The Change in Scope (CIS) Process

If you need to make a change to your scope of project, you must submit a CIS request through the Electronic Handbooks (EHBs). This allows HRSA to review and approve the change. There are two kinds of CIS requests:

• Formal - a formal CIS is for a significant change.
• Scope Adjustment - a scope adjustment is for a smaller change.

Formal CISs include:

• Add a new, additional, or specialty service to scope
• Delete an existing service from scope
• Add a new service site to scope
• Convert an existing administrative-only site to a service/administrative site or service site
• Delete an existing service site from scope
• Convert an existing service site or service/admin site to an admin-only site
• Add a new target population

Scope Adjustments include:

• Update a required service
• Update an additional or specialty service
• Add an admin-only site
• Delete an admin-only site
• Update information about a site (such as hours of operation, months of operation, zip codes)
• Add, remove or update other activities/locations

There are some updates to scope that are done by a health center through a self-update module in EHBs. HRSA does not review these submissions.

Self-Updates include:

• Site name
• Service delivery site type (can only switch between administrative/service delivery site and service delivery site)
• Web URL
• Site phone number
• Site setting
• FQHC site National Provider Identification (NPI) number
• FQHC site Medicare billing number status
• FQHC site Medicare billing number

No. A change not listed under Formal CIS, Scope Adjustment CIS, or Self-Updates, as described in the previous question, does not require the submission of a CIS into the Electronic Handbooks (EHBs). Examples of changes that do not require HRSA approval may include, but are not limited to, hiring a new provider for a service already in scope or expanding in-scope services at other existing sites. For more information about in-scope services, refer to the Form 5A Service Descriptors (PDF - 294 KB)resource.

Submit a CIS request at least 60 days before you plan to implement the change.

1. Consult with BPHC Point of Contact.
2. Review PIN 2008-01: Defining Scope of Project & Policy for Requesting Changes (PDF - 224 KB)  and PAL 2014-10: Updated Process for Change in Scope Submission, Review and Approval Timelines (PDF - 126 KB) .
3. Use the sample forms and instructions as a guide to complete the CIS.

Complete and submit the official forms through the Electronic Handbooks (EHBs).

HRSA may take up to 60 days to review and approve a CIS, and returns any submissions that need corrections. Once you resubmit a CIS, HRSA may take another 60 days to review and approve it. In unique cases, HRSA may extend the review period beyond 60 days.

If HRSA approves a Formal CIS, you will receive a Notice of Award (NoA) or Notice of Look-Alike Designation (NLD). You then have 120 days to implement the change, for example, opening a health center site or beginning to provide a new health care service. When this change happens, you must submit a Scope Verification task in the Electronic Handbooks (EHBs). Once HRSA accepts the verification, HRSA will issue a new NoA or NLD confirming the updates to your scope of project.

HRSA does not issue a NoA or NLD for Scope Adjustment CISs or Self-Updates, however your scope of project updates in EHBs. For additional information, refer to PAL 2014-10: Updated Process for Change in Scope Submission, Review and Approval Timelines (PDF - 126 KB) .

Refer to the resource list below to get familiar with the CIS process. Some resources apply to all change in scope requests; others are specific for changes to services, sites, target populations, and other activities.