1. Project Title: Rural Communities Opioid Response Program-Implementation 2. Request Amount: $1,000,000 3. Applicant: Chestnut Health Systems 4. Address: 1003 Martin Luther King Blvd Bloomington, Illinois 61701 5. Applicant Organization Facility Type: Not-for-profit behavioral health, CCBHC and FQHC 6. Project Director and Title: Daniel Hutchison, Medication Assisted Recovery Coordinator 7. Project Director Contact Information: 618-205-8114; e-mail: ddhutchison@chestnut.org 8. Are you a current FY20 or FY21 RCORP-Implementation award recipient: No 9. EIN/DUNS Number Exception Request: No 10. Learned of Funding Opportunity: Grants.gov 11. Number of Consortium Members and List of Consortium Members: Six; Chestnut Health Systems (Applicant Organization), Community Resource Center, Macoupin County Health Department, Clinton County Probation Department, Prairie Counseling Center and Health Sisters Health Systems (HSHS) St. Joseph Hospital, Highland. 12. Previous or Current Consortium Grant Recipient: Previous, FY19 RCORP-Planning 13. Brief Description of the Target Population: Individuals in the defined service area who are at high risk, in treatment and/or are in recovery from OUD. Youth/school aged children and adults in the service area in the form of prevention education and stigma reduction. The majority of the targeted population are Caucasian with people of color representing a small portion of the target population. It is projected that zero percent of the targeted population will be Native American. 14. Target Service Area: The identified service area for this project includes the rural tracts of Bond, Clinton and Madison Counties along with the rural County of Marion. Specific Targeted population(s)/areas of rural service areas/census tracts include: o Section I: Section I is a list of non-Metro counties arranged by State. The entire area of these counties is - considered rural Marion. o Section II: is a lis
t of Metropolitan counties in which we have identified certain Census Tracts that are considered rural. Only the area of the identified tracts is considered rural in those Metropolitan counties: ? Bond, Clinton and Madison: • Bond County: 17005951200 , 7005951300 • Clinton County : 17027900200, 17027900300, 17027900401, 17027900402, 17027900500, 17027900601 • Madison County: 17119403601, 17119403603, 17119403604 15. Does target service area overlap with an existing FY 19 or FY 20 RCORP Implementation award recipient’s service area: No, however our service area does overlap with a FY 2021 RCORP Implementation award that is also serving Marion County Illinois. We will coordinate with the awarded organization to ensure service areas and/or services are complimentary to each other and not duplicated.