- Scope of Services
- Performance Measures
- Performance Standards
- Award and Funding Information
- Eligibility Information
- Application and Submission Information
- Funding Restrictions
- Award Administration Information
- Mandatory Forms -- Required for All Agencies
Scope of Services
The scope of activities for this Add-On is in direct response to legislative initiative to increase access to case management, mental health, and domestic violence services to constituents with no Medicaid or other health insurance along with limited English-speaking abilities. These activities to improve access will be launched by case management staff, outreach workers, and intake assistants to handle client flow and admissions. Furthermore, funding will be available 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. To increase awareness of these services and generate referrals, a robust campaign will be launched to engage other community providers such as Welcoming Centers, and medical clinics, to name a few. One other component of this initiative is to minimize barriers such as lack of transportation by providing resources via transit passes and shared rides as needed.
- Time Period for Required Periodic Financial Reports. N/A Grantee will be paid via invoice.
- 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.
- 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.
- 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.
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:
- Schedule and hold at least one initial, individual face-to-face meeting with each potential utilizer to: (1) Provide literature and brochures on domestic violence prevention options and support services; (2) Identify relevant services and supports available to potential utilizers to ensure safe and successful transitions. Repeat meetings will be held if requested by the potential utilizer, as often as desired and reasonably available.
- Provide information to potential service utilizers during the first face-to-face meeting, or as requested, on the array of services and supports, by defining and explaining terms such as (but not limited to) ACT, CST, medication administering and monitoring, supportive employment, housing assistance, peer support, etc.
- Use innovative ways to engage populations outside of these deliverables.
- 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, available services and supports.
- 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.
- 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.
- Provide a written "menu" of services, supports, and housing options 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, Domestic Violence Services, Housing Placement Assistance, and Post-Partum Depression 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.
- Number of constituents referred to receive case management and domestic violence services.
- Number of constituents admitted for case management and domestic violence services will have an assessment scheduled and completed.
- Number of constituents without Medicaid and other health insurance who received services.
- Number of constituents assisted in applying for Medicaid.
- Number of community engagement and promotional activities conducted.
- Number of constituents received transportation support via transit fare or shared rides.
- Number of constituents in need of housing.
- Number of constituents assisted in applying for housing services.
- 80% of constituents admitted for case management and domestic violence services had an assessment scheduled and completed.
- 100% of constituents admitted for case management and domestic violence services did not have Medicaid or other health insurance.
- 95% of constituents deemed eligible were assisted in applying for Medicaid.
- 90% of constituents deemed eligible received transportation support.
- 90% of constituents in need of housing were assisted in applying for housing.
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.
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 are those that are necessary, reasonable, and permissible under the law and can be found in 2 CFR 200 - Subpart E - Cost Principles.
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:
- 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.
- 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
- 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.
- 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 an 8-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:
- Applicant has performed satisfactorily during the most recent past funding period.
- All required reports have been submitted on time, unless a written exception has been provided by the Division.
- No outstanding issues are present (i.e. in good standing with all pre-qualification requirements); and
- Funding for the budget year has been appropriated in the state's approved fiscal year budget.
This funding opportunity is limited to those who currently have an award for this program.
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:
- Apply for or update their DUNS number.
- Apply for or update their SAM registration and receive a SAM cage code. This must be done annually.
- Be registered and in good standing with the Illinois Secretary of State (This is not required of governmental entities and schools.)
- Register with the GATA system.
- Registration in CSA
- 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.
- 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.
- Register with the Centralized Repository Vault (CRV).
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.
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 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.
- 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 Submission Information
Address to Request Application Packet
Each applicant must have access to the internet. Applicants may obtain application forms at the Division's Grant Information website.
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. The applicant must check the box "I Agree", sign and date this document (electronic signature is permitted).
- The Application Packet
- Submission shall include the 3-page Uniform Application
- Subrecipient budget(s)
- 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.
- Subrecipient budgets shall be submitted on the DHS/DMH Budget template (GOMBGATU-3002-(R-02-17) as an attachment.
- Attachments must be submitted at the time of the application packet in a separate pdf document.
Application Packet Submission Due Dates and Times
- 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.
- 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.
- 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.
* 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.
- IDHS/DMH is under no obligation to review applications that do not comply with the above requirements.
- Applicants will receive an email to notify them that the application was received. The email reply will be sent to the original sender of the application materials.
- The subject line of the email MUST state:
- Entity Name;
- Program Name ("Adolescent Intensive Outpatient Program 515-AIOP")
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 begin the registration as soon as possible so they may submit a signed budget in CSA by the application due date. 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 8 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. Applicants will NOT be issued an award without a fully approved budget in the CSA System. \
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.
Award Administration Information
DHS anticipates that the term of the agreement resulting from this Program Grant Opportunity will be upon execution 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.
State Award Notices
It is anticipated that a Notice of State Award (NOSA) will be made in November 2021.
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:
- The terms and conditions of the award.
- 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.
A Notice of Non-Selection shall be sent via email to the applicants not receiving awards.
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.
State Awarding Agency Contact(s)
Point of Contact:
Name: Barb Roberson
Email Address: DHS.DMHGrantApp@illinois.gov
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
- Uniform State Grant Application submitted to the proper email
- Subrecipient Budget(s) Template GOMBGATU-3002-(R-02-17) (pdf), if applicable.
- 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".