FOA Content HRSA-26-057 .pdf

Notice of Funding Opportunity

Application due 07/10/2026

Maternal and Child Health Bureau Division of Home Visiting and Early Childhood Systems

Early Childhood Comprehensive Systems SEED Project: Scaling Effective Early Childhood Systems Development (ECCS SEED) Opportunity number: HRSA-26-057

Contents Before you begin 3

Step 1: Review the Opportunity 4 Basic information 5

Eligibility 7

Program description 9

Award information 19

Step 2: Get Ready to Apply 22 Get registered 23

Find the application package 23

Application writing help 24

Step 3: Build Your Application 25 Application checklist 26

Application contents and format 28

Step 4: Understand Review, Selection, and Award 41 Application review 42

Selection process 47

Award notices 48

Step 5: Submit Your Application 49 Application submission and deadlines 50

Other submissions 50

Step 6: Learn What Happens After Award 51 Post-award requirements and administration 52

Reporting 55

Contacts and Support 57

Appendices 60

Endnotes 71

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 07/10/2026.

All activities proposed in your application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate: racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 7

Program description 9

Award information 19

Basic information Health Resources Services Administration

Maternal and Child Health Bureau

Division of Home Visiting and Early Childhood Systems

This program will improve access to quality health and human services for families who are expecting a baby, or have children up to age 5. Funding “seeds” community projects to establish scalable and sustainable systems of care that serve eligible families.

Summary The Early Childhood Comprehensive Systems: Scaling Effective Early Childhood Systems Development (ECCS SEED) Initiative will advance the U.S. Department of Health and Human Services’ Make America Healthy Again (MAHA) priorities by preventing chronic disease and improving early childhood health and development.

ECCS SEED will fund eligible entities to connect families to evidence-based health services in their communities. Parent leaders and state and local partners will guide this work to ensure services meet families’ needs.

ECCS SEED will:

1. Establish or expand Coordinated Intake and Referral Systems (CIRS).

• CIRS gives families an easy single-entry point to assess their health needs and efficiently connect them to services that support healthy children and families.

2. Implement evidence-based early childhood health and development models in high-need communities.

• Evidence-based early childhood development models improve health and well-being for both parents and their young children and prevent chronic disease.

Models are implemented community-wide in pediatric or public health settings, including those in rural areas.

3. Lead effective state-level early childhood coordination.

• Effective state-led coordination improves how health care, early learning, family services, and economic support agencies work together to support healthy early childhood development. State-led coordination also expands successful approaches to additional communities in the state, Tribe, or territory.

Have questions?

Go to Contacts and Support.

Key facts Opportunity name:

Early Childhood Comprehensive Systems SEED Project: Scaling Effective Early Childhood Systems Development

(ECCS SEED)

number:

version:

Initial

93.491

Key dates

6/08/2026 webinar:

deadline:

07/10/2026

09/30/2026

09/30/2026

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

4. Achieve sustainability.

• Align project activities with other local, state and federal funding sources so that longer-term funding can sustain the work in the future.

Through these areas of focus, ECCS SEED will show measurable improvements in family health outcomes to ensure children grow up in healthy, safe, and nurturing families and communities.

Funding details Application type: New

Expected total available funding in FY 2026: $7,000,000

Expected number and type of awards: 8 Cooperative agreements

Funding range per award: Up to $875,000

We plan to fund awards in five 12-month budget periods for a total five-year period of performance from 09/30/2026 to 07/31/2031.

Eligibility You can apply if your organization is a domestic public or private entity, including an Indian tribe or tribal organization, as those terms are defined in 25 U.S.C. § 5304 (formerly 25 U.S.C. § 450b). See 42 CFR § 51a.3(a). If funded, for-profit organizations are prohibited from earning profit from the federal award (see 2 CFR 200.400(g)).

Types of eligible organizations These types of domestic organizations may apply:

• State governments.

• 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)

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

• Nonprofits having a 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.

• Private institutions of higher education.

• For profit organizations other than small businesses.

• Small businesses.

• Others. (see text field entitled “Additional Information on Eligibility” for clarification)

Additional information on eligibility “Domestic” means the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

Individuals are not eligible applicants under this NOFO.

https://www.ecfr.gov/current/title-2/part-200#p-200.400(g)

Completeness and responsiveness criteria We will review your application to make sure it meets these basic requirements to move forward in the competition.

We will not consider an application that:

• Is from an organization that does not meet all eligibility criteria.

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

• Is submitted after the deadline.

• Does not include all required application forms and attachments described in the application checklist.

Application limits You may not submit more than one application. If you submit more than one application, we will only accept the last on-time submission.

Cost sharing This program has no cost-sharing requirement. If you choose to share in the costs of the project, we will not consider it during merit review. Recipients agree that once committed, cost sharing amounts are enforceable and subject to reporting and auditing requirements under 2 CFR 200.

Post-award requirements Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

Program description Purpose The Early Childhood Comprehensive Systems: Scaling Effective Early Childhood Systems Development (ECCS SEED) Initiative will improve access to quality care for prenatal-to-age-5 (P-5) families. It will promote healthy child development and family well-being by identifying family needs early – like mental health support, parenting education, food or housing assistance – and connecting both children and caregivers to high-quality services. These services are critical because children’s early years shape their health for life.

Effective systems of care for P-5 families:

• Boost families’ strengths through parenting education that help build positive, nurturing relationships between parents and their children.

• Improve efficiencies in health systems by detecting and addressing developmental concerns among young children through timely screening and referrals to early intervention.

• Address the root causes of chronic disease early in life by reducing stressors and connecting families to services, such as mental health care, nutrition assistance, and stable housing.

• Support[1] flourishing among young children by promoting preventive care and healthy child development, and track progress on child health outcomes.

Centralized Intake and Referral Systems (CIRS) ECCS SEED recipients will establish or expand centralized intake and referral systems (CIRS) for P-5 families that offer easy, timely screenings of families’ health needs, starting in pregnancy, and connect families to appropriate resources. This includes addressing parents’ concerns for their kids and linking them to services that prevent chronic health issues, such as regular well-child visits, early intervention, WIC[2], housing supports, and more. ECCS SEED recipients will work toward making CIRS services universally accessible to all P-5 families in their state and will increase CIRS participation by health and family service providers. CIRS improves health at a population level.

Evidence-based early childhood health and development community models ECCS SEED recipients will select one high-need community of focus[3] and implement an evidence-based early childhood health and development model in that community.

These models offer parenting education and whole family (parent and child) health screenings, and support timely well-child visits. They are offered in places that are easy for pregnant women and families with young children to access, such as their homes, pediatric care practices, or community-based settings. See Appendix C for examples of evidence-based early childhood health and development models. ECCS SEED recipients will work toward making the selected model universally accessible to all P-5 families in the community.

State-level early childhood coordination Guided by family experiences, ECCS SEED recipients will support state-level leadership and early childhood coordination so that state and local agencies that serve P-5 families work together to better support early childhood health and development. This approach brings together health care providers, child care and early learning providers, human service agencies, and family leaders into a cross-sector system that is easy for P-5 families to navigate and meets their health needs.

Achieve program sustainability ECCS SEED recipients will develop a sustainability plan and secure funding to maintain project activities beyond the period of performance. This includes aligning the ECCS SEED project with longer-term funding streams that could sustain and expand specific ECCS SEED activities. Examples of other funding streams could include Medicaid/CHIP, Title V Maternal and Child Health Services Block Grant (Title V), Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV), state general funds, public-private partnerships or philanthropic funds.

Program goals ECCS SEED will support a comprehensive standard of care for all P-5 families that builds family strengths, provides preventive care and education, conducts whole family (caregiver and child) screenings, connects P-5 families to services, and ensures families can access intensive interventions when needed. Through this work, ECCS SEED is designed to achieve measurable improvements in child flourishing.[4]

The program goals are to:

• Increase access to coordinated, comprehensive care for P-5 children and families.

• Improve the quality of services to meet the health needs of both parents/caregivers and children during the P-5 period.

Program objectives

• Establish or expand centralized intake referral systems (CIRS), working toward statewide reach.

◦ 80% of unique families (counted once, not duplicated) connected to CIRS have been screened for whole family (parent and child) health needs.

◦ 60% of unique children (9-30 months) connected to CIRS (counted once, not duplicated) have received timely developmental screening using a validated parent-completed tool.

• Implement an evidence-based early childhood development model in pediatric or public health settings in your community of focus.

◦ All identified pediatric or public health providers in your community of focus have implemented the model.

◦ 60% of P-5 families served by the model have received a timely well-child visit.

• Lead statewide coordination of P-5 early childhood systems.

◦ You have convened state and local cross-sector partners and trained parent leaders, and engaged both in decision-making.

◦ You have developed and implemented state and local guidelines and policies to improve early childhood health and development, and P-5 family well-being.

• Secure long-term and sustainable funding to spread project activities statewide.

◦ You have obtained at least one other source of funding to expand or enhance ECCS SEED activities.

◦ You have obtained other sources of funding to sustain successful ECCS SEED activities.

Background History The ECCS SEED supports state capacity and infrastructure building to coordinate community early childhood systems. ECCS SEED advances CISS priorities including:

expanding maternal and infant health home visiting programs; increasing obstetrician and pediatrician participation in state Title V and Medicaid plans; developing capacity of maternal and child health centers; serving rural populations; and expanding outpatient and community-based service programs for children with special health care needs.

Since 2002, the ECCS Program has funded efforts to coordinate statewide, cross-sector early childhood systems to improve early childhood health outcomes. Over time, ECCS has helped states:

• Strengthen cross-sector collaboration.

• Involve families with young children in strategic planning.

• Develop governance structures that reflect family and community needs.

Over time, ECCS transformed early childhood systems by making parent voice central in decision-making. Between 2021 and 2024, family participation in state early childhood program planning grew fivefold from 86 to 463 parents. ECCS funding increased access to P-5 services, helping states identify and address early signs of child developmental delays and chronic health issues, while promoting whole family well-being.

ECCS SEED represents the next evolution of the ECCS program. ECCS SEED moves from solely supporting statewide efforts to “seeding” community-wide projects, backed by state leadership, to establish impactful and scalable systems of care for P-5 families in high-need communities, including in rural areas. Both state and local components of ECCS SEED build on activities included in previous ECCS-funded statewide early childhood strategic plans.

Need The period from pregnancy through age five (P-5) is crucial for healthy child development.[5] Early experiences and relationships shape health across the lifespan.[6]

During this time, however, many pregnant women and parents of young children feel stressed and overwhelmed. These challenges can make it harder for caregivers to provide safe, stable, nurturing relationships (known as early relational health - see Appendix A) that young children need to thrive.[7],[8] Negative experiences in early childhood are linked to health problems later in life, including heart disease, diabetes, and other chronic diseases.

Missed opportunities to identify developmental delays early can affect children’s health and development, school readiness, and long-term well-being.[9] Some communities face additional barriers to health and well-being because of geographic isolation and fewer services available,[10] such as tribal communities, rural/frontier areas, and communities with high rates of infant mortality.

Evidence shows that identifying and addressing child, family, and community risk factors early in life can prevent chronic disease and behavioral health conditions and promote lifelong health.[11] Family-centered interventions that assess needs and connect families to health care, early learning, and human services can reduce stress and challenges in the home, and help parents better support and bond with their young children.

Despite this evidence, gaps in services often limit families’ access to comprehensive preventive care during the P–5 period. Limited coordination across health, early childhood, and social service systems leads to inefficiencies that burden families, providers, and public and private health care payers. High-quality, coordinated state and local maternal and early childhood systems of care can better connect families to a full range of supports that promote well-being.[12] CIRS during the P-5 period can identify family needs early and increase efficient referrals to appropriate clinical and community supports.[13]

Health providers play a critical role in effective CIRS. When health providers connect parents to clear referral pathways and follow-up to ensure receipt of care, families are more likely to access evidence-based services. This coordinated approach leads to improved child development, stronger family functioning, and better long-term health outcomes compared to fragmented or lower-quality care.[14] In addition, a range of evidence-based models implemented in pediatric and community-based settings have been shown to significantly improve child and family health.[15] When implemented across a community and guided by family input, these models can help improve population-level outcomes for children and families.[16],[17]

Program requirements and expectations Application requirements Successful applicants will demonstrate state, Tribe, or territory leadership and the ability to work across sectors to implement, learn from, spread, and sustain efforts that strengthen early childhood systems for P-5 families. You are expected to:

• Advance and coordinate state-level systems implementation and policy.

• Secure and collaborate with community partners.

• Engage families in program design and implementation.

• Use data to support continuous quality improvement.

• At a minimum, successful applicants will involve these key sectors:

◦ Clinical and public health.

◦ Early care and education.

◦ Human services, including food and housing assistance.

For the purposes of this NOFO, HRSA defines community-level efforts as activities implemented among all P-5 families within a selected community of focus. Your community of focus must be a county, multiple counties, county equivalent(s), or a comparable geographic area for Tribal or territory applicants. You must identify community-specific data sources for your proposed community of focus to establish baseline process and outcome measures, as described below, and to meet annual performance reporting requirements.

A funding preference will be given to applicants focusing on local implementing communities with high-infant mortality rates.

Core activities Successful ECCS SEED recipients will accomplish the following:

Core activity 1: Establish or expand Coordinated Intake and Referral Systems (CIRS).

• Establish new or expand existing CIRS to assess and respond to the needs of P-5 families - Build referral pathways among health providers and other family-serving systems to improve systems navigation and care coordination for P-5 families.

• Increase reach - Establish CIRS within your community of focus and work towards statewide expansion adding new providers each year, particularly health providers.

• Track and achieve outcomes - Use CIRS to:

◦ Increase screenings of whole family needs.

◦ Improve timely child developmental screenings.

◦ Monitor referral completion.

◦ Improve service coordination.

◦ Reduce wait times between intake, referral and service delivery.

Core activity 2: Implement an evidence-based early childhood health and development model.

• Implement community-wide - In your community of focus, work with clinical providers and/or public health organizations to implement an evidence-based model that promotes nurturing parent-child relationships, supports healthy child development, and provides preventive education to parents. Examples include Reach Out and Read, Family Connects, and Infant Early Childhood Mental Health Consultation (IECMHC), among others. See Appendix C for a list of additional models.

◦ Implement across multiple settings and providers within the community of focus, in locations familiar to P–5 families, such as homes, community health centers, pediatric practices, WIC offices, or local health departments. Select a model responsive to community needs, informed by family input and local data, and work toward serving all P–5 families within the community of focus.

• Track and achieve outcomes – Use the model to:

◦ Increase timely well-child visits.

◦ Promote child flourishing in P-5 families.

◦ Increase the number of parents and their children served by the model.

◦ Train, support, and monitor providers to ensure high-quality implementation.

Core activity 3: Lead state-level early childhood systems (ECS) coordination.

• Provide strategic statewide ECS leadership – Lead and coordinate statewide early childhood systems efforts to align ECCS SEED activities with broader ECS strategic plans.

• Engage parent and caregiver leaders – Engage, train and compensate parents and caregivers with experience navigating early childhood services in program design, implementation, and decision-making.

• Facilitate ECS cross-sector collaboration – Bring together statewide ECS partners across health, early care and education, and human services to identify and address systems gaps, reduce duplication and administrative burden, increase efficiency, and improve the care for P-5 families. Use existing early childhood advisory groups when appropriate and include Tribes/Tribal Organizations as applicable. Other example partners are listed in Appendix B.

• Develop policies and guidelines – Develop or update state and local administrative policies and guidelines to improve early childhood health and development and P-5 family well-being. Examples include: developing ways to bill for P-5 family services in new settings, establishing governance structures that include paid family leaders, creating incentives for high-quality pediatric medical homes, or developing cross-sector data sharing agreements.

• Provide Technical Assistance (TA) and use Continuous Quality Improvement (CQI) –

◦ For CIRS implementation: Provide TA and CQI to support implementation, expansion, and sustainability of CIRS informed by family and provider experience data.

◦ For community-wide early childhood development model implementation:

Build provider capacity to tailor and implement the evidence-based model effectively, documenting lessons learned to inform expansion and sustainability efforts. Use CQI, including family and provider experience data, to improve timely well-child visits and child flourishing in P-5 families.

Engage partners in CQI, including community service providers, families served, model developers (as appropriate), and experts in CQI methods.

Core activity 4: Secure long-term, sustainable funding.

• Pursue sustainability - Plan for sustainability early by identifying long-term funding sources to support CIRS and community-based early childhood development models. Potential sources may include state funds, philanthropic or private funding, Medicaid or CHIP, Title V, or MIECHV. See Appendix C for additional examples of sustainability strategies.

• Obtain sustainable funding for successful activities - Throughout award period, transition from ECCS SEED funds to sustainable funding sources to support successful project activities.

Performance measurement, evaluation, and continuous quality improvement Successful applicants will:

• Set up data collection systems within 6 months of award and confirm baseline estimates with HRSA.

• Maintain robust Continuous Quality Improvement (CQI) and performance measurement to track progress, support accountability, and inform improvements at state and community levels. Identify processes and mechanisms for continuous learning through data-informed quality improvement. This may include:

◦ Outlining a feedback loop that uses family experiences and outcomes to inform ECCS SEED strategy, administrative policies, model implementation, and resource allocation.

◦ Using validated tools to track data and inform CQI cycles both statewide and at community levels. See Appendix D for examples.

◦ Tracking progress toward all ECCS SEED objectives and outcomes.

Required reporting You will report progress towards program objectives to HRSA annually through the Discretionary Grant Information System (DGIS).

You will also complete progress reports with qualitative and quantitative elements, and requests for information, as required. HRSA will provide additional reporting instructions after awarding funds. *Represent questions asked in progress reports.

You will provide baseline estimates for select measures in your application and confirm or update those estimates within 6 months post award. See the Performance Reporting and Evaluation for more information.

Performance measures successful applicants will track Establish or expand CIRS.

• Number of TA activities for CIRS implementation, by audience and method.

• Number of unique families who have used the CIRS.*

• Number of unique providers who have used the CIRS.*

• Number of referral sources represented in CIRS, by type.*

◦ Referral source types will be categorized as health, early care and education, and human services.*

• Average amount of time between whole family health screening and referral process through CIRS.*

• Percentage of unique families connected to the CIRS with whole family health needs screened.

◦ Whole family health needs will be categorized as health, early care and education, and human services.

• Percentage of children (aged 9–30 months) connected to the CIRS with a timely developmental screening using a validated parent-completed tool, as aligned with MIECHV.

https://mchb.hrsa.gov/data-research/discretionary-grants-information-system-dgis https://mchb.hrsa.gov/sites/default/files/mchb/programs-impact/performance-indicators-sys-outcomes-summary.pdf

• Percentage of unique families connected to the CIRS with appropriate services received.

Implement an evidence-based model in pediatric or public health settings in your community of focus.

• Percentage of trained providers reporting increased knowledge on the model.

• Percentage of trained providers reporting action steps towards model implementation, collected one-month post-training.

• Number of P-5 families in the community of focus reached via the implemented model.*

• Percentage of children (aged 6 months–5 years) reached via the implemented model that are flourishing, as aligned with the National Survey of Children’s Health.

• Percentage of children (aged 0–5 years) reached via the implemented model who received a timely well-child visit, as aligned with MIECHV.

State-level coordination of P-5 ECS.

• Number of guidelines and policies developed and implemented.

• Number of individuals, organizations, and localities implementing guidelines and policies.

• Number of family members engaged in program development and evaluation.

Secure long-term, sustainable funding.

• Percentage of ECCS SEED funding allocated for direct/enabling services or systems-level activities.

• Other sources of funding for ECCS SEED activities and dollar amount secured from each source.

• Number of communities across state reached via CIRS.*

Statutory authority The ECCS SEED program is authorized by 42 U.S.C. § 701(a)(3) (Title V, § 501(a)(3) of the Social Security Act).

https://nschdata.org/browse/survey/results?q=10092&r=1 https://nschdata.org/browse/survey/results?q=10092&r=1 https://mchb.hrsa.gov/sites/default/files/mchb/programs-impact/performance-indicators-sys-outcomes-summary.pdf

Award information Cooperative agreement terms Our responsibilities Aside from monitoring and technical assistance, we also get involved in these ways:

• Participate in the planning and development of all phases of this cooperative agreement.

• Participate, as appropriate, in relevant meetings, committees, conference calls, and working groups related to the cooperative agreement and its projects to provide strategic input and support alignment with federal goals.

• Review plans for activities, procedures, measures, and tools for accomplishing the goals of the cooperative agreement.

• Assist to support collaboration with federal and state contacts, HRSA-funded grants, and other entities.

• Participate with award recipients in peer-to-peer information exchange and the dissemination of project findings, best practices, and lessons learned from the project.

Your responsibilities You must follow all relevant laws and policies. Your other responsibilities will include:

• Work with the federal project officer during the award to refine data and reporting plans to align with the ECCS SEED performance measurement approach.

• Collaborate with HRSA on CQI efforts, including responding to surveys, participating in interviews, and providing other reports upon request.

• Participate in peer networking and other TA opportunities.

• Provide advanced notice of any publications or materials produced, giving the federal project officer the opportunity to review, discuss, and provide input on any publications, audiovisuals, and/or other materials produced as part of the project (drafts and final products).

Funding policies and limitations Changes in HHS regulations As of October 1, 2025, HHS has adopted 2 CFR Part 200, with some modifications included in 2 CFR Part 300. These regulations replace those in 45 CFR Part 75.

Policies

• To make an award, funding must be available and allocated for this program and purpose, at which point we will move forward with the review and award process.

• Have clear policies and good financial practices to avoid spending HRSA funds on unallowable activities. Like other award rules, we may audit your policies, procedures, and controls.

• Support beyond the first budget year will depend on:

◦ Appropriation of funds.

◦ Your satisfactory progress in meeting the project’s objectives.

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

• If we receive more funding for this program, we may:

◦ Fund more applicants from the rank order list.

◦ Extend the period of performance.

◦ Award supplemental funding.

General limitations

• For guidance on some types of costs we do not allow or restrict, see:

◦ Project Budget Information in the Application Guide.

◦ 2 CFR Part 200 Subpart E - General Provisions for Selected Items of Cost.

◦ Allowable and Unallowable Costs and Activities, in the HHS Grants Policy Statement.

• All costs must be reasonable, necessary, allocable to the award, and adequately documented (2 CFR 200.403).

• You cannot earn profit from the federal award. See 2 CFR § 200.400(g).

• Current appropriations law includes a salary limit of $228,000 as of January 2026 that applies to this program. You may pay salaries at a higher rate if the rate beyond the salary rate limit (Executive Level II) is paid with non-HHS funds. For help calculating salaries under this limit, read more at “salary rate limitation” in the Two-Tier Application Guide [PDF].

https://www.ecfr.gov/current/title-2/part-200 https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=13 https://www.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.hhs.gov/sites/default/files/hhs-grants-policy-statement-april-2025-archived.pdf#page%3D81 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.404 https://www.ecfr.gov/current/title-2/section-200.405 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRea20080eff2ea53/section-200.403 https://www.ecfr.gov/current/title-2/part-200#p-200.400(g) https://www.hrsa.gov/sites/default/files/hrsa/grants/two-tier-application-guide.pdf#page%3D17

Indirect costs Indirect costs are costs you charge across more than one project that cannot be easily separated by project. For example, this could include utilities for a building that supports multiple projects.

To incur 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 at the time of award.

Method 2 – De minimis rate. Per 2 CFR § 200.414(f), if you do not have a current negotiated indirect cost rate, you may elect to charge a 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 up to 15% of modified total direct costs (MTDC). See 2 CFR § 200.1 for the definition of MTDC. You can use this rate indefinitely for all your federal awards or until you choose to receive a negotiated rate.

Consider your indirect costs when developing your budget.

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 2 CFR 200.307.

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)) https://www.ecfr.gov/current/title-2/section-200.307

Step 2:

Get Ready to Apply

Get registered 23

Find the application package 23

Application writing help 24

Get registered SAM.gov You must have an active account with SAM.gov to apply. 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.

• You must agree to the financial assistance general certifications and representations specifically. Those for contracts are different.

When you register, you will also receive your required Unique Entity Identifier (UEI).

Once you register:

• You will have to maintain your registration throughout the life of any award.

• If your organization has multiple UEIs, use the one associated with your physical location.

If you need additional information about user roles in SAM.gov, see “Get registered:

SAM.gov user roles” in the Application Guide [PDF].

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 and How to Apply for Grants.

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 HRSA-26-057.

After you select the opportunity, we recommend that you click the Subscribe button to get updates.

https://sam.gov/content/entity-registration https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hhs.gov/sites/default/files/financial-assistance-general-certification-representations.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D4 https://grants.gov/applicants/applicant-registration http://www.grants.gov/quick-start-guide/applicants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/search-grants

Application writing help Visit HHS Tips for Preparing Grant Proposals.

Visit HRSA’s How to Prepare Your Application page for more guidance.

See Apply for a Grant for other help and resources.

FAQs will be posted on our TA webpage after the webinar with a link to Grants.gov Related Documents tab.

Join the webinar For more information about this opportunity, join the webinar. More information on the HRSA-26-057 webinar will be posted at a later date to the documents tab in Grants.gov.

We recommend that you “Subscribe” to the NOFO on Grants.gov to receive updates when we post documents.

We will record the webinar.

https://www.hhs.gov/grants-contracts/grants/get-ready-for-grants-management/tips-for-preparing-grant-proposals/index.html https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant

Step 3:

Build Your Application

Application checklist 26

Application contents and format 28

Application checklist There are two types of forms in Grants.gov.

• Some forms allow you to upload components of your application to the form.

These include components like your project narrative, budget and budget narrative, and attachments, as applicable.

• Other forms are more typical, fill-in-the-blank forms.

Make sure that you have everything you need to apply.

Narratives

Component

Grants.gov form Included in page limit*?

Project narrative Project Narrative Attachment form Yes

Budget narrative Budget Narrative Attachment form Yes

Attachments Insert each in the Attachments Form in this order.

Included in

2. Staffing plan and job descriptions

4. Project organizational chart

6. Agreements with other entities

7. Funding preference or priority documentation

8. Multi-year budgets, fifth year budget No

Other required forms Upload using each required form in Grants.gov.

Forms Submission requirement

Application for Federal Assistance (SF-424) With application.

Project Abstract Summary form With application.

Grants.gov Lobbying form With application.

*Only what you attach in these forms counts toward the page limit. The forms themselves do not count.

Application contents and format This section includes guidance on each component found in the application checklist.

Application page limit: 40 pages

Submit your information in English and express whole number budget figures using U.S. dollars.

Required format Required format for project summary, project narrative, budget narrative, and attachments

Font: A readable font like Arial, Courier, CG Times, or Times New Roman.

File format: We only accept the following document formats:

• .PDF - Adobe Portable Document Format

• .DOC/.DOCX - Microsoft Word

• .RTF - Rich Text Format

• .TXT - Text

• .WPD - Word Perfect Document

• .XLS/.XLSX - Microsoft Excel

• .VSD - Microsoft Visio

Size: 12-point font Footnotes, charts, graphics, and budget tables may be 10-point or higher.

Ink color: Black

Spacing: Single-spaced, including all text and tables.

Alignment: Left

Headings: Bold all headings and align left.

Size: 8.5 x 11 (Make sure the print area is set and allows printing to 8.5 x 11.)

Margins: 1-inch on all sides.

Footer: On each page as the footer, include your organization’s name and page numbers. If a competing continuation or competing supplement, also include your 10-digit award number.

Page numbering:

• Do not number the standard OMB-approved forms.

• Number each attachment page sequentially (that is, 1, 2, 3).

• Reset the numbering for each attachment.

• Treat each attachment as a separate section.

File names: You can find guidance for naming your files in the Application Guide.

Project narrative Introduction See merit review criterion 1: Need

• State the purpose of your ECCS SEED Initiative, and goals for state/Tribe/territory (referred to as “state” in this NOFO), in alignment with the NOFO Purpose.

• Describe how ECCS SEED funding will help you advance the goals and objectives outlined in the NOFO Purpose.

• Identify your community of focus and specify if it is a rural community, as applicable.

◦ You can determine if a county is rural using HRSA’s rural eligibility assessment tool.

• Identify your key partners statewide and at the community level.

• Provide the estimated number of P-5 families within your community of focus using the American Community Survey (ACS), if available, or another comparable data source if ACS is not available for your community of focus. Use the most recently available data.

• Briefly describe the evidence-based model you plan to implement in your community of focus to improve quality of care for P-5 families, and the community settings you will target for implementation.

Need See merit review criterion 1: Need

Needs of P-5 families

• Describe the early childhood health and development needs, and family well-being needs of P-5 families in your state and within your community of focus.

◦ Include state- and community-level data on high priority maternal and child health outcomes, relevant vital statistics, demographics, and service receipt, utilization and/or need patterns (including referrals), as available.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page%3D26 https://data.hrsa.gov/topics/rural-health/rural-health-eligibility https://data.hrsa.gov/topics/rural-health/rural-health-eligibility

◦ Include state-level estimates of rates for developmental screenings, well-child visits, and child flourishing.

▪ Consider using the most current NSCH data as well as data available from the Title V Information System, and Medicaid Core Set Data Dashboard.

◦ If applicable, describe any specific needs of rural communities you intend to serve.

◦ If applicable, describe needs and provide data identifying communities with high infant mortality rates if you propose including these areas in your community of focus. See Attachment 7 for more information on funding priority communities.

System needs

• Describe the extent to which these needs are reflected in a statewide early childhood systems strategic plan or needs assessments used to guide state Medicaid/CHIP, Title V or MIECHV activities.

System gaps

• Describe the systems gaps statewide and in your community of focus that affect P-5 whole family needs and child developmental screenings, timely well-child visits, and child flourishing.

• Identify current challenges in your state’s early childhood system.

Examples include:

◦ Fragmented governance.

◦ Limited CIRS infrastructure.

◦ Lack of sustainable financing options.

◦ Underrepresentation of family and community voices in decision-making.

◦ Gaps in workforce capacity.

◦ Inefficient or inadequate cross-sector coordination.

◦ Poor data integration.

Approach See merit review criterion 2: Response

Establish or expand Coordinated Intake and Referral Systems (CIRS).

• Describe how you will establish or expand CIRS to improve system navigation and care coordination for P-5 families, including in your community of focus, and work towards statewide reach. Set clear goals for the scaling you aim to achieve for each year of the initiative.

https://mchb.tvisdata.hrsa.gov/ https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/welcome https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/welcome

• Describe how your CIRS will increase whole family needs screenings and improve receipt of timely child developmental screenings and assure the CIRS is responsive to families’ needs.

• Describe what specific screenings, assessments, and referrals will contribute to whole family needs assessments through the CIRS.

◦ At a minimum these should include assessments for parent and child health, early care and education needs, and human services needs.

• Clearly list the providers (See Appendix A) and service delivery entities that will be included in the CIRS and describe how you will increase the number and types of participating providers, especially health providers, over time, based on families’ needs.

• Describe the coordinated data infrastructure that will support the CIRS, and how you will monitor referral completion, improve service coordination, and reduce wait times between intake, referral and service delivery.

Implement an evidence-based model for early childhood health and development.

• State the evidence-based model for early childhood health and development you plan to implement in your community of focus and note in which clinical or public health settings you will implement, as appropriate for the model. Refer to Appendix C for examples.

• Explain why the model is well suited to local P-5 families’ needs, and how you will tailor the model to the community of focus.

• Describe how you will work toward universal, community-wide implementation to reach more families each year of the award. Set clear goals for the scaling you aim to achieve for each year of the initiative.

• Describe how the model will increase timely well-child visits and child flourishing, and how the model will connect families to CIRS to meet their whole family needs.

• Describe how you will learn from implementation of the model in your community of focus and prepare to scale effective model service delivery to other communities.

◦ Note whether you plan to expand the model to additional communities during the award period.

Lead state-level early childhood coordination.

• Provide strategic statewide ECS leadership:

◦ Describe how you will provide strategic leadership and coordination of state and community maternal and early childhood systems efforts.

◦ Describe how you will align ECCS SEED activities with broader ECS strategic plans or initiatives, and partner with existing state and local ECS advisory groups.

• Engage parent and caregiver leadership:

◦ Describe how you will meaningfully engage, train, and compensate parents and caregivers as leaders in ECS design and program decision-making, including how you will build on or expand existing parent engagement efforts.

• Facilitate ECS cross-sector collaboration:

◦ Describe how you will collaborate with statewide ECS partners across health, early care and education, and human services sectors essential to early childhood health and development.

◦ Describe your partnerships with Medicaid/CHIP, Title V, MIECHV, and other state partners.

• Develop policies and guidelines:

◦ Describe how you will identify state and local administrative policies and guidelines that need to be updated or developed to improve early childhood health and development and P-5 family well-being. Share how you will work with partners to update or develop them.

• Provide Technical Assistance (TA) and use Continuous Quality Improvement (CQI):

◦ Describe how you will provide TA to support implementation, expansion, and sustainability of CIRS in your community of focus, and other communities when you expand.

◦ Describe how you will build the capacity of community service providers to help them tailor and implement the evidence-based model in your community of focus.

◦ Describe how you will use CQI to monitor progress, improve child and family outcomes, and document lessons learned to inform sustainability and expansion.

High-level work plan See merit review criteria 2: Response and 4: Impact

• Provide a work plan timeline in Attachment 1 that includes each major activity that you will use to achieve each of the objectives proposed in the Approach, Performance reporting and evaluation, and Sustainability section for the entire period of performance.

• Organize your workplan and timeline by project goal or objective and identify responsible staff and partners. Clearly distinguish between statewide and community-level tasks and responsibilities.

Resolving challenges See merit review criterion 2: Response

• Identify potential anticipated barriers you may face in this initiative and how you propose to resolve them.

• Specifically consider how you will address possible challenges associated with:

◦ Cross-sector collaboration.

◦ Partnering with families and community members.

◦ Obtaining sustainable funding sources.

◦ Providing technical assistance for identified capacity needs.

Performance reporting and evaluation See merit review criteria 3: Performance reporting and evaluation and 5: Resources and capabilities

• Describe how you will carry out high-quality monitoring and performance improvement for activities both statewide and at the community level:

◦ This includes supporting the measurement and CQI capacity of community partners and any related TA or information technology resources you will provide.

Measurement strategy

• Describe how you will begin work with initial community partners in the first 6 months to collect the required measures described in the Performance Measurement, Evaluation, and CQI.

• Provide baseline estimates for the measures listed below. See the Performance Measurement, Evaluation, and CQI section for more information. Note that you will confirm or update baselines in the first 6 months of the award, so estimates (including 0) are appropriate:

◦ Number of P-5 families in the community of focus reached via the implemented model.

◦ Number of communities across state reached via CIRS.

▪ If establishing a new CIRS, 0 is acceptable.

◦ Number of unique families who have used the CIRS.

▪ If establishing a new CIRS, 0 is acceptable.

◦ Number of…