State Planning Grant-Health Care Access for the Uninsured


The purpose of the State Health Access Program is to support States that demonstrate they are ready to implement a program design which provides the uninsured with access to health insurance. The overarching program goal is to provide support to States to implement program designs already developed which provide access to affordable health care coverage to all or a segment of the uninsured citizens in a State.

General information about this opportunity
Last Known Status
Deleted 02/05/2016 (Archived.)
Program Number
Federal Agency/Office
Agency: Department of Health and Human Services
Office: Health Resources and Services Administration
Type(s) of Assistance Offered
Program Accomplishments
Not Applicable.
Section 301 of the Public Health Service Act, as amended (42 U.S.C. 241(a)); Public Law 111-8.
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
States and US Territories and Possessions.
Eligible applicants are any public State entity designated by the Governor of that State. The Governor must be the requestor of the grant and only one entity per State is permitted to apply. For purposes of this grant program, the term State refers to any of the 50 States, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands and Federally Recognized Indian Tribal Government and Native American Organizations are eligible to apply.
Beneficiary Eligibility
See above.
A letter signed by an authorized individual on behalf of the lead State agency or organization designated by the Governor must be included. The letter should indicate the potential grant’s principal contact person, the amount of funding requested, and the names of all agencies and organizations participating in the proposed program. The project must be directed by a component of State government.

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.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is required. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
Application Procedure
OMB Circular No. A-102 applies to this program. This program is excluded from coverage under OMB Circular No. A-110. 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. Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions.
Award Procedure
Each of the applications will undergo an eligibility and conformance review by Federal staff at the State Health Access Program Office. Applications that meet the eligibility and conformance review criteria will be assigned to members of an Objective Review Committee (ORC) that will review them based on the evaluation criteria listed in the application guidance. The results of the ORC reviews will be shared with the Associate Administrator, Healthcare Systems Bureau, who will make the final decisions. Notification is made in writing by a Notice of Award.
Contact the headquarters or regional office, as appropriate, for application deadlines.
Approval/Disapproval Decision Time
The time required for the applications to be approved or disapproved is projected to be 90 days.
Not Applicable.
Applicants responding to this announcement may request funding for a project period of up to five (5) years. Renewals will be determined by the Associate Administrator, Healthcare Systems Bureau. Extensions must be requested in writing addressed to the Grants Management Specialist.
How are proposals selected?
Please see program guidance.
How may assistance be used?
The purpose of the State Health Access Program (SHAP) is to support States that are ready to implement a program design to provide the uninsured with access to affordable health care coverage. Eligible States will be required to demonstrate that they have achieved the key State and local statutory or regulatory changes required to implement the new program within twelve months of the grant start date. The types of activities that can be supported through this grant can be widely varied, including but not limited to: “three share” community coverage (employer, State or local government, and the individual); reinsurance plans that subsidize a certain share of carrier losses within a certain risk corridor; subsidized high risk insurance pools; health insurance premium assistance; creation of a State insurance “connector” authority to develop new, less expensive, portable benefit packages for small employers and part-time and seasonal workers; development of statewide or automated enrollment systems for public assistance programs; health savings accounts; and innovative strategies to insure low-income childless adults. States may choose to implement one activity or a combination of activities. Other innovative programs that expand insurance to a targeted or comprehensive uninsured population will also be considered.

The majority of awarded funds are to be spent directly on implementation activities to start up program operations that are important to the implementation of the health care coverage program. Examples could include funding the administration of a “connector” model, designing or expanding a management information system to enhance enrollment capacities, development and dissemination of outreach and enrollment materials, development of a comprehensive website which facilitates education of and enrollment into the program, or to pay the start up costs of providing premium subsidies to those eligible for the program.

The intention behind the funding of these types of activities is to demonstrate how a state can significantly increase the State’s health care coverage under an expansion program. For example, the funded activity may result in an important increase in enrollment or a measurable improvement in progress toward attracting hard to reach target populations. Thus, an evaluation plan must be included in the application which describes the evaluation design and data collection methods to be used.

Two types of State grants are available under this program: 1) targeted grants of $2-4 million a year for a 5 year grant period for States focusing health coverage initiatives on a limited sub population(s); and 2) grants of $7-10 million a year for a 5 year grant period for States planning more comprehensive coverage initiatives .
What are the requirements after being awarded this opportunity?
Successful applicants must comply with the administrative requirements outlined in 45 CFR Part 74 (non-governmental) or 45 CFR Part 92 (governmental), as appropriate. Reports are to be provided as outlined in the grant conditions. Reports are to be provided as outlined in the grant conditions. The awardee will be required to submit performance and progress reports as well as status-federal financial reports (see the program announcement and notice of award for details for each required report). The awardee must submit a quarterly electronic Federal Financial Report (FFR) Cash Transaction Report via the Payment Management System within 30 days of the end of each calendar quarter. A Federal Financial Report (SF-425) according to the following schedule: A final report is due within 90 days after the project period ends. If applicable, the awardee must submit a Tangible Personal Property Report (SF-428) and any related forms within 90 days after the project period ends. New awards (“Type 1”) issued under this funding opportunity announcement are subject to the reporting requirements of the Federal Funding Accountability and Transparency Act (FFATA) of 2006 (Pub. L. 109–282), as amended by section 6202 of Public Law 110–252, and implemented by 2 CFR Part 170. Grant and cooperative agreement recipients must report information for each first-tier subaward of $25,000 or more in federal funds and executive total compensation for the recipient’s and subrecipient’s five most highly compensated executives as outlined in Appendix A to 2 CFR Part 170 (FFATA details are available online at Competing continuation awardees, etc. may be subject to this requirement and will be so notified in the Notice of Award. Expenditure reports are not applicable. Performance monitoring is not applicable.
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 Federal Financial Review (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.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formulas are not applicable to this program.
Matching Requirements: Percent: 20.%. States shall be required to demonstrate their seriousness of intent by matching twenty (20) percent of the Federal grant through non-Federal resources, which could be a combination of State, local, and private dollars from insurers, providers, and other private organizations. Waiver of the matching requirement shall be possible if financial hardship is demonstrated. Evidence of financial hardship should be strongly supported through a letter from the State’s Budget or fiscal Officer with thorough justification provided. In addition, States are required to demonstrate their ability to financially sustain the health care coverage program without Federal grant funding after the five-year grant period. .
MOE requirements are not applicable to this program.
Length and Time Phasing of Assistance
Funds are available to grantees on an as needed basis throughout the budget period and payments are made through the DHHS Payment Management System. 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.
Who do I contact about this opportunity?
Regional or Local Office
See Regional Agency Offices. Michelle Herzog, Director, State Health Access Program, Healthcare Systems Bureau, Health Resources and Service Administration, Room 08W12, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-0650. Fax: (301) 443-1221. Email:
Headquarters Office
Michelle Herzog 5600 Fishers Lane, Room 08W12,, Rockville, Maryland 20857 Phone: (301) 443-0650
Website Address
Financial Information
Account Identification
(Project Grants) FY 13 $0; FY 14 est $0; and FY 15 est $0
Range and Average of Financial Assistance
Range - $2,000,000-$10,000,000.
Average Award - 5,000,000.
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
Examples of Funded Projects
Not Applicable.


Federal Grants Resources