HRSA 330 Health Center Program Guide

The practitioner's reference for Section 330 compliance — covering eligibility, NOFO applications, the 19 Program Requirements, UDS reporting, budget management, and the mistakes that trip up even experienced health center grants managers.

What Is the HRSA Section 330 Program?

The Health Center Program, authorized under Section 330 of the Public Health Service Act (42 U.S.C. § 254b), is the federal government's primary vehicle for funding community-based primary care. Administered by the Health Resources and Services Administration (HRSA) Bureau of Primary Health Care (BPHC), the program funds Federally Qualified Health Centers (FQHCs) to deliver comprehensive primary care, behavioral health, dental, and enabling services to medically underserved populations regardless of ability to pay.

The program is listed under CFDA 93.224 (now known as the Assistance Listing Number) and represents the largest federal investment in community-based primary care. In FY 2024, HRSA awarded over $6 billion through the Health Center Program, supporting nearly 1,400 health center organizations operating more than 15,000 service delivery sites nationwide. These health centers serve over 30 million patients annually, including populations experiencing homelessness, residents of public housing, migratory and seasonal agricultural workers, and residents of rural and urban medically underserved areas.

Section 330 Funding Streams

The Health Center Program operates through several distinct funding authorities, each targeting a specific population or need. Understanding these streams is critical because each carries its own eligibility criteria, reporting requirements, and compliance expectations.

Funding StreamAuthorizing SectionTarget Population
Community Health Centers (CHC)330(e)Medically underserved areas/populations
Migrant Health Centers (MHC)330(g)Migratory and seasonal agricultural workers
Health Care for the Homeless (HCH)330(h)People experiencing homelessness
Public Housing Primary Care (PHPC)330(i)Residents of public housing

Many health centers hold multiple funding streams simultaneously — for example, a CHC with 330(e) base funding plus a 330(h) Homeless designation. Each stream adds service requirements, reporting obligations, and population-specific compliance expectations. Your UDS reporting must disaggregate data by funding stream, and your budget must demonstrate how funds are allocated across streams.

The Compliance Landscape

Health center compliance operates on multiple levels. At the federal level, Section 330 grantees must satisfy 19 Program Requirements established by BPHC, comply with the Uniform Administrative Requirements under 2 CFR Part 200, and meet the terms and conditions of their Notice of Award. Health centers that receive $750,000 or more in federal expenditures in a fiscal year must also complete a Single Audit under the provisions of Subpart F of 2 CFR 200.

Beyond the federal layer, health centers must comply with state licensure requirements, state-specific Medicaid managed care contracts, FTCA medical malpractice coverage requirements (for deemed health centers), and any supplemental funding requirements from state or local sources. The layered compliance environment is one of the primary reasons that health center grants management requires dedicated staff with deep program knowledge.

Key Dates and Deadlines

Health center grants managers track a continuous calendar of compliance deadlines. The major recurring obligations include:

DeadlineTypical Due DatePortal
UDS Annual ReportMid-February (for prior calendar year)EHBs
SF-425 Federal Financial Report30 days after each budget period quarterEHBs
Non-Competing Continuation (NCC)~120 days before budget period startEHBs
FTCA Deeming ApplicationVaries (typically annually)EHBs
Single Audit (if applicable)9 months after fiscal year endFederal Audit Clearinghouse
Service Area Competition (SAC)Per NOFO (typically 3–5 year cycle)EHBs

FQHC Designation and Its Significance

Organizations that receive Section 330 grant funding are automatically designated as Federally Qualified Health Centers (FQHCs). This designation unlocks significant financial benefits beyond the grant itself, including enhanced Medicaid and Medicare reimbursement through the Prospective Payment System (PPS), eligibility for the 340B Drug Pricing Program, National Health Service Corps (NHSC) site eligibility, and Federal Tort Claims Act (FTCA) medical malpractice coverage.

For many health centers, the value of FQHC designation — particularly enhanced reimbursement and 340B savings — far exceeds the dollar amount of the Section 330 grant itself. This is why maintaining compliance with the 19 Program Requirements is existential: losing the grant means losing the designation, which means losing the financial infrastructure that supports the entire organization. For a deeper look at how FQHC designation connects to your funding strategy, see our FQHC compliance portal.

How This Guide Is Organized

This guide is structured around the lifecycle of a Section 330 grant — from determining eligibility through ongoing compliance management. Each section is written for grants managers, compliance officers, and finance directors who manage Section 330 awards on a day-to-day basis.

Frequently Asked Questions

What is the difference between an FQHC and an FQHC Look-Alike?

An FQHC receives Section 330 grant funding directly from HRSA and is automatically designated as federally qualified. An FQHC Look-Alike (LAL) meets all of the same 19 Program Requirements and undergoes similar HRSA oversight, but does not receive Section 330 grant funding. Look-Alikes still receive enhanced Medicaid and Medicare reimbursement under PPS and are eligible for 340B, but they do not receive FTCA coverage and cannot access HRSA-specific supplemental funding opportunities. Many organizations pursue Look-Alike designation as a stepping stone toward a Section 330 New Access Point (NAP) application. For detailed eligibility criteria, see the eligibility requirements page.

How often do health centers need to recompete for Section 330 funding?

Health centers participate in the Service Area Competition (SAC) on a rolling cycle, typically every 3 to 5 years. Between competitions, grantees submit Non-Competing Continuation (NCC) applications annually to maintain funding. The NCC is not a formality — HRSA reviews operational and financial performance, and continuation funding can be reduced or conditioned based on compliance issues. New Access Point (NAP) competitions occur when Congress appropriates expansion funding, though the timing is not predictable. See the application and NOFO guide for details on each competition type.

What happens during an Operational Site Visit (OSV)?

An OSV is HRSA's on-site assessment of a health center's compliance with the 19 Program Requirements. BPHC consultants review governance documents, board meeting minutes, financial systems, sliding fee discount policies, credentialing files, quality improvement programs, and clinical operations. The visit typically lasts 2–3 days and results in findings categorized as met, partially met, or not met. Findings of non-compliance trigger progressive action, which can range from conditions of award to potential termination. Health centers typically receive 60–90 days notice before an OSV. See our compliance requirements page for OSV preparation strategies.

What is the Uniform Data System (UDS) and when is it due?

The UDS is an annual reporting requirement for all Section 330 grantees and Look-Alikes. It captures comprehensive data on patient demographics, services provided, clinical quality measures, staffing, costs, and revenue across the calendar year (January 1 – December 31). The report is due in mid-February of the following year — typically around February 15 — and is submitted through the Electronic Handbooks (EHBs) portal. UDS data drives HRSA's oversight decisions, informs funding allocations, and feeds into the public Health Center Program data dashboard. Data quality errors in UDS can trigger BPHC follow-up and can negatively impact competitive applications. See the reporting requirements page for a detailed UDS walkthrough.

Can a health center use Section 330 funds for construction or renovation?

Section 330 operational grant funds generally cannot be used for major construction. However, minor alteration and renovation (A&R) may be allowable with prior HRSA approval, subject to thresholds defined in the Notice of Award conditions. Major capital projects require separate capital development funding — HRSA periodically releases Capital Development NOFOs for this purpose. Any facility changes that alter the approved scope of project (adding or removing sites, changing service capacity) require a Change in Scope (CIS) request through EHBs before implementation. See the budget and financial management page for details on allowable costs and prior approval requirements.

How does Section 330 interact with other federal funding?

Health centers commonly hold multiple federal awards simultaneously — Ryan White HIV/AIDS Program funds, SAMHSA behavioral health grants, CDC screening grants, and others. Each award carries its own compliance framework under 2 CFR 200, and costs must be properly allocated across funding sources. The Section 330 grant cannot be used to supplant (replace) funding available from other sources, and cost allocation plans must demonstrate that shared costs are distributed equitably. Health centers receiving $750,000 or more in total federal expenditures must complete a Single Audit that covers all federal programs. The interplay between Section 330 requirements and other federal grant requirements is one of the most challenging aspects of health center financial management.

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