Section R9-18-102. Grant Application

A.      A local health department may request funds from the Depart- ment 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 R9-18-101(16)(d), which will be pro- vided in the designated service area;

c.         Which of the local health department services, iden- tified 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 sub- section (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 depart- ment 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 subsec- tion (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 posi- tion; 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 pack- age 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 R9-18-103(A)(2), to clarify incomplete or ambig- uous information contained in the local health department’s application.

Historical Note

Adopted effective April 22, 1988 (Supp. 88-2). Amended by final rulemaking at 12 A.A.R. 3715, effective Novem- ber 11, 2006 (Supp. 06-3).