Cooperative Agreements to States/Territories for the Coordination and Development of Primary Care Of

To coordinate local, State, and Federal resources contributing to primary care service delivery and workforce issues in the State to meet the needs of medically-underserved populations through health centers and other community-based providers of comprehensive primary care and the retention, recruitment,
and oversight of health professions for medically underserved populations.
Related Programs

Examples of Funded Projects

A cooperative agreement to a State Health Department engaged in the following: (1) statewide primary health care planning and resource coordination; (2) health systems development; (3) National Health Service Corps monitoring activities; (4) supporting the use of State resources (including Medicaid, Children's Health Insurance Program, Area Health Education Centers, and Maternal and Child Health) for primary care purposes to medically underserved populations; and (4) promoting partnerships with State and Regional Primary Care Associations, State Offices of Rural Health, Ryan White, and Maternal and Child Health.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - Office of Shortage Designation Branch, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 8C-26, Rockville, Maryland 20857.

Telephone: (301) 594-0816.
Website Address

Program Accomplishments

In FY 08, 53 applicants were funded. It is anticipated that 53 new awards will be funded in FY 09.

Uses and Use Restrictions

Recipients will be expected to perform State-wide primary care planning and resource coordination, including Medicaid, Children's Health Insurance program, State Offices of Rural Health, Ryan White Area Health Education Centers, Maternal and Child Health, etc.; support health systems development, primary care practitioners retention and recruitment, National Health Services Corps monitoring activities, as well as activities relating to other special populations including rural populations; and conduct operational and administrative support activities.

Eligibility Requirements

Applicant Eligibility

States or territories, political subdivisions of States, agencies of States, or other public entities that operate solely within one State.

Beneficiary Eligibility

Medically underserved populations within States will benefit from this program.


Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.

Aplication and Award Process

Preapplication Coordination

This program is excluded for coverage under E.O.


Application Procedures

Grant applications and required forms for this program can be obtained from Please visit the Web site at to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator for the Bureau of Health Professions. The Associate Administrator has the authority to make final selections for awards.

Award Procedures

The Division of Independent Review is responsible for managing objective reviews within Health Resources and Services Administration. Applications will receive an objective and independent review performed by a committee of experts. Applications are reviewed for merit and are recommended for approval or disapproval. Each applicant will receive written notification of the outcome of the objective review process, including summary of the expert committee's assessment of the application's merits and weaknesses, and whether the application was selected for funding. Applicants who are selected for funding may be required to respond in a satisfactory manner to conditions placed on their application before funding can proceed. Final decisions are made jointly by the Associate Administrator for Health Professions and the Associate Administrator for Primary Care. Letters of notification do not provide authorization to begin performance. The Notice of Grant Award, which is signed by Grants Management Officer and is sent to the applicant's agency's Authorized Representative, is the authorizing document.

Deadlines .


Public Health Service Act, Section 330(k), 330(m) and 333(d).

Range of Approval/Disapproval Time

90 to 120 days.


Not applicable.


Support is recommended for a specified project period, not in excess of 3 years. After initial awards are made, projects may be renewed annually depending on the submission and approval of a satisfactory application. Future funding is contingent on the availability of funds for such purposes.

Assistance Considerations

Formula and Matching Requirements

There are no statutory formula or matching requirements.

Length and Time Phasing of Assistance

Awards are made annually. After awards are issued, funds are released in accordance with DHHS payment procedures, which may be through an Electronic Transfer System or a Monthly Cash Request System.

Post Assistance Requirements


Grantees are required to submit annual program reports.

Financial status reports are required no later than 90 days after the end of each budget period.

Final financial status and progress reports are due 90 days after the end of a project period.


In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.


All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.

Financial Information

Account Identification



(Grants) FY 07 $10,000,000; FY 08 est $10,000,000; and FY 09 est $10,000,000.

Range and Average of Financial Assistance

Average award per recipient $188,679.

Regulations, Guidelines, and Literature

This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

Information Contacts

Regional or Local Office

Office of Shortage Designation Branch, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 8C-26, Rockville, Maryland 20857. Telephone: (301) 594-0816.

Headquarters Office

Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: (301) 443-2385; Research and Training Branch: (301) 443-3099; Government and Special Focus Branch: (301) 443-3288.

Criteria for Selecting Proposals

Applicants will be evaluated in the following areas: (1) Ability to assess and analyze the State's health policy environment, its unmet need for preventive and primary care services, its health care marketplace and its major disparities in health outcomes; and (2) develop and implement strategies and activities to effectively assist health centers and NHSC delivery sites in their response to these State environmental conditions and needs identified.

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