Division of Mental Health

Scope of Services (3C Providers) The Grantee shall implement Promoting Integration of Physical and Behavioral Health Care in Illinois (PIPBHC) for adults with serious mental illnesses and children with serious emotional disturbances, who may also have additional co-occurring illnesses or disorders. Individuals who receive care for behavioral health conditions usually have physical health needs, and the reverse is also true; individuals who have medical needs often have behavioral health needs. This grant will help Grantees promote and expand integrated, co-located care services in three largely rural counties. Services will include screening, diagnosis, prevention and treatment of mental and substance use disorders as well as co-occurring physical health conditions and chronic diseases. Scope of Services (Custom TriWest) The Provider will perform evaluation / consultation services requested by DMH. These evaluation consultation services are part of DMH’s oversight of the Promoting Integration of Primary and Behavioral Health Care (PIPBHC) Grant. Performance Requirements (3C Providers) Each Grantee will: 1. Work with their local Federally Qualified Healthcare Center (FQHC) partner to promote full integration and collaboration in clinical practice between primary and behavioral health care within identified and proposed jurisdiction. 2. Ensure all staff are trained in agreed upon Evidence-Based Practices (EBPs) to improve the overall wellness and physical health status of adults with serious mental illnesses (SMI) and children with serious emotional disturbances (SED). 3. Work with TriWest Group to enhance data collection, measurement, and reporting for primary care and behavioral health care. 4. Promote and offer integrated care services in co-located sites that include screening, diagnosis, prevention, and treatment of mental and substance use disorders, and co-occurring physical health conditions and chronic diseases. 5. Appropriate Grantee staff will participate in all DMH planning, learning collaborative teleconferences, and project meetings conducted by DHS/DMH and/or TriWest Group. Performance Requirements (Custom TriWest) 1. Evaluation: The Provider will train PIPBHC Grant Community Providers in using the SAMHSA-required data collection tools and in developing procedures to ensure compliance with SAMHSAs expectations. The Provider will conduct site visits and provide on-demand technical assistance to PIPBHC Grant providers. The Provider will plan and help conduct quantitative outcomes analyses, using the SAMHSA-required tools for tracking health outcomes. The Provider will engage in ongoing project coordination. 2. Infrastructure Support: The Provider will conduct annual assessments of PIPBHC community providers’ adherence to their chosen models of primary and behavioral health care integration, mid-year fidelity checks, and project coordination. The infrastructure support will be provided on-site and in a collaborative and respectful manner. The Provider will provide periodic meeting opportunities for PIPBHC community providers and DMH to review the results of both the evaluation and the infrastructure support activities. Payment Terms Grantees will receive payment by one of the three payment methodologies (Advance Payment, Reimbursement or Working Capital Advance). Grantees will automatically be paid via Reimbursement Method unless a request for Advance Payment Method or Working Capital Advance Method is made using the IDHS Advance Payment Request Cash Budget Template (Cash Budget). I. Advance Payment Method (Advance and Reconcile) A. An initial payment will be processed in an amount equal to the first two months' cash requirements as reflected in the Advance Payment Requirements Forecast (Cash Budget) Form submitted with the Grantee's application. The initial payment will be processed upon execution of the grantee's Uniform Grant Agreement. B. Grantees must submit monthly invoices in the format and method prescribed in the Grantee's executed Uniform Grant Agreement. Invoices must be submitted no later than 15 days following the end of any respective monthly invoice period, or as indicated in their UGA Exhibit F - Payments. Invoices must include only allowable incurred costs that have been paid by the Grantee. For programs that have Grantee matching requirements, allowable costs are only reimbursable when matching costs have also been incurred. C. Subsequent monthly payments will be based on each monthly invoice submitted to the grant program, and will be adjusted up or down, based on a comparison of actual cumulative expenditures to cumulative advance payments, to date. D. Grantees that do not expend all advance payment amounts by the end of the grant term or that are unable to demonstrate that all incurred costs were necessary, reasonable, allowable, or allocable as approved in their respective grant budget, must return the funds or be subject to grant funds recovery. E. Grantees may be required to submit supporting documentation for their requests at the request of and in a manner prescribed by the Grantor. F. Failure to abide by advance payment governance requirements may result in grantee losing their right to advance payments. II. Reimbursement Method A. IDHS will disburse payments to Grantee based on actual allowable costs incurred as reported in the monthly financial invoice submitted for the respective month, as described below. B. Grantees must submit monthly invoices in a format prescribed by Grantor. Invoices must include all allowable incurred costs for the first and each subsequent month of operations until the end of the Award term. Invoices must be submitted no later than 15 days following the end of any respective monthly invoice period, or as indicated in their UGA Exhibit F - Payments. As practicable, Grantor shall process payment within 30 calendar days after receipt of the invoice, unless the State awarding agency reasonably believes the request to be improper. C. Grantees may be required to submit supporting documentation for their requests at the request of and in a manner prescribed by the Grantor. III. Working Capital Advance Method A. IDHS Grant Program Managers will advance working capital payments to the grantee to cover their estimated disbursement needs for an initial period not to exceed two months of grant expenses. Startup costs may be approved if determined by IDHS Grant Program Managers to be allowable. B. Grantees must submit monthly invoices for each of the one or two months covered by the Working Capital Advance in the format and method prescribed by the Grantor. Invoices must be submitted no later than 15 days following the end of any respective monthly invoice period, or as indicated in their UGA Exhibit F - Payments. Invoices must include only allowable incurred costs that have been paid by the grantee. For grant programs that have grantee matching requirements, allowable costs are only reimbursable when matching costs have also been incurred. C. Grantees may be required to submit supporting documentation for their requests at the request of and in a manner prescribed by the Grantor. D. Working Capital Advance Payments are limited to a single occurrence per grant term. E. Following the initial working capital advance payment, grantees will be paid via reimbursement method unless an IDHS Advance Payment Request Cash Budget Template is submitted for Advanced Payment Method. Additional Advance Payments Additional working capital advance payments may be considered on a case-by-case basis. Such requests must be made in writing, may require supporting documentation and must be approved by IDHS Executive Staff. Note: If you will be submitting the Advance Payment Request Cash Budget, it must be submitted with the application packet 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 Monthly Invoices and Quarterly PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov Monthly Invoices and Quarterly PFR Email Address for Colbert Consent Decree: DHS.Colbert.Invoices@illinois.gov Payment Forms 1. Monthly Invoice IL444-5257 2. Advance Payment Request Cash Budget Form (IL444-4985) Only if requesting an advance payment

Substance Abuse and Mental Health Services Projects of Regional and National Significance CFR 200/45 CFR Part 75 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS awards; also the HHS Grants Policy Statement.

Children's Health Act of 2000, Section 520 A-J,581,582, Public Law 106-310; Public Health Service Act, Title V, Section 509; 516, 42 U.S.C 290bb. Mental Health Community Services Act (405 ILCS 30/) Public Health Service Act, Subpart 1 and III, Title XIX, Part B.

Illinois Administrative Code Part 7000 Grant Accountability and Transparency Act

Performance Measures (Generic 3C Providers) 1. Number of individuals who present for services (baseline). 2. Number of individuals for whom baseline data is reported in the federal (“SPARS”) reporting system. 3. Number of individuals for whom follow-up data is reported into SPARS at required intervals. 4. Number of individuals treated at appropriate levels of care. 5. Number of individuals retained in long-term treatment. 6. Number of individuals participating in activities or skill enhancements. 7. Number of individuals enrolled at beginning of fiscal year/previous quarter. 8. Number of individuals enrolled at end of quarter. 9. Number of staff hired/retained in positions on the PIPBHC team. 10. Number of staff trained on specific practices that are identified by the agency as supportive of success of integration of care. 11. Number of staff trained or receiving refresher training in PIPBHC expectations on Wellness and Recovery Action Plan (WRAP), wellness self-management, and principles and practices of wellness and recovery, including all agency-selected evidence-based practices that will be used with PIPBHC clients during the current fiscal year. 12. Number of agency policies to which changes were made during the year to accommodate the provision of integrated care. Performance Measures (Custom TriWest) 1. Number of Grant Community Providers 2. Number of Grant Community Providers receiving training sessions. 3. Number of Grant Community Providers who had a site visit conducted. 4. Number of Grant Community Providers receiving a mid-year fidelity check. 5. Number of Grant Community Providers who had on-site infrastructure support visits. 6. Number of meetings held with DMH. Performance Standards (Generic 3C Providers) 1. 100% of individuals who presented for services (baseline) were treated at appropriate levels of care. 2. 80% or more of individuals were retained in long-term treatment. 3. 100% of individuals participated in activities or skill enhancements to promote health and mental health wellness and recovery. 4. 10% or more increase in program enrollment each quarter. 5. 100% of staff hired received ongoing training on specific practices that are identified by the agency as supportive of success of integration of care. 6. 100% of staff were trained in PIPBHC expectations on Wellness and Recovery Action Plan (WRAP), wellness self-management, and principles and practices of wellness and recovery, including all agency-selected evidence-based practices that will be used with PIPBHC clients. Performance Standards (Custom TriWest) 1. 100% of Grant Community Providers received training sessions. 2. 100% of Grant Community Providers received a site visit. 3. 100% of Grant Community Providers had mid-year fidelity checks by the end of the second quarter. 4. 100% of Grant Community Providers had on-site infrastructure support visits. 5. 30 or more meetings held with DMH.

Yes

(Grantor-Specific Terms) This Notice of State Award (NOSA) is not an agreement nor a guarantee of an agreement. IDHS will publish its agreements in the CSA Tracking System after the NOSA is accepted. A signed hard copy is not needed. You also have the option to decline. If your responses to the ICQ questions indicate a weakness in the identified areas below, a Corrective Action Plan (CAP) is required to be submitted to DHS after execution of the grant agreement. Within 30 days of award, please send an email to DHS.DMHGrantApp@Illinois.gov to begin communicating the direction and requirements of the CAP. (Program-Specific Terms) The following are GATA exceptions and are not required for this program: MERIT BASED REVIEW: This grant has an exception because grantees are named in federal award. NOFO: This grant has an exception because grantees are named in federal award. The eligibility and program requirements outlined in this funding opportunity must be adhered to as the funded project is implemented. Grantees must comply with the milestones and deliverables, performance standards, performance measures, performance data collection and specific conditions as reflected in the grant agreement, DMH Attachment B and Program Manual. Additional terms and/or conditions may be applied to this award if outstanding financial or programmatic compliance issues are identified by IDHS.

Nonprofit Organizations;

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: • The applicant has met the Prequalification and Mandatory Requirements listed in this funding opportunity. • This funding opportunity is limited to those who currently have an award for this program. • 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 a Nonprofit Organization • Eligibility for this program is statutorily limited to a State or appropriate State agency (e.g., state mental health authority, the single state agency (SSA) for substance abuse services, the State Medicaid agency, or the state health department) in collaboration with one or more qualified community health programs, as described in section 1913(b)(1) of the PHS Act as amended; or one or more community health centers as described in section 330 of the PHS Act, as amended (e.g., community health centers, health care for the homeless, public housing health centers, and migratory and seasonal agricultural workers health centers).

NA

Direct Payments for Specific Use

Human Services

Entity must include a Rule 132 Certified Community Mental Health Center as well as a Federally Qualified Health Center. These can be two separate entities that work in partnership, or a single entity with both types of certifications.

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 procedures, refer to IDHS GATA Prequalification Assistance. Applicants must be prequalified; therefore, applications from entities that have not prequalified prior to the due date of this application will NOT be reviewed and will NOT be considered for funding. 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 FY 24 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 April 6, 2023, 12:00 PM Central Time. Registration in CSA The 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. 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 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. Indirect Cost Rate Election: • 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. The organization must provide a copy of the federal NICRA and submit an Indirect Cost Rate Proposal in the Crowe Activity Review System (CARS). • 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 and would like to negotiate a rate with the State of Illinois. • De Minimis Rate. An organization may elect a De Minimis rate of 10% of modified total direct cost (MTDC)**. Once established, the De Minimis rate may be used indefinitely. If programs elect to use the De Minimis rate, it is critical that program budgets accurately calculate the MTDC base. Please see the regulation below and note the exclusions to MTDC. **2 CFR § 200.68 Modified Total Direct Cost (MTDC). MTDC means all direct salaries and wages, applicable fringe benefits, materials and supplies, services, travel, and subawards and subcontracts up to the first $25,000 of each subaward or subcontract (regardless of the period of performance of the subawards and subcontracts under the award). MTDC excludes equipment, capital expenditures, charges for patient care, rental costs, tuition remission, scholarships and fellowships, participant support costs and the portion of each subaward and subcontract in excess of $25,000. Other items may only be excluded when necessary to avoid a serious inequity in the distribution of indirect costs, and with the approval of the cognizant agency for indirect costs. • No 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 the Indirect Cost Rate Election System. • State Funded Universities/Institutions: Maximum reimbursement for indirect costs is restricted to 10% Off Campus and 20% On Campus with MTDC base. Crowe Activity Review System (CARS). CARS 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 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 CARS 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 CARS system within the required timeframes will not be allowed to claim indirect cost reimbursement. For more information see: Centralized Indirect Cost Rate User Manual GATA 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: o 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) o Capital expenditures for general purpose equipment, including any vehicle regardless of cost, buildings, and land (2 CFR 200.439) o Capital expenditures for improvements to land, buildings, or equipment which materially increase their value or useful life (2 CFR 200.439) o 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). o Deposits for items, services, or space • Simplified Acquisition Threshold: 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 must be aware of the following regarding the Simplified Acquisition Threshold as it will be applicable to any qualifying subaward: o That the grantee agency, prior to making a subaward with a total amount of funds 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); o 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 the awarding agency previously entered and is currently in the designated integrity and performance system accessible through SAM; o That the awarding agency 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 awards when completing the review of risk posed by applicants as described in §200.205 awarding agency review of risk posed by applicants.

Address to Request Application Package Application materials are provided throughout this announcement. Applications will be made available in user/printer friendly format and may be found on the FY24 Division of Mental Health web site. Additional copies may be obtained by contacting the Department at the email address below. Each applicant must have access to the internet. The Division’s web page will contain information regarding the materials necessary for submission. Program Email Address: 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 subject to Executive Order 12372, "Intergovernmental Review of Federal Programs." 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. 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: a. Entity Name; b. Program 510-FPBH Illinois Promoting Integration of Primary and Behavioral Health Care Project Budget Requirements 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 3 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: a. Holds an elected or appointed office in Illinois. b. Holds a seat in the Illinois General Assembly. c. 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. 2. Grantee has a financial interest, including ownership of stocks or bonds, in a firm which is a vendor or contractor. 3. Grantee has outstanding financial commitments to any vendor or contractor. 4. 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. 5. 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 • Uniform Application for State Grant Assistance • Project Narrative • Advance Payment Request Cash Budget Form submit as a separate attachment (no submission will result in default to Reimbursement Method) • Uniform Grant Budget Template (In CSA) | Instructions • Conflict of Interest Disclosure submit as a separate attachment

Project Narrative A Project Narrative is required to support the Uniform Application for State Grant Assistance (GA) for non-competitive grants. The purpose of the Project Narrative is to describe the organization’s program activities and design for implementing and administering the program for the upcoming State Fiscal Year (SFY). This Project Narrative will include information that is specific to your organization’s proposed program services and be considered part of your grant agreement. Submission of this Project Narrative is required to fulfill contractual obligations.

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, 2023. • Technology: Agencies awarded funds through this funding notice should have a computer that meets the following minimum specifications for the purpose of utilizing any required IDHS web-based reporting system and the receipt/submission of electronic program and fiscal information: o Internet access, preferably high-speed o Email capability o Microsoft Excel o Microsoft Word o Adobe Reader The purchase of this technology would be an allowable expenditure under the grant and may be budgeted for as part of this application. • Site Visits: The applicant agrees to participate in site visits/quality reviews as requested by the Department. • Sectarian Issue: Provider organizations may not expend federal or state funds for sectarian instruction, worship, prayer, or to proselytize. If the Provider organization is a faith-based or a religious organization that offers such activities, these activities shall be voluntary for the individuals receiving services and offered separately from the program. • Hiring and Employment Policy: It is the policy of the Department to encourage cultural diversity in the work environment and to promote employment opportunities through its programs. The Department philosophy is that the program workforce should appropriately reflect the populations to be served, with special attention given to hiring individuals indigenous to those communities. Consistent with Department policy, whenever a position becomes available, funded programs are encouraged to consider TANF clients for employment, contingent upon their qualifications in the areas of education and work experience. • Publication of Studies, Reports or other Program Products: The applicant agrees that products produced for the Department under this award, including, but not limited to research reports, data, analyses, and policy recommendations are the property of the Department and will not be published or distributed except as prescribed by the Department. Agreement Terms IDHS anticipates that the term of the agreement resulting from this Program Grant Opportunity will be July 1, 2023, continuing through September 29, 2023, 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 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 will receive a Notice of State Award (NOSA) via the Illinois GATA Grantee Portal. It is important to keep contact information in the Illinois GATA Grantee Portal updated since the main contact is the person notifications are sent to. 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). Note: The Department cannot issue a NOSA until the successful applicant has an approved budget entered into CSA. 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). 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. The agency awarded funds through this Funding Opportunity must further 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.). Additional terms and conditions may apply.

March 27, 2023, 12:00 PM CST

90 days

NA. This grant is a non-competitive grant, and therefore a Merit Based Review is not conducted.

This program will be awarded as a 3-month term agreement. Continued Funding of this Program is at the sole discretion of IDHS and is contingent on meeting the follow criteria: 1. Applicant has performed satisfactorily during the most recent past funding period. 2. All required reports have been submitted on time, unless a written exception has been provided by the Division. 3. No outstanding issues are present (i.e. in good standing with all pre-qualification requirements); and 4. Funding for the budget year has been appropriated in the state's approved fiscal year budget.

Statutory formulas are not applicable to this program. This program has no matching requirements. CMHS and CSAT, STOP DFC. MOE requirements are not applicable to this program.

• 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 Federal appropriated funds. Funding Restrictions The applicant must develop a budget consistent with program requirements. 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 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.

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. Time Period for Required Periodic Financial Reports. Unless a different reporting requirement is specified in Exhibit E, Grantee shall submit financial reports to Grantor pursuant to Paragraph 10.1 and reports must be submitted no later than 30 days after the quarter ends. 2. Time Period for Close-out Reports. Grantee shall submit a Close-out Report pursuant to Paragraph 10.2 and no later than 30 days after this Agreement's end of the period of performance or termination. 3. Time Period for Required Periodic Performance Reports. Unless a different reporting requirement is specified in Exhibit E, Grantee shall submit Performance Reports to Grantor pursuant to Paragraph 11.1 and such reports must be submitted no later than 30 days after the quarter ends. 4. Time Period for Close-out Performance Reports. Grantee agrees to submit a Close-out Performance Report, pursuant to Paragraph 11.2 and no later than 30 days after this Agreement's end of the period of performance or termination. 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 PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov PFR Email Address for Colbert Consent Decree: DHS.Colbert.Invoices@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

See JCAR Title 44 Illinois Administrative Code 7000.90 Auditing Standards

See JCAR Title 44 Illinois Administrative Code 7000.430 Record Retention

Federally Funded

$305.596

$24,145 - 114,598

NA

CFR 200/45 CFR Part 75 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS awards; also the HHS Grants Policy Statement. Title 59: Mental Health of the Administrative Code

NA

IL Department of Human Services, Division of Mental Health

https://www.dhs.state.il.us/page.aspx?item=148580

None

None

FY 2024 : $305,596