93.324 - State Health Insurance Assistance Program (SHIP) Base Grant

FFY2025 State Health Insurance Assistance Program (SHIP) Basic Grant Year 1 of 5-year grant for the Illinois Department on Aging, Senior Health Insurance Program.

Expand outreach efforts and one-on-one counseling on Medicare coverage, Medicare Advantage plans and Medicare Part D plans; and adhere to the Volunteer Risk Program Management manual policies.

SHIP was created in Section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 (Pub. L. 101-508, 104 Stat. 1388). The text of the provision is available at the link below. The title of the section is, "HEALTH INSURANCE INFORMATION, COUNSELING AND ASSISTANCE GRANTS." https://www.ssa.gov/OP_Home/comp2/F101-508.html

This grant shall not restrict indirect costs to the grant. The grantee shall either submit evidence of a federally negotiated rate, the rate as approved through the GATA Indirect Cost Rate System or accept the de minimus rate. To charge indirect costs to a grant, the applicant organization must have an annually negotiated indirect cost rate agreement (NICRA). There are three types of NICRAs: a) Federally Negotiated Rate. Organizations that receive direct federal funding may have an indirect cost rate that was negotiated with the Federal Cognizant Agency. Illinois will accept the federally negotiated rate. The organization must provide a copy of the federally NICRA. b) State Negotiated Rate. The organization must negotiate an indirect cost rate with the State of Illinois if they do not have a Federally Negotiated Rate; or the organization may elect to use the de minimis rate. If an organization has not previously established in indirect cost rate, an indirect cost rate proposal must be submitted to the State of Illinois through the indirect cost rate system, CARS, no later than three (3) months after the effective date of the award. If an organization previously established an indirect cost rate, the organization must annually submit a new indirect cost proposal, through CARS, within six (6) months after the close of the grantee’s fiscal year. All grantees must complete an indirect cost rate negotiation or elect the de minimis rate in CARS to claim indirect costs. Indirect costs claimed without an established negotiated rate or a de minimis rate election in CARS may be subject to disallowance. c) De minimis Rate. An organization that has never received a Federally Negotiated Rate may elect a de minimis rate of 15% of modified total direct cost (MTDC). Once established, the de minimis rate may be used indefinitely. The State of Illinois must verify the calculation of the MTDC annually to accept the de minimis rate. The Department reserves the right to limit the amount and/or type of indirect costs allowed to be charged to this grant award. For example, the cost of independent research and development, including their proportionate share of indirect costs, are unallowable under this grant award. Grantees have discretion not to claim payment for indirect costs. Grantees that elect not to claim indirect costs cannot be reimbursed for indirect costs. The organization must record an election of “No Indirect Costs” into CARS.

Submissions shall be submitted electronically via AmpliFund by October 27, 2025, 5:00 p.m. It is the responsibility of the applicant to ensure the application is received timely. Submission received after this date and time shall not be considered or evaluated for award. Grantees may request confirmation of receipt from Rachael.baskett@illinois.gov and Matthew.Rousey2@illinois.gov Received shall be defined as submission via AmpliFund prior to the due date and time of this Notice of Funding Opportunity.

All submissions shall include a list of proposed subgrantees and the grant amount to each, with no subgrant site and/or service location being over $2,500.00 unless accompanied by a detailed explanation in both the Narrative and Budget areas of the application. In addition to the Narrative and Budget, the Scope of Work and Work Plan documents should be included in all submissions. Decisions regarding general award and overages more than $2,500 will be made based on two (2) factors; first, based on funding availability and second, on a case-by-case consideration. Examples of previously approved exceptions include high performing STARS data entry SHIP sites, newly opened SHIP sites, and SHIP sites in need of updated/new computers, PPE and/or miscellaneous supplies for SHIP counseling. A list of eligible SHIP sub sites, based on reported Client contacts within STARS, shall be provided for all applicants as an attachment available on this Notice of Funding Opportunity. Eligible sites are those sites with 25 or more client contacts as listed on the eligibility chart. Any site that is NEW and meeting the requirements for site establishment, shall be offered a grant. The Eligible SHIP sub sites chart is attached in the Questions Submission information section of this Notice of Funding Opportunity. New sites are noted on this chart which has already been reviewed and approved by the Department.

Please contact Aging.gata@illinois.gov with all AmpliFund questions.

Awards shall be made by geographic regions consistent with the 13 Planning and Service Areas (PSA) set forth by the Illinois Department on Aging. See Illinois Area Agencies on the Aging Map, available at the following link: https://www2.illinois.gov/aging/PartnersProviders/Pages/aaa_map.aspx Entities in PSAs 1-13 may apply for this award.

This funding does not apply to beneficiaries.

Applicable costs and administrative procedures will be determined in accordance with Part 75 of Title 45 of the Code of Federal Regulations, which establishes uniform administrative requirements, cost principles and audit requirements for Health and Human Services (HHS) award. https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 .

An eligible applicant must be a certified SHIP site for the State of Illinois, and the site must be registered as an active site on SHIP Data Tracking and Reporting System (STARS) for the purpose of counseling and/or monitoring work performed. Applicants must be structured to award sub-grants to all SHIP sites in good standing with SHIP. For purposes of this grant, “Good Standing” means there is a SHIP Coordinator and/or SHIP Counselor(s) who is actively performing SHIP counseling and/or outreach; actively reports beneficiary contacts including group or media outreach; education in STARS and demonstrates service to a minimum-25 client contacts (or more) within the reporting period of September 1, 2024 - February 28, 2025.. New SHIP sites meeting requirements for eligibility shall be offered a grant and are listed on the chart provided as an attachment to this Notice of Funding Opportunity.

The SHIP mission is to empower, educate and assist Medicare-eligible individuals, their families, and caregivers through objective outreach, counseling, and training, to make informed health insurance decisions that optimize access to care and benefits. The FIRST PURPOSE OF THIS GRANT is to strengthen the capability of local SHIP offices in their efforts to support the community as they perform personalized counseling, education, and outreach to help achieve the program mission. SHIP was created in Section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 (Pub. L. 101–508, 104 Stat. 1388). The text of the provision is available at the link below. The title of the section is, “HEALTH INSURANCE INFORMATION, COUNSELING, AND ASSISTANCE GRANTS.” https://www.ssa.gov/OP_Home/comp2/F101-508.html I. The first objective of this funding opportunity is to demonstrate how funds received will be used to enhance the SHIP local network through outreach efforts, one-on-one counseling, and partnership building, such as, issuing sub-awards to SHIP sites in the applicable PSA. Funds are to be used to support locally accessible counseling services and efforts to meet the below identified SHIP objectives of this grant. THE GRANTEE SHALL: a. provide funding to all eligible SHIP sites within the applicable PSA. A list of eligible SHIP sites is provided with the Notice of Funding Opportunity package. Eligible SHIP sites are those which have had at least 25 client contacts within the period of September 1, 2024 - February 28, 2025. A SHIP site ineligible per the provided eligibility list, but ineligibility was due to STARS reporting restrictions, may be approved for a subgrant; however, the grantee MUST provide justification for the exception in the grant application narrative and budget sections with the sub-grant listing. A SHIP site ineligible per the provided eligibility list, but ineligibility was due to STARS reporting restrictions, may be approved for a subgrant; however, the Applicant MUST note the exception in the grant application with the sub-grant listing in both the Narrative and Budget areas of the application. Any SHIP site, newly opened/reopened as of September 1, 2024 may be eligible for funding. It is also possible to have a special circumstances where a SHIP site, not on the eligibility list may be eligible for funding: (i.e., STARS data entry discrepancies}. In either case, funding requests MUST include a detailed explanation in the narrative and budget sections of the application and must be preapproved by SHIP Administration. b. sub-grant to local SHIP sites to provide accurate, objective, and comprehensive counseling and assistance. c. educate local SHIP sites on the latest changes in Medicare plans and advise clients on the various types of Medicare coverage such as Medicare Advantage plans and Medicare Part D plans. d. support local SHIP sites as they provide beneficiaries access to enrollment assistance through the locally based SHIP sites performing Medicare plan analysis and enrollment via Medicare.gov website tools; https://www.medicare.gov/ e. support local SHIP sites as they counsel beneficiaries on their retiree insurance benefits or Medicare supplement insurance policies including performing Medicare supplement policy quotes on the Medigap Plan Finder https://www.medicare.gov/medigap-supplemental-insurance-plans/#/m??year=2025&lang=en on the SHIP TA center website https://ilaging.illinois.gov/ship.html f. support local SHIP sites as they are assisting beneficiaries with enrollment in the Medicare Part D Extra Help/Low-Income Subsidy (LIS) program by using the on-line application through the Social Security Administration (SSA) website https://www.ssa.gov/medicare/part-d-extra-help g. support local SHIP sites to assist beneficiaries with the Medicare Savings Program application located on the Application for Benefit Eligibility website (ABE system) at https://www.abe.illinois.gov/abe/access h. support local SHIP sites assisting beneficiaries in determining which forms of coverage best meet an individual’s coverage needs (for example, considerations relative to enrollment in Medicaid with a spend down or changing Medicare drug plans to save the beneficiary additional out-of-pocket expenses) utilizing innovative approaches to enhance beneficiaries understanding of all programs, coverages and how each interact and impact the lives of the beneficiaries. i. support local SHIP sites to conduct outreach (in person, virtually via Zoom, Skype, WebEx, etc.) to educate Medicare beneficiaries and their caregivers about choices for Medicare coverage and their Rights and Guarantees under Medicare law; and promote awareness of the SHIP program through locally based media, radio, and website public service announcements, and social media platforms such as Facebook, or X (formerly Twitter); j. footnote all materials developed with this grant, i.e., flyers, brochures, pamphlets, PowerPoint presentations, social media, etc. as ACL as the funding source as such: “This (project/publication/program/website, etc.) (is/was) supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award with 100% funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by the ACL/HHS or the U.S. Government.” k. recruit volunteers by working with the local site SHIP coordinator, collecting, and submitting the screening applications to SHIP staff, and monitoring for adequate staffing of the local sites. Potential counselors can be non-paid volunteer staff and/or paid staff and will be screened by the SHIP administration at IDoA; and l. monitor sub-grantees at local SHIP sites using the SHIP data tracking system and report findings in programmatic reports to SHIP. m. Utilize the GATA Programmatic Report forms and instructions found on the Amplifund system, GATA Website and submit reports into this system, the Grantee shall: i. Ensure sub-grantees report all counseling activity and outreach in STARS. ii. Monitor reporting monthly by running advance searches through STARS on each sub- grantee. iii. Report technical issues, trends, and best practices to SHIP in monthly Programmatic Report for all sub-grantees. iv. Monitor sub-grants with local sites reporting expenses incurred to SHIP. II. The SECOND OBJECTIVE of this funding opportunity requires monitoring for compliance with ACLs’ Policy 3.38-3.40 (SHIP MANUAL) – Criminal background checks of all SHIP sites within the grantees geographical area. Criminal records searches are to be conducted upon hire and/or as part of the SHIP certification process. It is best practice to repeat background checks on a regular basis of all SHIP-certified staff (coordinators, counselors, and volunteers), applying/working/promoted into a “position of trust”. “Position of trust” includes any position in which the SHIP staff are in contact and/or have access to confidential information via any type of electronic devices, physical documentation, phone, or direct contact with SHIP clients. *A copy of the Illinois “Volunteer Risk and Program Management” (VRPM) manual is included as an attachment in the Question Submission Information Section of this Notice of Funding Opportunity to be shared with all funding recipients of this grant. This manual provides information received from ACL on a nationwide move to increase volunteers, how to retain volunteers, and how to protect clients and counselors through criminal background checks. This applies to both paid and unpaid SHIP counselors. All approved grant recipients shall receive a listing of SHIP sites and corresponding SHIP counselors in their geographical area to use in monitoring criminal background check compliance. Deliverables or Milestones The Grantee shall be responsible for ensuring all sites adhere to the standard requirements of SHIP, including reporting in the SHIP Data Tracking and Reporting System (STARS). The performance measures are mandated by the Administration for Community Living (ACL), US Department of Health and Human Services and are comprised of data entries of client contacts and public and media forms that are entered into a web-based system for SHIP Data Tracking and Reporting System (STARS) that is used by all SHIP programs in the United States and its territories. SHIP certified counselors who have successfully completed SHIP training and certification and are registered on the SHIP Data Tracking and Reporting System (STARS), are mandated to enter work performed in this data collection system. All data entered by SHIP counselors is monitored using five performance measures established by ACL. Should you need more information on STARS and reporting, About U. S. State Health Insurance Assistance Programs www.shiphelp.org includes an outline of the types of counseling activities that should be reported, instructions for logging phone calls, one-on-one counseling services, the demographics of each person served, and other related information. Any work performed within a month should be reported into the STARS Data System as a beneficiary contact (counseling) or a group or media outreach event, (health fair, webinar, teleconference, etc.), in a timely manner. Counseling conducted in one month, must be entered in the STARS Data System by the end of the following month the counseling was rendered, as outlined in ACLs’ Reporting Schedule. The Grantee shall be responsible for ensuring all sites adhere to the standard requirements of SHIP, including reporting in the SHIP Data Tracking and Reporting System (STARS). See attachment of STARS Reporting timelines in the Question Submission Attachment area of this Notice of Funding Opportunity. Grant Administration Contact Name, Title and Contact Information: Sandy Leith, SHIP Director Illinois Department on Aging Senior Health Insurance Program 1 Natural Resources Way, Suite 100 Springfield, IL 62702 Telephone Number: 217-900-0004 TTY#: 711 Email Address: Sandy.Leith@Illinois.Gov Performance Measures and Standards (Program Level) Beneficiary Contact Forms, Group Outreach and Education, and Media Outreach and Education forms in STARS must be answered as to whether the contact was MIPPA-qualifying. At the top of each form, it is required that MIPPA must be marked “Yes” if the contact was MIPPA-qualifying and marked “No” if it was not. Performance Measures (Program Level) PM1: Beneficiary Contact Form (BCF) – Percentage of total one-on-one client contacts (in-person office, in-person home, telephone (all durations), and contacts by e-mail, postal mail, or fax) per Medicare beneficiaries in the state. This performance measure covers every one-on-one interaction SHIPs have with beneficiaries or on behalf of a beneficiary and is reported on the Client Contact Form in the SHIP data system. It includes in-person counseling sessions (in the office or at the beneficiary’s home); telephone conversations of all durations (including on-line call formats such as Skype); and email, postal mail, and fax correspondence. It does not count unsuccessful attempts to reach beneficiaries (such as leaving messages); individuals reached through public events (unless the presenter has substantial individual interaction with a beneficiary after the event); contacts when the only purpose is to schedule a meeting; or mass emails. PM2: Outreach Contacts – Percentage of persons reached through presentations, booths/exhibits at health/senior fairs, and enrollment events per Medicare beneficiaries in the State. The performance measure is the number of people reached through presentations, booths/exhibits at health/senior fairs or special events, and Enrollment Events. The event must include the provision of Medicare or SHIP information to the public and is reported on the Group Outreach and Education (GOE) form and/or the Media Outreach and Education (MOE) form. To count outreach contacts, SHIPs must have the ability to monitor attendance and must provide an opportunity for participants to ask questions and provide clarification at the time of the presentation. PM3: Contacts with Medicare Beneficiaries under 65 – Percentage of contacts with Medicare beneficiaries under the age of 65 per Medicare beneficiaries under 65 in the State. This performance measure includes the number of one-on-one contacts with Medicare beneficiaries who are under the age of 65. The beneficiary must be receiving or applying for Medicare and Social Security benefits due to a disability or receiving Medicare because of the diagnosis of End Stage Renal Disease. This does not include soon-to-be new to Medicare beneficiaries (i.e., those entering Medicare at age 65). PM4: Hard-to-Reach Contacts – Percentage of low-income, rural, and non-English contacts per total “hard-to-reach” Medicare beneficiaries in the State. This performance measure is based on the number of contacts made with any of the designated hard- to-reach populations divided by the total number of beneficiaries in that population. The designated hard-to-reach populations include: 1. Low-income beneficiaries – all contacts with beneficiaries whose income is below 150% Federal Poverty Level; 2. Rural beneficiaries – all contacts with beneficiaries that live in areas with a population fewer than 50,000 as designated by the Office of Management and Budget (OMB); and 3. Non-native English-speaking beneficiaries – all contacts with beneficiaries where English is not the beneficiaries first language as indicated on the Client Contact From. Beneficiaries can self-select, or the counselor can reasonably conclude that the client is not fluent in understanding, speaking, reading, and/or writing the English language. Each section of this Performance Measure will be calculated by taking the total client contacts reached in the hard- to reach category divided by the total beneficiary population in that category. Some beneficiaries could fall into multiple categories and thus be counted multiple times in the numerator and denominator. PM5: Enrollment Contacts – Percentage of unduplicated enrollment contacts (i.e., contacts with one or more qualifying enrollment topic(s) discussed) per total Medicare beneficiaries in the state. This performance measure is the total unduplicated enrollment contacts as reported on the beneficiary contact form. It includes eighteen possible enrollment topics and will only count once per client contact. It includes the following categories: Medicare Part D: (1) Eligibility/Screening; Medicare Part D: (3) Plans comparison; Medicare Part D: (4) Plan Enrollment/Disenrollment; Medicare Part D: (10) Plan Non-Renewal; Part D LIS Extra Help: (11) Eligibility; Medicare Advantage: (27) Eligibility Screening; Medicare Advantage: (29) Plans Comparison; Medicare Advantage: (30) Plan Enrollment/Disenrollment; Medicare Advantage: (36) Plan Non-Renewal; Medicare Supplement/Select: (37) Eligibility/Screening; Medicare Supplement/Select: (37) Eligibility/Screening; Medicare Supplement/Select: (39) Plan Comparison; Medicare Supplement/Select: (45) Plan Non-Renewal; Medicaid: (46) MSP Screening; Medicaid: (47) MSP Application Assistance; Medicaid: (48) Medicaid Screening; Medicaid: (49) Medicaid Application Assistance. Performance Standards - Specifications of Performance Measures Requirements GRANTEE SHALL ensure the following: 1. Certified SHIP Counselors shall enter all client contacts in the SHIP data collection system by the close of the month following the month of the contact. Dates are detailed in the chart in “Amplifund attachment – STARS timeline” of this Notice of Funding Opportunity. 2. Enter all outreach and other contacts as specified in “Amplifund attachment – SHIP VRPM MANUAL SHIP BASIC: of this Notice of Funding Opportunity, meeting the dates detailed in the chart “Amplifund attachment – STARS timeline:. 3. Ensuring all client contacts are entered appropriately by the Grantee's and Sub-Grantee's staffs. 4. Address performance concerns with SHIP Director. 5. Develop a plan with the SHIP Director to address any under-reporting by Grantee or Sub-Grantees. Grantee shall meet all specifications as detailed in the Narrative submitted with the Grant Application, incorporated reference and herein made a part hereof.

A Notice of State Award (NOSA) shall be sent to each successful applicant using the Grant Accountability and Transparency Act web-portal https://grants.illinois.gov/portal/ A Uniform Grant Agreement shall be sent to the Grantee once the awarded entity has signed the NOSA. The NOSA shall include estimated project start date, programmatic and financial special conditions.

The NOSAs shall include all necessary information regarding terms, conditions, and additional requirements of the resulting grants.

Grantees shall be required to submit MONTHLY financial and programmatic reports. Reports are due by the 15th of the following month of the grant. (i.e., Reports for the month of October are due by November 15th). Information from the SHIP Reporting System shall be included in each monthly grant report. Grant reports shall be submitted using GATAs Periodic Performance Report and Periodic Financial Report, and SHIP BASIC Supplemental report. Reports will be submitted via e-mail to the SHIP Grant Manager at Stacy.L.Johnson2@illinois.gov

Rachael Baskett 217-782-3816 (Office) Rachael.Baskett@illinois.gov and/or Matthew.Rousey2@illinois.gov.

1. https://www.illinois.gov/aging/ship/Pages/default.aspx 2. The Department reserves the right to award to all, some, or none of the applicant entities for this funding opportunity. All awards are contingent upon funding. 3. Availability of Appropriation; Sufficiency of Funds. This Agreement is contingent upon and subject to the availability of sufficient funds. Grantor may terminate or suspend this Agreement, in whole or in part, without penalty or further payment being required, if (i) sufficient funds for this Agreement have not been appropriated or otherwise made available to the Grantor by the State or the Federal funding source, (ii) the Governor or Grantor reserves funds, or (iii) the Governor or Grantor determines that funds will not or may not be available for payment. Grantor shall provide notice, in writing, to Grantee of any such funding failure and its election to terminate or suspend this Agreement as soon as practicable. Any suspension or termination pursuant to this Section will be effective upon the date of the written notice unless otherwise indicated.