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  5. FY 2023 ECV Frequently Asked Questions

FY 2023 ECV Frequently Asked Questions

These are common questions and corresponding answers for the fiscal year (FY) 2023 Expanding COVID-19 Vaccination (ECV) awards. Refer to the ECV Technical Assistance webpage for more information.

Please submit additional questions through the BPHC Contact Form. Under COVID-19, select COVID-19 Funding as the question type, and then select Expanding COVID-19 Vaccination (ECV). 

Access more COVID-19 Information for Health Centers and Partners. Access additional COVID-19 Frequently Asked Questions.

On this page:

Reporting requirements

How will I report my COVID-19 vaccination data?

Throughout the ECV period of performance, you must report your COVID-19 vaccination data through the Health Center COVID-19 survey, which will track COVID-19 vaccinations, vaccination events, and community collaboration. Failure to respond regularly to the Health Center COVID-19 survey may result in HRSA placing additional terms, conditions, and/or reporting requirements on your award. 

(Added: 12/14/2022) 

What is the Status Update Report?

The Status Update Report is a new reporting requirement that must be submitted by all active ECV awardees to document ECV progress during the initial 6-month period of performance. Awardees must provide a detailed narrative update, including successes and lessons learned, for activities identified in their approved ECV Activity List and budget. The Status Update Report will be available in the Electronic Handbooks (EHBs) on July 1, 2023 and must be submitted in the EHBs by July 24, 2023.

(Added: 05/25/2023)

What am I required to include in my final report? 

You must submit a final report within 90 days of the period of performance ending. Reports will document the completed activities and use of ECV funds and may request additional information such as issues and barriers experienced while implementing projects. Details will be posted on the ECV technical assistance webpage.

(Added: 12/14/2022) 

Can I submit the final report early?

Yes, HRSA highly encourages ECV awardees who have completed all approved ECV activities to complete and submit their final report in the EHBs. The final report will open in the EHBs July 1, 2023 and the final deadline to submit is March 30, 2024.

(Added: 05/25/2023)

Accessing ECV funding

Do health centers need to apply for ECV funding?

To expedite distribution of this critical funding, HRSA has made funds immediately available and will collect post-award application submissions within 30 days of award through the ECV Post-Award Application Submission requirement in EHBs. Post-award applications include budget information and activities/purchases to be supported by the funding.

(Added: 12/14/2022) 

What is the PIN to access ECV funding in the Payment Management System?

Health centers will use the same PIN they use to access their H80 or L2C grant funding through the Payment Management System (PMS). If you experience any issues accessing your ECV grant funding, please contact your PMS accountant, whom you can identify through Find Your PMS Liaison Accountant, and/or contact the Grants Management Specialist identified in your ECV notice of award.

(Added: 12/14/2022) 

Funding purpose and methodology

What is the purpose and what are the allowed uses of Expanding COVID-19 Vaccination (ECV) funding for health centers?

On Friday, December 9, 2022, HRSA awarded $350 million in funding provided by the Paycheck Protection Program and Health Care Enhancement Act (PDF) to approximately 1,470 HRSA-supported health centers (activity code H8G). The purpose of the ECV funding is to support health centers to increase access to, confidence in, and demand for updated COVID-19 vaccines within their service areas. Health centers will use these one-time funds, with an emphasis on activities within 3 months of award, on outreach and education, community engagement, and coordinated partner events, including those with local faith- and community-based organizations, to increase updated COVID-19 vaccinations among underserved populations. More information regarding the allowable uses of ECV funds is available on the  ECV funds is available on the ECV Post-Award Application Submission Guidance webpage.  

(Updated: 12/27/2022) 

How did HRSA determine the amount of ECV funding for each award recipient?

HRSA used the following distribution formula:

  • Base value of $47,650, plus
  • $9 per patient reported in the 2021 UDS.

(Added: 12/14/2022) 

What is the authority for ECV funding?

ECV funding is authorized through the Paycheck Protection Program and Health Care Enhancement Act, Provider Relief Fund (PDF). Therefore, HRSA issued these awards with the activity code H8G separately from other grant awards. You must separately track and account for ECV activities supported through this funding. To correctly attribute costs to separate grants, you must 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, to substantiate the charging of any salaries and other project activities costs. 

(Added: 12/14/2022) 

What is the period of performance for the use of the ECV funding?

ECV awards have a 6-month period of performance (December 1, 2022 – May 31, 2023). HRSA’s expectation is that these funds will be prioritized for use in the first 3 months to mitigate adverse impacts of an anticipated increase in COVID-19 transmission this winter. 

(Added: 12/14/2022) 

Which health centers are eligible to receive ECV funding?

Health centers that receive Health Center Program (H80) funding and look-alikes that received American Rescue Plan (L2C) awards are eligible for ECV funding.  

(Added: 12/14/2022) 

Can I request a project period extension for the ECV award if I need more time is needed to complete approved activities?

ECV funding is intended to mitigate adverse impacts of an anticipated increase in COVID-19 transmission this winter and activities should be prioritized to occur as soon as possible. However, if you need additional time beyond the 6-month period of performance to complete your approved activities, you must submit an Extension Without Funds (no cost extension) prior approval request. Extension requests must be made through HRSA's Electronic Handbooks (EHBs) no sooner than 2 months prior to the ECV period of performance end date. You may not use this one-time extension to expend unused funds for any other purpose or activity beyond the allowable activities listed on your notice of award. All extension requests are subject to HRSA approval. Contact your Grants Management Specialist with questions. 

(Added: 12/14/2022) 

What should I do if I do not think I can use the ECV funds?

If you cannot use all or part the funding in accordance with the terms of the award for the allowable uses of funds, you must 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 listed on your notice of award as soon as possible to discuss the process to relinquish your award.  

(Added: 12/14/2022) 

What tools are available to help increase COVID-19 vaccine confidence and uptake?

See CDC’s Vaccinate with Confidence webpage, the HHS COVID-19 Public Education Campaign, and HRSA's COVID-19 Resources for Community-Based Outreach. See the Technical Assistance (TA) section of the ECV TA webpage for additional resources information about COVID-19 vaccination and working with community partners to increase COVID-19 vaccine confidence and uptake.

(Added: 01/12/2023)

Post-award application submission

How do I submit my ECV Post-Award Application Submission?

Health centers must submit ECV project information through a submission task in the H8G grant folder in EHBs. See the instructions to add your H8G grant folder to your EHBs portfolio. In EHBs, you will complete the SF-424A Budget Information form and attach a budget narrative and activities list. See the ECV Post-Award Application Submission Guidance for details.

(Added: 12/14/2022) 

Does my health center Board of Directors have to approve the ECV Post-Award Application Submission prior to submission?

Yes. Your governing board must approve all applications related to your Health Center Program project, including the ECV Post-Award Application Submission.

(Added: 12/14/2022) 

Can I draw down funds before my Post-Award Application Submission is approved?

Yes. You may draw down funds prior to the approval of your ECV Post-Award Application Submission to meet immediate cash needs to increase access to, confidence in, and demand for updated COVID-19 vaccines. If you draw down funds before your ECV Post-Award Application Submission is approved, your budget must include costs that were drawn down from December 1 until submission of the budget to HRSA. Approval is not guaranteed, and you incur costs prior to the approval of your Post-Award Application Submission at your own risk. If you draw down funds and incur costs, and your ECV Post-Award Application Submission is not approved, BPHC staff will work with you to revise your submission. 

(Added: 12/14/2022) 

Can I use my ECV funding for activities outside of those listed in the guidance? Can I write-in activities?

No. ECV funds are specifically to be used for COVID-19 vaccination-related activities outlined in the ECV Post-Award Application Submission Guidance and Activity List (PDF - 178 KB). Complete and upload the ECV Activity List template indicating the activities you will conduct to support updated COVID-19 vaccination. You may not write-in self-defined activities. If you are unsure if an activity fits within the allowable activities, contact the ECV technical assistance team by using the BPHC Contact Form.

(Added: 12/14/2022) 

How should I present my ECV budget 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 federal and non-federal project funding for the 6-month period of performance. Note: The federal funding amount cannot exceed the total ECV award amount.
  • Section B- Budget Categories: Enter an object class category (line item) budget for the 6-month period of performance. 
  • Section C- Non-Federal Resources: Enter the amount of other sources of funding that will support ECV activities, if any. Do not include any other Health Center Program funding (e.g., H80, H8F, L2C).
  • 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 costs that may appear to be out of the ordinary. Enter the type of indirect rate (provisional, predetermined, final, fixed, or de minimis) that will be in effect during the period of performance. If you include indirect costs in your budget, upload a copy of your current indirect cost rate agreement with your Post-Award Application Submission. If you do not have a current indirect cost rate agreement and wish to claim indirect costs, you may use a de minimus rate up to 10 percent of modified total direct costs.

In your Budget Narrative, break out federal and non-federal funding by object class category (with detail and personnel justification table) for the 6-month period of performance. Your budget narrative must align with the SF-424A and Activities List.

(Added: 12/14/2022) 

Does the federal executive salary limitation apply to ECV funding?

Yes. ECV funding may not be used to pay the salary of an individual at a rate in excess of Federal Executive Level II, which is $212,100 effective January 1, 2023. This amount reflects an individual’s annualized base salary including bonuses and overtime, but not including fringe and any income that an individual may be permitted to earn outside of the duties to your organization.

(Added: 01/12/2023)

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

You will receive an email in EHBs when your proposed scope of activities has been accepted, but you will not receive another Notice of Award.

(Added: 01/12/2023)

Allowable activities and costs

How can I use ECV funds to buy COVID-19 vaccines given the following ECV terms?
  • ECV funds may not be used to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. 
  • You may not use this funding for costs that are reimbursed or compensated by other federal or state programs.

To make sure you have enough of the newest vaccine in fall 2023, you can use ECV funds to pre-order planned but not yet available COVID-19 vaccines. This includes past costs for pre-orders that other sources have not and will not reimburse. 

Consult your grants management specialist if this changes your current approved budget by more than 25%.

You must seek reimbursement for ECV-purchased vaccines given to people with payer sources (e.g., Medicaid, Medicare, private insurance) and adjust your financial records accordingly. We view reimbursed funds as program income that must be used in accordance with 45 CFR Part 75.307. 

(Added: 09/01/2023)

Can I use ECV funds to continue an activity that was paid for under previous federal awards (H80, H8C, H8D, H8E, H8F, L2C)?

As indicated in the ECV Post-Award Application Submission Guidance, you may not use ECV funds for costs already paid for by H80, H8C, H8D, H8E, H8F, or L2C funding. As stated on your notice of award, the ECV one-time funds should be used for activities that supplement and do not supplant planned activities that are using other funds to increase access to, confidence in, and demand for updated COVID-19 vaccines.

You must monitor expenditures from all sources to ensure compliance with all funding requirements, and continue to adhere to the Uniform Administrative Requirements, federal cost principles, and audit requirements for HHS awards (45 CFR Part 75), and your organization’s policies. To meet program requirements and correctly attribute costs to specific programs, you must 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: 12/14/2022) 

Can I use ECV funds for costs incurred before December 1, 2022?

No. You cannot use these funds for costs incurred before the period of performance start date of December 1, 2022. 

(Added: 12/14/2022) 

Can I reallocate salaries to ECV from another funding source, in order to support ECV activities?

Because ECV funds are for new and additional COVID-19 vaccination-related activities, you cannot use ECV funds to support COVID-19 vaccination-related activities that are already planned under another funding source. However, if personnel are not working on COVID-19 vaccination-related activities, you may reallocate those salaries to ECV instead of the original funding source (e.g., H8F, H80) to pay those individuals to engage in new or additional COVID-19 vaccination-related activities. Charges to federal awards for salaries and wages must be based on records that accurately reflect the work performed. The records must support the distribution of the employee’s salary or wages among specific activities or costs. Your system of internal controls should include processes to review after-the-fact interim charges made to a federal award based on budget estimates (45 CFR §75.430(i)(1)). Please contact your grants management specialist with specific questions related to reallocating salaries.

(Added: 12/27/2022)

Can I use ECV funds for bonuses or overtime pay?

ECV funds may be used for bonuses and overtime pay only for personnel who are providing COVID-19 vaccination-related activities. Personnel who will be paid with grant funding must receive salary and benefits consistent with your health center's policies and procedures. Note that ECV 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 bonuses and overtime, but not including fringe and any income that an individual may be permitted to earn outside of the duties to your organization.

(Updated: 01/12/2023)

Can I use ECV funds for enabling services to support COVID vaccination activities?

Yes. ECV funds may be used to for enabling services to increase access to, confidence in, and demand for updated COVID-19 vaccines within your service area. This includes support for outreach, patient education, translation, interpretation, and transportation that supports COVID-19 vaccination. Enabling services may be provided directly by health center staff or through formal contracts/agreements with community partners, in alignment with your Health Center Program scope of project.

(Updated: 12/27/2022) 

How should I use ECV funds to support the needs of special populations (i.e., homeless individuals, migrant and seasonal agricultural workers, and/or residents of public housing)?

HRSA encourages all health centers to consider how to leverage ECV funding to meet the needs of underserved individuals in their service areas, including the unique needs of homeless individuals, migrant and seasonal agricultural workers and their families, and residents of public housing. For example, consider ways to leverage ECV funding such as:

  • Expanded access to updated COVID-19 vaccination at multiple locations, including renting space or temporary structures where vaccination-related activities are taking place
  • Informal opportunities for health center providers and staff to share information and respond to questions about vaccines
  • Working with community partners, including faith communities, that serve similar populations
  • Targeted outreach and education in multiple languages about updated COVID-19 vaccines 
  • Addressing social and other barriers to COVID-19 vaccination access

You can also contact HRSA’s National Training and Technical Assistance Partners (NTTAP) for more information and resources for working with special populations.

(Updated: 12/27/2022) 

What types of organizations can health centers collaborate with to provide COVID-19 vaccinations, outreach, and education?

HRSA encourages you to work with community partners to support outreach and education and provide access to COVID-19 vaccination in ways that best meet community needs. Examples of community- and faith-based organizations include Women Infants and Children (WIC), Head Start, and other early childhood partners; organizations that serve older adults, people with disabilities, or other targeted sub-populations; groups that focus on housing, food security, employment, education, behavioral health services, or health-related social needs; and other organizations that bring people together, like places of worship and charities. 

As part of the American Rescue Plan, HRSA has awarded nearly $390 million to develop and support a community-based workforce to engage in locally tailored efforts to build vaccine confidence and bolster COVID-19 vaccinations in underserved communities. See the CBO webpage for the full list of 158 awarded organizations. These organizations and their local partners have community outreach workers engaging in community-based outreach to build COVID-19 vaccine confidence and connect families to vaccine providers. If you have questions about the CBO program, contact CBOVaccineOutreach@hrsa.gov. 

Stay tuned to the BPHC Primary Health Care Digest where HRSA will highlight additional technical assistance resources, including best practices for expanding the reach of and strategically targeting COVID-19 vaccination efforts in your community.

(Added: 12/14/2022) 

Can I use ECV funds to partner with faith-based organizations, including places of worship?

HRSA encourages health centers to work with faith-based organizations and places of worship to increase confidence in and access to COVID-19 vaccinations. Keep in mind that organizations that engage in explicitly religious activities (such as worship and religious instruction) must perform those activities outside of (separately from) activities supported with federal funding (including ECV awards or subawards). See the HHS Center for Faith-based and Neighborhood Partnerships for more information on federal regulations.

Examples of partnership activities could include:

  • Planning, promoting, and hosting COVID-19 vaccination events at places of worship
  • Joining religious leaders in street outreach about COVID-19 vaccination opportunities
  • Distributing COVID-19 vaccination information to faith-based congregations
  • Providing transportation from places of worship to COVID-19 vaccination locations

(Added: 01/12/2023)

Can I use ECV funds to rent space for vaccination events?

Yes. ECV funds may be used to support rent for space or temporary structures where vaccination-related activities are taking place. Note that activities must be aligned with your Health Center scope of project. Therefore, other activities and locations must be included on your Form 5C: Other Activities/Locations (PDF - 103 KB).

(Added: 12/14/2022) 

Can I use ECV funds for equipment, like a mobile van or health information technology systems?

No. ECV funds cannot be used to purchase equipment, including a mobile van and electronic health record (EHR) systems. Equipment means tangible personal property (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost of $5,000 or more. The cost to rent or lease new equipment may be an allowable use of funds. A new information technology system that is paid by a monthly or other periodic subscription fee with no upfront costs would be considered a lease.

As this is one-time funding for a 6-month period of performance, your budget narrative should provide justification for the cost of the lease, the timeframe and terms of the lease, and how you plan to continue to pay for it with other funding after the grant ends. Note that if you have ARP (H8F) funds remaining, your H8F grant can be used for equipment. Reach out to your grants management specialist with any questions. 

(Updated: 12/27/2022) 

Can I use ECV funds for a mobile van’s operating costs, like gas?

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

(Added: 12/14/2022)

Can I pool ECV funds for shared costs for health center activities?

Yes. To maximize cost effectiveness, multiple health centers may choose to pool ECV funds to support COVID-19 vaccination outreach and education, community engagement, and coordinated events to increase updated COVID-19 vaccinations among underserved populations. To do so, each participating health center must demonstrate that the shared activities are specific to their ECV project. 

Each health center must document that they are following their organizational financial policies and procedures, especially those regarding oversight of contractors and procurements, and be in compliance with the Procurement Standards in 45 CFR part 75, except those waived by OMB Memo 21-20 (PDF - 372 KB)  regarding geographical preferences and contracting small and minority businesses, women’s business enterprises, and labor surplus area firms. Health centers must also 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: 12/14/2022) 

Can I offer incentives to patients and staff for COVID-19 vaccination, and can I use ECV funds to pay for the incentives?

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

Health centers may also use ECV grant funds to offer certain incentive items, as long as the specific associated costs are allowable under grants regulations (45 CFR 75) and other federal regulations. If a health center chooses to use ECV grant funds to pay for incentives for COVID-19 vaccination, certain limitations apply. Specifically, ECV funds may not be used for cash gift cards, food, or other costs prohibited under 45 CFR 75 or other federal regulations. Use of funds for incentive costs must be supported by written health center policies or procedures. If you choose to include incentive costs in your ECV budget, provide details on the types of incentives these costs will support and a justification regarding how such items will incentivize vaccination.

As a reminder, when developing your ECV budget:

It is also recommended that any health center considering incentives for vaccination (using either non-grant funds, in-kind contributions, or ECV funds) also review related information from the HHS Office of the Inspector General (OIG) regarding the offer or provision of cash, cash-equivalent, or in-kind incentives or rewards to federal health care program beneficiaries who receive COVID-19 vaccinations during the public health emergency. This and other information regarding administrative enforcement authorities, including the federal anti-kickback statute, is available from the HHS OIG. For specific inquiries, please contact OIGComplianceSuggestions@oig.hhs.gov.

(Added: 12/14/2022) 

Can I use ECV funds to support COVID-19 vaccination events that also provide access to influenza vaccines?

You may use ECV funds to support planning for and hosting vaccination events that offer updated COVID-19 vaccines in addition to influenza or other vaccines, but you may not use ECV funds to purchase influenza or other routine vaccines.

(Added: 12/14/2022) 

Can I use ECV funds for hazard pay or a "pandemic premium"?

ECV funds may be used for hazard and premium pay for personnel who are providing COVID-19 vaccination-related activities if you have policies and procedures in place that cover this type of pay. Personnel who will be paid with grant funding must receive salary and benefits consistent with your health center's policies for paying salaries under unexpected or extraordinary circumstances from all funding sources, federal and non-federal. You must document that you are following your organizational policy for charging salaries during unexpected and extraordinary circumstances. Note that hazard pay is included in the salary limitation of $212,100 that applies to this funding.

(Updated: 01/12/2023) 

Can I use ECV funds to cover revenue lost as a result of the COVID-19 public health emergency?

No. You may not use ECV funds to replace lost revenue (e.g., reimbursement for dental or primary care visits from public and private health insurance sources). 

(Added: 12/14/2022) 

How do ECV allowable costs compare to American Rescue Plan (ARP) allowable costs?

ARP allowed a wider range of activities than is permissible under ECV, including enhancing and expanding health care services and infrastructure. See the table below for examples of select cost items.

Select Cost Items Allowable under ARP? Allowable under ECV?
COVID-19 vaccination Yes Yes
COVID-19 testing and contact tracing Yes No
COVID-19 treatment Yes No
Modify, enhance, and expand non-COVID-19 related health care services to maintain capacity to provide comprehensive health care such as dental, vision, and behavioral health services Yes No
Enabling services Yes Allowable only if supporting COVID-19 vaccination-related activities
Outreach and education Yes Allowable only if supporting COVID-19 vaccination-related activities
Staff training Yes Allowable only if supporting COVID-19 vaccination-related activities
Minor alteration & renovation Yes No
Equipment, including HIT systems and mobile units Yes No
Supplies to support provision of services via telehealth Yes No
Lost wages for personnel and contractors No No

(Added: 12/14/2022) 

Scope of Project

How do I determine if I need to submit a change in scope?

The technical assistance materials on the scope of project webpage and Considerations for Health Center Scope of Project and the COVID-19 Public Health Emergency can support you in assessing your scope of project (Form 5A: Services Provided, Form 5B: Service Sites, and Form 5C: Other Activities/Locations). Contact your H80/LAL program specialist for additional guidance. 

(Added: 12/14/2022) 

If I will be administering COVID-19 vaccinations at locations that are not included on my Form 5B: Service Sites, must I submit a change in scope request?

If you do not have ‘Immunizations’ listed as an activity on Form 5C: Other Activities/Locations (PDF - 103 KB), you must submit a brief Scope Adjustment request via EHBs to add this activity to your scope of project. When completing the Form 5C Scope Adjustment, select ‘Immunizations’ as the ‘Activity,’ under ‘Frequency’ state ‘as needed’; and under ‘Activity Location’ state ‘various locations within the community as appropriate to respond to vaccination needs’. Once approved by HRSA, this activity will be documented as in-scope on your Form 5C.

(Added: 12/14/2022) 

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