Sec. 10.08.05.05. Application Procedure

A. An applicant shall apply for a State grant by completing an application with the Department on a form provided by the Department, and shall file the completed application for State grant funds with the Office of Capital Planning, Budgeting, and Engineering Services.

B. The Department shall provide any notice and information to the State Clearinghouse for Intergovernmental Assistance that may be required under COMAR 14.24.04.

C. The applicant shall comply with all applicable federal and State laws and regulations in effect at the time of application.

D. At the time of filing the application, the applicant shall file a written statement with the Department containing the following information or material:

(1) Current or intended program of services;

(2) The number of personnel employed or to be employed at the facility, by occupation, and all perquisites, salaries, and any compensation paid, or to be paid, to the personnel;

(3) Expenses incurred, or to be incurred, in carrying out qualified facility operations;

(4) Schedule of rates charged, or to be charged, for services rendered at the facility;

(5) Agreement to admit eligible persons on the basis of their need for services without regard to race, religion, national origin, color, or disability;

(6) If an applicant is currently operating as a federally qualified health center, a certified, audited profit-and-loss statement and balance sheet for the most current year;

(7) If the applicant is applying for poverty funding under Regulation .08D of this chapter, an agreement that the majority of the individuals served by the applicant will be poverty-designated clients, as defined in Regulation .08D(2) of this chapter, for each year for a period of 30 years following the completion or acquisition of the facility; and

(8) Letter from Health Resources Services Administration (HRSA) granting federally qualified health center status to the nonprofit and designated site or a letter from HRSA stating that the "need" score in the applicant's letter of intent is competitive and invites the applicant to submit a full application for designation as a federally qualified health center.

E. The Secretary shall approve applications that meet the requirements of this regulation and that set forth the priorities of the Department as stipulated in the annual application instructions.