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  5. FY 2023 COVID-19 Bridge Funding Frequently Asked Questions

FY 2023 COVID-19 Bridge Funding Frequently Asked Questions

Get answers to questions about the fiscal year (FY) 2023 Health Center Program COVID-19 Bridge Access Program Funding awards. 

Submit other questions through the BPHC Contact Form. Under COVID-19, select COVID-19 Funding as the question type, then select Bridge Access Program. 

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How to get Bridge funding

Do health centers need to apply for Bridge funding?

No. You do not have to apply. If you received a Bridge award, you will provide information about your use of funds through a post-award submission. Your submission is due in the Electronic Handbooks (EHBs) by October 2, 2023. 

See the Bridge Funding Post-Award Submission Guidance for more information.

(Added: 9/8/2023) 

What is the PIN for Bridge funding in the Payment Management System (PMS)?

You will use the same PIN you use for your H80 or L2C grant funding through the PMS. 

If you have any issues, you can:

(Added: 9/8/2023) 

Post-award submission

How do I submit my Bridge funding post-award submission?

See the Bridge Funding Post-Award Submission Guidance for details.

Follow the instructions to add your H8L grant folder to your EHBs portfolio. 

Complete the submission task in your H8L grant folder in EHBs: 

  • Complete the SF-424A Budget Information form.
  • Upload your budget narrative.

(Added: 9/8/2023) 

Can I draw down funds before my post-award submission is approved?

If you draw down funds before your Bridge funding post-award submission is approved, you incur costs at your own risk. 

(Added: 9/8/2023) 

Can I use my Bridge funding for activities outside of those listed in the guidance? 

No. Use Bridge funding only for the following COVID-19 related activities: 

  • COVID-19 testing. 
  • COVID-19 vaccination.
  • COVID-19 therapeutics. 
  • Enabling/patient support services (such as outreach, education, enrollment assistance, transportation, translation, and care coordination) to support COVID-19 related services.
  • Community COVID-19 vaccination events.
  • Personnel who support COVID-19 related services and care delivery, including personnel costs necessary to develop, support, or expand collaborations, including collaborations with state/jurisdiction immunization programs
  • Supplies that support COVID-19 related services and care delivery.

Submit a question using the BPHC Contact Form if you are unsure about an activity.

(Added: 9/8/2023) 

How should I present my Bridge funding request on the SF-424A and budget narrative?

Complete the SF-424A Budget Information Form in EHBs:

  • Section A – Budget Summary: Under New or Revised Budget, enter the Bridge funding amount from your notice of award in the federal column. Do not include any amount under the Estimated Unobligated Funds category.
  • Section B – Budget Categories: Enter an object class category (line item) budget from September 1, 2023, to December 31, 2024.
  • Section C – Non-Federal Resources: Enter the amount of other sources of funding that will support these activities, if any. 
  • Section D – Forecasted Cash Needs: Optional.
  • Section E – Budget Estimates of Federal Funds Needed for Balance of the Project: Leave blank.
  • Section F – Other Budget Information (if applicable): Explain any direct charges that may appear to be out of the ordinary. If you include indirect costs in your budget, enter the type of indirect rate (e.g., final, provisional, de minimis). Upload your indirect cost rate agreement, if applicable. If you have never received an indirect cost rate agreement, you may use a de minimis rate up to 10% of modified total direct costs.

In your budget narrative, break out federal and non-federal funding by object class category for the 16-month period of performance. Make sure the personnel justification table includes salary for 16 months. The sum of the line-item costs for each category must match the SF-424A, Section B. 

Clearly state that no staff member will be budgeted at more than 1 FTE across all federal awards.

(Added: 9/8/2023) 

Does the federal executive salary limitation apply to Bridge funding?

Yes. You may not use Bridge funding to pay a person more than $212,100 (Federal Executive Level II, effective January 1, 2023). This is a person’s annual base salary, including bonuses and overtime. It does not include fringe or any income they earn outside your organization. See the sample budget for more information.

(Added: 9/8/2023) 

How will I know my post-award submission has been approved?

You will receive an email in EHBs when we accept your proposed scope of activities. You will not receive another notice of award.

(Added: 9/8/2023) 

Allowable activities and costs

Can I use Bridge funding to do more of an activity that was part of a previous federal award (H8C, H8D, H8E, H8F, H8G, L2C)?

Yes. But you may not use Bridge funding for the same costs already paid for by any other federal award. 

(Added: 9/8/2023) 

Can I combine Bridge funding with other federal funding (H80, H8F, H8G, L2C) to do a COVID-19-related activity?

Yes. You must:

  • Monitor expenses from all sources to ensure compliance with all funding requirements. 
  • Follow the Uniform Administrative Requirements, federal cost principles, and audit requirements for HHS awards (45 CFR Part 75), and your organization’s policies. 
  • Meet program requirements and correctly assign costs to specific programs. 
  • Maintain appropriate records and cost documentation as required by 45 CFR §75.302 – Financial Management and Standards for Financial Management Systems, and 45 CFR §75.361 – Retention Requirement for Records.

(Added: 9/8/2023) 

Can I use Bridge funding for costs incurred before September 1, 2023?

You can use Bridge funding for costs dating back to June 1, 2023. The pre-award costs must be for allowable activities that were necessary for your proposed Bridge activities, as required by 45 CFR§ 75.458 - Pre-award costs. 

Describe the pre-award costs in detail, including the date incurred, and explain how the costs were necessary for Bridge funding activities in your budget narrative. 

(Added: 9/8/2023) 

How can my health center get no-cost COVID-19 vaccines?

To get COVID-19 vaccines through the CDC Bridge Access Program, contact your jurisdiction’s immunization program. State and local health departments are expected to direct 25% of their Bridge Access Program COVID-19 vaccine allocation to health centers. See the CDC Bridge Access Program - Information for Health Centers.

(Updated: 11/14/2023) 

Can I use Health Center Program grant funds to cover the cost of administering COVID-19 vaccines?

You may use Health Center Program operational funding (H80) or Bridge or Expanding COVID-19 Vaccination (ECV) funding for allowable costs related to administration of COVID-19 vaccines. The following considerations apply:

  • If you use vaccine from the CDC Bridge Access Program for uninsured or underinsured individuals, you may not charge the patient. You may use our grant funds to cover the vaccine administration cost.
  • If you do not use vaccine from the CDC Bridge Access Program, you must make every reasonable effort to collect reimbursement. This includes billing Medicare, Medicaid, CHIP, and other public and private insurance or assistance programs.  If there are out of pocket costs to the patient, you would apply your sliding fee schedule based on income and family size. You should consider any cost sharing restrictions or prohibitions. If the reimbursement does not cover the full vaccine administration cost, you may use our grant funds to cover the difference. 

For more information review Billing and Cost Sharing for COVID-19 Vaccination, Testing, and Treatment.

(Added: 11/14/2023) 

 

Can I use Bridge funding to buy COVID-19 vaccines, therapeutics, and testing supplies?

You must make every reasonable effort to get vaccines, therapeutics, and other COVID-19 supplies through the HHS programs that provide them free to health centers. 

If through reasonable efforts you are not able to meet the COVID-19-related needs of your patients and community at no cost and in a timely manner, then:

  • The cost of vaccines, therapeutics, and testing supplies is an allowable use of Bridge funding. 
  • You must document both the unmet need among your population and the reasonable efforts made by your health center to get COVID-19 supplies for free. 

You may use Bridge funding for pre-orders of the 2023-2024 COVID vaccine dating back to June 1, 2023.

(Added: 9/8/2023) 

How do I show unmet need and my reasonable efforts to get vaccines, therapeutics, or testing supplies for my patients and community?

You must be able to show you have made every reasonable effort to get vaccines, therapeutics, and other COVID-19 testing supplies through the following HHS programs:

If you applied and were denied participation in these programs, or if they do not provide a sufficient or timely supply of vaccines, therapeutics, or testing supplies to meet the anticipated needs of your patient population, you must document this. Do not submit this documentation with your Bridge post-award submission. HRSA may request this documentation later.

(Added: 9/8/2023) 

Do I have to provide COVID-19 vaccines for free? 

You must not charge any out-of-pocket costs for vaccines that you receive through the CDC Bridge Access Program for uninsured or underinsured individuals. 

You must seek reimbursement for vaccines administered to people with insurance (e.g., Medicaid, Medicare, private insurance). Review Billing and Cost Sharing for COVID-19 Vaccination, Testing, and Treatment for information about reimbursement and when to apply your sliding fee discounts. 

(Added: 9/8/2023) 

Can I use Bridge funding for bonuses, overtime, or hazard pay? 

You can use Bridge funding for bonuses, overtime, or hazard pay only for personnel who are providing COVID-19 related activities. Personnel you pay with grant funding must receive salary and benefits consistent with your health center's policies and procedures. You must document that you are following your policies.

Note that bonuses, overtime, and hazard pay are included in the salary limitation of $212,100 that applies to this funding.

(Added: 9/8/2023) 

How should I use Bridge funding to meet the needs of my community?

Consider the needs of underserved people in your service area, including people experiencing homelessness, migrant and seasonal agricultural workers, and residents of public housing. 

For example, you can use Bridge funding to:

  • Expand access to COVID-19 vaccination in the community where people gather.
  • Have informal gatherings in multiple languages for health center staff to answer questions about COVID-19.
  • Work with community and faith groups to reach people they serve.
  • Address barriers to COVID-19 vaccination and treatment.
  • Provide transportation to COVID-19 vaccination locations from places where people work, worship, and live.

Contact our National Training and Technical Assistance Partners (NTTAP) for more information and resources for working with special populations.

(Added: 9/8/2023) 

Can I use Bridge funding to rent space for vaccination events?

Yes. You can use Bridge funding to rent space or temporary structures where COVID-19 related activities occur. Note that other activities and locations which do not meet the service site definition must be included on your Form 5C: Other Activities/Locations (PDF - 103 KB).

(Added: 9/8/2023) 

Can I use Bridge funding for a mobile van’s operating costs, like gas?

If you use the mobile van to carry out COVID-19-related activities, you can use Bridge funding for costs related to the mobile van, like gas. 

(Added: 9/8/2023) 

Can I use Bridge funding to buy equipment? 

No. You cannot use Bridge funding to buy equipment, including a mobile van or electronic health record system. This includes equipment with a useful life of more than one year that costs $5,000 or more per unit.

(Added: 9/8/2023) 

Can I use Bridge funding to rent or lease equipment such as health information technology (HIT) systems or mobile vans? 

If necessary for Bridge funding activities, the cost to rent or lease new equipment may be an allowable use of funds. Include these costs under “Other” in your budget. A new HIT system that is paid by a monthly or other periodic subscription fee with no upfront costs would be considered a lease. 

If you include leased equipment in your budget, provide the timeframe for the lease and how you will continue to pay for it after the Bridge grant ends. Contact your grants management specialist with any questions. 

(Added: 9/8/2023) 

Can I offer incentives to patients and staff for COVID-19 vaccination? Can I use Bridge funding to pay for the incentives?

You can use non-grant funds or leverage partnerships with or donations from other community organizations or businesses to offer small rewards as an incentive for receiving the COVID-19 vaccine. Examples include a nominal gift card to a local business or store, food, a meal, or a free admission voucher to a local event or attraction.

You can use Bridge funding for certain incentive items if the costs are allowable under grants regulations (45 CFR 75) and other federal regulations. You cannot use Bridge funds for cash gift cards, food, or other costs prohibited under 45 CFR 75 or other federal regulations. You must have written health center policies or procedures that cover using funds for incentive costs.

If you choose to include incentive costs in your budget, detail the types of incentives these costs will support and explain how such items will incentivize COVID-19 vaccination.

You must:

If you are considering providing incentives (using non-grant funds, in-kind contributions, or Bridge funds), note that most COVID-19 flexibilities ended on May 11, 2023. For more information, see this announcement. Contact the HHS Office of the Inspector General (OIG) at OIGComplianceSuggestions@oig.hhs.gov with questions about the potential impact of incentives and the federal anti-kickback statute.

(Added: 9/12/2023)

Can I use Bridge funding for COVID-19 vaccine events that also provide influenza vaccines?

Yes. You can use Bridge funding for planning and hosting events that offer COVID-19 as well as influenza or other vaccines. 

You may not use Bridge funding to buy influenza or other vaccines.

(Added: 9/8/2023) 

How do the allowable costs for Bridge funding compare to ECV and American Rescue Plan (ARP) awards?

ARP awards allowed a wider range of activities than we permit under the Bridge funding and ECV awards. Refer to the table for examples of select cost items.

Select Cost Items Allowable under ARP? Allowable under ECV? Allowable under Bridge?
COVID-19 vaccination Yes Yes Yes
COVID-19 testing Yes No Yes
COVID-19 treatment Yes No Yes
Health care services to maintain capacity  Yes No No
Enabling services Yes Only if supporting COVID-19 vaccination-related activities Only if supporting COVID-19 related activities
Outreach and education Yes Only if supporting COVID-19 vaccination-related activities Only if supporting COVID-19 related activities
Staff training Yes Only if supporting COVID-19 vaccination-related activities Only if supporting COVID-19 related activities
Minor alteration & renovation Yes No No
Equipment, including HIT systems and mobile units Yes No No
Telehealth supplies  Yes No Only if supporting COVID-19 related activities

(Added: 9/8/2023) 

Reporting requirements

Is the HRSA Health Center COVID-19 survey required?

Yes. You must respond to this survey until it ends. 

(Added: 9/8/2023) 

Will I submit progress reports for the Bridge funding?

Yes. You will submit periodic progress reports and a final report. We will post details about required reporting when available.

(Added: 9/8/2023) 

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