515-IHPA IL Health Practice Alliance 25-444-22-3116 LAO

Program Summary

Awarding Agency Name Illinois Department of Human Services
Awarding Division Name Division of Mental Health
Agency Contact Barb Roberson DHS.DMHGrantApp@illinois.gov
Announcement Type Non-Competitive/Exception
Funding Opportunity Title 515-IHPA IL Health Practice Alliance
Funding Opportunity Number 25-444-22-3116
Application Posting Date October 1, 2024
Application Closing Date October 30, 2024, 12:00 PM CST
Catalog of State Financial Assistance (CSFA) Number 444-22-3116
Catalog of State Financial Assistance (CSFA) Popular Name 515-IHPA IL Health Practice Alliance
Assistance Listing Number (s) NA
Award Funding Source: State
Estimated Total Program Funding $2.1 Million
Number of Anticipated Awards: 1
Award Range: NA
Cost Sharing or Matching Requirement? No
Indirect Costs Allowed? Yes
Restrictions on Indirect Costs? NA

Program Description

There are too few Black and Brown Clinicians (Psychologists, Social Workers (LSW/LCSW), Counselors (LPC/LCPC), and Licensed Marriage and Family Therapists (LMFT)), in large part due to high barriers to becoming a clinician (tuition, unpaid practicum requirements). Furthermore, there is an unmet need for evidence-based therapy and psychological testing in the Medicaid population Therefore, the Illinois Health Practice Alliance has goals of this initiative that are twofold: (1) increase the number of Black and Brown clinicians by reducing barriers to becoming a clinician and (2) increase access for Medicaid recipients to receive integrated, trauma-informed evidence-based therapy and Psychological Testing. Grantee will report on the number of therapy and testing sessions offered at each site, and the number of individuals served. Grantee will also report on the of the number of students involved in the program. Grantee will conduct in-person check in events with students, supervisors, and legislators, to discuss program impact. The success of these goals lies in the establishment of training programs at 5 host sites. One site will host a Doctoral-level psychology program and the other four sites will host Master's-level programs. The following providers have been selected to be host sites:

  1. Bobby E Wright - Doctoral-level Psychology program
  2. The Link & Option Center, Inc. - Master's-level program
  3. Habilitative Systems, Inc. - Master's-level programs
  4. Hoyleton Youth and Family Services - Master's-level program
  5. The Kenneth Young Center - Master's-level program

Performance Requirements

The Grantee, IHPA will create paid internship Master-level programs at four host sites for Black and Brown Social Work, Counseling, and Family Therapy students, that provide immediate evidence-based therapy to attributed IHPA members. The Grantee will also create a Doctoral-level psychological testing practicum program for Black and Brown Psychology students, that provides immediate testing for attributed members. These programs will create opportunities for Medicaid recipients to receive integrated, trauma-informed evidence-based therapy and Psychological Testing. The 5 host sites will:

  • Identify, select, and Inform Schools of Placement Opportunities
  • Hire 5 Psychologist/Practicum Coordinator/Supervisors
  • Develop IHPA Process for referring clients for services.
  • Develop Training Curriculum for master's and doctoral level students.
  • Interview and select 25 Students for program (as allowable by school placement timeline)
  • Interview Students for next cohort (as allowable by school placement timeline)
  • Both Master's-level students and Doctoral candidates will be offered supervision
  • Identify Medicaid recipients from the IHPA attribution population and provide them services.

Performance Measures:

  1. Number of Psychologists/Practicum Coordinators/Supervisors hired and working to administer program at the 5 sites.
  2. Number of Resources/Materials/Training Curriculums needed for the program.
  3. Number of Resources/Materials/Training Curriculums developed for the program.
  4. Number of schools Identified, selected, and informed of placement opportunities.
  5. Number of students accepted and involved in the Master's-level program.
  6. Number of students accepted and involved in the Doctoral-level program.
  7. Number of total hours of clinical supervision given to students.
  8. Number of hours of trauma-informed therapy sessions offered to clients at all sites.
  9. Total number of unique Medicaid recipients seen by students at all sites

Performance Standards:

  1. Five Psychologists/Practicum Coordinators/Supervisors hired and working at sites.
  2. 100% of Resources/Materials/Training Curriculums developed for the program.
  3. Five or more schools identified, selected, and informed of placement opportunities.
  4. Twenty students accepted and involved in the Master's-level program.
  5. Five students accepted and involved in the Doctoral-level program.
  6. Fifty total hours of clinical supervision has been given to students.
  7. Fifty total hours of trauma-informed therapy sessions offered to clients at all sites.
  8. Twelve total unique Medicaid recipients were seen by students at all sites.

Funding Priorities or Focus Areas

IDHS is working to counteract systemic racism and inequity, and to prioritize and maximize diversity throughout its service provision process. This work involves addressing existing institutionalized inequities, aiming to create transformation, and operationalizing equity and racial justice. It also focuses on the creation of a culture of inclusivity for all regardless of race, gender, religion, sexual orientation, or ability.

Authorizing Statutes or Regulations

  • 59 Ill. Admin, Code 132 (Rule 132), Section 132.150g
  • Mental Health Community Services Act (405 ILCS 30/ Section (f))
  • Illinois Administrative Code Part 7000 Grant Accountability and Transparency Act
  • Public Act 103-0589, Section 540 and Section 530

Applicant Eligibility

This non-competitive funding opportunity is limited to applicants that meet the following requirements. If these requirements are not met by deadlines listed in this opportunity an award will not be made:

  • This funding opportunity is a Legislative Add-On and the award will be issued in totality to Illinois Health Practice Alliance.
  • Applicant must comply with all applicable local (city, county) and state licensing, accreditation, and certification requirements, as of the due date of the application
  • More than one application per entity is not permitted
  • Applicants must be one of the following
    • Education Organizations
  • Applicant must be a Post-Secondary Educational Institution
  • The applicant has met the Prequalification and Mandatory Requirements listed in this funding opportunity.

Pre-Qualification

Applicant entities will not be eligible to apply for a grant award until they have prequalified through the Grant Accountability and Transparency Act (GATA) Grantee Portal. Registration and prequalification are required annually. During prequalification, verifications are performed including a check of federal Debarred and Suspended status on the Illinois Stop Payment List and good standing with the Secretary of State. An automated email notification is sent to the entity alerting them of "qualified" status or providing information about how to remediate a negative verification (e.g., inactive UEI, not in good standing with the Secretary of State). A federal Debarred and Suspended status cannot be remediated.

For assistance navigating government application prequalification procedure, refer to Grant Applicant Pre-Qualification and Pre-Award Requirements (state.il.us) (pdf).

Applicants will not receive an award if pre-award requirements are not met.

The following information is required to complete registration:

  • Organization's Unique Entity Identifier (UEI); For additional information on UEI, refer to Section Unique Entity Identifier and System for Award Management (SAM) below;
  • Organization's Federal Employer Identification Number (FEIN);
  • Organization type;
  • Illinois Secretary of State File ID (required for non-profits, for-profits and limited liability corporations);
  • Organization's name;
  • Organization's mailing address;
  • Organization's primary email address;
  • Organization's primary phone number;
  • Organization's fiscal year-end date

Unique Entity Identifier (UEI) and System for Award Management (SAM)

Each applicant is required to:

  • Be registered in SAM.gov before submitting its application. Provide a valid unique entity identifier in its application; if your organization does not yet have a UEI you must request one.
  • Continue to maintain an active SAM registration with current information at all times during which it has an active award, an application, or plan under consideration by the Department

The Department may not make an award to an applicant until the applicant has complied with all applicable unique entity identifier and SAM requirements. If an applicant has not fully complied with the requirements by the time the Department is ready to make an award, the Department 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.

Pre-Award Requirements

The pre-award process includes a financial and administrative risk assessment utilizing an Internal Controls Questionnaire (ICQ). The ICQ is completed for the organization. The Department may NOT issue a Notice of Award or a Grant Agreement to any applicant that does not have a submitted and approved FY25 ICQ.

Applicants that have not completed an ICQ for the grant award year at the time of application will be contacted by the Department to complete this pre-award requirement.

This grantee pre-award requirement is mandated by Federal Uniform Guidance (2 CFR 200) and the Grant Accountability and Transparency Act (GATA). Grantees must complete these requirements prior to receiving a grant award from the State of Illinois.

The deadline to submit the ICQ is at time of application.

Registration in CSA

The Community Service Agreement Tracking System is the system the IDHS utilizes for approving budgets and issuing grant awards. 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. While registration in CSA is not part of the prequalification process, successful applicants will NOT be issued an award without a fully approved budget in the CSA System.

State and Federal Laws and Regulations

The agency awarded funds through this funding opportunity must agree to comply with all applicable provisions of state and federal laws and regulations pertaining to nondiscrimination, sexual harassment and equal employment opportunity including, but not limited to: The Illinois Human Rights Act (775 ILCS 5/1-101 et seq.), The Public Works Employment Discrimination Act (775 ILCS 10/1 et seq.), The United States Civil Rights Act of 1964 (as amended) (42 USC 2000a-and 2000H-6), Section 504 of the Rehabilitation Act of 1973 (29 USC 794), The Americans with Disabilities Act of 1990 (42 USC 12101 et seq.), and The Age Discrimination Act (42 USC 6101 et seq.).

Indirect Cost Rate

Indirect Costs may be applied to this grant award. Indirect cost rates must be approved.

Indirect Cost Requirements and Restrictions

  • In order to charge indirect costs to this grant, the applicant organization must have a Federal or State annually negotiated indirect cost rate agreement (NICRA) or must elect to use the De Minimis Rate.
  • Every organization that receives a state award must make an indirect cost rate proposal or election in the State of Illinois Grantee Portal, Centralized Indirect Cost Rate Election System, including organizations that are choosing not to claim payment for indirect costs.
  • The Illinois Centralized Indirect Cost Rate System will allow your organization to document your already established federally approved indirect cost rate or complete an indirect cost rate proposal (see State Negotiated Rate above). Submission requirements are located on page 2 of the Uniform Grant Budget Template as well as 2 CFR 200 Appendices IV, V & VII.
  • Organizations which have not previously made an indirect cost rate election must submit an election (and indirect cost rate proposal, if necessary) immediately and no later than 3 months after receiving an award notification. If the organization elects to submit a Federally Negotiated Rate or a State Negotiated Rate, they will receive an invitation to submit their proposal in the Illinois Centralized Indirect Cost Rate System.
  • Organizations that have previously established an indirect cost rate election and would like to continue with a Federal or State Negotiated Rate must submit a new indirect cost rate election immediately and no later than 6 months after the close of their organization's fiscal year.
  • Organizations that do not make a submission inside the Illinois Centralized Indirect Cost Rate System within the required timeframes will not be allowed to claim indirect cost reimbursement.
  • For more information, see:

Grant Fund Use Requirements

All applicants will use grant funds according to the guidelines, conditions, and parameters set forth in this funding notice and in compliance with federal statutes, regulations and the terms and conditions of any applicable federal awards.

Please refer to 2 CFR 200 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, PART 200 Subpart E - Cost Principles to determine the appropriateness of costs.

  • Allowable costs are those that are necessary and reasonable based on the activity(ies) contained in the Scope of Work, are justified in the Budget Narrative, and are allowable under Subpart E of 2 CFR 200. It is expected that administrative costs, both direct and indirect, will represent a small portion of the overall program budget. Any budget deemed to include inappropriate or excessive administrative costs will not be approved. Program budgets and narratives must detail how all proposed expenditures are necessary for program implementation.
  • Unallowable costs: Please refer to 2 CFR 200 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, PART 200 Subpart E - Cost Principles to determine the appropriateness of costs. In addition, and specific to this grant, the following costs will be unallowable without specific prior written approval from IDHS:
    • Entertainment costs, except where specific costs that might otherwise be considered entertainment have a programmatic purpose and are authorized in the approved budget (2 CFR 200.438)
    • Capital expenditures for general purpose equipment, including any vehicle regardless of cost, buildings, and land (2 CFR 200.439)
    • Capital expenditures for improvements to land, buildings, or equipment which materially increase their value or useful life (2 CFR 200.439)
    • Food, and other goods or services for personal use of the grantee's employees, contractors, or consultants of the grantee unless authorized as per diem under the State of Illinois Governor's Travel Control Board (2 CFR 200.445).
    • Deposits for items, services, or space

Simplified Acquisition Threshold

  • It is anticipated that this grant award may receive over $250,000. Potential grantees under this funding announcement may receive an award in excess of the Simplified Acquisition Threshold (currently $250,000) (Refer to 2 CFR 200 Section 200.1). Therefore, the grantee is subject to Simplified Acquisition Threshold and related requirements.
  • IDHS prior to making an award with a total amount greater than the simplified acquisition threshold, is required to review and consider any information about the applicant that is in the designated integrity and performance system accessible through SAM (currently FAPIIS) (see 41 U.S.C. 2313);
  • That an applicant, at its option, may review information in the designated integrity and performance systems accessible through SAM and comment on any information about itself that a State or Federal awarding agency previously entered and is currently in the designated integrity and performance system accessible through SAM
  • IDHS will consider any comments by the applicant, in addition to the other information in the designated integrity and performance system, in making a judgment about the applicant's integrity, business ethics, and record of performance under State and Federal awards when completing the review of risk posed by applicants as described in § 200.206.

Application and Submission Requirements

Address to Request Application Package

  • The complete application package (including links to required forms) is available throughout this opportunity.
  • Each applicant must have access to the internet. The Department's website will contain information regarding the materials necessary for submission.
  •  DHS.DMHGrantApp@illinois.gov

Content and Form of Application Submission

Uniform Application for State Grant Assistance

The Uniform Application for State Grant Assistance is a three-page document used to formalize organization's request to apply for funding.

Page 1 of the application is pre-populated with the appropriate information. Applicants must not complete anything on Page 1. The correct application must be used.

Page 3 of the document requires the amount applying for, signature and the organization's authorized representative.

Application Submission Dates and Times

Intergovernmental Review

This funding opportunity is not subject to Executive Order 12372, Intergovernmental Review of Federal Programs.

Application Submission

  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. IDHS cannot guarantee a start date of July 1, 2023, if application submissions are received after the due date referenced in the Program Summary above.
  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. The email of the original sender of the application will be used for official communication between the Department and the applicant organization for matters regarding this application.
  4. 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.
  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. 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-IHPA IL Health Practice Alliance

Budget Requirements

Funding Restrictions

The applicant must develop a budget consistent with program requirements. Proposed budgets must be sufficiently detailed and justified to be approved by IDHS.

Deadline for submission of the budget, in the CSA Tracking System, is the same as the application deadline.

  • The CSA Tracking System is where the IDHS requires all applicants to enter their GATA Budget information. It is also where IDHS staff will review and take action on the proposed budget. The CSA Tracking system requires that you have different credentials than what you have for the Illinois GATA Grantee Portal. Please follow the directions below to sign the proposed budget.
  • 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". A copy is not to be submitted along with the application packet.
  • 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, and 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. Applicants will NOT be issued an award without the applicant's fully approved budget in the CSA System.

Subrecipient budget(s)

  • If applicant is planning to use a subrecipient, a pdf copy of the subrecipient budget must be submitted as a separate pdf document with the application packet.
  • Subrecipient budgets shall be submitted on the IDHS/DMH Budget template (GOMBGATU-3002-(R-02-17).

Grantee Conflict of Interest Disclosures

Every grantee and subrecipient must disclose in writing any actual or potential Conflict of Interest as part of the grant application packet using the Grantee Conflict of Interest Disclosure Form IL444-5205.

Grantee Conflicts of Interest include, but are not limited to:

  1. Grantee has an employee, board member, trustee, or immediate family member who:
    1. Holds an elected or appointed office in Illinois.
    2. Holds a seat in the Illinois General Assembly.
  2. Is an officer or employee of any State board, commission, authority, or holds an elected or appointed position or is employed in any of the offices or agencies of State government.
  3. Grantee has a financial interest, including ownership of stocks or bonds, in a firm which is a vendor or contractor.
  4. Grantee has outstanding financial commitments to any vendor or contractor.
  5. Grantee has a close personal relationship. such as a spouse, dependent child, or member of the technical advisor's household, that may compromise or impair the fairness and impartiality of the technical advisor and grants officer during the solicitation development, proposal evaluation, award selection process, and management of an award.
  6. Grantee has any negotiation of employment with current or potential sub-recipient or vendor.

Additional examples of Grantee Conflicts of Interest can be found in the Grant Accountability and Transparency Act (GATA) Website Resource Library.

Simplified Acquisition Threshold - Federal Awards

Potential grantees under this funding announcement may receive an award in excess of the Simplified Acquisition Threshold, currently $250,000 (Refer to 2 CFR 200 Section 200.88). Therefore, the grantee is subject to Simplified Acquisition Threshold. Refer to Section "Preapplication Coordination", "Grant Fund Use Requirements".

Mandatory Submissions

Award Procedures

Applicants agree to provide program services as described throughout this Funding Opportunity.

Start Date: Applicants must be in a position to begin offering services on July 1, 2024.

Agreement Terms

IDHS anticipates that the term of the agreement resulting from this Program Grant Opportunity will be July 1, 2024, continuing through June 30, 2025, 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. Post Award Requirements of Applicant

Post Award Requirements of Applicant

If the State share of any State award may include more than the requirements applicable reflected in 2 CFR 200, Appendix XII - Award Term and Condition for Recipient Integrity and Performance Matters then the recipient of the grant, during that period of time must maintain the currency of information reported to the System for Award Management (SAM) that is made available in the designated integrity and performance system (currently the Federal Awardee Performance and Integrity Information System (FAPIIS)) about civil, criminal, or administrative proceedings described in paragraph 2 of this award term and condition. This is a statutory requirement under section 872 of Public Law 110-417, as amended (41 U.S.C. 2313). As required by section 3010 of Public Law 111-212, all information posted in the designated integrity and performance system on or after April 15, 2011, except past performance reviews required for Federal procurement contracts, will be publicly available.

State Award Notices

  • Applicants recommended for funding under this non-discretionary opportunity will receive a Notice of State Award (NOSA). This notification is sent to the main contact listed in the Grantee Portal; therefore, it is important to keep contact information in the Grantee Portal updated. The NOSA shall include:
    • Grant award amount
    • The terms and conditions of the award
    • Specific conditions, if any, assigned to the applicant based on the fiscal and administrative risk assessment (ICQ).
  • Note: The Department cannot issue a NOSA until the successful applicant has an approved budget entered into CSA. The applicant shall receive the NOSA through the Grantee Portal. The NOSA must be Accepted or Declined by the grants officer (or equivalent). This acceptance of the NOSA effectively accepts the state award amount and all conditions set forth within the notice. This accepted NOSA is the document authorizing the Department to proceed with issuing a grant agreement. The NOSA must be Accepted or Declined through the Grantee Portal. A hard copy is not required.
  • The NOSA must be accepted by the grants officer (or equivalent). This effectively accepts the state award amount and all conditions set forth within the notice. This accepted NOSA is the document authorizing the Department to proceed with issuing a grant.
  • The NOSA is NOT an authorization to begin performance (to the extent that it allows charging to State awards of pre-award costs at the non-State entity's own risk).
  • After the Uniform Grant Agreement is published in the CSA Tracking System, it must be signed, and the signature page submitted to the Office of Contract Administration at DHS.OCA.SignaturePages@illinois.gov.
  • An award is NOT considered to be fully executed until both parties have signed the grant agreement. 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.

Payment Terms

  • It is the policy of the Illinois Department of Human Services (IDHS) that this policy complies with 2 CFR 200.302, 2 CFR 200.305, 31 CFR 205 (procedures implementing Cash Management Improvement Act and Treasury-State Agreement (TSA)), and 44 Ill. Admin. Code 7000.120 (GOMB Adoption of Supplemental Rules for Grant Payment Methods). Three different award payment method exist, namely Advance Payment, Reimbursement, and Working Capital Advance.
  • Grantees selecting the Advance Payment Method, or the Working Capital Advance Payment Method must complete the Advance Payment Request Cash Budget Template as described in the procedures above. In addition, please note: If you will be submitting the Advance Payment Request Cash Budget, it must be submitted with the application materials as a separate document.

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. All invoices shall be HIIPA compliant and encrypted utilizing DHS approved encryption software, and emailed to DMH at the email address:

Monthly Invoices and Quarterly PFR Email Address for General Grants: DHS.DMHQuarterlyReports@illinois.gov  

Payment Forms

Monthly Invoice IL444-5257

Advance Payment Request Cash Budget Form (IL444-4985) Only if requesting an advance payment

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. Providing the requested information does not obligate IDHS to provide funding nor should an agency draw any conclusions about the department's intentions to fund or not fund the application.

Administrative and National Policy Requirements

  • The agency awarded 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.
  • You can find a sample of the grant agreement at IDHS Uniform Grant Agreement.

Renewals

This program will be awarded as a 12-month term agreement. IDHS/DMH does not anticipate there will be renewals.Formula and Matching Requirements

Formula and Matching Requirements

Cost Sharing or Matching:

Grantees are not required to participate in cost sharing or provide match.

Uses and Restrictions

  • This funding opportunity is considered a new application.
  • The release of this funding opportunity does not obligate the Illinois Department of Human Services to make an award.
  • 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.
  • Serves as Maintenance of Effort to the Federal Substance Abuse and Mental Health Services Administration Community Mental Health Block Grant

Allowable Costs

All applicants will use grant funds according to the guidelines, conditions, and parameters set forth in this funding notice and in compliance with federal statutes, regulations and the terms and conditions of any applicable federal awards.

Reports

  • Upon execution of the grant agreement, reporting shall be in accordance with the requirements set forth in the Uniform Grant Agreement and related Exhibits which includes, but is not limited to the following:
    • Periodic Financial Reports.
    • Close-out Reports.
    • Periodic Performance Reports.
    • Close-out Performance Reports.
    • Other Unique Programmatic Reporting Requirements: Additional annual performance data may be collected as directed by the Department and in a format prescribed by the Department.
  • If the State share of any State award may include more than $500,000 over the period of performance, applicants are also subject to the reporting requirements reflected in Appendix XII to 2 CFR 200.
  • Non-compliance with any of the identified reports may lead to being placed on the Illinois Stop Payment List (SSPL).
  • 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 IDHS website.

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