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pdfU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Healthcare Systems Bureau
Health Care and Other Facilities
Health Care and Other
Facilities Awards
(HRSA-05-144)
Catalog of Federal Domestic Assistance (CFDA) No. 93.887
NEW CONGRESSIONAL INITIATIVES GUIDANCE
Fiscal Year 2005
Application Due Date: refer to notification letter
Office:
E-mail:
Telephone:
Fax:
Division of Facilities Compliance and Recovery
[email protected]
301-443-5656
301-443-0619
Date of Issuance: May 17, 2005
Authorization: Public Law 108-447
Foreword
Funds covered in this New Congressional Initiatives Guidance are made available through the
Department of Health and Human Services Appropriations Act, FY 2005. Funds awarded will provide
for infrastructure development and improvements to health care and related facilities through
construction, renovation and equipment projects. As you are planning your project, we encourage you
to consider bioterrorism infrastructure needs, such as enhanced isolation capacity, decontamination,
infection control capabilities, or other projects that have components which address bioterrorism and
emergency preparedness requirements.
HCOF 2005 Program Guidance
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List of Common Acronyms in Program Guidance
A/EAIA BPHC CFDA DES DFCR DGMO DHHS DUNS GAC HRSA NFI OFAM OMB PHS PMS PSC SHPO HSB SPOC THPO -
Architectural/Engineering
American Institute of Architects
Bureau of Primary Health Care
Catalog of Federal Domestic Assistance
Division of Engineering Services
Division of Facilities Compliance and Recovery
Division of Grants Management Operations
Department of Health and Human Services
Data Universal Numbering System
Grants Application Center
Health Resources and Service Administration
Notice of Federal Interest
Office of Federal Assistance Management
Office of Management and Budget
Public Health Service
Payment Management System
Program Support Center
State Historic Preservation Officer
Healthcare Systems Bureau
State Single Point of Contact
Tribal Historic Preservation Officer
HCOF 2005 Program Guidance
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Table of Contents
I.
FUNDING OPPORTUNITY DESCRIPTION _______________________________________________________ 6
1. Background __________________________________________________________________________________ 6
2. Purpose _____________________________________________________________________________________ 6
II.
AWARD INFORMATION_______________________________________________________________________ 7
1. Summary of Funding __________________________________________________________________________ 7
III.
ELIGIBILITY INFORMATION ________________________________________________________________ 7
1. Eligible Applicants ____________________________________________________________________________ 7
2. Cost Sharing/Matching_________________________________________________________________________ 7
IV.
APPLICATION AND SUBMISSION INFORMATION _______________________________________________ 8
1. Address to Request Application Package __________________________________________________________ 8
2. Content and Form of Application Submission ______________________________________________________ 8
3. Application Format____________________________________________________________________________ 9
4. PHS Form 5161-1 – Simplified Application Instructions ____________________________________________ 10
A.
General Information and Instructions ______________________________________________________ 10
B.
Application for Federal Assistance (SF 424) (Face Page) _______________________________________ 10
C.
Instructions for the SF 424 (Application Face Page): __________________________________________ 11
D.
SF-424A – Budget Info– Non-Construction Programs -Pages 1 & 2 - Not applicable. _______________ 11
E.
Instructions for the SF-424A: Pages 3 & 4 __________________________________________________ 11
F.
SF-424B - Assurances – Non-Construction Programs _________________________________________ 11
G.
SF-424C - Budget Information – Construction Programs ______________________________________ 11
H.
SF-424C – Instructions for the SF 424C_____________________________________________________ 11
I.
SF-424D – Assurances – Construction Programs _____________________________________________ 17
J.
Certifications___________________________________________________________________________ 17
K.
Program Narrative ______________________________________________________________________ 17
L.
PHS-5161 – Checklist____________________________________________________________________ 17
M.
SF-LLL - Disclosure of Lobbying Activities _________________________________________________ 17
N.
SF-LLL-A - Disclosure of Lobbying Activities Continuation Sheet ______________________________ 17
5. Budget Justification __________________________________________________________________________ 18
6. Itemized Equipment List ______________________________________________________________________ 18
7. Capitalization Policy: Example Capitalization Policy Statement ______________________________________ 18
8. Submission Dates and Time: ___________________________________________________________________ 19
A.
Submission Requirements ________________________________________________________________ 20
B.
How to send the Application Electronically __________________________________________________ 20
9. Intergovernmental Review _____________________________________________________________________ 21
10. Funding Restrictions__________________________________________________________________________ 22
HCOF 2005 Program Guidance
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11. Additional Application Requirements For Construction-Related Projects ______________________________ 22
A.
Selection of an Architectural and Engineering (A/E) Firm _____________________________________ 23
B.
Notice of Federal Interest (NFI) ___________________________________________________________ 23
C.
Construction Contract Deadline ___________________________________________________________ 24
D.
Design and Construction Requirements_____________________________________________________ 24
E.
Force Account Projects __________________________________________________________________ 27
F.
Environmental Analysis__________________________________________________________________ 27
Environmental Analysis Checklist _________________________________________________________ 28
G.
Information Regarding the Property _______________________________________________________ 39
H.
Cultural Resource Assessment, Historic Preservation (HP) Section 106 Review ____________________ 40
I.
Executive Orders 13202 and 13208 (Preservation of Open Competition)__________________________ 44
J.
Examples of Construction Requirements and Awardee Self-Certification Letters __________________ 49
Architect/Engineer Pre-Certification Statement ______________________________________________ 52
Architect/Engineer Certification of Final Design _____________________________________________ 53
K.
V.
Example of Notice of Federal Interest ______________________________________________________ 55
APPLICATION REVIEW INFORMATION _______________________________________________________ 56
1. Review Criteria ______________________________________________________________________________ 56
2. Review and Selection Process___________________________________________________________________ 56
VI.
AWARD ADMINISTRATION INFORMATION ____________________________________________________ 56
1. Award Notices _______________________________________________________________________________ 56
2. Drawing Down Funds _________________________________________________________________________ 56
3. Change of Scope to the Award Project ___________________________________________________________ 57
4. Major Award Obligation ______________________________________________________________________ 57
5. Administrative and National Policy Requirements _________________________________________________ 57
6. Reporting ___________________________________________________________________________________ 58
VII.
AGENCY CONTACTS_________________________________________________________________________ 59
1. DIVISION OF FACILITIES COMPLIANCE AND RECOVERY ____________________________________ 59
2. DIVISION OF GRANTS MANAGEMENT OPERATIONS _________________________________________ 60
3. DIVISION OF ENGINEERING SERVICES______________________________________________________ 61
4. DIVISION OF PAYMENT MANAGEMENT (PMS) _______________________________________________ 62
VIII. OTHER INFORMATION ______________________________________________________________________ 62
1. COMMON ERRORS TO AVOID ______________________________________________________________ 62
2. FREQUENTLY ASKED QUESTIONS __________________________________________________________ 63
3. BUDGET EXAMPLES________________________________________________________________________ 66
4. EXAMPLE OF “SPECIFICS OF AWARD” ______________________________________________________ 70
HCOF 2005 Program Guidance
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I. FUNDING OPPORTUNITY DESCRIPTION
1. Background
Since 1998, assistance provided under HHS appropriations has supported the construction,
renovation and equipment needs at facilities such as hospitals, outpatient clinics, skilled
nursing facilities, university academic programs, health departments, trauma care centers,
drug abuse centers, research centers, etc.
2. Purpose
The Division of Facilities Compliance and Recovery (DFCR) within the Health Resources
and Services Administration (HRSA) administers the “Health Care and Other Facilities”
(HCOF) construction program. These funds are non-competitive and are specifically
designated by Congress each year in the annual Department of Health and Human Services
appropriation.
Applications may be submitted for:
(1) Renovation or new construction,
(2) construction projects for which Federal assistance is limited to “design only”,
(3) construction/renovation/moveable equipment, and
(4) moveable equipment only.
Funding is limited to only earmarked entities identified in the annual HRSA Appropriation.
No other applicants will be considered.
The purpose of this guide is to provide applicants with written guidance to complete the required
forms and take the necessary steps to satisfy the requirements in order to receive Federal funds.
Applicants should utilize the “HCOF Checklist” provided in this guide (see page 9) to ensure
that all application requirements are addressed. Applicants should use the Simplified
Application Instructions outlined in this guide (see page 10) to complete the PHS Form
5161-1. This guide is not designed to be all inclusive but rather provide information necessary to
successfully fulfill the application requirements.
HCOF 2005 Program Guidance
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HCOF Federal Funding Requirements by Project Type
Equipment Only:
Construction/Renovation and
Construction/Renovation/Equipment:
Design Only:
The General PHS Form
5161-1 (see page 10)
Itemized Equipment List
The General PHS Form 5161-1
(see page 10)
Itemized Equipment List (if applicable)
Submit an application to the Division of
Engineering Services (DES).
The General PHS Form 5161-1
(see page 10)
Review and documented approval from
the State Historic Preservation
Officer/Tribal Historic Preservation
Officer.
Completion of an Environmental
Analysis.
Provide documented proof of title/lease
information.
Adhere to Federal Construction
Requirements.
Schematic Designs
Notice of Federal Interest (if meets
criteria)
Abide by E.O. 13202 and 13208
(Preservation of Open Competition)
Submit an application to the
Division of Engineering Services
(DES).
Review and documented approval
from the State Historic
Preservation Officer/Tribal
Historic Preservation Officer.
Completion of an Environmental
Analysis.
II. AWARD INFORMATION
1. Summary of Funding
The HCOF program will provide funding during Federal fiscal year 2005. Approximately
$400 million is expected to be available to fund approximately 750 projects specifically
EARMARKED in the FY 2005 Congressional Appropriation Bill.
III. ELIGIBILITY INFORMATION
1. Eligible Applicants
Eligible applicants are those projects specifically EARMARKED in the Congressional
Appropriation Bill.
2. Cost Sharing/Matching
There are no matching requirements.
HCOF 2005 Program Guidance
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IV. APPLICATION AND SUBMISSION INFORMATION
1. Address to Request Application Package
Application Materials
Applicants must submit proposals using Public Health Service (PHS) Application Form
5161-1. The forms may be obtained from the following site:
http://www.hrsa.gov/grants/forms.htm.
However, much of this generic application does not need to be filled out for the HCOF
earmarks. Applicants should only provide information for the sections identified in the
Simplified Application Instructions (see page 10).
2. Content and Form of Application Submission
Application Format Requirements
The Program Narrative may not exceed 10 pages in length. Pages must be numbered
consecutively.
A. Number of Copies
Submit one (1) original and one (1) unbound copy to the GAC. Applications may also be
submitted electronically to HRSA (see page 20). In addition to submitting an application
to the GAC, one (1) copy should be sent to the DES, if applicable (see page 61) and one
copy should be sent to the Single Point of Contact (SPOC) if applicable (page 21). Please
do not bind or staple the application. The application must be single sided.
B. Font
Please use an easily readable typeface, such as Times Roman, Courier, CG Times, or
Arial. The text and table portions of the application must be submitted in not less than 12
point and 1.0 line spacing. Applications not adhering to 12-point font requirements may
be returned.
C. Paper Size and Margins
For scanning purposes, please submit the application on 8 ½” x 11” white paper.
Margins must be at least one (1) inch at the top, bottom, left and right of the paper.
Please left-align text.
D. Numbering
Please number the pages of the application sequentially from page 1 (face page) to the
end of the application, including charts, figures, tables, and appendices.
E. Names
Please include the name of the applicant on each page.
F. Section Headings
Please put all section headings flush left in bold type.
HCOF 2005 Program Guidance
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3. Application Format
To expedite the review of your application, arrange your application in the order of the
HCOF Complete Application Checklist outlined below. Incomplete applications may be
delayed for review until all necessary components of the application are received.
HCOF Complete Award Application Checklist
Face Sheet—Standard Form 424
Budget Page—Standard Form 424(c)
BUDGET INFORMATION – CONSTRUCTION PROGRAMS
Construction Assurances—Standard Form 424D
Certifications, (pages 17-19 of Form PHS 5161)
Project Summary Page—summary of Program Narrative- (Not to exceed 1
page)
Program Narrative -Include information if the Project will not meet the
Preservation of Open Competition requirement – (Not to exceed 10 pages).
(See pages 44- 48)
PHS Checklist from Form PHS 5161, (pages 25-26 of Form PHS 5161)
Budget Justification
Itemized Equipment List
The applicant’s assurance that it has a capitalization policy (if the unit cost of
equipment items is less than $5,000) – See page 18.
Information Regarding the Property (Title/Lease) ¹
(See page 39)
Environmental Impact Analysis Checklist ²
(See page 28)
Proposed method of financing the non-Federal share (Discuss in the Program
Narrative)
Schematic Drawings ¹ (See page 23)
Published Notice 2 (See page 40)
Cultural Resource Assessment, Historic Preservation (HP) Section 106
Review 2 (See page 40)
1
2
Not needed for equipment only or design only projects.
Not needed for equipment only projects.
HCOF 2005 Program Guidance
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4. PHS Form 5161-1 – Simplified Application Instructions
(For both equipment only and construction-related projects)
Only part of the instructions included in the PHS Form 5161-1 should be followed for the
HCOF application. To complete the PHS Form 5161-1, follow the simplified instructions
below:
A. General Information and Instructions
Page 2 – # 2, Paragraph 2 – If applying for a non-competing continuation, follow the
instructions indicated in the PHS Form 5161-1 with the exception of “Information on the
qualifying experience of key personnel added since the previous application” - Not
applicable.
Page 2 – #3 & #4 - Not applicable.
Page 2 – Project Development – “When applicable, comments must be sought from State
Single Points of Contact … (see page 21).”
Page 3 – With the exception of the PRIVACY ACT, this page is not applicable to this
program.
B. Application for Federal Assistance (SF 424) (Face Page)
Follow the instructions provided on the Instructions for the SF 424 page. Please note:
DUNS Number - All applicant organizations are now required to have a Data Universal
Numbering System (DUNS) number in order to apply for an award from the Federal
Government. The DUNS number is a unique nine-character identification number
provided by the commercial company, Dun and Bradstreet. There is no charge to obtain
a DUNS number. Information about a DUNS number can be obtained at
http://www.hrsa.gov/grants/preview/dunsccr.htm, or by calling 1-866-705-5711.
Please include the DUNS number next to the OMB Approval Number on the application
face page. The application will not be reviewed without a DUNS number.
The applicant organization will be required to register with the Federal Government’s
Central Contractor Registry (CCR) to do electronic business with the Federal
http://www.hrsa.gov/grants/preview/dunsccr.htm.
Employer Identification Number (EIN) – Enter the applicant’s nine-digit IRS taxpayer
identification number used to submit the organization’s payroll taxes to the IRS. Contact
the organization’s Chief Financial Officer/Accounting or Business Department to verify
that this information is complete. Attach a copy of either the IRS letter identifying the
EIN or a copy of the payroll tax report which displays the EIN number to this application.
HCOF 2005 Program Guidance
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The EIN with documentation is essential to establishing an account for your organization
in the HHS Payment Management System (PMS).
LINE 9 – Enter “Health Resources and Services Administration.”
LINE 10 – Enter “93.887.”
LINE 11 – Indicate that the project is for one of the following: new construction,
renovation, design only, or equipment only.
LINE 13 – Indicate the estimated start and end dates for the actual project (All Notices of
Award will be given a September 1 start date. This does not prevent a facility from
starting its project earlier, but it is the earliest date that funds can be drawn down. If it is
critical that your facility draw down funds earlier, contact your Program Officer to
discuss. The end date for the project is determined by the applicant, based on the
estimated amount of time needed to complete the project. The total project period cannot
exceed 5 years. No exceptions are allowed. The applicant may discuss time frames with
DES before completing this section.).
LINE 15 – For 15a, only enter the amount you are to receive under the Health Care and
Other Facilities (HCOF) award program. The other blocks under number 15, added with
15a, should represent total project costs. Do not fill out line 15f.
LINE 16 – see page 21.
C. Instructions for the SF 424 (Application Face Page):
Use the instructions provided in the PHS Form 5161-1 to complete the SF 424
Application Face Page.
D. SF-424A – Budget Info– Non-Construction Programs -Pages 1 & 2 - Not applicable.
E. Instructions for the SF-424A: Pages 3 & 4 - Not applicable.
F. SF-424B - Assurances – Non-Construction Programs – Not applicable.
G. SF-424C - Budget Information – Construction Programs
Please complete the Budget Information—Construction Programs (Standard Form 424c)
for all projects. Equipment only projects should use Standard Form 424c as well. DO
NOT USE THE NON-CONSTRUCTION FORMS, SF 424A AND SF 424B.
Note: Feasibility studies, program development, and operating costs are not allowable.
H. SF-424C – Instructions for the SF 424C
Follow the instructions provided below to complete the SF-424C.
HCOF 2005 Program Guidance
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Column A – Total Cost
LINE 1—Administrative and legal expense: Enter amounts needed for administrative
expenses including such items as travel, legal fees, personnel and consultant costs and
any other costs expected to be incurred in administering the award. Generally,
administrative and legal expenses should be less than 10% of total project costs.
Include:
−
−
−
Salary of applicant’s staff and consultant fees that are directly related to the
administration of the technical aspects of the proposed project;
Costs of obtaining required data for the environmental analysis report; and
Liability insurance.
Exclude:
−
−
−
−
−
−
Salary of applicant’s staff and consultant fees which are not related to the
administration of the technical aspects of the proposed project;
Bonus payments to construction contractors;
Costs of groundbreaking and dedication ceremonies and items such as plaques;
Indirect expenses such as general department operations and maintenance;
Expendable office, medical, and laboratory supplies; and
Fund-raising expenses.
LINE 2—Land, structures, right-of-way, appraisals, etc: Enter amounts directly
associated with the acquisition of land, existing structures, and related right-of-way.
Land or the cost of purchasing a building is not allowable. These expenses should be
placed in column 2b.
LINE 3—Relocation expenses and payments: Generally, this line does not need to be
filled out for the HCOF Award Program.
Include:
−
−
Relocation payments to be made to displaced persons, business concerns and
nonprofit organizations for moving expenses and replacement housing.
Relocation advisory assistance and the net amounts for replacement (last resort)
housing. This line is limited to approved applicants whose project involves the
displacement of persons and businesses who must comply with the provisions of
the Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970 ((42 U.S.C. 4601 et seq.) 84 Stat.1894) and 49 CFR Part 24.
Exclude:
−
Relocation administration expensed on this line should be included in Line 1.
HCOF 2005 Program Guidance
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LINE 4—Architectural and engineering basic fees: Enter basic fees for architectural
and engineering services.
Include:
−
−
−
Fees associated with architectural and engineering professional services;
Associated expenses for preparation of specifications and reproduction of design
documents; and
For construction award programs, costs incurred before an award for architect’s
fees and consultant’s fees necessary to the planning and design of the project are
allowable if the project is approved and funded.
Exclude:
−
−
Architectural and engineering fees for work that is not within the scope of the
approved project. Also, costs of abandoned designs are unallowable; and
Elaborate or extravagant designs, materials, or projects that are above the known
local costs for comparable buildings.
LINE 5—Other architectural and engineering fees: Enter amounts for other
architectural and engineering services, such as surveys, tests, and borings. Include
preliminary expenses associated with the approved award.
LINE 6—Project inspection fees: Enter fees for inspection and audit of construction and
related programs.
Include:
−
Clerk-of-the-works, inspection fees, structural certification, etc., to be provided by
architectural engineering firm or the applicant’s staff.
Exclude:
−
Fees not associated with the requested project.
LINE 7—Site Work: This line is for costs associated with the development of land
where the primary purpose of the award is land improvement. The primary purpose of
the HCOF award program is to create construction related projects. Therefore, no costs
should be entered on this line for the HCOF award program. Site work normally
associated with a construction project should be included on line 9 (construction).
LINE 8—Demolition and removal: Enter the costs of demolition or removal of
structures or improvements. Reduce the costs on this line by the amount of expected
proceeds from the sale of salvage. Exclude costs not associated with the requested award.
HCOF 2005 Program Guidance
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LINE 9—Construction: Enter amounts for the actual construction of, addition to, or
renovation of a facility. Also include in this category the amounts for project
improvements, such as sewers, streets, landscaping, and lighting. Reasonable costs for
necessary items attributable to construction are considered “allowable costs” for Federal
funding. The following samples are allowable post-award costs.
Include:
−
Costs of fixed equipment necessary for the functioning of the facility. FIXED
EQUIPMENT is equipment, the cost of which is included in the construction
contract, which requires modification of the facility for its satisfactory installation
or removal. Examples of fixed equipment include but are not limited to the
following:
fume hoods
linear accelerator
laboratory casework
sinks
fixed shelving
−
−
−
−
−
−
−
−
sterilizers (built-in units)
lavatories, water closets, and showers
refrigerators (built-in-type)
drinking fountains
Costs of constructing new building(s) to be used for the program. This includes
costs of materials and labor within the local range of comparable buildings;
Construction costs for expansion, remodeling, and alteration of existing buildings,
which will be used for the program;
Sanitary sewer, storm sewer, and portable water connections, providing that such
municipal utilities are located in streets, roads, and alleys contiguous to the site;
Costs of connecting to existing central utility distribution systems contiguous to
the site, such as steam and chilled water that service a campus from centrally
located boiler and refrigeration plants. Prorated costs for new boilers and chillers
to serve the proposed facility are acceptable;
Site clearance, grading, land improvement costs, including reasonable costs for
landscaping, sidewalks, drives, and parking areas which are located on the site
and are essential for the use and operation of an approved project. Reasonable
landscaping costs for seeding, sodding, and other plant materials are also
allowable;
Special features for earthquake resistance code requirements. Use nationally
recognized codes adopted by authorities having jurisdiction;
Costs of eliminating architectural barriers to the handicapped; and
Costs of pollution control equipment for the facility’s boilers, incinerators, waste
water treatment, etc., which may be required by local, State, or Federal
regulations. The facility must meet requirements of both current and future
pollution abatement regulations as described in currently approved pollution
plans.
Exclude:
HCOF 2005 Program Guidance
Page 14 of 70
−
−
−
Relocation of utilities that are off site and off site improvements;
Prorated cost of existing central utility plant and distribution systems, which serve
the proposed facility; and
Works of art
LINE 10—Equipment: Enter amounts for equipment, exclusive of fixed equipment,
which is part of the construction contract.
Include:
−
MOVABLE EQUIPMENT, i.e., equipment is defined as an article of nonexpendable, tangible personal property having a useful life of more than 1 year
and an acquisition cost which equals or exceeds the lesser of (a) the capitalization
level established by the applicant for its financial statement purposes, or (b)
$5,000. Moveable equipment (Line 10 “equipment” of Form 424c) can be readily
shifted from place to place without requiring a change in the utilities or structural
characteristics of the space. This equipment is usually purchased outside of any
construction contract. This category includes such items as video systems,
moveable desks, chairs, operating and obstetrical tables, anesthesia apparatus,
oxygen tents, wheeled equipment, computers with software and licenses, but does
not include items that are expendable at the time of use (such as food, fuel,
dressings, drugs). All radiographic equipment, including CAT scanners and
MRI-s, is considered moveable;
−
Fixed equipment if it is not part of the construction contract.
Items with a unit cost of LESS THAN $5,000 are only allowable if the applicant
submits a copy of its capitalization policy used for its financial statement purposes (see
page 18 for an example) showing that it capitalizes individual items or groups of items
at a specified level less than $5,000. Items below the applicant’s capitalization policy
minimum will not be allowed.
Exclude:
−
−
−
Equipment that does not meet the equipment definition above;
Donated equipment , Leased equipment, or Equipment purchased through a
conditional sales contract (lease purchasing); and
Fixed equipment, i.e., equipment that requires a change in the utilities or
structural characteristics of the space and is purchased as part of the construction
contract. The cost of fixed equipment that is part of the construction contract is to
be included in Line 9 Construction of Form 424C.
LINE 11—Miscellaneous: Enter amounts for items not specifically mentioned above
that are directly related to the project.
HCOF 2005 Program Guidance
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Exclude:
−
Additional expense resulting from the rejection of an alternate bid at the start of
construction and later reinstating the bid at an increased cost due to escalation.
The cost of alternate bid work is allowable only up to the amount of the original
bid submitted; and
−
Sales taxes, Federal excise taxes and other taxes when the applicant is exempt
from such taxes or is entitled to a refund by the State or Federal Government after
payment.
LINE 12—Sub-total: Enter the sum of Lines 1 through 11.
LINE 13—Add Contingencies: Enter the estimated amount for contingencies. Compute
this amount as follows.
The contingency fund is established to provide for some unforeseen problems. THE
ALLOWABLE CONTINGENCY OF THIS PROGRAM IS LIMITED TO 5
PERCENT of Line 9 (Construction) and line 10 (equipment). However, if the facility
has already awarded a construction contract, the contingency is LIMITED TO 2
PERCENT of the construction line. If the equipment is already purchased, there is no
contingency for that line.
LINE 14— Subtotal: Add line 12 and line 13.
LINE 15— Project (program) income: This is not applicable to this program.
LINE 16— Total project costs: Enter the sum of Lines 12 and 13.
LINE 17— Federal assistance requested - Do not calculate the eligible cost percentage.
For the amount of Federal assistance (17c), enter the amount you are to receive under the
HCOF Award Program.
Column B – Costs Not Allowable for Participation
Only costs defined as non-allowable in the Program Guidance should be entered in
Column B. Projects that are construction/renovation only but not requesting funding for
equipment should enter on line 10a and 10b of the Form 424c the estimated or total cost
of the moveable equipment and leave line 10c blank. Most applications will have no
costs entered in column B. Do not include costs in Column B merely to reduce Column
C to the award amount.
Column C –Total Allowable Costs--Subtract column B from column A.
HCOF 2005 Program Guidance
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I. SF-424D – Assurances – Construction Programs
(Note that equipment only projects are considered construction for the purposes of
this award)
Page 16 of the PHS-5161 - Provide the information requested and sign.
The Davis-Bacon Act listed in Item # 13 does not apply to this program.
J. Certifications -Pages 17-19 – Provide the information requested and sign.
K. Program Narrative -Pages 21-24 – Use only the information provided below to
complete this section:
DESCRIBE THE ENTIRE PROJECT, even if the award is requested for only part of the
project. The program narrative can be no more than 10 pages.
If the Federal award is not expected to cover the total project cost, the applicant must
describe and provide by source the dollar amount of the other sources of funding to make
up the difference. Include letters of commitment from all sources. This will assure
HRSA that the project can be successfully completed.
L. PHS-5161 – Checklist
Page 25-26 - Provide the information requested. Please note:
Part C - Program Director/Project Director/Principal Investigator Section - This
should be completed with information on the person who will be sending monitoring
reports to DFCR regarding the status of the project. The Business Official Section on the
left side refers to the responsible individual for the financial management of this award.
This individual should be the Chief Financial Officer, Accounting Director or the
Executive Director of the organization. The Project Director is not the person who
generally has financial responsibility for the organization.
On the last line of the Business Official Section there is a request for the “Applicant
Organization’s 12-Digit DHHS EIN (if already assigned).” Any organization that
currently has any DHHS award where it is receiving it through the Payment Management
System (PMS) will already have a 12-digit DHHS EIN set up to drawdown funds. Your
business or finance office will know if the organization has a PMS account and will be
able to provide this number. This number will expedite the processing of your award.
M. SF-LLL - Disclosure of Lobbying Activities
Provide signed information requested (if applicable).
N. SF-LLL-A - Disclosure of Lobbying Activities Continuation Sheet
Provide the information requested (if applicable).
HCOF 2005 Program Guidance
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5. Budget Justification
The Budget Narrative/Justification must provide a written description of the method used in
preparing the construction budget and address each line under column A, B and C of the
Budget Page (Standard Form 424c). Describe how each item will support the achievement of
proposed objectives. Provide line item information to explain the costs entered in
Application Form 5161-1, Standard Form 424c. Clearly describe each cost element and
explain how each cost contributes to meeting the project’s objectives/goals. Be very careful
about showing how each item in the miscellaneous category is justified. The budget
justification MUST be concise. Do NOT use the justification to expand the project narrative.
See above for allowable costs. Discuss the reasonableness and allocation of the proposed
costs.
6. Itemized Equipment List
ALL REQUESTS FOR MOVABLE EQUIPMENT MUST INCLUDE ITEMIZATION AND
UNIT PRICE, e.g.,
Items
2 centrifuges
2 freezers
4 incubators
TOTAL
Cost
@ $27,000
@ $30,000
@ $25,000
Total Cost
$54,000
$60,000
$100,000
$214,000
7. Capitalization Policy: Example Capitalization Policy Statement
Memorial Hospital
_____ New
Accounting Policy #____
___ Reviewed Date ______
____ Revised Date _________
Capitalization of assets for depreciation
Any item with a value of $400 or an aggregate of like items whose value totals $400, with an estimated useful
life of three years, will be capitalized for depreciation. Items to be depreciated will use the half-year
convention in the year of acquisition and year of disposition.
Notification process for the acquisition, disposal or transfer of fixed assets:
The Accounting Department must be notified and review all disposals, transfers of assets, trade-ins, sales or
other changes in asset location, statute or disposition prior to the actual asset change taking place.
Department heads will use the proper forms with Administrative approval to notify the Accounting
Department of changes.
Approved by:_____________________________
CEO
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8. Submission Dates and Time:
The due date for applications will be given in the notification letter sent to earmarked
entities identified in the annual HRSA Appropriation.
Applications will be considered as meeting the deadline if they are either:
i.
received on or before the due date; or
ii.
postmarked or E-marked on or before the due date.
If needed, a one-time extension for up to 30 days may be approved. Submit a written request to
the appropriate Grants Management Specialist (see page 60) by fax or e-mail. Please
remember that delayed submission of the application may delay the award of funds.
The Chief Grants Management Officer (CGMO) or a higher-level designee may authorize an
extension of published deadlines when there are justified circumstances such as acts of God
(e.g. floods or hurricanes), widespread disruptions of mail service, or other disruptions of
services, such as a prolonged blackout. The authorizing official will determine the affected
geographical area(s).
In the event that questions arise about meeting the application due date, applicants must have a
legible dated receipt from a commercial carrier or the U.S. Postal Service. Private metered
postmarks will not be accepted as proof of timely mailing.
Electronic Submission: Applications must be submitted by 5:00 P.M. ET. To ensure that you
have adequate time to follow procedures and successfully submit the application, we
recommend you start submission no later than noon on the due date. Applications submitted
electronically will be time/date stamped electronically, which will serve as receipt of
submission.
Upon receipt of a paper application, the Grants Application Center will mail an
acknowledgement of receipt to the applicant organization’s Program Director. If you do not
receive this notice in 15 days, contact the Grants Application Center to find out the status of
your proposal. Do not mail anything to this address other than the proposal package
unless specifically requested to do so.
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A. Submission Requirements – Application must be mailed or sent electronically
Where to mail the application:
i.
Send original and one copy to:
The HRSA Grants Application Center
The Legin Group, Inc.
Attn: HCOF Award Program
Program Announcement # HRSA-05-144
CFDA No. 93.887
901 Russell Avenue, Suite 450
Gaithersburg, MD 20879
Telephone: 877-477-2123
ii.
Send one copy to (Not necessary for equipment only projects):
Division of Engineering Services (See page 61)
iii.
Send one copy to:
State Single Point of Contact (SPOC) – if applicable, see website on page 22
for those states using the SPOC process and their addresses. Contact the SPOC
to determine what, if anything, needs to be submitted.
B. How to send the Application Electronically:
HRSA encourages applicants to submit applications electronically using the HRSA
Electronic Handbooks (EHBs). To register and/or log-in to prepare your application, go
to https://grants.hrsa.gov/webexternal/home.asp. For assistance in using the online
application system, call 877-GO4-HRSA (877-464-4772) between 8:30am to 5:30pm
ET, or email [email protected].
Create application narratives and spreadsheets separately and submit as attachments to
the application. You will be prompted to “upload” your attachments at strategic points
within the application interface. The following document types will be accepted as
attachments: WordPerfect (.wpd); Microsoft Word (.doc); Microsoft Excel (.xls); Rich
Text Format (.rtf); and Portable Document Format (.pdf). If there are tables that are not
supported as data entry forms from within the application, download them to your hard
drive, fill in and then upload as attachments with your applications. Applications
submitted electronically will be time/date stamped electronically, which will serve as
receipt of submission.
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The standard forms, such as PHS Form SF-5161, must be completed on line.
Online applications are required to submit ONLY one form in signed hard copy: the
SF-424/5161 Face Sheet, since that all other elements of the application have been
captured and transmitted electronically.
Formal submission of the electronic application: Applications completed online are
considered formally submitted when the Authorizing Official electronically submits the
application to HRSA. However, to complete the submission requirements, a hard-copy
of the SF-424/5161 Face Sheet must be printed, signed, and submitted to the HRSA
Grants Application Center. The SF-424 can be printed from the online application.
For an online application, the signed SF-424/5161 must be sent to the HRSA GRANTS
APPLICATION CENTER at the above address and received by HRSA by no later than
five days after the due date indicated in the cover letter.
Applications will be considered as having met the deadline if: (1) the application has
been successfully transmitted electronically by your organization’s Authorizing Official
on or before the deadline date and time, and (2) the signed SF-424 Face Sheet is
received by HRSA no later than five days after the deadline date.
REMINDER: Only applicants who apply online are permitted to forego hard-copy
submission of all application forms EXCEPT the signed SF-424 Face Sheet.
If the application is submitted as a hard-copy, the rules of submission as described in
Section I of this guidance must be followed.
To look for funding opportunities, go to http://www.hrsa.gov/grants and follow the
links. Information on grant opportunities both within HRSA and in other Federal
agencies is also available through http://www.grants.gov, the official E-Grants website
where applicants can find and apply for federal funding opportunities.
PLEASE NOTE THAT IT USUALLY TAKES ABOUT TWO WEEKS
PROCESSING TIME BEFORE OUR SYSTEM CAN ACCEPT AN
ELECTRONIC APPLICATION, SO PLEASE ALLOW ADEQUATE LEAD
TIME.
9. Intergovernmental Review
Executive Order 12372/ State Single Point of Contact: Health Care and Other Facilities is
a program subject to the provisions of Executive Order 12372, as implemented by 45 CFR
100. Executive Order 12372 allows States the option of setting up a system for reviewing
applications from within their States for assistance under certain Federal programs.
Application packages made available under this guidance will contain a listing of States,
which have chosen to set up such a review system, and will provide a State Single Point of
Contact (SPOC) for the review. Information on states affected by this program and State
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Points of Contact may also be obtained from the Grants Management Officer listed in the
AGENCY Contact(s) section, as well as from the following Web site:
http://www.whitehouse.gov/omb/grants/spoc.html.
All applicants other than federally recognized Native American Tribal Groups should
contact their SPOC as early as possible to alert them to the prospective applications and
receive any necessary instructions on the State process used under this Executive Order.
Letters from the State Single Point of Contact (SPOC) in response to Executive Order
12372 are due sixty days after the application due date.
10. Funding Restrictions funding is limited to only earmarked entities identified in the HHS
appropriation.
11. Additional Application Requirements For Construction-Related Projects
For renovation, new construction, and design only projects there are several additional
requirements that an applicant must meet. In addition to completing the PHS Form 5161-1
applicants have to complete all tasks outlined in the table below. These include: (1) Filing
a Notice of Federal Interest, which prohibits the mortgaging or selling of the project assets
without HHS permission; (2) Submitting an Environmental Analysis checklist; (3)
Adhering to Federal Construction Requirements; (4) Provide title/lease information; (5)
Drawing down award funds as project costs are incurred in the same proportion as the
award is to the projected total project cost; (6) Providing documented approval from the
from State and Tribal Historic Preservation Officer section 106 Review requirements; (7)
Submitting an application to the DES for review; (8) Abiding by E.O. 13202 and 13208
Preservation of Open Competition; (9) Providing certifications indicating that final working
drawings were designed in accordance with mandatory requirements and bid tabulation.
If possible, we highly recommend that an application be submitted for an equipment only project.
There are several advantages to an equipment only project:
i.
The DES will not need certifications indicating that final working drawings
were designed in accordance with mandatory requirements and bid tabulation;
ii.
A filing of a NFI, which prohibits the mortgaging or selling of the project assets
without HHS permission, is not required for equipment only projects;
iii.
An Environmental Analysis checklist does not have to be submitted;
iv.
The project is exempt from Federal Construction Requirements;
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v.
The facility does not have to provide title information;
vi.
The awardee can draw down the award funds in proportion to the level of
Federal participation as soon as the equipment is purchased and delivered to the
site. Draw downs for equipment only projects can be made earlier than projects
that include both construction and equipment. For projects that include both
construction and equipment, recipients can only draw down the percentage of
funds in the same proportion as estimated in the total project costs as costs are
incurred;
vii.
The project is exempt from Historic Preservation section 106 Review
requirements; and
viii.
An application will not need to be submitted to the DES for review.
A. Selection of an Architectural and Engineering (A/E) Firm
Consider the following when submitting your application:
Preliminary schematic drawings must be included in the application package.
Schematic drawings are not detailed like blueprints. An architect does not need to
prepare these line drawings. Before the drawings are prepared, the applicant may want
to discuss the design, costs and lead times with the appropriate DES.
If the project is proposed to be design-build or using a construction manager,
immediately call DES to discuss special requirements.
The proposed construction project must meet the Preservation of Open Competition
requirement (see pages 44-48).
B. Notice of Federal Interest (NFI)
Interests in the property are not subordinated to those of non-Federal parties. Generally,
Federal interest may not be subordinated without a compensating financial benefit to the
Government. NFI filings are required for new construction and for “major” renovations
(total costs of more than $500,000). Contact the Grants Management Specialist for
additional requirements for a leased building (see page 60). If the award is for
moveable equipment only, design only or if it is for “minor” renovations (total cost of
less than $500,000), the filing of a NFI will not be required. The period of the NFI is in
perpetuity. If the applicant has extensive land holdings, to avoid having to request the
Secretary’s permission on its use and disposition, an applicant might want to provide a
land description limited to the awarded project when doing the filing.
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If the applicant owns the property, you must submit evidence of ownership with the
application. Acceptable evidence of ownership may include a written legal document
from an attorney.
If the project is located in leased property, the lessee must have undisturbed use of the
premises for a period of at least 25 years, including the time of construction or
modernization, and 20 years of undisturbed operation. A 5 or 10 year lease with an
option of renew for a certain number of periods that total to at least 25 years may be
acceptable. Also include written evidence that the lessor has consented to the
renovation of the leased property and has agreed to the filing of a NFI in the property.
For more information, visit the following websites:
HHS Grants Policy Directive 3.04, “Property”
(www.hhs.gov/grantsnet/adminis/gpd/gpd304.htm)
Frequently Asked Questions #7 and #8 (www.hhs.gov/grantsnet/faqs/property.htm)
See page 55 for an example of a NFI.
C. Construction Contract Deadline
The awardee must enter into a construction contract approved by HRSA within 12
months of the issuance of the Notice of Award, or the award may be withdrawn.
Additional time can be provided, if needed, if the award recipient is making reasonable
progress. Contact the Grants Management Specialist.
The award may be terminated for cause if the awardee materially fails to comply with
the terms and conditions of the above regulations and policies.
D. Design and Construction Requirements
After an award has been made, the awardee must contact the appropriate DES for
guidance before proceeding with the development of the project. The DES will provide
engineering and construction assistance, monitoring, and surveillance on federally
assisted projects to ensure that the design, bidding documents and construction comply
with Federal requirements. A listing of DES offices, which indicates the areas covered,
is included on page 61.
The awardee must select a qualified team for site selection, building design, and
construction inspection. The Government is not involved in the selection process and
does not require that the awardee either select a certain firm or choose from a list of
approved firms.
It is suggested that the AIA Document B 141, “Standard Form of Agreement between
Owner and Architect,” be used. When using this document in negotiations with an
architectural and engineering form, the awardee is advised to amend the terms and
HCOF 2005 Program Guidance
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conditions to fit the specific needs of the project for professional services and other
requirements. Limit the contract to an individual project; open-ended agreements are
not allowed. Applicants must submit a copy of the proposed agreement to the DES,
which services projects in the applicant’s State if technical assistance is desired.
In addition to stipulating the basic fee (usually 5 to 15 percent of the construction bid
cost), the agreement with the architectural and engineering firm should also provide for
the following professional services:
i.
Preparing a design management plan as soon as possible after the contract is
executed. The plan should define how the architectural and engineering firms
will accomplish the work, preferably by tasks, with a schedule for each task. A
design development schedule setting forth target dates for completion of the
various design phases should be included;
ii.
Performing a computer analysis to select a design which reduces energy
consumption for heating and cooling. (This item is recommended although
optional at this time.);
iii.
Obtaining a list of prime contractors and subcontractors in order to secure
clearance for construction competitive bidding. This clearance is necessary to
ensure that the contractors and subcontractors shown on the U.S. General
Accounting Office “Consolidated List of Persons or Firms Currently Debarred
for Violations of Various Public Contracts Acts Incorporating Labor Standards
Provisions” are not awarded contracts;
iv.
Preparing a list of points of critical inspection and all points required by State
and local authorities;
v.
Attending a pre-construction conference;
vi.
Conducting periodic site visits during construction. The visits should be at least
monthly, depending upon the nature and complexity of the project; and
vii.
Coordinating a joint final inspection of construction with the contractor and the
DES representative (if necessary).
The following requirements (use the current code) must be incorporated in the review
and evaluation of all drawings and specifications:
i.
ii.
Life Safety Code—National Fire Protection Association (NFPA) Publication
No. 101 and supplements that apply to the code classification and type of
occupancy of the particular facility;
Accommodations for the Physically Handicapped—Americans with Disabilities
(ADA)—Accessibility Guidelines for Buildings and Facilities*;
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iii.
Protection of the natural environment, including protection against natural
disasters—National Environmental Policy Act of 1969*;
iv.
Uneconomical, hazardous, or unnecessary use of flood plains for construction—
Executive Order 11296, 31f FR 10663 (August 10, 1966). Flood insurance
coverage—Section 202 of the Flood Protection Act of 1973* (information
pertinent to this assessment may be obtained by contacting the local planning
agency of the Flood Plain Program. Contact the DES for your area);
v.
Provisions for potable water supply—Safety of Public Water Systems Act (Title
XIV of the PHS Act);
vi.
Preservation of historical and archeological sites—section 106, National
Historic Preservation Act of 1966* and the Historical and Archeological
Preservation Act of 1960*;
vii.
Conservation of vital energy resources (gas, oil, electricity, etc.)—American
Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE)
standards for energy conservation. This is of national significance and shall be a
salient factor in the planning and design of new facilities;
viii.
Tornadoes—There is no universally accepted national code requiring protection
of life and property against tornadoes, even though this natural phenomenon
results yearly in loss of life and damage to facilities costing millions of dollars.
In geographic areas subject to periodic occurrence of tornadoes, the design of
facilities should include special structural and other features to protect life and
minimize damage to facilities from tornadoes;
ix.
Seismic design—Use adopted State or local code in force;
x.
Plumbing—National Standard Plumbing Code: National Association of
Plumbing—Heating—Cooling Contractors, 1016 20th Street, NW, Washington,
DC 20036;
xi.
Standard for Non-Flammable Medical Gas Systems, latest edition; National Fire
Protection Association, 470 Atlantic Avenue, Boston, MA 02110;
xii.
Vacuum Systems—Standard for Medical-Surgical Vacuum System in Hospitals
pamphlet P-2.1: Compressed Gas Association (OGA), 500 Fifth Avenue, NY,
NY 10036;
xiii.
Electric System—National Electric Code, latest edition, National Fire Protection
Association, 470 Atlantic Avenue, Boston, MA 02110; and
xiv.
Radiation Protection—Handbook Reports No. 33 and 34; National Council on
Radiation Protection (NCP) PO Box 30175, Washington, DC 20008.*
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*And all subsequent amendments.
Where State and local codes or requirements exceed the design requirements described
above or standards incorporated in them, the more stringent requirements will be
applied. State and local codes may be used as a basis for facility design in lieu of the
above design requirements if a prior determination has been made by DES that the
specific State or local code is equivalent to, or exceeds, HHS requirements.
Regarding design issues, refer to the latest edition of the document “Guidelines for
Construction and Equipment of Hospital and Medical Facilities.” This document can be
purchased from the American Institute of Architects (AIA) Order Department, PO Box
60, Williston, Vermont 05495-0060; (1-800-365-ARCH).
E. Force Account Projects
If in-house personnel are selected in accordance with the applicant organization’s own
policies for design work done in-house and for construction work done in-house,
maintain documentation justifying their use in terms of economy and qualifications.
The total cost for in-house personnel plus the fee for the architect and engineer must not
exceed the prevailing architectural and engineering fee costs (usually 5 to 15 percent of
the construction bid cost). If an applicant chooses to use its architectural and
engineering staff in lieu of selecting a private firm, the applicant must obtain approval
from the DES prior to beginning the design phase. The applicant must also show that it
is more cost effective in comparison to outsourcing the work, the need for record
keeping, time constraints, and other reasons for doing the work in-house. The applicant
should state who takes final responsibility for design and/or construction. A licensed
architect must stamp drawings and specifications. The facility must be able to obtain a
building permit and a certificate of occupancy upon completion from local authorities.
F. Environmental Analysis
An Environmental Analysis Checklist (see below) must be submitted with the
application for all projects except equipment only projects.
The National Environmental Policy Act of 1969 (NEPA), 42 USC 4321 (P.L. 91-190,
Sec. 2, Jan. 1, 1970, 83 Stat., 852), requires Federal agencies to assess the environment
impacts of major Federal actions, including construction projects supported in whole or
in part through Federal contracts, grants, subsidies, loans, or other forms of funding
assistance.
If the project has a significant environmental impact, a full Environmental Impact
Statement (EIS) must be prepared and released by the Federal Government before the
award. In those cases where there is a finding of no significant impact (FONSI), the
Government will prepare a statement, which will become part of the award file.
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Environmental Analysis Checklist
An Environmental Impact Analysis Assessment must be submitted with the application for all
projects except equipment only projects.
The National Environmental Policy Act of 1969 (NEPA), 42 USC 4321 (P.L. 91-190, Sec. 2, Jan. 1, 1970, 83
Stat. 852.), required federal agencies to assess the environmental impacts of major federal actions,
including construction projects supported in whole or in part through federal contracts, grants, subsidies,
loans, or other forms of funding assistance.
CONSIDER EACH QUESTION AND IN EACH CASE WHERE THE ANSWER IS AFFIRMATIVE,
DESCRIBE THE IMPACT AND ANY MITIGATING ACTIONS TO BE TAKEN.
I.
USE OF NATURAL RESOURCES
This set of criteria is concerned with the
use and accessibility of nonrenewable natural
resources such as land, minerals, and fuels
as well as the flow resources (water and air)
which are constantly renewed but in which
short-term or local shortages might occur.
CRITERIA
DESCRIPTION OF ENVIRONMENTAL IMPACT
Does the project:
(1)
Change traditional use of the land parcel
and every other page reference
Present Zoning:____________________
(by rezoning, etc.)?
Present Use of Site:_______________
Proposed Zoning:___________________
(2)
Alter the use of other land by related
HCOF 2005 Program Guidance
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development of stores, roads or site
changes?
(a)
Generate new stores?
(b)
Cause new roads?
(c)
Cause new parking?
Does the project:
(3)
Use land for purposes unsuitable to its
physical characteristics?
(4)
Include the use of wetlands (swamps,
marshes, etc.)?
(5)
Block access to known mineral deposits?
(6)
Increase fuel and mineral consumption in
State by more than 1% annually?
Consider these items before
answering question (3): Soil borings
have/have not been completed.
Proposed facility will/will not have
foundations similar to other
facilities in the area. The facility
is/is not in a flood plain.
(Sand, gravel, clay, stone or other
common building materials are not
considered mineral deposits.)
Estimated annual fuel requirements:
___________gallons of fuel
___________cubic feet of natural gas
___________tons of coal
___________kwh of electricity
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Expected source of these fuels:
(7)
Decrease the volume of water in a lake,
river, water table, reservoir, etc?
Does the project:
(8)
Change traditional use of a body of
water?
(9)
Not comply with the local and State land
use planning?
II.
POLLUTION
This set of criteria is concerned with the
processes which generate pollution. These
include the introduction of pollutants into
the environment, changes in the flow of
energy through the environment, changes in
the composition of environments through the
augmentation or deletion of substances
which are naturally present. The criteria
are also directly concerned with the
production and one-time use of materials
and the proper disposal of wastes.
CRITERIA
Does the project:
(1)
Increase identifiable ambient air
pollution levels from a new emission
source or from existing sources?
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(2) Increase identifiable ambient air
pollution levels through a major increase
in the number of or use of automobiles, trucks,
etc.?
(3) Exceed City or State health standards
with exhausts from fume hoods?
Approximate number of new
employees?_______
(4)
Involve:
(a)
Dredging or swamp drainage?
(b)
Construction of a waste treatment
plant?
(c)
Discharge of untreated human waste
directly into a lake, river, etc.?
(d)
Discharge of laboratory wastes or
biohazard wastes directly into a
lake, river, etc.?
(5)
Overload existing waste treatment
plants due to new loads (volume,
chemicals, toxicity, etc.)?
Does the project:
Obtain a connection permit or other
approval from local sewer authority.
(6) Cause soil erosion (after completion of
construction phase) or leaching of foreign
substances (such as salt) into soil?
(7)
Allow seepage of contaminants into the
water table?
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(8)
Increase the stress placed upon an
identified earthquake fault?
(9)
Create an identifiable change in aquatic
life by discharge of hot water?
If yes, please include a statement
from a structural engineer.
(10) Decrease the percolation on over one acre
of land?
(11) Cause storm water runoff onto land owned
by others?
(12) Produce noises considered offensive to a
human population will the facility emit
noises in excess of local noise
standards?
(13) Create sounds which result in changes in
behavior patterns of animals? Is
facility near wildlife sanctuary? Are
outdoor animal facilities included?
(14) Introduce major new sources of unshielded
radiation will the facility contain x-ray
machines. If so will they meet AEC
Standards?
(15) Cause shock waves and/or vibration (After
construction phase)?
(16) Change the direction and wind velocity as
to affect the local population (i.e.
high-rise building)?
(17) Cause a new, large volume of production
of nonrecycled items?
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(18) Result in the non-recycling of recyclable
items such as laboratory glassware,
animal cages and office paper?
If no, project includes:
(#)________ glassware washing
machines, and
(#)________ cage washing
machines.
(19) Generate solid wastes which cannot be
properly disposed of by existing facilities?
(20) Dispose of solid wastes in polluting
landfills, wells, caves, etc.?
If yes, describe proposed methods
and disposal sites.
(21) Require storage of waste pending
technology for safe disposal?
(22) Not comply with Federal, State and local
requirements for waste handling,
transportation or disposal methods?
III. POPULATIONS
This section of the initial criteria addresses
changes in human, animal, and plant
populations. In this section the affected area
is defined as being greater than 160 acres in
size.
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CRITERIA
Will facility cause:
(1) A 5% change in the density of the local
population?
Estimated local population:_________
Number of new employees:____________
(2)
Transportation, health, education and/or
welfare service to be altered?
(3)
Social service needs to change by
altering population's age pattern (new
schools, etc.)?
(4)
Change in the transient population by 5%?
(5)
Changes in genetic engineering directed
toward the human population?
(6)
Local, State or Federal standards
pertaining to population densities or
conservation of plants and animals to be
violated?
Include estimated number of
visitors, patients, and students.
Describe any approvals needed or
already obtained.
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IV.
HUMAN SERVICES
As society has evolved, traditional
self-sufficient human communities have given way
to dense populations which are dependent upon the
development and application of technology. Man's
highly complex, technological environments are
maintained by a variety of services ranging from
the provision of the basic necessities of food
and water to a complex system of economic
exchange. These services are largely
interdependent and their complexities must be
considered. In this section, the human
environment being impacted upon is
defined as less than 160 acres in
size.
CRITERIA
Could the project disrupt:
(1)
Food supplies for 48 hours?
(2)
Water supplies for over 48 hours?
(3)
Electrical power for 48 hours?
(4)
Heating supplies (natural gas, heating
oil) for over 48 hours?
(5)
Or deprive, population of housing for
over 48 hours?
(6)
Removal of sewage for more than 12 hours?
(7)
Removal of solid waste (trash) for more
than seven (7) days?
(8)
Existing health services to respond in
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case of a disaster?
(9)
Telephone, telegraph, radio or mail
service for over two (2) weeks?
(10) Transit service for more than two
(2)weeks?
Does the project use more than 5% of:
(1)
Remaining electrical capacity?
Estimated daily usage is_____kwh.
Please obtain an approval letter
from local utility or plant
engineer.
(2)
Remaining water?
Estimated daily usage
is_____gallons.
Please obtain approval letter from
local authority.
(3)
Available capacity of the sewage
treatment system (branch lines, mains,
plants)?
(4)
(5)
Available capacity of trash disposal
system (collection, incinerator plant,
landfill)?
Available heating fuel (gas, coal or
heating oil)?
Estimated daily flow is_____gallons.
Please obtain approval letter from
local authority.
Also, clearly explain proposed
handling and disposal of chemical
wastes, biohazardous wastes,
syringes and other special wastes.
(Annual quantities are already
described.) Explain which of these
fuels, if any, are in short supply.
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Does the project decrease:
(1)
Food delivery system by removal of retail
food stores, etc. by 5%?
(2)
By 5%, area's domestic housing by
demolition, closing, etc.?
Will any housing be demolished,
closed, etc.?
Does project decrease:
(3)
(4)
Use of existing transit systems (bus,
train, etc.) by more than 5%?
Relate to extent of new employment.
Accessibility to routine health services
by altering point of service delivery?
Will facility:
(1)
Increase the patient load of the area's
routine health care services by more than
5%?
(2)
Change the availability of social
services by opening or closing
facilities?
(3)
Increase the number of social services
recipients by more than 5% (by
unemployment)?
(4)
Cause discontinuation of existing stops
or train stations?
(5)
Increase the annual volume of telephone,
telegraph, or mail by more than 5%?
Relate to new employment or change
in location of employees
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V.
(6)
Eliminate employment sources for 10% of
the population?
(7)
Change school enrollment by more than 5%?
HUMAN VALUE
CRITERIA
Will the project:
(1)
Encroach upon any historical,
architectural, or archeological cultural
property?
(a)
(b)
Historical Preservation: Obtain
clearance letter from State
Office.
Architectural, Archeological
and Cultural: Obtain clearance
from local government or local
society.
See page 40 for more information
on a and b.
(2)
Affect any endangered species?
(3)
Violate local, State or Federal standards
on aesthetics, odor or noise?
The fifth set of criteria is directed
toward human values concerning the quality
of the environment which are generally
agreed upon to the extent that they are
stated in statutes, standards, or
regulation
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G. Information Regarding the Property
Discuss whether the applicant has possession of the site or intends to acquire the site
through eminent domain, negotiated purchase, or other means.
i.
If the applicant has a title,
−
Attach an opinion from acceptable counsel describing the interest
that the applicant has in the site and certifying that the estate or
interest is legal and valid;
−
Attach the title.
or
ii.
If the applicant intends improvement of a leasehold interest, these requirements
must be met:
−
−
−
Attach the lease.
The lease must be renewable to meet the 25 years of possession
requirement.
The property owner must agree to the filing of a NFI.
iii.
Discuss the status of preliminary drawings as of the application date.
iv.
Attach copies of the completed outline specifications.
v.
Attach a plot plan.
vi.
Where applicable, attach site survey, soil investigation reports, copies of land
appraisals, and certification from the architect on the feasibility of improving
existing site topography.
vii.
Indicate target dates for bid advertisement, contract award, construction start,
construction completion, and occupancy.
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H. Cultural Resource Assessment, Historic Preservation (HP) Section 106 Review
Grant applications for Health Care and Other Facilities (HCOF) funds for construction
and renovation related projects must be reviewed under the terms of section 106 of the
National Historic Preservation Act (NHPA). The NHPA requires Federal agencies to
take into account the effects of their undertakings on historic properties and afford the
Advisory Council on Historic Preservation (ACHP) the opportunity to comment.
Construction and renovation of facilities with HCOF funds are considered
“undertakings” as that term is defined under the Act and 36 CFR.800.16(y) of the
ACHP’s regulations. The procedures to be followed in complying with section 106 are
set forth in the regulations at 36 CFR Part 800 (see http://www.achp.gov).
EQUIPMENT ONLY PROJECTS DO NOT REQUIRE A SECTION 106 REVIEW IF
THERE ARE NO PLANNED ALTERATIONS OF THE FACILITIY TO
ACCOMMODATE THE EQUIPMENT.
Under section 106, prior to the expenditure of HCOF funds, an assessment must be
made of the potential effects of undertakings on historic properties. Undertakings
include any district, site, building, structure or object that is eligible for or listed on the
National Register of Historic Places (NRHP). Pursuant to the regulations at 36 CFR
Part 800, the responsible Federal official must make a decision regarding the project’s
effect on historic properties in consultation with the State Historic Preservation Officers
(SHPO), Tribal Historic Preservation Officers (THPO), representatives of the local
government, affected Indian tribes and Native Hawaiian organizations, and other
interested parties.
However, the ACHP’s regulations provide for applicants or their authorized
representatives to initiate the section 106 compliance consultations when authorized to
do so by the Federal agency. All HCOF applicants and their authorized
representatives are hereby authorized to initiate the section 106 process with the
State Historic Preservation Officer (SHPO). HRSA has notified the involved SHPOs
that the applicant will be so authorized. (See section below titled “Working with
Tribal Historic Preservation Officers” if your project is located on Tribal Lands.)
HCOF funds may be used to hire consultants to complete the applicant’s section 106
and other related historic preservation responsibilities. An applicant should discuss
with the SHPO whether to hire a consultant to assist with the section 106 review. In
most cases, it would be advantageous to the applicant. The SHPO should have a list of
qualified consultants in the area.
When consulting with SHPOs, the applicants/authorized representatives should identify
the organization they are representing, include an appropriate contact person within the
organization, and describe the undertaking needing the section 106 review.
Until the applicant/authorized representative discusses the project with the SHPO, it
should be assumed that construction or renovation of structures may potentially impact
HCOF 2005 Program Guidance
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cultural and historic properties (For information on SHPOs, see
www.ncshpo.org/stateinfolist/fulllist.htm.)
HRSA remains legally responsible for all findings and determinations made by
applicants on its behalf.
Renovation of historic buildings must meet local and Federal standards regarding
treatment and design. The HRSA has adopted the policy that project activities, to the
extent feasible, should retain, respond to, and respect the use and character of historic
properties included or eligible for inclusion on the NRHP. In addition, projects that are
visible, or in close proximity to a historic district, building, or structure on the Register,
must comply with the Secretary of the Interior’s Standards for Rehabilitation and
Guidelines for Rehabilitating Historic Structures (www2.cr.nps.gov/tps/secstan1.htm),
and other Federal guidelines related to architectural design and treatment.
Decommissioning or abandonment of a facility may be considered an adverse effect if
the facility is eligible for or listed on the NRHP. When, as part of a HCOF award
activity, a property will be decommissioned or abandoned, section 106 requires
consideration of this action as well.
Construction of new facilities or the expansion of existing buildings may require
consideration of effects on archeological properties and sites of religious and cultural
significance to Native Americans. The applicant/authorized representative should
notify both the SHPO and HRSA Program Officer prior to funding any type of surveys
to identify properties eligible for listing in the National Register.
Please note that section 106 is a consultative process that does not preordain a
preservation outcome. Rather, the applicant must consider historic preservation issues
as part of project planning. Early coordination with the SHPOs, and notification and
involvement of stakeholders, will assist applicants in completing section 106 reviews in
a timely and complete manner. The applicant/authorized representative must publish a
Notice in the largest newspaper in the area giving details of its project and asking that
comments from interested parties be sent to the applicant. The applicant/authorized
representative must also attempt to contact any local interest groups and provide them a
chance to comment on the project (SHPOs are a good resource to obtain a list of local
organizations). The applicant/authorized representative must send a copy of the Notices
and any comments to the SHPO and the HRSA Program Officer responsible for the
project. The applicant should also address how it proposes to resolve the issue(s).
The section 106 review attempts to resolve two key issues. The first is whether the
proposed project has an effect on historic properties. The term effect is defined under
36 CFR 800.16(i) as an “alteration to the characteristics of historic property qualifying
it for inclusion in, or eligibility for the National Register.” The project’s impact on the
property’s use, character, location, and setting is to be considered when determining its
effect on the historic property. The second issue is whether any effect on the historic
HCOF 2005 Program Guidance
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property will be adverse. An effect is considered adverse under 36 CFR 800.5(a)(1)
when it will endanger those qualities that make the property eligible for inclusion in the
National Register. Adverse effects can be direct or indirect. Typical examples include:
•
Physical destruction or damage
•
Alteration inconsistent with the Secretary of the Interior’s Standards for the
Treatment of Historic Properties
•
Relocation of the property
•
Change in the character of the property’s use or setting
•
Introduction of incompatible visual, atmospheric, or audible elements
•
Neglect and deterioration
Where it is determined that the construction or renovation of a facility receiving HCOF
funds will have an adverse effect on a historic property, the HCOF Program Officer will
enter into the consultation process and assist the applicant in developing a
Memorandum of Agreement (MOA) that outlines the agreed upon mitigation measures
with the SHPO and the ACHP (if it decides to participate).
In cases where the consultation is terminated without an agreement between the
applicant and SHPO to resolve adverse effects, the HCOF Program Officer will consult
with the ACHP.
WORKING WITH PROJECTS LOCATED ON TRIBAL LANDS
HRSA has notified THPOs, Indian Tribes and Native Hawaiian organizations of the
Congressional Earmarks and asked for their comments on the proposed projects before
the Federal assistance is awarded. In accordance with 36 CFR Section 800.2(c)(2),
HRSA shall ensure that all consultations with THPOS/Indian Tribes are conducted in a
manner respectful of Tribal sovereignty and the government to government relationship
between the Federal government and Indian Tribes. This policy, therefore, is not
intended to modify or limit such requirements. HRSA recognizes its Tribal consultation
responsibility. Only if the THPO/Tribe decides to forgo its government to government
relationship in this instance and the THPO/Tribe agrees to work with the applicants
directly, will the applicant/authorized representative contact the THPO/Tribe. (For
information on THPOs, see www.nathpo.org).
When the applicant’s project is located on Tribal Lands, the applicant should contact the
HRSA Project Officer. The Project Officer will contact the THPO/Tribe to determine if
they will agree to work with the applicant directly. If so, the applicant will follow the
HCOF 2005 Program Guidance
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guidelines as set forth in this document for SHPOs. If the THPO/Tribe decides not to
work directly with the applicant, the applicant will still be responsible for conducting
the section 106 process, however, the applicant will supply the required information to
the Project Officer who will work with the THPO/Tribe.
SUMMARY OF THE HISTORIC PRESERVATION PROCESS INVOLVING
SHPOs
MOVEABLE EQUIPMENT ONLY PROJECTS ARE EXEMPT FROM SECTION
106 REVIEW IF THERE ARE NO PLANNED ALTERATIONS OF THE FACILITIY
TO ACCOMMODATE THE EQUIPMENT.
If it is a construction or renovation related project, the applicant/authorized
representative should contact the appropriate SHPO to discuss the project. If it is
determined that the project may effect an historic property the applicant/authorized
representative should publish a notice in the largest newspaper in the area describing the
project, and contact local interest groups requesting comments.
The applicant/authorized representative must provide the SHPO with information that
will support a finding that:
1. The property is not historic;
2. The property is historic, with the project causing no potential adverse effects; or
3. The property is historic and the project may cause adverse effects and provide a
resolution to the adverse effects.
The SHPO will then either concur or disagree with the finding. If there is a
disagreement that cannot be resolved after consultation, the HRSA will request that the
ACHP review the finding.
A construction related award applicant must submit, either with the award application
or as a later supplement to the application, a letter from the SHPO indicating 1 or 2
above, or the applicant should notify the HRSA Program Officer that a MOA needs to
be developed.
GRANT DRAW DOWNS ARE NOT ALLOWED UNTIL EITHER THE SHPO/THPO
STATES 1 OR 2 ABOVE OR A MOA IS FINALIZED BY ALL PARTIES.
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I. Executive Orders 13202 and 13208 (Preservation of Open Competition)
PRESERVATION OF OPEN COMPETITION AND GOVERNMENT
NEUTRALITY TOWARDS GOVERNMENT CONTRACTOR’S LABOR
RELATIONS ON FEDERAL FUNDED CONSTRUCTION PROJECTS
The EO 13202 and 13208 (see pages 44-48) apply to awards issued under this program
and requires that neither the bid specifications, project agreements, nor other controlling
documents for construction contracts, shall contain any provision that:
i.
Require or prohibit bidders, offerors, contractors, or subcontractors to enter into
or adhere to agreements with one or more labor organizations, on the same or
other related construction project(s); or
ii.
Otherwise discriminate against bidders for becoming or refusing to become or
remain signatories to agreements with one or more labor organizations, on the
same of other related construction project(s).
If your facility has already begun construction and you have a Project Labor Agreement
(PLA) that is a pre-hire agreement that governs labor relations at a construction site,
contact DES to discuss the situation.
HCOF 2005 Program Guidance
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Federal Register / Vol. 66, No. 36 / Thursday, February 22, 2001 / Presidential Documents 11225
Presidential Documents
Executive Order 13202 of February 17, 2001
Preservation of Open Competition and Government Neutrality
Towards Government Contractors’ Labor Relations on Federal and
Federally Funded Construction Projects
By the authority vested in me as President by the Constitution and laws of the United States of
America, including the Federal Property and Administrative Services Act, 40 U.S.C. 471 et seq., and
in order to (1) promote and ensure open competition on Federal and federally funded or assisted
construction projects; (2) maintain Government neutrality towards Government contractors’ labor
relations on Federal and federally funded or assisted construction projects; (3) reduce construction
costs to the Federal Government and to the taxpayers; (4) expand job opportunities, especially for
small and disadvantaged businesses; and (5) prevent discrimination against Government contractors or
their employees based upon labor affiliation or lack thereof; thereby promoting the economical,
nondiscriminatory, and efficient administration and completion of Federal and federally funded or
assisted construction projects, it is hereby ordered that:
Section 1. To the extent permitted by law, any executive agency awarding any construction contract
after the date of this order, or obligating funds pursuant to such a contract, shall ensure that neither the
awarding Government authority nor any construction manager acting on behalf of the Government
shall, in its bid specifications, project agreements, or other controlling documents:
(a) Require or prohibit bidders, offerors, contractors, or subcontractors to enter into or adhere to
agreements with one or more labor organizations, on the same or other related construction project(s);
or
(b) Otherwise discriminate against bidders, offerors, contractors, or subcontractors for becoming or
refusing to become or remain signatories or otherwise to adhere to agreements with one or more labor
organizations, on the same or other related construction project(s).
(c) Nothing in this section shall prohibit contractors or subcontractors from voluntarily entering into
agreements described in subsection (a).
Sec. 2. Contracts awarded before the date of this order, and subcontracts awarded pursuant to such
contracts, whenever awarded, shall not be governed by this order.
Sec. 3. To the extent permitted by law, any executive agency issuing grants, providing financial
assistance, or entering into cooperative agreements for construction projects, shall ensure that neither
the bid specifications, project agreements, nor other controlling documents for construction contracts
awarded after the date of this order by recipients of grants or financial assistance or by parties to
cooperative agreements, nor those of any construction manager acting on their behalf, shall contain any
of the requirements or prohibitions set forth in section 1(a) or (b) of this order.
Sec. 4. In the event that an awarding authority, a recipient of grants or financial assistance, a party to a
cooperative agreement, or a construction manager acting on behalf of the foregoing, performs in a
manner contrary to the provisions of sections 1 or 3 of this order, the executive agency awarding the
contract, grant, or assistance shall take such action, consistent with law and regulation, as the agency
determines may be appropriate.
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11226
Federal Register / Vol. 66, No. 36 / Thursday, February 22, 2001 / Presidential
Documents
Sec. 5. (a) The head of an executive agency may exempt a particular project, contract, subcontract,
grant, or cooperative agreement from the requirements of any or all of the provisions of sections 1 and
3 of this order, if the agency head finds that special circumstances require an exemption in order to
avert an imminent threat to public health or safety or to serve the national security.
(b) A finding of ""special circumstances" " under section 5(a) may not be based on the possibility or
presence of a labor dispute concerning the use of contractors or subcontractors who are nonsignatories
to, or otherwise do not adhere to, agreements with one or more labor organizations, or concerning
employees on the project who are not members of or affiliated with a labor organization.
Sec. 6. (a) The term ""construction contract" " as used in this order means any contract for the
construction, rehabilitation, alteration, conversion, extension, or repair of buildings, highways, or other
improvements to real property.
(b) The term ""executive agency" " as used in this order shall have the same meaning it has in 5
U.S.C. 105, excluding the General Accounting Office.
(c) The term ""labor organization" " as used in this order shall have the same meaning it has in 42
U.S.C. 2000e(d).
Sec. 7. With respect to Federal contracts, within 60 days of the issuance of this order, the Federal
Acquisition Regulatory Council shall take whatever action is required to amend the Federal
Acquisition Regulation in order to implement the provisions of this order.
Sec. 8. As it relates to project agreements, Executive Order 12836 of February 1, 1993, which, among
other things, revoked Executive Order 12818 of October 23, 1992, is revoked.
Sec. 9. The Presidential Memorandum of June 5, 1997, entitled ""Use of Project Labor Agreements for
Federal Construction Projects" " (the ""Memorandum""), is also revoked.
Sec. 10. The heads of executive departments and agencies shall revoke expeditiously any orders, rules,
regulations, guidelines, or policies implementing or enforcing the Memorandum or Executive Order
12836 of February 1, 1993, as it relates to project agreements, to the extent consistent with law.
Sec. 11. This order is intended only to improve the internal management of the executive branch and
is not intended to, nor does it, create any right to administrative or judicial review, or any right,
whether substantive or procedural, enforce able by any party against the United States, its agencies or
instrumentalities, its officers or employees, or any other person.
THE WHITE HOUSE, February 17, 2001
[FR Doc. 01-4622
Filed 02-21-01; 11:16 am] Billing code 3195-01-P
HCOF 2005 Program Guidance
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18717
Federal Register Vol. 66, No. 70
Wednesday, April 11, 2001
Presidential Documents
Title 3—
The President
Executive Order 13208 of April 6, 2001
Amendment to Executive Order 13202, Preservation of Open Competition and Government
Neutrality Towards Government Contractors’ Labor Relations on Federal and Federally Funded
Construction Projects
By the authority vested in me as President by the Constitution and the laws of the
United States of America, including the Federal Property and Administrative
Services Act, 40 U.S.C. 471 et seq., and in order to (1)
promote and ensure open competition on Federal and federally funded or assisted construction projects;
(2) maintain Government neutrality towards Government contractors’ labor relations on Federal and
federally funded or assisted construction projects; (3) reduce construction costs to the Federal
Government and to the tax payers; (4) expand job opportunities, especially for small and disadvantaged
businesses; (5) prevent discrimination against Government contractors or their employees based upon
labor affiliation or lack thereof; and (6) prevent the inefficiency that may result from the disruption of a
previously established contractual relationship in particular cases; thereby promoting the economical,
nondiscriminatory, and efficient administration and completion of Federal and federally funded or assisted
construction projects, it is hereby ordered that Executive Order 13202 of February 17, 2001, is amended
by adding to section 5 of that order the following new subsection:
HCOF 2005 Program Guidance
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18718
Federal Register / Vol. 66, No. 70 / Wednesday, April 11, 2001 / Presidential Documents
(c) The head of an executive agency, upon application of an awarding authority, a recipient of grants or
financial assistance, a party to a cooperative agreement, or a construction manager acting on behalf
of the foregoing, may exempt a particular project from the requirements of any or all of the
provisions of sections 1 and 3 of this order, if the agency head finds: (i) that the awarding
authority, recipient of grants or financial assistance, party to a cooperative agreement, or
construction manager acting on behalf of the foregoing had issued or was a party to, as of the date
of this order, bid specifications, project agreements, agreements with one or more labor
organizations, or other controlling documents with respect to that particular project, which
contained any of the requirements or prohibitions set forth in sections 1(a) or (b) of this order; and
(ii) that one or more construction contracts subject to such requirements or prohibitions had been
awarded as of the date of this order.
THE WHITE HOUSE, April 6, 2001.
[FR Doc. 01–9086
Filed 4–10–01; 8:45 am] Billing code 3195–01–P
HCOF 2005 Program Guidance
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J.
(1) Examples of Construction Requirements from DES and (2) Examples of
Awardee Self-Certification Letters for Construction Projects
REGISTERED MAIL
RETURN RECEIPT
(Date)
(Name and Address of Awardee’s
Authorized Representative)
Subject: Project No. XXXXX-XX-X
(Name of Awardee)
(City, State)
“Information for Awardee”
Dear Mr./Ms. XXXXXX:
This is to inform you that our office, the Division of Engineering Services (DES) is responsible for
certifying to the HRSA Division of Facilities Compliance and Recovery (DFCR) that your (PL XXXXX funded) project will be designed, bid, constructed, and ultimately completed in accordance with all
applicable federal requirements. To that end, our involvement will require the receipt of proper
documentation and concomitant certification from you at the various phases of the project.
We have received a copy of the “Notice of Award” issued , as well as “Specifics of Award”, and
“Conditions of Award.” Hence, we outline below the procedures that shall be followed for the
expeditious flow through the various phases of your project.
1. If you have not yet done so, it is expected that you will engage the services of an
architect/engineer (A/E) to develop the pertinent construction documents as well as to
supervise the construction phase of the project. Accordingly, you’re A/E will submit to the
Director, DES a pre-certification statement attesting to his suitable involvement in this
project (see enclosed “Architect/Engineer Pre-Certification Statement”). This statement
should be submitted within 30 days from the date of this letter. If this deadline is not
feasible, it is imperative that you contact us to work out an extension in time.
2. The project must be designed in accordance with the mandatory requirements imposed on
federally assisted construction projects as well as all applicable program standards, state
codes, and local codes and ordinances. Accordingly, your A/E will certify (before
construction bidding and contract award) that the final working drawings and final technical
specifications were so developed (see enclosed “Architect/Engineer Certification of Final
Design”). It is expected that the design documents will be completed by the estimated
completion date so stated in the pre-certification statement, and that the certification
of final design statement will be submitted to DES within 30 days of that date.
HCOF 2005 Program Guidance
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3. You must certify that the various bonding and insurance requirements for federally assisted
construction projects will be met (see enclosed, “Statement of Assurance of Awardee’s and
Contractor’s Bonding and Insurance Coverage”).
4. It is your responsibility to award the construction contract(s) under a process where
maximum competition is achieved in order to obtain the most reasonable price. Therefore,
competitive bidding by formal advertisement must be used except when construction
management procedures are employed. Accordingly, you will submit to us your bid
tabulations, certified by the A/E, and your formal recommendation of award. The
recommendation should also include a statement of determination that the selected
contractor is not on the U.S. General Services Administration Lists of Parties Excluded
from Federal Procurement or Non-Procurement Programs (debarred list). If you award the
contract to any qualified bidder other than the lowest bidder, provide proper documentation
for your decision. Subsequently, a copy of your award letter(s) to the successful
contractor(s) will also be submitted to DES. The bid tabulations, certification, award
recommendation, “debarred list” statement, award letter, and bonding and insurance
statement (see item 3) must be submitted within 30 days of the scheduled contract
award date.
5. During the construction phase, submit a quarterly construction report to DES informing us
of the progress of the project including problems/issues that were observed or need to be
addressed. This report should include the percentage of completion to date, percentage of
time elapsed, and projected completion date. The report should also include a running
tabulation of any change orders processed, with copies of the respective approved change
orders attached. The report must be submitted on a timely basis, no later than 30 days
from the end of the report period.
6. Submit written notification to the Director, DES when the project is completed. The letter
will include statements assuring that the project has been completed in accordance with the
previously certified contract documents and that the project is free of mechanics’ liens.
(Also see related item 7 below.)
7. You must sign, date and submit to this office a statement in which you certify 1) the project
has been constructed in conformance with the applicable federal statutes and regulations,
2) the final project costs and their respective allowable and non-allowable components
(submit a final SF 424C “Budget Page”), 3) the Substantial Completion Date, 4) a copy of
the certificate of occupancy issued by the Authority Having Jurisdiction, and
5) photographs of the front and rear of the project and each of the major rooms in the
project, with a brief description written on the back. Both the notification of project
completion letter (see item 6) and the certification statement must be submitted within
30 days of project completion.
We look forward to working with you toward a successful project. DES is committed to
processing your project in an orderly and prompt manner. Cooperation between DES and
HCOF 2005 Program Guidance
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you, the awardee, is crucial to ensure the continued disbursement of your award funds
without interruption. Mr./Ms. XXXXXX of my staff has been designated as your DES
Project Manager. He/She can be reached at (phone number). If you have any questions
regarding the above information, please feel free to call:
Sincerely,
Emilio M. Pucillo, R.A.
Director
Enclosures: Architect/Engineer Pre-Certification Statement
Architect/Engineer Certification to Final Design
Applicant’s Assurance – Bonding and Insurance Coverage
cc: Michele Kanner, DFCR w/o encl
Note: The A/E will submit the following statement to DES on the firm’s letterhead. The document
may be modified as necessary to meet the specific conditions of the project.
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Architect/Engineer Pre-Certification Statement
I hereby certify that (name of firm) has been engaged by (name of awardee) to provide design and
construction supervision services for (describe project) in accordance with the Owner/Architect
Agreement signed and executed on (date).
I further certify the following:
1. (Name of firm) is licensed to practice in the State of (indicate state).
2. The executed Agreement is for this project only, and is not “open-ended.”
3. The project will be designed and constructed in accordance with all mandatory requirements
imposed on federally-assisted construction projects by specific laws enacted by Congress,
Presidential Executive Orders, or Departmental Policy. The project design will also meet all
applicable program standards, state codes, and local codes and ordinances. Such federallymandated standards include (but are not limited) to the following, as applicable:
•
•
•
AIA Guidelines for Design and Construction of Hospital and Health Care Facilities
(2001 edition).
NFPA 101 Life Safety Code (2003 edition).
ADA Accessibility Guidelines for Building and Facilities.
4. (Name of firm) will promptly notify (name of awardee) of any conflict between any federal
standard and state or local standard as the issue may arise in the course of the project design.
The issue will be brought to the attention of DES for resolution.
5. It is estimated that final working drawings and final technical specifications should be
completed by (indicate date). (Name of firm) will promptly notify DES of any changes in the
design schedule, including a proposed revised estimated completion date. The proposed
revised date must be agreeable to both (name of firm) and (name of awardee); and concurred by
DES.
_____________________________________
(Signature of firm’s authorized representative)
___________________
(Date)
Note: The A/E will submit the following statement to DES on the firm’s letterhead. The document
may be modified as necessary to meet the specific conditions of the project.
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Architect/Engineer Certification of Final Design
I hereby certify that (name of firm) has completed the final working drawings and final technical
specifications for the (describe project) in accordance with the Owner/Architect Agreement signed and
executed on (date).
I further certify that the project was designed in accordance with all mandatory requirements imposed
on federally-assisted construction projects by specific laws enacted by Congress, Presidential
Executive Orders, or Departmental Policy, as well as all applicable program standards, state codes, and
local codes and ordinances.
_____________________________________
(Signature of firm’s authorized representative)
___________________
(Date)
Note: The awardee will submit the following statement to DES. The document may be modified as
necessary to meet the specific conditions of the project.
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Statement of Assurance of Awardee’s and Contractor’s Bonding and Insurance
Coverage
I hereby certify that (name of contractor) has been selected to construct (describe project) in
accordance with the Owner/Contractor Agreement signed and executed on (date).
I further certify that (name of contractor) is providing appropriate insurance and bonding coverage for
this project in accordance with HRSA/DES requirements and as further described:
1.
2.
3.
4.
5.
Performance Bond – 100 percent of the contract sum.
Payment (Labor and Material) – 100 percent of the contract sum.
Comprehensive General Liability Insurance: $500,000 per occurrence (minimum).
Property Damage Liability Insurance: (amount established by the awardee).
Automobile Liability Insurance: at least $ 200,000 per person and $ 500,000 per occurrence
for bodily injury and $ 20,000 per occurrence for property damage.
6. Inclusion of the subcontractors’ activities within the contractor’s own policy, otherwise each
subcontractor must maintain the same levels of insurance under separate policy for the life of
the subcontract.
I further certify that (name of awardee) maintains sufficient liability and property insurance against
claims that may arise from operations under the construction contract, as well as sufficient property
insurance covering the entire work at the site to the full insurable value. This insurance includes the
interests of (name of awardee), (name of contractor), and the subcontractors involved in the work.
________________________________________
(Signature of awardee’s authorized representative)
___________________
(Date)
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K. Example of Notice of Federal Interest
On ________________________, 20_______, the Department of Health and Human Services funded
award number ________________________ to ________________________________. The award
provided Federal funds for (describe use of Federal support, e.g., new construction of a building),
which is located on the following land in ________________________ County, State of
_________________________, particularly described as follows: (LEGAL DESCRIPTION OF
PROPERTY)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
The award incorporated conditions, which include restrictions on usage of the aforementioned property
and provided for a continuing Federal interest in the property from the date of occupancy:
Specifically, the property may not be: (1) used for any purpose inconsistent with the approved
program of utilization, (2) mortgaged or otherwise used as collateral without the written permission of
the Secretary, DHHS, or (3) sold or transferred to another party without written permission of the
Secretary, DHHS (or employee who has the authority to give this permission of the Secretary, DHHS).
These conditions are in accordance with HHS Grants Policy Directive 3.04, “Property.”
These award conditions and requirements cannot be nullified or voided through a transfer of
ownership. Therefore, advance notice of any proposed change in usage or ownership must be given to
the Secretary, DHHS.
Signature:
_____________________________________
Name: (please type)
_____________________________________
Title:
_____________________________________
Date:
_____________________________________
HCOF 2005 Program Guidance
Page 55 of 70
V. APPLICATION REVIEW INFORMATION
1. Review Criteria – The application received will be evaluated on its own merit to
determine how well the application meets the evaluation criteria listed below:
i.
The appropriateness of the project design, facility construction/renovation plans
and time frames for initiation through completion of the project. Schematic
drawings must be provided with the application when the project is for new
construction or renovation (see page 23 for an explanation of schematic
drawings).
ii.
The reasonableness and justification for the itemized costs in the construction
budget.
iii.
The adequacy and completeness of the description of scope of services and/or
activities to be provided in spaces constructed or renovated with the requested
HRSA funding.
2. Review and Selection Process – Federal program staff will review the earmarked
applications. There are no funding priorities or preferences.
VI. AWARD ADMINISTRATION INFORMATION
1. Award Notices
This program uses a single application due date which is 30 days after the application
materials are mailed. Applicants can obtain an automatic 30-day extension.
Applications are reviewed in the order in which they are received. Applicants can
expect to hear from HRSA within 90 days of submitting their application. However,
not all applications will be awarded in 90 days due to factors such as deficiencies in the
application and the volume of applications which HRSA must review and process.
All applicants will be notified in writing of the actions taken on their application. If the
application is approved and funds are available, a Notice of Award is issued. This
document, which includes the Specifics of Award (see page 69 for an example),
Conditions of Award, and Approved Construction Budget, indicates the amount of
Federal funds awarded, types of expenditures authorized, project description, award
conditions and other necessary information.
If you have not received a Notice of Award by October 15th, 2005, please contact the
DGMO.
2. Drawing Down of Award Funds
Awards under this Program will be paid using the DHHS Payment Management System
(PMS). For construction/renovation projects, funds may be drawn down as
project costs are incurred, in the same proportion as the award is to the projected
total cost. For instance, consider a project in which the drawdown percentage is 80
HCOF 2005 Program Guidance
Page 56 of 70
percent ($400,000 award/$500,000 total costs). The amount of funds that can be
requested for each draw request cannot be more than 80 percent of the cost incurred.
Therefore, when $50,000 of cost is incurred, $40,000 may be drawn from the award.
The balance must be paid for by the awardee’s other sources of funds.
For equipment only and design only projects, the drawdown percentage is calculated
by dividing the grant amount by total eligible costs (line 16c of the Budget Page).
For awardees that currently use PMS, the payment process is the same as for other
awards; the awardee submits periodic cash requests to be reimbursed for allowable
costs. Do not submit construction vouchers or other such documents to PMS.
Awardees that do not currently have an account with PMS will have to establish one in
order to access funds. Contact PMS for information about the process of establishing a
PMS account. Please recognize that PMS will not create an account for your
organization until an award notice has been issued. Contact the Division of Payment
Management for detailed drawdown information (See page 62).
3. Change of Scope to the Project
In the event of a change of scope to your project contact DFCR immediately. A change
of scope would include: new location, major redesign (e.g., a change in the number of
floors or a change in the primary purpose of the project), or major (greater than 10
percent) change in the total budget. Please note that change orders (10 percent or less
of the project) or minor line item budget changes would not constitute a change of
scope. These should be discussed with the appropriate DES office or their designated
agent.
4. Major Award Obligations
All institutions of higher education, hospital, and nonprofit organizations that are
recipients of HRSA funding, including awards which involve the acquisition of real
property, will follow the requirements including 45 CFR §74.21, “Standards for
Financial Management Systems,” and §74.26, “Non-Federal Audits.” State and local
governments will follow 45 CFR §92.20, “Standards of Financial Management
System,” and §92.26, “Non-Federal Audit.” Additionally, HHS policies regarding the
protection of the Federal interest in real property acquired by a HHS award as described
in HHS Grants Policy Directive 3.04 “Property” are applicable.
5. Administrative and National Policy Requirements
Public Policy Issuance
Healthy People 2010
Healthy People 2010 is a national initiative led by HHS that sets priorities for all
HRSA programs. The initiative has two major goals: (1) to increase the quality and
years of a healthy life; and (2) eliminate our country’s health disparities. The program
consists of 28 focus areas and 467 objectives. HRSA has actively participated in the
HCOF 2005 Program Guidance
Page 57 of 70
work groups of all the focus areas, and is committed to the achievement of the
Healthy People 2010 goals.
Applicants must summarize the relationship of their projects and identify which of
their programs objectives and/or sub-objectives relate to the goals of the Healthy
People 2010 initiative.
Copies of the Healthy People 2010 may be obtained from the Superintendent of
Documents or downloaded at the Healthy People 2010 website:
http://www.health.gov/healthypeople/document.
The Public Health Service strongly encourages all award recipients to provide a smokefree workplace and to promote the non-use of all tobacco products. Further, Public Law
103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in
some cases, any portion of a facility) in which regular or routine education, library, day
care, health care or early childhood development services are provided to children.
6. Reporting
The successful applicant under this guidance must:
A. Comply with audit requirements of Office of Management and Budget (OMB)
Circular A-133. Information on the scope, frequency, and other aspects of the
audits can be found on the Internet at www.whitehouse.gov/omb/circulars;
B. Submit a PMS Quarterly Report. The reports identify cash expenditures against the
authorized funds for all of the applicant’s awards in the system. Failure to submit
the report will result in the inability to access award funds. Submit report to the
address indicated by PMS;
C. Submit a Financial Status Report (FSR – SF 269A). A final financial status report is
required within 90 days of the end of each Budget Period. The report is an
accounting of expenditures under the project that year with a final reporting of all
expenditures upon completion or end of the project period;
D. Submit a self-certification letter to DES (see page 49 for an example). Most
projects are monitored this way although DES, after discussion with DFCR, has the
option to do a more intensive type of monitoring. DES will send a letter after the
award has been issued to the awardee with information regarding specific
monitoring procedures. This will include submitting a certification that the final
working drawings and technical specifications were designed in accordance with the
mandatory requirements imposed on federally assisted construction projects. Bid
tabulation, certified by the A/E firm, and the formal recommendation of award must
also be submitted to DES. A QUARTERLY CONSTRUCTION REPORT MUST
BE SUBMITTED TO DES.
E. Submit Progress Reports to your Program Analyst. A condition of the award is that
the awardee submits progress reports. They should be sent by mail, fax, or e-mail to
HCOF 2005 Program Guidance
Page 58 of 70
the Division of Facilities Compliance and Recovery, Room 10-105, Parklawn
Building, 5600 Fishers Lane, Rockville, Maryland 20857, or by fax 301 443-0619.
(The facility will be notified of the e-mail address for the facility’s program contact
when it receives its Notice of Award. E-mailing is the preferred way of receiving
information.) The reports will be due annually. The awardee will be notified of the
due dates. The reports must continue to be sent until the awardee notifies DFCR
that the project is completed. At that time the awardee must submit a final Budget
Page (Form 424c) and a final itemized movable equipment list.
Some examples of progress report information to be provided are:
VII.
i.
For construction projects, provide the estimated or actual date of construction
start and construction completion. The awardee will submit information on the
percent of completion of construction, and a written explanation for any
significant delay or problems.
ii.
For equipment only projects, provide the estimated or actual date of delivery of
equipment. In addition, the awardee will submit information on the percent of
the dollar value of equipment delivered, and a written explanation for any
significant delays or problems.
iii.
For design only projects, provide the estimated or actual date of the selfcertification statement to DES that final working drawings and final technical
specifications were done in accordance with the mandatory requirements
imposed on federally assisted construction projects. The awardee will provide a
written explanation for any significant delays or problems.
AGENCY CONTACTS
1. DIVISION OF FACILITIES COMPLIANCE AND RECOVERY
Paul T. Murphy, Chief
301-443-5656
[email protected]
Program Analysts
Stephanie Alexander
Torrance Brown
Hermione Caplan
Matt Kozar
Chris Rudy
Audry Sartin
David Trejo
Bryan West
301-443-0095
301-443-8225
301-443-8138
301-443-1034
301-443-1844
301-443-5767
301-443-0534
301-443-4686
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
Fax Number 301-443-0619
HCOF 2005 Program Guidance
Page 59 of 70
2. DIVISION OF GRANTS MANAGEMENT OPERATIONS
Neal Meyerson, Lead Grants Management Specialist for Construction
Email: [email protected]
Phone: 301 443-5906
Marilyn Stewart, GMS
Email: [email protected]
Phone: 301 443-9022
States: CT, MA, ME, NH, RI, VT, NY, NJ, PR, VI
LaShawna Smith, GMS
Email: [email protected]
Phone: 301 443-4241
States: AK, AR, DC, DE, ID, LA, MD, NM, OK, OR, TX, VA, WA, WV
Stephanie Young, GMS
Email: [email protected]
States: PA: A-Me
Phone: 301 594-1246
Tammy Jeffs, GMS
Email: [email protected]
Phone: 301 443-5419
States: PA: Mi – Z, CO, MT, ND, SD, UT, WY
Anifa Williams, GMS
Email: [email protected]
States: AL, FL, GA, KY, MS
Phone: 301 594-5242
Tonya Randall, GMS,
Email: [email protected]
States: NC, SC, TN
Phone: 301-594-4259
John Gazdik, GMS,
Email: [email protected]
States: OH, MN, IN
Phone: 301 443-6962
Carolyn Cobb, GMS,
Email: [email protected]
States: IL, MI, WI
Phone: 301 443-0829
Darren Buckner, GMS,
Email: [email protected]
States: IA, KS, MO, NE
Phone: 301 443-1913
Janene Dyson, GMS,
Email: [email protected]
Phone: 301 443-8325
States: AZ, CA, HI, NV, Guam
Fax Number 301-594-4073
HCOF 2005 Program Guidance
Page 60 of 70
3. DIVISION OF ENGINEERING SERVICES
Ms. Teresa Bilyk, R.A., New York Office
Chief, Design and Construction
Division of Engineering Services
26 Federal Plaza, Room 3309
New York, New York 10278
Phone: 212-264-3600
Fax Number: 212-264-0121
Email: [email protected]
States Covered: Connecticut, Delaware, District of Columbia, Illinois, Indiana, Iowa,
Kansas, Maine, Maryland, Massachusetts, Michigan Missouri, Nebraska, New
Hampshire, New Jersey, New York, Ohio, Pennsylvania, Puerto Rico, Rhode Island,
Vermont, Virgin Islands, Virginia, West Virginia, and Wisconsin.
Mr. Roger Springer, R.A., Dallas Office
Project Coordinator
Division of Engineering Services
1301 Young Street, Room 1073
Dallas, Texas 75202-5433
Phone: 214-767-1113
Fax : 214-767-5196
Email: [email protected]
States covered: Alabama, Arkansas, Colorado, Florida, Georgia Kentucky, Louisiana,
Mississippi, Montana, New Mexico, North Carolina, North Dakota, Oklahoma, South
Carolina, South Dakota, Tennessee, Texas, Utah and Wyoming
Mr. George Bennett, R.A., Seattle Office
Project Coordinator
Division of Engineering Services
2201 Sixth Avenue, MS RX-23
Blanchard Plaza Building
Seattle, Washington 98121-2500
Phone: 206-615-2046
Fax: 206-615-2457
Email: [email protected]
States covered: Alaska, Arizona, California, Hawaii, Idaho, Nevada, Oregon Trust
Territories of the Pacific Island and Washington
HCOF 2005 Program Guidance
Page 61 of 70
4. DIVISION OF PAYMENT MANAGEMENT (PMS)
1-877-614-5533
www.dpm.psc.gov
VIII. OTHER INFORMATION
1. COMMON ERRORS TO AVOID
−
Using the Non-Construction Budget Page 424a instead of the Construction
Budget Page 424c in the PHS 5161-1. All projects under the HCOF award
program are considered to be construction, including equipment only and design
only projects.
−
Requesting award funds for the purchase or rental of land and/or structures.
−
Contingency is greater than 5 percent of lines 9 (Construction) and 10
(Equipment) if it is a renovation or new construction.
−
Contingency is greater than 5 percent of line 10 (Equipment) for an equipment
only project. Indicating a contingency cost if the equipment is already
purchased.
−
Requesting funds to be drawn down before project costs are incurred or are
proportionately more than the Federal share (see page 56).
−
On the Budget page, having Column C, line 16, add up exactly to the award
amount. Column C is for Total Eligible Project Costs, and it would only equal
the award amount when the award would fund 100 percent of the project.
−
Having unrealistic design, cost or time frames projected because the applicant
did not understand the whole construction monitoring and review process (see
page 58).
−
Submitting non-construction costs (e.g. operating costs such as salaries,
equipment leasing, supplies, research costs, etc.).
−
Not signing nor including the Construction Assurances for an equipment only
request. (They are required for all projects.)
−
Providing an itemized equipment list with some items that have a unit cost of
less than $5,000 and did not submit an assurance that the unit cost is allowable
under the facility’s capitalization policy.
−
Indicating Total Project Costs on the Budget Page and Face Page which do not
equal.
HCOF 2005 Program Guidance
Page 62 of 70
2. FREQUENTLY ASKED QUESTIONS
Question 1:
What is the Catalog of Federal Domestic Assistance number
for this program?
Answer:
93.887
Question 2:
Can I have additional time to prepare the application?
Answer:
If additional time is needed, submit a written request with
justification for the delay by email, fax or regular mail to your
designated Grants Management Specialist. You can have a onetime extension for up to 30 days.
Question 3:
What can I do to receive award funds as quickly as possible?
Answer:
All Federal funds will be awarded with a budget start date of
September 1. If you need your award expedited, submit your
application before the due date. Please recognize that this is a
very large program, and awards will be made over several
months as they are received and reviewed. If your application is
late or has missing, incomplete, or unclear items, processing will
be delayed. Last year many awards were not issued until midOctober, although the award funds were committed by September
30.
Question 4:
Are matching funds required?
Answer:
There are no requirements for the applicant to provide matching
funds. Federal funds are provided up to 100% of allowable
project costs. While there is no cost-sharing or matching
requirement, HRSA does require applicants to show the total
costs of the project. This is necessary to establish the percentage
of Federal participation in the project.
Question 5:
Are indirect costs allowed?
Answer:
No, indirect costs are not allowed on construction awards.
Question 6:
When can I make a public announcement about the project?
Answer:
The identity of these projects is public information and you are
free to make an announcement at any time. However, an
announcement about the receipt of award funds should not be
made until you have received the Notice of Award.
HCOF 2005 Program Guidance
Page 63 of 70
Question 7:
Can we be reimbursed with award funds for equipment we
have already purchased?
Answer:
Yes, under certain circumstances. Contact your program contact
listed in the Agency Contacts section of this application guide for
further information.
Question 8:
We have already started construction on the project. How
should we proceed?
Answer:
Contact the DES for guidance before you submit the application.
Also contact DFCR for guidance. The simplest solution would
be to get an equipment only project that would not require
construction compliance to Federal requirements.
Question 9:
We know what we want to build, but we don’t have a site yet.
What should we do?
Answer:
Submit the application on time and include as much information
as possible. Site information can be submitted before the award
is issued. If it is not received before the award is issued, a
condition of award will require it to be submitted within a
specified time period.
Question 10:
We have a site for the project, but we haven’t fully developed
the facility design. How should we proceed?
Answer:
Submit the application on time and include as much information
as possible. Additional information can be submitted before the
award is issued or after issuance in response to a condition of
award.
Question 11:
Certain aspects of the project may change in the future. How
should we handle this?
Answer:
Most projects undergo some change. Submit a complete
application on time with as much information as possible. The
project description, budget, and other information should reflect
current plans. If there are changes after the award is issued, they
can be handled by a “change of scope” request. Contact DFCR
for further information about this process.
Question 12:
There is existing financing on the project site. Is this
allowable, and what do we need to do about this?
Answer:
Yes, it is allowable and is generally not a concern to HRSA. The
requirement that the property not be mortgaged or refinanced
HCOF 2005 Program Guidance
Page 64 of 70
without DHHS approval only applies to financing that takes place
after the awardee accepts the award. If you intend to mortgage
the Federal assisted property to obtain financing, please highlight
that in your application, and contact DFCR as soon as your plan
is firmed up.
Question 13:
What is the role of the DES with the award and how does it
differ from my contact in the Division of Facilities
Compliance and Recovery (DFCR)?
Answer:
Your DFCR contact is involved in programmatic issues and
normal award oversight and administration. DES is actively
involved in overseeing the construction process. For example,
DES in most cases must approve your certifications. Contact
DES for additional information.
Question 14:
What are financial reporting requirements?
Answer:
Recipients submit a Financial Status Report (SF269) when the
project has been completed. The DGMO will send instructions to
the awardee at the appropriate time.
Question 15:
Does the Davis-Bacon Act apply to this award program?
Answer:
No.
Question 16:
What major unallowable costs should I be aware of?
Answer:
Major unallowable items include land acquisition, building
acquisition, operating costs, landscaping costs other than sod and
seed, decorations or artwork, and equipment with a unit cost of
less than $5,000 (see page 15, line 10 for exceptions regarding
the unit cost of equipment). There may be other unallowable
costs, and applicants are urged to contact the DFCR for guidance
on questionable items.
Question 17:
Does this award require Public Health Impact Statements?
Answer:
No.
Question 18:
How do I determine if the property or building is historic?
Answer:
You must discuss your situation with the State Historical
Preservation Officer (SHPO). You cannot always judge a
building just by its age. It may also be considered historic merely
by being in a historic area, or having an archeological site (see
page 40).
HCOF 2005 Program Guidance
Page 65 of 70
3. BUDGET EXAMPLES
EXAMPLE INCLUDES COSTS NOT ALLOWABLE FOR PARTICIPATION
OMB Approval No. 0348- 0041
BUDGET INFORMATION - Construction Programs
NOTE: Certain Federal assistance programs require additional computations to arrive at the Federal share of project costs eligible for participation. If
such is the case you will be notified.
COST
CLASSIFICATION
1. Administrative and
legal expenses
2. Land, structures,
rights-of-way, appraisals,
etc.
3. Relocation expenses
and payments
b. Costs Not Allowable
for Participation
a. Total Cost
c. Total Allowable Costs
(Column a- b)
$
21000.00 $
(1)
500.00
$
20,500.00
$
38000.00 $
(2)
38000.00
$
0.00
$
.00 $
.00 $
0.00
4. Architectural and
engineering fees
$
12000.00 $
$
8000.00
5. Other architectural and
engineering fees
$
.00 $
.00 $
0.00
6.
Project inspection fees
$
2000.00 $
.00 $
2000.00
7.
Site work
$
.00 $
.00 $
.00
8. Demolition and
removal
$
9000.00 $
.00 $
9000.00
9.
$
200000.00 $
.00 $
200000.00
10. Equipment
$
35000.00 $
.00 $
35000.00
11. Miscellaneous
$
10000.00 $
.00 $
10000.00
12. SUBTOTAL (sum of
lines 1- 11)
$
327000.00 $
42,500.00 $
284,500.00
13. Contingencies
$
17250.00 $
5500.00 $
11750.00
14. SUBTOTAL
$
344250.00 $
48,000.00 $
296,250.00
$
.00 $
.00 $
0.00
$
344250.00 $
48000.00 $
296,250.00
Construction
15. Project (program)
income
16. TOTAL PROJECT
COSTS (subtract #15 from
#14)
(3)
4000.00
(4)
FEDERAL FUNDING
17. Federal assistance requested, calculate as follows:
(Consult Federal agency for Federal percentage share).
Enter the resulting Federal share.
Enter eligible costs from line 16c
Multiply X (include decimal point in
%
number)
*
$
248600.00
Previous Edition Usable
Standard Form 424C (Rev. 7-97)
Prescribed by OMB Circular A-102
Authorized for Local Reproduction
Ineligible Examples Mentioned in the Program Guide
1. Bonus Payment to contractor
Do not calculate this percentage.
2. Land Purchase
3. Cost of abandoned designs
4. Maximum contingency of 5% allowed of lines 9 (if new construction)
and 10 (equipment).
HCOF 2005 Program Guidance
Page 66 of 70
EXAMPLE CONSTRUCTION ONLY – EQUIPMENT WILL NOT BE FUNDED THROUGH THE AWARD
OMB Approval No. 0348- 0041
BUDGET INFORMATION - Construction Programs
NOTE: Certain Federal assistance programs require additional computations to arrive at the Federal share of project costs eligible for participation. If
such is the case you will be notified.
COST
CLASSIFICATION
b. Costs Not Allowable
for Participation
a. Total Cost
c. Total Allowable Costs
(Column a- b)
1. Administrative and legal
expenses
$
295000 $
$
295000.00
2. Land, structures, rights-ofway, appraisals, etc.
$
$
.00 $
0.00
3. Relocation expenses and
payments
$
$
.00 $
0.00
4. Architectural and
engineering fees
$
1033000 $
.00 $
1033000.00
5. Other architectural and
engineering fees
$
108000 $
.00 $
108000.00
6.
Project inspection fees
$
164000 $
.00 $
164000.00
7.
Site work
$
$
.00 $
.00
8.
Demolition and removal
$
43000 $
.00 $
43000.00
9.
Construction
$
8250000 $
.00 $
8250000.00
10. Equipment
$
688000 $
688000.00 $
0.00
11. Miscellaneous
$
2000 $
.00 $
2000.00
12. SUBTOTAL (sum of lines
1- 11)
$
10583000 $
688000.00 $
9895000.00
13. Contingencies
$
412500 $
.00 $
412500.00
14. SUBTOTAL
$
10995500 $
688000.00 $
10307500.00
15. Project (program) income
$
$
.00 $
0.00
16. TOTAL PROJECT
COSTS (subtract #15 from
#14)
$
10995500 $
688000.00 $
10307500.00
FEDERAL FUNDING
17. Federal assistance requested, calculate as follows:
(Consult Federal agency for Federal percentage share).
Enter the resulting Federal share.
Enter eligible costs from line
16c Multiply X (include decimal
%
point in number)
*
Authorized for Local Reproduction
$
8890000.00
Standard Form 42C (Rev. 7-97)
Prescribed by OMB Circular A-102
*Do not calculate this percentage.
HCOF 2005 Program Guidance
Page 67 of 70
EXAMPLE AWARD REQUESTED FOR DESIGN ONLY
OMB Approval No. 0348- 0041
BUDGET INFORMATION - Construction Programs
NOTE: Certain Federal assistance programs require additional computations to arrive at the Federal share of project costs eligible for participation. If
such is the case you will be notified.
COST
CLASSIFICATION
1. Administrative and
legal expenses
2. Land, structures,
rights-of-way, appraisals,
etc.
3. Relocation expenses
and payments
b. Costs Not Allowable
for Participation
a. Total Cost
c. Total Allowable Costs
(Column a- b)
$
$
$
$
.00 $
.00 $
0.00
$
.00 $
.00 $
0.00
4. Architectural and
engineering fees
$
1050000.00 $
.00 $
1050000.00
5. Other architectural and
engineering fees
$
.00 $
.00 $
0.00
6.
Project inspection fees
$
.00 $
.00 $
0.00
7.
Site work
$
.00 $
.00 $
0.00
8. Demolition and
removal
$
.00 $
.00 $
0.00
9.
$
.00 $
.00 $
0.00
10. Equipment
$
.00 $
.00 $
0.00
11. Miscellaneous
$
.00 $
.00 $
0.00
12. SUBTOTAL (sum of
lines 1- 11)
$
1050000.00 $
0.00 $
1050000.00
13. Contingencies
$
.00 $
.00 $
0.00
14. SUBTOTAL
$
1050000.00 $
0.00 $
1050000.00
$
.00 $
.00 $
0.00
$
1050000.00 $
0.00 $
1050000.00
Construction
15. Project (program)
income
16. TOTAL PROJECT
COSTS (subtract #15 from
#14)
FEDERAL FUNDING
17. Federal assistance requested, calculate as follows:
(Consult Federal agency for Federal percentage share).
Enter the resulting Federal share.
Enter eligible costs from line 16c
Multiply X (include decimal point in
%
number)
*
$
960000.00
Standard Form 424C (Rev. 7-97)
Prescribed by OMB Circular A-102
*Do not calculate this percentage.
HCOF 2005 Program Guidance
Page 68 of 70
EXAMPLE AWARD REQUESTED EQUIPMENT ONLY (NO CONSTRUCTION INVOLVED)
OMB Approval No. 0348- 0041
BUDGET INFORMATION - Construction Programs
NOTE: Certain Federal assistance programs require additional computations to arrive at the Federal share of project costs eligible for participation. If
such is the case you will be notified.
COST
CLASSIFICATION
1. Administrative and
legal expenses
2. Land, structures,
rights-of-way, appraisals,
etc.
3. Relocation expenses
and payments
b. Costs Not Allowable
for Participation
a. Total Cost
c. Total Allowable Costs
(Column a- b)
$
$
$
$
.00 $
.00 $
0.00
$
.00 $
.00 $
0.00
4. Architectural and
engineering fees
$
.00 $
.00 $
0.00
5. Other architectural and
engineering fees
$
.00 $
.00 $
0.00
6.
Project inspection fees
$
.00 $
.00 $
0.00
7.
Site work
$
.00 $
.00 $
0.00
8. Demolition and
removal
$
.00 $
.00 $
0.00
9.
$
.00 $
.00 $
0.00
10. Equipment
$
2787000.00 $
.00 $
2787000.00
11. Miscellaneous
$
.00 $
.00 $
0.00
12. SUBTOTAL (sum of
lines 1- 11)
$
2787000.00 $
0.00 $
2787000.00
13. Contingencies
$
.00 $
.00 $
0.00
14. SUBTOTAL
$
2787000.00 $
0.00 $
2787000.00
$
.00 $
.00 $
0.00
$
2787000.00 $
0.00 $
2787000.00
Construction
15. Project (program)
income
16. TOTAL PROJECT
COSTS (subtract #15 from
#14)
FEDERAL FUNDING
17. Federal assistance requested, calculate as follows:
(Consult Federal agency for Federal percentage share).
Enter the resulting Federal share.
Enter eligible costs from line 16c
Multiply X (include decimal point in
%
number)
*
$
1830000.00
Standard Form 424C (Rev. 7-97)
Prescribed by OMB Circular A-102
*Do not calculate this percentage
HCOF 2005 Program Guidance
Page 69 of 70
4. EXAMPLE OF “SPECIFICS OF AWARD”
AWARDS FOR HEALTH FACILITIES AND OTHER CONSTRUCTION
Grant Number: ######
Recipient:
Type of Facility: Community Center
Description of Facility (Proposed):
Construction of a two story 18,000 SF of health and human services center for residents. The project
will consist of 42 parking spaces, demolition of an existing 2,800 SF structure, and construction of the
new Center.
Site of Construction/Renovation:
91st Street and Baltimore Street, Pleasantville, Maryland
Restriction on Use of Federal Funds:
Federal funds are not eligible for participation in the cost of landscaping (other than sodding and
seeding); offsite utilities or improvements; works of art; move-in costs; administrative overhead;
space for revenue purposes; and any scope of work or cost not previously approved.
Usage Requirement:
The facility is to be used for the purpose provided by Federal funds and stated in the approved
application for this award.
Recording the Federal Interest:
The recipient must record, at the local land records office, the notice of the Federal Interest in the
awardee’s premises. A copy of the official recording must be provided to the DFCR before Federal
funds can be released.
Construction Contract:
If the recipient has not entered into a construction contract that has the approval of the Division of
Engineering Services within one year of the award date, the Healthcare Systems Bureau may consider
withdrawing the award.
HCOF 2005 Program Guidance
Page 70 of 70
| File Type | application/pdf |
| File Title | Microsoft Word - hrsa05144.doc |
| Author | JJohns |
| File Modified | 2005-05-19 |
| File Created | 2005-05-19 |