HRSA-26-009 Full Announcement.pdf

Notice of Funding Opportunity

Application due Tuesday, March 31, 2026

Bureau of Primary Health Care (BPHC) Health Center Program

Fiscal Year (FY) 2026 National Technical Assistance Programs (NTAP) Cooperative Agreements Opportunity number: HRSA-26-009

Contents

Step 1: Review the Opportunity 4 Basic Information 5

Funding details 5

Eligibility 7

Program description 9

Award information 29

Step 2: Get Ready to Apply 33 Get registered 34

Find the application package 34

Application writing help 35

Step 3: Build Your Application 36 Application checklist 37

Application contents and format 38

Step 4: Understand Review, Selection, and Award 53 Application review 54

Selection Process 61

Award notices 61

Step 5: Submit Your Application 62 Application submission and deadlines 63

Other submissions 63

Step 6: Learn What Happens After Award 64 Post-award requirements and administration 65

Reporting 66

Contacts and Support 67

Before you begin 3

Contents 2

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 Tuesday, March 31, 2026.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 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 7

Program description 9

Award information 29

Basic Information Health Resources and Services Administration (HRSA)

Bureau of Primary Health Care (BPHC)

Health Center Program

Leverage your expertise to be a national technical assistance provider to health centers in one of three identified areas.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

Fiscal Year (FY) 2026 National Technical Assistance Programs (NTAP) Cooperative Agreements

Opportunity number:

HRSA-26-009

Announcement version:

Initial

Federal assistance listing:

93.129

Key dates

NOFO issue date:

December 23, 2025

Application deadline:

March 31, 2026

Expected award date is by:

July 29, 2026

Expected start date:

August 1, 2026

See other submissions that may apply to this NOFO.

Summary The FY 2026 National Technical Assistance Programs (NTAP) Cooperative Agreements support three national organizations to develop and deliver technical assistance (TA) to existing and potential health centers with a focus on:

• Supporting the delivery of comprehensive, high-quality primary health care.

• Improving chronic disease management, nutrition, and preventive services.

• Improving operational effectiveness, efficiency, and quality.

• Addressing emergent public health needs and priorities.

• Complying with and exceeding Health Center Program and supplemental funding requirements.

Funding details Application Types: New

Expected total available funding in FY 2026: $24,000,000

Expected number and type of awards: 3 Cooperative Agreements (CA)

Funding range per award: $8 million

We plan to fund awards in four 12-month budget periods for a total 4-year period of performance from August 1, 2026 to July 31, 2030.

Fiscal Year (FY) 2026 National Technical Assistance Programs (NTAP) Cooperative Agreements awards depend on the appropriation of funds and are subject to change based on the availability and amount of appropriations.

We will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where we anticipate substantial involvement with the recipient during the planned project.

Step 1: Review the Opportunity 5

You may request supplemental funding at any point in your period of performance to address unique national health center TA needs that continue or enhance activities within the funded scope of work. We may support such supplemental projects if funding is available, the request is reasonable, sufficient time remains in the budget period, and the activities are aligned with HRSA priorities and non-duplicative of work performed by HRSA or other NTAPs.

The number of projected awards and the maximum funding amount for each NTAP category are indicated in Table 1.

Table 1: NTAP categories and funding amounts

Category Number of awards Maximum funding amount per year

Clinical and Preventive Excellence 1 total $8,000,000

Operational Excellence 1 total $8,000,000

National TA and Coordination Center

1 total $8,000,000

Step 1: Review the Opportunity 6

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

• State governments

• County governments

• City or township governments

• Special district governments

• Public and State controlled institutions of higher education

• Native American tribal governments (Federally recognized)

• Native American tribal organizations (other than Federally recognized tribal governments)

• Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education

• Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education

• Private institutions of higher education

• For-profit organizations other than small businesses

• Small businesses

• Faith-based organizations

“Domestic” means the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

Individuals are not eligible applicants under this NOFO.

Step 1: Review the Opportunity 7

Completeness and responsiveness 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.

• Does not include a project work plan.

• Requests funding above the award ceiling of $8 million.

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.

Post-award requirements

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.

Step 1: Review the Opportunity 8

Program description Purpose National Technical Assistance Programs (NTAPs) develop, deliver, coordinate, and evaluate technical assistance (TA) to existing and potential health centers, both directly and collaboratively with other HRSA-funded TA programs. FY 2026 NTAP award recipients will receive funding to provide high-impact TA that supports health centers to:

• Deliver comprehensive, high-quality primary health care.

• Improve chronic disease management, nutrition, and preventive services.

• Improve operational effectiveness, efficiency, and quality.

• Address emergent public health needs and priorities.

• Meet and exceed compliance with the Health Center Program and supplemental funding requirements.

Background The Department of Health and Human Services (HHS) is dedicated to improving the health and well-being of all Americans. This aligns with the president’s Make America Healthy Again (MAHA) priorities, which focus on addressing the root causes of America’s health crisis through preventing and managing chronic disease for children, adults, and older adults across the United States.

Health centers are community-based and patient-directed organizations that provide affordable, accessible, and high-quality primary health care to medically underserved communities. For many communities, the health center is the first point of access for any health care need. Health centers play a critical role in addressing barriers to care and providing access to a continuum of health services that help the nation prevent and manage chronic disease. In 2024, over 32 million people received care from a HRSA-funded health center, including over 9.4 million children under the age of 18 and about 9.9 million rural residents.

Health centers need TA to identify and implement evidence-based interventions and promising practices that help them provide access to primary health care services that best meet their patients’ and communities’ needs. As the needs of health centers and their communities evolve, NTAPs tailor technical assistance and resources to meet those needs.

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

Step 1: Review the Opportunity 9 https://www.whitehouse.gov/fact-sheets/2025/02/fact-sheet-president-donald-j-trump-establishes-the-make-america-healthy-again-commission/ https://www.whitehouse.gov/fact-sheets/2025/02/fact-sheet-president-donald-j-trump-establishes-the-make-america-healthy-again-commission/

NTAPs maximize the impact of the Health Center Program to best manage chronic diseases and improve patient outcomes. This includes preparing for and responding to primary health care needs that change because of emergencies or emerging priorities.

This funding will allow NTAPs to develop, deliver, coordinate, and evaluate TA for health centers across seven performance domains:

• Governance, leadership, and management.

• Workforce.

• Financial sustainability.

• Community health and health-related needs.

• Quality, patient care, and safety.

• Patient experience.

• Access and affordability.

NTAPs will also provide TA to health centers at or below the third quartile of clinical and operational performance outcome measures. These health centers can benefit the most from targeted assistance, tailored and shared learning, and peer-to-peer networking.

NTAPs will develop and coordinate their TA resources with HRSA-supported TA programs, including other NTAPs, Primary Care Associations (PCAs), and Health Center Controlled Networks (HCCNs) to maximize the impact of all HRSA-supported TA.

The following definitions apply to this notice of funding opportunity:

• Existing health center: Health Center Program (H80) award recipients and organizations with a look-alike designation.

• Potential health center: Organizations applying for or interested in applying for New Access Points or Service Area Competition funding or look-alike designation.

• Technical assistance (TA): Delivery of targeted support, expertise, and advice to improve performance. Formats may include:

◦ In-person and virtual courses, seminars, and workshops to build knowledge, skills, and best practices.

◦ Individual, small group, and cohort to help implement skills and apply concepts and tools introduced during broader TA activities.

• HRSA-supported TA programs: NTAPs, Primary Care Associations (PCAs), and Health Center Controlled Networks (HCCNs).

• Uniform Data System (UDS): A standardized system for H80 award recipients and look-alikes to report on a core set of measures each calendar year.

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

Step 1: Review the Opportunity 10 https://bphc.hrsa.gov/about-health-center-program https://bphc.hrsa.gov/focus-areas/health-center-performance-improvement https://bphc.hrsa.gov/technical-assistance/technical-assistance-programs/primary-care-associations https://bphc.hrsa.gov/technical-assistance/strategic-partnerships/health-center-controlled-networks https://bphc.hrsa.gov/technical-assistance/strategic-partnerships/health-center-controlled-networks https://bphc.hrsa.gov/technical-assistance/strategic-partnerships https://data.hrsa.gov/tools/data-reporting

Program requirements and expectations NTAP categories Three awards will be made. For award details, see Table 1.

NTAP program requirements NTAPs will develop, deliver, coordinate, and evaluate TA activities for existing and potential health centers. TA activities will help achieve the FY 2026 NTAP objectives.

Your application must:

• Document your understanding of the national, regional, and other needs (as applicable) in the areas outlined in the purpose section of this NOFO.

• Demonstrate your experience and ability to develop and conduct opportunities for health centers to learn and share knowledge.

• Describe how you will identify best practices that increase TA effectiveness, efficiency, and quality for health centers.

• Identify other organizations that you will work with to ensure you have the necessary subject matter expertise to support health centers across all objectives.

If awarded, you must do the following:

• Conduct TA.

◦ Begin delivering TA within 60 days of award.

◦ Help health centers identify and apply validated screening tools and adopt evidence-based and promising practices and innovations to address patient needs.

◦ Adjust your TA according to changes in the health center landscape and emerging priorities.

◦ Ensure health centers have broad access to TA resources regardless of H80 award, LAL designation, NTAP membership, or geographic location.

◦ Do not charge for the TA that you provide only with HRSA funds. If you fund TA with a mix of HRSA and non-HRSA funds, you may charge participants to offset non-HRSA costs if you can show that the charge is not a barrier to access. For example, by ensuring that the TA activity is also available for free online.

• Collaborate with HRSA, health centers, and other HRSA-supported TA programs.

◦ Inform HRSA of trends or barriers affecting health center performance and HRSA priorities.

◦ Disseminate shared learning, tools, resources, and data from health centers.

Step 1: Review the Opportunity 11

◦ Coordinate with other HRSA-supported TA programs to align and strengthen TA offerings, share resources, and avoid duplicating efforts.

◦ Participate in a HRSA-sponsored NTAP Forum.

◦ Collect and evaluate TA outcomes and share results with HRSA, health centers, and HRSA-supported TA programs.

◦ Contribute to the national health center TA needs assessments on topics relevant to your NTAP category.

◦ Share resources and products you develop with HRSA funds through the Health Center Resource Clearinghouse.

◦ Make sure any publications you develop or purchase through this award meet HRSA guidelines for data rights.

▪ As described in 2 CFR § 200.315(b), you own the copyright for materials that you develop through this award, and HHS reserves a royalty-free, nonexclusive, and irrevocable right to reproduce, publish, or otherwise use those materials for federal purposes, and to allow others to do so.

▪ The federal government can also obtain, reproduce, publish, or use data produced through this award and can allow others to receive, reproduce, publish, or otherwise use such data for federal purposes. See 2 CFR § 200.315(d).

• Manage your project.

◦ Meet the requirements for numbers, types, sessions, and participants for TA activities each budget period. See Table 2 and Table 3.

◦ Continue to make progress on the objectives, even if you meet your objective target early in the period of performance.

◦ Get approval from HRSA before changing or removing any program objective, unless this NOFO says you may do so. See NTAP objectives and measures.

TA formats You will deliver TA using three formats: (1) national audience activity, (2) national community of practice, and (3) outcomes-focused cohort. Each of these formats counts as one activity toward your overall required number of activities.

• National audiences: You are required to provide general, short-term, and didactic sessions that address priority needs of many health centers. Example TA activities are:

◦ Webinars.

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

Step 1: Review the Opportunity 12 https://www.healthcenterinfo.org/ https://www.ecfr.gov/current/title-2/part-200/section-200.315#p-200.315(b) https://www.ecfr.gov/current/title-2/part-200/section-200.315#p-200.315(d)

◦ Developing and sharing digital resources, such as readiness tools, implementation manuals, and fact sheets.

◦ Identifying and sharing evidence-based and promising practices.

• National community of practice (CoP): You are required to facilitate the regular interaction of small groups and support their peer learning to address a specific topic and area of need. These activities must include the following:

◦ Run each CoP for one budget year.

◦ Offer at least six sessions for each CoP.

◦ Address the unique needs of the participating health centers.

◦ Provide data in your progress reports on participating health centers’ improvement toward the NTAP objective(s) of the CoP.

◦ National TA and Coordination Center: Your CoPs must focus on developing health center leadership and their unique roles in facilitating health center change. Each CoP must have leadership representatives from a minimum of 12 participating health centers. You will provide documentation of commitment from participating health centers’ leadership post-award.

• Outcomes-focused cohorts: You are required to offer intensive, targeted one-on-one support and opportunities for peer learning for health centers performing in or below the third quartile in the selected clinical or operational performance measures. Activities should include planning, action periods, coaching, scale-up of models, and evaluation, and be structured to build upon existing or new support that health centers may receive. These activities must include the following:

◦ Run each cohort for a three-year period. During your period of performance, you will spend about:

▪ Six months planning and recruiting cohort members.

▪ Three years engaging with health centers.

▪ Six months evaluating the cohort’s impact.

◦ Work with HRSA post-award to enroll health centers in each cohort. HRSA may provide direction in the development of cohorts based on 2025 UDS quartile data.

◦ For each cohort, engage at least 40 health centers performing in or below the third quartile in the clinical or operational performance measures that you select.

◦ Provide documentation of commitment from participating health centers’ leadership within six months post-award.

◦ Track cohort progress for the selected measure at least bi-annually to support evaluation of the program.

Step 1: Review the Opportunity 13

◦ Note: This category of TA is not applicable to the National TA and Coordination Center NTAP.

Additional requirements for the National TA and Coordination Center NTAP only

• Coordinate and conduct a national TA needs assessment in years one and three.

Provide a report on findings by quarter one of the following budget year (years two and four).

◦ The assessments may focus on different topic areas to gather a broader range of data.

• Publicly share the findings of your needs assessments and share results with HRSA-supported TA programs to inform future TA offerings.

• Maintain and improve the Health Center Resource Clearinghouse, keeping it a central place for high-quality, accessible TA resources.

• Facilitate collaboration across HRSA-supported TA programs to promote alignment and reduce duplication.

• Evaluate coordination activities and regularly collect input from HRSA-supported TA programs and health centers to assess the impact of TA activities. See the NTAP TA webpage for examples.

• Coordinate responses to public health needs and priorities, as needed.

• Note: If a new applicant is awarded as the National TA and Coordination Center through this NOFO, the new award recipient must work with the previous award recipient to acquire all materials from the Health Center Resource Clearinghouse within 30 days of award. The current award recipient must conduct an orderly phase-out of the Health Center Resource Clearinghouse and transition the consolidated access to TA resources, as appropriate, to the new award recipient.

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

Step 1: Review the Opportunity 14 https://www.healthcenterinfo.org/ https://bphc.hrsa.gov/funding/funding-opportunities/national-technical-assistance-programs

Table 2: Minimum requirements per budget year for the Clinical and Preventive Excellence and Operational Excellence NTAPs

Minimum total number of activities

Minimum number of national audience activities

Minimum number of national communities of practice

Minimum number of national communities of practice sessions

Minimum number of outcomes-focused cohorts

Minimum number of health centers for outcomes-focused cohort

36 22 8 6 sessions per CoP

(8 x 6) = 48 sessions total

6 40 health centers per cohort

(6 x 40) = 240 health centers total

Note: Health centers may experience barriers that prevent participation in the full three years of an outcomes-focused cohort. You must maintain active participation of at least 90 percent of your cohort members from year to year.

Table 3: Minimum requirements per budget year for the National TA and Coordination Center NTAP

Minimum total number of activities

Minimum number of national audience activities

Minimum number of national communities of practice

Minimum number of national communities of practice sessions

Minimum number of health centers in national communities of practice for health center leadership

36* 18 12 6 sessions per CoP

(12 x 6) = 72 sessions total

12 health centers per CoP

(12 x 12) = 144 health centers total

*After you meet the minimum requirements for each TA format, add activities using any TA format to meet the minimum total number of activities.

If you do not meet these requirements, you may jeopardize your NTAP funding per 2 CFR § 200. We will assess you for compliance during the period of performance. If we identify noncompliance, we will place a condition on your award. If you do not resolve the issue successfully, we may cancel all or part of your award (see penalties for noncompliance outlined by 2 CFR § 200.339).

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

Step 1: Review the Opportunity 15 http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl https://www.ecfr.gov/current/title-2/section-200.339

NTAP objectives and measures Below are the objectives you will work on during the period of performance, according to your NTAP category. You must align your activities with these objectives throughout the four-year period of performance.

• You must propose a minimum number of TA activities based on the technical assistance format. See Table 2 and Table 3.

• You will address each objective with at least one activity. You may choose the TA formats, unless otherwise indicated.

• You may select objectives for your CoPs, unless otherwise indicated. You will develop metrics to measure the effectiveness of your CoP TA.

• Outcomes-focused cohorts must address specific objectives, as indicated.

• You are expected to tailor TA activities to address the barriers, challenges, and performance needs of health centers, including health centers serving special medically underserved populations, with a focus on continuous quality improvement.

• You may revise your emerging issues objective at the beginning of each budget period.

Table 4: Clinical and Preventive Excellence NTAP

Objective Number

Objective Measure

1 Access to comprehensive primary care

Increase the number of health centers that receive TA to optimize the delivery of required health services and increase access to integrated, comprehensive, high-quality primary health care in their communities.

This includes helping health centers measure and strengthen clinical access to reduce barriers to timely preventive and chronic care services. These measures should include:

• Visit completion rates.

• Care continuity.

• Clinical staffing ratios.

• Patient follow-up.

The number of health centers that receive this TA.

2 Chronic disease management The number of health centers that receive this TA.

Step 1: Review the Opportunity 16

Objective Number

Objective Measure

Increase the number of health centers that receive TA on preventing and managing chronic disease to improve health outcomes in at least three of the following topics:

• Controlled hypertension.

• Depression remission.

• Diabetes (glycemic control).

• Mental health and substance use disorder management.

3 Preventive services

Increase the number of health centers that receive TA to support three or more of the following preventive screening services:

• BMI screening (adults).

• Cancer screening (breast, cervical, colorectal).

• Depression screening.

• Tobacco use screening.

• Weight assessment and counseling for nutrition and physical activity for children and adolescents.

• Childhood development screenings and evaluations.

The number of health centers that receive this TA.

4 Care continuity and coordination

Increase the number of health centers that receive TA on care continuity and coordination to improve overall patient experience and health outcomes using a validated measure of patient experience.

You must include the following topics:

• Meaningful patient engagement.

• Patient access to personal health information.

• Obtaining and using patient feedback.

• Effective communication between patients and care teams.

Validated measures may include:

The number of health centers that receive this TA.

Step 1: Review the Opportunity 17

Objective Measure

• Medicare Merit-Based Incentive Payment System Patient- Centered Primary Care Measure (PCPCM).

• Consumer Assessment of Healthcare Providers and Systems (CAHPS).

5 Emerging issues (applicant choice)

Develop one objective and associated measure for TA to health centers on emerging clinical issues or evolving trends in improving access to care, processes, patient safety, or patient outcomes in one or more of the following topics:

• Nutrition.

• Child and adolescent health.

• Maternal health.

• Mental health and substance use disorder.

• Environmental hazards and toxins.

• Other.

Developed by you.

6 Outcomes-focused cohorts to improve clinical performance

Support six cohorts of health centers in or below the third quartile in clinical performance to improve clinical outcomes and access to comprehensive, high-quality care.

You must have two cohorts for each of the two required clinical topics (four cohorts total):

• Controlled hypertension.

• Weight assessment and counseling for nutrition and physical activity for children/adolescents.

You must have two additional cohorts. Select from the following clinical topics for these cohorts:

• Cancer screening (breast, cervical, colorectal).

• Diabetes (glycemic control).

• Body mass index (BMI) screening and follow-up plan.

• Screening for depression and follow-up plan.

• Tobacco use: Screening and cessation intervention.

The percentage of health centers in the cohorts that advance toward the next highest quartile for the selected measure.

Use the corresponding UDS measures that align with the 2025 UDS Manual measures, and list the percentage for each selected measure:

• Controlled hypertension:

Table 7, Sec B, line i.

• Weight assessment and counseling for nutrition and physical activity for children/adolescents:

Table 6B, line 12.

• Cancer screening:

◦ Breast: Table 6B, line 11a.

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

Step 1: Review the Opportunity 18 https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-Measures/2025_Measure_483_MIPSCQM.pdf https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-Measures/2025_Measure_483_MIPSCQM.pdf https://www.ahrq.gov/cahps/cahps-database/research-datasets/index.html https://www.ahrq.gov/cahps/cahps-database/research-datasets/index.html https://bphc.hrsa.gov/sites/default/files/bphc/compliance/2025-uds-manual.pdf

Objective Measure

Each cohort must include at least 40 health centers and should focus on improving performance for a single performance measure. You may include additional measures to support a more comprehensive approach.

◦ Cervical: Table 6B, line 11.

◦ Colorectal: Table 6B, line 19.

• Diabetes (glycemic control): Table 7: Sec C, line i.

• BMI screening and follow-up plan: Table 6B, line 13.

• Screening for depression and follow-up plan: Table 6B, line 21.

• Tobacco use: Screening and cessation intervention:

Table 6B, line 14a.

Note: HRSA will provide guidance and relevant UDS data post-award to inform cohort selection and measure alignment.

7 Mental health services

Increase the number of health centers that receive TA to improve mental health services, including:

• Enhancing the quality of integrated mental health services.

• Identifying and treating conditions early.

• Managing behavioral health conditions.

The number of health centers that receive this TA.

8 Oral health and prevention services

Increase the number of health centers that assess their primary health care and oral health service integration and receive TA to increase access to integrated oral health services, with an emphasis on prevention and health education.

The number of health centers that receive this TA.

9 Patient support services The number of health centers that receive this TA.

Step 1: Review the Opportunity 19

Objective Measure

Increase the number of health centers that receive TA on enhancing patient support services to improve access and continuity of care.

You must include the following topics:

• Case management.

• Care coordination.

• Transportation services.

• Outreach services.

10 Prevention of intimate partner violence (IPV) and human trafficking

Increase the number of health centers that receive TA on developing and implementing evidence-based strategies, protocols, and partnerships to prevent, identify, and respond to IPV and human trafficking.

The number of health centers that receive this TA.

11 Clinical quality improvement, assurance, and patient safety

Increase the number of health centers that receive TA on implementing continuous clinical quality improvement and assurance strategies to create a culture of quality and safety.

This objective may require collaboration with a HRSA-supported patient safety/risk management contractor.

The number of health centers that receive this TA.

12 Clinical practice transformation

Increase the number of health centers that receive TA assessing health care quality and practice transformation to increase integrated, team-based practice models and patient-centered care models. These practices should improve health outcomes, support workforce development, and align value-based priorities.

The number of health centers that receive this TA.

13 Community health and health-related needs

Increase the number of health centers that receive TA to strengthen their capacity to identify and address the health-related needs of the communities they serve.

You may include topics such as:

The number of health centers that receive this TA.

Step 1: Review the Opportunity 20

Objective Measure

• Community engagement and community partnerships to improve health, access to resources, and expand outreach efforts.

• Conducting and applying community health needs assessments to inform services and partnerships.

• Designing health strategies tailored to community challenges and needs.

• Using data to identify and respond to areas of need in the community.

Table 5: Operational Excellence NTAP

Objective Number

Objective Measure

1 Access to comprehensive primary care

Increase the number of health centers that receive TA to optimize the delivery of required health services and improve access to integrated, comprehensive, high-quality primary health care in their communities.

This includes helping health centers measure and strengthen operational access to ensure timely access to care. Measures include:

• Appointment availability.

• Patient wait times.

• Service utilization patterns.

• Care team capacity.

The number of health centers that receive this TA.

2 Chronic care management and preventive services

Increase the number of health centers that receive TA to enhance operations that support the delivery of integrated, team-based care for chronic disease prevention, management, and evidence-based screening services. This includes patient-centered medical home recognition, workforce capacity, team-based care, and care coordination to improve health outcomes in three or more topics.

You must include the following two required topics:

The number of health centers that receive this TA.

Step 1: Review the Opportunity 21

Objective Measure

• Controlled hypertension.

• Weight assessment and counseling for nutrition and physical activity for children/adolescents.

You must address one additional topic. Select from the following topics:

• Depression remission.

• Diabetes (glycemic control).

• Mental health and substance use disorder management.

• BMI screening (adults).

• Cancer screening (breast, cervical, colorectal).

• Depression screening.

• Tobacco use screening.

• Childhood development screenings and evaluations.

3 Workforce recruitment, retention, and development

Increase the number of health centers that receive TA to help them recruit, retain, and develop staff.

You must include the following topics:

• Team-based primary health care model implementation.

• Administrative and policy areas of licensure, liability, protection, and scope of practice.

• Partnerships with education and training programs to expand all levels of the health workforce, including career ladders.

• Workforce development and resilience.

• Strengthening leadership and oversight capacity for governing boards.

The number of health centers that receive this TA.

4 Financial and resource management

Increase the number of health centers that receive TA to increase their financial and resource management skills to improve sustainability and patient outcomes.

You must include topics such as:

• Implementing value-based care and innovation models.

• Payor and revenue management.

The number of health centers that receive this TA.

Step 1: Review the Opportunity 22

Objective Measure

• Improving revenue cycle efficiency and revenue metrics, such as reduced claim denials or billing turnaround times.

• Contracting.

5 Emerging issues (applicant choice)

Develop one objective and associated measure for TA to health centers on emerging operational issues or evolving trends in improving access to care, processes, patient safety, or outcomes.

Developed by you.

6 Outcomes-focused cohorts to improve operational performance

Support six cohorts of health centers in or below the third quartile in operational and financial performance to improve financial sustainability, operational efficiency, and access to care.

You must have two cohorts for each of the two required operational topics (four cohorts total):

• Staffing and utilization.

• Days cash on hand.

You must have two additional cohorts. Select from the following operational topics for these cohorts:

• Cost per patient.

• Days in net accounts receivables.

• Bottom line margin/net profit margin.

• Operating margin.

Each cohort must include at least 40 health centers and should focus on improving performance for a single performance measure. You may include additional measures to support a more comprehensive approach.

The percentage of health centers in the cohorts that advance toward the next highest quartile for the selected measure.

Use the corresponding UDS measures that align with the 2025 UDS Manual or audit measures.

• Staffing and utilization:

Table 5.

• Days cash on hand.

• Cost per patient: Table 8A.

• Days in net accounts receivables.

• Bottom line margin/net profit margin.

• Operating margin.

Note: HRSA will provide guidance and relevant UDS data post-award to inform cohort selection and measure alignment.

7 Health information technology (HIT) and data management

The number of health centers that receive this TA.

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

Step 1: Review the Opportunity 23 https://bphc.hrsa.gov/sites/default/files/bphc/compliance/2025-uds-manual.pdf

Objective Measure

Increase the number of health centers that receive TA to strengthen HIT infrastructure and data management, including health information exchange, registries, and the adoption of digital health tools. Such tools include remote monitoring devices, patient portals, and telehealth visits to support efficient, high-quality care delivery.

You must include the following topics:

• Cybersecurity and data privacy.

• Data management and patient engagement and access to information.

• Artificial intelligence (AI) and AI adoption.

• Patient level reporting.

• Clinical dashboards.

• Interoperability and data sharing.

• Fast Healthcare Interoperability Resources (FHIR) capabilities and enhancements.

8 Pharmacy management and optimization

Increase the number of health centers that receive TA to implement and improve pharmacy services, including maximizing participation in new pharmacy management pilots, models, and practice changes.

The number of health centers that receive this TA.

9 Capital planning, growth, and operational development

Increase the number of health centers that receive TA to develop comprehensive capital plans that support facility improvements, infrastructure expansion, technology investments, and operational performance to ensure long-term sustainability, growth, and expanded access to integrated, comprehensive primary care.

You must include topics such as:

• Developing strategies to upgrade infrastructure.

• Enhancing infrastructure to support continuity of operations during emergencies.

• Ensuring facilities effectively meet patient care needs.

• Leveraging funding to support the continuity of operations.

The number of health centers that receive this TA.

Step 1: Review the Opportunity 24

Objective Measure

• Prioritizing investments to align with operational goals and infrastructure needs.

• Developing strategies to forecast future growth to support service delivery expansion.

10 Health center expansion of services

Increase the number of health centers that receive TA to strategically expand services (for example, dental and behavioral health) through operational planning, resource alignment, and integration into existing systems of care.

The number of health centers that receive this TA.

11 Workflow optimization

Increase the number of health centers that receive TA to improve the efficiency of clinical and operational workflows using operational metrics. These measures must include:

• Intake time (average time between patient starts to meet demand).

• Cycle time (total time to complete a process visit).

The number of health centers that receive this TA.

12 Train-the-trainer for PCAs and HCCNs

Increase the capacity of PCAs and HCCNs to deliver high-impact TA to health centers with the “train-the-trainer” model.

You must include topics such as:

• Scalable training curriculum.

• Developing and sharing with PCAs and HCCNs tools to support health centers in priority areas of need.

The number of PCAs and HCCNs that receive this TA.

13 Preparedness for emergencies and environmental hazards

Increase the number of health centers that receive TA to improve their capacity to mitigate, prepare for, respond to, and recover from public health emergencies, and the health-related impacts of disasters and environmental hazards.

The number of health centers that receive this TA.

Step 1: Review the Opportunity 25

Table 6: National TA and Coordination Center NTAP

Number

Objective Measure

1 Health Center Resource Clearinghouse—maintenance and materials development

Maintain the Health Center Resource Clearinghouse platform and add TA materials to the platform.

The number of TA materials on the Health Center Resource Clearinghouse platform.

2 Health Center Resource Clearinghouse—TA access

Increase the number of people who access TA learning resources on the Health Center Resource Clearinghouse platform.

The number of individuals who access TA learning resources on the Health Center Resource Clearinghouse platform.

3 TA needs assessment

Conduct TA needs assessments in years one and three that document and analyze the most significant TA needs of the Health Center Program awardees and look-alikes.

The percentage of health center program awardees and look-alikes that complete the TA needs assessment.

4 Strategic engagement

Increase the number of health centers that receive TA to foster partnerships and collaboration to align efforts for improved health outcomes, including engaging key stakeholders such as health care providers and community organizations.

The number of health centers who receive this TA.

5 Facilitation and information sharing among HRSA-supported TA programs

Strengthen collaboration and knowledge exchange among HRSA-supported TA programs to help them collaborate, share knowledge, and coordinate strategies to improve health center performance.

This includes:

• Facilitating regular communication among NTAPs, PCAs, and HCCNs.

• Hosting cross-program peer learning groups.

• Identifying opportunities for shared innovation, resource development, and train-the-trainer models.

• Reducing duplicated efforts.

The number of NTAPs, PCAs, and HCCNs that receive this

TA.

Step 1: Review the Opportunity 26

Objective Measure

6 National CoP to improve health centers’ leadership and governing boards

Increase the number of health centers that receive TA to strengthen the capacity of their leadership and governing boards, including C-suites such as CEOs, CMOs, CFOs, CTOs, governing board chairs, and new health center leaders, to strengthen organizational capacity, leadership effectiveness, and strategic decision-making to improve comprehensive, high-quality primary health care.

Activities must include at least 12 national CoP that focus on the following:

• Board engagement.

• Executive leadership development.

• Governance.

• Performance improvement strategies.

• Financial and operational oversight.

• Strategic planning.

• Compliance aspects of health centers and preparation for operational site visits (OSVs).

The number of health centers’ board members and executive staff who receive this TA.

7 Coordinating responses to public health needs and priorities

Increase the effectiveness and timeliness of TA delivered across the Health Center Program by coordinating and supporting responses to emergent public health needs and priorities.

This includes the following activities to ensure continuity of operations, quality care delivery, and rapid response to evolving public health needs and priorities:

• Identifying, synthesizing, and disseminating timely information.

• Sharing resources across TA programs, including NTAPs, PCAs, and HCCNs.

• Facilitating alignment of strategies in collaboration with HRSA, health centers, and TA programs.

The number of coordinated, timely TA activities in response to emergent public health needs and priorities, in collaboration with HRSA and other TA programs. This should include the number of shared resources or communication products distributed nationally.

Step 1: Review the Opportunity 27

Objective Measure

8 Support health center compliance with program requirements

Provide TA to health centers to support continual compliance with program requirements.

This includes helping health centers prepare for upcoming operational site visits (OSVs).

The number of health centers that receive this TA.

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

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

Step 1: Review the Opportunity 28 https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254b&num=0&edition=prelim

Award information Cooperative agreement terms Our responsibilities Aside from monitoring and technical assistance, we also get involved in these ways:

• Collaborate with you to revise and approve the objectives and activities in your project work plan (PWP) according to our priorities and changes in the health care landscape, such as identifying and prioritizing TA on using federal funds.

• Establish standard measures that you will use to evaluate success. These measures may evolve throughout the period of performance.

• Monitor and help you carry out your PWP through regular collaborative meetings and progress report reviews.

• Review and help you develop key deliverables, including approving your publication plan and national TA resources before you publish, distribute, and/or post them online.

• Attend and participate in NTAP-related meetings, as appropriate.

• Find opportunities to coordinate activities with other federally funded award recipients to support the objectives.

• Conduct a site visit during the four-year period of performance to review your activities, assess key accomplishments, and identify promising practices. We may conduct an additional site visit as needed.

• Provide a data use agreement (that you must sign) before sharing data that will help you achieve your approved objective targets.

Your responsibilities You must follow all relevant laws, regulations, and policies. Your other responsibilities will include:

• Collaborate with HRSA to revise and carry out your PWP based on administration, HHS, and HRSA priorities, and changes in the health care landscape.

• Provide input on standard measures all NTAPs will use to evaluate success.

• Submit publications developed with NTAP funds to HRSA for review. When submitting to HRSA, you must include the publication’s purpose, target audience, publication mode or type, and projected publication date.

Step 1: Review the Opportunity 29

• Acknowledge federal funding by adding an acknowledgment statement on all publications and national TA resources produced with HRSA funds, in accordance with the requirements listed on How to Acknowledge Federal Funding.

• Participate in HRSA and related stakeholder meetings, including at least one NTAP forum, as appropriate.

• Coordinate with national, federal, state, and local organizations to help develop and carry out your PWP.

• Ensure compliance with the NTAP program requirements and expectations, including ensuring that activities supported in whole or in part with NTAP funds are available to all existing and potential health centers.

• Participate in a HRSA-led NTAP site visit and any additional site visits during the four-year period of performance.

• Sign and adhere to all data use agreements that govern Uniform Data System (UDS) and non-UDS data sources before you request data from us that is not publicly available.

Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS will adopt 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.

• All uses of funds must align with your scope of project.

• 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.

• Support beyond the first budget year will depend on:

◦ Available funds.

◦ Your satisfactory progress in meeting the project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

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

◦ Fund more applicants from the rank order list.

◦ Extend the period of performance.

◦ Award supplemental funding.

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

Step 1: Review the Opportunity 30 https://www.hrsa.gov/grants/manage-your-grant/acknowledge-hrsa-funding https://data.hrsa.gov/tools/data-reporting https://data.hrsa.gov/tools/data-reporting https://www.ecfr.gov/current/title-2/part-200

General limitations

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

Budget Information in Section 3.1.4 of the Application Guide. You can also see 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

• 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 NTAP purpose.

• Direct patient care.

• New construction activities, including additions or expansions.

• Alteration or renovation (A/R) of facilities.

• Reserve requirements for state insurance licensure.

• Support for lobbying or advocacy efforts.

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 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 charge 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.

Method 2 – De minimis rate.