These are common questions and corresponding answers for the Renewal of Designation (RD) application, which is a request for continued designation by an existing Health Center Program look-alike (LAL). Refer to the RD technical assistance webpage often for updates.
Changes to periods of designation
-
Why are you changing the period of designation for look-alikes from three years to four years?
-
The change to a four-year period of designation will:
- Reduce the burden on look-alikes by extending the timing between operational site visits (OSVs) from every three years to every four years, and their RD application submission to every four years.
- Provide HRSA with increased operational flexibility and efficiency by distributing the review and processing of RD applications, Program Analysis and Recommendations (PARs), and OSVs more evenly across the four-year designation cycle of look-alikes without sacrificing the integrity of compliance reviews for the Health Center Program.
Look-alikes that fail to comply with Health Center Program requirements will still receive a one-year designation.
(Updated: 8/15/2025)
-
When will the period of designation changes take place?
-
Beginning in FY 2026, look-alikes with a December 31, 2025 period of designation end date will receive a one-year extension and will instead submit a Look-Alike Annual Certification (AC).
All other Look-Alikes with a period of designation end date in FY 2026 will transition to a four-year period of designation following submission and approval of their Look-Alike application.
HRSA will later announce which look-alikes in FY 2027 and FY 2028 will receive a one-year extension and will instead submit a Look-Alike AC. By FY 2029, all look-alikes will have a four-year period of designation.
(Updated: 8/15/2025)
-
Why are some health centers receiving a one-year extension with funding while others receive a four-year period of designation?
-
A Health Center Program look-alike cohort consists of look-alikes that apply to continue serving their service area with period of designation start dates in the same month (January through June) in a fiscal year. HRSA must ensure that each cohort is consistently handled when establishing look-alike periods of designation or providing extensions to an existing period of designation. By FY 2029, all look-alikes will have a four-year period of designation.
(Updated: 8/15/2025)
-
When will look-alikes receive notice that their period of designation is shifting to four-years?
-
HRSA will notify the impacted look-alikes later this summer. These look-alikes will be required to submit an Annual Certification in lieu of a Renewal Designation. Look-alikes receiving the one-year extensions in FY 2027 and FY 2028 will be notified in advance regarding any changes.
(Updated: 8/15/2025)
-
Is HRSA changing the certification period start dates for look-alikes through these actions?
-
HRSA is not planning at this time to shift any look-alikes from their current certification period start months.
(Updated: 8/15/2025)
Review Process
-
If areas of non-compliance are identified during the RD application review, will there be an opportunity to address them prior to HRSA making final designation renewal decisions?
-
Yes. If you apply for an RD and we identify areas of non-compliance during the application prefunding review, you will have 14 calendar days to submit documentation demonstrating compliance before the final award decision. The HRSA Reviewer will contact your Authorized Organization Representative (AOR) through the EHBs.
(Updated: 8/15/2025)
-
How will HRSA notify me if there are any compliance findings during the review of my RD application?
-
The HRSA Reviewer will contact your Authorizing Organization Representative (AOR) through the HRSA Electronic Handbooks (EHBs) using a feature called “Correspondence Request”. The HRSA Reviewer will request additional information on any areas of non-compliance identified through the review.
These requests will appear in your AOR’s EHBs Pending Tasks list as “Urgent Application Correspondence” tasks. As indicated in the Correspondence Request, you will have up to 14 calendar days to submit documentation demonstrating compliance.
HRSA Reviewers will also contact your AOR by phone when a Correspondence Request is sent. This is to ensure the AOR has received the request and to answer any questions the AOR may have.
Your AOR should respond to Compliance Request tasks via EHBs as soon as possible. We will not provide a deadline extension. Information shared via methods other than the EHBs Correspondence Request submission (e.g., phone calls, emails) will NOT be considered in our final compliance assessment.
(Updated: 8/15/2025)
-
Will I be able to ask questions about the application review process, including questions about the EHBs Correspondence Request received from the HRSA Reviewer?
-
Yes. If the AOR receives a Correspondence Request in EHBs regarding your RD application, the HRSA Reviewer will also contact your AOR by phone when a Correspondence Request is sent. The purpose of this phone contact is to ensure your AOR received and reviewed the request, specify the reason for the findings of non-compliance based on the content of the application, and answer questions related to the Correspondence Request.
(Updated: 7/5/2023)
-
Is there anything I can do to prepare for correspondence on compliance findings during the review of my RD application?
-
Yes, to be prepared for correspondence on any compliance findings during the review of your RD application you should ensure that contact information (email and phone number) in EHBs for the AOR – the individual who submits your RD application – is up to date and accurate. The EHBs Correspondence Request will be initiated by a HRSA Reviewer and will come from EHBSupport@hrsa.gov. Also, you can add this email address to a “safe sender” or contacts list to avoid messages potentially going to your junk folder.
(Updated: 8/15/2025)
-
How can I check and/or change my health center’s Authorizing Official in EHBs?
-
You can check and change the AOR via EHBs using the process identified in the resource guide (PDF - 301 KB) on this topic.
(Updated: 7/5/2023)
-
What steps can my health center take to prepare a high-quality RD application?
-
There are several steps health centers can take to prepare a high-quality RD application.
Carefully review and refer to the Health Center Program Compliance Manual. Review and follow the RD Instructions on the RD technical assistance webpage. The RD instructions clearly indicate what portions of the application are used to assess compliance.
Ensure the narrative responses, forms, and attachments in your application support your health center’s demonstration of compliance and provide consistent information throughout the application.
(Updated: 7/5/2023)
-
If my health center has existing, unresolved progressive action conditions related to Health Center Program requirements, will this impact my Renewal of Designation?
-
Yes, current unresolved progressive action conditions may impact the health center’s period of designation length. Therefore, if your health center has current, unresolved progressive action conditions, take corrective action and submit responses that demonstrate compliance.
If you do not resolve conditions that you received through the progressive action process outlined in Chapter 2: Health Center Program Oversight of the Health Center Program Compliance Manual, you will receive a one-year period of designation, or HRSA may terminate your designation.
(Updated: 8/15/2025)
-
If my health center is designated for a one-year period of performance, are we required to submit a plan to come into compliance and respond to active progressive action conditions?
-
Yes, if you receive a one-year period of designation and you do not submit the required Compliance Achievement Plan within 120 days of designation or demonstrate good cause for not submitting it, HRSA will terminate your LAL designation. For the EHBs 120-day Compliance Achievement Plan, you must provide a plan that:
- Discusses your organization’s approach for achieving compliance with all areas of non-compliance that have been identified through progressive action conditions on the Notice of Look-Alike Designation; and
- Indicates that compliance will be demonstrated within the timeframes and deadlines specified by these progressive action conditions.
(Updated: 8/15/2025)
-
Will health centers with a one-year designation period have an operational site visit (OSV) during the one-year period?
-
Yes, an OSV will be scheduled within two to four months of your designation period start date. The timing of this OSV is to provide health centers with an opportunity to address any non-compliance issues prior to a HRSA decision to designate an organization for a new period of performance.
(Updated: 7/5/2023)
-
If a health center had a one-year designation period in the two years prior (e.g., health center received a one-year designation period in both 2022 and 2023) to the upcoming designation period, is the organization at risk not to receive a subsequent renewal of designation?
-
Consistent with Health Center Program statute and the Health Center Program Compliance Manual Chapter 2: Health Center Program Oversight process: A health center look-alike will not receive a renewal of designation if the health center had consecutive one-year designation periods in the previous two years.
(Updated: 7/5/2023)