Delta Health Care Service Grant Program

FY 26 Notice of Funding Opportunity

Delta Health Care Services Grant Program
Fiscal Year 2026
Notice of Funding Opportunity
Funding Opportunity Number: RDBCP-DHCS-2026
Publication Date: April 1, 2026
Application Due Date: June 1, 2026
J.R. Claeys
RBCS Administrator
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PROGRAM SOLICITATION INFORMATION
Funding Opportunity Title: Delta Health Care Services Grant Program (DHCS)
Funding Opportunity Number: RDBCP-DHCS-2026
Announcement Type: Notice of Funding Opportunity (NOFO)
Assistance Listing Number: 10.874
Dates: Completed electronic applications must be submitted through www.grants.gov by 11:59 p.m.
Eastern Time (ET) on June 1, 2026. DHCS program will start accepting applications on April 1, 2026. Late
or incomplete applications will not be accepted.
Executive Summary:
This Notice of Funding Opportunity (Notice) announces that the Rural Business Service (RBCS, Agency) is
accepting fiscal year (FY) 2026 applications for the Delta Health Care Services (DHCS) grant program. The
purpose of this program is to provide financial assistance to address the continued unmet health needs
in the Delta Region through cooperation among health care professionals, institutions of higher
education, research institutions, and economic development entities in the Delta Region. FY
2026 funding is approximately $6,000,000, which includes $3,000.000 carryover funding from FY 25. All
applicants are responsible for any expenses incurred in developing their applications. Ten percent
of funds must support projects located in persistent poverty counties in the Delta Region and as
described under paragraph 1.2(b) of this Notice.
TIPS FOR APPLICANTS
• To do business with the Federal Government and to submit your application electronically using
Grants.gov, you must—
o Have a Unique Entity Identifier (UEI) and a Taxpayer Identification Number (TIN);
o Be registered in SAM.gov (System for Award Management), the Government's primary
registrant database;
o Provide your UEI number and TIN on your application; and
o Maintain an active SAM registration with current information throughout the
application review period and, if you are awarded a grant, during the project period.
• Register and submit applications early. DO NOT WAIT UNTIL THE DAY OF THE APPLICATION
DEADLINE.
• Thoroughly read this Notice of Funding Opportunity (NOFO) and follow all the instructions.
• Thoroughly review the guidelines and policies as outlined in this notice to ensure the application
is received and eligible for consideration, and to understand allowable and unallowable costs.
• Apply for the correct grant program
o Assistance Listing number “10.874” and Funding Opportunity Number “RDBCP-DHCS-
2026”
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• Make sure you have the most recent copy of Adobe Reader installed on your computer and that
it is compatible with Grants.gov software. Grants.gov supports Adobe Reader version 9.0.0 and
higher.
• Limit Application File Name Characters (50 or less).
• When uploading attachments, click the “Add Attachments” button (do NOT use the “paperclip”
icon in Adobe Reader). Acceptable file types include .doc, .docx, .pdf, .jpg, .jpeg, .png, .gif, .xls,
.xlsx, .txt, .ppt, and .pptx. If you would like to submit another file type, please contact the
program office first for approval.
• Do not password-protect your documents and make sure all tracked-changes are “accepted”.
• Avoid Special Characters in File Names ($, %, &, *, Spanish "ñ", etc.).
• Input the correct UEI number on the SF-424 cover page.
• Review the Grants.gov Applicant User and Registration Guides:
https://www.grants.gov/applicants/applicant-faqs
https://www.grants.gov/applicants/workspace-overview
TABLE OF CONTENTS
1.0 Program Description .............................................................................................................. 5
1.1 RBCS Key Priorities ............................................................................................................................ 5
1.2 Purpose of the Program .................................................................................................................... 5
1.3 Statutory and Regulatory Authority .................................................................................................. 5
1.4 Definitions ......................................................................................................................................... 6
1.5 Application of Awards ....................................................................................................................... 7
2.0 Federal Award Information .................................................................................................... 7
3.0 Eligibility Information ............................................................................................................ 8
3.1 Eligible Applicants ............................................................................................................................. 8
3.2 Cost Sharing or Matching .................................................................................................................. 9
3.3 Other ................................................................................................................................................. 9
4.0 Application and Submission Information .............................................................................. 10
4.1 Address to Request Application Package ........................................................................................ 10
4.2 Content and Form of Application Submission ................................................................................ 11
4.3 Unique Entity Identifier and System for Award Management ....................................................... 13
4.4 Submission Dates and Times........................................................................................................... 13
4.5 Intergovernmental Review ............................................................................................................. 13
4.6 Funding Restrictions........................................................................................................................ 14
4.7 Other Submission Requirements .................................................................................................... 14
5.0 Application Review Information ........................................................................................... 15
5.1 Evaluation Criteria ........................................................................................................................... 15
5.2 Review Selection Processes ............................................................................................................ 16
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6.0 Federal Award Administration Information .......................................................................... 17
6.1 Federal Award Notices .................................................................................................................... 17
6.2 Administrative and National Policy Requirements ......................................................................... 17
6.3 Reporting......................................................................................................................................... 18
7.0 Federal Award Agency Contacts ........................................................................................... 18
8.0 Other Information................................................................................................................ 18
8.1 Paperwork Reduction Act ............................................................................................................... 18
8.2 National Environmental Policy Act ................................................................................................. 18
8.3 Federal Funding Accountability and Transparency Act .................................................................. 19
8.4 Equal Opportunity for Religious Organizations. ............................................................................. 19
8.5 Nondiscrimination Statement ......................................................................................................... 19
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1.0 PROGRAM DESCRIPTION
1.1 RBCS Key Priorities
Rural Business Cooperative Service Priorities: The Agency encourages applicants to consider projects
that will advance the following RBCS Priorities:
Domestic Manufacturing and Industrial Capacity
Domestic Energy Production and Energy Security
New and expanded markets for American Farmers and Rural Producers
Program integrity, including the prevention and reduction of fraud, waste, and abuse
1.2 Purpose of the Program
The primary objective of the program is to provide financial assistance to address the continued
unmet health needs in the Delta Region through cooperation among health care professionals,
institutions of higher education, research institutions, and other individuals and entities in the Delta
Region. Grants are awarded on a competitive basis.
1.3 Statutory and Regulatory Authority
(a) Statutory. The DHCS program is authorized by Section 379G of the Consolidated Farm and Rural
Development Act (7 U.S.C. 2008u).
(b) Persistent Poverty Counties. The Full-Year Continuing Appropriations and Extensions Act, 2025
(P.L. 119-4) and the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and
Veterans Affairs, and Extensions Act, 2026 (P.L. 119-37), provide funds under the authority and
conditions provided in the applicable appropriations Acts. The Full-Year Continuing Appropriations and
Extensions Act, 2025, incorporating the Consolidated Appropriations Act, 2024 (P.L. 118-42),
Division B, Title VII, Section 736, and the Continuing Appropriations, Agriculture, Legislative Branch,
Military Construction and Veterans Affairs, and Extensions Act, 2026 (P.L. 119-37), Division B , Title VII,
Section 733 (Section 73, allocate funding for projects in Persistent Poverty Counties. Persistent Poverty
Counties as defined in Section 736 and Section 733 is “any county that has had 20 percent or more of its
population living in poverty over the past 30 years, as measured by the 1990 and 2000 decennial
censuses, and 2007–2011 American Community Survey 5-year average, or any territory or possession of
the United States[.]” Another provision in Section 736 expands the eligible population in Persistent
Poverty Counties to include any county seat of such a Persistent Poverty County that has a population
that does not exceed the authorized population limit by more than 10 percent. Therefore, applications
for projects in Persistent Poverty County seats with populations up to 55,000 (per the 2020 Census) are
eligible. Funding in the amount of $600,000 (equal to 10% of allocation) will be allocated to support
Persistent Poverty Counties.
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1.4 Definitions
Academic Health and Research Institute – A combination of a medical school, one or more other
health profession schools or educational training programs (such as allied health, dentistry, graduate
studies, nursing, pharmacy, or public health), and one or more owned or affiliated teaching or health
systems; or a health care nonprofit organization or health system, including nonprofit medical and
surgical hospitals, that conduct health related research.
Conflict of Interest –A situation in which a person or entity has competing personal, professional,
or financial interests that make it difficult for the person or business to act impartially. Federal
procurement standards prohibit transactions that involve a real or apparent conflict of interest for
owners, employees, officers, agents, or their immediate family members having a financial or other
interest in the outcome of the Project; or that restrict open and free competition for unrestrained trade.
Specifically, Project Funds may not be used for services or goods going to, or coming from, a person or
entity with a real or apparent conflict of interest, including, but not limited to, owner(s) and their
immediate family members. An example of a conflict of interest includes when the consortium
member’s employees, board of directors, or the immediate family of either, have the appearance of a
professional or personal financial interest in the recipients receiving the benefits or services of the
grant.
Under 2 CFR 400.2 occurs when personal, professional, or financial interests compromise impartiality
in Federal award actions. Recipients must maintain written standards of conduct, disclose potential
conflicts in writing, and ensure no employee, officer, agent, or their immediate family participates in
decisions where they have a financial or other interest. Project funds cannot be used for goods or
services from entities with real or apparent conflicts, including owners or their families. Organizational
conflicts—such as those involving parent or affiliate entities—must also be addressed to preserve open
and fair competition and prevent undue influence.
Consortium – A group of three or more entities that are regional Institutions of Higher Education,
Academic Health and Research Institutes, and/or Economic Development Entities located in the Delta
Region that have at least one year of prior experience addressing the health care issues in the region. At
least one of the consortium members must be legally organized as an incorporated organization or
other legal entity and have legal authority to contract with the Federal Government.
Delta Region – The 252 counties and parishes within the states of Alabama, Arkansas, Illinois,
Kentucky, Louisiana, Mississippi, Missouri, and Tennessee that are served by the Delta Regional
Authority. To view the areas identified within the Delta Region visit dra.gov/about-dra/dra-states.
Economic Development Entity – Any public or non-profit organization whose primary mission is to
stimulate local and regional economies within the Delta Region by increasing employment opportunities
and duration of employment, expanding or retaining existing employers, increasing labor rates or wage
levels, reducing outmigration, and/or creating gains in other economic development-related variables
such as land values. These activities should primarily benefit low- and moderate-income individuals in
the Delta Region.
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Health System – The complete network of agencies, facilities, and all providers of health care to meet
the health needs of a specific geographical area or target population.
Institution of Higher Education – A postsecondary (post-high school) educational institution that
awards a bachelor’s degree or provides not less than a two-year program that is acceptable for full
credit toward such a degree, or a postsecondary vocational institution that provides a program of
training to prepare students for gainful employment in a recognized occupation.
Nonprofit Organization – Any organization or institution, including an accredited institution of higher
education, no part of the net earnings of which may inure, to the benefit of any private shareholder or
individual.
Project – All activities funded by the DHCS grant.
Project Funds – Grant funds requested plus any other contributions to the proposed Project.
Rural and rural area– Includes (1) Any area of a state other than (a) a city or town that has a
population of more than 50,000 inhabitants, according to the latest decennial census of the United
States and (b) any urbanized area contiguous and adjacent to a city or town described in (a); and
(2) Urbanized areas that are rural in character as defined by 7 U.S.C. 1991(a)(13). For the purposes of
this definition, cities and towns are incorporated population centers with definite boundaries, local self-
government, and legal powers set forth in a charter granted by the State.
State – Includes each of the 50 States, the Commonwealth of Puerto Rico, the Virgin Islands of the
United States, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and, as
may be determined by the Secretary to be feasible, appropriate and lawful, the Federated States of
Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.
1.5 Application of Awards
The Agency will review, evaluate, and score applications received in response to this Notice. Awards
under the DHCS Program will be made on a competitive basis. The Agency advises all interested parties
that the applicant bears the full burden in preparing and submitting an application in response to this
notice.
2.0 FEDERAL AWARD INFORMATION
Type of Awards: Grants
Fiscal Year Funds: FY 2026
Available Funds: Funding is approximately $6,000,000. This includes $3,000,000 in carryover funds from
FY 25. RBCS may at its discretion, increase the total level of funding available under this Notice from any
available source provided the awards meet the requirements of the statute which made the funding
available to the Agency.
Minimum Award Amounts: The minimum award amount is $50,000.
Maximum Award Amounts: The maximum award amount is $1,000,000.
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Anticipated Award Date: August 31, 2026
Performance Period: Up to 24 months
Type of Assistance Instrument: Financial Assistance Agreement (Grant Agreement)
3.0 ELIGIBILITY INFORMATION
3.1 Eligible Applicants
Applicants must meet all the following eligibility requirements. Your application will not be considered
for funding if it does not provide sufficient information to determine eligibility or is missing required
elements. Applicants that fail to submit the required elements by the application deadline will
be deemed ineligible and will not be evaluated further. Information submitted after the application
deadline will not be accepted. Grants funded through DHCS may be made to a Consortium as defined
in Section 1.3 of this Notice. One member of the Consortium must be designated as the by the other
members of the Consortium and have legal authority to contract with the Federal Government.
The lead entity is the recipient (see 2 CFR 200.1) of the DHCS grant funds and accountable for
monitoring and reporting on the Project performance and financial management of the grant. It is
expected that the recipient will make subawards in the form of a grant, cooperative agreement, or
contract, as appropriate, to the other members of the Consortium. If a grant or cooperative agreement
is awarded, the organization receiving the subaward is a subrecipient (see 2 CFR 200.1) and the recipient
is responsible for complying with all applicable requirements of 2 CFR part 200, including provisions for
making and monitoring an award. If a contract is awarded, the organization receiving the subaward is a
contractor, and the recipient is responsible for following its written procurement procedures
and complying with the Federal Acquisition Regulation. Both subrecipients and contractors are required
to comply with all applicable laws and regulations, including performance and financial reporting, as
described in their award document.
(a) An applicant is ineligible if they do not submit Evidence of Eligibility and Consortium Agreements
as described in Section 4.2 of this Notice.
(b) An applicant is ineligible if they have been debarred, suspended, or otherwise excluded from
participation in Federal assistance programs, under 2 CFR Part 180 (OMB Guidelines to Agencies on
Government-Wide Debarment and Suspension (Nonprocurement),) and 2 CFR Part 417
(Nonprocurement Debarment and Suspension). These regulations require verification of exclusion status
through the SAM.gov Exclusions list before awarding funds. Additional disqualifying conditions include:
An outstanding judgment obtained by the United States in a Federal Court (other than U.S. Tax Court),
delinquency on Federal income taxes, or delinquency on other Federal debt. Applicants must certify in
their applications that none of these conditions apply. The Agency will verify compliance using the Do
Not Pay system and SAM.gov prior to award.
(c) Any corporation (1) that has been convicted of a felony criminal violation under any Federal law
within the past 24 months or (2) that has any unpaid Federal tax liability that has been assessed, for
which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being
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paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax
liability, is not eligible for financial assistance provided with funds appropriated by the Further
Consolidated Appropriations Act, 2024 (Public Law 118-47), Division B, Title VII, Sections 744 and 745
unless a Federal agency has considered suspension or debarment of the corporation and has made a
determination that this further action is not necessary to protect the interests of the Government.
(d) Applications will be deemed ineligible if the application includes any funding restrictions identified
under Section 4.6.
3.2 Cost Sharing or Matching
There are no cost sharing or matching requirements associated with this grant. However, if you are
adding any other contributions to the proposed Project, you must provide documentation indicating
who will be providing the matching funds, the amount of funds, when those funds will be provided, and
how the funds will be used in the Project budget. Examples of acceptable documentation include: a
signed letter from the source of funds stating the amount of funds, when the funds will be provided, and
what the funds can be used for or a signed resolution from your governing board authorizing the use of
a specified amount of funds for specific components of the Project. The matching funds you identify
must be for eligible purposes and included in your work plan and budget. Additionally, expected
program income may not be used as matching funds at the time you submit your application. If you
choose, you may use a template to summarize the matching funds. The template is available either from
your RD State Office or the program website at: www.rd.usda.gov/programs-services/delta-health-care-
services-grants.
3.3 Other
(a) Use of Funds. Your application must propose to use Project Funds for eligible purposes. Eligible
Project purposes include: (1) the development of health care services; (2) the development of health
education programs; (3) the development of health care job training programs; and (4) the development
and expansion of public health-related facilities in the Delta Region.
(b) Project Eligibility. The proposed Project must take place within the Delta Region as defined in this
Notice. However, the applicant need not propose to serve the entire Delta Region. The Agency
will allocate at least ten percent of available funds to support projects located in persistent poverty
counties as described in Section 1.2(b). The application must identify if the Project will be located in a
persistent poverty county, or counties and the total Project Funds associated with supporting persistent
poverty counties.
(c) Project Input. Your proposed Project must be developed based on input from local governments,
public health care providers, and other entities in the Delta Region.
(d) Grant Period Eligibility. All awards are limited to up to a 24-month grant period based upon the
complexity of the Project. Your proposed grant period should begin no earlier than September
1, 2026, and should end no later than 24 months following that date. If you receive an award, your grant
period will be revised to begin on the actual date of award the date the financial assistance agreement is
executed by the Agency, and your grant period end date will be adjusted accordingly. Your Project
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activities must begin within 90 days of the date of award. If you request funds for a time
period beginning before September 1, 2026, and/or ending later than 24 months from that date, your
application will be ineligible. The length of your grant period should be based on your Project’s
complexity, as indicated in your application work plan.
(e) Multiple Application Eligibility. The Consortium, including its members, is limited to submitting one
application for funding under this Notice. We will not accept applications from Consortiums that include
members who are also members of other Consortiums that have submitted applications for funding
under this Notice. If we discover that a Consortium member is a member of multiple Consortiums with
applications submitted for funding under this Notice, all applications will be considered ineligible for
funding.
(f) Satisfactory Performance Eligibility. If you have an existing DHCS award, you must be performing
satisfactorily to be considered eligible for a new DHCS award. Satisfactory performance includes being
up to date on all financial and performance reports as prescribed in the grant award, and current on
tasks and timeframes for utilizing grant and matching funds as approved in the work plan and budget. If
you have any unspent grant funds on DHCS awards made prior to FY 2022 your application will not be
considered for funding. If your FY 2023 or FY 2024 award has unspent funds of 50 percent or more than
what your approved work plan and budget projected at the time your FY 2026 application is evaluated,
your application may not be considered for funding. The Agency will verify the performance status of FY
2023 and FY 2024 awards and make a determination after the FY 2026 application period closes.
(g) Completeness Eligibility. Your application must provide all the information requested in Section 4.2
of this Notice. Applications lacking sufficient information to determine eligibility and scoring will
be deemed ineligible and will not be considered for scoring.
(h) Indirect Costs. Your negotiated indirect cost rate approval does not need to be included in your
application, but you will be required to provide it if a grant is awarded. Approval for indirect costs that
are requested in an application without an approved indirect cost rate agreement is at the discretion of
the Agency.
4.0 APPLICATION AND SUBMISSION INFORMATION
4.1 Address to Request Application Package
The application guide and necessary forms are available at Grants.gov. Additionally, the application
guide, general program information, and other application tools for this funding opportunity
is located at www.rd.usda.gov/programs-services/delta-health-care-services-grants. Use of the
application guide is strongly recommended to assist you with the application process. You may also
contact your RD State Office for more information. Contact information for RD State Offices
is located at www.rd.usda.gov/contact-us/state-offices.
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4.2 Content and Form of Application Submission
You must submit your application electronically through Grants.gov. Your application must contain all
required information. To apply, you must follow the instructions for this funding announcement
at Grants.gov. Please note that we cannot accept applications through mail, courier delivery, in-person
delivery, email, or fax. Paper applications are not accepted.
You can locate the Grants.gov downloadable application package for this program by using a keyword,
the program name, or the Assistance Listing Number for this program. When you enter
the Grants.gov website, you will find information about applying electronically through the site, as well
as the hours of operation.
You must submit all application documents electronically through Grants.gov. Applications must
include electronic signatures. Original signatures may be required if funds are awarded. After applying
electronically through Grants.gov, you will receive an automatic acknowledgement
from Grants.gov that contains a Grants.gov tracking number.
The organization submitting the application will be considered the lead entity. The Contact/Program
Manager must be associated with the lead entity submitting the application.
Your application must also contain the following required forms and proposal elements:
(a) Form SF-424, Application for Federal Assistance. The application for Federal assistance must be
completed by the lead entity as described in Section 3.1. of this Notice. Your application must include
your Unique Entity Identifier (UEI) and System for Award Management (SAM) Commercial code and
expiration date. If you do not include the expiration date and the UEI in your application, it will not be
considered for funding. The form must be signed by an authorized representative.
(b) Form SF-424A, Budget Information - Non-Construction Programs. This form must be completed
and submitted as part of the application package.
(c) Form SF-424C, Budget Information - Construction Programs. This form must be completed, signed,
and submitted as part of the application package for construction Projects.
(d) Executive Summary. A summary of the proposal, not to exceed one page, briefly describing the
Project, tasks to be completed, and other relevant information that provides a general overview of the
Project must be provided.
(e) Evidence of Eligibility. Evidence of the Consortium's eligibility to apply under this Notice must be
provided. This section must include a detailed summary demonstrating that the applicant is a
Consortium as defined in Section 1.3 of this Notice and explain how each Consortium member meets
the definition of an eligible entity as defined in Section 1.3 of this Notice.
(f) Consortium Agreements. The application must include a formal written agreement with each
Consortium member that addresses the negotiated arrangements for administering the Project to meet
Project goals, the Consortium member’s responsibilities to comply with administrative, financial, and
reporting requirements of the grant, including those necessary to ensure compliance with all applicable
Federal regulations and policies, and facilitate a smooth functioning collaborative venture. Under the
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agreement, each Consortium member must perform a substantive role in the Project and not merely
serve as a conduit of funds to another party or parties. This agreement must be signed by an authorized
representative of the lead entity and an authorized representative of each partnering consortium
entity.
(g) Scoring Criteria. Each of the scoring criteria in this Notice must be addressed in narrative form.
Failure to address each scoring criterion will result in the application being determined ineligible.
(h) Performance Measures. The Agency has established annual performance measures to evaluate the
DHCS program. Estimates on the following performance measures, as part of your application, must be
provided:
(1) Number of businesses assisted;
(2) Number of jobs created;
(3) Number of jobs saved; and
(4) Number of individuals assisted/trained.
It is permissible to have a zero in a performance element. When calculating jobs created, estimates
should be based upon actual jobs to be created by your organization as a result of the DHCS funding or
actual jobs to be created by businesses as a result of assistance from your organization. When
calculating jobs saved, estimates should be based only on actual jobs that would have been lost if your
organization did not receive DHCS funding or actual jobs that would have been lost without assistance
from your organization.
You can also suggest additional performance elements, for example where job creation or jobs saved
may not be a relevant indicator. These additional elements should be specific, measurable performance
elements that could be included in an award document.
(i) Financial Information and Sustainability. Current financial statements and a narrative description
demonstrating sustainability of the Project, all of which show sufficient resources and expertise to
undertake and complete the Project and how the Project will be sustained following completion must be
provided. Applicants must provide three years of pro-forma financial statements for the Project.
(j) Evidence of Legal Authority and Existence. The lead entity must provide evidence of its legal
existence and authority to enter into a grant agreement with the Agency and perform the activities
proposed under the grant application.
(k) Service Area Maps. Maps with sufficient detail to show the area that will benefit from the
proposed facilities and services and the location of the facilities improved or purchased with grant
funds, if applicable, must be provided.
(l) Environmental information necessary to support the Agency’s environmental finding.
Required information can be found in 7 CFR part 1b. Construction related activities funded by RD
must comply with State and local building codes and 7 CFR part 1924. Depending on the actions
anticipated, an appropriate 7 CFR part 1b compliant environmental document must be submitted and
approved, prior to commencement of construction.
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4.3 Unique Entity Identifier and System for Award Management
(a) At the time of application, each applicant must have an active registration in the System for
Award Management (SAM) before submitting its application in accordance with 2 CFR part 25. To
register in SAM, entities will be required to obtain a Unique Entity Identifier (UEI). Instructions for
obtaining the UEI are available at https://sam.gov/content/entity-registration.
(b) Each applicant must maintain an active SAM registration, with current, accurate and complete
information, at all times during which it has an active Federal award or an application under
consideration by a Federal agency.
(c) Each applicant must ensure they complete the Financial Assistance General Certifications and
Representations in SAM.
(d) Applicants must provide a valid UEI in its application, unless determined exempt under 2 CFR
25.110.
(e) The Agency will not make an award until the applicant has complied with all SAM requirements
including providing the UEI. If an applicant has not fully complied with the requirements by the time the
Agency is ready to make an award, the Agency may determine that the applicant is not qualified to
receive a Federal award and use that determination as a basis for making a Federal award to another
applicant.
4.4 Submission Dates and Times
Completed applications must be submitted electronically to Grants.gov by 11:59 p.m. Eastern
Time June 1, 2026, to be eligible for funding. Please review the Grants.gov website
at Grants.gov/register for instructions on the process of registering your organization as soon as possible
to ensure you can meet the electronic application deadline. Grants.gov will not accept
applications submitted after the deadline. All application documents identified in this Notice
are required in the submission to be considered a complete application.
The Agency will not solicit or consider new scoring or eligibility information that is submitted after the
application deadline. The Agency reserves the right to contact applicants to seek clarification on
materials contained in the submitted application. See the application guide for a full discussion of each
item comprising a complete application. For complete application requirements, refer to Section 4.2 of
this Notice.
4.5 Intergovernmental Review
Executive Order (EO) 12372, Intergovernmental Review of Federal Programs, applies to this program.
This EO requires that Federal agencies provide opportunities for consultation on
proposed assistance with State and local governments. Many states have established a Single Point of
Contact (SPOC) to facilitate this consultation. For a list of States that maintain a SPOC, please see
the USDA Website: https://www.usda.gov/about-usda/general-information/staff-offices/office-chief-
financial-officer/federal-financial-assistance-policy/intergovernmental-review. If your State has a SPOC,
you may submit a copy of the application directly for review. Any comments obtained through the SPOC
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must be provided to your State Office for consideration as part of your application. If your state has
not established a SPOC, you may submit your application directly to the Agency.
4.6 Funding Restrictions
Project funds may not be used for ineligible purposes. In addition, you may not use Project Funds for
the following:
(a) To duplicate current services or to replace or to substitute support previously provided, however,
Project Funds may be used to expand the level of effort or a service beyond what is currently
being provided;
(b) To pay for costs to prepare the application for funding under this Notice;
(c) To pay for costs of the Project incurred prior to the effective date of the period of performance;
(d) To pay expenses for applicant employee training not directly related to the Project;
(e) To fund political activities;
(f) To pay for assistance to any private business enterprise which does not have at least 51 percent
ownership by those who are either citizens of the United States or reside in the United States after
being legally admitted for permanent residence;
(g) To pay any judgment or debt owed to the United States;
(h) To engage in any activities that are considered a Conflict of Interest, as defined by this Notice; or
(i) To fund any activities prohibited by 2 CFR part 200.
In addition, your application will not be considered for funding if it does any of the following:
(1) Assists a hemp producer without a valid license issued by a State, Tribe or USDA, as applicable,
or in accordance with 7 CFR part 990.
(2) Requests more than the maximum grant amount; or
(3) Proposes ineligible costs that equal more than 10 percent of the Project Funds.
The Agency will consider your application for funding if it includes ineligible costs of 10 percent or less
of total Project Funds, if it is determined eligible otherwise. However, if your application is successful,
those ineligible costs must be removed and replaced with eligible costs before the Agency will make the
grant award or the amount of the grant award will be reduced accordingly. If the Agency cannot
determine the percentage of ineligible costs, your application will not be considered for funding.
4.7 Other Submission Requirements
To submit an application, you must follow the instruction for this funding opportunity at Grants.gov. A
password is not required to access the website. You should not submit your application in more than
one format or in more than one submission. Applications will only be accepted through Grants.gov.
Applications will not be accepted if the text is less than 11-point font. Applicants having technical
difficulties with submitting an application should contact Grants.gov directly. Technical
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difficulties submitting an application through Grants.gov will not be a reason to extend the application
deadline.
5.0 APPLICATION REVIEW INFORMATION
5.1 Evaluation Criteria
All eligible and complete applications will be evaluated based on the following criteria. Evaluators will
base scores only on the information provided or cross-referenced by page number in each individual
scoring criterion. DHCS is a competitive program, so you will receive scores based on the quality of your
responses. Simply addressing the criteria will not guarantee higher scores. The total points possible for
the criteria are 100. The minimum score requirement for funding is 60 points. It is at the Agency’s
discretion to fund applications with a score of 59 points or less if it is in the best interest of the Federal
Government.
(a) Community Needs and Benefits Derived from the Project (maximum of 30 points). A panel of USDA
employees will assess how the Project will benefit the residents in the Delta Region. This criterion will be
scored based on the documentation in support of the community needs for health services and public
health-related facilities and the benefits to people living in the Delta Region derived from the
implementation of the proposed Project. It should lead clearly to the identification of the Project
participant pool and the target population for the Project and provide convincing links between the
Project and the benefits to the community to address its health needs. You must discuss the:
(1) Health care needs/issues/challenges facing the service area and explain how the identified
needs/issues/challenges were determined. Discussion should also identify problems faced by the
residents in the region.
(2) Proposed assistance to be provided to the service area and how the Project will benefit the
residents in the region.
(3) Implementation plan for the Project and provide milestones which are well-defined and can be
realistically completed.
(4) Expected outcomes of the proposed Project and how they will be tracked and monitored.
Applicants must provide specific, quantifiable outcomes for all proposed project activities. Outcomes
must be stated in measurable terms and directly tied to the project’s goals and work plan. Each
application is required to identify performance metrics, the target values for each metric, and the
method that will be used to measure and report progress.
(b) The Project Management and Organization Capability (maximum of 30 points). A panel of USDA
employees will evaluate the Consortium’s experience, past performance, and accomplishments
addressing health care issues to ensure effective Project implementation. This criterion will be
scored based on the documentation of the Project’s management and organizational capability. You
must discuss:
(1) Your organization’s management and fiscal structure including well-defined roles for
administrators, staff, and established financial management systems.
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(2) Relevant qualifications, capabilities, and educational background of the identified key personnel
(at a minimum, the Project Manager) who will manage and implement programs.
(3) Your organization’s current successful and effective experience (or demonstrated experience
within the past five years) addressing the health care issues in the Delta Region.
(4) Your organization’s experience managing grant-funded programs.
(5) The extent to which administrative/management costs are balanced with funds designated for the
provision of programs and services.
(6) The extent and diversity of eligible entity types within the applicant’s Consortium of regional
institutions of higher education, academic health and research institutes, and economic development
entities located in the Delta Region.
(c) Work Plan and Budget (maximum of 30 points). You must provide a work plan, construction
project scope, if applicable and budget that includes the following: (1) the specific activities, such as
programs, services, trainings, and/or construction-related activities for a facility to be performed under
the Project; (2) the estimated line item costs associated with each activity, including grant funds and
other necessary sources of funds; (3) the key personnel who will carry out each activity (including each
Consortium member’s role); and (4) the specific time frames for completion of each activity.
An eligible start and end date for the Project and for individual Project tasks must be clearly shown
and may not exceed Agency specified timeframes for the grant period as referenced in Section 3.3 (d).
You must show the source and use of both grant and other contributions for all tasks. Other
contributions must be spent at a rate equal to, or in advance of, grant funds.
A panel of USDA employees will evaluate your work plan for detailed actions and an accompanying
timetable for implementing the proposal. Clear and comprehensive work plans detailing all project
goals, tasks, timelines, costs, and responsible personnel in a logical and realistic manner will result in a
higher score.
(d) Local Support (maximum 10 points). A panel of USDA employees will evaluate your application for
local support of the proposed Project. Your discussion on local support should include previous and/or
expected local support and plans for coordinating with local government institutions, public health care
providers, and other entities in the Delta Region. Evidence of support must be included in your
application and should be provided in the form of letters of support from local entities, residents and/or
stakeholders.
5.2 Review Selection Processes
Applications will be funded in highest ranking order until the funding limitation has been
reached. Applications that cannot be fully funded may be offered partial funding at the Agency’s
discretion. If your application is ranked and not funded, it will not be carried forward into the next
competition. The Agency reserves the right to offer the applicant less than the grant funding requested.
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6.0 FEDERAL AWARD ADMINISTRATION INFORMATION
6.1 Federal Award Notices
Successful applicants will receive notification for funding by electronic mail, containing instructions on
requirements necessary to proceed with execution and performance of the award. Applicants
must comply with the terms of the award, including meeting all applicable statutes and regulations
before the grant award can be approved and funded.
If you are not selected for funding, you will be notified in writing by electronic mail and informed of
any review and appeal rights. Funding of successfully appealed applications will be limited to available
FY 2026 funding.
6.2 Administrative and National Policy Requirements
(a) Civil Rights. All awards of Federal financial assistance made under this NOFO are subject to
applicable civil rights laws, which may include Title VI of the Civil Rights Act of 1964, Section 504 of the
Rehabilitation Act of 1973, the Age Discrimination Act of 1975, Title VIII of the Civil Rights Act of 1968,
Title IX of the Education Amendments Act of 1973, and the Equal Credit Opportunity Act of 1974.
(b) Build America, Buy America (BABAA). Awardees that are Non-Federal Entities, defined pursuant to
2 CFR 200.1 as any State, local government, Indian Tribe, Institution of Higher Education, or nonprofit
organization, shall be governed by the requirements of Section 70914 of the Build America, Buy America
Act (BABAA) within the Infrastructure Investment and Jobs Act (Public Law 117-58), and its
implementing regulations at 2 CFR part 184. Any requests for waiver of these requirements must
be submitted pursuant to USDA’s guidance available online at usda.gov/ocfo/federal-financial-
assistance-policy/USDABuyAmericaWaiver.
(c) Additional requirements that apply to grantees selected for this program can be found in 2 CFR
parts 25, 170, 180, 200, 400, 415, 417, 418, and 421; and 48 CFR 31.2, and successor regulations to
these parts. All recipients of Federal financial assistance are required to report information about first
tier subawards and executive compensation (see 2 CFR part 170). You will be required to have the
necessary processes and systems in place to comply with the Federal Funding Accountability and
Transparency Act reporting requirements (see 2 CFR 170.200(b), unless you are exempt under 2 CFR
170.110(b).These regulations may be obtained at ecfr.gov.
The following additional requirements apply to grantees selected for this program:
(a) Execution of an Agency approved Financial Assistance Agreement.
(b) Acceptance of a written Letter of Conditions.
(c) Submission of Form RD 1940-1, Request for Obligation of Funds.
(d) Submission of Certification for Contracts, Grants and Loans.
(e) SF-LLL, Disclosure of Lobbying Activities if applicable.
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6.3 Reporting
After grant approval and through grant completion, you will be required to provide the following:
(a) A SF-425, Federal Financial Report, and a project performance report will be required on a
semiannual basis (due 30 working days after the end of the semiannual period). For the purposes of this
grant, semiannual periods end on June 30th and December 31st. The project performance reports shall
include a comparison of actual accomplishments to the objectives established for that period.
(b) Reasons why established objectives were not met, if applicable.
(c) Reasons for any problems, delays, or adverse conditions, if any, which have affected or will affect
attainment of overall project objectives, prevent meeting time schedules or objectives, or preclude the
attainment of particular objectives during established time periods. This disclosure shall be
accompanied by a statement of the action taken or planned to resolve the situation.
(d) Objectives and timetable established for the next reporting period.
(e) A final project and financial status report within 120 days after the expiration or termination of the
grant.
(f) Outcome project performance reports and final deliverables.
(g) An annual audit in accordance with 2 CFR part 200 subpart F unless the recipient expends less
than $1,000,000 in total Federal awards during its fiscal year.
7.0 FEDERAL AWARD AGENCY CONTACTS
For general questions about this funding opportunity, please contact your USDA RD State Office.
Contact information for RD State Offices can be found at rd.usda.gov/contact-us/state-offices. You may
also contact Ann Stahl, Business Loan and Grant Analyst, Intermediary Branch, Program Management
Division, USDA, 1400 Independence Avenue, SW, Washington, D.C. 20250; or email ann.stahl@usda.gov;
or call 567-245-3383 for further information.
8.0 OTHER INFORMATION
8.1 Paperwork Reduction Act
Under the Paperwork Reduction Act (44 U.S.C. 3501 et seq.), OMB must approve all ‘‘collection of
information’’ as a requirement for ‘‘answers to * identical reporting or recordkeeping requirements
imposed on ten or more persons *’’ (44 U.S.C. 3502(3)(A)). The Agency has concluded that the
reporting requirements contained in this rule/funding announcement will involve less than 10 persons
and do not require approval under the provisions of the Act.
8.2 National Environmental Policy Act
All recipients under this Notice are subject to the requirements of 7 CFR part 1b. The Agency will
review each grant application to determine its compliance with 7 CFR part 1b. The applicant may be
asked to provide additional information or documentation to assist the Agency with this determination.
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8.3 Federal Funding Accountability and Transparency Act
All applicants, in accordance with 2 CFR part 25, must be registered in SAM and have a UEI number
as stated in Section 4.3 of this notice. All recipients of Federal financial assistance are required to report
information about first-tier sub-awards and executive total compensation in accordance 2 CFR part 170.
8.4 Equal Opportunity for Religious Organizations.
(a) Faith-based organizations may apply for this award on the same basis as any other organization, as
set forth at, and subject to the protections and requirements of, this part and any applicable
constitutional and statutory requirements, including 42 U.S.C. 2000bb et seq. USDA will not, in the
selection of recipients, discriminate for or against an organization on the basis of the organization's
religious character, motives, or affiliation, or lack thereof, or on the basis of conduct that would not be
considered grounds to favor or disfavor a similarly situated secular organization.
(b) A faith-based organization that participates in this program will retain its independence from the
Government and may continue to carry out its mission consistent with religious freedom and conscience
protections in Federal law. Religious accommodations may also be sought under many of these religious
freedom and conscience protection laws.
(c) A faith-based organization may not use direct Federal financial assistance from USDA to support or
engage in any explicitly religious activities except when consistent with the Establishment Clause of the
First Amendment and any other applicable requirements. An organization receiving Federal financial
assistance also may not, in providing services funded by USDA, or in their outreach activities related to
such services, discriminate against a program beneficiary or prospective program beneficiary on the
basis of religion, a religious belief, a refusal to hold a religious belief, or a refusal to attend or participate
in a religious practice.
8.5 Nondiscrimination Statement
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights
regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in
or administering USDA programs are prohibited from discriminating based on race, color, national
origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public
assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program
or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint
filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information
(e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the State or local
Agency that administers the program or contact USDA through the Telecommunications Relay Service at
711 (voice and TTY). Additionally, program information may be made available in languages other than
English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint
Form, AD-3027, found online at usda.gov/about-usda/general-information/staff-offices/office-assistant-
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secretary-civil-rights/how-file-program-discrimiint and at any USDA office or write a letter addressed to
USDA and provide in the letter all of the information requested in the form. To request a copy of the
complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
(a) mail: U.S. Department of Agriculture,
Office of the Assistant Secretary for Civil Rights,
1400 Independence Avenue, SW, Mail Stop 9410,
Washington, D.C. 20250-9410;
(b) fax: (202) 690-7442; or
(c) email: program.intake@usda.gov.
USDA is an equal opportunity provider, employer, and lender.
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Application Template Guide

Program Overview

The Delta Health Care Services Grant Program is authorized under Section 379G of the Consolidated Farm and Rural Development Act, as amended.

The Delta Health Care Services Grant Program is designed to provide financial assistance to address the continued unmet health needs in the Delta Region, through cooperation among non-profits, health care professionals, institutions of higher education, research institutions, and other entities in the Delta Region. Grant funds may be utilized for the development of health care services; health education programs; health care job training programs; and for the development and expansion of public health-related facilities in the Delta Region.

# Before You Get Started

# Checklist

Program requirements are detailed in the Notice and the information contained in this guide.

Before you submit your application, please ensure that you have addressed all the following elements.

Required Forms (see links below for fillable forms)

Form SF 424, “Application for Federal Assistance”

Form SF-424A “Budget Information – Non-Construction Programs”

Construction Applications Must Include:

Form SF 424, “Application for Federal Assistance”

Form SF-424C “Budget Information - Construction Programs”

RD Form 1940-20 “Request for Environmental Information”

Section 1. Executive Summary

Description of your proposed project, not to exceed one page

Section 2. Evidence of Eligibility

Legal Authority and Existence – Appendix B

Consortium Located in the Delta Region

Certification – Multiple Grants (Appendix C)

Certification – Currently Active DHCS Grant (Appendix C)

Certification – Federal Judgements (Appendix C)

Applicant Type

Lead Applicant- Consortium Partner 1

Consortium Partner 2

Consortium Partner 3

Indicate Eligibility of Additional Consortium Partners Individually

Section 3. Consortium Agreement

Agreement between all Consortium members. – Appendix D

Section 4. Scoring Criteria

Community Needs and Benefits Derived

Project Management and Organizational Capability

Work Plan and Budget

Local Support

Administrator Discretionary Points

Section 5. Financial Information and Stability

Financial Information and Stability Narrative

Financial Statements – Appendix E

Appendices

Appendix A – Additional Consortium Members

Appendix B - Legal Authority and Existence

Appendix C – Certifications

Appendix D – Consortium Agreement

Appendix E – Financial Information and Sustainability – Financial Statements

Appendix F – Documentation for Local Support

Appendix G – Documentation for Verification of Matching Funds (If applicable)

Appendix H – Service Area Maps

# Required Standard Forms

All SF Forms

https://www.grants.gov/web/grants/forms/sf-424-family.html

RD FORM 1940-20, “Request for Environmental Information”

http://www.rd.usda.gov/files/IA_1940-20.pdf

# Important Application Resources

SAM Registration

Register at no charge at https://www.sam.gov/SAM/

# Application Template

SECTION 1: EXECUTIVE SUMMARY OF PROJECT

[Insert a description of your project containing the following information; 1) legal name of lead applicant, 2) consortium members, 3) applicant type (including consortium members) 4) application type (development of health care services, health education programs, health care job care training programs, or the development and/or expansion of health related facilities, 5) and a summary of your project and tasks to be completed. The application must identify if the project will be in a persistent poverty county, or counties and the project funds associated with supporting persistent poverty counties.   Limit one page.]

SECTION 2: EVIDENCE OF ELIGIBILITY

Use Section A. Program Description of the Notice, “Definitions”, to address this section. Certify the following by reading and checking the following statements:

2.1 Evidence of Legal Authority & Existence

We have or can obtain the legal authority to carry out the purpose of the grant and are in good standing in the State where our business is incorporated and/or in the State that is the primary location of our business operations for the DHCS project.

In Appendix B, please attach a copy of, or excerpt from your organizational documents showing legal authority to carry out the purpose of the grant on behalf of your organization, along with a Certificate of Good Standing or letter from a State agency or equivalent authority.

2.2 Located in the Delta Region

[Insert a discussion demonstrating that each Consortium member is located in the Delta Region as defined in Section A of the Notice.]

2.3 Multiple Grant Eligibility

Applicants (including its members) may not submit more than one application for funding under this Notice. We will NOT accept applications from Consortiums that include members who are also members of other Consortiums that have submitted applications for funding through this program.

In Appendix C, each Consortium member must certify that it is submitting only one application in response to the Notice.

2.4 Currently Active DHCS Award

If the lead entity, or any of its Consortium members, has an existing DHCS award, it must be performing satisfactorily to be considered eligible for a funding through this program. Satisfactory performance includes, but is not limited to, being up-to-date on all financial and performance reports and being current on all tasks as approved in the work plan.

In Appendix C, each Consortium member must certify if it currently has an active DHCS award.

2.5 No Current Outstanding Federal Judgements

In Appendix C, each Consortium member must certify that it does not have any outstanding judgements against it.

2.6 Applicant Type

[Insert a discussion demonstrating how each Consortium member meets the definition of an eligible entity (academic health and research institute, economic development, or regional institution of higher education) as defined under the Definitions of the Notice.]

Example: Lead Applicant (Consortium Member 1), a non-profit organization located in Anywhere, Alabama, is an economic development entity with a mission to support, represent and promote the local business community while enhancing successful partnerships that are vital to the region. Lead Applicant’s goal is to relieve unemployment in the State, encourage the increase of business activity and commerce and a balanced economy in low and moderate income communities throughout Anywhere County. Our nutrition services business incubation program has graduated 9 companies and supported 244 employees...

SECTION 3: CONSORTIUM AGREEMENT

Your Consortium agreement must be included in Appendix D. Agreements must include the following (at minimum):

Legal name of each consortium member partnering on the project

Negotiated arrangements for administering the project

Consortium member’s responsibilities to comply with administrative, financial and reporting requirements of the grant

Signature of the authorizing official from each Consortium member

A sample agreement is included in Appendix D.

SECTION 4: SCORING CRITERIA

The Agency will select and rank applications for funding based on the score an application has received in response to the Scoring Documentation. For each criterion, you must demonstrate how the project has merit and provide rationale for the likelihood of success. Responses that do not address all aspects of the criterion in a meaningful way, or that do not convey relevant project information will receive lower scores. DHCS is a competitive program, so your responses will be evaluated on the quality of each response. Simply providing an answer will not guarantee higher scores. The maximum number of points that will be awarded to an application is 110. The minimum score necessary to receive funding is 60 points. You must review the Notice at section E.1. for a detailed description of the graduated scoring thresholds for each criterion.

4.1 The Community Needs and Benefits Derived from the Project (0-30 points)

This section should document how the Project will meet the communities need for health services and public health related facilities and specifically describe the benefits to the people living in the Delta Region. It should lead clearly to the identification of the Project participant pool and the target population for the Project and provide convincing links between the Project and the benefits to the community to address its health needs.

• Describe the Health care needs/ issues/challenges facing the service area and explain how the identified needs/issues/challenges were determined. Discussion should also identify problems faced by the residents in the region.

• [Insert Description]

(2) Discuss the proposed assistance to be provided to the service area and how the Project will benefit the residents in the region.

• [Insert Description]

(3) Explain how the project will be implemented and provide milestones which are well-defined and can be realistically completed.

• [Insert Description]

(4) Discuss expected outcomes of the proposed Project and how they will be tracked and monitored. You should attempt to quantify benefits in terms of outcomes from the Project; that is, ways in which peoples’ lives, or the community, will be improved. Provide estimates of the number of people affected by the benefits arising from the Project.

How many businesses assisted as a result of the project?

Number of jobs expected to be created or saved

Number of individuals assisted or trained

It is permissible to have a zero in a performance element. When you calculate jobs created, estimates should be based upon actual jobs to be created by your organization as a result of the DHCS funding or actual jobs to be created by businesses as a result of assistance from your organization. When you calculate jobs saved, estimates should be based only on actual jobs that have been lost if your organization did not receive DHCS funding or actual jobs that would have been lost without assistance from your organization.

You can also suggest additional performance elements for example where job creation or jobs saved may not be a relevant indicator. These additional criteria should be specific, measurable performance elements that could be included in an award document.

4.2 Project Management and Organizational Capability (0-30 points)

This section should document the project’s management and organizational capability. The Agency will evaluate the applicant’s experience, past performance, and accomplishments addressing health care issues to ensure effective project implementation.

• Describe the organization’s management and fiscal structure including: well-defined roles for administrators, staff, and established financial management systems. Applicant is encouraged to describe the actual financial system used in managing funds.

[Insert Description]

• Describe the qualifications, capabilities, and educational background of the identified key personnel (at a minimum the Project Manager) who will manage and implement programs and how they will contribute to the success of the project.

[Insert Description]

• Describe the applicant’s current successful and effective experience (or demonstrated experience within the past five years) addressing the health care issues in the Delta Region.

[Insert Description]

• Describe the applicant’s experience managing grant-funded programs. Applicant should provide a list of current and past grants, and an indication of whether the grants are still open or if they have been successfully closed.

[Insert Description]

• Describe how administrative/management costs are balanced with funds designated for the provision of programs and services. Applicant should provide a clear description of the percentage of funds being used for administrative vs. programmatic costs.

[Insert Description]

• Detail the extent and depth of membership in the applicant’s Consortium of regional institutions of higher education, academic health and research institutes and economic development entities located in the Delta Region, providing a detailed description of the roles of each member.

• [Insert Description]

4.3 Work Plan and Budget (0-30 points)

Provide a detailed work plan and budget below that shows how the project’s goals will be accomplished in accordance with the requirements in the NOTICE, including:

• the specific activities, such as programs, services, trainings, and/or construction-related activities for a facility to be performed under the Project;

• the estimated line item costs associated with each activity, including grant funds and other necessary sources of funds;

• the key personnel who will carry out each activity (including each Consortium member’s role); and

• the specific time frames for completion of each activity.

An eligible start and end date for the Project and for individual Project tasks must be clearly shown and may not exceed Agency specified timeframes for the grant period. You must show the source and use of both grant and other contributions for all tasks.

• Insert Work Plan narrative here (upload additional pages as needed):

[Insert work plan narrative]

• Project Budget Summary

Summarize the total project budget by task. Insert additional rows as needed. Sample included below.

• Task Budget Format

• Provide a budget table for each task that will be completed for each main activity listed above.

• Edit budget categories and add additional task tables as needed.

Provide explanation/clarification for each task budget, including the basis for budget figures:

[Insert task budget explanation]

4.4 Local Support (0-10 points)

Your discussion should include documentation detailing support solicited from local government, public health care providers, and other entities in the Delta Region. Evidence of support can include;

but is not limited to surveys conducted amongst Delta Region residents and stakeholders,

notes from focus groups, or letters of support from local entities. The letter/surveys/supporting documentation should be included in Appendix F. Summaries should include date of the letter and name and position of the author. Surveys should include dates the surveys were conducted, survey questions, results of the survey and demographic of the participants included in the survey. You will score higher if you demonstrate strong support from potential beneficiaries and other developmental organizations.

[Insert Discussion]

4.5 Administrator Discretionary Points (0-10 points)

The Administrator may choose to award:

up to 10 points to support geographic distribution of funds and/or key priorities as follows:

Assisting rural communities recover economically through more and better market opportunities and through improved infrastructure.

Ensuring all rural residents have equitable access to RD programs and benefits from RD funded projects.

Reducing climate pollution and increasing resilience to the impacts of climate change through economic support to rural communities.

[Insert Discussion]

SECTION 5: FINANCIAL INFORMATION & SUSTAINABILITY

• You must provide a narrative description demonstrating sustainability of the project, detailing sufficient resources and expertise to undertake and complete the project and how the project will be sustained following completion. Current financial statements and 3-years of pro-forma statements must be included in Appendix E.

• [Insert Narrative Description]

Current financial statements included in Appendix E.

Balance Sheet (Most Current)

Income Statement (Most Current)

Audited Financial Statement (Most Current)

3-years pro-forma statements include in Appendix E.

PROCEED TO APPENDICES

# APPENDICES

APPENDIX A: Additional Consortium Members

Please feel free to continue to add as necessary.

Legal Name of Consortium Member 4:

Applicant Type:

Academic Health & Research Institute

Economic Development Entity

Institution of Higher Education

Legal Name of Consortium Member 5:

Applicant Type:

Academic Health & Research Institute

Economic Development Entity

Institution of Higher Education

Legal Name of Consortium Member 6:

Applicant Type:

Academic Health & Research Institute

Economic Development Entity

Institution of Higher Education

Legal Name of Consortium Member 7:

Applicant Type:

Academic Health & Research Institute

Economic Development Entity

Institution of Higher Education

APPENDIX B: Evidence of Legal Authority and Existence

Please attach evidence of Legal Authority and Existence (Examples: By-Laws, Articles of Incorporation or Organization, Letter or Certificate of Good Standing from your Secretary of State or equivalent agency).

APPENDIX C: Certifications

Each Consortium Member Must Certify the Following:

We, , certify the following to the best of our knowledge and belief, that:

Multiple Grant Eligibility

We are submitting only one application in response to this solicitation.

Currently Active Delta Health Care Service Award

We DO NOT have a currently active DHCS grant with unused funds.

OR

We DO have a currently active DHCS grant with unused funds and are performing satisfactorily, as defined in Section C.3.f. of this Notice.

Scheduled completion date of currently active DHCS grant:

Certification of Federal Judgements

The United States has not obtained an unsatisfied judgment against my property and we will not use grant funds to pay any judgments obtained by the United States.

Print Name of Consortium Authorized Representative: _______________________________________________

Title of Consortium Authorized Representative: _____________________________________________________

Signature of Consortium Member

Authorized Representative: _______________________________________________ Date: ________________

APPENDIX D: Consortium Agreement

Consortium Agreement TEMPLATE

This Agreement, which includes any referenced attachments, is made among the organizations listed below.

, whose registered office is at ; and

, whose registered office is at ; and

, whose registered office is at .

These organizations will be referred to individually as a “Member” and collectively as “Members” throughout this Agreement.

• Purpose. The purpose of this Agreement is to specify the responsibilities of the Consortium Members in carrying out the Project, to identify the rights and obligations of the Members, and to complete the Project, including producing deliverables, as described in Attachment A – Work Plan.

• Duration. This Agreement shall commence on the Effective Date and continue until the completion of the Project on [INSERT DATE]. The duration of this Agreement may be extended beyond the completion date, at any time prior to that date, by written agreement of the Members.

• Definitions. The following terms are defined for this Agreement.

Confidential Information means all information that is marked as Confidential and is disclosed by one Member to the others for the purpose of completing the Project. It includes, but is not limited to, the following: ideas, financial information, marketing information, work plans, computer systems and software, products and services, records, reports, documents, papers, and any other materials that are generated through work on the Project.

Consortium means the Members collectively.

Effective Date means the date when all members have signed this Agreement.

Lead Institution means the Member who is designated in Section IV of this Agreement. This Member is authorized as the Consortium’s agent to sign agreements in the Consortium’s name and on behalf of the Project in accordance with Section IV of this Agreement.

Project means the work described in Attachment A – Work Plan.

Project Manager means the person appointed by the Lead Institution to run the day-to-day operation of the Project and report directly to the Lead Institution.

Personnel means any employee, director, agent, contractor, or other individual engaged by a Member.

• Lead Institution. The Lead Institution for this Agreement is designated as . The Lead Institution is responsible for the following:

• Taking all reasonable steps to seek and obtain the prior approval of each of the other Members before signing agreements for the benefit of the Project;

• Monitoring Project progress and notifying other Members of any concerns in meeting progress goals;

• Ensuring completion of Project tasks by assigning tasks to other Members, completing tasks with its Personnel, and/or by contracting with qualified individuals on behalf of the Consortium;

• Providing deliverables to USDA/Rural Development and other funding partners as required by any financial assistance agreements related to the Project;

• Submitting all progress, performance, and financial reports to USDA/Rural Development and other funding partners as required by any financial assistance agreements related to the Project;

• Appointing a Project Manager; and

• Managing the Project’s finances in accordance with appropriate accounting principles, applicable State and Federal laws and regulations, and any financial assistance agreements related to the Project.

• Project Resources.

• Allocation of Funds. The chart below lists the funds contributed to the Project.

• Distribution. Funds for the Project that are received from non-Consortium organizations will be paid to the Lead Institution and then distributed to Members as needed to carry out the Project as described in Attachment A – Work Plan. When necessary, the Lead Institution will also be responsible for receiving contributions from Members to pay for Project expenses.

• Invoicing. When allowable costs are incurred by Members, an invoice should be submitted to the Lead Institution as soon as they have been paid. Supporting documentation for the costs should be included with the invoice.

• Responsibilities of the Members. The Members agree to undertake the following:

• To procure and maintain its own liability insurance, to cover the Member’s liabilities and those of its Personnel;

• To comply with and to assist the Lead Institution with compliance with all applicable laws, regulations, and financial assistance agreements related to the Project;

• To indemnify and hold harmless the other Members from and against all costs, liabilities, injuries, direct, indirect or consequential loss (all three of which terms include, without limitation, pure economic loss, loss of profits, loss of business, depletion of goodwill and like loss), damages, claims, demands, proceedings or legal costs (on a full indemnity basis) and judgments which they incur or suffer as a result of a breach of this Agreement or negligent acts or omissions or willful misconduct of the Member and/or its Personnel including without limitation any resulting liability the Consortium has to the funder or to any third Member;

• To provide appropriate facilities and services as necessary to achieve proper performance of the Member’s assigned tasks;

• To provide Personnel, as needed, to perform assigned tasks and to attend Project-related meetings;

• To complete the tasks assigned to it by the Lead Institution and any other obligations under this Agreement;

• To provide all information, such as financial records and progress reports, needed by the Project Manager and Lead Institution to fulfill the obligations incurred by this Agreement;

• To notify each of the other Members when the Member becomes aware of any significant delay in performance;

• To inform each of the other Members when a Member receives relevant communications from a third Member about the Project;

• To ensure the accuracy of any information it provides under this Agreement, to the best of the Member’s ability; and

• To avoid issuing press releases or other publicity materials relating to the Consortium and/or the Project without obtaining prior approval from the other Members.

The signatories below certify that they have authority to enter into this Agreement.

Approved by an Authorized Representative of [INSERT NAME OF MEMBER 1]:

______________________________________________________________________________Name (Please Print)

_____________________________________________________________________________Title (Please Print)

_______________________________________________ ________________________

Signature Date

Approved by an Authorized Representative of [INSERT NAME OF MEMBER 2]:

______________________________________________________________________________Name (Please Print)

_____________________________________________________________________________Title (Please Print)

_______________________________________________ ________________________

Signature Date

Approved by an Authorized Representative of [INSERT NAME OF MEMBER 3]:

______________________________________________________________________________Name (Please Print)

_____________________________________________________________________________Title (Please Print)

_______________________________________________ ________________________

Signature Date

ATTACHMENT A – WORK PLAN

APPENDIX E: Financial Information & Sustainability

Attach copies of the lead applicant’s current financial statement as well as 3-years of pro-forma financial statements for the project.

APPENDIX F: Documentation - Local Support

In this section, attach copies of letters of support, surveys and/or other documentation demonstrating support of the project from local stakeholders in the Delta Region.

APPENDIX G: Documentation for Verification of Matching Funds

Documentation verifying matching funds must be included in your application. If grant funds are awarded, this information will be re-verified upon execution of the grant agreement. Verification Templates are included in this Application Guide for each type of contribution to the project, and you may select the template(s) appropriate for your project: 1) Applicant cash; 2) Applicant approved loan or line-of-credit; and/or 3) Third-Party cash.

If you have questions about your project budget or eligible use of grant and/or matching funds, please contact your Rural Development State Office. Contact information is available for each state at http://www.rd.usda.gov/contact-us/state-offices.

APPENDIX G.1 Verification of Matching Funds (Other Contributions): Applicant Cash

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The use of this form is optional, but highly recommended. If the applicant is contributing cash-on-hand to pay for goods and/or services during the grant period that are eligible expenses for the project, the expenditure is considered as a “matching fund”. The applicant must sign this statement to verify (a) the amount of cash contribution, (b) the source of the cash contribution and (c) use of the cash contribution. A copy of a bank statement with an ending date within one month of the application submission deadline and showing an ending balance equal to or greater than the amount of Cash Contribution proposed is also required at time of application (note: please redact any account numbers appearing on your statement).

Legal Name of Applicant: _______________________________________________________________

Title of Applicant’s DHCS Project: ________________________________________________________

Total Project Cost: $____________ DHCS Grant Request: $_____________

Total Applicant Cash Contribution: $_____________

Identify all source(s), amounts, and uses of Applicant Cash Contribution that your organization currently has available and committed to eligible DHCS project expenditures during the grant period proposed in the SF424 form and Section 6. Include a copy of an account statement from each source dated within 30 days of the application submission showing an ending balance equal to or greater than the amount of Cash Matching Funds proposed.

Has your organization formally approved the Cash Contribution and Purpose at time of application?

Yes No ________________Date of Approval ______N/A

Print Name of Applicant/Authorized Representative: _________________________________________________

Title of Applicant/Authorized Representative: _______________________________________________________

Signature of Applicant or

Authorized Representative: ______________________________________________ Date: ________________

APPENDIX G.2 Verification of Matching Funds (Other Contributions): Applicant Approved Loan or Line of Credit

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Use of this form is optional, but highly recommended. Ask your lending institution to provide all of the information below, at time of application, to verify your approved Loan or Line of Credit that will be used as matching funds for your DHCS project during the grant period proposed in the SF424 form and Section 6 – Work Plan and Budget.

For purposes of facilitating the Work Plan and Budget Activities identified in the associated DHCS application, and as an Authorized Representative of the lending institution identified below, I verify and confirm the following information:

Legal Name and Address of Lender Providing Loan or Line of Credit for Delta Health Care Service Grant Matching Funds:

_____________________________________________________________________________________

_____________________________________________________________________________________

Legal Name and Address of Intended Recipient/Borrower of Loan DHCS application:

_____________________________________________________________________________________

_____________________________________________________________________________________

Total Amount of Loan or Line of Credit to be Used for Eligible DHCS Project Purposes: $____________

Brief Description of Borrower’s Use of Loan/LOC Funds: [Insert description]

Will the Loan or Line of Credit be provided to the Borrower during the proposed grant period, or on a specific date within the proposed grant period? Yes No

Date(s) of Transfer or Availability of the Funds to Borrower (month/day/year): ________________

Date of Loan/LOC Approval ____________________ N/A

Print Name of Authorized Representative for Lending Institution: ____________________________________________________________________________

Title of Authorized Representative: __________________________________________________________________

Signature of

Authorized Representative: _____________________________________________ Date: _________

APPENDIX G.3 Verification of Matching Funds (Other Contributions): Third-Party Cash

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The use of this form is optional, but highly recommended. The Third-Party contributor must complete and sign where indicated to verify the (a) amount of cash to be donated, and (b) when it will be donated, indicating specific dates (month/day/year) corresponding to the grant period proposed in the SF424 form and Section 6-Work Plan and Budget, or to dates within the grant period, when matching funds will be made available to the project.

For purposes of facilitating the Work Plan and Budget Activities identified in the associated FY2020 Delta Health Care Services Grant (DHCS) application, and as an Authorized Representative of the third-party organization identified below, I verify and confirm the following information:

Legal Name and Address of Third-Party providing Matching Funds:

____________________________________________________________________________________________

Legal Name of Intended Recipient of Third-Party CASH Match:

________________________________________________________________________________________

Total Amount of Third-Party CASH Contribution Match to be Donated for Eligible DHCS Project Purposes:

$_______________

Will the Third-Party CASH Match be provided to the Intended Recipient during the proposed grant period?

Yes No

Dates of Transfer/Availability___________________ (month/day/year)

Name of Financial Institution currently holding Third-party cash match to be transferred to Intended Recipient: __________________________________________________________________

Does your organization understand that cash matching funds from third-parties cannot be used to provide services which directly benefit the third-party contributor, and that contributors of cash matching funds may not limit how or where the funds are used? Yes No

Has your organization approved the Third-Party CASH transfer amount and DHCS general purpose?

Yes No Date of Approval______________ N/A

Print Name of Authorized Representative

For Third-Party Organization: ___________________________________________________________________

Title of Authorized Representative: _______________________________________________________________

Signature of Authorized Representative: ____________________________________ Date: _________________

APPENDIX H: Service Area Maps

Attach maps with sufficient detail to show the area that will benefit from the proposed services and/or facilities and the location of the facilities improved or purchased with grant funds (if applicable).