Section 425.100  Purpose

 

The purpose of this Part is to implement the Civil Money Penalty Reinvestment Program through the Improving Quality of Life and Care Grant Program that provides grants to improve quality of life or quality of care for residents by equipping facility staff, administrators, and stakeholders with technical tools and assistance to enhance resident care.

 

Section 425.105  Definitions

 

"Act" means the Nursing Home Care Act.

 

"Department" means the Illinois Department of Public Health.

 

"Director" means the Director of the Department of Public Health.

 

"Civil money penalty (CMP)" means penalties imposed on facilities for noncompliance pursuant to Sections 1819 and 1919 of the Social Security Act.

 

"Civil Money Penalty Reinvestment Program (CMPRP)" means the federal program, wherein CMMS disburses CMP funds to the Department pursuant to 42 CFR 488.433 to be used for activities that protect or improve the quality of care or quality of life for residents.

 

"Certified" means a facility for which a determination has been made by the Department that providers and suppliers are in compliance with applicable conditions of participation, conditions for coverage, conditions for certification, or requirements.

 

"CMMS" means the Centers for Medicare & Medicaid Services.

 

"Cost-share" means the portion of project costs, including third party in-kind contributions, not paid by State, federal, or federal pass-through funds, unless otherwise authorized by statute.

 

"Decertified" means a facility that no longer meets compliance requirements for certified facilities.

 

"Facility" means a skilled nursing facility as defined in 42 CFR 483.5 that is certified.

 

"GATA" means the Grant Accountability and Transparency Act [30 ILCS 708].

 

"GATA Rules" means 44 Ill. Adm. Code 7000.

 

"GATU" means the Grant Accountability and Transparency Unit within the Illinois Governor's Office of Management and Budget.

 

"Grant Agreement" means the written contract between the Department and a Grantee setting forth the terms for project funding.  The Grant Agreement will be based on GATU's Uniform Grant Agreement (see GATA Rules Section 7000.370).

 

"Grantee" means the successful applicant for funding of a project pursuant to the Civil Money Penalty Reinvestment Program.

 

"Improving Quality of Life and Care (IQLC) Grant Program" means a grant program, utilizing CMP funds as a part of the CMPRP to provide grants to improve quality of life or quality of care for facility residents by equipping facility staff, administrators, and stakeholders with technical tools and assistance to enhance resident care.

 

"Resident" means a person receiving personal or medical care, including but not limited to mental health treatment, psychiatric rehabilitation, physical rehabilitation, and assistance with activities of daily living, from a facility.  (Section 1-122 of the Act)

 

Section 425.110  Incorporated and Referenced Materials

 

a)         The following federal and State statutes are referenced in this Part:

 

1)         Social Security Act (42 U.S.C. 1395i-3 and 1396r)

 

2)         Grant Accountability and Transparency Act [30 ILCS 708]

 

3)         Grant Funds Recovery Act [30 ILCS 705]

 

4)         Nursing Home Care Act [210 ILCS 45]

 

b)         The following federal regulations and State of Illinois administrative rules are referenced in this Part:

 

1)         42 CFR 488.433, Survey, Certification, and Enforcement Procedures (October 1, 2020)

 

2)         Governor's Office of Management and Budget, Grant Accountability and Transparency Act (44 Ill. Adm. Code 7000)

 

c)         The Centers for Medicare and Medicaid Services Memorandum S&C: 12-13-NH, available at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/SCLetter12_13.pdf, is referenced in this Part.

 

Section 425.115  CMP Fund Uses

 

a)         CMP funds shall only be used as follows:

 

1)         To support activities that protect or improve the quality of care or quality of life for residents, including but not limited to:

 

A)        Assistance to support and protect residents of a facility that voluntarily or involuntarily closes or is decertified;

 

B)        Time-limited expenses incurred in the process of relocating residents to home and community-based settings or another facility when a facility is voluntarily or involuntarily closed or downsized pursuant to an agreement with the State Medicaid Agency;

 

C)        Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities;

 

D)        Facility improvement initiatives, such as joint training of facility staff and surveyors or technical assistance for facilities implementing quality assurance and performance improvement programs; and

 

E)        Except as provided in subsection (c), development and maintenance of temporary management or receivership capability such as but not limited to, recruitment, training, retention or other system infrastructure expenses.

 

2)         To cover allowable expenses, as defined by CMMS and included in the approved State Plan, incurred by the Department that are necessary to administer, monitor, or evaluate the effectiveness of projects utilizing CMP funds.

 

b)         The Department may target CMP funds for projects or programs available through various organizations that are knowledgeable, skilled, and capable of meeting the project’s purpose in its area of expertise as long as the criteria in subsection (a) are met and the use is consistent with the requirements of 42 CFR 488.433.

 

c)         CMP funds shall not be used for the following, including but not limited to:

 

1)         Activities or projects that have been disapproved by CMMS;

 

2)         Survey and certification operations or State expenses other than those listed in subsection (a)(2);

 

3)         Capital expenses of a facility;

 

4)         Facility services or supplies that are the responsibility of facilities, such as laundry, linens, food, heat, and staffing costs;

 

5)         Funding projects, items or services that are not directly related to improving the quality of life and care of residents;

 

6)         Projects for which a conflict of interest or the appearance of a conflict of interest exists;

 

7)         Projects lasting longer than three years;

 

8)         Temporary manager salaries, except as provide in subsection (c); and

 

9)         Supplementary funding of federally required services (e.g., Quality Improvement Organization-Quality Improvement Network Initiatives).

 

d)         A temporary manager's salary may not be paid with CMP funds and must be paid by the facility.  If the facility is closing, CMMS plans to stop or suspend continued payments to the facility during the temporary manager's duty period, and CMMS determines that extraordinary action is necessary to protect the residents until relocation efforts are successful, CMP funds may be used to pay the manager's salary.

 

Section 425.120  Eligibility

 

a)         CMP funds may be granted to any entity for proper use of CMMS-approved projects to protect or improve the quality of life or quality of care for facility residents provided that the responsible receiving entity is:

 

1)         Qualified and capable of carrying out the intended project or use;

 

2)         Not in any conflict of interest relationship with the entity or entities that will benefit from the intended project or use; and

 

3)         Not paid by a State or federal source to perform the same function as the CMP project or use.

 

b)         Examples of eligible organizations include, but are not limited to:

 

1)         Illinois facilities;

 

2)         Professional or state nursing home associations and advocacy groups;

 

3)         Consumer advocacy organizations;

 

4)         Resident or family councils;

 

5)         Quality improvement organizations;

 

6)         Private contractors; and

 

7)         State long-term care Ombudsman programs.

 

Section 425.125  Required CMMS Approval

 

a)         Each specific use of CMP funds must be approved by CMMS.  The Department is not obligated to fund projects or activities that are not approved by CMMS.

 

b)         The Department will submit proposed projects that meet the requirements of Section 425.115(a) to CMMS for approval before executing any contract or Grant Agreement for the expenditure of CMP funds.

 

c)         The Department will notify applicants of CMMS approval or denial within 30 days after receipt of the CMMS approval or denial.

 

Section 425.130  Information to Be Made Available to the Public

 

The Department will make information regarding the use of CMP funds available on the Department’s website, including but not limited to the award amounts for approved projects, the Grantee or contract recipients, the results of approved projects, and other information.

 

Section 425.200  Funding

 

a)         The IQLC Grant Program is funded by fines deposited to the Public Health Services Fund [210 ILCS 45/3-310].

 

b)         The grant cycle runs from July 1 through June 30 of the State's fiscal year.

 

c)         The Department will determine annually the availability of funds for purposes of the IQLC Grant Program.  Annual funds for the IQLC Grant Program will be determined solely by the Department and will not exceed $3,000,000.

 

d)         The maximum grant award to any single project shall be limited to $500,000.

 

e)         The IQLC Grant Program requires an applicant cost-share of 5% of the grant award or $1,000, whichever is less.

 

f)         The IQLC Grant Program will provide the approved funding assistance on a cost reimbursement basis.

 

Section 425.205  GATA Requirements

 

a)         The IQLC Grant Program is subject to GATA.

 

b)         Each Grantee must complete the prequalification process and be determined "qualified" by GATU (see Section 7000.70 of the GATA Rules).

 

c)         The Department will provide public notice of IQLC Grant Program funding opportunities according to Section 7000.310 of the GATA Rules, including:

 

1)         Notifying the public of available IQLC grants in the Catalog of State Financial Assistance (CSFA);

 

2)         Providing official public notice of competitively issued grant funding opportunities through a Notice of Funding Opportunity (NOFO) generated from the CSFA and posted on the GATA website (www.grants.illinois.gov).

 

d)         The Department will conduct a merit-based review of grant applications pursuant to Section 7000.350 of the GATA Rules and Section 425.215.

 

e)         After completion of the merit-based review of the grant applications, the Department will submit projects tentatively selected for CMP funding to CMMS for approval pursuant to Section 425.125.  CMMS approval of the proposed CMP-funded project or CMP fund use is a pre-award requirement.

 

f)         The Department will not issue a Notice of State Award (NOSA) pursuant to Section 7000.360 of the GATA Rules until it has received approval from CMMS for the proposed CMP project or CMP fund use.

 

g)         After acceptance of the NOSA by the Grantee, the Department will execute a written Grant Agreement with the Grantee using the uniform GATU template pursuant to Section 7000.370 of the GATA Rules.

 

h)         All grants and Grantees shall comply with GATA and the GATA Rules, including the required disclosures and the prohibition of conflicts of interest.

 

Section 425.210  Application Procedures and Required Information

 

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.

 

Section 425.215  Merit Based Review of Grant Applications

 

a)         Competitive grants under the IQLC Grant Program shall have evaluation criteria designed to determine whether the proposed CMP fund project or use will protect or improve the quality of care or quality of life for residents. 

 

b)         The evaluation criteria and process will be set forth in the NOFO and will comply with Section 7000.350 of the GATA Rules.  At a minimum, the evaluation criteria shall include:

 

1)         Need:  Identification of stakeholders, data, facts and evidence that demonstrate proposed CMP grant project or CMP fund use will protect or improve the quality of care or quality of life for residents;

 

2)         Capacity:  The ability of a grant applicant to execute the proposed CMP grant project or CMP fund use according to project requirements;

 

3)         Quality:  The totality of features and characteristics of proposed CMP grant project or CMP fund use that indicates its ability to protect or improve the quality of care or quality of life for residents;

 

4)         Sustainability:  The continuation of benefits from CMP grant project or CMP fund use after the project is completed.  The probability of continued long-term benefits.  The resilience to risk of the net benefit over time;

 

5)         Duplication of Effort:  The extent to which the objectives of a CMP grant project or CMP fund use do not duplicate existing requirements or other federal or state services; and where duplication of said project is outweighed by creating future improvements to the quality of care and/or quality of life for residents;

 

6)         Cost Effectiveness:  Productiveness relative to the cost and ability to utilize and optimize resources, measure the results of strategies, objectives and outcomes where benefits are non-financial; and

 

7)         Feasibility:  Likelihood the CMP grant project or CMP fund use can be accomplished by the applicant within the proposed time and budget given their experience, expertise, and available resources.

 

Section 425.220  Grant Disbursements

 

a)         The grant award will be paid to the Grantee as reimbursements for expenditures made by the Grantee.

 

b)         Reimbursements will be specified in the NOSA.

 

c)         Upon project completion or for interim reimbursement requests, the Grantee must submit a project billing request listing and verifying all funds expended on the project for which reimbursement is sought, as well as required billing documentation, and in accordance with the Grant Agreement’s terms.

 

d)         The Grantee shall keep adequate records relating to its administration of a project, particularly relating to all incurred costs.  These records shall be available for audit by the Department and the State Auditor General.  The Department reserves the right to conduct on-site visits with the purpose of reviewing or auditing a project.  All records shall be retained in accordance with the State Records Act [5 ILCS 160].  Grantees are subject to the record retention requirements and auditing standards stipulated by GATU (see GATA Rules Section 7000.430(a) and Section 7000.90).

 

e)         All purchases must be completed or legally obligated prior to the end of the term of the Grant Agreement to be eligible for reimbursement.  For purposes of this subsection (e), legally obligated means that a Grantee has a signed purchase agreement obligating the funds for the purchase of products or services allowable under the Grant Agreement.

 

Section 425.225  Grant Term

 

a)         All Grant Agreements executed pursuant to this Part shall not exceed one year unless the requirements of GATA Rules Section 7000.370 have been satisfied.  In no event shall the grant term exceed three years.

 

b)         The project must not be initiated and costs shall not be incurred prior to the beginning of grant term.  Costs incurred prior to the beginning of the grant term are not eligible for reimbursement.

 

c)         Grant funds are available as reimbursements for expenditures by a Grantee during the grant term.

 

Section 425.230  Change in Ownership

 

The organization or facility that requests CMP funding is accountable and responsible for all CMP funds granted.  If a change in ownership occurs after CMP funds are granted or during the course of the project, the primary point of contact shall notify the Department.  Notice regarding a change in ownership shall be provided to the Department and shall include a description of the impact, if any, on the CMP Grant Project.  The Department will communicate the change to CMMS.

 

Section 425.235  Denial, Suspension, Revocation or Termination of Grant Award

 

a)         The Director may suspend or revoke the Grant Agreement of a Grantee when finding substantial or continued failure to comply with this Part or the Grant Agreement.  Except as provided in subsection (b), the Director shall provide notice and an opportunity for the grant applicant or Grantee to request a hearing before executing the denial, suspension, or revocation.

 

b)         If the Director finds that the public interest, health, safety, or welfare requires emergency action, then the Director may immediately order summary suspension of a grant agreement pending proceedings for revocation.  The Director's order shall be written and shall include the reasons for the findings.  The proceedings shall be promptly instituted and promptly determined.

 

c)         The notice of denial shall be made by regular mail.  The notice of suspension or revocation shall be made by certified mail or personal service.  These notices shall state the reasons for the proposed action and shall provide the opportunity to request a hearing.  If a written hearing request is not received within 10 business days after receipt of the notice, then the right to a hearing is deemed waived (see 2 CFR 200.342 and 44 Ill. Adm. Code 7000.80 and 7000.260).

 

d)         A denial or termination due to the General Assembly's failure to appropriate funds is not subject to this Section.

 

Section 425.240  Grant Funds Recovery

 

Grants made under this Part are subject to the provisions of the Illinois Grant Funds Recovery Act.  If a provision of this Part conflicts with a provision of the Illinois Grant Funds Recovery Act, then the provision of the Illinois Grant Funds Recovery Act controls.

 

Section 425.245  Public Credit

 

To educate the public and promote the IQLC Grant Program, the Grantee shall give public credit to the "Illinois Department of Public Health – Improving Quality of Life and Care Grant Program" and coordinate with the Department on any publication, written document, news article, television or radio release, interview, or personal presentation, if initiated by the Grantee, that refers to the grant funded project.

 

Section 425.250  Program Information and Contact

 

For information on the Civil Money Penalty Reinvestment Program, contact:

 

Illinois Department of Public Health

Office of Health Care Regulation, Bureau of Long-Term Care

525 West Jefferson Street, Springfield, Illinois 62761

Telephone:  217-782-5180

Email:  DPH.HCR.CMPGRANT@illinois.gov