The American Rescue Plan Act Emergency Rural Health Care Grant Program, 44332-44344 [2021-17199]

Agencies

• DEPARTMENT OF AGRICULTURE
• Rural Housing Service

[Federal Register Volume 86, Number 153 (Thursday, August 12, 2021)]
[Notices]
[Pages 44332-44344]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-17199]


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DEPARTMENT OF AGRICULTURE

Rural Housing Service

[Docket No. RHS-21-CF-0009]


The American Rescue Plan Act Emergency Rural Health Care Grant 
Program

AGENCY: Rural Housing Service, Department of Agriculture (USDA).

ACTION: Notice of Funds Availability (NOFA).

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SUMMARY: The Rural Housing Service (RHS), a Rural Development agency of 
the United States Department of Agriculture (USDA), announces the 
availability of up to $500 million in grant funding, appropriated under 
the American Rescue Plan Act of 2021, for the establishment of the 
Emergency Rural Health Care (ERHC) Grant Program. As authorized under 
Section 1002 of the American Rescue Plan Act of 2021, funds will be 
made available and distributed between two tracks of funding to 
eligible applicants: Track One, Recovery grants to offer support for 
rural health care services in the form of immediate relief to address 
the economic conditions arising from the COVID-19 emergency; and Track 
Two, Impact grants to offer longer-term funding to advance ideas and 
solutions to support long-term sustainability of rural health.

DATES: Applications for the ERHC Grant Program must be submitted to the 
applicable USDA Rural Development

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Office (See ADDRESSES section for details). Track One, Recovery 
applications will be accepted on a continual basis, beginning on the 
publication date of this Notice, until funds are exhausted. The 
applicable USDA Rural Development State Office will conduct an initial 
review, rating, and selection of complete applications received by 4:00 
p.m. local time on October 12, 2021. Subsequent application reviews, 
rankings, and selections will occur in additional rounds for all 
complete applications until all remaining funds are utilized. Track 
Two, Impact applications must be received by the applicable USDA Rural 
Development Office by 4:00 p.m. local time on October 12, 2021. Track 
Two, Impact applications received after October 12, 2021 will not be 
considered.
    Comments related to the collection of information must be submitted 
by October 12, 2021. Please follow the directions provided in Section 
IX of this NOFA.

ADDRESSES: This funding opportunity will be made available for 
informational purposes on Grants.gov.
    Application Submission: Track One, Recovery applications will be 
submitted to a processing office as designated by the USDA Rural 
Development State Office in the state where the applicant's project is 
located. Agency state office contact information is available at 
https://www.rd.usda.gov/about-rd/state-offices. Track Two, Impact 
applications will be submitted to a processing office as designated by 
the USDA Rural Development State Office in the state where the 
applicant is headquartered. For applicants with headquarters located in 
the District of Columbia, applications will be submitted to the USDA 
Rural Development National Office, ATTN: Jamie Davenport, 1400 
Independence Ave., SW, STOP 0787, Washington, DC 20250. Both paper and 
electronic applications must be received by the Agency by the deadlines 
stated in the DATES section of this Notice. The use of a courier and 
package tracking for paper applications is strongly encouraged.

FOR FURTHER INFORMATION CONTACT: Jamie Davenport: USDA Rural 
Development, Community Facilities Program. Telephone: (202) 720-0002, 
email: [email protected]. Persons with disabilities that require 
alternative means for communication should contact the U.S. Department 
of Agriculture (USDA) Target Center at (202) 720-2600 (voice).

SUPPLEMENTARY INFORMATION:

Authority:

    This solicitation is authorized pursuant to the American Rescue 
Plan Act of 2021 (Pub. L. 117-2), 7 CFR part 3570, subpart B; 7 U.S.C. 
8103(f)), Farm Security and Rural Investment Act, 2002; 7 U.S.C. 
1926(a)(13), and the Consolidated Farm and Rural Development Act; 7 
U.S.C. 1926(a)(26).

Rural Development Funding Priorities

    The Agency encourages applicants to consider projects that will 
advance the following key priorities:
    [cir] Assisting rural communities recover economically from the 
impacts of the COVID-19 pandemic, particularly disadvantaged 
communities;
    [cir] Ensuring all rural residents have equitable access to RD 
programs and benefits from RD funded projects; and
    [cir] Reducing climate pollution and increasing resilience to the 
impacts of climate change through economic support to rural 
communities.
    For further information, visit https://www.rd.usda.gov/priority-points.

Congressional Review Act

    Pursuant to Subtitle E of the Small Business Regulatory Enforcement 
Fairness Act of 1996 (also known as the Congressional Review Act or 
CRA), 5 U.S.C. 801 et seq., the Office of Information and Regulatory 
Affairs in the Office of Management and Budget designated this action 
as a major rule as defined by 5 U.S.C. 804(2), (Pub. L. 104-121), 
because it is likely to result in an annual effect on the economy of 
$100,000,000 or more. Accordingly, there is a 60-day delay in the 
effective date of this action. Application rating, ranking, and 
selection will not begin until after October 12, 2021. Therefore, the 
60-day delay required by the CRA is not expected to have a material 
impact upon the administration and/or implementation of the ERHC Grant 
Program.

Background

    USDA's Rural Development Agencies, comprising the Rural Business-
Cooperative Service (RB-CS), Rural Housing Service (RHS), and the Rural 
Utilities Service (RUS), are leading the way in helping rural America 
improve the quality of life and increase the economic opportunities for 
rural people. RHS offers a variety of programs to build or improve 
housing and essential community facilities in rural areas. The Agency 
also offers loans, grants, and loan guarantees for single- and multi-
family housing, child-care centers, fire and police stations, 
hospitals, libraries, nursing homes, schools, first responder vehicles 
and equipment, housing for farm laborers and much more. The Agency also 
provides technical assistance loans and grants in partnership with non-
profit organizations, Indian tribes, state and Federal government 
agencies, and local communities.
    The American Rescue Plan Act of 2021 (ARPA), Public Law 117-2, was 
signed by the President on March 11, 2021. It provides the Rural 
Housing Service Community Facilities (CF) Program up to $500,000,000 in 
grant funding for eligible CF applicants and eligible CF facilities to 
help broaden access to COVID-19 vaccines and testing, health care 
services including telehealth services, food assistance through food 
banks and food distribution facilities, and collaborative, evidence-
based support for the long-term sustainability of rural health care.
    Nearly one in five Americans live in rural areas and depend on 
local hospitals for care. Data shows that between January 2013 and 
February 2020, 101 rural hospitals closed in 28 states. According to 
data from the U.S. Department of Health and Human Services (HHS) and a 
recent study by the U.S. Government Accountability Office (GAO), 
counties with a hospital closure experience an immediate and steady 
decline in availability of health care providers compared to counties 
that do not experience a closure. Rural residents in these counties 
must travel an additional median distance of 20 miles to access health 
care services after a closure. Furthermore, HHS data shows that 
Medicare fee-for-service beneficiaries are less healthy in areas with 
hospital closures compared to their counterparts in service areas 
without closures. In addition, HHS data shows that rural hospitals 
operated under negative margins before closure and hospitals that 
remain open are increasingly showing signs of financial distress.
    The financial stress on rural hospitals and the negative impact on 
rural residents was exacerbated by the COVID-19 pandemic. In 2020 
alone, 20 hospitals closed and as many as 453 more rural hospitals are 
considered highly vulnerable for future closure. It is estimated that 
rural hospitals lost an estimated 70 percent of their income in 2020 
due to delayed and deferred care caused by the pandemic. Rural 
residents are generally older, less healthy, and more reliant on 
government payors than their urban counterparts.
    In designing this ERHC program, USDA determined that the challenges 
facing rural health care are primarily two-fold: immediate financial 
needs stemming from COVID-19 related

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expenses and long-term access and availability of rural health care 
services that have been further hampered as a result of the COVID-19 
pandemic. In response to these challenges, this ERHC Grant Program NOFA 
provides two tracks of funding: Track One for recovery grants to 
support immediate financial relief needs and Track Two for impact 
grants to advance ideas and solutions to support the long-term 
sustainability of rural health care.

Overview

    Federal Agency: Rural Housing Service (RHS), (USDA).
    Funding Opportunity Title: The American Rescue Plan Act Emergency 
Rural Health Care (ERHC) Grant Program.
    Funding Opportunity Number: USDA-RHS-ERHC-2021.
    Announcement Type: Notice of Funds Availability.
    Assistance Listings (AL) Number: 10.766.
    Due Date for Applications: Track One, Recovery applications will be 
accepted on a continual basis and will be evaluated as long as funding 
remains available. Complete applications received by 4:00 p.m. local 
time on October 12, 2021 will be evaluated and ranked according to the 
scoring criteria in this Notice. Applications subsequently received 
and/or deemed complete will be evaluated and ranked as long as funding 
remains available.
    Applications for Track Two, Impact applications must be received by 
4:00 p.m. local time on October 12, 2021. Applications received after 
4:00 p.m. local time on October 12, 2021 will not be considered.
    For further information, visit the Emergency Rural Health Care 
Grant Program web page at https://www.rd.usda.gov/erhc.

Items in Supplementary Information

I. Funding Opportunity Description
II. Federal Award Information
III. Definitions
IV. Eligibility Information
V. Application Submission Information
VI. Application Review Information
VII. Federal Awarding Administration Information
VIII. Federal Awarding Agency Contacts
IX. Other Information

I. Funding Opportunity Description

A. Background

    This NOFA is being issued pursuant to the recently passed American 
Rescue Plan Act of 2021 and is considered to be Economically 
Significant and Major. Funds will be administered in accordance with 
this NOFA and will be distributed between two tracks of funding: Under 
Track One, Recovery grants are designed to provide emergency grant 
funding for eligible CF applicants to help rural hospitals and local 
communities broaden access to COVID-19 vaccines and testing, health 
care services including telehealth services, and food assistance 
through food banks and food distribution facilities in rural areas.
    Track Two, Impact grants are designed to plan for, implement, and 
evaluate models to support the long-term sustainability of rural health 
care. Long-term sustainability is defined as improved health outcomes, 
improved access to quality health care, and creating and maintaining 
health care as a key economic driver of small communities. Details on 
eligible Community Facilities (CF) applicants and eligible CF 
facilities may be found in Section IV. Eligibility Information of this 
Notice.
    Applicants may request assistance for costs for a performance 
period of up to 36 months. Track One, Recovery applicants may 
additionally request pre-award costs incurred on or after March 13, 
2020. Applicants may not request assistance for expenses or losses that 
have been reimbursed from other Federal sources or that other Federal 
sources are obligated to reimburse.
    Rural communities face unique challenges due to the COVID-19 
pandemic that include financial and economic vulnerability. At the same 
time, rural communities have essential community infrastructure needs 
that are essential to promote vaccine administration and distribution, 
conduct COVID-19 testing, provide access to quality health care 
services, and support the needs of food banks and food distribution 
facilities. This program provides critical grant funding to support 
rural communities' health care needs in the face of COVID-19.

B. Program Description

    This program is designed for essential community facilities located 
in rural areas, primarily serving rural areas, and serving populations 
with median household income that is lower than ninety percent of the 
State nonmetropolitan median household income. Within these parameters, 
the Agency is further encouraging investment in distressed communities. 
RD utilizes the Distressed Communities Index, developed by the Economic 
Innovation Group (EIG), which combines seven publicly available metrics 
to assess the economic well-being of communities. For more information 
on EIG's Distressed Communities Index, visit https://eig.org/dci. EIG's 
Distressed Community Map can be found at the following website: https://ruraldevelopment.maps.arcgis.com/apps/webappviewer/?id=06a26a91d074426d944d22715a90311e. As part of its annual 
performance plan and strategic goals and objectives, the Agency tracks 
the percent of RD assistance that goes to distressed communities in its 
loan and grant programs and will do the same for this program.

C. Implementation of the American Rescue Act of 2021 Provisions

    Track One, Recovery grant funds will be allocated to USDA Rural 
Development State Offices. The allocation of funds will be based on an 
adaptation of 7 CFR part 1940, subpart L, Methodology and Formulas for 
Allocation of Loan and Grant Program Funds. USDA Rural Development 
State Offices will have until June 30, 2022 to obligate funds allocated 
to their respective state. After June 30, 2022, unobligated funds may 
be pooled into the USDA Rural Development National Office Reserve to 
fund additional qualified applications based on the evaluation criteria 
specified in this Notice. The Agency intends to provide a minimum 
$350,000,000 to fund eligible facilities under Track One.
    Track Two, Impact grant funds will be held within the USDA Rural 
Development National Office Reserve. The Agency intends to provide up 
to $125,000,000 to fund no more than 15 projects under Track Two. Any 
unobligated funds for Track Two, Impact grants will be made available 
for Track One, Recovery grants.

II. Federal Award Information

A. Assistance Listings (AL) Number: 10.766

    Assistance Listings (AL) Title: American Rescue Plan Act Emergency 
Rural Health Care (ERHC) Grant Program.

B. Available Funds

    The American Rescue Plan Act of 2021 provides $500,000,000 in 
budgetary authority for this program through September 30, 2023. The 
Agency may publish future notices in the Federal Register to align with 
the demand for these grants.

C. Funding Limitations

    The Agency will review and evaluate applications received as set 
forth in this NOFA. The Agency anticipates that demand for grant 
funding may exceed the supply of funds and will assign

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points to each application in accordance with the scoring and selection 
criteria for the applicable funding track outlined in this Notice.

III. Definitions

    The terms and conditions provided in this NOFA are applicable to 
and for purposes of this NOFA only. Unless otherwise provided in the 
award documents, all financial terms not defined herein shall have the 
meaning as defined by Generally Accepted Accounting Principles (GAAP).
    Agency means the Rural Housing Service (RHS), an agency of the U.S. 
Department of Agriculture.
    Consortium means institutions of health care, higher education, 
academic health and research institutes, federally-recognized tribes, 
or economic development entities (inclusive of tribal economic 
development entities), or combination thereof, located in the region 
identified to be served that have experience in addressing these issues 
in the region.
    Eligible Project Costs means only those costs incurred during the 
grant period and eligible pre-award period and that are directly 
related to the use and purposes of the American Rescue Plan Act's 
Emergency Rural Health Care Grant Program.
    GAAP means accounting principles generally accepted in the United 
States of America.
    Poverty line means the level of income for a family of four as 
defined by section 673(2) of the Community Services Block Grant Act (42 
U.S.C. 9902(2)).
    Rural and rural area mean a city, town, or unincorporated area with 
a population of not more than 20,000 inhabitants in accordance with 7 
U.S.C. 1991(a)(13). Population may be adjusted by exclusion of 
individuals incarcerated on a long-term or regional basis and the 
exclusion of the first 1,500 individuals who reside in housing located 
on a military base. The boundaries for unincorporated areas will be 
based on Census Designated Place(s). Population data from the most 
recent decennial census of the United States will be used. For projects 
located on tribal trust land, the population of the tribal trust land, 
based on the most recent decennial census, will be used to determine 
the rural area regardless of whether the tribal trust land is located 
within the boundaries of a city or town.
    Rural Development (RD) means a mission area within USDA which 
includes Rural Housing Service, Rural Utilities Service, and Rural 
Business-Cooperative Service.
    State nonmetropolitan median household income (MHI) means the 
median household income of the State's nonmetropolitan counties and 
portions of metropolitan counties outside of cities, towns, or places 
of 50,000 or more population.

IV. Eligibility Information

A. Applicant Eligibility

    (1) An eligible applicant under this program must be one of the 
types of entities outlined in 7 CFR 3570.61(a):
    (a) Public body, such as a municipality, county, district, 
authority, or other political subdivision of a State. State public 
bodies are not eligible for assistance under this program.
    (b) Nonprofit corporation or association. Applicants, other than 
nonprofit utility applicants, must have significant ties with the local 
rural community. Such ties are necessary to ensure to the greatest 
extent possible that a facility under private control will carry out a 
public purpose and continue to primarily serve rural areas. Nonprofit 
Track Two, Impact applicants must demonstrate a consortium of partners 
that demonstrate significant ties with the local rural community(ies) 
as referenced in paragraph (2) of this section.
    (c) Federally recognized Indian Tribe, including a political 
subdivision of a Tribe, in a rural area.
    (2) In addition to meeting the eligibility requirements of Section 
IV(A)(1) above, Track Two, Impact grant applicants must establish a 
network or consortium of entities for the purposes of this grant. The 
network or consortium shall:
    (a) Be comprised of at least three or more health care provider 
organizations, economic development entities, federally-recognized 
tribes, and/or institutions of higher education, academic health, and 
research institutes (including the applicant organization).
    (b) Be comprised of rural and/or urban nonprofit entities, as long 
as at least 66% (two-thirds) of network members are located in a rural 
area and primarily serve a rural area as defined by this Notice; and
    (c) Identify one lead entity to serve as the primary applicant and 
recipient of the Track Two, Impact grant funds and accountable for 
monitoring and reporting on the project performance and financial 
management of the grant. The lead entity or applicant must be an 
eligible entity described above in Section IV (A) (1), although 
significant ties to the local rural community may be satisfied as long 
as at least 66% (two-thirds) of consortium members are located in a 
rural area and primarily serve a rural area. The lead entity must also 
be legally organized as an incorporated organization or other legal 
entity with legal authority to contract with the Federal Government.

B. Project Location Eligibility

    To be eligible for grant funds under this Notice, the eligible 
facility or project to be financed must be located in a rural area as 
defined in section 343(a)(13)(C) of the Consolidated Farm and Rural 
Development Act (7 U.S.C. 1991(a)(13)) and must primarily serve rural 
residents. The terms ``rural'' and ``rural area'' mean any area other 
than a city, town, or unincorporated area that has a population of 
greater than 20,000 inhabitants. Population may be adjusted by 
exclusion of individuals incarcerated on a long-term or regional basis 
and the exclusion of the first 1,500 individuals who reside in housing 
located on a military base. The boundaries for unincorporated areas in 
determining populations will be based on the Census Designated 
Places(s) (CDP). Data from the most recent decennial census of the 
United States will be used in determining population. For projects 
located on tribal trust land, the population of the tribal trust land, 
based on the most recent decennial census, will be used to determine 
the rural area regardless of whether the tribal trust land is located 
within the boundaries of a city or town.
    Non-public body applicants are not required to be headquartered in 
a rural area. However, applicants must demonstrate how the facility to 
be financed with these grant funds is located in and will primarily 
serve rural areas. For Track Two, Impact grants, the lead applicant 
must demonstrate how the project is for the benefit of facilities 
located in rural areas and which primarily serve rural areas.
    When considering whether a facility primarily serves rural 
residents, the Agency will consider the applicant or facility's normal 
service territory, excluding any temporary expansion of service area 
resulting from the COVID-19 pandemic.

C. Eligible Grant Amounts

    An applicant is limited in the amount of grant funds that can be 
requested to assist a facility, depending on the population to be 
served and the median household income of that population. Facilities 
and projects must demonstrate other sources of funds to fund the 
remaining portion of project costs. In these cases, grant assistance 
will be provided on a graduated scale with smaller communities with the 
lowest

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median household income being eligible for a higher proportion of grant 
funds. Grant funds will be limited to:
    (1) The percentages of eligible project costs as outlined below:
    (a) Up to 75 percent when the proposed project is located in a 
rural community having a population of 5,000 or less and the median 
household income of the population to be served by the proposed 
facility is below the poverty line or 60 percent of the State 
nonmetropolitan median household income, whichever is greater.
    (b) Up to 55 percent when the proposed project is located in a 
rural community having a population of 12,000 or less and the median 
household income of the population to be served by the proposed 
facility is below the poverty line or 70 percent of the State 
nonmetropolitan median household income, whichever is greater.
    (c) Up to 35 percent when the proposed project is located in a 
rural community having a population of 20,000 or less and the median 
household income of the population to be served by the proposed 
facility is below the poverty line or 80 percent of the State 
nonmetropolitan median household income, whichever is greater.
    (d) Up to 15 percent when the proposed project is located in a 
rural community having a population of 20,000 or less and the median 
household income of the population to be served by the proposed 
facility is below the poverty line or 90 percent of the state 
nonmetropolitan median household income, whichever is greater.
    (e) In-kind contributions are not an acceptable source of cost-
sharing funds. Applicants must utilize cash contributions to fund the 
remaining project costs and these funds must be expended for an 
eligible purpose outlined in this Notice.
    (i) If requesting Track One, Recovery funds for lost revenue or 
staffing expenses as defined in paragraphs D.(1)(c) and D.(1)(f) of 
this section, respectively, applicants may utilize the applicable 
percentage of lost revenue or staffing expenses to satisfy the cost-
sharing requirement. For example, an applicant that experienced 
$100,000 in lost revenues associated with a facility located in a rural 
community of less than 5,000 population and a median household income 
of less than 60 percent of the state nonmetropolitan median household 
income is eligible for a maximum project cost of 75 percent. In this 
example, the applicant can request $75,000 for grant funding associated 
with lost revenues and the remaining $25,000 in lost revenues serves as 
the balance of the total project cost.
    (ii) Applicants may not use grant funds received under other Rural 
Development (RD) programs to satisfy cost-sharing or matching 
requirements. Federal and state resources may be acceptable sources to 
the extent it is allowable under the Federal or state program(s).
    (iii) If awarded grant funds under this program, grant funds may 
not be utilized as matching funds for other Federal programs.
    (2) Under Track One, Recovery, the maximum grant assistance allowed 
is $1,000,000. Under Track Two, Impact, the maximum grant assistance 
allowed is $10,000,000.
    (3) Under Track One, Recovery, the minimum grant assistance allowed 
is $25,000. Under Track Two, Impact, the minimum grant assistance is 
$5,000,000.
    (4) Applicants may request and receive assistance under both Track 
One and Track Two awards. Applicants may submit only one application 
for Track Two assistance. Affiliated entities may only participate in a 
single Track Two application.
    (5) Applicants may request assistance for more than one project 
location. An applicant entity with wholly owned affiliated entities or 
subsidiaries may apply on behalf of one or more affiliated entities. An 
Affiliate is an entity controlling or having the power to control 
another entity, or a third party or parties that control or have the 
power to control both entities.
    (6) If it is determined that an applicant is affiliated with 
another entity that has also applied, then the maximum grant award 
applies to all affiliated entities as if they applied as one applicant.

D. Eligible Use of Grant Funds

    Grant funds must be used to support health care and nutritional 
assistance needs in correlation with the COVID-19 pandemic and as 
defined below. Funds may be requested for one or more purposes outlined 
below:
    (1) Track One, Recovery funds must be used to support immediate 
health care needs stemming from the COVID-19 pandemic, to support 
preparedness for a future pandemic event, and/or to increase access to 
quality health care services to improve community health outcomes. To 
be eligible for this program, a project must support the health care 
needs, including access to nutrition assistance through food banks and 
food distribution facilities, for a rural community(ies). Funds 
requested from the categories below may be requested for expenses 
incurred during the grant period and/or the eligible pre-award period 
dating back to March 13, 2020:
    (a) Increase capacity for vaccine distribution, including cold 
storage, vehicle, transportation, and other equipment expenses.
    (b) Provide medical supplies and equipment to increase medical 
surge capacity, including personal protective equipment and laboratory 
equipment.
    (c) Reimburse for health care-related revenue lost during the 
COVID-19 pandemic, including revenue losses incurred prior to the 
awarding of the grant through March 13, 2020. Requests for this 
category must include a certification from a certified public 
accountant (CPA) that the calculation of health care-related lost 
revenue requested is accurate and in alignment with previous years' 
revenue. When calculating lost revenue, CPAs may use budgeted revenues 
if the budget(s) and associated documents covering calendar year 2020 
were established and approved on or before March 13, 2020. To be 
considered an approved budget, the budget must have been ratified, 
certified, or adopted by the applicant's financial executive or 
executive officer as of that date, and the CPA will be required to 
attest that the budget was established and approved on or before March 
13, 2020. The CPA certification must also definitively state that these 
lost revenues have not been reimbursed from other Federal or state 
resources.
    (d) Increase telehealth capabilities, including the purchase of and 
training needed for provider and end-user telehealth equipment, 
telehealth software, telehealth electronic security upgrades, 
electronic health records, data sharing capacity, video and 
teleconference services, and other underlying health care information 
systems.
    (e) Construct or renovate temporary or permanent structures to 
provide health care services, such as vaccine administration, testing, 
and facility modifications. Examples of facilities offering health care 
services include health care clinics, hospitals, medical offices, 
outpatient facilities, mobile health clinics, mental/behavioral health, 
and addiction treatment centers, assisted and skilled living 
facilities, rehabilitation facilities, urgent care, telehealth 
facilities, and wellness centers. Any construction work completed with 
grant funds under this award shall meet the Davis-Bacon Act conditions 
set forth in section 9003(f) of the Farm Security and Rural Investment 
Act of 2002 (7 U.S.C. 8103(f)).
    (f) Support staffing needs for vaccine administration and/or 
testing. Requests

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for this category must include a certification from a certified public 
accountant (CPA) that these staffing expenses have not been reimbursed 
from other Federal or state resources.
    (g) Support facility, equipment, and operating expenses associated 
with food banks and food distribution facilities, including 
transportation, vehicles, food storage, and other equipment. Operating 
expenses are limited to the grant award period and pre-award cost 
period.
    (h) To pay professional service fees and charges, but only when 
such expenses are a necessary part of a facility or project allowable 
under this Notice, are a secondary part of the grant amount requested, 
and when the Agency agrees that the amounts are reasonable and 
customary for the type of facility and--
    (i) The professional service provider is selected through a 
qualifications-based selection process; or
    (ii) The professional service provider is the project architect, 
project engineer, environmental professional, environmental consultant, 
or legal counsel, in which case a competitive qualifications-based 
procurement process is not required.
    (i) To pay for pre-award costs incurred between March 13, 2020 and 
the proposed project start date for any eligible category in paragraph 
D.(1)(a) through (h) of this section. Applicants should note that any 
pre-award activities related to construction or renovation costs must 
still adhere to requirements specified in this Notice, including Davis-
Bacon Act requirements and all Agency environmental requirements as 
specified in 7 CFR part 1970.
    (2) Track Two, Impact funds must be used to support the long-term 
sustainability of rural health care. Long-term sustainability is 
defined as improved health outcomes, improved access to quality health 
care, and creating/maintaining sustainable economic development for 
small communities. Often, health care is the key economic driver for 
small rural communities and the closures of these facilities creates 
negative ripple effects throughout the regional economy. Projects 
funded under Track Two, Impact funds must define how the proposed 
project will contribute to improving rural health care access, rural 
health outcomes, and/or the economic viability of rural health care. 
Track Two, Impact applicants may request and use grant funding for one 
or more of the following activities:
    (a) Establish or scale a regional partnership or consortium of 
community leaders and health care partners to plan, implement, and 
evaluate a model(s) to support solving regional health care problems 
and the long-term sustainability of rural health care. Health care 
networks can be an effective strategy to help small rural health care 
providers align resources, achieve economies of scale and efficiencies, 
share decision-making authority, collaboratively address community 
challenges, and create impactful, innovative solutions as a group 
rather than single providers.
    (b) Establish or scale an evidence-based model and disseminate 
lessons learned for possible replication in other small communities and 
regions.
    (c) Identify a health-related problem within the applicant's 
region, develop and implement a method and solution to overcome the 
problem and conduct a program evaluation to examine health related 
outcomes, long-term sustainability, and replicability. Implementation 
may include construction or other related expenses that adhere to 
requirements specified in this Notice.
    The Agency encourages, but does not require, that applicants 
consider the following high need topical areas: development of 
integrated health care models, reducing facility bypass whether through 
telemedicine or business plan adjustments, telehealth, electronic 
health data sharing, workforce development, transportation, 
paramedicine, obstetrics, behavioral health, farmworker health care, 
cooperative home care, and supporting health care as a small community, 
anchor institution.
    (d) Establish a methodology to calculate summary impact measures or 
an estimated return on investment for the grant funds requested, 
including job creation/retention numbers, and improving quality of 
life.
    (e) Cover the cost of technical assistance to assist with one or 
more aspects of project implementation, project evaluation, data 
sharing, and/or reporting requirements.
    (f) Cover indirect costs in an amount up to a federally negotiated 
indirect cost rate. A copy of the current rate agreement must be 
provided with the application. Applicants without a negotiated indirect 
cost rate, except for those non-Federal entities described in Appendix 
VII to Part 200--States and Local Government and Indian Tribe Indirect 
Cost Proposals, paragraph (D)(1), may use the de minimis rate of 10 
percent of modified total direct costs. Lead applicants may not request 
indirect costs on behalf of any other consortium member.
    (g) Make sub-awards in the form of a grant, cooperative agreement, 
or contract, as appropriate, to other members of the consortium or 
other service providers such as technical assistance providers. If a 
grant or cooperative agreement is awarded, the organization receiving 
the subaward is a subrecipient (see 2 CFR 200.1), and the recipient is 
responsible for complying with all applicable requirements of 2 CFR 
part 200, including provisions for making and monitoring an award. If a 
contract is awarded, the organization receiving the subaward is a 
contractor, and the recipient is responsible for following its written 
procurement procedures and complying with the Federal Acquisition 
Regulation. Both subrecipients and contractors are required to comply 
with all applicable laws and regulations, including performance and 
financial reporting, as described in their award document.
    (h) To pay professional service fees and charges associated with 
the grant
    request if the Agency agrees that the amounts are reasonable and 
customary for the type of facility and
    (i) the professional service provider is selected through a 
qualifications-based selection process; or
    (ii) the professional service provider is the project architect, 
project engineer, appraiser, environmental professional, environmental 
consultant, or legal counsel, in which case a competitive 
qualifications-based procurement process is not required.
    (3) Grant funds must not be used to reimburse for the following 
purposes:
    (a) Expenses or losses that have been reimbursed from any other 
sources or that other sources are obligated to reimburse.
    (b) Expenses related to staffing needs may not exceed an annual 
salary of $100,000, as prorated over the applicable time period. This 
limitation is placed on cash compensation and does not include other 
health care or retirement plan compensation.
    (c) Construction, renovation, purchase, or acquisition costs for 
facilities located in nonrural areas.
    (d) Purchase or acquisition costs for facilities or property.
    (e) Pay for existing indebtedness unrelated to the COVID-19 
pandemic.
    Refinance may be eligible for Track One, Recovery applicants for 
short-term debt incurred for an eligible purpose outlined in paragraph 
D. (1) above.
    (f) With exception for eligible pre-award costs for Track One, 
Recovery
    applicants, paying obligations incurred before the beginning date 
or after the ending date of the grant agreement; and

[[Page 44338]]

    (g) Any purpose prohibited in 2 CFR part 200 or 2 CFR part 400.

V. Application Submission Information

A. Request Application Package

    Entities wishing to apply for assistance may download the 
application documents and requirements outlined in this NOFA from the 
ERHC Grant Program web page: https://www.rd.usda.gov/erhc.
    Track One, Recovery applicants must submit application packages to 
the USDA Rural Development office in their state. Applications will be 
processed by the USDA Rural Development State Office in the state where 
the applicant's project is located. For project activities located in 
more than one state, the applicant's headquarters location will 
determine the applicable USDA Rural Development State Office. Agency 
state office contact information is available at https://www.rd.usda.gov/about-rd/state-offices.
    Track Two, Impact applicants must submit application packages to 
the USDA Rural Development office in the state in which the applicant 
organization is headquartered. If a Track Two applicant is 
headquartered in the District of Columbia, the applicant must submit 
its application package to the USDA Rural Development National Office 
and the application will be processed by the USDA Rural Development 
Maryland/Delaware State Office.

B. Content and Form of Application Submission

    For Track One, Recovery applicants, the applicable USDA Rural 
Development State Office will conduct an initial review, rating, and 
selection of complete applications received by the date established in 
this Notice, according to the selection criteria in this Notice. 
Subsequent application reviews, rankings, and selections will occur for 
all complete applications until funding has been fully utilized. 
Complete applications must contain all parts necessary for the Agency 
to determine applicant and project eligibility, ensure environmental 
and architectural requirements are met, calculate a priority score, and 
rank the application in order to be considered. Track One, Recovery, 
applications deemed incomplete as of the date established in this 
Notice will compete for any remaining funding once the applicant 
submits a complete application. For as long as funding remains 
available, the applicable USDA Rural Development State Office will work 
with Track One, Recovery applicants to reach a complete application 
status.
    For Track Two, Impact applicants, the applicable USDA Rural 
Development State Office will conduct initial eligibility reviews. The 
USDA Rural Development National Office will coordinate application 
reviews, rankings, and selections based on the information received by 
the Agency as of the deadline established in this Notice.
    The application for Track One and Track Two funding must include 
the following:
    (a) A summary page, double-spaced between items, listing the 
following (this information should not be presented in narrative form):
    (1) Track of funding requested: Track One, Recovery or Track Two, 
Impact;
    (2) Applicant's name;
    (3) Amount of grant request, and
    (4) Project description, no more than three sentences summarizing 
applicant entity, location of assistance, and purpose and use of the 
grant funds.
    (b) A detailed Table of Contents containing page numbers for each 
component of the application.
    (c) One executed complete application. This includes the SF-424 
``Application for Federal Assistance,'' and SF-424A ``Budget 
Information--Non-Construction Programs'' or SF-424C ``Budget 
Information--Construction Programs.''
    (d) Organizational documents that demonstrate the applicant is an 
eligible entity as described in Section IV. Eligibility Information. 
Nonprofits must provide articles of organization, incorporation, or 
association; by-laws; evidence of good standing; and evidence of ties 
to the local rural community. Ties to the local rural community may be 
demonstrated through: (1) Close association with, or controlled by a 
local unit of government; (2) Broad-based ownership and control by 
members of the community, as demonstrated through a listing and 
description of board members; and/or (3) Substantial public funding as 
demonstrated through pledged taxes, local government sources, or 
community-wide fundraising campaign.
    (e) Evidence of eligibility. Applicants must submit sufficient 
documentation to demonstrate how the health care facility(ies) or 
project to be funded through this grant primarily serves rural areas, 
is located in a rural area, and serves a population with a median 
household income below the poverty line or applicable percentage 
defined in this Notice. This submission must describe the proposed 
facility or project and its service area, including:
    (1) Location of facility, including population demographics of that 
location.
    (2) Description of area and number and demographics (if known) of 
populations to be served, sufficiently detailed to verify Project 
Location Eligibility as outlined in Section IV. Eligibility Information 
of this Notice; and
    (3) Evidence that the facility or project will primarily serve 
rural residents.
    (f) A written budget narrative providing a detailed project budget, 
which also includes the following information:
    (1) The amount of funds requested from each Eligible Use of Grant 
category, with a description of how the figure was calculated.
    (2) A breakdown of project cost demonstrating the percentage of 
total project costs that this grant assistance will cover. This grant 
will cover a portion of total project costs as outlined in this Notice, 
and dependent on population and median household income.
    (3) The time period for which this assistance is requested. All 
awards are limited to up to a 36-month grant period based upon the 
complexity of the project. In limited circumstances and only with prior 
Agency approval, the Agency may grant a no cost extension to the grant 
period. Under no circumstance shall the grant period extend beyond five 
full fiscal years past the award date.
    For planning purposes, applicants should assume that the proposed 
grant period will begin no earlier than November 1, 2021 and should end 
no later than 36 months following that date. Eligible pre-award costs 
may be requested for costs incurred between March 13, 2020, and the 
project start date. If you receive an award, your grant period will be 
revised to begin on the actual date of award--the date the grant 
agreement is executed by the Agency--and your grant period end date 
will be adjusted accordingly.
    (g) Environmental information necessary to support the Agency's 
environmental finding. Required information can be found in 7 CFR part 
1970.
    (h) For projects involving construction, a preliminary 
architectural feasibility report or engineering documentation, 
completed in accordance with Agency guidelines in RD Instruction 1942-
A, Guide 6.
    (i) Description and certification of applicant's cost share 
sources. For Track One, Recovery applicants seeking funds for lost 
health care-related revenue or staffing associated with COVID-19 
vaccines and/or testing, the applicant's

[[Page 44339]]

required cost share can be the applicable percentage of lost health 
care revenue and actual staffing expenses.
    (j) Three years of the most recent audits or financial statements, 
including a current balance sheet and income and expense statement. If 
audits are not available, applicants may provide this information on 
Forms RD 442-7, ``Operating Budget,'' including projected cash flow; RD 
442-2, ``Statement of Budget, Income and Equity,'' and RD 442-3 
``Balance Sheet.''
    (k) Intergovernmental Review comments, if applicable, from the 
local planning district commission.
    (l) Certification of Non-Lobbying Activities.
    (m) Standard Form LLL, ``Disclosure of Lobbying Activities,'' if 
applicable.
    (n) Certification regarding any known relationship or association 
with an Agency employee in accordance with 7 CFR part 1900, subpart D.
    (o) For applicants requesting funds under Track One, Recovery, a 
written narrative that includes:
    (1) Description of how the assistance requested will broaden access 
to COVID-19 vaccines, COVID-19 testing, health care services and/or 
food bank or food distribution assistance in rural communities.
    (2) If requesting funds for lost health care revenue or for 
staffing needs, a CPA issued certification stating that:
    (a) No funds requested have been reimbursed from other Federal or 
state sources.
    (b) No funds requested are obligated to be reimbursed from other 
Federal or state sources; and
    (c) Funds requested are reasonable, appropriate, and align with 
actual or anticipated costs and/or lost revenues during the grant 
period.
    (q) For applicants requesting funds under Track Two, Impact, 
provide a written narrative that addresses the following:
(1) Organizational Capacity and Strength of Consortium
    (a) Evidence of an agreement formalizing a consortium for purposes 
of this grant funding. The agreement must address the negotiated 
arrangements for administering the grant funding to meet an applicant's 
project goals and the roles and responsibilities of each consortium 
member to comply with the administrative, financial, and reporting 
requirements of the grant and all other applicable Federal regulations 
and policies. This agreement must be signed by an authorized 
representative of the lead entity applicant and an authorized 
representative of each partnering consortium entity.
    (b) Describe the actual composition of the consortium members and 
how each member is appropriate and needed to successfully accomplish 
project activities.
    (c) Describe the abilities and contributions of the lead applicant 
organization and other consortium members. Provide a brief overview 
such as each organization's current mission, scope of current 
activities, demonstrated experience serving rural populations, key 
personnel to manage the award project, and access to financial 
practices and systems to ensure that Federal funds can be properly 
accounted for and managed.
    (d) Evidence and description of how the consortium will maintain 
ties to the local rural community(ies). If the lead applicant is 
located in an urban area, describe the geographical relationship to the 
proposed rural service population, and plans to ensure that rural 
populations are served. Urban applicants must describe how they will 
ensure a high degree of local rural control in the project. At least 
66% (two-thirds) of consortium members must be located in a rural area 
and primarily serve a rural area as defined by this Notice.
    (e) Describe how the consortium will impact rural community(ies) 
and providers, and how the network will strengthen its relationship 
with the community and region it serves.
    (f) Identify the project director for the award (or strategy for 
hiring), along with key activities and approximate percentage of time 
to be devoted to this project.
(2) Workplan and Proposed Budget
    (a) Provide a project work plan that clearly illustrates the 
consortium's goals, strategies, activities, and measurable outcomes 
proposed during the entire period of performance. The work plan must 
identify the individual or organization responsible for carrying out 
each activity, include a timeline for the period of performance, and 
illustrate its relation to the COVID-19 pandemic.
    (b) Provide a complete, consistent, and detailed budget 
presentation for up to a three-year period of performance through the 
submission of the SF-424A budget form and a Budget Narrative that 
justifies the appropriateness of the requested funds. The budget should 
be reasonable in relation to the objectives, the complexity of the 
activities, and the anticipated results. The budget narrative should 
logically and clearly document how and why each line item request (such 
as personnel, travel, equipment, contractual service, etc.) supports 
the goals and activities of the proposed award-funded activities.
(3) Evaluation, Impact, and Replicability
    (a) Describe how the proposed progress toward meeting program goals 
contributes to the long-term sustainability of rural health care by 
improving rural health care access, improving rural health outcomes, 
and sustaining health care as an economic driver for the rural 
community or region.
    (b) Describe how progress toward meeting program goals and 
determination of a return on investment will be tracked, measured, and 
evaluated. How will this assessment contribute to the consortium's 
quality improvement efforts and sustainability beyond the period of 
Federal funding?
    (c) Explain a process for evaluating how the consortium's resources 
will be leveraged and utilized to increase access to health care 
services, improve rural health outcomes, and/or support health care as 
a key economic driver for small communities. Include a discussion 
regarding the consortium's plan for any necessary data collection 
efforts amongst members of the consortium, as well as any plans to 
solicit or provide technical assistance to support these efforts.
    (d) Identify factors and strategies that will lead to project 
viability, sustainability of the consortium's activities after Federal 
funding ends, and establishment of an evidence-based model for 
dissemination of lessons learned for future replication.

C. Dun and Bradstreet Data Universal Numbering System (DUNS) for Award 
Management (SAM)

    Grant applicants must obtain a Dun and Bradstreet Data Universal 
Numbering System (DUNS) number and register in the System for Award 
Management (SAM) prior to submitting an application pursuant to 2 CFR 
25.200(b). In addition, an entity applicant must maintain registration 
in SAM at all times during which it has an active Federal award or an 
application or plan under consideration by the Agency. The applicant 
must ensure that the information in the database is current, accurate, 
and complete. Applicants must ensure they complete the Financial 
Assistance General Certifications and Representations in SAM. 
Similarly, all recipients of Federal financial assistance are required 
to report information about first-tier subawards and executive 
compensation in accordance to 2 CFR part 170. So long as an entity 
applicant does not have an

[[Page 44340]]

exception under 2 CFR 170.110(b), the applicant must have the necessary 
processes and systems in place to comply with the reporting 
requirements should the applicant receive funding. See 2 CFR 
170.200(b).
    An applicant, unless excepted under 2 CFR 25.110(b), (c), or (d), 
is required to:
    (a) Be registered in SAM before submitting its application;
    (b) Provide a valid DUNS number in its application; and
    (c) Continue to maintain an active SAM registration with current 
information at all times during which it has an active Federal award or 
an application or plan under consideration by a Federal awarding 
agency.
    The Federal awarding agency may not make a federal award to an 
applicant until the applicant has complied with all applicable DUNS and 
SAM requirements and, if an applicant has not fully complied with the 
requirements by the time the Federal awarding agency is ready to make a 
Federal award, the Federal awarding agency may determine that the 
applicant is not qualified to receive a Federal award and use that 
determination as a basis for making a Federal award to another 
applicant.
    As required by the Office of Management and Budget (OMB), all grant 
applications must provide a DUNS number when applying for Federal 
grants, on or after October 1, 2003. Organizations can receive a DUNS 
number at no cost by calling the dedicated toll-free number at 1-866-
705-5711 or via internet at https://fedgov.dnb.com/webform. Additional 
information concerning this requirement can be obtained on the 
Grants.gov website at https://www.grants.gov. Similarly, applicants may 
register for SAM at https://www.sam.gov or by calling 1-866-606-8220.
    The applicant must provide documentation that they are registered 
in SAM and their DUNS number. If the applicant does not provide 
documentation that they are registered in SAM and their DUNS number, 
the application will not be considered for funding.
    You no longer must complete the following forms for acceptance of a 
federal award. This information is now collected through your 
registration or annual recertification in SAM.gov in the Financial 
Assistance General Certifications and Representations section:
     Form AD-1047, ``Certification Regarding Debarment, 
Suspension, and Other Responsibility Matters-Primary Covered 
Transactions.''
     Form AD-1048, ``Certification Regarding Debarment, 
Suspension, Ineligibility and Voluntary Exclusion. Lower Tier Covered 
Transactions.''
     Form AD-1049, ``Certification Regarding Drug-Free 
Workplace Requirements (Grants).''
     Form AD-3031, ``Assurance Regarding Felony Conviction or 
Tax Delinquent Status for Corporate Applicants.''

D. Instructions and Resources

    Instructions and additional resources for compiling and submitting 
an application are available on the Emergency Rural Health Care Grant 
Program web page at: https://www.rd.usda.gov/erhc.

E. Submission Dates and Times

    The deadline date for applications to be considered for funding is 
specified in the DATES section at the beginning of this notice.

VI. Application Review Information

    Applications will first be reviewed to determine if they meet the 
eligibility requirements in this Notice. If an application is deemed 
ineligible, the application will not be processed, evaluated, or 
scored. The Agency will notify ineligible applicants in writing 
regarding the reason(s) for ineligibility.
    Applications deemed eligible will be evaluated based on the 
criteria below. Complete applications received by the deadline 
specified in this Notice will be scored and ranked to determine which 
applications are funded. Eligible and complete Track One, Recovery 
applications received after the deadline specified in this Notice will 
be reviewed and processed according to the criteria below for as long 
as funding remains available.
    The Agency will review each grant application to determine 
eligibility. The applicant may be asked to provide additional 
information or documentation to assist the Agency with this 
determination.

A. Evaluation Criteria

    Applications will be evaluated based only on the information 
provided in the application. References to websites or publications 
will not be reviewed, so full documentation and support of application 
criteria is encouraged. Scoring and ranking of applications will be a 
function of the criteria below.
    (1) Track 1, Recovery applicants will receive a score based on the 
criteria below (maximum 100 points):
    a. Distressed Communities/Communities below the poverty line 
threshold priority. 15 points will be given for facilities located in 
distressed communities according to the EIG index or communities below 
the poverty line. For applications supporting two or more facility 
locations, these priority points will only be given if 50 percent or 
more of the requested award funds will support distressed communities 
or those communities below the poverty line. EIG's Distressed Community 
Map can be found here: https://ruraldevelopment.maps.arcgis.com/apps/webappviewer/?id=06a26a91d074426d944d22715a90311e. Maximum 15 
points will be given.
    b. Income priority. If the median household income of the 
facility's service area is below the higher of the poverty line or--
    i. 60 percent of the State nonmetropolitan median household income: 
20 points.
    ii. 70 percent of the State nonmetropolitan median household 
income: 15 points.
    iii. 80 percent of the State nonmetropolitan median household 
income: 10 points; or
    iv. 90 percent of the State nonmetropolitan median household 
income: 5 points.
    c. Population priority. If the facility is located in a rural 
community having a population, according to the most recent decennial 
census, of--
    i. 5,000 or less: 15 points.
    ii. 5,001 to 10,000: 10 points; or
    iii. 10,001 to 15,000: 5 points.
    d. COVID-19 vaccine administration or testing priority. 20 points 
will be given to applications that directly support activities to 
administer COVID-19 vaccines or conduct COVID-19 testing. Maximum 20 
points will be given.
    e. COVID-19 Impacts priority. 20 points will be given to 
applications with projects located in one of the top 10 percent of 
counties or county equivalents based upon county risk score in the 
United States. The risk score is calculated based on COVID-19 confirmed 
cases (per 10,000 population); Distressed Communities Index (DCI); Job 
Loss Projections (Bureau of Labor Statistics data) and the Center for 
Disease Control's (CDC) Social Vulnerability Index (SVI). Counties that 
qualify for the COVID-19 impact priority points are listed on the RD 
web page at https://www.rd.usda.gov/priority-points. For applications 
supporting two or more facility locations, these priority points will 
only be given if 50 percent or more of the requested award funds will 
support these high COVID-19 impact

[[Page 44341]]

counties. Maximum 20 points will be given.
    f. Equity priority. 10 points will be given to applications with 
projects located in a community with a score of 0.75 or above according 
to the CDC's Social Vulnerability Index. Applicants may verify whether 
projects qualify for these priority points by viewing the RD web page 
at https://www.rd.usda.gov/priority-points. For applications supporting 
two or more facility locations, these priority points will only be 
given if 50 percent or more of the requested award funds will support 
these communities identified for priority points through the CDC's 
Social Vulnerability Index. Maximum 10 points will be given.
    (2) Track Two, Impact applicants will receive a score based on the 
criteria below (maximum score 100 points):
    a. Distressed Communities/Communities below the poverty line 
threshold priority. 10 points will be given for facilities or projects 
targeting distressed communities according to the EIG index or 
communities below the poverty line. For applications supporting two or 
more facility locations, these priority points will only be given if 50 
percent or more of the requested award funds will support distressed 
communities or those communities below the poverty line. EIG's 
Distressed Community Map can be found here: https://ruraldevelopment.maps.arcgis.com/apps/webappviewer/?id=06a26a91d074426d944d22715a90311e. Maximum 10 points will 
be given.
    b. Income priority. If the median household income of the project's 
service area is below the higher of the poverty line or--
    i. 60 percent of the State nonmetropolitan median household income: 
15 points.
    ii. 70 percent of the State nonmetropolitan median household 
income: 12 points.
    iii. 80 percent of the State nonmetropolitan median household 
income: 9 points; or
    iv. 90 percent of the State nonmetropolitan median household 
income: 6 points.
    c. Population priority. If the project or facility(ies) will be 
located in a rural community having a population, according to the most 
recent decennial census, of--
    i. 5,000 or less: 10 points.
    ii. 5,001 to 10,000: 6 points; or
    iii. 10,001 to 15,000: 3 points.
    d. Need, Methodology, and Innovation (maximum 25 points). The 
Agency will utilize a panel of internal and/or external qualified 
reviewers to assess need, methodology, and innovation along the 
following factors:
    i. The extent to which the application clearly describes the 
purpose of the proposed project, the local/regional health care 
environment and how the need was identified, expected outcomes, focus 
area(s) and the aim(s) the project would support.
    ii. The extent to which the applicant describes an innovative 
approach to address the need, goals, and objectives and the 
appropriateness of the proposed strategy.
    iii. The extent to which the applicant's project will provide 
demonstrable impact to rural community(ies) and the health care 
community.
    Maximum 25 points will be given.
    e. Organizational Capacity and Strength of Consortium (maximum 15 
points). The Agency will utilize a panel of internal and/or external 
qualified reviewers to assess organizational capacity and strength of 
consortium along the following factors:
    i. Clarity of the roles and responsibilities for each consortium 
member and the extent to which the network members demonstrate the 
strength of their mutual commitment in carrying out the planning 
activities.
    ii. The extent to which the application identifies the composition, 
capacity, and expertise of each consortium member and successfully 
connects this expertise to the consortium members' (and project 
director's) proposed responsibilities.
    iii. The extent to which the application describes the geographical 
relationship with the rural service population. Urban-based applicants 
also must demonstrate how the rural population will be served, and that 
a high degree of local rural control of the project will be maintained.
    iv. Strength of the relationship between the consortium and the 
community or region it serves. Degree to which the consortium 
collaborates with appropriate organizations in the community to fulfill 
the goals of the consortium and the project.
    v. Strength and qualifications of the project director, who will 
dedicate an appropriate amount of their time to the program and be 
responsible for monitoring the program and ensuring award activities 
are carried out. This element includes measuring the effectiveness of 
the application in clearly demonstrating how the project director's 
role contributes to the success of the network.
    Maximum 15 points will be given.
    f. Workplan and Proposed Budget (maximum 10 points). The Agency 
will utilize a panel of internal and/or external qualified reviewers to 
assess the workplan and proposed budget along the following factors:
    i. The feasibility of activities and objectives identified in the 
work plan including measurable outcomes and the extent to which the 
expected outcomes this program will accomplish by the end of the period 
of performance.
    ii. The reasonableness of the proposed budget for each year of the 
period of performance in relation to the objectives, the complexity of 
the project activities, and the anticipated results.
    Maximum 10 points will be given.
    g. Evaluation, Impact, and Replicability (maximum 10 points). The 
Agency will utilize a panel of internal and/or external qualified 
reviewers to assess evaluation, impact, and replicability along the 
following factors:
    i. The clarity and appropriateness of the proposed goals, 
objectives, strategy to calculate summary impact measures and/or return 
on investment, and extent to which project activities would result in 
achieving the proposed goals outlined in the work plan. The extent to 
which measures are able to be tracked, to assess whether the program 
objectives will be met and the extent to which these can be attributed 
to the program.
    ii. The appropriateness and strength of data collection efforts 
from the lead applicant as well as other members of the consortium, 
including any plans to solicit or provide technical assistance to 
support data collection efforts.
    iii. The appropriateness and strength of the proposed process for 
evaluation.
    iv. The extent to which the applicant clearly identifies factors 
and strategies that will lead to viability and sustainability of the 
network beyond Federal funding, and after the program ends. The clarity 
and reasonableness of proposed steps to disseminate lessons learned and 
encourage replication where appropriate.
    Maximum 10 points will be given.
    h. Equity priority (maximum 5 points) will be given to applications 
with projects located in a community with a score of 0.75 or above 
according to the CDC's Social Vulnerability Index. For applications 
supporting two or more project locations, these priority points will 
only be given if 50 percent or more of the requested award funds will 
support these communities identified for priority points through the 
CDC's Social Vulnerability Index. Applicants may verify whether 
projects qualify for these priority points through a link on the RD 
website.
    Maximum 5 points will be given.

[[Page 44342]]

B. Review and Selection Process

    All complete applications will be competed/ranked as specified 
above. Due to the competitive nature of this program, applications 
receiving the same score will be competed/ranked based on the Income 
priority score, and then if necessary, the Population priority score. A 
complete application contains all information requested by this Notice 
and is sufficient to allow the determination of eligibility, score, 
rank, and compete the application for funding, subject to funds 
available. USDA Rural Development State Offices will work with Track 
One, Recovery applicants to obtain a complete application for as long 
as funding remains available.
    For Track One, Recovery applicants, determinations of eligibility, 
scoring, and ranking will occur at the applicable USDA Rural 
Development State Office where the project is located. Applications 
will compete for available funding allocated to the applicable USDA 
Rural Development State Office. If no funding remains available at the 
applicable State Office, the project will compete for available funding 
held in the USDA Rural Development National Office reserve.
    For Track Two, Impact applicants, eligibility determinations will 
occur at the applicable USDA Rural Development State Office where the 
lead applicant is headquartered. If a Track Two applicant is 
headquartered in the District of Columbia, the applicant must submit 
its application package to the USDA Rural Development National Office 
and the application will be processed by the USDA Rural Development 
Maryland/Delaware State Office. The USDA Rural Development National 
Office will coordinate the application review, ranking, and selection 
for Track Two, Impact applications. These applications will be 
evaluated by an Application Review Panel consisting of qualified health 
care experts using the criteria described in Section VI Application 
Review Information of this Notice. Panel members will be selected by 
the Agency and will be qualified to evaluate the type of work proposed 
by the applicant. If you are interested in serving as a non-Federal 
independent panel reviewer and have expertise as it relates to rural 
health care, please send a resume addressing relevant qualifications 
and experience to [email protected] no later than October 1, 
2021.
    In accordance with 2 CFR 200.206, the Agency will conduct a review 
of risk posed by applicants. For Track One, Recovery and Track Two, 
Impact applications that exceed $250,000, the Agency will review and 
consider any information about the applicant that is in the designated 
integrity and performance system accessible through SAM, currently the 
Federal Awardee Performance and Integrity Information System (FAPIIS). 
Applicants have the option to review information in FAPIIS and comment 
on any information about itself that a Federal awarding agency 
previously entered. The Agency will consider any comments by the 
applicant, in addition to the other information in FAPIIS, in making a 
judgment about the applicant's integrity, business ethics, and record 
of performance under Federal awards when completing the review of risk 
posed by applicants.
    Applicants selected for funding will be provided a Letter of 
Conditions. Upon acceptance of the conditions, the applicant will sign 
and return to the processing office Forms RD 1942-46, ``Letter of 
Intent to Meet Conditions'', and RD 1940-1, ``Request for Obligation of 
Funds.'' The grant is approved on the date an Agency signed copy of 
Form RD 1940-1, ``Request for Obligation of Funds,'' is mailed to the 
applicant.
    Prior to the disbursement of grant funds, applicants approved for 
funding will be required to sign an Agency approved Grant Agreement, 
meet any pre-disbursement conditions outlined in the Letter of 
Conditions, and meet the applicable Statutory or Regulatory authority 
for this action listed in Section I. Funding Opportunity Description.
    In the event the application is not approved, the applicant will be 
notified in writing of the reasons for rejection and provided 
applicable review and appeal rights in accordance with 7 CFR part 11.

VII. Federal Awarding Administration Information

    For Track One, Recovery grant recipients, the USDA Rural 
Development State Office in the state where the applicant's project is 
located will administer the selected awards. For Track Two, Impact 
grant recipients, the USDA Rural Development State Office in the state 
where the lead applicant is headquartered will administer the selected 
awards. Agency state office contact information is available at https://www.rd.usda.gov/about-rd/state-offices.
    As outlined in the letter of conditions and grant agreement issued 
by the Agency, grant recipients will be required to provide annual 
financial statements in accordance with 2 CFR part 200 as adopted by 
the Agency in 2 CFR part 400. Grant recipients will also provide 
performance and financial monitoring and reporting information in 
accordance with 2 CFR part 200, subpart D, ``Post Federal Award 
Requirements.''

VIII. Federal Awarding Agency Contacts

    Jamie Davenport: USDA Rural Development, Community Facilities 
Program. Telephone: (202) 720-0002, email: [email protected]. 
Persons with disabilities that require alternative means for 
communication should contact the U.S. Department of Agriculture (USDA) 
Target Center at (202) 720-2600 (voice).

IX. Other Information

A. Paperwork Reduction Act

    In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 
chapter 35), USDA requested that the Office of Management and Budget 
(OMB) conduct an emergency review by July 16, 2021 of a new information 
collection that contains the Information Collection and Recordkeeping 
requirements contained in this notice.
    In addition to the emergency clearance, the regular clearance 
process is hereby being initiated to provide the public with the 
opportunity to comment under a full comment period, as the Agency 
intends to request regular approval from OMB for this information 
collection. Comments from the public on new, proposed, revised, and 
continuing collections of information help us assess the impact of our 
information collection requirements and minimize the public's reporting 
burden. Comments may be submitted regarding this information collection 
by the following method:
     Federal eRulemaking Portal: Go to https://www.regulations.gov and, in the ``Search'' box, type in the Docket No. 
RHS-21-CF-0009. A link to the Notice will appear. You may submit a 
comment here by selecting the ``Comment'' button or you can access the 
``Docket'' tab, select the ``Notice,'' and go to the ``Browse & Comment 
on Documents'' Tab. Here you may view comments that have been submitted 
as well as submit a comment. To submit a comment, select the 
``comment'' button, complete the required information, and select the 
``Submit Comment'' button at the bottom. Information on using 
Regulations.gov, including instructions for accessing documents, 
submitting comments, and viewing the docket after the close of the 
comment period, is available through the site's ``FAQ'' link at the 
bottom. Comments on this information collection must be received by 
October 12, 2021.

[[Page 44343]]

    Copies of all forms, regulations, and instructions referenced in 
this NOFA may be obtained from RHS. Data furnished by the applicants 
will be used to determine eligibility for program benefits. Furnishing 
the data is voluntary; however, the failure to provide data could 
result in program benefits being withheld or denied.
    Comments are invited on (a) whether the collection of information 
is necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility; (b) the 
accuracy of the agency's estimate of burden including the validity of 
the methodology and assumptions used; (c) ways to enhance the quality, 
utility and clarity of the information to be collected; and (d) ways to 
minimize the burden of the collection of information on those who are 
to respond, including through the use of appropriate automated, 
electronical, mechanical, or other technological collection techniques 
or other forms of information technology.
    OMB Control Number: 0575-0200.
    Title: American Rescue Plan Act Emergency Rural Health Care (ERHC) 
Grant Program.
    Type of Request: New collection.
    Abstract: The American Rescue Plan Act Emergency Rural Health Care 
Grant Program was authorized by the American Rescue Plan Act of 2021 to 
assist rural hospitals and local communities broaden access to COVID-19 
vaccines, health care services, and food assistance through food banks 
and food distribution facilities, and projects supporting the long-term 
sustainability of rural health care. As authorized under Section 1002 
of the American Rescue Plan Act, funds will be made available to 
eligible applicants to offer support for rural health care services in 
the form of immediate relief, longer-term funding to advance ideas and 
solutions to support long-term sustainability of rural health, and 
provide expeditious relief to address the current economic conditions 
arising from the COVID-19 emergency.
    Estimate of Burden: Public reporting burden for this collection of 
information is estimated to average 3.70 hours per response.
    Respondents: Public bodies, nonprofits, and Federally recognized 
Tribes.
    Estimated Number of Respondents: 3,392.
    Estimated Number of Responses per Respondent: 16.
    Estimated Number of Total Annual Responses: 54,300.
    Estimated Total Annual Burden and Record Keeping Hours on 
Respondents: 201,272 hours.
    Copies of this information collection can be obtained from MaryPat 
Daskal, Chief, Branch 1, Rural Development Innovation Center, U.S. 
Department of Agriculture, 1400 Independence Ave. SW Washington, DC 
20250. Phone: 202-720-7853.
    All responses to this information collection and recordkeeping 
notice will be summarized and included in the request for OMB approval. 
All comments will also become a matter of public record.

B. Civil Rights

    Programs referenced in this Notice are subject to applicable Civil 
Rights Laws. These laws include the Equal Credit Opportunity Act, Title 
VI of the Civil Rights Act of 1964, Title VIII of the Civil Rights Act 
of 1968, and Section 504 of the Rehabilitation Act of 1973.

C. Intergovernmental Review

    The Emergency Rural Health Care Grant Program is subject to 
Executive Order 12372, ``Intergovernmental Review of Federal 
Programs.'' Submit one copy of the application to the State government 
single point of contact, if one has been designated, at the same time 
as application submission to the Agency. If the project is located in 
more than one state, submit a copy to each applicable state government 
single point of contact. Go to https://www.whitehouse.gov/wp-content/uploads/2020/04/SPOC-4-13-20.pdf for state office contact information. 
Applications from Federally recognized Indian tribes are not subject to 
this requirement.

D. Executive Order 13175, Consultation and Coordination With Indian 
Tribal Governments

    Executive Order 13175 requires federal agencies to consult and 
coordinate with tribes on a government-to-government basis on policies 
that have tribal implications. USDA's Office of Tribal Relations and 
Rural Development hosted a tribal consultation held virtually on May 4, 
2021. The virtual meeting consisted of more than 120 participants, 30 
of whom identified as Tribal Leaders or their proxies. USDA attendees 
included the Director of the Office of Tribal Relations, the Acting 
Administrator of RD's Rural Housing Service, RD's Chief Innovation 
Officer, and RD's National Native American Coordinator.
    Tribal leaders expressed strong interest in broad flexibility of 
program design, allowing use of funds for construction, and offering 
grant sizes considerably larger than the existing average Community 
Facilities grant of $30,000 to support sizable, long-lasting impacts. 
Leaders highlighted specific needs around behavioral health, workforce 
development, data availability, food sovereignty, poverty, substance 
use disorders, and other infrastructure needs such as broadband and 
water. Leaders expressed concern that the cost-sharing requirements 
imposed in the statute may be too burdensome and highlighted the need 
for streamlined applications and limited reporting and federal data 
collection requirements.
    This NOFA takes into consideration Tribal leader comments, 
particularly with respect to award size and use of funds. Cost-sharing 
requirements are mandated in the American Rescue Plan Act.

E. Federal Funding Accountability and Transparency Act

    All applicants, in accordance with 2 CFR part 25, must have a DUNS/
UEI number, which can be obtained at no cost via a toll-free request 
line at (866) 705-5711 or online at https://fedgov.dnb.com/webform. All 
recipients of Federal financial assistance are required to report 
information about first-tier sub-awards and executive total 
compensation in accordance with 2 CFR part 170.

F. Non-Discrimination Statement

    In accordance with Federal civil rights laws and U.S. Department of 
Agriculture (USDA) civil rights regulations and policies, the USDA, its 
Mission Areas, agencies, staff offices, employees, and institutions 
participating in or administering USDA programs are prohibited from 
discriminating based on race, color, national origin, religion, sex, 
gender identity (including gender expression), sexual orientation, 
disability, age, marital status, family/parental status, income derived 
from a public assistance program, political beliefs, or reprisal or 
retaliation for prior civil rights activity, in any program or activity 
conducted or funded by USDA (not all bases apply to all programs). 
Remedies and complaint filing deadlines vary by program or incident.
    Program information may be made available in languages other than 
English. Persons with disabilities who require alternative means of 
communication to obtain program information (e.g., Braille, large 
print, audiotape, American Sign Language) should contact the 
responsible Mission Area, agency, or staff office; the USDA

[[Page 44344]]

TARGET Center at (202) 720-2600 (voice and TTY); or the Federal Relay 
Service at (800) 877-8339.
    To file a program discrimination complaint, a complainant should 
complete a Form AD-3027, USDA Program Discrimination Complaint Form, 
which can be obtained online at https://www.ocio.usda.gov/document/ad-3027, from any USDA office, by calling (866) 632-9992, or by writing a 
letter addressed to USDA. The letter must contain the complainant's 
name, address, telephone number, and a written description of the 
alleged discriminatory action in sufficient detail to inform the 
Assistant Secretary for Civil Rights (ASCR) about the nature and date 
of an alleged civil rights violation. The completed AD-3027 form or 
letter must be submitted to USDA by:
    (1) Mail: U.S. Department of Agriculture, Office of the Assistant 
Secretary for Civil Rights, 1400 Independence Avenue SW, Washington, DC 
20250-9410; or
    (2) Fax: (833) 256-1665 or (202) 690-7442; or
    (3) Email: [email protected].

Chadwick Parker,
Acting Administrator, Rural Housing Service.
[FR Doc. 2021-17199 Filed 8-11-21; 8:45 am]
BILLING CODE 3410-XV-P