or Miscellaneous Costs
        • Grant Exclusive Line
        • Item Indirect Cost
      • Provide addresses for all site locations in the geographic area and estimated travel times for clients to reach nearest location.
      • Describe your agencies methods for minimizing staff travel requirements.
      • Describe ADA accessibility of all facilities.
    3.  Quality of Program/Services
      1. Demonstrate that the project, in total, is well articulated and in alignment with the project requirements.
      2. Provide a complete summary of methods and procedures that will be used to accomplish goals stated in the scope of work.
      3. Provide an explanation of the societal and personal impact of the project.
      4. Provide evidence to support that the project is cost effective.
      5. Provide a description of the agency's quality assurance process to ensure accuracy and timeliness of all quarterly and annual requirements.
      6. Provide a description of any bilingual or translator services your agency will offer.
      7. The Provider will design a survey to determine the effectiveness of the services provided.
        • Required Survey Information: Survey must collect data from the individual served, or guardian as applicable. Data to be collected includes, but is not limited to:
          • How did you learn about the services provided by the (add name of grantee)? Options must include but are not limited to:
            • I was referred by another dentist or dental provider;
            • I saw a brochure or pamphlet about the services offered;
            • I learned about (Grantee's Name) services from another person who previously received services from the (Grantee's Name);
            • I learned about (Grantee's Name) services from an agency which provides other services or supports for me or other people with developmental disabilities.
          • What is the reason for your visit today? Options must include, but are not limited to:
            • I wanted to learn about how to take better care of my teeth and mouth (Oral Hygiene).
            • This was a regular check-up for me.
            • I had a problem with my teeth, gums or mouth which required help from a dentist.
          • Why did the individual or guardian use the services provided by the grantee? Options must include, but are not limited to:
            • I have never needed a dentist;
            • I use another dentist for regular check-ups;
            • I needed a dentist, but could not afford the cost of a dentist;
            • I needed a dentist, but could not find a dentist who would accept my insurance or Medicaid;
            • I needed a dentist but could not find a dentist who would serve me.
          • Tell us about your visit today:
            1. How long did you have to wait for an appointment?
              • One day or less
              • Between 1 to 7 days
              • Up to 30 days
              • Over 30 days
            2. Once you arrived for your appointment time, how long did it take for you to be seen?
              • 1 - 5 minutes
              • 5 - 10 minutes
              • 10 - 20 minutes
              • over 20 minutes
            3. Were your dental needs met?
              • Yes, my dental needs were met today.
              • No, my dental needs were NOT met today.
              • If no, please explain
        1. Would you use this dental service again?
          • Yes, I will use this dental service again
          • No, I will not use this dental service again
          • If no, please explain
  8. Design and submit examples of informational materials such as a brochure, web page, or postcard notifying the public of services and supports available.
  9. Design and submit an implementation plan to expand into underserved areas by identifying pockets of areas in need of dental services, type of services required and location of individuals.

C. Eligibility Information

Failure to meet the eligibility criterion by the application deadline will result in the return of the application without review or, even though an application may be reviewed, will preclude the agency from making an award.

An entity may not apply for a grant until the entity has registered and pre-qualified through the Grant Accountability and Transparency Act (GATA) Grantee Portal, http://www.grants.illinois.gov/portal/ . Registration and pre-qualification are required annually. During pre-qualification, verifications are performed including a check of federal SAM.gov Exclusion List and status on the Illinois Stop Payment List. The Grantee Portal alerts the entity alerts of "qualified" status or informs how to remediate a negative verification (e.g., inactive DUNS, not in good standing with the Secretary of State). Inclusion on the SAM.gov Exclusion List cannot be remediated.

Key elements to be addressed are:

  1. Eligible Applicants.
  • This funding opportunity is open to all agencies that can meet the terms outlined in this NOFO. All applicants are required to provide the requested information as outlined in this NOFO to be considered for funding in FY2020. The funding opportunity is not limited to those who currently receive or previously received grant funding.
  • Applicant entities may not apply for this grant until the entity has registered and pre-qualified through the Grant Accountability and Transparency Act (GATA) website, www.grants.illinois.gov. Registration and pre-qualification are required annually. During pre-qualification, verifications are performed including a check of federal Debarred and Suspended and status on the Illinois Stop Payment List. An automated email notification to the entity alerts them of "qualified" status or informs the entity on how to remediate a negative verification (e.g., inactive DUNS, not in good standing with the Secretary of State). A federal Debarred and Suspended status cannot be remediated. The pre-qualification process also includes a financial and administrative risk assessment utilizing an Internal Controls Questionnaire. A Programmatic Risk Assessment must also be completed for each separate grant for which an applicant intends to apply. Applications from entities that have not completed the GATA pre-qualification process prior to the due date of this application will NOT be reviewed and will NOT be considered for funding. A screenshot verifying that this pre-qualification has been completed must be included with the application.

Applicants proposed budget must be entered into the IDHS CSA system (http://www.dhs.state.il.us/Page.aspx?item=61069). The completed budget must be electronically signed and submitted in the CSA system, and a printed copy of the signed and submitted budget must be included with the application. It is essential that, at a minimum, the applicant agency's Chief Executive Officer (CEO) or equivalent, or the Chief Financial Officer (CFO) or equivalent must be registered in the CSA system to electronically sign the required budget documents prior to submission. For more information about submitting a budget in the CSA system, see: DHS Budget Training Manual (Revision 3/28/18) (pdf)

The applicant will 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.).

  1. Cost Sharing or Matching.
    • Cost sharing is not required.
  2. Indirect Cost Rate.
    • In order to charge indirect costs to a grant, the applicant organization must have an annually negotiated indirect cost rate agreement (NICRA). There are three types of NICRAs: a) Federally Negotiated Rate. 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 federally NICRA. b) State Negotiated Rate. The organization may negotiate an indirect cost rate with the State of Illinois if they do not have a Federally Negotiated Rate. If an organization has not previously established an indirect cost rate, an indirect cost rate proposal must be submitted through State of Illinois' centralized indirect cost rate system no later than three months after receipt of a Notice of State Award (NOSA). If an organization previously established an indirect cost rate, the organization must annually submit a new indirect cost proposal through CARS within six months after the close of the grantee's fiscal year. C) De Minimis Rate. An organization that has never negotiated an indirect cost rate with the Federal Government or the State of Illinois is eligible to elect a De Minimis rate of 10% of modified total direct cost (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.

All grantees must complete an indirect cost rate negotiation or elect the De Minimis Rate to claim indirect costs. Indirect costs claimed without a negotiated rate or a De Minimis Rate election on record in the State of Illinois' centralized indirect cost rate system may be subject to disallowance.

Limitations on indirect costs restrict the amount and/or type of indirect costs that can be charged to grant awards. Indirect cost limitations and restrictions must be clearly stated in this section.

Grantees have discretion and can waive payment for indirect costs. Grantees that elect to waive payments for indirect costs cannot be reimbursed for indirect costs. The organization must record an election to "Waive Indirect Costs" into the State of Illinois' centralized indirect cost rate system.

  1. Other, if applicable.

Applicants may submit a separate application for each of the geographical area.

Start Up: Selected applicants must be prepared to commence services on July 01, 2019. This includes the hiring of qualified staff.

Attachment A/Program Manual: Applicants must agree to adhere to all applicable portions of the Uniform Grant Agreement Attachment A (Developmental Disabilities) and Program Manual for fiscal year 2020 as well as all subsequent revisions to Attachment A and Program Manual for the length of the grant agreement.

Cultural and Linguistic Competence: All services must be provided in a culturally sensitive manner inclusive of respecting differences related to ethnicity, race, religion, age, gender, abilities, and communication preferences. Where needed or requested, the grantee agrees to secure interpreter services to promote the full inclusion of persons seeking or receiving services, their legal guardian, and their family members.

Data Collection and Reporting: Selected applicants will be required to document service provision and maintain accurate, comprehensive service records for all persons seeking or receiving services in the assigned service area(s). Applicants will provide periodic reports to the Division to demonstrate compliance with all performance measures as well as provide ad hoc reports as requested by the Division.

Meeting Participation: Selected applicants must ensure agency participation in all training activities and meetings with Division personnel as requested.

D. Application and Submission Information

1. Address to Request Application Package.

  • Application materials are provided the following link and throughout the announcement http://intranet.dhs.illinois.gov/oneweb/page.aspx?item=114761.
  • Additional copies may be obtained by contacting the contact persons listed below.
  • Each applicant must have access to the internet. The Department's 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 web site and comply with any instructions or requirements related to the NOFO.
  • Contact Persons:
    • Christina Miller or Christina Suggs
    • IDHS, Division of Developmental Disabilities, Bureau of Reimbursement and Program Support
    • 600 East Ash, Building 400 Christina.Miller@illinois.gov; Christina.Suggs@illinois.gov
    • Phone: Christina Miller at (217) 524-9057 or Christina Suggs at (217) 782-0632.

2. Content and Form of Application Submission.

REQUIRED CONTENTS OF AN APPLICATION:

A single uniform application for state grant assistance has been designed for use with all grants. This document will be used by all entities applying for any grant with any state agency. The specific conditions related to each grant will be addressed in the exhibit sections of the grant agreement, but the same form will be used by each state agency.

Applications must also include a budget. The budget form is also a standard template. The budget for any IDHS grant will be submitted via the Community Service Agreement System (CSA System).Each division's program and fiscal staff will work with grantees to negotiate a budget for the final grant award. The budget may need to be revised over the course of the grant process or during the ongoing award. The division will work with its respective grantees if this happens.

Additionally, applicants are required to submit a Program Plan. The program plan must demonstrate the need for services, demonstrate the agency's capacity to support programs and provide a comprehensive description of service delivery. Each section of the program plan must be completed.

All applications must include the following mandatory forms/attachments:

  1. Uniform Application (pdf) for State Grant Assistance
  2. Program Plan
  3. Uniform Grant Budget - (CSA System)
  4. If indirect costs are included in the budget, and you have a current approved NICRA, please state the NICRA has been uploaded in the State of Illinois Indirect Cost System if indirect costs are included in the budget

Content, form and format requirements:

  1. This Notice of Funding Opportunity does not require the process of pre-application, letters of intent or white paper submission.
  2. The application format requirement for all documents to be printed on one side using Letter size (8 1/2" x 11") paper. All documents must have one-inch margins. Format all pages to display and print page numbers. The documents must be submitted in black and white print with a minimal font of 12 size. Electronic submission is required.
  3. The application must be no more than 100 pages. This includes any pieces that may be submitted separately by third parties.

3. Dun and Bradstreet Universal Numbering System (DUNS) Number and System for Award Management (SAM). Each applicant is required to:(unless the applicant is an individual or Federal or State awarding agency that is exempt from those requirements under 2 CFR § 25.110(b) or (c), or has an exception approved by the Federal or State awarding agency under 2 CFR § 25.110(d)).

  1. Be registered in SAM before submitting its application. To establish a SAM registration, go to www.SAM.gov and/or utilize this instructional link: How to Register in SAM from the www.grants.illinois.gov
  2. Provide a valid DUNS number in the application; and
  3. Continue to maintain an active SAM registration with current information at all times during which it has an active Federal, Federal pass-through or State award or an application or plan under consideration by a Federal or State awarding agency. It also must state that the State awarding agency 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 the State awarding agency is ready to make a Federal pass-through or State award, the State awarding agency may determine that the applicant is not qualified to receive a Federal pass-through or State award and use that determination as a basis for making a Federal pass-through or State award to another applicant.

4. Submission Dates and Times.

Applications must be received no later than 5:00 p.m. Central Standard Time on June 20th, 2019.

  1. If the due date falls on a Saturday, Sunday, or Federal or State holiday, the reporting package is due the next business day.
  2. What the deadline means: The date and time by which the State awarding agency must receive the application.
  3. The effect of missing a deadline: Applications received after the due date and time will not be considered for review or funding.
  4. The application container will be time-stamped upon receipt. 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 application was received on time at the location listed above.

Acknowledgement of receipt: Applicants will receive an email (within 72 hours of receipt or 120 hours if received on a non-business day) notifying them that their application was received and if it was received by the due date and time. This email reply will be sent to the original sender of the application.

5. Intergovernmental Review, if applicable.

Not Applicable

6. Other Submission Requirements.

Delivery Method: The Division will ONLY accept applications submitted by electronic mail. Applications will NOT be accepted if received by fax machine, hard copy, disk or thumb drive. Applications will be processed as they are received.

Submit the completed grant application to:

DHS.DDDBCR@illinois.gov with the subject line indicating:

Subject Line: Applicants Organization Name, Funding Opportunity # (20-444-24-0829-00),xx= geographic area (ex: NE=01, NW=02, C=03, S=04); Program Contact Name (Christina Miller)

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. Do not forget the subject line above.

E. APPLICATION REVIEW INFORMATION

1. Criteria

Funding for FY20 is not guaranteed. All applicants must continue to demonstrate that they meet all requirements under this NOFO described throughout. Applications that fail to meet the criteria described in the "Eligible Applicants" and the "Mandatory Requirements of the Applicant" will not be scored and considered for funding.

Review teams comprised of at least 3 individuals employed by IDHS serving in the Division of Developmental Disabilities will be assigned to review applications. Each application will first be scored individually. Then, review team members will collectively review the application, their scores, and comments to ensure review team members have not missed items within the application that other review team members identified. Application highlights and concerns will be discussed. Individual review team members may choose to adjust scores to appropriately capture content that may have been missed initially. Scores will then be sent to the application Review Coordinator to be compiled and averaged to produce the single final application score.

Three areas of proposals will be analyzed in the merit-based review process: Need, Capacity, & Quality of Program/Service. Proposals will be evaluated utilizing a standardized tool developed by the Division. Scores will be weighted as follows:

  • Need - Description of Need / Executive Summary 20% of total score
  • Capacity - Agency Qualification/Organizational Capacity 40% of total score
  • Quality of Program/Services 40% of total score

Applications will be evaluated on the following criteria:

Need - Description of Need / Executive Summary 20% of total score

The applicants proposal will be evaluated based on the following:

  • Analysis of the needs of individuals and the programs plan for meeting those needs.
  • Target audiences clearly defined and realistic.
  • Underserved populations identified, as well as a description of insufficient services and resources to meet the level of need or risk in the community.
  • Data, facts, and/or evidence demonstrating that the proposal supports the grant program purpose.

The idea applicant will:

* Display an exceptional understanding of client needs in the geographical area and have a realistic plan to address those needs.

  • Capacity - Agency Qualification/Organizational Capacity 40% of total score

The applicant's proposal will be evaluated based on the following:

Description of the process your agency will follow to be fully ready to begin providing service by July 1, 2019.

The agency's organizational chart and highlight key personnel and their educational background, qualifications, certifications, and licenses, including years of experience serving specialized populations.

Description of the agency's prior experience serving a population with developmental disabilities.

Description of the agency's qualifications as they relate to the requirements outlined in the Division's procedural manuals and applicable legislative rules.

Estimated budget projections utilizing the Uniform Grant Budget Template in CSA. Each of the following must be addressed:

  1. Salaries and Wages
  2. Fringe Benefits
  3. Travel
  4. Equipment
  5. Supplies
  6. Contractual Services & Sub-awards
  7. Consultant Services and Expenses
  8. Construction
  9. Occupancy - Rent and Utilities
  10. Research & Development
  11. Telecommunications
  12. Training and Education
  13. Direct Administrative Costs
  14. Other or Miscellaneous Costs
  15. Grant Exclusive Line Item
  16. Indirect Cost

Addresses for all site locations in the geographic area and estimated travel times for clients to reach nearest location.

The agencies methods for minimizing staff travel requirements.

ADA accessibility of all facilities.

The ideal applicant will:

  1. provide a detailed description of the process the agency will undertake to ensure services are operational no later than July 1, 2019. The timeline must be feasible and include enough detail for the Division to evaluate the merits and potential risk.
  2. demonstrate that key personnel (Dentist, Hygienists, Dental Assistants, Dental Manager, Interns or Residents etc.) have the appropriate educational level and experience in developmental disability programs of more than 20 years.
  3.  demonstrate that the agency has experience providing services to persons with Developmental Disabilities. 
  4.  demonstrate that the applicant possesses all the qualifications outlined in the Division's procedural manuals and applicable legislative rules.
  5. submit a budget proposal that is within the cost range provided.
  6. show the annual salary rate and the percentage of time to be devoted to the project and length of time projected to work on the project.
  7. submit documentation to support that compensation to be paid for employees engaged in grant activities is consistent with that paid for similar work within the applicant organization.
  8. submit a description of the responsibilities and duties of each position in relationship to fulfilling the project goals and objectives.
  9. submit justification and description of each position (including vacant positions) and relate each position specifically to program objectives.
  10. ensure personnel costs do not exceed 100% of their time on all active projects.
  11. provide documentation showing that fringe benefit projections are based on actual known costs or an established formula.
  12. ensure fringe benefits are for the personnel listed in direct salaries and wages, and only for the percentage of time devoted to the project.
  13. provide a clear description of how the computation for the fringe benefit rate used was calculated. If a fringe benefit rate was not used, then the submission must show how the fringe benefits were computed for each position.
  14. ensure all elements that comprise fringe benefits are included in the submission.
  15. provide sufficient justification for fringe benefits.
  16. provide travel projections which must include: origin and destination, estimated costs and types of transportation, number of travelers, related lodging and per diem cos, brief description the ravel involved, its purpose, and explanation of how the proposed travel is necessary for successful completion of the project.
  17. provide training projections with travel and meals for trainees listed separately, showing the number of trainees and unit costs involved and location of travel if known (If not, indicate "location to be determined".)
  18. indicate source of travel policies applied: (Applicant policy or State of Illinois Travel Regulations) NOTE: Dollars requested in the travel category must be for staff only. Travel for consultants must be shown in the consultant category along with the consultant's fee.
  19. provide projections for training participants, advisory committees, review panels, etc. and itemize them and place them in the "Miscellaneous" category.
  20. provide justification for the use of all equipment items and relate them to specific program objectives.
  21. ensure all equipment listed meets the following criteria: Equipment is defined as an article of tangible personal property that has a useful life of more than one year and a  per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established by the non-Federal entity for financial state purposes, or $5,000. An applicant organization may classify equipment at a lower dollar value but cannot classify it higher than $5,000 (Note: Organization's own capitalization policy for classification of equipment can be used.)
  22. project both the annual (for multiyear awards) and total costs for equipment.
  23. provide cost benefits analysis of purchasing versus leasing equipment, especially high cost items and those subject to rapid technical advances.
  24. project costs for rented or leased equipment in the "Contractual" category and explain how the equipment is necessary for the success of the project.
  25. provide a narrative describing the procurement method to be used.
  26. project costs of office supplies and show the basis for computation.
  27. project postage costs and the basis for computation.
  28. project training material costs and show the basis for computation.
  29. project copying paper costs and show the basis for computation.
  30. project other expendable items such as books, and hand-held tape recorders and show the basis for computation.
  31. provide a description of the product or service to be procured by contract and an estimate of the cost. Provide information on how the agency will promote free and open competition in awarding contracts.
  32. provide a separate justification for sole source contracts in excess of $150,000
  33. provide separate budgets for each subaward or contract, regardless of the dollar value and indicate the basis for the cost estimates in the narrative.
  34. describe products or services to be obtained and indicate the applicability or necessity of each to the project.
  35. project consultant services fees for each consultant and enter the name if known, describe the service to be provided, estimate the hourly or daily fee (8-hour day), estimate the amount of time required for the project.
  36. list all consultant expenses to be paid from the grant with the individual consultant in addition to their fees (i.e. travel, meals, lodging, etc.) provide information detailing the agency's formal written procurement policy or indicate that the Federal Acquisition Policy is to be used.
  37. provide a description of any proposed construction project including drawings, estimates, formal bids, etc.
  38. explain how rental and utility expenses are allocated for distribution as an expense to the program/service.
  39. provide a projection of monthly rental and utility costs by major type, provide the square footage costs, project the number of months of rental, and provide a total monthly rental and utility cost.
  40. provide a description and estimated cost of all research activities, both basic and applied, and all development activities that are performed by non-Federal entities directed toward the production of useful materials, devices, systems, or methods, including design and development of prototypes and processes.
  41. explain how telecommunication expenses are allocated for distribution as an expense to the program/services. Project the costs by item and major type. Provide the basis of the computation.
  42. describe the training and education costs associated with employee development. Include rental space for training (if required), training materials, speaker fees, substitute teacher fees, other applicable expenses. Itemize pamphlets, notebooks, videos, and other various handouts ordered for specific training activities.
  43. ensure direct charging of salaries for administrative and clerical staff only when all the following conditions are met: 1. Administrative or clerical services are integral to a project or activity 2. Individuals involved can be specifically identified with the project or activity. 3. Such costs are explicitly included in the budget or have the prior written approval of the State awarding agency; and 4. The costs are not also recovered as indirect costs.
  44. provide a description of items by type of material or nature of expense that are not included in other categories of the submission. Include a breakdown of costs by quantity and cost per unit if applicable. State the necessity of other costs for successful completion of the project and exclude unallowable costs such as printing, memberships & subscriptions, recruiting costs, etc.
  45. detail costs directly related to the service or activity of the program that is an integral line item for budgetary purposes. (Must have program approval to use this category.)
  46. provide the most recent indirect cost rate agreement information with the itemized budget.
  47. provide the most recent indirect cost rate agreement information with the itemized budget.
  48. will utilize the indirect cost rate(s) negotiated by the organization with the cognizant negotiating agency to compute indirect costs (F&A) for a program budget.
  49. will calculate the amount for indirect costs by calculating and applying the current negotiated indirect costs rate(s) to the approved base(s).
  50. provide a breakdown of the indirect costs in the budget worksheet and narrative.
  51. ensure that centralized operating sites are conveniently located to minimize travel times and provide information about travel times requirements.
  52. provide an evaluation of any geographic areas not covered.
  53. provide information validating that all sites are fully ADA accessible.
  • Quality of Program/Services 40% of total score

The applicant's proposal will be evaluated based on the following:

  1. How well the proposal demonstrates alignment with the project requirements
  2. The feasibility of the methods and procedures that will be used to accomplish goals stated in the scope of work.
  3. The assessment of the societal and personal impact of the project and the plan to mitigate any negative societal or personal impact. The plan will be evaluated based on risk, mitigation plan, and overall assessment detail.

The ideal candidate will:

  • provide examples of well-designed outreach information that will be used to advertise program to the community. For example: informational materials such as a brochure, web page, or postcard notifying the public of services and supports available.
  • provide documentation that personnel conducting services have at least one of the following qualifications: Dentist, Dental Assistant, Dental Hygienists, Dental Manager, Interns, or Residents.
  • Provide examples of prior experience serving persons with developmental disabilities or any other specialty population.
  • Provide examples of an implementation plan to expand into underserved areas by identifying pockets of areas in need of dental services, type of services required and location of individuals.
  • Provide a well-designed survey with adequate content to assess the quality and value of services to individuals.

2. Review and Selection Process.

Any internal documentation used in scoring or awarding of grants shall not be considered public information.

Recommendations for award will be made by the Director of Developmental Disabilities and the Final award decisions will be made by the Secretary, Department of Human Services. The Division reserves the right to negotiate with successful applicants to adjust award amounts, service areas, etc.

The Department will follow the Merit-based review process established by the Governor's Office of Management and Budget Award Administration Information.

Merit-Based Review for competitive grants in Illinois including fully or partially funded Federal, Federal-Pass Through and State funded grants shall comply with GATA Legislation 30 ILCS 708 and 2 CFR 200 Uniform Requirements. Grants funded solely by private funds are not subject to GATA legislation and 2 CFR 200 requirements.

Merit Based Review, 2 CFR 200.204. For competitive grants unless prohibited by Federal statute, the Federal awarding agency must design and execute a merit review process for applications. This process must be described or incorporated by reference in the applicable funding opportunity process.

  1. Receipt of Grant Application Proposals - A record shall be prepared that shall include the name of the grantor, title of the grant, each grant applicant and a notation of date and time of grant application receipt.
  2. The Division of Developmental Disabilities will keep a file of the grant award process that includes the written determination of award, grant application and requirements. The Grant Award file shall be available to Federal and State audit organizations, the Office of the Auditor General, and the Executive Inspector General.
  3. Competitive Grant evaluation criteria is tied to objectives or purpose of the federal or state grant program.
    1. Evaluation criteria includes the following criteria categories:
      1. Need
      2. Capacity
      3. Quality
    2. Definitions for the Merit-Based Review required evaluation criteria categories include:
      1. Need: Identification of stakeholders, facts and evidence that demonstrate the proposal supports the grant program purpose.
      2. Capacity: The ability of an entity to execute the grant program according to project requirements.
      3. Quality: The totality of features and characteristics of a service, project or product that indicated its ability to satisfy the requirements of the grant program.
    3. Other evaluation criteria for Merit-Based Review will be considered in addition to the required criteria. Other criteria categories include:
      1. Cost Effectiveness
      2. Sustainability
      3. Grant Specific Criteria - Quality of Survey, Materials for dissemination and expansion plan.
  4. Merit based review of the Competitive Grant Application shall evaluate process description, criteria and importance stated in the grant application.
    1. Evaluation will be based on numerical rating:
      1. The scoring tool shall reflect the evaluation criteria and ranking set forth in the grant application and any sub-criteria available at the opening.
      2. Evaluation Committee members will have an individual score sheet which is completed independent of the whole committee.
      3. A summary score sheet that shows the comparative scores and resulting finalist for award will be completed.
      4. Any significant or substantial variance between evaluator scores shall be reviewed and documented, including revision of individual scores.
      5. Overall Score on the scoring tool must result in a score greater than 50% in order to receive award.
    2. If an award decision is made after the Merit Based Review is performed, the awarding shall verify that the entity has completed the following pre-award requirements:
      1. Grantee pre-qualification
      2. Conflict of Interest and Mandatory Disclosures
      3. Fiscal and Administrative Risk Assessment
      4. Programmatic Risk Assessment
  5. Award
    1. An award shall be made pursuant to a written determination based on the evaluation criteria set forth in the grant application and successful completion of finalist requirements.
    2. A Notice of State Award (NOSA) will be issued to the Merit Based finalists that have successfully completed all grant award requirements. Based on the NOSA, the Merit Based finalist is positioned to make an informed decision to accept the grant award. The NOSA shall include:
      1. The terms and conditions of the award.
      2. Specific conditions assigned to the grantee based on the fiscal and administrative and programmatic risk assessments and the merit-based review.
    3. Upon acceptance of the grant award, announcement of the grant award shall be published by the awarding agency to www.grants.illinois.gov.
    4. A written Notice of Denial shall be sent to the applicants not receiving awards.
  6. Merit-Based Evaluation Appeal Process
    1. Competitive grant appeals are limited to the evaluation process. Evaluation scores may not be protested. Only the evaluation process is subject to appeal.
    2. Appeals Review Officer - The Agency Head or designee may appoint one or more Appeal Review Officers (ARO) to consider the grant-related appeals and make a recommendation to the Agency Head or designee for resolution.
    3. Submission of Appeal
      1. An appeal must be submitted in writing in accordance with the grant application document.
      2. An appeal must be received within 14 calendar days after the date that the grant award notice has been published.
      3. The written appeal shall include at a minimum the following:
        1. the name and address of the appealing party
        2. identification of the grant
        3. a statement of reasons for the appeal
    4. Response to Appeal
      1. The State agency must acknowledge receipt of an appeal within fourteen (14) calendar days from the date the appeal was received.
      2. The State agency must 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 the agency within the time period set in the request.
    5. Stay of Grant Agreement/Contract Execution
      1. When an appeal is received the execution of the grant. agreement/contract shall be stayed until the appeal is resolved or;
      2. The Agency head or designee determines the needs of the State require moving forward with the grant execution.
      3. The state need determination and rational shall be documented in writing.
    6. 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
        3. Rationale for the determination
    7. Effect of Judicial Proceedings. If an action concerning the appeal has commenced in a court or administrative body, the Agency Head or designee may defer resolution of the appeal pending the judicial or administrative determination.

3. Anticipated Announcement and State Award Dates

The Division will notify all applicants on selection or non-selection no later than June 27th 2019

F. AWARD ADMINISTRATION INFORMATION

1. State Award Notices

  • A Notice of State Award (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 conditions of the award.
    • Specific conditions assigned to the grantee based on the fiscal and administrative and programmatic risk assessments.
  • 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.
  • Upon acceptance of the grant award, announcement of the grant award shall be published by the awarding agency to Grants.Illinois.gov

2. Administrative and National Policy Requirements.

See section C.3 above.

3. Reporting

Quarterly reporting will be completed utilizing the Periodic Performance Report (GOMBGATU-4001) and Periodic Financial Report (GOMBGATU-4002). Quarterly reports will be submitted no later than 15 days after end of each period. 1st Quarter Reports are due NLT October 15th, 2nd Quarter Reports are due NLT January 15th, 3rd Quarter Reports are due NLT April 15th, 4th Quarter Reports are due NLT July 15th.

Under the terms of the Grant Funds Recovery Act (30ILCS 705/4.1), "Grantor agencies may withhold or suspend the distribution of grant funds for failure to file required reports." If the report is more than 30 calendar days delinquent, without any approved written explanation by the grantee, the entity will be placed on the Illinois Stop Payment List. (Refer to the Grantee Compliance Enforcement System for details about the Illinois Stop Payment List: https://www.illinois.gov/sites/GATA/Pages/ResourceLibrary.aspx )

Monthly service delivery reporting through the ROCS data base or alternative systems determined by the Division is required.

G. STATE AWARDING AGENCY CONTACT(S)

Questions and Answers

If you have any questions about this NOFO, please send them via email to Christina.Miller@illinois.gov with "Dental NOFO" in the subject line of the email.

Questions with their respective answers will be posted on the IDHS website.

The information in the FAQ section may be updated periodically, applicants are encouraged to check it frequently. Only written answers posted on the website will be considered valid and official.

H. OTHER INFORMATION

Not applicable

MANDATORY FORMS - REQUIRED FOR ALL AGENCIES - All information below must be submitted electronically.

  1. Uniform Application for State Grant Assistance
  2. Program Plan
  3. Uniform Grant Budget (CSA System)
  4. Coversheet (pdf) (include this with your submission)