2712 Rincon Family Services Initiative Add-On Program (515-RICN)

Scope of Services

The scope of activities for this Add-On is in direct response to legislative initiative to reduce the stigma surrounding behavioral health access through increased access to mental health counseling, case management services, mental health treatment in underserved communities for persons with no Medicaid or other health insurance. To improve access Grantee will provide community wide forums and workshops in underserved and underrepresented neighborhoods to decrease mental health stigma. Grantee will dispatch case management staff and outreach workers into the community as well as provide workshops and other training functions through the Rincon New Hope School of Counseling. Additionally, DMH funding will be utilized to cover the costs for constituents with no health insurance while case management support is provided to assist in securing Medicaid, housing, and other needs identified.

Program Deliverables

Performance Requirements:

Outreach Deliverables

Outreach services are required to educate and inform the community of services, opportunities and resources available to them. The Grantee will deliver the following Outreach services, of which there is a preference for peer-based provision of such, i.e. individuals with lived recovery experience:

  1. Schedule and hold at least four (4) community outreach events to: (1) Provide literature and brochures on mental health treatment and support services; (2) Conduct Informationals and forums to encourage participation in Mental Health First Aide trainings.
  2. Provide information to potential service utilizers, related to trauma care including Think Trauma and other strategies to address trauma and delinquency; trauma's impact on development; coping strategies; and vicarious trauma, organizational stress, and self-care.
  3. Use innovative ways to engage populations outside of these deliverables.
  4. Hold informational question and answer sessions with community members at least twice a year to address the array of community resources available and how they are obtained. Discussions should include providing information regarding housing options, employment services and other available social services and supports.
  5. Provide a warm hand-off to the Assessment staff to obtain consent for Assessment whenever possible and especially when requested or needed based on the interaction with the utilizer.
  6. Document the outcome of each outreach interaction with potential utilizers, such as but not limited to questions and/or concerns raised, reasons for not moving forward or declining outreach.
  7. Provide a written "menu" of services, supports, and community resources that may be available potential utilizers and explain how the Grantee will assist in applying for these services.

Case Management Deliverables

Case Management staff coordinate the care and services at each step of the process for potential utilizers in the community. Case Management staff must demonstrate leadership and accountability in managing their caseloads and ensuring the best care and services are provided to service utilizers. This includes but is not limited to being able to navigate changes at the system or individual level, the ability to clearly communicate with the interdisciplinary team, service utilizers, participant supporters and providers, and the ability to advocate for participants and resolve conflicts. Case Management staff must engage in ongoing learning and professional development and seek appropriate certifications as needed. Coordination activities include, but are not limited to the following:

Care Management Staffing

Grantee will maintain a full array of Case Management staff with the required education and clinical background to support the positions, up to but not limited to Masters Degrees in Social Work, Psychology, or other highly-related fields.

Grantee Service Capacity Deliverables

The Grantee shall ensure staffing levels are adequate to accommodate all potential utilizers that accept services based on the outreach conducted by the Grantee. This includes all services available to the utilizer, including Outreach, Assessment, Service Planning, Mental Health Services. Grantee must have sufficient staff and resources to provide these services and supports according to the specifics contained in Exhibit E-Performance Measures and Reporting, and Exhibit F-Performance Standards, and within the time frames identified. Any failure to meet these performance measures in a timely manner will require a justification of said deficiencies, including identify staffing resources that may have contributed to the deficiency. Grantee is required to maintain sufficient staff to perform all obligations under this Grant


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 constituents referred to receive case management services.
  2. Number of Mental Health First Aide Trainings Conducted.
  3. Number of persons who completed Mental Health First Aide Trainings.
  4. Number of constituents without Medicaid and other health insurance who received services.
  5. Number of constituents assisted in applying for Medicaid.
  6. Number of community engagement and promotional activities conducted.
  7. Number of constituents received transportation support via transit fare or shared rides.

Performance Standards

  1. 80% of constituents admitted for case management had an assessment scheduled and completed.
  2. 90% of persons attending Mental Health First Aide Training completed a post training.
  3. 95% of constituents deemed eligible were assisted in applying for Medicaid.
  4. 90% of constituents deemed eligible received transportation support.

Program Deliverables

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

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

Applicant Eligibility

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.

Cost Sharing or Matching:


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.

Prior to applying, every applicant must first be registered and prequalified through the following steps. This must be done on or before the application's due date or the application CANNOT be accepted for review.

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.
    2. It is strongly recommended that if an applicant entity is not already registered in the CSA Tracking System, they should begin the registration as soon as possible so they may submit a signed budget in CSA by the application due date.

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 process so do not wait until the application due date to begin the process.

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, which are due no later than December 6, 2021:

  1. Applicant Entities must complete an 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.

Application Procedures

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. The template may be found on the GATA website under "B, Budget", "Uniform Budget Template for FY20"

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. Application submissions received after the due date will not be considered for review or funding, and will be immediately disqualified.
  3. 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.
  4. 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 before the submission deadline date and time.

    * 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.

  5. IDHS/DMH is under no obligation to review applications that do not comply with the above requirements.
  6. 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.
  7. The subject line of the email MUST state:
    1. Entity Name;
    2. Program 515-RICN Rincon Family Services

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 by the application due date. 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 12 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 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.

Agreement Terms

DHS anticipates that the term of the agreement resulting from this Program Grant Opportunity will be July 1, 2022 continuing through June 30, 2023 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.

Award Procedures

Applicants 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. The grant agreement will also be published in the CSA Tracking System for signature.

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 renewal of funding does not compel IDHS to make an award.

This funding opportunity is considered a new application.

Post Assistance Requirements

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. See a sample of the agreement.

Uses and Restrictions

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/Federal 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.

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".