Title X Family Planning Services Grants

2027 Title X Services NOFO_PA-FPH-27-001_PDF.pdf

U.S. Department of Health and Human Services
Office of Population Affairs
Notice of Funding Opportunity
Title X Family Planning Services Grants
Opportunity Number
PA-FPH-27-001
Application Due Date
January 9, 2027
Technical Assistance Webinar Date
September 15, 2026

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Table of Contents
SUMMARY .................................................................................................................................... 2
A. ELIGIBILITY INFORMATION ............................................................................................... 4
B. AGENCY PRIORITIES ............................................................................................................. 7
C. PROGRAM DESCRIPTION .................................................................................................... 8
1. Background ............................................................................................................................. 8
2. Expectations for Recipients ..................................................................................................... 9
3. Federal Involvement in the Project ...................................................................................... 15
4. Eligibility criteria for project participants ............................................................................. 16
D. AWARD INFORMATION...................................................................................................... 16
E. APPLICATION CONTENTS AND FORMAT ....................................................................... 16
1.Format of the Application ...................................................................................................... 16
2. Content .................................................................................................................................. 20
F. SUBMISSION REQUIREMENTS AND DATES ................................................................... 30
G. APPLICATION REVIEW INFORMATION .......................................................................... 37
1. Responsiveness Review ........................................................................................................ 39
2. Merit Review Criteria............................................................................................................ 40
3. Merit Review and Selection Process ..................................................................................... 41
4. Review of Risk Posed by Applicant ...................................................................................... 42
H. AWARD NOTICES ................................................................................................................. 43
I. AWARD REQUIREMENTS AND ADMINISTRATION ....................................................... 44
1. Administrative and National Policy Requirements .............................................................. 44
2. Program Specific Terms and Conditions .............................................................................. 45
3. Award Closeout ..................................................................................................................... 46
4. Lobbying Prohibitions ........................................................................................................... 46
5. Non-Discrimination Requirements ...................................................................................... 46
6. Smoke- and Tobacco-free Workplace ................................................................................... 47
7. Acknowledgement of Funding .............................................................................................. 47
8. HHS Rights to Materials and Data ........................................................................................ 47
9. Trafficking in Persons ........................................................................................................... 48
10. Efficient Spending ............................................................................................................... 48
11. Whistleblower Protection .................................................................................................... 48
12. Health Information Technology (IT) Interoperability ........................................................ 48

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13. Certain telecommunications and video surveillance services or equipment ...................... 49
14. Human Subjects Protection ................................................................................................. 49
15. Research Integrity ............................................................................................................... 50
16. Reporting ............................................................................................................................. 50
J. CONTACTS .............................................................................................................................. 52
K. OTHER INFORMATION ....................................................................................................... 54
1. Application Checklist ............................................................................................................ 54
2. Acronyms .............................................................................................................................. 55
3. Glossary ................................................................................................................................. 55
4. Object Class Descriptions and Required Justifications ......................................................... 55
5. Considerations in Recipient Plans for Oversight of Federal Funds ...................................... 62
6. Financial Assistance General Certifications and Representations ........................................ 63
7. Protections for Healthcare Entities under Weldon and Other Conscience Protection Statutes
................................................................................................................................................... 64
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BASIC INFORMATION
Opportunity Title
Title X Family Planning Services
Program Office
Office of Population
Application Submission and Format
Affairs
Electronic application submitted via Grants.gov ONLY.
Opportunity Number
PA-FPH-27-001
Award Type Application Deadline
Grant January 9, 2027
Announcement Type Technical Assistance Webinar Date
Initial September 15, 2026
Technical Assistance Webinar Details
Assistance Listing
visit the OPA website at https://opa.hhs.gov/about/news/grant-
93.217 (Family Planning)
award-announcements for details
Eligible Applicants (see Section A.1 for full details)
_________
Executive Order 12372 does apply to this NOFO (see section F.3.D)
Estimated Total
Estimated Period of Performance (months)
Funding Available
60
Up to $ 257,000,000
Estimated Number of
Anticipated Award Date
Awards
April 1, 2027
up to 90
Anticipated Award
Anticipated Project Start Date
Funding Range
April 1, 2027
$200,000 - $22M
QUESTIONS?
OASH_Grants@hhs.gov
Additional contact information in Section G
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SUMMARY
The Office of Population Affairs (OPA) announces the anticipated availability of funds for
Fiscal Year (FY) 2027 grants under the authority of Title X of the Public Health Service
Act, Section 1001 (42 U.S.C. §300).
This notice solicits applications for projects to provide Title X services throughout the 50
United States, District of Columbia, Guam, the Commonwealth of Puerto Rico, the
Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, the U.S. Outlaying
Islands (Midway, Wake, et al.), the Republic of the Marshall Islands, the Federated State
of Micronesia, and the Republic of Palau (hereafter, States). OPA intends to make
available approximately up to $257 million for up to 90 grant awards for a period of up to
five (5) years. The actual amount available will not be determined until enactment of the
FY 2027 federal budget.
OPA’s Title X Family Planning Program funds “voluntary family planning projects [that]
offer a broad range of acceptable and effective family planning methods and services
(including natural family planning methods, infertility services, and services for
adolescents).” (Title X of the Public Health Service Act, 42 U.S.C. 300 et seq., available
at https://opa.hhs.gov/sites/default/files/2020-07/title-x-statute-attachment-a_0.pdf). The
Title X Program is implemented through competitively awarded grants to a diverse
network of public and private nonprofit entities. The program helps millions of low-
income and uninsured Americans develop health literacy and access family planning and
related health services, empowering individuals and families to make informed decisions
and navigate chronic health conditions and pregnancy with confidence. By offering
counseling and education to improve individuals’ optimal health outcomes, Title X
promotes the level of health literacy necessary to support informed consent across the
reproductive lifespan. For example, endometriosis often goes undiagnosed for years
because symptoms such as severe menstrual pain or irregular bleeding are frequently
normalized or minimized. Body literacy counseling helps patients recognize that these
experiences are not “normal” features of womanhood, but potential indicators of an
underlying condition, prompting earlier discussion with providers, timely diagnosis,
appropriate treatment, and improved long-term reproductive and overall health outcomes.
Likewise, foundational knowledge of reproductive physiology enables patients and
couples to recognize early signs of dysfunction, seek timely evaluation, and participate
meaningfully in care decisions. Persistent gaps in reproductive knowledge highlight the
need for such education. For example, a survey conducted for OPA in 2020 found that
only 50% of women and 38% of men know that a woman’s ovaries do not keep
producing new eggs until menopause (https://opa.hhs.gov/sites/default/files/2021-
01/fertility-knowledge-survey-findings-exec-summary-2020.pdf). By supporting body
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literacy education alongside evidence-based evaluation and treatment of chronic disease,
Title X services can help patients move beyond symptom-focused care toward informed,
preventive, and restorative approaches to reproductive health.
These efforts align with HHS’s focus on addressing the root causes of chronic illnesses
by targeting conditions that affect reproductive health and fertility. By promoting
strategies that support education and counseling on reproductive health goals, reduce
chronic disease, and assist individuals seeking to achieve healthy pregnancies, the Title X
Program strengthens American families, individuals, and communities.
This notice solicits applications from public and private nonprofit entities to establish and
operate voluntary Title X projects. These projects include a broad range of effective and
acceptable services, including pregnancy testing and counseling, basic infertility services,
sexually transmitted infection (STI) services (such as HIV prevention education,
counseling, testing, and referral), health literacy, reproductive goals counseling to
increase optimal health outcomes, and other preconception health services. Title X
services also help address and provide referrals for health conditions that affect fertility,
including endometriosis, polycystic ovary syndrome (PCOS), and uterine fibroids in
women, as well as low sperm count, low sperm motility, low testosterone, and erectile
dysfunction in men. OPA seeks a broad competition for Title X grant awards and are
interested in innovative strategies to address chronic disease; reduce overmedicalization
by strengthening approaches focused on underlying behavioral and lifestyle factors of
health and evidence-based practices such as fertility-awareness based methods; promote
health and body literacy; advance reproductive goals counseling for all clients; and
support family formation.
All activities funded under this announcement must be in compliance with the
requirements of the Title X statute, legislative mandates, and regulations. Copies of the
Title X statute, regulations, and legislative mandates may be downloaded from the OPA
website at https://opa.hhs.gov/grant-programs/title- x-service-grants/title-x-statutes-
regulations-and-legislative-mandates.
While there is not a fixed cost-sharing percentage or amount, projects must include
financial support from sources other than Title X. The proposed project budget must
reflect non-federal financial support in addition to Title X funds on both the Standard Form
(SF) 424A, Budget Information for Non-Construction Programs, and in the budget
narrative. Recipients will provide family planning services that are in compliance with the
Title X statute, regulations, and legislative mandates and that are guided by OPA’s key
priorities.
OPA encourages applicants to review all program requirements, eligibility information,
application format and submission information, evaluation criteria, and other information
in this funding announcement to ensure that their application complies with all
requirements and instructions.
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The Office of the Assistant Secretary for Health (OASH) Grants and Acquisitions Management
Division (GAM) will administer this competition.
We encourage you to review all program requirements, eligibility information, application
format and submission instructions, and other content of this notice to ensure your application
complies with all requirements.
A. ELIGIBILITY INFORMATION
1. Eligible Applicants
Any public or private nonprofit entity is eligible to apply.
You must meet all of the eligibility requirements in order for us to review your application.
Eligible Entities
Additional examples of eligible organizations include:
Any public or private nonprofit entity located in a State (which includes one of the 50
United States, District of Columbia, Guam, the Commonwealth of Puerto Rico, the
Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, the U.S. Outlaying
Islands (Midway, Wake, et al.), the Republic of the Marshall Islands, the Federated State
of Micronesia, and the Republic of Palau (hereafter, States) is eligible to apply for a grant
under this announcement. Faith-based organizations and American Indian/Alaska
Native/Native American (AI/AN/NA) organizations are eligible to apply for Title X
family planning services grants. Examples of eligible Organizations include:
• State Governments
• U.S. territories
• County Governments
• City or township governments
• Special district governments
• Independent school districts
• Public and State controlled institutions of higher education
• Native American tribal governments (Federally recognized)
• Public Housing authorities/Indian housing authorities
• Native American tribal organizations (other than federally
recognized tribal governments)
• Nonprofits having 501(c)(3) status with the IRS, other than
institutions of higher education
• Nonprofits without 501(c)(3) status with the IRS, other than
institutions of higher education
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• Non-profit private institutions of higher education
PDPI Eligibility
There is no restriction on an individual’s eligibility to be Project Director (PD)/Principal
Investigator (PI) on an application. However, we will not make an award with a PD/PI who has
an active government-wide exclusion, suspension, or debarment recorded in SAM.gov.
We expect that throughout the period of performance the PD/PI will be involved in, and have
substantial knowledge about, all aspects of the project. Although your organization may
recognize co-PD/PIs on team-managed projects, we recognize only a single PD/PI who will be
responsible for the programmatic aspects of the project.
Other Considerations
Submitting Multiple Applications
You may submit more than one application, but each application must be for a distinctly
different project.
If you submit multiple applications for the same project, we will accept only the last application
submitted a Grants.gov timestamp that is before the due date and time. We will disqualify all
other versions of the application. See Section G.1.b for all disqualification factors.
Submitting an Application as a Group or Consortium
For any given project, we will only make an award to a single eligible entity. More than one
entity may choose to work together on a project under this opportunity, but only one entity may
submit the application. If awarded, that entity will be the award recipient and will be responsible
for conducting the project.
The other entities may participate in the project, if awarded, and would be responsible to the
recipient for their respective roles, typically as subrecipients.
Groups may form a consortium, partnership, or other legally recognized entity for the purpose of
applying for this opportunity and carrying out any awarded project. The resulting entity must
exist and be legally recognized when it applies and must have an active registration in SAM.gov.
We will conduct a risk assessment on the applying entity (Section F.4) prior to making any
award.
Eligibility Documentation
Entity eligibility documentation (e.g., proof of 501(c)(3) status as determined by the Internal
Revenue Service or an authorizing Tribal Resolution) must be included in the submitted
application. For additional information, see Section 4.a. It is important that your organization is
correctly classified in your SAM registration (Section F.2.a).
During our review of your application, we might request additional documentation to support
your eligibility. This request means only that your application is under review and not that you
will receive an award.
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More specific information on the type of documentation that we might request specific to this
opportunity appears in Section F.4.b.
Application Disqualification
We will disqualify applications that fail to meet the eligibility, responsiveness, formatting, and
submission requirements (Sections G.1.b) prior to conducting merit review. Disqualified
applications will not undergo further review.
We will notify disqualified applicants at the end of the competition when we announce the award
recipients.
2. Application Responsiveness Criteria
We will review your application to determine whether it meets the responsiveness criteria below.
If your application does not meet the responsiveness criteria, we will disqualify it from the
competition; we will not review it beyond the initial screening.
The responsiveness criteria are as follows:
• Family Participation Certification. Applicants must include a written statement
in the appendix of the application certifying that:
“if funded, this Title X Family Planning Services project will encourage
family participation in the decision of minors to seek family planning services
and will provide counseling to minors on how to resist attempts to coerce
minors into engaging in sexual activities.”
3. Cost Sharing or Matching
Program regulations at 42 C.F.R. § 59.7(c) stipulate that ``No grant may be made for an amount
equal to 100 percent of the project's estimated costs.'' Also, 42 C.F.R. § 59.7(b) states that “No
grant may be made for less than 90 percent of the project's costs, as so estimated, unless the grant
is to be made for a project that was supported, under section 1001, for less than 90 percent of its
costs in fiscal year 1975. In that case, the grant shall not be for less than the percentage of costs
covered by the grant in fiscal year 1975.''
While there is not a fixed cost-sharing percentage or amount, projects must include financial
support from sources other than Title X. The proposed project budget should reflect financial
support in addition to Title X funds on both the Standard Form (SF) 424A, Budget Information,
and in the budget narrative and justification. The amount and source(s) of these funds must be
clearly identified separately from the requested Title X support as indicated on the SF 424A,
as well as on the SF 424, Application for Federal Assistance. The OASH Grants and Acquisition
Management (GAM) Division will review applications to ensure that the requested amount of
Title X funding is in compliance with this business requirement.
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The cost sharing requirements outlined above are waived for any grant made to the U.S. Virgin
Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of
Palau, Federated States of Micronesia, and the Republic of the Marshall Islands. Although
projects are expected to identify additional sources of funding and not solely rely on Title X
funds, there is no specific amount of level of financial match requirement for this program.
B. AGENCY PRIORITIES
Required Alignment with OASH Mission and Agency Priorities
The recipients of this award must implement any funds awarded under this NOFO to effectuate
program goals and agency priorities in accordance with the Priorities of the Office of the
Assistant Secretary for Health and when authorized by law according to the Title X statute,
regulations, legislative mandates, and additional program guidance. Funded activities must
advance and support OASH’s mission to improve the health and well-being of Americans.
Consistent with OASH’s mission, in carrying out any project that is funded under this NOFO,
recipients must align program design and activities with the following agency priorities, where
consistent with the authority and scope of the award:
1) Address the chronic disease epidemic
2) End diversity, equity, and inclusion (DEI) policies and practices across
OASH’s programs
3) Reduce overmedicalization in health care and increase focus on optimal
health and addressing underlying root causes
4) Provide medically accurate and reliable information necessary for
informed consent
5) Promoting evidence-based care through the delivery of Title X services
6) Enforce the Hyde Amendment
7) Ensure gold standard science, curtail corporate capture and prevent
conflicts of interest
8) To the extent allowed under Federal law and regulations, including the
preliminary injunction issued in New York, et al. v. DOJ, et al. (DRI),
1:25-cv-00345, OASH will prioritize programs, partnerships, and
funding mechanisms that further the agency’s priority to ensure that
federal resources are not used to facilitate or incentivize illegal
immigration
9) Ensure adolescent program materials are age-appropriate
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10) Protect parental rights to direct the religious upbringing of their children
In addition, the recipient is required to administer any project that is awarded under this NOFO in
accordance with the following objectives in Title X that are authorized to advance them:
11) Promote body and health literacy
12) Advance reproductive goals counseling
13) Implement a Quality Improvement and Quality Assurance (QI/QA) Plan with the
goal to achieve optimal health outcomes
The recipients must demonstrate ongoing compliance with these priorities, in all programs that are
authorized to advance them, through program design, implementation, reporting, and evaluation.
Failure to meaningfully align funded activities with the applicable requirements may result in
corrective action, additional reporting requirements, or other actions consistent with federal grant
regulations found at 2 C.F.R. Part 200 and the terms and conditions of this award (including
termination pursuant to 2 C.F.R. 200.340(a)(4) for no longer effectuating program goals or agency
priorities).
C. PROGRAM DESCRIPTION
The Office of the Assistant Secretary for Health (OASH), Office of Population Affairs
(OPA) announces the anticipated availability of funds for Fiscal Year (FY) 2027 grants
under the authority of Title X of the Public Health Service Act, Section 1001 (42 U.S.C.
§300).
The primary focus of OASH is to lead Americans toward healthier lives by promoting
health and well-being across the lifespan. This includes the reproductive lifespan,
supported through innovative, evidence-based programs, services, partnerships, and
research that strengthen family formation and assist clients in achieving healthy
pregnancies. Grants funded through this NOFO will expand access to Title X family
services for millions of Americans, helping them build body literacy, address infertility,
plan and space pregnancies, and navigate reproductive health conditions such as
endometriosis, polycystic ovary syndrome (PCOS), and uterine fibroids in women, as
well as low sperm count, low sperm motility, low testosterone levels, and erectile
dysfunction in men.
Background
Title X clinics provide services to clients of both sexes and all ages, including adolescent
clients, with priority given to persons from low-income families. Title X services are
voluntary, confidential, and provided regardless of one’s ability to pay or a client's
religion, race, color, national origin, disability, age, sex, number of pregnancies, or
marital status. For many clients, Title X clinics are their only ongoing source of health
care and health education.
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The majority of the clients served by Title X providers are low-income, female, and under
30 years old. In order to ensure that all prospective low-income clients are able to access
services, there is no charge for services to people with family incomes below 100% of the
most recent federal poverty level (FPL) guidelines, and services are discounted on a
sliding scale for people with family incomes between 101-250% of the FPL. In 2023,
60% of clients had family incomes at or below 100% FPL, while 83% had family
incomes below 250% of the FPL. Detailed information about current and past clients
served by Title X recipients and the broad range of services provided to clients by Title X
recipients is available in the Family Planning Annual Report (FPAR) available on the OPA
website at https://opa.hhs.gov/research-evaluation/title-x-services- research/family-
planning-annual-report.
The Title X statute specifies that local and regional public or private nonprofit entities may
apply directly to the Secretary for a Title X family planning services grant under this
announcement. For applicants that will not provide all services directly, you must
document, in your application, the process and selection criteria you will use to identify
qualified subrecipients to fulfill Title X activities. You should also show how your
subrecipients will provide the required services and best serve individuals in need
throughout the anticipated service area. Applicants must additionally outline how all
subrecipients, through their activities and services, will comply with Title X statutory and
regulatory requirements and OPA program guidance.
Expectations for Recipients
a. Comply with Title X Statute, Regulations, Legislative Mandates, and
Additional Program Guidance
All activities funded under this announcement must be in compliance with the
requirements of the Title X statute, legislative mandates, and applicable regulations.
We also expect all activities funded under this announcement to be in compliance
with additional program guidance issued by OPA.
1. Title X Statute
Requirements regarding the provision of family planning services under Title X are in
the statute (Title X of the Public Health Service Act, 42 U.S.C. 300 et seq., available
at https://opa.hhs.gov/sites/default/files/2020-07/title-x-statute-attachment-a_0.pdf)
and in the implementing regulations which govern project grants for family planning
services (42 C.F.R. part 59, subpart A). In addition, sterilization of clients as part of
the Title X program must be consistent with 42 C.F.R. part 50, subpart B
(“Sterilization of Persons in Federally Assisted Family Planning Projects”).
Title X of the Public Health Service Act authorizes the Secretary of HHS to award
grants for projects to provide family planning services to any person desiring such
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services, with priority given to individuals from low-income families. Section 1001 of
the Act, as amended, authorizes grants “to assist in the establishment and operation of
voluntary family planning projects which shall offer a broad range of acceptable and
effective family planning methods and services (including natural family planning
methods, infertility services, and services for adolescents).”
In addition, Section 1001 of the statute requires that, to the extent practicable, Title X
service providers shall encourage family participation in family planning services
projects. Finally, Section 1001(b) assures the right of local and regional entities to
apply directly to the Secretary for Title X grant funds.
Section 1008 of the Act, as amended, stipulates, “None of the funds appropriated
under this title shall be used in programs where abortion is a method of family
planning.”
2. Title X Regulations
On October 4, 2021, OPA issued a final rule, (42 C.F.R. Part 59), to revise the
regulations that govern the Title X family planning program by readopting the 2000
regulations (65 F.R. 41270), with several revisions to ensure access to quality family
planning services for clients, especially low-income clients.
The 2021 final rule includes a description of what programs the regulations apply to (§
59.1), definitions (§ 59.2), who is eligible to apply for a family planning services grant
(§ 59.3), how one applies for a family planning services grant (§ 59.4), requirements
that must be met by a family planning project (§ 59.5), procedures to assure the
suitability of informational and educational material (print and electronic) (§ 59.6),
criteria HHS will use to decide which family planning services projects to fund and in
what amount (§ 59.7), how grants are awarded (§ 59.8), for what purposes the grant
funds may be used (§ 59.9), confidentiality (§ 59.10), and additional conditions (§
59.11). A copy of the 2021 final rule is available at
https://www.govinfo.gov/content/pkg/FR-2021-10-07/pdf/2021-21542.pdf.
3. Legislative Mandates
The following legislative mandates have been part of the Title X appropriations language
for the last several years. This NOFO assumes these provisions will be carried forward in
FY 2027, please review all applicable Title X appropriations when completing your
application. Title X family planning services projects should include administrative,
clinical, counseling, and referral services, as well as training of staff necessary to ensure
adherence to these requirements.
“None of the funds appropriated in this Act may be made available to any entity
under Title X of the PHS Act unless the applicant for the award certifies to the
Secretary of Health and Human Services that it encourages family
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participation in the decision of minors to seek family planning services and
that it provides counseling to minors on how to resist attempts to coerce minors
into engaging in sexual activities;” and “Notwithstanding any other provision
of law, no provider of services under Title X of the PHS Act shall be exempt
from any State law requiring notification or the reporting of child abuse, child
molestation, sexual abuse, rape, or incest.”
4. Additional Program Guidance
We also expect recipients to follow additional program guidance issued by OPA.
Additional program guidance includes, but is not limited to, occasional Program Policy
Notices issued by OPA to provide clarity and guidance on policy issues relevant to Title
X recipients.
i.Address OPA Program Priorities
In addition to the statute, regulations, legislative mandates, and additional program
guidance that apply to Title X, Title X grantees should align their programs with OPA priorities to
the extent authorized by law and within the scope of the program, OPA expects recipients to
develop and implement plans to address the program priorities and provide evidence of
the project’s capacity to address program priorities. OPA’s program priorities for
recipients funded under this NOFO are in part informed by the Office of the Assistant
Secretary for Health’s Statement of Priorities (available at https://health.gov/priorities),
and are as follows:
1. Addressing the chronic disease epidemic through the delivery of Title X
services
Chronic disease prevention and management are essential to improving public health and
promoting healthy pregnancies and family formation. HHS is leading a science-driven
response to the nation’s chronic disease epidemic, with a focus on identifying and
addressing root causes that contribute to poor health outcomes, including those affecting
fertility and reproductive health. OASH’s health programs and offices play a central role
in developing solutions to reduce the burden of chronic disease through efforts that
address nutrition, physical activity, sleep, and exposure to harmful chemical and
environmental toxins. Integrating these priorities within the Title X program helps
strengthen reproductive health outcomes by addressing conditions that affect women,
such as hormonal imbalances, polycystic ovary syndrome (PCOS), endometriosis, and
uterine fibroids, as well as conditions that affect men, including low sperm count, low
sperm motility, low testosterone levels, and erectile dysfunction. Title X services may
also address lifestyle and behavioral factors—such as sleep quality, nutrition, physical
activity, and pornography use—that influence hormonal function and health in males and
females.
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We expect recipients to demonstrate how their Title X projects will contribute to broader
HHS efforts to reduce chronic disease risks across the reproductive lifespan, improve
health outcomes, and support individuals seeking to achieve healthy pregnancy. Key
strategies for addressing chronic disease through Title X services include, but are not
limited to, providing education and counseling on nutrition, sleep, stress, and physical
activity; incorporating screening and referral pathways for health conditions linked to
chronic disease and infertility in both women and men; collaborating with community
health partners to reduce environmental exposures; and integrating health literacy
education to help clients better understand and manage their reproductive and overall
health. Additional information on HHS priorities and strategies related to addressing
chronic disease is available at https://health.gov/priorities,
https://www.whitehouse.gov/wp-content/uploads/2025/05/MAHA-Report-The-White-
House.pdf, and https://www.whitehouse.gov/wp-content/uploads/2025/09/The-MAHA-
Strategy-WH.pdf.
2. Reducing overmedicalization in health care and increasing focus on
optimal health through the delivery of Title X services
Promoting better health outcomes requires a balanced approach to care that emphasizes
optimal health (defined as physical, mental, and social wellbeing), not just medical
intervention. OPA recognizes the overreliance on pharmaceutical and surgical treatments.
Over the years, the Center for Disease Control and Prevention’s National Survey of
Family Growth reports have shown a decrease in females’ current use of any
contraception (approximately 65% of females of reproductive age in both 2015-2017 and
2017-2019 data, then 54% in the most recent 2022-2023 report).1 According to the 2023
National Health Statistics Report, the most common reason women reported
discontinuing use related to dissatisfaction was side effects.2 This approach has failed to
adequately address the root causes of the nation’s chronic disease burden, resulting in
ongoing health challenges that affect fertility, pregnancy outcomes, and long-term health
outcomes. Through the delivery of Title X services, OPA seeks to strengthen approaches
that focus on the underlying behavioral and lifestyle factors of health—such as nutrition,
sleep, physical activity, stress management, and environmental factors—that impact
overall health and are shown to be effective in improving optimal health.
1 Centers for Disease Control and Prevention. Current Contraceptive Status Among Women Aged 15–49: United
States, 2015-2017. December 2018. https://www.cdc.gov/nchs/products/databriefs/db327.htm; Centers for Disease
Control and Prevention. Current Contraceptive Status Among Women Aged 15–49: United States, 2017–2019.
https://www.cdc.gov/nchs/products/databriefs/db388.htm; Centers for Disease Control and Prevention. Current
Contraceptive Status Among Females Ages 15–49: United States, 2022–2023. August 2025.
https://www.cdc.gov/nchs/products/databriefs/db539.htm.
2 Daniels K, Abma JC. Contraceptive methods women have ever used: United States, 2015–2019. National Health
Statistics Reports; no 195. Hyattsville, MD: National Center for Health Statistics. 2023. DOI:
https://doi.org/10.15620/cdc:134502.
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We expect applicants to demonstrate how their Title X projects will integrate
noninvasive, evidence-based practices that promote health literacy, fertility awareness,
and reproductive health without unnecessary medicalization or symptom suppression.
Key strategies for advancing optimal health through Title X services include, but are not
limited to, expanding access to fertility-awareness–based methods (often referred to as
natural family planning); providing education and counseling that encourage lifestyle
practices supporting reproductive health and healthy pregnancies; fostering collaboration
with community-based programs that address wellness and environmental health; and
incorporating approaches that empower individuals to understand and manage their own
health.
3. Promoting body and health literacy through the delivery of Title X
services
Body literacy is foundational to informed decision-making, reproductive health, and
lifelong health. OPA recognizes that gaps in biological understanding contribute to
delayed diagnosis of health conditions and to the nation’s growing infertility crisis, which
now affects approximately one in five married women of reproductive age with no prior
births, according to the CDC.3 As part of this priority, Title X family planning clinics will
be required to incorporate foundational body and health literacy into reproductive health
counseling. This includes education on menstrual cycle physiology, hormonal health,
male and female fertility awareness, and early indicators of reproductive disorders such
as endometriosis, polycystic ovary syndrome (PCOS), thyroid dysfunction, metabolic
disorders, and other conditions that often first emerge in adolescence. Body literacy
counseling should equip individuals to recognize when symptoms such as pain, irregular
cycles, hormonal disruption, or changes in sexual health warrant further medical
evaluation rather than symptom suppression. By integrating body literacy into Title X
services, OPA seeks to ensure that women and men understand the health significance of
ovulation, endocrine function, and lifestyle factors that influence fertility, reproductive
health, and future family formation, as well as pregnancy planning and risk reduction.
4. Advancing reproductive goals counseling through the delivery of Title X
services
Reproductive goals counseling supports individuals in making informed, intentional
decisions about education, work, relationships, marriage, and childbearing across the
lifespan, while advancing optimal health and wellbeing. OPA’s Fertility Knowledge
Survey, conducted in 2020, found that over 65% of both women and men want or intend
to have (more) children, but only 32% of women and 9% of men have discussed their
plans to have children with a medical provider.
3 Centers for Disease Control and Prevention. National Survey of Family Growth (2015-2019), May 2024.
https://www.cdc.gov/nchs/nsfg/key_statistics/i-keystat.htm#infertility
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(https://opa.hhs.gov/sites/default/files/2021-01/fertility-knowledge-survey-findings-exec-
summary-2020.pdf). OPA recognizes that many individuals lack access to resources that
integrate family goals into broader life planning, often due to longstanding omissions in
educational and counseling environments. As part of this priority, Title X clinics will be
expected to offer reproductive goals counseling that presents evidence-informed
pathways associated with improved economic stability and family stability, including
completion of education, participation in the workforce, and marriage prior to
childbearing. Research demonstrates that individuals who follow this sequence
experience substantially lower risks of poverty across socioeconomic groups. Program
counseling should affirm marriage and parenthood as meaningful and valued components
of adult life, particularly in counseling adolescents on longterm reproductive goals, and
support informed decision-making by helping individuals understand how life choices,
reproductive health, and fertility intersect to shape long-term stability, health, and
wellbeing. As part of these efforts to support family planning, Title X clinics are expected
to provide services that support individuals and families seeking to have children.
5. Promoting evidence-based care through the delivery of Title X services
Protecting children and adolescents and ensuring that federally supported programs
reflect the best available scientific evidence are central to promoting lifelong physical and
reproductive health. HHS will prioritize funding for grantees who maintain a science-
driven approach to healthcare, including by protecting children, respecting biological
reality, and upholding scientific integrity across its programs. Integrating these priorities
within the Title X program ensures that program activities reflect evidence-based
practices and biological and reproductive health. To the extent permitted by applicable
law, including any applicable court orders, we expect recipients to demonstrate how their
Title X projects promote physical and reproductive health priorities established by HHS.
Key strategies include, but are not limited to, providing developmentally appropriate
counseling rooted in biological science; ensuring referral pathways align with evidence-
based care; and collaborating with community partners to promote practices that support
healthy adolescent development.
6. Enforcing the Hyde Amendment through the delivery of Title X services
Protecting the integrity of taxpayer funding and advancing programs that respect the
dignity of human life are core HHS responsibilities. The Hyde Amendment expressly
prohibits the use of federal funds administered by HHS to pay for elective abortion.
OASH’s programs and offices play an essential role in implementing this statutory
requirement across the Department’s activities. Integrating Hyde compliance within the
Title X program strengthens its capacity to support women, families, and communities
while ensuring adherence to federal law. To the extent permitted by applicable law,
OASH will prioritize programs and funding that uphold Hyde protections and do not use
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taxpayer resources to promote or support elective abortion. As referenced above in the
“Expectations for Recipients,” Section 1008 of the Public Health Service Act, as
amended, stipulates, “None of the funds appropriated under this title shall be used in
programs where abortion is a method of family planning.” We expect recipients to
demonstrate how their Title X projects maintain strict separation from prohibited
activities and contribute to broader HHS efforts to safeguard life-affirming, lawful, and
ethical program delivery. Key strategies include, but are not limited to, implementing
robust financial and programmatic safeguards; providing clear guidance to staff and
subrecipients on Hyde requirements; and establishing monitoring processes that ensure
ongoing compliance among staff and subrecipients.
7. Ensuring OASH funds benefit eligible individuals and not illegal aliens
through the delivery of Title X services
Federal law requires that taxpayer-funded public benefits be administered in a manner that serves
eligible individuals and does not encourage or support illegal immigration. To the extent allowed
under Federal law and regulations, including the preliminary injunction issued in New York, et
al. v. DOJ, et al. (DRI), 1:25-cv-00345, OASH is committed to ensuring that Title X funds are
used exclusively to benefit individuals who are lawfully eligible to receive federally funded
services. Pursuant to Executive Order 14218 (available at
https://www.govinfo.gov/content/pkg/DCPD-202500283/pdf/DCPD-202500283.pdf) and in
alignment with OASH’s priorities (available at https://health.gov/priorities), OASH will
prioritize programs, partnerships, and funding mechanisms that further the agency’s priority to
ensure that federal resources are not used to facilitate or incentivize illegal immigration.
8. Implement a Quality Improvement and Quality Assurance (QI/QA) Plan
We expect recipients to implement a quality improvement and quality assurance (QI/QA) plan
that involves collecting and using data to monitor the delivery of quality family planning
services, inform modifications to the provision of services, inform oversight and decision-
making regarding the provision of services, and assess patient satisfaction. We expect recipients
to address oversight and service provision at the recipient level, the subrecipient level, and the
service site level within their QI/QA plan.
As a part of the QI/QA plan, all recipients must collect and report FPAR 2.0 data to OPA on an
annual basis and are expected to use their FPAR data to inform their QI/QA activities.
Additional information about FPAR 2.0, including the data elements and response options, is
available on the OPA website at https://opa.hhs.gov/research-evaluation/title-x-services-
research/family-planning-annual-report/fpar2.
3. Federal Involvement in the Project
If you receive an award, we will encourage you to seek the advice and opinion of federal staff
when problems arise. However, you would be responsible for making sound programmatic and
administrative judgments. The responsibility for operating decisions will be yours and does not
shift to HHS, OASH, or OPA.
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Under a grant, the program office’s involvement may include routine monitoring and technical
assistance such as monthly conference calls, occasional site visits, ongoing review of plans and
progress, participation in relevant meetings, provision of training and technical assistance.
4. Eligibility criteria for project participants
You must not restrict participation in the project on the basis of race, color, national origin,
religion, sex, disability, age, or another protected characteristic (See Section I.5).
D. AWARD INFORMATION
Budget period(s)
We expect to fund awards in 12-month budget periods for a total period of performance up to 60
month(s). However, we may approve shorter periods of performance. Budget periods may vary
from the estimated 12 months because of the timing of award issuance or other administrative
factors.
For multi-year projects, recipients must submit a non-competing continuation (NCC) application
for each budget period after the first. We will provide guidance generally 3 months prior to the
end of the active budget period. Continuation funding is contingent upon the availability of
funds, satisfactory progress of the project, appropriate stewardship of federal funds, and the best
interests of the government. Funding for all approved budget periods after the first is generally
the same as the initial award amount and may be subject to any offset with funds unused in a
previous budget period.
E. APPLICATION CONTENTS AND FORMAT
1.Format of the Application
You must prepare your application using the forms and information described in this NOFO.
The official online application package on Grants.gov contains all necessary forms and guidance
for preparing an application. This package includes but is not limited to:
• Full Text of the NOFO
• Standard forms (required) and their instructions
o SF-424 Application for Federal Assistance
o SF-424A Budget Information for Non-Construction Programs
o SF-LLL Disclosure of Lobbying Activities
o Project Abstract Summary
• Sample templates, if available.
In addition to the four standard forms in the application package, your application will consist of
3 sections of materials you prepare:
1. Project Narrative
2. Appendices to the Project Narrative
3. Budget Package
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We strongly encourage you to read all instructions for the application format and content to
avoid disqualification of your application. An application checklist is available in Section J.1.
a. Project Narrative - Formatting
Following the formatting instructions below will help ensure that your application is readable for
review process. Acceptable electronic file formats are in Section E.3.a.
Names of Individuals
We encourage you to use individuals’ full names (first, middle, last) on the standard forms and
any other documents such as résumés/curricula vitae/biographical sketches to distinguish them
for verification in the SAM exclusion records. Delays may result in award processing if full
names are not provided.
You should avoid submitting personally identifiable information such as personal contact
information (e.g., home address and telephone number) on résumés/curricula vitae/biographical
sketches. Do not submit social security numbers.
If you receive an award, only one Project Director/Principal Investigator (PD/PI) will be named
on the award documents. (Section A.1.b) Avoid using a placeholder or honorary PD/PI. If you
have not hired an individual to be the PD/PI, you should name an interim PD/PI, and your
application should clearly identify that person as such.
We typically expect the PD/PI to be named on the SF-424 in box 8.f. Avoid naming grant writers
in box 8.f unless they have the expertise to respond to technical questions about the proposed
project in a timely manner.
Identify other personnel who are essential or key to the execution of the proposed project clearly
in your project narrative.
If you receive an award, a request for a change in PD/PI or key personnel under any
circumstance requires prior approval of the grants management officer before becoming
effective. We may disallow any costs incurred as a result of that change prior to our approval.
See Section I.1.c.
Page Formatting
If you submit documents that do not conform to the following instructions, GAM will disqualify
your application during the review process (SectionF.1.b).
Use an easily readable typeface, such as Times New Roman or Arial.
Use a 12-point font.
Use an 8.5” X 11” page size. Any other size page (e.g., A4, legal) will disqualify your
application.
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You must double-space the Project Narrative pages or we will disqualify your application. You
may single-space tables or use alternate fonts, but you must ensure the tables are easy to read.
Do not number pages or include a table of contents. Our grants management system will generate
page numbers once your application is complete.
You must submit your application in the English language and in terms of U.S. dollars (2 C.F.R.
§ 200.111(a)).
Page Limits
Your project narrative and appendices must adhere to these page limits.
The page limits do not include the budget package (Section D.2.c)
The page limits do not include the required forms (SF-424, SF-424A, SF-LLL, and the Project
Abstract Summary)
If your application exceeds the specified page limits when printed on 8.5” X 11” page, we will
not review your application further.
We encourage you to print out your application before submitting it to ensure that it is within the
page limits and is easy to read. Do not reduce pages to fit multiple pages on a single sheet to
avoid exceeding the page limitation.
Do not hyperlink to documents or sites outside of your application to augment your application.
Reviewers will not be permitted to follow links to external content during their assessment of
your application. The one exception to this is a link to your internal controls as part of your
budget package (Section D.2.c.3).
Page Limit
Project Narrative _____50____
Project Narrative plus Appendices ____100_____
Labeling Proprietary Information
Proprietary information includes patentable ideas, trade secrets, privileged or confidential
commercial or financial information, the disclosure of which may harm the applicant. You
should include proprietary information in your application only to the extent that it is essential to
the reviewers’ understanding of the project. Proprietary information should not appear in your
Project Abstract Summary.
If your application contains proprietary information, you should clearly label the top of the first
page of the project narrative. For example,
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Contains proprietary or confidential information that [Your Organization Name] requests not be
released to persons outside the government, except for purposes of review and evaluation.
Awarded applications are subject to release under the Freedom of Information Act (FOIA) with
redactions as the FOIA statute permits.
b. Appendices to the Project Narrative – Formatting
Your appendices should include any specific items outlined in Section D.2.b. Your documents
should be easy to read.
You should use the same formatting specified for the Project Narrative. However, documents
such as résumés/curricula vitae/biographical sketches, organizational charts, tables, Memoranda
of Agreement (MOAs) or Letters of Commitment (LOCs) may have formatting common to those
documents, so long as the pages are easy to read. For example, resumes, MOAs and LOCs may
be single-spaced.
You must upload all of your appendices as a single, consolidated file in the Attachments section
of your Grants.gov application. You must use an acceptable file format (Section E.3.a). We
strongly encourage you to convert your file(s) to PDF format before uploading and review them
to ensure accurate conversion.
Your Project Narrative plus the Appendices may not exceed the total number of pages for the
application (Section D.1.a).
Budget Package - Formatting
The budget narrative should use the formatting required of the project narrative for the
explanatory text. Budget tables may be single-spaced but should be laid out in an easily readable
format and within the printable margins of an 8.5” x 11” page. You must use an acceptable file
format (Section E.3.a). We do not accept Excel or other similar spreadsheet formats.
The application page limit does not include the SF-424A or the budget narrative (including
budget tables).
We recommend you present budget amounts and computations in a columnar format: first
column, object class categories; second column, federal funds requested; third column, non-
federal resources; and last column, total budget.
Federal Funds Non-Federal
Object Class Total Budget
Requested Resources
Personnel $100,000 $25,000 $125,000
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2. Content
a. Project Narrative - Content
The Project Narrative is the most important part of your application. We will use it as the
primary basis to determine whether your project merits an award. The project narrative should
provide a clear and concise description of your project. We recommend that your project
narrative include the following components with the requested information. Labeling the sections
accordingly will help the reviewers find information quickly.
You must clearly describe the administrative, management, and clinical capability of the
applicant organization and plans for delivering family planning services that meet the
expectations outlined in the NOFO. You should include all services to be provided by the
project as part of the program plan. Proposed projects must adhere to all requirements of
the Title X statute; applicable regulations, including regulations regarding sterilization of
persons in federally assisted family planning projects; and legislative mandates.
Successful proposals should include the following:
1) Proposed Service Area and Plans to Address the Need for Title
X Services
a. Describe the proposed service area, including the service area
boundaries, and the need for Title X services in the proposed service
area. Describe the current availability of Title X services in the
proposed service area and any existing gaps in the availability or
accessibility of services.
b. Describe your process for assessing the need for services within
the proposed service area and how you have/will continue to use the
results of your assessment to inform and improve service delivery.
c. Using and citing current data, describe the clients in need of
services in the proposed service area and any factors associated with
access and utilization of Title X services (e.g., geography,
transportation, occupation, transience, unemployment, income
level, educational attainment). Also describe any unique health care
needs or characteristics that impact health status and delivery of
family planning services (e.g., language barriers, food insecurity,
housing insecurity, financial strain, lack of transportation, the
physical environment, intimate partner violence, human
trafficking). Describe the structure of your Title X network, including
your recipient organization, any subrecipients that will assist in
carrying out the proposed project, and the proposed services sites
where family planning services will be delivered. To the extent that
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you will not provide all services directly, describe the process and
selection criteria that will be used to select subrecipients and service
sites, including a description of eligible entities for funding as
subrecipients.
d. For each direct service site, describe the location of the site
compared to the identified need; the days/hours of planned
operation; the estimated number of clients expected to receive
services at the site; the broad range of acceptable and effective
medically approved family planning methods (including natural
family planning methods) and services (including pregnancy testing
and counseling, assistance to achieve pregnancy, basic infertility
services, STI services, reproductive health condition services,
preconception health services, and adolescent-friendly health
services) that will be provided directly at the site; and a justification
for any methods and services that will not be available at the site
along with a description of how you will ensure client access for the
methods and services not available directly at the site.
e. Describe how you will address identified health care access and
utilization barriers and other factors that impact health status to
ensure the availability and accessibility of Title X services within
the proposed service delivery area.
f. Describe how you plan to educate clients and the broader service
delivery area about the availability of family planning services.
g. Describe the number of clients in need of services, particularly
low-income clients, to be served, the broad range of services and
methods that will be provided, and how the proposed project will
expand access to Title X services to clients in need of services in the
defined service area. Describe the number of unduplicated clients
that you project to serve on an annual basis. Include how that
determination took into consideration recent or potential changes in
the local health care landscape (e.g., potential changes in insurance
coverage), organizational structure, and/or workforce.
h. Describe how grant funds will be used to best address the
identified needs. Demonstrate that the cost per client and cost per
encounter are reasonable. Describe other non-Title X resources
available to address the needs for these services within the proposed
service area and how grant funds will be used to leverage and expand
available resources and not duplicate them.
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2) Plan to deliver Title X services in compliance with the
statute, regulations, legislative mandates and aligned with
OPA program priorities
a. Describe how you will implement Title X family planning
services that are in compliance with the Title X statute, regulations,
and legislative mandates. Your plan should include a description of
how you will ensure compliance with the statute, with each
provision of the regulation (42 C.F.R. Part 59, Subpart A §59.1-
§59.11), and with each legislative mandate.
b. Describe plans and strategies for providing family planning
services that address OPA program priorities and data collection
requirements, including:
o Addressing the chronic disease epidemic through the
delivery of Title X services
o Reducing overmedicalization and increasing focus on
optimal health through the delivery of Title X services
o Promoting body and health literacy through the delivery of
Title X services
o Advancing reproductive goals counseling through the
delivery of Title X services
o Promoting evidence-based care through delivery of services
o Enforcing the Hyde Amendment
o Implementing a QI/QA plan, including but not limited to,
collecting, reporting, and using FPAR 2.0 data.
c. Clearly describe your project plan including goal statements and
related outcome objectives that are S.M.A.R.T. (Specific,
Measurable, Achievable, Realistic and Time-framed) and designed
to provide services that are in compliance with the Title X statute,
regulations, and legislative mandates and that address OPA’s
program priorities. The activities proposed are feasible, are clearly
connected to the identified needs, and likely to achieve the stated
outcomes.
d. Describe any major anticipated barriers and describe how you
propose to overcome such barriers.
3) Project management and capability
a. Describe your project management structure and how it will
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enable accountability and rapid and effective use of grant funds.
b. Describe the expertise and experience of your organization and
other organizations that will partner with you on the project to deliver
Title X services. Provide evidence of your experience working in the
proposed service area and with the community(ies) to be served.
c. Describe your experience and expertise providing clinical health
services, specifically quality Title X services.
d. Describe the key management team for your project. Describe
how the makeup and distribution of functions among key
management staff, and their qualifications, support the operation
and oversight of the proposed project.
e. Describe the facilities where your project will be administered and
where family planning services will be delivered. Describe how the
location of project facilities will ensure continued access to Title X
for clients in the proposed service area.
f. Provide a staffing plan which is reasonable and adheres to the Title
X regulatory requirement that family planning medical services be
performed under the direction of a clinical services provider, with
services offered within their scope of practice and allowable under
state law, and with special training or experience in family planning.
Staff providing clinical services should be licensed and function
within the applicable professional practice acts for the State in which
they practice. Demonstrate that proposed staff have the expertise
needed to implement Title X family planning services. Describe
how the size, demographics, and health care needs of the service
area/client population were considered when determining the
number and mix of staff, and how you maintain documentation of
licensure and credentialing verification for clinical staff.
g. Describe your plans for providing ongoing training and
professional development for staff across your recipient network.
h. Describe how you will monitor and oversee provision of Title X
services across your network to ensure compliance and continuous
quality improvement, including detailed plans for subrecipient
monitoring.
i. Describe how your financial accounting and internal control
systems will align with the requirements of 42 C.F.R. § 59.5 and §
59.7.
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j. Demonstrate your ability to make use of non-federal resources
(i.e., non-Title X funds) within the community to be served and the
degree to which those resources are used to enhance the range of
family planning services provided through the project.
b. Appendices to the Project Narrative - Content
All items described in this section will count toward the total page limit of your application. You
must submit them as a single electronic file uploaded to the Attachments section of your
Grants.gov application.
Samples and optional forms/templates for some of these items are located under the Related
Documents tab for this NOFO on Grants.gov.
Your application should include the following appendices:
1) Work Plan
Your work plan should reflect, and be consistent with, the Project Narrative and Budget
Narrative, and must cover all years of the period of performance. However, each year’s
activities should be fully attainable in one budget year. You may propose multi-year
activities, as well as activities that build upon each other, but each phase of the project
must be discreet and attainable within a single budget year.
Your work plan should include a statement of the project’s overall goal, anticipated
outcome(s), key objectives, and the major tasks, action steps, or products that will be
pursued or developed to achieve the goal and outcome(s). For each major task of each
year, action step, or product, your work plan should identify the timeframes involved
(including start and end dates), and the lead person responsible for completing the task.
You must include a detailed list of all the services proposed to be provided by your project.
If some or all of the services will be provided by subrecipients, you must include a list of
these entities. For each direct service site:
• describe the location of the site compared to the identified need;
• the days/hours of planned operation;
• the estimated number of clients expected to receive services at the site;
• the broad range of acceptable and effective medically approved
family planning methods (including fertility awareness-based
methods) and services (including pregnancy testing and counseling,
assistance to achieve pregnancy, basic infertility services, STI
services, preconception health services, reproductive goals counseling,
body literacy counseling, and adolescent- friendly health services) that
will be provided directly at the site; and
• a justification for any methods and services that will not be available
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at the site along with a description of how you will ensure client
access for the methods and services not available directly at the site.
Title X service sites that are unable to provide clients with access to a broad range of
acceptable and effective medically approved family planning methods and services must
be able to provide a prescription to the client for their method of choice or referrals to
another provider, as requested.
2) Schedule of Discounts and Billing
A schedule of discounts, based on ability to pay, is required for those from families with
incomes between 101-250% of the Federal Poverty Level. For those from families whose
income exceeds 250% of the Federal Poverty Level, charges must be made in accordance
with a schedule of fees designed to recover the reasonable cost of providing services.
Include a schedule of discounts for your projects and the methodology for how you
developed/will develop this schedule. If you propose to have the sub recipient(s) develop
their own schedule(s) of discounts, you should include guidance on how the schedule(s)
of discounts are developed and how you intend on monitoring subrecipient development
and implementation of the schedule of discounts. Also include a description of the
processes in place to ensure that persons from low-income families, with incomes that
fall at or below 100% of the current FPL, will not be charged except where third parties
are authorized or legally obligated to pay; and that all reasonable efforts will be made to
obtain third party payment without the application of any discounts. Include evidence that
you have the ability to bill third parties, including private and public insurance such as
Medicaid, when appropriate, and the ability to facilitate enrollment of clients into
Medicaid.
3) Coverage Map
You must include a coverage map of your proposed service area that clearly shows the
location of proposed Title X service sites compared to the need for services.
4) Letters of Commitment from Referral Entities
You may include signed Letters of Commitment for the organizations that have been
specifically named as referral entities (organizations that provide services that are not
paid with Title X funds, but that may contribute to continuum of care for clients) to carry
out any aspects of the project not provided by subrecipients. The signed letters of
commitment should include the specific role and resources that will be provided (if any),
or activities that will be undertaken, in support of the applicant. The entity’s expertise,
experience, and access to the targeted population(s) should also be described in the letter
of commitment.
Letters of commitment are not the same as letters of support. Letters of support are letters
that are general in nature that speak to the writer’s belief in the capability of an applicant
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to accomplish a goal/task. Letters of support also may indicate an intent or interest to
work together in the future, but they lack specificity. You should NOT provide letters of
support, and letters of support such as this will not be considered during the review.
5) Curriculum Vitae/Resume for Key Project Personnel
You must submit with your application curriculum vitae and/or resumes of all key
personnel. Key Personnel includes those individuals who will oversee the technical,
professional, and managerial functions and/or assume responsibility for assuring the
validity and quality of your organization’s program. This includes at a minimum the
Project Director, Program Manager/Coordinator, and Medical Director. We encourage
individuals to use their full name (first, middle, last) on these documents to distinguish
them for verification in the System for Award Management exclusion records.
6) Family Participation Certification
You must include a written statement certifying that, if funded, your Title X Family
Planning Services project will encourage family participation in the decision of minors to
seek family planning services, and that they will provide counseling to minors on how to
resist attempts to coerce minors into engaging in sexual activities. See Section F.1.
c. Budget Package - Content
A complete budget package consists of the following required components:
• SF-424A “Budget Information Non-Construction Programs”
• Budget narrative with detailed justification by cost category/object class, and
• Plan for oversight of federal funds.
You should include supporting documentation for your budget (e.g., a copy of your approved
indirect cost rate) as part of the budget package, not as part of your appendices to the project
narrative. There is no page limit for the budget package contents. If you are recommended for an
award, you may be asked to provide additional information about your budget package.
Throughout your budget package, “Federal resources” refers only to the funds you are requesting
from the program office for this project. “Non-federal resources” are all other non-HHS/OASH
federal and non-federal resources. Funds from federal grant programs typically are not eligible as
cost share for other federal grants. It is your responsibility to confirm with other federal agencies
whether funds you receive from them are eligible resources to apply to your proposed project.
1. Standard Form SF-424A
You must enter the project budget according to the directions provided with the standard form.
You must provide costs by object class category for the first 12 months (i.e., first budget period)
of the proposed project using Section B, box 6 of SF-424A. If the estimated period of
performance is 12 months or less, this will be your total budget request for the entire project.
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"Federal resources" refers only to the funds for which you are applying under this NOFO. "Non-
federal resources" are all other resources (federal and non-federal).
Do not include costs beyond the first budget period in the object class budget in box 6 of SF-
424A or box 18 of SF-424. The amounts entered in these sections should only reflect the first
budget period.
If there is a discrepancy between your SF-424A and budget narrative and justification, we will
rely on the narrative and justification to determine the final amounts.
2. Budget Narrative with Justification
Your budget narrative must include a detailed line-item budget and must include calculations for
all costs and activities by the “object class categories” identified on SF-424A. You must provide
a detailed justification for the costs by object class. The object class budget organizes your
proposed costs into a set of defined categories.
Use the guidelines in Section J.4 for preparing the detailed object class budget.
Budget Periods
Your budget narrative must describe the first budget period in detail. For each proposed cost for
the first budget period, provide a justification that includes explanatory text and line-item detail.
You should describe how you derived your categorical costs. Your justification should show the
necessity and reasonableness of the proposed costs for the project.
For subsequent budget years in an anticipated multi-year period of performance, provide a
summary narrative and line-item budget for each year beyond the first. For categories or items
that differ significantly from the first budget period, provide a detailed justification explaining
these changes.
Funding levels for all approved budget periods after the first are generally the same as the initial
award amount and are subject to an offset with funds unused in the previous budget period.
Carryover of unobligated funds from one budget period to the next requires prior approval.
Determining Proposed Costs
Your budget narrative should justify the overall cost of the project as well as the proposed cost
per activity, service delivered, and/or product. For example, the budget narrative should define
the amount of work you have planned and expect to perform, what it will cost, and an
explanation of how the result is cost effective. If you are proposing to provide services to clients,
you should describe how many clients you expect to serve, the unit cost of serving each client,
and how this is cost effective.
Proposed costs must adhere to the cost principles described in 2 C.F.R. §200.416. We have
provided additional information on the most common cost categories for applications for OASH
awards in Section J.4.
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Budget calculations must include estimation methods, quantities, unit costs, and other similar
quantitative detail sufficient to verify the calculations. Carefully review Funding Restrictions
(below) for specific information regarding allowable, unallowable, and restricted costs.
Describing Federal and Non-federal Share
Both federal and non-federal resources (if applicable) must be detailed and justified in the budget
narrative. “Federal resources” refers only to the HHS/OASH funds for which you are applying
under this NOFO. “Non-federal resources” are all other non-HHS/OASH federal and non-federal
resources.
If matching or cost sharing is required or offered voluntarily, you must include a detailed listing
of any funding sources identified in box 18 of SF-424 (Application for Federal Assistance).
Indirect Costs
Indirect costs for training are limited to a fixed rate of eight percent of the modified total direct
costs (MTDC) exclusive of tuition and related fees, direct expenditures for equipment, and
subawards in excess of $50,000 (2 C.F.R. § 200.414 (c)(1).
Funding Restrictions
The following restrictions apply to costs you may propose and be awarded.
Pre-Award Costs
Pre-award costs are NOT allowed. Pre-award costs (2 C.F.R. § 200.458) are those
incurred prior to the effective date of the Federal award directly pursuant to the
negotiation and in anticipation of the Federal award where such costs are necessary for
efficient and timely performance of the scope of work.
Salary Rate Limitation
Each year’s appropriations act limits the salary rate that you may charge to the grants and
cooperative agreements that we award. You must not use award funds to pay the salary
of an individual at a rate in excess of Federal Executive Pay Scale Executive Level II.
As of January 2026, the Executive Level II maximum salary is $228,000. This amount
reflects an individual’s base salary exclusive of fringe benefits and any income that an
individual working on the award project may be permitted to earn outside of the duties to
the applicant organization. This salary rate limitation also applies to
subawards/subcontracts under an HHS/OASH award.
An example of the application of this limitation for an individual devoting 50% of their
time to this award is broken down below:
Salary Rate Limitation
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Direct salary ($350,000 x 0.5) =
Individual’s actual
$175,000
base full-time salary
$350,000 with 50%
Fringe (25% of salary) = $43,750
of time devoted to
project, i.e., 0.5 FTE Total = $218,750
Direct salary ($225,700 x 0.5) =
Individual’s base
$112,850
full-time salary
adjusted to
Fringe (25% of salary) =
Executive Level II:
$28,212.50
$225,700 with 50%
of time devoted to the Total amount allowed =
project $141,062.50
Appropriate salary rate limits will apply as required by law.
Vehicle Purchase
We will not approve a vehicle purchase at the time of award even when included in your
application. You must obtain prior approval before the purchase of a mobile health unit
or any other vehicle with award funds. A request for prior approval must include a
detailed justification of the need for the vehicle that includes an analysis of comparing
purchase, lease, and other alternatives. Equipment purchases are subject to transfer to
another federal project or sale at the end of the period of performance (2 C.F.R. §
200.313(e)).
Construction Costs
We will not approve construction costs. This includes major improvements to or
significant renovations of facilities.
3. Plan for Recipient Oversight of Federal Award Funds
You must include a plan for oversight of federal award funds which describes:
• how your organization will provide oversight of federal funds and how award activities
and partner(s) will adhere to applicable federal award and programmatic regulations.
Include identification of risks specific to your project as proposed and how your
oversight plan addresses these risks.
• the organizational systems that demonstrate effective control over and accountability for
federal funds and program income, compare outlays with budget amounts, and provide
accounting records supported by source documentation.
• for any program incentives proposed, the specific internal controls that will be used to
ensure only qualified participants will receive them and how they will be tracked.
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• organizational controls that will ensure timely and accurate submission of Federal
Financial Reports to the OASH Grants and Acquisitions Management Division via the
Payment Management System as well as timely and appropriate withdrawal of cash from
the Payment Management System.
If your internal controls are available online, you may provide a link as part of your plan
in the budget narrative. Although merit reviewers are not permitted to access any external
materials linked in the application as part of their review, this link would facilitate review of
your proposal if recommended for risk assessment (Section F.4).
Section J.5 contains questions you may find useful in preparing your Recipient Plans for
Oversight of Federal Funds.
a. Project Abstract Summary Guidance
You must complete the Project Abstract Summary form. The application page limit does not
include the Project Abstract Summary Form. Research projects may enter zero for “Estimated
number of people to be served as a result of the award of this grant.”
The abstract will serve as the application summary going forward. Do not include sensitive or
proprietary information in your abstract.
If your project is funded, we will publish the abstract on TAGGS.hhs.gov and USASpending.gov
as you submitted it. You may request to edit it later, or we may ask you to edit it later to reflect
any negotiated changes to the project. The abstract may also appear on the program office
website or other government websites.
Your abstract should contain:
• Specifics about the project purpose
• Activities that you will perform
• Expected deliverables and outcomes
• Intended project beneficiary(ies) or participant(s)
Your description of the project should be brief and use plain language an average reader can
understand. You should limit abbreviations, acronyms, or jargon without definitions. The
abstract should be unique to your project.
F. SUBMISSION REQUIREMENTS AND DATES
1.Obtaining an Application Package
The official complete application package is available on Grants.gov. Search either the
Assistance Listing number or the NOFO number PA-FPH-27-001.
The package consists of several Adobe PDF format documents. This is a standard format widely
accessible across multiple platforms including mobile devices. The Acrobat Reader application is
available at https://www.adobe.com/acrobat/pdf-reader.html.
All materials will be under the Package tab on the page for this opportunity on Grants.gov. If you
have problems locating the application package, contact:
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OASH Grants and Acquisitions Management Division
1101 Wootton Parkway. Plaza Level
Rockville, MD 20852
Phone: 240-453-8822
Email: OASH_Grants@hhs.gov
Email will often result in the fastest response.
2. Required Registrations
You must have an active registration in SAM.gov and Grants.gov to apply for this opportunity.
It is your responsibility to plan ahead to ensure adequate time to register in both systems before
submitting your application. We recommend beginning the registration process immediately, but
no later than 30 days prior to the application deadline with a goal of your registration being
complete at least 15 days prior to the application deadline.
a. Unique Entity Identifier and System for Award Management (SAM)
Grants.gov will not accept an application unless you have an active SAM.gov registration and
received a Unique Entity Identifier (UEI). There is no fee for registering in SAM.gov.
In cases where an individual is an eligible applicant (see Section A.1.a), the individual does not
need a SAM.gov registration. However, the individual must still create a Grants.gov account.
Grants.gov will assign a default UEI value where applicable.
We cannot make an award to your entity unless it has an active SAM registration. In accordance
with 2 C.F.R. § 25.205, if you have not complied with this requirement, we may:
• determine that you are not qualified to receive an award; and
• use that determination as a basis for making an award to another applicant.
Should you successfully compete and receive an award, all first-tier subrecipients must have a
UEI number at the time you make a subaward to them.
Registering in SAM
Your organization must register online in the System for Award Management (SAM).
Grants.gov will reject submissions from applicants with nonexistent or expired SAM
Registrations. You will find instructions on the Grants.gov website as part of the
organization registration process.
Complete a SAM registration (or renewal) as soon as possible if you do not currently
have an active registration that will remain active through the competitive process.
Registration will include obtaining a unique entity identifier (UEI). SAM.gov provides
an Entity Registration Checklist to help you prepare the necessary documentation.
You may register in SAM as an entity applying for either
• Federal Assistance Awards Only (e.g., grants and cooperative agreements) or
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• All Awards (including procurement awards).
If you chose to register for All Awards, you must answer Yes to the question “Do you
wish to apply for a federal financial assistance project or program, or is your entity
currently the recipient of funding under any federal financial assistance project or
program?” Failure to do so will require us to obtain a separate assurance document from
you during our risk assessment (Section E.3) and may delay any award.
The list of representations and certifications to be certified as part of your registration is
reproduced in Section J.6 with the corresponding HHS regulation citations. By
submitting your application to this NOFO, your authorized representative certifies to
these representations and certifications by signing Box 21 of SF-424A.
Make sure your SAM registration information is accurate, especially your organization’s
legal name and physical address including your ZIP+4. Should you successfully compete
and receive an award, this is the legal name and address we must use on the NOA.
During your registration, your organization will need to designate an E-Business Point of
Contact (EBiz POC). The EBiz POC will need to be the individual to set up your
Grants.gov account.
SAM Registration Renewal
If your organization has previously registered in SAM, confirm your status and
determine whether you need to update or renew it. You must renew your SAM
registration each year.
If you are successful and receive an award, you must maintain an active SAM
registration with current information at all times during an active award or an application
or plan under consideration by an HHS agency.
Timing of Registration
It may take up to 2-3 weeks (or longer during periods of high volume) for a registration
to become active in SAM. After that, it may take an additional 24-72 hours for SAM to
synchronize with Grants.gov. Grants.gov must recognize your SAM registration as active
to accept your application. We strongly encourage confirming your registration status
well before you are ready to submit your application to Grants.gov.
b. Grants.gov Registration
The Grants.gov Applicant Registration page provides the most up to date guidance on
registering. There is no fee for registering to use Grants.gov.
Your EBiz POC may begin creating your account prior to receiving your UEI from
SAM.gov. However, your will need to complete the SAM.gov registration prior to
complete your Grants.gov registration.
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Grants.gov is a platform that allows you to have multiple users with a variety of role-
based access to perform actions on application(s). You must register an authorizing
official for your organization. We do not determine who your organization’s authorizing
official is; your organization makes that decision. However, your authorizing official(s)
must have the authority to act on behalf of your organization.
You may consider registering a backup authorized organization representative(s) in
Grants.gov to ensure someone is available to submit your application. We will not extend
due dates because your authorized official is unavailable.
We encourage potential applicants to familiarize themselves with the Workspace
Overview and options as soon as possible.
3. Submission Instructions
It is your responsibility to read and understand the instructions to submit a complete and properly
formatted application.
a. Electronic Application Submission
We require that all applications be submitted electronically via Grants.gov unless the Grants
Management Officer has granted an exemption in writing (See Section E.3).
Grants.gov Information
You may access the application for this opportunity on Grants.gov. Search for the
downloadable application page by the NOFO number PA-FPH-27-001 or Assistance
Listing number 93.217.
To ensure successful submission of your application, you should carefully follow the
step-by-step instructions on the site. These instructions are kept up-to-date and also
provide links to Frequently Asked Questions and other troubleshooting information. You
are responsible for reviewing all Grants.gov submission requirements on the Grants.gov
site.
You should contact Grants.gov with any questions or concerns regarding the technical
system questions about the electronic application process (Section I).
See Section F.2 for requirements related to UEI numbers and SAM registration.
Electronic File Submission
Applications, excluding required standard forms, must be submitted as three (3) files.
Any additional files submitted as part of the Grants.gov application will not be accepted
for processing and will be excluded from the application during the review process.
Merit reviewers are not permitted to follow embedded links to materials outside of the
application. Your content must fit within the page limits of the application.
File 1 The complete Project Narrative
All documents that make up the Appendices
File 2
described in Section D.3.c
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The entire Budget Package including supporting
File 3 documentation described in the Budget Narrative
content section.
Acceptable File Formats
All files uploaded for your application must be in an acceptable file format and must
contain a valid file format extension in the filename.
We only accept the file formats identified in the table to ensure compatibility across our
other systems although Grants.gov will allow you to attach unacceptable formats.
We strongly encourage you to upload your application in Adobe PDF format. By
converting to PDF prior to submission, you may prevent any unintentional changes that
might occur with submission of an editable document. Most commonly available
applications for document preparation have the ability to “Save As” or “Print To PDF.”
We do not recommend submitting scanned copies through Grants.gov unless you have
confirmed the clarity of the scan and the readability of the documents.
Any file submitted as part of the Grants.gov application that is not in a file format listed
as acceptable will not be imported for processing and will be excluded from the
application during the review.
We will not contact you for resubmission of files to the correct the file type.
We will not contact you for passwords or for resubmission of unprotected files. We will
forward unprotected information in the application forwarded for consideration, but we
will not forward password protected portions.
Acceptable File Formats (extension)
• Adobe PDF (.pdf)
• Microsoft Word (.doc or .docx)
• Image formats (.jpg, .gif, .tif, or .bmp only)
Unacceptable File Formats (extension)
• Microsoft Excel files (.xls) or other similar spreadsheet files
• Any compressed file formats (e.g., .zip, .rar, or Adobe Portfolio)
• Any password protected files
Timing Considerations
We strongly encourage you to submit your application a minimum of 4-5 days prior to
the application closing date. You are responsible for allowing time for system
registrations and where applicable State Single Point of Contact (SPOC) notifications
(Section E.3.d).
Do not wait until the last day in case you encounter technical difficulties, either on your
end or with Grants.gov. Grants.gov can take up to 48 hours to notify you of a successful
or rejected submission. You are better off having a less-than-perfect application
successfully submitted and under consideration than no application.
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If your submission fails due to a system problem with Grants.gov, we may accept your
application if you provide verification from Grants.gov indicating system problems
existed at the time of your submission and that time was before the submission deadline.
If you have reported a system problem to the Grants.gov helpdesk, obtain a ticket
number to provide us so that we can verify the problem.
A “system problem” does not include known issues for which Grants.gov has posted
instructions regarding how to submit an application successfully, such as compatible
Adobe versions or file naming conventions. Nor does a “system problem” include issues
that should have been identified by reviewing and confirming your account status prior to
the submission deadline.
Exemption to the Grants.gov Submission Requirement
We will consider an exemption to the Grants.gov submission requirement only under
limited circumstances. To obtain an exemption, you must request one via email from
GAM at OASH_Grants@hhs.gov. Your request must provide details as to why you are
technologically unable to submit electronically through Grants.gov. You should submit
your request at least 4 business days prior to the application deadline to ensure we can
review your request at least to 2 business days before the deadline.
In your e-mail requesting an exemption include:
• the NOFO number;
• your organization’s UEI number;
• your organization’s name, address and telephone number;
• the name and telephone number of your Authorizing Official;
• the Grants.gov Tracking Number (e.g., GRANT####) assigned to your submission; and
• a copy of the “Rejected with Errors” notification from Grants.gov.
We will not grant an exemption to the electronic submission requirement for:
• Failure to have an active System for Account Management (SAM) registration prior to
the application due date.
• Failure to follow Grants.gov instructions to ensure software compatibility.
• Failure to have the correct permission levels configured in your Grants.gov workspace.
GAM will only accept applications via alternate methods (i.e., PDF via email or
hardcopy paper via U.S. mail or other provider) from applicants with prior written
approval. If you receive an exemption, you must still submit your complete application,
and we must receive it by the due date.
We will accept only applications submitted through Grants.gov or a pre-approved
alternate format.
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b. Submission Dates and Times
You must submit your application for this funding opportunity by January 9, 2027.
Your submission time is the date and time stamp provided by Grants.gov when you complete
your submission. If you do not submit your application by the due date and time, we will not
review it, and it will receive no further consideration.
It is your responsibility to review all instructions available on Grants.gov for successfully
submitting an application. For information on registering for Grants.gov or to receive assistance
on any technical system questions, contact Grants.gov directly (Section I).
c. NOFO Technical Assistance Webinar
We will provide a technical assistance webinar for applicants on September 15, 2026.
You should review the entire announcement prior to attending to have any questions answered
well in advance of the application due date. You should also subscribe to this opportunity on
Grants.gov to receive any amendments, revisions, question and answer documents, or other
updates.
Following the webinar, we will typically post an FAQ addressing common questions including
those of general applicability asked during the webinar. We will also post a link to the recorded
TA webinar.
Out of fairness to all applicants, we do not provide one-on-one consultation on the specific
content development for any applications.
d. Intergovernmental Review
Applications under this opportunity are subject to the requirements of Executive Order 12372,
‘‘Intergovernmental Review of Federal Programs,’’ as implemented by 45 C.F.R. part 100,
‘‘Intergovernmental Review of Department of Health and Human Services Programs and
Activities.’’
As soon as possible, you should discuss the project with the State Single Point of Contact
(SPOC) for the State in which your organization is located.
The SPOC should forward any comments to
Department of Health and Human Services
OASH Grants & Acquisitions Management
ATTN: Grants Management Officer
1101 Wootton Parkway, Plaza Level
Rockville, MD 20852.
The SPOC has 60 days from the due date listed in this announcement to submit any comments.
For further information, contact the OASH Grants and Acquisitions Management Division
(Section I).
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4. Other Submission Requirements
a. Program-Specific Requirements
Non-profit Status
If you are a non-profit organization, please submit documentation of nonprofit status.
Any of the following constitutes acceptable proof of such status:
(a) A reference to the Applicant organization’s listing in the Internal Revenue
Service’s (IRS) most recent list of tax-exempt organizations described in the IRS
code;
(b) A copy of a currently valid IRS tax exemption certificate;
(c) A statement from a State taxing body, State attorney general, or other appropriate
State official certifying that the applicant organization has a nonprofit status and
that none of the net earnings accrue to any private shareholders or individuals; or
(d) A certified copy of the organization’s certificate of incorporation or similar
document that clearly establishes nonprofit status.
b. Follow-up Submission Requirements
We may request additional documentation during the review process. We suggest having these
documents readily available. Requests will only come from the OASH GAM staff. If you have
any concern about the validity of a request, please contact us through the contact information
provided in Section J.
Requested documentation may include a copy of your:
• Approved negotiated indirect cost rate, if not submitted in your budget package
• Internal controls
• Authorizing Tribal Resolution
We may request additional documentation as needed during our risk assessment process in
Section G.4.
Failure to provide the requested documentation by the requested deadline may result in our no
longer considering your application and moving on to another to make an award.
You should not interpret a request for information as an indication that we will make an award to
you. A request only means that we are continuing to review your application.
G. APPLICATION REVIEW INFORMATION
Your application will undergo a series of reviews designed to ensure compliance with statutory
and regulatory requirements, alignment with agency priorities, and responsible stewardship of
Federal funds, consistent with Executive Order 14332, “Improving Oversight of Federal
Grantmaking” (available at https://www.whitehouse.gov/presidential-
actions/2025/08/improving-oversight-of-federal-grantmaking/), which aims to “strengthen
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oversight and coordination of, and to streamline, agency grantmaking to address […] problems,
prevent them from recurring, and ensure greater accountability for use of public funds more
broadly.”
a. Application Qualification and Alignment Review
Applications will first undergo an initial qualification and alignment review conducted by HHS
GAM personnel in coordination with Federal program staff, including senior Department
officials or other designated Presidential appointees, consistent with the Executive Order on
“Improving Oversight of Federal Grantmaking.”
This review includes the following components:
• Eligibility Review to determine whether you are an eligible applicant as described in
Section A.
• Responsiveness Review to determine whether the application meets the responsiveness
criteria described in Section F.1. and aligns with the purpose and objectives of the
funding opportunity.
• Formatting Review to determine whether your application meets the formatting
requirements described in Section D.1.
• Consistent with the Executive Order on “Improving Oversight of Federal Grantmaking,”
applications will be reviewed by a senior appointee or appointee’s designee to assess
alignment with:
o HHS, OASH, and OPA priorities;
o Principles of accountability, transparency, and effective Federal grant stewardship
The Grants Management Officer will coordinate with Federal staff, including a senior appointee
or senior appointee’s designee to relay to you a final determination of eligibility based on this
initial review. This decision is not appealable.
b. Merit Review
Consistent with the HHS Grants Policy Statement, effective October 1, 2025 (available at
available at https://www.hhs.gov/sites/default/files/hhs-grants-policy-statement-oct-2025.pdf), an
independent merit review panel will evaluate applications that are qualified and eligible. These
reviewers are experts in their fields, and are drawn from academic institutions, non-profit
organizations, state and local government, and Federal government agencies.
We do not disclose the identities of our review panelists. Each is vetted during the selection
process to identify and manage any real or apparent conflict of interests.
Using the Merit Review Criteria, the reviewers will provide comments and rate the applications.
We will provide reviewer comments to applicants after we have made final award decisions and
issued notices of award. We do not provide scores.
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c. Programmatic Technical Review and Risk Assessment
In addition to the independent merit review panel, federal staff will review each application for
technical (programmatic), budgetary, and grants management compliance.
1. Responsiveness Review
The responsiveness review assesses your application at a high level to determine whether the
application has addressed the subject matter of the opportunity or met any legal requirements.
The criteria, if any, we describe below facilitate a go/no-go determination by the review team.
Failure to address the responsiveness criteria clearly and provide the required information will
result in disqualification.
a. Responsiveness Criteria
For this opportunity, the responsiveness criteria are:
• Family Participation Certification. Applicants must include a written statement
in the appendix of the application certifying that:
“if funded, this Title X Family Planning Services project will encourage
family participation in the decision of minors to seek family planning services
and will provide counseling to minors on how to resist attempts to coerce
minors into engaging in sexual activities.”
b. Disqualifying Criteria
Disqualification means we will not review the application and will give it no further
consideration.
We will disqualify applications:
• not submitted electronically via Grants.gov (unless an exemption was granted by
the grants management officer in writing 2 business days prior to the deadline)
• not submitted by the due date and time (Section E.3.b)
• not submitted by an eligible applicant (Section A.1.a)
• submitted multiple times for the same project from the same organization, except
for the last application received by the deadline (Section A.1.c)
• not meeting the Responsiveness Criteria (Section F.1.a), if any
• not including a non-federal sources justification in the budget narrative when
including cost-sharing (voluntary or required) (Section A.3)
• requesting total funds (direct plus indirect costs) that are either:
o Above the Award Ceiling of $5,000,000; or
o Below the Award Floor of $0.
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• missing or incomplete required forms in the application package found on
Grants.gov including SF-424; SF-424A, SF-LLL, and the Project Abstract
Summary (Section D)
• not meeting the formatting requirements (Section D), specifically:
o not submitted in the English language and U.S. dollars (2 C.F.R. §
200.111(a))
o not submitted with
▪ an 8 ½ ” x 11” page size
▪ 1” margins on all sides (top, bottom, left and right)
▪ a font size of not less than 12 points
▪ a Project Narrative that is double-spaced
o exceeding the 50-page limit for the Project Narrative
o exceeding the total 100-page limit for the Project Narrative plus
Appendices combined, excluding SF-424, SF-424A, SF-LLL, Project
Abstract Summary, and Budget Narrative with budget tables
2. Merit Review Criteria
Federal staff and an independent merit review panel will assess all qualified eligible applications
according to the following criteria. Disqualified applications will not be reviewed against these
criteria.
a. Proposed Service Area and Plans to Address Demonstrated Need for Title X
Family Planning Services
• The extent to which the applicant substantiates, using current and relevant
data, that Title X family planning services are needed locally within the
proposed service area, particularly among low-income families as prioritized
in Title X statute (15 points)
• The extent to which the applicant clearly identifies the number of clients,
and, in particular, the number of low-income clients to be served, and
describes the broad range of methods and services that will be provided to
address client needs. For applicants that will not provide all services directly,
the extent to which the applicant has described a rigorous and transparent
process and criteria for selecting, monitoring, and overseeing qualified
subrecipients to ensure alignment with Title X activities and agency
priorities. (10 points)
b. Plan to Deliver Family Planning Services in Compliance with the
Statute, Regulations, Legislative Mandates, and Aligned with
OPA Program Priorities
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• The degree to which the project plan adequately provides for the requirements set
forth in the Title X statute, regulations (42 C.F.R. part 59, subpart A), and
legislative mandates (15 points)
• The extent to which the applicant proposes strategies that meaningfully advance
OPA’s program priorities as discussed in section 2(a)(4)(b), “Address OPA
Program Priorities” and HHS priorities. (35 points)
c. Project Management and Capability
• The relative need of the applicant, including the extent to which the applicant’s
project management plan shows the applicant’s need for funds and the
applicant’s capability to make effective use of grant funds. (5 points)
• The adequacy of the applicant’s facilities and staff, including evidence of an
infrastructure that is sustainable in ensuring continued access to family
planning services for clients in the proposed service area. (10 points)
• The capacity of the applicant to make rapid and effective use of the Federal
assistance. Applicants must demonstrate/explain how they propose to use the
federal assistance to provide quality family planning services that meet the
needs of and improve access for clients in the proposed service area. (5
points).
d. Budget
• The relative availability of non-Federal resources within the community to be
served and the degree to which those resources are committed to the project,
including the degree to which the budget and budget narrative identify other
sources of revenue, including but not limited to the estimated amount of program
income and how the applicant proposes to invest it back into the proposed Title
X project (5 points)
3. Merit Review and Selection Process
Application Status Inquiries
During the review process, we do not release information about individual applications. If you
would like to track your application, please see the instructions on Grants.gov.
If you receive communications to negotiate an award or request additional or clarifying
information, this does not mean you will receive an award. It only means that your application is
still under consideration.
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Federal Staff Review
In addition to the independent merit review panel, Federal staff will review each application for
technical (programmatic), budgetary, and grants management compliance.
OPA is responsible for facilitating the process of evaluating applications and setting
funding levels according to the criteria set forth in Title X regulations at 42 C.F.R.
§59.7(a) and described above.
The Office of Population Affairs will coordinate with a senior appointee to provide
recommendations for funding to the Grants Management Officer to conduct the required risk
analysis consistent with 2 CFR 200 and applicable HHS policy. No award decision is final until a
Notice of Award is issued by the Grants Management Officer, in coordination with a senior
appointee or appointee’s designee, consistent with the Executive Order on “Improving Oversight
of Federal Grantmaking.”
4. Review of Risk Posed by Applicant
Before issuing any award, GAM evaluates each recommended application for risks in
accordance with 2 C.F.R. § 200.206. This evaluation may incorporate results of the evaluation
for eligibility or of the quality of an application.
Risk Factors Considered
We will use a risk-based approach and may consider any items such as the following:
a. Your financial stability;
b. Quality of management systems and ability to meet the management standards prescribed
in 2 C.F.R. part 200;
c. History of performance. Your record in managing Federal awards, if you are a prior
recipient of Federal awards, including timeliness of compliance with applicable reporting
requirements, conformance to the terms and conditions of previous Federal awards, and if
applicable, the extent to which any previously awarded amounts will be expended prior to
future awards; however, not being a prior recipient of a Federal award shall not
negatively impact a determination of award;
d. Reports and findings from audits performed; and
e. Your ability to effectively implement statutory, regulatory, or other requirements
imposed on non-Federal entities.
Also, prior to making a Federal award with a total Federal share greater than the simplified
acquisition threshold (currently $250,000), GAM must review and consider any information
about you that is in the designated integrity and performance system accessible through the
System for Award Management (SAM) (formerly the Federal Awardee Performance and
Integrity Information System (FAPIIS)).
If you are a prior Federal award recipient, the information in the system must, at a minimum,
demonstrate a satisfactory record of executing programs or activities under Federal grants,
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cooperative agreements, or procurement awards; and integrity and business ethics.” 2 C.F.R. §
300; see also 2 C.F.R. §200.206. You have the option to review information in SAM and
comment on any information about your organization that a Federal awarding agency previously
entered and is currently available through SAM.
During this review, the agency may request more details or action from you, as consistent with
the HHS Grants Policy Statement (https://www.hhs.gov/sites/default/files/hhs-grants-policy-
statement-oct-2025.pdf ).
GAM will consider any comments by you, other information in the designated system, and input
from Federal staff including a senior appointee or that appointee’s designee. This review will
inform judgments regarding your integrity, business ethics, and record of performance and
responsible stewardship of Federal awards.
Risk Review Outcomes
If, after consideration of risk factors, Federal staff including a senior appointee’s review, and
applicable integrity and performance information, GAM does not make an award to you because
we determine that your organization does not meet either or both of the minimum qualification
standards as described in 2 C.F.R. § 200.206, we must report that determination to FAPIIS, if
certain conditions apply. See 2 C.F.R. § Part 300.
If we determine that a federal award will be made, specific conditions that correspond to the
degree of risk assessed will be applied to the Federal award. Such conditions may include
additional programmatic or financial reporting or releasing funds on a reimbursable rather than
cash advance basis.
H. AWARD NOTICES
Upon completion of risk analysis and concurrence of the GMO, GAM will issue Notices of
Award (NOAs). No award decision is final until the GMO issues a NOA. All award decisions,
including the level of funding, if an award is made, are final and you may not appeal.
We are not obligated to make any federal award as a result of this NOFO. If we make
awards, the awards may be for periods shorter than indicated. Only the GMO can bind the
federal government to the expenditure of funds.
Funded Applications
If you are successful, you will receive official notice of your award with a Notice of Award
(NOA) via a system notification from our grants management system (Grant Solutions) and/or
via e-mail. The NOA includes the amount awarded for the specified budget period, the
purpose(s) of the award, the anticipated length of the period of performance, terms and
conditions of the award, and the amount of cost share or matching, if applicable.
If you receive an NOA, we strongly encourage you to read the entire document to ensure your
organization’s information is correct and that you understand all terms and conditions. You
should pay specific attention to the terms and conditions, as some may require a time-limited
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response. The NOA will also identify the Grants Management Specialist (GMS) and Federal
Project Officer (FPO) assigned to the award for assistance and monitoring. The GMS and FPO
will work as a team. Any questions or concerns during the project should be communicated to
both the GMS and FPO.
Pre-award costs are not allowed. If you begin a project prior to receiving a NOA or the project
period start date on the NOA, you incur costs at your own risk. We will disallow the costs and
will not approve them retroactively.
We intend to award funds as much in advance of the anticipated project start date (See
Overview, page 1) as practicable, with a goal of 10-15 days. Note this is an estimated start date
and award announcements may be made at a later date and with a later period of performance
start date.
Unfunded Applications
If you are unsuccessful or your application was disqualified, OASH will notify you by email
and/or letter. If the merit review panel reviewed your application, you may receive summary
comments pertaining to the application resulting from the review process. We do not release
application scores.
You may receive a letter indicating that your application was “approved, but unfunded” (ABU).
This does not mean you will receive an award or funding. Applications designated ABU are
kept active for up to 12 months. During that time, a program office may consider an ABU
application for award should funds become available. However, an ABU status does not
guarantee that we will fund your project.
We will not transfer an ABU application for consideration under a new NOFO. You would have
the option to resubmit your application, with any updated material, for consideration under that
new NOFO.
I. AWARD REQUIREMENTS AND ADMINISTRATION
The following subsections describe the administrative requirements and the terms and conditions
that will apply to any award you might receive under this NOFO. HHS awards are subject to the
2 C.F.R. part 200 effective October 1, 2025.
1. Administrative and National Policy Requirements
a. Recipient Responsibilities
You will have the full responsibility for the conduct of the approved project or activity and for
adherence to all award terms and conditions, statutory, regulatory, or policy requirements
applicable to grants and cooperative agreements. The approved project or activity is the project
described in your application subject to any OASH GMO approved amendments. Approval of
the project does not waive or negate any statutory, regulatory, or policy requirements applicable
to grants and cooperative agreements.
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You will be encouraged to seek the advice and opinion of the federal project officer and grants
management specialist on special problems that may arise. Such advice does not diminish your
responsibility for making sound programmatic and administrative judgments and does not imply
that the responsibility for operating decisions has shifted to HHS, OASH, or the program office.
b. Accepting an Award
You accept an award and its terms and conditions by drawing or otherwise obtaining funds for
the award from the grant payment system. By accepting an award, you agree to comply with the
applicable federal requirements for grants and cooperative agreements, including those in the
SAM registration certifications and representations, and to the prudent management of all
expenditures and actions affecting the award, including the monitoring of any subrecipients.
You must comply with all terms, conditions, and requirements outlined in the Notice of Award,
including: award policy terms and conditions contained in the HHS Grant Policy Statement
(GPS, effective October 1, 2025, available at https://www.hhs.gov/sites/default/files/hhs-grants-
policy-statement-oct-2025.pdf), and its subsequent updates, all requirements imposed by
program statutes and regulations, Executive Orders, and HHS grant administration regulations;
and requirements or limitations in any applicable appropriations acts.
c. Scope of the Award and Prior Approvals
You may only use award funds to support activities in your funded project. HHS GPS Section II
and 2 C.F.R. § 200.308 describe the aspects of your funded project that will require prior
approval from the OASH GMO for any changes. Some of the award modifications to an
approved project that will require prior GMO approval include:
• a change in the scope or the objective(s) of the project (even if there is no associated
budget revision, such as reduction in services, closing of service or program site(s)).
• significant budget revisions, including changes in the approved cost-sharing or matching;
• a change in a key person(s) specified in your application;
• reduction in time devoted to the project by the approved PD/PI, either as percentage of
full-time equivalent of 25% or more or absence for 3 months or more; or
• the transferring of any work to another entity or individual through contract, subaward, or
other means that differs from described in the awarded proposal.
d. Applicable Termination Provisions
If you receive an award, HHS may terminate it for any of the conditions in 2 C.F.R. § 200.340.
2. Program Specific Terms and Conditions
We may include on any awards made under this opportunity the following as special terms and
requirements.
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a. Paperwork Reduction Act Clearance Packages
Any collection of information you conduct as defined in 5 C.F.R. § 1320.3(c) may require OMB
clearance under the Paperwork Reduction Act (PRA) if it is a requirement of your award to
collect that information. You would be responsible for preparing the clearance package
necessary to obtain PRA clearance and submitting it to the project officer. The project officer
will assist in the submission of the package to OMB and notify you when the approval has been
received or request additional information.
3. Award Closeout
When the award expires, you must submit within 120 days all necessary documentation to
closeout your award. If we do not receive acceptable final performance, financial, and property
reports in a timely fashion and we determine that closeout cannot be completed with your
cooperation, we must complete a unilateral closeout with the information available to us (2
C.F.R. § 200.344). See Section I.3 for specific detail.
If you do not submit all reports within one year of the period of performance end date, we must
report your material failure to comply with the terms and conditions of the award with the OMB-
designated integrity and performance system. As a result, we may also determine that
enforcement actions are necessary, including actions such as withholding support or a high-risk
designation on an existing or future award.
4. Lobbying Prohibitions
In general, any funds from an award made under this NOFO must not be used for other than
normal and recognized executive legislative relationships. See 2 C.F.R. § 200.450.
You must not use funds for publicity or propaganda purposes, for the preparation, distribution, or
use of any kit, pamphlet, booklet, publication, electronic communication, radio, television, or
video presentation designed to support or defeat:
• the enactment of legislation before the Congress or any State or local legislature or
legislative body, except in presentation to the Congress or any State or local legislature
itself, or
• any proposed or pending regulation, administrative action, or order issued by the
executive branch of any State or local government, except in presentation to the executive
branch of any State or local government itself.
You must not use any funds awarded to pay the salary or expenses of any employee or
subrecipient, or agent acting for you, related to any activity designed to influence the enactment
of legislation, appropriations, regulation, administrative action, or Executive Order proposed or
pending.
5. Non-Discrimination Requirements
If you receive an award, you must follow all applicable nondiscrimination laws. You agree to
this when you register in SAM.gov. You must also submit an Assurance of Compliance (HHS-
690). To learn more, see the HHS Office for Civil Rights website.
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6. Smoke- and Tobacco-free Workplace
We strongly encourage all award recipients to provide a smoke-free workplace and to promote
the non-use of all tobacco products. This is consistent with the HHS mission to protect and
advance the physical and mental health of the American people.
7. Acknowledgement of Funding
Each year’s annual appropriation requires that when issuing statements, press releases, requests
for proposals, bid solicitations and other documents describing projects or programs funded in
whole or in part with Federal money, all organizations receiving Federal funds, including but not
limited to State and local governments and recipients of Federal research grants, shall clearly
state— (1) the percentage of the total costs of the program or project which will be financed with
Federal money; (2) the dollar amount of Federal funds for the project or program; and (3)
percentage and dollar amount of the total costs of the project or program that will be financed by
non-governmental sources.
You must also acknowledge Federal support in any publication you develop using funds awarded
under this program, with language such as:
This [project/publication/program/website, etc.] was supported by [Award Number]
issued by the Office of the Assistant Secretary for Health of the U.S. Department of
Health and Human Services (HHS) as part of a financial assistance award totaling $XX
with 100 percent funded by Organization Name.
You must also include a disclaimer stating the following:
The contents are solely the responsibility of the author(s) and do not necessarily
represent the official views of, nor an endorsement by, Organization Name, OASH,
HHS, or the U.S. Government. For more information, please visit [Organization Name
website, if available].
8. HHS Rights to Materials and Data
All publications you develop or purchase with funds awarded under this announcement must
adhere to the requirements of the program. You own the copyright for materials that you develop
under an award, and pursuant to 2 C.F.R. § 200.448 the HHS awarding agency reserves a
royalty-free, nonexclusive, and irrevocable right to reproduce, publish, or otherwise use those
materials for federal purposes, and to authorize others to do so.
In addition, pursuant to 2 C.F.R. § 200.448, the federal government has the right to obtain,
reproduce, publish, or otherwise use data produced under this award and has the right to
authorize others to receive, reproduce, publish, or otherwise use such data for federal purposes.
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