Service Area Competition Frequently Asked Questions

These are common questions and answers for the fiscal year (FY) 2026 Service Area Competition (SAC) funding opportunity.

Refer to Apply for Service Area Competition (SAC) often for updates.

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Eligibility

Who is eligible to apply for SAC funding?

You may apply if you are a private, non-profit entity or a public agency in the United States or its territories. You may be a faith-based or community-based organization or a Native American tribe or tribal organization. In addition, you must propose to provide continuity of care in an area announced on the FY 2026 SAC Service Area Announcement Table (SAAT).

See Section III: Eligibility Information of the Notice of Funding Opportunity (NOFO) for a detailed list of eligibility requirements.

(Updated: July 2025)

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

If your city/state and ZIP codes are not listed in the SAAT, then your area is not currently announced under an open NOFO for FY26 SAC funding. If your area is not announced, check back frequently. The SAAT is updated throughout the year.

To be eligible for SAC funding, you must propose to serve an announced service area.

(Updated: July 2025)

How do I determine my Service Area Competition ID number?

Each service area listed in the SAAT has a Service Area Competition ID (SAC ID) number. It appears in the lefthand column of the table. This number is unique to each announcement and funding opportunity. It is not permanently associated with your grant or your service area.

You must include the SAC ID in the Project Abstract you submit in Grants.gov. You must also include it in your application’s Summary Page in the Electronic Handbooks (EHBs). We will use this number as the first step in verifying that you have applied for an announced service area.

(Updated: July 2025)

Can you explain the requirement that the ZIP code patient percentages should total at least 75% of the current patients served?

The SAAT lists ZIP codes where the currently funded health center serves patients. The percentage listed for each ZIP code reflects the proportion of the health center’s patients who live in that ZIP code.

If you are a new or competing supplement applicant, you must propose to serve at least 75% of the current health center’s patients within the service area. To show this, you must propose to serve any combination of the current health center’s ZIP codes that total at least 75% of the ZIP Code Patient Percentage column. We will add up the percentages from the SAAT table that correspond to the ZIP codes you list on Form 5B: Service Sites to see if you have met this requirement.

(Updated: July 2025)

If all the ZIP code patient percentages for a service area in the SAAT do not total at least 75%, how can I meet the requirement?

In rare instances the patient percentages for all of the ZIP codes listed for a service area in the SAAT do not total 75%. If this is the case, you must enter all of the ZIP codes listed in the SAAT for the service area on Form 5B in the Service Area ZIP Codes field.

(Updated: July 2025)

Can I apply to serve multiple service areas?

Yes, but you must submit a separate application for each service area. Each application should address the specific service area for which you are applying. Do not cross-reference application materials from one application to another. Each application should stand alone.

If you intend to apply for two or more service areas under a single opportunity number (e.g., HRSA-26-006), you must contact the SAC Response Team for guidance in advance of the Grants.gov deadline. Use the BPHC Contact Form.

(Updated: July 2025)

Have the program names for the funding to support special medically underserved populations changed?

The acronyms used to describe the special medically underserved populations have been updated to align with the Health Center Program’s authorizing legislation. Section 330(g) funding is referred to as Migratory and Seasonal Agricultural Workers (MSAW), Section 330(h) funding is referred to as Homeless Populations (HP), and Section 330(i) funding is referred to as Residents of Public Housing (RPH).

(Updated: July 2025)

Can I request funding for a population (CHC, MSAW, HP, and RPH) that is not listed under the service area in the SAAT?

No. Your funding request should maintain the funding distribution as listed in the SAAT. You may not request funding for a population type that is not listed in the SAAT for the specific service area for which you are applying.  

(Updated: July 2025)

Can you explain the requirement that applicants for Homeless Population (HP) and/or Residents of Public Housing (RPH) funding must use the funds to “supplement, and not supplant” expenditures for these populations?

If you are a new or competing supplement applicant for a service area that includes HP and/or RPH funding, you can’t use this funding to supplant other resources (federal, state, local, or private funds) for services that you already provide to these populations. You must attest on the Summary Page that you will use this funding to supplement, and not supplant, your expenditures and the value of in-kind contributions for delivering services to these populations.

If you are a competing continuation applicant, you are not required to complete the HP/RPH attestation on the Summary Page.

(Updated: July 2025)

Service Area Announcement Table

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

Use the drop-down lists in the SAAT to select any combination of period of performance end date, NOFO number, state, city, and/or ZIP code to create a customized list of available service areas. 

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

(Updated: July 2025)

How do I use the SAAT to find additional information about a service area?

Use the drop-down arrow in the SAAT to access more information about a service area. For each area, you will be able to see:

  • The NOFO number that the service area is announced under, the Grants.gov and EHBs deadlines, and service area type (either Urban or Rural). 
  • The total funding available and the required funding distribution by population type.
  • The service area map and the list of ZIP codes and ZIP code patient percentages.

(Updated: July 2025)

Where can I find the urban/rural designation for my service area on the SAAT?

For each service area, the urban/rural designation can be found in the SAC ID Information table, labeled Service Area Type. You should refer to this designation when responding to the related question in the Need section of the Project Narrative and Form 1A: General Information Worksheet (PDF - 100 KB).

(Updated: July 2025)

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

The Patient Origin Map displays:

  • ZIP Code Tabulation Areas (ZCTAs). These are generalized representations of the U.S. Postal Service’s ZIP codes created by the U.S. Census Bureau to define geographic areas. ZCTAs may contain several ZIP codes.
  • The percentage of current patients from each ZCTA.

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: July 2020)

What is the Health Center Program GeoCare Navigator and how do I use it to complete my SAC application?

The Health Center Program GeoCare Navigator is our mapping tool used to create service area maps. (It replaced the UDS Mapper as of March 2024.)

Your SAC application must include an upload of the service area map for the proposed project that shows:

  • The proposed health center site(s) listed on Form 5B: Service Sites 
  • Proposed service area ZIP codes consistent with the ZIP codes you list on Form 5B 
  • Any medically underserved area (MUAs) and/or medically underserved populations (MUPs)
  • Health Center Program award recipients and look-alikes
  • Other health care providers serving the proposed ZIP codes

You may use multiple maps to display large service areas. For further guidance, see the HCP GeoCare Navigator User Guide (PDF - 3 MB) and Introductory Video.

(Updated: July 2025)

Funding priority

Are there opportunities to receive priority points outside of the review criteria?

Priority points are available for competing continuation applicants. We only grant points to applicants with no active conditions related to Health Center Program requirements at the time of award decisions.

The criteria are:

  • Patient Trend (5 points): You will be granted a funding priority if you have a positive or neutral (does not exceed a 5 percent decrease) 3-year patient trend, as documented in UDS.
  • Patient-Centered Medical Home (PCMH) Recognition (5 points): You will be granted a funding priority if you have one or more sites with PCMH recognition at the time we review your application.

(Updated: July 2025)

Budget

Should I apply for the funding amount in the SAAT even if our most current Notice of Award lists a different amount of funding?

Yes, your request for funding should not be more than the Total Funding amount listed in the SAAT for the service area for FY 2025.

Available funding for a service area can change slightly as FY 2024 funding actions are completed. Check the SAAT prior to submitting your application in EHBs to confirm the final FY 2025 funding amount.

(Updated: May 2024)

How do you make funding reductions based on a reduced patient projection?

If your patient projection is less than 95 percent of the listed patient target, your funding will be reduced as shown in the NOFO’s Funding Reduction by Proposed Patients table. If you do not reduce your budget submission consistent with your patient projection, we will apply the reduction. You will then be required to submit a revised budget.

(Added: May 2024)

What should I 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. We consider 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 these documents must not exceed the Total Funding amount listed in the SAAT.

(Updated: June 2021)

Can I request funding above the amount listed in the SAAT for my service area if the number of patients I serve has increased over the years?

No. Your funding request can’t exceed the current funding level listed in the SAAT. Additional funding is not awarded if you project more patients.

(Updated: May 2022)

Forms

Do I need to provide patient and visit baseline data for population and service types on Form 1A: General Information Worksheet?

If you are a competing continuation applicant, your baseline data for populations and service types will pre-populate from available 2024 UDS data. You will not be able to enter data in the applicable fields.

If you are a new or competing supplement applicant, you must provide the number of current unduplicated patients and visits for each population type category and service type category to establish a baseline.

(Updated: July 2025)

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

You must propose to serve patients for each service type listed in the SAAT for the service area you are applying to serve. Refer to the Form 1A instructions (PDF - 211 KB) for more information.

(Updated: July 2025)

What population types must I project patients for on Form 1A: General Information Worksheet?

You must propose to serve patients for each population type listed in the SAAT for the service area you are applying to serve. Refer to the Form 1A instructions (PDF - 100 KB) for more information.

(Added: July 2025)

What evidence of public or nonprofit status should I provide on Form 1C: Documents on File?

You should provide the date of last review or revision for the documentation that demonstrates that you are a nonprofit or public agency. Refer to Chapter 1: Health Center Program Eligibility of the Health Center Program Compliance Manual for information about such documentation. If you are a new applicant, you must also submit this documentation in Attachment 11: Evidence of Nonprofit or Public Agency Status.

Please reference the NOFO for a list of the items that we will accept as evidence.

(Updated: July 2025)

Should I include all contracted staff on Form 2: Staffing Profile?

Yes. Select the relevant boxes for contracted staff in the Contract/Agreement FTE column. The number of contracted staff is not shown on this form. Do not include contracted staff in the totals for Direct Hire FTEs.

(Updated: June 2021)

How do I 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 select 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. Make certain that you include all ZIP codes that you project to serve.

If you are a competing continuation applicant, we pre-populate and lock all data on Form 5B. However, per Chapter 3: Needs Assessment of the Health Center Program Compliance Manual, you must review your service area each year. You must compare the ZIP codes in your scope on Form 5B: Service Sites with patient origin data reported by ZIP code in UDS. You should request a scope adjustment, if necessary, to update your Form 5B service area ZIP codes, based on where patients live. (See Demonstrating Compliance in Chapter 3 of the Compliance Manual.) If your SAC application is already underway when your change in scope request is approved, you can update Form 5B: Service Sites by selecting the Refresh from Scope button on the application form. 

(Updated: July 2025)

Application submission

How do I submit my application?

The SAC funding opportunity requires a two-phase application process. For Phase 1, you must submit your application electronically through Grants.gov. We encourage you to register or update your registration for Grants.gov as soon as possible to maximize time for Phase 2. For Phase 2, you will submit supplemental information in EHBs.

(Added: May 2024)

Health Center Program requirements and compliance assessment

Where in my application do I demonstrate compliance with Health Center Program requirements?

Beginning in FY 2025, we moved elements of the Project Narrative related to compliance to Appendix A: Health Center Program Compliance. Upload a narrative as Attachment 13: Health Center Program Compliance as detailed in Appendix A.

(Updated: July 2025)

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

During the SAC application review process and throughout the period of performance, you will be assessed to demonstrate compliance with Health Center Program requirements. 

  • If you do not demonstrate compliance in your SAC application, you may receive a condition on your award and a one-year period of performance.
  • If you do not resolve conditions that you received prior to your SAC award through the progressive action process outlined in Chapter 2: Health Center Program Oversight of the Health Center Program Compliance Manual, you will receive a one-year period of performance, or HRSA may terminate your award.
  • If you have received two consecutive one-year periods of performance and you are still not compliant with all Health Center Program requirements at the time we make award decisions, we will not award your Health Center for a new project period.

(Updated: July 2025)

Does a tribal entity have to meet all Health Center Program requirements?

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

(Updated: July 2025)

Will I be able to address areas of non-compliance that are identified during the SAC application review before a final award decision is made?

If you are a competing continuation or competing supplement applicant and we identify areas of non-compliance during the application prefunding review, you will have 14 calendar days to submit documentation demonstrating compliance before the final award decision.

This does not apply to new applicants that are only eligible to receive a one-year period of performance.

(Updated: July 2025)

If I have existing, unresolved progressive action conditions related to Health Center Program requirements, will this impact my SAC award?

Yes, current unresolved progressive action conditions may impact your health center’s period of performance length.

Respond to and resolve outstanding conditions before you submit your SAC application. If you do not resolve conditions that you received prior to your SAC award through the progressive action process outlined in Chapter 2: Health Center Program Oversight of the Health Center Program Compliance Manual, you will receive a one-year period of performance, or HRSA may terminate your award. If you have received two consecutive one-year periods of performance and you are still not compliant with all Health Center Program requirements at the time we make award decisions, we will not award you Health Center Program funding for a new project period.

Submit questions to the BPHC Contact Form.

(Updated: July 2025)

If I am awarded a one-year period of performance, am I required to submit a plan to come into compliance and respond to active progressive action conditions?

Yes. If awarded a one-year period of performance, you must respond to both a 120-day Compliance Achievement Plan condition and to any progressive action conditions on your Notice of Award.

For the 120-day Compliance Achievement Plan condition, you must provide us with a plan that:

  • Discusses your approach for achieving compliance with all areas of non-compliance that have been identified through progressive action conditions on the Notice of Award (NOA); and
  • Indicates that compliance will be demonstrated within the timeframes and deadlines specified by these progressive action conditions.

If you do not submit the required Compliance Achievement Plan within 120 days of award or demonstrate good cause for not submitting it, HRSA will terminate your award (refer to Section 330(e)(1)(B) of the PHS Act).

(Updated: July 2025)

If I receive a one-year period of performance, will I have an operational site visit (OSV) during the one-year period?

Yes, we will schedule an OSV to monitor compliance and performance with all Health Center Program requirements within two to four months of the award start date. 

(Updated: July 2025)

If I had a one-year period of performance in the two years prior to the upcoming period of performance, am I at risk of not receiving a subsequent award?

HRSA will NOT issue a SAC award if you had two consecutive one-year periods of performance, and you are still not compliant with all Health Center Program Requirements at the time we make award decisions. If no fundable applications are received, the service area will be re-competed. This is consistent with Health Center Program statute and the Health Center Program Compliance Manual Chapter 2: Health Center Program Oversight process.

(Updated: July 2025)

Additional information

How can I find a PDF version of a SAC Notice of Funding Opportunity (NOFO)?

On Apply for Service Area Competition (SAC), under "When to apply," you can find a table of SAC NOFO releases. When the NOFO is released, you can select the NOFO number to see the grant opportunity on the Grants.gov page.

In Grants.gov, select Package and select Preview in the Actions column. In the Opportunity Package Details view, select Download Instructions to access the PDF of the NOFO.

(Added: May 2024)

What if I am not eligible or am unable to apply for a SAC funding opportunity? Are there other HRSA funding opportunities that I could apply to?

If you are unable to provide continuity of care in a defined and announced service area, go to Find Grant Funding for additional information. 

(Added: May 2024)

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

Receiving a SAC award does not mean your health center automatically becomes an FQHC. The FQHC designation for Medicare/Medicaid is administered by the Centers for Medicare & Medicaid Services (CMS). Contact your State Medicaid office to determine the process and timeline to become 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: May 2022)

How do I receive Health Center Program updates?

The HRSA Primary Health Care Digest is a bi-weekly email newsletter containing information about the Health Center Program, including all competitive funding opportunities. If you are interested in Health Center Program funding, we encourage you to subscribe several staff.

(Updated: July 2025)

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