Application Notes:

Mandatory phase I applications must be received by close of business on April 10, 2025.

Prior to finalizing their phase I application, applicants are highly encouraged to contact the appropriate IHS area office listed on pages 29-30 of the NOFA file to verify eligible user populations and service areas.

Phase I applications must be emailed or mailed to the appropriate Indian Health Service (IHS) area office listed on pages 29-30 of the NOFA file. Emailed submissions are preferred, and applicants submitting more than one application must send separate emails. Mailed submissions must include the original application and one signed copy. Refer to page 26 of the NOFA file for additional submission instructions.

Phase I applications must include:

• Cover sheet
• Signature sheet
• Table of contents
• Project summary (2 pages max)
• Federally recognized tribe documentation
• Signed tribal resolution
• Evaluation criteria and weighting form
• Letter signed by the area director describing how the project meets the area facilities master plan
• Phase I application checklist
• Attachments:
  • User population document
  • Existing facilities document
  • Isolation distance supporting document
  • Health status calculations

Phase I applications must be formatted on standard-sized, single-spaced, and consecutively numbered pages with one-inch margins using at least an 11-point black font. Each page of the application must include a header or footer identifying the applicant. For email submission, phase I applications must be submitted in .pd format.

Phase I applications will be evaluated according to the following criteria:

• Facility resources deficiency (400 points)
• Health status (200 points)
• Isolation to service (100 points)
• Facility size (150 points)
• Tribe funding equipment (50 points)

Applicants with the highest-ranking phase I applications will be invited on May 22, 2025, to complete full applications, which must be received by August 14, 2025.

Refer to the NOFA file for additional application information.

Match Notes:

There are no specific matching requirements for this program; however, applicants must expend tribal, private, or other available non-Indian Health Service (IHS) funds to complete the proposed facility. In exchange, the funding agency will provide the initial equipment for the facility, and enter into a 20-year nominal lease for the facility and request annual appropriations for the operation and maintenance of the facility during the lease period.

Additional priority will be given to applicants that agree to fund the initial equipment portion of the project.

Funding Notes:

An unspecified amount of funding is available to support awards through this program.

In addition, in return for the applicant leasing the tribally owned health care facility to the funding agency for 20 years under a no-cost government lease, the funding agency will:

• Include funding for supplies, staffing, operation, and maintenance of the health care facility in the annual appropriation request
• Provide the initial equipment for the facility, if agreed to in the application process
• Request initial appropriations from Congress for an aggregate total, over one or more years, of 85 percent of the projected total staffing need, at beneficial occupancy minus the existing staff

Staffing and operations funding provided through this program may not be used as collateral in obtaining funding for facility construction.

Funds may not be used for retroactive projects in which facilities have already been acquired by the applicant or if a notice to proceed with construction has been issued prior to an executed joint venture agreement (JVA) between the funding agency and the applicant.