77 Ill. Adm. Code 655.50
Application Content and Process
Section 655
Section 655.50Â Application
Content and Process
a)Â Â Â Â Â Â Â Â Applications for grants under this authority shall be made in
the format specified in the "Application and Plan for Health Services
Grant" (Form EBA 1, available from the Department of Public Health, 535
West Jefferson, Springfield, Illinois 62706).
b)Â Â Â Â Â Â Â Â Applications shall include a program narrative which
incorporates:
1)Â Â Â Â Â Â Â Â An identification of the incidence of problem pregnancy and
related problems in the area to be served by the project;
2)Â Â Â Â Â Â Â Â A description of the economic conditions and income level in the
geographic area to be served;
3)Â Â Â Â Â Â Â Â A description of existing problem pregnancy-related services
including where, how, by whom and to whom they are provided and the extent to
which they are coordinated in the geographic area to be served;
4)Â Â Â Â Â Â Â Â A description of major unmet needs for services for those
persons at risk of initial or repeat problem pregnancies, the number of persons
currently served in the area and the number of persons not being served in the
area;
5)Â Â Â Â Â Â Â Â A description of the core services to be included in the
project or provided by the grantee, to whom they will be provided, how they
will be linked, and their source of funding, to include some, but not
necessarily all, of the following:
A)Â Â Â Â Â Â Â Health and Mental Health Counseling
B)Â Â Â Â Â Â Â Vocational Counseling
C)Â Â Â Â Â Â Â Education services which supplement regular school programs to
help prevent adolescent pregnancy and to assist pregnant adolescents and
adolescent parents to remain in school or to continue their education
D)Â Â Â Â Â Â Â Primary and Preventive Health Services including Pre- and
Post-Natal Care
E)Â Â Â Â Â Â Â Nutrition Services and Nutrition Information and Counseling
F)Â Â Â Â Â Â Â Â social services;
6)Â Â Â Â Â Â Â Â A description of how those persons needing services other than
those provided directly by the grantee will be identified and how access and
appropriate referral to those services will be provided;
7)Â Â Â Â Â Â Â Â A description of the fee schedule, if any, to be used for any
services provided directly by the grantee and the method by which it was
derived;
8)Â Â Â Â Â Â Â Â A description of all the services and activities to be linked,
the results expected from the provision of such services and activities, and a
description of the procedures to be used for evaluating those results;
9)Â Â Â Â Â Â Â Â A description of the administrative structure of the agency or
organization and its staff, including curriculum vitae of professional staff
(including volunteer staff) of the agency who will be providing project
services;
10)Â Â Â Â Â Â Â Â Policies and procedures manual of agency; and
11)Â Â Â Â Â Â Â Â Written agreements with service providers and agencies with
which the project will be linked.
c)Â Â Â Â Â Â Â Â A detailed budget shall be submitted on the forms described
above and shall include all information and signatures required in the
instructions for their completion.
d)Â Â Â Â Â Â Â Â Applications for continuation of funding in subsequent years
shall include a detailed budget, a performance report, and a plan of activities
for the new project year. Continuation applications shall be submitted to the
Department no later than April 1 of each year.