Frequently Asked Questions (FAQs)

We understand you may have questions about the Emergency Rural Health Care program (ERHC). Please see the FAQs below. As we hear from you, we will post more questions and answers.

Also, we will host a series of informational webinars to help you learn more about who can apply, how the funding can be used, and where to submit an application. To register for the next webinar, please visit the upcoming events page.

FAQs

Eligibility


  • To be eligible for grant funds under this program, a facility or project must be located in a city, town, or unincorporated area with 20,000 or fewer residents. The facility or project must also primarily serve rural residents in cities, towns, or unincorporated areas with populations of 20,000 or fewer. An applicant’s total service area population may exceed 20,000, but a majority of the population must live in rural areas.

  • For population data, use the 2010 Decennial Census. As of the date the Notice of Funding Availability (NOFA) published (August 2021), the 2020 localized decennial census data was not yet available. Population data may be found at Total Population (Table P1) in the 2010 Decennial Census, available at this link: https://go.usa.gov/xF6wZ. Choose “Geos,” then “Place,” and search for your community after selecting your state.

    This data source is provided for information purposes only. The Rural Development State Office, in the state where the project is located, will determine the maximum percentage of grant for which the project is eligible.

  • Rural Development relies on the 2006-2010 American Community Survey dataset for MHI data, available at this link: https://go.usa.gov/xF6wf. To access the MHI in the past 12 months (in 2010 inflation-adjusted dollars) (Table B19013), choose “Geos,” then “Place,” and search for your community after selecting your state. (If your community does not show up, try “Geos,” then “County Subdivision,” then your state and then your county, and search for your community.)

    This data source is provided for information purposes only. The Rural Development State Office, in the state where the project is located, will determine the maximum percentage of grant for which the project is eligible.

  • Facilities must be organized as a public body, nonprofit, or federally-recognized Tribe. Facilities also must provide health care services or provide nutritional assistance as a food bank or food distribution facility, although this does not have to be the sole or majority purpose of the organization.

  • The NOFA specifies grant funds must be used to support health care and nutritional assistance. Further, the NOFA specifies that lost revenue is limited to “health care-related revenue lost during the COVID-19 pandemic.” Organizations providing services such as assisted living, transitional housing or adult care services are limited in the funds they can request that relate to health care-related revenue only. To the extent that organizations provide services such as primary, behavioral, or specialty care, they can request funding for lost revenue associated with those services only.

  • No. The “unable to obtain reasonable credit elsewhere” limitation sometimes associated with other federal loan and grant programs does not apply to grants made under the Emergency Rural Health Care Program. Section 1002 of the American Rescue Plan does not reference a “credit elsewhere” limitation.

  • The population limit relates to the population of the city or town where the project is located. It does not include the population of the entire service territory of the project. A project must be located in a city, town, or unincorporated area with a population of 20,000 or fewer and must primarily serve rural residents.

  • This depends on the federal program providing the CARES Act (or other relief) funding. Applicants should review their award documents or consult with the federal program officials associated with the funding to determine whether it can be used as matching funds for other federal awards. While USDA-RD does not have a limitation, the other federal program may.

  • Yes. An applicant with facilities in urban and rural locations can apply on behalf of the facilities located in rural areas only. Applicants can be headquartered in urban areas and request funds for facilities located in – and primarily serving – rural areas.  

    Funds awarded under the grant must be used for the benefit of facilities located in rural areas of 20,000 or fewer residents. By a margin of 51 percent, the rural facility must also primarily serve residents residing in areas of 20,000 or fewer residents.   
     

 

Track One:


  • Yes, although the entity must also qualify as a nonprofit, public body or federally-recognized Tribe. Track One grant requests must also be in response to the pandemic.

  • Renovations for expanded services that are related to the pandemic may be eligible for ERHC funds.

  • For lost revenue applicants, the remaining lost revenue constitutes the "match" required. In this example, an applicant can receive a grant of up to 35 percent of the lost revenue. The remaining $65,000 is the lost revenue that will not be reimbursed.

  • A food pantry is eligible as long as it is organized as a public body, nonprofit, or federally-recognized Tribe and meets other eligibility requirements with respect to population and MHI. This grant program may fund increased expenses incurred after March 13, 2020 that are above and beyond the food pantry’s normal expenses. These increased expenses must be in relation to the pandemic; for example, increased demand for food.

  • Food banks and food distribution facilities can apply for funding to support facility, equipment, and operating expenses that correlate to the COVID-19 pandemic, and that have not been covered by other federal or state sources. The cost of food may be one of the largest operating expenses for a food bank.

    For the cost of food to be an eligible expense under the grant, the applicant must demonstrate the amount requested in correlation to the COVID-19 pandemic. For example, an applicant can compare food expenses during the pandemic to the corresponding periods before the pandemic to justify the added expenses. These added expenses are eligible expenses that may be covered through the Emergency Rural Health Care Grant Program.

  • Track One funds can be used for equipment and supplies that support health care and nutritional assistance needs in correlation with the pandemic. This can include equipment and supplies to support vaccine distribution and administration, to increase medical surge capacity, to increase telehealth capabilities, to improve or expand health care services, or to support preparedness for a future pandemic event. Equipment and supplies can also be used to support COVID-19 testing for members of the public.    

 

Track Two:


  • All grant funds – Track One and Track Two – must be used to support health care or nutritional assistance needs in correlation with the COVID-19 pandemic. The pandemic has impacted nearly all aspects of providing rural health care, and the critical issues challenging the availability of rural health care have been intensified by the pandemic.

    Track Two funds must be used to support the long-term sustainability of rural health care. Track Two applicants must define how the proposed project will contribute to improving rural health care access, rural health outcomes, or the economic viability of rural health care. It is not necessary that Track Two applications directly relate to COVID-19 health care, vaccines, or testing.

  • In the application submission, the applicant should outline the purpose of the proposed project, the needs of the rural community(ies), how the need was identified, expected outcomes, focus area(s), and the aim(s) the project will support. The applicant should provide an assessment of the innovative nature of the strategy. The applicants should also summarize the expected outcomes (with quantifiable impact whenever possible) to the rural community(ies) and the health care community.

  • Track Two applicants must establish a consortium of at least three or more separate entities. This consortium may be comprised of rural and urban entities, as long as at least two-thirds of the network members are located in – and primarily serve – a rural area. The lead entity or applicant can be located in an urban area. The consortium must identify a lead entity to serve as the primary applicant and recipient of the grant funds. The lead entity or applicant must be an eligible entity, meaning a public body, nonprofit, or federally-recognized Tribe. If the lead entity is a nonprofit, the requirement for the nonprofit to demonstrate significant ties to the local community can be met if at least two-thirds of the consortium members are located in – and primarily serve – a rural area.

  • A Track Two lead entity or applicant can be located in a rural or urban area and must identify a consortium for purposes of this grant. The lead entity or applicant must be an eligible entity, meaning a “public body, nonprofit, or federally-recognized Tribe.” If the lead entity is a nonprofit, the requirement for the nonprofit to demonstrate significant ties to the local community can be met if at least two-thirds of the consortium members are located in – and primarily serve – a rural area.

    All Track Two consortium members must be designated nonprofits. These consortium members can be organized as public bodies, nonprofit health care provider organizations, economic development entities, federally-recognized Tribes, or institutions of higher education and research.
     

  • An eligible applicant can submit only one application for Track Two funding. However, that application can encompass more than one facility or project as long as both are supportive of the applicant’s model to solve a particular regional health care need. 

  • Yes. Separate hospitals that are part of a larger health care system that each have their own tax ID and their own governing board can be separate members in a Track Two consortium. If the hospitals are wholly-owned subsidiaries of the larger health care system or share a governing board, then these hospitals do not constitute separate members of the consortium.

  • RD is not prioritizing construction for Track Two projects. RD supports projects that plan for, implement, and evaluate models to solve regional health care problems and to support the long-term sustainability of rural health care.  

    With the help of an identified consortium, Track Two applicants are expected to: 

    •    Identify a regional health care need 
    •    Identify expected outcomes and aims of the proposed project 
    •    Identify and implement the steps necessary to further the project
    •    Evaluate the project’s progress and success toward meeting program goals to support the long-term sustainability of rural health care     

    Applicants can request Track Two funding for personnel costs, construction, equipment, and technical assistance, or for indirect costs to carry out eligible activities described above and as specified in the NOFA. 
     

  • To the extent that construction of a new health center will support the applicant’s model to solve a regional health care problem, then yes, funds can potentially be used for this purpose. Track Two grants must support projects that plan for, implement, and evaluate models to solve regional health care problems and to support the long-term sustainability of rural health care. Track Two applicants are expected – with the help of an identified consortium – to identify a regional health care need, identify expected outcomes and aims of the proposed project, identify and implement the steps necessary to further the project, and evaluate the project’s progress and success toward meeting program goals to support the long-term sustainability of rural health care. 
     

  • The NOFA allows applicants to utilize grant funds to pay professional service fees and charges under certain circumstances:

    •    The expenses are a necessary part of a facility or project allowable under the Emergency Rural Health Care program
    •    The expenses are a secondary part of the grant amount requested
    •    Rural Development agrees the amounts are reasonable and customary
    •    The professional service provider is selected through a qualifications-based selection process, OR the professional service provider is a project architect, project engineer, environmental professional, consultant, or legal counsel, in which case a competitive procurement process is not required

    Rural Development does not consider packaging expenses, including origination costs, a necessary part of a facility or project allowable under this program. 
     

 

Application Submission and Award:


  • Applicants can request both Track One and Track Two funding. Multiple Track One applications are allowed, but the total grant amount requested under Track One cannot exceed $1 million. Applicants may submit only one Track Two application. If applying for both Tracks One and Two, the applications are not required to be related.  

  • Track One: Recovery applications must be submitted to the USDA Rural Development state office in the state in which the applicant’s project is located. 

    Track Two: Impact applications must be submitted to the USDA Rural Development state office in the state in which the applicant is headquartered. For applicants with headquarters located in the District of Columbia, applications must be submitted to: 

    USDA Rural Development National Office
    ATTN: Jamie Davenport
    1400 Independence Avenue, SW, STOP 0787
    Washington, DC 20250

    Agency state office contact information is available. 

    Please refer to the NOFA and Track One Application Checklist and Track Two Application Checklist for more detail on required application documents.

  • Application rating, ranking, and selection will not begin until after October 12, 2021. The proposed grant period for Track One will begin no earlier than November 1, 2021. The time frame in which funds can be used will depend on the specific grant request, but will not exceed three years after award. The proposed grant period for Track Two will begin no earlier than January 1, 2022. The time frame in which the funds can be used will not exceed three years.

  • Under this Emergency Rural Health Care program, applicants with projects located in one of the top 10 percent of high-risk counties or county equivalents as determined by the COVID-19 Economic Risk Assessment Dashboard are eligible for COVID-19 Impact priority points. This dashboard is updated monthly, and Rural Development will rely on a county’s risk score as of the date the application is submitted to determine whether priority points are appropriate. For more information and to view the dashboard, please visit Rural Developments Priority Points.