Health Center Program Look-Alike (LAL) Initial Designation (ID) Application Instructions & Resources

Overview

Health Center Program look-alikes are health centers that, like Health Center Program award recipients, improve the health of the nation’s underserved communities and vulnerable populations by expanding access to comprehensive, culturally competent, quality primary health care services. While LALs do not receive Health Center Program funding, once designated, they become eligible to apply for several beneficial programs:

• Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) reimbursement through the Centers for Medicare and Medicaid Services (CMS)
• HRSA’s 340B Federal Drug Pricing Program
• National Health Service Corps

Health Center Program LALs ensure access to comprehensive primary health care services that are responsive to identified health care needs, provide services to all persons regardless of ability to pay, and meet all Health Center Program requirements.

Who Can Apply?

Organizations eligible to apply for LAL ID include public or nonprofit organizations that provide comprehensive primary care to underserved populations and operate in compliance with Health Center Program requirements. See the Eligibility section of the LAL ID application instructions for the full list of eligibility criteria. Applicants must demonstrate eligibility and compliance (based on the Health Center Program Compliance Manual) both in the LAL ID application and during an operational site visit.

How to Apply

Submit your ID application via the HRSA EHBs. Note that you must first register in the System for Award Management. Applications are accepted on a rolling basis. Once you begin your application in HRSA EHBs, you have 90 days to complete and submit your application.

Technical Assistance Resources

• Initial Designation Technical Assistance Webinar Slides (PDF - 937 KB): overview of the LAL ID application process
• Health Center Program Compliance Manual: guidance for ensuring compliance with Health Center Program requirements (required for LAL ID eligibility)
• Site Visit Protocol: tool for assessing compliance during the operational site visit
• Supplement for Virtual LAL ID Operational Site Visit (OSV): an overview of modifications taken to adapt the on-site LAL ID OSV processes to a virtual site visit format
• EHBs Look-Alike Initial Designation User Guide: HRSA EHBs application module instructions
• Unmet Need Score (UNS) Workbook (XLSX - 25 MB)
• UDS Mapper: Health Center Program mapping and data tool
• Health Center Program Strategic Partnerships (PCAs and NTTAPs): state and national technical assistance providers
• Medically Underserved Area/Population (MUA/MUP) Designations: geographic areas and populations with a lack of access to primary care services (required for LAL ID eligibility if requesting CHC designation)
• State Primary Care Offices (PCOs): support state-wide assessment and expansion of primary care (including applications to HRSA for MUA/MUP designations)

Sample Application Components

The following forms and templates are for planning purposes only. Applicants must upload attachments and enter information into EHBs according to the LAL ID instructions.

• Attachment 2: Instructions for Service Area Map and Table (PDF - 3 MB)
• Form 1A: General Information Worksheet (PDF - 132 KB)
• Form 1C: Documents On File (PDF - 192 KB)
• Form 2: Staffing Profile (PDF - 137 KB)
• Form 3: Income Analysis (PDF - 131 KB)
• Form 3A: Look-Alike Budget Information (PDF - 139 KB)
• Form 4: Community Characteristics (PDF - 122 KB)
• Form 5A: Services Provided (PDF - 113 KB)
• Form 5B: Service Sites (PDF - 119 KB)
• Form 5C: Other Activities/Locations (PDF - 112 KB)
• Form 6A: Current Board Member Characteristics (PDF - 114 KB)
• Form 6B: Request for Waiver of Board Member Requirement (PDF - 111 KB)
• Form 8: Health Center Agreements (PDF - 103 KB)
• Form 12: Organization Contacts (PDF - 94 KB)

Performance Measures

The following samples and templates are for planning purposes only. Applicants must enter information into EHBs.

• Performance Measure Crosswalk
• Performance Measure Fillable Form (PDF - 141 KB)
• Clinical Performance Measure Form Field Guide and Sample (PDF - 130 KB)

For more information on performance measures, see:

• Health Center Data for Uniform Data System (UDS) resources, including the most recent updates to the reporting system for Health Center Program performance measures and patient data
• 2020 UDS Manual (PDF - 1 MB) for definitions and UDS reporting details

Contact

Look-Alike Initial Designation Program Information

LAL ID Technical Assistance Web Form

• Complete the Contact Form, Contact Record, Organization, Contact Verification screens
• Select Applicant as Requestor Type
• Select “Health Center” on the Health Center or EHBs Question screen
• Select Look-Alike (LAL) and Look-Alike Initial Designation

Phone: 301-594-4300

HRSA EHBs Support

Health Center Program Support Web Form

• Complete the Contact Form, Contact Record, Organization, Contact Verification screens
• Select Applicant as Requestor Type
• Select “EHBs” on the Health Center or EHBs Question screen
• Select Look-Alike (LAL) - Systems Questions

Phone: 877-464-4772

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