Title 42The Public Health and WelfareRelease 119-73

§300s–1 Medical facility project applications

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER XIV— - HEALTH RESOURCES DEVELOPMENT › Part Part C— - General Provisions › § 300s–1

Last updated Apr 6, 2026|Official source

Summary

A medical facility project cannot get a loan, loan guarantee, or grant under part A or B unless an application is filed and approved by the Secretary. If several groups work together on a project, any one of them or all of them can file the application. The Secretary decides the form and way the application must be sent. The application must show certain things, such as a State Agency finding that the services are needed, proof you can’t finish the project without the grant (when asking for a grant), an impact evaluation if services or facilities will be closed or changed, a description of the site, plans and specifications that meet the rules, and proof the site title will belong to the applicant or a public/nonprofit operator. It must show funding is available to finish and run the project, say what kind of help is requested, promise to pay required local wages, and for outpatient projects, show a general hospital is available for patients who need it. Approved projects must serve all people in the area and provide a reasonable amount of care to those who can’t pay, as financially possible. The Secretary may waive some site, plan, or title rules for small modernization loans (part A) of $20,000 or less for outpatient facilities serving medically underserved populations.

Full Legal Text

Title 42, §300s–1

The Public Health and Welfare — Source: USLM XML via OLRC

(a)No loan, loan guarantee, or grant may be made under part A or B for a medical facilities project unless an application for such project has been submitted to and approved by the Secretary. If two or more entities join in a project, an application for such project may be filed by any of such entities or by all of them.
(b)(1)An application for a medical facilities proj­ect shall be submitted in such form and manner as the Secretary shall by regulation prescribe and shall, except as provided in paragraph (2), set forth—
(A)in the case of a modernization project for a medical facility for continuation of existing health services, a finding by the State Agency of a continued need for such services, and, in the case of any other project for a medical facility, a finding by the State Agency of the need for the new health services to be provided through the medical facility upon completion of the project;
(B)in the case of an application for a grant, assurances satisfactory to the Secretary that (i) the applicant making the application would not be able to complete the project for which the application is submitted without the grant applied for, and (ii) in the case of a project to construct a new medical facility, it would be inappropriate to convert an existing medical facility to provide the services to be provided through the new medical facility;
(C)in the case of a project for the discontinuance of a service or facility or the conversion of a service or a facility, an evaluation of the impact of such discontinuance or conversion on the provision of health care in the health service area in which such service was provided or facility located;
(D)a description of the site of such project;
(E)plans and specifications therefor which meet the requirements of the regulations prescribed under section 300s(2) of this title;
(F)reasonable assurance that title to such site is or will be vested in one or more of the entities filing the application or in a public or other nonprofit entity which is to operate the facility on completion of the project;
(G)reasonable assurance that adequate financial support will be available for the completion of the project and for its maintenance and operation when completed, and, for the purpose of determining if the requirements of this subparagraph are met, Federal assistance provided directly to a medical facility which is located in an area determined by the Secretary to be an urban or rural poverty area or through benefits provided individuals served at such facility shall be considered as financial support;
(H)the type of assistance being sought under part A or B for the project;
(I)reasonable assurance that all laborers and mechanics employed by contractors or subcontractors in the performance of work on a project will be paid wages at rates not less than those prevailing on similar construction in the locality as determined by the Secretary of Labor in accordance with section 3141–3144, 3146, and 3147 of title 40, and the Secretary of Labor shall have with respect to such labor standards the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 FR 3176; 5 U.S.C. Appendix) and section 3145 of title 40;
(J)in the case of a project for the construction or modernization of an outpatient facility, reasonable assurance that the services of a general hospital will be available to patients at such facility who are in need of hospital care; and
(K)reasonable assurance that at all times after such application is approved (i) the facility or portion thereof to be constructed, modernized, or converted will be made available to all persons residing or employed in the area served by the facility, and (ii) there will be made available in the facility or portion thereof to be constructed, modernized, or converted a reasonable volume of services to persons unable to pay therefor and the Secretary, in determining the reasonableness of the volume of services provided, shall take into consideration the extent to which compliance is feasible from a financial viewpoint.
(2)(A)The Secretary may waive—
(i)the requirements of subparagraph (D) of paragraph (1) for compliance with modernization and equipment standards prescribed pursuant to section 300s(2) of this title, and
(ii)the requirement of subparagraph (E) of paragraph (1) respecting title to a project site,
(B)A project referred to in subparagraph (A) is a project—
(i)for the modernization of an outpatient medical facility which will provide general purpose health services, which is not part of a hospital, and which will serve a medically underserved population as defined in section 300s–3 of this title or as designated by a health systems agency, and
(ii)for which the applicant seeks a loan under part A the principal amount of which does not exceed $20,000.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Codification In subsec. (b)(1)(I), “section 3141–3144, 3146, and 3147 of title 40” substituted for “the Act of
March 3, 1931 (40 U.S.C. 276a—276a–5, known as the Davis-Bacon Act)” and “section 3145 of title 40” substituted for “section 2 of the Act of
June 13, 1934 (40 U.S.C. 276c)” on authority of Pub. L. 107–217, § 5(c), Aug. 21, 2002, 116 Stat. 1303, the first section of which enacted Title 40, Public Buildings, Property, and Works.

Prior Provisions

A prior section 300s–1 was redesignated 300s–1a and amended as part of the general revision of this subchapter by Pub. L. 96–79. A prior section 1621 of act July 1, 1944, as added Jan. 4, 1975, Pub. L. 93–641, § 4, 88 Stat. 2265, which related to the allocation among States of the total amount of principal of loans and loan guarantees, was classified to section 300q–1 of this title, prior to repeal as part of the general revision of this subchapter by Pub. L. 96–79.

Statutory Notes and Related Subsidiaries

Effective Date

Section effective Oct. 1, 1979, see section 204 of Pub. L. 96–79, set out as an

Effective Date

of 1979 Amendment note under section 300q of this title.

Reference

Citations & Metadata

Citation

42 U.S.C. § 300s–1

Title 42The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73