FY 2021 SBSS Frequently Asked Questions

Updated: 3/30/2021

Introduction

The information provided below, along with the SBSS Electronic Handbooks (EHBs) User Guide for Applicants and example forms available on the SBSS technical assistance webpage will support the development of your SBSS application in response to the SBSS notice of funding opportunity (NOFO). If your question is not answered through these resources, submit it through the BPHC Contact Form. Select:

  • Requester Type: Current Award Recipient
  • Health Center or EHBs Question category: Health Center
  • BPHC Category: Applications
  • BPHC Subcategory: Service Expansion – School-Based Service Sites (SBSS)

Eligibility

  1. Are look-alikes and/or other entities not currently receiving Health Center Program funding eligible to apply for SBSS funding?

    No. Only current Health Center Program award recipients with an active H80 grant award may apply for SBSS funding.

  2. Do I need to be currently operating a school-based service site to apply for SBSS funding?

    No. If you do not already have a school-based service site in your H80 scope of project, you may propose one or more in your SBSS application. Any site added through this funding opportunity must be: (1) located in your current service area, and (2) located in a school or on school grounds. Refer to the NOFO for key definitions, guidance, and resources. Refer to the Sites resources on the Scope of Project webpage for detailed guidance on adding a new site.

  3. What counts as a school when determining where to propose expanding school-based services?

    The SBSS NOFO focuses on the expansion of health center services at or on the grounds of schools that serve children and adolescents. For the purposes of this NOFO, schools are defined as preschool, kindergarten, primary, and secondary schools (preschool through grade 12).

  4. What letters of support are required to be eligible?

    To be considered eligible, you must include a letter of support specific to the proposed SBSS project from each school or school district in which expanded services will be provided. If you do not provide a letter of support from each school or school district, your application will be deemed ineligible.

  5. How will HRSA determine if my service delivery site is a school-based service site?

    HRSA will determine if your service delivery site is a school-based service site by reviewing the Site Setting field of Form 5B: Service Sites and confirming that the “School” option is selected. If the “School” option is not selected, you will be deemed ineligible. If you have an existing service site, HRSA will review the Form 5B: Service Sites that is currently in EHBs. If you are proposing a new site, or proposing minor alteration and renovation at an existing site, HRSA will review Form 5B: Service Sites submitted with your SBSS application. For the purpose of SBSS, school refers to preschool through grade 12 (see FAQ number 3).

  6. How do we record our mobile unit on Form 5B: Service Sites if it is on school grounds during the day and parked at our health center at night?
    A mobile unit on the grounds of a school counts as a school-based service site. For the site address on Form 5B, list the primary address where the unit is parked. This may or may not be the school’s address (e.g., the unit is on school grounds during the day and parked at one of your health center sites). You must select “School” as the Site Setting on Form 5B to be eligible and describe where the mobile unit provides services in your application’s narrative.

Scope of Project

  1. If we purchase a new mobile unit, would this be considered an expansion of our existing school-based service site or a new site?

    Any mobile unit purchased with SBSS funding must be used to increase the number of patients served at school-based service sites. Purchasing a mobile unit for this purpose would be considered a new site, and each mobile unit should be listed as a separate site on Form 5B: Service Sites. New sites are required to be operational within 120 days of award.

    Refer to PIN 2008-01 for special instructions for recording mobile unit sites. If you are proposing a mobile unit, list the primary address where the unit is parked as the site address. This may or may not be at or on school grounds (e.g., the unit is on school grounds during the day and parked at one of your health center sites). You must select the “School” option as the Site Setting on Form 5B to be eligible.

  2. How does HRSA define service expansion for this NOFO?

    Service expansion addresses unmet need in your approved service area by increasing the number of patients served at school-based sites. This may include adding or expanding one or more of the following services at a new or existing school-based service site:

    • General primary medical care,
    • Mental health,
    • Substance use disorder,
    • Oral health,
    • Vision, and/or
    • Enabling services

    Expanded services may be provided to health center patients through face-to-face and/or telehealth visits to school-based service site patients. However, a school-based service site, by definition, must include some face-to-face services.

    If scope adjustments and change in scope requests for new services are required for Form 5A: Services Provided, you must submit these changes outside of the SBSS application, and obtain approval before implementation. Access the technical assistance materials on the Scope of Project webpage and contact your H80 project officer for guidance in determining if a scope adjustment or change in scope will be necessary.

  3. Is guidance available for the number of additional school-based service site patients I should plan to serve?

    Patient increase projections should be realistic and achievable and based on need, capacity, and, if you are currently operating school-based service sites, your school-based service site patient trend. Keep in mind that your overall increase in school-based service site patients, based on your UDS data over time, will be used to inform decisions about SBSS funding beyond the initial 2 years of funding.

  4. Can I propose a new site that will offer only one service, such as medical services?

    Yes, a school-based service site may offer only one service, such as medical services. However, patients of the school-based service site must have access to the full range of required Health Center Program services, either through other sites in the health center’s scope of project and/or by referral.

  5. Can I propose to provide services only to children and adolescents who attend the school affiliated with my school-based service site?

    No. Your school-based service site must ensure members of the general community, including students and staff, will have access to all required primary health care services, not only during school hours, but also when the school is closed. This can be accomplished through services at your school-based site, at your other in-scope sites, or through referrals. Health centers are encouraged to determine how to best ensure access to services to those other than students.

  6. Can I propose to operate a school-based service site at a non-public school?

    Yes. School-based service sites may be located at non-public schools. Such sites must ensure access to services for all individuals who seek care and may not be limited to the school community.

  7. Do I need to include a Memorandum of Understanding (MOU) from a school with my application?

    While a formal MOU is not required, a letter of support from each school and/or school district in which service expansion is proposed, is required. If such letters are not provided, your application will be ineligible for review.

Telehealth

  1. Does my SBSS project have to support the use of telehealth?

    No. However, you should consider whether telehealth would be an appropriate means to increase the number of patients school-based service sites serve. Locations where all services are exclusively delivered via telehealth are not allowable since they would not meet the “face-to-face” criterion of the service site definition (see PIN 2008-01: Defining Scope of Project and Policy for Requesting Changes).

  2. Can I use SBSS funding to provide services to patients at a school-based service site via telehealth from another site in my scope of project?

    Yes. SBSS funding may be used to provide services to health center patients through face-to-face and/or telehealth visits to students located at school-based service sites. Keep in mind that a school-based service site, by definition, must include some face-to-face services. As you develop your project, it may be helpful to consider that a school-based service site is an access point for comprehensive primary care services and is not intended to take the place of or duplicate care provided directly by the school (e.g., routine school nurse services). For more information and different telehealth scenarios, see PAL 2020-01: Telehealth and Health Center Scope of Project.

  3. Are SBSS awards subject to telecommunications and video service 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 will be provided in the SBSS Notice of Award. HHS is developing an implementation strategy and guidance. You should incorporate these new requirements into procurement policies and procedures.

Budget and Project Planning

  1. I am proposing multiple school-based service sites. What address should I list in my application?

    On the Project/Performance Site Locations Form in the Grants.gov section of your application, list the address for the primary school-based service site where you will be expanding services. For Form 5B: Service Sites in the EHBs section of your application, list all proposed new school-based service sites, as applicable. In the Response section of your Project Narrative, name all sites (you do not need to provide the site address), both existing and new, where service expansion will occur.

  2. Due to the ongoing COVID-19 pandemic, will HRSA extend the 120-day requirement for new school based service sites being open and operational?

    Applications must present a reasonable and achievable plan to have all proposed new school-based service sites open and operational within 120 days of award (approximately late December 2021). However, additional time may be permitted beyond 120 days if health centers experience unanticipated challenges implementing proposed timelines, such as if schools where sites are proposed are not open in the fall.

  3. How do I determine the appropriate proportions to distribute the budget across CHC, MHC, HCH, and PHPC funding sub-programs?

    If your H80 award is funded through more than one sub-program/population type (Community Health Center = CHC, Migrant Health Center = MHC, Health Care for the Homeless = HCH, and/or Public Housing Primary Care = PHPC), you will need to distribute your budget proportionally. If you have questions about the appropriate sub-program amount, contact your Grants Management Specialist or the SBSS technical assistance team using the BPHC Contact Form. Select “Health Center” on Question screen, “Applications” for BPHC Category and Service Expansion- School-Based Service Sites (SBSS)” for Sub-category.

  4. 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. Refer to section 5.2 of HRSA’s SF-424 Two-Tier Application Guide for further guidance. See the SBSS technical assistance webpage for an example Budget Narrative.

  5. Am I required to have an indirect cost rate agreement?

    If you include indirect costs in your budget, you must provide your indirect cost rate agreement. Your indirect cost rate agreement does not count toward the 60-page limit. 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 charted as direct line-item costs.

    Under 45 CFR § 200,414(f), you 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. Upload a copy of the agreement in Attachment 3: Other Relevant Documents.

  6. Will SBSS funding continue beyond the two years?

    Although you will apply for two years of funding, SBSS funding may extend to future years. Future funding is subject to the availability of appropriated funds for SBSS in subsequent fiscal years, satisfactory increase in the number of patients served at your school-based sites, as measured by the Total School-Based Health Center Patients measure, found in Table 4, Line 24 of the UDS Manual and Tables, and a decision that continued funding is in the best interest of the federal government.

Minor Alteration and Renovation (A/R) and Equipment

  1. What is minor A/R?

    Allowable minor A/R is work required to reconfigure interior space to enable you to increase the number of patients served at your school-based service sites. This type of project does not increase the total square footage of an existing building, and does not require ground disturbance. An allowable minor A/R project must be a stand-alone project consisting of work in an existing facility required to:

    • Install fixed equipment,
    • Modernize, improve, and/or reconfigure the interior arrangements or other physical characteristics of a facility,
    • Repair and/or replace the exterior envelope,
    • Improve accessibility such as curb cuts, ramps, or widening doorways, and/or
    • Address life safety requirements.

    Minor A/R and equipment costs combined are limited to $150,000 in year 1. Minor A/R costs are not allowable in year 2. Major A/R (i.e., renovations with a total budget of $500,000 or more) and new construction (e.g., adding floors or build-outs to a current facility, expanding parking areas) are not allowable.

  2. What are allowable equipment purchases?

    Equipment purchases must support an increase in the number of patients accessing comprehensive primary care at school-based service sites. Equipment includes non-expendable, moveable items (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost of $5,000. Examples include:

    • Mobile unit for the purpose of service expansion.
    • Telehealth equipment.
    • Dental chairs and other dental equipment.
    • Spot vision screeners.
    • EHR systems (with the exception of licenses, which count as supplies).
  3. Can I use one-time funding to pay for a portion of a large equipment purchase?

    Yes. You can use other funding sources to cover the remaining costs of purchasing equipment beyond the $150,000 SBSS limit.

  4. Is equipment installation considered a minor A/R cost or an equipment cost?

    The work required to install equipment is considered minor A/R. Minor A/R also includes costs such as enhancing or installing heating, ventilation, and air conditioning (HVAC) to promote air quality and hygiene, signs in or on an existing building, and lighting.

  5. Can I use SBSS funds to purchase a vehicle to transport patients?

    No. Vehicles for transportation are not allowable. However, a mobile unit in which health care services are delivered is not considered a vehicle and is an allowable cost (see PIN 2008-01: Defining Scope of Project and Policy for Requesting Changes). 

  6. If we propose minor A/R, what are the environmental and historic preservation requirements?

    See the Capital Development page for detailed information on environmental and historic preservation compliance requirements. Although applicants proposing minor A/R projects typically do not require preparation of a full Environmental Assessment under the National Environmental Policy Act (NEPA), you should consider the following:

    • If the proposed project involves exterior work (e.g., windows) or work on a building that is over 50 years old, the project may require State Historic Preservation Office (SHPO) consultation under Section 106 of the NEPA.
    • Buildings constructed prior to 1985 may require submission of a hazmat study abatement plan.
    • If the site is located in a coastal state, the project may require compliance with the Coastal Zone Management Act.
    • If the proposed project is in a 100- or 500-year floodplain, it may require compliance with Executive Order (E.O.) 11988, Floodplain Management.
  7. Can I propose minor A/R for a site that is leased?

    Yes, leasehold improvements are allowed. However, SBSS funds cannot be used to address facility needs that are part of the terms of the lease (i.e., the obligations of the lessor). If proposing minor A/R for a leased facility, you must attach a signed Landlord Letter of Consent (LLOC) from the facility owner in the Other Requirements for Sites form.

Project Narrative

  1. Can I use 2019 UDS data as my baseline for projecting the school-based service site patient increase?

    HRSA will track your progress using your 2020 UDS data as the baseline. You may reference other years of UDS data in your Project Narrative, as desired.

  2. New What letters of support should I include in my application?

    In addition to the letters of support required for eligibility, for each new school-based service site that you propose, you should include letters of support from the following in your service area: Health Center Program award recipients and look-alikes, other health providers/organizations, and community based organizations that serve children and adolescents. If you are unable to obtain these collaborative letters of support, you must document efforts to obtain these letters in the Collaboration section of your Project Narrative.

Staffing

  1. May I add personnel as part of my SBSS project?

    Personnel costs are allowable to support service delivery to an increased number of patients through school-based service sites.

  2. Can I use SBSS funding for recruitment incentives to secure qualified personnel for this project?

    Yes. Recruitment incentives may be part of a salary package supported by SBSS funding, if consistent with your health center’s standard practice. Any incentives should be covered through your indirect cost rate, if applicable. If you have no indirect cost rate agreement, incentives should be charged as direct costs.

  3. Can I use SBSS funding to pay recruitment agency fees?

    Yes. Costs or fees associated with an outside recruitment agency to hire personnel to support the SBSS project are allowed.

  4. May SBSS funding be used to increase salaries for existing personnel who are currently compensated at less than 100 percent FTE with federal funding?

    SBSS 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 FTE across all federal awards.

Reporting

  1. How will I report on my service expansion efforts beyond the increase in the number of patients served by my school-based service sites?

    In addition to your UDS reporting, you will describe other aspects of progress (e.g., on planned activities) through semi-annual progress reports and a Non-Competing Continuation (NCC) progress report.

  2. Can I use my H80 Budget Period Progress Report (BPR) to report initial SBSS progress?

    No. You will report SBSS progress through semi-annual progress reports and a Non-Competing Continuation (NCC) that is separate from your H80 BPR NCC.

  3. How will HRSA assess my increase in the number of patients served?

    HRSA will use the Total School-Based Health Center Patients measure, found in Table 4, Line 24 of the UDS Manual and Tables. Your baseline will be the number of school-based service site patients you included in your 2020 UDS report. Note that the UDS measure includes the number of patients served at all of your school-based service sites. For the purpose of this NOFO, school-based service sites are defined as Health Center Program award recipients’ service delivery sites that are located at or on the grounds of a school, school grounds including preschool, kindergarten, and primary through secondary schools (preschool through grade 12); however, when submitting your UDS reports, you will follow the UDS measure definition and include the patients served at school-based service sites on or near school grounds, including preschool, kindergarten, and primary through secondary schools.

Date Last Reviewed:  March 2021