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Federal Register / Vol. 86, No. 153 / Thursday, August 12, 2021 / Notices 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 qualificationsbased 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.1a 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. Longterm 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
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partners to plan, implement, and evaluate a models 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 evidencebased model and disseminate lessons learned for possible replication in other small communities and regions.
c Identify a health-related problem within the applicants 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 200States and Local Government and Indian Tribe Indirect Cost Proposals, paragraph D1, 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.

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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 COVID19 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 preaward costs for Track One, Recovery applicants, paying obligations incurred before the beginning date or after the ending date of the grant agreement; and
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