Most grant writers know that the Health Resources and Services Administration’s (HRSA) annual Service Area Competition (SAC) Notice of Funding Opportunity (NOFO) process is a key mechanism for keeping federally qualified health centers (FQHCs) alive and well: most FQHCs—which are sometimes called “Section 330 providers” or, more generically, “community health centers.” The FY ’24 HRSA SAC competition started in June and will run through at least December.
While FQHCs get higher Medicaid reimbursement rates than typical for-profit healthcare providers, as well as other organizational benefits enabling them to provide healthcare services to low-income communities and individuals, the SAC grant usually accounts for somewhere between 5% and 15% of the FQHC’s annual operating budget. Although the percentage can be higher or lower, without their SAC grant, most FQHCs will move from “financially functional” to “not quite there.” We can help make sure your FQHC gets there, by making sure your grant-making function works well.
FQHC Look-Alikes, which are nonprofits that have achieved a partial FQHC designation from HRSA, are typically eager to compete for SAC grants because operating as a Look-Alike without the extra funding boost from the SAC grant is hard. It’s like having a rocket that’s 90% powerful enough to get into space: the rocket won’t make it and will fall back to the earth. The dollar gap between a financially functional FQHC and an FQHC that may become defunct could be small, but in operational terms it’s massive. The same is often true for non-FQHC primary care providers like “free clinics” and even small for-profit group practices that mostly provide services to Medicaid patients. Thus, the competition for some SAC service areas can be intense, as the current FQHC Section 330 grantee will attract challengers. We say simply, “may the best applicant win,” but you’ll get an edge if we write your SAC proposal.
So, whenever HRSA starts publishing SAC NOFOs, usually in May or June, the whole FQHC world pays attention.* We, as grant writers, are a small but real part of that world, so we also pay attention. We’ve written dozens of funded SAC applications, and if you’re looking for SAC proposal grant-writing help, call us at 800.540.8906 ext. 1, or email us at seliger@seliger.com.
The sooner you call, the better: that said, we do sometimes write last-minute SACs: one memorable year, an FQHC CEO called us to say that his agency’s SAC deadline had passed. Normally, that’d be the end of the story—a nonprofit organization can’t submit a grant application after the deadline passes—but he kept talking and told us that he’d only discovered his SAC deadline had passed when his HRSA Program Officer called him to say, “Where’s your SAC proposal?” After some comedic back and forth, he told us that his Program Officer told him to get his SAC proposal submitted within a week. This led to his panic call to us. We bid assignments based on how complex the application is and how long we have to complete it; the reader will not be surprised to know that the latter half of that equation led to an unusually high bid, but we got his SAC proposal completed in a week and it was funded.
We can sometimes complete complex assignments like SAC proposals at the last minute, so, if you’re reading this and sweating because of how little time you have left, give us a call.
SAC grants are typically for a three year period of performance. While HRSA offers various forms of “Technical Assistance,” most of this is not very useful; we’ve had clients who attempted to use HRSA’s “Technical Assistance,” only to seek us out instead. HRSA can’t even be bothered to offer SAC narrative templates, so keep that in mind when contemplating how much technical assistance HRSA might truly offer.
The first FY ’24 NOFO was released June 26, implying the rest will be released in the following months. Call us to make your SAC process easy.
We’ve written SACs under a wide array of circumstances. Sometimes, FQHCs will call and hire us before the SAC NOFO is issued. More commonly, we get calls and emails during the open SAC competition process. All else being equal, you’re better off getting in touch sooner rather than later, but don’t despair if you’re working at the last minute: we can likely help. That’s true whether you’re a new, competing continuing, or competing supplemental applicant. We’ll help describe what makes your service population unique, and explain why your service population needs the healthcare services it does.
* I’ve wondered whether the plural of “notice of funding opportunity” should be “notices of funding opportunity,” “notices of funding opportunities,” or “notice of funding opportunities.” If you have an opinion on this matter, please email us and tell us what you think and why you think it. Extra credit if you work at HRSA.
