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FY 2023 ECV Post-Award Application Submission Guidance

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Purpose

Health centers are uniquely positioned to expand and accelerate updated COVID-19 vaccination activities to mitigate potential adverse impacts of an anticipated increase in COVID-19 transmission this winter. The fiscal year (FY) 2023 Expanding COVID-19 Vaccination (ECV) award is being made available immediately 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 three months of award, on outreach and education, community engagement, and coordinated partner events to increase updated COVID-19 vaccinations among underserved populations, including health center patients and other residents of their service areas. These 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.

Authority

The authority for these awards is the Paycheck Protection Program and Health Care Enhancement Act, (PDF) P.L. 116-139, Division B, Title I.

Eligibility

Funding under the Paycheck Protection Act is available for eligible health care entities. For purposes of ECV funding, eligibility is limited to (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 previously received American Rescue Plan Act (ARP) funding (L2C).

Period of Performance

The six-month period of performance for this award is December 1, 2022 to May 31, 2023. HRSA’s expectation is that these funds will be prioritized for use in the first three months.

Funding Summary

The Health Resources and Services Administration (HRSA) will award approximately $350 million in grants to health centers, as defined in Eligibility. This is one-time funding, with no expectation of continued funding beyond the six-month period of performance. HRSA determined each health center’s award amount for this funding using the following formula:

  • Base value of $47,650, plus
  • $9 per patient reported in the 2021 Uniform Data System (UDS).

ECV funding specifically targets the urgent need for additional activities to increase confidence in and uptake of updated COVID-19 vaccines among harder hit and higher risk populations, with an emphasis on outreach, communication, and education, and mobile, drive-up, walk-up, or community-based vaccination events – all with an end goal of increasing the number of Americans that receive the updated COVID-19 vaccine. Health centers will use these funds for Health Center Program in-scope activities aimed at increasing equitable availability and uptake of updated COVID-19 vaccines by addressing the unique access barriers experienced by the underserved populations they serve. These funds will also indirectly support efforts to increase flu and childhood vaccinations through co-occurring vaccinations. This ECV funding builds on COVID-19 investments previously provided by HRSA under the FY 2021 American Rescue Plan Act (ARP), P.L. 117-2, which supported critical and ongoing activities related to COVID-19 testing, vaccination, and therapeutics.

Allowable Activities

Funding may support the following vaccine-related activities:

  • Outreach and Education: Increase vaccine confidence and demand by performing vaccine-related outreach to promote health center and community-based vaccination efforts and locations for vaccination, and to provide COVID-19 vaccine education, including through distribution of in-person and online education materials and through formal and informal opportunities for health center providers and staff to share information and respond to questions about vaccines. HRSA encourages health centers to work with community- and faith-based organizations to help amplify and extend reach of these education and outreach efforts, including in multiple languages and through direct engagement with communities.
  • Working with Community Partners: Increase confidence in and access to COVID-19 vaccinations by working with established or new community partners (e.g., Women Infants and Children (WIC), Head Start, and other early childhood partners; community-based organizations that focus on, for example, older adults or other targeted sub-populations, housing, food security, employment, education, behavioral health services). HRSA encourages health centers to conduct vaccine confidence campaigns, planning for and hosting community vaccine clinics, which may be hosted by community partners or at partner sites, but where health centers provide vaccination-related services independently of those community partners. HRSA also encourages health centers to work with community- and faith-based organizations to host events and develop and deliver messaging tailored to community needs.
  • Vaccine Administration: Administer updated COVID-19 vaccinations at permanent and temporary health center service sites or other locations, including through mobile, drive-up, walk-up, or community-based vaccination events and routine patient appointments (e.g., well-child visits). Updated COVID-19 vaccine events may also be used to administer COVID-19 primary series and/or other (e.g., influenza) vaccines. All vaccine administration activities should be carried out in alignment with CDC, state/jurisdiction, and other public health guidance, as well as the requirements of the Health Center Program.
  • Enabling Services: Facilitate access to COVID-19 vaccination by expanding health center enabling services (e.g., transportation, translation, interpretation), including coordinating these services with community- and faith-based organizations.
  • Personnel: Hire and/or contract additional health center providers, clinical staff, and other personnel (e.g., community health workers, patient/community education specialists, others) as needed to support related activities, including COVID-19 vaccination, outreach and education, and coordination of messaging, events, and other activities with community- and faith-based organizations.
  • Hours and Availability: Extend health center operating hours, mobile and home services, street outreach, and off-site vaccination locations to expand opportunities for COVID-19 vaccination.
  • Training: Train health center workforce on patient-centered, culturally affirming strategies to increase COVID-19 vaccination, vaccine confidence, and address social and other barriers to COVID-19 vaccination access.
  • Supplies: Purchase COVID-19 vaccination supplies, materials, and signage to promote vaccination events and to support outreach efforts, tailored messaging, and other communications to increase vaccine confidence.

Required ECV Post-Award Application Submission

As stated on your notice of award, you must complete and submit the following post-award application documents via the HRSA Electronic Handbooks (EHBs) within 30 days of the award release date. You may draw down funds prior to the approval of your ECV Award Submission to meet immediate cash needs to increase access to, confidence in, and demand for updated COVID-19 vaccines. When you draw down award funding, you are accepting all terms conditions of the award, and all applicable statutes and regulations. Non-compliance with the Terms or Conditions is grounds for HRSA to take actions pursuant to 45 CFR § 75.371 – Remedies for non-compliance, which may include repayment of all or part of the award.

If you draw down funds before your ECV Award Submission is approved, your submitted budget must include costs that were drawn down from the period of performance start date until submission of the budget to HRSA. Approval is not guaranteed, and you incur costs prior to the approval of your submission at your own risk. 

If you cannot use all or part of your ECV funding in accordance with the terms on your award for the allowable activities noted, 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 as soon as possible after the award release date to discuss the process to relinquish your award. Health centers may change plans to use ECV funding to respond to evolving community, patient, and organizational needs, consistent with the purpose and allowable uses of the funds. The HRSA notice of award provides details about allowable rebudgeting. 

  1. SF-424A Form (PDF - 100 KB): Provide an SF-424A budget form that includes only the ECV funds awarded. 

    • In Section A – Budget Summary, under New or Revised Budget, enter the federal and non-federal project funding for the six-month period of performance. The federal funding amount cannot exceed the total ECV 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 six-month period of performance. 
    • In 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 funding).
      The following are ineligible costs for purposes of this funding opportunity:
    • Costs not aligned with the ECV purpose. 
    • Costs already paid for by any other federal awards, including H80, H8F, and L2C funding.
    • Costs that are reimbursed or compensated by other federal or state programs. 
    • Equipment purchases, including electronic health record (EHR) systems.
    • Construction and alteration/renovation projects. 
    • Facility or land purchases.
  2. Budget Narrative: Upload a detailed budget narrative that clearly details federal and non-federal costs by object class category for the six-month period of performance. 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 to be supported with ECV funding. 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 exclusive of fringe and any income that an individual may be permitted to earn outside of the duties to your organization. 

    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 ten 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 you negotiate an indirect cost rate agreement. Upload your indirect cost rate agreement, if applicable.

  3. ECV Activity List (PDF - 178 KB): Complete and upload the ECV Activity template indicating the activities you will conduct to support updated COVID-19 vaccination. 

ECV Reporting

You must respond to the HRSA Health Center COVID-19 survey, which tracks COVID-19 testing and vaccination data, and the impact of COVID-19 on operations, patients, and staff. The COVID-19 survey also supports the Health Center COVID-19 Dashboard that provides an overview of COVID-19 vaccinations, including the: 

  • Number of updated COVID-19 vaccinations, including by race and ethnicity
  • Number of COVID-19 primary immunization series completed, including by race and ethnicity
  • Number of COVID-19 vaccination events (e.g., mobile van, pop-up, school-based, and/or family vaccination clinics) 
    • Of these clinics, how many were hosted in collaboration with a community- or faith-based organization?

As stated on your notice of award, you must submit a final report at the end of the period of performance. 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. HRSA will post details to the ECV technical assistance webpage when available.

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

Technical Assistance

See the ECV technical assistance webpage or submit your question using the BPHC Contact Form. COVID-19 frequently asked questions and resources are available at COVID-19 Information for Health Centers.
 

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