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Federal Register / Vol. 86, No. 153 / Thursday, August 12, 2021 / Notices 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 4427, Operating Budget, including projected cash flow; RD 4422, Statement of Budget, Income and Equity, and RD 4423 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 COVID19 vaccines, COVID19 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:

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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 applicants 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
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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 organizations 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 communityies. 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 communityies 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 consortiums 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 COVID19 pandemic.
b Provide a complete, consistent, and detailed budget presentation for up to a three-year period of performance through the submission of the SF424A
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,
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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 consortiums quality improvement efforts and sustainability beyond the period of Federal funding?
c Explain a process for evaluating how the consortiums 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 consortiums 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 consortiums 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
25.200b. 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
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