IMC.RFA.Final.pdf

VIRGINIA DEPARTMENT OF HEALTH (VDH)

REQUEST FOR APPLICATIONS

Virginia Rural Health Transformation Program (RHTP)

Innovative Maternal Care

Issuing Agency/Organization:

Virginia Department of Health (VDH)

Program Name: Innovative Maternal Care

CFDA / Assistance Listing:

93.798 - Rural Health Transformation Program

Federal Award Identification Number

(FAIN):

RHTCMS332088

Federal Award Date: December 29, 2025

Awarding Agency:

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), Office of Acquisitions and Grants Management

Statutory Authority: Section 71401 of Public Law 119-21

Primary Recipient:

Virginia Department of Medical Assistance Services (DMAS) 600 E Broad St, Suite 1300, Richmond, VA 23219-1856

Federal Funds Expiration Date:

October 30, 2030

RFA Reference Number:

VDH-26-705-0387

Initiative: Connected to Care, Closer to Home

Sub-initiative: Innovative Maternal Care

RFA Issue Date: September 4, 2026

Q&A Period/Response Schedule (If applicable):

Questions must be submitted no later than September 25, 2026, at 5:00 PM ET.

Responses to questions received during the Q&A period will be compiled and posted as an addendum in eVA following the close of the Q&A period.

Pre-application Conference Info (If applicable):

September 16, 2026 at 2:00 PM EST

Conference Link:

https://vdhoep.webex.com/vdhoep/j.php?MTID=m5fb0d18c5b3d6bec13f5788533dd3299

Application Deadline: October 6, 2026 at 5:00 PM EST

Decision Timeline (If desired to disclose):

VDH anticipates issuing award notifications on or around November 13, 2026. This date is subject to change based on the application review and award process.

Submission Method: Please submit applications via the eVA procurement portal.

Estimated Award Range:

VDH anticipates awarding approximately $11.6 million over the initial performance period. Individual award amounts will range from $50,000 to $1,000,000, reflecting the scope and scale of the applicant’s proposed project.

https://vdhoep.webex.com/vdhoep/j.php?MTID=m5fb0d18c5b3d6bec13f5788533dd3299 https://eva.virginia.gov/

VA RHTP – Innovative Maternal Care

Subaward Period of Performance:

Date of execution – September 30, 2027 (Initial Budget Within five (5) business days following the end of each reporting period, according to the reporting schedule provided by VDH. Period). Subject to the availability of funding, satisfactory performance, and continued programmatic alignment, awards may be eligible for continuation funding through September 30, 2030.

Geographic Scope:

Eligible applicants must be physically located in, or provide direct services to, rural

Virginia communities as defined under Virginia’s RHTP. The Program’s baseline definition of rurality is based on the Federal Office of Rural Health Policy (FORHP) definition. Over the course of the Program, Virginia may build upon the FORHP baseline definition to better reflect the Commonwealth’s unique rural landscape and the needs of rural communities. Applicants should refer to the RHTP website for the most up-to-date rural definition and eligibility requirements. The current list of FORHP-designated localities is available in Appendix A.

Agency Program Contact:

Brandon Rivenbark Rural Hospital Program Manager Brandon.rivenbark@vdh.virginia.gov

(804) 835-2618 mailto:Brandon.rivenbark@vdh.virginia.gov

Table of Contents

PART I: PROGRAM BACKGROUND

1.1 Innovative Maternal Care Initiative Background

1.2 Program & RFA Purpose

1.3 Program Objectives for this RFA

1.4 Eligible Applicants

1.5 Available Funding & Award Structure

1.6 Project Duration and Continuation Opportunities

PART II: REQUIRED SCOPE OF WORK

2.1 Scope of Work Overview

2.2 Required Activities

2.3 Innovation Expectations

2.4 Required Partnerships and Coordination

2.5 Geographic Scope

2.6 Expected Project Deliverables

PART III: REQUIRED PERFORMANCE METRICS AND MILESTONES

3.1 Required Program Metrics

3.2 Additional Project-Specific Performance Measures

3.3 Required Program Milestones

PART IV: APPLICATION REQUIREMENTS

4.1 Cover Page

4.2 Executive Summary

4.3 Project Narrative

4.4 Budget Requirements

4.5 Organizational Capacity

4.6 Key Personnel & Staffing

4.7 Letters of Support and Memoranda of Understanding (if applicable)

4.8 Active SAM.gov Registration Confirmation and Debarment Certification

PART V: REVIEW CRITERIA AND SCORING

5.1 Review Process

5.1 Review Criteria and Scoring Rubric

PART VI: AWARD TERMS, REPORTING, AND COMPLIANCE REQUIREMENTS

6.1 Federal Regulatory Framework

6.2 Reporting Schedule

6.3 Sub-awardee Monitoring

6.5 Prohibited Uses of Funds

6.6 Record Retention and Audit Requirements

6.7 Data Integrity and Intellectual Property

6.8 Prior-Approval Triggers

6.9 Remedies for non-compliance

6.10 Required Certifications and Assurances Prior to Award

6.11 Pre-Award Financial Documentation and Risk Assessment

6.12 Payment and Reimbursement

6.13 Continuation Funding

Appendix A

PART I: PROGRAM BACKGROUND

1.1 Innovative Maternal Care Initiative Background

The Innovative Maternal Care sub-initiative is part of the Virginia Rural Health Transformation Program (RHTP), established under Section 71401 of Public Law 11921 and administered by The Centers for Medicare & Medicaid

Services (CMS). Virginia’s rural communities experience persistent gaps in access to maternal healthcare, including limited clinical availability, workforce shortages, care coordination challenges, behavioral health disparities, and long travel distances for prenatal and postpartum care.

The Innovative Maternal Care Initiative addresses these rural health challenges by supporting investments that expand maternal healthcare access, strengthen regional maternal health infrastructure, and improve care coordination for pregnant and postpartum individuals residing in rural communities. Program activities align with the Commonwealth’s 2025 approved Rural Health Transformation application and CMS strategic goals by supporting care delivery transformation, maternal/infant health improvements, and evidence informed models that improve maternal outcomes.

As a designated RHTP subrecipient, the Virginia Department of Health (VDH) will carry out the Innovative

Maternal Care Initiative through the issuance of this Request for Applications (RFA).

Rather than funding isolated projects, the Innovative Maternal Care Initiative is intended to support sustainable, community-driven approaches that strengthen local systems of care, improve coordination across clinical and community partners, and increase access to comprehensive maternal health services in rural Virginia. VDH seeks projects that create lasting improvements in how care is delivered, coordinated, and sustained beyond the five-year period of this federal funding.

1.2 Program & RFA Purpose

The purpose of this RFA is to solicit applications for funding under the Innovative Maternal Care sub-initiative of the Connected to Care, Closer to Home initiative. This RFA seeks to support rural maternal health projects that expand access to comprehensive prenatal, perinatal, postpartum, and maternal behavioral health services within Federal Office of Rural Health Policy (FORHP) designated rural communities.

Program Vision and Funding Priorities

VDH’s vision for the Innovative Maternal Care Initiative is to support community-driven, evidence-informed projects that produce meaningful and sustainable improvements in access to maternal healthcare for individuals residing in rural Virginia. Through this RFA, VDH seeks to strengthen local and regional maternal health systems by supporting partnerships, service delivery models, and infrastructure that address identified gaps in prenatal, perinatal, postpartum, and maternal behavioral healthcare.

Applicants are encouraged to propose projects that respond to locally identified maternal health needs and demonstrate meaningful collaboration among healthcare providers, community-based organizations, public health agencies, and other partners. VDH recognizes that rural communities differ significantly across Virginia, and innovative solutions may vary based on community context, available resources, and identified gaps.

Projects should demonstrate the potential for sustainability, scalability, or replication in other rural Virginia communities and address one or more of the following:

• Expand timely access to prenatal and postpartum care;

• Strengthen maternal care coordination, navigation, and referral pathways;

• Develop or expand regional maternal health hubs and coordinated networks of care;

• Integrate maternal behavioral health and substance use disorder services;

• Address transportation, language, workforce, technology, and other barriers affecting rural access to maternal health and related services;

• Expand community-based supports, including community health workers, doulas, peer support, home visiting programs, and other trusted community partners;

• Leverage telehealth, mobile healthcare delivery, digital health technologies, and other technology-enabled approaches, where appropriate, to improve access to prenatal, postpartum, behavioral health, specialty, and supportive maternal healthcare services, particularly in geographically isolated or underserved rural communities.

• Establish collaborative partnerships to improve rural maternal health services among healthcare providers, hospitals, rural health clinics, federally qualified health centers, local health departments, behavioral health providers, community-based organizations, and other regional partners

For purposes of this RFA, innovation does not require development of an entirely new model of care. Innovation may include implementing an evidence-informed practice in a rural community where it has not previously existed, adapting an existing model to better meet local needs, creating new partnerships between organizations, integrating services across sectors, leveraging technology to improve access, or redesigning workflows to improve maternal health outcomes.

VDH intends to support a geographically diverse portfolio of high-quality projects across Virginia’s Rural Health Transformation Program regions. VDH’s goal is to make at least one award supporting eligible rural communities within each region, subject to the quality of applications received, availability of funding, and the results of the competitive review process. Geographic distribution will not supersede application quality, programmatic alignment, organizational capacity, or responsible stewardship of federal funds. VDH reserves the right not to make an award within a region if no application serving that region meets the minimum standards for funding.

This approach is intended to promote equitable access to Rural Health Transformation Program investments across Virginia while ensuring that awards are made based on merit and the potential for meaningful impact.

VDH anticipates serving as an active implementation partner throughout the period of performance by providing technical assistance, learning collaborative opportunities, performance improvement support, and other resources designed to assist awardees in successfully implementing their projects and advancing rural maternal health outcomes.

1.3 Program Objectives for this RFA

The objectives of this RFA are to support applicants in advancing the following initiative specific goals aligned to CMS strategic priorities:

Objective Description CMS Strategic Goal Alignment

Expand access to high quality prenatal and postpartum care in rural communities through evidence informed service delivery models.

Maternal/Infant Health; Sustainable Access

Strengthen maternal care coordination and navigation, including referral pathways between community‑based organizations and clinical providers.

Rural Provider Partnerships; Care Coordination

Enhance maternal behavioral health supports, including perinatal mental health infrastructure.

Behavioral Health Integration

Improve maternal health equity by reducing disparities in rural access to care, strengthening language services, and supporting culturally informed care.

Rural Health Infrastructure; Health Equity

Strengthen sustainable rural maternal health infrastructure through regional partnerships, innovative care models, and community-based collaboration.

Rural Health Infrastructure;

Sustainability

1.4 Eligible Applicants

To be eligible for an award under this RFA, applicants must:

• Be a legally organized entity in good standing that is capable of receiving and administering federal subaward funding. Eligible applicants include, but are not limited to:

Licensed Emergency Medical Services (EMS) agencies;

Nonprofit organizations;

State, local, or Tribal governmental entities;

Hospitals and health systems;

Federally Qualified Health Centers (FQHCs);

Primary Care Clinics;

Rural Health Clinics (RHCs); and

Institutions of higher education

• Hold an active SAM.gov registration with a current Unique Entity Identifier (UEI) and have no active exclusions, debarments, or suspensions.

• Demonstrate organizational capacity to manage federal funds in accordance with the requirements of 2 CFR Part 200, including financial management, procurement, reporting, and grant administration.

• Operate in, or demonstrate the capacity to provide direct services benefiting, one or more Federal Office of Rural Health Policy (FORHP)-designated rural Virginia localities identified in Appendix A.

Collaborative applications involving multiple organizations are strongly encouraged. When multiple organizations participate, one eligible entity must serve as the lead applicant and assume responsibility for all programmatic, financial, contractual, and reporting requirements associated with the subaward.

Applicants proposing collaborative projects should clearly describe the roles and responsibilities of each partner, including governance, service delivery, data sharing, and performance monitoring.

1.5 Available Funding & Award Structure

Funding available under this RFA includes:

• Up to $1,000,000 annually for competitive organizational awards supporting community-driven maternal health models;

o Applicants should request funding that is reasonable, proportional to the proposed scope of work, and supported by a detailed budget justification. VDH anticipates funding a mix of smaller, targeted projects and larger regional initiatives based on the quality, scope, and anticipated impact of applications received.

Regardless of award amount, the following conditions apply to all awards under this RFA:

• Initial subaward period: From execution of the subaward agreement through September 30, 2027.

• VDH anticipates that there will be minimal funding availability for direct administrative costs and no availability for indirect costs. Applicants should attempt to minimize administrative expenses in their application's budget proposal to align to RHTP program requirements.

• No cost sharing or matching is required.

• Sub-awardees must demonstrate satisfactory performance to receive renewal funding in each subsequent budget period.

• Pre-award costs are not allowable.

• Applicants and funded partners that operate a labor and delivery unit must maintain that unit throughout the applicable award period when the unit is material to the approved project. Closure or suspension of the unit may constitute a material failure to perform and may result in termination of the award, disallowance of costs, and repayment of grant funds, subject to the terms of the executed subaward agreement and applicable federal and state requirements.

1.6 Project Duration and Continuation Opportunities

The Virginia Department of Health (VDH) recognizes that innovative maternal health projects may vary considerably in scope, complexity, and implementation timeline. The initial subaward period of performance for projects funded under this RFA will begin upon execution of the subaward agreement and extend through September 30, 2027. Applicants are encouraged to propose projects with a duration that is appropriate for the proposed activities and expected outcomes. Some projects may focus on planning, capacity building, or pilot implementation, while others may support expansion, refinement, or broader implementation of established models. Applicants should clearly describe the anticipated project timeline and identify the activities expected to be completed during the initial award period.

VDH anticipates that the Innovative Maternal Care Initiative will support a balanced portfolio of both new and expanded projects throughout the Rural Health Transformation Program (RHTP) period of performance. Subject to continued funding from the Centers for Medicare & Medicaid Services (CMS), allocations from the Department of Medical Assistance Services (DMAS), satisfactory project performance, compliance with award requirements, and continued alignment with program priorities, VDH may offer continuation funding for selected projects funded under this RFA.

Continuation funding is not guaranteed and will be contingent upon the availability of funding, satisfactory project performance, achievement of required milestones, compliance with reporting requirements, and VDH's programmatic priorities. Future funding opportunities may include a combination of continuation awards for existing projects and competitive funding opportunities for new projects to support continued innovation and address emerging maternal health priorities in rural Virginia.

PART II: REQUIRED SCOPE OF WORK

2.1 Scope of Work Overview

The Virginia Department of Health (VDH) seeks to fund innovative, community-driven projects that improve access to comprehensive maternal healthcare services for individuals residing in Virginia's federally designated rural communities. Through the Innovative Maternal Care Initiative, funded under the Virginia Rural Health

Transformation Program (RHTP), VDH will support projects that strengthen local and regional systems of care, improve coordination across healthcare and community partners, and expand sustainable models that address the unique maternal health needs of rural populations.

Applicants are encouraged to develop proposals that respond to identified community needs while leveraging existing resources, partnerships, and evidence-informed practices. Recognizing that maternal health challenges differ across rural Virginia, VDH seeks projects that are tailored to local circumstances while aligning with the overarching goals of the Rural Health Transformation Program.

Successful projects should demonstrate measurable improvements in access to care, care coordination, patient experience, and health outcomes while creating sustainable infrastructure that can continue beyond the period of grant funding.

Projects funded under this initiative must support one or more of the following overarching goals:

• Improve timely access to prenatal, delivery, and postpartum care.

• Strengthen coordination among clinical providers, public health, behavioral health, and community-based organizations to improve access to and continuity of maternal care.

• Address barriers to maternal healthcare through innovative service delivery models.

• Improve maternal health outcomes through evidence-informed practices.

• Develop sustainable systems capable of supporting long-term improvements in rural maternal health.

Applicants may propose projects of varying duration and scope based on the needs of the target population and the complexity of the proposed intervention. VDH recognizes that some innovative maternal health projects may focus on planning, capacity building, or pilot implementation, while others may support expansion, refinement, or broader implementation of established models. Applicants should propose a realistic implementation timeline that reflects the scope of the proposed project and clearly identify the activities expected to be completed during the initial award period.

2.2 Required Activities

All funded projects shall implement activities necessary to successfully administer and operate the proposed initiative. At a minimum, awardees will be expected to complete the following requirements throughout the project period.

A. Project Administration

Awardees shall:

• Designate a project lead who will serve as the primary individual responsible for overall project implementation, coordination, and oversight o The Project Lead may be an existing or newly designated staff member and is not required to hold a specific organizational title, provided the individual has sufficient authority and responsibility to coordinate project activities and ensure compliance with award requirements.

• Maintain appropriate fiscal oversight and grant management practices

• Participate in all VDH technical assistance, meetings, and learning collaborative activities

• Submit all required programmatic and financial reports according to established reporting schedules

• Maintain documentation demonstrating progress toward project objectives

B. Community Assessment and Planning

During the planning phase, awardees shall:

• Assess maternal health needs within the proposed service area

• Identify existing assets, gaps, and barriers affecting maternal health services

• Engage community stakeholders in project planning and implementation

• Develop workflows that support coordinated maternal healthcare delivery

• Establish partnerships necessary to implement proposed activities

• Develop implementation and sustainability planning

C. Project Implementation Awardees shall implement evidence-informed strategies designed to improve maternal healthcare access and outcomes within their proposed service area.

Projects may include one or more of the following activities, as appropriate to community need:

Clinical Care Delivery

• Examples include:

o Expanding prenatal and postpartum care access o Telehealth or virtual maternal health services o Mobile maternal health o Technology-enabled maternal care o Lactation support services o Integrated behavioral health services o Substance use disorder treatment integration

Care Coordination and Patient Navigation

• Examples include:

o Community health worker programs supporting prenatal, postpartum, and maternal healthcare access o Doula integration into prenatal, delivery, and postpartum care o Maternal health care coordination and case management o Patient navigation across prenatal, delivery, postpartum, behavioral health, and specialty care services o Referral management and closed-loop referral process for maternal health services o Connection to community resources and social supports that address barriers to maternal healthcare o Cross-sector coordination among maternal healthcare providers, behavioral health providers, public health, and community-based organizations Workforce Development

• Examples include:

o Recruitment and retention strategies for maternal healthcare professionals serving rural communities o Cross-training of healthcare providers to strengthen the delivery of prenatal, postpartum, and maternal behavioral health, and related services o Continuing education and professional development focused on rural maternal healthcare needs o Development or expansion of interdisciplinary maternal care teams o Training and workforce development for community health workers, doulas, peer support specialists, and other community-based maternal health workers o Development of innovative staffing or workforce models that expand access to maternal healthcare services in rural communities

Community-Based Supports

• Examples include:

o Transportation assistance designed to improve access to prenatal, postpartum, behavioral health, specialty, and other maternal healthcare services o Maternal health education, including prenatal and postpartum education and support o Community outreach and engagement to connect pregnant and postpartum individuals with maternal health services o Interventions addressing health-related social needs that create barriers to accessing or completing maternal healthcare o Partnerships with community-based organizations to strengthen maternal health referral pathways, navigation, and supportive services o Culturally and linguistically responsive maternal health programming designed to meet the needs of rural populations o Peer support, home visiting, and other community-based services supporting pregnant and postpartum individuals

2.3 Innovation Expectations

Innovation within this initiative does not require creation of an entirely new model of care. Rather, innovation may include implementing evidence-informed practices in rural communities where they do not currently exist, expanding successful models to underserved populations, strengthening collaboration among organizations, redesigning care delivery workflows, integrating technology, or developing new approaches that improve maternal health outcomes.

Applicants should clearly describe:

• What makes the proposed project innovative within the proposed community.

• How the project differs from existing services.

• Why Rural Health Transformation Program funding is necessary to implement the proposed approach.

• How the project will improve access, coordination, quality, or maternal health outcomes.

2.4 Required Partnerships and Coordination

Sub-awardees are strongly encouraged to develop partnerships with rural healthcare providers, community organizations, local health districts, behavioral health providers, home visiting programs, regional referral networks, and other entities that support maternal health access. Applicants must describe how these partnerships will contribute to program implementation, service delivery, care coordination, and sustainability.

If formal Memorandums of Understanding (MOUs) or partnership agreements are required for the proposed project, applicants must submit these documents with their application. If no specific partnership documents are required, applicants must still demonstrate meaningful collaboration with key maternal health stakeholders.

2.5 Geographic Scope

Applicants must provide services that benefit individuals residing in Federal Office of Rural Health Policy-designated rural communities in Virginia. A complete list of eligible Virginia localities, corresponding FIPS codes, and Rural Health Transformation Program regions is provided in Appendix A.

Applicants must identify each eligible locality proposed to be served and provide the corresponding FIPS code and Rural Health Transformation Program region. Applicants may propose to serve one locality, multiple localities, or a regional service area, provided that the application clearly describes the target population, demonstrated need, service delivery approach, and anticipated reach within the identified rural communities.

Projects may include partners or service providers located outside an eligible rural locality when their participation is necessary to deliver services to eligible rural residents. However, applicants must clearly demonstrate that RHTP-funded services and benefits will primarily support eligible rural Virginia communities.

2.6 Expected Project Deliverables

All awardees will be expected to produce, at a minimum:

• A finalized implementation plan

• A project work plan with milestones

• Quarterly programmatic reports

• Performance measure reporting

• Required financial reports

• Participation in VDH technical assistance and learning collaborative activities

• A sustainability plan

• A final project report summarizing accomplishments, outcomes, lessons learned, and recommendations

PART III: REQUIRED PERFORMANCE METRICS AND

MILESTONES

3.1 Required Program Metrics

Performance measurement is a critical component of the Innovative Maternal Care Initiative and the Virginia Rural Health Transformation Program (RHTP). Performance monitoring will include both statewide/locality-level measures generated by VDH and project-specific performance data collected and reported by subrecipients.

Together, these measures will support program accountability, continuous quality improvement, statewide evaluation, and assessment of the Initiative’s impact on maternal health in Virginia’s rural communities.

VDH-Generated Required Metrics

VDH will be responsible for generating and monitoring the following three CMS-required performance metrics for the Innovative Maternal Care Initiative. These measures will be calculated for the rural localities targeted by funded projects using Virginia’s All-Payer Claims Database (APCD) and other appropriate statewide data sources. Subrecipients will not be responsible for independently calculating or reporting these three measures.

• Metric 1a: HEDIS Measure PPC- Timeliness of prenatal care in rural localities targeted by the sub-initiative

• Metric 1b: HEDIS Measure PPC- Completion of postpartum care in rural localities targeted by the sub-initiative

• Metric 2: Rate of postpartum hospital readmissions in rural localities targeted by the sub-initiative

Applicants should consider how their proposed activities may contribute to the broader aims reflected in these required metrics, including improving timely access to prenatal care, increasing completion of postpartum care, and reducing avoidable postpartum hospital readmissions. VDH will work collaboratively with selected subrecipients and the statewide evaluation partner to assess how individual project activities and project-specific measures contribute to the broader evaluation of the Innovative Maternal Care Initiative.

Required Subrecipient Measure: Individuals Served

All subrecipients will be required to report the number of unique individuals served or directly reached through the funded project, including the number residing within FORHP-designated rural localities identified in Appendix A.

VDH will provide additional definitions, reporting specifications, and templates following award to promote consistency across funded projects.

3.2 Additional Project-Specific Performance Measures

In addition to the VDH-generated required metrics and required subrecipient measure identified in Section 3.1, applicants are encouraged to propose project-specific performance measures that reflect the unique goals, activities, and anticipated outcomes of their proposed project. These measures should demonstrate project implementation, progress, and impact within the proposed service area while supporting the broader goals and intended outcomes of the Innovative Maternal Care Initiative.

Recognizing that funded projects may vary in scope, target population, and implementation strategy, project-specific performance measures are intended to provide applicants with flexibility to evaluate the effectiveness of their individual interventions while contributing to the broader goals of the Innovative Maternal Care Initiative.

Applicants should identify performance measures that are:

• Directly aligned with the proposed project activities and objectives;

• Measurable using available data sources;

• Appropriate for the target population and proposed service area;

• Capable of demonstrating meaningful progress throughout the project period; and

• Aligned with the goals and intended outcomes of the Innovative Maternal Care Initiative and, where applicable, supportive of the VDH-generated measures identified in Section 3.1.

Project-specific performance measures may include process measures, output measures, and outcome measures, as appropriate to the proposed project.

Examples of project-specific performance measures include, but are not limited to:

Activity Type Example Measures

Access to Maternal Care Number of prenatal visits completed; postpartum visits completed; new patients served; reduced wait times for appointments; telehealth encounters

Activity Type Example Measures

Care Coordination Care coordination encounters; referrals completed; closed-loop referrals;

patient navigation services provided; care plans developed

Behavioral Health Integration

Maternal depression screenings completed; behavioral health referrals;

integrated behavioral health visits; substance use disorder screening and referral

Community Partnerships New partnerships established; community outreach events conducted;

referral agreements executed; collaborative meetings held

Patient Engagement and Experience

Patient satisfaction; participation in education programs; barriers to care reduced; patient retention in care

Workforce and Capacity Building

Providers trained; workforce recruitment or retention; implementation of new clinical workflows; adoption of evidence-informed practices

Applicants are encouraged to describe how their proposed project-specific performance measures align with the broader goals and intended outcomes of the Innovative Maternal Care Initiative and, where applicable, support the VDH-generated measures identified in Section 3.1.

VDH may work collaboratively with awardees following award to refine project-specific performance measures and reporting expectations to ensure consistency with statewide evaluation activities and alignment with the Virginia Rural Health Transformation Program.

3.3 Required Program Milestones

Awardees are expected to achieve measurable implementation milestones throughout the project period that demonstrate progress toward successful implementation, effective project management, and long-term sustainability. While individual projects may vary in scope and approach, all awardees should incorporate milestones that reflect the planning, implementation, evaluation, and sustainability activities necessary to achieve the goals of the Innovative Maternal Care Initiative.

Applicants shall identify project-specific milestones within the required Work Plan and describe their overall implementation and project management approach in Section D of the Project Narrative. Project milestones should be realistic, measurable, and aligned with the proposed activities, deliverables, and performance measures described in Sections 3.1 and 3.2.

The following milestones represent the anticipated phases of project implementation and are intended to provide general guidance for applicants. VDH recognizes that individual project timelines may vary and may work collaboratively with awardees following award to refine project milestones and implementation schedules, as appropriate.

Milestone Activities Completed Required By

Project Planning and Start-

Up

Staffing completed, partnerships established, implementation planning completed, baseline data collection

Within 60 days of award

Milestone Activities Completed Required By

Project Implementation Service delivery, care coordination, community engagement, performance monitoring

Throughout project period

Project Closeout Evaluation, sustainability planning, final reporting, dissemination of lessons learned

September 30, 2027

Performance Monitoring and

Quality Improvement

Monitor project performance, participate in required reporting and evaluation activities, and use data to inform continuous quality improvement and project refinement.

Throughout project period

Sub-awardees must document milestone completion through required reporting deliverables. If a milestone is not met, the sub-awardee must notify the issuing agency immediately and propose corrective action in accordance with Part VI.

PART IV: APPLICATION REQUIREMENTS

A complete and responsive application must include all components identified in this section. Applications that are submitted after the deadline, omit a required component, or do not comply with the submission, formatting, or page-limit requirements of this RFA may be deemed nonresponsive and may not advance to merit review.

Applicants should present information clearly and concisely and ensure consistency across the Executive Summary, Project Narrative, work plan, performance measures, staffing information, and budget. Each application must provide sufficient detail for reviewers to evaluate the proposed project using the review criteria described in Part V.

Formatting Requirements:

Unless otherwise specified, all application materials must comply with the following requirements:

• Font: Arial

• Font Size: 12-point for all narrative text; 10-point minimum may be used within tables, charts, figures, and graphics

• Margins: 1-inch on all sides

• Spacing: Single-spaced

• Page Size: 8.5” x 11”

• Page Numbering: Consecutively number all pages of the application package

• File Format: PDF (unless otherwise specified)

• Page Limits: Page limits apply only to the sections identified in the RFA. Content exceeding the stated page limits will not be reviewed.

Component Page Limit

Application Cover Page 1 Page

Executive Summary 2 Pages

Project Narrative (as described in Section 4.3) 8 Pages

Budget and Budget Narrative (Please use attached budget template)

2 Pages for narrative N/A for Budget sheet (use template)

Organizational Capacity Statement 1 Page

Key Personnel Resumes or Bio-sketches No page limit

Component Page Limit

Letters of Support / MOUs (if applicable) As applicable

Active SAM.gov Registration Confirmation and Debarment Certification

No page limit

Work Plan No page limit; submitted as appendix

Applicants must submit all required components through eVA in accordance with the submission instructions provided on the cover page of this RFA.

4.1 Cover Page

Applicants shall complete and submit the Application Cover Page using the form provided below as part of this Request for Applications (RFA). The Application Cover Page serves as the official application transmittal and provides key organizational and contact information for the applicant.

APPLICANT ORGANIZATION AND PROJECT INFORMATION

Project Title

Total Funding Requested (USD)

Legal Name of Organization

DBA / Trade Name (if applicable)

Organization Type ☐ State agency

☐ Local government

☐ Tribal entity

☐ Nonprofit 501(c)(3)

☐ For-profit entity

☐ Institution of higher education

☐ Hospital / Health System

☐ Other (specify): Click or tap here to enter text.

Year Established

Number of Employees

Organization Website

EIN (Federal Tax ID, 9 digits)

Unique Entity Identifier (UEI)

SAM.gov Registration Active (Y/N)

Mailing Address (Street)

City, State, ZIP

AUTHORIZED ORGANIZATIONAL REPRESENTATIVE (AOR) CERTIFICATION

By signing below, the Authorized Organizational Representative certifies that all information in this application is true, accurate, and complete; that the organization accepts all conditions of a Virginia RHTP subrecipient award; and that the organization will comply with 2 CFR Part 200, CMS RHTP Program Terms and Conditions, and all applicable federal and state requirements.

Full Name

Title

Email

Direct Phone

Date

AOR Signature:

Applicants are responsible for ensuring that all information provided on the Application Cover Page is complete and accurate. The Authorized Organizational Representative must have the legal authority to submit the application and enter into a subaward agreement on behalf of the applicant organization.

Required Submission:

• Completed Application Cover Page (1 page)

4.2 Executive Summary

Applicants shall submit an Executive Summary that provides a concise overview of the proposed project. The Executive Summary should summarize the key elements of the application and provide reviewers with a clear understanding of the proposed project, the need it addresses, the applicant's approach, and the anticipated impact on maternal health services within the proposed rural service area.

The Executive Summary should be written as a stand-alone summary of the proposed project and should accurately reflect the information presented throughout the remainder of the application.

At a minimum, the Executive Summary shall include:

• A brief description of the applicant organization and its role in the proposed project.

• The proposed project title and a concise overview of the proposed project.

• A description of the rural community (or communities) and target population to be served.

• A summary of the maternal health needs, service gaps, or barriers that the proposed project is intended to address.

• A high-level overview of the proposed activities, implementation approach, and anticipated partnerships.

• A summary of the expected project outcomes and how the proposed project aligns with the goals of the Innovative Maternal Care Initiative and the Virginia Rural Health Transformation Program (RHTP).

• The total amount of funding requested.

The Executive Summary should not introduce new information that is not otherwise addressed within the Project Narrative.

• Executive Summary (maximum 2 pages)

4.3 Project Narrative

The Project Narrative is the primary component of the application and should clearly describe the proposed project, the applicant's capacity to successfully implement the proposed activities, and how the project will advance the goals of the Innovative Maternal Care Initiative. Applicants should respond to each section below in the order presented and provide sufficient detail to enable reviewers to fully evaluate the proposed project using the evaluation criteria outlined in Part V of this RFA.

Do not omit or combine sections. Narrative responses should be concise, well organized, and supported by relevant data or examples where appropriate. Pages exceeding the stated page limits will not be reviewed.

Section A: Program Design

Describe the proposed maternal health project and how it will advance the goals of the Virginia Rural Health

Transformation Program (RHTP) and the Innovative Maternal Care Initiative. Applicants should clearly explain the proposed model of care, the need for the project, and how the proposed activities will improve access to maternal healthcare services within the proposed rural service area.

At a minimum, applicants shall address the following:

• Identify the applicable Rural Health Transformation Program initiative (Connected Care Closer to Home) and sub-initiative (Innovative Maternal Care).

• Describe the proposed project, including the target population, geographic service area, and primary activities to be implemented.

• Describe the evidence-informed practices, models of care, or best practices that support the proposed approach and explain why they are appropriate for the identified community.

• Explain how the proposed project addresses identified maternal health needs, service gaps, and barriers to care within the proposed rural community or region.

• Describe the anticipated impact of the proposed activities on maternal health access, care coordination, quality, and outcomes.

• Present a clear theory of change or project logic that connects project activities to anticipated outputs, outcomes, and long-term impact.

• Explain how the proposed project represents an innovative or transformational approach that builds upon or enhances existing maternal health services rather than simply maintaining current operations.

Page Limit: 2.5 pages

Section B: Stakeholder Engagement

Applicants shall describe how key stakeholders will be engaged in the planning, implementation, and ongoing oversight of the proposed project. Successful projects should demonstrate meaningful collaboration among healthcare providers, public health agencies, community-based organizations, and other partners that contribute to improving maternal health services within the proposed rural service area.

At a minimum, applicants shall address the following:

• Identify the organizations and stakeholders that will participate in the proposed project and describe each partner's role and responsibilities.

• Describe how partnerships were established and how stakeholders contributed to the development of the proposed project.

• Explain how communication, decision-making, and project oversight will be coordinated among participating organizations.

• Describe how the proposed project will leverage existing community resources, programs, and initiatives to avoid duplication and strengthen local maternal health infrastructure.

• Explain how individuals with lived experience, patients, families, or community representatives will be engaged in project planning, implementation, and evaluation, where appropriate.

• Describe any existing or anticipated partnerships with hospitals, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Local Health Districts, behavioral health providers, community-based organizations, Medicaid Managed Care Organizations, or other organizations that support the proposed project.

Page Limit: 1 page

Section C: Performance Metrics and Evaluation Plan

Applicants shall describe how they will measure project implementation and success throughout the period of performance. The evaluation plan should focus primarily on project-specific performance measures that are appropriate to the proposed intervention while describing, where applicable, how the project may contribute to the broader Initiative outcomes identified in Section 3.1.

At a minimum, applicants shall address the following:

• Describe how the proposed project aligns with the broader maternal health outcomes reflected in Section 3.1, as applicable

• Identify proposed project-specific performance measures in accordance with Section 3.2 and explain how they will demonstrate project implementation, progress, and success;

• Describe proposed data sources, data collection methods, and reporting processes for project-specific measures;

• Explain how performance data will be used for continuous quality improvement and project management;

• Identify anticipated data collection or reporting challenges; and

• Identify staff or partners responsible for project-level performance measurement and reporting.

Page Limit: 1.5 pages

Section D: Implementation Approach and Project Management

Applicants shall describe the overall approach that will be used to implement and manage the proposed project during the initial award period. This section should explain the applicant's implementation strategy, how project activities will be coordinated and monitored, and how the applicant will address potential challenges to successful implementation.

At a minimum, applicants shall address the following:

• Describe the major phases of project implementation and how activities will be sequenced and coordinated.

• Describe the approach for managing and overseeing project implementation, including coordination among key personnel and partner organizations.

• Explain how project progress will be monitored to ensure activities, milestones, and deliverables remain on schedule.

• Describe potential implementation risks, barriers, or dependencies and the strategies that will be used to mitigate or address them.

• Explain how implementation activities will support the broader goals and intended outcomes of the Innovative Maternal Care Initiative and achievement of applicable project-specific performance measures, including alignment with the VDH-generated measures identified in Section 3.1, where applicable.

• For projects involving multiple phases or activities extending beyond the initial award period, describe how activities proposed during the initial award period contribute to the project's broader implementation strategy. Continuation funding is not guaranteed.

Required Work Plan: In addition to the narrative above, applicants are required to complete and submit a Work

Plan as an appendix to the application. Applicants may use the VDH-provided Work Plan Template or submit a comparable format that includes the same required information. The Work Plan should translate the implementation approach described in the Project Narrative into a structured project management tool identifying major activities, milestones, timelines, responsible parties, anticipated deliverables, and associated performance measures for the initial award period. The Work Plan will not count toward the Project Narrative page limit.

Page Limit: 2 pages

Section E: Sustainability Plan

Applicants shall describe their strategy for sustaining successful project activities beyond the period of grant funding. Sustainability planning should consider how effective practices, partnerships, and infrastructure developed through the Innovative Maternal Care Initiative will continue to improve maternal health services within the proposed service area.

At a minimum, applicants shall address the following:

• Describe how successful project activities will be integrated into ongoing organizational operations, where appropriate.

• Identify potential long-term funding sources, reimbursement strategies, or organizational resources that may support continuation of project activities.

• Describe how partnerships established through the project will be maintained beyond the grant period.

• Explain how workforce capacity, organizational infrastructure, and community engagement efforts will support long-term sustainability.

• Describe how project outcomes and lessons learned will be used to inform future maternal health initiatives within the community or region.

Applicants are not required to demonstrate that all project activities will continue indefinitely; however, they should present a realistic strategy for maintaining the project's most impactful components beyond the period of RHTP funding.

Page Limit: 1 page

4.4 Budget Requirements

Applicants shall submit a complete project budget using the VDH Budget Template (Microsoft Excel) provided as part of this Request for Applications (RFA). The completed budget template must include all anticipated project costs associated with implementation of the proposed project and must be submitted in its original Excel format.

In addition to the completed budget template, applicants shall submit a Budget Narrative that provides sufficient detail to explain and justify the proposed budget. The Budget Narrative must not exceed two (2) pages and should clearly describe how the requested resources support the proposed project activities, work plan, performance measures, and anticipated outcomes.

At a minimum, the Budget Narrative should address the following, as applicable:

• Personnel positions, including each position's role, responsibilities, and level of effort.

• Fringe benefits and the basis for calculating fringe benefit costs.

• Contractual or consultant services, including the scope of work and purpose of each contract.

• Equipment purchases and their…