Overview -- Criteria for Prior Approval of a Change in Federal Scope Request

All requests for change in Federal scope of project requiring prior approval will be reviewed by HRSA to determine if the request complies with the following criteria:

• meets the "no additional section 330 funding" requirement;
• does not shift resources away from providing services for the current target population;
• furthers the mission of the health center by increasing or maintaining access and improving or maintaining quality of care for the current target population;
• is fully consistent with section 330 of the PHS Act, applicable regulations and policies, including appropriate governing board representation for changes in service sites and populations served;
• provides for appropriate credentialing and privileging of providers;
• does not eliminate or reduce access to a required service;
• does not result in the diminution of the grantee’s total level or quality of health services currently provided to the target population;
• continues to serve a Medically Underserved Area (MUA) or Medically Underserved Population (MUP).  Please note that the service site does not have to be located in an MUA to serve it;
• demonstrates approval from the health center’s Board of Directors regarding the change of scope and documentation of this approval in the Board minutes; and
• does not significantly affect the current operation of another health center located in the same or adjacent service area, as demonstrated by a Board of Directors-endorsed letter of support from neighboring health centers or an explanation why such a letter(s) cannot be obtained. 

Requests for a change in Federal scope of project to add specialty services must meet all of the following additional requirements:

• demonstrates, in narrative format and with data, that there is current unmet need in the target population for the proposed new service;
• demonstrates that the proposed new service is necessary for the adequate support of primary health care to the target population (i.e., demonstrates that the proposed services function as a logical extension of the required primary health care services already provided by the health center and/or that the proposed services complement the required primary health care services);
• demonstrates that adding the new service will not jeopardize the health center’s overall financial stability and will be accomplished with no additional grant funds; and
• describes the location of the proposed new service, and demonstrates that the services will be provided at an approved site within the scope of project, a proposed new site proximate to available FQHC services, or at a location where in-scope services are provided but that does not meet the definition of a service site.