Survivorship Pilot Program
CSFA Number: 482-00-1628
Agency Name
Department Of Public Health (482)
Agency Contact
Shelly Reeter
Short Description
Southern Illinois Healthcare will be charged with hiring an oncology dietician to establish a new program for cancer survivors and their families. The grant will provide $65,000.00 to implement strategies between July 1, 2019 and June 30, 2020. The program will implement a holistic approach that includes nutrition classes and alternative treatment options to ensure the optimum health for survivors.

The pilot program will enhance the current survivor services provided through the cancer center. Although the project will focus primarily on cancer survivors and their families, some of the resources may be used to educate caregivers as well.

The application will be reviewed, evaluated and funded based on program need, availability of funds and history of efficient use of project funds.

Quarterly progress reports to the Department will be submitted by the applicant and will be used to track progress made towards achievement of the program goals and objectives. Fiscal reimbursement requests shall be made quarterly. Failure to submit required reports in a timely manner will result in reimbursement delays.
Subject Area
Program Function
Enabling Legislation
Objectives and Goals
Types of Assistance
Uses and Restrictions
Use of Funds. All grant funds must be used for the sole purposes set forth in the grant proposal and application and must be used in compliance with all applicable laws. Grant funds may not be used as matching funds for any other grant program. Use of grant funds for prohibited purposes may result in loss of grant award and/or place the grantee at risk for recouping of those funds used for the prohibited purpose. Expenditure reports must be submitted monthly. To be reimbursable under the Department/Office of Health Promotion Grant Agreement, expenditures must meet the following general criteria:
• Be necessary and reasonable for proper and efficient administration of the program and not be a general expense required to carry out the overall responsibilities of the applicant.
• Be authorized or not prohibited under federal, state or local laws, or regulations.
• Conform to any limitations or exclusions set forth in the applicable rules, program description, or grant agreement.
• Be accorded consistent treatment through application of generally accepted accounting principles, appropriate to the circumstances.
• Not be allocable to or included as a cost of any state or federally-financed program in either the current or a prior period.
• Be net of all applicable credits.
• Be specifically identified with the provision of a direct service or program activity.
• Be an actual expenditure of funds in support of program activities, documented by check number, and/or internal ledger transfer of funds.
• Not be used for research or clinical care.

NOTE: Grantee should prepare a budget that reflects expenses for the grant term. Use whole numbers and round to the nearest dollar. Once approved, the budget will be incorporated into the grant. Using the forms provided in this packet, submit additional information or justification as required in the allowable costs list section. Specific line items listed in the detailed budget must be explained on the budget forms. The grantee may divide employee work time among multiple staff directly involved in the Program development, implementation and evaluation. The allocation of employee work time in the grant budget must reflect and be commensurate with program activities attributed to the specific program staff in the approved Scope of Work Plan. Program staff members funded 100% from the grant are expected to work solely on this grant program and may not be funded by other IDPH grant programs. Use the Personnel Loading Chart found in the appendix to detail staff.

If the grantee is anticipating the use of sub-contractors/sub-grantees, those should be listed under the Contractual Costs section of the Budget Detail Template and the Contractual Services section of the grant application. For such sub-contractors and/or sub-grantees, justification should be of sufficient detail to document the items requested are essential to the achievement of the work plan activities. Complete Subcontractor Table found in the appendix to provide information for each subcontractor that will be used to provide services under this grant. If a vendor is to be determined, indicate so on the table.

Contractual Services are costs such as contractual employees, repair and maintenance of equipment, media development and placement, software for support of program objectives, among other costs. Payments (or pass-through) to subcontractors are to be shown in the Contractual Services section of the application (Section 5) as well as in the Budget Detail section.

The grantee acknowledges they must expend funds in accordance with the budget approved by the Department and in line with the line item categorical amounts approved in that budget. Ten (10%) of the grant amount shall be distributed upon execution. The grantee is required to submit monthly documentation of actual expenditures incurred for conducting activities through use of the Department's reimbursement certification form. If changes in line items of the approved budget are necessary, the grantee must submit a Budget Adjustment Request in writing on Department forms for approval by the Department prior to making any of the requested expenditure changes. Documentation of actual expenditures incurred for the grant period must be submitted within 30 days after the close of the grant period (Friday, July 31, 2020). Any funds not documented and approved by the Department must be returned to the Department.

Allowable costs. Examples of allowable costs are listed below. This is not meant to be a complete list, but rather specific examples of items within each line item category.

Personal Services:
• Gross salaries paid to agency employees directly involved in the provision of program services. All salaries to be provided as in-kind need to be documented and noted on the budget sheet as such.
• Employer's portion of fringe benefits actually paid on behalf of direct services employees. Examples include FICA (Social Security), life/health insurance, workers compensation insurance, unemployment insurance and pension/retirement benefits.

Contractual Services:
• Contractual employees (requires prior program approval).
• Postage, postal services, overnight mailing, or other carrier costs.
• Photocopies. If paid to a duplicating business, list the number of copies and costs. If charged by copy on a leased photocopy machine, list cost per actual copy.
• Telecommunications. Allowable charges are monthly telephone service costs for land lines and installation, repair, parts and maintenance of telephones and other communication equipment.
• Payments or pass-throughs to subcontractors or sub grantees are to be shown in the Contractual Services section. All subcontracts or sub grants require an attached detail line item budget supporting the contractual amount.
• Printing. Any printing job, e.g., letterpress, offset printing, binding, lithographing services, must be requested as a prior approval item in the budget submission. This expense requires substantive documentation as to its relevance to the work plan before approval will be granted. The cost of the printing may not exceed $1,000 or 5 percent of the total budget, whichever is less.

• Auto travel mileage at no higher than 53.5 cents - the state reimbursement rate as of January 1, 2017.
• Rail transportation expenses.
• Lodging. The rate must be in accordance with Illinois Travel Control Board rates or justification must be provided.
• Per Diem.

• Office supplies.
• Educational and instructional materials and supplies, including booklets and reprinted pamphlets. The budget narrative must describe the connection between the purchase of these materials and approved work plan before it will be approved.
• Paper supplies.
• Envelopes and letterhead.

Unallowable Cost List. Unallowable or prohibited uses of grant funds include, but are not limited, to the following:
• Political or religious purposes.
• Contributions or donations.
• Incentives, including but not limited to t-shirts, bags, backpacks, hats, pencils, rulers, coloring books, stress balls, band-aid holders, mugs and cookware..
• Fundraising or legislative lobbying expenses.
• Payment of bad or non-program related debts, fines or penalties.
• Contribution to a contingency fund or provision for unforeseen events.
• Food, alcoholic beverages, gratuities or entertainment.
• Membership fees.
• Interest or financial payments or other fines or penalties.
• Purchase or improvement of land or purchase, improvement, or construction of a building.
• Lease of facility space.
• Any expenditure that may create conflict of interest or the perception of impropriety.
• Audit expenses.
• Equipment.
• Prescription drugs.
• Conference registration fees, including registration fees to attend or exhibit at events that can be defined as fundraisers.
• Exhibit fees.
• Subscriptions.
• Association dues.
• Expenses for credentialing (e.g., CHES certification).
• Airfare.
• Out-of-state travel.
Eligibility Requirements
Southern Illinois Healthcare is the only eligible applicant for this grant.
Eligible Applicants
Application and Award Processing
The grant will be awarded upon the approval of the application.
Assistance Consideration
Post Assistance Requirements
Regulations, Guidelines, Literature
Funding By Fiscal Year
FY 2018 : $73,765
FY 2019 : $75,000
FY 2020 : $65,000
Federal Funding
Notice of Funding Opportunities
Agency IDGrantee NameStart DateEnd DateAmount
03284001HSouthern Illinois Hospital Services (AKA- Southern Illinois Healthcare)07/01/201906/30/202065,000