Fiscal Year 2027 Title X Services - PA-FPH-27-001: QUESTIONS AND ANSWERS

Established in 1970, Title X is governed by statutory language (42 U.S.C. 300 et seq.) and regulations (42 CFR part 59, subpart A).

Any public or private nonprofit entity located in a U.S. state or territory is eligible. This includes state and local governments, tribal governments and organizations, public and private institutions of higher education, faith-based organizations, and nonprofits with or without 501(c)(3) status.

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
• Non-profit private institutions of higher education

Yes. Both faith-based organizations and American Indian/Alaska Native/Native American organizations are explicitly eligible to apply.

No. Any eligible entity as defined in the NOFO may apply, including organizations that have not previously received Title X funding.

An estimated $257 million is available, with up to 90 grant awards anticipated for a period of up to five (5) years. Individual awards range from $200,000 to $22,000,000.

Yes. A technical assistance webinar is posted on OPA’s website at https://opa.hhs.gov/grant-programs/funding-opportunities#TitleX.

Yes, the technical assistance webinar slides for this NOFO will be posted to Grants.gov under “Related Documents” tab.

Subscribe to opportunity PA-FPH-27-001 on Grants.gov to receive notifications of any updates, amendments, or Q&A documents. To subscribe, search for the NOFO on Grants.gov, navigate to the opportunity page, and click the subscribe button.

Applications must be submitted via Grants.gov by January 11, 2027 at 11:59pm EST.

Projects have an anticipated start date of April 1, 2027.

Awards are for a 5-year period of performance, beginning on the anticipated project start date of April 1, 2027.

No. Continuation funding is contingent upon availability of funds, satisfactory project progress, appropriate stewardship of federal funds, and the best interests of the government.

This is a new competition for funds to support new Title X family planning services grants. It is not a continuation funding opportunity for existing grants.

If you are registering a new entity or renewing your registration, you must submit a notarized letter formally appointing an Entity Administrator to SAM.gov. For detailed instructions on the content of the letter and process for domestic entities see: https://www.fsd.gov/gsafsd_sp?sys_kb_id=8cfe46491b1cb8909ac5ddb6bc4bcbbb&id=kb_article_view&sysparm_rank=1&sysparm_tsqueryId=c6131c131bdcf0d0a7d7da49bc4bcb1a

A quick start guide for registrants is available at https://www.fsd.gov/sys_attachment.do?sys_id=80f49f211bdcfc909ac5ddb6bc4bcb76.

You should allow a minimum of five days to complete an initial SAM registration. Allow up to 10 business days after you submit your registration for it to be active in SAM. This timeframe may be longer if SAM flags the information you provide for manual validation. You will receive an email alerting you when your registration is active.

If your organization is already registered in SAM, you must renew your SAM registration each year. Organizations registered to apply for Federal awards through http://www.grants.gov will need to renew their registration in SAM. You should make sure your SAM registration information is accurate, especially your organization’s legal name and physical address including your ZIP+4. For instructions on updating this information see: https://www.fsd.gov/sys_attachment.do?sys_id=d08b64ab1b4434109ac5ddb6bc4bcbbc

Carefully follow all eligibility, responsiveness, formatting, and submission requirements in the NOFO. Review the Disqualification Criteria section closely before submitting.

Grants.gov may take up to 48 hours to notify you of a successful submission. Applicants are strongly encouraged to submit at least 4–5 days before the closing date.

Yes. Job descriptions may be submitted in place of CVs or resumes for positions not yet filled at the time of application submission.

Yes, as long as each application is for a distinctly different project. If multiple applications are submitted for the same project, only the last application received before the deadline will be reviewed.

All applications must be submitted electronically through Grants.gov. Paper or email submissions are only accepted with prior written approval from the Grants Management Officer, requested at least 4 business days before the deadline.

The actual award amounts will be determined after applications have been reviewed and risk assessment completed.  Nothing is final until the Notice of Award (NOA) is issued.

Applications go through a multi-step review: (1) an initial qualification and alignment review for eligibility, responsiveness, and formatting; (2) an independent merit review panel scoring; and (3) a programmatic, budgetary, and grants management review by federal staff, including review by a senior appointee consistent with Executive Order 14332.

If the merit review panel reviewed your application, you may receive summary comments after final award decisions are announced. Scores are not released.

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. The Title X statute, legislative mandates, and applicable regulations are available on the OPA website at https://opa.hhs.gov/grant-programs/title-x-service-grants/title-x-statutes-regulations-and-legislative-mandates.

OPA and OASH priorities can be found at https://health.gov/priorities. They include:

• Addressing the chronic disease epidemic
• Ending diversity, equity, and inclusion (DEI) policies and practices across OASH’s programs
• Reducing overmedicalization in health care and increasing focus on optimal health and addressing underlying root causes
• Providing medically accurate and reliable information necessary for informed consent
• Promoting evidence-based care through the delivery of Title X services
• Enforcing the Hyde Amendment
• Ensuring gold standard science, curtail corporate capture and prevent conflicts of interest 
• Prioritizing 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 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.
• Ensuring adolescent program materials are age-appropriate Protecting 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:

• Promote body and health literacy
• Advance reproductive goals counseling
• Implement a Quality Improvement and Quality Assurance (QI/QA) Plan with the goal to achieve optimal health outcomes

No. Section 1008 of the Public Health Service Act prohibits the use of Title X funds in programs where abortion is a method of family planning.

Yes. Applicants must certify that their project will encourage family participation in the decision of minors to seek family planning services. This certification is a required responsiveness criterion following the statue. Applicants should refer to the Title X statute, regulations, and legislative mandates for minor services.

Yes. Clients with family incomes at or below 100% of the Federal Poverty Level (FPL) must be served at no charge. Clients with incomes between 101–250% FPL must be served on a sliding-scale discount basis.

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. Information about FPAR 2.0, including the data elements and response options, is available at https://opa.hhs.gov/research-evaluation/title-x-services-research/family-planning-annual-report-fpar.

The information collection (reporting requirements) and format for this report have been approved by the Office of Management and Budget (OMB) and assigned OMB N. 0990-0479 (expires 9/30/2028).

All applications must be submitted electronically through Grants.gov. Paper or email submissions are only accepted with prior written approval from the Grants Management Officer.

• Font: 12-point, easily readable (e.g., Times New Roman or Arial)
• Page size: 8.5" x 11"
• Margins: 1" on all sides
• Project Narrative must be double-spaced
• Project Narrative: maximum 50 pages Project Narrative plus Appendices combined: maximum 100 pages
• Submitted in English and in U.S. dollars

The SF-424 Application for Federal Assistance, SF-424A Budget Information for Non-Construction Programs, and SF-LLL Disclosure of Lobbying Activities are required standard forms.

Yes. The Project Abstracts Summary form must be completed. The application page limit does not include the Project Abstract Summary Form.

Three files are required:

1. Project Narrative
2. Appendices (as a single consolidated file)
3. Budget Package

Your application should include the following appendices: a Work Plan, Schedule of Discounts and Billing, Coverage Map, Letters of Commitment from Referral Entities, Curriculum Vitae/Resumes for key personnel, and the Family Participation Certification.

Yes. Federal regulations prohibit awarding 100% of project costs with Title X funds. Projects must include financial support from non-Title X sources, which must be clearly identified in the budget. (Note: this requirement is waived for certain U.S. territories.)

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.

Budget calculations must include estimation methods, quantities, unit costs, and other similar quantitative details sufficient to verify the calculations. Carefully review Funding Restrictions for specific information regarding allowable, unallowable, and restricted costs.

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).

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.

The maximum award is $22,000,000. Applications requesting more than this will be disqualified.

The minimum award is $200,000. Applications requesting less will be disqualified.

No. Costs incurred prior to the Notice of Award date are not allowable.

No. Construction costs and major facility renovations are not permitted.

Not at the time of award. Prior approval from the Grants Management Officer is required before purchasing any vehicle, including mobile health units. Details on what to include in your prior approval request are specified on page 29 of the NOFO.

Yes. No individual's salary may be charged to the award at a rate exceeding the Executive Level II cap, which is $228,000 as of January 2027.

If the safety net hospital meets the criteria listed in the NOFO for “eligible entities" they are eligible to apply for the Title X funding. They can find the eligible entity information on page 4 of the NOFO.

Section C of the NOFO states that recipients are expected 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.” The NOFO goes on to provide that “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.” As referenced in that NOFO section, section 1008 of the Public Health Service Act, provides that “[n]one of the funds appropriated under this title shall be used in programs where abortion is a method of family planning.” In addition, section E.2.a of the NOFO asks applicants, as part of their plan to address OPA program priorities, to “describe 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,” including strategies for “Enforcing the Hyde Amendment.

Starting on page 16, the NOFO states under “Page Formatting” that applications must use an easily readable typeface, such as Times New Roman or Arial, in 12-point font and on 8.5” x 11” pages. Applications submitted on any other page size, including A4 or legal paper, may be disqualified during the review process under section F.1.b. The Project Narrative must also be double-spaced, although tables may be single-spaced or use alternate fonts if they remain easy to read. Please also refer to the page-formatting criteria on page 16 when preparing the service-site materials.

Starting on page 19 the NOFO, under “Proposed Service Area and Plans to Address the Need for Title X Services,” provides relevant guidance in sections 1.c. and 1.d. Section 1.c. asks applicants to describe the structure of the Title X network, including the recipient organization, any subrecipients that will support the proposed project, and the proposed service sites where family planning services will be delivered. If all services will not be provided directly, the application should explain the process and selection criteria for choosing subrecipients and service sites, including the eligible entities that may receive funding as subrecipients. Section 1.d. further asks applicants to describe, for each direct service site, the site’s location in relation to the identified need, planned days and hours of operation, estimated client volume, and the broad range of acceptable and effective medically approved family planning methods and services that will be provided. This includes natural family planning methods, 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. The application must also justify any methods or services that will not be available at a site and describe how clients will access those methods or services through other arrangements.

Near the top of page 5 the NOFO, under “PD/PI Eligibility,” section A.1.b states that the PD/PI is expected to remain involved in and have substantial knowledge of all aspects of the project throughout the period of performance. Although an organization may identify co-PD/PIs for a team-managed project, only one PD/PI will be recognized as responsible for the programmatic aspects of the project. Page 16, under “Names of Individuals,” further explains that only one PD/PI will be listed on the award documents. Applicants should not use a placeholder or honorary PD/PI. If the PD/PI has not yet been hired, the application should name an interim PD/PI and clearly identify them as such. The PD/PI will typically be listed on the SF-424 in box 8.f.; grant writers should not be listed there unless they have the expertise to respond to technical questions about the proposed project in a timely manner. Other personnel essential to carrying out the project should be clearly identified in the Project Narrative.