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migrant health programs), or subpart agricultural workers and their bei G (relating to grants for technical as- in such area, including approp: 10p sistance), as applicable. In addition, tios of primary care physicians

NO applications must include:

eral or family practice, interna (1) A statement of specific, measur- cine, pediatrics, or obstetrics a. be able objectives and the methods to be cology, to such population; used to assess the achievement of the (11) Health indices for sad id objectives in specified time periods and lation, such as infant mortality at least on an annual basis.

(iii) Economic factors affectes de (2) The precise boundaries of the population's use of health catchment area to be served by the ap such as percentage of such popul plicant. In addition, the application with incomes below the povert 1 shall include information sufficient to (iv) Demographic factors to enable the Secretary to determine that such population's need and dec the applicant's catchment area meets health services, such as perce=1 the following criteria:

such population age 65 and over (1) The size of such area is such that (v) Special factors of access 5K the services to be provided by the ap- from the conditions of employee plicant are available and accessible to such workers (including working the residents of the area promptly and housing, and sanitation). as appropriate;

(5) Position descriptions for y (ii) The boundaries of such area con- nel who will be utilized in casa form, to the extent practicable, to rel- the activities of the projecte evant boundaries of political subdivi- statement indicating the Deti sions, school districts, and areas served positions to be supported by Federal and State health and social funds to accomplish the objetos

21 service programs; and

the project. (iii) The boundaries of such area (6) Letters and other forms eliminate, to the extent possible, bar- dence showing that efforts bi* 142 riers resulting from the area's physical made to secure financial and PR characteristics, its residential pat- sional assistance and support * terns, its economic and social project within the proposed can groupings, and available transpor- area and the continuing involve tation.

the community in the developire (3)(i) The number of migratory agri- operation of the project. cultural workers and members of their (7) An assurance that an indere families, and seasonal agricultural certified public accountant will workers and members of their families gaged to certify that the projec which resided in the project's tem for the management and Co catchment area in the most recent cal- its finances will be in accor endar year for which statistical data sound financial management pra acceptable to the Secretary is avail- including applicable Federa] 14 able; and

ments. (ii) The approximate period or peri- (8) A list of all services propos ods of residence of all groups of migra- be provided by the project. tory agricultural workers and their (9) A list of services which are families counted under paragraph provided directly by the (b)(3)(i) of this section.

through its own staff and resources (4) The results of an assessment of a description of any contractu the need that the population to be other arrangements (including served has for the services to be pro- of documents, where available) este vided by the project (or in the case of into, or planned for the proviso: 12 applications for planning and develop services. ment projects, the methods to be used (10) The schedule of fees and/or at in assessing such need), taking into ments and schedule of discOUDES consideration the following factors: services provided by the project.

(1) Available health resources in rela- (11) If the applicant provides ser tion to size of the catchment area and to populations other than migran population of migratory and seasonal and seasonal agricultural workers

zilies, identification of such ignated direct costs (such as fringe as.

benefit rates) subject to upward (withCuads granted under this part and

in the limits of available funds) as well sul funds required to be expended by

as downward adjustments to actual s as a condition of any such grant costs when the amount properly ex

e used to provide services to indi- pended by the grantee for provisional 20 are not migratory or seasonal items has been determined by the Secal workers or members of the fam

retary: Provided, however, That no h workers.

grant shall be made for an amount in idence that all applicable re- excess of the total costs found necits for review and/or approval essary by the Secretary to carry out plication under title XV of the the project. been met.

(i) In determining the percentage of i assurance that the project

project costs to be borne by the grantconducted in accordance with

ee, factors which the Secretary will licable requirements of this

take into consideration will include

the following: > application must be executed

(A) The ability of the grantee to flndividual authorized to act for

nance its share of project costs from Sicant and to assume on behalf

non-Federal sources; applicant the obligations im

(B) The need in the area served by y the statute, the applicable *ons of this part, and any addi

the project for the services to be pro-**-onditions of the grant.

vided; and

(C) The extent to which the project Public Health Service Act, 58 Stat.

will provide services in an innovative at. 631 (42 U.S.C. 216); sec. 329, Pubh Service Act, 95 Stat. 569 (42 U.S.C.

manner which the Secretary desires to stimulate in the interest of developing

more effective health service delivery 406, Nov. 25, 1977, as amended at 48

systems on a regional or national June 24, 1983; 48 FR 45559, Oct. 6,


(ii) At any time after approval of an Accord with health planning. application under this part, the Secnt may be made under this part

retary may retroactively agree to a the applicable requirements of

percentage of project costs to be borne V of the Act relating to review

by the grantee lower than that deterproval by the appropriate health

mined pursuant to paragraph (a)(2)(i) of ig agencies have been met.

this section where he finds that

changed circumstances justify a smallAmount of grant.

er contribution. She amount of any award under

(iii) In determining the grantee's art will be determined by the

share of project costs, costs borne by ary on the basis of his estimate Federal grant funds, or costs used to sum necessary for a designated

match other Federal grants, may not n of direct project costs plus an

be included except as otherwise probe prekonal amount for indirect costs, if

vided by law or regulations. Tices Nhich will be calculated by the (b) All grant awards shall be in writely ary either:

ing, and shall set forth the amount of Pare

On the basis of the estimate of the funds granted and the period for which 2015 | indirect costs reasonably relat- support is recommended. the project; or

(c) Neither the approval of any projOn the basis of a percentage of all, ect nor any grant award, shall commit For the portion of, the estimated direct or obligate the United States in any

of the project when there are rea- way to make any addit, supplepo le assurances that the use of such mental, continuation,

award die di antage will not exceed the approxi- with respect to any appr dect or

actual indirect costs. Such award portion thereof. For con on sup include an estimated provisional port, grantees must mak

e apter the int for indirect costs or for des.. plication.

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hea vide

856.107 Priorities for grants.

paragraphs (a)(2) through (a) CFF (a) Grants under sections 319(c) section, in the order set forth Ser (1)(A), 319(d)(1)(A), 319(d)(1)(B) of the

(c) For the purposes of this the Act and subparts B, C, and D of this

the applicable calendar year vi vide part shall be made in accordance with

calendar year for which data of the following priorities:

vided in accordance with $56.10 ale

( (1) Highest priority will be given to

this subpart. approvable applications which propose to serve catchment areas in which 6,000

856.108 Use of grant funds. or more migratory agricultural work

(a) Any funds granted purs sul ers and members of their families re- this part, as well as other fun ! side for more than two months in the used in performance of the calendar year.

project, may be expended and (2) Second priority will be given to carrying out the approved It ( approvable applications which propose accordance with section 319 40 to serve catchment areas in which the applicable regulations of the fewer than 6,000 but more than 1,000 mi- the terms and conditions of the gratory agricultural workers and mem- and the applicable cost primo bers of their families reside for more scribed in subpart Q of 45 Chem than two months in the applicable cal- (b) Project funds awarded endar year.

part may be used for, but de

an (3) Third priority will be given to ap- limited to, the following:

pro provable applications which propose to (1) The costs of acquiring serve catchment areas in which migra- ernizing existing buildings tory agricultural workers and members the costs of amortizing the of their families reside but in which of, and paying interest on, fewer than 1,000 such persons reside for only in accordance with sul more than two months in the applica- this part and as approved is ble calendar year.

award; (4) Fourth priority will be given to (2) The costs of obtaining

the approvable applications which propose assistance to develop and in to serve catchment areas in which mi- management or service cape part gratory agricultural workers and mem- the project but only as approved

Tev! bers of their families reside in the ap Secretary; plicable calendar year but in which no (3) To reimburse members such persons reside for more than two grantee's governing board esta months in such year.

pursuant to $56.304 of subpart cture (5) Fifth priority will be given to ap- visory council established purs 56,1 provable applications which propose to $56.603(g) of subpart F, if any,

The serve catchment areas in which no mi- sonable expenses actually inct gratory agricultural workers or mem- reason of their participation is bers of their families reside for any pe- tivities of such board or council riod in the applicable calendar year but (4) To reimburse such goes in which 6,000 or more seasonal agricul- board or advisory council member of

I ti tural workers and the members of their are individuals eligible to be ser

ben families reside.

the project for wages lost by thi (6) Lowest priority will be given to participation in the activities approvable applications which propose board or council; to serve catchment areas in which no (5) The cost of delivering health migratory agricultural workers ices to migratory agricultural members of their families reside for seasonal agricultural workers ) any period in the applicable calendar members of their families with its year and in which fewer than 6,000 sea- project's catchment area, with of sonal agricultural workers and the following limitations: members of their families reside.

be used to pay the (b) Grants under sections 319(C) (1)(B) services to such in and 319(d)(1)(C) of the Act and subparts lies with annual E and F of this part will be made in ac- those set forth cordance with priorities set forth in CSA Income Povi


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30.2) issued by the Community jected to discrimination under any pro3 Administration, and to pay gram or activity receiving Federal fision of the cost of services pro- nancial assistance. A regulation implei accordance with the schedule menting such title VI, which applies to unts which, under such sched- grants made under this part, has been ncompensated; Provided, That issued by the Secretary of Health and arges will be made to such indi- Human Services with the approval of

and families in accordance with the President (45 CFR part 80). In addiup of subpart C or $56.603(e) of tion, no person shall, on the grounds of F, as applicable;

age, sex, creed, or marital status (uneasonable effort shall be made less otherwise medically indicated), be ct such charges under a billing excluded from participation in, be deections system; and

nied the benefits of, or be subjected to the charge to grant funds shall discrimination under any program or

any amounts collected pursu- activity so receiving Federal financial paragraph (b)(5)(11) of this sec- assistance.

(b) Attention is called to the requiree le cost of insurance for medical ments of section 504 of the Rehabilitancy and out-of-area coverage; tion Act of 1973, as amended, which

provides that no otherwise qualified Eine cost of providing to the staff handicapped individual in the United

verning board, if any, of the States shall, solely by reason of his

training related to the manage- handicap, be excluded from participaninf an ambulatory care facility, tion in, be denied the benefits of, or be

the staff of a project funded subjected to discrimination under any das subpart C, D, or F of this part, program or activity receiving Federal

128 related to the provision of pri- financial assistance. ecosant supplemental and environmental dus u services provided or to be pro

$56.111 Confidentiality. sy the project, consistent with All information as to personal facts est ulicable requirements of 45 CFR and circumstances obtained by the

project staff about recipients of servor serior approval by the Secretary of ices shall be held confidential and shall et anis ns of the budget and project plan not be divulged without the individ

uired whenever there is to be a ual's consent except as may be required but cant change in the scope or na- by law or as may be necessary to proeis project activities.

vide service to the individual or to pro

vide for medical audits by the SecGrant payments.

retary or his designee with appropriate bPart? Secretary shall from time to safeguards for confidentiality of pases scanake payments to a grantee of all tient records. Otherwise, information partidortion of any grant award, either may be disclosed only in summary, staboard is ance or by way of reimbursement tistical, or other form which does not burse penses incurred or to be incurred, identify particular individuals. eligible necessary to promote prompt I CODIC, extent he determines such pay

856.112 Publications and copyright. Suges tion and advancement of the ap

Except as may otherwise be provided the project.

under the terms and conditions of the award, the grantee may copyright

without prior approval any publicadelírero. Nondiscrimination.

astic Attention is called to the require- tions, films, or similar materials develal Foz of title VI of the Civil Rights oped or resulting from a project sup

f 1964 (78 Stat. 252, 42 U.S.C. 20000 ported by a grant under this part, subent art.) and in particular section

ject, however, to a royalty-free, nonAct which provides th.

exclusive and irrevocable license or Me United States $

rht in Government to reproduce, ids of race, color, or

blish, use, disseminate, e excluded from par

such materials, and to the nied the benefits o

to do so.


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$ 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 indirect 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;

(ii) Any credits for earded this pursuant to paragraph (b) of scie: tion;

(iii) Any other amounts due tra to subparts F, M, and 0 of 6 me 74.

15 Such total sum shall constituz owed by the grantee to the Government and shall be from the grantee or its sacs assignees by setoff or other provided by law. $56.114 Applicability of 450

74. The provisions of 45 CFR DE tablishing uniform administi quirements and cost principa apply to all grants under this States and local governmezi terms are defined in subpart ye part 74. The relevant provis following subparts of part 1

of apply to grants to all other by ganizations under this part: se 45 CFR PART 74


De Subpart

fac A General.

(c B Cash depositories. C Bonding and insurance. D Retention and custodial requ- the

records. F Grant-related income. G Matching and cost sharing.

ter K Grant payment requirements tha L Budget revision procedures.

der M Grant closeout, suspension. L nation.

(d O Property. Q Cost principles. Subpart B-Grants for pande

and Developing

Health Centers $ 56.201 Applicability. addition to the regulations of

The regulations of this sutz alat A of this part, are applicable to awarded pursuant 319(c)(1)(A) of the Act for proja le, planning and developing health centers in high impact $56.202 Application.

10po: To be approved by the under this subpart, an applicatch grant must, in addition to mee requirements of $56.104 of subpe"

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