Supervised Residential (830)
CSFA Number: 444-22-1202
Agency Name
Department Of Human Services (444)
Agency Identification
DMH
Agency Contact
Barb Roberson
217-557-5876
Barb.roberson@illinois.gov
Short Description
Scope of Services
The Grantee shall deliver recovery-oriented community residential facilities leased or owned by DMH Community Grantees to individuals who have substantial levels of psychiatric disability and meet medical necessity. Community Grantees must have at least one awake, on-site staff person available 24 hours a day, seven days a week.

Deliverables
The Grantee shall deliver residential care to eligible individuals who meet medical necessity criteria prescribed by DMH who need 24 hour/ 7 day a week supervision including skills training and supports. Grantee shall register all individuals served under this Exhibit in accordance with the requirements of the Provider Manual and shall report individuals served in this level of care through the submission of claims according to requirements prescribed by the Community Mental Health Service Definition and Reimbursement Guide available at http://www.hfs.illinois.gov/assets/cmhs.pdf.

Community Grantees must have at least one awake, on-site staff person available 24 hours a day, seven days a week. The Supervised Residential program shall fund the non-rehabilitative and non-therapeutic costs, such as facility depreciation or rent, utilities, food for Clients and staff costs, associated with providing this level of care and shall not include any costs associated with the delivery and billing of any other available service reimbursable by the Illinois Department of Healthcare and Family Services (HFS) or DHS/DMH.

The Grantee shall exhaust all other resources, including but not limited to Medicaid, Medicare or other insurance, to assure DHS/DMH is the funder of last resort for this level of care. Grantee shall comply with all requirements of the Provider Manual, including but not limited to Grantee monitoring and utilization management.

Reporting Requirements:
1. Financial Report in accordance with Exhibit C.
2. Performance Report in accordance with Exhibit E.

Payment
Reference the Uniform Grant Agreement, Article IV Payment, Section 4.2 Return of Grant Funds and 4.3 Cash Management Improvement Act of 1990. Payment will be issued monthly and reconciled with reported allowable expenses. Grantee shall submit a quarterly Periodic Financial Report (GOMBGATU-4002 (N-08-17)) to the appropriate email address below no later than November 1, February 1, May 1, and August 1. 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

DMH reporting templates and detailed instructions for submitting reports can be found in the Provider section of the DHS website.

Performance Measures
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 no later than November 1, February 1, May 1, and August 1. Reporting templates and instructions for submitting reports can be found in the Provider section of the DHS website.

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

The following are included in the reporting template:
1. Number of individuals served.
2. Number of individuals for whom registration is submitted in accordance with Provider Manual requirements.
3. Number of individuals who have claims for nights of care.
4. Number of individuals for whom claims for nights of care are submitted in accordance with DHS/DMH requirements.
5. Number of available capacity for this level of care.
6. Number of available capacity for this level of care utilized during the quarter as reported via claims submissions and monthly capacity reports.
7. Number of weeks in reporting period.
8. Number of weeks in reporting period Grantee has at least one awake, on-site staff person available 24 hours a day, seven days a week.

Performance Standards
1. 100% of individuals served are registered in accordance with Provider Manual requirements.
2. 100% of claims for nights of care are submitted in accordance with DHS/DMH requirements.
3. 85% or more of the available capacity for this level of care is utilized in each quarter.
4. 100% of weeks in reporting period have at least one awake, on-site staff person available 24 hours a day, seven days per week.
Subject Area
Human Services
Program Function
Housing
Enabling Legislation
Mental Health Community Services Act (405 ILCS 30/)

Public Health Service Act, Subpart 1 and III, Title XIX, Part B.
Objectives and Goals
The Grantee shall deliver residential care to eligible individuals who meet medical necessity criteria prescribed by DMH who need 24 hour/ 7 day a week supervision including skills training and supports. Grantee shall register all individuals served under this Exhibit in accordance with the requirements of the Provider Manual and shall report individuals served in this level of care through the submission of claims according to requirements prescribed by the Community Mental Health Service Definition and Reimbursement Guide available at http://www.hfs.illinois.gov/assets/cmhs.pdf.

Community Grantees must have at least one awake, on-site staff person available 24 hours a day, seven days a week. The Supervised Residential program shall fund the non-rehabilitative and non-therapeutic costs, such as facility depreciation or rent, utilities, food for Clients and staff costs, associated with providing this level of care and shall not include any costs associated with the delivery and billing of any other available service reimbursable by the Illinois Department of Healthcare and Family Services (HFS) or DHS/DMH.

The Grantee shall exhaust all other resources, including but not limited to Medicaid, Medicare or other insurance, to assure DHS/DMH is the funder of last resort for this level of care. Grantee shall comply with all requirements of the Provider Manual, including but not limited to Grantee monitoring and utilization management.

Reporting Requirements:
1. Financial Report in accordance with Exhibit C.
2. Performance Report in accordance with Exhibit E.
Types of Assistance
Direct Payments for Specific Use
Uses and Restrictions
Funding Restrictions
DHS/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
Allowable costs are those that are necessary, and reasonable and permissible under the law and can be found in 2 CFR 200 - Subpart E - Cost Principles.

Unallowable Costs
Please refer to 2 CFR 200 - Subpart E - Cost Principles to see a collection of unallowable costs.

Indirect Cost Rate Requirements
Please refer to 2 CFR 200.414 regarding Indirect (F&A) Costs.

In order to charge indirect costs to a grant, agencies must have an annually negotiated indirect cost rate agreement (NICRA). There are three types of NICRAs: a. Federally Negotiated Rate; b. State Negotiated Rate and c. De Minimis Rate

Eligibility Requirements
All Applicants must make certain the following are completed before an award can be made.
1. Complete and submit a Grant Application to DHS.GrantApp@illinois.gov. Each application must be sent in a separate email. Links are provided under the "GA" column at http://www.dhs.state.il.us/page.aspx?item=120031. Page 1 of the applications are pre-populated.
a. The subject line of the email MUST state:
i. Provider Organization Name
ii. CSFA Number (444-22-XXXX)
iii. Contact Name (Barb Roberson)
2. Complete and submit the Fiscal and Administrative Risk Assessment, also known as the ICQ, (short for Internal Control Questionnaire). This is done only once per entity per fiscal year via the GATA Grantee Portal https://www2.illinois.gov/sites/GATA/Pages/default.aspx. While it does not have to be completed prior to submitting the application, this step must be done before an applicant or their application can be considered for an award.
3. Complete and Submit the Programmatic Risk Assessment (PRA) for each grant opportunity. Links are provided under the "PRA" column below;
4. Complete and submit the FY 2021 Uniform Grant Budget in the IDHS CSA Tracking System (http://www.dhs.state.il.us/page.aspx?item=61069)

In addition, the following are eligibility requirements:
a. Register with the Illinois Grant Accountability and Transparency Act Grantee Portal.
b. Have a current DUNS number;
c. Have a current FEIN Number;
d. Have a current System for Award Management Account SAM.gov account;
e. Be in Good Standing with the Illinois Secretary of State, (government entities are exempt);
f. Register and access both the Illinois Department of Human Services Community Service Agreement (CSA) tracking system and the Centralized Repository Vault (CRV);
g. If indirect costs are included in the budget, have an annually negotiated indirect cost rate agreement (NICRA).
h. Not be on the Department of Healthcare and Family Services Provider Sanctions list;
i. Not be on the Federal Excluded Parties List.
Be certified by IDHS as a Community Mental Health Provider or a Community Mental Health Center;
Eligible Applicants
Government Organizations; Nonprofit Organizations;
Application and Award Processing
1. Complete and submit a Grant Application to DHS.GrantApp@illinois.gov. Each application must be sent in a separate email. Links are provided under the "GA" column at http://www.dhs.state.il.us/page.aspx?item=120031. Page 1 of the applications are pre-populated.
a. The subject line of the email MUST state:
i. Provider Organization Name
ii. CSFA Number (444-22-XXXX)
iii. Contact Name (Barb Roberson)
2. Complete and submit the Fiscal and Administrative Risk Assessment, also known as the ICQ, (short for Internal Control Questionnaire). This is done only once per entity per fiscal year via the GATA Grantee Portal https://www2.illinois.gov/sites/GATA/Pages/default.aspx. While it does not have to be completed prior to submitting the application, this step must be done before an applicant or their application can be considered for an award.
3. Complete and Submit the Programmatic Risk Assessment (PRA) for each grant opportunity. Links are provided under the "PRA" column below;
4. Complete and submit the FY 2021 Uniform Grant Budget in the IDHS CSA Tracking System (http://www.dhs.state.il.us/page.aspx?item=61069)
Assistance Consideration
The Community Mental Health Block Grant requires Maintenance of Effort be met.

Post Assistance Requirements
Reporting Requirements
1. Financial Report in accordance with Payments
2. Performance Report in accordance with Performance Measures.
DMH reporting templates and detailed instructions for submitting reports can be found in the Provider section of the IDHS website at http://www.dhs.state.il.us/page.aspx?item=95429. FY21 reports will be uploaded prior to the due date of the first report.
Regulations, Guidelines, Literature
Title 59: Mental Health of the Administrative Code

45 CFR Part 96; also portions of 2 CFR Part 200/45 CFR Part 75

DHS/DMH Attachment B
DHS/DMH Program Manual
Federal Funding
Notice of Funding Opportunities
Agency IDAward RangeApplication Range
Details18-444-22-1202-01$125872 - $47196911/14/2017 - 12/14/2017 : 5:00 pm
Details18-444-22-1202-02$217700 - $21770001/12/2018 - 02/13/2018 : 5:00 pm
Agency IDGrantee NameStart DateEnd DateAmount
45CYB00630-45CYB00630THE THRESHOLDS07/01/201906/30/20202,680,729
45CYB00036-45CYB00036BRIDGEWAY INC07/01/201906/30/20201,598,742
45CYB00318-45CYB00318HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC. HRDI07/01/201906/30/20201,425,539
45CYB04028-45CYB04028THE THRESHOLDS07/01/201906/30/2020967,536
45CYB00490-45CYB00490MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS07/01/201906/30/2020938,220