American Rescue Plan Funding for Health Centers Frequently Asked Questions (FAQs)

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Funding Purpose and Methodology

What are the purposes and allowed uses of American Rescue Plan funding for health centers (H8F)?

On Thursday, April 1, 2021, HRSA awarded more than $6.1 billion in funding provided by the American Rescue Plan Act to 1,377 HRSA-funded health centers (activity code H8F). The purposes of the American Rescue Plan funding are to prevent, mitigate, and respond to coronavirus disease 2019 (COVID-19) and to enhance health care services and infrastructure. Consistent with these purposes, funding may support a wide range of in-scope activities, which may change as COVID-19 circumstances and related community, patient, and organizational needs evolve over the 2-year period of performance.

More information regarding the allowable uses of H8F funds is available on the H8F Activities and Allowable Uses of Funds webpage. For additional information, see the H8F technical assistance webpage.

(Added: 4/12/2021)

How was the amount of H8F funding determined for each health center award recipient?

HRSA used the following distribution formula:

  • Base value of $500,000, plus
  • $125.00 per patient reported in the 2019 UDS, plus
  • $250.00 per uninsured patient reported in the 2019 UDS.

(Added: 4/12/2021)

Why was the H8F funding issued through a separate grant?

To support tracking of American Rescue Plan spending, awards were issued separately from a health center’s operational (H80) grant award with the activity code H8F. As is the case with fiscal year 2020 COVID-19 supplemental funding, health centers will need to separately track and account for their H8F activities supported through this funding.

To meet program requirements and correctly attribute costs to specific programs, HRSA award recipients must maintain appropriate records and cost documentation as required by 45 CFR §75.302 - Financial Management and Standards for Financial Management Systems, and 45 CFR §75.361 - Retention Requirement for Records, to substantiate the charging of any salaries and other project activities costs. For additional information on maintaining compliance with Health Center Program requirements (e.g., applicability of sliding fee policy, billing and collections) during the COVID-19 public health emergency, see the Health Center Program’s COVID-19 Frequently Asked Questions.

(Added: 4/12/2021)

What is the period of performance for the use of the H8F funding?

H8F awards have a 2-year period of performance. Refer to the H8F notice of award for specific start and end dates. Funding is available for immediate use, and pre-award costs dating back to January 31, 2020 expended in alignment with the purposes of H8F funding are permitted.

(Added: 4/12/2021)

Can a health center request a project period extension for the H8F award if more time is needed to complete approved activities?

HRSA awarded one-time H8F funding with a 2-year period of performance. If you need additional time (up to 12 months) to complete your approved project or program-related activities, you must submit a separate Extension Without Funds (no cost extension) prior approval request to HRSA. Extension requests must be made through HRSA's Electronic Handbooks (EHBs) prior to the H8F project period end date. You may not use this one-time extension to expend unused funds for new or additional project or program-related activities. All extension requests are subject to HRSA approval. Contact your Grants Management Specialist with questions.

(Added: 4/12/2021)

What is the PIN to access H8F funding in the Payment Management System?

Health centers will use the same PIN they use to access their H80 grant funding through the Payment Management System (PMS). If you experience any issues accessing your H8F grant funding, please contact your PMS accountant, whom you can identify through Find Your PMS Liaison Accountant, and/or contact the assigned Grants Management Specialist identified in your H8F notice of award.

(Added: 4/12/2021)

Are Health Center Program look-alikes eligible to receive American Rescue Plan funding?

Health Center Program look-alikes are eligible for funding under the American Rescue Plan – Funding for Look-Alikes (ARP-LAL) Notice of Funding Opportunity, which was issued on April 19, 2021. Applications are due by May 14, 2021. More information is available on the ARP-LAL technical assistance webpage.

(Updated: 4/29/2021)

Award Submission Requirement

Do health centers need to apply for H8F funding?

To expedite distribution of this critical funding, HRSA has made funds immediately available and will collect budget and activities/costs to be supported by the funding through the H8F award submission requirement in HRSA's EHBs.

(Added: 4/12/2021)

How do health centers submit their H8F award submission requirement?

Health centers must submit H8F project information through a submission task in the H8F grant folder in HRSA’s EHBs. See the instructions to add your H8F grant folder to your EHBs portfolio. For COVID-19 funding awarded in fiscal year 2020, health centers submitted an activity overview as an attachment. For H8F, health centers will select activities from prepopulated options in the Work Plan section of the Project Overview form in the EHBs. See the H8F Award Submission Requirement Guidance for details.

(Added: 4/12/2021)

Maintaining Capacity and Personnel Support

Can health centers use H8F funds to continue an activity that was paid for under previous federal awards (H80, H8C, H8D, H8E)?

As indicated in the H8F Award Submission Guidance, you may not use H8F funds for costs already paid for by H80, H8C, H8D, or H8E funding. However, H8F funds may support new costs to continue or expand activities initiated with your prior COVID award or other sources of funding that are ending or have recently ended.

You must monitor expenditures from all sources to ensure compliance with the individual funding requirements, and continue to adhere to the Uniform Administrative Requirements, federal cost principles, and audit requirements for HHS awards (45 CFR Part 75), and your organization’s policies. To meet program requirements and correctly attribute costs to specific programs, HRSA award recipients must maintain appropriate records and cost documentation as required by 45 CFR §75.302 – Financial Management and Standards for Financial Management Systems, and 45 CFR §75.361 – Retention Requirement for Records.

(Added: 4/29/2021)

Can health centers use H8F funds to cover revenue lost as a result of the COVID-19 public health emergency?

No. Federal award funds do not replace lost revenue (e.g., reimbursement for dental or primary care visits from public and private health insurance sources). However, health centers are permitted to increase their reliance on grant funds to cover fixed operational costs.

This increased reliance on grant funds is an allowable expenditure under H8F funds. Your health center may use H8F funds to cover allowable operational costs going back to January 31, 2020.

Your health center may also rebudget your H80 award as needed to cover allowable operational costs differently than originally proposed (e.g., move personnel originally budgeted under your H80 grant to your H8F grant), for obligations incurred since January 31, 2020. As a reminder, if you rebudget your H80 award for more than 25% or to a line item that previously had no federal funds, grant rules require you to submit a prior approval request to your Grants Management Specialist via HRSA’s EHBs.

Separate from Health Center Program funding, health centers may be eligible to be reimbursed or compensated for lost revenues through other federal or state programs. For information on other resources available during the COVID-19 public health emergency, see the Health Center Program’s COVID-19 Frequently Asked Questions.

(Added: 4/12/2021)

Can health centers use H8F funds for hazard pay or a "pandemic premium"?

H8F funds may be used for hazard and premium pay if you have policies and procedures in place that cover this type of pay. Personnel who will be paid with grant funding must receive salary and benefits consistent with your health center's policies for paying salaries under unexpected or extraordinary circumstances from all funding sources, federal and non-federal. You must document that you are following your organizational policy for charging salaries during unexpected and extraordinary circumstances.

(Added: 4/12/2021)

Can health centers use H8F funds for raises or bonuses for any health center personnel?

Yes. H8F funds can be used for raises and bonuses that align with your organization’s policies and procedures consistently applied across the organization. You must document that you are following your organizational personnel policies, including those for charging salaries during unexpected and extraordinary circumstances. You must also maintain appropriate records and cost documentation as required by 45 CFR § 75.302 – Financial Management and Standards for Financial Management Systems, and 45 CFR § 75.361 – Retention Requirement for Records.

For example, you would document that you have not been able to give raises or pandemic bonuses that were approved or part of existing policy due to a shortfall of funds. You would also show evidence that you could not pay out of other funding sources, and that the staff are working on activities that are in scope and allowed uses of H8F funds.

(Added: 4/29/2021)

Other Uses of Funds

Can health centers use H8F funds to conduct COVID-19 contact tracing?

H8F funds may be used for COVID-19 contact tracing of health center patients, provided such activities are within the health center’s scope of project. Contact tracing activities should follow CDC and other applicable public health guidance, and be coordinated as appropriate with federal, state, and local public health response efforts.

Health center contact tracing activities other than those described above, as well as activities performed on behalf of a third party, including on behalf of a federal, state, or local public health agency, would constitute another line of business outside the scope of the Health Center Program project. See the Health Center Program COVID-19 Frequently Asked Questions for additional information.

(Added: 4/12/2021)

Can health centers use H8F funds to support antibody testing?

Yes. H8F funding may support a wide range of testing and testing-related in-scope activities that may change as COVID-19 needs and guidance evolve within your community.

The term "diagnostic test" generally refers to a molecular or antigen test, both of which can be used to diagnose infection with the SARS-CoV-2 virus. The terms "antibody test" or "serological test" generally refer to tests that detect antibodies to the SARS-CoV-2 virus. More information is available in the Food and Drug Administration’s FAQs on Testing for SARS-CoV-2 and in the Testing section of the Health Center Program’s COVID-19 Frequently Asked Questions.

(Added: 4/12/2021)

Can health centers use H8F funds to rent space, including temporary structures?

H8F funds may be used to support rent of an approved site to perform in-scope activities, including temporary structures.

(Added: 4/12/2021)

Can health centers use H8F funds for supplies necessary for health center personnel to participate in telehealth from their homes, such as tablets, phones, webcams, and speakers?

Yes. H8F funds may be used to purchase supplies necessary for health center personnel to use telehealth to perform in-scope services. For additional information, refer to COVID-19 Grantee Frequently Asked Questions.

(Added: 4/12/2021)

Can health centers use H8F funds for enabling services?

Yes. H8F funds may be used to support, expand, or increase enabling services. This includes but is not limited to support for outreach, patient education, eligibility assistance to support insurance enrollment, translation, interpretation, and transportation that supports COVID-19 testing, treatment, and vaccination, as well as comprehensive primary care.

(Added: 4/12/2021)

Can health centers use H8F funds for services not directly related to COVID-19?

As indicated in the American Rescue Plan, funds may be used to modify, enhance, and expand health care services and infrastructure. Therefore, H8F funds may be used to modify, enhance, and expand non-COVID-19 related health care services, including mental health, substance use disorder, dental, vision, pharmacy, and other in-scope services. This may include personnel and the purchase of supplies, equipment, and vehicles to support expanded services. All services must be within the health center’s approved scope of project and conducted on behalf of the health center. See the H8F Activities and Allowable Uses of Funds webpage.

(Added: 4/12/2021)

Can health centers use H8F funds to support routine immunizations?

As indicated in the American Rescue Plan, funds may be used to modify, enhance, and expand health care services. Therefore, H8F funds may be used to support the provision of routine immunizations—including influenza vaccines—provided such activities are within the health center’s scope of project. Immunizations performed on behalf of the health center should be reflected as required services on a health center’s Form 5A: Services Provided. Health centers may also use H8F funds to provide outreach or education about immunizations. More information about the provision of routine immunizations is available in the Providing Care During Emergencies section of the Health Center Program’s COVID-19 Frequently Asked Questions.

(Added: 4/12/2021)

Can health centers use H8F funds to support early childhood health activities, such as developmental screenings?

Yes. H8F funds may be used for costs related to enhancing early childhood health care, including personnel who may promote developmental health, providing developmental screening and interventions that align with in-scope services, and connecting families with other needed services. In your H8F Work Plan, you would write in such activities under the corresponding category, which will most likely be Maintaining and Increasing Capacity and/or Recovery and Stabilization. See the related examples on the H8F Activities and Allowable Uses of Funds webpage.

(Added: 5/6/2021)

Can health centers use H8F funds for food for patients experiencing unemployment and/or homelessness?

H8F funding may not be used for food, unless the provision of food is specifically part of your health center’s treatment plan (e.g., special meals for diabetic patients), supported by written health center policies, and part of the health center’s scope of project.

(Added: 4/12/2021)

Can health centers use H8F funds for patient incentives, such as gift cards?

H8F funds may not be used for cash gift cards. Funds may be used for items explicitly tied to carrying out the H8F purpose. Examples include hand sanitizer, supplies that align with patient’s treatment plans, and vouchers for transportation. Use of funds for such costs must be supported by written health center policies, and part of the health center’s scope of project.

(Added: 4/29/2021)

Can health centers use H8F funding for hotel/motel costs, housing, or other rental space for patients to quarantine or self-isolate?

No. H8F funds may not be used for temporary housing costs or long-term housing/lodging costs for patients who may require quarantine or isolation. Health centers may provide these services outside the Health Center Program scope of project as another line of business.

(Added: 4/29/2021)

Can health centers use H8F funds for minor alteration and renovation (A/R) at temporary sites or sites that are intended to be brought into scope at a later date?

Temporary sites are not eligible for minor A/R unless they become permanent in-scope sites. You may include costs for activities to be performed at a site that will be brought into scope as a permanent site at a future date within the 2-year period of H8F funding. You may not perform proposed activities at this site until receiving HRSA approval to add the permanent site to scope. In your H8F award submission, you will indicate on the Project Overview Form that changes will be required to your Form 5B: Service Sites. For additional information, review the technical assistance materials on the Scope of Project webpage and related Considerations for Health Center Scope of Project and the COVID-19 Public Health Emergency. Contact the Program Official listed on your notice of award for guidance.

(Added: 4/29/2021)

Can health centers pool their H8F funds for contract costs for outreach on COVID-19 testing and vaccinations offered by their organizations?

Yes. To maximize cost effectiveness, multiple health centers may choose to enter into a shared contract for outreach and education that will support their H8F activities. To do so, each participating health center must demonstrate that the contracted activities are specific to their H8F project. You must document that you are following your organizational financial policies and procedures, especially those regarding procurements, and be in compliance with the Procurement Standards in 45 CFR part 75, except those waived by OMB Memo 21-20 (PDF - 372 KB) regarding geographical preferences and contracting small and minority businesses, women’s business enterprises, and labor surplus area firms. You must also maintain appropriate records and cost documentation as required by 45 CFR § 75.302 – Financial Management and Standards for Financial Management Systems, and 45 CFR § 75.361 – Retention Requirement for Records.

(Added: 4/29/2021)

Date Last Reviewed:  May 2021