bility for services including criteria for partial payment schedules, and longrange financial planning; (iv) Evaluating center activities including services utilization patterns, productivity of the center, patient satisfaction, achievement of project objectives, and development of a process for hearing and resolving patient grievances; (v) Assuring that the center is operated in compliance with applicable Federal, State, and local laws and regulations; and (vi) Adopting health care policies including scope and availability of services, location and hours of services, and quality-of-care audit procedures. $51c.305 Grant evaluation and award. Within the limits of funds determined by the Secretary to be available for such purpose, the Secretary may award grants under this subpart to applicants therefor which will, in his judgment, best promote the purposes of section 330(d)(1)(A) of the Act and the applicable regulations of this part, taking into consideration; (a) The extent to which the project would provide for the elements set forth in §51c.303; (b) The relative need of the population to be served for the services to be provided; (c) The potential of the center for the development of new and effective methods for health services delivery and management; (d) The soundness of the fiscal plan for assuring effective utilization of grant funds and maximizing non-grant revenue; (e) The administrative and management capability of the applicant; (f) The extent to which grants approved under this part will provide for an appropriate distribution of resources throughout the country, taking into consideration the following factors: (1) The urban-rural area to be served; (2) The nature of the organization applying; (3) The organizational structure for delivery of services; (g) The number of users of the center and the level of utilization of services in previous operational periods, if any; and (1) The extent to which center ations will emphasize direct bei services, efficiency of operations sound financial management Subpart D-Grants for Operaty $51c.401 Applicability. The regulations of this subpart addition to the regulations of sp A are applicable to grants awarded suant to section 330(d)(1)(B) of the for the costs of operation of proj which provide health services to m cally underserved populations. $51c.402 Application. To be approved by the Secret under this subpart, an application grant must, in addition to meeting requirements of $51c.104 of subpar contain information sufficient to able the Secretary to determine the project for which the gran sought will meet the requirement § 51c.403 of this subpart. $51c.403 Project elements. A project for the operation of a munity health project supported this subpart must: und (a) Meet all of the requirements * §51c.303 of this part except for part graph (h). (b) Provide those services enumer ated in §51c.102(c)(1) of this part which the Secretary determines to be feasible and desirable and which are specified in the grant award. (c) Establish a governing board meet vuirements of § 51c.304 by th ing th lo ( W in it se A C of the period of support under sec330(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 §51c.403(a); and ) Taking into consideration the foling: The degree to which the project ld provide the services enumerated 51c.102(c)(1) and the feasibility of A providing all of such enumerated Grant rices by the end of the period of supt under section 330(d)(1)(B) of the and this subpart; nity) Whether the project will have a licablerning board meeting the require I open eal d pop tion ed by nts of §51c.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 or 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 ad management; (vi) The soundness of the fiscal plan or assuring effective utilization of rant funds and maximizing non-grant ments venue; (vii) The administrative and manageent 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 same entity under section 330(d)(1)(B) of the Act; (2) Not make any grant under section 330(d)(1)(B) to an entity which, for the same project, has been awarded more 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] $51c.502 Definitions. (a) Equipment means nonexpendable personal property as defined in 45 CFR 74.132. (b) Existing building means a completed or 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 teristics of the building sufficient to show that it is or that it will be, after alteration and renovation or after modernization, suitable for use by the project; (3) A detailed estimate of the cost of the proposed acquisition and/or modernization; (4) A description of, and copies of any relevant documents concerning, any existing or proposed financing arrangements for the acquisition and/or modernization; (5) The proposed schedule for acquisition and/or modernization and occupancy; (6) An assessment of the environmental impact of the proposed acquisition and/or modernization as called for by section 102(2)(c) of the National Environmental Policy Act of 1969 (42 U.S.C. 4332(c)) and such information as may be necessary to comply with the National Historic Preservation Act of 1966 (16 U.S.C. 470(f)); (7) Reasonable assurances that (i) The applicant has or will obtain 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 (in the case of interim facilities, for the period constituting the estimated useful life of such facilities) undisturbed use and possession for the purpose of the operation of the project; (ii) The building will be used for the purposes for which the grant is made; (iii) The building complies, or after alteration and renovation or after modernization will comply, with applicable State and local codes and with: (A) "American National Standard Specifications for Making Buildings and Facilities Accessible to, and Usable by, the Physically Handicapped" Number ANSI A117.1-1961 (R 1971), as modified by other standards prescribed by the Secretary or the Administrator of the General Services Administration. The applicant shall be responsible for conducting inspections to insure compliance with the specifications; (B) The applicable standards set forth in Life Safety Code 1973, NFPA No. 101, which is hereby incorporated by reference and made a part hereof. Copies of such document are available for examination at the Department's and Re gional Offices' Information Ce listed in 45 CFR 5.31 and may is obtained from the National Fir tection Association, 470 Atlanti nue, Boston, MA 02210 for S copy. (2) bore form the Da ar no his (iv) In the case of a public app with an approved project whic volves the displacement of perse businesses on or after January! whose real property has or taken, the applicant will comp the provisions of the Uniform ho tion Assistance and Real Prope quisition Policies Act of 1970 (2) 91-646) and the applicable re in issued thereunder (45 CFR part (v) Sufficient funds will be a to meet any portion of the co quiring and/or modernizing the ing not borne by the grant part; (vi) Sufficient funds will be a after acquisition and/or moder of the building for effective building for the purposes of th (vii) The applicable require the Flood Disaster Protectio 1973 have been met; WO ma [4] F (8) Such other informatio Secretary may reasonably req (b) Requirement for acquisitio Except for a grant solely for tion of principal and payment est on an existing loan, an ap for a grant for a project which the acquisition of an existing must include, in addition to quirements of paragraph (a) of the tion, evidence satisfactory to the retary that the applicant has ex other alternatives to the propos quisition (such as leasing facili acquiring other facilities i project's catchment area) and t proposed acquisition constitut soundest alternative from a fi and program standpoint. (c) Requirements for moder grants. In addition to the requir of paragraph (a) of this section plication for a grant for a which includes modernization o isting building must include lowing: (1) Plans and specifications proposed modernization which o the standa specifi §51c.503(a)(7)(iii) to ster 2 easonable assurance that any laor mechanic employed by any ctor or subcontractor in the perace of work on the modernization t will be paid wages at rates not han 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 sic rate of pay for all hours 1 in any workweek in excess of 8 in any calendar day; and Copies of any construction and als contracts already entered r the proposed modernization. 57000, Dec. 30, 1976, as amended at 43 Feb. 7, 1978] 4 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 asces provided pursuant to this sub Approval of estimated cost. Not into any contract for the acquisind/or modernization funded under fr part where the cost of such ac ion and/or modernization exceeds timates in the application, withe prior approval of the Secretary. Von-default. Make every effort to at any default on any loan seby the building and, in the event lefault, promptly notify the Secof the default and make every on a timely basis to cure the de Requirements for acquisition grants. ddition to the requirements of graph (a) of this section, a grantee h has received a grant under sec330 of the Act for a project which des the acquisition of an existing ing must: Bona-fide sale. Acquire or, in the of a grant solely for amortization incipal and payment of interest on xisting loan, have acquired the exg building pursuant to a bona-fide involving an actual cost to the apsint and resulting in additional or toved facilities for the purposes of project. (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 §51c.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 §51c.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 pliers a percentage preference over non-local contractors bidding for the same contract. Such practices are precluded by this paragraph. (3) Construction contracts. (i) Include the following conditions and provisions in all construction contracts for the modernization project: (A) The provisions set forth in "DHHS Requirements for Federally Assisted Construction Contracts Regarding Labor Standards and Equal Employment Opportunities," Form DHHS 514 (rev. 7/76) (issued by the Office of Grants Administration Policy, U.S. Department of Health and Human Services) 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 pertaining to Executive Order 11246, 30 FR 12319 (September 24, 1965), as amended, relating to nondiscrimination in construction contract employment, except in the case of contracts in the amount of $10,000 or less; (B) That the contractor shall furnish performance and payment bonds each of which shall be in the full amount of the contract price, and shall maintain, during the life of the contract, adequate fire, workmen's compensation, public liability, and property damage insurance: Provided, however, That in the case of a State or local unit of government which enters into a construction contract of less than $100,000, State or local provisions with respect to performance and payment bonds shall be deemed to meet the requirements of this paragraph; and (C) That the Secretary shall 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. (ii) Executive Order 11246. Comply with the applicable requirements of Executive Order 11246, 30 FR 12319 (September 24, 1965) as amended, relating to nondiscrimination in construction contract employment, and the applicable rules, regulations, and procedures prescribed pursuant thereto. (4) Modernization supervision. Provide and maintain competent and adequate Grant funds may be used to am the principal of or pay interest loan or mortgage on an existing t ing acquired under this part, incl a building purchased by a grantee to the promulgation of this part only if the building is being used the purposes of section 330 and plies with the applicable provision this subpart and only to the exten Secretary finds such principal amo and interest rates to be reasonable. [41 FR 5700, Dec. 30, 1976] § 51c.507 Facility which has previ received Federal grant. No grant for the acquisition of cility which has previously recei 6 S U 3 |