Have a question about the Health Center Program Compliance Manual? Ask it Now
Note: This chapter contains language that was revised based on the Bipartisan Budget Act of 2018. View the revisions (PDF - 582 KB).
330(g) Migratory and Seasonal Agricultural Worker (MSAW):
For the purposes of health centers receiving a Health Center Program award or designation under section 330(g) of the Public Health Service Act, the population served includes:
- Migratory agricultural workers who are individuals whose principal employment is in agriculture, and who have been so employed within the last 24 months, and who establish for the purposes of such employment a temporary abode;
- Seasonal agricultural workers who are individuals whose principal employment is in agriculture on a seasonal basis and who do not meet the definition of a migratory agricultural worker;
- Individuals who are no longer employed in migratory or seasonal agriculture because of age or disability who are within such catchment area; and/or
- Family members of the individuals described above.
Agriculture refers to farming in all its branches, as defined by the North American Industry Classification System under codes 111, 112, 1151, and 1152.
(Section 330(g) of the PHS Act)
330(h) Homeless Population:
For the purposes of health centers receiving a Health Center Program award or designation under section 330(h) of the Public Health Service Act, the population served includes individuals:
- Who lack housing (without regard to whether the individual is a member of a family);
- Whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations;
- Who reside in transitional housing; and/or
- Who reside in permanent supportive housing or other housing programs that are targeted to homeless populations.
Under section 330(h) a health center may continue to provide services for up to 12 months to formerly homeless individuals whom the health center has previously served but are no longer homeless as a result of becoming a resident in permanent housing and may also serve children and youth at risk of homelessness, homeless veterans, and veterans at risk of homelessness. (Section 330(h) of the PHS Act)
330(i) Residents of Public Housing:
For the purpose of health centers receiving a Health Center Program award or designation under section 330(i) of the Public Health Service Act, the population served includes residents of public housing and individuals living in areas immediately accessible to public housing. Public housing includes public housing agency-developed, owned or assisted low-income housing, including mixed finance projects, but excludes housing units with no public housing agency support other than Section 8 housing vouchers. (Section 330(i) of the PHS Act)
Additional Services (Additional Health Services):
Services that are not included as required primary health services and that may be offered as appropriate to meet the health needs of the population served by the health center. (Section 330(b)(2) of the Public Health Service Act)
Awardee (award recipient):
For public agency health centers only. The established body that serves as a public center’s governing board when the public agency determines that it cannot meet the Health Center Program governing board requirements directly. (Section 330(r)(2)(A) of the Public Health Service Act)
A contract is used for the purpose of obtaining goods and services needed to carry out the project or program under a Federal award. It does not include a legal instrument, even if the health center considers it a contract, when the substance of the transaction meets the definition of a Federal award or subaward. Characteristics of a contract are when the contractor:
- Provides the goods and services within normal business operations;
- Provides similar goods or services to many different purchasers;
- Normally operates in a competitive environment;
- Provides goods or services that are ancillary to the operation of the Federal program; and
- Is not subject to compliance requirements of the Federal program as a result of the relationship (although similar requirements may apply for other reasons, including as a result of contractual provisions).
(45 CFR 75.2 and 45 CFR 75.351)
The process of assessing and confirming the license or certification, education, training, and other qualifications of a licensed or certified health care practitioner.
EHB: HRSA’s Electronic Handbooks:
HRSA’s Web-based grants interface, used for all Health Center Program award or designation management activities.
Federal award (award, Federal grant):
The Federal financial assistance that a non-Federal entity receives directly from a Federal awarding agency, such as HRSA, or indirectly from a pass-through entity. For the purposes of the Compliance Manual (unless specified differently), this refers to Federal award funding under section 330 of the Public Health Service Act or the “Health Center Program award.” (45 CFR 75.2)
Federal Poverty Guidelines (FPG):
The Federal Poverty Guidelines (FPG) are a simplification of the poverty thresholds, which are updated each year by the Census Bureau, and are used for administrative purposes — for instance, determining financial eligibility for certain Federal programs. The guidelines reflect annual income levels below which a person or family is considered to be living in poverty, and the amounts increase according to the size of the family. The guidelines are updated annually by HHS in the Federal Register. (Federal Poverty Guidelines)
Federally Qualified Health Center (FQHC):
A Medicare/Medicaid designation administered by CMS. Eligible organizations include organizations receiving grants under section 330 of the PHS Act, look-alikes, and certain tribal organizations. (Section 1861(aa)(4)(B) and section 1905(l)(2)(B) of the SSA)
Fitness for duty Formerly referred to as “health fitness”:
Fitness for duty, for purposes of this Compliance Manual, means the ability to perform the duties of the job in a safe, secure, productive, and effective manner.
Form 5A: Services Provided:
Official documentation of the required and additional health services (See Chapter 4: Required and Additional Health Services) included in a health center’s HRSA-approved scope of project, and their corresponding mode(s) of service delivery. This form is contained in the health center’s folder in EHB. (Scope of Project)
Form 5B: Service Sites:
Official documentation of the service delivery sites (see Service Site (PDF - 224 KB)) included in a health center’s HRSA-approved scope of project. This form is contained in the health center’s folder in EHB. (Scope of Project)
Limited English Proficiency (LEP):
LEP persons include individuals who do not speak English as their primary language and/or who have a limited ability to read, write, speak, or understand English; and who may be eligible to receive language assistance with respect to the particular service, benefit, or encounter. (HHS Office for Civil Rights)
Organizations that do not receive a Health Center Program Federal award but are designated by HRSA as meeting Health Center Program requirements. (Section 1861(aa)(4)(B) and section 1905(l)(2)(B) of the SSA)
Primary Source Verification:
Verification by the original source of a specific credential of the accuracy of a qualification reported by an individual health care practitioner. Primary source verification could include direct correspondence, telephone, fax, e-mail, or paper or online reports received from original sources (for example, telephone confirmation from an educational institution that the individual graduated with the degree[s] listed on his or her application, confirmation through a state’s database that a provider’s license is current, reports from credentials verification organizations).
The process of authorizing a health care practitioner’s specific scope and content of patient care services.
Required Services (Required Health Services):
Required services are those services that a health center must provide, as defined in Section 330(b)(1) of the Public Health Service Act.
(Section 330(a)(1) of the Public Health Service Act)
Scope of Project:
Defines the service sites, services, providers, service area(s), and target population included in the HRSA-approved Health Center Program project. (Policy Information Notice 2008-01: Defining Scope of Project and Policy for Requesting Changes (PDF - 224 KB))
Service Area (also referred to as a “catchment area”):
The precise boundaries, as defined by the health center, of the geographic area to be served under the Health Center Program project, including identified medically underserved population or populations within that area. (42 CFR 51c.102)
Locations where a health center either directly or through a subrecipient or contractual arrangement provides services and where all of the following conditions are met:
- Health center encounters are generated by documenting in the patients’ records face- to-face contacts between patients and providers
- Providers exercise independent judgment in the provision of services to the patient
- Services are provided directly by or on behalf of the health center, whose governing board retains control and authority over the provision of the services at the location
- Services are provided on a regularly scheduled basis (Policy Information Notice 2008-01: Defining Scope of Project and Policy for Requesting Changes (PDF - 224 KB))
Special Population [Special Medically Underserved Population]:
HRSA may award funding or designation under sections 330(g), (h), or (i) of the PHS Act for the delivery of services to a special medically underserved population. See definitions for 330(g) Migratory and seasonal agricultural workers; 330(h) Homeless individuals; and 330(i) Residents of public housing.
An award provided by a pass-through entity to a subrecipient for the subrecipient to carry out part of a Federal award received by the pass-through entity. It does not include payments to a contractor or payments to an individual that is a beneficiary of a Federal program. A subaward may be provided through any form of legal agreement, including an agreement that the pass-through entity considers a contract. See also “Pass-Through Entity.” (45 CFR 75.2)
Per 45 CFR 75.2, a non-Federal entity that receives a subaward from a pass-through entity to carry out part of a Federal program but does not include an individual that is a beneficiary of such program. A subrecipient may also be a recipient of other Federal awards directly from a Federal awarding agency.
Characteristics which would lend support to the classification of the non-Federal entity as a subrecipient include when the non-Federal entity:
- Determines who is eligible to receive what Federal assistance
- Has its performance measured in relation to whether objectives of a Federal program were met
- Has responsibility for programmatic decision making
- Is responsible for adherence to applicable Federal program requirements specified in the Federal award
- In accordance with its agreement, uses the Federal funds to carry out a program for a public purpose specified in authorizing statute, as opposed to providing goods or services for the benefit of the pass-through entity (45 CFR 75.2)
Uniform Data System (UDS):
The UDS is a core set of information appropriate for reviewing the operation and performance of health centers. The UDS annually collects a variety of information, including patient demographics, services provided, staffing, clinical indicators, utilization rates, costs, and revenues.
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (45 CFR Part 75):
Sometimes referred to as the “HHS grant regulations.” Final requirements for Federal awards to non-Federal entities located in Title 2 of the Code of Federal Regulations as adopted by HHS at 45 CFR Part 75. These requirements supersede and streamline requirements from previous OMB Circulars A-21, A-87, A-110, and A-122 ; Circulars A-89, A-102, and A-133; and the guidance in Circular A-50 on Single Audit Act follow-up. (45 CFR Part 75)
Volunteer Health Professional (VHP):
For the purposes of being deemed as PHS employees for the purposes of liability protections under section 224(q) of the PHS Act, a health care practitioner shall be considered to be a volunteer health professional at a deemed health center if the following conditions are met:
- The service is provided to patients at the sponsoring health center facilities or through offsite programs or events carried out by the sponsoring health center.
- The deemed health center is sponsoring the health care practitioner.
- The health care practitioner does not receive any compensation for the service from the patient, the sponsoring health center, or any third-party payer (including reimbursement under any insurance policy, health plan, or Federal or state health benefits program). However, the health care practitioner may receive repayment from the health center for reasonable expenses incurred in providing the service to the patient.
- Before the service is provided, the health care practitioner or the deemed health center posts a clear and conspicuous notice at the site where the service is provided of the extent to which the legal liability of the health care practitioner is limited pursuant to subsection 224(q).
- At the time service is provided, the VHP is licensed or certified in accordance with applicable Federal and state laws regarding the provision of the service.
- The sponsoring health center must maintain all relevant documentation certifying that the VHP meets the requirements to be considered a volunteer.
(Section 224(q) of the PHS Act)