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List of Additional Requirements

Additional Requirement – 8: Public Health System Reporting Requirements

This program is subject to the Public Health System Reporting Requirements. Under these requirements, all community-based non-governmental organizations submitting health services applications must prepare and submit the items identified below to the head of the appropriate State and/or local health agency(s) in the program area(s) that may be impacted by the proposed project no later than the application deadline date of the Federal application. The appropriate State and/or local health agency is determined by the applicant. The following information must be provided:

  1. A copy of the face page of the application (SF 424).
  2. A summary of the project that should be titled “Public Health System Impact Statement” (PHSIS), not exceed one page, and include the following:
    • A description of the population to be served.
    • A summary of the services to be provided.
    • A description of the coordination plans with the appropriate state and/or local health agencies.

If the State and/or local health official should desire a copy of the entire application, it may be obtained from the State Single Point of Contact (SPOC) or directly from the applicant.

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