The provision of comprehensive, culturally
competent, quality primary health care
services to the medically underserved
is a hallmark of the Health Center Program.
The specific services offered by individual
health centers are described in each
center’s “scope of project.” These
are the services for which Health Center
Program funds and other grant-supported
resources may be used.
Services supported by the Federal section
330 grant must include certain “required
primary health services” listed in the
Health Center Program’s authorizing
statute.2
Health centers may also provide “additional”
health services that are “necessary
for the adequate support of the [required]
primary health services”3and
that are “appropriate to meet the health
needs of the population served by the
health center.”4
Although the Health Center Program’s
authorizing statute does not specifically
prohibit health centers from offering
particular services, Department of Health
and Human Services (DHHS) grants regulations
and policy require prior approval before
new services may be added to a health
center’s federally-approved scope of
project.5
Since the Health Center Program began
over 40 years ago, the complexity and
volume of services offered in ambulatory
care settings have greatly expanded.
Many technological advances now allow
providers to safely perform complicated
procedures on an outpatient basis, rather
than in a hospital. These and other
circumstances have contributed to an
increasing number of requests from health
centers to add specialty services to
their Federal section 330 scope of project.
This PIN provides guidance to health
centers seeking to add specialty services
to the scope of project by describing
the factors HRSA will use to evaluate
these requests. HRSA believes that
health centers planning to submit an
application for a change in the Federal
scope of project to add specialty services
should be aware of the factors that
will be considered when HRSA makes decisions
regarding these applications. Our intention
is to provide health centers with a
better understanding of HRSA’s evaluation
criteria for requests to add specialty
services to their Federal scope of project,
thereby improving health centers’ ability
to submit requests that are eligible
for approval.