FY 2021 NHCI-HC Frequently Asked Questions (FAQs)

Updated: 1/19/2021

Eligibility

  1. Which health centers may receive NHCI-HC funding?

    Health Center Program operational (H80) grant award recipients may request NHCI-HC funding. HRSA will only consider funding submissions from health centers that meet the following award criteria:

    • Attest to fully participate in the training and technical assistance activities offered in support of the award;
    • Achieved blood pressure control in less than 58.9 percent of patients 18 to 85 years of age who have been diagnosed with hypertension using 2019 Uniform Data System (UDS) data or 2020 data to date from their electronic health record (EHR) universe; and
    • Served at least 100 patients 18 to 85 years of age who have been diagnosed with hypertension using 2019 UDS data or 2020 data to date from their EHR universe.

    If you are one of the approximately 50 health centers that used a sample of patient charts to report 2019 UDS data (i.e., chart audit), then you must provide 2020 data to date that represent your entire patient chart universe to be considered for funding.

  2. How did HRSA notify health centers about the NHCI-HC funding?

    Individuals registered as the project director, business official, and authorizing official for your H80 award received an email through EHBs. The email provides a link to the NHCI-HC technical assistance webpage where you will find submission guidance and resources, and instructions on how to access the EHBs submission module.

  3. Who do I contact if my health center did not receive the notification email and I think that I am eligible for this funding?

    Check with the individuals who are the project director, business official(s), and authorizing official(s) in EHBs for your H80 award. They may need to check their spam folders. If none of these individuals received the notification email, contact the NHCI-HC technical assistance team through the BPHC Contact Form HRSA BPHC exit disclaimer.

  4. Does HRSA have enough funding to award more than 400 health centers if health centers may provide 2020 data to demonstrate alignment with award criteria? 

    HRSA plans to fund all eligible submissions that meet the award criteria.

Budget Requirements

  1. Is the funding amount from the November 17 email (subject: Updated EHBs Link: FY 2021 Supplemental Funding for Hypertension) available for each year?

    No. The funding amount provided in the email notifying you of the NHCI-HC supplement is the total available funding that you may use across the three years, as needed. You do not need to spend it evenly across all three years.

  2. If I use 2020 data to demonstrate that my health center meets the award criteria, will HRSA adjust my award amount to reflect 2020 data in the funding formula?

    No. HRSA will base funding formulas on 2019 data, regardless of whether a health center uses 2019 or 2020 data to demonstrate alignment with the award criteria.

  3. Who can I contact with questions about the funding distribution across sub-programs provided in my NHCI-HC notification email?

    If you have questions about the maximum funding request distribution across sub-programs (i.e., Community Health Center (CHC), Migrant Health Center (MHC), Health Care for the Homeless (HCH), and/or Public Housing Primary Care (PHPC)) that HRSA provided in the notification email, contact the NHCI-HC technical assistance team through the BPHC Contact Form HRSA BPHC exit disclaimer.

  4. Who can I contact if I have questions about other budget-related issues?

    All budget condition and business, administrative, and fiscal questions should be directed to the grants management specialist listed on your notice of award.

  5. Should I include non-federal funding in my NHCI-HC budget proposal?

    You are not required to include non-federal funding in your NHCI-HC budget proposal. If you choose to do so, include only non-federal funds that you will leverage to support your NHCI-HC project, and do not duplicate previously projected non-federal resources under your H80 award.

  6. How will I present my NHCI-HC funding request if there is only one award for all three years?

    All NHCI-HC funding will be awarded in FY 2021, so you will request the total across all three years of funds on the SF-424A form. You will, however, show how you plan to use the funding in year 1, year 2, and year 3 separately in the Budget Narrative.

  7. Will NHCI-HC funding continue beyond the three years?

    No. NHCI-HC funding can support NHCI-HC activities over a three-year period through the end of your FY 2023 H80 budget period, subject to performance and HRSA approval of carryover requests.

  8. May NHCI-HC funding be used to increase full time equivalents (FTEs) of existing salary of existing personnel who are currently compensated at less than 100 percent FTE with federal funding?

    NHCI-HC funding may be used to compensate personnel with a commensurate increase in FTE, in alignment with your existing written policies and procedures and 45 CFR §75.430. Salaries may not exceed 100 percent across all federal awards.

  9. May NHCI-HC funding be used to incentivize patients’ participation in NHCI-HC-supported activities?

    Patient participation incentives are permitted only if they are a documented and required part of a clinically-proven program to be used in carrying out the project (i.e., program provides a gift card of nominal value to purchase healthy food after a patient attends a certain number of sessions). Your budget narrative must provide the evidence base for any incentive that you plan to purchase. If patient-related incentives are included in the NHCI-HC budget, they must align with your organization’s established policies and procedures and should be for a specific type of purchase (e.g., can only purchase food) or the card recipient must sign a waiver that the cards will not be used for prohibited items such as alcohol, tobacco, or firearms. 

  10. May NHCI-HC funding be used to reimburse my health center for revenue lost when a provider is participating in a NHCI-HC-supported activity, such as a training?

    No. NHCI-HC funding may not be used to offset lost revenue or productivity. However, you may use NHCI-HC funding to support a substitute provider who provides temporary clinical services in the absent provider’s place.

  11. If I plan to contract FTEs, must I include them on the Personnel Justification Table?

    Yes. You must include on the Personnel Justification Table all direct hire and contractual personnel FTEs that you propose to support with NHCI-HC funding, including current personnel whose FTE you will increase using NHCI-HC funds. The annualized salary and FTE must be included, along with the federal amount requested.

  12. Am I required to submit my indirect cost rate agreement?

    Only provide your indirect cost rate agreement if it has recently been negotiated or updated and you include indirect costs in your proposed budget. If you do not have an indirect cost rate agreement, costs that would be included in such a rate (e.g., accounting services) may be charged as direct line-item costs. Under 45 CFR § 200.414(f), organizations that have never received a negotiated indirect cost rate may elect to charge a de minimis rate of 10 percent of modified total direct costs, which may be used indefinitely. If chosen, this methodology must be used consistently for all Federal awards.

  13. Are there any formatting guidelines for the Budget Narrative attachment?

    Yes. Use single line spacing and an easily readable font, such as Times New Roman, Arial, or Courier. The font should be size 10-point or larger. You may submit a Microsoft Excel file, but limit the Excel workbook to one tab (i.e., spreadsheet) and ensure that the print area is set to the information HRSA needs to review, minimizing blank cells where possible. See the NHCI-HC technical assistance webpage for an example Budget Narrative.

Allowed Uses of Funds

  1. Do I have to use NHCI-HC funds to purchase and distribute self-measured blood pressure (SMBP) devices?

    You must ensure access to and support of the use of Bluetooth or wireless-enabled SMBP devices for a majority of your patients with hypertension. Ensuring access may include the purchase of devices and/or the use of such devices already available at the health center to be distributed to patients.

  2. What are the bulk costs for SMBP devices?

    HRSA anticipates that bulk purchased devices will cost about $60 per unit. Technical assistance will be available on SMBP device options and considerations to award recipients soon after awards, including potential guidance to support bulk purchasing.

  3. What costs are allowed to support the use of SMBP devices?

    Allowed costs include personnel (e.g., health information technology staff, patient educators), training (e.g., adopting new workflows that follow clinical guidelines, teaching patients to use SMBP devices), supplies (e.g., SMBP devices, outreach materials), and equipment (e.g., servers, EHR purchase or upgrade). 

  4. Are costs to ensure the security of data transmitted by Bluetooth and wireless-enabled devices allowed?

    Yes. You are responsible to protect the confidentiality, integrity, and availability of personal health information, including safeguarding data from accidental and intentional disclosure. Detailed resources are available in the Office of the National Coordinator for Health Information Technology Health IT Playbook Chapter 7: Privacy & Security. You may use funds to support the safety of patient data, including servers, firewall protection software, and training for personnel and patients on topics such as proper use of devices and patient portals, security of passwords, and available data safety features.

  5. Are costs to support sufficient internet access to use the SMBP devices allowed?

    Yes. You may use funds to support patients’ use of SMBP devices, such as hot spots and facilitating the enrollment individuals in the Federal Communication Commission’s (FCC) Lifeline HRSA BPHC exit disclaimer subsidy program, which provides data, voice plans, and often phones to eligible individuals. If you choose to do so, you must maintain records describing how you determined the necessity of this cost. In addition, the NHCI-HC award-specific training and technical assistance may address patients’ internet access barriers.

  6. Are costs for other hypertension treatment activities allowed?

    Yes. You may use funds to support the use of hypertension treatment strategies other than remote patient monitoring through SMBP devices if they directly address the NHCI-HC purpose and requirements. Examples of such costs include nutrition counseling and patient education.

  7. Are NHCI-HC awards subject to telecommunications and video service and equipment prohibitions?

    Yes. Federal Register Notice (FRN) 85 FR 49506 prohibits you from procuring or contracting to procure certain telecommunications or video surveillance equipment or services produced by Huawei Technologies Company, ZTE Corporation, Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, and Dahua Technology Company, as well as their subsidiaries and affiliates. Additional information is provided in the FRN and in your NHCI-HC Notice of Award. HHS is developing an implementation strategy and guidance. You should incorporate these new requirements into procurement policies and procedures.

  8. Am I required to add personnel as part of my NHCI-HC project?

    There is no required FTE increase for this one-time funding that is not expected to continue beyond three years. You may use NHCI-HC funds to add new personnel or increase part-time personnel FTE to support your health center with achieving the NHCI-HC purpose and objectives.

  9. Can I use NHCI-HC funding to hire a driver to transport patients or for transporation vouchers?

    Yes. Transportation is an allowed enabling service if it moves health center patients to or from a service on your currently approved Form 5A (i.e., the service is within the scope of your Health Center Program project) and the service is provided by a health center provider. NHCI-HC funds cannot be used to purchase or lease a vehicle to transport patients.

Project Overview Form

  1. Is it required to fully participate in training and technical assistance activities offered in support of the award?

    You must select “Yes” to indicate that you will fully participate in future training and technical assistance activities offered in support of your award to be considered for funding. This will also include data submission requirements to support initiative evaluation and continuous quality improvement.

  2. What 2020 data may I use to demonstrate that my health center meets the award criteria?

    You can submit 2020 data from your EHR universe to demonstrate alignment with the award criteria. These data should be from January 1, 2020 to date. However, if you are using population health management tools to assist with aggregation and analysis of your clinical quality measure (CQM) reporting across sites, then you may use the latest data available. Please clearly describe the data source and measurement period in the 2020 Data Source field on the Project Overview Form.

  3. Can I use patient chart samples to report data for the hypertension metrics?

    No. You must use data that represent your entire patient chart universe to provide 2020 data. This should be from your EHR, if available.

  4. What resources are available to help me determine if my NHCI-HC project will require a change in scope?

    The scope of project webpage provides technical assistance materials. Contact your project officer for any additional guidance.

  5. Can I make changes to my scope of project through the NHCI-HC submission?

    No. However, you may submit a change in scope (CIS) request for HRSA prior approval, including scope adjustment or formal CIS through your project officer whenever you are ready. It is recommended that you submit such requests approximately 60 days before implementing a change, and you may submit a prior approval before receiving your NHCI-HC award.

Project Plan Form

  1. Why do I need to include an activity description in the milestone field?

    It is necessary to identify the related activity in the Milestone field because the system will not link activities and milestones.

  2. What is the difference between the Target Date field and the Milestone field?

    For each listed activity, you must click on the calendar icon next to the Target Date field to enter the milestone target accomplishment date. Then, in the Milestone field, state whether it will be ongoing or limited to year 1, year 2, or year 3.

  3. Who should outreach activities engage?

    Proposed outreach should reach new and existing patients who may be at risk for hypertension, or who may otherwise benefit from hypertension prevention, treatment, and related services.

  4. Does ensuring access to remote monitoring for a majority of patients diagnosed with hypertension mean that more than half of my hypertensive patients need to use remote monitoring SMBP devices each year?

    No. By the end of the 3-year period, you must have made access to SMBP devices available to a majority of your patients diagnosed with hypertension. You have flexibility in how you meet this requirement. In addition to devices you purchase and provide to patients, you may include devices already in use by your hypertensive patients and those provided through SMBP device loaner programs. HRSA understands that not every patient to whom you make a SMBP device available will participate. Technical assistance will be available on SMBP device options and considerations to award recipients soon after award.

  5. Is there a minimum requirement for the number of SMBP devices distributed? 

    You must ensure access to and support the use of SMBP devices for a majority (greater than 50 percent) of your adult patients with hypertension.

  6. What target date of accomplishment should I use for ongoing activities?

    Use December 31, 2023 for all ongoing activities, even if this is not the FY 2023 budget period end date for your H80 award.

Equipment List Form

  1. Do I need to complete an Equipment List Form for each year that I request NHCI-HC funds to purchase equipment? 

    Yes. Select the Equipment List Form that correlates with the budget year (i.e., Year 1, Year 2, or Year 3 tab in EHBs). 

  2. What is the total allowed equipment request amount for this submission?

    The total for equipment costs cannot exceed $150,000 across all three years (i.e., Year 1, Year 2, and Year 3).

  3. How do I determine if an equipment item is clinical or is non-clinical?

    To differentiate between non-clinical and clinical equipment, refer to the definitions of “general equipment” and “specialized equipment,” respectively, in 45 CFR § 75.2. An example of non-clinical equipment is information technology equipment. Examples of clinical equipment include point of care laboratory tests, EHR systems and upgrades, and telehealth systems.

  4. How should I categorize equipment that costs less than $5,000?

    For budget purposes, the only items that should be listed on the Equipment line are those with a unit price of $5,000 or more. Items with a unit cost of less than $5,000 are listed under Supplies.

Resources

  1. What resources are available for me to help me with my submission?

    • Visit the Million Hearts website for more information regarding self-measured blood pressure monitoring
    • The ONC Health IT and ONC Patient Engagement Playbooks provide strategies, recommendations, and best practices to implement and use health information technology. 
    • HRSA has several strategic partnerships that provide national-level training and technical assistance. The HITEQ HRSA BPHC exit disclaimer Center offers training on integrating EHR and health information technology, or health IT systems. Health Center Controlled Networks (HCCNs) work together to improve clinical practices by making health information technology easier for patients and providers to use, increasing the security of patient information, and using data to improve patient care. 
    • The Federal Communications Commission (FCC) Lifeline HRSA BPHC exit disclaimer subsidy program is a program to help make communications services more affordable for eligible consumers.

Other

  1. What if I have additional questions or issues with my submission? 

    For submission information, please refer first to the resources available on the NHCI-HC technical assistance webpage. For outstanding questions, use Health Center Program SupportHRSA BPHC exit disclaimer (select Application for Issue Type, then select National Hypertension Control Initiative for issue subtype). All inquiries will be directed to the NHCI-HC team. 

  2. What if I have issues with the EHBs?

    For EHBs system issues, health centers should utilize Health Center Program Support HRSA BPHC exit disclaimer. Select “Application Systems Question”, then National Hypertension Control Initiative for issue subtype or the designated phone line, 1-877-464-4772, option 2.

Date Last Reviewed:  January 2021