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Service Area Competition Frequently Asked Questions

These are common questions and answers for the fiscal year (FY) 2025 Service Area Competition (SAC) funding opportunity.

Refer to Apply for Service Area Competition (SAC) often for updates.

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Eligibility

Who is eligible to apply for SAC funding?

You may apply if you are a private, non-profit entity or a public agency in the United States or its territories. You may be a faith-based or community-based organization or a tribe or tribal organization. In addition, you must propose to provide continuity of care in an area announced on the FY 2025 SAC Service Area Announcement Table (SAAT).

See Section III: Eligibility Information of the Notice of Funding Opportunity (NOFO) for a detailed list of eligibility requirements.

(Updated: 5/23/2024)

If my city and state is not listed in the Service Area Announcement Table (SAAT), can I still apply for SAC funding?

If your city/state and ZIP codes are not listed in the SAAT, then your area is not currently announced under an open NOFO for FY25 SAC funding. If your area is not announced, check back frequently. The SAAT is updated throughout the year.

To be eligible for SAC funding, you must propose to serve an announced service area.

(Updated: 5/23/2024)

How do I determine my Service Area Competition ID number?

Each service area listed in the SAAT has a Service Area Competition ID (SAC ID) number. It appears in the righthand column of the table. This number is unique to each announcement and funding opportunity. It is not permanently associated with your grant or your service area.

You must include the SAC ID in the Project Abstract you submit in Grants.gov. You must also include it in your application’s Summary Page in the Electronic Handbooks (EHBs). We will use this number as the first step in verifying that you have applied for an announced service area.

(Added: 5/23/2024)

Can you explain the requirement that the ZIP code patient percentages should total at least 75% of the current patients served?

The SAAT lists all of the ZIP codes where the currently funded health center serves patients. The percentage for each ZIP code reflects the proportion of the health center’s patients who live in that ZIP code.

If you are a new or competing supplement applicant, you must propose to serve at least 75% of the current health center’s patients within the service area. To show this, you must propose to serve any combination of the current health center’s ZIP codes that total at least 75%. We will add up the percentages from the SAAT table that correspond to the ZIP codes you list on Form 5B: Service Sites to see if you have met this requirement.

(Added: 5/23/2024)

If all the ZIP code patient percentages for a service area in the SAAT do not total at least 75%, how can I meet the requirement?

Sometimes the patient percentages for all of the ZIP codes listed for a service area in the SAAT do not total 75%. If this is the case, you must enter all of the ZIP codes listed in the SAAT for the service area on Form 5B in the Service Area ZIP Codes field.

(Updated: 5/23/2024)

Can I apply to serve multiple service areas?

Yes, but you must submit a separate application for each service area. Each application should address the specific service area for which you are applying. Do not cross-reference application materials from one application to another. Each application should stand alone.

If you intend to apply for two or more service areas under a single opportunity number (e.g., HRSA-25-012), you must contact the SAC Response Team for guidance well in advance of the Grants.gov deadline. Call 301-594-4300 or use the BPHC Contact Form.

(Updated: 5/23/2024)

Can I request funding for a population (CHC, MHC, HCH, PHPC) not listed under the service area in the SAAT?

No. Your funding request should maintain the funding distribution as listed in the SAAT. You may not request funding for a population type that is not listed in the SAAT for the specific service area for which you are applying.

(Updated: 5/23/2024)

Can you explain the requirement that applicants for Health Care for the Homeless (HCH) and/or Public Housing Primary Care (PHPC) funding must use the funds to “supplement, and not supplant” expenditures for these populations?

If you are a new or competing supplement applicant for a service area that includes HCH and/or PHPC funding, you can’t use this funding to supplant other resources (federal, state, local, or private funds) for services that you already provide to these populations. You must attest on the Summary Page that you will use this funding to supplement, and not supplant, your expenditures and the value of in-kind contributions for delivering services to these populations.

If you are a competing continuation applicant, you are not required to complete the HCH/PHPC attestation on the Summary Page.

(Updated: 5/23/2024)

Service Area Announcement Table

How do I search for available service areas in the SAAT?

Use the drop-down lists in the SAAT to select any combination of period of performance end date, NOFO number, state, city, and/or ZIP code to create a customized list of available service areas. Only cities and states with service areas announced in an open NOFO will be available in the drop-down lists.

Use the ZIP code search by typing a five-digit ZIP code into the search field. All open service areas announced to date that contain the ZIP code will be included in the results.

(Updated: 5/23/2024)

How do I use the SAAT to find additional information about a service area?

Use the drop-down arrow in the SAAT to access more information about a service area. You will be able to see the NOFO number that the service area is announced under as well as the Grants.gov and EHBs deadlines. You will also find the funding distribution by population type as well as ZIP codes and ZIP code patient percentages for the service area.

In addition, you can find the Supplemental Funding table listing any supplemental awards that should be addressed in the RESPONSE section of your Project Narrative.

(Updated: 8/15/2024)

How does the Patient Origin Map align with the ZIP codes listed in the SAAT?

The Patient Origin Map displays:

  • ZIP Code Tabulation Areas (ZCTAs). These are generalized representations of the U.S. Postal Service’s ZIP codes created by the U.S. Census Bureau to define geographic areas. ZCTAs may contain several ZIP codes.
  • The percentage of current patients from each ZCTA.

For a list of ZIP codes and related ZCTAs, refer to the Zip Code to ZCTA Table. To ensure eligibility, new and competing supplement applicants must include a combination of SAAT Service Area ZIP Codes (not ZCTAs) where ZIP code patient percentages total at least 75 percent on Form 5B: Service Sites (include all SAAT Service Area Zip Codes for a proposed service area where the sum of all ZIP code patient percentages is less than 75 percent).

(Added: 7/31/2020)

What is the Health Center Program GeoCare Navigator and how do I use it to complete my SAC application?

The Health Center Program GeoCare Navigator is our new mapping tool used to create service area maps. (It replaced the UDS Mapper as of March 2024.)

Your SAC application must include an upload of the service area map for the proposed project that shows:

  • The proposed health center site(s) listed on Form 5B: Service Sites 
  • Proposed service area ZIP codes consistent with the ZIP codes you list on Form 5B 
  • Any medically underserved area (MUAs) and/or medically underserved populations (MUPs)
  • Health Center Program award recipients and look-alikes
  • Other health care providers serving the proposed ZIP codes

You may use multiple maps to display large service areas. For further guidance, see the HCP GeoCare Navigator User Guide (PDF - 3 MB) and Introductory Video.

(Updated 8/15/2024)

Funding priority

Are there opportunities to receive priority points outside of the review criteria?

Priority points are available for competing continuation applicants. We only grant points to applicants with no active conditions related to Health Center Program requirements at the time of application submission.

The criteria are:

  • Patient Trend (5 points): You will be granted a funding priority if you have a positive or neutral (does not exceed a 5 percent decrease) 3-year patient trend, as documented in UDS.
  • Patient-Centered Medical Home (PCMH) Recognition (5 points): You will be granted a funding priority if you have one or more sites with PCMH recognition at the time we review your application.

(Updated: 5/23/2024)

Budget

Should I apply for the funding amount in the SAAT even if our most current Notice of Award lists a different amount of funding?

Yes, your request for funding should not be more than the Total Funding amount listed in the SAAT for the service area for FY 2025.

Available funding for a service area can change slightly as FY 2024 funding actions are completed. Check the SAAT prior to submitting your application in EHBs to confirm the final FY 2025 funding amount.

(Updated: 5/23/2024)

How do you make funding reductions based on a reduced patient projection?

If your patient projection is less than 95 percent of the listed patient target, your funding will be reduced as shown in the NOFO’s Funding Reduction by Proposed Patients table. If you do not reduce your budget submission consistent with your patient projection, we will apply the reduction. You will then be required to submit a revised budget.

(Added: 5/23/2024)

What should I do if the budget figures change between the Grants.gov submission and the EHBs submission?

Only estimated budget information is required on the SF-424 in Grants.gov. We consider the budget information provided in EHBs on the SF-424A and Budget Narrative to be your official proposed budget. The amount of federal funding that you request on these documents must not exceed the Total Funding amount listed in the SAAT.

(Updated: 6/11/2021)

Can I request funding above the amount listed in the SAAT for my service area if the number of patients I serve has increased over the years?

No. Your funding request can’t exceed the current funding level listed in the SAAT. Additional funding is not awarded if you project more patients.

(Updated: 5/24/2022)

Forms

Do I need to provide patient and visit baseline data for population and service types on Form 1A: General Information Worksheet?

If you are a competing continuation applicant, your baseline data for populations and service types will pre-populate from available 2023 UDS data. You will not be able to enter data in the applicable fields.

If you are a new or competing supplement applicant, you must provide the number of current unduplicated patients and visits for each population type category and service type category to establish a baseline.

(Added: 5/23/2024)

What service types must I project patients for on Form 1A: General Information Worksheet?

You must propose to serve patients for each service type listed in the SAAT for the service area you are applying to serve. Refer to the Form 1A template (PDF - 245 KB) for instructions.

(Added: 5/24/2022)

What evidence of public or nonprofit status should I provide on Form 1C: Documents on File?

You should provide the date of last review or revision for the documentation that demonstrates that you are a public or nonprofit entity. See Chapter 1: Health Center Program Eligibility of the Health Center Program Compliance Manual for information about such documentation. If you are a new applicant, you must also submit this documentation in Attachment 11: Evidence of Nonprofit or Public Center Status.

(Updated: 5/24/2022)

How can I change SF-424 information submitted in Grants.gov?

The Basic Information completed in Grants.gov is imported into EHBs. You may edit this information if necessary, but you can’t edit the Estimated Funding section.

(Updated: 5/23/2024)

Should I include all contracted staff on Form 2: Staffing Profile?

Yes. Select the relevant boxes for contracted staff in the Contract/Agreement FTE column. The number of contracted staff is not shown on this form. Do not include contracted staff in the totals for Direct Hire FTEs.

(Updated: 6/11/2021)

How do I enter ZIP codes on Form 5B: Service Sites?

If you are a new or competing supplement applicant, you must enter ZIP codes in the Service Area Zip Codes field on Form 5B for service delivery sites and administrative/service delivery sites. You can enter up to five ZIP codes at a time. Once you select the Save Zip Codes button, the five ZIP codes will be saved to the page and you can add more. This process can be repeated as many times as necessary.

If you are a competing continuation applicant, we pre-populate and lock all data on Form 5B. However, per Chapter 3: Needs Assessment of the Health Center Program Compliance Manual, you must review your service area each year. You must compare the ZIP codes in your scope on Form 5B: Service Sites with patient origin data reported by ZIP code in UDS. You should request a scope adjustment, if necessary, to update your Form 5B service area ZIP codes, based on where patients live. (See Demonstrating Compliance in Chapter 3 of the Compliance Manual.) If your SAC application is already underway when your change in scope request is approved, you can update Form 5B: Service Sites by selecting the Refresh from Scope button on the application form.

(Updated: 5/23/2024)

Application submission

How do I submit my application?

The SAC funding opportunity requires a two-phase application process. For Phase 1, you must submit your application electronically through Grants.gov. We encourage you to register or update your registration for Grants.gov as soon as possible to maximize time for Phase 2. For Phase 2, you will submit supplemental information in EHBs.

If someone else is working on the application in EHBs, they must select the Submit to AO button. Then the AO must log in to EHBs and submit the application to us prior to the EHBs deadline.

(Added: 5/23/2024)

When can I begin the EHBs submission process?

You can begin Phase 2 in EHBs only after Phase 1 in Grants.gov has been successfully submitted. We will send an email confirmation with the application tracking number to the Authorized Organization Representative (AOR) registered in Grants.gov. The AOR can then complete the application in EHBs.

We encourage you to apply early in Grants.gov to maximize time to complete the EHBs phase of the process.

(Updated: 5/23/2024)

How will I be notified if my application was not successfully submitted?

Your AOR should check their email, including spam folders, for notifications and/or error messages from Grants.gov. Grants.gov will send a series of email messages to the Workspace owner and participants with the AOR role to notify you when the Grants.gov application has been validated or if there are errors. If there are errors, you must correct them and re-submit the application in Grants.gov before the deadline.

In EHBs, you must fix all validation errors before your Authorizing Official (AO) can submit the application to us. The status of the application in EHBs will appear as "Application Submitted to HRSA" once it has been successfully submitted.

(Updated: 5/23/2024)

How do I make changes to an application that was submitted in EHBs?

Your AO can reopen the application in EHBs before the EHBs deadline. For additional details and step-by-step instructions with screenshots, refer to the Reopen Submitted Applications Help webpage. The AO must resubmit the reopened application in EHBs by 5:00 p.m. ET on the EHBs due date for the application to be considered.

(Updated: 6/11/2021)

How can I check and/or change my health center’s AO in EHBs?

You can check and change the AO in EHBs using the process identified in the resource guide (PDF - 301 KB) on this topic.

(Updated: 4/27/2023)

How can I access a prior SAC application?

In your EHBs Grant Folder, there is a tab for “Last Awarded Application”. If you are an AO or Project Director (PD) for your grant, you can view the application by clicking on that tab. If you need to update your AO or PD, use the resource guide (PDF - 301 KB).

(Added: 8/15/2024)

Health Center Program requirements and compliance assessment

Where in my application do I demonstrate compliance with Health Center Program requirements?

For FY 2025, we moved elements of the Project Narrative related to compliance to Appendix A: Health Center Program Compliance. Upload a narrative as Attachment 13: Health Center Program Compliance as detailed in Appendix A.

(Added: 5/23/2024)

What happens if I am not compliant with all Health Center Program requirements at the time of application?

During application prefunding reviews and throughout the period of performance, you will be routinely assessed for program compliance. If you are found to be non-compliant, we may place a condition on your award. We will follow the Progressive Action policy and process outlined in Chapter 2: Health Center Program Oversight of the Health Center Program Compliance Manual.

If you are a competing continuation applicant and have any conditions related to Health Center Program requirements at the time SAC award decisions are made but you did NOT have consecutive one-year periods of performance in FY 2023 and FY 2024, you will receive a one-year period of performance. If you did have consecutive one-year periods of performance in those years, you will NOT receive an FY 2025 SAC award.

(Updated: 5/23/2024)

Does a tribal entity have to meet all Health Center Program requirements?

No, the Health Center Program governance requirements do not apply to Native American tribes or tribal groups under the Indian Self-Determination Act, or urban Indian organizations under the Indian Health Care Improvement Act (25 U.S.C. 1651).

(Updated: 6/11/2021)

Will I be able to address areas of non-compliance that are identified during the SAC application review before a final award decision is made?

If you are a competing continuation or competing supplement applicant 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.

This does not apply to new applicants that are only eligible to receive a one-year period of performance.

(Added: 5/23/2024)

How will you notify me if there are any compliance findings during the review of my SAC application?

The HRSA Reviewer will contact your AO through EHBs using a feature called “Correspondence Request.” The HRSA Reviewer will request additional information on any areas of non-compliance identified through the review. You can submit additional information that may correct these program compliance issues prior to award.

These requests will appear in your AO’s EHBs Pending Tasks list as “Urgent Application Correspondence” tasks. The AO will also be notified through an EHBs-generated email. As indicated in the Correspondence Request, you will have up to 14 calendar days to respond with additional information demonstrating compliance. There are no extensions or exceptions.

HRSA Reviewers will also contact your AO by phone when a Correspondence Request is sent. This is to ensure the AO has received the request and to answer any questions the AO may have.

Your AO 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: 5/23/2024)

Is there anything I can do to prepare for correspondence on compliance findings during the review of my SAC application?

Yes. To be prepared, ensure that contact information (email and phone number) in EHBs for the AO are up to date and accurate. The EHBs Correspondence Request will be sent by a HRSA Reviewer and will come from ‘HRSA GEMS’: oitgems@hrsa.gov. Your AO can add this email address to a “safe sender” or contacts list to avoid messages potentially going to their junk folder.

(Added: 4/27/2023)

If I have existing, unresolved progressive action conditions related to Health Center Program requirements, will this impact my SAC award?

Yes, current unresolved progressive action conditions may impact your health center’s period of performance length.

During application prefunding reviews and throughout the period of performance, you will be routinely assessed for program compliance. If you are found to be non-compliant, we may place a condition on the award. We will follow the Progressive Action policy and process outlined in Chapter 2: Health Center Program Oversight of the Health Center Program Compliance Manual.

Respond to and resolve outstanding conditions before you submit your SAC application. Contact a Program Specialist with questions about responding to conditions and refer to the progressive action condition language on the Notice of Award.

If you are a competing continuation applicant and have any conditions related to Health Center Program requirements at the time of the SAC award decision, you will qualify for a one-year period of performance. You will be awarded a one-year period of performance if you did NOT have consecutive one-year periods of performance in the two fiscal years prior.

(Added: 4/27/2023)

If I am awarded a one-year period of performance, am I required to submit a plan to come into compliance and respond to active progressive action conditions?

Yes. If awarded a one-year period of performance, you must respond to both a 120-day Compliance Achievement Plan condition and to any progressive action conditions on your Notice of Award.

For the 120-day Compliance Achievement Plan condition, you must provide us with a plan that:

  • Discusses your approach for achieving compliance with all areas of non-compliance that have been identified through progressive action conditions on the Notice of Award; and
  • Indicates that compliance will be demonstrated within the timeframes and deadlines specified by these progressive action conditions.

(Updated: 5/23/2024)

If I receive a one-year period of performance, will I have an operational site visit (OSV) during the one-year period?

Yes, we will schedule an OSV within two to four months of your period of performance start date. This OSV will let you address any non-compliance issues before our decision to award a new period of performance.

(Added: 4/27/2023)

If I had a one-year period of performance in the two years prior to the upcoming period of performance, am I at risk of not receiving a subsequent award?

You will not receive a SAC award if you had consecutive one-year periods of performance in the two prior fiscal years. This is consistent with Health Center Program statute and the Health Center Program Compliance Manual Chapter 2: Health Center Program Oversight process.

(Added: 5/23/2024)

If I am a first time SAC awardee, can I receive a three-year period of performance?

No. As stated in the SAC NOFO, we award new applicants a one-year period of performance.

(Added: 4/27/2023)

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 AO receives a Correspondence Request in EHBs, the HRSA Reviewer will also contact them by phone. The HRSA Reviewer will be able to answer questions related to the Correspondence Request at this time.

For additional questions about the application review process, you can use the BPHC Contact Form.

(Updated: 5/23/2024)

Additional information

How can I find a PDF version of a SAC Notice of Funding Opportunity (NOFO)?

On Apply for Service Area Competition (SAC), under "When to apply," you can find a table of SAC NOFO releases. When the NOFO is released, you can select the NOFO number to see the grant opportunity on the Grants.gov page.

In Grants.gov, select Package and select Preview in the Actions column. In the Opportunity Package Details view, select Download Instructions to access the PDF of the NOFO.

(Added: 5/23/2024)

Where can I find the supplemental funding list referenced in the RESPONSE section of the Project Narrative?

To see if your service area has been awarded any supplemental awards, use the drop-down arrow in the SAAT to view the Supplemental Funding table, which lists four supplemental awards (since FY 2020) and the year they were last awarded. If any supplements were awarded in the service area, you must describe how you will maintain access to those expanded services as detailed in the NOFO under the RESPONSE section of your Project Narrative.

For more information about each supplemental award, click on the links provided in the Tips drop-down in the SAAT.

(Added: 8/15/2024)

What if I am not eligible or am unable to apply for a SAC funding opportunity? Are there other HRSA funding opportunities that I could apply to?

If you are unable to provide continuity of care in a defined and announced service area, go to Find Grant Funding for additional information. Opportunities such as Health Center Program New Access Points (NAP) may be available for organizations proposing to provide services in a new area.

(Added: 5/23/2024)

If I receive a SAC award, do I automatically become a Federally Qualified Health Center (FQHC)?

Receiving a SAC award does not mean your health center automatically becomes an FQHC. The FQHC designation for Medicare/Medicaid is administered by the Centers for Medicare & Medicaid Services (CMS). Contact your State Medicaid office to determine the process and timeline to become eligible for payment as an FQHC under Medicaid. To enroll in Medicare, first obtain a National Provider Identifier (NPI). You may enroll in Medicare electronically via the Medicare Provider Enrollment, Chain, and Ownership System.

(Updated: 5/24/2022)

How do I receive Health Center Program updates?

The HRSA Primary Health Care Digest is a weekly email newsletter containing information about the Health Center Program, including all competitive funding opportunities. If you are interested in Health Center Program funding, we encourage you to subscribe several staff.

(Updated: 6/11/2021)

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