or

increased enrollment cannot be achieved until a later school year (but not later than the first school year after the normal graduation date of the first class which enters the center after completion of the construction), he may determine that major expansion will occur during the first full school year after completion of construction if the increased enrollment will equal such amount in excess of 5 percentum of such highest enrollment as the Surgeon General may specify.

(c) Amount of construction grantless than maximum. In determining the extent to which less than the maximum allowable construction grant may be made, the Surgeon General shall take into consideration the most effective use of available Federal funds to further the purposes of the Act.

§ 57.808 Terms and conditions.

In addition to any other requirements imposed by law or determined by the Surgeon General to be reasonably necessary with respect to particular projects to fulfill the purpose of the grant, each grant shall be subject to the condition that the applicant will furnish and comply with the following assurances. The Surgeon General may at any time approve exceptions to these terms and conditions where he finds that such exceptions are not inconsistent with the Act and the purposes of the program, and may require additional assurances where he finds that such additions are necessary to carry out the purposes of the Act.

(a) Title. That applicant has or will have a fee simple or such other estate or interest in the site, including necessary easements and rights-of-way, sufficient to assure for a period of not less than 20 years undisturbed use and possession for the purpose of the construction, equipment and operation of the facility;

(b) Approval of drawings and specifications. That the Surgeon General's approval of the final working drawings and specifications, which conform to the minimum standards of construction and equipment as specified in § 57.812, will be obtained before the project is advertised or placed on the market for bidding (see § 57.811(a) with respect to the acquisition of facilities);

(c) Competitive bids. That applicant will perform actual construction work by the lump sum (fixed price) contract method; employ adequate methods of obtaining competitive bidding prior to awarding the construction contract, either by public advertising or circularizing three or more bidders, and award the contract to the responsible bidder submitting the lowest acceptable bid; and will purchase all fixed equipment (including such fixed equipment as is not purchased through the construction contract) by adequate methods of competitive bidding and award the contract to the responsible bidder submitting the lowest acceptable bid, except that competitive bidding procedures need not be employed for the purchase of specific fixed equipment items which are not included in the construction contract where such action is found by the Surgeon General, upon written justification by the applicant, to be required by the needs of the program (see § 57.811(c) with respect to the acquisition of facilities);

(d) Approval of estimated cost. That applicant will enter into no contract or contracts for construction, for the project or a part thereof, the cost of which is in excess of the estimated cost approved in the application for that portion of the work covered by the plans and specifications, without the prior approval of the Surgeon General;

(e) Costs in excess of approved costs. That applicant will finance all costs in excess of the estimated costs approved by the Surgeon General and submit to the Surgeon General for prior approval changes that substantially alter the scope of work, functions, utilities, or safety of the facility;

(f) Completion responsibility. That applicant will be responsible for the completion of the project in accordance with the grant application and approved plans and specifications;

(g) Records and accounts. That applicant will maintain adequate and separate accounting and fiscal records and accounts for all funds provided from any source to pay the cost of the project, and permit audit of such records and accounts at any reasonable time;

(h) Progress reports. That applicant will furnish progress reports and such other information as the Surgeon General may require;

(1) Construction supervision. That applicant will provide and maintain competent and adequate architectural and engineering supervision and inspection at the construction site to insure that the completed work conforms with the approved plans and specifications;

(j) Non-Federal share. That sufficient funds will be available to meet the nonFederal share of the cost of construction;

(k) Funds for operation. That sufficient funds will be available when construction is completed for effective use of the facility for the purpose for which it is being constructed;

(1) Authorized uses. That for not less than 10 years after completion of construction, the facility will be used for the purposes of the training for which it is to be constructed, and will not be used for secretarian instruction or as a place for religious worship;

(m) Labor standards; insurance; inspection. (1) That any laborer or mechanic employed by any contractor or subcontractor in the performance of work on the construction of the facility will be paid wages at rates not less than those prevailing on similar construction in the locality as determined by the Secretary of Labor in accordance with the Davis-Bacon Act (40 U.S.C. 276 et seq.), and will receive compensation at a rate not less than one and one-half times his basic rate of pay for all hours worked in any work week in excess of 8 hours in any calendar day or 40 hours in the work week (40 U.S.C. 327-332); and

(2) That the following conditions and provisions will be included in all contracts for such construction work:

(i) The provisions set forth in Labor Standards Provisions for Construction Grant Programs (issued by the Architectural, Engineering and Equipment Branch, Division of Hospital and Medical Facilities, Public Health Service, U.S. Department of Health, Education and Welfare) pertaining to the Davis-Bacon Act, the Contract Work Hours Standards Act, and the Copeland Act (AntiKickback) Regulations, except in the case of contracts in the amount of $2,000

or less; and, except in the case of contracts in the amount of $10,000 or less, the provisions pertaining to Executive Order No. 11246, September 24, 1965 (30 F.R. 12319), relating to nondiscrimination in construction contract employment;

(ii) The contractor shall furnish performance and payment bonds in the full amount of the contract price, and shall maintain, during the life of the contract, adequate fire, workman's compensation, public liability and property damage insurance;

(iii) Representatives of the Public Health Service and such other persons as the Surgeon General may designate will have access at all reasonable times to work wherever it is in preparation or progress, and the contractor shall provide proper facilities for such access and inspection.

(n) Expansion of training capacity. That, in the case of an application to expand the training capacity of an existing training center for allied health professions personnel, for the first full school year after the completion of the project and for each of the 9 school years thereafter, the enrollment of full-time students at such center will exceed the highest enrollment at such center for any of the 5 full years preceding the year in which application is made by at least 5 percentum of such highest enrollment. The requirements of this paragraph shall be in addition to the increase required under section 792(b) (2) of the Act with respect to a basic improvement grant application, where assurance of such increase has been given by the center;

(0) Professional certification. That with respect to any project relating to facilities for curriculums which lead to the baccalaureate or equivalent degree or to a higher degree, such curriculums will qualify graduates for eligibility for professional certification, registration or licensure, or such other professional recognition as the Surgeon General may find acceptable.

§ 57.809 Nondiscrimination.

(a) Executive Order 11246. Each construction grant is subject to the condition that the grantee shall comply with the requirements of Executive Order

11246, September 24, 1965 (30 F.R. 12319), and the applicable rules, regulations, and procedures prescribed pursuant thereto (see § 57.808(m) (2) (i) ).

(b) Civil Rights Act of 1964. Attention is called to the requirements of Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d; 78 Stat. 252), which provides that no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. A regulation implementing such Title VI, applicable to grants for construction of teaching facilities, has been issued by the Secretary of Health, Education, and Welfare with the approval of the President (45 CFR Part 80).

[33 F.R. 5265, Apr. 2, 1968; 33 F.R. 6244, Apr. 24, 1968]

§ 57.810 Good cause for other use of completed facility.

If, within 10 years after completion of any construction for which a construction grant has been made, the facility shall cease to be used for the training purposes for which it was constructed, the Surgeon General, in determining whether there is good cause, pursuant to section 791(d) (2) of the Act, for releasing the applicant or other owner of the facility from the obligation so to use the facility, shall take into consideration the extent to which:

(a) Other teaching use. The facility will be devoted by the applicant or other owner to the teaching of other medical, dental health, or allied health personnel covered by the Act;

(b) Utilization of other facilities. There are reasonable assurances that for the remainder of the 10-year period other facilities not previously utilized for teaching allied health professions personnel will be so utilized and are substantially the equivalent in nature and extent for such purposes.

(a) Minimum standards of construction; exceptions. The Surgeon General's approval of the architectural program and structural description which conform (or upon completion of any necessary construction will conform) to the minimum standards of construction and equipment as specified in § 57.812, shall be obtained before entering into a final or unconditional contract for such acquisition. Where the Surgeon General finds that exceptions to or modifications of any of such minimum standards of construction and equipment would be consistent with the purposes of the Act and of the program, he may authorize such exceptions or modifications.

(b) Estimated cost of acquisition and remodeling; suitability of facility. Each application for a project involving the acquisition of existing facilities shall include in the detailed estimates of the cost of the project the cost of acquiring such facilities and the cost of remodeling, renovating or altering such facilities to serve the purposes for which they are acquired. Such application shall demonstrate to the satisfaction of the Surgeon General that the architectural, structural and other pertinent features of the facility, as modified by any proposed exrenovation, pansion, remodeling, alteration, will be clearly suitable for the purposes of the program, and, to the extent of the costs in which Federal participation is requested, are not in excess of what is necessary for the services proposed to be provided in such facilities.

or

(c) Determination of necessary cost. The necessary cost of acquisition of existing facilities will be determined on the basis of such documentation submitted by the applicant as the Surgeon General may prescribe (including the reports of such real estate appraisers as the Surgeon General may approve) and other relevant factors.

(d) Bona fide sale. Federal participation in the acquisition of existing facilities is on condition that such acquisition constitutes a bona fide sale involving an actual cost to the applicant and will result in additional or improved facilities for purposes of the program.

(e) Facility which has previously received Federal grant. No grant for the acquisition of a facility which has pre

viously received a Federal grant for construction, acquisition, or equipment shall serve either to reduce or restrict the liability of the applicant or any other transferor or transferee of the facility with respect to any right of recovery on the part of the Federal government or to relieve such applicant or other transferor or transferee from any obligation of accountability imposed by the Federal government by reason of such prior grant.

§ 57.812

Minimum standards of construction and equipment.

(a) Introduction. (1) The standards set forth in this subpart have been established by the Surgeon General as required by the Act. These standards constitute minimum requirements for construction and equipment and shall apply to all projects (including those for the purchase or renovation of existing buildings) for which Federal assistance is requested under the Act. The Surgeon General may approve plans and specifications which contain deviations from the requirements prescribed, if he is satisfied that the purposes of such requirements have been fulfilled. In addition to these requirements, it is recognized that the project will have to meet the requirements of local codes and ordinances relating to construction.

(2) Hospital teaching facilities constructed under this Act shall comply with the requirements of "General Standards of Construction and Equipment for Hospital and Medical Facilities" (PHS No. 930-A-7), and any amendments or revisions thereof, which document is incorporated by reference in § 53.101 (a) of this chapter. Said document will be provided to all applicants for the construction of such hospital teaching facilities, and is available to any interested person, whether or not affected by the provisions of this part, upon request to the Regional Office of the Department of Health, Education, and Welfare, or the Public Inquiries Branch, Public Health Service, Washington, D.C.

(b) Architectural. The following requirements have been established to assure an orderly development of the project and to provide a uniform method for the preparation and review of drawings, specifications, and estimates:

(1) Facilities shall be fire safe, structurally safe, and so planned as to carry out effectively the proposed program.

(2) Appropriate public facilities including entrances, toilet rooms, and elevators shall be designed to provide easy access for physically handicapped persons needing wheelchairs, walkers, and other aids. Minimum requirements shall be those set forth in the United States of America Standards Institute Standard No. A117.1961, "American Standard Specifications for Making Buildings and Facilities Accessible to, and Usable by, the Physically Handicapped."

(c) Construction including fire-resistive requirements—(1) Foundations. Foundations shall rest on natural solid ground if a satisfactory soil is available at reasonable depths. Proper soil bearing values shall be established in accordance with recognized standards. If solid ground is not encountered at practical depths, the structure shall be supported on driven piles or drilled piers designed to support the intended load without detrimental settlement, except that onestory buildings may rest on a fill designed by a soils engineer. When engineered fill is used, site preparation and all grading shall be done under the direct full-time supervision of the soils engineer. The soils engineer shall issue a final report on the grading operation and a certification of compliance with the job specifications. Special review and approval by the Public Health Service will be required for foundations supported on engineered fill. All footings shall extend to a depth not less than 1 foot below the estimated maximum frost line.

(2) One-story buildings. One-story buildings shall be of not less than 1-hour fire-resistant construction throughout, with the following exceptions:

(i) Walls enclosing stairways, elevator shafts, chutes, and other vertical shafts, boiler rooms, and storage rooms of 100 square feet or greater area shall be of 2-hour fire-resistive construction.

(ii) If non-load-bearing partitions other than corridor partitions are of nonflammable construction, they may be nonfire rated.

(iii) Heavy timber construction may be used in auditoriums and administration areas, provided that these areas are so located as to be freestanding buildings

or, if attached to the main building, are suitably fire separated therefrom, do not form a major circulation element in the facility, and do not serve as a required means of egress.

(3) Multistory buildings. (i) For all buildings more than one story in height, the structural framework and building elements shall be an appropriately fireresistive combination of materials using steel, concrete, or masonry, except that load-bearing masonry walls may be used for buildings up to and including three stories in height.

(ii) Bearing walls and walls enclosing stairways, elevator shafts, chutes, and other vertical shafts, boiler rooms, and storage rooms of 100 square feet or greater area shall be of 2-hour fireresistive construction.

(iii) Corridor partitions shall be of 1hour fire-resistive construction.

(iv) Columns, girders, trusses, floor construction including beams, and roof construction including beams shall be of not less than 12-hour fire-resistive construction.

(v) Beams supporting masonry shall be individually protected with not less than 2-hour fire-resistive construction.

(vi) Non-load-bearing partitions other than corridor partitions may be of 1hour fire resistive construction utilizing fire-retardant-treated wood studs or if of noninflammable construction, they may be nonfire rated.

(4) Fire ratings. Fire resistive ratings shall be determined in accordance with American Society for Testing and Materials Standard No. E-119;

(i) Interior finish of walls and ceilings of all exitways, storage rooms, and areas of unusual fire hazard shall have a flame spread rating of not more than 25;

(ii) All other areas shall have a flame spread rating of not more than 75, except that up to 10 percent of the aggregate wall and ceiling area may have a finish with a rating up to 200;

(iii) Floor finish materials shall have a flame spread rating of not more than 75;

(iv) Flame spread ratings for each specific product shall be determined by an independent testing laboratory in accordance with American Society for Testing and Materials Standard No. E-84.

(5) Exits. Exit facilities shall comply with the requirements of the Life Safety

Code, National Fire Protection Association Standard No. 101.

(d) Mechanical. All installations of fuel burning equipment, steam, heating, air conditioning and ventilation, plumbing, and other piping systems shall comply with the recommendations of the following:

National Board of Fire Underwriters, 85 John Street, New York, N.Y. 10038. American Standards Association, 70 East 45th Street, New York, N.Y. 10017. Boilers shall meet the requirements of the American Society of Mechanical Engineers (ASME) codes relating to pressure vessels, and shall be installed to meet all requirements of State and local codes and regulations.

(e) Electrical. All electrical installations and equipment shall comply with the requirements of local and State codes and the applicable sections of the National Electrical Codes and the following:

(1) Hazardous

locations. Installations and equipment in rooms in which flammable anesthetic and disinfecting agents are used or stored shall comply with the requirements of NFPA No. 56 and No. 70.

(2) Fire alarms. Manually operated fire alarm system installations shall comply with the requirements of NFPA No. 72 and shall be located as required by the Life Safety Code, NFPA No. 101.

(3) Radiation protection. Radiation protection in rooms in which X-ray, gamma-ray, or beta-ray producing equipment is used shall comply with the requirements of the following handbooks of the National Bureau of Standards: Handbook 55-Protection Against BetatronSynchrontron Radiations up to 100 Million Electron Volts;

Handbook 73-Protection Against Radiations
From Sealed Gamma Sources;
Handbook 76-Medical X-ray Protection up
to Three Million Volts.

(4) Emergency electric service. Emergency exist lighting shall comply with the requirements of the National Electrical Code and shall be located as required by the Life Safety Code.

(f) Elevators, dumbwaiters, and escalators. Installation of elevators, dumbwaiters, and escalators shall comply with the requirements of the American Standard Safety Code for Elevators, Dumbwaiters, and Escalators, ASA A 17. 1-1960.