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CAH Subcontract Program Application Items

These are the items needed to complete and submit an application to the North Dakota Critical Access Hospital (CAH) Subcontract Program.

Hospital Information

  • Hospital name
  • County
  • Address
  • Phone number
  • Name of contact person
  • Email address of contact person

Project Description

  • Provide a brief description of your facility's identified financial or operational areas for improvement. What type of activity are you proposing? Why should your facility be selected to receive funding?
  • Include the goals, action steps, and specific project deliverables. Make sure they are time sensitive and measurable. Include a timeline with specific dates. All project activities must be completed by August 31, 2024. If you prefer to upload a workplan, you may do so.
  • Upload workplan (optional – may include as a supplement/replacement of the goals, action steps, deliverables, and timeline).
  • Provide a description of anticipated outcomes. What is the intended plan for using the information/resources obtained through this project? Explain the plan for results and follow-through.

Budget and Budget Narrative

The budget section should cover such areas as line item expenses, contractual costs, as well as in-kind contribution. See Sample Budget and Sample Budget Narrative.

Rural Hospital Flexibility funds cannot be used: for direct patient care, healthcare services, equipment, or supplies; to purchase vehicles or communications equipment; to purchase or acquire real property or to improve existing property; for building and/or physical structural improvements; for hospital personnel time or associated expenses; for t-shirts, hats, prizes; or for the purchase of food.

These subcontracts are intended to fund new activities, not any activity or projects which begin before the Flex subcontract is awarded.

Budget Narrative: Following in the order of your line item budget, please describe the items listed in detail that will assist the reviewers in understanding the proposed budget. The budget narrative should identify line item expenses and explain how the line items are determined and/or calculated.

Project Management Contact

  • Name
  • Title
  • Email

Hospital Official Contact

Hospital official authorized to enter into contract:

  • Name
  • Title
  • Email