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  5. CARE Frequently Asked Questions

CARE Frequently Asked Questions

Find answers to frequently asked questions about your fiscal year (FY) 2023 Capital Assistance for Hurricane Response and Recovery Efforts (CARE) award. 

Refer to the Notice of Funding Opportunity (NOFO) and technical assistance webpage for more information. 

Submit additional questions through the BPHC Contact Form. 

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General award questions

Who should I contact with specific questions about my CARE award?

Your CARE award has two primary points of contacts: 

  • Your Investment Oversight Advisor (IOA): They can respond to questions on project changes, drawings, or other general program office conditions. This person is also referred to as your Program Official Contact in notices of award and your Project Officer (PO) in the Electronic Handbooks; and 
  • Your grants management specialist (GMS): They can respond to budget questions, property questions (lease, deed, Landlord Letters of Consent, Notices of Federal Interest) and procurement questions related to 45 CFR part 75. 

(Added: 9/11/2023)

Funding purpose and approach

How can I use CARE funding?

You may use funds to: 

  • Respond and recover from emergency disaster impacts 
  • Increase the ability and capability to prepare, respond, and recover from future emergencies and support the continuity of access to primary care services for underserved populations.

(Updated: 9/11/2023)

How much total CARE funding was awarded?

We awarded $64 million in CARE funding. 

(Updated: 9/11/2023)

How many projects are allowed per application and what types of projects are permitted?

You may apply for up to three projects:

  • Construction of a New Facility (one site only)
  • Construction/Expansion (C/E) of an Existing Facility (one site only)
  • Alteration/Renovation of an Existing Facility (A/R) (one site only)
  • Equipment Only (multiple sites)

Applicants can select a combination of project types. Each project must have a distinct site location, except for equipment projects.

(Added: 4/26/2023)

Can I use CARE funding to buy a new building or land?

No.

(Added: 4/26/2023)

How much time will be allowed to complete the proposed project(s)?

Each award recipient will have three years from the award start date to complete their project(s).

(Added: 4/26/2023)

Were look-alikes eligible for CARE funding?

No.

(Added: 4/26/2023)

Where can I find the FEMA incident period?

Appendix A in the CARE NOFO describes in detail the locations and incident periods for Hurricanes Fiona and Ian. 

(Added: 4/26/2023)

Does the Davis-Bacon Act apply to activities using CARE funds?

No. However, you must follow state and local laws for prevailing wages and fair labor policies.

(Added: 4/26/2023)

Allowed uses of funds

Can I use CARE funding to support the installation of solar microgrids?

Yes. The costs for solar microgrids and installation may be allowable for health centers to propose in their CARE application. Given the variability of the associated needs and activities to support the installation of the solar microgrids at different health center sites, we will still need to review the proposed project and costs to ensure that they are permissible given the parameters of the use of the CARE funds.

(Added: 6/29/2023)

Can I use CARE funding to support in-progress activity at a site that previously received HRSA capital funding?

CARE funding may not supplant other resources (federal, state, local, or private funds), and projects must be separate and distinct from any other existing construction-related projects.

(Added: 4/26/2023)

Can I use CARE funding to cover costs incurred before the award date?

Physical construction activities (e.g., installation of utilities, demolition) that occurred before the award date are unallowable. Other preconstruction activities, such as design development, budgeting, hiring an architect, surveys, and testing, may be allowable expenses if they occurred up to 90 days before the award start date. You must submit a separate prior approval request for such pre-award costs.

(Added: 4/26/2023)

Can I use CARE funding to support a project at an administrative-only site?

Yes. However, you may not use CARE funds to propose adding a new administrative-only site. 

(Added: 4/26/2023)

Can I use CARE funds to buy a modular unit?

Yes. 

(Added: 4/26/2023)

Can I use CARE funding for operational costs?

No. You may not use CARE funding for costs such as providing direct services, clinical full-time equivalents, staffing costs not directly related to the proposed project, rent, mortgage payments or refinanced credit facilities.

(Added: 4/26/2023)

Can a health center add services to its Health Center Program scope of project through this funding?

No. CARE award recipients cannot add services to their Health Center Program scope of project through this funding. You must submit any change to services through a separate change in scope request. See Policy Information Notice 2008-01: Defining Scope of Project and Policy for Requesting Changes (PDF - 224 KB).

(Added: 4/26/2023)

If I plan to use New Market Tax Credits (NMTC) with CARE funding, what information will you need to assess the NMTC financing?

If you plan to use NMTC, you must submit a prior approval request. You should contact your assigned Grants Management Specialist for instructions. The request will consist of the following documentation:

  • Detailed description of the financing for the project, including the proposed NMTC arrangement and other associated financing resources, such as bridge financing.
  • Description of the benefits of the proposed NMTC financing for the project (e.g., comparison of NMTC loan rates and associated cost savings compared to other loans or bond rates available to the health center).
  • Description of the financial risks associated with the proposed NMTC financing and corresponding mitigation strategies to protect the health center’s and HRSA’s interest in the associated property.
  • Assurance that you will complete the project approved by HRSA as proposed, under federal interest requirements and the approved timeline.
  • Letter of commitment from the Community Development Entity.
  • Proposed schedule of cash draws (dates and amounts) from the appropriate Payment Management System subaccount.

If there is a requirement for HRSA to subordinate federal interest and/or grant permission to transfer property to a Limited Liability Company, send this information with the request for prior approval.

(Added: 4/26/2023)

Are there any project activities that can begin if there are outstanding conditions for that project?

CARE funds are restricted and may not be drawn down until all program- and grant-specific conditions of the award associated with the project(s) have been met and lifted from the Notice of Award. The only exceptions to this restriction are for limited pre-construction activities related to meeting an award condition, such as expenses for completing architectural and engineering plans, meeting licensing and permitting requirements, historic preservation consultation with the State Historic Preservation Office/Tribal Historic Preservation Office, and/or preparing the Environmental Assessment.

(Added: 4/26/2023)

Can I use funds to test for asbestos, lead-based paint, and other hazardous materials at our site?

Yes. However, you may not use the funds for hazardous material abatement, such as the removal and disposal of asbestos containing materials or lead paint abatement. 

(Added: 4/26/2023)

Are mobile vans and other vehicles an allowable cost?

You may use CARE funds to buy a new or replacement mobile medical van. Other vehicle purchases (e.g., passenger cars) are unallowable.

(Added: 4/26/2023)

Are supplies an allowable cost?

No. Expendable supplies (e.g., office supplies, medical supplies, educational supplies) are unallowable. Supplies with a useful life of more than one year may be included as movable equipment.

(Added: 4/26/2023)

What is movable equipment?

Movable equipment includes non-expendable items with a useful life of more than a year that you can readily shift from place to place without needing a change in the utilities or structure of the facility.

(Added: 4/26/2023)

Can I use CARE funds to lease movable equipment?

No. 

(Added: 4/26/2023)

Can I use CARE funding to buy a new electronic health record (EHR) system?

No. You may not use CARE funding for costs related to a new EHR system, to buy an EHR system, or to support current EHR operations or maintenance. However, you may use the funding to buy equipment associated with using an existing EHR system, such as software, site licenses, laptops, and/or servers.

(Added: 4/26/2023)

Leasehold improvements and federal interest

Can CARE funding be used at a leased site?

Yes. However, you may not use CARE funds to address facility needs that are part of the terms of the lease (i.e., the obligation of the lessor). For more information about leasehold improvements, see the Leasehold Improvements section in the NOFO.

(Added: 4/26/2023)

Is a Notice of Federal Interest (NFI) required?

Depending on the scope of work, the property owner may be required to consent and file an NFI. Your Notice of Award will say if an NFI is applicable.

If an NFI is required, the award recipient must submit the NFI after the award of the grant, but before starting physical work on the project.

For more information about filing an NFI, see the Federal Interest in Real Property FAQs (PDF - 500 KB). You can also view a sample NFI (PDF - 297 KB).

(Added: 4/26/2023)

What if there is already a HRSA NFI on the property?

NFIs must specify the grant under which the capital funding was provided. NFIs that cite other grant programs cannot be substituted. Existing NFIs may be amended to add in the new grant and project description with the existing grant information on issuance of a Notice of Award.

(Added: 4/26/2023)

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