1195 Notice of Funding Opportunity (796)

Notice of Funding Opportunity (NOFO) - Summary Information

1. Awarding Agency Name: Illinois Department of Human Services/Division of Mental Health
2. Agency Contact:

Name: Barb Roberson

Email: Barb.Roberson@illinois.gov

Phone: 217-557-5876
3. Announcement Type: Initial announcement
4. Type of Assistance Instrument: Grant
5. Funding Opportunity Number: 22-444-22-1195-01
6. Funding Opportunity Title: 1195 Neuropsych Assessment
7. CSFA Number: 444-22-1195
8. CSFA Popular Name: Neuropsych Assessment (796)
9. CFDA Number(s): NA
10. Anticipated Number of Awards:
  1. Colbert
  2. Williams
11. Estimated Total Program Funding:

Total Funding: $173,892

Colbert Funding: $105,006

Williams Funding: $68,886
12. Award Range NA
13. Source of Funding: State
14. Cost Sharing or Matching Requirement: No
15. Indirect Costs Allowed Yes
16. Posted Date: March 10, 2021
17. Closing Date for Applications: April 15, 2021, 5:00 PM CST
18. Technical Assistance Session: Session Offered: No

Agency-specific Content for the Notice of Funding Opportunity


  • Program Description


  • Scope of Services
    The Grantee will fulfill two needs related to the Colbert and Williams Consent Decrees. First, the Grantee will facilitate completion of face-to-face neuropsychological assessments/evaluations on identified Williams and Colbert Class Members when there is a suspicion of dementia or other organic brain syndrome and, if so, to determine whether the disease is so severe or persistent it adversely affects the individual's ability and capability to transition from a nursing home setting to independent living (Permanent Supportive Housing (PSH)) or other appropriate community-based housing alternatives. The outcome of this clinical battery/assessment will recommend the most appropriate level of care setting and, if transition is the outcome, the individual's capability to maintain wellness in the community.
  • Second, the Grantee will conduct desk audits to determine if Colbert Class Members meet certain exclusionary criteria. The Colbert Consent Decree specifies when a Class Member can be excluded from outreach or assessment activities. The Exclusionary Criteria defined in the Colbert Consent Decree are severe dementia or another clinically significant and progressive cognitive disorder that is unlikely to improve. Exclusionary Criteria must be assessed by a qualified professional and confirmed by a physician unaffiliated with the nursing facility.
  • The Williams and Colbert Consent Decree requires that a strength-based assessment, one that considers individual goals, interests and desires, as well as, explores other indicators such as risks (medical, behavioral and physical), criminal histories, functional capability and cognitive abilities, is conducted on consenting residents of the nursing facilities/ Specialized Mental Health Rehabilitation Facility (NFs//SMHRFs). Class Members who have not been recommended for transition due to the suspicion of dementia, Alzheimer's or other organic brain syndrome may have a secondary, specialized assessment conducted by a Board-Certified neuropsychologist to determine the severity of the disease. This specialized assessment as conducted by the neuropsychologist is to include confirmation by a medical doctor of the exclusionary diagnosis.
     

Deliverables
Performance Requirements:
There are two types of services required under this grant - (1) face-to-face assessments and (2) desk reviews.

Each assessment is estimated at an average of nine hours to complete.

The Grantee will:

  1. Accept referrals from DMH Comprehensive Class Member Transition Program on behalf of Williams and Colbert Class Members who require a specialized neuropsychological assessment.
  2. Schedule time slots for each Class Member referred.
  3. Review medical, clinical charts and/or other pertinent documents made available by the NF/SMHRF and documentation from the community mental health center, as appropriate.
  4. Conduct interviews with family members, guardians or significant others, as appropriate, about the Class Member's past and present functional levels, capabilities and performances.
  5. Conduct a face-to-face interview with the Class Member using state-of-the art batteries or appropriate assessment tool.
  6. Complete narrative reports on assessment outcomes with recommendations.
  7. Complete all assessment outcomes for Class Members who have not been recommended for transition with diagnoses documentation, when appropriate (severe dementia, a cognitive or physical condition requiring 24hr level of care and not likely to improve) as confirmed by a medical doctor. 

Each desk review will take no longer than one hour to complete.
The Grantee will:

    1. Accept referrals from DMH Comprehensive Class Member Transition Program on behalf of Williams and Colbert Class Members who require an exclusionary criteria desk review. Exclusionary Criteria consist of:
      1. Severe dementia; or
      2. Clinically significant and progressive cognitive disorder or medical condition that is not likely to improve.
    2. Assign to a member of the UIC DoP Medical Review Team within one (1) business of receiving the referral packet.
    3. Review medical, clinical charts and/or other pertinent documents made available by the nursing facility (NF/SMHRF) and documentation from the community mental health center, as appropriate.
      1. Initial history and physical
      2. MD Notes (3 months)
      3. RN Notes (3 months)
      4. Recent Labs or brain scans
      5. MoCA/MoCA Blind/MMSE
      6. Geriatrician Notes (if applicable)
      7. CCMPT Assessment (when available)
    4. The entire desk review process should be confirmed within three (3) business days after receipt of all required documentation.
    5. Complete the Exclusionary Criteria Desk Evaluation to confirm diagnosis and/or exclusionary criteria.
    6. Complete the Attestation document for each desk review completed.
    7. The Attestation should be submitted to CCMTP Administrative Staff within one (1) business day of completion.

  • Payment
    Reference the Uniform Grant Agreement, Article IV Payment, Section 4.3 Cash Management Improvement Act of 1990 and Section 4.7 Timely Billing Required. Grantee shall submit allowable grant expenses on the appropriate DMH invoice template to the email address indicated on the template no later than the 30th day of the month following the end of the service month. Invoiced expenses should be consistent with the approved annual grant budget. Any expenditure variances require prior Grantor approval in accordance with Article VI of the grant agreement to be reimbursable. All invoices shall be HIPPA compliant and encrypted utilizing DHS approved encryption software if so indicated on the invoice template. Invoices shall serve as the request for reimbursement as well as the Periodic Financial Report.
  • DMH invoice templates can be found in the Provider section of the DHS website.
  • Rate: $263 per hour (neuropsychological assessment); $263 per hour (MD confirmation of exclusionary diagnosis)

    Performance Measures
  1. Number of Class Members referred by DMH Comprehensive Class Member Transition Program for a neuropsychological assessment, during the quarter.
  2. Number of Class Members referred by DMH Comprehensive Class Member Transition Program who received a neuropsychological assessment, during the quarter.
  3. Number of referrals scheduled for a neuropsychological assessment.
  4. Number of Class Members for whom neuropsychological assessments were initiated.
  5. Number of Class Members for whom neuropsychological assessments were completed.
  6. Number of Class Members who self-aborted the assessment.
  7. Number of Class Members whose assessment was aborted by the clinician due to distress or other symptoms.
  8. Number of Class Members assessed and recommended for transition, based on clinical appropriateness.
  9. Number of Class Members assessed and not recommended for transition.
  10. Number of Class Members assessed and not recommended for transition that included proper documentation of an exclusionary diagnosis as confirmed by a medical doctor.

    Exclusionary Criteria
    1. Number of Class Members referred by DMH Comprehensive Class Member Transition Program who received an exclusionary criteria desk review during the quarter.
    2. Number of Class Members for whom an exclusionary criteria desk reviews were completed.
    3. Number of Class Members whose records were reviewed, and they were not recommended for transition that included proper documentation of an exclusionary diagnosis as confirmed by a medical doctor. 

Performance Standards

  1. 100% of Class Members referred by DMH Comprehensive Class Member Transition Program received a neuropsychological assessment, during the quarter. 2
  2. 100 % of referrals scheduled for an assessment.
  3. 100% of Class Members neuropsychological assessments were initiated.
  4. 80% of Class member's neuropsychological assessments were completed.
  5. Less than 10% of Class Members self-abort the assessment.
  6. Less than 10% of Class Members assessment session is aborted by the clinician due to distress or other symptoms.
  7. 40% of Class Members assessed were recommended for transition, based on clinical appropriateness.
  8. 60% of Class Members assessed were not recommended for transition and included the proper documentation for an exclusionary diagnosis confirmed by a medical doctor.
  • Exclusionary Criteria
    1. 100% of Class Members referred by DMH Comprehensive Class Member Transition Program who receive an exclusionary criteria desk review during the quarter.
    2. 100% of Class Members for whom an exclusionary criteria desk reviews were completed.
    3. 95% of Class Members whose records were reviewed, and were not recommended for transition due to documentation of an exclusionary diagnosis as confirmed by a medical doctor.


Funding Information

This NOFO is considered a competitive grant application for funding. It is not a guarantee of funding.

Applicants must submit a program plan which supports the level of funding (See Summary Information) and detailed service delivery and deliverables (See Section A). This award utilizes state appropriated funds for Williams and Colbert Consent Decree Class Members and is subject to appropriation.

  1. Funding Restrictions

    IDHS/DMH is not obligated to reimburse applicants for expenses or services incurred prior to the complete and final execution of the grant agreement and filing with the Illinois Office of the Comptroller.

  2. Allowable Costs

    Allowable costs are those that are necessary, reasonable and permissible under the law and can be found in 2 CFR 200 - Subpart E - Cost Principles.

  3. Unallowable Costs

    Please refer to 2 CFR 200 - Subpart E - Cost Principles to see a collection of unallowable costs.

  4. Indirect Cost Rate Requirements

    Please refer to 2 CFR 200.414 regarding Indirect (F&A) Costs. To charge indirect costs to a grant, agencies must have an annually negotiated indirect cost rate agreement (NICRA). If the agency has multiple NICRAs, IDHS will accept only the lesser rate. Below are the types of NICRAs:

    1. 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.
    2. State Negotiated Rate: The organization must negotiate an indirect cost rate with the State of Illinois by completing an indirect cost rate proposal in the CARS system if they do not have a Federally Negotiated Rate or elect to use the De Minimis Rate.
    3. De Minimis Rate: Any non-Federal entity that does not have a current negotiated (including Provisional) rate, except for those non-Federal entities described in appendix VII, Paragraph D.1.b of Part 200, may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) which may be used indefinitely.
    4. Elect to decline any indirect cost rate: Grantees have discretion not to claim payment for indirect costs. Grantees that elect not to claim indirect costs cannot be reimbursed for indirect costs. The organization must record an election of "No Indirect Costs" into CARS.

Renewals

This program will be awarded as a 12-month term agreement with two, one-year renewal options. Renewals are at the sole discretion of the IDHS and are contingent on meeting the following criteria:

  1. Applicant has performed satisfactorily during the most recent past funding period.
  2. All required reports have been submitted on time, unless a written exception has been provided by the Division.
  3. No outstanding issues or outstanding Corrective Action Plans (CAPs) are present (i.e. in good standing with all pre-qualification requirements); and
  4. Funding for the budget year has been appropriated in the state's approved fiscal year budget.


Eligibility Information

Eligible Applicants

This funding opportunity is limited to Cook County for Colbert.  For Williams this funding opportunity is statewide. This funding opportunity is not limited to those who currently have an award.

Prior to applying for any Notice of Funding Opportunity (NOFO), every applicant must first be registered and prequalified through the following steps and continue to maintain prequalification status 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. This must be done on or before the application's due date (See Box 17 of the NOFO Summary above) or the application CANNOT be accepted for review.

  1. Apply for or update their DUNS number. This must be done annually.
  2. Apply for or update their SAM registration and receive a SAM cage code. This must be done annually.
  3. Be registered and in good standing with the Illinois Secretary of State. (This is not required of governmental entities and schools.)
  4. Register with the GATA/CSFA system at https://grants.illinois.gov/registration/.  
  5. Register and access both the IDHS Community Service Agreement (CSA) tracking system and the Centralized Repository Vault (CRV).

During pre-qualification, verifications are performed to ensure the applicant is not on the Federal Excluded Parties List; not on the Illinois Stop Payment list; and not on the Department of Healthcare and Family Services Provider Sanctions List.

In addition, the following must be submitted before an award can be made. The due date for the following is April 15, 2021, 5:00 PM CST:

Fiscal and Administrative Risk Assessment (ICQ) for the fiscal year you are applying. Grantees must complete this on the GATA/CSFA system. Be sure to click "submit" to submit your answers when complete. This is done only once per entity per fiscal year.

Programmatic Risk Assessment (PRA). Potential grantees must submit a PRA for each program applied for.

Cost Sharing or Matching: Not required.

Indirect Cost Rate: See Section B Funding Information, #4 Indirect Cost Rate Requirements.

Other: Two applications may be submitted per entity. One application may be submitted for the Colbert Consent Decree and one for the Williams Consent Decree. A Separate application and Program Proposal are required for each consent decree. Each application will have a suffix already included on line 6 of the application. The correct application must be used.


Application and Submission Information

Application Package

Each applicant must have access to the internet. Applicants may obtain application forms at the Division's Grant Information website https://www.dhs.state.il.us/page.aspx?item=130322. It is the responsibility of each applicant to monitor that website and comply with any instructions or requirements relating to the NOFO.

Questions

IDHS encourages inquiries concerning this funding opportunity and welcomes the opportunity to answer questions from applicants. Questions and DHS/DMH Responses "Q&A" will be posted to the DMH Grant Information website and updated periodically at the following link

https://www.dhs.state.il.us/page.aspx?item=131631.

Questions about this NOFO, must be sent via email to DHS.DMHGrantApp@illinois.gov. The subject line of the email MUST state: "Program 796 Neuropsych Assessment - Question(s)". Questions will only be accepted electronically.

Content and Form of Application Submission

Each applicant is required to submit a Uniform Application for State Grant Assistance. This is a 3-page document with the first page already completed by the Division of Mental Health. This document must be signed and dated. There are two applications as follows:

  1. Williams Consent Decree (WCD)
  2. Colbert Consent Decree (CCD)

A separate Application, Program Proposal and Subrecipient Budget(s) (if applicable) are required for each consent decree. Each application will have a suffix on line 6 CSFA Title.

For example, if an applicant applies for funding for Williams services and Colbert services, they must submit two applications, one associated with each consent decree for the program. The correct Consent Decree application must be submitted, or the application CANNOT be accepted for review.

  1. Page 1 of the applications are pre-populated with the appropriate suffix code. Applicants do not need to complete anything on Page 1.
  2. On Page 3, applicants will need to include only the amount, for which they are applying, for the specific consent decree on each individual application.

Program Proposal

  1. A Program Proposal for each consent decree is required
    1. Each Program Proposal must be specific to the Consent Decree (Williams or Colbert).
  2. The Program Proposal must not exceed 10 pages. If there are more than 10 pages, the remaining pages will not be reviewed
  3. Attachments must not contain criteria information. Attachments are NOT included in the page limitations.
  4. The Program Proposal, including attachments should be sequentially page numbered.
  5. All documents must be typed using 12-point type,100% magnification and use black typeface on a white background, Except for letterhead and stationery for letter(s) of support.
  6. The Program Proposal must be typed single-spaced with 1-inch margins on all sides.
  7. The PDF submission must be on 8 1/2 x 11-inch page size .
  8. The submission shall include the 3-page Uniform Application,10-page Program Proposal and attachments. These must be in PDF format and submitted as one document.
  9. The Program Proposal must include which consent decree is being applied for (Williams or Colbert).

Subrecipient budget(s)

  1. All subrecipient budget(s) with narrative must be included with the application package.
  2. Subrecipient budgets shall be submitted on the DHS/DMH Budget template (GOMBGATU-3002-(R-02-17)).

Submission Dates and Times

  1. To be considered for award, application materials must be in the possession of the IDHS/DMH email address DHS.DMHGrantApp@illinois.gov and by the designated date and time listed in Box 17 of the NOFO Summary above. Emails into this box are electronically date and time stamped upon arrival. For your records, please keep a copy of your email submission with the date and time the proposal was submitted, along with the email address to which it was sent. The deadline will be strictly enforced. Applications after the deadline CANNOT be accepted for review. In the event of a dispute, the applicant bears the burden of proof that the proposal was received on time at the location listed above. If an applicant experiences technical difficulties, an email must be sent to DHS.DMHGrantApp@illinois.gov prior to the submission deadline. If State systems are deemed to be working properly, it is the applicant's responsibility to ensure their application materials arrive at the appropriate email address before the submission deadline date and time.
  2. Applications and Program Proposals will only be accepted electronically and should be emailed to DHS.DMHGrantApp@illinois.gov. Those that are delivered by any other means will not be accepted and will be immediately disqualified. IDHS/DMH is under no obligation to review applications that do not comply with the above requirements.
  3. Applicants will receive an email to notify them that the application was received and if it was received by the due date and time. The email reply will be sent to the original sender of the application and program proposal. Applications and program proposals received after the due date and time will not be considered for review and funding. There will be no exceptions.
  4. Submit the completed Application,10-page Program Proposal and attachments as a single document to: DHS.DMHGrantApp@illinois.gov. The submission must not be encrypted.  The subject line of the email MUST state: "Your Organization's Name; Program 796 Neuropsych Assessment; (Specify Williams or Colbert)" and be in the following order:
    1. Uniform State Grant Application (3-page document) (Not included in page limit)
    2. Program Proposal - Must not exceed 10 pages; If there are more than 10 pages, the remaining pages will not be reviewed
    3. Attachments (Not included in page limit). This would include Linkage Agreements (if applicable).
  5. The following mandatory documents must be submitted prior to the due date listed in Box 17 of the NOFO Summary above:
    1. Uniform Grant Application (UGA) for State Grant Assistance (one per consent decree - see Section D, 3).
    2. Program Proposal
    3. Uniform Grant Budget (UGB) submitted in the CSA Tracking System

Budget Requirements

A budget and budget narrative need to be completed in the CSA tracking system. There is space when preparing the budget on each line item for the budget narrative. Instructions for the CSA Tracking System can be found at https://www.dhs.state.il.us/page.aspx?item=61069. For Budget Information click on https://www.dhs.state.il.us/page.aspx?item=95348

  1. A Budget Template and Instructions can be used as a tool to assist in determining expenses; however, the final budget must be completed in the CSA Tracking System. The pdf budget or paper copy will not be accepted nor should be included in the application packet.
  2. A separate Budget must be submitted for each Consent Decree and the following suffix used:
    1. Williams Consent Decree (WCD)
    2. Colbert Consent Decree (CCD)

      For example, if an applicant applies for funding for Williams services and Colbert services, they must submit two budgets, one associated with each consent decree for the program.

      On page 1 of the budget entry, the applicant MUST also include additional coding on the budget in the CSA system for the NOFO suffix.

  3. The budget narrative should describe how the specified resources and personnel have been allocated for services and activities described in the budget.
  4. The budget should be prepared to reflect a full fiscal year.

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

Applicant must annually apply or update their DUNS number and their SAM registration and receive a SAM cage code, and continue to maintain an active SAM registration with current information at all times during which it has an active award or an application or plan under consideration by a Federal or State awarding agency. The IDHS cannot make an 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 an award, the IDHS may determine that the applicant is not qualified to receive an award and use that determination as a basis for making an award to another applicant.

Funding Restrictions

IDHS/DMH is not obligated to reimburse applicants for expenses or services incurred prior to the complete and final execution of the grant agreement and filing with the Illinois Office of the Comptroller.

Agreement Terms

The term of the agreement will be July 1, 2021 and continuing through June 30, 2022 and will require the mutual consent of both parties, be dependent upon the Grantee's performance and adherence to program requirements and the availability of funds. IDHS may withdraw this Notice of Funding Opportunity at any time prior to the actual time a fully executed agreement is filed with the State of Illinois Comptroller's Office.


Application Review Information

Program Proposal Criteria

The maximum possible score is 100 points. All submissions will be reviewed, evaluated and based on the Criteria listed below. The purpose of this section is for the applicant to present the agency description, history, achievements, service description, financial overview and future.

Criteria Purpose Score
Executive Summary The purpose of this section is for the applicant to present the agency description, history, achievements, service description, financial overview and future plans. 5
Capacity - Agency Qualifications/Organizational Capacity The purpose of this section is for the applicant to present an accurate picture of the agency's ability to meet and execute the program requirements, including physical plant, personnel, and training. 15
Need - Description of Need The purpose of this section is for the applicant to provide a clear and accurate picture of the need for these services within the community and how the proposed project will meet these needs. In addition, identification of stakeholders, and specific data or other evidence that demonstrates how the proposal supports the grant program purpose should be included. 10
Quality - Description of Program Services The purpose of this section is for the applicant to provide a detailed, clear and accurate picture of its intended program design that indicates its ability to satisfy the requirements of the grant program. 30
Data Collection, Evaluation and Reporting The purpose of this section is for the applicant to describe how they intend 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, Grantees will be expected to collect, and report data indicators and measures as described in this NOFO. 10
Resource Availability The purpose of this section is for the applicant to describe what resources and other knowledge, skill and abilities in addition to those specific to the duration of the funding cycle the applicant possesses or will budget for in order to support the objective of this program. 20
Budget and Budget Narrative The purpose of this section is to evaluate the budget for Narrative Inclusion, Fiscal Soundness and Programmatic Soundness. 10

Proposals will be reviewed by IDHS/DMH staff familiar with the requirements of the program including services to be performed in specified geographic location, if applicable. Review team members will have no conflicts of interest and will read and evaluate proposals independently.


Merit-Based Evaluation Appeal Process

Competitive program grant appeals are limited to the merit-based evaluation process only. Evaluation scores cannot be protested. Only the evaluation process is subject to appeal.

An appeal must be submitted electronically, in accordance with the grant application document.

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

  1. the name and address of the appealing party.
  2. identification of the grant.
  3. a statement of reasons for the appeal

Appeals are to be submitted to the following address: DHS.DMHGrantApp@illinois.gov.

Response to appeal: The appealing party must supply any additional information requested by DHS/DMH within a reasonable time period.


Anticipated Announcement and State Award Dates

It is anticipated that Notices of State Award (NOSA) will be made in June 2021.

Applicants recommended for funding under this NOFO following the above review and selection process will receive a Notice of State Award (NOSA) via the Grantee Portal. It is important to keep contact information in the Grantee Portal updated since the main contact is the person notification is sent to.

The NOSA shall include:

  1. The terms and conditions of the award.
  2. Specific conditions assigned to the grantee based on the potential grantee answers on the Fiscal and Administrative Risk Assessment (ICQ), the Programmatic Risk Assessment and the Merit-Based Reviews.

The NOSA is not an authorization to begin performance or incur costs. The NOSA is a notice of the State's intention to make an award but should not be construed as a guarantee of award. A grant award is not considered to be fully executed until both parties have signed the grant agreement

After acceptance of the NOSA, announcement of the grant award shall be published by the awarding agency at www.grants.Illinois.gov. The grant agreement will also be published in the CSA Tracking System for signature.

A Notice of Non-Selection shall be sent via email to the applicants not receiving awards.


Award Administration Information

Administrative and National Policy Requirements

Applicants awarded these 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 including indirect cost rate requirements in Section B Funding Information, #4 Indirect Cost Rate Requirements.

The legal agreement between IDHS and the successful applicant(s) will be the standard IDHS Uniform Grant Agreement. If selected for funding, the applicant will be provided an IDHS grant agreement for signature and return. A sample of the agreement may be found at https://www.dhs.state.il.us/page.aspx?item=29741.

Reporting

Reporting Requirements:

  1. Time Period for Required Periodic Financial Reports. N/A Grantee will be paid via invoice.
  2. Time Period for Close-out Reports. Grantee shall submit a Close-out Report pursuant to Paragraph 13.2 and no later than 60 days after this Agreement's end of the period of performance or termination.
  3. Time Period for Required Periodic Performance Reports. Unless a different reporting requirement is specified in Exhibit G, Grantee shall submit Performance Reports to Grantor pursuant to Paragraph 14.1 and such reports must be submitted no later than 30 days after the quarter ends.
  4. Time Period for Close-out Performance Reports. Grantee agrees to submit a Close-out Performance Report, pursuant to Paragraph 14.2 and no later than 60 days after this Agreement's end of the period of performance or termination.

The Grantee shall submit quarterly Periodic Performance Report (GOMBGATU-4001 (N-08-17)) and the Periodic Performance Report Template by Program (PRTP) to the appropriate email address below. Reporting templates and instructions for submitting reports can be found in the Provider section of the DHS website.

PPR and PRTP Email Address for All Grants: DHS.DMHQuarterlyReports@illinois.gov


State Awarding Agency Contact(s)

If you need to contact the Division of Mental Health, please contact:

Barb Roberson at the following email DHS.DMHGrantApp@illinois.gov


Other Information

  1. IDHS reserves the right to request additional information that could assist with its award decision. Applicants are expected to provide the additional information within a reasonable time period. Failure to provide the information could result in the rejection of the proposal.
  2. The release of this Notice of Funding Opportunity does not compel IDHS to make an award.
  3. This funding opportunity is considered a new application.
  4. Useful websites

Apply for an Employer Identification Number (EIN) Online

https://www.irs.gov/businesses/small-businesses-self-employed/apply-for-an-employer-identification-number-ein-online  

Grant Accountability and Transparency Act website:  https://www.illinois.gov/sites/gata/Pages/default.aspx

Illinois Grant Accountability and Transparency Act (GATA) (30ILCS 708/):  http://ilga.gov/legislation/ilcs/ilcs3.asp?ActID=3559&ChapterID=7

2 CFR 200 Electronic Code of Federal Regulations:  http://www.ecfr.gov/

Uniform Administrative Requirements, Cost Principles and Audit Requirements (2 CFR 200):  https://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl

OMB Uniform Guidance:  https://www.grants.gov/web/grants/learn-grants/grant-policies/omb-uniform-guidance-2014.html 

IDHS website: www.dhs.state.il.us

CSA Tracking System: https://www.dhs.state.il.us/page.aspx?item=61069  

For Budget Information click on https://www.dhs.state.il.us/page.aspx?item=95348


Mandatory Forms -- Required for All Agencies

  1. Uniform State Grant Application
  2. Program Proposal
  3. Subrecipient Budget(s) Template GOMBGATU-3002-(R-02-17)
  4. Budget using the Uniform Grant Budget (UGB) Template (in the CSA Tracking System) https://www.dhs.state.il.us/Page.aspx?item=61069)