FY 2021 Service Area Competition (SAC) Frequently Asked Questions (FAQs)

Below are common questions and corresponding answers for the fiscal year (FY) 2021 Service Area Competition (SAC) funding opportunity. New FAQs will be added as necessary. Refer to the SAC Technical Assistance webpage often for updates.

Eligibility

  1. Can we apply for SAC funding if we do not currently receive Health Center Program funding? Can we apply to serve multiple service areas?

    Yes, you can apply for SAC funding if you do not currently receive Health Center Program funding, 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-21-002), you must contact the SAC Response Team at 301-594-4300 or using the BPHC Contact Form HRSA BPHC exit disclaimer for guidance well in advance of the Grants.gov submission deadline.

  2. 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 Change in Scope (CIS), 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).

  3. 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, enter all zip codes listed in the SAAT for that service area on Form 5B. This is an eligibility criterion, so it is recommended that you double-check this before submitting your application.

Program Requirements

  1. 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.

    If you have any conditions on your SAC award, following The Compliance Resolution process for competing continuation applicants, you will receive a 1-year period of performance and must submit a Compliance Achievement Plan within 120 days of receipt of your Notice of Award (NoA) outlining a plan to come into compliance.

  2. 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 Indian tribes or tribal or Indian organizations under the Indian Self-Determination Act, or urban Indian organizations under the Indian Health Care Improvement Act (25 U.S.C. 1651).

  3. 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.  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.

Service Areas

  1. 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.

  2. 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 HRSA BPHC exit disclaimer. 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).

  3. What do the green, yellow, and pink shading mean in the SAAT?

    Green shading on zip codes indicates the current award recipient’s defined service area from Form 5B: Service Sites.

    Yellow shading represents a service area where the current award recipient is in a first 1-year period of performance.

    Pink shading represents a service area where the current award recipient is in a second consecutive 1-year period of performance. These service areas are in jeopardy of having a gap in Health Center Program funding and services if HRSA does not receive an eligible, fundable application.

  4. Where can we get more information about the Patient Target in the SAAT?

    Reference the Patient Target FAQs for more information.

  5. Why are there fewer service areas announced in the SAAT this year than in previous years?

    To provide flexibility during the COVID-19 pandemic response, HRSA extended the periods of performance of the majority of health centers scheduled to complete a SAC in FY 2021. Health centers that had a 2-year or 3-year period of performance ending in FY 2021 received a 12-month extension with funds and will be announced for competition in an FY 2022 SAC.

Application Preparation and Submission Requirements

  1. Does HRSA have guidelines (e.g., font type, font size) for the narrative and attachments of the SAC application?

    Yes, you should submit single-spaced narrative documents with 12 point, easily readable font (e.g., Times New Roman, Arial, Courier), and 1-inch margins. Smaller font (no less than 10 point) may be used for tables, charts, and footnotes. HRSA will accept PDF, Microsoft Word, and/or Excel files. If using Excel or other spreadsheet documents, be aware that reviewers will only see information that is set in the “Print Area” of the document. Upload the attachments in portrait orientation. For more information, reference the SF-424 Two-Tier Application Guide (PDF - 719 KB). Your total page count should not exceed 160 pages.

Performance Measures

  1. How should we develop baselines and goals for the performance measures?

    Baselines should be developed using data that are valid, reliable, and whenever possible, derived from currently established management information systems. Data sources may include electronic health records, disease registries, and/or chart sampling. Refer to the SAC Technical Assistance webpage for technical assistance resources.

    If data are not available to develop baselines, enter zeros in the Numerator and Denominator fields and provide an explanation in the Comments field describing when baseline data will be available. Competing continuation applicants cannot change the pre-populated baseline data from the 2019 UDS report for required performance measures. However, baseline data will be blank and must be completed for the three new clinical performance measures (Depression Remission at 12 Months, Breast Cancer Screening, and HIV Screening) and one revised clinical performance measure (HIV Linkage to Care).

    Goals (projected data) should be realistic for achievement by December 31, 2022 (measurement period will be calendar year 2022). They should be based on data trends and expectations, factoring in predicted contributing and restricting factors.

Budget

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

    Yes, the federal request for funding should not exceed the Total Funding amount listed in the SAAT for the service area for FY 2021.

    Available Funding for a service area has the potential to change slightly as FY 2020 funding actions are completed. Check the SAAT prior to submitting the application in EHBs to confirm the final FY 2021 funding amount and support submission of an accurate budget request.

  2. 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. In EHBs, provide actual budget information on the SF-424A and Budget Narrative. 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 available as listed in the SAAT.

Forms

  1. 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. The abstract that was attached in Grants.gov can be deleted and replaced in EHBs on the SF-424 Part 2 page, under the Project Description section.

  2. 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 should not be included in the Direct Hire FTE column.

  3. Should the same information be provided on the Project Performance Site Location(s) Form in Grants.gov and on Form 5B: Service Sites in EHBs?

    Enter information for the site that you consider to be your primary service delivery site on the Project Performance Site Location(s) Form.

    If you are a competing continuation applicant, Form 5B: Service Sites will be pre-populated from your current scope of project and cannot be modified through this application.

    If you are a new or competing supplement applicant, complete Form 5B: Service Sites for each proposed administrative, service delivery, and administrative/service delivery site.

  4. What are “Other Activities/Locations” and how should these be recorded on Form 5C: Other Activities/Locations?

    Use this form to document activities that support the scope of project that:

    • Take place at locations that do not meet the definition of a service site,
    • Are conducted on an irregular timeframe/schedule, and
    • Offer a limited activity from within the full complement of health center activities included in the scope of project.

    For further information on Other Activities and Locations, review PIN 2008-01: Defining Scope of Project and Policy for Requesting Changes.

  5. What organizations are eligible for a waiver of the governance requirements on Form 6B: Request for Waiver of Board Member Requirements?

    If you are requesting funding for only MHC, HCH, and/or PHPC (i.e., are not requesting CHC funding), you may request a waiver of the board composition requirement. See Chapter 20: Board Composition of the Health Center Program Compliance Manual.

Attachments

  1. To whom should letters of support be addressed and how should they be provided?

    Letters of support should be addressed to the appropriate applicant organization contact person (e.g., board, CEO). They should not be addressed to HRSA or mailed separately from the application. Letters of support must be included with the application as Attachment 9: Collaboration Documentation or they will not be considered by objective reviewers. Consider the 160 page limit when adding letters of support beyond those requested in the SAC notice of funding opportunity.

  2. Our health center is currently operational at all proposed sites. What should be included in Attachment 12: Operational Plan?

    If you are already operational, ensure that the application as a whole demonstrates this. Additionally, planned changes to factors such as access to care, services, outreach, and collaborations/partnerships (or any other changes that would result from the award) should be included in the plan.

Application Submission

  1. 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 by the Grants.gov due date 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.

  2. 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.

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

    A new EHBs feature allows the AOR 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 AOR must resubmit the reopened application in EHBs by 5:00 p.m. ET on the EHBs due date for the application to be considered.

Additional Information

  1. 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 HRSA BPHC exit disclaimer.

Date Last Reviewed:  July 2020