Read this along with the Expanding Nutrition Services (ENS) notice of funding opportunity and example forms. Find additional technical assistance resources on Apply for FY 2026 Expanding Nutrition Services.
Jump to:
- Nutrition services
- Allowable use of funds
- Budget requirements
- Minor alteration and renovation (A/R) and equipment
- Scope of project
- Other
Nutrition Services
What providers and personnel can deliver nutrition services?
Nutrition services may be led by different providers and personnel. They may have a variety of roles, including:
- Registered Nutritionists and Dieticians.
- Care Coordinators.
- Health Educators.
- Community Health Workers.
(Added: 4/29/2026)
How must nutrition services be provided?
For ENS funding, you must start or expand nutrition services, either directly or by contract. You must document this on Form 5A, columns I or II.
(Added: 4/29/2026)
Who can benefit from nutrition services?
Many patients can benefit from nutrition services. Examples include those who are:
- Diagnosed with diet-related chronic conditions, such as diabetes, hypertension, or obesity.
- Pregnant.
- Improving their family’s food literacy.
- Malnourished.
- Under or overweight.
- Working toward a healthier lifestyle.
(Added: 4/29/2026)
How will I report an increase in the number of nutrition services patients and/or visits?
We will add new nutrition services measures to the Uniform Data System (UDS) in 2027. You will use the new measures in both Table 5: Staffing and Utilization and Table 6A: Selected Diagnoses and Services Rendered to report nutrition services patients and nutrition services visits. We will use the differences between your 2027 and 2028 data to decide if you meet the ENS objective.
(Added: 4/29/2026)
What other data can we use to track our performance?
There are measures related to nutrition in the 2025 UDS Manual (PDF - 4 MB): Tables 6A, 6B, and Appendix E. Examples include:
- Number of patients with lack of expected normal physiological development; nutritional deficiencies in children (Table 6A).
- Use of telemedicine for nutrition and dietary counseling (Appendix E).
You can also use the measures established by your health center that are not in UDS. These measures should clearly show how your activities will prevent and manage chronic conditions by the end of the two-year period of performance.
(Added: 4/29/2026)
Allowable uses of funds
What are some allowable uses of ENS funds?
You may use ENS funds to support a variety of costs. Examples include:
- Hiring nutritionists, dietitians, health educators, community health workers, care coordinators, or other providers.
- Contracting with a specialist to train your staff in medical nutrition therapy or nutrition instruction.
- Providing cooking demonstrations and meal planning education for patients.
- Developing a nutrition patient education class for patients with diabetes.
- Using apps or text messaging campaigns to deliver nutrition interventions.
- Purchasing supplies to support a teaching kitchen.
- Purchasing supplies to start a food garden.
(Added: 4/29/2026)
Can I use ENS funds to pay for limited food-related costs?
Yes. Nutrition services may include hands-on approaches to teach patients the skills and knowledge needed to change their food behaviors. This may include demonstrating how to grow, select, and prepare fresh produce and other healthy ingredients. Food purchased with ENS funds must be specific to patient prevention and treatment plans. If your proposed activities require the use of food, clearly document the necessity in your Project Narrative: Response section.
For additional examples, see Appendix B: Example Allowable Food Costs in the FY26 ENS NOFO.
(Added: 4/29/2026)
What food safety requirements must I follow when distributing food?
You must maintain operations in compliance with all Health Center Program requirements. You must also follow other applicable federal, state, and local laws, regulations, and policies. These include distinct statutory, regulatory, accreditation, licensing, and policy requirements for food safety and handling. Consult your legal counsel for assistance.
(Added: 4/29/2026)
Can I use ENS funds to pay for health information technology (health IT)?
Yes, if it will support new or expanded nutrition services. Examples include:
- Digital tools to improve patient engagement, such as mobile health apps, remote patient monitoring, and technology-supported health education.
- Data analytic tools, including AI, to identify patients who may benefit from early intervention and track completion of nutrition referrals.
- Electronic health record (EHR) upgrades, such as triggered alerts to prompt providers to offer nutrition counseling or referrals for patients.
(Added: 4/29/2026)
Can I use ENS funds to deliver nutrition services through telehealth?
Yes. Telehealth can support the provision of nutrition services by reducing barriers to engaging in care. For example, many patients prefer to participate in cooking classes from their own homes. See the HHS Telehealth Guide for resources on using telehealth for nutrition care and services.
(Added: 4/29/2026)
Can I use ENS funding for recruitment incentives to secure qualified personnel for this project?
Yes. You may include recruitment incentives in a salary package that you support with ENS funding. You should cover these costs through your indirect cost rate. If you do not have an indirect cost rate agreement, you may charge recruitment incentives as direct costs.
(Added: 4/29/2026)
Budget requirements
How much funding can I request on the SF-424A?
You can request up to $350,000 in ENS funding for years 1 and 2.
In Sections A, B, and C of your SF-424A, record information for year 1 (up to $350,000).
In Section E, record information for year 2 (up to $350,000).
(Added: 4/29/2026)
How do I fill out the different sections of the SF-424A?
- Section A: Request year 1 federal funding (up to $350,000) in the Federal column under New or Revised Budget. We will award funding based on your current H80 award proportions. Enter any other support for ENS in the Non-Federal column.
- Section B: Break out year 1 federal (up to $350,000) and non-federal funding by object class category. Enter any minor A/R costs on the construction line and any equipment costs on the equipment line. You may use up to $150,000 of the $350,000 for these costs.
- Section C: Break out year 1 non-federal funding by source.
- Section D: Leave blank.
- Section E: Request year 2 federal funding (up to $350,000) in the “first” future year column. Leave other columns blank.
- Section F: Enter the type of indirect rate that will be in effect during the period of performance.
Do not duplicate federal or non-federal resources included on your H80 award or any other Health Center Program award.
(Added: 4/29/2026)
Minor alteration and renovation (A/R) and equipment
Can I use ENS funds to create a space to distribute food?
Yes. Examples include:
- Converting a space to distribute food from a contracted farm or grocer.
- Creating a food pantry where patients can get healthy food samples to fill components of food prescriptions and obtain samples of food recommended during counseling and education activities.
(Added: 4/29/2026)
May I use ENS funds to create a food garden?
Yes. The food garden must be created on the health center’s existing property. You can use ENS funds to create a rooftop food garden or to install food garden beds (raised or not raised).
(Added: 4/29/2026)
Can I use ENS funds to create a teaching kitchen?
Yes. You may use ENS funds to convert an existing health center space to a teaching kitchen for cooking demonstrations.
(Added: 4/29/2026)
What equipment may I purchase with ENS funding?
Examples include:
- Telemedicine carts to support delivering nutrition consultations during food pantry pick up at remote locations.
- EHR upgrades to add a clinical decision support system for patient referrals to nutrition services.
- Kitchen equipment to support instructional cooking programs, such as refrigerators, sinks, and ranges.
- Portable greenhouses to place in existing landscaped areas around your health center to extend the growing season of plants and produce.
(Added: 4/29/2026)
If I use ENS funds to purchase a mobile unit, can I also use the mobile unit for other purposes?
Yes. But the primary purpose of the mobile unit must be to provide nutrition services.
(Added: 4/29/2026)
Scope of project
How do I know if my ENS project will require a change in scope?
You must start or expand nutrition services with ENS funding. This means you must add Nutrition to your scope of project (Form 5A, columns I or II, under Additional Services) within 120 days of award if you do not already have it in scope.
Use the materials on the Scope of Project webpage to assess your scope of project. Contact your H80 Project Officer for additional guidance.
(Added: 4/29/2026)
Can I make changes to my scope of project through the ENS application?
No. But you may submit a change in scope (CIS) or scope adjustment request through the Electronic Handbooks (EHBs) at any time. Submit requests 60 days before you want to make the change.
(Added: 4/29/2026)
Other
How do I complete the Application for Federal Assistance (SF-424)?
Follow the instructions in Section 3.1.1 of the Application Guide (PDF - 755 KB) and the form instructions in Grants.gov Forms. This table includes information on how to respond to specific sections.
| Box Number | Field | Response |
|---|---|---|
| 1 | Type of Submission | Application |
| 2 | Type of Application |
Revision, Option E: Other Write in “Competing Supplement” |
| 3 | Date Received | Leave blank (completed automatically in Grants.gov) |
| 4 | Applicant Identifier | Enter your H80 number |
| 5a, 5b | Federal Entity Identifier, Federal Award Identifier | Leave blank |
| 12 | Funding Opportunity Number | HRSA-26-099 |
| 14 | Areas Affected by Project | List the main site for your project |
| 15 | Descriptive Title of Applicant’s Project |
Insert a short description of your project and how it will expand nutrition services. Limit the description to 1-3 sentences and base it on your Project Abstract Summary. Use this document (PDF - 50 KB) for example titles and more information |
| 16 | Congressional Districts | Include the congressional district for your main site (we do not require an attachment) |
| 17 | Proposed Project | September 1, 2026, to August 31, 2028 |
| 18 | Estimated Funding ($) | Up to $350,000 |
| 19 | Is Application Subject to Review Under Executive Order 12372 Process? | Select a. if your state is on the list of State Points of Contact (SPOC list (PDF - 94 KB)). If not, select b. Program is subject to E.O. 12372 but has not been selected by the State for review. |
(Added: 4/29/2026)
Are all the services and activities that I propose in my project covered by FTCA?
Not necessarily. Even if a service or activity is allowed in your scope of project, it may not be covered by FTCA. See the requirements in the FTCA Health Center Policy Manual (PDF - 406 KB), including section C. If you are proposing non-FTCA-covered services and activities, consider obtaining gap coverage or alternate medical malpractice coverage for those services and activities. See section H.3: Gap Coverage of the FTCA Health Center Policy Manual. Refer to the FTCA webpage for more information.
(Added: 4/29/2026)