§  54.610   Letters of agency (LOA).

   (a) Authorizations. Under the Healthcare Connect Fund Program, the
   Consortium Leader must obtain the following authorizations:

   (1) Prior to the submission of the request for services, the Consortium
   Leader must obtain authorization, the necessary certifications, and any
   supporting documentation from each consortium member to permit the
   Consortium Leader to submit the request for services and prepare and
   post the request for proposal on behalf of the member.

   (2) Prior to the submission of the funding request, the Consortium
   Leader must secure authorization, the necessary certifications, and any
   supporting documentation from each consortium member to permit the
   Consortium Leader to submit the funding request and manage invoicing
   and payments on behalf of the member.

   (b) Optional two-step process. The Consortium Leader may secure both
   required authorizations from each consortium member in either a single
   LOA or in two separate LOAs.

   (c) Required information in a LOA. (1) An LOA must include, at a
   minimum, the name of the entity filing the application (i.e., lead
   applicant or Consortium Leader); the name of the entity authorizing the
   filing of the application (i.e., the participating health care
   provider/consortium member); the physical location of the health care
   provider/consortium member site(s); the relationship of each site
   seeking support to the lead entity filing the application; the specific
   timeframe the LOA covers; the signature, title and contact information
   (including phone number, mailing address, and email address) of an
   official who is authorized to act on behalf of the health care
   provider/consortium member; the signature date; and the type of
   services covered by the LOA.

   (2) For health care providers located on Tribal lands, if the health
   care facility is a contract facility that is run solely by the tribe,
   the appropriate Tribal leader, such as the Tribal chairperson,
   president, or governor, shall also sign the LOA, unless the health care
   responsibilities have been duly delegated to another Tribal government
   representative.