Code of Massachusetts Regulations
114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY
Title 114.5 CMR 10.00 - Criteria and procedures for awarding one-time grants to non-profit providers of elder care services
Section 10.05 - Materials to be Submitted by Applicants
Universal Citation: 114.5 CMR 10.00 MA Code of Regs 10.05
Current through Register 1531, September 27, 2024
(1) All applicants must submit the following required programmatic material.
(a) Table of Contents listing at least all of
the items required in 114. 5 CMR 10.05.
(b)
Narrative. The
narrative may not exceed six typewritten double-spaced pages, and must include
the following items:
1. Cover page with name,
address, and FEIN number (if available) of organization; name, occupational
title, telephone number, fax number and e-mail address of grant application
contact; and name, occupational title and signature of the organization's
representative that is authorized to execute a contract with the Division. The
cover page must clearly state the total amount of grant funding requested and
the type of grant for which the Applicant intends to apply
(i.e., equipment purchase/upgrade, conversion/ renovation of
existing space, or acquisition/construction costs of new physical
space).
2. Narrative description of
organization. This must include information on the number of clients and the
geographic region it serves, as well as the types of services
provided.
3. Narrative summary of
request for grant funding, justification for the amount of funds needed, and a
timetable for the expenditure of grant funds, if approved. The summary must
describe how the request will fulfill all the grant requirements listed in 114.
5 CMR 10.03.
4. Documentation of
any efforts the applicant has made to secure grant funds for this project from
other sources, if applicable.
5.
Listing of the source and amount of other funds that will be leveraged by the
award of these grant funds, if applicable.
6. Discussion of the future financial sustain
ability of this project if the funds are awarded.
(2) All applicants must submit the following required financial material.
(a) An
overview of existing financial resources of the applicant through the
submission of either 114. 5 CMR 10.05(2)(a)1. or 2.:
1. The most recent Uniform Financial
Statement (UFR) submitted to the State Operational Services Division;
or
2. If the applicant did not
submit a UFR to the State Operational Services Division in fiscal year 1999 or
2000, the applicant's most recent audit, certified financial statement or
independent accountant's review report.
(b) A detailed plan of projected grant
expenditure uses; and
(c) Projected
revenue collections resulting from expansion, if applicable.
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