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.