V. General Requirements for Requesting
a Change in Scope of Project
Health centers must obtain prior
approval for significant changes in
the approved Federal scope of project.16
Adding a service not currently included
in Form 5 – Part A (“Services Provided”)
is considered a significant change and,
therefore, requires prior approval.
17
Prior approval is also required if a
grantee is providing a service via an
informal referral arrangement and wants
to provide the service directly or by
formal agreement.
Once a service is included in the
approved Federal scope of project,
it must be offered on a sliding fee
scale and be available equally to
all patients regardless of ability
to pay. Health centers, therefore,
must thoroughly investigate the costs,
benefits, and risks (e.g., financial
risks) of adding any new service (including
specialty services) to the scope of
project. Additional costs may include,
for example, salaries, bad debt, equipment
and training-related costs. In
general, a health center must demonstrate
that it is equipped in terms of technology,
finances, and personnel to provide
the additional services and continue
to demonstrate that all required primary
health services will remain available
to all patients before proposing to
add additional health services.
issued
December 18, 2008 |
