NOFO: OTPP-2

In 2013, 1,072 people in Illinois died of an opioid overdose; by 2023, this number had more than doubled to 2,855. The state’s non-Hispanic Black population has the highest overdose fatality rate (69.3 percent), followed by the non-Hispanic White population (17.7 percent). [1] To hold companies responsible for their roles in the opioid crisis, the Illinois Attorney General has engaged in multiple investigations, lawsuits, and settlements with opioid manufacturers, distributors, and chain pharmacies. The funds from the settlements will support recovery in communities hardest hit by the opioid crisis and throughout the state.

The Illinois Office of Opioid Settlement Administration (OOSA) is the entity responsible for planning, administering, and managing fifty-five percent (55%) of the funds received from opioid settlements according to the Illinois Opioid Allocation Agreement and Executive Order 2022-19. The established processes ensure transparency and consideration of regional needs, such as overdose rates, disparities created for specific populations, and resources to address opioid-related harms. OOSA is housed within IDHS’ Division of Behavioral Health and Recovery (DBHR).

About IDHS/DBHR

The mission of IDHS/DBHR is to advance health and wellness for all people of Illinois through a comprehensive system of prevention, treatment, harm reduction, and recovery services. DBHR is responsible for ensuring that children, adolescents, and adults throughout Illinois have access to comprehensive substance use and mental health services. DBHR operates a statewide system that supports prevention, intervention, treatment, harm reduction, and recovery services for individuals, families, and communities through a combination of State and Federal funding. The system includes community-based mental health and substance use services delivered through partners and inpatient mental health services through twenty-seven (27) community hospitals with psychiatric units and seven (7) state-operated hospitals. DBHR is also responsible for regulating all substance use intervention and treatment providers in the State of Illinois to ensure safety and quality of care.

DBHR focuses on improving outcomes, expanding access to care, reducing stigma, and providing coordinated care for people with behavioral health needs. It aims to create a more connected, responsive, and effective system of care through partnership with communities and providers.

Funding Source

The Office of the Illinois Attorney General has certified—and the Governor’s Opioid Overdose Prevention and Recovery Steering Committee has approved—the use of up to an estimated $9,600,000 over three (3) years from the Illinois Opioid Remediation State Trust Fund (Fund) to establish Opioid Treatment Program Partnership (OTPP) programs in accordance with the Illinois Opioid Allocation Agreement and the Fund allocation process. An initial round (OTPP) was awarded in 2025 to three subrecipients. This round (OTPP-2) seeks to award the remaining funds.

In April 2023, IDHS/DBHR awarded Advocates for Human Potential, Inc. (AHP) a grant to serve as the RCCA. The RCCA administers subawards with organizations providing prevention, intervention, treatment, and harm reduction services for people with substance use disorders in accordance with state-approved strategies and the scope of services provided by IDHS.

The funds from the settlements will support prevention efforts in communities hit hardest by the opioid crisis and throughout the state. Fund distributions must be used equitably in service areas disproportionately affected by the opioid crisis as outlined in the Illinois Opioid Allocation Agreement, such as areas with the following characteristics:

• High opioid fatality rates, including the following:
  • Counties other than Cook County with a crude rate of 1.8 or greater per 100,000 people
  • Community areas within Cook County with more than 100 overdoses (fatal and nonfatal) within the most recent year included in the Drug overdose mortality rate dashboard by Chicago Health Atlas
• Concentrated poverty, including the following:
  • Counties other than Cook County with a poverty rate greater than twelve percent (12%)
  • ZIP Codes within Cook County with a poverty rate greater than twelve percent (12%), per the Poverty rate dashboard by Chicago Health Atlas
• Concentrated firearm violence, including communities eligible for Reimagine Public Safety Act (RPSA) funding (RPSA Eligible Community Areas/Municipalities and Associated Programming)
• Other conditions that hinder the communities from reaching their full potential for health and well-being, including counties other than Cook with a crude nonfatal overdose rate of 4.0 or greater per 100,000 people, as listed in the Illinois Overdose Data Dashboard

MAR is the use of medications in conjunction with behavioral therapies to treat substance use disorders. FDA-approved medications for OUD include buprenorphine, methadone, and naltrexone.[i] These medications have been shown to reduce the risk of overdose, use of emergency medical services, and mortality[ii] and to improve outcomes such as retention in treatment[iii] and maternal and fetal outcomes for pregnant and parenting people.[iv]

However, even though they are recommended as the standard of care, these medications remain underutilized due to stigma and lack of access.[v] As of the release of the March 2022 Overdose Response Funding report, IDHS considered 39 counties to be “MAR deserts,” meaning that no MAR providers were located within the counties’ geographic boundaries. SAMHSA maintains an up to date Opioid Treatment Program Directory, which can be filtered by state.

Partnerships between OTPs and healthcare facilities that provide physical (medical), behavioral health, and recovery support services to people with OUD can facilitate more equitable access to life-saving methadone and other OUD medications, while simultaneously connecting them to services that address social determinants of health.

AHP anticipates a minimum of four (4) organizations will be awarded funding for OTPP to increase access to all forms of MAR throughout Illinois for people with OUD or polysubstance use disorder (including opioids), focusing on disparately impacted populations. To achieve this goal, OTPP subrecipients shall accomplish the following objectives:

• Forge partnerships between OTPs and FQHCs, hospitals, clinics, or public departments of health.
• Establish new OTPs, new medication units (satellites) of existing OTPs, or new partnerships allowing greater access to all three forms of FDA-approved medications to treat SUDs in regions of the state not currently served adequately by existing OTPs and medication units (“MAR deserts”).
• Create collaborative care models supported by the above partnerships to ensure patients have access to comprehensive SUD services, including physical (medical), behavioral health, and recovery support services (42 CFR § 8.2).

Of the three (3) years of potential funding, startup expenses will be allocated for the first year only. Additional startup expenses may be considered for health organizations that have not completed the regulations process within the first award year, but a failure to meet deliverable timelines will be reviewed as part of a subrecipient’s performance, and funding beyond the first year of the award is not guaranteed.

Funded partnerships must accept people who receive Medicaid/Medicare and/or are uninsured.

All subrecipients are required to obtain and/or maintain the following:

• Accreditation by an Accreditation Body,
• Certification by SAMHSA in accordance with 42 CFR Part 8 Subpart C,
• Registration with the Drug Enforcement Administration (DEA), and
• Licensing by the Division of Behavioral Health and Recovery (DBHR).

This funding opportunity will prioritize services to be delivered to and within areas of the state not currently served by OTPP-awarded organizations. Services to other regions and communities will be considered.

The tasks required and associated performance measures, standards, and potential metrics to be collected are as follows:

Task 1. Fulfill Award Administration Requirements

OTPP subrecipients must fulfill obligations detailed in Section H.10. Reporting and Grants Administration Requirements, including the following:

• Organizational Needs Assessment: Complete an organizational needs assessment (ONA) survey.
• Implementation and Sustainability Plan Development: Develop and update an implementation and sustainability plan (ISP), which informs the performance metrics used for program activities.
• Equity and Racial Justice Plan Development: Develop and implement an equity and racial justice (ERJ) plan.
• Performance Reporting: Complete quarterly periodic performance reports (PPRs).
• Fiscal Reporting: Complete monthly periodic financial reports (PFRs).
• Training and Technical Assistance Participation: Participate in project status meetings (PSMs) and training and technical assistance (TTA) as prescribed.
• Data Collection and Reporting with the RCCA Opioid Abatement Strategies Effectiveness Evaluator Subrecipient: Identify performance metrics, collect relevant data to evaluate program effectiveness, and perform monthly evaluation reporting (MER).

Anticipated performance measures for these activities are detailed in Section C.4. Deliverables and Performance Measures.

Task 2. Staff and Administer Program

The subrecipient must establish and maintain program leadership and staffing, operations, information technology, and other administrative infrastructure required to support program activities pursuant to administrative and legislative requirements, and proportional to the needs of the program.

The following deliverables are required:

Task 2.a. Identify Program Staff

The subrecipient must allocate or hire sufficient staff to support the delivery of the tasks. SAMHSA recommends that OTP staffing patterns align with the size of the OTP, the scope of practice, the extent of services provided, and the number of patients served.

At a minimum, a medical director and a program sponsor must be designated and fulfill the responsibilities identified in Certification and Treatment Standards for Opioid Treatment Programs, Federal Opioid Use Disorder treatment standards (42 CFR § 8.12). If new staff are to be hired, interim staff must be available at the beginning of the period of performance. Program leadership must be supported by administrative, finance, and legal staff to ensure program operations comply with legislative and administrative requirements pursuant to the subaward agreement.

Leadership and direct service staff should be reflective of the community/population being served. Preference is given to subrecipients that commit to having direct service staff who both live and work in their communities.

Task 2.a. Performance Measures

2.a.1. Submit a Program Organizational Chart detailing assigned staff (or designated to-be-hired), their roles, and matrixed supports within fifteen (15) days from the beginning of the period of performance. This organizational chart should include a list of names and emails of all individuals assigned to work on the program in any capacity and should designate key personnel

Task 2.b. Maintain staffing

Subrecipient shall maintain staffing throughout the period of performance in accordance with approved implementation plan and roles required. Changes in key personnel require prior approval if identified by name or position in the award or application (2 CFR 200.308(f)(2), Ill. Admin Code 7000.370).

Task 2.b. Performance Measures

2.b.1. Staffing metrics maintained per ISP (reported on PPR).

2.b.2. Obtain prior approval at least 15 days prior to making of changes in key personnel. Notify of staffing changes. Submit updated organizational chart and staff list within fifteen (15) days of a key personnel change.

Task 3. Provide Community Outreach and Education (If Applicable)

This task is applicable only to subrecipients seeking to offer MAR services at a location at which methadone is not currently dispensed.

Any subrecipient seeking to establish a new OTP or to extend OTP services to a new location using a medication unit must develop a plan to engage with the community and conduct listening sessions with community leaders and community members to and educate them on opioid reduce stigma, identify concerns, and gather information.:

Task 3.a. Develop a Community Relations Plan

The subrecipient must develop and follow a Community Relations Plan. The Community Relations Plan must include, at minimum, the following:

• Identification of community leaders (e.g., elected officials, business owners, law enforcement, faith community, and grassroots organizations)
• Points of contact within the OTP and community
• Communications protocols
• Opportunities for paid work experiences to enhance and expand the workforce

Task 3.a. Performance Measures

Submit a Community Relations Plan within sixty (60) days of the beginning of the period of performance.

Task 3.b. Conduct Listening Sessions

The subrecipient must hold community listening sessions in the neighborhood in which the OTP or medication unit will be located, to build relationships among local interest-holders. These sessions should be used to reduce stigma among community groups, identify potential concerns, and gather information on local needs from the perspective of the community. Participants may include publicly elected representatives, local community, healthcare, and social service providers, substance use treatment programs, business organization leaders, community and health planning agency directors, leaders of neighborhood associations, schools, local law enforcement, and religious and spiritual organizations.

The subrecipient must then develop policies and procedures that are consistent with the best practices outlined in CARF International’s Community Relations Tips for Opioid Treatment Programs to address the community’s concerns, including but not limited to the following:

• Maintaining exterior/grounds
• Preventing loitering
• Preventing medication diversion
• Minimizing traffic disruptions

Task 3.b. Performance Measures

Conduct no fewer than three (3) Community Listening Sessions within one hundred twenty (120) days of the beginning of the period of performance. Document sessions by producing summary notes of meetings that include identified concerns, potential mitigation strategies discussed, and any specific information about population and/or geographic needs for such services in the community. Submit community listening session documentation within one hundred fifty (150) days of the beginning of the period of performance.

Submit community relations policies and procedures within one hundred fifty (150) days of the beginning of the period of performance.

Task 4. Secure MAR Location (If Applicable)

This task is applicable only to subrecipients seeking to offer MAR services at a location at which methadone is not currently dispensed.

The subrecipient must secure and prepare an appropriate location for MAR services. Activities include:

• Establish Site Control
• Comply with Local Zoning
• Build Out MAR Site
• Meet Technology Needs

Task 4.a. Establish Site Control

The subrecipient must establish control of the site for MAR services through one of the following:

• Contract of sale
• Lease agreement
• Binding option to lease or purchase
• Memorandum of understanding with an FQHC, hospital, clinic, or public department of health

Expenses associated with Task 4.a. include initial payments and legal costs.

Task 4.a. Performance Measures

Submit evidence of site control within ninety (90) days of the beginning of the period of performance.

Task 4.b. Comply with Local Zoning

If applicable, the subrecipient must comply with all applicable local zoning regulations before establishing MAR services. Expenses associated with Task 4.b. include legal costs, when applicable and appropriate.

Task 4.b. Performance Measures

Submit a local certificate of zoning (if applicable) within one hundred eighty (180) days of the beginning of the period of performance. (If not applicable because of local jurisdiction choice, provide a signed statement attesting so.)

Task 4.c. Build Out MAR Site

The site must meet all state and federal requirements, including client privacy and secure storage of medications. Expenses associated with Task 4.c. include, but are not limited to, those associated with the following:

• Architectural design
• Private areas for dispensing medications
• Private cashier areas for accepting payments
• Modifying restrooms for conducting urinalysis screens
• Modifying computer equipment (e.g., privacy filters)
• Compliance with Occupational Safety and Health Administration standards
• Medication storage and inventory management equipment
• Architect’s Life Safety Inspection and Report

Task 4.c. Performance Measures

Submit an Architect’s Life Safety Inspection and Report to IDHS within one (1) year of the beginning of the period of performance.

Task 4.d. Meet Technology Needs

The OTP or medication unit must install an electronic health record (EHR) system meeting the following minimum requirements:

• Certified by the Office of the National Coordinator for Health Information Technology (ONC)
• Interoperable with EHR of any partner designated to provide health or dental services to OTP participants.

Task 4.d. Performance Measures

Submit evidence of EHR interoperability, which may be in the form of an attestation signed by all parties along with documentation of ONC certification, prior to administering MAR and within thirty (30) days of DBHR issuing a license to operate at the location.

Task 5. Meet OTP Qualifications

Subrecipient and its medical partner shall obtain and maintain all credentials required to serve as an OTP, including but not limited to those described in Tasks 5.a., 5.b., 5.c., 5.d., and 5.f.

Subrecipients seeking to offer MAR services at (a) a new location or (b) at an existing treatment location not approved for dispensing methadone may include the cost of obtaining new accreditation, certification, registration, and licensing under this task in their proposed budget.

Per 42 CFR § 8.12(b)(2), the medical director shall be responsible for ensuring that the subrecipient and its medical partner(s) collectively comply with all applicable federal, state, and local laws and regulations related to OTP.

Task 5.a. Obtain and Maintain OTP Credentials and Requirements

Subrecipient and its medical partner shall collectively apply for, meet requirements for, submit, and maintain all credentials required to serve as an OTP, including but not limited to the following:

• DBHR licensing to provide American Society of Addiction Medicine Level 1 services (Task 5.b.)
• SAMHSA certification (Task 5.c.)
• Medicaid Certification (Task 5.d.)
• Accreditation by a SAMHSA-approved body (Task 5.e.)
• DEA registration (Task 5.f.)

Of the 3 years of funding, startup expenses will be allocated for the first year only for all tasks. Additional startup expenses may be considered for health organizations that have not completed the regulations process, but a failure to meet deliverable timelines will be reviewed as part of a subrecipient’s performance, and funding beyond the first year of the award is not guaranteed.

Task 5.a. Performance Measures

Obtain and submit documentation of all required credentials and requirements within one year and maintain credentials throughout period of performance.

Task 5.b. Obtain and Maintain DBHR Licensing

The subrecipient must be licensed by IDHS/DBHR to dispense methadone at the selected site.

Task 5.b. Performance Measures

Obtain IDHS/DBHR licensing within one (1) year of the beginning of the period of performance and submit documentation issued by IDHS/DBHR..

Task 5.c. Secure Accreditation from SAMHSA-approved Body

The subrecipient must be the subject of a current, valid accreditation by a SAMHSA-approved accreditation body (e.g., CARF or the Joint Commission), as required by federal regulations (42 CFR Part 8 Subpart C).

Task 5.c. Performance Measures

Obtain accreditation within one (1) year of the beginning of the period of performance and submit documentation issued by the accrediting body.

Task 5.d. Secure SAMHSA Certification

The subrecipient must be the subject of a provisional or final SAMHSA certification, as required by federal regulations (42 CFR § 8.11), meaning that the subrecipient’s organizational structure and facilities shall be adequate to ensure quality patient care and to meet the requirements of all pertinent federal, state, and local laws and regulations.

This task also requires the subrecipient and its medical partner(s) collectively to provide all FDA-approved medications for OUD (methadone, buprenorphine, buprenorphine/naloxone, and IM naltrexone). The OTP must provide all medications unless the medical partner can provide buprenorphine, buprenorphine/naloxone, and IM naltrexone. All patients must be counseled on all options.

To obtain certification, the subrecipient must develop a Diversion Control Plan (42 CFR § 8.12(c)) as part of its quality assurance program, containing “specific measures to reduce the possibility of diversion of dispensed [medications for OUD (MOUD)], and that assigns specific responsibility to the OTP providers and administrative staff for carrying out the diversion control measures and functions described in the [Diversion Control Plan].”

The subrecipient must also, as a requirement of certification, establish patient admission criteria that establish relevant policies and procedures aligned with 42 CFR § 8.12(e), including but not limited to, identifying personnel qualified to make a clinical determination that the patient meets diagnostic criteria, and policies and procedures related to informed consent to treatment.

Task 5.d. Performance Measures

• Submit a Diversion Control Plan within sixty (60) days of DBHR issuing a license to operate an OTP at the location.
• Submit patient admission criteria within sixty (60) days of DBHR issuing a license to operate an OTP at the location.
• Obtain SAMHSA provisional certification within sixty (60) days of DBHR issuing a license to operate an OTP at the location and submit documentation issued by SAMHSA.
• Obtain SAMHSA certification within one (1) year of the beginning of the period of performance and submit documentation issued by SAMHSA.

Task 5.e. Secure Medicaid Certification

The subrecipient must be certified to bill Medicaid for all OTP services provided to Medicaid recipients.

Task 5.e. Performance Measures

Obtain Medicaid certification within one (1) year of the beginning of the period of performance and submit documentation issued by CMS.

Task 5.e. Register with DEA

The subrecipient must submit to inspection of the facility by DEA, as required by federal regulation (42 CFR § 8.11(e)(6)) and must submit all paperwork needed for registration.

Task 5.e. Performance Measures

Obtain DEA registration within one (1) year of the beginning of the period of performance and submit evidence issued by DEA.

Task 6. Forge Healthcare Partnerships and Deliver Services

The subrecipient must establish memorandum(a) of understanding with at least one healthcare partner and, in collaboration with that partner, provide collaborative care in the form of medical and behavioral health care and regularly conduct coordination of services activities.

Task 6.a. Establish Memorandum(a) of Understanding

The subrecipient must establish memoranda of understanding (MOUs) with at least one medical partner: either an FQHC, hospital, clinic, or public department of health. The MOU shall describe how the OTP and its medical partner(s) meet the following requirements:

• The OTP and its medical partner(s) shall collectively meet the requirements established in Tasks 5.a., 5.b., 5.c., 5.d., 5.e., and 5.f. to provide all FDA-approved medications for OUD (methadone, buprenorphine, buprenorphine/naloxone, and intramuscular [IM] naltrexone).
• The OTP shall provide all medications unless the medical partner can provide buprenorphine, buprenorphine/naloxone, and IM naltrexone.
• All patients shall be counseled on all options.
• All parties shall counsel patients on harm reduction, including prescribing/dispensing naloxone to patients.
• Individuals who do not meet criteria for treatment shall be offered, preferably via warm handoff, connections to harm reduction and recovery support services.

The MOU(s) must address which party is responsible for meeting the requirements of 42 CFR Part 8, including but not limited to the following activities in a manner consistent with all state and federal regulations:

• Employing “practitioners and other licensed/certified health care providers, including counselors,” who “comply with the credentialing and maintenance of licensure and/or certification requirements of their respective professions” (42 CFR § 8.12(d)).
• “Procedures designed to ensure that patients are admitted to treatment by qualified personnel who have determined, using accepted medical criteria, that: The person meets diagnostic criteria for a moderate to severe OUD; the individual has an active moderate to severe OUD, or OUD in remission, or is at high risk of recurrence or overdose” (42 CFR § 8.12(e)).
• Documentation of admissions decisions in the patient’s clinical record (42 CFR § 8.12(e)).
• Ensuring that each patient voluntarily provides informed consent to MAR, or for persons under 18 years of age, a parent, legal guardian, or responsible adult designated by the relevant state authority consents in writing (42 CFR § 8.12(e)).
• Maintaining withdrawal management procedures for patients who chose to taper from MAR (42 CFR § 8.12(e)).
• Providing “medical, counseling, vocational, educational, and other screening, assessment, treatment, [and recovery support] services to meet patient needs” (42 CFR § 8.12(f)).
• Conducting “full in-person physical examinations,” including serology and other clinically appropriate tests, “within 14 calendar days following a patient’s admission to the OTP” (42 CFR § 8.12(f)).
• Performing “serology testing and other testing as deemed medically appropriate by the licensed OTP practitioner” (42 CFR § 8.12(f)).
• Completing screening and full examination via telehealth when applicable “if a practitioner or primary care provider determines that an adequate evaluation of the patient can be accomplished via telehealth” (42 CFR § 8.12(f)).
• Confirming pregnancy when appropriate and employing “evidence-based treatment protocols for the pregnant patient” when appropriate (42 CFR § 8.12(f)).
• Providing “prenatal care and other sex-specific services, including reproductive health services” (42 CFR § 8.12(f)).
• Conducting physical examinations not less than one (1) time each year, including a “review of MOUD dosing, treatment response, other substance use disorder treatment needs, responses and patient-identified goals, and other relevant physical and psychiatric treatment needs and goals” (42 CFR § 8.12(f)).
• Providing “adequate substance use disorder counseling and psychoeducation,” “including harm reduction education and recovery-oriented counseling.” “Refusal of counseling shall not preclude [a person] from receiving MOUD” (42 CFR § 8.12(f)).
• Providing “counseling on preventing exposure to, and the transmission of, human immunodeficiency virus (HIV), viral hepatitis, and sexually transmitted infections (STIs)” and providing “services and treatments or actively [linking] to treatment each patient who has received positive test results” (42 CFR § 8.12(f)).
• Conducting random drug testing using “drug tests that have received the [FDA’s] marketing authorization” (42 CFR § 8.12(f)).
• Making clinical determinations on dispensing medication for unsupervised use (42 CFR § 8.12(i)).
• Ensuring that take-home medications are labeled and packaged correctly to deter diversion (42 CFR § 8.12(i)).

Task 6.a. Performance Measures

Submit signed MOUs within one hundred twenty (120) days after the beginning of the period of performance.

Task 6.b. Provide Collaborative Medical and Behavioral Health Care

Provide Collaborative Medical and Behavioral Health Care

The subrecipient and its medical partner(s), under the direction of the Project Director, shall provide collaborative care (CC) in the form of medical and behavioral health care services in accordance with the MOU (See Task 6.a.) and in accordance with all applicable state and federal regulations in the delivery of services, including but not limited to the following:

• Privacy and confidentiality shall be maintained (42 CFR § 8.12(g)).
• The subrecipient and its medical partner(s) shall dispense (for the treatment of OUD) only those medications currently approved by the FDA for that purpose (42 CFR § 8.12(h)).
• OTP programs shall provide low-barrier services to medication:
  • Same-day admission and medication access is preferred.
  • Services to high-risk groups (e.g., individuals experiencing homelessness, those who are justice involved, and pregnant/postpartum persons) shall be expedited.
• The subrecipient or its partners shall offer counseling but shall not condition access to MOUD on participation in counseling (42 CFR § 8.12(f)(5)).

Subrecipients shall report the number of individuals receiving FDA-approved MOUD (by type) and the number of individuals receiving naloxone at the OTP, including (when available) the location of medical partner.

Subrecipient shall report the number of individuals receiving both MOUD and either

1. A physical examination conducted by a medical partner; or
2. A diagnostic or treatment visit with a medical partner for a condition other than a SUD.

This report shall also include the number of individuals receiving MOUD, within each category, who

1. Are pregnant or up to twelve (12) months postpartum,
2. Have a positive HIV test, or
3. Have a positive viral hepatitis test, along with the number of each who received medical services related to same from a medical partner.

Task 6.b. Performance Measures

Subrecipient shall report collaborative care services delivered in any month in which the subrecipient or its medical partner(s) provides MOUD under an OTP certification on the MER.

Task 6.c. Conduct Coordination of Services Activities

Subrecipient and its medical partner(s) shall conduct coordination of services (CS) activities by conducting regular case conferences or other methods on a regular basis (in person or virtually).

Task 6.c. Performance Measures

Subrecipient shall submit frequency, number, and method of activities associated with coordination of services in any month in which the subrecipient or its medical partner(s) provides MOUD under an OTP certification through MER.

Task 6.d. Provide Limited/Ad Hoc Transportation Services (optional)

The subrecipient may optionally provide limited transportation services to ensure that OTP clients receive medical care from the subrecipient’s medical partners. The OTP may achieve this through providing a shuttle service on designated days of the month for people otherwise unable to obtain medical services. Alternatively, the OTP may choose to address transportation needs on an ad hoc basis, by providing occasional transit passes, taxi vouchers, etc., to enable people to obtain access to medical care either from the OTP site or the individual’s home. The subrecipient is expected to counsel individuals about transportation options (e.g., paratransit) for which they might be eligible. This task includes reporting on the number of trips provided and individuals served.

Task 6.d. Performance Measures

Report transportation services delivered in any month in which the subrecipient or its medical partner(s) provides MOUD under an OTP certification on the MER.

The following table details (a) the deliverables required according to the scope of services and (b) associated performance measures, standards, and potential metrics (subject to change) to be collected by task. Time periods refer to the days from the beginning of the period of performance, unless otherwise specified. Standards for activities refer to percentages of those described in the ISP. 

Task 1: Fulfill Award Administration Requirements 

Task 2: Staff and Administer Program 

Task 3: Provide Community Outreach and Education 

Task 4: Secure MAR Location 

Task 5: Meet OTP Qualifications 

Task 6: Forge Healthcare Partnerships and Deliver Services 

The following sections discuss allowable and unallowable costs for this funding opportunity. 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 

• Allowable costs are those that are necessary and reasonable based on the activity contained in the statement of work (SOW), are justified in the Budget Narrative, and are allowable and allocable under 2 CFR §§ 200.400–476.  
• Specifically, “Allowable Cost” means a cost allowable to a project (i.e., that can be paid for using award funds). Costs will be considered to be allowable if they: 
  • are reasonable and necessary for the performance of the award; 
  • are allocable to the specific project; 
  • are treated consistently in like circumstances to federally-financed, State-financed, and other activities of the awardee; 
  • conform to any limitations of the cost principles or the sponsored agreement; 
  • are accorded consistent treatment (a cost may not be assigned to a State or federal award as a direct cost if any other cost incurred for the same purpose in like circumstances has been allocated to the award as an indirect cost); 
  • are determined to be in accordance with generally accepted accounting principles; 
  • are not included as a cost or used to meet federal cost-sharing or matching requirements of any other program in either the current or prior period; 
  • are not used to meet the match requirements of another State or federal grant; and 
  • are adequately documented.  

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 

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: 

• https://www.ecfr.gov/current/title-2/section-200.438Capital expenditures for general purpose equipment, including any vehicle regardless of cost, buildings, and land (2 CFR § 200.439) 

• Capital expenditures for improvements to land, buildings, or equipment that materially increase their value or useful life (2 CFR § 200.439) 

• https://www.ecfr.gov/current/title-2/section-200.445Deposits for items, services, or space 

• Costs of membership (2 CFR § 200.454; 2 CFR § 200.450) 

• Meetings or conventions, unless directly related to the program and approved in advance by the RCCA 

• Any other costs not expressly included in the plan and budget 

Indirect Cost Rate 

To charge indirect costs to this grant, the applicant organization must: (1) have a federal annually NICRA, or (2) elect to use the de minimis rate and specify what percentage (up to fifteen percent [15%] of modified total direct cost [MTDC]) the applicant chooses. See 2 CFR § 200.414. 

Indirect Cost Rate Election 

• Federally Negotiated Rate: Organizations that receive direct federal funding may have an indirect cost rate that was negotiated with a federal cognizant agency. The organization must provide a copy of the federal NICRA. Organizations must notify the RCCA of any changes to their previously established NICRA no later than six (6) months after the close of the organization’s fiscal year. 

• De minimis Rate: An organization may elect a de minimis rate of up to fifteen percent (15%) of 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 regulation 2 CFR § 200.1 below and note the exclusions to MTDC. 

**2 CFR § 200.1, Modified Total Direct Costs, means “all direct salaries and wages, applicable fringe benefits, materials and supplies, services, travel, and up to the first $50,000 of each subaward (regardless of the period of performance of the subawards 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 in excess of $50,000. 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” 

Subrecipients have discretion not to request payment for indirect costs. Subrecipients that elect not to claim indirect costs cannot be reimbursed for indirect costs. The organization must record an election of “No Indirect Costs” in the Budget Workbook link in Section J.1., Mandatory Forms.  

Subrecipients shall adhere to the requirements outlined in the following: 

• Grant Accountability and Transparency Act (GATA)  
• Illinois Administrative Code, Government Contracts, Title 44, Part 7000 
• Grantmaking, Procurement, and Property Management, and federal regulations under Grants and Agreements, 2 CFR § 200, et al. 
• The requirements and policies outlined in the applicable fiscal year version of the IDHS Division of Behavioral Health and Recovery Contractual Policy Manual 
• Any other federal or state statutes, regulations, or policies specified in the Subaward Agreement or its attachments.