Highlights: The Bipartisan Budget Act of 2018 Provides Community Health Centers with More Funding and More Scrutiny

By Published On: February 13, 2018

On February 9, President Trump signed into law the long-awaited Bipartisan Budget Act of 2018 (Pub. Law 115-123). The major spending bill reauthorizes a total of $7.8 billion dollars in funding for the community health center program for Fiscal Years (FY) 2018 and 2019.

The spending bill amends Section 330 of the Public Health Service Act (42 U.S.C. 254b) in a number of ways. A few of the highlights include:

  1.  Specifying that need for health services must be “unmet” in the health center’s catchment area. (§254b(k)(2)).
  2. Requiring the health center’s governing board to approve the selection of a director for the center “who shall be directly employed by the center.” (§254b(k)(3)(H)).
  3. A new section under §254b(e)(6) New Access Points and Expanded Services, which describes the process that the Secretary will undertake when considering and approving applications for New Access Points and Expanded Services.
  4. Prohibiting the Secretary from approving health centers’ Section 330 applications, including those for New Access Points and Expanded Services, unless the health center “has written policies and procedures in place to ensure the appropriate use of Federal funds in compliance with applicable Federal statutes, regulations, and the terms and conditions of the Federal award.” (§254b(e)(6)).

What Health Centers Should Be Aware of Prior to Applying for Section 330 Funding

As recipients of federal funding, health centers have long been required to maintain certain policies and procedures to ensure the effective control over, and accountability for, all federal funds. However, these requirements are typically triggered at the point when the health center is awarded the Section 330 grant. The spending bill amendments shift that timeframe by explicitly requiring that those policies and procedures be implemented prior to a grant application being approved. This change indicates Congress’ intent for HHS’ heightened scrutiny of health centers’ internal controls and financial management systems not only during the federal grant award period but before the grant is awarded as well.

Written Policies and Procedures

Here are just some of the written policies and procedures that health centers should focus on prior to applying for Section 330 grants:
•Standards of Conduct – written standards of conduct covering conflicts of interest (including organizational conflicts of interest, if applicable) and governing the actions of its employees engaged in the selection, award, and administration of federally funded contracts (see 45 CFR Part 75.327(c)(1)).
• Payment – written procedures that minimize the time elapsing between the transfer of Federal award funds from HHS and the disbursement of those funds by the health center (see 45 CFR Part 75.305(b))
• Cost Allowability – written procedures for determining the allowability of costs in accordance with 45 CFR Part 75, Subpart E and the terms and conditions of the Federal award
• Procurements – written procedures for procurement transactions (see 45 CFR Part 75.328(c))
While the funding under the Bipartisan Budget Act of 2018 is certainly great news for health centers, as the proverbial “they” say, with more money comes more responsibility.

To learn more about federal grants management join us for any of our upcoming Federal Funding Academy or Health Center Trainings, or contact an attorney at Feldesman Tucker Leifer Fidell LLP at (202) 466-8960.


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