FY 2023 Service Area Competition (SAC) Frequently Asked Questions

Updated: 5/24/2022

Below are common questions and corresponding answers for the fiscal year (FY) 2023 Service Area Competition (SAC) funding opportunity. New FAQs will be added as necessary. Refer to the SAC Technical Assistance webpage often for updates.

On this page:

Eligibility

Can we apply for SAC funding if we do not currently receive Health Center Program funding? 

Yes, you can apply for SAC funding if you do not currently receive Health Center Program funding. Ensure that you select “New” for your application type in Grants.gov.

(Updated: 6/11/2021)

Who is eligible to apply for SAC funding?

Eligible applicants must be a domestic public or private, nonprofit entity. Faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply. Refer to Section III: Eligibility Information of the Notice of Funding Opportunity (NOFO) for a detailed list of eligibility requirements.

(Added: 5/24/2022)

Can we apply to serve multiple service areas?

Yes, but you must submit a separate application for each service area. If you intend to apply for two or more service areas announced under a single opportunity number (e.g., HRSA-23-018), you must contact the SAC Response Team at 301-594-4300 or using the BPHC Contact Form for guidance well in advance of the Grants.gov submission deadline. 

(Updated: 5/24/2022)

Does the eligibility criterion regarding service area zip codes apply to competing continuation applicants?

No, because HRSA pre-populates and locks all data on Form 5B: Service Sites for competing continuation applicants. However, per Chapter 3: Needs Assessment of the Health Center Program Compliance Manual, you are required to annually review your service area by comparing the zip codes in your scope on Form 5B: Service Sites with patient origin data reported by zip code in the Uniform Data System (UDS). You should request a Scope Adjustment, if necessary, to update your Form 5B service area zip codes, based on where patients reside (see Demonstrating Compliance in Chapter 3 of the Compliance Manual). If your SAC application is already underway when your CIS request is approved, you can update Form 5B: Service Sites by clicking the Refresh from Scope button on the application form in the Electronic Handbooks (EHBs). 

(Updated: 5/24/2022)

If the zip code patient percentages for a service area in the Service Area Announcement Table (SAAT) do not total at least 75 percent, what should we do?

If the zip code patient percentages for all zip codes listed for a service area in the SAAT do not total at least 75 percent, you must enter all zip codes listed in the SAAT for that service area on Form 5B in the Service Area Zip Codes field. This is an eligibility criterion, so it is recommended that you double-check this before submitting your application.

(Updated: 5/24/2022)

If our city and state is not listed in the Service Area Announcement Table (SAAT), can we still apply for SAC funding?

Applicants for SAC funding must propose to serve an announced service area. Announced service areas can be found in the SAAT by city/state or zip code. If your city/state and zip codes are not listed in the SAAT, then that area is not an eligible area for FY23 SAC funding.

(Updated: 5/24/2022)

Can we request funding for a population not listed in the Service Area Announcement Table (SAAT) under our service area?

No, you may not add new population types (those noted in the SAAT with $0 in funding). One of the SAC eligibility requirements is to serve all the population types listed in the SAAT for the service area and maintain the funding distribution from the SAAT in your funding request.

(Updated: 5/24/2022)

We noticed new requirements regarding “supplement not supplant” for Health Care for the Homeless (HCH) and/or Public Housing Primary Care (PHPC) applicants. Can we apply for HCH and/or PHPC funding to cover costs for services already being provided by my organization?

If you are a new or competing supplement applicant applying for HCH and/or PHPC funding, you cannot use that funding to supplant other resources for existing services (federal, state, local, or private funds). Applicants must attest on the Summary Page that they will use this funding to supplement, and not supplant, the expenditures of the health center and the value of in-kind contributions for the delivery of services to these populations.

Competing continuation applicants applying for continued HCH and/or PHPC funding within their current service area are not required to complete the HCH/PHPC attestation on the Summary Page.

(Updated: 5/24/2022)

Program Requirements

What happens if we are not compliant with all Health Center Program requirements at the time of application?

Both during application prefunding reviews and throughout the period of performance, you will be routinely assessed for program compliance. In circumstances where you are determined to be non-compliant with one or more conditions related to Health Center Program requirements, HRSA will place a condition on the award and will follow the Progressive Action policy and process outlined in Chapter 2: Health Center Program Oversight of the Health Center Program Compliance Manual. Additionally, you must submit a Compliance Achievement Plan within 120 days of release of your Notice of Award (NoA) outlining a plan to come into compliance.

If you are a competing continuation applicant and have any conditions related to Health Center Program requirements at the time SAC award decisions need to be made, you will qualify for a one-year period of performance. You will be awarded a one-year period of performance if you did NOT have consecutive one-year periods of performance in FY 2021 and FY 2022 due to non-compliance with Health Center Program requirements. You will NOT receive an FY 2023 SAC award if you had consecutive one-year periods of performance in FY 2021 and FY 2022 due to non-compliance with Health Center Program requirements.

(Updated: 5/24/2022)

Does a tribal organization have to meet all of the Health Center Program requirements?

No, the Health Center Program governance requirements do not apply to Native American tribes or tribal, Native American, or Urban Indian groups under the Indian Self-Determination Act, or urban Indian organizations under the Indian Health Care Improvement Act (25 U.S.C. 1651). 

(Updated: 6/11/2021)

Service Areas

How do we search for available service areas in the SAAT?

In the SAAT, use the drop-down lists to select any combination of period of performance end date, city, and/or state to create a customized list of available service areas. Only the cities and states with service areas announced to date will be available for selection from the drop-down lists. Note that the cities available for selection are based on the location of the current Health Center Program award recipient’s administrative site.

Use the zip code search by typing a five-digit zip code into the search field. All service areas announced to date that contain the zip code will be included in the results. 

(Added: 7/31/2020)

How does the Patient Origin Map align with the zip codes listed in the SAAT?

The Patient Origin Map displays: (1) zip code tabulation areas (ZCTAs), which are generalized representations of United States Postal Service zip codes and (2) the percentage of the current patients from each ZCTA. Note that ZCTAs may contain several zip codes.

For a list of zip codes and related ZCTAs, refer to the Zip Code to ZCTA Table. To ensure eligibility, new and competing supplement applicants must include a combination of SAAT Service Area Zip Codes (not ZCTAs) where zip code patient percentages total at least 75 percent on Form 5B: Service Sites (include all SAAT Service Area Zip Codes for a proposed service area where the sum of all zip code patient percentages is less than 75 percent). 

(Added: 7/31/2020)

Funding Priority

Am I eligible for priority points?

The funding priority continues to be available for competing continuation applicants. However, several changes were made to priority point eligibility and criteria for assigning points. Points will only be granted to competing continuation applicants with no active conditions related to Health Center Program requirements at the time of application submission. The five priority points previously associated with compliance are now granted based on having one or more sites with Patient Centered Medical Home (PCMH) recognition at the time of application review.

A positive or neutral three-year patient growth trend (does not exceed a five percent decrease) continues to be worth five points.

Information about PCMH is available on the National Committee for Quality Assurance website

(Updated: 5/24/2022)

How is patient growth calculated when assessing the funding priority?

The most recent three-year data, as reported in the Universal Data System (UDS), are utilized to calculate the patient growth trend. The calculation for the three-year growth trend is as follows: [(Most current Total Patients value – Total Patients value from two years prior)/Total Patients value from two years prior] x 100.

(Updated: 5/24/2022)

Performance Measures

Do we have to complete the Clinical and Financial Performance Measures form as part of our SAC application?

Clinical and Financial Performance Measures are no longer included in the SAC application. You must complete the attestation in the Summary Page acknowledging that you understand that you are required to report full UDS data on an annual basis. 

(Added: 6/11/2021)

Budget

Should we apply for the funding amount in the Service Area Announcement Table (SAAT) even if our most current Notice of Award lists a different amount of funding?

Yes, your federal request for funding should not exceed the Total Funding amount listed in the SAAT for the service area for FY 2023.

Available funding for a service area has the potential to change slightly as FY 2022 funding actions are completed. Check the SAAT prior to submitting your application in EHBs to confirm the final FY 2023 funding amount and support submission of an accurate budget request. 

(Updated: 5/24/2022)

What should we do if the budget figures change between the Grants.gov submission and the EHBs submission?

Only estimated budget information is required on the SF-424 in Grants.gov. HRSA considers the budget information provided in EHBs on the SF-424A and Budget Narrative to be your official proposed budget. The amount of federal funding that you request on the SF-424A and Budget Narrative in EHBs must not exceed the amount of Total Funding listed in the SAAT

(Updated: 6/11/2021)

Can we request funding above the amount listed in the SAAT for our service area if the number of patients that we serve has steadily increased over the years?

No, a SAC applicant’s funding request can’t exceed the current funding level listed in the SAAT. Additional funding is not awarded if the applicant projects more patients.

(Added: 5/24/2022)

Forms

What service types must we project patients for on Form 1A: General Information Worksheet?

You must propose to serve patients for each service type that is listed in the SAAT for the service area you are applying to serve. Refer to the Form 1A template (PDF - 132 KB) on the SAC Technical Assistance webpage for instructions on completing the form.

(Added: 5/24/2022)

What type of evidence of nonprofit or public center status should be provided for Form 1C: Documents on File?

You should provide the date of last review or revision for the documentation that demonstrates that you are a domestic public or private, nonprofit entity. See Chapter 1: Health Center Program Eligibility of the Health Center Program Compliance Manual for information about such documentation. New applicants must also submit this documentation in Attachment 11: Evidence of Nonprofit or Public Center Status.

(Updated: 5/24/2022)

How can we change SF-424 information submitted in Grants.gov?

The Basic Information completed in Grants.gov is imported into EHBs. With the exception of the Estimated Funding section, you may edit this information if necessary.

(Updated: 5/24/2022)

Should all contracted staff be included on Form 2: Staffing Profile?

Yes, select the relevant boxes for contracted staff in the Contract/Agreement FTE column. Contracted staff are not quantified on this form, and numbers for contracted staff should not be included in the Direct Hire FTE column. 

(Updated: 6/11/2021)

How do we enter zip codes on Form 5B: Service Sites?

If you are a new or competing supplement applicant you must enter zip codes in the Service Area Zip Codes field on Form 5B for service delivery sites and administrative/service delivery sites. You can enter up to five zip codes at a time. Once you click the Save Zip Codes Button, the five zip codes will be saved to the page and you can add more. This process can be repeated as many times as necessary.

If you are a competing continuation applicant, HRSA pre-populates and locks all data on Form 5B.

(Added: 5/24/2022)

Application Submission

How do I submit my application?

The SAC funding opportunity requires a two-phase application process. For Phase 1, HRSA requires applicants to submit their application electronically through Grants.gov. Applicants are encouraged to register or update their registration for Grants.gov as soon as possible to maximize time to complete Phase 2 of the application process. For Phase 2, applicants submit supplemental information in the Electronic Handbooks (EHBs).

(Added: 5/24/2022)

When can we begin the EHBs submission process?

You can begin Phase 2 in EHBs only after Phase 1 in Grants.gov has been successfully submitted (no later than the Grants.gov deadline) and HRSA has issued an email confirmation to the Authorized Organization Representative (AOR) containing the application tracking number. The AOR registered in Grants.gov will be notified by email when the application is ready in EHBs.

You are encouraged to apply early in Grants.gov to maximize time to complete the EHBs phase of the application process. 

(Updated: 6/11/2021)

How will we be notified if our application was not successfully submitted?

Monitor your e-mail accounts, including spam folders, for e-mail notifications and/or error messages from Grants.gov. Grants.gov will send a series of email messages to the Workspace owner and participants with the AOR role to notify you if the Grants.gov application has been validated or if there are errors. If there are errors, you must correct the errors and re-submit the application in Grants.gov prior to the deadline.

In EHBs, all validation errors must be resolved before the application can be submitted to HRSA by the Authorizing Official (AO). The status of the application in EHBs will appear as "Application Submitted to HRSA" once it has been successfully submitted.

If users with privileges to work on the application click the Submit to AO button in EHBs, the AO must login to EHBs and submit the application to HRSA prior to the EHBs deadline. 

(Added: 7/31/2020)

How do I make changes to an application that was submitted in EHBs?

EHBs allow the AO to reopen the application in EHBs prior to the EHBs deadline. For additional details and step-by-step instructions with screenshots, refer to the Reopen Submitted Applications Help webpage. The AO must resubmit the reopened application in EHBs by 5:00 p.m. ET on the EHBs due date for the application to be considered. 

(Updated: 6/11/2021)

Additional Information

If we receive a SAC award, do we automatically become a Federally Qualified Health Center (FQHC)?

Receiving a SAC award does not mean your health center will automatically become an FQHC. An FQHC is a designation for Medicare/Medicaid designation administered by the Centers for Medicare and Medicaid Services (CMS). Contact your State Medicaid office directly to determine the process and timeline for becoming eligible for payment as an FQHC under Medicaid. To enroll in Medicare, first obtain a National Provider Identifier (NPI). You may enroll in Medicare electronically via the Medicare Provider Enrollment, Chain, and Ownership System.

(Updated: 5/24/2022)

How do we receive Health Center Program updates?

The HRSA Primary Health Care Digest is a weekly email newsletter containing information pertaining to the Health Center Program, including the release of all competitive funding opportunities. Organizations interested in Health Center Program funding are encouraged to subscribe several staff

(Updated: 6/11/2021)

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