Grant Agreement Invoice & Reporting Requirement
FY24 Instructions and Requirements
Please refer to each Uniform Grant Agreement Exhibits -Deliverables, Payment Terms, Performance Measures and Performance Standards for invoice and reporting instructions and requirements.
Invoices/PFRs
The Monthly Invoice IL444-5257 template must be used for all DMH programs and submitted no later than 15 days after the end of the month. For Program 850 please consult your individual Exhibit -Payment Terms. For Program 796, please use the Monthly Fixed Rate Grant Invoice IL444-4579 template.
DMH Programs require submission of a quarterly Periodic Financial Report (PFR) (GOMBGATU-4002-PFR). Quarterly PFRs do not require a signature, only a typed name and title of authorized grantee representative, date submitted, email, and phone number in the Grantee Certification section.
Grantees should select the applicable invoice template, complete all required fields, type signature, date, and email to DMH at the email address:
Monthly Invoices and Quarterly PFR Email Address for General Grants: DHS.DMHQuarterlyReports@Illinois.gov
Monthly Invoices and Quarterly PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov
Monthly Invoices and Quarterly PFR Email Address for Colbert Consent Decree: DHS.Colbert.Invoices@illinois.gov
Grantee reimbursements will be disbursed after the invoice is correctly completed, submitted, and approved by DMH Fiscal.
Periodic Performance Reports
Performance reporting has 2 elements that are required quarterly for all grants:
- Part I - a standard GOMBGATU-4001 template, which is required for all DMH grants. Instructions for this template are included with the document.
- Part II - a grant specific DMH Excel Performance Report Template by Program (PRTP) which is required in lieu of items 14 through 22 on the GOMBGATU-4001.
The GOMBGATU-4001 will capture information common to all DMH grants, while the PRTP is designed to capture the specific programmatic deliverables of each grant. Be sure to check the red box on the GOMBGATU-4001 under item #13 and enter the statement, "Information included on DHS/DMH provided program template," in the text box below the red check box. Continue completing items 23-26. Please contact your Program Contact for the PRTPs for each program.
The GOMBGATU-4001 and PRTP do not require a signature. The GOMBGATU-4001 only requires a typed name and title of authorized grantee representative, email, and phone number in the Grantee Certification section.
All Periodic Performance Reports, PPR, and PRTP, should be submitted to DHS.DMHQuarterlyReports@Illinois.gov .
Notices will be sent to any grantee missing due dates to prompt compliance and avoid stop payment.
Report Labeling for Submission
Please follow the below Program 590 Crisis Care example for labeling protocol to ensure documents are directed to the appropriate place for processing.
- If Colbert or Williams Consent Decree, please include COCD for Colbert and WMCD for Williams.
- For the Invoice examples: "Agency Name_FY24_July_590_Crisis Care_Invoice" and "Agency Name_FY24_July_590_Crisis Care_COCD_Invoice"
- For the Periodic Financial Report (PFR) only if invoice is not required using DMH Grants Invoice/PFR template: "Agency Name_FY24_Q1_590_Crisis Care_PFR" or "Agency Name_FY24_Q1_590_Crisis Care_COCD_PFR"
- For the Periodic Performance Report (PPR) using GOMBGATU-4001 template: "Agency Name_FY24_Q1_590_4001_PPR"
- For the Periodic Performance Report using DMH Performance Report Template by Program (PRTP): "Agency Name_FY24_Q1_590_Excel_PRTP"
All Invoices Containing Protected Health Information
Special emailing instructions apply to protect consumer protected health information (PHI). Grantees should follow instructions from the Program Contact on the program specific submission of necessary PHI. PHI must be encrypted and sent to a specific person as noted below.
Williams invoices must be encrypted to Rebecca Paz and Connie Mariscal-Garcia and submitted to: DHS.DMHWilliamsInvoices@illinois.gov .
Colbert invoices must be encrypted to Rebecca Paz and submitted to DHS.Colbert.Invoices@illinois.gov .
For questions regarding programs and document requirements, please refer to your Program Contact.
FY24 Instructions and Requirements
Please refer to each Uniform Grant Agreement Exhibits B, C, E, and F for invoice and reporting instructions and requirements.
Invoices/PFRs
The Monthly Invoice IL444-5257 (pdf) template must be used for all DMH programs and submitted no later than 15 days after the end of the month. For Program 850 please consult your individual Exhibit C.
DMH Programs require submission of a quarterly Periodic Financial Report (PFR) (GOMBGATU-4002-PFR (pdf)). Quarterly PFRs do not require a signature, only a typed name and title of authorized grantee representative, date submitted, email, and phone number in the Grantee Certification section.
Grantees should select the applicable invoice template, complete all required fields, type signature, date, and email to DMH at the email address:
Monthly Invoices and Quarterly PFR Email Address for General Grants: DHS.DMHQuarterlyReports@Illinois.gov
Monthly Invoices and Quarterly PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov
Monthly Invoices and Quarterly PFR Email Address for Colbert Consent Decree: DHS.Colbert.Invoices@illinois.gov
Grantee reimbursements will be disbursed after the invoice is correctly completed, submitted, and approved by DMH Fiscal.
Periodic Performance Reports
Performance reporting has 2 elements that are required quarterly for all grants:
- Part I - a standard GOMBGATU-4001 (pdf) template, which is required for all DMH grants. Instructions for this template are included with the document.
- Part II - a grant specific DMH Excel Performance Report Template by Program (PRTP) which is required in lieu of items 14 through 22 on the GOMBGATU-4001.
The GOMBGATU-4001 will capture information common to all DMH grants, while the PRTP is designed to capture the specific programmatic deliverables of each grant. Be sure to check the red box on the GOMBGATU-4001 under item #13 and enter the statement, "Information included on DHS/DMH provided program template," in the text box below the red check box. Continue completing items 23-26. Please contact your Program Contact for the PRTPs for each program.
The GOMBGATU-4001 and PRTP do not require a signature. The GOMBGATU-4001 only requires a typed name and title of authorized grantee representative, email, and phone number in the Grantee Certification section.
All Periodic Performance Reports, PPR, and PRTP, should be submitted to DHS.DMHQuarterlyReports@Illinois.gov.
Notices will be sent to any grantee missing due dates to prompt compliance and avoid stop payment.
Report Labeling for Submission
Please follow the below Program 590 Crisis Care example for labeling protocol to ensure documents are directed to the appropriate place for processing.
- If Colbert or Williams Consent Decree, please include COCD for Colbert and WMCD for Williams.
- For the Invoice: "Agency Name_FY24_July_590_Crisis Care_Invoice" or "Agency Name_FY24_July_590_Crisis Care_COCD_Invoice"
- For the Periodic Financial Report (PFR) only if invoice is not required using DMH Grants Invoice/PFR template: "Agency Name_FY24_Q1_590_Crisis Care_PFR" of "Agency Name_FY24_Q1_590_Crisis Care_COCD_PFR"
- For the Periodic Performance Report (PPR) using GOMBGATU-4001 template: "Agency Name_FY24_Q1_590_4001_PPR"
- For the Periodic Performance Report using DMH Performance Report Template by Program (PRTP): "Agency Name_FY24_Q1_590_Excel_PRTP"
All Invoices Containing Protected Health Information
Special emailing instructions apply to protect consumer protected health information (PHI). Grantees should follow instructions from the Program Contact on the program specific submission of necessary PHI. PHI must be encrypted and sent to a specific person as noted below.
Williams invoices must be encrypted to Rebecca Paz and Connie Mariscal-Garcia and submitted to: DHS.DMHWilliamsInvoices@illinois.gov.
Colbert invoices must be encrypted to Rebecca Paz and submitted to DHS.Colbert.Invoices@illinois.gov.
For questions regarding programs and document requirements, please refer to your Program Contact.
