Notice of Funding Opportunity

Application due 09/09/2026

Bureau of Primary Health Care (BPHC) Health Center Program

Fiscal Year 2027 Expanding Nutrition Services Opportunity number: HRSA-27-099

Contents Before you begin 3

Step 1: Review the Opportunity 4 Basic information 5 Funding details 5 Eligibility 6 Program description 8 Award information 10

Step 2: Get Ready to Apply 13 Get registered 13 Find the application package 13 Application writing help 14

Step 3: Build Your Application 15 Application checklist 16 Application contents and format 18

Step 4: Understand Review, Selection, and Award 30 Application review 31 Selection process 35 Award notices 36

Step 5: Submit Your Application 37 Application submission and deadlines 38 Other submissions 38

Step 6: Learn What Happens After Award 40 Post-award requirements and administration 41 Reporting 45

Contacts and Support 46

Endnotes 51

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on 09/09/2026.

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate: racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Funding details 5

Eligibility 6

Program description 7

Award information 9

Basic information Health Resources and Services Administration (HRSA)

Bureau of Primary Health Care (BPHC)

Health Center Program

Increase access to nutrition services at HRSA-funded health centers.

Summary The purpose of Fiscal Year (FY) 2027 Expanding Nutrition Services (ENS) funding is to increase access to nutrition services at HRSA-funded health centers. Nutrition services can help to prevent, manage, and treat diseases and conditions through nutritional and food-based interventions. Health centers will use ENS funding to increase the number of nutrition services patients or visits.

Funding details Application types: Competing supplement

Expected total available funding in FY: 2027: $125,000,000

Expected number and type of awards: 357 Grants (G)

Funding range per award: $350,000

We plan to fund awards in 2 12-month budget periods for a total 2-year period of performance from 12/01/2026 to 11/30/2028.

Have questions?

Go to Contacts and Support.

Key facts name:

Nutrition Services number:

version:

Initial

93.224

Key dates

07/08/2026 deadline:

09/09/2026

12/01/2026

12/01/2026

See other submissions that may apply to this NOFO.

Eligibility Types of eligible organizations These types of domestic organizations may apply:

You can apply if you are a Health Center Program award recipient with an active H80 award. A Health Center Program (H80) award is funded under section 330(e) of the Public Health Service (PHS) Act.

Individuals are not eligible applicants under this NOFO.

Completeness and responsive criteria We will review your application to make sure it meets these basic requirements to move forward in the competition.

We will not consider an application that:

• Is from an organization that does not meet all eligibility criteria.

• Is submitted after the deadline.

• Does not include a Project Narrative.

• Requests above the amount of $350,000 annually.

Application limits You may submit only one application. If you submit more than one application, we will accept the last on-time submission.

Cost sharing This program has no cost-sharing requirement. If you choose to share in the costs of the project, we will not consider it during merit review. Recipients agree that once committed, cost sharing amounts are enforceable and subject to reporting and auditing requirements under 2 CFR 200.

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

Program description Purpose Fiscal Year (FY) 2027 Expanding Nutrition Services (ENS) funding will support HRSA-funded health centers to increase access to nutrition services. Nutrition services can help to prevent, manage, and treat diseases and conditions through nutritional and food-based interventions.

Goal Applicants for this funding must increase the number of nutrition services patients or visits.

Background Three in four American adults and more than 40 percent of school-aged children have at least one chronic condition[1]. The United States has high rates of nutrition-related chronic conditions such as obesity, heart disease, and diabetes[2]. Nutrition services can help to prevent and manage chronic conditions. These services may include nutritional assessments, patient education and counseling on healthy eating, and connection to food resources. A variety of personnel may be involved, including nutritionists, dietitians, health educators, care coordinators, and community health workers. Successful delivery of nutrition services may require patient support services, such as case management, outreach, eligibility assistance, and transportation.

Partnerships with farms, food banks, schools, other health care providers, and community-based organizations, can increase efficiency and impact.

The Health Center Program is well positioned to expand access to nutrition services through comprehensive primary and preventive care. More than 32 million people received care from HRSA-funded health centers in 2024. Health centers already assess weight, provide nutrition counseling, and help millions of patients achieve better outcomes, such as controlled A1c levels and blood pressure. However, health centers can expand these services to support increased nutrition and food-based interventions that promote health and reduce disease.

The Make America Healthy Again (MAHA) initiative addresses the nation’s chronic disease epidemic. ENS aligns with the MAHA priority to guide patients and families in making lifestyle changes in a trusted primary care setting. For many communities, the health center is the first point of access for any health care need. ENS funding will support health centers in expanding nutrition services to better manage and prevent chronic conditions and improve patient outcomes.

https://www.hhs.gov/maha/index.html

Program requirements and expectations

• You must propose to increase the number of nutrition services patients or visits.

◦ HRSA will add a new nutrition services measure to the Uniform Data System (UDS) Table 5: Staffing and Utilization in 2027. We will use the difference between your 2027 and 2028 data for this measure to determine if you meet the ENS objective.

• You must propose to start or expand nutrition services either directly or by contract (Form 5A, columns I or II).

• You must add nutrition services to your scope of project within 120 days of award if you are not already providing them (Form 5A, columns I or II).

Statutory authority Section 330 of the Public Health Service (PHS) Act (42 U.S.C. 254b)

Nutrition services can help to prevent, manage, and treat diseases and conditions through nutritional and food-based interventions. These services may include:

Nutritional assessment and treatment, including counseling and patient education.

Medical Nutrition Therapy.

Nutrition instruction (for example, promote healthy eating and meal preparation, improve food literacy).

Weight management programs (for example, group visits).

Nutritional and food-based interventions to help prevent, manage, and treat diet-related chronic diseases and promote health.

Nutrition services are separate and distinct from:

Basic nutrition recommendations or dietary education given during general primary care visits.

Helping patients apply for or enroll in food assistance programs that would be recorded under the Eligibility Assistance service, such as Supplemental Nutrition state, and local nutrition and food assistance programs.

https://bphc.hrsa.gov/sites/default/files/bphc/about/form5a.pdf https://bphc.hrsa.gov/sites/default/files/bphc/about/form5a.pdf https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title42-section254b&num=0&edition=prelim https://www.cdc.gov/diabetes-toolkit/php/reimbursement/medical-nutrition-therapy.html

Award information Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS has adopted 2 CFR Part 200, with some modifications included in 2 CFR Part 300. These regulations replace those in 45 CFR Part 75.

Policies

• To make an award, funding must be available and allocated for this program and purpose, at which point we will move forward with the review and award process.

• Have clear policies and good financial practices to avoid spending HRSA funds on unallowable activities. Like other award rules, we may audit your policies, procedures, and controls.

• All uses of funds must align with your H80 scope of project. Your scope of project includes the approved service sites, services, providers, service area, and target population supported (wholly or in part) by your approved health center budget.

• The federal award may be terminated in part or in its entirety by the federal agency or pass-through entity if an award no longer meets the program goals or agency priorities.

• You must maintain your H80 award status throughout the ENS period of performance to maintain this funding.

• You must have accounting structures and internal controls in place that provide accurate and complete information for costs associated with this award. HRSA funding and expenditures for ENS must be tracked and documented in alignment with the specifications described in 2 C.F.R. § 200.302.

• You must comply with Health Center Program requirements as described in the Health Center Program Compliance Manual, and applicable law and regulations.

• If we receive more funding for this program, we may:

◦ Fund more applicants from the rank order list.

General limitations

• For guidance on some types of costs we do not allow or restrict, see:

◦ Project Budget Information in the Application Guide.

◦ 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

◦ Allowable and Unallowable Costs and Activities, in the HHS Grants Policy Statement.

https://www.ecfr.gov/current/title-2/part-200 https://www.ecfr.gov/current/title-2/section-200.302 https://bphc.hrsa.gov/compliance/compliance-manual/introduction https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D13 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html

• All costs must be reasonable, necessary, allocable to the award, and adequately documented (2 CFR 200.403).

• You cannot earn profit from the federal award. See 2 CFR § 200.400(g).

• Current appropriations law includes a salary limit of $228,000 as of January 2026 that applies to this program. You may pay salaries at a higher rate if the rate beyond the salary rate limit (Executive Level II) is paid with non-HHS funds.

Program-specific statutory or regulatory limitations You may not spend funds for:

• Costs already paid for by any other federal awards.

• Costs not aligned with the ENS purpose.

• Gift cards or other cash equivalent incentives.

• Costs for services and activities that are not provided directly by or on behalf of the health center.

• Purchase or upgrade of an electronic health record (EHR) that is not certified by the office of the National Coordinator for Health Information Technology’s Health IT Certification Program.

• New construction activities, including additions or expansion.

• Major alteration or renovation (A/R) projects valued at $1,000,000 or greater in total federal and non-federal costs (excluding the cost of movable equipment).

• Purchase and installation of trailers and prefabricated modular units.

• Concrete or asphalt paving of new areas outside of a building.

• Facility or land purchases.

Under existing law, and consistent with Executive Order 13535 (75 FR 15599), you must not use federal funds to provide abortions, except in cases of rape or incest, or when a physician certifies that the woman has a physical disorder, physical injury, or physical illness that would place her in danger of death unless an abortion is performed. This includes all funds awarded under this notice and is consistent with past practice and long-standing requirements.

See Manage Your Grant for other information on costs and financial management.

Indirect costs are costs you charge across more than one project that cannot be easily separated by project. For example, this could include utilities for a building that supports multiple projects.

To incur indirect costs, you can select one of two methods:

Method 1 – Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency at the time of award.

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.404 https://www.ecfr.gov/current/title-2/section-200.405 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.403 https://www.ecfr.gov/current/title-2/part-200#p-200.400(g) https://www.healthit.gov/topic/certification-ehrs/onc-health-it-certification-program-test-method https://www.healthit.gov/topic/certification-ehrs/onc-health-it-certification-program-test-method https://www.hrsa.gov/grants/manage-your-grant

Method 2 – De minimis rate. Per 2 CFR § 200.414(f), if you do not have a current negotiated indirect cost rate, you may elect to charge a de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is up to 15% of modified total direct costs (MTDC). See 2 CFR § 200.1 for the definition of MTDC. You can use this rate indefinitely for all your federal awards or until you choose to receive a negotiated rate.

Consider your indirect costs when developing your budget.

Program income Program income is money earned as a result of your award-supported project activities. You must use any program income you generate from awarded funds for approved project-related activities. Find more about program income at 2 CFR § 200.307.

The non-federal share of the project budget includes all program income sources such as fees, premiums, third-party reimbursements, and payments generated from the delivery of services. The non-federal share also includes other revenue sources such as:

• State, local, or other federal grants or contracts.

• Private support, donations, or contributions.

• Income generated from fundraising.

In accordance with 42 USC § 254b(e)(5)(D), health centers must use non-grant funds, including funds in excess of those originally expected, “as permitted under this section,” and may use such funds “for such other purposes as are not specifically prohibited under this section if such use furthers the objectives of the project.”

https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC)) https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#200.307 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#200.307 https://www.govinfo.gov/content/pkg/USCODE-2021-title42/html/USCODE-2021-title42-chap6A-subchapII-partD-subparti.htm

Step 2:

Get Ready to Apply

Get registered 13

Find the application package 13

Application writing help 14

Get registered SAM.gov You must have an active account with SAM.gov to apply. This includes having a Unique Entity Identifier (UEI). SAM.gov registration can take several weeks. Begin that process today.

To register:

• Go to SAM.gov Entity Registration and select Get Started. From the same page, you can also select the Entity Registration Checklist for the information you will need to register.

• You must agree to the financial assistance general certifications and representations specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier (UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

If you need additional information about user roles in SAM.gov, see “Get registered:

SAM.gov user roles” in the Application Guide.

Grants.gov You must also have an active account with Grants.gov. You can see step-by-step instructions at the Grants.gov Quick Start Guide for Applicants.

If you have already registered on Grants.gov, make sure your account is active, and your Authorized Organization Representative (AOR) is approved.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Search Grants at Grants.gov and search for opportunity number HRSA-27-099.

After you select the opportunity, we recommend that you click the Subscribe button to get updates.

https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D4 https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/search-grants

Application writing help Visit HHS Tips for Preparing Grant Proposals.

Visit HRSA’s How to Prepare Your Application page for more guidance.

See Apply for a Grant for other help and resources.

Frequently Asked Questions (FAQs) will be posted on the ENS technical assistance (TA) webpage.

Join the webinar For more information about this opportunity, details will be posted on the ENS TA webpage.

https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services

Step 3:

Build Your Application

Application checklist 16

Application contents and format 18

Application checklist There are two types of forms in Grants.gov:

• Some forms allow you to upload components of your application to the form.

These include components like your project narrative, budget and budget narrative, and attachments, as applicable.

• Other forms are more typical, fill-in-the-blank forms.

Make sure that you have everything you need to apply.

Narratives

Component

Grants.gov form Included in page limit?

Project narrative Use the Project Narrative Attachment form.

Yes

Budget narrative with staff justification table

Use the Budget Narrative Attachment form.

Yes

Attachments Insert each in the Attachments Form in this order.

You may download the forms below from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage.

Component Included in

1. H80 Grant Number Form (Required) No

2. Form 1B: Funding Request Summary (Required) No

3. Equipment List Form (as applicable) No

4. Environmental and Information Documentation (EID) Checklist Form (as applicable) No

5. Minor A/R Project Cover Page Form (as applicable) No

6. Other Requirements for Sites Form (as applicable) No

7. Property Information (as applicable) and Landlord Letter of Consent (as applicable) No

8. Floor Plans/Schematic Drawings/Site Plans (as applicable) No https://www.grants.gov/search-results-detail/362823

Component Included in

9. Minor A/R Budget Justification (as applicable) and Copy of Form 5B: Service Sites for Minor A/R Project (as applicable)

No

10. Other Relevant Documents (as applicable) Yes

Other required forms Complete each required form in Grants.gov.

Component

Application for Federal Assistance (SF-424)

Budget Information for Non-Construction Programs (SF-424A)

Project Abstract Summary form

Disclosure of Lobbying Activities (SF-LLL), optional

Project/Performance Site Location(s)

Grants.gov Lobbying form

Key Contacts

Included in page limit?

No

No

No

No

Application contents and format This section includes guidance on each component found in the application checklist.

Application page limit: 50. We will not review any pages that exceed the page limit.

Submit your information in English and express whole number budget figures using U.S. dollars.

Required format Required format for project summary, project narrative, budget narrative, and attachments.

Font: A readable font like Arial, Courier, CG Times, or Times New Roman

File format: We only accept the following document formats:

• .PDF - Adobe Portable Document Format

• .DOC/.DOCX - Microsoft Word

• .RTF - Rich Text Format o .TXT - Text

• .WPD - Word Perfect Document

• .XLS/.XLSX - Microsoft Excel

• .VSD - Microsoft Visio

Size: 12-point font Footnotes, charts, graphics, and budget tables may be 10-point or higher.

Ink color: Black

Spacing: Single-spaced, including all text and tables

Alignment: Left

Headings: Bold all headings and align left

Size: 8.5 x 11 (Make sure the print area is set and allows printing to 8.5 x 11.)

Margins: 1-inch on all sides

Footer: On each page as the footer, include your organization’s name and page numbers. If a competing continuation or competing supplement, also include your 10-digit award number.

Page numbering:

• Do not number the standard OMB-approved forms.

• Number each attachment page sequentially (that is, 1, 2, 3).

• Reset the numbering for each attachment.

• Treat each attachment as a separate section.

File names: You can find guidance for naming your files in the Application Guide.

Other required forms You will need to complete some other forms. Upload the following forms at Grants.gov.

You can find them in the NOFO application package or review them and any available instructions at Grants.gov Forms.

Forms Submission requirement

Application for Federal Assistance (SF-424) With application.

Budget Narrative Attachment Form With application.

Project Narrative Attachment Form With application.

Project/Performance Site Location(s) With application.

Project Abstract Summary Form With application.

Budget Information for Non-Construction Programs (SF-424A) With application

Grants.gov Lobbying Form With application.

Key Contacts With application.

Disclosure of Lobbying Activities (SF-LLL) With application.

Form instructions The Application Guide has detailed instructions for:

• The Application for Federal Assistance (SF-424).

• The Budget Information for Non-Construction Programs (SF-424A).

Application for federal assistance

(SF-424)

This form collects general information and is your application for federal assistance.

Follow the instructions in Section 3.1.1 of the Application Guide and the form instructions in Grants.gov Forms.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D26 https://grants.gov/forms/forms-repository/sf-424-family https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D8 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D8 https://grants.gov/forms/forms-repository/sf-424-family

Project abstract summary form instructions Complete the information in the Project Abstract Summary form. Include a short description of your proposed project. Include the needs you plan to address, whether you will add nutrition services with this funding or expand services you already offer, your proposed increase in the number of nutrition services patients or visits, and how your project aligns with MAHA priorities, such as:

• Disease Prevention.

• Fighting the Chronic Disease Epidemic.

• Nutrition.

When writing your summary:

• Use 4,000 characters or fewer. Make sure it’s clear, accurate, and short.

• Do not refer to other parts of the application.

• Do not include personally identifiable information (PII).

If you receive an award, we’ll put your project abstract on public websites and databases, including USAspending.gov.

When filling out your SF-424 form, pay attention to Box 15: Descriptive Title of Applicant’s Project.

We share what you put there with USAspending. This is where the public goes to learn how the federal government spends its money.

Instead of just a title, insert a short description of your project and what it will do.

See instructions and examples.

https://www.hhs.gov/maha/index.html https://grants.gov/learn-grants/grant-terminology#p https://www.usaspending.gov/ https://www.hhs.gov/sites/default/files/hhs-writing-award-descriptions.pdf

Project/performance site location(s) Follow the form instructions in Grants.gov Forms. Use the “Next Site” option rather than “Additional Location(s)” to add more than one project/performance site location.

The project narrative is required for completeness.

In this section, you will describe all aspects of your project.

Use the section headers and the order listed. Number your responses in each section.

This ensures reviewers can understand your proposed project.

Project narrative Need See merit review criterion 1: Need

1. Describe the need to start or expand your nutrition services to help prevent and manage chronic conditions in your service area. Include the following data to demonstrate unmet need:

a. Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (UDS Table 6B Quality of Care Measures, Line 12).

b. Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow- Up Plan (UDS Table 6B Quality of Care Measures, Line 13).

c. Additional UDS Table 6B Quality of Care Measures, as appropriate.

d. Other relevant data specific to your service area.

2. Describe any challenges with your current health center workforce that impact your capacity to start or expand nutrition services. Workforce challenges may include personnel, training, roles, or workflows.

Response See merit review criterion 2: Response

1. Describe how you will:

a. Increase the number of patients receiving nutrition services and/or the number of nutrition-related visits.

b. Help prevent and manage chronic conditions through expanded nutrition services.

c. Coordinate care for patients with inconsistent access to adequate nutritious food.

https://grants.gov/forms/forms-repository/sf-424-family https://bphc.hrsa.gov/sites/default/files/bphc/compliance/2025-uds-manual.pdf

d. Advance the skills and knowledge of your workforce to support expanded nutrition services.

2. Describe your quality improvement plan to improve patient health outcomes related to nutrition services.

3. Explain how any proposed equipment and/or minor A/R costs are necessary for your project. Describe how you will complete all equipment purchases and/or minor A/R within 12 months of award.

Collaboration See merit review criterion 3: Collaboration

1. Describe how you will work with organizations in your service area that improve patient health through better nutrition. If applicable, include how you will leverage expertise of Health Center Technical Assistance Programs, such as Primary Care Associations (PCAs), Health Center Controlled Networks (HCCNs), or National Technical Assistance Program (NTAPs).

2. Describe how you will link patients to partners that support access to healthy food, such as food banks, mobile markets, or community-supported agriculture.

3. Explain how your project aligns with and does not duplicate existing federal programs that may be operating in your service area, like those proposed or currently funded by MAHA ELEVATE, National Diabetes Prevention Program, IHS Produce Prescription Pilot Program, USDA Food and Nutrition Service Programs, Healthy Start, Maternal Child Health Nutrition Training Program, or Gus Schumacher Nutrition Incentive Program (GusNIP). If there are no other federal programs operating in your service area, state this in your narrative.

Impact See merit review criterion 4: Impact

1. Describe how you will measure the impact of your project by the end of the two-year period of performance. Include:

a. Number of nutrition services patients and/or visits. HRSA plans to add a nutrition services measure to 2027 UDS.

b. Other measures to demonstrate that your project has helped prevent and manage chronic conditions.

2. Describe how you will measure the impact of your program beyond the two-year period of performance. Include:

a. Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (UDS Table 6B Quality of Care Measures, Line 12).

https://bphc.hrsa.gov/technical-assistance/technical-assistance-programs https://www.cms.gov/priorities/innovation/innovation-models/maha-elevate https://www.cdc.gov/diabetes-prevention/index.html https://www.ihs.gov/nutrition/produce-prescription-programs/ https://www.fns.usda.gov/ https://www.fns.usda.gov/ https://mchb.hrsa.gov/programs-impact/healthy-start https://mchb.hrsa.gov/programs-impact/focus-areas/mch-workforce-development/awards#mch-nutrition-training-program https://mchb.hrsa.gov/programs-impact/focus-areas/mch-workforce-development/awards#mch-nutrition-training-program https://www.nifa.usda.gov/grants/programs/gus-schumacher-nutrition-incentive-program-gusnip https://www.nifa.usda.gov/grants/programs/gus-schumacher-nutrition-incentive-program-gusnip

b. Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow- Up Plan (UDS Table 6B Quality of Care Measures, Line 13).

c. Targeted patient health outcomes you identified in your Need and Response sections.

Capacity See merit review criterion 5: Capacity

1. Describe your skills, expertise, and organizational capacity to start or expand your nutrition services.

2. Describe your use of screening tools to assess the nutritional status of your patients. If you do not currently use screening tools for this purpose, describe your use of other risk identification screening tools to inform program development.

3. Describe your capability to implement, monitor, and adapt the project throughout the period of performance.

Budget and budget narrative See merit review criterion 6: Support Requested

Your budget should follow the instructions in budget narrative: detailed instructions section of the Application Guide and the instructions listed in this section. Your budget should show a well-organized plan.

HHS now uses the definitions for equipment and supply in 2 CFR § 200.1. The new definitions change the threshold for equipment to the lesser of your capitalization level or $10,000 and the threshold for supplies to below that amount.

The total project or program costs are all allowable (direct and indirect) costs used for the ENS award. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement.

As you develop your budget:

• Make sure costs are reasonable, allowable, allocable, and consistent with your project’s purpose and activities.

• Follow the restrictions on spending funds. See funding policies and limitations.

• Comply with all related HHS policies and other federal requirements.

You may use up to $150,000 for one-time costs in year 1 to meet this program’s objective, including:

• Moveable equipment that costs $10,000 or more.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D13 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Equipment) https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#p-200.1(Supply)

• A single minor alteration or renovation (A/R) project. The total federal and non-federal cost of the A/R project must be less than $1,000,000, excluding the cost of moveable equipment.

Your total budget must:

• Include the requested federal funds.

• Include all non-federal funds that will support your project, as applicable.

• Directly relate to and support the proposed project.

• Comply with all related HHS policies and other federal requirements.

Use of grant funds for food purchases is allowed for this NOFO due to its focus on nutrition services. If approved by HRSA, you may use federal funds to purchase healthy foods for patients if the purchases are necessary for proposed activities that will meet the ENS objective. For examples of allowable food costs, see Appendix B: Example Allowable Food Costs.

Budget Information Form for Non- Construction Programs (SF-424A) Complete the Budget Information Form in Grants.gov. This form collects your project budget information. Use the instructions here if they contradict Section 3.1.4 of the Application Guide.

• Section A – Budget Summary: Under New or Revised Budget, in the

Federal column, enter the Federal funding requested for year 1 (up to $350,000). We will award funding based on your current H80 award proportions. The Federal amount refers to only the ENS funding requested, not all federal funding that you receive. Enter other support for the ENS project in the Non-Federal column. Leave the Estimate Obligated Funds column blank.

• Section B – Budget Categories: Enter an object class category (line item) budget for year 1. Include only Federal funding. The amounts for each category in the Federal and Non-Federal columns, as well as the totals, should align with the Budget Narrative. You may request up to $150,000 for equipment and minor A/R in year 1. If you request funds for equipment, include that amount on the equipment line. If you request funds for minor A/R, include that amount on the construction line.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf

• Section C – Non-Federal Resources: Enter all sources of funding for year 1 except for the federal funding request. The total in Section C must match the Non-Federal Total in Section A. When providing Non-Federal resources by funding source, include other Federal funds supporting the proposed project in the “other” category.

• Section D – Forecasted Cash Needs: Leave this section blank.

• Section E – Budget Estimates of Federal Funds Needed for Balance of the Project: Enter the federal funding request (up to $350,000) for year 2 in the (a) first column. The other columns must remain $0. Any funding beyond year 2 will be based on appropriations, satisfactory progress in meeting the project’s objective, and a decision that continued funding is in the government’s best interest.

• Section F – Other Budget Information: Enter the type of indirect rate (provisional, predetermined, final, fixed, or de minimis) that will be in effect during the period of performance. If applicable, explain amounts for individual object class categories that may appear to be out of the ordinary in Direct Charges.

Budget Narrative with Staff Justification Table The budget narrative, which includes the Staff Justification Table, supports the information you provide in Section B: Object Class Categories of the SF-424A. It gives an itemized breakdown and clear justification of the costs you request. The merit review committee reviews the budget narrative.

To create your budget narrative, see detailed instructions in Section 3.1.5 of the Application Guide.

See the ENS TA webpage for a sample Budget Narrative.

Submit a detailed budget narrative that outlines federal and non-federal costs for each budget year of the two-year period of performance. For year two, highlight the changes from year 1 or clearly indicate that there are no substantive changes.

Make sure your budget narrative aligns with your Minor A/R Budget Justification and Equipment List form if you request this funding. See Appendix A: Minor A/R Requirements for details.

The sum of line-item costs for each category must align with those in your SF-424A.

Your budget narrative must:

• Show that you will use the awarded funds to meet the program objectives.

• Clearly detail the proposed costs for each line item on your SF-424A, Section B, with calculations for how you estimated each cost.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D18

• Not include ineligible costs.

• Not exceed $150,000 in minor A/R and equipment costs.

• Provide us with enough information to determine that you will use the funds awarded separately and distinctly from other Health Center Program support.

• Include a staff justification table attachment, as shown in section 3.1.4 of the Application Guide.

• Explain the purpose of any contracts and subawards, including how you estimated the costs. You must provide oversight of services provided through such arrangements to ensure compliance with Section 330 requirements. See Chapter 12: Contracts and Subawards in the Compliance Manual.

Attachments See Section 3.2.6 of the Application Guide.

Place your attachments in this order in the Attachments Form. See application checklist to determine if they count toward the page limit.

Attachment 1: H80 Grant Number Form (Required)

Does not count towards the page limit.

Provide your current H80 grant number in the H80 Grant Number Form. We will use this to help determine eligibility. You can download this form from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage.

Attachment 2: Form 1B: Funding Request Summary (Required)

Does not count towards the page limit.

Use Form 1B to summarize data from your SF-424A. Enter the amount of federal ENS funding you requested on the SF-424A in the Federal Funding Request box. Use the radio buttons to indicate if you are requesting funding for one-time expenses. You can download this form from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage.

Attachment 3: Equipment List Form (As applicable)

Does not count towards the page limit.

If you request one-time funding for equipment, you must complete the Equipment List Form. You can download this form from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage. Total federal equipment and minor A/R costs combined in year one cannot exceed $150,000. Enter the amount for your request on the Equipment row of the SF-424A: Budget Information Form.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D13 https://bphc.hrsa.gov/compliance/compliance-manual/chapter12 https://bphc.hrsa.gov/compliance/compliance-manual/chapter12 https://bphc.hrsa.gov/compliance/compliance-manual/introduction https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D25 https://www.grants.gov/search-results-detail/362823 https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services https://www.grants.gov/search-results-detail/362823 https://www.grants.gov/search-results-detail/362823 https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services

Equipment is:

• Moveable and can be readily shifted from place to place without requiring a change in the utilities or structural characteristics of the space.

• Non-expendable, tangible personal property, including IT systems.

• Useful for more than one year.

• At a cost of $10,000 or more per unit, or the lesser capitalization level established by the recipient.

Any equipment you purchase with ENS funds must be:

• Pertinent to the ENS project.

• Procured through a competitive process.

• Maintained, tracked, and disposed of in accordance with 2 CFR Part 200.

• Used only at in-scope service sites.

Complete the following for each item on the Equipment List Form:

• Type: Select clinical or non-clinical.

• Item Description: Provide a description of each item.

• Unit Price: Enter the price of each item.

• Quantity: Enter the number of each item to be purchased.

• Total Price: The system will calculate the total price by multiplying the unit price by the quantity entered.

Attachment 4: Environmental and Information Documentation (EID) Checklist Form (As applicable)

Does not count towards the page limit.

If you request one-time funding for minor A/R, you must complete the Environmental Information Documentation (EID) Checklist Form. You can download this form from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage. Follow the instructions on the form.

Attachment 5: Minor A/R Project Cover Page Form (As applicable)

Does not count towards the page limit.

If you request one-time funding for minor A/R, you must complete the Minor A/R Project Cover Page Form. You can download this form from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage. Follow the instructions on the form.

Ground disturbance is allowed for ENS if limited to food garden beds (raised or not raised).

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200 https://www.grants.gov/search-results-detail/362823 https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services https://bphc.hrsa.gov/funding/funding-opportunities/expanding-nutrition-services

Attachment 6: Other Requirements for Sites Form (As applicable)

Does not count towards the page limit.

If you request one-time funding for minor A/R, you must complete the Other Requirements for Sites Form. You can download this form from the HRSA-27-099 announcement in Grants.gov under Related Documents or the ENS TA webpage. Follow the instructions on the form.

Attachment 7: Property Information (As Applicable) and Landlord Letter of Consent (As applicable)

Does not count towards the page limit.

If you request one-time funding for minor A/R, provide a copy of the title, deed, or lease for the site of your project.

If your minor A/R will be on leased property, include a Landlord Letter of Consent. You may use this template for the letter.

Attachment 8: Floor Plans/Schematic Drawings/Site Plans (As applicable)

Does not count towards the page limit.

Provide a floor plan drawn to scale for your minor A/R project. It must show the location of the work and dimensions of the impacted area. All drawings must be consistent with your proposed activities. It must include:

• Rough dimensions of the facility and total square footage

• The area in the facility that will not be affected distinct from the area being altered or renovated

• Total square footage of the impacted area

• Labels for each room where major project components are occurring, such as exam room, reception area, or break room

You may mark up and make notations on an existing plan or diagram to show the area of the renovation. Provide the existing and marked-up plans.

Attachment 9: Minor A/R Budget Justification (As applicable) and Copy of Form 5B:

Service Sites for Minor A/R Project (As applicable)

Does not count towards the page limit.

Combine the Minor A/R Budget Justification and Copy of Form 5B: Service Sites for Minor A/R Project into one attachment.

Minor A/R Budget Justification https://www.grants.gov/search-results-detail/362823 https://bphc.hrsa.gov/sites/default/files/bphc/funding/lloc-minorrenovation.pdf

• Provide a budget justification for your minor A/R project. Describe each line item in detail. Identify other funding sources that will support your minor A/R project and whether you have already secured these funds.

• Explain how the costs will support your project’s purpose and provide a timeline for when you will start and complete each proposed minor A/R activity. Include the number of months necessary for each activity.

• See the ENS TA webpage for a sample minor A/R budget justification, including allowable and unallowable costs.

Copy of Form 5B: Service Sites for Minor A/R Project

• You may propose one minor A/R project at a site in your scope of project. Attach the Form 5B: Service Sites form for the site of your minor A/R project.

• You can get a copy of your Form 5B in your Scope folder in the HRSA Electronic Handbooks.

Attachment 10: Other Relevant Documents (As applicable)

Counts towards the page limit.

Use Attachment 10 to add other relevant documents to support your proposed project.

If you are requesting indirect costs, provide your indirect cost rate agreement. You do not need to attach anything if you indicated in your budget narrative on the indirect cost rate line that you are using the de minimis rate of 15%. Your indirect cost agreement does not count towards the page limit.

Step 4:

Understand Review, Selection, and Award

Application review 31

Selection process 35

Award notices 36

Application review Initial review We will review your application to make sure that it meets eligibility criteria, including the completeness and responsiveness criteria. If your application does not meet these criteria, we will not fund it. If this is the case, we will notify your authorized official.

We will not review any pages that exceed the page limit. Pages that exceed the page limit will be redacted and will not be reviewed. Only the content within the page limit will be used to determine eligibility.

Merit review A panel reviews all applications that pass the initial review. You can find more about the merit review process in the application guide. The members use these criteria:

Criterion Total number of points = 100

1. Need 20 points

2. Response 20 points

3. Collaboration 15 points

4. Impact 20 points

5. Capacity 20 points

6. Support Requested 5 points

Criterion 1: Need (20 points) See the project narrative Need section.

The panel will review your application for:

• The extent to which you describe the need to start or expand nutrition services to help prevent and manage chronic conditions in your service area.

• The extent to which you use data to demonstrate unmet need, including:

◦ Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents data (UDS Table 6B Quality of Care Measures, Line 12).

◦ Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow- Up Plan data (UDS Table 6B Quality of Care Measures, Line 13).

https://bphc.hrsa.gov/sites/default/files/bphc/compliance/2025-uds-manual.pdf

◦ Additional UDS Table 6B measures, as appropriate.

◦ Other relevant data specific to your service area.

• The strength of your description of challenges with your current health center workforce that impact your capacity to start or expand nutrition services.

Criterion 2: Response (20 points) See the project narrative Response section.

The panel will review your application for:

• The strength of your plan to increase the number of patients receiving nutrition services and/or the number of nutrition-related visits.

• The strength of your explanation for how your project will help prevent and manage chronic conditions through expanded nutrition services.

• The strength of your plan to coordinate care for patients with inconsistent access to adequate nutritious food.

• The extent to which you describe how your project will advance the skills and knowledge of your workforce to support expanded nutrition services.

• The strength of your quality improvement plan to improve patient health outcomes.

If applicable:

• How well you justify the necessity of the equipment and/or minor A/R costs for your project.

• The feasibility of your plan to complete all equipment purchases and/or minor A/R within 12 months of award.

Criterion 3: Collaboration (15 points) See the project narrative Collaboration section.

The panel will review your application for:

• The strength of your plan to partner with organizations in your service area that improve patient health through better nutrition.

◦ If applicable, the extent to which you describe how you will leverage the expertise of Health Center Technical Assistance Programs, such as PCAs, HCCNs, or NTAPs.

• The extent to which you describe how you will link patients to partners that support access to healthy food.

• The strength of your project plan to align with and not duplicate federal programs operating in your service area.

◦ If there are no federal programs operating in your service area, clearly state this in your narrative.

Criterion 4: Impact (20 points) See the project narrative Impact section.

The panel will review your application for:

• The strength of your plan to monitor the impact of your project by the end of the two-year period of performance, including:

◦ The number of nutrition services patients and/or visits so you can report it under the nutrition services measure HRSA will add to the 2027 UDS.

◦ Your use of other measures of success to help prevent and manage chronic conditions.

• The strength of your plan to measure the impact of your project beyond the two-year period of performance, including:

◦ Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (UDS Table 6B Quality of Care Measures, Line 12).

◦ Preventive Care and Screening: Body Mass Index (BMI) Screening…