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  5. School-Based Service Expansion Frequently Asked Questions

School-Based Service Expansion Frequently Asked Questions

The Fiscal Year (FY) 2023 School-Based Service Expansion (SBSE) Notice of Funding Opportunity (NOFO) is the primary guidance for your SBSE application. View additional technical assistance resources on the FY 2023 SBSE technical assistance webpage.

On this page:

Awards

What Health Center Program school-based funding has HRSA awarded?

HRSA issued two rounds of awards for applications submitted in response to the FY 2021 Health Center Program Service Expansion: School-Based Service Sites (SBSS) NOFO (HRSA-21-093). Additional information for both rounds of award recipients is available on the School-Based Service Expansion overview webpage. See who received an award below.

(Updated: 3/2/2023)

Eligibility

Can past SBSS award recipients apply for FY 2023 SBSE funding?

Yes. In your application, you must explain how your SBSE project is distinct from your SBSS project (in the Response section of the Project Narrative and the Budget Narrative).

(Added: 3/2/2023)

Can look-alikes and other organizations not currently receiving Health Center Program funding apply for SBSE funding?

No. Only current Health Center Program award recipients with an H80 grant award can apply for SBSE funding.

(Updated: 3/2/2023)

Where are school-based service sites located? 

For the purposes of the SBSE NOFO, a school-based service site must be located at or on the grounds of a school, defined as a preschool, kindergarten, primary, or secondary school (preschool through grade 12), including public and private schools. 

(Updated: 3/2/2023)

Is approval from the school required? 

Yes. To be eligible, you must include proof of support in Attachment 1 from either the school or school district for each proposed school-based site in your application. This can be a commitment letter or a Memorandum of Understanding (MOU) that includes: 

  • Specific support for the proposed school-based service expansion;
  • The school’s name and address where the school-based service site is or will be located; and
  • School or school district official’s signature. 

If you are proposing to use SBSE funds for multiple sites, include a letter or MOU from each school or school district. If your sites are located at multiple schools in the same school district, one letter or MOU is acceptable if it clearly states each school where sites are or will be located. If you are proposing to provide services to schools using a mobile unit, include a letter or MOU from each school or school district where the mobile unit will provide services. 

(Added: 3/2/2023)

Do I need to already operate a school-based service site to apply for this funding?

No. You can use SBSE funding to establish your first school-based service site.

(Updated: 3/2/2023)

What are the requirements for a new school-based service site?

Any site added through this funding opportunity must: (1) meet the definition of a service site, including providing some in-person services, (2) be located in your current service area, (3) be located in a school or on school grounds, (4) provide mental health services, and (5) be open and operational within 120 days of award.

(Updated: 3/2/2023)

Can I propose to expand only one service at a school-based service site?

Yes. You may propose to expand one or more of the following services:

  • General primary medical care,
  • Mental health,
  • Substance use disorder,
  • Oral health,
  • Vision, and/or
  • Enabling (e.g., case management, health education, transportation).

You must provide mental health services at each school-based service site included in your application. If you do not already provide mental health services at a proposed school-based service site, you must propose to expand mental health services directly or by contract through your SBSE application. 

You can propose to add or expand only mental health services at a site, or if mental health services are already provided at an existing site, you can propose to add or expand one of the other services. 

(Added: 3/2/2023)

What is the maximum award amount for FY 2023 SBSE? 

If you propose a new school-based service site, alone or in addition to expansion of services at existing school-based service site(s), the maximum federal funding that you can apply for is $350,000 per year. 

If you propose to expand services at existing school-based service site(s) only, the maximum federal funding that you can apply for is $250,000 per year. 

(Added: 3/2/2023)

Scope of Project

Can a school decide which services our school-based site provides?

No. Health centers partner with schools to determine how best to meet the health care needs of the students in the school. However, the health center’s governing board has authority over which services are provided at school-based service sites. For more information, see Partnerships between Schools and HRSA-Supported Health Centers: 10 Need-to-Know Tips (#8) (PDF - 139 KB).

(Added: 3/2/2023)

Can our school-based service site provide services to the school community only?

If your school-based service site limits access to services (e.g., because the school restricts access), you must ensure that individuals who are not students can access the full range of health care services at another health center service site.

(Updated: 3/2/2023)

How do I determine my estimated increase in school-based service site patients? 

When developing your estimated increase in school-based patients, you should consider the number of school-based patients included in your 2022 Uniform Data System (UDS) report, the need for services in the school community, provider capacity, patient increases based on previous service expansion, and performance or patient trends at other school-based service sites. Your estimated patient increase should be realistic and achievable. Note that students who only receive screening services or mass treatment, such as COVID-19 testing, vaccinations, or fluoride treatments at a school do not count as school-based service site patients in the UDS. Your overall increase in school-based service site patients, based on your UDS data over time, will be used to inform decisions about SBSE funding beyond the initial two years of funding.

(Updated: 3/2/2023)

How do I determine if my SBSE project will require a change in scope? 

You can view your scope of project in the Approved Scope section of your H80 grant folder in EHBs. The Scope of Project webpage provides guidance to help you determine if you need a change in scope (CIS). If needed, you must request a CIS for Form 5A and/or Form 5C outside of the SBSE application. For example, if your health center provides mental health services by referral only (Column III), you will have to request a formal CIS to Form 5A to meet the requirement to provide mental health services directly (Column I) or by contract (Column II) at each school-based service site included in your application. If you are adding a new site, you will submit Form 5B: Service Sites in the application instead of submitting a CIS request.

(Added: 3/2/2023)

Can I propose mental health services through formal written referral arrangement (Column III) only?

No. You are required to provide mental health services directly (Column I) and/or by contract (Column II) at each proposed school-based service site. For more information about service delivery methods, see the Form 5A Column Descriptors (PDF - 315 KB)

(Added: 3/2/2023)

Application Components

How can I access the SBSE NOFO and application package?

Follow the instructions below:

  • Go to Grants.gov
  • Search Grants using Opportunity Number HRSA-23-097
  • Click the Opportunity Number link (HRSA-23-097)
  • Click the Package tab (rightmost tab)
  • Under Actions, click on Preview
    • Click the Download Instructions gray bar for the NOFO
    • Click the links to view the forms to be submitted in Grants.gov
  • Click the APPLY button to login and use the Grants.gov Workspace to apply

(Added: 3/2/2023)

How do I complete the fields in the SF-424 submitted in Grants.gov?

See the Application for Federal Assistance (SF-424) form instructions (PDF - 313 KB). The table below includes information on how to respond to specific sections.

Box Number Field Response
1 Type of Submission Application
2 Type of Application New
3 Date Received Leave blank (completed automatically in Grants.gov)
4 Applicant Identifier Enter your H80 award number 
5a, 5b Federal Entity Identifier, Federal Award Identifier Leave blank
12 Funding Opportunity Number HRSA-23-097
14 Areas Affected by Project List where you will implement your SBSE project. The attachment is not required.
15 Descriptive Title of Applicant’s project “Health Center Program School-Based Service Expansion”
16 Congressional Districts  Include the congressional district for your main site. The attachment is not required. 
17 Proposed Project Start and End Dates The period of performance is September 1, 2023 to August 31, 2025
18 Estimated Funding ($) Enter amount of SBSE funding requested for Year 1 in a. Federal box (up to $350,000 for proposals to establish a new school-based service site; up to $250,000 for proposals to expand services at existing school-based service site(s) only)
19 Is Application Subject to Review Under Executive Order 12372 Process? Select a. if your state is included in the SPOC list (PDF - 332 KB).
If not, select b. Program is subject to E.O. 12372 but has not been selected by the State for review.

(Added: 3/2/2023)

Can I propose both new and existing sites in our application? 

Yes. You may add a new school-based service site to your Health Center Program scope of project, expand services at an existing school-based service site, or both. 

(Added: 3/2/2023)

How do I document new sites in our application?

There are six places in the application where you must document your new sites:

  • In the Introduction of your Project Narrative, provide the name and address of new site(s). If the new site is a mobile unit, list the schools the mobile unit will visit. 
  • In Form 1B: Funding Request Summary, indicate that you are proposing a new site, and if it is a mobile unit. 
  • In Form 5B: Service Sites, provide information on each new site separately. Note that the site setting must be ‘School’. 
  • In your Project Work Plan, demonstrate that each proposed new site will be open and operational within 120 days of award.
  • In Attachment 2, upload a map that clearly indicates the location of each new school-based service site. 
  • In Attachment 3, provide letters of support from other Health Center Program award recipients and look-alikes in your service area that demonstrate support for the proposed new school-based service site(s) OR upload documentation that you reached out to other health centers to request a letter of support.

(Added: 3/2/2023)

How do I document existing sites in our application? 

There are four places in the application where you must document your existing sites:

  • In the Introduction of your Project Narrative, provide the name and address of existing site(s). If the existing site is a mobile unit, list the schools the mobile unit will visit. 
  • In Form 1B: Funding Request Summary, indicate that you are proposing to expand services at existing site(s), and if it is a mobile unit.  
  • In Form 5B: Service Sites, you will pick existing site(s) from your scope. You can only pick sites with a ‘School’ site setting. Note that you may adjust the site setting to ‘School’ through the self-update scope module in EHBs, if needed. See the instructions to change a field in Form 5B. 
  • In your Project Work Plan, demonstrate that you will expand services at each proposed site within 120 days of award.

(Added: 3/2/2023)

How do I complete the Project Work Plan? Do I have to include activities in every category? 

You will complete four fields to document your two-year work plan. Start by selecting one of the services you will add or expand at your school-based service site(s). Then select one or more activity categories and activity subcategories, and write in activity descriptions, to fully outline your plan. You do not need to add an activity in each activity category. Be sure to complete all steps as many times as necessary to fully outline your proposed activities to expand all services included in your application.

You must select mental health services if you do not already provide mental health services directly or by contract at each school-based service site included in the application. Include activities that demonstrate expanded services will be implemented and any new site(s) will be open and operational within 120 days of award. 

(Added: 3/2/2023)

Why do I need to request letters of support if I propose a new site? 

Requesting a letter of support ensures that other health centers are aware of your plans to add sites in your shared service area and promotes collaboration and coordination of health care in your community.

(Added: 3/2/2023)

Budget

How should I present my funding request on the SF-424A and in other budget documents?

Complete the SF-424A: Budget Information Form in EHBs:

  • Section A – Budget Summary: Under New or Revised Budget, enter the SBSE federal funding requested in the Federal column (up to $350,000 for proposals to establish a new school-based service site; up to $250,000 for proposals to expand services at an existing school-based service site). Enter the non-federal project funding for Year 1 in the Non-Federal column.
  • Section B – Budget Categories: Enter an object class category (line item) budget for Year 1 broken out by federal and non-federal funding. The amounts for each category should align with the Budget Narrative. If applicable, enter minor A/R costs for Year 1 on the construction line.
  • Section C – Non-Federal Resources: Not including the SBSE federal funding request, enter the amount of all other sources of funding for Year 1. 
  • Section D – Forecasted Cash Needs: Optional
  • Section E – Budget Estimates of Federal Funds Needed for Balance of the Project: Enter the federal funds requested (up to $350,000 for proposals to establish a new school-based service site; up to $250,000 for proposals to expand services at an existing school-based service site) for Year 2 in the (a) First column.
  • Section F – Other Budget Information (if applicable): Explain any direct charges that may appear to be out of the ordinary. If you include indirect costs in your budget, enter the type of indirect rate (e.g., final, provisional, de minimis) that will be in effect during the period of performance and upload your indirect cost rate agreement, if applicable. If you do not have a current indirect cost rate agreement, you may use a de minimus rate up to 10% 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 Year 1 and Year 2. Align Year 1 with the SF-424A Section B – Budget Categories. Your budget narrative should also be consistent with your Project Work Plan. If you propose to use SBSE funds for equipment, you must complete the Equipment List form, and include the total amount of equipment in your budget narrative.

If you propose to use SBSE funds for minor alteration/renovation (A/R), submit a separate minor A/R budget justification in the Minor A/R Project Cover Page and include the total amount for minor A/R in your budget narrative.
(Added: mm/dd/2023)

(Added: 3/2/2023)

How do I determine the appropriate proportions to distribute the budget across CHC, MHC, HCH, and PHPC funding sub-programs?

If your H80 award is funded through more than one sub-program/population type (Community Health Center = CHC, Migrant Health Center = MHC, Health Care for the Homeless = HCH, and/or Public Housing Primary Care = PHPC), you should distribute the federal funding requested proportionally in the SF-424A: Budget Information Form, Section A. If you have questions about the appropriate proportions, contact the SBSE technical assistance team using the BPHC Contact Form. Under Funding, select Applications (NOFOs), then select SBSE.

(Added: 3/2/2023)

Should I include contractors in the Personnel Table? 

Yes. In your Budget Narrative, include a table of personnel with the annualized salary, FTE, and federal amount requested for all direct hire and contracted personnel that you propose to support with SBSE funding. For more information, see the sample Budget Narrative with Personnel Table on the SBSE technical assistance webpage.

(Added: 3/2/2023)

Does the federal executive salary limitation apply to SBSE funding? 

Yes. SBSE funds 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: 3/2/2023)

Allowed Use of Funds

Can I use SBSE funding for personnel and recruitment costs?

Yes. Personnel costs are allowable to support service delivery at school-based service sites. SBSE funds may be used for costs or fees associated with an outside recruitment agency to hire personnel to support the SBSE project. Recruitment bonuses may be part of a salary package supported by SBSE funding, if consistent with your health center’s policies and standard practice. 

(Added: 3/2/2023)

Can I use SBSE funding to provide services to school-based patients via telehealth?

Yes. Virtual visits can provide patient-centered access to services. Keep in mind that you must provide some in-person service at each school-based service site. For example, mental health services may be provided virtually to patients at a school-based service site via telehealth from another site in your scope of project, if you are providing other services in-person at the school-based service site. For more information and different telehealth scenarios, see PAL 2020-01: Telehealth and Health Center Scope of Project (PDF - 176 KB).

(Updated: 3/2/2023)

Can I use SBSE funding for minor alteration and renovation (A/R) and equipment costs?

Yes. In Year 1, you may use up to $150,000 of your funding for minor A/R and equipment costs combined. For minor A/R to be allowable, the total federal and non-federal cost of the A/R project must be less than $500,000, excluding the cost of moveable equipment. Permanently affixed equipment (e.g., heating, ventilation, and air conditioning (HVAC), generators, signs in or on the existing building, lighting) is categorized as minor A/R rather than equipment costs. See the SBSE technical assistance webpage for guidance on the required minor A/R forms and attachments. 

(Updated: 3//2023)

If I propose to use SBSE funding for minor alteration and renovation (A/R), do I have to submit a Landlord Letter of Consent? 

Yes, if you do not own the property where the site is located. In most cases, the property owner, or landlord, will be the school district. The Landlord Letter of Consent must be signed by the property owner. See the Landlord Letter of Consent Template (PDF - 61 KB) (PDF - 61 KB). 

(Added: 3/2/2023)

If I propose to use SBSE funding for minor alteration and renovation (A/R), what are the environmental and historic preservation requirements?

Learn more about information on environmental and historic preservation compliance requirements. Although minor A/R projects typically do not require a full Environmental Assessment under the National Environmental Policy Act (NEPA), you may need to comply with other requirements, as applicable:

  • If the proposed project involves exterior work (e.g., windows, signage) or work on a building that is over 50 years old, the project may require State Historic Preservation Office (SHPO) consultation under Section 106 of the NEPA.
  • Buildings constructed prior to 1985 may require submission of a hazmat study and abatement plan.
  • If the site is located in a coastal state, the project may require compliance with the Coastal Zone Management Act.
  • If the proposed project is in a 100- or 500-year floodplain, it may require compliance with E.O. 11988, Floodplain Management.

(Added: 3/2/2023)

Mobile Units

Can I use one-time funding to pay for a portion of a large equipment purchase, like a mobile unit?

Yes. You can use up to $150,000 in SBSE funding toward the cost of a mobile unit. Non-federal funds can cover the remaining costs of purchasing equipment beyond the $150,000.

(Updated: 3/2/2023)

If we replace an existing mobile unit, would this be considered an existing site? 

Yes, if your mobile unit is documented in your scope of project, replacing that mobile unit is considered an existing site. Select the mobile unit from the “Pick Site from Scope” section for Form 5B: Service Sites. 

(Added: 3/2/2023)

Is a new mobile unit considered a new site? 

Yes. A new mobile unit that meets the definition of a service site and provides school-based services would be considered a new site unless the mobile unit is replacing an existing mobile unit. See the Scope of Project webpage for the definition of a service site. 

(Added: 3/2/2023)

Should I list the school names and school addresses visited by a mobile unit in Form 5B? 

No. Do not list the school names and addresses that the mobile unit will visit in Form 5B. List the school names and addresses in your Project Narrative Introduction. In Form 5B, list the primary address where the unit will be parked as the site address. This may or may not be on school grounds (e.g., if the unit is on school grounds during the day and parked at one of your health center sites at night, enter the health center address on Form 5B).

(Added: 3/2/2023)

 

Reporting

How will I report on my school-based service expansion efforts?

You will include the number of school-based service site patients in annual Uniform Data System (UDS) reports. Since patients and services are not tracked by site in UDS, you will also report on your progress adding and expanding services, in particular mental health services, through semi-annual progress reports and a Non-Competing Continuation (NCC) progress report. See the School-Based Service Expansion overview webpage for details about progress reports.

(Updated: 3/2/2023)

How will HRSA assess my increase in the number of school-based service site patients served?

HRSA will assess your school-based service site patient increase using data reported in UDS Table 4, Line 24. For FY 2023 SBSE award recipients, your baseline is the number of school-based service site patients you included in your 2022 UDS report. HRSA will compare this 2022 data to equivalent data in your 2024 UDS report. 

(Updated: 3/2/2023)

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