Ariz. Admin. Code § R9-1-602 - Grant Application

A. A local health department may request funds from the Department through a Per Capita Matching Grant by submitting an application to the Department that includes:

1. A narrative plan for the period corresponding to the state fiscal year, which specifically identifies:

a. A designated service area;

b. The local health department services, such as those specified in R9-1-601(16)(d), which will be provided in the designated service area;

c. Which of the local health department services, identified in subsection (A)(1)(b), the local health department provided in the last three years; and

d. The number of individuals projected to receive the local health department services identified in subsection (A)(1)(b);

2. A budget for the period corresponding to the state fiscal year, which identifies:

a. The total cost for providing local health department services within the designated service area;

b. A list of all sources of funds to be used by the local health department for providing local health department services within the designated service area; and

c. The proportionate shares of the total cost to be paid by funds obtained from the sources listed in subsection (A)(2)(b);

3. A chart that shows the organizational structure of the local health department, including:

a. The names of the incumbents in each position; and

b. A designation of the types of local health department services performed by the incumbent in each position; and

4. The signature of an individual authorized by the local health department's County Board of Supervisors, under A.R.S. § 11-201, to submit the application.

B. A local health department shall submit an application to the Department so that the application is:

1. Received by the Department on or before December 31 of the current state fiscal year; or

2. Postmarked, or accepted for delivery by an express package delivery service, on or before December 31 of the current state fiscal year, and received by the Department on or before January 5 of the current state fiscal year.

C. A local health department shall furnish to the Department any other information as may be requested by the Department, as specified in R9-1-603(A)(2), to clarify incomplete or ambiguous information contained in the local health department's application.

Notes

Ariz. Admin. Code § R9-1-602

New Section R9-1-602 recodified from R9-18-102 at 26 A.A.R. 3319, with an immediate effective date of December 7, 2020 (Supp. 20-4).