Supportive Housing Program 26-444-80-0658-01 Attachment A - Program Application

Supportive Housing Program - Program Application: Attachment A - Fiscal Year 2026

*For an interactive copy of this document please email Charlotte D. Flickinger: Charlotte.D.Flickinger@Illinois.gov

Application Checklist

Required Attachments: ALL applicants MUST be Pre-qualified at the time of application submittal. Applications must include the following mandatory forms/attachments in the order identified below.

In the space provided, indicate "X" for included items, "N/A" for items that do not apply to the application. Please do not leave this item blank.

1. Signed Uniform Application for State Grant Assistance _____
2. Signed Conflict of Interest Disclosure _____
3. Completed Program Application Packet Checklist _____
4. Complete Attachment A _____
   1. Applicant and Project Details _____
   2. Executive Summary _____
   3. Capacity/Agency Qualifications _____
   4. Community Identification/Description of Need _____
   5. Quality/Description of Program Services, Design and Implementation _____ 
   6. Justification of Budgeted Costs _____
   7. Prior Award Authorization _____
   8. Authorization (signature) _____
5. Uniform Grant Budget - The proposed budget must be entered, signed, and submitted in CSA and is required for the application to be considered complete. A hard copy of this signed and submitted budget must be included with the application. _____
6. Federal or State approved NICRA, if applicable _____
7. Copy of Applicant's current Federal Form W-9 _____
8. Subcontractor(s)' W-9, if applicable _____
9. Partnership Agreements/MOUs with partner organizations _____
10. Eligibility documentation _____
    1. Not-for-Profit or Community-based Organization: 501(c)(3) determination letter from IRS _____
    2. Governmental Unit: Governmental exemption letter from IDOR, _____
    3. Project Site(s) Owner: Documented ownership of Program site(s), which may be evidenced by Commitment under the LIHTC or Permanent Supportive Housing Program (see narrative guidance for Need: Impact below). _____
11. Resumes of Key Staff _____
12. Job Descriptions for To-Be-Hired Staff _____
13. Subcontractor Budgets, Narratives, and agreements (if applicable) _____
14. Workflow/Organizational Chart _____
15. Funding Match Documentation (commitment(s). in-kind documentation) _____
16. Current Fire Safety Inspection for the primary location where services are delivered  _____
17. Applicant Intake and Assessment Forms _____
18. Additional forms used to assist participants (as applicable) _____

Optional Attachments: These attachments may be submitted at the discretion of the applicant.

1. Screenshot or statement indicating the applicant is pre-Qualified at the time of application. _____
2. Current equity-driven applicant policies _____
3. Staff development and training in equitable program design and delivery _____
4. Additional supplemental documentation (insert additional rows as needed): _____

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Applicant and Project Details

General Applicant Information

1. Project Name:
2. Legal Name of Applicant: 
3. Applicant Address:
4. Mailing Address (if different):
5. Email Address:
6. Federal Employer Identification No. (FEIN):
7. Number of years in operation:
8. Type of Entity (Government, Non-profit, Public Housing Authority, etc.):
9. Board of Directors (as applicable):
10. Board Chair:
11. Member(s):
12. Continuum of Care Membership (name of CoC):

Applicant Contact Information

1. Executive Director Name:
2. Email Address:
3. Telephone Number:

1. Program Contact Name:
2. Email Address:
3. Telephone Number:

1. Fiscal Contact Name:
2. Email Address:
3. Telephone Number:

Emergency Phone Numbers After Hours (no office phone numbers)

1. Name and Title:
2. Mobile Telephone Number:
3. After-Hours and Weekend Phone Numbers:
4. Publicly Listed Phone Number:

Project subcontractor(s) (as applicable)

1. Subcontractor Name:
2. Mailing Address:
3. Contact Person:
4. Contact Email:
5. Contact Telephone:
6. Amount of Subcontractor Agreement:
7. Subcontractor Name:
8. Mailing Address:
9. Contact Person:
10. Contact Email:
11. Contact Telephone:
12. Amount of Subcontractor Agreement:
13. Additional information if space is insufficient:

Project-Specific Information

1. FY 26 Amount Requested:
2. Project Physical Address:
3. Project Physical County:
4. Project Counties/Areas Served:
5. Number of Units:
6. Max Person Capacity:
7. SHP Units:
8. Permanent or Transitional:
9. Number of New Units:

Source(s) of Required 25% Funding Match

1. Source:
2. Amount:

1. Source:
2. Amount:

1. Source:
2. Amount:

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Executive Summary (1 page) - up to 5 Points

Provide a one-page summary description of the proposal, including the information below.

1. Location(s) of housing and number of units to be coupled with supportive services. Insert additional pages as needed.
2. Brief summary of the applicant's experience with similar projects.
3. Proposed geographic coverage (provide community area(s), zip codes and county(ies)).
4. Target population
5. Coordination efforts with Continuum of Care and other entities
6. Brief description of supportive services to be offered to each participant, as appropriate, to assist participants move to the highest level of self-sufficiency, in addition to required case management, counseling, and advocacy services
7. SFY 2026 Proposed
   • Number of households identified for the SHP Program
   • Number of unduplicated participants proposed to be served for the grant period

Capacity/Agency Qualifications (3 page maximum) - up to 30 Points

Provide an overview of agency capacity. Required supporting documentation is noted in each category and must be included to achieve full points.

1. Operational Capacity (up to 8 points). Provide a brief history of the applicant organization and its accomplishments with similar projects and programs. Include applicant and subcontractor (where applicable) qualifications to provide the proposed services specific to this project and how those services fit within the overall mission of applicant. Discuss any appropriate certifications that apply.
2. Equity-focused Culture (up to 8 points). Describe how the organization has and continues to build its capacity to operate with a racial/cultural equity lens. Provide examples of employing equity principals into outreach and engagement, programming, and creating or updating equity-driven policies. Supporting documentation may include current relevant policies, training, documentation of prior outcomes, and other information the applicant deems relevant.
3. Staff Expertise (up to 8 points). Provide a brief description of qualifications of key staff who will be responsible for the delivery of the services including their educational background, years of experience, language capacity and other relevant information. Attach current resumes of key staff.
4. Performance/Data Management (up to 63 points). Describe applicant past performance in utilizing awarded funds and meeting State reporting requirements. Describe applicant's data collection and reporting process, including staff involved, technology used and experience with data analysis and reporting. Describe how the Organization:
   1. collects and maintains data;
   2. measures activities versus outcomes;
   3. uses collected data for program planning, evaluation, and improvement; and
   4. ensures timely reporting.
5. Performance/Reporting (up to 3 points).  Describe applicant past performance in utilizing awarded funds and meeting State reporting requirements, including how the applicant ensures timely reporting. 

Community Identification/Description of Need (3 page maximum) - up to 20 Points

Detail need for program-related services within the proposed geographic service area.

1. Geographic Service Area (up to 5 points). Describe the proposed geographic coverage area, including information such as the population size, ,as representative age groups, unemployment rate, number/percentage of households at or below 15% of the area median income as defined by the U.S. Department of Housing and Urban Development; and general economic status of the proposed geographic coverage area.
2. Target Populations (up to 5 points). Describe the target population(s) and others who are most in need of services. Indicate reason(s) for selecting any specific populations within the universe of eligible Participants.
   1. For the proposed geographic service area, estimate target population size, including distribution among age groups, to the extent practicable.
   2. Describe the extent to which target populations present in the proposed service area are overrepresented in the overall homeless population, including people of color and LGBTQ+, youth experiencing homelessness, and others to be served.
3. Supportive Services (up to 5 points). Describe specific supportive services the applicant anticipates will be in high demand or require a high level of attention in the proposed service area. For the proposed service area:
   1. What are the target populations' greatest service needs?
   2. What are the common barriers they face while trying to access resources for human services and development resources?
   3. What are the unmet needs of the target population in the geographic service location?
4. Impact (up to 5 points).
   1. Describe the impact the Project will have on the target population and proposed geographic service area (up to 3 points); and
   2. The Project is supportive permanent housing funded through the 2023 and 2024 Permanent Supportive Housing or Low Income Housing Tax Credit programs administered by the Illinois Housing Development Authority. Capacity to administer the Supportive Housing Progam must be evidenced by a partnership agreement or subcontract with a qualified service provider and documentation of award under a referenced program to be eligible for points under this category. (up to 2 points).

Quality/Description of Program Services, Design, and Implementation (Provider Program Plan) (5 page maximum) - up to 30 Points

Describe program design (including partnerships/linkages), implementation details, and proposed outcomes.

Note: to achieve maximum points, all relevant supporting documentation, including evidence of partnerships, resumes of identified staff, as well as job descriptions for any to-be-hired positions, should be attached and referenced in this portion of the narrative.

1. Program Design (up to 10 points)
   • plan for outreach, including a description of existing referral agreements and proposed community engagement activities;
   • plan for service provision, including:
     • a complete list of services to be provided based on the needs described above;
     • whether a proposed service will be performed by applicant or other (named) organizations/agencies;
     • supporting documentation for existing community alliances, partnerships, and linkages with community providers that enhance service provision; and
     • indicate how the plan for service provision is increased, enhanced, and/or improved over the prior term (current Providers only).
   • processes and interval of required case management, counseling, and advocacy;
   • process for determining and offering tailored participant services, which must include but not be limited to (as applicable): SOAR services; accessing mainstream public benefits; substance use and mental health services; health care and urgent care services, immigration legal services; workforce development; and other services relevant to the target population;
   • other program delivery enhancements (current Providers only).
2. Program Implementation. (up to 10 points)
   1. Provide the proposed project implementation workflow, indicating key project staff and summary responsibilities/activities. The description of key activities should also identify responsible staff or partner for each and will include the following activities, at a minimum:
      • outreach and engagement
      • intake and assessment
      • case management
      • service provision (by type of service, if applicable);
      • service referrals and partnership management;
      • project management;
      • fiscal management and reporting;
      • data collection and maintenance;
      • outcome measure tracking and analysis; and
      • performance reporting
      • Please note: the Department is aware that every application is unique. Therefore, qualified staff may be responsible for multiple activities and multiple staff may be responsible for one activity. This should be noted on the workflow. Additional activities may also be included as needed.
   2. Provide applicant's plan for processing participant applications, including walk-ins and referrals from the Coordinated Waitlist and other sources. Describe how the applicant helps potential participants obtain required documentation to overcome barriers to entry. Include the primary reason(s) for refusing program entry. (up to 5 points)
      
3. Proposed Outcomes. Provide anticipated outcomes for the following performance measures for the grant term (up to 5 points):
   • Households
   • Households with children
   • Shelter nights
   • Meals to be provided, served, purchased, or vouchered during the fiscal year (Transitional Housing only);
   • Individuals exiting Supportive Housing Program for permanent or transitional housing.
   • Supportive services issued
   • Participants enrolled in education, job prep, vocational training or employment services

Note: Supportive services to be provided and progress toward anticipated outcomes will be reported and measured at least quarterly, as required by the Government Accountability and Transparency Act (GATA), in a form prescribed by the Department.

Budget & Costs Justification (2 pages) - up to 15 Points:

1. Submit a budget in the CSA system for the period for which the services are anticipated to be delivered in State Fiscal Year 2026. (5 points)
2. Provide a breakdown for each requested line item in narrative form here and briefly describe the duties they will perform for this Program. (5 points)
3. Include an anticipated average service cost per participant whether provided by the applicant or a subcontractor. (5 points)
4. Prior utilization of funds awarded will be a consideration of award and fund allocation. Applicants who did not fully expend previously committed funds will not receive maximum points under this category.

 Prior Award Information

• FY 23 Unspent Award Dollars: $
• FY 24 Unspent Award Dollars: $
• FY 25 Unspent at time of Application: $

Authorization

I hereby affirm that I am duly authorized to submit proposals on behalf of the applicant organization, and all information contained herein is true and correct to the best of my knowledge, information, and belief, and that the funds shall be used only for the purposes described in the funding application, and that the award of such grant funds is conditioned on this certification.

Signature: ________________________________________ Date: _______________________