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  5. School-Based Service Expansion (SBSE) Frequently Asked Questions

School-Based Service Expansion (SBSE) Frequently Asked Questions

Get answers to questions about fiscal year (FY) 2023 SBSE awards. 

The Notice of Funding Opportunity (NOFO) guides how you carry out SBSE activities. View more resources on the SBSE technical assistance webpage.

 

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Awards

What Health Center Program school-based funding has HRSA awarded?

We issued two rounds of awards for the FY 2021 Health Center Program Service Expansion: School-Based Service Sites (SBSS) NOFO (HRSA-21-093). We also issued a round of awards for the FY 2023 Health Center Program School-Based Service Expansion (SBSE) NOFO (HRSA 23-097). 

All award recipients can find more information on the School-Based Service Expansion overview webpage. See who received an award:

(Updated: 9/25/2023)

When must my newly awarded site(s) be open and operational?

Within 120 days of the notice of award (NoA) release date, you must verify that the funded site(s) have been implemented. For FY 2023 SBSE awardees, the award release date was September 25, 2023. See your NoA for more details.

(Updated: 10/9/2023)

Reporting

How will I report on my school-based service expansion efforts?

In your annual Uniform Data System (UDS) reports you will include the number of patients served at school-based service sites. Through semi-annual progress reports and a Non-Competing Continuation (NCC) progress report you will also report on your progress opening new SBSE-funded sites and adding or expanding services, including required mental health services. See the SBSE overview webpage for details about progress reports.

(Updated: 3/2/2023)

How will you assess my increase in the number of school-based service site patients served?

We will assess the increase using data reported in UDS Table 4, Line 24. For FY 2023 SBSE award recipients, your baseline is the number of school-based service site patients you included in your 2022 UDS report. We will compare this 2022 data to equivalent data in your 2024 UDS report. 

(Updated: 3/2/2023)

If we have a school-based site in scope that did not receive school-based (H2E) funding, can we include those patients in our school-based patient count in the UDS?

Yes. You should report patients served at all in-scope school-based service sites in UDS Table 4, line 24, regardless of whether they received H2E funding.

(Updated: 10/9/2023)

If children receive only one service at a school-based site—for example, dental services—may we count them as school-based patients?

Yes. You should include patients who received countable visits within any of the service categories (medical, dental, mental health, etc.) when conducted at an approved school-based service site. Note that students who only receive screening services or mass treatment at school, such as COVID-19 testing, vaccines, or fluoride, do not count as school-based service site patients in the UDS.

(Updated: 10/9/2023)

Will my school-based service site patient numbers as reported in the UDS affect my patient target?

No. The number of school-based service site patients reported in your UDS will not impact your health center patient target.

(Added: 10/25/2023)

How do I count school-based patients if the school-based service site also serves some adults in the community?

In general, anyone who receives primary health care services as a countable visit at your school-based site is considered a school-based service site patient. Note that patients who only receive screening services or mass treatment, such as COVID-19 testing, vaccines, or fluoride, do not count as school-based service site patients in the UDS.  Refer to the 2023 UDS Manual for further guidance.

(Updated: 10/25/2023)

Eligibility

Where are school-based service sites located? 

For the purposes of the SBSE award, a school-based service site must be at or on the grounds of a school. This is defined as a preschool, kindergarten, primary school, or secondary school (i.e., preschool through grade 12). It includes public and private schools. 

(Updated: 3/2/2023)

What are the requirements for a new school-based service site?

Any site added through this funding opportunity must: 

  • Meet the definition of a service site, including providing some in-person services.
  • Be in your current service area.
  • Be at a school or on school grounds.
  • Provide mental health services.
  • Be open and operational within 120 days of award.

(Updated: 3/2/2023)

Do community partners such as Boys and Girls Clubs count as a school-based site?

No. School-based sites must be located at or on the grounds of a school.

(Updated: 10/9/2023)

Scope of Project

Can the school decide which services my school-based site provides?

No. Health centers partner with schools to determine how best to meet the health care needs of the students in the school. However, the health center’s governing board has authority over which services are provided at school-based service sites. For more information, see Partnerships between Schools and HRSA-Supported Health Centers: 10 Need-to-Know Tips (#8) (PDF - 139 KB).

(Added: 3/2/2023)

Can my school-based service site provide services to the school community only?

If your school-based service site limits access to services (for example, because the school restricts access to students and parents only), you must ensure that people in the area can access the full range of health care services at another health center service site.

(Updated: 3/3/2023)

How do I estimate my increase in school-based service site patients? 

You should have considered the number of school-based patients included in your 2022 UDS report, the need for services in the school community, provider capacity, patient increases based on previous service expansion, and performance or patient trends at other school-based service sites. Your estimated patient increase should be realistic and achievable. 

Note that students who only receive screening services or mass treatment at school, such as COVID-19 testing, vaccines, or fluoride, do not count as school-based service site patients in the UDS. 

We will use your overall increase in school-based service site patients, based on your UDS data over time, to inform decisions about SBSE funding beyond the initial two years of funding.

(Updated: 3/2/2023)

How can I tell if my SBSE project will require a change in scope (CIS)? 

View your scope of project in the Approved Scope section of your H80 grant folder in EHBs. The Scope of Project webpage provides guidance to help you tell if you need a CIS. If needed, you must request a CIS for Form 5A and/or Form 5B outside of the SBSE application. 

For example, if your health center provides mental health services by referral only (Column III), you will have to request a formal CIS for Form 5A of your H80 grant to meet the requirement to provide mental health services directly (Column I) or by contract (Column II) at each school-based service site included in your application. If you are adding a new site, you will submit Form 5B: Service Sites in the application instead of submitting a CIS request.

(Added: 3/2/2023)

Can I propose mental health services through formal written referral arrangement (Column III) only?

No. FY 2023 SBSE award recipients are required to provide mental health services directly (Column I) and/or by contract (Column II) at each proposed school-based service site. For more information about service delivery methods, see the Form 5A Column Descriptors (PDF - 315 KB).  

(Updated: 9/25/2023)

Can we move the project to a different school than the one described in our funded application?

Please contact us through the BPHC Contact Form to discuss any changes. Under Funding, select Supplemental Grant Award, then School Based Service Sites, and describe the issue. A School-Based Investment Team member will respond to you promptly. Note that changes to the project may require prior approval from HRSA.

(Added: 10/25/2023)

We expect a delay with the renovations needed to open the site. Can we request an extension to the 120-day site implementation condition?

If necessary, you may request an extension of up to 120 days via EHBs. Please contact the School-Based Investment Team through the BPHC Contact Form first to discuss any delays or challenges you’re experiencing.

(Added: 10/25/2023)

Budget

Should I include contractors in the Personnel Table? 

Yes. In your Budget Narrative, include personnel tables that list all direct hire and contracted personnel you propose to support with SBSE funding. These tables should show the annualized salary, FTE, and federal amount requested for each person. For more information, see the SBSE Sample Budget Narrative.

(Added: 3/2/2023)

Does the federal executive salary limitation apply to SBSE funding? 

Yes. SBSE funds may not be used to pay anyone more than Federal Executive Level II (which is $212,100 as of January 1, 2023). This reflects their annualized base salary, including bonuses and overtime, but not fringe and any income they may be permitted to earn outside of the health center.

(Added: 10/9/2023)

Allowed use of funds

Can I use SBSE funding for personnel and recruitment costs?

Yes. You may use SBSE funds for personnel costs to support service delivery at school-based service sites. You may also use SBSE funds for costs or fees for an outside recruitment agency to hire personnel to support the SBSE project. You may include recruitment bonuses in a salary package supported by SBSE funding if consistent with your health center’s policies and standard practice. 

(Added: 3/2/2023)

Can I use SBSE funding to provide services to school-based patients via telehealth?

Yes. You may use telehealth to ensure access to services. Keep in mind that you must provide some in-person service at each school-based service site. For example, you may provide mental health services virtually to patients at a school-based service site via telehealth from another site in your scope of project, if you are providing other services in-person at the school-based service site. 

For more information and different telehealth scenarios, see PAL 2020-01: Telehealth and Health Center Scope of Project (PDF - 176 KB).

(Updated: 3/2/2023)

Can I use SBSE funding for minor alteration and renovation (A/R) or equipment costs?

Yes, but only if you proposed A/R and/or equipment in your funded application. In Year 1, you may use up to $150,000 of your funding for minor A/R and equipment costs combined. For minor A/R to be allowable, the total federal and non-federal cost of the A/R project must be less than $500,000, excluding the cost of moveable equipment. Permanently affixed equipment (e.g., HVAC, generators, signs, lighting) is categorized as minor A/R rather than equipment costs. See the Capital Development Grants webpage for guidance on the required minor A/R forms and attachments. 

(Updated: 3/2/2023)

If I proposed to use SBSE funding for minor A/R, do I have to submit a Landlord Letter of Consent? 

Yes, if you do not own the property where the site is located. In most cases, the property owner, or landlord, will be the school district. The property owner must sign the Landlord Letter of Consent. See the Landlord Letter of Consent Template (PDF - 61 KB). 

(Added: 3/2/2023)

If I proposed to use SBSE funding for minor A/R, what are the environmental and historic preservation requirements?

Learn more about information on environmental and historic preservation compliance requirements. Although minor A/R projects typically do not require a full Environmental Assessment under the National Environmental Policy Act (NEPA), you may need to comply with other requirements:

  • If the proposed project involves exterior work (e.g., windows, signs) or work on a building that is over 50 years old, the project may require State Historic Preservation Office (SHPO) consultation under Section 106 of the NEPA.
  • Buildings constructed prior to 1985 may require a hazmat study and abatement plan.
  • If the site is in a coastal state, the project may require compliance with the Coastal Zone Management Act.
  • If the proposed project is in a 100- or 500-year floodplain, it may require compliance with E.O. 11988, Floodplain Management.

(Added: 3/2/2023)

Mobile units

Can I use one-time funding to pay for a portion of a large equipment purchase, like a mobile unit?

Yes. You can use up to $150,000 in SBSE funding toward the cost of a mobile unit. Non-federal funds can cover the remaining costs of equipment beyond $150,000.

(Updated: 3/2/2023)

If I replace an existing mobile unit, would this be considered an existing site? 

Yes. If your mobile unit is documented in your scope of project, replacing that mobile unit is considered an existing site. 

(Added: 3/2/2023)

Is a new mobile unit considered a new site? 

Yes. A new mobile unit that meets the definition of a service site and provides school-based services would be considered a new site unless the mobile unit is replacing an existing mobile unit. See the Scope of Project webpage for the definition of a service site. 

(Added: 3/2/2023)

Should I list the school names and school addresses visited by a mobile unit in Form 5B? 

No. Do not list the school names and addresses that the mobile unit will visit in Form 5B. List the primary address where the unit will be parked as the site address. This may or may not be on school grounds. For example, if the unit is on school grounds during the day and parked at one of your health center sites at night, enter the health center address on Form 5B.

(Updated: 10/9/2023)

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