CMS-3Y3-25-001_1.13.2025.pdf

Notice of Funding Opportunity

Application due March 7, 2025

Connecting Kids to Coverage Outreach and Enrollment Cooperative Agreements Opportunity number: CMS-3Y3-25-001

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 6

Program description 8

Step 2: Get Ready to Apply 14

Get registered 15

Find the application package 15

Join the webinar 16

Step 3: Prepare Your Application 17

Application contents and format 18

Step 4: Learn About Review and Award 36

Application review 37

Award notices 42

Step 5: Submit Your Application 43

Application submission and deadlines 44

Step 6: Learn What Happens After Award 47

Post-award requirements and administration 48

Contacts and Support 52

Appendix A: CKC National Campaign 54

Appendix B: Definition of Frequently Used Terms 56

Endnotes 58

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up-to-date.

SAM.gov registration (this can take several weeks)

You must have an active account with SAM.gov. This includes having a Unique

Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days)

You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date

Applications are due by 11:59 p.m. Eastern Time on March 7, 2025.

To help you find what you need, this NOFO uses internal links. In Adobe

Reader, you can go back to where you were by pressing Alt + Left Arrow

(Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

Jump to a step

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 6

Program description 8

Basic information Centers for Medicare & Medicaid Services

Center for Medicaid and CHIP Services

Reaching out to children and families to help them enroll or remain in Medicaid and CHIP so fewer children are uninsured.

Have questions?

See Contacts and

Support.

Key facts

Opportunity name:

Connecting Kids to

Coverage Outreach and

Cooperative

Agreements

Opportunity number:

CMS-3Y3-25-001

Announcement type:

New

Assistance listing:

93.767

Key dates

Application submission deadline: March 7, 2025

Informational webinar:

January 28, 2025, and

February 13, 2025

Expected award date:

July 1, 2025, and April 1, Expected earliest start date: July 1, 2025, and

April 1, 2026

See other submissions for other time frames that may apply to this

NOFO.

Summary The Centers for Medicare & Medicaid Services (CMS) is seeking applications for the Connecting Kids to Coverage (CKC) Outreach and Enrollment

Cooperative Agreements program. You may use funds to:

• Target eligible, unenrolled children and help enroll them in Medicaid and the Children’s Health Insurance Program (CHIP).

• Improve retention of eligible children who are already enrolled.

Funding details Type: Cooperative agreement, which means that both you and CMS will have roles in the project. Throughout the life of your project, we will be there to help and work with you.

Expected total funding for the program: $66.3 million, subject to availability of funds

Expected total awards: 22, depending on requested and awarded amounts

Funding range per applicant for the period of performance: Up to $3 million

For new recipients and existing recipients awarded under CMS-2Y2-22-001:

• We will provide funding in five budget periods of twelve months each over a five-year period of performance.

• The expected earliest start date for the award is July 1, 2025.

For existing recipients awarded under CMS-2D2-23-001:

• We will provide funding in one 15-month budget period and three

12-month budget periods over the five-year performance period.

• The expected earliest start date for the award is April 1, 2026.

All budget periods will end on June 30, 2030.

Step 1: Review the Opportunity 5

Eligibility Eligible applicants Only these types of organizations may apply, per the statute, 42 USC

1397mm(f)(1):

• Government organizations:

◦ State governments.

◦ County governments.

◦ City or township governments.

◦ Special district governments.

◦ Native American tribal governments (federally recognized).

◦ Native American tribal organizations (other than federally recognized tribal governments).

◦ Indian tribes or tribal consortia, tribal organizations, urban Indian organizations receiving funds under Title V of the Indian Health Care

Improvement Act (25 U.S.C. § 1651 et seq.), or Indian Health Service providers.

• Education organizations:

◦ Independent school districts.

◦ Public and state-controlled institutions of higher education.

◦ Private institutions of higher education.

• Nonprofit organizations:

◦ Nonprofits that have a 501(c)(3) status with the IRS, other than institutions of higher education.

◦ Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education.

◦ Community and consumer-focused nonprofit groups.

◦ Other organizations.

Other eligibility requirements If you have previously been awarded a CKC cooperative agreement funded under Section 2113 of the Social Security Act, you may apply for a new CKC cooperative agreement if your proposal meets one of the following criteria:

• Your proposal is new and distinct from those previously funded.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 6 https://uscode.house.gov/view.xhtml?req=1397mm%28f%29%281%29&f=treesort&fq=true&num=5&hl=true&edition=prelim&granuleId=USC-prelim-title42-section1397mm https://uscode.house.gov/view.xhtml?req=1397mm%28f%29%281%29&f=treesort&fq=true&num=5&hl=true&edition=prelim&granuleId=USC-prelim-title42-section1397mm https://uscode.house.gov/view.xhtml?path=/prelim@title25/chapter18&edition=prelim https://uscode.house.gov/view.xhtml?path=/prelim@title25/chapter18&edition=prelim

• You wish to continue activities you are conducting or previously conducted, if those activities were successful in enrolling and/or retaining eligible children in Medicaid and CHIP. You will need to submit data to demonstrate you were successful. We will not consider previous recipients who did not meet at least 40% of their combined new enrollment and renewal goals for children each budget year.

Completeness and responsiveness criteria We will review your application to make sure it meets the requirements found in the eligibility, applications contents and format, and application submission and deadlines sections.

We won’t consider an application that:

• Is from an organization that doesn’t meet all eligibility criteria.

• Requests funding above the award ceiling shown in the funding range.

• Is submitted after the deadline.

• Is not submitted through Grants.gov.

The Division of Grants director or deputy director may choose to continue the review process for an ineligible application if it is in the best interests of the government to meet the objectives of the program.

Eligibility limitations International organizations and for-profit entities are not eligible to apply.

Application limits You may submit only one application under this NOFO.

Cost sharing This program has no cost-sharing requirement. If you choose to include cost-sharing funds, we won’t consider it during review. However, we will hold you accountable for any funds you add, including through reporting.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 7 https://word-edit.officeapps.live.com/we/wordeditorframe.aspx?ui=en%2DUS&rs=en%2DUS&wopisrc=https%3A%2F%2Fgartner365.sharepoint.com%2Fsites%2FNOFO100Workspace%2F_vti_bin%2Fwopi.ashx%2Ffiles%2Fc9adf7b3174248389fe1e0ed6c0eda17&wdenableroaming=1&mscc=1&hid=76C609A1-F0D0-4000-D371-AEFE4FBF67D1&wdorigin=ItemsView&wdhostclicktime=1707421111271&jsapi=1&jsapiver=v1&newsession=1&corrid=de92e597-126e-4505-8b92-89252560edb8&usid=de92e597-126e-4505-8b92-89252560edb8&sftc=1&cac=1&mtf=1&sfp=1&instantedit=1&wopicomplete=1&wdredirectionreason=Unified_SingleFlush&rct=Normal&ctp=LeastProtected#_Funding_Details https://word-edit.officeapps.live.com/we/wordeditorframe.aspx?ui=en%2DUS&rs=en%2DUS&wopisrc=https%3A%2F%2Fgartner365.sharepoint.com%2Fsites%2FNOFO100Workspace%2F_vti_bin%2Fwopi.ashx%2Ffiles%2Fc9adf7b3174248389fe1e0ed6c0eda17&wdenableroaming=1&mscc=1&hid=76C609A1-F0D0-4000-D371-AEFE4FBF67D1&wdorigin=ItemsView&wdhostclicktime=1707421111271&jsapi=1&jsapiver=v1&newsession=1&corrid=de92e597-126e-4505-8b92-89252560edb8&usid=de92e597-126e-4505-8b92-89252560edb8&sftc=1&cac=1&mtf=1&sfp=1&instantedit=1&wopicomplete=1&wdredirectionreason=Unified_SingleFlush&rct=Normal&ctp=LeastProtected#_Application

Program description Statutory authority Section 2113 of the Social Security Act (42 USC 1397mm).

Purpose The purpose of this funding opportunity is to provide funding for eligible organizations to enroll and retain eligible children in Medicaid and CHIP, as authorized by the Social Security Act.

We use the following definitions in this NOFO:

• “Children” refer to individuals up to age 21 for Medicaid, or up to age 19 for

CHIP.

• “Parents” refer to parents or guardians of CHIP-or Medicaid-eligible children.

Background Section 2113 of the Social Security Act (42 USC 1397mm) established the

Connecting Kids to Coverage (CKC) grants program. Since 2009, CMS has awarded $270.9 million in CKC outreach and enrollment grants to 338 eligible entities, including community-based organizations, tribes, states, and local governments.

The services of CKC recipients are fundamental to enrolling and retaining eligible children in Medicaid and CHIP. They will continue to play a critical role in minimizing coverage gaps to support the goal of making health care accessible and affordable for children and families.

Program requirements and expectations Project activities You must use funds for activities that:

• Educate families about the availability of free or low-cost health coverage under Medicaid and CHIP.

• Identify children likely to be eligible for these programs.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 8 https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397mm&num=0&edition=prelim https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html

• Help families, including parents and pregnant women, apply for and renew their coverage.

If you are funded, you will be required to participate in CKC National

Campaign activities and strategies, including:

• Sponsoring training webinars and meetings.

• Developing articles on key topics for partners.

• Creating and updating print and digital campaigns in English, Spanish, and other languages.

• Distributing public service announcements.

Data and reporting requirements If funded, you will be required to collect and report data to CMS about your progress toward your goals. You must follow a detailed data dictionary and upload the data to a web-based portal that we will provide. We will give you tools to submit all required data and reports.

We may require you to report additional data over the course of the project so we can fully assess your performance.

Timely and accurate data collection and reporting is foundational to the monitoring, oversight, and evaluation of the project.

Cooperative agreement terms Cooperative agreements require substantial CMS project involvement after an award is made. There are specific roles for both you and CMS. We may be in contact at least once a month, and more frequently when appropriate.

Your responsibilities if awarded funding

• Comply with the terms and conditions of the award.

• Collaborate with CMS staff to implement and monitor the project.

• Ensure key personnel have timely access to all CMS-required systems.

• Attend and take part in CMS-sponsored onboarding, meetings, and technical assistance trainings.

• Immediately notify CMS of needed and anticipated modifications to your approved project plans.

• Submit all required performance measures, assessments, evaluations, and financial reports included in the terms and conditions of the award.

Step 1: Review the Opportunity 9

• Attend monthly calls with the CMS project officer or grants management specialist to discuss your project’s progress and challenges. The meetings will include key personnel at your organization as well as the

CMS project officer.

• Participate in CMS-sponsored onboarding, meetings, and technical assistance trainings.

• Participate in CKC National Campaign activities.

Our responsibilities

• Monitor the project’s performance and progress.

• Collaborate with you and provide substantial input into planning and implementing the project.

• Provide substantial input into evaluation activities.

• Make recommendations for continuing the project.

• Review and approve website content before launch and updates.

• Review and approve all key personnel.

• Communicate with you at least monthly through conference calls, technical assistance, and consultation.

• Review and provide feedback on all required performance assessment reports.

• Review and approve all required submitted data.

• Provide a structured approach to sharing, integrating, and actively applying improvement concepts, tactics, and lessons learned.

Substantial involvement relates to programmatic involvement, not administrative oversight.

Funding policies and limitations Limitations We do not allow the following costs:

• Pre-award costs.

• Matching requirements for any other federal funds or local entities.

• Services, equipment, or supports that are the legal responsibility of another party under federal, state, or tribal law, such as vocational rehabilitation or education services.

Step 1: Review the Opportunity 10

• Services, equipment, or supports that are the legal responsibility of another party under any civil rights law, such as modifying a workplace or providing accommodations that are required by law.

• Goods or services not allocable to the project.

• Supplanting existing state, local, tribal, or private funding for infrastructure or services, such as staff salaries.

• Construction.

• Capital expenditures for improvements to land, buildings, or equipment that materially increase their value or useful life as a direct cost, except with our prior written approval.

• Independent research and development, including their share of indirect costs. See 45 CFR 75.476.

• Funds related to any activity designed to influence the enactment of legislation, appropriations, regulations, administrative actions, or executive orders.

• Certain telecommunications and video surveillance equipment. See 2 CFR

200.216.

• Meals, unless in limited circumstances such as:

◦ For subjects and patients under study.

◦ Where specifically approved as part of the project or program activity, such as in programs providing children’s services.

◦ As part of a per diem or subsistence allowance provided in conjunction with allowable travel.

• Other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a state, local, or tribal government in policymaking and administrative processes within the executive branch of that government, funding awarded under this NOFO may not be used for:

◦ Paying the salary or expenses of any grant recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulations, administrative actions, or executive orders proposed or pending before Congress or any state government, state legislature, or local legislature or legislative body.

◦ Lobbying. However, awardees can lobby at their own expense if they can keep federal funds separate from their other financial resources used for lobbying.

• To pay for direct services to beneficiaries.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 11 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-E/subject-group-ECFR8a7b546124f3ead/section-75.476 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-C/section-200.216 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-C/section-200.216

• To pay for contracted evaluation services.

• Costs associated with enrolling individuals who are not eligible for federally funded Medicaid and/or CHIP.

For guidance on some types of costs that we restrict or do not allow, see 45

CFR part 75, General Provisions for Selected Items of Cost.

General policies

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Satisfactory progress in meeting your project’s objectives.

◦ A decision that continued funding is in the government’s best interest.

• If we receive more funding for this program, we will consider:

◦ Funding more applicants.

◦ Extending the period of performance.

◦ Awarding supplemental funding.

Indirect costs Indirect costs are costs you charge across more than one project that cannot be easily separated by project.

To charge indirect costs you can select one of two methods:

Method 1 — Approved rate. You currently have an indirect cost rate approved by your cognizant federal agency.

Method 2 — De minimis rate. Per 2 CFR 200.414(f), if you have never received a negotiated indirect cost rate, you may elect to charge a de minimis rate. If you are awaiting approval of an indirect cost proposal, you may also use the de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs.

This rate is 15% of modified total direct costs (MTDC). See 2 CFR 200.1 for the definition of MTDC. You can use this rate indefinitely.

Salary rate limitation The salary rate limitation in the current appropriations act applies to this program. As of January 2024, the salary rate limitation is $221,900. We will update this limitation in future years.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 12 https://www.ecfr.gov/current/title-45/part-75/subject-group-ECFR5d90ba314caea08 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Modified%20Total%20Direct%20Cost%20(MTDC))

Program income Program income is money earned as a result of your award-supported project activities. You must use any program income you generate from awarded funds for approved project-related activities. Find more about program income at 45 CFR 75.307.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 13 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307

Step 2:

Get Ready to Apply

In this step

Get registered 15

Find the application package 15

Join the webinar 16

Get registered SAM.gov You must have an active account with SAM.gov. This includes having a Unique

Entity Identifier. SAM.gov registration can take several weeks. Begin that process today.

To register, go to SAM.gov Entity Registration and select “Get Started.” From the same page, you can also select the “Entity Registration Checklist” for the information you will need to register.

When you register or update your SAM.gov registration, you must agree to the financial assistance general certifications and representations [PDF]. You must agree to those for grants specifically, as opposed to contracts, because the two sets of agreements are different. You will have to maintain your registration throughout the life of any award.

Grants.gov You must also have an active account with Grants.gov.

You can see step-by-step instructions at the Grants.gov Quick Start Guide for

Applicants.

Need help? See Contacts and Support.

Find the application package The application package has all the forms you need to apply. You can find it online. Go to Grants Search at Grants.gov and search for opportunity number

CMS-3Y3-25-001.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 15 https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf http://grants.gov/applicants/applicant-registration https://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/quick-start-guide/applicants http://grants.gov/search-grants

Join the webinar We will host two webinars to provide details about the Connecting Kids to

Coverage program and answer your questions about this funding opportunity.

The webinars will be held January 28 and February 13, 2025, from 1 to 2 p.m.

ET.

You can register for the webinar at CMS’s Zoom site.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 2: Get Ready to Apply 16 https://cms.zoomgov.com/webinar/register/WN_jNmIVEhYTsGNQMH-wWwQjA

Step 3:

Prepare Your Application

In this step

Application contents and format 18

Application contents and format

Component Submission format

Project abstract Use the Project Abstract Summary form.

Project narrative Use the Project Narrative Attachment form.

Budget narrative Use the Budget Narrative Attachment form.

Attachments Insert each in the Other Attachments form.

Other required forms Upload using each required form.

See requirements for other submissions.

Your organization’s authorized organizational representative (AOR) must certify and submit your application. The AOR is the person who can make legally binding commitments for your organization.

We will provide instructions on document formats in the following sections.

See completeness and responsiveness criteria to understand what may disqualify your application from consideration.

Project abstract Limit to one page. May be single-spaced. Follow other formatting requirements for the project narrative.

Write a one-page summary of your proposed project, including its purpose and outcomes. Do not include any proprietary or confidential information. We will use this document for information sharing and public information requests if you get an award. Include:

• The name of your organization.

• The names of any subrecipients or sub-awardee organizations, if applicable.

• Project goals.

• Total budget amount.

• A description of how you will use funds.

• If you are a current or previous CKC grantee, historical achievement on project enrollment and renewal goals.

Step 3: Prepare Your Application 18

Project narrative The project narrative is the most important part of your application and should clearly describe your proposed project. You must address the proposed goals, measurable objectives, and milestones in accordance with the instructions in the following sections.

See the merit review criteria to understand how reviewers will assess and score your project narrative.

Your project narrative should include:

• Targeted populations: Who are you going to serve?

• Proposed activities: What are you going to do?

• Project goals: What do you expect to achieve?

• Capabilities: Why are you qualified to serve the targeted populations?

• Work plan and timeline: What is your action plan to meet the project goals and carry out the proposed activities?

• Data collection plan: How will you collect data to demonstrate progress toward your project goals?

Targeted populations: Who are you going to serve?

• Describe the targeted populations, including geographic areas.

• Tribal applicants only: Clearly define the tribal populations for the project (federally recognized Indian tribes and geographic locations or counties).

• Provide data on the number or rate of uninsured children in the target population, as well as estimates of the number or percent of children eligible for Medicaid or CHIP.

◦ If such data does not exist, provide other demographic data that shows the target population’s need for health coverage. This could include poverty data, school lunch participation data, or other data.

• Identify barriers to enrolling and retaining the targeted population.

Proposed activities: What are you going to do?

• Describe the year-round outreach, application, and enrollment strategies and messaging that you will use to conduct the required activities:

◦ Identifying children likely to be eligible for these programs.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 19 https://www.shadac.org/news/2023-acs-tables-state-and-county-uninsured-rates-comparison-year-2022 https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html

◦ Educating families about the availability of free or low-cost health coverage under Medicaid and CHIP.

◦ Helping families, including parents and pregnant women, apply for and renew coverage.

• Describe how you will make the most of the following three important aspects of enrolling eligible children (and parents or pregnant women, if applicable) in Medicaid and CHIP:

◦ Outreach and enrollment at back-to-school time.

◦ Reminding families that they can enroll in Medicaid and CHIP year-round.

◦ Keeping eligible people insured under Medicaid and CHIP.

• Discuss where you will conduct outreach and enrollment activities and explain why you chose those settings.

• Describe how you will help families apply for and renew their enrollment in a culturally and linguistically appropriate manner.

• Describe how you will track and report on the number of children, parents, and pregnant women the project assists and the outcome of those interactions.

We encourage you to consider any of the following outreach strategies:

• Involving schools and other programs serving young people in outreach, enrollment, and retention activities.

• Targeting subgroups of children with lower-than-average health coverage rates (such as adolescents, Latino/as, American Indians or Alaska Natives, or children in rural areas) to bridge racial and demographic health coverage disparities.

• Creating application assistance resources to provide high-quality, reliable

Medicaid/CHIP enrollment and renewal services in local communities.

• Working with organizations that serve parents and children released from incarceration.

• Partnering with organizations that focus on children and families who are homeless or at risk of homelessness.

• Working with organizations that serve children with special health care needs, including mental health and behavioral health needs.

• Using social media to conduct virtual outreach.

• Recruiting and employing linguistically and culturally diverse staff from the local community.

Step 3: Prepare Your Application 20

• Partnering with other local and state health and human services programs and agencies to identify uninsured children and enroll them in coverage, such as:

◦ The Supplemental Nutrition Assistance Program (SNAP).

◦ Childcare agencies.

◦ Child welfare agencies.

◦ Head Start.

◦ The Special Supplemental Nutrition Program for Women, Infants, and

Children (WIC).

• Partnering with tribal programs that work with children and families.

• Using parent mentors and community health workers to help families enroll in Medicaid and CHIP, retain coverage, and find resources to address their health care needs.

Project goals: What do you expect to achieve?

Using the following table, develop project goals for all five budget years. The people you help must be eligible for federally funded Medicaid and/or CHIP.

You must consider the following in establishing your project goals:

• Size of the geographic areas where you will work.

• Size and health care needs of the populations you plan to serve.

• Amount of funding you are requesting for the budget periods and how you will use the funds to meet your goals.

Step 3: Prepare Your Application 21

Table: Project goals

As a direct result of CKC funding, number of: Year 1 Year 2 Year 3 Year 4 Year 5

Children who will apply for health coverage.

Children who will be newly enrolled in Medicaid or CHIP.

Children whose enrollment in Medicaid or CHIP will be renewed.

Parents who will apply for health coverage (if applicable).

Parents who will be newly enrolled in Medicaid (if applicable).

Parents who will renew their enrollment in

Medicaid (if applicable).

Pregnant women who will apply for health coverage (if applicable).

Pregnant women who will be newly enrolled in

Medicaid or CHIP (if applicable).

• Describe why these goals are achievable for your organization and service delivery area. Proposed goals must be realistic and supported by quantitative and qualitative data on your target population, including:

◦ Information on the number or percent of uninsured children, parents, and/or pregnant women in the community.

◦ Your ability to reach this population.

• You should only report on applications, enrollments, and renewals that are directly attributed to CKC funding. If you receive funding from another federal source conducting similar work, do not report the results of that work here.

When deciding on your goals, please consider the following.

• The emphasis of the CKC program is enrolling eligible children in

Medicaid and CHIP, but a large body of research finds that when eligible parents get enrolled in health insurance, their children are more likely to get enrolled and receive necessary preventive care.[1]

◦ This means that messaging and strategies that help enroll eligible parents can also lead to enrolling eligible children.

Step 3: Prepare Your Application 22

◦ Forty states and the District of Columbia have expanded their

Medicaid programs to cover more low-income adults. This provides an important opportunity to take a two-generation approach, helping parents apply for coverage as a way to get more eligible children enrolled.

• We encourage applicants to include pregnant women as a target population. Infants born to pregnant women who are enrolled in Medicaid or CHIP are automatically eligible for Medicaid or CHIP, so enrolling pregnant women also helps enroll newborn children.

Capabilities: Why are you qualified to serve the targeted populations?

Capacity to implement

• Describe your capacity to implement the proposed project. Include information about your:

◦ Level of knowledge about Medicaid and CHIP eligibility and enrollment procedures.

◦ Previous experience conducting health coverage outreach and enrollment activities.

◦ Capacity to reach target populations in your community.

• Include information about your experience conducting outreach and enrollment activities for other public benefit programs.

• Describe your readiness to implement the project, including how much time you will spend on start-up activities during the 90-day planning period.

Community partnerships

• Describe the community partnerships you plan to use. If you plan to use partners for this project, these partnerships should already be established. For each partner, please describe:

◦ Why you selected the partner.

◦ How you will monitor the partner’s activities.

◦ The partner’s compatibility with the goals of this program.

◦ The partner’s credibility.

◦ The partner’s former and current successes with outreach to the targeted populations.

◦ The partner’s readiness to implement the current project.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 23 https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map

Special considerations for applicants that represent collaborative efforts, if applicable

If you represent a collaborative, you must identify all member organizations and their roles and responsibilities. Your proposal must designate a lead organization that will serve as the funding recipient. Proposals from collaboratives will be considered on their strengths and merits in the same way as proposals from individual entities.

Proposals must include documentation of the collective. If applicable, this documentation must provide information about past joint endeavors. You can include either:

• A letter of commitment from the director (or other responsible person) of each organization participating in the collaborative as a subrecipient. The letter must confirm the organization’s participation in the collaborative and the role it will play.

• One statement of collaborative effort that lists each partner organization, the role it will play, and the signature of the director (or other responsible person).

Staffing plan

• Describe how you will staff the project, including the number of staff, their skills and credentials, how they will be recruited and retained, and their roles on the project.

• Include brief job descriptions and resumes for the project director and

AOR, if available.

◦ We require the project director to devote at least 25% of their time to this project. They will serve as the main point of contact and will be responsible for day-to-day project activities. They are expected to participate in key training activities we identify and fully cooperate and work collaboratively with us and all contractors associated with the cooperative agreement.

• Outline related work experience of the project director and other key personnel.

• State the percentage of time that each person will be working on this project and the percentage of time they will spend on duties outside this project.

• Describe how the project director will develop and provide on-the-job training and foster a team culture that promotes collegiality and collective achievement.

Step 3: Prepare Your Application 24

Planning period

• You will be given a 90-day planning period to ensure that needed project leadership has been hired, the participating employees are fully trained, and both leadership and employees are actively working on the project.

You can use grant money to employ individuals and begin operations during this time.

• We may waive or reduce the 90-day planning period if your outreach and enrollment efforts are well established and if your project leadership, staff, and support are already in place.

• We expect that 50% of the staff paid under the cooperative agreement, including the project director, will be hired and trained by the end of the

90-day planning period.

Work plan and timeline: What is your action plan to meet the project goals and carry out the proposed activities?

Your work plan should address all components of your project plan in your proposed activities section.

Your work plan should also align with your project goals. The work plan and timeline should document activities, realistic and achievable milestones, and timeframes that will enable you to achieve your stated goals. You should also identify who will be responsible for each activity.

• As an attachment, provide a chart, table, or graph depicting a realistic timeline with goals and objectives that align with your proposed project narrative for the first budget period.

• See the work plan attachment section for more details about what to include.

Data collection plan: How will you collect data to demonstrate progress toward your project goals?

• Describe clearly how you will collect the required data and verify the number of new Medicaid and CHIP enrollments, renewals, and denials resulting from your CKC funding.

◦ Describe whether you have used this collection and reporting plan before and how it has been successful.

◦ If it is a new plan, describe why you chose this plan, what obstacles you may encounter, and how you will quickly address these obstacles.

Step 3: Prepare Your Application 25

◦ Also describe any nonrequired data or metrics the project will collect and report, why the data is useful, and how you will collect, report, and use it.

• Describe how you will ensure that you are only reporting data on applications, enrollments, renewals, and denials that arose from this cooperative agreement.

◦ If your staff is partly funded by this cooperative agreement, describe how you will determine what percentage of their results can be attributed to this grant.

• Describe how you will ensure the accuracy of any data reported by subrecipients.

◦ Describe how you will monitor subrecipients during the entire period of performance to ensure that they use the most effective strategies, and how you will resolve any obstacles that could prevent you from reaching your goals.

• Discuss what data you will use to determine whether you are meeting your goals and whether you need to make changes during the project to remain on course.

◦ Discuss how you would make these changes.

◦ Discuss how you will assess your progress and your subrecipients, recognize any obstacles, and implement course corrections in a timely fashion.

• Describe how you will verify your data submissions.

◦ The best way to verify data is with the state or county Medicaid or

CHIP agencies. This typically requires you to establish a detailed memorandum of understanding (MOU) or other data-sharing agreement with your state or county agency. This would allow you to submit detailed identifying information about the people you have assisted and receive verification of their enrollment status.

◦ If you are not a state entity, you must describe your plan to secure an

MOU or other data-sharing agreement with the state or county agencies within 120 days after you have been awarded the cooperative agreement.

◦ We recognize that it may not always be possible to obtain data from state or county sources. Therefore, all nonstate applicants must also describe alternative methods for verifying new enrollments and renewals that do not depend on cooperation by state or county agencies and that you can implement with the requested funding.

Step 3: Prepare Your Application 26

◦ If you do not obtain an MOU or create and implement a well-designed and effective alternative data methodology within 120 days from the date of the award, we may terminate the award.

Required format for project narrative Page limit: 40, excluding attachments

Endnotes are not included in the page limit.

File name: Project Narrative

File format: PDF

Font size: 12-point font

Font color: Black

Footnotes and text in graphics may be 10-point.

Spacing for project abstract, tables, and footnotes: Single-spaced

Spacing for main content: Double-spaced

Margins: 1-inch

Page size: 8.5 x 11

Include consecutive page numbers throughout.

Step 3: Prepare Your Application 27

Budget narrative The budget narrative supports the information you provide in Standard Form

424-A. See other required forms.

It includes added detail and justifies the costs you ask for. As you develop your budget, consider:

• If the costs are reasonable and consistent with your project’s purpose and activities.

• The restrictions on spending funds. See funding policies and limitations.

HHS now uses the definitions for equipment and supplies in 2 CFR 200.1. The new definitions change the threshold for equipment to the lesser of the recipient’s capitalization level or $10,000 and the threshold for supplies to below that amount.

To create your budget narrative, see detailed instructions and a template on our website.

In your budget narrative, you will:

• Identify a project director who will dedicate sufficient time and effort to manage and provide oversight of the program.

• Include a yearly breakdown of costs for each line item in your SF-424A.

• Describe the proposed costs for each activity or cost within the line item.

• Define the proportion of the requested funding you will spend on each activity.

• Justify the costs and describe how you calculated them.

• Explain how you separate costs and funding administered directly by you, as the lead agency, from funding you subcontract to other partners.

• Be clear about how costs link to each activity and the goals of this program.

• Mention any outside funding that other entities will contribute.

• For states: Make sure the state funds you spend on outreach and enrollment activities during the period of performance are not less than the amount you spent in the federal fiscal year before the first fiscal year of the grant.

• Attest that you will not finance the same scope of work under more than one CKC award or other federal or nonfederal funding stream.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 28 https://www.ecfr.gov/current/title-2/part-200#p-200.1(Equipment) https://www.ecfr.gov/current/title-2/part-200#p-200.1(Supplies) https://www.cms.gov/about-cms/work-us/grants-cooperative-agreements/how-apply-cms-grants/budget-and-budget-narrative

For the first- and third-year budget periods only: Submit budget estimates for one or two employees to attend a two-day in-person meeting in the

Baltimore, Maryland, area.

Note that you will only be allowed to spend $6,000 per budget period on promotional items and incentives, subject to prior approval by CMS.

Promotional items and incentives must be consistent with grants guidance and regulations.

• For existing AI/AN 2023 recipients only: Provide a detailed budget that clearly supports the proposed activities for the first 15-month budget period and includes a high-level summary of budget costs for Years 3 through 5.

Required format for budget narrative Page limit: 10

File name: Budget Narrative

File format: PDF

Font size: 12-point font

Font color: Black

Margins: 1-inch

Page Size: 8.5 x 11

Include consecutive page numbers throughout.

Step 3: Prepare Your Application 29

Attachments You will upload attachments in Grants.gov using the Other Attachments form.

Work plan Provide a chart, table, or graph depicting a realistic timeline with goals and objectives that are consistent with those outlined in your proposed project narrative.

Your work plan and timeline should cover the first budget period.

• For most applicants, this is a 12-month period from July 1, 2025, to June

30, 2026.

• If you are a CKC AI/AN 2023 grantee, your first budget period will be the

15-month period from April 1, 2026, to June 30, 2027.

The work plan should document key activities, associated timeframes, and responsible staff. It must align with your project plan and project goals.

The work plan should include:

• Program goals: Indicate the overall purpose of the project. This may include quantitative goals.

• Targeted populations and proposed geographic service areas: Indicate who you will serve and where you will provide services.

• Objectives: Define how you will achieve your program goals through the activities laid out in your project plan.

• Activities: Identify the tasks required to achieve your project goals.

• Timeframes: Indicate the duration of each activity.

• Outcomes: Identify how you will measure the success of your activities by the end of the budget period.

• Target numbers: Include your targets for each outcome.

Two sample work plan templates are provided here as guides. They show how you can outline program goals for your work plan in the first budget period.

Step 3: Prepare Your Application 30

Year 1 Work Plan: Sample 1 Program goal: To enroll/retain 9,817 children, 3,355 parents, and 2,082 pregnant women in the Medicaid/CHIP program.

Targeted populations and geographic service area: Children, parents, and pregnant women in Florida (statewide).

Objective: Enrollment/retention activities will be designed to support and encourage communities through a multipronged approach, maximizing strategies that have proven to be effective at the local level.

Timeframe: July 1, 2025, to June 30, 2026

Table: Work plan sample 1 activities, target numbers, and staff

Activities Target numbers Responsible staff

Provide direct assistance through referrals from community partners and in-reach activities to newly eligible families.

Year one:

1,930 children

623 parents

265 pregnant women

Project director and their staff, and five local subcontracted partners.

Identify and train, in-person and virtually, new application sites.

10 new sites Project director and their staff.

Help families with application issues.

100% of families will be assisted by project staff on their post-application issues.

Project staff and five local subcontracted partners.

Outcomes:

• # of targeted populations enrolled.

• # of new sites identified.

Step 3: Prepare Your Application 31

Year 1 Work Plan: Sample 2 Program goal: Collaborate on enrollment efforts with Denali KidCare partners and staff, create partner workshops, and conduct community outreach strategies to increase awareness.

Targeted populations and geographic service area: Children, parents, and pregnant women in Alaska (statewide).

Objective: Increase awareness about Denali KidCare.

Timeframe: July 1, 2025, to June 30, 2026

Table: Work plan sample 2 activities, target numbers, and staff

Activities Target number Responsible staff

Formalize collaborative partnerships to maximize outreach and education.

62 partnerships Project director and their staff, and five local subcontracted partners.

Conduct community partner workshops on using Denali

KidCare knowledge and best practices for increasing enrollment and retention.

40 community partner workshops

Project staff.

Participate in school-, hospital-, and community-based events to promote Denali KidCare.

113 community events

6,250 individuals reached

Project staff and five local subcontracted partners.

Outcomes:

• # of community partner workshops.

• # of community events and individuals reached.

Step 3: Prepare Your Application 32

Indirect cost agreement If you include indirect costs in your budget using an approved rate, include a copy of your current agreement approved by your cognizant agency for indirect costs. If you use the de minimis rate, you do not need to submit this attachment.

Proof of nonprofit status If your organization is a nonprofit, you need to attach proof. We will accept any of the following:

• A copy of a current tax exemption certificate from the IRS.

• A letter from your state’s tax department, attorney general, or another state official saying that your group is a nonprofit and that none of your net earnings go to private shareholders or others.

• A certified copy of your certificate of incorporation. This document must show that your group is a nonprofit.

• Any of these documents for a parent organization. Also include a statement signed by an official of the parent group stating that your organization is a nonprofit affiliate.

Resumes and job descriptions For key personnel, attach resumes for positions that are filled. If a position isn’t filled, attach the job description with qualifications.

Business assessment of applicant organization Maximum 12 pages, single-spaced.

We must assess your organization’s risk before we can make an award. This analysis includes your organization’s:

• Financial stability.

• Quality of management systems.

• Internal controls.

• Ability to meet the management standards prescribed in 45 CFR Part 75.

For us to complete your assessment, you must review, answer, and attach the business assessment questions found on our website at Business Assessment of Applicant Organization [PDF].

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 33 https://www.ecfr.gov/current/title-45/part-75#p-75.2(Cognizant%20agency%20for%20indirect%20costs) https://www.ecfr.gov/current/title-45/part-75#p-75.2(Cognizant%20agency%20for%20indirect%20costs) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://www.cms.gov/files/document/business-assessment-template-revised.pdf https://www.cms.gov/files/document/business-assessment-template-revised.pdf

Letter of commitment or statement of collaborative effort (if applicable) Provide one of the following:

• A letter of commitment from the director (or other responsible person) of each organization participating in the collaborative as a subrecipient. The letter must confirm the organization’s participation in the collaborative and the role it will play.

• One statement of collaborative effort that lists each partner organization, the role it will play, and the signature of the director (or other responsible person).

Other required forms You will need to complete four other required forms. Submit the following required forms through Grants.gov. You can find them in the NOFO application package or review them and their instructions at Grants.gov Forms. .

Form Submission requirement

Application for Federal Assistance

(SF-424)

With the application. See extra instructions in the next section.

Budget Information for Non-

Construction Programs (SF-424A)

With the application.

Disclosure of Lobbying Activities (SF-

LLL)

With the application.

Project/Performance Site Location(s)

Form

With the application.

Extra instructions for SF-424: Application for Federal Assistance

• To write your Descriptive Title of Applicant’s Project in Item 15, see the

Descriptive Title of Applicant’s Project instructions on our website.

• Check “No” to item 19c. State that review under Executive Order 12372 does not apply.

• Your AOR must electronically sign this form. When the AOR authorizes an application, they agree to assume all award obligations.

1. Review 2. Get Ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 3: Prepare Your Application 34 https://grants.gov/forms/forms-repository/sf-424-individual-family https://www.cms.gov/about-cms/work-us/grants-cooperative-agreements/how-apply-cms-grants https://www.archives.gov/federal-register/codification/executive-order/12372.html

Pre-award requirements None.

Step 3: Prepare Your Application 35

Step 4:

Learn About Review and Award

In this step

Application review 37

Award notices 42

Application review Initial review We review each application to make sure it meets basic requirements.

We will review your application to make sure that it meets both the completeness criteria and the responsiveness criteria. If your application does not meet these criteria, we will not move it to the merit review phase.

We will not review any pages that exceed the page limit.

Merit review A merit review panel reviews all…