Signature Date

Notice of Funding Opportunity

Application due 07/10/2026

MATERNAL AND CHILD HEALTH BUREAU

Emergency Medical Services for Children (EMSC) National Pediatric Readiness Coordinating Center Cooperative Agreement

HRSA-26-051

Table of Contents Before You Begin

Step 1: Review the Opportunity

Basic information

Funding details

Eligibility

Program description

Award information

Step 2: Get Ready to Apply

Get registered

Find the application package

Application writing help

Step 3: Build Your Application

Application checklist

Application contents and format

Step 4: Understand Review, Selection, and Award

Application review

Selection process

Award notices

Step 5: Submit Your Application

Application submission and deadlines

Other submissions

Step 6: Learn What Happens After Award

Post-award requirements and administration

Reporting

Contacts and Support

Agency contacts

Help with systems

Appendices

Before You Begin Health Resources and Services Administration

MATERNAL AND CHILD HEALTH BUREAU

Division of Child, Adolescent, and Family Health | Emergency Medical Services for Children (EMSC) Branch

Emergency Medical Services for Children (EMSC) National Pediatric Readiness Coordinating Center Cooperative Agreement

HRSA-26-051

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.

Step 1: Review the Opportunity

Basic information Tagline: Expanding and improving emergency medical services for children

Summary The Emergency Medical Services for Children (EMSC) program, established in 1984, supports projects to improve emergency care for children with trauma and other critical conditions. These projects strengthen Pediatric Readiness [1],[2],[3] in hospital Emergency Departments (EDs) and prehospital Emergency Medical Services (EMS) agencies. The EMSC National Pediatric Readiness Coordinating Center (NPRCC) supports and coordinates these efforts. This Notice of Funding Opportunity (NOFO) explains how to apply for funding under the NPRCC Cooperative Agreement.

If you are awarded funding, you will:

• Coordinate with key partners to develop and update Pediatric Readiness guidelines for hospital EDs and EMS agencies.

• Centralize technical assistance and quality improvement (QI) learning collaboratives to increase adoption of Pediatric Readiness guidelines and support state Pediatric Readiness Recognition Programs.

• Increase awareness among health care providers and the public about the role of Pediatric Readiness in improving outcomes for children.

• Measure progress in Pediatric Readiness through a web-based data collection system for hospital EDs and EMS agencies.

Have questions? Go to Contacts and Support.

Key facts

Opportunity name:

Emergency Medical Services for Children (EMSC) National Pediatric Readiness Coordinating Center Cooperative Agreement

Opportunity number:

HRSA-26-051

Announcement version:

initial

Federal assistance listing:

93.127

Key dates

NOFO issue date:

06/08/2026

Informational webinar:

Join the webinar

Application deadline:

07/10/2026

Expected award date is by:

07/01/2026

Expected start date:

07/01/2026

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

[1] EMS and fire-rescue agencies and emergency departments that have pediatric-specific champions, competencies, policies, equipment, and other resources needed to provide high-quality emergency care for children are described as “pediatric ready.”

https://emscimprovement.center/domains/pediatric-readiness

Funding details Application Types:

New https://emscimprovement.center/domains/pediatric-readiness

Expected total available funding in FY:

2026: $4,200,000

Expected number and type of awards:

1 CA (Cooperative Agreement)

Funding range per award:

$3,900,000 - $4,200,000

FY26 will be funded at 3.9M; subsequent years at 4.2M

We plan to fund awards in four 12-month budget periods for a total four- year period of performance from 07/01/2026 to 06/30/2030.

The program and awards depend on the appropriation of funds and are subject to change based on the availability and amount of appropriations.

Eligibility You can apply if you are a state government or accredited school of medicine in a state.

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

State governments

Public and State controlled institutions of higher education

Private institutions of higher education

Additional information on eligibility

The eligible applicants are state governments and accredited schools of medicine.

Individuals are not eligible applicants under this NOFO.

Other eligibility criteria Evidence of experience in developing and implementing Pediatric Readiness improvements at the national and state levels.

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.

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 NPRCC vision: To save over 2,000 children’s lives each year by ensuring that all hospital EDs and EMS agencies are Pediatric Ready.

The NPRCC will:

• Coordinate development and centralize technical assistance.

• Increase awareness and measure Pediatric Readiness in hospital EDs and EMS agencies.

Together, these efforts will support the adoption of Pediatric Readiness guidelines.

These guidelines aim to make sure that:

• All children receive high-quality emergency care when needed, regardless of where they live, attend school, or travel in the U.S.

• Every hospital ED and EMS agency has the staff, skills, policies, equipment, and resources needed to provide high-quality care for children.

Note: Find a glossary of key terms and acronyms we use in this NOFO in the appendices.

Funding Opportunity Goals

• To ensure all children have access to high-quality emergency medical care for children by improving Pediatric Readiness in hospital EDs and EMS agencies nationwide.

Background The NPRCC demonstration program brings together Pediatric Readiness activities from two previous EMSC programs:

• EMSC Innovation and Improvement Center (EIIC), and

• EMSC Data Center (EDC).

The HRSA EMSC portfolio also includes:

• EMSC State Partnerships (EMSC SP), and

• Pediatric Emergency Care Applied Research Network (PECARN).

The problem Each year in the United States, about 30 million children receive care from over 5,000 EDs and 18,000 EMS agencies.[4],[5] Most children—about 80%—go to community EDs that mainly treat adults rather than specialized pediatric centers.

These community EDs and EMS agencies treat fewer children than adults and often have lower Pediatric Readiness. This means they may not have the equipment, training, staff, and procedures to provide high-quality care for sick or injured children. As a result, children may face higher risks of serious illness or death. [6],[7],[8] Improving Pediatric Readiness could prevent many of these deaths—potentially saving more than 2,000 children every year.[9],[10]

By working with programs like the Title V Maternal and Child Health (MCH) Services Block Grant, states can better address children’s emergency care needs.[11]

Addressing the problem Experts have created and shared guidelines to help EDs and EMS agencies improve Pediatric Readiness.[12],[13] These guidelines, along with recent research, support nationwide efforts to strengthen emergency care for children.

The 2021 National Pediatric Readiness Project (NPRP) assessment showed that about 80% of participating hospital EDs reported improvements, including:

• Pediatric-specific credentialing of practitioners.

• Pediatric-focused QI activities.

• Patient safety practices, such as measuring weight in kilograms.[14]

• Policies that support pediatric care, including family-centered care.

Hospitals with pediatric emergency care coordinators (PECCs) tend to have higher Pediatric Readiness.[15] PECCs help EDs and EMS agencies adopt guidelines and use new evidence to improve care.[16] However, the number of hospitals with PECCs dropped from 2013 to 2021,[17] especially in smaller community EDs.

The NPRCC program Together, the EIIC and EDC—now the NPRCC—have:

• Helped states develop Pediatric Readiness Recognition Programs for EDs and EMS agencies.

• Led national quality improvement initiatives in EDs and EMS agencies.

• Provided expert support for EMS system data collection.

• Supported community engagement with families.

• Built a web-based system to help EDs measure their Pediatric Readiness.

During the NPRCC period of performance, the program will expand on these accomplishments and continue promoting effective, evidence-based approaches to improve pediatric emergency care readiness.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11000559/#:%7E:text=high%2Drisk%20population.-,INTRODUCTION,emergency%20readiness%20may%20compromise%20care.

Program requirements and expectations sIf you are awarded funding, you must carry out four key objectives through the activities described here and report on the required performance measures for each objective.

Objective 1: Coordinate development of guidelines Coordinate with key partners to develop and update Pediatric Readiness guidelines for hospital EDs and EMS agencies.

You are expected to:

• Partner with multidisciplinary organizations,[18] accreditation agencies,[19] and federal agencies.[20]

• Promote the importance of Pediatric Readiness as a public health priority and support state Recognition Programs.

• Increase participation of hospital EDs and EMS agencies in the national Pediatric Readiness assessment to ensure representative data.[21]

• Engage the EMSC Family Advisory Network (FAN) to support Pediatric Readiness efforts.

Objective 2: Centralize technical assistance and learning collaborative Centralize technical assistance and QI learning collaborative to:

• Increase adoption of Pediatric Readiness guidelines.

• Support state Pediatric Readiness Recognition Programs.

For hospital EDs, prehospital EMS agencies, and practitioners You are expected to:

• Develop, centralize, and share current technical assistance resources.

• Lead QI learning collaboratives to increase adoption of Pediatric Readiness guidelines, including disaster care guidance.

• Consider the needs of rural and American Indian/Alaska Native (AI/AN) communities in all activities.

• Evaluate the effectiveness of QI learning collaboratives in improving Pediatric

Readiness.

• Maintain a public website with evidence-based resources, training programs, and continuing education opportunities.

• Use QI learning collaboratives to test new approaches and identify best practices.

• Address gaps in pediatric emergency care, including mental health care.

• Share technical assistance and evidence-based resources through:

o EMSC University.

o Podcasts and webinars.

o User-friendly toolkits.

o Self-directed learning.

o New technologies (such as artificial intelligence).

o Simulation resources (such as patient simulators).

o Continuing education courses for EMS providers across disciplines.[22]

For EMSC state partners https://emscimprovement.center/about/emsc/emsc-u/

You are expected to:

• Develop, centralize, and share technical assistance and evidence-based resources to expand state Pediatric Readiness Recognition Programs and improve EMSC SP Performance Measures.

• Consider the needs of rural and AI/AN communities in all activities.

• Provide support and resources to:

o Help public health providers understand the importance of Pediatric Readiness in hospital EDs and EMS systems.j o Strengthen partnerships between EMSC state partners and state MCH Programs, including Title V MCH Services Block Grant recipients highlighting Title V guidance in emergency preparedness activities.

o Identify and support partnerships to advance Pediatric Readiness statewide.

o Engage the FAN, families, and children to share perspectives and improve

Pediatric Readiness in hospital EDs and EMS agencies.

Objective 3: Increase awareness Increase awareness among the broader health care community and public of the impact of Pediatric Readiness to saving children’s lives in the U.S.

You are expected to:

• Develop resources in partnership with youth, parents, and families to help EMSC state partners and the broader community communicate the importance of Pediatric Readiness.

• Develop and implement a dissemination plan to improve communication of Pediatric Readiness benefits to key audiences, including:

o Hospital EDs, including critical access and community hospitals.

o Prehospital EMS agencies.

o EMSC state partners.

o State, local, and AI/AN governments and communities.

o Families of children with special health care needs.

o The general public.

• Establish a national steering committee that includes:

o FAN representatives.

o EMSC state partners.

o Hospital and EMS accreditation organizations.

o State and federal governments.

o Regional Pediatric Pandemic Network grant recipients.

o Title V MCH Services Block Grant recipients and their State Medicaid and

Medicare partners.

• Work with the steering committee to develop clear messages and evidence-based resources to increase adoption of Pediatric Readiness, including in rural and AI/AN communities o Use current technologies to share these messages nationwide.

o Disseminate evidence-based resources through peer-reviewed publications, reports, and fact sheets.

https://amchp.org/emergency-preparedness-current-initiatives/#:%7E:text=Through%20the%20lens%20of%20workforce,disabled%20people%20across%20the%20lifespan.

https://amchp.org/emergency-preparedness-current-initiatives/#:%7E:text=Through%20the%20lens%20of%20workforce,disabled%20people%20across%20the%20lifespan.

Objective 4: Measure progress Measure Pediatric Readiness in hospital EDs and EMS agencies using a web-based data system.

You are expected to:

• Develop and maintain a web-based data system for hospital EDs and EMS agencies that:

o Serves as a centralized database for contact information.

o Allows users to complete Pediatric Readiness assessments.

o Collects and analyzes data and provides feedback.

o Connects users to QI tools and resources.

• Conduct Pediatric Readiness assessments in selected states within two years of the national assessment, in coordination with HRSA and representing all EMSC regions.

• Conduct the national Pediatric Readiness assessment within five years of the previous assessment.

• Analyze and share assessment results at the state and national levels with EMSC SP Managers and State Title V Directors.

• Estimate the proportion of children with access to highly prepared hospital EDs and EMS agencies.

Performance Measures You are required to measure program performance. This includes tracking key activities and objectives, as well as Discretionary Grants Information System (DGIS) measures noted in the Reporting section.

You must collect and report annually on the following:

• Objective 1: Coordinate development of guidelines o Number and percentage of partners participating in Pediatric Readiness activities.

(Target: 80%)

• Objective 2: Centralize technical assistance and learning collaborative o Number and percentage of EMSC SP recipients receiving technical support.

(Target: 100%) o Number and percentage of EMSC recipients participating in QI collaborative.

(Target: 90%) o Number of EMS professionals participating in QI collaborative.

o Number and percentage of hospital EDs and EMS agencies participating in QI collaborative. (Target: 80%) o Number and percentage of hospital ED and EMS agency PECCs participating in

QI collaborative. (Target: 90%) o Number of QI activities, trainings, and guidelines implemented.

o Number of state Pediatric Readiness Recognition Programs established with

NPRCC technical assistance.

o Percentage of EMSC SP grant recipients accessing evidence-based resources and technical assistance. (Target: 100%) https://media.emscimprovement.center/documents/EMSC_Regions_Map.pdf o Number of learning modules developed to advance Pediatric Readiness for EMSC grant recipients, hospital ED and EMS practitioners, and FAN representatives.

(Target: 4)

• Objective 3: Increase awareness o Number and percentage of committee members participating in Pediatric

Readiness strategic meetings. (Target: 100%) o Number of resources developed for EMSC SP grant recipients.

o Number of resources shared with EMSC SP grant recipients.

o Number and percentage of Pediatric Readiness informational, educational, and promotional activities that include family members (such as FAN representatives). (Target: 100%) o Number of published dissemination resources (such as peer-reviewed journals, annual reports, topic-specific fact sheets).

Objective 4: Measure progress o Number and percentage of Pediatric Readiness assessments completed. (Target:

70% response rate for hospital EDs and 50% response rate for EMS agencies.)

o Number of Pediatric Readiness measures developed, jointly with HRSA, to demonstrate improvement. (Target: 2) o Number of data analysis projects completed to assess and share improvements resulting from implementation of Pediatric Readiness. (Target: 4)

Statutory authority 42 U.S.C. 300w-9 (Public Health Service Act, Title XIX, § 1910)

[5]https://www.hmpgloballearningnetwork.com/site/emsworld/press-release/1224176/nasemso-releases-2020-national-ems-assessment#:~:text=More%20than%2018%2C200%20local%20EMS,Puerto%20Rico%20and% 20American%20Samoa.

[6] Remick K, Smith M, Newgard CD, Lin A, Hewes H, Jensen AR, Glass N, Ford R, Ames S, Cook J, Malveau S, Dai M, Auerbach M, Jenkins P, Gausche-Hill M, Fallat M, Kuppermann N, Mann NC. Impact of individual components of emergency department Pediatric Readiness on pediatric mortality in US trauma centers. J Trauma Acute Care Surg. 2023 Mar 1;94(3):417-424.

doi: 10.1097/TA.0000000000003779. Epub 2022 Sep 1. PMID: 36045493; PMCID:

PMC9974586.

[7] Newgard, C. D., Lin, A., Olson, L. M., Cook, J. N. B., Gausche-Hill, M., Kuppermann, N., Goldhaber-Fiebert, J. D., Malveau, S., Smith, M., Dai, M., Nathens, A. B., Glass, N. E., Jenkins, P. C., McConnell, K. J., Remick, K. E., Hewes, H., Mann, N. C., & Pediatric Readiness Study Group (2021). Evaluation of Emergency Department Pediatric Readiness and Outcomes Among US Trauma Centers. JAMA Pediatrics, 175(9), 947–956.

https://doi.org/10.1001/jamapediatrics.2021.1319 https://www.hmpgloballearningnetwork.com/site/emsworld/press-release/1224176/nasemso-releases-2020-national-ems-assessment#:%7E:text=More%20than%2018%2C200%20local%20EMS,Puerto%20Rico%20and%20American%20Samoa https://www.hmpgloballearningnetwork.com/site/emsworld/press-release/1224176/nasemso-releases-2020-national-ems-assessment#:%7E:text=More%20than%2018%2C200%20local%20EMS,Puerto%20Rico%20and%20American%20Samoa https://www.hmpgloballearningnetwork.com/site/emsworld/press-release/1224176/nasemso-releases-2020-national-ems-assessment#:%7E:text=More%20than%2018%2C200%20local%20EMS,Puerto%20Rico%20and%20American%20Samoa https://www.hmpgloballearningnetwork.com/site/emsworld/press-release/1224176/nasemso-releases-2020-national-ems-assessment#:%7E:text=More%20than%2018%2C200%20local%20EMS,Puerto%20Rico%20and%20American%20Samoa https://doi.org/10.1001/jamapediatrics.2021.1319

[8] Steering Committee on Quality Improvement and Management and Committee on hospital Care. Policy Statement—Principles of Pediatric Patient Safety: Reducing Harm Due to Medical Care. Pediatrics 2011;127:1199–1210

[9] Lieng, M. K., Marcin, J. P., Sigal, I. S., Haynes, S. C., Dayal, P., Tancredi, D. J., Gausche- Hill, M., Mouzoon, J. L., Romano, P. S., & Rosenthal, J. L. (2022). Association between emergency department Pediatric Readiness and transfer of noninjured children in small rural hospitals. The Journal of Rural Health: Official journal of the American Rural Health Association and the National Rural Health Care Association, 38(1), 293–302.

https://doi.org/10.1111/jrh.12566

[10] Newgard CD, Lin A, Goldhaber-Fiebert JD, et al. State and National Estimates of the Cost of Emergency Department Pediatric Readiness and Lives Saved. JAMA Netw Open.

2024;7(11):e2442154. doi:10.1001/jamanetworkopen.2024.42154

[11] For more information on Title V Maternal and Child Health Block Grant visit:

https://mchb.hrsa.gov/programs-impact/title-v-maternal-child-health-mch-services-block-grant

[12]Pediatric Readiness in the Emergency Department

[13]The Prehospital Pediatric Readiness Project

[14] Ward, C. E., Taylor, M., Keeney, C., Dorosz, E., Wright-Johnson, C., Anders, J., & Brown, K. (2023). The Effect of Documenting Patient Weight in Kilograms on Pediatric Medication Dosing Errors in Emergency Medical Services. Prehospital Emergency Care, 27(2), 263–268.

https://doi.org/10.1080/10903127.2022.2028045

[15] Foster, A. A., Li, J., Wilkinson, M. H., Ely, M., Gausche-Hill, M., Newgard, C., & Remick, K. (2023). Pediatric emergency care coordinator workforce: A survey study. Journal of the American College of Emergency Physicians Open, 4(4), e13006.

https://doi.org/10.1002/emp2.13006

[16] Institute of Medicine 2007. Emergency Medical Services: At the Crossroads. Washington, DC: The National Academies Press. https://doi.org/10.17226/11629

[17] Remick KE, Hewes HA, Ely M, et al. National Assessment of Pediatric Readiness of US Emergency Departments During the COVID-19 Pandemic. JAMA Netw Open.

2023;6(7):e2321707.doi:10.1001/jamanetworkopen.2023.21707

[18] Multidisciplinary organizations: Professional organizations, American College of Emergency Physicians, Association of Maternal & Child Health Programs

[19] National associations, such as the Children’s Hospital Association and the American Hospital Association; and accrediting entities

[20] Federal Partners: Federal Office of Rural Health Policy, Indian Health Service (IHS); other HRSA MCHB Programs, such as, the Pediatric Emergency Care Applied Research Network (PECARN), and the Regional Pediatric Pandemic Network (RPPN)

[21] The National Pediatric Readiness Project and the National Prehospital Pediatric Readiness Project https://mchb.hrsa.gov/programs-impact/title-v-maternal-child-health-mch-services-block-grant https://www.acep.org/patient-care/policy-statements/pediatric-readiness-in-the-emergency-department https://naemsp.org/prehospital-episode/episode-137-the-prehospital-pediatric-readiness-project/ https://doi.org/10.1080/10903127.2022.2028045 https://doi.org/10.1002/emp2.13006 https://doi.org/10.17226/11629

[22] For example: Emergency Medical Technicians, Paramedics, Registered Nurses, Advanced Registered Nurse Practitioner, Doctor of Osteopathic Medicine, and Medical Doctors.

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

• Helping you plan and carry out NPRCC program activities, including working with you to identify staff who will support these efforts.

• Connecting you with federal and state partners, and with national and professional organizations, to support collaboration.

• Reviewing, approving the materials you create (e.g, publications and presentations), and giving feedback on your meeting, conference, and travel plans.

• Helping you plan, develop, schedule, and assess meetings, seminars, and QI learning collaboratives.

• Supporting the design, direction, and evaluation of activities, including those that address new or emerging issues.

• Continually reviewing your procedures and project status to assess program needs.

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

• Following the requirements for planning and implementing NPRCC program activities as outlined in this NOFO, including:

o Collaborating with EMSC grant recipients, stakeholders, and HRSA contractors.

o Planning, conducting, and documenting site visits, advisory and steering committee meetings, and other meetings.

o Managing logistics and coordination for EMSC All-Grantee Meetings every other year, including the fifth year of performance, if extended.

o Obtaining prior approval for travel not included in the approved budget.

o Working closely with HRSA EMSC program staff by:

Participating in monthly calls and at least one in-person meeting each year.

Responding to requests in a timely manner.

Allowing sufficient time for HRSA review and approval of materials.

Submitting a quarterly travel plan at least 30 days before each quarter.

• Acknowledging and complying with federal requirements by:

o Allowing HRSA full access to all data generated under this agreement.

o Granting the government a royalty-free, nonexclusive, and irrevocable license to use materials developed.

o Maintaining adequate staffing and notifying HRSA of key staff changes.

o Providing de-identified, aggregate data upon request.

o Ensuring all products are free and publicly accessible.

o Transferring all materials within 90 days after the project period ends.

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.

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

o Fund more applicants from the rank order list.

o Extend the period of performance.

o Award supplemental funding.

General limitations

• For guidance on some types of costs we do not allow or restrict, see o Project Budget Information in the Application Guide.

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

o 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.

Program-specific statutory or regulatory limitations By statute, no more than three grants may be awarded in a state in a fiscal year. Contact the HRSA EMSC Project Officer to confirm current EMSC grant locations and determine whether a state has reached this limit.

Please note: This funding opportunity does NOT support research activities. Therefore, applicants may not use research indirect cost rates.

See Manage Your Grant for other information on costs and financial management.

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.

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.ecfr.gov/current/title-2/part-200/subject-group-ECFRed1f39f9b3d4e72 https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html https://www.hhs.gov/grants-contracts/grants/grants-policies-regulations/index.html 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/grants/manage-your-grant

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.

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

o Fund more applicants from the rank order list.

o Extend the period of performance.

o Award supplemental funding.

Step 2: Get Ready to Apply

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.

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.

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 https://sam.gov/content/entity-registration 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=4 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

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-26-051.

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

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 Grants.gov Related Documents tab.

Join the webinar For more information about this opportunity, join the webinar. More information on the HRSA- 26-051 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.

We will record the webinar. If you are not able to join live, you can replay it at XXX

Have questions? Go to Contacts and Support.

Step 3: Build Your Application

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

Use the Project Narrative Attachment form.

Project Narrative Attachment form. Yes

◻ Budget narrative Budget Narrative Attachment form. Yes https://www.grants.gov/search-grants https://www.grants.gov/search-grants 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

Use the Budget Narrative Attachment form.

Attachments Insert each in the Attachments Form in this order.

Component Included in page limit*?

◻ 1. Work plan Yes ◻ 2. Staffing plan and job descriptions Yes ◻ 3. Biographical sketches No ◻ 4. Agreements with other entities Yes ◻ 5. Maintenance of effort documentation Yes ◻ 6. Multi-year budgets, fifth year budget No ◻ 7. Funding preference or priority documentation Yes ◻ 8. Project organizational chart Yes ◻ 9. Tables and charts Yes ◻ 10. Other relevant document Yes ◻ 11. Other relevant document Yes ◻ 12. Other relevant document Yes ◻ 13. Other relevant document Yes ◻ 14. Other relevant document Yes ◻ 15. Other relevant document Yes Other required forms Upload using each required form in Grants.gov.

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

Project/Performance Site Location(s) With application.

Project Abstract Summary Form With application.

Budget Information for Non-Construction Programs (SF-424A) With Application Grants.gov Lobbying Form With application.

Key Contacts 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: 70

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 o .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

Describe the role of the NPRCC program to achieve the purpose and requirements.

Need See merit review criterion 1: Need

• Describe the health care issues affecting pediatric emergency care in hospital and prehospital settings, including rural and AI/AN settings.

https://www.hrsa.gov/sites/default/files/hrsa/grants/application-guide.pdf#page=26

• Describe the pediatric emergency care needs the project will address.

• Describe gaps in knowledge and practice among hospital ED and EMS providers and systems in caring for children.

• Discuss barriers in emergency care delivery and systems that the project will address.

• Use demographic data whenever available and cite sources.

Approach See merit review criterion 2: Response

• Describe how you will address identified needs and meet all program requirements and expectations in this NOFO.

• Describe how you will coordinate the development of Pediatric Readiness guidelines.

• Describe how you will collaborate with partners to expand and improve Pediatric

Readiness.

• Describe how you will centralize technical assistance and develop tools and strategies for training, outreach, and collaboration for hospital EDs, EMS agencies, practitioners, and EMSC State Partners.

• Describe your plan to increase awareness by developing resources, implementing a dissemination plan, and sharing information broadly to support the adoption of Pediatric Readiness.

• Explain how you will develop and maintain a web-based data system that meets program requirements for hospital EDs and EMS agencies.

• Explain how you will use assessment results and identified needs to improve Pediatric Readiness over time.

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

Describe a clear plan to meet all NPRCC program requirements and expectations during the period of performance, including:

• How you will influence hospital EDs, EMS agencies, and public health systems.

• How you will develop a web-based data system to measure and track improvements in

Pediatric Readiness at the state and national levels.

• How you will use assessment findings to support adoption of evidence-based practices by hospital EDs, EMS providers, and EMSC grant recipients.

• How you will share Pediatric Readiness results and best practices with EMSC State

Partnership Managers, State Title V Directors, and national audiences.

• A timeline of activities, including responsible staff and the role of key stakeholders in planning and implementation.

Resolving challenges See merit review criterion 2: Response

Describe the challenges you may face when designing and carrying out your work plan activities.

Explain how you’ll resolve them.

Performance management

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

• Outcomes: Describe the expected outcomes (desired results) of the funded activities.

• Performance measurement and reporting:

o Describe your plan to measure and track required performance measures.

o Explain how you will collect, manage, and report data accurately and on time.

o Explain how you will store and protect data securely, including how you will address cybersecurity risks.

o Describe how you will monitor and analyze data to improve program performance.

• Program evaluation: Describe how you will evaluate the project in alignment with HHS Evaluation Policy, and OMB Memorandum M-20-12. Include:

o Evaluation questions, methods, data sources, and timeline.

o Potential evaluation challenges and how you will address them.

o Explain your organization’s ability to carry out the evaluation, including staff experience and expertise.

o Describe how you will share evaluation results, assess the effectiveness of dissemination, and ensure findings are applicable at the national level and can be replicated by other organizations.

See the reporting section for more information.

Sustainability See merit review criterion 4: Impact

We expect you to sustain key project elements that improve practices and outcomes for the target population. Propose a plan for project sustainability after the period of federal funding ends.

• Highlight key elements of your projects. Examples include training methods or strategies that have been effective in improving practices.

• Describe the actions you’ll take to obtain future sources of funding.

• Determine the timing to become self-sufficient.

• Discuss challenges that you’ll likely encounter in sustaining the program. Include how you will resolve these challenges.

Organizational information See merit review criterion 5: Resources and capabilities

Briefly describe your organization’s mission, structure, and current activities. Explain how these activities and resources will help you meet program requirements. You’ll include a project organizational chart in your attachments.

• Discuss how you’ll follow the approved project, keep track of all federal funds, and record all costs to avoid issues during the project audit.

• Describe how you’ll assess the unique needs of the people who live in the community you serve.

https://aspe.hhs.gov/reports/department-health-human-services-evaluation-policy https://aspe.hhs.gov/reports/department-health-human-services-evaluation-policy https://www.whitehouse.gov/wp-content/uploads/2020/03/M-20-12.pdf

• Describe your organizational profile, budget, partners, key processes, and your key staff’s experience, skills, and knowledge.

Budget and budget narrative See merit review criterion 6: Support requested

Your budget should follow the instructions in budget narrative: detailed instructions section of the Application Guide and the instructions listed in this section. Your budget should show a well-organized plan.

HHS now uses the definitions for equipment and supply 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.

The total project or program costs are all allowable (direct and indirect) costs used for the HRSA award activity or project. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement (which may include maintenance of effort, if applicable).

The budget narrative supports the information you provide in Standard Form 424-A. It includes an itemized breakdown and a clear justification of the costs you request. The merit review committee reviews both.

As you develop your budget, consider:

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

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

Include these costs in your budget:

• Staff:

o Include sufficient subject expertise in these fields:

Pediatric emergency care (hospital and prehospital).

Family and community engagement.

Knowledge management.

Training and education.

Quality improvement.

Performance measurement.

Communications and dissemination.

Project management and operations.

Data systems, management, and analysis.

o Ensure sufficient full-time staff to support EMSC grant recipients and respond to technical assistance requests.

o Identify funding sources for staff supported by other federal grants.

• Travel:

o Budget for staff to attend EMSC PECARN meetings once a year. Find more information about the EMSC PECARN Program.

https://www.ecfr.gov/current/title-2/part-200#p-200.1(Equipment) https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200#p-200.1(Supply) http://www.pecarn.org/ o Budget for one annual HRSA strategic planning meeting in the Washington, DC area.

o Budget for the All-Grantee Meeting in years two and four.

o Budget for 12 EMSC site visits per year, based on HRSA priorities.

• Contractual:

o Describe the purpose, cost estimates, and deliverables for each contract.

o Include costs for communication activities to support awareness and adoption of best practices.

o Include costs for:

All-Grantee Meetings with an estimated 400 attendees in years two (2) and four (4).

One in-person EMSC meetings per year (approximately 200 attendees each, including one in the Washington, DC area).

o A virtual learning environment for hospital ED and EMS representatives, including PECCs, EMSC SP managers, and FAN members.

o A public website with evidence-based resources, training, and educational materials.

o Development and maintenance of a web-based data system to measure Pediatric Readiness.

To create your budget narrative, see budget narrative detailed instructions in the Application Guide.

[23] Kuo, D. Z., Houtrow, A. J., Arango, P., Kuhlthau, K. A., Simmons, J. M., & Neff, J. M.

(2012). Family-centered care: Current applications and future directions in pediatric health care.

Maternal and Child Health Journal, 16(2), 297–305. https://doi.org/10.1007/s10995-011-0751-7

[24] Committee on Hospital Care. (2003). Family-centered care and the pediatrician’s role.

Pediatrics, 112(3), 691–696. https://doi.org/10.1542/peds.112.3.691

[25] Remick, K., Gausche-Hill, M., Joseph, M. M., Brown, K., Snow, S. K., Wright, J. L., et al.

(2018). Pediatric readiness in the emergency department. Pediatrics, 142(5), e20182459.

https://doi.org/10.1542/peds.2018-2459

[26] Moore, B., Shah, M. I., Owusu-Ansah, S., Gross, T., Brown, K., Gausche-Hill, M., Remick, K., Adelgais, Lyng, J., K., Rappaport, L., Snow, S., Wright-Johnson, C., Leonard, J. C., et al.

(2020). Pediatric readiness in emergency medical services systems. Pediatrics, 145(1), e20193307. https://doi.org/10.1542/peds.2019-3307

Attachments Place your attachments in this order in the Attachments Form. See application checklist to determine if they count toward the page limit.

Unless the instructions below require it, do not submit organizational brochures or other promotional materials (for example, slides, films, clips).

Attachment 1: Work Plan https://doi.org/10.1007/s10995-011-0751-7 https://doi.org/10.1542/peds.112.3.691

Attach the project’s work plan. Make sure it includes everything required in the Requirements and expectation section.

Attachment 2: Staffing plan and job descriptions Include a staffing plan that identifies project staff and provides key information about each position, including education, experience, and level of effort.

Provide a one-page job description for each key staff member that describes their role, responsibilities, and qualifications.

Attachment 3: Biographical sketches Include biographical sketches for individuals in key positions listed in Attachment 2.

Each sketch must be no more than two pages and should not include non-public, personally identifiable information. For positions not yet filled, include a letter of commitment with the biographical sketch.

Attachment 4: Agreements with other entities Provide documents that show your working relationships with partners mentioned in your project. For any contracts or agreements, include sections that explain roles and deliverables.

You do not need to include full agreements, only the relevant parts. Make sure all letters of agreement are signed and dated.

Attachment 5: Project organizational chart Provide a one-page diagram showing the full project organizational structure.

Attachment 6: Tables and charts Provide tables or charts that give more detail about the proposal. These might be Gantt, PERT, or flow charts.

Attachment 7-12: Other relevant documents You may use attachments 7 through 12 to add other relevant documents.

Other required forms

You will need to complete some other forms. Upload the following forms at Grants.gov. You can find them in the NOFO application package or review them and any available instructions at Grants.gov Forms.

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

Project/Performance Site Location(s) With application.

Project Abstract Summary Form With application.

Budget Information for Non-Construction Programs (SF-424A) With Application

Grants.gov Lobbying Form With application.

Key Contacts With application.

Form instructions https://grants.gov/learn-grants/grant-terminology#p https://grants.gov/learn-grants/grant-terminology#p https://grants.gov/forms/forms-repository/sf-424-family

The application guide has detailed instructions for:

• The Application for Federal Assistance (SF-424).

• The Budget Information for Non-Construction Programs (SF-424A).

Project abstract summary form instructions Complete the information in the Project Abstract Summary form. Include a short description of your proposed project. Include the needs you plan to address, the proposed services, and the population groups you plan to serve. When writing your summary:

Use 4,000 characters or fewer.

Make sure it’s clear, accurate, short.

Do not refer to other parts of the application.

Do not include personally identifiable information (PII) in abstract form.

If you receive an award, we’ll put your project abstract on public websites and databases, including USAspending.gov.”

Important: Public information

When filling out your SF-424 form, pay attention to Box 15: Descriptive Title of Applicant’s Project.

We share what you put there with USAspending. This is where the public goes to learn how the federal government spends their money.

Instead of just a title, insert a short description of your project and what it will do.

See…