42 U.S.C. § 300s–1: Medical facility project…

Summary

No loan, loan guarantee, or grant for a medical facility project can be given under parts A or B unless the Secretary approves an application first. If several groups work together on a project, any one of them or all of them can file the application. The application must follow the form the Secretary sets and must include proof of need from the State Agency (either to keep existing services or to add new services), proof that a grant is really needed if one is requested, an analysis if services or facilities will be stopped or changed, a description of the site, plans that meet the rules, proof that the site’s ownership will be or become held by the applicant or a public/nonprofit operator, proof of enough money to finish and run the project (with certain federal help counted), the type of federal help wanted, a promise to pay workers prevailing wages, for outpatient projects a way to get hospital care when needed, and a promise the facility will serve people in the area and offer a reasonable amount of care to those who cannot pay (as finance allows). The Secretary can waive some site, equipment, and title paperwork rules for small loans. That applies to outpatient modernization projects that give general health services, are not part of a hospital, serve a medically underserved population, and seek a Part A loan with principal of $20,000 or less.

Title 42, §300s–1

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

(a)Submissions

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)Form; required provisions; waiver; projects subject to requirements

(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,

in the case of an application for a project described in subparagraph (B) of this paragraph.

(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.

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.

§300s–1 Medical Facility Project Applications

Summary

Title 42, §300s–1

Notes & Related Subsidiaries

Editorial Notes

Prior Provisions

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Citations & Metadata