Regions Donated Funds Initiative (520)
CSFA Number: 444-22-0626
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 Title XX Donated Funds Initiative (DFI) supports service program development in three specific service need categories selected by the Illinois Department of Human Services, Division of Mental Health (IDHS/DMH). Service areas covered by this exhibit include: 1) Mental Health Outreach and Engagement; 2) Recovery Support and Mentoring; and 3) Tele-health.

Deliverables
Title XX program plans must address one of the following desired deliverables:
1. Develop a Mental Health Outreach and Engagement Program that focuses on mental health prevention, promotion, stigma reduction and awareness for a defined geographical area of Illinois.
2. Develop a Recovery Support and Mentoring program that helps orient and maintain recovery support specialist(s) in one or more IDHS/DMH Grantee agencies.
3. Develop a Telehealth network that links two or more mental health service sites for a defined geographical area of Illinois.
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 4.3 Cash Management Improvement Act of 1990 and Section 4.7 Timely Billing Required. Grantee shall submit allowable grant expenses on the appropriate DMH invoice template within 30 days of the end of the service quarter to the email address indicated on the template no later than November 1, February 1, May 1, and August 1. Invoiced expenses should be consistent with the approved annual grant budget. Any expenditure variances require prior Grantor approval in accordance with Article VI of the grant agreement to be reimbursable. All invoices shall be HIPPA compliant and encrypted utilizing DHS approved encryption software if so indicated on the invoice template. Invoices shall serve as the request for reimbursement as well as the Periodic Financial Report.

DMH invoice templates 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


Note: due to the wide variety of services provided by DMH Title XX vendors, all measures may not be applicable.
The following are included in the reporting template:
1. Total number of unduplicated individuals served by this contract.
2. Mental Health Prevention & Education
a. Number of outreach and marketing activities to multiple community sites within the defined geographical area.
b. Number of individuals who attended individual training events within the defined geographical area.
c. Number of individuals who attended group training events within the defined geographical area.
d. Number of individuals who completed training evaluations.
3. Peer Support and Mentoring
a. Number of employees with lived experience in recovery from a mental illness to be part of the professional staff.
b. Number of employed peer staff using the Title XX agreement resources in pursuit of the Certificate of Recovery Support Services (CRSS).
c. Number of peer support staff linked by the targeted service provider(s) to the Recovery Support Network activities offered by the IDHS/DMH.
4. Measures for Telehealth
a. Number of Telehealth network sites within the defined geographical area established and in operation.
b. Number of clients that received Rule 132 mental health services via the Telehealth network.
c. Number of periodic customer satisfaction surveys completed.
Performance Standards
The Grantee shall achieve the minimum performance standards for the type of Title XX DFI initiative supported by the agreement. Quarterly performance measures will be evaluated for compliance with the appropriate standards below.

1. Mental Health Prevention & Education
a. 12 or more distinct outreach marketing activities conducted at community sites or within the defined geographical area.
b. Individual training events at least 25 participants from the defined geographical area.
c. Group training events at least 25 participants from the defined geographical area.
d. 100% of training and education event participants completed training evaluations.
2. Peer Support and Mentoring
a. Employed one or more person with lived experience in recovery from a mental illness on the professional staff.
b. 100% of peer staff used the Title XX agreement resources and continue to progress toward completion of the Certificate of Recovery Support Services (CRSS) credential
c. 100% peer support staff employed by the targeted service provider(s) linked to the Recovery Support Network activities offered by the IDHS/DMH.
3. Telehealth
a. Two or more Telehealth network sites, within the defined geographical area, are established and operational.
b. 25 or more individuals received Rule 132 mental health services delivered via the Telehealth network.
c. 100% of periodic customer satisfaction surveys completed.
Subject Area
Human Services
Program Function
Health
Enabling Legislation
Social Security Act, Title XX, as amended; Omnibus Budget Reconciliation Act of 1981, as amended, Public Law 97-35; Jobs Training Bill, Public Law 98-8 and 473; Medicaid and Medicare Patient and Program Act of 1987; Omnibus Budget Reconciliation Act of 1987, Public Law 100-203; Family Support Act of 1998, Public Law 100-485; Omnibus Budget Reconciliation Act of 1993, Public Law 106-66, 42 U.S.C 1397 ET seq.
Objectives and Goals
Title XX program plans must address one of the following desired deliverables:
1. Develop a Mental Health Outreach and Engagement Program that focuses on mental health prevention, promotion, stigma reduction and awareness for a defined geographical area of Illinois.
2. Develop a Recovery Support and Mentoring program that helps orient and maintain recovery support specialist(s) in one or more IDHS/DMH Grantee agencies.
3. Develop a Telehealth network that links two or more mental health service sites for a defined geographical area of Illinois.
Reporting Requirements:
1. Financial Report in accordance with Exhibit C.
2. Performance Report in accordance with Exhibit E.
Types of Assistance
Formula Grants
Uses and Restrictions
Federal funds may be used by States for the proper and efficient operation of social service programs. Except for items (1) and (4) below, for which a waiver from the Secretary may be requested, Federal funds cannot be used for the following: (1) The purchase or improvement of land, or the purchase, construction, or permanent improvement of any building or other facility; (2) the provision of cash payments for costs of subsistence or the provision of room and board (other than costs of subsistence during rehabilitation, room and board provided for a short term as an integral but subordinate part of a social service, or temporary shelter provided as a protective service); (3) the payment of wages to any individual as a social service (other than payment of wages to welfare recipients employed in the provision of child day care services); (4) the provision of medical care (other than family planning services, rehabilitation services or initial detoxification of an alcoholic or drug dependent individual) unless it is an integral but subordinate part of a social service for which grants may be used; (5) social services (except services to an alcoholic or drug dependent individual or rehabilitation services) provided in and by employees of any hospital, skilled nursing facility, intermediate care facility, or prison, to any individual living in such institution; (6) the provision of any educational service which the State makes generally available to its residents without cost and without regard to their income; (7) any child day care service unless such service meets applicable standards of State and local law; (8) the provision of cash payments as a service; or (9) for payment for any item or service (other than an emergency item or service) furnished by an individual or entity during the period when such individual or entity is excluded pursuant to Section 1128 or Section 1128(A) of the Social Security Act from participation in this program; or at the medical direction or on the prescription of a physician during the period when the physician is excluded based on Section 1128 or 1128(A) from participation in the program and when the person furnishing such item or service knew or had reason to know of the exclusion (after a reasonable time period after reasonable notice has been furnished to the person). A State may transfer up to 10 percent of its allotment for any fiscal year to the preventive health and health services, alcohol and drug abuse, mental health services, maternal and child health services, and low-income home energy assistance block grants.
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.
Eligible Applicants
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);

DMH invoice templates can be found in the Provider section of the DHS website.
Assistance Consideration
The Title XX Donated Funds Initiative (DFI) requires a 25% in kind match of the funds awarded that the Grantees are required to meet.
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
45 CFR 96

DHS/DMH Attachment B
DHS/DMH Program Manual
Federal Funding
Notice of Funding Opportunities
Agency IDAward RangeApplication Range
Details18-444-22-0626-01$35000 - $22200003/25/2017 - 05/01/2017 : 12:00 pm
Agency IDGrantee NameStart DateEnd DateAmount
45CYB03438-45CYB03438Metropolitan Family Services07/01/201906/30/2020290,812
45CYB03457-45CYB03457Sinnissippi Centers, Inc.07/01/201906/30/2020253,500
45CYB03436-45CYB03436Chestnut Health Systems, Inc.07/01/201906/30/2020170,200
45CYB03441-45CYB03441NAMI METRO-SUBURBAN, INC07/01/201906/30/2020167,900
45CYB03442-45CYB03442SERTOMA CENTRE INC07/01/201906/30/2020116,500