PKG00294471.pdf

Notice of Funding Opportunity

Application due 12/11/26

Bureau of Health Workforce Division of Medicine and Dentistry

Teaching Health Center Graduate Medical Education (THCGME) Program Opportunity number: HRSA-27-017

Contents 2

Contents Before you begin 4

Step 1: Review the Opportunity 5

Basic information 6

Eligibility 8

Program description 11

Award information 14

Step 2: Get Ready to Apply 17

Get registered 18

Find the application package 18

Application writing help 19

Step 3: Build Your Application 20

Application checklist 21

Application contents and format 22

Step 4: Understand Review, Selection, and Award 30

Application review 31

Selection process 32

Award notices 32

Step 5: Submit Your Application 33

Application submission and deadlines 34

Other submissions 35

Step 6: Learn What Happens After Award 36

Post-award requirements and administration 37

Reporting 41

Contacts and Support 43

Contents 3

Appendices 46

Endnotes 54

Before you begin 4

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 12/11/2026.

All activities proposed in your application 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.

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.

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

Step 1:

Review the Opportunity

In this step

Basic information 6

Eligibility 8

Program description 11

Award information 14

Step 1: Review the Opportunity 6

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

Basic information Health Resources and Services Administration

Bureau of Health Workforce

Division of Medicine and Dentistry

The THCGME Program supports the training of residents in primary care residency programs in community-based ambulatory patient care centers

Summary The Teaching Health Center Graduate Medical Education (THCGME) Program supports primary care residency training in community-based ambulatory patient care centers.

This opportunity is available only to current HRSA THCGME Program recipients seeking continuation awards to maintain filled resident Full-Time Equivalent (FTE) positions.

To be eligible, current recipients must:

• Be funded under previous announcement HRSA-23-013.

• Have a current period of performance that ends on June 30, 2027.

This multi-year funding opportunity will extend the period of performance for eligible recipients by an additional two years, to June 30, 2029.

Funds awarded through this notice may only be used to support costs associated with resident FTE training. Specifically, awards may support:

• Direct expenses associated with sponsoring approved graduate medical residency training programs.

• Indirect expenses associated with the additional costs related to teaching residents in residency training programs.

Opportunity name:

Teaching Health Center Graduate Medical Education (THCGME) Program

Opportunity number:

HRSA-27-017

Announcement version:

93.530

NOFO issue date:

10/29/2026

Informational webinar:

Application deadline:

12/11/2026

Expected award date is by:

06/01/2027

07/01/2027

See other submissions for other time frames that may apply to this NOFO.

Step 1: Review the Opportunity 7

Funding details Application Types: Competing continuation

Expected total available funding in FY 2027: $20,960,000

Expected number and type of awards: 12 G (Grant)

Funding range per award: $320,000 - $2,880,000

We plan to fund awards in two 12-month budget periods for a total of two years. The period of performance is from 07/01/2027 to 6/30/2029. The THCGME Program payment is formula-based, and the anticipated FY 2027 interim payment rate is $160,000 per resident FTE. In subsequent fiscal years, the payment rate may change due to available appropriations and/or changes in payment methodology. HRSA may adjust recipient funding levels beyond the first year if a recipient is unable to fully succeed in achieving the goals listed in their application.

Step 1: Review the Opportunity 8

Eligibility Eligible applicants are current THCGME Program payment recipients that received funding under HRSA-23-013, and are a community-based, ambulatory patient care center that operates an accredited primary care residency program, individually or through a graduate medical education (GME) consortium that operates an accredited primary care residency program, in one of the following specialties/disciplines:

• Family Medicine

• Internal Medicine

• Pediatrics

• Internal Medicine-Pediatrics

• Obstetrics and Gynecology

• Psychiatry

• General Dentistry

• Pediatric Dentistry

• Geriatrics

Types of eligible organizations These types of *domestic organizations may apply if they otherwise meet the eligibility criteria.

Others (see text field entitled “Additional Information on Eligibility” for clarification)

*“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.

Additional information on eligibility

Existing HRSA THCGME Program payment recipients must continue to meet the program’s eligibility requirements to remain eligible for HRSA THCGME funding.

Applicants must be community-based, ambulatory patient care centers that operate an accredited primary care residency program. They may operate individually or through a graduate medical education (GME) consortium. The residency program must be in one of the following specialties/disciplines:

• Family Medicine

• Internal Medicine

Step 1: Review the Opportunity 9

• Pediatrics

• Internal Medicine-Pediatrics

• Obstetrics and Gynecology

• Psychiatry

• General Dentistry

• Pediatric Dentistry

• Geriatrics

Program payment recipients that fail to meet any eligibility criteria will not be considered for funding under this announcement.

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.

• Requests funding above the award ceiling shown in the funding range.

• Is submitted after the deadline.

• Fails to include all required documents.

• Requests funding for residency program development.

• Requests funding for a residency program in a specialty/discipline outside those listed in the Eligibility section.

Application limits You may submit more than one application under the same Unique Entity Identifier (UEI) if each proposes a distinct project. We will only review your last validated application for each distinct project before the deadline.

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.

Step 1: Review the Opportunity 10

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 11

Program description Purpose The purpose of the THCGME Program is to provide funding to support the training of residents in primary care medical and dental residency training programs in community-based, ambulatory patient care centers. These programs will prepare residents to provide high-quality care, particularly in rural and medically underserved communities, and develop competencies to serve a wide range of populations and communities.

This notice announces the opportunity to apply for continuation awards to support maintenance of filled resident Full-Time Equivalent (FTE) positions that are funded by HRSA under announcement HRSA-23-013. Applications through this FY 2027 Notice of Funding Opportunity (NOFO) will extend the period of performance for positions funded for an additional two years beyond the periods of performance listed in the original grants.

Organizations applying for continued support for more than one residency program must submit a separate application for each unique program.

Funding through this opportunity will support maintenance of approved HRSA-funded resident FTE positions for existing HRSA THCGME Program payment recipients only.

Applications seeking support for an expanded number of resident FTE positions or the establishment of new resident FTE positions will not be considered under this notice.

Funding opportunity goals

• Increase the supply of primary care medical and dental residents that are trained in community-based settings.

Background The THCGME Program was created to meet the growing need for primary care and to offer a new residency model focused on training physicians and dentists in community-based settings. Evidence shows that using a community-based model increases physicians in high-need locations.[1],[2] The THCGME Program further supports medical and dental residency training focusing on rural and medically underserved areas. Since the program’s inception in 2011, over 3,000 new physicians and dentists have entered the workforce through this program.

Step 1: Review the Opportunity 12

The National Center for Health Workforce Analysis (NCHWA) projects that the total demand for primary care physicians will grow by 39,530 FTEs between 2023 and 2038.

NCHWA also predicts a 7.9% increase in national demand for oral health professionals, including endodontists, general dentists, oral surgeons, orthodontists, pediatric dentists, periodontists, and other dentists. While the overall supply of some oral health professionals may meet the projected demand for their professions, NCHWA data projects shortages in general dentistry for all years covered by the current projections (2023 to 2038). People outside of metro areas face additional difficulties in accessing dental care. The projections predict that in 2038, there will be a projected shortage of dentists in 46% of non-metro areas.

Program goal and objectives Goal Increase the supply of primary care medical and dental residents that are trained in community-based settings.

Objectives To support the continued training of primary care medical and dental residents in existing HRSA THCGME-funded residency programs.

Existing HRSA THCGME residency program recipients may only request the number of resident FTEs previously approved in prior competition HRSA-23-013.

Program requirements and expectations Award recipients are required to participate in federally designed evaluations to assess program effectiveness and efficiency upon request.

Reconciliation: All HRSA THCGME funding is subject to annual reconciliation.

• During reconciliation, any changes to the number of resident FTEs you report will be calculated to determine the final amount payable for the budget period.

• You must make sure that the FTEs you report are accurate, and you may face audits.

• You must coordinate with teaching hospitals to avoid over-reporting FTEs for THCGME Program funding. Over-reporting could result in overpayment to recipients, which HRSA will recoup.

Other funding sources:

Under 42 U.S.C. § 256h(e) (Title III, § 340H(e) of the Public Health Service Act), recipients must coordinate THCGME payments with other federal GME payments, Step 1: Review the Opportunity 13 including those from the Centers for Medicare & Medicaid Services (CMS) and HRSA GME programs (e.g., CHGME). This coordination prevents duplicate payments for the same resident FTE training time. This requirement also applies to funding from federal, state, local, Tribal, non-profit or for-profit entities. Recipients must not use THCGME funds to replace or supplant other available funding. HRSA may suspend or terminate current or future federal awards if a recipient replaces or supplants other funding.

HRSA may also recover misused federal funds and take other actions allowed by law.

Recipients must not claim a resident’s FTE training time for THCGME payment if an affiliate hospital claims that same time to receive federal direct medical education (DME) payments (e.g., CMS, CHGME).

• If an affiliated hospital receives federal DME payments for a resident’s time, that time is not eligible for THCGME payment and will be excluded or subject to reduction during reconciliation.

• If an affiliated hospital does not receive federal DME payments for a resident’s training time, that time may be eligible for THCGME payment.

• Federal indirect medical education (IME) payments (e.g., CMS IME or CHGME IME) are not considered duplicative. An affiliated hospital’s receipt of IME payment will not result in a reduction to THCGME payments.

Recipients are responsible for coordinating with affiliated training sites. They must ensure that resident FTE training time is reported accurately and complies with all federal requirements.

Accreditation/institutional sponsorship: The eligible community-based ambulatory patient care center or GME consortium carrying out the THCGME program must be accredited in one of the primary care disciplines listed in the Eligibility section.

• The eligible entity must be listed as the institutional sponsor by the relevant accrediting body, such as the Accreditation Council for Graduate Medical Education (ACGME) or the American Dental Association’s Commission on Dental Accreditation (CODA).

• The eligible entity must be named on the program’s relevant accreditation documentation.

• The eligible entity must maintain their accreditation throughout the full period of performance. Failure to maintain accreditation may be grounds for suspension or termination of current and future federal awards, recovery of misused federal funds, and other remedies available by law.

Notification: In the event of an organizational change to program directors, sponsoring institutions, consortia members or other significant items, you must immediately notify HRSA and submit a prior approval request for the change through the HRSA Electronic Handbooks (EHBs) system (https://grants.hrsa.gov).

https://grants.hrsa.gov/

Step 1: Review the Opportunity 14

National Provider Identifier numbers: You must apply for and report National Provider Identifier (NPI) numbers for THCGME-supported residents.

Statutory authority 42 U.S.C. § 256h (Title III, § 340H of the Public Health Service Act)

Award information 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.

• Support beyond the first budget year will depend on:

◦ Appropriation of 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.

https://uscode.house.gov/view.xhtml?req=(title%3A42%20section%3A256h%20edition%3Aprelim)%20OR%20(granuleid%3AUSC-prelim-title42-section256h)&f=treesort&edition=prelim&num=0&jumpTo=true https://www.ecfr.gov/current/title-2/part-200 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-300

Step 1: Review the Opportunity 15

General limitations

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

◦ 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.

• 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. For help calculating salaries under this limit, read more at “salary rate limitation” in Step 1 of the How to Apply – Application Guide.

• To promote objectivity in research, you cannot have a financial conflict of interest.

See 42 CFR 50.

Program-specific statutory or regulatory limitations

• Payments made through this announcement are to only be used for the direct expenses associated with sponsoring an approved graduate medical residency training program and indirect expenses associated with the additional costs relating to teaching residents in residency training programs.

• THCGME Program funds may not be used for residency program development (e.g., the costs associated with accreditation).

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

THCGME Program payment overview

• The FY 2027 HRSA THCGME Program payment is formula-based and provides payment for both the direct expenses associated with sponsoring approved graduate medical residency training programs and indirect expenses associated with the additional costs related to teaching residents in residency training programs. The expected FY 2027 award amount is $160,000 per resident FTE.

• Future per resident amounts may vary based on funding and changes as determined appropriate by the Secretary.

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

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 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.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D6 https://www.ecfr.gov/current/title-42/chapter-I/subchapter-D/part-50/subpart-F#subpart-F https://www.hrsa.gov/grants/manage-your-grant https://www.hrsa.gov/grants/manage-your-grant

Step 1: Review the Opportunity 16

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.

https://www.ecfr.gov/current/title-2/section-200.307

Step 2:

Get Ready to Apply

Get registered 18

Find the application package 18

Application writing help 19

Step 2: Get Ready to Apply 18

Get registered SAM.gov You must have an active account with SAM.gov to apply. 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.

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 and How to Apply for Grants.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number HRSA-27-017.

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

If you need additional information about getting registered or finding the application package, see Step 2 in the How to Apply – Application Guide.

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://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/search-grants https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D8

Step 2: Get Ready to Apply 19

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.

Join the webinar For more information about this opportunity, Visit the Bureau of Health Workforce’s open opportunities website. The webinar will be recorded.

FAQs will be posted on the Bureau of Health Workforce’s open opportunities website.

Have questions? Go to Contacts and Support.

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://bhw.hrsa.gov/programs https://bhw.hrsa.gov/programs

Step 3:

Build Your Application

Application checklist 21

Application contents and format 22

Step 3: Build Your Application 21

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 See the instructions for the project narrative, form, and the budget and budget narrative.

Form Included in page limit*?

Research & Related Other Project Information Yes*

Research & Related Budget Yes*

Attachments See instructions for attachments.

Included in page limit*?

1. Accreditation Documentation Yes

2. Residency Program Organizational Chart Yes

3. Letters of Agreement, Memoranda of Understanding and Contracts

Yes

4. Staffing Plan and Job Description Yes

5. Eligible Resident/Fellow FTE Chart Yes

6. THCGME Program Assurances Yes

7. Other relevant document Yes

8. Other relevant document Yes

9. Other relevant document Yes

10. Other relevant document Yes

Step 3: Build Your Application 22

Included in page limit*?

11. Other relevant document Yes

12. Other relevant document Yes

13. Other relevant document Yes

14. Other relevant document Yes

15. Other relevant document Yes

Other required forms See form instructions.

Form Included in page limit*?

SF-424 (R&R) No

R&R Subaward Budget Attachment(s) No

Project Abstract Summary Form No

Research & Related Senior/Key Person Profile form No

Project/Performance Site Location(s) No

Disclosure of Lobbying Activities (SF-LLL) No

* Unless otherwise indicated, only what you attach to a form counts toward the page limit. The form itself does not count.

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

Application page limit: 60 pages

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

Step 3: Build Your Application 23

Required format You can find technical guidance for formatting your application documents in Step 5 of the NOFO and in Step 5 of the How to Apply - Application Guide.

Project narrative Since you are submitting a request to continue your program, you are not required to submit a project narrative unless you have updates from your original application under HRSA-23-013. If you have updates, upload the project narrative as an attachment to the Research & Related Other Project Information Form.

Budget and budget narrative The THCGME Program is a formula-based payment program that does not require submission of a formal budget. An Eligible Resident/Fellow FTE Chart for the number of resident FTEs requested is required.

Your application package contains a required R&R Budget Form.

• Input zeros in blocks A-K.

• Use block L. Budget Justification - Attach the Resident FTE Request Justification to the SF-424 R&R Budget Form.

Attachments See section 3.2 of the HRSA R&R Application Guide.

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

Unless the instructions below require it, do not submit organizational brochures or other promotional materials (for example, slides, films, clips).

Attachment 1: Accreditation documentation Required – Counts toward page limit.

Provide the most current accreditation documentation for the sponsoring institution and residency training program from the applicable accrediting body (ACGME or CODA).

Documentation must clearly identify the residency program’s institutional sponsor, number of approved resident positions, dates of accreditation, and any noted citations (if applicable). Do not submit only a link to the accrediting body’s website. You must submit the accreditation documentation.

https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D25 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D25

Step 3: Build Your Application 24

Attachment 2: Residency program organizational chart Required – Counts toward page limit.

Provide a one-page diagram that shows the organizational structure of the residency program, including the community-based ambulatory patient care center and all major training partners.

Attachment 3: Letters of agreement, memoranda of understanding and contracts Required – Counts toward page limit.

• Provide documents from the last five years that describe working relationships between your organization and other organizations and programs referenced in your application. Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and partners and any deliverables.

• You do not need to submit complete agreements. Instead, submit only the sections that describe the working relationship between your organization and the other organization.

• Make sure any letters of agreement are signed and dated.

Letters of agreement from training partners must address understanding and steps to ensure that THCGME resident FTEs will not also be submitted to Medicare GME or the CHGME Payment Program for the purposes of receiving GME payments.

Affiliation agreements with entities that have not previously trained medical residents must include acknowledgment that new residents rotating at these sites will trigger the CMS resident FTE cap building period.

Step 3: Build Your Application 25

Attachment 4: Staffing plan and job description Required – Counts toward page limit.

See Section 3.1.7 of the R&R Application Guide.

Include a staffing plan that shows the staff positions that will support the project and key information about each. Justify your staffing choices, including education and experience qualifications.

For key personnel, attach a one-page job description including their role, responsibilities, and qualifications.

Attachment 5: Eligible Resident/Fellow FTE Chart Required – Counts toward page limit.

Upload a copy of the completed Eligible Resident/Fellow FTE Chart. The chart must include the total resident training numbers from the five previous academic years (AY 2022-2023 through AY 2026-2027) and planned total resident training numbers for AY 2027-2028 through AY 2028-2029. THCGME Program-supported resident FTEs documented in this chart may not exceed the number stated in your most recent HRSA THCGME Program Resident FTE Approval Letter. Requests for resident FTEs beyond this number will not be considered through this announcement.

Attachment 6: THCGME Program Assurances Required – Counts toward page limit.

Appendix A provides THCGME Program information on resident FTE time that qualifies to receive THCGME payments. You must submit a signed THCGME Program Assurances document confirming that you have reviewed and will comply.

Please see Appendix A for instructions.

https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D22

Step 3: Build Your Application 26

Attachment 7: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 8: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 9: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 10: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 11: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 12: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 13: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 14: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Attachment 15: Other relevant documents As Applicable – Counts toward the page limit.

Include here any other documents that are relevant to the application.

Step 3: Build Your Application 27

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

SF-424 R&R (Application for Federal Assistance) form

With application.

Project Abstract Summary Form With application.

R&R Subaward Budget Attachment With application

Research & Related Other Project Information With application.

Research & Related Senior/Key Person Profile (Expanded)

With application.

Project/Performance Site Location(s) With application.

Disclosure of Lobbying Activities (SF-LLL) If applicable, with the application or before award.

Form instructions In addition to the requirements for the budget narrative, project narrative, and attachments, following are instructions for each of the other forms required by this NOFO. See the application checklist for a full list of all application requirements.

https://grants.gov/forms/forms-repository/sf-424-family

Step 3: Build Your Application 28

SF-424 (R&R) application for federal assistance This is your application for federal assistance. Follow the instructions in Step 3 section of the How to Apply – Application Guide.

Project abstract summary form

Does not count toward the page limit

Complete the information in the Project Abstract Summary Form. Include a short description of your proposed project. Include any needs you plan to address, the proposed services, and the population groups you plan to serve compared to your previous application. For more information, see section 3.1.2 of the R&R Application Guide.

The abstract must also include:

• Name of the graduate medical residency training program.

• Discipline of the graduate medical residency training program.

• Eligible entity type:

o State the type and name of the community-based ambulatory patient care center as described in the eligibility section.

o State whether the community-based ambulatory patient care center operates the residency program alone or as part of a GME consortium.

• The year the program first began training residents.

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

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

https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D17 https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D17 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D14 https://www.hrsa.gov/sites/default/files/hrsa/grants/research-related-application-guide.pdf#page%3D14 https://www.usaspending.gov/ https://www.hhs.gov/sites/default/files/hhs-writing-award-descriptions.pdf

Step 3: Build Your Application 29

• A brief overview of the graduate medical residency training program that includes the name of the accredited sponsoring institution (as designated by ACGME or CODA) and a description of the main primary care training location, including populations served.

• Resident FTE positions requested under this program for AY 2027-2028, including:

o The total number to be funded in AY 2027-2028.

o The number to be funded in AY 2027-2028 by Post Graduate Year (PGY) (e.g., X-X-X).

• Rotation sites:

o State if residents within your program will perform rotations at any new rotation site(s) that have not provided resident training in any prior AY.

Research & related other project information

In addition to the requirements in the project narrative section, you will provide some additional information in this form.

• Complete sections 1 through 6.

• Upload a blank document in item 7: Project Summary/Abstract to avoid a cross-form error with your Project Abstract Summary Form.

• Upload your project narrative (if applicable) in item 8.

• Leave items 9, 10, and 11 blank.

Research & related senior/key person profile (expanded) Include biographical sketches for people who will hold the key positions.

• Try to use no more than two per person.

• Do not include non-public personally identifiable information.

• If you include someone you have not hired yet, include a letter of commitment from that person with their biographical sketch.

• Upload sketches in the Research & Related Senior/Key Person Profile form.

• Include:

o Name and title o Education and training – for each entry include Institution and location, degree and date earned, if any, and field of study.

o Section A, Personal Statement. Briefly describe why the individual’s experience and qualifications make them well-suited for their role.

https://grants.gov/learn-grants/grant-terminology#p

Step 3: Build Your Application 30 o Section B, Positions and Honors. List in chronological order previous and current positions. List any honors. Include present membership on any federal government public advisory committee.

o Section C, Other Support. This section is optional. List selected ongoing and completed projects during the last three years. Begin with any projects relevant to the proposed project. Briefly indicate the overall goals of the projects and responsibilities of the person.

o Other information. If they apply, include language fluency and experience working with populations that are culturally and linguistically different from their own.

R&R subaward budget attachment(s) form The THCGME Program is a formula-based payment program that does not require submission of a formal budget with subaward attachments.

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.

Disclosure of lobbying activities (SF-LLL) form Follow the form instructions in Grants.gov Forms.

https://www.grants.gov/forms https://www.grants.gov/forms

Step 4:

Understand Review, Selection, and Award

In this step

Application review 31

Selection process 32

Award notices 32

Step 4: Understand Review, Selection, and Award 31

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.

This program is formula-based. We review your application on its technical merit.

We will distribute funds among eligible organizations with complete applications. We use the data supplied in applications to calculate award amounts.

We will fund existing HRSA-funded THCGME Program payment recipients, previously awarded under HRSA-23-013, that meet eligibility requirements and validate the number of resident FTEs requested for continued THCGME Program support.

Risk review Before making an award, we review your award history to assess risk. We need to ensure all prior awards were managed well and demonstrated sound business practices. We:

• Review any applicable past performance.

• Review audit reports and findings.

• Analyze the budget.

• Assess your management systems.

• Ensure you continue to be eligible.

• Make sure you comply with any public policies.

We may ask you to submit additional information.

As part of this review, we use SAM.gov Entity Information Responsibility/Qualification to check your history for all awards likely to be more than $250,000 over the period of performance. You can comment on your organization’s information in SAM.gov. We’ll consider your comments before making a decision about your level of risk.

If we find a significant risk, we may choose not to fund your application or to place specific conditions on the award.

For more details, see 2 CFR 200.206.

https://sam.gov/content/entity-information https://www.ecfr.gov/current/title-2/section-200.206

Step 4: Understand Review, Selection, and Award 32

Selection process When making funding decisions, we consider:

• The amount of available funds.

• Assessed risk.

• The results of reviewing the progress report submitted with a competing continuation application that seeks a new period of performance.

• Alignment with HRSA Mission and Strategic Priorities.

We may:

• Fund applications in whole or in part.

• Fund applications at a lower amount than requested.

• Choose to fund no applications under this NOFO.

Additionally, we may not make an award if you are delinquent on two or more Single Audit Reports.

You cannot appeal a denial, or the amount of funds awarded.

Award notices We issue Notices of Award (NOA) on or around the start date listed in the NOFO. See “how we make awards” in Step 4 of the How to Apply – Application Guide for more information.

By drawing down funds, you accept the terms and conditions of the award.

https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D23

Step 5:

Submit Your Application

Application submission and deadlines 34

Other submissions 35

Step 5: Submit Your Application 34

Application submission and deadlines Your organization’s authorized official must certify your application. Make sure you have everything you need. See Step 5 in the How to Apply – Application Guide for more detailed information on submitting your application.

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 How to Apply – Application Guide.

https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D25 https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D1 https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D1

Step 5: Submit Your Application 35

Application deadline You must submit your application by 12/11/2026, at 11:59 p.m. ET.

Grants.gov creates a date and time record when it receives applications.

If you need a deadline extension, see “requesting a deadline waiver” in Step 5 of the How to Apply – Application Guide.

Submission method Grants.gov You must submit your application through Grants.gov. You may do so using Grants.gov Workspace. This is the preferred method. For alternative online methods, see Applicant System-to-System.

For instructions on how to submit in Grants.gov, see the Quick Start Guide for Applicants. Make sure that your application passes the Grants.gov validation checks, or we may not get it. Do not encrypt, zip, or password protect any files.

If Grants.gov rejects your application due to errors, you must correct and resubmit before the deadline.

If you want to know more about correcting errors or tracking your application, you can refer to Step 5 in the How to Apply in the Application Guide.

Have questions? Go to Contacts and Support.

Other submissions Intergovernmental review This NOFO is not subject to Executive Order 12372, Intergovernmental Review of Federal Programs. No action is needed.

https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D28 https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D25 https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D25 https://www.grants.gov/system-to-system/applicant-system-to-system/ https://www.grants.gov/system-to-system/applicant-system-to-system/ http://www.grants.gov/quick-start-guide/applicants http://www.grants.gov/quick-start-guide/applicants https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D27 https://www.hrsa.gov/sites/default/files/hrsa/grants/how-to-apply-application-guide.pdf#page%3D25 https://www.archives.gov/federal-register/codification/executive-order/12372.html

Step 6:

Learn What Happens After Award

In this step

Post-award requirements and administration 37

Reporting 41

Step 6: Learn What Happens After Award 37

Post-award requirements and administration Administrative and national policy requirements There are important rules you need to know if you get an award. You must follow:

• All terms and conditions in the Notice of Award.

• The regulations at 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, modifications at 2 CFR 300, or any superseding regulations.

• The HHS Grants Policy Statement. This document is incorporated by reference in your Notice of Award. If there are any exceptions to the GPS, they’ll be listed in your Notice of Award.

• All federal statutes and regulations relevant to federal financial assistance, including those highlighted in HHS Grants Policy Statement, Appendix D: HHS Administrative and National Policy Requirements.

• See the requirements for performance management in 2 CFR 200.301.

• All anti-discrimination laws: By applying for or accepting federal funds from HHS, you certify compliance with all federal antidiscrimination laws and these requirements. Complying with those laws is a material condition of receiving federal funding streams. You are responsible for ensuring subrecipients, contractors, and partners also comply.

Required Alignment with HRSA Mission and Strategic Priorities Recipients must use funds awarded under this NOFO to implement program goals or agency priorities in accordance with the HRSA vision, mission, core values, and strategic priorities, where authorized by law.

In administering programs under this and all funding announcements, HRSA prioritizes:

• Evidence-based healthcare: Funding activities supported by rigorous scientific evidence, particularly for programs serving children and adolescents, where HRSA is committed to approaches that reflect the highest standards of clinical care and child safety.

https://www.ecfr.gov/current/title-2/part-200 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-D/section-200.301 https://www.hrsa.gov/about/priorities https://www.hrsa.gov/about/priorities

Step 6: Learn What Happens After Award 38

• Biological and physiological integrity: Recognizing the relevance of biological sex to health outcomes, HRSA encourages applicants to account for sex-based health factors in program design, data collection, and service delivery where scientifically appropriate.

HRSA will implement these priorities consistent with applicable laws, regulations, court orders, and all required administrative procedures.

Funded activities must advance HRSA’s vision of protecting and improving the health and well-being of Americans. The particular focus is on those who are medically vulnerable, or live in areas with limited access to care. HRSA’s duty is to serve wisely, effectively, and with measurable results that justify every taxpayer dollar invested.

Consistent with HRSA’s priorities, in carrying out any project funded under this NOFO, the recipient must adhere to the following principles, where they are consistent with the authority and scope of the award and its activities:

• Gold standard science: Design and deliver services using gold standard evidence-based and evidence-informed approaches, establish measurable performance goals, and use data to monitor outcomes and drive continuous improvement.

• Program integrity and fiscal stewardship: Recipients must:

o Administer funds in accordance with all applicable federal statutes, regulations, and award conditions.

o Maintain strong internal controls.

o Prevent waste, fraud, and abuse.

• Partnership and local leadership: Coordinate with state, tribal, territorial, local, and community partners, as appropriate, and tailor services to meet community-identified needs while respecting local decision-making authority.

Recipients must manage any project awarded under this NOFO in accordance with the following objectives in programs authorized to advance them:

Make America Healthy Again (MAHA): HRSA prioritizes the health and well-being of all Americans by supporting common-sense, evidence-based health policies that promote:

• Personal responsibility.

• Strong families and communities.

• Proper nutrition.

• The prevention and management of chronic disease, while ensuring access to high-quality, affordable physical and mental health care.

Step 6: Learn What Happens After Award 39

Child protections, biological integrity, parental rights, and lawful use of funds: HRSA prioritizes safeguarding children’s health and safety by:

• Not supporting medical interventions for gender dysphoria in minors that lack a strong evidence base.

• Applying sex-based definitions grounded in biological reality.

• Supporting parental authority, transparency, and choice in education, including school-based health centers that respect parental rights and religious upbringing.

• Ensuring taxpayer funds are not used to promote or support elective abortions, consistent with federal law and the Hyde Amendment.

Advancing evidence-based, merit-driven, and ethically grounded health care: HRSA will prioritize unbiased, transparent science; merit-based workforce…