As I mentioned the other day, I got a copy of the grant that Gary Marks put through in 2008 to HRSA (for reference, the funding opportunity was HRSA-08-100, which I'm guessing is a designation for congressional earmarks. The cast number itself is HRSA-09-098) . I've been puzzled for awhile just how the earmarking works, as had been told by Chet Edward's office that the GRMC didn't qualify for a grant, and thus GRMC/Gary Marks asked Edwards for an earmark. HRSA, who is the one that sent out the paper for the earmark, required a grant application be supplied. I called HRSA a few minutes ago to understand better just how that works. I mean, it isn't as if GRMC competed with other hospitals or medical centers for taxpayer funded grants; it's that money was carved out for them without having to compete.  The HRSA person I spoke with said that their department gets instructions on who to give money to directly from Congress, their request(s) are sent directly to HRSA and then an award is cut. Who gets the *grant* ie earmark is spelled out in the legislation. HRSA requires that the grant application be sent in, and then they cut what amounts to a check, but is called an NGA "Notes of Grant Award", which can be used to transfer money electronically.

Another thing in the grant application I noticed which sheds yet a bit MORE light on those 14.5 million dollar certificates of obilgation that Somervell County passed. From F Approach.

Much of the work has already been done as Glen Rose Medical Cneter contracted with the architectural firm of Perkins and Will, Inc. Perkins and Will worked with the staff of Glen Rose Medical Center for over 6 months to design the facility expansion and then spent the next 6-9 months completing the final design and specifications. Additionally, a contract was established with Robbins and Morton (construction contractor) to provide a guaranteed mininum price to assure that the securing of any financing will cover the cost of the project

What was that guaranteed minimum price?

The cost of the project will be funded by the Certificates of Obligations to be issued by Somervell County. Initial resolutions have been passed and a public hearing was held on March 24, 2008. The next step will be action to Issue the Certificates of Obligation and this is scheduled for April 14, 2008. The amount of issuance is currently for $14.5 million. This would fund the project and then the funding from this grant would support 2.2 % of the cost of this project.

Why was it necessary for GRMC and Somervell County to work together about the Cerificates of Obligation? From the Budget Narrative. Because the application requires showing that non federal support would be given by some entity.

Funding (Non Federal Share) -The Somervell County Commissioners Court has taken the initial steps to obtain  $14.5 million to fund this project through the issuance of Certificates of Obligation. A resolution was passed in February announcing the issuance and calling for a public hearing. This public hearing was held on March 24, 2008. There were no comments registered at this hearing. The next step will take place on Apirl 14 at which time the Commissioner's Court will vote to formally issue the certificate of obligation. This will formally establish funding and the funding will be secured. The committment required by this application for Non-Federal Support will be provided after the April 14 date when the Commissioners Court will have passed the motion for Issuance.

If I am understandiing this right, the reason there had to be a guarantee of non-federal funds was to make sure the project of expansion went through regardless of the *grant*/earmark.

The fact that the county will be providing 98% of this funding for this project establishes a cooperative effort with this private non-profit organization, Glen Rose Medical Foundation, Inc.

Well, yeah. Because Somervell County OWNS the land, the equipment and the building. GRMF LEASES same from them for ONE DOLLAR PER YEAR.  Now, is the other 2 percent coming from the earmark from Chet Edwards? Because Edwards certainly didn't get a 14. 5 million dollar earmark for GRMC/GRMF.

One more time to put a cap on it. Somervell County HAD to do a CO hearing for private non-entity GRMF or GRMF couldn't have put in the paperwork to apply for the Chet Edwards earmark through HRSA.

Since, in the public hearing notices that went out about the CO, it said that Somervell County was doing a loan to GRMC of the 14.5 million, where is the agreement or contract for GRMC to pay it back? Is there one? I've seen the CO agreement and I've seen the lease. Or is it rather that the money was loaned with no intent for a payback but instead property valuations were raised for Somervell County to make the payments, with part of that money coming from the Edwards earmark.

As a side note, Mr Marks salary for overseeing the project is $120,000 to $160,000. It's not clear from the rendering of the information in the paragraph about qualifications if that is on top of his regular salary as CEO of GRMC/GRMF.