1. A. An applicant for temporary emergency funding shall submit to the Commission a letter of request outlining the need for temporary emergency funding.

2. B. A letter of request shall include the following elements:

   1. (1) Information and documentation sufficient to establish the applicant's qualification as a community health resource as specified in COMAR 10.45.05.02, .03, or .04;
   2. (2) A brief description of the applicant's mission, programs, and service area;

   3. (3) The name, address, and location of the applicant, including the:

      1. (a) Name, title, address, telephone number, and email address of the director; and
      2. (b) Name and email address of the applicant's contact person;
   4. (4) The signature of an individual responsible for conducting the affairs of the applicant and legally authorized to execute contracts on the applicant's behalf;

   5. (5) A brief account of the organizational and financial structure of the applicant, including the applicant's:

      1. (a) For-profit or not-for-profit status; and
      2. (b) Financial stability over the 3-year period prior to the date of application; and

   6. (6) The nature of the program or service whose existence or funding is threatened, including:

      1. (a) The significance of the program or service to its target group and to the geographic area in which it operates;
      2. (b) The customary and usual amount of funds needed to provide the service or operate the program on a monthly, quarterly, or annual basis;
      3. (c) The normal or usual funding source or sources for the program or service;
      4. (d) The number and area of residence of low income, underinsured, or uninsured persons served by the program or service on a monthly, quarterly, or annual basis;
      5. (e) A concise explanation of why the temporary emergency for which funding is sought could not have been anticipated;
      6. (f) A concise account of any and all emergency funding requests by the applicant over the past 3 years and the results of those requests;
      7. (g) The specific amount of funding requested and the amount of time over which the funding will be expended;
      8. (h) A list of all other potential sources of funding, both internal and external, that have been approached by the applicant for this temporary emergency and their responses;
      9. (i) A clear explanation of how the requested funds will enable the applicant to stabilize the threatened service or program; and
      10. (j) Any other information that the Commission may require on the emergency grant application form.

Authority: Health-General Article, §§19-2107, 19-2109, and 19-2201, Annotated Code of Maryland

Effective date:

Regulations .01 — .08 adopted as an emergency provision effective June 1, 2007 (34:13 Md. R. 1149); adopted permanently effective November 5, 2007 (34:22 Md. R. 1977)