39-5908. RURAL HEALTH CARE ACCESS AND PHYSICIAN INCENTIVE APPLICATIONS REQUIRED. (1) A completed grant application must be submitted by the applicant for the purpose of requesting a grant or contract, on or before the conclusion of the application period specified for the appropriate grant cycle. All applications must include the required information.

(2) The grant application and any attachments submitted by the applicant shall be the primary source of information for awarding a grant. Additionally, the board may request and/or use other information known to it in making its decision.

(3) All rural health care access applications shall include:

(a) Geographical area of need;

(b) Individual or entity requesting funds;

(c) Narrative description of the methods to be used to address needs and demonstrate the potential of the project to improve access to health care services in the community;

(d) Identification of measurable goals, objectives to be used to reach the goals, and the resources necessary to complete each activity;

(e) Estimation of how long it will take to accomplish the individual activities of the project;

(f) Demonstrated community and organizational support for the project;

(g) County or local governmental endorsement;

(h) Operating budget including:

(i) Proportion of operating budget, if any, the applicant proposes to match with the rural health care access grant funds;

(ii) Documentation of one (1) or more vendor price quotes for all proposed equipment purchases;

(iii) Contact person for verification of fiscal information;

(i) Federal tax identification number; and

(j) Other information required by the board.

(4) All rural physician incentive applications shall:

(a) Be on a form prescribed by the rural health care access and physician incentive board; and

(b) Include a letter of support along with supporting documentation.

History:

[39-5908, added 2000, ch. 262, sec. 2, p. 737; am. 2012, ch. 44, sec. 10, p. 137.]