FY 2022 Service Area Competition (SAC) Frequently Asked Questions (FAQs)

Below are common questions and corresponding answers for the fiscal year (FY) 2022 Service Area Competition (SAC) funding opportunity. New FAQs will be added as necessary. Refer to the SAC Technical Assistance webpage often for updates.

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.

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-22-002), 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.

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).

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

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 will have any conditions on your SAC award, including conditions based on HRSA’s review of your application (for all applicants) and conditions carrying over from one period of performance to another (for competing continuation applicants), you will receive a 1-year period of performance. 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.

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).

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

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.

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).

Funding Priority

What changes are there to the funding priority?

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 awarded to competing continuation applicants (1) with no active conditions related to Health Center Program requirements at the time of application submission, and (2) that are not currently in a one-year period of performance. The 5 priority points previously associated with these factors (compliance) are now awarded based on having one or more sites with PCMH recognition at the time of application review.

A positive or neutral patient growth trend (+/- 5 percent) continues to be worth 5 points, though HRSA will consider both a 2-year trend and a 3-year trend when determining priority points.
Information about Patient-Centered Medical Home is available on the National Committee for Quality Assurance website.

How is patient growth calculated when assessing the funding priority?

HRSA has changed the calculation for patient growth to account for the affect of COVID-19 on the number of health center patients. The most recent 2- or 3-year data, as reported in the Universal Data System (UDS), are utilized to calculate the patient growth trend. The calculation for the 3-year growth trend is as follows: [(Most current Total Patients value – Total Patients value from 2 years prior)/Total Patients value from 2 years prior] x 100. The calculation for the 2-year growth trend is as follows: [(Most current Total Patients value – Total Patients value from 1 year prior)/Total Patients value from 1 year prior] x 100.

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.

Budget

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, your federal request for funding should not exceed the Total Funding amount listed in the SAAT for the service area for FY 2022.

Available funding for a service area has the potential to change slightly as FY 2021 funding actions are completed. Check the SAAT prior to submitting your application in EHBs to confirm the final FY 2022 funding amount and support submission of an accurate budget request.

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.

Forms

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 of the Compliance Manual for information about such documentation. New applicants must also submit this documentation in Attachment 11: Evidence of Nonprofit or Public Center Status.

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 provided in Grants.gov can be deleted and replaced in EHBs on the SF-424 Part 2 page, under the Project Description section.

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.

Application Submission

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.

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.

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.

Additional Information

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:  June 2021