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  5. FY 2023 COVID-19 Bridge Funding Post-Submission Guidance

FY 2023 COVID-19 Bridge Funding Post-Submission Guidance

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Purpose

In support of the HHS Bridge Access Program for COVID-19 Vaccines and Treatments, HRSA is making funding available to health centers to continue essential COVID-19-related services and mitigate adverse impacts of COVID-19 on underserved populations as COVID-19 vaccines and therapeutics move to the commercial market beginning in the fall of 2023. Approximately $81.1 million is available to health centers through Health Center Program COVID-19 Bridge Access Program funding (Bridge funding). 

Health centers will use these one-time funds to support patients and residents of their communities, including uninsured and underinsured individuals by:

  • Maintaining COVID-19 vaccination, testing, and therapeutics related services; and 
  • Providing enabling services (e.g., outreach, education, enrollment assistance, transportation, translation, care coordination) to support COVID-19 related needs.

Under the HHS Bridge Access Program, the Centers for Disease Control and Prevention (CDC) will purchase COVID-19 vaccines and distribute them through state and local health department (S/LHD) immunization programs. Health centers will need to enroll as 317 adult immunization1  providers with their S/LHD immunization program to request Bridge Access Program COVID-19 vaccines for uninsured and underinsured individuals. The ability to enroll with a S/LHD immunization program and receive vaccines through it depends on multiple factors, including state-level vaccine availability, number of counties in the state, and enrollment demand2 .  To address test-to-treatment needs, health centers may continue to order testing supplies and therapeutics through HRSA at no cost as long as they are available.

Authority

The authority for these awards is section 2401 of the American Rescue Plan Act of 2021 (PDF) (PDF - 652 KB), P.L. 117-2.

Eligibility

Eligible award recipients include (1) entities that currently receive Health Center Program (H80) grant funding and (2) federally qualified health centers as described in section 1861(aa)(4)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(4)(B)) that received American Rescue Plan Act (ARP) grant funding (L2C).

Period of performance

The period of performance is September 1, 2023 through December 31, 2024.  

Award information

HRSA determined each health center’s award amount using the following formula:

  • Base value of $10,029, plus
  • $11.53 per uninsured patient reported in the 2022 Uniform Data System (UDS).

Allowable activities

Funding may support COVID-19-related activities to ensure continued and equitable access to COVID-19 testing, vaccination, and treatment. This includes activities that support: 

  • 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

When planning your activities and Bridge funding costs, keep in mind that you must make every reasonable effort to get vaccines, therapeutics, and other COVID-19 supplies through the HHS programs that provide free COVID-19 supplies to health centers, as detailed below:

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, the purchase of vaccines, therapeutics, and testing supplies is an allowable use of these funds. If you use Bridge funding for such purposes, you must document both the unmet need among your population and the reasonable efforts made by your health center to secure COVID-19 supplies that are otherwise available through the HHS programs detailed above. You must maintain documentation of your reasonable efforts to obtain them for free and how the result of those efforts was insufficient to meet the needs of your community.

Your Bridge funding activities must align with your Health Center Program scope of project. You must follow all Health Center Program requirements, including those related to billing, collections, and sliding fee discounts. 

You must not charge any individual any out-of-pocket costs for vaccines that you receive through the CDC Bridge Access Program for uninsured and underinsured individuals. Review the Billing and Cost Sharing Overview for COVID-19 Vaccination, Testing, and Treatment resource for information about reimbursement and your sliding fee. 

Required post-award submission

As stated on your notice of award, you must complete and submit the following via the HRSA Electronic Handbooks (EHBs) within 30 days of the award release date. If you draw down Bridge funds before HRSA approves your post-award submission, you will incur costs at your own risk. 

1. SF-424A Form (PDF - 147 KB): In EHBs, complete the SF-424A budget form with only the awarded Bridge funding. 

  • In Section A – Budget Summary, under New or Revised Budget, enter your Bridge funding amount in the federal column. Do not include any amount under Estimated Unobligated Funds. 
  • In Section B – Budget Categories, enter an object class category (line item) budget from September 1, 2023 to December 31, 2024. 
  • In Section C – Non-Federal Resources, enter the amounts of other sources of funding that will support these activities, if any. Do not include any HRSA Health Center Program funding under activity codes such as H80, H8F, H8G, or L2C.

If you cannot use all or part of your Bridge funding in accordance with the terms on your award for the allowable activities noted above, you should relinquish all or part of the award back to HRSA. If you choose to relinquish all or part of your award, contact the grants management specialist noted on your notice of award to discuss the relinquishment process. 

As appropriate, and consistent with the purpose and allowable uses of the funds, you may adjust plans to use this funding to respond to evolving community, patient, and organizational needs to continue essential COVID-19-related services and mitigate adverse impacts of COVID-19 on underserved populations. The HRSA notice of award provides details about allowable rebudgeting.

The following are ineligible costs for purposes of these funds:

  • Costs not aligned with the Bridge funding purpose. 
  • Costs already paid for by any other federal awards, including H80, H8F, H8G and L2C funding from HRSA.
  • Costs that are reimbursed or compensated by federal or state programs.
  • Equipment purchases, including electronic health record (EHR) systems, vehicles, and mobile units.
  • Construction and alteration/renovation projects. 
  • Facility or land purchases.

2. Budget Narrative: Upload a budget narrative that clearly details costs by object class category from September 1, 2023 to December 31, 2024. Funding may support costs dating back to June 1, 2023, if aligned with the allowable activities above and necessary for efficient and timely performance of your Bridge funding activities. In your budget narrative, provide a detailed description of the pre-award costs, including the date incurred.

The sum of line-item costs for each category must align with those on the SF-424A, Section B. Include the calculations for how you derive each cost and a detailed list of personnel that Bridge funding will support. Award funds may not be used to pay the salary of an individual at a rate in excess of Executive Level II, which is currently $212,100. This amount reflects an individual’s base salary including overtime and bonus pay, but not including fringe benefits. Include a statement that no staff member will be budgeted at more than 1 FTE across all federal awards. 

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

Your budget may include indirect costs if your organization has an existing negotiated indirect cost rate agreement. Upload your indirect cost rate agreement, if applicable. If you do not have a negotiated indirect cost rate, you may elect to charge a de minimis rate of 10 percent of modified total direct costs. Costs must be consistently charged as either indirect or direct costs and may not be charged as both. 

Include the following chart in your budget narrative indicating the activities that Bridge funding will support. If you do not propose COVID-19 vaccination activities, explain how other resources will support COVID-19 vaccination for uninsured and underserved populations in your service area. See the sample budget narrative. 

Allowable Activities  Indicate “Yes” for the activities you will conduct with Bridge funding
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  

Monitoring and reporting

You must respond to the HRSA Health Center COVID-19 survey until HRSA ends the survey. As stated on your notice of award, you must submit periodic progress reports. HRSA will monitor implementation of Bridge funding in part by comparing your progress on activities with your budget narrative. In addition, you will submit a final report at the end of the period of performance. Reports will document completed activities and use of Bridge funding, and may request additional information such as issues or barriers you experienced. HRSA will post details to the Bridge technical assistance webpage when available.

All health centers will also continue to report COVID-19 testing and vaccination data through HRSA’s Uniform Data System.

Technical assistance

Submit your questions using the BPHC Contact Form (under Funding, select Supplemental Grant Award (e.g., COVID/ARP, PCHP, Capital), and select FY23 COVID-19 Bridge Funding).

COVID-19 frequently asked questions and resources are available at COVID-19 Information for Health Centers.

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