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FY 2022 Substance Abuse Block Grant Survey

Each year, Illinois Department of Human Services/ Division of Substance Use Prevention and Recovery (IDHS/SUPR) survey all funded providers to assess your organization's compliance to with the Substance Abuse Block Grant's (SABG) reporting requirements and priorities regarding charitable choice, trauma-informed care, primary healthcare, mental health services, electronic health records and recovery support services. This survey is mandatory for all funded providers and is due no later than Wednesday, October 27, 2021. If you have any questions, please contact Paul Stieber, Block Grant Administrator, at Paul.Stieber@Illinois.gov.

Question Title

* 1. Organization Information

Organization Name

Representative & Title

Street Address

City/Town

ZIP/Postal Code

County

Fax

Email Address

Phone Number

Question Title

* 2. Does your agency have an established partnership with any primary health care organizations?

Yes

Don't Know

Question Title

* 3. Is your agency a Medicaid certified community mental health provider?

Yes

No, but we are in the process of becoming certified.

Don't know.

Question Title

* 4. Does your organization use an electronic health record (EHR)?

Yes, all electronic, all sites. No paper charts.

Yes, all electronic at some sites, paper or combo electronic/paper at others.

No, but we plan to implement.

No, and we have no plans to implement.

Question Title

* 5. Is your organization a Religious Organization?

Yes