APPLICANT ELIGIBILITY REQUIREMENTS:
1. Funding, under this authority, may be provided only to a Federally recognized
Indian Tribe or Tribal Organization, which, prior to submitting a FY 2024 Application, operates an Indian health care facility pursuant to a health care services contract or compact under The Indian Self-Determination and Education Assistance Act, P.L. 93-638, when the facility:
• Is not owned or constructed by the IHS; or
• Was not originally owned or constructed by the IHS and transferred to the
Tribe.
2. If the health care facility entails an Emergency Room (ER), hospital, and/or urgent
care in the proposed project, it must be located apart from a hospital.
3. The proposed project must not have received any funding already under Section
301 or Section 307 of P.L. 94-437.2
4. Upon completion of the proposed project, the health care facility will:
• Serve no less than 500 eligible Indians annually; and
• Provide ambulatory care in a service area (specified in the services contract entered into under the P.L. 93-638) having not less than 2,000 eligible Indians.
5. Applicants must be able to provide reasonable assurances, that upon completion
of the proposed project, the applicant will:
• Have adequate financial support to provide the proposed health care
services;
• Make the health care facility available to eligible Indians without regard to
ability to pay or source of payment; and
• Provide services to non-eligible persons on a cost basis, per Federal Law
without diminishing the quality or quantity of services to eligible Indians.
6. A need must exist for increased ambulatory health care services.
7. The current facility must have insufficient capacity to deliver needed services.
8. The T/TO’s financial management systems must meet the requirements of 25 CFR Parts 900.44 and 900.45. To be in compliance, the Single-Agency Audits provided in compliance with the 2 CFR Part 200 may not have any significant and material weaknesses or unresolved issues of fraud or improper use of previously provided Federal funds.
Small Ambulatory Program (SAP)
Section 306 of the IHCIA, P.L. 94-437, authorizes the IHS to award funds to Tribes and/or Tribal organizations for construction, expansion, or modernization of ambulatory health care facilities. Where non-Indians will be served in a facility, the funds awarded under this authority may be used only to support construction proportionate to services provided to eligible American Indian and Alaska Native (AI/AN) people. In fiscal year 2024 the program received $25 million in funding. Participants in this program are selected competitively from eligible applicants.
Participants in this program are selected competitively from eligible applicants who meet the following criteria
Only federally recognized Tribes that operate non-IHS outpatient facilities under P.L. 93-638 contracts are eligible to apply for this program.
Facilities for which construction is funded under Section 301 or Section 307 of P.L. 94- 437 are not eligible for this type of program.
Priority will be given to Tribes that can demonstrate a need for increased ambulatory health care services and insufficient capacity to deliver such services.
The completed facility will be available to eligible Indians without regard to ability to pay or source of payment.
The applicant can demonstrate the ability to financially support services at the completed facility.
The completed facility will:
Have sufficient capacity to provide the required services.
Serve at least 500 eligible AI/AN people annually.
Provide care for a service area with a population of at least 2,000 eligible person