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bility for services including criteria for (h) Whether the center's cateanz partial payment schedules, and long- area is exclusive of the area servei range financial planning;

another center; (iv) Evaluating center activities in- (1) The degree to which the applier cluding services utilization patterns, intends to integrate services super productivity of the center, patient sat- by a grant under this subpart 7 isfaction, achievement of project objec- health services provided under tives, and development of a process for Federally assisted health service hearing and resolving patient griev- reimbursement programs or project ances;

(j) The extent to which comi (v) Assuring that the center is oper- resources will be utilized by the y ated in compliance with applicable ect; Federal, State, and local laws and reg- (k) The extent to which the ulations; and

will provide preventive health ser (vi) Adopting health care policies in- so as to maintain and improve : cluding scope and availability of serv- health status of the population sa ices, location and hours of services, and

and quality-of-care audit procedures.

(1) The extent to which center of

ations will emphasize direct be $510.306 Grant evaluation and award. services, efficiency of operations Within the limits of funds deter

sound financial management. mined by the Secretary to be available for such purpose, the Secretary may Subpart D-Grants for Opeuty award grants under this subpart to ap- Community Health Project plicants therefor which will, in his judgment, best promote the purposes of

g516.401 Applicability. section 330(d)(1)(A) of the Act and the The regulations of this subpar applicable regulations of this part, tak- addition to the regulations of sata ing into consideration;

A are applicable to grants awarded? (a) The extent to which the project suant to section 330(d)(1)(B) of the would provide for the elements set for the costs of operation of pro forth in $510.303;

which provide health services to a (b) The relative need of the popu- cally underserved populations. lation to be served for the services to be provided;

851c.402 Application. (c) The potential of the center for the To be approved by the Secres development of

and effective methods for health services delivery

under this subpart, an application to

grant must, in addition to meetin and management;

requirements of $51c.104 of subpar (d) The soundness of the fiscal plan contain information sufficient to for assuring effective utilization of able the Secretary to determine grant funds and maximizing non-grant the project for which the grass revenue;

sought will meet the requirements (e) The administrative and manage- $510.403 of this subpart. ment capability of the applicant; (f) The extent to which grants ap

8510.403 Project elements. proved under this part will provide for A project for the operation of a * an appropriate distribution of re- munity health project supported was sources throughout the country, taking this subpart must: into consideration the following fac- (a) Meet all of the requirements tors: (1) The urban-rural area to be served;

$510.303 of this part except for pl

graph (h). (2) The nature of the organization applying;

(b) Provide those services enume"

ated in $51c.102(c)(1) of this part (3) The organizational structure for delivery of services;

the Secretary determines to be feasib (g) The number of users of the center

and desirable and which are specilia

in the grant award. and the level of utilization of services in previous operational periods, if any;

(c) Establish a governing board meet ingt uirements of $510.304 by the

new

while

than one grant under section 330(c) of the Act;

(3) Not make a grant under section 330(d)(1)(B) to an entity which has been awarded a grant under section 330(d)(1)(A) of the Act.

Subpart E-Acquisition and Modernization of Existing Buildings $51c.501 Applicability.

The regulations of this subpart, in addition to the regulations of the other applicable subparts of this part, are applicable to grants under section 330 of the Act for project costs which include the cost of acquisition and/or modernization of existing buildings (including the cost of amortizing the principal of, and paying the interest on, loans), except that, these regulations are not applicable to grants for project costs which include the costs of modernization of existing buildings if those costs can otherwise be supported under subparts B, C, or D of this part. (43 FR 5352, Feb. 7, 1978)

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of the period of support under sec

330(d)(1)(B) of the Act and this art. -.404

Grant evaluation and award. Within the limits of funds detered by the Secretary to be available such purpose, the Secretary may rd grants under this subpart to apants therefor which will, in his ment, best promote the purposes of ion 330(d)(1)(B) of the Act and the licable regulations of this part, ) Where the project meets the reements of 8510.403(a); and ) Taking into consideration the foling: ) The degree to which the project ud provide the services enumerated 351c.102(c)(1) and the feasibility of providing all of such enumerated rices by the end of the period of supat under section 330(d)(1)(B) of the

and this subpart; i) Whether the project will have a serning board meeting the requirents of $510.304 by the end of the ped of support under section (d)(1)(B) of the Act and this subpart; iii) The degree to which the appliat intends to integrate services suprted by a grant under this subpart th health services provided under her Federally assisted health service

reimbursement programs ojects; (iv) The need of the population to be rved for the services to be provided; (v) The potential of the project for

e development of new and effective ethods for health services delivery id management; (vi) The soundness of the fiscal plan ir assuring effective utilization of rant funds and maximizing non-grant evenue;

(vii) The administrative and managehent capacity of the applicant; and

(viii) The extent to which community esources will be utilized in the projct. (b) The Secretary may:

(1) Make no more than two grants for he

entity under section 330(d)(1)(B) of the Act;

(2) Not make any grant under section 330(a)(1)(B) to an entity which, for the same project, has been awarded more

or

or

8510.502 Definitions.

(a) Equipment means nonexpendable personal property as defined in 45 CFR 74.132.

(b) Existing building means a completed substantially completed structure, and may include the realty on which it is or is to be located.

(c) Modernization means the alteration, repair, remodeling and/or renovation of a building (including the initial equipment thereof and improvements to the building's site) which, when completed, will render the building suitable for use by the project for which the grant is made. (43 FR 5352, Feb. 7, 1978)

$51c.503 Application.

(a) General requirements. An application for a grant under this part for a project under subparts B, C, or D which includes the acquisition and/or modernization of an existing building must include the following:

(1) A legal description of the site and a drawing showing the location of the building:

(2) A description of the architectural, structural, and other pertinent charac

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teristics of the building sufficient to gional Offices Information ( show that it is or that it will be, after listed in 45 CFR 5.31 and may alteration and renovation or after mod- obtained from the National Form ernization, suitable for use by the tection Association, 470 Atlan: project;

nue, Boston, MA 02210 for su (3) A detailed estimate of the cost of copy. the proposed acquisition and/or mod- (iv) In the case of a public ay ernization;

with an approved project (4) A description of, and copies of any volves the displacement of Ders relevant documents concerning, any businesses on or after January. existing or proposed financing arrange- whose real property has or ments for the acquisition and/or mod- taken, the applicant will come ernization;

the provisions of the Uniforms (5) The proposed schedule for acquisi- tion Assistance and Real Proper tion and/or modernization and occu- quisition Policies Act of 1970 ? pancy;

91-646) and the applicable rerum (6) An assessment of the environ- issued thereunder (45 CFR part 2 mental impact of the proposed acquisi- (v) Sufficient funds will be s. tion and/or modernization as called for to meet any portion of the coe by section 102(2)(c) of the National En- quiring and/or modernizing the vironmental Policy Act of 1969 (42 ing not borne by the grant a U.S.C. 4332(c)) and such information as part; may be necessary to comply with the (vi) Sufficient funds will be ni National Historic Preservation Act of after acquisition and/or modes 1966 (16 U.S.C. 470(1));

of the building for effective (7) Reasonable assurances that- building for the purposes of this

(i) The applicant has or will obtain a (vii) The applicable require fee simple or such other estate or in- the Flood Disaster Protectie terest in the site, including necessary 1973 have been met; easements and rights-of-way, sufficient (8) Such other informatio to assure for a period of not less than Secretary may reasonably requ 20 years (in the case of interim facili- (b) Requirement for acquisitica ties, for the period constituting the es- Except for a grant solely for & timated useful life of such facilities) tion of principal and payment undisturbed use and possession for the est on an existing loan, an as purpose of the operation of the project; for a grant for a project which :

(ii) The building will be used for the the acquisition of an existing purposes for which the grant is made; must include, in addition to

(iii) The building complies, or after quirements of paragraph (a) of t alteration and renovation or after mod- tion, evidence satisfactory to ernization will comply, with applicable retary that the applicant has et State and local codes and with:

other alternatives to the proposta (A) “American National Standard quisition (such as leasing facilisi Specifications for Making Buildings acquiring other

facilities in and Facilities Accessible to, and Usa- project's catchment area) and thái ble by, the Physically Handicapped" proposed acquisition constitute Number ANSI A117.1–1961 (R 1971), as soundest alternative from a fics modified by other standards prescribed and program standpoint. by the Secretary or the Administrator (c) Requirements for modertimi of the General Services Administra- grants. In addition to the requires tion. The applicant shall be responsible of paragraph (a) of this section, for conducting inspections to insure plication for a grant for a compliance with the specifications; which includes modernization of

(B) The applicable standards set forth isting building must include the in Life Safety Code 1973, NFPA No. 101, lowing: which is hereby incorporated by ref- (1) Plans and specifications for erence and made a part hereof. Copies proposed modernization which com of such document are available for ex- to the standa specified amination at the Department's and Re- $510.503(a)(7)(iii)

easonable assurance that any la

or mechanic employed by any ctor or subcontractor in the perace of work on the modernization t will be paid wages at rates not aan those prevailing on similar in the locality as determined by secretary of Labor under the Bacon Act (40 U.S.C. 276a et seq.) ill receive compensation at a rate ss than one and one-half times Lsic rate of pay for all hours

i in any workweek in excess of 8 pone in any calendar day; and

Copies of any construction and als contracts already entered ir the proposed modernization. 57000, Dec. 30, 1976, as amended at 43

Feb. 7, 1978) 1.25 D3 34 Project elements.

General requirements. A grantee

has received a grant under sec30 of the Act for a project which es the acquisition and/or modtion of an existing building must: Assurances. Comply with the ases provided pursuant to this sub

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(2) Standards of construction and equipment. Except in the case of a grant solely for amortization of principal and payment of interest on an existing loan, obtain a determination by the Secretary that the facility conforms (or upon completion of any necessary alteration and renovation or modernization will conform) to the standards set forth in $510.503(a)(7)(iii) of this subpart before entering into a final or unconditional contract for the acquisition. Where the Secretary finds that exceptions to or modifications of any such standards would be consistent with the purposes of the Act and of the program, he may authorize such exceptions or modifications.

(3) Financing. Where the grantee will obtain a loan secured by the building in order to acquire the building, obtain such financing at the lowest current rate prevailing in the area for comparable loans on comparable facilities.

(c) Requirements for modernization grants. In addition to the requirements of paragraph (a) of this section, a grantee which has received a grant under section 330 of the Act for a project which includes the modernization of an existing building must:

(1) Costs in excess of approved costs. Finance all costs in excess of the estimated costs approved in the application and submit to the Secretary for prior approval any changes that substantially alter the scope of the function, utilities, or safety of the facility.

(2) Competitive bids. (i) Obtain the approval of the Secretary before the project is advertised or placed on the market for bidding; such approval must include a determination by the Secretary that the final plans and specifications conform to the standards set forth in 8510.503(a)(7)(iii) of these regulations.

(ii) Except as otherwise provided by State or local law, contract for construction (including the purchase and installation of built-in equipment) on a lump sum fixed-price basis, and award contracts on the basis of competitive bidding obtained by public advertising with award of the contracts to the lowest responsive and responsible bidders. The provision for exceptions based on State and local law shall not be invoked to give local contractors or sup

Approval of estimated cost. Not Ainto any contract for the acquisi

ad/or modernization funded under meni fubpart where the cost of such ac

ion and/or modernization exceeds timates in the application, withle prior approval of the Secretary.

Von-default. Make every effort to of an At any default on any loan se

by the building and, in the event

Lefault, promptly notify the SecItisfaciat of the default and make every

on a timely basis to cure the de

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Requirements for acquisition grants. ddition to the requirements of graph (a) of this section, a grantee

has received a grant under sec330 of the Act for a project which

des the acquisition of an existing

Ang must: the Bona-side sale. Acquire or, in the

of a grant solely for amortization

incipal and payment of interest on nizarkisting loan, have acquired the exincm & building pursuant to a bona-fide

involving an actual cost to the apficatiosent and resulting in additional or a whidroved facilities for the purposes of

his

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pliers a percentage preference over architectural or engineering non-local contractors bidding for the vision and inspection at the moders same contract. Such practices are pre- tion site to insure that the compe cluded by this paragraph.

work conforms with the plans and (3) Construction contracts. (i) Include ifications. the following conditions and provisions (5) Completion responsibility. Conci in all construction contracts for the the modernization in accordance modernization project:

the grant application and the apr (A) The provisions set forth in plans and specifications. “DHHS Requirements for Federally As- (6) Progress reports. Furnish prie sisted Construction Contracts Regard- reports and such other informa ing Labor Standards and Equal Em- concerning the modernization as ployment Opportunities," Form DHHS Secretary may require. 514 (rev. 7/76) (issued by the Office of (d) The Secretary may at any * Grants Administration Policy, U.S. De- approve exceptions to the proviso partment of Health and Human Serv- this section where he finds that ices) pertaining to the Davis-Bacon exceptions are not inconsistent Act, the Contract Work Hours Stand- section 330 of the Act, other read ards Act, and the Copeland Act (Anti

ments of law, or the purposes Kickback) Regulations, except in the program. case of contracts in the amount of

(41 FR 57000, Dec. 30, 1976, as amended $2,000 or less; and pertaining to Execu- FR 5352, Feb. 7, 1978) tive Order 11246, 30 FR 12319 (September 24, 1965), as amended, relating to 851c.505 Determination of cost

. nondiscrimination in construction con- The cost of acquisition ande: * tract employment, except in the case ernization of existing building of contracts in the amount of $10,000 or which funds may be granted unte less;

part will be determined by (B) That the contractor shall furnish retary, utilizing such docce performance and payment bonds each submitted by the applicant ass of which shall be in the full amount of retary may prescribe (includini the contract price, and shall maintain, ports of such real estate appraient during the life of the contract, adequate fire, workmen's compensation,

the Secretary may approve) and public liability, and property damage

relevant factors, taking into cons" =

ation only that portion of the esc insurance: Provided, however, That in the case of a State or local unit of gov

building necessary for the operativo the approved project.

S ernment which enters into a construc

30 tion contract of less than $100,000,

(41 FR 5700, Dec. 30, 1976)

U State or local provisions with respect

351c.506 Use of grant funds. to performance and payment bonds shall be deemed to meet the require

Grant funds may be used to am ments of this paragraph; and

the principal of or pay interest (C) That the Secretary shall have ac

loan or mortgage on an existing 3 cess at all reasonable times to work

ing acquired under this part, incl. wherever it is in preparation

a building purchased by a grantee

or progress, and the contractor shall pro

to the promulgation of this part

, vide proper facilities for such access

only if the building is being user and inspection.

the purposes of section 330 and to (ii) Executive Order 11246. Comply

plies with the applicable provisio-lat with the applicable requirements of

this subpart and only to the exter Executive Order 11246, 30 FR 12319 (Sep

Secretary finds such principal tember 24, 1965) as amended, relating to

and interest rates to be reasonable

. oz nondiscrimination in construction con- (41 FR 5700, Dec. 30, 1976) tract employment, and the applicable rules, regulations, and procedures pre

351c.507 Facility which has previous scribed pursuant thereto.

received Federal grant. (4) Modernization supervision. Provide and maintain competent and adequate cility which has previously received

No grant for the acquisition of s! 12

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