Fiscal Year (FY) 2022 Look-Alike Renewal of Designation Instructions & Resources

Important Notice:

Due to the ongoing COVID-19 public health emergency, HRSA has extended designation periods by one year for LALs that had a 3-year designation period scheduled to end in FY 2022. Extension notices of LAL designation have been issued. These LALs, like all LALs whose designation period end date is not in FY 2022 (October 1, 2021 — September 30, 2022) should submit an FY 2022 AC.

Look-Alike RD Application Availability and Deadline Schedule

*EHBs access and deadline dates are auto-generated by EHBs. Please work within these dates and, if needed, request technical assistance prior to the deadline if the deadline falls on a weekend or holiday.

About the RD Application

The purpose of the RD is to ensure continued access to comprehensive, culturally competent, high-quality primary health care services for communities and populations currently served by LAL organizations. An RD application is a request for continued designation by an existing LAL.

How to Apply

Existing LALs will receive an email notification from the HRSA Electronic Handbooks (EHBs) when the RD application is available for input and submission. If you do not receive an email regarding access 180 calendar days prior to the end of your current LAL designation period, contact your HRSA project officer for assistance.

RD Submission Schedule

The EHBs system will send an e-mail notice to your organization’s contacts identified in the system 180 days prior to the end of the current designation period to inform them the application is accessible. You will have 90 calendar days to complete the RD application and have your Authorizing Official (AO) submit it in EHBs. To remain designated, you must submit your RD application by the established deadline (90 days prior to the end of your current designation period). See a list of FY 2022 RD deadlines.

Technical Assistance Resources

• Health Center Program Compliance Manual
• Renewal of Designation User Guide
• EHBs: Updating Your Role in Your Health Center (PDF - 301 KB)

Submission Components, Attachments, and Program Specific Forms

These Program Specific Forms will be completed in the EHBs. The versions provided below are for reference and planning purposes only:

• Cover Page (PDF - 35 KB)
• 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 Requirements (PDF - 111 KB)
• Form 8: Health Center Agreements (PDF - 103 KB)
• Form 12: Organization Contacts (PDF - 94 KB)
• Scope Certification Form (PDF - 151 KB)

Data and Mapping

• 2021 UDS Manual (PDF - 4 MB)
• How to Create a Service Area Map and Data Table (PDF - 3 MB)
• Service Area Map and Table Sample (PDF - 246 KB)
• Uniform Data System (UDS) Resources
• UDS Mapper Tutorials

Contacts

To make sure you receive our reply email, add 'BPHCAnswers@hrsa.gov' to your address book.

RD Application Information

Karen Fitzgerald, MPH
HRSA Bureau of Primary Health Care
Office of Policy and Program Development
301-594-4300 | BPHC Contact Form

EHBs Application Assistance

Health Program Center Support
877-464-4772
Health Center Program Support Questions Web Form