Understanding the NOFO Landscape
The Health Center Program operates through several distinct Notice of Funding Opportunity (NOFO) competitions. Each serves a different purpose, targets different applicants, and follows a different timeline. Understanding which NOFO applies to your situation is the first step in the application process.
All Section 330 NOFOs are published on Grants.gov and announced through HRSA's Bureau of Primary Health Care (BPHC) communications. However, the primary application portal for most Health Center Program NOFOs is HRSA's Electronic Handbooks (EHBs), not Grants.gov. This is an important distinction — many applicants who are accustomed to other federal grants expect to submit through Grants.gov, but HRSA uses EHBs for most Health Center Program competitions.
Types of Section 330 Competitions
New Access Points (NAP)
NAP competitions provide funding to establish new health center service delivery sites or to fund new organizations as Section 330 grantees for the first time. NAP NOFOs are released when Congress appropriates expansion funding, which means they do not follow a predictable schedule. When released, NAP competitions are highly competitive — typically attracting 3–5 applications for every award. Awards generally range from $650,000 to $800,000 per year for a 3-year project period.
NAP applications require the most comprehensive documentation of any Section 330 competition. Applicants must demonstrate every element of eligibility, provide a detailed needs assessment, present a 3-year operational plan, submit a complete budget with justification, and provide evidence of community support and organizational capacity. Organizations with existing FQHC Look-Alike designation have a significant advantage because they can point to an established track record of meeting the 19 Program Requirements.
Service Area Competition (SAC)
SAC is the periodic re-competition for existing service areas. When a current grantee's project period ends (typically every 3–5 years), HRSA opens the service area to competition. The current grantee must reapply and may face competition from other qualified organizations seeking to serve the same area. In practice, incumbent grantees win the vast majority of SAC competitions, but HRSA has awarded SAC funds to new organizations when incumbents demonstrate significant compliance or performance problems.
SAC applications are comprehensive but benefit from the applicant's existing operational data. Current grantees should leverage their UDS data, OSV results, and patient outcome trends to demonstrate effectiveness. The project narrative should emphasize improvements made during the prior project period and present a compelling vision for the next period.
Supplemental Funding Opportunities
HRSA periodically releases supplemental funding NOFOs limited to current Section 330 grantees. These include:
- •Expanded Services: Funding to add new service types (behavioral health, oral health, pharmacy, vision) to existing operations
- •Quality Improvement: Targeted funding for clinical quality measure improvement and health IT adoption
- •Capital Development: Funding for construction, renovation, or equipment acquisition
- •Behavioral Health Integration: Funding to integrate mental health and substance use disorder services into primary care
Supplemental NOFOs typically have shorter application periods (30–60 days) and less burdensome application requirements than NAP or SAC. However, they often require a Change in Scope (CIS) request if the funded activity changes your approved scope of project.
Non-Competing Continuation (NCC)
Between competitive cycles, current grantees submit annual Non-Competing Continuation applications to maintain their funding. The NCC is submitted through EHBs approximately 120 days before the start of the next budget period. While not a competition, the NCC is a compliance checkpoint — HRSA reviews performance, financial status, and compliance with conditions of award before releasing continuation funding.
The NCC requires an updated budget, progress report, and response to any outstanding conditions of award. Funding levels may be adjusted based on congressional appropriations, performance, or compliance issues. Do not treat the NCC as a formality — late or incomplete NCC submissions can delay funding by weeks or months.
The EHBs Application Portal
HRSA's Electronic Handbooks (EHBs) is the primary portal for Health Center Program applications, reporting, and compliance management. If you are applying for Section 330 funding, you will spend significant time in EHBs — and the system has its own learning curve.
EHBs Access and Roles
Organizations must register in EHBs and designate an Authorized Organization Representative (AOR) who has legal authority to submit applications and reports on behalf of the organization. Additional users can be granted access with specific roles (e.g., data entry, review, submission). Key points:
- •The AOR is typically the CEO, Executive Director, or authorized designee
- •Only the AOR can submit applications and certify reports
- •Multiple users can work on an application simultaneously, but only one user can edit a specific form at a time
- •EHBs has scheduled maintenance windows — do not plan to submit on the deadline day without confirming system availability
Application Forms in EHBs
A typical Section 330 application in EHBs includes the following components:
| Component | Description | Key Tips |
|---|---|---|
| SF-424 Face Page | Standard federal grant application cover page | Ensure UEI matches active SAM.gov registration |
| SF-424A Budget | Federal budget form with standard object class categories | Must align precisely with budget narrative |
| Project Narrative | Need, response, evaluative measures, impact, support | Follow the NOFO outline precisely; use NOFO language |
| Budget Narrative/Justification | Line-by-line explanation of every budget item | Every line must connect to activities in project narrative |
| Scope of Project (Form 5A/5B/5C) | Sites, services, service area, and provider staffing | Forms 5A/5B/5C must be internally consistent |
| Bylaws and Board Documentation | Current bylaws, board roster, meeting minutes | Board composition must demonstrate 51% patient majority |
| Sliding Fee Discount Schedule | Board-approved fee schedule based on FPL | Must include nominal charge for patients below 100% FPL |
| Attachments | Letters of support, MOUs, organizational chart, etc. | Follow the NOFO attachment checklist exactly |
Key Application Components
Project Narrative
The project narrative is the heart of your application and the primary document reviewers use to assess your proposal. For most Section 330 NOFOs, the narrative is structured around five sections:
- •Need: Document the health needs, access barriers, and demographics of your target population using quantitative data from your needs assessment, Census data, state health statistics, and community input. Reviewers want specific numbers, not general statements.
- •Response: Describe how your proposed services address the documented needs. Be specific about service delivery models, staffing configurations, hours of operation, and how you will reach underserved populations. Every service described here must appear on your Form 5B.
- •Evaluative Measures: Present your quality improvement framework, including the clinical quality measures you will track, patient satisfaction methodology, and how you will use data to improve services. Reference UDS clinical measures by name and number.
- •Impact: Describe the expected outcomes of your project in terms of patients served, visits delivered, quality targets, and community health impact. Projections should be realistic and consistent with your budget and staffing plan.
- •Support: Demonstrate organizational capacity, financial management systems, governance structure, and community partnerships. Letters of support from community organizations, referring providers, local government, and the patient population strengthen this section.
Scope of Project Forms
The Form 5 series defines the approved scope of your project and becomes the baseline against which HRSA measures compliance throughout the project period:
- •Form 5A — Service Sites: Lists every service delivery site including address, hours, and services available. Any change to sites during the project period requires a Change in Scope request.
- •Form 5B — Services Provided: Lists all services offered (directly or by referral/contract) by category. This form defines what you are funded to do. Adding or removing service types requires CIS approval.
- •Form 5C — Other Activities: Describes non-clinical activities funded by the grant, including enabling services, community outreach, and quality improvement activities.
The most common application error related to scope forms is internal inconsistency: services described in the narrative that do not appear on Form 5B, sites listed on Form 5A with service configurations that differ from Form 5B, or staffing levels that cannot support the services listed. Cross-reference all three forms against your narrative and budget before submission.
Scoring Criteria
Section 330 competitive applications (NAP and SAC) are scored by independent review panels using criteria defined in the NOFO. While specific point allocations vary by NOFO, the general scoring framework is consistent:
| Criterion | Typical Weight | What Reviewers Look For |
|---|---|---|
| Need | 20–30 points | Documented unmet need with specific data, MUA/MUP status, community input |
| Response | 25–35 points | Logical service model, adequate staffing, realistic patient projections |
| Evaluative Measures | 10–15 points | Clear QI framework, specific measures, data infrastructure |
| Impact | 10–15 points | Measurable outcomes, realistic projections tied to budget and capacity |
| Organizational Capacity | 15–20 points | Financial systems, governance, management team, compliance track record |
| Budget/Resources | 5–10 points | Reasonable costs, complete justification, alignment with narrative |
Applications are scored by panels of external reviewers, and HRSA also applies programmatic and geographic considerations to final funding decisions. An application that scores well technically but proposes to serve an area already well-covered by existing grantees may not be funded. Conversely, applications in areas with documented gaps may receive priority consideration.
Application Timeline Planning
A realistic timeline for a competitive Section 330 application — whether NAP or SAC — typically spans 12–18 months from initial decision to submit. The NOFO itself usually provides 60–90 days from publication to deadline, but that window is far too short to build an application from scratch.
| Phase | Lead Time | Key Activities |
|---|---|---|
| Pre-Application | 12–18 months before | Eligibility self-assessment, registration completion, board recruitment, needs assessment, Look-Alike designation (if applicable) |
| Readiness | 6–12 months before | Financial systems audit, sliding fee schedule development, policy development, community partnership building |
| NOFO Release | Day 1 of application period | Read the entire NOFO, attend technical assistance webinars, identify all requirements and attachments |
| Drafting | Weeks 1–4 | Narrative drafts, budget development, Form 5 completion, attachment collection |
| Internal Review | Weeks 4–6 | Cross-reference all forms for consistency, finance review of budget, board review and approval |
| External Review | Weeks 6–8 | Peer review by grants consultant or PCA, mock scoring against NOFO criteria |
| Final Submission | 5–7 days before deadline | Final edits, EHBs upload, AOR certification, confirmation receipt |
Submit at least 5 business days before the deadline. EHBs can experience high traffic near NOFO deadlines, and technical issues on deadline day are not typically accepted as grounds for a late submission.
Technical Assistance Resources
HRSA provides several technical assistance resources for Section 330 applicants:
- •Primary Care Associations (PCAs): State-level organizations funded by HRSA to support health centers. Most PCAs offer application assistance, training, and peer review for NAP and SAC applicants. Contact your state PCA early in the process.
- •National Training and Technical Assistance Partners (NTTAPs): Organizations funded by HRSA to provide specialized technical assistance in areas like financial management, health IT, and clinical quality improvement.
- •BPHC Technical Assistance Webinars: HRSA holds webinars for each NOFO explaining requirements and answering questions. These webinars are recorded and posted on the BPHC website.
- •HRSA's BPHC Contact Center: For specific questions about NOFO requirements, EHBs issues, or application status. Contact information is provided in each NOFO.
After Submission: What to Expect
After submitting your application, the review and award process typically follows this timeline:
- •Administrative review (2–4 weeks): HRSA checks that the application is complete and the applicant is eligible. Incomplete applications may be returned without review.
- •Independent review panel (4–8 weeks): External reviewers score the application against NOFO criteria.
- •Programmatic review (2–4 weeks): BPHC staff review top-scoring applications for programmatic and geographic considerations.
- •Notice of Award (4–8 months after deadline): Successful applicants receive a Notice of Award through EHBs. The NoA specifies the award amount, budget and project period, conditions of award, and required post-award actions.
Once funded, the compliance obligations begin immediately. Review the compliance requirements page to understand what HRSA expects from day one, and the budget management page for financial administration guidelines. For common pitfalls that new grantees encounter, see the common mistakes guide.