[Federal Register Volume 67, Number 61 (Friday, March 29, 2002)]
[Notices]
[Pages 15206-15208]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-7739]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Emergency Awards for Healthcare Under Section 319 of the PHS Act 
Grants for Immediate Response

AGENCY: Department of Health and Human Services.

ACTION: Notice of availability of funds.

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SUMMARY: The Department of Health and Human Services (HHS) announces 
the availability of a competitive grant program for the purpose of 
providing emergency funding for health-related costs incurred by 
organizations as a result of the terrorist acts that occurred on 
September 11, 2001.
    Name of Grant Program: Grants for Immediate Response.
    Program Authorization: Section 319 of the Public Health Service 
Act, 42 U.S.C. 247d.
    Amount of funding available: $140 million. There is no cap on the 
amount of funding for an applicant.
    Eligible Applicants: Public entities, not-for-profit entities, and 
Medicare and Medicaid enrolled suppliers and institutional providers 
that incurred healthcare-related costs which were directly attributable 
to the public health emergency resulting from terrorist acts on 
September 11, 2001. Examples of applicants that may be eligible for 
this program include, but are not limited to, hospitals, clinics, 
faculty practices, mental health providers, blood centers, home health 
agencies, and ambulance companies.
    This program is intended to provide funding to those organizations 
that were most directly affected in the disaster response efforts. 
Accordingly, in addition to meeting the organizational requirements 
described above, an applicant must also provide healthcare services in 
the following geographic areas:
    NY: New York County, Queens County, Kings County, Bronx County, 
Richmond County, Westchester County, Nassau County.
    NJ: Hudson County, Essex County, Bergen County, Union County, 
Middlesex County.
    VA: Fairfax County, Arlington City, Alexandria City.
    DC: Washington, D.C.
    MD: Montgomery County, Prince George's County.
    PA: Somerset County.
    The highest priority for funding will be given to the following 
applicants:
     A healthcare entity that treated the greatest number of 
patients injured at a terrorist attack site (i.e., World Trade Center; 
Pentagon; Somerset, PA plane crash site), particularly those entities 
that provided specialized services such as burn care and severe trauma 
care.
     A healthcare entity that is located closest to an attack 
site and/or where traffic disruptions and road/tunnel/bridge closings 
restricted patient access to the facility or services.
    Applicants with multiple sites or operating divisions that are part 
of one corporation must submit one consolidated application for the 
entire corporate entity; however, a separate analysis must be provided 
for each site where losses are claimed. Applicants that are subsidiary 
corporations of a parent organization or system should only include 
information and data for their specific corporation. For systems with 
multiple corporate subsidiaries each corporate entity that requests 
grant support must file a separate application. This program is 
intended to cover the net losses to a corporation as a result of the 
September 11 terrorist acts; therefore, for a multi-site applicant, any 
losses at one site must be reduced by any gains at another site.
    Applicants that submitted applications for the first round of 
funding ($35 million) under the Grants for Immediate Response program, 
but who were deemed ineligible or did not receive the full funding for 
which they were deemed eligible, must submit all information outlined 
in this notice, and must meet all requirements in this notice, in order 
to receive consideration for funding under this program.
    Faith-based and community organizations that provide healthcare 
services, meet the above criteria and have incurred allowable costs are 
eligible to receive funding from this program. Individuals are not 
eligible for funding under this program.
    Allowable costs: Healthcare-related costs incurred by an eligible 
applicant as a result of the terrorist acts on September 11, 2001. 
Requests can include costs incurred between September 11, 2001 and 
December 31, 2001. ``Healthcare-related costs'' is defined as increased 
expenses or lost revenues related to the provision of patient care.
    Personnel costs, supplies, and contractual expenses for health care 
services are examples of allowable expenses. Lost or foregone revenues 
incurred during the period from September 11, 2001 through December 31, 
2001, will also be considered eligible costs for the purposes of this 
program. All eligible costs must directly relate to the provision of 
health care.
    Allowable costs are costs for which payment and/or reimbursement 
has not been (and is not expected to be) received and/or the applicant 
is not eligible for reimbursement. This program will cover only direct 
costs (i.e., costs that can be specifically identified with a 
particular project or program).
    Costs for which funding is awarded will be subject to verification 
and validation, including audits by the Office of the Inspector 
General, after grants are awarded. The grants are also subject to the 
general provisions applicable to Federal grants awarded by the 
Department of Health and Human Services (see 45 CFR parts 74 and 92), 
including applicable cost principles incorporated by those regulations. 
For profit organizations should pay particular attention to 45 CFR 
74.81, which requires that no HHS funds may be paid as profit to any 
recipient even if the recipient is a commercial organization.
    Unallowable costs: Unallowable costs include, but are not limited 
to, the following:
     Costs that are eligible for reimbursement or payment from 
any other sources (including FEMA funding for crisis counseling, 
emergency protective measures and damaged buildings, equipment, and 
vehicles)
     Research activities
     Legal costs
     Political and lobbying activities
     Subgrants to other organizations
     Purchase of real property
     Indirect costs and overhead
     Expenses intended to prepare for future similar events
     Increased expenses or lost revenues unrelated to the 
provision of healthcare
     Costs related to the start-up of new services
    Applicant submission: All applications must be submitted to the 
following addresses:


[[Page 15207]]


1. HRSA Grants Application Center (Original Copy), 901 Russell Avenue, 
Suite 450, Gaithersburg, MD 20879.
2. Division of Facilities Compliance and Recovery (Duplicate Copy), 
Room 10C-16, 5600 Fishers Lane, Rockville, MD 20857.

    Applications must be postmarked by May 13, 2002, and must be 
received in time for submission to the Objective Review Committee. A 
legibly dated receipt from a commercial carrier or the U.S. Post Office 
will be accepted in lieu of a postmark. Private metered postmarks shall 
not be acceptable as proof of timely mailing. The submission of 
application spreadsheets, which must be done on disk or electronically, 
must comply with the above due date.
    Application requirements: All of the information enumerated in 
items 1 through 9 below must be submitted in the application. All 
information must be submitted on standard size paper (8.5"  x  11"). 
Information must be submitted in the same order as presented below. 
Failure to address all information in each item may result in an 
applicant being deemed ineligible or receiving a reduced level of 
funding.
    These application requirements include the submission of four 
spreadsheets. These spreadsheets must be submitted electronically or on 
disk, as well as by hard copy with the rest of the application. Further 
information on the spreadsheets and submission requirements is provided 
in item 9 below. Failure to adequately complete each set of 
spreadsheets may result in reduced or denied funding. Spreadsheets can 
be downloaded from the following Web site: http://www.hrsa.gov/osp/gir2.htm.
    1. Standard Form 424 with attached assurances and certifications. 
The CFDA # for this program is 93.003. This form and attachments can be 
downloaded from the following Web site: http://www.hrsa.gov/osp/gir2.htm. Additionally, you may call Mr. Eulas Dortch at 301 443-8007 
if you would like these forms mailed to you.
    2. Narrative information. Information in this section may not 
exceed 6 pages. Any narrative information in excess of 6 pages may not 
be considered in the review of an application. Applicants with multiple 
sites must provide the narrative information broken out for each site 
(each site is allowed 6 pages of narrative).
    a. Summary narrative of actions taken by the applicant in providing 
patient care services, or preparing to provide patient services, to 
victims of the World Trade Center, Pentagon, or Somerset, PA terrorist 
acts. Describe actions taken, and number of patients from the attack 
zones treated, and types of patient care provided. Information included 
in this section must reconcile with data contained in Spreadsheet(s) 
#1--Response Efforts and Access Restrictions.
    b. Summary narrative of impediments resulting from the terrorist 
attacks, including traffic restrictions that prevented patients from 
accessing/utilizing your facility/service. Indicate your facility's 
location in relation to the traffic restrictions. Indicate what travel 
restrictions were imposed, the time period during which travel 
restrictions were in place, the area covered, and the extent to which 
patients and/or emergency vehicles could not access your facility or 
services. Provide an estimate of the total patients (inpatient and 
outpatient) that were unable to access your facility because of these 
restrictions, beginning September 11, 2001. Information included in 
this section must reconcile with data contained in Spreadsheet(s) #1--
Response Efforts and Access Restrictions.
    c. Summary narrative of total financial impact on healthcare 
services of the applicant directly attributable to the terrorist 
attacks had from September 11, 2001, through December 31, 2001. This 
should only address those services that provide or directly support 
healthcare services of the applicant. If the applicant provides 
services not directly related to the provision or support of healthcare 
services, those costs should be excluded from this application. Provide 
an estimate of the lost patient revenues and explain the methodology 
used in estimating the lost revenues. Provide an estimate of increased 
expenses and identify those activities that required additional 
expenses. Information included in this section must reconcile with data 
contained in Spreadsheet(s) #2--Breakdown of Lost Revenues and 
Increased Expenses.
    d. Itemization and justification for all increased expenses and 
lost revenues described in 2c above. Funding can be sought for a 
combination of lost revenues and increased expenses; in such cases 
clearly delineate the amount attributable to lost revenue and the 
amount attributable to increased expenses. Increased expenses should be 
clearly itemized to show how each component of these costs was 
determined and calculated. The itemization of increased expenses must 
clearly identify and offset any additional revenues received due to the 
increased expenses. Lost revenues should be separately shown and also 
must be clearly itemized to show how each component of these costs was 
determined and calculated. The itemization of lost revenues must 
clearly identify and offset any reduced expenses related to lost 
revenues. All assumptions should be clearly identified and the basis 
for assumptions explained. Funds previously received under HRSA's 
Grants for Immediate Response program or any other funding relief must 
be clearly identified and it must be clear that eligible costs that 
were funded with any such grant award are not being duplicated in this 
request. Information included in this section must reconcile with data 
contained in Spreadsheet(s) #2--Breakdown of Lost Revenues and 
Increased Expenses.
    e. Compare the operating results shown in the income statement for 
the 4-month period from September 2001 through December 2001 with the 
same period for 2000. In order to normalize the information being 
compared, identify all retroactive rate settlements (positive and 
negative), one-time transactions, and any other information that 
distorts the comparison and which occurred in either 2000 or 2001. 
Explain how these transactions impact the comparative analysis and make 
adjustments accordingly. The summary impact of all such transactions 
must be clearly identified on Spreadsheet #3 and narrative information 
must clearly document each transaction. Provide an explanation if the 
4-month period during 2001 does not have a negative variance (as 
compared to the same 4-month period in 2000) equal to or greater than 
the increased expenses and decreased revenues for which grant funding 
is sought. This analysis must reconcile with data contained in 
Spreadsheet(s) #3--Breakout of Income and Expenses. Funding 
determinations will in part be based on an assessment of the negative 
variance (for the overall organization) in operating performance for 
September 2001 through December 2001 as compared to the same period 
during 2000.
    f. If there is not a clear and direct link between any of the 
identified costs and the terrorist acts, provide an explanation of the 
relationship.
    3. Identify the location where the services for which funding is 
sought were provided. Identify the closest intersection to the site 
where the applicant provides patient services. Include a map marking 
such location along with a legend showing relative distance and any 
travel restrictions noted in section 2b above. If funding for multiple 
sites is sought, note the location of each site.

[[Page 15208]]

    4. List all sites where the applicant provides healthcare services, 
including sites for which losses are not requested in this application. 
For each site where losses have not been documented as part of this 
grant application, provide summary financial information explaining how 
those sites performed during the period from September 2001 through 
December 2001, in relation to performance during the same period in 
2000.
    5. From the internal financial statements of the applicant, a copy 
of the Income Statement/Comparative Statement of Operations for the 
entire corporation/organization along with all schedules showing 
operating statistics (inpatient and outpatient) and staffing/FTE 
information for each of the following periods. These statements and 
schedules should be included in the internal financial statements of 
the applicant and are to be submitted separate from, and in addition 
to, all spreadsheets required in item 2 above; however, information 
shown in the spreadsheets must reconcile to these statements and 
schedules. These statements and schedules shall be certified as true 
and accurate by the Chief Financial Officer of the applicant.
     Year-to-date for the 8 months ending August 31, 2000
     Year-to-date for the 8 months ending August 31, 2001
     Year-to-date for the 12 months ending December 31, 2000
     Year-to-date for the 12 months ending December 31, 2001
    6. IRS confirmation of public or not-for profit status, or evidence 
of status as Medicare or Medicaid enrolled supplier or institutional 
provider.
    7. Listing of any additional Federal, State, or private agencies or 
organizations and/or any insurance company from which funding relief 
and/or insurance (including business loss insurance) has been sought in 
relation to the September 11, 2001, terrorist acts (e.g., HRSA, FEMA, 
Red Cross). Include amount of funding requested and description/
explanation of basis for any such request, and the outcome or pending 
status of each request. Any funding that has been received must be 
clearly identified in your budget itemization and justification 
included in the narrative and shall be offset against any eligible 
losses to avoid duplicative funding. Identify and segregate any funding 
being sought for mental health services and explain why funding is not 
available from the $22 million provided by FEMA for crisis counseling.
    8. Statement/assurance from an authorized representative of the 
applicant that:
    a. Expenses/lost revenues for which grant funding is sought are not 
eligible for reimbursement and/or payment from Medicare, Medicaid, 
FEMA;
    b. Reimbursement and/or payment will not be sought from Medicare, 
Medicaid, or FEMA for any expenses/lost revenues covered by the grant;
    c. Grant funds will not be used to supplant any Federal or non-
Federal funds that are received for the activities or purposes for 
which funding is sought; and
    d. If the applicant has sought funding from another source for the 
same expenses and/or lost revenues and is uncertain as to whether such 
request(s) will be approved, it must include an assurance that if that 
funding is received, funding from this program will be returned.
    9. Application Spreadsheets. Four spreadsheets are described below. 
Spreadsheets should be downloaded from the following Web site: http://www.hrsa.gov/osp/gir2.htm.
    Do not change the format or add any additional rows or columns to 
the spreadsheets. All of the spreadsheets must be completed by all 
applicants. If any of the information requested on a spreadsheet is not 
readily available, then reasonable efforts will be made to develop and/
or obtain the information. Be sure to submit spreadsheets for all 
components of a corporation/organization as specified below. 
Spreadsheets can be found at the following website. These spreadsheets 
must be submitted electronically or by disk, in accordance with the 
specific instructions in this section. Electronic submissions should be 
sent to the following e-mail address: [email protected]. In the subject 
line identify the applicant name and Employee Identification Number. If 
submitting the information by disk, it must be sent to the following 
address: Mr. Eulas Dortch, HRSA/OSP/DFCR, 5600 Fishers Lane, Room 10C-
16, Rockville, MD 20857.
    Disks and/or electronic submission of application spreadsheets are 
subject to the same due dates as the application. Additionally, a hard 
copy of all spreadsheets must be included with each application. Each 
hard copy spreadsheet must be signed by the Chief Financial Officer, 
attesting to the accuracy of the information.
    a. Spreadsheet #1--Response Efforts and Access Restrictions. A 
separate spreadsheet must be completed for each site where losses are 
claimed. Additionally, a consolidated spreadsheet must be completed for 
the entire corporation/organization.
    b. Spreadsheet #2--Breakdown of Lost Revenues and Increased 
Expenses. A separate spreadsheet must be completed for each site where 
losses are claimed. Additionally, a consolidated spreadsheet must be 
completed for the entire corporation/organization. The consolidated 
spreadsheet may not exceed the sum of the losses at individual sites. 
The maximum amount an applicant will be eligible to receive shall not 
exceed the losses documented in these spreadsheets.
    c. Spreadsheet #3--Breakout of Income and Expenses. A separate 
spreadsheet must be completed for each site where the applicant 
provides healthcare services. Additionally, a consolidated spreadsheet 
must be completed for the entire corporation/organization.
    d. Spreadsheet #4--Operating Statistics and Staffing Information. A 
separate spreadsheet must be completed for each site where the 
applicant provides healthcare services. Additionally, a consolidated 
spreadsheet must be completed for the entire corporation/organization.
    Review Criteria: 1. Demonstration that the services provided, 
expenses incurred, and/or lost revenues for which the grant is sought 
are attributable to terrorist acts on September 11, 2001.
    2. Soundness of the narrative.
    3. Reasonableness and clarity of budget justification, particularly 
the methodology and calculations.
    4. Consistency of documented costs with the negative financial 
impact shown in the financial statements.
    5. Demonstration of most direct participation in the response 
efforts as evidenced by any of the following:
    a. Proximity to the attack zone.
    b. Number of patients from the attack zone served by the applicant.
    c. Provision of specialized services to patients from the attack 
zone by the applicant.
    Program Contact Person: Mr. Eulas Dortch , Director, Division of 
Facilities Compliance and Recovery, HRSA Office of Special Programs, 
Room 10C-16, 5600 Fishers Lane, Rockville, MD 20857, 301 443-8007 
(phone), 301 443-0619 (fax), [email protected] (e-mail).

    Dated: March 26, 2002.
Tommy G. Thompson,
Secretary.
[FR Doc. 02-7739 Filed 3-28-02; 8:45 am]
BILLING CODE 4165-15-P