2741 - Joliet Hospice (515-HSIC) Grant Information

Scope of Services

Provider will hire new staff for their Pediatric and Serious Illness Care program. These positions will serve patients in 11 counties. In home services will be provided for patients and families with serious illness and/or in need of hospice care. Clinical staff will conduct intakes and assessments for patients and families. Counseling will be provided for caregivers, children, and families. Expanded outreach services will be available to both existing and new patients.Deliverables

Performance Requirements:

Grantee shall enhance their various community base programs. This program shall Provide earlier and broader access to care for pediatric patients and their families. Provide patients and families with increased support and better access to necessary community resources that serve to improve quality of life and help achieve program of keeping patients at home and out of the acute care hospital setting. Expand geographic footprint throughout the 11 counties and expand outreach efforts to both existing and new referral partners.


Reference the Uniform Grant Agreement, Article IV Payment, Section 4.2 Return of Grant Funds and 4.3 Cash Management Improvement Act of 1990. Payment will be issued monthly and reconciled with reported allowable expenses.

Performance Measures

  1. Number of persons who received an assessment through this grant
  2. Number of patients/families served through the Serious Illness program
  3. Number of families receiving services through the hospice grief program

Performance Standards

  1. 100% of patients at intake receive an assessment
  2. 100% of patients/families in the serious illness care program will receive the necessary services
  3. 100% of the patients from the hospice care program are receiving services

Uses and Restrictions

This opportunity is considered a grant agreement and is a non-competitive application for funding. It is not a guarantee of funding. This award utilizes State appropriated funds.

Eligibility Requirements

Grantees shall provide services to eligible participants without regard to race, gender, sexual orientation, age, ethnicity, color, religion, disability and national origin/ancestry. Participants cannot be required to become members of, or participate in, any organization, religion, political group, or community service program as a condition of receiving service.

Registration and Pre-Qualification

All entities must be qualified to do business with the State of Illinois. To be qualified for a grant award. The following information is required to complete registration:

  1. Apply for or update their DUNS number.
  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.
  5. Registration in CSA
    1. The CSA Tracking System is where the Illinois Department of Human Services (IDHS) expects all applicant entities to enter their GATA Budget information. It is also where IDHS staff will review and take action on the proposed budget.
  6. Register with the Centralized Repository Vault (CRV).

PLEASE NOTE: Prior to an External Illinois.gov ID is approved, if you are a new DHS provider, you will need to provide registration information through the contact listed in this opportunity.

It is strongly recommended that if an applicant entity is not already registered in the CSA Tracking System and CRV, they should begin the registration as soon as possible. It may take several days to complete the registration.

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.

Pre-Award Requirements

State agencies are federally required to evaluate the risk posed by each applicant. Risk assessments are a pre-award requirement and include two components. Entities must complete an:

  1. Internal Controls Questionnaire (ICQ) as the Fiscal and Administrative Risk Assessment. The ICQ is completed once, annually. All state agencies will utilize the results of the ICQ. The entity can access the ICQ from the grantee portal.
  2. Programmatic Risk Assessment (PRA). Potential grantees must submit a Programmatic Risk Assessment. This must be done for each program applied for. The entity can access the PRA under "PRA" of the DMH Grant website.

Cost Sharing or Matching: None.

Application and Award Processing

Content and Form of Application Submission

  1. 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. The applicant must check the box "I Agree", sign and date this document (electronic signature is permitted).
  2. The Application Packet
    1. Submission shall include the 3-page Uniform Application
    2. Subrecipient budget(s)
      1. If applicant is planning to use a sub-grantee, a pdf copy of the sub-grantee budget must be submitted at the time of the application packet.
      2. Subrecipient budgets shall be submitted on the DHS/DMH Budget template (GOMBGATU-3002-(R-02-17) as an attachment.

Application Packet Submission Due Dates and Times

  1. To be considered for award, application materials will only be accepted electronically. Applications must be in the possession of the DMH email address DHS.DMHGrantApp@illinois.gov.
  2. 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 it was submitted, along with the email address to which it was sent.
  3. If an applicant experiences technical difficulties, an email must be sent to DHS.DMHGrantApp@illinois.gov.  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.

    * If you have difficulty emailing the document due to the file size, please utilize the CMS File Transfer Utility. Please follow the instructions to attach your application. Remember to include the subject line below.

  4. IDHS/DMH is under no obligation to review applications that do not comply with the above requirements.
  5. 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 materials.
  6. The subject line of the email MUST state:
    1. Applicant Entity Name;
    2. "515-HSIC Joliet Hospice"

Budget Requirements

The CSA Tracking System is where the DHS requires all applicant entities to enter their GATA Budget information. It is also where DHS staff will review and take action on the proposed budget.

It is strongly recommended that if an applicant entity is not already registered in the CSA Tracking System, they should provide registration information through the contact listed in this opportunity as soon as possible so the applicant entity may submit a signed budget in CSA. New entity registration must first be done prior to receiving an Illinois external ID. It may take several days to complete the registration process so do not wait until the application due date to begin the process.

A budget and budget narrative need to be completed, electronically signed, and submitted in the CSA tracking system with the status as "GATA Budget signed and submitted to program review". At a minimum, the following is required: 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.

There is space when preparing the budget on each line item for the budget narrative. For each line in the budget the applicant will describe why each expenditure is necessary for program implementation and how the amount was determined. Please include cost allocations as necessary. The Budget narrative (including MTDC base exclusions as appropriate) must clearly identify indirect costs, direct program costs, direct administrative costs, describe how the specified resources and personnel have been allocated for the tasks and activities within each line item. See instructions for the CSA Tracking System and Budget Information. The budget should be prepared to reflect 7 months.

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.

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

Applicants 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 DHS cannot make an award to an applicant until the applicant has complied with all applicable DUNS and SAM requirements.

Award Administration Information

Applicant 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, if any, assigned to the applicant based on the fiscal and administrative review assessment (ICQ) and programmatic risk assessment (PRA).

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 in the CSA Tracking System for signature.

Award and Funding Information

This funding opportunity is considered a new application.

This opportunity is considered a grant agreement and is a non-competitive application for funding. It is not a guarantee of funding. This award utilizes State appropriated funds.

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.

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.

Unallowable Costs

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

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:

  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.


This program will be awarded as a 7-month term agreement. This is the first renewal of two. 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 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.

Post-assistance Requirements

Agreement Terms

DHS anticipates that the term of the agreement resulting from this Program Grant Opportunity will be December 1, 2021 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 opportunity at any time prior to the actual time a fully executed agreement is filed with the State of Illinois Comptroller's Office.

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 under Award and Funding Information, Indirect Cost Rate Requirements.

The legal agreement between IDHS and the applicant(s) will be the standard IDHS Uniform Grant Agreement. The applicant will be provided an IDHS grant agreement for signature and return. Click here for a sample of the agreement.


Reporting requirements for the grant agreement shall be in accordance with the requirements of the Uniform Grant Agreement.

Reporting Requirements:

  1.  Time Period for Required Periodic Financial Reports. Unless a different reporting requirement is specified in Exhibit G, Grantee shall submit financial reports to Grantor pursuant to Paragraph 13.1 and reports must be submitted no later than 30 days after the quarter ends.
  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.

Grantee shall submit a quarterly Periodic Financial Report (GOMBGATU-4002 (N-08-17)) to the appropriate email address. Reported expenses should be consistent with the approved annual grant budget. Any expenditure variances require prior Grantor approval in accordance with Article VI of the Uniform Grant Agreement to be reimbursable.

PFR Email Address for General Grants: DHS.DMHQuarterlyReports@illinois.gov  

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

DMH reporting templates and detailed instructions for submitting reports can be found in the Provider section of the DMH website.

Sources Additional Information

State Awarding Agency Contact(s)

Point of Contact:

Name: Barb Roberson

Email Address: DHS.DMHGrantApp@illinois.gov

Other Information

IDHS reserves the right to request additional information. Applicants are expected to provide the additional information within a reasonable time. Failure to provide the information could result in the rejection of the application. NOTE: Providing the requested information does not obligate DHS to provide funding nor should an agency draw any conclusions about the department's intentions to fund or not fund the application.

The release of this funding does not compel IDHS to make an award.

This funding opportunity is considered a new application.

Mandatory Forms -- Required for All Agencies

  1. Uniform State Grant Application submitted to the proper email
  2. Subrecipient Budget(s) Template GOMBGATU-3002-(R-02-17), if applicable.
  3. Budget submitted using the Uniform Grant Budget (UGB) in the CSA Tracking System with the status as "GATA Budget signed and submitted to program review".

Useful Websites

Apply for an Employer Identification Number (EIN) Online

Grant Accountability and Transparency Act website (GATA) (30ILCS 708/)

2 CFR 200 Electronic Code of Federal Regulations

Uniform Administrative Requirements, Cost Principles and Audit Requirements (2 CFR 200)

OMB Uniform Guidance

IDHS website CSA Tracking System Budget Information