Track Two: Impact Grants
The Emergency Rural Health Care Grant Program through USDA Rural Development is funded by The American Rescue Plan Act of 2021. Its goal is to help rural communities manage the COVID-19 pandemic by increasing access to testing, vaccines, and general health services. It also supports food banks and food distribution.
Track Two: Impact Grants are for developing and promoting long term solutions to rural health care issues. Projects should support long term sustainability, defined as “improved health outcomes, improved access to quality health care, and creating and maintaining sustainable economic development for small communities.” Funds must be used to address problems in connection with the COVID-19 pandemic.
Impact Grants will be awarded in amounts for $5 – 10 million and all application must be in to your State Rural Development office by October 12, 2021. Unlike Track One, no applications to Track Two will be accepted after that date.
Eligibility
Public bodies such as municipalities, counties, and other sub-State level government entities are eligible to apply; State level bodies are not eligible. Federally recognized Tribes located in rural areas are also eligible, as are non-profit organizations. Non-profits must be able to demonstrate that they are significantly involved in the rural community in which grant funds will be spent.
The facility or project must be located in an area that meets the legal definition of ‘rural’ for Community facility loans and grants. This definition is “any area other than a city, town, or unincorporated area that has a population of greater than 20,000 inhabitants (Source).” Non-governmental applicants are not required to be headquartered in a rural area, but the funded project must primarily serve a rural area.
Track Two applicants must also establish a network of three or more organizations to administer this project. These groups can be healthcare providers, economic development organizations, federally-recognized Tribes, or colleges and universities. This network can include rural and non-rural organizations, but at least two-thirds of the members must be located in rural areas. One member organization will serve as the lead applicant and will be responsible for tracking progress and reporting.
Cost Share
Cost-sharing is required, but the percentage of the project cost you must pay depends on the community’s population and median household income. The percentages cited below are the minimum amount you would be expected to provide.
| Population | Median Household Income | Cost share |
| 5,000 or fewer | Below the poverty line or 60% of state nonmetropolitan MHI (whichever is greater) | 25% |
| 12,000 or fewer | Below the poverty line or 70% of state nonmetropolitan MHI (whichever is greater) | 45% |
| 20,000 or fewer | Below the poverty line or 80% of state nonmetropolitan MHI (whichever is greater) | 65% |
| 20,000 or fewer | Below the poverty line or 90% of state nonmetropolitan MHI (whichever is greater) | 85% |
If you serve multiple communities, you will need to calculate a weighted median household income. An example of how to do this can be found on page 10 of the Application Guide. When in doubt, check with your State Rural Development office. In kind contributions can not be used as part of your cost share.
Eligible Activities
Grant funds may be used for one or more of the following activities:
- Establishing or building on an existing network of community leaders and healthcare professionals. The purpose of this network would be to create long term, sustainable solutions to rural healthcare problems.
- Creating or building on an existing evidence-based model for rural healthcare and sharing the lessons learned from that model for possible replication.
- Developing and implementing a solution to a health-related issue identified in your region. This includes an evaluation of the method for sustainability and replicability.
- Paying for the technical assistance needed to implement, evaluate, or otherwise administer your project.
- Making sub-awards to other members of your project network through grants, cooperative agreements, or contracts.
- Paying professional services such as an architect, engineer, lawyer, or environmental consultant.
Application Requirements
Every application must include:
- SF-424: Application for Federal Assistance
- Either SF-424A: Budget Information – Non-Construction Programs or
- SF-424C: Budget Information – Construction Programs
- Documents proving eligibility
Non-profit organizations must also provide:
- Articles of organization, incorporation, or association
- By-laws
- Evidence of good standing – this is typically a certificate from your state Secretary of State’s office
- Evidence of ties to the local rural community – You can demonstrate this by showing that you are (1) closely associated with or controlled by a unit of local government, (2) owned or controlled by members of the community by providing a list of board members, (3) receiving substantial public funding.
- Evidence of eligibility (will primarily serve a rural area with a median household income below the poverty line or the percentage applicable to your cost-share)
- Three years of the most recent audits or financial statements, including a current balance sheet and income and expense statement
- Intergovernmental Review comments, if applicable, from the local planning district commission
- Certification of Non-Lobbying Activities or
- Disclosure of Lobbying Activities
- Certification regarding any known relationship or association with a USDA employee
- Certification from a CPA of how lost revenue was calculated, if you’re applying to be reimbursed
Construction projects will require an Environmental Report or Environmental Assessment and a preliminary architectural feasibility report or engineering
documentation. Work with your Rural Development Office to determine the specific requirements for your project.
