Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 425 - CIVIL MONEY PENALTY REINVESTMENT PROGRAM
Subpart B - IMPROVING QUALITY OF LIFE AND CARE (IQLC) GRANT PROGRAM
Section 425.210 - Application Procedures and Required Information
Universal Citation: 77 IL Admin Code ยง 425.210
Current through Register Vol. 48, No. 12, March 22, 2024
a) IQLC grant applications are only available electronically through the Department's electronic grant administrative and management system.
b) Completed applications must be submitted to the Department through the Department's electronic grant administrative and management system. Mailed, faxed or e-mailed applications will not be accepted.
c) Grant applications received after the application deadline will not be considered. The application deadline will be provided in the NOFO.
d) All IQLC Grant Program applications must contain the following required information:
1) Applicant Contact Information for the
primary point of contact (POC) who is responsible for the project
implementation, including:
A) Name;
B) Phone number;
C) Email; and
D) Address: Street, City, County,
State/Territory, Zip Code.
2) Applicant Organization Information for the
organization requesting CMP funds, including:
A) Name;
B) Phone number;
C) Email address;
D) Mailing address: Street, City, County,
State/Territory, Zip Code;
E)
Website address, if available;
F)
National Provider Identifier, if applicable;
G) Whether the organization is a facility;
and
H) If the organization is a
facility, an accounting of whether any outstanding CMPs are due and if the
facility is in bankruptcy or receivership.
3) A description of the history of the
organization requesting CMP funds, including the organization's mission
statement and number of years in service.
4) A statement of the organization's
capabilities, including products and services relevant to the proposed CMP
project.
5) A statement indicating
whether other funding sources have been applied for or granted for the proposal
or project, and identifying information about the funding sources, including
amounts applied for or granted.
6)
Project Title
A) Provide the title of the
proposed project.
B) If the project
is an extension to a new facility location, a statement of whether the project
is an extension of an IQLC Grant Program project approved after April 1, 2018,
and if results have been provided to the Department. Applicants must include
the approval letter for the existing IQLC Grant Program project in their
submittal and a description of the results of the project as an attachment to
the application.
7)
Project Time Period: Provide the proposed start and end dates for the proposed
project.
8) Project Category:
Identify the appropriate category that best describes the focus of the proposed
project.
A) Consumer Information: Projects
that share information about resident and resident representative rights, the
facility care process, and other useful consumer information to ensure quality
care in facilities.
B) Resident or
Family Council: Projects that focus on resident and family council development
or improvement in resident-centered services.
C) Direct Improvements to Quality of Care:
Projects that directly improve care for facility residents.
D) Culture Change/Direct Improvements to
Quality of Life: Projects that enhance a resident's self-esteem and dignity.
Culture change is the common name given to the national movement for the
transformation of older adult services, based on person-directed values and
practices where the voices of elders and those working with them are considered
and respected.
E) Training:
Training that covers material that directly benefits the residents and the
facility.
F) Other projects that
protect or improve the quality of care or quality of life for
residents.
9) Summary of
the Project and its Purpose
A) Description of
the problem or gap in services the project proposes to address;
B) Description of project goals and
objectives; and
C) Description of
the plan to implement the project, including an implementation
timeline.
10) Project
Deliverables: List any physical items that will be deliverables as a result of
funding the project (e.g., electronics, training materials,
curricula).
11) Total CMP Fund
Request Amount:
A) Provide the amount of CMP
funds requested annually and for the entire project.
B) The total amount of non-CMP funds received
for the project including how the cost-share requirements are met.
12) Detailed Line Item Budget:
Applicants must provide a detailed line item budget using a budget template
provided by the Department to outline specific cost requirements within each of
the following budget categories:
A) Personnel:
an employee of the organization whose work is tied to the proposed
project;
B) Travel: provide
mileage, lodging and per diem as applicable;
C) Equipment purchase and rentals: materials
central to the roll out of the project;
D) Contractual: the cost of project
activities to be undertaken by a third-party contractor. Each contractor should
be budgeted separately;
E) Other
direct costs: expenses not covered in any of the previous costs;
F) Total indirect costs: overhead costs
allocable to the project such as a negotiated rate with a university;
and
G) Cost-sharing: total non-CMP
funds received or anticipated for this project. The cost-sharing amount must be
subtracted from the total project cost.
13) Budget Narrative:
A) The budget narrative must:
i) Justify the indirect costs and
cost-sharing amounts included in the detailed line item budget; and
ii) Explain the costs calculation and
methodology.
B) If
cost-sharing is included, it should be listed for each year of the project. If
the proposed project is a component of a larger program, identify other funding
sources for the proposal, and indicate the specific funding amount to be
provided by those sources. Other federal funding does not constitute
cost-sharing.
14)
Benefit to Facility Residents: a description of how the proposed project will
directly benefit facility residents.
15) Facility and Community Involvement:
A) A brief description of how the facility
community, including residents and family councils and direct care staff, will
be involved in the development and implementation of the project.
B) If the organization applying is not a
facility, include letters of support in the application submission to
demonstrate facility support and buy-in for the proposed project.
16) Other Partnering Entities
A) If applicable, list any other entity or
entities that will be partnering with the applicant on this project (e.g.,
individuals, organizations, associations, facilities).
B) Include specific deliverables for which
the partnering entity or entities will be responsible.
C) If applicable, include the amount of
funding partnering entity or entities will receive.
17) Performance Monitoring and Evaluation: A
description of how the project's performance will be monitored or evaluated
(including specific outcome metrics) and the intended outcomes.
18) Duplication of Effort: an explanation
that demonstrates the project will not duplicate or overlap with the
responsibility of the facility to meet existing Medicare and Medicaid
requirements and other applicable statutory and regulatory requirements, nor
duplicate federal or state services.
19) Risks: a description of the potential
risks or barriers associated with implementing the project and the plan to
address these concerns.
20)
Sustainability: a description of how the project or outcomes will be sustained
after CMP funding concludes.
21)
Attestation Statement that includes the following:
A) Name of the applicant;
B) Signature of the applicant;
C) Date of signature.
Disclaimer: These regulations may not be the most recent version. Illinois may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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