migrant health programs), or subpart G (relating to grants for technical assistance), as applicable. In addition, applications must include:

(1) A statement of specific, measurable objectives and the methods to be used to assess the achievement of the objectives in specified time periods and at least on an annual basis.

(2) The precise boundaries of the catchment area to be served by the applicant. In addition, the application shall include information sufficient to enable the Secretary to determine that the applicant's catchment area meets the following criteria:

(1) The size of such area is such that the services to be provided by the applicant are available and accessible to the residents of the area promptly and as appropriate;

(ii) The boundaries of such area conform, to the extent practicable, to relevant boundaries of political subdivisions, school districts, and areas served by Federal and State health and social service programs; and

(iii) The boundaries of such area eliminate, to the extent possible, barriers resulting from the area's physical characteristics, its residential patterns, its economic and social groupings, and available transportation.

(3)(i) The number of migratory agricultural workers and members of their families, and seasonal agricultural workers and members of their families which resided in the project's catchment area in the most recent calendar year for which statistical data acceptable to the Secretary is available; and

(ii) The approximate period or periods of residence of all groups of migratory agricultural workers and their families counted under paragraph (b)(3)(i) of this section.

(4) The results of an assessment of the need that the population to be served has for the services to be provided by the project (or in the case of applications for planning and development projects, the methods to be used in assessing such need), taking into consideration the following factors:

(i) Available health resources in relation to size of the catchment area and population of migratory and seasonal

agricultural workers and their heir f in such area, including appropropula

tios of primary care physicians NOTE: eral or family practice, interna on-Fed cine, pediatrics, or obstetrics and he pro cology, to such population; ay no

(ii) Health indices for suci ¿iduals lation, such as infant mortality ricul

(iii) Economic factors affectines of population's use of health (12) such as percentage of such popuirer with incomes below the poverty the

(iv) Demographic factors act ha such population's need and demi (13) health services, such as percen such population age 65 and over, the

(v) Special factors of access art. from the conditions of employme_(c) such workers (including working a the housing, and sanitation).

(5) Position descriptions for of th nel who will be utilized in canyosed regul the activities of the projec statement indicating the net ons positions to be supported (Sec. funds to accomplish the obj890, the project.

lic H

254b)

(6) Letters and other forms dence showing that efforts han 42 F made to secure financial and R 2 983] sional assistance and support project within the proposed ca 156.1 area and the continuing involve the community in the developme A operation of the project.

only

itle

lan

(7) An assurance that an indepe certified public accountant will and a gaged to certify that the project tem for the management and co its finances will be in accor

36.1

this

sound financial management pra(a) including applicable Federal re ments.

Secr

port

(8) A list of all services propost be provided by the project.

(9) A list of services which are

add

provided directly by the y through its own staff and resourcecr (1) a description of any contractu other arrangements (including of documents, where available) en to

cctua

into, or planned for the provisie (2)

services.

a

Da

rce

(10) The schedule of fees and/or ments and schedule of discounts services provided by the project. (11) If the applicant provides serve to populations other than migra and seasonal agricultural workers

ailies, identification of such

ns.

inds granted under this part and El funds required to be expended by

as a condition of any such grant e used to provide services to indi10 are not migratory or seasonal al workers or members of the famCh workers.

idence that all applicable reits for review and/or approval plication under title XV of the been met.

1 assurance that the project conducted in accordance with licable requirements of this

application must be executed dividual authorized to act for icant and to assume on behalf applicant the obligations imy the statute, the applicable ons of this part, and any addionditions of the grant.

Public Health Service Act, 58 Stat. at. 631 (42 U.S.C. 216); sec. 329, Pubh Service Act, 95 Stat. 569 (42 U.S.C.

406, Nov. 25, 1977, as amended at 48 June 24, 1983; 48 FR 45559, Oct. 6,

Accord with health planning. nt may be made under this part the applicable requirements of V of the Act relating to review proval by the appropriate health ng agencies have been met.

Amount of grant.

he amount of any award under art will be determined by the ary on the basis of his estimate sum necessary for a designated n of direct project costs plus an onal amount for indirect costs, if which will be calculated by the cary either:

On the basis of the estimate of the indirect costs reasonably relatthe project; or

On the basis of a percentage of all, portion of, the estimated direct of the project when there are reale assurances that the use of such ntage will not exceed the approxiactual indirect costs. Such award include an estimated provisional int for indirect costs or for des

ignated direct costs (such as fringe benefit rates) subject to upward (within the limits of available funds) as well as downward adjustments to actual costs when the amount properly expended by the grantee for provisional items has been determined by the Secretary: Provided, however, That no grant shall be made for an amount in excess of the total costs found necessary by the Secretary to carry out the project.

(i) In determining the percentage of project costs to be borne by the grantee, factors which the Secretary will take into consideration will include the following:

(A) The ability of the grantee to finance its share of project costs from non-Federal sources;

(B) The need in the area served by the project for the services to be provided; and

(C) The extent to which the project will provide services in an innovative manner which the Secretary desires to stimulate in the interest of developing more effective health service delivery systems on a regional or national basis.

(ii) At any time after approval of an application under this part, the Secretary may retroactively agree to a percentage of project costs to be borne by the grantee lower than that determined pursuant to paragraph (a)(2)(i) of this section where he finds that changed circumstances justify a smaller contribution.

(iii) In determining the grantee's share of project costs, costs borne by Federal grant funds, or costs used to match other Federal grants, may not be included except as otherwise provided by law or regulations.

(b) All grant awards shall be in writing, and shall set forth the amount of funds granted and the period for which support is recommended.

(c) Neither the approval of any project nor any grant award, shall commit or obligate the United States in any way to make any addit, supplemental, continuation, o with respect to any appr portion thereof. For con port, grantees must mak plication.

§ 56.107 Priorities for grants.

(a) Grants under sections 319(c) (1)(A), 319(d)(1)(A), 319(d)(1)(B) of the Act and subparts B, C, and D of this part shall be made in accordance with the following priorities:

(1) Highest priority will be given to approvable applications which propose to serve catchment areas in which 6,000 or more migratory agricultural workers and members of their families reside for more than two months in the calendar year.

(2) Second priority will be given to approvable applications which propose to serve catchment areas in which fewer than 6,000 but more than 1,000 migratory agricultural workers and members of their families reside for more than two months in the applicable calendar year.

(3) Third priority will be given to approvable applications which propose to serve catchment areas in which migratory agricultural workers and members of their families reside but in which fewer than 1,000 such persons reside for more than two months in the applicable calendar year.

(4) Fourth priority will be given to approvable applications which propose to serve catchment areas in which migratory agricultural workers and members of their families reside in the applicable calendar year but in which no such persons reside for more than two months in such year.

(5) Fifth priority will be given to approvable applications which propose to serve catchment areas in which no migratory agricultural workers or members of their families reside for any period in the applicable calendar year but in which 6,000 or more seasonal agricultural workers and the members of their families reside.

(6) Lowest priority will be given to approvable applications which propose to serve catchment areas in which no migratory agricultural workers or members of their families reside for any period in the applicable calendar year and in which fewer than 6,000 seasonal agricultural workers and the members of their families reside.

(b) Grants under sections 319(c) (1)(B) and 319(d)(1)(C) of the Act and subparts E and F of this part will be made in accordance with priorities set forth in

(a) Any funds granted purs subpa this part, as well as other fun (ii) used in performance of the col project, may be expended sand co carrying out the approved (ii) accordance with section 319 of clu the applicable regulations of that t the terms and conditions of the and the applicable cost prince scribed in subpart Q of 45 CFmer (b) Project funds awarded and (7) part may be used for, but nee limited to, the following:

(1) The costs of acquiring ernizing existing buildings the costs of amortizing the of, and paying interest on, only in accordance with sul this part and as approved in award;

(2) The costs of obtaining assistance to develop and im

tion:

(6)

and

proje

men

and und

trai mar

heal

vide the

part

management or service capa (c the project but only as approv revi Secretary;

Big

ure

(3) To reimburse members grantee's governing board est pursuant to §56.304 of subpart C visory council established purs 56. § 56.603(q) of subpart F, if any, sonable expenses actually inc reason of their participation it tivities of such board or council.

(4) To reimburse such g board or advisory council membe are individuals eligible to be ser the project for wages lost by re participation in the activities board or council;

ame

ra

8

(5) The cost of delivering healt ices to migratory agricultural seasonal agricultural workers members of their families with project's catchment area, witht following limitations: grant funde

be used to pay the ful services to such in lies with annual i those set forth in "CSA Income Pove

30.2) issued by the Community 3 Administration, and to pay tion of the cost of services pro1 accordance with the schedule unts which, under such schedncompensated; Provided, That arges will be made to such indiand families in accordance with of subpart C or $56.603(e) of F, as applicable;

easonable effort shall be made ct such charges under a billing ections system; and

The charge to grant funds shall

any amounts collected pursuNa paragraph (b)(5)(ii) of this sec

Che cost of insurance for medical ncy and out-of-area coverage; Che cost of providing to the staff verning board, if any, of the training related to the manageof an ambulatory care facility,

the staff of a project funded subpart C, D, or F of this part, g related to the provision of prisupplemental and environmental services provided or to be proby the project, consistent with licable requirements of 45 CFR

rior approval by the Secretary of rns of the budget and project plan aired whenever there is to be a cant change in the scope or na* project activities.

Grant payments.

Secretary shall from time to nake payments to a grantee of all Portion of any grant award, either ance or by way of reimbursement Spenses incurred or to be incurred,

extent he determines such paynecessary to promote prompt tion and advancement of the ap1 project.

5.0 Nondiscrimination.

Attention is called to the requireof title VI of the Civil Rights f 1964 (78 Stat. 252, 42 U.S.C. 2000d .) and in particular section m Act which provides the

he United States ids of race, color, or e excluded from pai enied the benefits c

jected to discrimination under any program or activity receiving Federal financial assistance. A regulation implementing such title VI, which applies to grants made under this part, has been issued by the Secretary of Health and Human Services with the approval of the President (45 CFR part 80). In addition, no person shall, on the grounds of age, sex, creed, or marital status (unless otherwise medically indicated), be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity so receiving Federal financial assistance.

(b) Attention is called to the requirements of section 504 of the Rehabilitation Act of 1973, as amended, which provides that no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.

§ 56.111 Confidentiality.

All information as to personal facts and circumstances obtained by the project staff about recipients of services shall be held confidential and shall not be divulged without the individual's consent except as may be required by law or as may be necessary to provide service to the individual or to provide for medical audits by the Secretary or his designee with appropriate safeguards for confidentiality of patient records. Otherwise, information may be disclosed only in summary, statistical, or other form which does not identify particular individuals.

§ 56.112 Publications and copyright.

Except as may otherwise be provided under the terms and conditions of the award, the grantee may copyright without prior approval any publications, films, or similar materials developed or resulting from a project supported by a grant under this part, subject, however, to a royalty-free, nonexclusive, and irrevocable license or ht in e Government to reproduce, slagrublish, use, disseminate, such materials and to to do so.

$56.113 Grantee accountability.

(a) Accounting for grant award payments. All payments made by the Secretary shall be recorded by the grantee in accounting records separate from the records of all other funds, including funds derived from other grant awards. With respect to each approved project, the grantee shall account for the sum total of all amounts paid as well as other funds and in-kind contributions by presenting or otherwise making available evidence satisfactory to the Secretary of expenditures for direct and indirect costs meeting the requirements of this part: Provided, however, That when the amount awarded for in

direct costs was based on a predetermined fixed-percentage of estimated direct costs, the amount allowed for indirect costs shall be computed on the basis of such predetermined fixed-percentage rates applied to the total, or a selected element thereof, of the reimbursable direct costs incurred.

(b) Accounting for interest earned on grant funds. Pursuant to section 203 of the Intergovernmental Cooperation Act of 1968 (42 U.S.C. 4213), a State will not be held accountable for interest earned on grant funds, pending their disbursement for grant purposes. A State, as defined in section 102 of the Intergovernmental Cooperation Act, means any one of the several States, the District of Columbia, Puerto Rico, any territory or possession of the United States, or any agency or instrumentality of a State, but does not include the government of the political subdivisions of the State. All grantees

other than a State, as so defined, must return all interest earned on grant funds to the Federal Government.

(c) Grant closeout-(1) Date of final accounting. A grantee shall render, with respect to each approved project, a full account, as provided herein, as of the date of the termination of grant support. The Secretary may require other special and periodic accounting.

(2) Final settlement. There shall be payable to the Federal Government as final settlement with respect to each approved project, the sum of:

(1) Any amount not accounted for pursuant to paragraph (a) of this section;