515-HDSD Health Disparities & Social Determinants (25-444-22-3307) LAO

Summary Information

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 Legislative Add-On/Exception
Public Act SB 251, Public Act 103-0589, Section 540
Funding Opportunity Title 515-HDSD Health Disparities & Social Determinants
Funding Opportunity Number 25-444-22-3377
Application Posting Date December 12, 2024
Application Closing Date January 7, 2025, 12:00 PM (Noon) Central Time
Catalog of State Financial Assistance (CSFA) Number 444-22-3377
Catalog of State Financial Assistance (CSFA) Popular Name 515-HDSD Health Disparities & Social Determinants
Catalog of Federal Domestic Assistance (CFDA) Number(s) Not Applicable

A. Funding Details

1. Total Amount of Funding

  1. The Department expects to award approximately $1,000,000.
  2. The source of funding for this program is State funds.

2. Number of Grant Awards

a. This funding opportunity is a Legislative Add-On (LAO) and the award will be issued in totality to Habilitative Systems.

3. Expected Dollar Amount of Individual Grant Awards

a. The Department anticipates that the dollar amount for this award will be $1,000,000

4. Renewal or Supplementation of Existing Projects Eligibility

  1. This program will be awarded as a 12-month term agreement.
  2. IDHS/DMH does not anticipate there will be renewals.

5. Procurement Contract Allowability

  1. Subcontractor Agreement(s) and budgets must be pre-approved by the Department and on file with the Department. Subcontractors are subject to all provisions of this Agreement. The successful applicant Agency shall retain sole responsibility for the performance and monitoring of the subcontractor.

6. Funding Restrictions

  1. Pre-Award Costs
    1. Pre-Award costs are not allowable for this award.
    2. IDHS grants are governed by 2 CFR. Part 200, Subpart E-Cost Principles and 30 ILCS 708 which include information on allowable costs, audit requirements, and financial records.
  2. Indirect Costs
    1. Indirect Costs may be applied to this grant award. Indirect Cost rates must be approved through the Illinois Indirect Cost Rate Election System (ICRES).

B. Key Dates

1. Application Posting Date

a.  12/12/2024

2. The Department must receive the Full Application Packet:

a. Due on January 7, 2025, at 12:00 p.m. (Noon) CST

3. Anticipated Start Date and Periods of Performance for grant awards

a. Subject to appropriation, the grant period will begin no sooner than 07/01/2024 and will continue through 06/30/2025.

C. Executive Summary

HSI will enhance its Urban Behavioral Health Services Institute (UBHSI) to address Health Disparities, Trauma and Social Determinants of Health (SDOH) in Chicago's Impoverished Communities. The range of treatment services vary in level of intensity; and may address a variety of needs, including, but not limited to, problem resolution, situational stressors, family relations, housing, interpersonal relationships, behavior management, mental health issues, life span issues, psychiatric illnesses, and/or other trauma (s). Providing training in these areas assure the needed impact at the community-based level to impact recidivism. With such a large presence in several communities spanning the Chicagoland area, HSI is dependent upon technology to ensure quality and efficient service delivery to its clients. A new hire and projected revenue will be used to enhance their sustainability efforts, improve outputs and outcomes, and increase their reach in the community.

The Gen Z Mental Health Ambassador program will continue to engage youth in mental health, substance disorder, trauma, mindfulness and cognitive behavior discussions.

Habilitative Systems, Inc. team members and partners will bring their experience with technical support to community providers and work to insulate small community-based organizations with tested and proven evidence-based practices in providing resources to address the trauma and the needs incurred from the violence that affects their communities.

D. Agency Contact Information

  1. If you have questions about this funding opportunity, please contact:
    1. Barb Roberson
    2. Email: DHS.DMHGrantApp@Illinois.gov

II. Eligibility

A. Eligible Applicants

  1. This funding opportunity is a Legislative Add-On and the award will be issued in totality to Habilitative Systems.
  2. The type of applicant for the grant award is a Nonprofit Organization
  3. The applicant must meet the Registration, Pre-qualification, and any other Mandatory Requirements listed in this funding opportunity.
    1. The Applicant must provide the following information via the Grantee Portal annually to be registered with the State of Illinois as an awardee:
      1. Organization Name and Contact Information
      2. Federal Employee Identification Number (FEIN)
      3. Unique Identity Number (UEI)
      4. Organization Type
    2. The Applicant must be prequalified; therefore, applications from entities that have not prequalified prior to the due date of this application will NOT be reviewed until applicant is prequalified. Items i) through v) below are the prequalification requirements.
      1. Unique Entity Identifiers and SAM Registration. Each applicant (unless the applicant is an individual or State awarding agency that is exempt from those requirements under 2 CFR § 25.110(b) or (c), or has an exception approved by the Federal or State awarding agency under 2 CFR § 25.110(d)) is required to:
        1. Be registered in SAM.gov before the application due date.
        2. Provide a valid unique entity identifier (UEI) in its application.
        3. 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 the awarding agency.
        4. The State Agency may not make an award until applicant has fully complied to all UEI and SAM requirements.
      2. Must be in "good standing" with the Illinois Secretary of State if the Illinois Secretary of State requires the entity's organization type to be registered.
      3. Must not be on the Illinois Stop Payment List.
      4. Must not be on the SAM.gov Exclusion List.
      5. Must not be on the Medicaid Sanctions List.
  4. The applicant will not receive an award if pre-award requirements are not met. Qualified status is re-verified nightly. If the entity's status changes, an email notice is sent to the designated entity representative with a link to the Grantee Portal.
  5. See Section number I(A)(6) for funding restrictions.
  6. Other factors that would disqualify an applicant or application include:
    1. Not Applicable

7. Limit on Number of Applications: More than one application per entity is not permitted.

B. Cost Sharing

  1. Providers are not required to participate in cost sharing or provide match.
  2. Serves as Maintenance of Effort to the Federal Substance Abuse and Mental Health Services Administration Community Mental Health Block Grant.

III. Program Description

Habilitative Systems, Inc. (HSI) is a nationally recognized and accredited behavioral health and human services agency that seeks to further develop a continuum of care model to enhance much-needed programs for underserved populations and people living with an array of health and human service needs. Headquartered on the west-side of Chicago, HSI has provided supportive programs to Chicago's most disadvantaged and vulnerable residents since 1978 and provides services to over 7,000 people annually in the North Lawndale, West Garfield, Austin, Humboldt Park, and Englewood communities.

HSI will enhance its Urban Behavioral Health Services Institute (UBHSI) to address Health Disparities, Trauma and Social Determinants of Health (SDOH) in Chicago's Impoverished Communities. As a Historically Black Community Based Organization (HBCBO), HSI will support other grass roots HBCBOs and create greater access to care. The range of treatment services vary in level of intensity; and may address a variety of needs, including, but not limited to, problem resolution, situational stressors, family relations, housing, interpersonal relationships, behavior management, mental health issues, life span issues, psychiatric illnesses, and/or other trauma (s). Providing training in these areas assure the needed impact at the community-based level to impact recidivism. With such a large presence in several communities spanning the Chicagoland area, HSI is dependent upon technology to ensure quality and efficient service delivery to its clients. Currently, each agency site has its own in-house network system without the capability to share data information across multiple platforms. The new hire and projected revenue will be used to enhance their sustainability efforts, improve outputs and outcomes, and increase their reach in the community. Our Gen Z Mental Health Ambassador program will continue to engage youth in mental health, substance disorder, trauma, mindfulness and cognitive behavior discussions. Habilitative Systems, Inc. team members and partners will bring their experience with technical support to community providers and work to insulate small community-based organizations with tested and proven evidence-based practices in providing resources to address the trauma and the needs incurred from the violence that affects their communities.

A.  Funding Priorities or Focus Areas

1. 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.

B.  Performance Requirements

The Grantee will:

  • Ensure alignment of core clinical models and functions to create synergies and magnify impact for all special populations served.
  • Ensure that racial and health equity inform HSI's work throughout its programs and operations.
  • Ensure Data Analytics inform decision-making and metrics to improve outcomes.
  • Address the disproportionate representation of African American children and adults in the Juvenile Justice, Child Welfare and Criminal Justice systems.
  • Create a documentary, APPS and video production that promote the collective well-being of community residents and enhancement of protective factors.
  • Recruit and train youth community health workers and ambassadors to participate in community health forums with peers.
  • Hire new staff to provide mental health services.

C. Performance Measures

  1. Number of unduplicated individuals engaged by the Gen Z Mental Health Ambassador program.
  2. Number of grass roots HBCBOs supported by grantee to create greater access to care.
  3. Number of treatment services provided to the community each quarter.
  4. Number of different types of treatment services provided to the community each quarter.

D. Performance Standards

  1. 3 or more individuals engaged by the Gen Z Mental Health Ambassador program.
  2. 5 or more grass roots HBCBOs supported by grantee to create greater access to care.
  3. 15 or more treatment services provided to the community each quarter.
  4. 5 or more different types of treatment services provided to the community each quarter.

E. Unallowable Costs

  1. The applicant 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.
  2. 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.
  3. 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.
  4. 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.

F. Program beneficiaries or program participants must meet the following requirements:

1. Not Applicable.

G. Authorizing Statutes or Regulations

  1. 59 Ill. Admin, Code 132 (Rule 132), Section 132.150g
  2. Mental Health Community Services Act (405 ILCS 30/ Section (f))
  3. Illinois Administrative Code Part 7000 Grant Accountability and Transparency Act
  4. SB 251, Public Act 103-0589, Section 540

IV. Application Contents and Format

A. Content and Form of Application Submission

  1. Required Content of Application

    1. The Application must include the required documents and demonstrate that the program eligibility requirements have been met. Refer to Section V. Submission Requirement and Deadlines for details.

  2. Budget and Budget Narrative

    1. Applicant must enter a budget electronically in the CSA system.
    2. The Budget must be electronically signed and submitted in the CSA system. The Budget must be signed by the Provider's Chief Executive Officer and/or Chief Financial Officer.
    3. IMPORTANT: Please be sure the budget status in CSA says "GATA Budget signed and submitted to program review." This status will appear after the budget is electronically signed by the agency CEO or CFO and submitted to IDHS. See IDHS CSA Tracking System webpage for additional information on CSA at Community Service Agreements (CSA) Tracking System. A copy is not to be submitted along with the application packet.
    4. The budget and narrative must tie fiscal activity to program objectives and deliverables and demonstrate that all proposed costs are:
      1. Reasonable and necessary
      2. Allocable, and
      3. Allowable as defined by program regulatory requirements and the Uniform Guidance (2CFR 200), as applicable.
    5. Deadline for submission of the budget, in the CSA Tracking System, is the same as the application deadline.
    6. A Budget Template 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. The applicant will NOT be issued an award without the applicant's fully approved budget in the CSA System.
    7. NOTE: The Illinois Department of Innovation & Technology (DoIT) is now disabling external Illinois.gov IDs if they have not been used for 114 days. If you receive the error "HPDIA0309W This account is disabled," your ID has been disabled and cannot be re-activated by changing your password. You need to contact the DoIT HelpDesk at [217-524-DoIT (3648) or 312-814-DoIT (3648)] or their website at Report A Problem. Request that they create an incident to re-enable your external ID. You will need to provide your external ID (firstname.lastname@external.illinois.gov) and the error message (this account is disabled). Please be sure to Reset Your Password every 3 months so your account is not disabled.
    8. 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.
    9. Instructions for the Budget Template
    10. Subcontractor budget(s), If applicable
      1. If applicant is planning to use a subcontractor, a pdf copy of the subcontractor budget must be submitted as a separate pdf document with the other application materials.
      2. Subcontractor budgets shall be submitted on the GATA Uniform Grant Budget Template (GOMBGATU-3002).
      3. For more information see Section I(A)(6).
  3. Required Forms
    1. 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.
      1. The document requires the signature and email address of the organization's authorized representative. This email address will be used for official communication between the Department and the applicant organization for matters regarding this application.
      2. Page one of the application is pre-populated with the appropriate information. Applicant must not complete anything on Page one.
      3. On Page three, the applicant will need to include the amount for which they are applying and sign.
      4. The correct application must be used.
    2. Grantee Conflict of Interest Disclosure - The grantee Conflict of Interest Disclosure is required for all grant award programs regardless if the grantee has identified a potential conflict or not. The document requires agencies to identify actual or potential conflicts of interest. The form must have a printed name and be signed by a representative of the organization.

V. Submission Requirements and Deadlines

A. Address to Request Application Package

  1. The complete application package is available through the Illinois Catalog of Financial Assistance and the Mental Health Grants - FY 2025 website.
  2. The applicant must have access to the internet. The Department's website will contain information regarding this funding opportunity and materials necessary for submission. It is the responsibility of each applicant to monitor the website and comply with any instructions or requirements related to this funding opportunity.
  3. A PDF copy may be obtained by emailing the Division of Mental Health at DHS.DMHGrantApp@Illinois.gov

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

  1. Each Applicant Must:
    1. Be registered in SAM.gov before submitting its application;
    2. Provide a valid Unique Entity Identifier (UEI) in its application; and
    3. Continue to maintain an active registration in SAM.gov with current information at all times during which it has an active award or an application or plan under consideration.
  2. The Department may not make an award until applicant has fully complied with all UEI and SAM Requirements.
  3. If individuals are eligible to apply, they are exempt from this requirement under 2 CFR 25.110(b).
  4. If the agency exempts any applicant from this requirement under 2 CFR 25.110(c) or (d), a statement to that effect.

C. Submission Instructions

  1. Actions needed prior to applying:
    1. The applicant must be registered with the State of Illinois and Pre-qualified in the GATA portal prior to applying for Illinois awards. Instructions for creating an account and registering are located at the following link: Illinois GATA Grantee Portal. Additionally, detailed instructions for registration and prequalification requirements, including the expected amount of time for completion are located here: Grant Applicant Pre-Qualification and Pre-Award Requirements (pdf)
    2. Registration in CSA is required. The Community Service Agreements (CSA) 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. The applicant will NOT be issued an award without a fully approved budget in the CSA System.
  2. The Methods for submitting the application:
    1. The applicant must electronically submit the complete application packet which includes the following attachments as separate pdf documents:
      1. Uniform Application for State Grant Assistance
      2. Grantee Conflict of Interest Disclosure
      3. Budget (entered into the CSA system as described in section (IV)(A)(4)
      4. Subcontractor Budgets, if applicable
      5. Advance Payment Request Cash Budget Form, if applicable
    2. Applications must be sent electronically to DHS.DMHGrantApp@Illinois.gov.  The application will be electronically time-stamped upon receipt. Application submissions or delivery to any other email address or contact, including other IDHS offices or employees, will not be considered for review or funding. Applications will not be accepted if received by fax machine, hard copy, disk, or thumb drive.
    3. Include the following in the subject line:
      1. Habilitative Systems
      2. 515-HDSD Health Disparities & Social Determinants
    4. Documents must NOT include a password.
    5. Software or Electronic Capabilities
      1. Each applicant must have access to the internet. The Department's website will contain information regarding this funding opportunity and materials necessary for submission.
  3. Pre-application materials must be submitted as follows:
    1. Not Applicable.
  4. If you are experiencing system problems or technical difficulties submitting your application, you may contact:
    1. Name: Barb Roberson
    2. Email: DHS.DMHGrantApp@Illinois.gov

D. Submission Dates and Times

  1. Full applications are due on January 7, 2025, at 12:00 p.m. (Noon) CST.
  2. Missed Deadlines
    1. For your records, please keep a copy of your submission with the date and time the application was submitted along with the email address to which it was sent.

E. Intergovernmental Review

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

VI. Application Review Information

A. Responsiveness Review

  1. The following are the criteria that must be met for eligibility:
    1. Applicant has a current registration with the State of Illinois in the Grantee Portal.
    2. Applicant has an active SAM.gov public account.
    3. Applicant has an active Unique Entity Identifier (UEI) with SAM.gov
    4. Applicant is in "good standing" with the Secretary of State.
    5. Applicant is not on the DHS Stop Payment List Service or the Illinois Stop Payment List.
    6. Applicant is not on the SAM.gov Exclusion List.
    7. Applicant is not on the Illinois Medicaid Sanctions List.
    8. Program specific eligibility restrictions
    9. Not Applicable.
  2. Restrictions on eligibility for State awards are referenced in 44 Ill Admin Code 7000.70. Program specific eligibility restrictions are referenced in this funding opportunity.

B. Risk Review

  1. IDHS conducts risk assessments for all awardees, prior to the award being issued.
    1. An agency wide Internal Control Questionnaire (ICQ) to be completed by the awardee within the Grantee Portal. The ICQ evaluates fiscal, administrative, and programmatic risk in the following categories:
      1. Quality of Management Systems
      2. Financial and Programmatic Reporting
      3. Ability to Effectively Implement Award Requirements
      4. Awardee Audits
    2. The deadline to submit the FY25 ICQ is January 7, 2025, 12:00 PM (Noon) Central Time
    3. A program specific Programmatic Risk Assessment conducted by the awarding agency to evaluate the following categories:
      1. Programmatic financial stability
      2. Management systems and standards that would affect the program.
      3. Programmatic audit and monitoring findings
      4. Ability to effectively implement program requirements.
      5. External partnerships
      6. Programmatic reporting
    4. Risk assessments are not intended to be punitive in nature, rather they are conducted in order to evaluate the support, technical assistance, and training that may be needed for the awardee and the level of monitoring that is needed for the award.
      1. Risk assessments may result in Specific Conditions being placed on the award to include more frequent monitoring or the implementation of a corrective action plan.
  2. Simplified Acquisition Threshold - Federal and State awards
    1. It is anticipated that grants under this award may receive award over the Simplified Acquisition Threshold defined in 48 CFR part2, subpart 2.1. Potential grantees under this funding announcement may receive an award in excess of the simplified acquisition threshold. Therefore, the grantee is subject to the simplified acquisition threshold and related requirements.
      1. Prior to making an award with a total amount greater than the simplified acquisition threshold, IDHS 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).
      2. 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.
      3. 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 applicants' integrity, business ethics, and record of performance under State and Federal awards when completing the review of risk posed by applicants as described in 2 CFR 200.206.

VII. Award Notices

A.  State Award Notices

  1. The applicant under this Non-Competitive funding opportunity will receive a Notice of State Award (NOSA). The NOSA shall include:
    1. Grant award amount
    2. The terms and conditions of the award
    3. Specific conditions, if any, assigned to the applicant based on the fiscal and administrative risk assessment (ICQ), programmatic risk assessments (PRA), and the Merit Review.
  2. Note: The Department cannot issue a NOSA until the successful applicant has an approved FY25 budget entered into the CSA system. The applicant shall receive the NOSA through the Grantee Portal. The NOSA must be signed by the grants officer (or equivalent). This signature effectively accepts the state award amount and all conditions set forth within the notice. The signed NOSA is the document authorizing the department to proceed with issuing an agreement. The Agency signed NOSA must be remitted to the Department as instructed in the notice.
  3. The NOSA is NOT an authorization to begin performance (to the extent that it allows charging to State awards of pre-award costs; pre-award costs are incurred at the non-State entities own risk unless they have received written prior approval to begin performance).
  4. The authorizing document to begin performance is the fully executed Uniform Grant Agreement (UGA) signed by the grants officer, or equivalent. This is the official document that obligates funds. The UGA is sent to the non-State entity via the CSA system. The non-State entity will print and sign the signature page of the UGA and return signature page to DHS.OCA.SignaturePages@illinois.gov.  A final signed copy of the UGA will be provided to the non-State entity via an upload into the CSA Tracking system.
  5. Applicants who are not eligible due to registration or pre-qualification issues will be notified that their application cannot be processed until the registration or pre-qualification issues are resolved.

VIII. Post-Award Requirements and Administration

A.  Administrative and National Policy Requirements

  1. 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.
  2. You can find a sample of the grant agreement at IDHS Uniform Grant Agreement.
  3. Payment Terms
    1. 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.
    2. 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.
    3. 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 listed above
    4. Invoice and PFR Email Address for General Grants: DHS.DMHQuarterlyReports@illinois.gov
    5. Invoice and PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov
    6. Invoice and PFR Email Address for Colbert Consent Decree: DHS.Colbert.Invoices@illinois.gov
  4. Payment Forms
    1. Monthly Invoice IL444-5257
    2. Advance Payment Request Cash Budget Form (IL444-4985) Only if requesting an advance payment

B. Reporting

  1. 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:
    1. Periodic Financial Reports submitted electronically in accordance with instructions in the UGA no more frequent than quarterly and no less frequent than annually, unless unusual circumstances exist.
    2. Periodic Programmatic Reports submitted electronically in accordance with instructions in the UGA no more frequent than quarterly and no less frequent than annually, unless unusual circumstances exist.
    3. Close-out Performance Reports and Financial Reports as instructed in the UGA.
    4. Other Unique Programmatic Reporting Requirements: additional annual performance data may be collected as directed by the Department and in the format prescribed by the Department.
    5. 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.
    6. Non-compliance with any of the identified reports may lead to being placed on the Illinois Stop Payment List (SSPL).
    7. Grantee shall submit these reports to the appropriate email address listed below. 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 UGA to be reimbursable.
      1. PFR Email Address for General Grants: DHS.DMHQuarterlyReports@illinois.gov
      2. PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov
      3. PFR Email Address for Colbert Consent Decree: DHS.Colbert.Invoices@illinois.gov
  2. The Grantee must 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.
    1. PPR and PRTP Email Address for All Grants: DHS.DMHQuarterlyReports@Illinois.gov
  3. DMH reporting templates and detailed instructions for submitting reports can be found in the Provider section of the IDHS website.

IX. Other Information

A.  Program Websites

B. Mandatory Forms and Submissions

  1. Uniform Application for State Grant Assistance
  2. Uniform Grant Budget Template (Submit in CSA) | Instructions
  3. Subcontract Budget, if applicable submit as a separate attachment
  4. Conflict of Interest Disclosure submit as a separate attachment
  5. Advance Payment Request Cash Budget Form submit as a separate attachment (no submission will result in default to Reimbursement Method)