Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program

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 - None.

Kathleen Klink, MD
Director, Division of Medicine and Dentistry
Telephone: 301 443-1467; Fax: 301 443-1945.
Website Address

Program Accomplishments

Not Applicable.

Uses and Use Restrictions

Payments are for direct and indirect expenses for expansion of existing or establishment of new residency training programs in qualified teaching health centers.

Eligible residencies include family medicine, internal medicine, pediatrics, med-peds, ob/gyn, psychiatry, general and pediatric dentistry, geriatrics.

Funding can only be used for the costs of new residents in a newly-established THC or an expanded number of residents in a pre-existing THC.

Payments made under the THCGME program will be coordinated with other payments for residency training, including payments for Children s Hospital GME and payments from the Centers for Medicare and Medicaid Services for other hospital-based GME.

Eligibility Requirements

Applicant Eligibility

Eligible entities include community-based ambulatory patient care centers that operate a primary care residency program.

Specific examples of eligible entities include, but are not limited to:
• Federally qualified health centers, as defined in section 1905(l)(2)(B) of the Social Security Act
• Community mental health centers, as defined in section 1861(ff)(3)(B) of the Social Security Act
• Rural health clinics, as defined in section 1861(aa) of the Social Security Act
• Health centers operated by the Indian Health service, an Indian tribe, or tribal organization, or an urban Indian organization, as defined in section 4 of the Indian Health Care Improvement Act
• An entity receiving funds under Title X of the Public Health Service Act.

In addition, the eligible entity must be listed as the institutional sponsor by the relevant accrediting body, including the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), or the American Dental Association (ADA).

Beneficiary Eligibility

The program supports high-quality primary care residency training in high-need, underserved communities.


Applicants should review the individual HRSA funding opportunity announcement 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. OMB Circular No. A-87 applies to this program.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is not applicable.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.


Application Procedures

OMB Circular No. A-102 applies to this program. OMB Circular No. A-110 applies to this program. HRSA requires all applicants to apply electronically through

Award Procedures

Each THC GME Payment Program application will be reviewed for eligibility including accreditation status, program approval, qualifications of the Project Director, completeness, accuracy and compliance with the requirements outlined in the funding opportunity announcement. Based on this review, the HRSA program official with delegated authority is responsible for final selection and formula-based funding decisions. Notification is made in writing by a Notice of Award.


Contact the headquarters or regional office, as appropriate, for application deadlines.


Section 340H of the Public Health Service Act, as added by Section 5508, Subpart XI of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148).

Range of Approval/Disapproval Time

Refer to the funding opportunity announcement for additional information.


Not Applicable.


Not Applicable.

Assistance Considerations

Formula and Matching Requirements

This program has no statutory formula.
This program has no matching requirements.
This program does not have MOE requirements.

Length and Time Phasing of Assistance

Up to five years. See the following for information on how assistance is awarded/released: Grantee drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.

Post Assistance Requirements


Refer to the funding opportunity announcement for additional information on program reports required.

Refer to the funding opportunity announcement for additional information on cash reports required.

Refer to the funding opportunity announcement for additional information on progress report required.

Refer to the funding opportunity announcement for additional information on expenditure reports required.

Refer to the funding opportunity announcement for additional information on performance monitoring required.


In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit 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.


Grantees are required to maintain grant accounting records 3 years after the date they submit the final FFR. If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.

Financial Information

Account Identification



(Formula Grants) FY 09 $0; FY 10 est $0; FY 11 est $230,000,000 - Formula grants and direct payments for a specific use.

Range and Average of Financial Assistance

An estimated $150,000 per resident per year will be paid to eligible entities for:
1. Direct expenses associated with sponsoring an approved graduate medical residency training program; and
2. Indirect expenses associated with the additional costs related to teaching residents in such training programs.

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.

HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at

Information Contacts

Regional or Local Office

None. Kathleen Klink, MD
Director, Division of Medicine and Dentistry
Telephone: 301 443-1467; Fax: 301 443-1945.

Headquarters Office

Kathleen Klink, MD 5600 Fishers Lane, Rockville, Maryland 20857 Phone: (301) 443-1467.

Criteria for Selecting Proposals

Formula grants to all eligible entities.

Vertical farms are designed in a way to avoid the pressing issues about growing food crops in drought-and-disease-prone fields miles away from the population centers in which they will be consumed.

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Edited by: Michael Saunders

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