PRA-0724 Global

444-26-0724 SABG - SUD Tx/RS Services General

Does your agency have a current SUPR Treatment license for all Treatment services and sites for which you have requested funding? Yes___ NO___ NA____

Are you able to provide services in accordance to the service protocols and requirements as outlined in the IDHS SUPR Contractual Policy Manual and the funding application? Yes___ NO___ NA____

Are you able to report services and/or expenditures as required on a monthly basis? Yes___ NO___ NA____

Entity Information

1. Quality of Management Systems and Ability to Meet the Management Standards

1.1. Do you have written policies and procedures that guide program delivery on the topics of:
1.2. Do you have internal controls that govern program delivery on the topics of:

1.5. Does the organization have a time and effort system that:

2. History of Performance

(The applicant's record in managing grant awards, if it is a prior recipient of awards, including timeliness of compliance with applicable reporting requirements, conformance to the terms and conditions of previous awards, and if applicable, the extent to which any previously awarded amounts will be expended prior to future awards)

2.4. Have there been any significant changes in your organization in the last fiscal year related to:

If "NO" to question 2.6, go to question 2.10

2.7. What responsibilities does the sub-grantee/sub-recipient/sub-award perform?

If "YES" to question 2.9, does it include:
2.10. Do you obtain prior written approval from the funding agency when:

3. Reports and Findings from Audits

Audits performed under Subpart F of this part or the reports and findings of any other available audit.

4. Applicant's Ability to Effectively Implement Statutory, Regulatory, or Other Requirements

4.3. To what extent is your organization able to comply with all statutory requirements of this program?

5. Grant Specific Questions




Programmatic Risk Assessment Certification

On behalf of the applicant entity, I attest that the statements included herein are true, complete and accurate to the best of my knowledge. All occurrences of non-compliance with programmatic requirements have been disclosed.