TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER u: MISCELLANEOUS PROGRAMS AND SERVICES
PART 970 WOMEN'S HEALTH CODE
SECTION 970.230 APPLICATION PROCEDURES


 

Section 970.230  Application Procedures

 

The Department will provide written application instructions and forms to potential applicants.

 

a)         All applications shall include the following:

 

1)         The principal investigator's name, address, and telephone and FAX and teletypewriter (TTY) numbers, if available;

 

2)         The name, address, and telephone and FAX and TTY numbers, if available, of the entity (such as a university) through which the application is being submitted, if different from the information provided in subsection (a)(1) of this Section;

 

3)         The curriculum vitae of the principal investigator;

 

4)         A one-page non-technical abstract that describes the significance of the applicant's project for breast and/or cervical and/or ovarian cancer research;

 

5)         The TIN;

 

6)         The signature of principal investigator or agency official authorized to certify the application;

 

7)         An approximate timetable for project completion;

 

8)         A detailed budget for the funding period, documenting sufficient resources to carry out the project.  The budget shall be by line item category and shall provide sufficient detail to justify the use of grant funds to support project activities.  The applicant shall indicate the total cost of conducting the projects, the anticipated funding request for years two and three of the project (if applicable), the source of other funds supporting the projects, and the amount of support requested from the Department;

 

9)         A signed Statement of Assurances indicating compliance with applicable State and federal requirements, such as the Fiscal Control and Internal Auditing Act, Office of Management and Budget (OMB) Circular A-128 (local governments), OMB Circular A-133 (not-for-profit organizations), bribery certification, contract debarment, unlawful discrimination, Illinois Human Rights Act, The Civil Rights Act of 1964, The Drug-Free Workplace Act of 1988, The Davis-Bacon Act of 1931, conflict of interest as specified in the Illinois Procurement Code [30 ILCS 500], and protection of the confidentiality of services;

 

10)         A statement of whether funds are being requested for a fellowship or a general award;

 

11)         A statement of the research question or hypothesis, or a description of interventions or model programs on which the research will be based;

 

12)         A prioritized listing of measurable objectives for the funding period;

 

13)         For each objective proposed for the first year of the project, a sequential listing of activities to achieve the objective, the time line for completing each activity, and identification of the individual responsible for coordinating the implementation of each objective; and

 

14)         The evaluation methods to be used to measure progress in achieving 

objectives and a plan for monitoring the overall project.

 

b)         If the funds are being requested to support a fellowship, the following information shall be provided, in addition to the information required in subsection (a) of this Section:

 

1)         The name of the individual to be supported through the fellowship;

 

2)         The curriculum vitae of  the individual; and

 

3)         At least one letter of recommendation from the principal investigator or agency official authorized to certify the application.

 

c)         All continuation applications shall contain the information required in subsection (a), as well as the following:

 

1)         A progress report that contains a description of the status of each activity of the project to date, using the evaluation methods and monitoring plan specified in subsection (a)(14) of this Section;

 

2)         Documentation of progress in meeting each project objective;

 

3)         The project objectives for the new grant year, along with activities and timelines for completion of each activity; and

 

4)         Any revisions in the evaluation methods or the monitoring plan, along with the rationale for such revisions.

 

(Source:  Added at 30 Ill. Reg. 17924, effective October 27, 2006)