Introduction
Finding funding for capital projects is a major concern for many rural healthcare facilities. Capital funding is defined as funding used to expand or renovate a building, purchase major equipment or construct a new facility for a rural health provider. In searching for funding for capital projects, it is very important that facilities consider and use a variety of potential sources, including public grants and loan programs, as well as private sources such as foundations and donations from local residents.
Frequently Asked Questions
Tools
Catalog of Federal Domestic Assistance (CFDA)
Database
Contains information on all available federal programs including grant eligibility, application procedures, selection criteria, and program deadlines.
Community Development Financial Institutions (CDFI) Fund
Web site
Awards money to community-based organizations that work in low-income urban and rural communities across America. This website allows you to search by state to find the CDFI office in your community.
Community Investment Profiles Database
Database
Allows you to search your state for community development investment institutions for housing, community development and small business as well as specific organizations.
Federal Funding Sources for Rural Areas
Database
Provides a searchable database of federal funding programs available to rural areas. Search by keyword or agency.
Federal Historic Preservation Tax Incentives Program
Web site
Fosters private sector rehabilitation of historic buildings and promotes economic revitalization. Available for buildings that are National Historic Landmarks, that are listed in the National Register, and that contribute to National Register Historic Districts and certain local historic districts. Contains information on individual states, which also have their own programs beyond the federal program.
Glossary of Financial and Business Terms
Web site
Contains a glossary of words and terms used in finance.
Hill-Burton Facilities Compliance and Recovery
Web site
Offers a fund program available for hospitals and other health facilities to use for construction and modernization. Facilities that receive Hill-Burton funds agree to provide
services to persons unable to pay, and make
their services available to all persons residing in the facility's area.
Low Income Housing Tax Credit
Web site
Encourages the construction and rehabilitation of apartments affordable to low-income families by offering a credit or reduction in tax liability for 10 years for the owners or developers of such housing.
RAC Funding Search
Database
Offers a searchable database for funding opportunities, updated daily from the Federal Register and other sources.
Rural Health Research: Capital funding
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of capital funding, produced by the Office of Rural Health Policy's funded rural health research centers.
Rural Housing and Economic Development Gateway
Web site
Connects rural organizations with information, technical assistance, training, and investment capital to help them develop, rebuild, and preserve affordable housing, local economies, and essential infrastructure.
Funding
BPHC Loan Guarantee Program
Loan program to Section 330 health centers to obtain a loan guarantee for the financing of a medical facility construction, renovation and modernization.
Calvert Foundation Loan Program
Loans to community organizations that act as financial intermediaries, including loan funds, microfinance institutions, affordable housing developers and social enterprises.
Charles A. Frueauff Foundation Grants
Awards grants in the areas of higher education, social services, health and hospitals.
Community Development Transportation Lending Services (CTAA)
Provides loan funding to support transit services in rural areas.
Federal Surplus Personal Property Donation Program
Enables certain nonfederal organizations to obtain property that the federal government no longer needs.
First Children's Finance Loan Fund
Loans and technical assistance to child care and early education businesses, especially those serving lower-income communities.
HUD 242 (FHA Section 242) - Helping Hospitals Get Capital Financing
Loan program to help hospitals finance new construction, refinancing, and modernization or to purchase major movable equipment such as hospital beds, wheeled equipment, and office machines.
HUD State Community Development Block Grant (CDBG) Program
Funding for revitalizing neighborhoods, expanding housing, improving community facilities and services, acquiring property such as land and buildings, and improvements to property.
Kroger Company Foundation
Capital campaigns, start up grants, and funding for special projects. Focuses only on areas where company has operations.
Rural Broadband Access Loans and Loan Guarantees Program
Loans and loan guarantees for the construction, improvement, and acquisition of facilities and equipment for broadband service in eligible rural communities.
Safety-net Facility Improvements
Facilities-capital challenge grant in community-based health centers through a variety of funding methods, including program-related investments or below market rate loans.
SBA Certified Development Company (504) Loan Program
Provides growing businesses with long-term, fixed-rate financing for major fixed assets, such as land and buildings.
Section 108 Loan Guarantee Program
Funding that provides communities with a source of financing for economic development, housing rehabilitation, public facilities, and large-scale physical development projects.
Small Business Investment Company (SBIC) Program
A program to provide financial assistance to small businesses in need of growth capital.
Surplus Real Property Available for Public Use
Disposal of surplus real property by lease, permits, sale, exchange, or donation.
USDA Business and Industry Guaranteed Loans
Helps create jobs and stimulates rural economies by providing financial backing for rural businesses.
USDA Community Facilities Loan and Grant Program
Funding to construct, enlarge, or improve essential community facilities for health care, public safety, and public services in rural areas.
Inactive Funding
Inactive Funding Opportunities -
Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.
Regulations, Forms & Other Useful Documents
Access Capital: New Opportunities for Meeting America's Primary Care Infrastructure Needs
Sponsoring organization: National Association of Community Health Centers
Examines why significant investments in health center infrastructure are critical to meeting rising numbers of medically underserved and uninsured people.
Date: 03 / 2008
Availability and Use of Capital by Critical Access Hospitals
Author(s): Walter Gregg
Sponsoring organization: Flex Monitoring Team
Examines the experiences of Critical Access Hospitals (CAHs) in meeting their capital needs. Discusses efforts to obtain capital, sources of capital, uses of capital, technical assistance resources, and current capital needs. Includes information on state capital programs available to CAHs.
Date: 03 / 2005
Beyond City Limits: The Philanthropic Needs of Rural America
Author(s): Rick Cohen
Sponsoring organization: National Committee for Responsive Philanthropy
Examines resource deficiencies in rural America concerning the availability and delivery of philanthropic capital from private foundations and corporations to rural community-based organizations.
Date: 05 / 2004
Federal Government Resources for Health Care Capital and Infrastructure in Rural Areas
Author(s): Joy McGlaun
Sponsoring organization: Office of Rural Health Policy
Describes various federal programs and agencies that provide funding for building, renovation, and major equipment (capital funding).
Date: 03 / 2009
Focus on Funding: Capital Improvements
Author(s): Beth Blevins
Sponsoring organization: Rural Assistance Center
Brief overview of capital funding for health care facilities. Includes case studies of recent capital funding projects.
Journal citation: Rural Monitor
Date: 2007
Focus on Health Care Finance White Paper II: Financing Options for Nonprofit Small and Rural Hospitals
Author(s): Thomas R. Green
Sponsoring organization: Lancaster Pollard
Outlines several programs and financial options available to non-profit community and rural hospitals. Discusses a hospital's strategic plan for future and financial operations.
Date: 05 / 2009
Foundations Providing Grants Applicable for Health Care Capital and Infrastructure in Rural Areas
Author(s): Joy McGlaun
Sponsoring organization: Office of Rural Health Policy
Overview of foundations that provide grants for rural health care capital and infrastructure.
Date: 05 / 2003
Guidelines for Design and Construction of Health Care Facilities
Sponsoring organization: American Institute of Architects
Referenced by architects, engineers, and health care professionals throughout the United States and in other countries who are planning new or renovated health care facility construction. Authorities in 42 states, the Joint Commission for the Accreditation of Healthcare Organizations, and several federal agencies use the Guidelines as a reference, code, or standard when reviewing construction designs and plans and completed healthcare facilities.
Date: 07 / 2006
How are Hospitals Financing the Future?: Capital Spending in Health Care Today
Sponsoring organization: Healthcare Financial Management Association
Provides benchmarks and measures to determine the adequacy of hospitals' capital spending and offers tools to improve capital planning. Includes statistics and data. Shows the difference in urban and rural hospital financing.
Date: 2004
Rate of Return on Capital Investments at Small Rural Hospitals
Author(s): Jeffrey Stensland, Astrid Knott, Ira Moscovice, Gestur Davidson
Sponsoring organization: University of Minnesota Rural Health Research Center
Discusses whether the aging of rural facilities is due to a lower rate of return on
capital investment at small rural hospitals.
Date: 01 / 2003
Rural Hospital Access to Capital: Issues and Recommendations
Author(s): Walter Gregg, Astrid Knott, Ira Moscovice
Sponsoring organization: University of Minnesota Rural Health Research Center
Identifies federal programs that have or could help rural hospitals meet their capital needs, assesses whether rural hospitals have difficulty getting capital under the current programs, and makes recommendations for improvement. The Hospital Mortgage Insurance Program (HUD 242) and USDA Community Facilities Program (CFP) are discussed.
Date: 07 / 2002
Organizations
Capital Link
Nonprofit/Foundation
Provides advisory services related to planning and financing capital projects for nonprofit community health centers to support and expand community-based health care.
Economic Development Administration (EDA)
Federal government
Works to generate jobs, help retain existing jobs, and stimulate industrial and commercial growth in economically-distressed rural and urban areas of the United States. Part of the U.S. Department of Commerce.
Federal Home Loan Banks (FHLB)
National organization
Represents all 50 states, with each state part of a regional FHLB. Offers low-cost funds to financial institutions for home mortgages, small businesses, and rural and agricultural loans, including the Community Investment Program with subsidized interest rates.
Foundation Center
Nonprofit/Foundation
Collects, organizes, and communicates information on U.S. philanthropy. Provides education and training on the grantseeking process. Provides free and fee-based information on grantseeking and foundation giving.
National Association of Health and Educational Facilities Finance Authorities (NAHEFFA)
National organization
Provides assistance and support to its member higher education authorities through education, communication, advocacy and leadership development so its members can better serve their varied constituents.
New Markets Tax Credit Coalition (NMTCC)
Nonprofit/Foundation
Comprised of local, regional and national community development organizations. Supports federal tax credits that would encourage private investment in community development.
Opportunity Finance Network
National organization
Consists of a national membership organization of community development financial institutions (CDFIs) which provides capital, technical assistance, and development services to support the revitalization of economically-disadvantaged urban, rural, and reservation-based communities across the United States.
Small Business Investment Company (SBIC)
Federal government
Works to aid, counsel, assist, and protect the interests of small business concerns.
USDA Rural Housing Service (RHS)
Federal government
Provides capital for community programs, single-family housing, and multi-family housing.
Terms & Acronyms
Application Procedures Set of instructions issued by funders, listing the necessary steps for proposal review. These include submission deadlines, letter of intent, contact person and mail address. These vary among the different funding organizations.
Block Grants Grants administered by the federal government to provide states with funding for a particular purpose, for example the delivery of maternal and child health services.
Building/Renovation Money raised for construction, renovation, remodeling, or rehabilitation of building; may be part of an organization's capital campaign.
Capital Campaign A campaign, usually extending over a period of years, to raise substantial funds for enduring purposes, such as building or endowments funds.
Community Development Financial Institutions (CDFI) Financial institutions that awards money to community-based organizations that work in low-income urban and rural communities across America.
Community Foundations Private funding from foundations involved in grant giving within a specific community, state or region.
Community Groups Local organizations which focus on supporting projects within their communities, for example churches, junior leagues, and civic associations.
Contract A binding agreement used to procure specified services.
Cooperative Agreement An agreement between a funding agency and grantee which allows the funder some control. These are often used by the government to conduct extramural clinical trials.
Corporate Foundations Private funding from foundations which receive contributions from a profit-making entity, for example a specific corporation.
Debt Reduction Also known as deficit financing. A grant to reduce the recipient organization's indebtedness; frequently refers to mortgage payments.
Demonstration Grants Grants administered by the federal government to demonstrate or establish the feasibility of a particular theory or approach, for example rural health outreach, network development, and telemedicine grant programs.
Department of Health and Human Services (DHHS) The United States government's principal and largest grant-making agency, including more than 300 programs. Often referred to as HHS.
Direct Giving Foundations Private funding from foundations which are usually corporations that donate goods and services for charitable causes, for example IBM Corporation.
Economic Development Administration (EDA) The U.S. Department of Commerce's Economic Development Administration provides grants for infrastructure development, local capacity building, and business development to help communities alleviate conditions of substantial and persistent unemployment and underemployment in economically distressed areas and regions.
Emergency Funds A one-time grant to cover immediate short-term funding needs on an emergency basis.
Form 990-PF The information statement submitted by foundations which outlines their assets and annual giving. This form is submitted to the State Attorney General's office and is made available for public review.
Formula Grants Grants administered by the federal government to provide funding to specified grantees on the basis of a specific formula, using indicators, for example per capita income, mortality or morbility rates, outlined in legislation or regulations such as certain substance abuse programs.
General Operating Support A grant made to further the general purpose or work of an organization, rather than for a specific purpose or project; also called unrestricted grants.
Grant Need-based financial aid that does not have to be repaid. May be offered by the Federal or state government, college or private foundation.
Grantsmanship The process of identifying funding needs and the steps in obtaining those funds.
In-Kind Support Nonmonetary contributions made by the grantee such as equipment, supplies, services, or technical expertise.
Letter of Intent/Inquiry The initial contact or letter with a funder outlining the proposed project or plan.
Loan Money lent for a specified period of time at a specific interest rate. Collateral is often necessary to receive the loan.
Loan Guarantee Loans provided to small businesses unable to secure financing on reasonable terms through normal lending channels. Should the borrower default on the loan, then the agency would pay the private financier for the loan.
Matching Funds Money which "matches" the funder's contribution. This money can come from a third party or the grantee.
Office of Grants Management (OGM) Part of the Department of Health and Human Services.
Private Foundations Private funding from foundations which receive income from an individual, family or group of individuals. The funding priorities of private foundations are usually based on the personal philosophies of the founding members.
Program Development Grants to support specific projects or programs as opposed to general purpose grants.
Program Officer The representative of the funding agency who is responsible for the grant's administration.
Project Grants Grants administered by the federal government to support individual projects in accordance with legislation that gives the funding agency discretion in selecting the project, grantee, and the amount of award, for example Area Health Education Centers - Model Programs.
Proposal Written plan submitted to potential funders. This contains the program's goals, objectives, methods, budget, and evaluation.
Request for Application (RFA) Announcement inviting proposals for a specified contract in support of a particular project or service.
Request for Proposal (RFP) Announcement inviting proposals for a specified type of grant.
Research Grants Grants administered by the federal government to support investigation aimed at the discovery of facts, clinical trials, revision of accepted theories, or applications of new or revised theories. Research grants for individuals are usually referred to as fellowships.
Seed Money A grant or contribution used to start a new project or organization. Seed grants may cover salaries and other operating expenses of a new project. Also known as "start-up-funds."
Solicited Proposal A grantseeker's response to a request for a proposal issued by a funding organization.
Technical Assistance Operational or management assistance given to nonprofit organizations; may include fund-raising assistance, budgeting and financial planning, program planning, legal advice, marketing, and other aids to management. Assistance may be offered directly by a foundation staff member or in the form of a grant to pay for the services of an outside consultant.
Unsolicited Proposal A proposal which originates from the grantseeking organization. Some organizations do not allow unsolicited proposals.
Voluntary Agencies Private organizations which support charitable programs that are consistent with their overall mission, for example the Red Cross.
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