MCHB HRSA-22-069 (H84) F2FHIC_Final.pdf

U.S. Department of Health and Human Services

Maternal and Child Health Bureau Division of Services for Children with Special Health Care Needs

Family-to-Family Health Information Centers

Funding Opportunity Number: HRSA-22-069

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings (AL/CFDA) Number: 93.504

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: January 5, 2022 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems may take up to 1 month to complete.

Issuance Date: September 30, 2021

Jessica Teel Senior Public Health Analyst, Division of Services for Children with Special Health Care Needs Telephone: (301) 945-5133 Email: jteel@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 701(c) (Title V, § 501(c) of the Social Security Act) mailto:jteel@hrsa.gov

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508 COMPLIANCE DISCLAIMER

Note: Persons using assistive technology may not be able to fully access information in this file. For assistance, please email or call one of the HRSA staff listed in Section VII.

Agency Contacts.

EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2022 Family-to-Family Health Information Centers. The purpose of this program is to provide information, education, technical assistance, and peer support to families of children and youth with special health care needs (CYSHCN) and the professionals who serve them.

Funding Opportunity Title: Family-to-Family Health Information

Centers

Funding Opportunity Number: HRSA-22-069

Due Date for Applications: January 5, 2022

Anticipated Total Annual Available FY 2022 Funding:

Up to $5,708,250

Estimated Number and Type of Award(s): Up to 59 grants

Estimated Annual Award Amount: Up to $96,750 per award subject to the availability of appropriated funds

Cost Sharing/Match Required: No

Period of Performance: June 1, 2022 through May 31, 2027

(5 years)

Eligible Applicants: Eligible applicants include any domestic public or private entity. Domestic faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply.

Eligibility for this funding opportunity is limited to applicants within the 50 states, the District of Columbia, the five U.S.

Territories (American Samoa, Guam, Puerto Rico, the Northern Mariana

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Islands and the U.S. Virgin Islands) and entities that will serve American Indian and/or Alaska Native tribes1.

See Section III.1 of this notice of funding opportunity (NOFO) for complete eligibility information.

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf, except where instructed in this NOFO to do otherwise.

Technical Assistance

HRSA has scheduled the following technical assistance:

Webinar

Day and Date: Wednesday, October 27, 2021 Time: 3 p.m. ET Call-In Number: 1 833 568 8864 US Toll-free Participant Code: 54026854 Weblink: https://hrsa-gov.zoomgov.com/j/1614479271?pwd=V3BKNFdKNFo4WlhERS9FUDdGM3NvUT09

HRSA will record the webinar and make it available at:

https://mchb.hrsa.gov/fundingopportunities/default.aspx.

1 Section 501(c)(5)(A) defines the term “Indian Tribe” as having “the meaning given such term in section 1603 of Title 25.” Section 1603 of Title 25 defines the term “Indian Tribe” as ”any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or group or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.],688), which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.” Accordingly, this NOFO will also refer to individuals of this population as American Indian and/or Alaska Native, as appropriate.

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://hrsa-gov.zoomgov.com/j/1614479271?pwd=V3BKNFdKNFo4WlhERS9FUDdGM3NvUT09 https://hrsa-gov.zoomgov.com/j/1614479271?pwd=V3BKNFdKNFo4WlhERS9FUDdGM3NvUT09 https://mchb.hrsa.gov/fundingopportunities/default.aspx

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING/MATCHING

3. OTHER

IV. APPLICATION AND SUBMISSION INFORMATION

1. ADDRESS TO REQUEST APPLICATION PACKAGE

2. CONTENT AND FORM OF APPLICATION SUBMISSION

i. Project Abstract

ii. Project Narrative

iii. Budget

iv. Budget Narrative

v. Program-Specific Forms

vi. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER TRANSITION

TO THE UNIQUE ENTITY IDENTIFIER (UEI) AND SYSTEM FOR AWARD MANAGEM ENT (SAM)

4. SUBMISSION DATES AND TIM ES

5. INTERGOV ERNM ENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW CRITERIA

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSM ENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIV E AND NATIONAL POLICY REQUIREM ENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Family-to-Family Health Information Centers (F2F HICs) Program. The purpose of this program is to provide information, education, technical assistance, and peer support to families of children and youth with special health care needs (CYSHCN) and the professionals who serve them.

This program will fund one F2F HIC in each of the 50 states, the District of Columbia, 5 U.S. Territories (Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands, and the Northern Mariana Islands); and up to 3 F2F HICs to serve American Indians/Alaska Natives.

Program Goal The goal of the F2F HIC Program is to promote optimal health and well-being for CYSHCN and their families by advancing a well-functioning system of services in which families and health professionals partner in health care decision-making. Recipients funded under this program are expected to integrate the following Family/Professional Partnership Program principles throughout project policies and activities: CYSHCN and their families should receive care in systems that are:

(1) family-centered, (2) culturally and linguistically appropriate, and (3) which promote shared decision-making between families of CYSHCN, health professionals, and appropriate state and community organizations.

Program Objectives The recipient will be responsible for collecting data and reporting annually on these objectives for the purposes of monitoring and evaluating the overall effectiveness of the program. Baselines for new recipients will be established for these measures within the first year of the award. Competing continuing recipients will use data from the last year (FY 2021) of the most recent award cycle as their baseline.

• By May 31, 2027, increase by 10 percent from baseline the number of families of CYSHCN and professionals who have received information, education, and/or training from F2F HICs.

• By May 31, 2027, increase by 10 percent from baseline the number of CYSHCN and families from underrepresented and diverse communities trained to partner at all levels of shared decision-making.

• By May 31, 2027, increase by 10 percent from baseline the number and type of state agencies/programs and community-based organizations assisted in providing services/information to families of CYSHCN.

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2. Background

About MCHB and Strategic Plan

The Maternal and Child Health Bureau (MCHB) administers programs with focus areas in maternal and women’s health, adolescent and young adult health, perinatal and infant health, child health, and children with special health care needs. To achieve its mission of improving the health and well-being of America’s mothers, children, and families, MCHB is implementing a strategic plan that includes the following four goals:

Goal 1: Assure access to high quality and equitable health services to optimize health and well-being for all MCH populations

Goal 2: Achieve health equity for MCH populations

Goal 3: Strengthen public health capacity and workforce for MCH

Goal 4: Maximize impact through leadership, partnership, and stewardship

The F2F HICs program addresses MCHB Goals 1–3 by:

• advancing a well-functioning system of services in which families and health professionals partner in health care decision-making (Goal 1);

• seeking to address health inequities and meet the needs of diverse and underserved families (Goal 2); and

• providing education and training for health professionals on how to work with parents/families of CYSHCN (Goal 3).

To learn more about MCHB and the bureau’s strategic plan, visit https://mchb.hrsa.gov/about.

This program is authorized by 42 U.S.C. § 701(c) (Title V, § 501(c) of the Social Security Act).

CYSHCN are those who have or are at risk of having a chronic physical, developmental, behavioral, or emotional condition and who require health and related services of a type or amount beyond that required by children generally.2 Approximately 13.9 million children in the United States (18.9 percent) have a special health care need and 1 in 4 households (28.1 percent) have 1 or more children with CYSHCN.3 CYSHCN often require a variety of services from multiple, diverse systems and need a number of different funding sources to pay for those services. Only 14.1 percent of CYSHCN receive services in a well-functioning system as characterized by family-professional partnerships, access to a medical home, adequate financing, coordinated services, screening, and transition to adult services.4

2 McPherson, M. Arango, P., Fox, H. A new definition of children with special health care needs. Pediatrics. 1998; 102: 137-140.

3 Data Resource Center for Child and Adolescent Health. Accessed at:

https://www.childhealthdata.org/browse/survey?s=2&y=32&r=1&t=2713 4 Children with Special Health Care Needs: NSCH Data Brief July 2020 accessed at https://mchb.hrsa.gov/sites/default/fi les/mchb/Data/NSCH/nsch-cshcn-data-brief.pdf https://mchb.hrsa.gov/about https://www.childhealthdata.org/browse/survey?s=2&y=32&r=1&t=2713 https://mchb.hrsa.gov/sites/default/files/mchb/Data/NSCH/nsch-cshcn-data-brief.pdf

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Within the population of CYSHCN, there are significant disparities in access to high-quality care. Only 9.3 percent of Hispanic children and 14.4 percent of Black children report receiving care in a well-functioning system, versus 15.6 percent of White children from the 2018–2019 National Survey of Children’s Health.5 Families of Black and Hispanic CYSHCN report having needs for care coordination that go unmet more frequently, as well as lower satisfaction with the care they receive.6 Language and cultural differences can also pose barriers to families in understanding diagnosis and treatment options as well as accessing services,7 underscoring the need for services for CYSHCN to need to be organized and provided in culturally responsive and linguistically appropriate ways.8

HRSA’s MCHB promotes family engagement as one of six core outcomes for CYSHCN.

Family engagement is defined as “patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system to improve health and health care.” 9 Actively engaging families as equal partners in their child’s health care system and decision making is associated with reduced unmet health needs and problems, improvement in specialty referrals, reduction of out of pocket expenses, and improvement in patient physical and behavioral function.10 In addition to family engagement, families of CYSHCN require an in-depth understanding of the health care system and options for health care. Both families and providers need training and support to improve quality of care, parent and family satisfaction, and families’ communication and relationships with health care providers.11

For many parents/families, the best sources of information are their peers – other families of CYSHCN experienced with navigating the health care system for themselves and their children. In order to help address the challenges for families in accessing care, the F2F HICs Program was developed to fill the gaps in information and support for families of CYSHCN and the providers who care for them. Providers benefit from the F2F HIC activities as well. From June 2019 to May 2020, nearly all (94 percent) of surveyed professionals (n=299) agreed the F2F HIC helped them better work with families and other health service professionals.

The F2F HIC Program was originally funded through a Special Projects of Regional and National Significance (SPRANS) pilot program in 2005, and is currently authorized and funded under § 501 (c) of the Social Security Act. The F2F HICs are staffed by parents

5 Data Resource Center for Child and Adolescent Health. Accessed at:

https://www.childhealthdata.org/browse/survey?s=2&y=32&r=1&t=2713 6 Pankewicz, A., Davis, R., Kim, J., Antonelli, R., Rosenburg, H., Berhane, Z., & Turchi, R. (2020). Children with special needs:

Social determinants of health and care coordination. Clinical Pediatrics 59(13) 1161-1168. DOI: 10.1177/0009922820941206 7 Hughes, D. (2015). In Their Own Words: Improving the Care Experience of Families with Children with Special Health Care Needs.

Accessed at:

https://www.lpfch.org/sites/default/files/field/publications/in_their_own_words_improving_the_care_experience_of_families_with_csh cn.pdf 8 Rosen-Reynoso, M., Porsch, M.V., Kwan, N., Bethell, C., Thomas, V., Robertson, J., Hawes, E., Foley, S., & Palfrey, J. (2016).

Disparities in access to easy-to-use services for children with special health care needs. Maternal and Child Health Journal, 20, 1041-1053. DOI: 10.1007/s10995-015-1890-z 9 Carman, K.L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement:

A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223–231.

10 Smalley et al. (2014). Family perceptions of shared decision-making with health care providers: Results of the National Survey of CYSHCN, 2009-2010. Doi 10.1007/s10995-013-1365-z 11 Marbell, P. (2017). Engaging families in improving the health care system for children with special health care needs. Lucile Packard Foundation for Children’s Health.

https://www.childhealthdata.org/browse/survey?s=2&y=32&r=1&t=2713 https://www.lpfch.org/sites/default/files/field/publications/in_their_own_words_improving_the_care_experience_of_families_with_cshcn.pdf https://www.lpfch.org/sites/default/files/field/publications/in_their_own_words_improving_the_care_experience_of_families_with_cshcn.pdf

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or caregivers of CYSHCN, who provide family-friendly support, education, and advocacy for families with CYSHCN.

Since the program’s inception in 2005, the network has grown from 29 to currently 59 funded F2F HICs (1 in each of the 50 states, the District of Columbia, the territories (Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands and the Northern Mariana Islands), and three organizations focused on serving Native Americans/American Indian Tribes. Preliminary data from June 1, 2019 – May 31, 2020 show that F2F HICs provided outreach and information to a total of 207,530 families and 97,655 health professionals through individualized assistance and/or training.

Examples of services include helping families maximize their health insurance coverage; understand their options for Medicaid, Supplemental Security Income, and Children’s Health Insurance Program (CHIP); access services and supports; and plan and manage transition points (into school, graduation, to adult services) in their children’s lives. 12

In expanding the F2F HICs Program’s reach to territories and tribal regions, the program has also enhanced partnerships with diverse and underserved communities in order to advance health equity. F2F HICs promote health equity by disseminating culturally and linguistically competent materials and resources in multiple languages, conducting outreach to culturally diverse communities, partnering with non-profit groups that represent the interest and needs of ethnic and cultural minorities, providing support groups, and subcontracting with members of specific communities to coordinate trainings. The U.S. Department of Health and Human Services defines equity as the consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality.13

MCHB is committed to promoting equity in health programs for mothers, children, and families. As such, the definition of equity provides a foundation for the development of programs that intend to reach underserved communities and improve equity among all communities. Addressing issues of equity should include an understanding of intersectionality and how multiple forms of discrimination impact individuals’ lived experiences. Individuals and communities often belong to more than one group that has been historically underserved, marginalized, or adversely affected by persistent poverty and inequality. Individuals at the nexus of multiple identities often experience unique forms of discrimination or systemic disadvantages, including in their access to needed services.14 The F2F HIC Program’s family-staffed model allows for the F2Fs to meet

12 Family-to-Family Health Information centers Helping Families of Children & Youth with Special Health Care Needs (CYSHCN) & the Professionals who Serve Them: 2018 Data Brief. September 2020 accessed at https://familyvoices.org/wp-content/uploads/2018/02/2017-2018F2FDataReport_4.11.19F.pdf 13 Executive Order 13985 on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, 86 FR 7009, at § 2(a) (Jan. 20, 2021), https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf.

14 See Executive Order 13988 on Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation, 86 FR 2023, at § 1 (Jan. 20, 2021), https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01761.pdf.

https://familyvoices.org/wp-content/uploads/2018/02/2017-2018F2FDataReport_4.11.19F.pdf https://familyvoices.org/wp-content/uploads/2018/02/2017-2018F2FDataReport_4.11.19F.pdf

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families where they are, making their role a critical component of advancing health equity for CYSHCN.

The F2F HIC Program fills a critical need for reliable information and support for all families with CYSHCN. Additionally, they serve as an important complement to, and resource for, other HRSA-funded programs that support direct health care service delivery or system infrastructure, such as Title V, and/or serve families with condition-specific health care needs. This investment is even more critical during the COVID-19 pandemic as families need assistance in navigating and accessing health care systems.

In response to the COVID-19 public health emergency, MCHB continues to prioritize meeting emerging needs, including routine childhood vaccinations and well-child visits;

funding telehealth expansion; and supporting vaccination, testing, contact tracing, and slowing the spread of the coronavirus. MCHB is committed to supporting states, jurisdictions, and tribes to provide services safely to MCH populations, and encourages them to follow appropriate CDC, state, and local health department guidance. Read more about MCHB’s response to COVID-19 at https://mchb.hrsa.gov/coronavirus-frequently-asked-questions.

For additional information about existing centers, please visit: http://www.fv-ncfpp.org/f2fhic/find-a-f2f-hic/.

II. Award Information

1. Type of Application and Award

Type(s) of applications sought: Competing Continuation, New

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA estimates approximately $5,708,250 to be available annually to fund up to 59 recipients. This includes 1 recipient in each of the 50 states, the District of Columbia, 5 U.S. Territories (Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands and the Northern Mariana Islands), and up to 3 F2F HICs to serve American Indians/Alaska Natives. You may apply for a ceiling amount of up to $96,750 total cost (includes both direct and indirect, facilities, and administrative costs) per year.

This program notice is subject to the appropriation of funds, and is a contingency action taken to ensure that, should funds become available for this purpose, HRSA can process applications and award funds appropriately.

The period of performance is June 1, 2022 through May 31, 2027 (5 years). Funding beyond the first year is subject to the availability of appropriated funds for the F2F HICs Program in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

https://mchb.hrsa.gov/coronavirus-frequently-asked-questions https://mchb.hrsa.gov/coronavirus-frequently-asked-questions http://www.fv-ncfpp.org/f2fhic/find-a-f2f-hic/ http://www.fv-ncfpp.org/f2fhic/find-a-f2f-hic/

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All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants include any domestic public or private entity. Domestic faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply. Eligibility for this funding opportunity is limited to applicants within the 50 states, the District of Columbia, the 5 U.S. Territories (American Samoa, Guam, Puerto Rico, the Northern Mariana Islands, and the U.S. Virgin Islands) and entities that will serve American Indian and/or Alaska Native Tribes.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA may not consider an application for funding if it contains any of the non-responsive criteria below:

• Exceeds the ceiling amount

• Fails to satisfy the deadline requirements referenced in Section IV.4

NOTE: Multiple applications from an organization are not allowable. You can only apply to one of the target areas described in Program-Specific Instructions: (1) states, (2) U.S. Territories, or (3) American Indians/ Alaska Natives. The application must clearly identify the target area. No more than one award will be made to conduct activities in a state, the District of Columbia, U.S. territory, or tribe. If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 workspace application package associated with this notice of funding opportunity (NOFO) following the directions provided at Grants.gov: HOW TO

APPLY FOR GRANTS.

The NOFO is also known as “Instructions” on Grants.gov. You must select “Subscribe” and provide your email address for HRSA-22-069 in order to receive notifications including modifications, clarifications, and/or republications of the NOFO on Grants.gov.

You will also receive notifications of documents placed in the RELATED DOCUMENTS tab on Grants.gov that may affect the NOFO and your application. You are ultimately responsible for reviewing the For Applicants page for all information relevant to this

NOFO.

2. Content and Form of Application Submission

Application Format Requirements Section 4 of HRSA’s SF-424 Application Guide provides general instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, etc. You must submit the information outlined in the HRSA SF-424 Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

See Section 8.5 of the HRSA SF-424 Application Guide for the Application Completeness Checklist.

Application Page Limit

The total size of all uploaded files included in the page limit shall be no more than the equivalent of 50 pages when printed by HRSA. The page limit includes the project and budget narratives, and attachments required in the Application Guide and this NOFO.

Please note: Effective April 22, 2021, the abstract is no longer an attachment that counts in the page limit. The abstract is the standard form (SF) "Project_Abstract Summary.” Standard OMB-approved forms included in the workspace application package do not count in the page limit. If you use an OMB-approved form that is not included in the workspace application package for HRSA-22-069, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace forms associated with this NOFO to avoid exceeding the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. It is therefore important to take appropriate measures to ensure your application does not exceed the specified page limit. Any application exceeding the page limit of 50 will not be read, evaluated, or considered for funding.

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under HRSA-22-069 prior to the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) You certify on behalf of the applicant organization, by submission of your proposal, that neither you nor your principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. § 3321).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachments 9–15: Other Relevant Documents.

See Section 4.1 viii of HRSA’s SF-424 Application Guide for additional information on all certifications.

Program-Specific Instructions In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 Application Guide (including the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

Selection of Target Area:

You should identify the target area to which you are applying. Please note that an applicant organization cannot apply or be awarded both a state/territory F2F award and a tribal F2F award in order to not duplicate services.

Target Area 1: States and District of Columbia You are expected to identify and work directly in the state you will serve or the District of Columbia.

Target Area 2: U.S. Territories You are expected to identify and work directly in the Territory you will serve.

Target Area 3: American Indians/Alaska Natives You are expected to clearly describe the geographic area and the tribe(s) you will serve.

Up to three (3) F2F HICs will be funded to serve the specific needs of American Indians/Alaska Natives with CYSHCN. To the extent possible, awards will be made so as not to duplicate coverage of an area or populations served by another tribal F2F HIC.

You should describe how you will interact with the state F2F(s) that serve that area, so as not to duplicate services. It is expected that you will clearly demonstrate knowledge of working with tribes, knowledge and understanding of tribal leadership and governance systems, and have existing professional working relationships with the tribe(s) with whom you intend to work. In addition, HRSA prefers that the staffing plan include representation from both the community and the Tribal Chairman/Governor’s office.

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75#se45.1.75_1371

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Additional Program Information All recipients for any of three target areas will be expected to demonstrate and use a strengths-based approach that supports protective, improved quality of life factors for CYSHCN and families.15 This approach should be family centered, culturally and linguistically appropriate, and promote shared decision making between families of CYSHCN, health professionals and appropriate state and community organizations. In addition, it is expected that you will have personnel on staff who are capable of engaging directly with families of the population(s) to be served.

Program Description The F2F HICs are statutorily required to:

1) Assist families of CYSHCN in making informed choices about health care in order to promote good treatment decisions, cost effectiveness, and improved health outcomes;

2) Provide information regarding the health care needs of, and resources available to, CYSHCN;

3) Identify successful health care models for CYSHCN;

4) Develop, with representatives of health care providers, managed care organizations, health care purchasers, and appropriate state agencies, a model for collaboration between families of CYSHCN and health professionals;

5) Provide training and guidance regarding the care of CYSHCN;

6) Conduct outreach activities for families of CYSHCN, health professionals, schools, and other appropriate entities and individuals; and

7) Staff centers with families of CYSHCN who have expertise in federal and state public and private health care systems, and with health professionals.

In addition to the seven statutorily required activities, the F2F HICs are expected to:

• Develop partnerships with organizations serving CYSHCN and their families, especially in activities addressing disparities and emerging health trends.

Partnerships should include state Title V programs. Additional partnerships could include, but not be not limited to the following: other state agencies/programs;

other programs serving children such as Head Start; primary health care organizations; parent/family-led organizations; population or condition-specific organizations; patient navigator programs; programs receiving funds from federal agencies such as the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMSHA); and other HRSA program/award recipients.

• Develop a Diversity and Inclusion Plan that addresses inclusion of underrepresented populations (e.g., rural, urban, race, ethnicity, disability, gender, sexual orientation, family structure, socioeconomic status) in family engagement activities such as training and leadership development across the state/jurisdiction.

Applicants are expected to develop a disparity impact statement within this plan using local data (e.g., the CDC Social Vulnerability Index (SVI)

15 Child Trends 2018: A State Multi-Sector Framework for Supporting Children and Youth with Special Health Care Needs. Lucile Packard Foundation for Children’s Health.

https://www.ssa.gov/OP_Home/ssact/title05/0501.htm https://www.atsdr.cdc.gov/placeandhealth/svi/index.html

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[https://www.atsdr.cdc.gov/placeandhealth/svi/index.html]))) to identify populations at highest risk for health disparities and low health literacy. The disparity impact statement will provide the framework for ongoing monitoring and determining the impact of the Family-to-Family Health Information Center. Below are available HHS resources:

o CMS.gov: Quality Improvement & Interventions: Disparity Impact Statement o SAMHSA.gov: Disparity Impact Statement

• Collect, monitor, analyze, and report on data as outlined in the Project Narrative

Section within Evaluation and Technical Support Capacity.

i. Project Abstract Use the Standard OMB-approved Project Abstract Summary Form 2.0 that is included in the workspace application package. Do not upload the abstract as an attachment or it will count toward the page limitation. For information required in the Project Abstract Summary Form, see Section 4.1.ix of HRSA’s SF-424 Application Guide.

The body of the abstract must adhere to the following format:

• Problem: Briefly state the principal needs and problems, which are addressed by the project.

• Goals and Objectives: Identify the major goal(s) and objectives for the period of performance.

• Methodology: Describe the programs and activities used to attain the objectives.

• Coordination: Describe the coordination planned with appropriate national, regional, state/territory/tribal and/or local health agencies to implement the proposed project.

• Evaluation: Briefly describe the evaluation methods to be used to assess program outcomes and the effectiveness and efficiency of the project in attaining goals and objectives.

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, the table below provides a crosswalk between the narrative language and where each section falls within the review criteria. Any forms or attachments referenced in a narrative section may be considered during the objective review.

Narrative Section Review Criteria

Introduction (1) Need

Needs Assessment (1) Need and (4) Impact

Methodology (2) Response and (4) Impact

Work Plan (2) Response, (3) Evaluative Measures, and

(4) Impact https://www.atsdr.cdc.gov/placeandhealth/svi/index.html https://www.atsdr.cdc.gov/placeandhealth/svi/index.html https://www.cms.gov/About-CMS/Agency-Information/OMH/resource-center/hcps-and-researchers/quality-improvements-and-interventions https://www.cms.gov/About-CMS/Agency-Information/OMH/resource-center/hcps-and-researchers/quality-improvements-and-interventions https://www.samhsa.gov/grants/grants-management/disparity-impact-statement

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Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures and

(5) Resources/Capabilities

Organizational Information (5) Resources/Capabilities

Budget and Budget Narrative (6) Support Requested

ii. Project Narrative This section provides a comprehensive description of all aspects of the proposed project. It should be succinct, self-explanatory, consistent with forms and attachments, and organized in alignment with the sections and format below so that reviewers can understand the proposed project.

Use the following section headers for the narrative:

INTRODUCTION -- Corresponds to Section V’s Review Criterion 1 Need

The application should clearly identify the proposed target area: (1) state (2) U.S.

Territory or (3) American Indians/Alaska Natives. If you plan to serve American Indians/Alaska Natives, you should clearly describe the geographic area and American Indian/Alaska Native tribes to be served.

HRSA expects that applications proposing to serve American Indians/Alaska Natives will demonstrate knowledge and understanding of Tribal leadership and governance systems of the tribe(s) to be served and experience in working with the target population.

This section should briefly describe the purpose and goals of the proposed project including a discussion of CYSHCN and their needs in the target population. You must concisely describe the problem, summarize the proposed project and the anticipated benefits of the project to the state/territory/tribe.

The project should clearly demonstrate how activities will engage families from planning to implementation.

NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criteria 1 Need and

4 Impact

• This section should describe the target population of families of CYSHCN to be served by the proposed project. The description should include specific needs for families in accessing health and related services as identified by families of CYSHCN and other key stakeholders; socio-cultural determinants of health; health disparities; and documentation of the target population’s unmet needs related to the program purpose. Include a description of agencies that serve CYSHCN in the state/territory/tribe(s) and can serve as partners.

• Demographic data of the population to be served, including geographic, economic, racial/ethnic, and linguistic data, should be included and cited whenever possible to support the information provided. Data can be both

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quantitative and qualitative. Relevant data from current/past activities, the National Survey for Children’s Health (NSCH), Title V MCH Block Grant activities supporting CYSHCN and other sources can be used. NSCH data must be no earlier than 2016.

• Discuss any relevant contributing factors and barriers in the state/territory/tribe(s) that the project will work to overcome. Also, discuss any needs of the state/territory/tribe(s) as they relate to health insurance, and improving health literacy of this population.

• You are encouraged to review the State Title V MCH Block Grant Program

Needs Assessment findings. The Title V MCH Services Block Grant statute requires each state and jurisdiction to conduct a statewide, comprehensive Needs Assessment every 5 years.

• You also are encouraged to review the Title V State Action Plans for your state/territory to document the need for proposed projects. States develop 5-year State Action Plans that document priority needs. In these plans, states take a further step and identify objectives, strategies, and relevant national performance measures to address needs in six population health domains including Children with Special Health Care Needs.

METHODOLOGY -- Corresponds to Section V’s Review Criteria 2 Response and

4 Impact Propose methods that will be used to meet each of the project goals and objectives.

You should propose activities that have a focus on overall health for the broad population of CYSHCN (as defined by HRSA).16 For example, if an applicant is a family organization with a history of funding that is condition-specific or related to the education, mental health, or developmental disabilities sectors, evidence of activities that address health for the broad CYSHCN population should be included in their application. Likewise, applicants that represent a primary medical focus should provide information about how families with questions in other sectors, for example, behavioral or educational, will be served or referred to appropriate services.

Propose methods that address the following:

• Statutorily required activities (please refer to Program Description section for full description) related to: 1) assisting families to make informed choices;

2) providing information; 3) identifying successful health care delivery models;

4) developing models for collaborations; 5) providing training and guidance;

6) conducting outreach activities; and 6) staffing by families and health professionals.

16 McPherson, M., Arango, P., Fox, H., Lauver, C., McManus, M., Newacheck, P. W., et al. (1998). A new definition of children with special health care needs. Pediatrics, 102(1 pt 1), 137-140.

https://www.childhealthdata.org/learn-about-the-nsch/NSCH https://mchb.tvisdata.hrsa.gov/ https://mchb.tvisdata.hrsa.gov/ https://mchb.tvisdata.hrsa.gov/ https://mchb.tvisdata.hrsa.gov/

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• Additional activities (please refer to Program Description section for full description) addressing the following:1) partnerships; 2) plan for developing a diversity and inclusion plan 3) collection, monitoring, analysis, and reporting on data, including program objectives as outlined in the Program Objectives section.

In addition, you should address how you will achieve the following:

• Identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities including development of the proposal, including the extent to which these contributors reflect the cultural, racial, linguistic, and geographic diversity of the populations and communities served.

o Engage key stakeholders in the needs assessment process including the CYSHCN program under the MCH Block Grant, families, and members of the targeted communities/population group. Other stakeholders could include community- and faith-based organizations, Tribal councils/governments and representatives from underrepresented and diverse communities.

• Report on the number of partnerships and demonstrate partner involvement in activities via the project work plan. Example of partners include, but need not be limited to the following: state Title V programs and other state/territory/tribal agencies programs; child-focused programs; primary care organizations;

parent/family-led organizations; parent navigator programs; federal agencies and HRSA programs/award recipients.

• Implement a plan for promoting the F2F HIC as a resource to serve families in the state/territory/tribal community. This activity could be addressed through outreach activities and partnerships with health clinics, mental and behavioral health groups, providers, community groups, and others.

• Implement a plan for project sustainability after the period of federal funding ends.

HRSA expects recipients to sustain key elements of the project, e.g., strategies or services and interventions, which have been effective in improving practices and those that have led to improved outcomes for the target population.

• Design activities to achieve results that will have state/territory/tribal and/or national level impact and/or are replicable in other states/territories/tribal settings.

• Implement a plan to ensure that project results will be effectively disseminated to key stakeholder audiences including Title V, families, providers, policy makers, other federal programs, and members of the targeted communities/population groups.

• By the end of year 2, develop a plan to address diversity, equity, and inclusion in the F2F HIC to ensure that the state/territory/tribe’s activities are inclusive of and address the needs of the populations it serves, including geography (e.g., rural, urban), race, ethnicity, disability, gender, sexual orientation, family structure, socio-economic status. (Please refer to Program Description section for full description).

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WORK PLAN -- Corresponds to Section V’s Review Criteria 2 Response, 3 Evaluative Measures, and 4 Impact Describe the activities or steps that you will use to achieve each of the core activities proposed in the methodology. Proposed activities should be clearly linked to the project goals and objectives. The application should show compelling evidence that such plans are supported and can be accomplished and sustained throughout the proposed period of performance.

• Use a timeline, time allocation table, graph, or chart that includes each activity and identifies responsible staff and partners, proposed outcome, intended impact, and how the activity’s outcome and impact will be measured. Describe how activities will help move toward greater engagement of families as co-producers and partners; for more information, reference:

http://www.pcmh.ca/documents/Family%20Engagement%20Harts%20Ladd er.pdf.

• Provides a logic model within Attachment 1 of the application. Applications lacking a complete and well-conceived evaluation protocol may not be funded.

RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion

2 Response

Discuss challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve such challenges.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to

Section V’s Review Criteria 3 Evaluative Measures and 5 Resources/Capabilities

You should describe the plan for meeting the objectives of the program as outlined in the Program Objectives section. Specifically, you should propose a plan to collect, analyze, and report on the following data to HRSA on an annual basis through performance reports, non-competing continuations, and feedback data collection forms. Data should include the following:

• The number of families and professionals who have been provided:

Information via direct one-on-one contact through an in-person contact or by telephone or virtual communication (unduplicated number - only including initial and not repeat contacts);

Training via presentations during conference sessions, workshops, and other activities.

NOTE: You should only count the number of families and professionals provided services supported by funding received through this NOFO.

• Percentage of families with CYSHCN served who report that the information or services received from Family-to-Family Health Information Centers helped prepare them to work with those who serve their children.

http://www.pcmh.ca/documents/Family%20Engagement%20Harts%20Ladder.pdf http://www.pcmh.ca/documents/Family%20Engagement%20Harts%20Ladder.pdf

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Collected through the OMB approved (OMB No. 0906-0400) feedback survey.

• Percentage of professionals served who reported the information or services received from the Family-to-Family Health Information Centers helped prepare them to work better with families of CYSHCN and/or others who serve CYSHCN. Collected through the OMB approved (OMB No.

0906-0400) feedback survey.

• The number and types of state agencies/programs and community-based organizations assisted in providing services to families of CYSHCN.

Examples include: the Newborn Screening Program, Early Hearing Detection and Intervention, Early Intervention/Part C, provider organizations, schools, faith-based organizations, etc.

Present an evaluation plan that contains: (1) strategies to identify/use appropriate data sources, collect and analyze data that will measure outcomes/impact of the project; (2) strategies to collect, analyze, and track data to measure outcomes/impact as it relates to different socio-cultural groups (e.g., race, ethnicity, language); (3) mechanisms to monitor and evaluate the efficiency of the proposed project activities/process; and (4) an explanation of how the data will be used to inform and improve the quality of program development and service delivery. Describe any data collection tools to be used (e.g., surveys, database) and key elements of those tools that will be used in the evaluation strategy.

Evaluation plans often evolve as a project progresses through a 5-year period of performance. HRSA will ask award recipients to provide updates to their evaluation plans and report findings of the evaluation in their annual progress report.

ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion 5 Resources/Capabilities

• Provide information on your organization’s current mission and structure;

fiscal, administrative, and managerial viability; and scope of current activities.

• Describe your organization’s proven and successful leadership role in activities undertaken related to the functions of F2F HICs and proposed activities.

• Provide information that demonstrates how the program meets the statutory requirement of being staffed by families who have expertise in federal and state public and private health care systems and by health professionals. If an applicant is a university or other type of organization, family staff must have equal decision-making authority for the F2F HICs project. Include a memorandum of agreement/understanding between your organization and the staff in Attachment 4 of the application.

Describe how these all contribute to your ability to conduct the program requirements and meet program expectation including other activities of the organization that could complement F2F HIC activities.

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• Address how the proposal builds upon your organization’s previous accomplishments and reflects documented success in working collaboratively with families, state/territory/tribe and community programs, and health agencies for CYSHCN, including Title V and other relevant organizations, in functions similar to those of a F2F HIC.

• Provide one organizational chart (a one-page figure that depicts the organizational structure of the project, including subcontractors and other significant collaborators) and describe the relationship of this program within the broader organization. Include as Attachment 5 of the application.

• Describe the staffing plan, which includes current experience, expertise, skills, and knowledge of staff, contractors, and partners; data collection capabilities; and previous work and materials.