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FY 2021 American Rescue Plan Funding for State and Regional Primary Care Associations (U5F) Award Submission Requirement Guidance


The American Rescue Plan Act of 2021 (P.L. 117-2) provides one-time funding for awards under Section 330 of the Public Health Service Act (42 U.S.C. 254b). State and Regional Primary Care Associations (PCAs) will utilize American Rescue Plan Act of 2021 (ARP) funding to provide training and technical assistance (T/TA) to health centers in their state or region in one or more of the following areas:

  1. Plan, prepare for, promote, distribute, administer, and track COVID-19 vaccines, and carry out other vaccine-related activities;
  2. Detect, diagnose, trace, and monitor COVID-19 infections and related activities necessary to mitigate the spread of COVID-19, including activities related to, and equipment or supplies purchased for, testing, contact tracing, surveillance, mitigation, and treatment of COVID-19;
  3. Purchase equipment and supplies to conduct mobile testing or vaccinations for COVID-19, purchase and maintain mobile vehicles and equipment to conduct such testing or vaccinations, and hire and train laboratory personnel and other staff to conduct such mobile testing or vaccinations, particularly in medically underserved areas;
  4. Establish, expand, and sustain the health care workforce to prevent, prepare for, and respond to COVID-19, and to carry out other health workforce-related activities;
  5. Modify, enhance, and expand health care services and infrastructure; and
  6. Conduct community outreach and education activities related to COVID-19.

Funding Summary

The Health Resources and Services Administration (HRSA) is awarding approximately $16.3 million appropriated by ARP to active PCAs through U5F awards to provide T/TA to health centers to respond to and mitigate the spread of COVID-19 and enhance health care services and infrastructure as described in items (1) – (6) listed in the previous section.

Funding is being made available for a 2-year period of performance. This is one-time funding, with no expectation of continued funding beyond the 2-year period of performance. Your award amount is equivalent to 25 percent of your FY 2020 PCA cooperative agreement (U58) award.

You must use U5F funds for the purposes described in items (1) – (6) in the previous section and in alignment with the goals and funding requirements of your PCA cooperative agreement (U58). U5F funding may support a wide range of in-scope T/TA activities within the required purposes during the 2-year period of performance, as well as pre-award costs for those activities dating back to January 31, 2020. This U5F funding is in addition to the previous FY 2020 PCA COVID-19 supplemental funding.

HRSA’s Standard Terms will be applied to this program. Please see section 5.1 of HRSA’s SF-424 Two Tier Application Guide (PDF - 701 KB) for additional information.

Funding must be used for the purposes described in items (1) – (6), to support a wide range of in-scope training and technical assistance (T/TA) activities to support health centers in your state or region in the following categories:

  • COVID-19 Vaccination Capacity  Plan, prepare for, promote, distribute, administer, and track COVID-19 vaccines, and to carry out other vaccine-related activities, including outreach and education.
  • COVID-19 Response and Treatment Capacity – Detect, diagnose, trace, monitor, and treat COVID-19 infections and related activities necessary to mitigate the spread of COVID-19, including outreach and education.
  • Maintaining and Increasing Capacity – Establish, modify, enhance, expand, and sustain the accessibility and availability of comprehensive primary care services to meet the ongoing and evolving needs of the service area and vulnerable patient populations.
  • Recovery and Stabilization – Ongoing recovery and stabilization, including enhancing and expanding the health care workforce and services to meet pent up demand due to delays in patients seeking preventive and routine care; address the behavioral health, chronic conditions, and other needs of those who have been out of care; and support the well-being of personnel who have been on the front lines of the pandemic.
  • Infrastructure – Modify and improve physical infrastructure, including A/R and purchase of mobile units and vehicles, to enhance or expand access to comprehensive primary care services, including costs associated with facilitating access to mobile testing and vaccinations, as well as other primary care activities.

Within the required purposes described in items (1) – (6), you have flexibility in how to use the funding consistent with those purposes as health centers’ COVID-19, primary care, and infrastructure T/TA needs evolve over the 2-year period of performance. You are encouraged to help health centers address:

  • Equitable access to COVID-19 vaccination, testing, and treatment;
  • Other current and anticipated COVID-19 and primary health care needs in your state or region; and
  • Population and social determinants of health that may impact access to care, contribute to poor health outcomes, and exacerbate health disparities.

Required U5F Award Submission

As stated on your notice of award, you must complete and submit the following components via the HRSA Electronic Handbooks (EHBs). Your notice of award will generate a reporting requirement task in your U5F folder. You must respond to that reporting requirement with the following documents within 60 days of the award release date. Funding may be utilized between May 1, 2021 (the U5F award start date) and approval of your U5F award submission only to address immediate health center T/TA needs related to preparing for, promoting, distributing, administering, and tracking COVID-19 vaccines, and other activities necessary to mitigate the spread of COVID-19, as described on your notice of award.

  1. SF-424A Form: Upload the SF-424A Budget Information form (PDF - 131 KB) for the U5F 2-year period of performance.

    • In Section A – Budget Summary, under New or Revised Budget, enter the federal project funding for the entire 2-year period of performance. The federal funding amount cannot exceed the U5F award amount. In the SF-424A, do not include any amount under Estimated Unobligated Funds. If you are considering or plan to relinquish all or part of the funding, see the related term on your notice of award.
    • In Section B – Budget Categories, enter an object class category (line item) budget for the entire 2-year period of performance.
    • In Section C – Do not provide other sources of funding. Leave this section blank.

    The following are ineligible costs for the purposes of this funding:

    • Costs already paid for by other federal or state programs, your PCA cooperative agreement (U58), or prior COVID-19 supplemental funding.
    • Direct patient care.
    • Construction/renovation of facilities.
    • Reserve requirements for state insurance licensure.
    • Support of lobbying/advocacy efforts.
    • Conference sponsorship.
    • Equipment, supplies, or staffing for use at the health center level or any other individual health center operational costs.
    • Incentives (e.g., gift cards, food).
    • Facility or land purchases.
    • Vehicle or mobile van purchases.
  2. Budget Narrative: Upload a detailed budget narrative that clearly details federal costs by object class category for each year of the 2-year period of performance. The 2-year sum of line item costs for each category must align with those on the SF-424A, Section B. Include the calculations for how you derived each cost and a detailed list of personnel to be supported with U5F funding. 1

    Funding may support costs dating back to January 31, 2020, expended in alignment with the purpose of U5F funding (items (1) – (6)). In your budget narrative, provide a detailed description of the pre-award costs, including the date incurred, as well as the costs incurred between the award date and your submission date. See the U5F budget narrative template for how to document such costs.

    Your budget may include indirect costs if your organization has an existing negotiated indirect cost rate agreement. If you have never received 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 modified total direct costs, and may not be double charged or inconsistently charged as both. If the de minimis rate is chosen, this methodology must be used consistently for all your federal awards until such time as you choose to negotiate an indirect cost rate agreement. Upload your indirect cost rate agreement, if applicable.

  3. U5F Project Work Plan: Provide a detailed 2-year project work plan. HRSA anticipates that project work plans may average 10 pages, but may be fewer or more than 10 pages, as needed.

    Activities must be consistent with the purpose of U5F funding (items (1) – (6)), align with the terms of your U5F award, and be consistent with your PCA cooperative agreement award (U58) goals and funding requirements. 2

    Refer to the list of allowable uses of funding and example activities for health centers when developing your U5F project work plan.

    U5F Project Work Plan Elements

    Use the work plan template emailed to the individuals registered as project director, business official, and authorizing official in the U58 grant folder in EHBs to complete your work plan. In the template you should organize your activities and related elements consistent with the following outline.

Activity Category Identify the category under which you propose to conduct T/TA activities. Group activities by category. You will include a separate table in the work plan for each proposed category.

  • COVID Vaccination Capacity
  • COVID Response and Treatment Capacity
  • Maintaining or Increasing Capacity
  • Recovery and Stabilization
  • Infrastructure
Activity Name and Description Link to U58 Goals Person Responsible Timeframe
Name and describe each new proposed T/TA activity. Describe how each proposed T/TA activity aligns with one or more of your PCA cooperative agreement (U58) goals:

  • Increase access to comprehensive primary care
  • Accelerate value-based care delivery
  • Foster a workforce to address current and emerging needs
  • Enhance emergency preparedness and response
  • Advance health center clinical quality and performance
Identify the person(s)/position(s) that will be responsible for conducting each proposed T/TA activity. Provide a timeframe for each proposed T/TA activity. This could be general (e.g., Year 1, Year 2, ongoing) or specific start and end dates.


Clearly document if the proposed activity already occurred (back to January 31, 2020) or occurred between the time of award and submission.

  1. Equipment List (as applicable): If you propose to use U5F funds for equipment, complete and upload an Equipment List form (PDF - 89 KB) for year 1 and/or year 2 (consistent with section B of the SF-424A and your budget narrative). Include all moveable equipment that has a useful life of more than one year and a per-unit acquisition cost of at least $5,000, including information technology systems. Moveable equipment can be readily shifted from place to place without requiring a change in the utilities or structural characteristics of the space. Any equipment purchased with U5F funds must be procured, maintained, tracked, and disposed of in accordance with 45 CFR part 75.

    As provided for in OMB Memorandum M-21-20, you may request through an EHBs Prior Approval Request submission that HRSA waive the procurement requirements contained in 45 CFR § 75.328(a) (2 CFR § 200.319(b)) regarding geographical preferences and 45 CFR § 75.330 (2 CFR § 200.321) regarding contracting small and minority businesses, women's business enterprises, and labor surplus area firms.

    Complete the following fields for each item on the Equipment List form:

    • Type – Select clinical or non-clinical.
    • Item Description – Provide a description of each item.
    • Unit Price – Enter the price of each item.
    • Quantity – Enter of the number of each item to be purchased.
    • Total Price – Multiply the unit price by the quantity entered.

    The selection of equipment should be based on a preference for recycled content, non-hazardous substances, non-ozone depleting substances, energy and water efficiency, and consideration of final disposal (disposed in a manner that is safe, protective of the environment, and compliant with all applicable regulations), unless there are conflicting health, safety, and performance considerations. You are strongly encouraged to employ the standards established by either the Electronic Product Environmental Assessment Tool (EPEAT) or ENERGY STAR®, where practicable, in the procurement of equipment. Following these standards will mitigate the negative effects on human health and the environment. Additional information for these standards can be found at and

U5F Progress Reporting

As stated on your notice of award, you must submit the following U5F reports in EHBs.

  • Quarterly progress reports that will describe the status of your activities and use of U5F funds. Details will be posted to the U5F technical assistance webpage when available.
  • A final report is due within 90 days after the period of performance. The final report will collect your 2-year progress achieved and the impact of the overall project, among other information. Additional guidance for your final report will be provided prior to the end of the period of performance.  

U5F resources are one-time, the allowable uses of funds are expansive within the parameters noted, and there is flexibility to use funds to address immediate and evolving needs, as well as costs incurred back to January 31, 2020. Because resources are both one-time and flexible, HRSA will consider your performance as indicated through the reports noted previously to inform decisions regarding potential future no-cost extension requests.

Technical Assistance

See the U5F technical assistance webpage to access:

  • Information for technical assistance call(s) to support this submission.
  • Sample U5F project work plan.
  • Templates for the SF-424A form, Equipment List form, and budget narrative.

For award submission questions:

  • Navigate to the BPHC Contact Form
  • For the Question Type – select Health Center
  • For the BPHC Category on the next page – select Applications
  • For the BPHC Sub Category on the next page – select Primary Care Associations (PCA)

For EHBs questions:

  • Navigate to the BPHC Contact Form
  • For the Question Type – select EHBs
  • For the BPHC Category on the next page – select Applications-Systems Questions
  • For the BPHC Sub Category on the next page – select Primary Care Associations (PCA)

For budget questions, contact the Grants Management Specialist listed on your notice of award.


  • 1.As per HRSA Standard Terms, 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 $199,300. This amount reflects an individual’s base salary exclusive of fringe and any income that an individual may be permitted to earn outside of the duties to your organization.
  • 2.PCA goals are defined in HRSA-20-021 as: increase access to comprehensive primary care, accelerate value-based care delivery, foster a workforce to address current and emerging needs, enhance emergency preparedness and response, and advance health center clinical quality and performance.
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