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

Added: 10/20/2021

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.

Added: 10/20/2021

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

Added: 10/20/2021

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).

Added: 10/20/2021

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) 

Added: 10/20/2021

A health center must contact HRSA as soon as possible but no later than 15 calendar days after initiating emergency response activities at the location. HRSA will determine on a case-by-case basis whether extraordinary circumstances justify an exception to the 15-day requirement.

A health center should use the BPHC Contact Form (preferred) or email BPHCOHCPMHCESupport@hrsa.gov to submit a temporary service site request. To submit a request on the BPHC Contact Form, a health center awardee or look-alike should:

1. Go to the “Program Monitoring H80” section;
2. Select “General H80 Award;” and
3. Select “Temporary Site Request (Emergency Need)” in the dropdown menu.

If a health center is unable to access the BPHC Contact Form or to email BPHCOHCPMHCESupport@hrsa.gov, a health center should contact Health Center Program Support at 1-877-464-4772.  

To learn more about what a health center must submit to HRSA in the request, refer to PAL 2020-05: Requesting a Change in Scope to Add Temporary Service Sites in Response to Emergency Events (PDF - 266 KB)

Added: 10/6/2022

A health center must contact HRSA to request approval for an extension of time beyond 90 days. Otherwise, HRSA’s approval of a temporary service site will automatically expire 90 days after the temporary service site’s approved effective date, regardless of the issue date of formal documentation, and HRSA will administratively remove the temporary service site from the health center’s scope of project.

A health center should use the BPHC Contact Form (preferred) or email BPHCOHCPMHCESupport@hrsa.gov to submit an extension request. To request an extension using the BPHC Contact Form, a health center awardee or look-alike should:

1. Go to the “Program Monitoring H80” section;
2. Select “General H80 Award;” and
3. Select “Temporary Site Request (Emergency Need)” in the dropdown menu.

If a health center is unable to access the BPHC Contact Form or to email BPHCOHCPMHCESupport@hrsa.gov, a health center should contact Health Center Program Support at 1-877-464-4772.  

To learn more about temporary service site requests, refer to PAL 2020-05: Requesting a Change in Scope to Add Temporary Service Sites in Response to Emergency Events (PDF - 266 KB)

Added: 10/6/2022

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.

Added: 10/20/2021