MCHB HRSA-22-081 (UF4) HV CoIIN_3.0_Final.pdf

U.S. Department of Health and Human Services

Maternal and Child Health Bureau

Division of Home Visiting and Early Childhood Systems

Home Visiting Collaborative Improvement and Innovation Network 3.0

(HV CoIIN 3.0)

Funding Opportunity Number: HRSA-22-081

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listings (AL/CFDA) Number: 93.870

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2022

Application Due Date: April 6, 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: January 6, 2022

Monique Fountain Hanna, MD, MPH, MBA Chief Medical Officer Division of Home Visiting and Early Childhood Systems Maternal and Child Health Bureau Health Resources and Services Administration Telephone: (215) 861-4393 Email: mfountain@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 711(h)(3) (Title V, § 511(h)(3) of the Social Security Act) mailto:mfountain@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 Home Visiting Collaborative Improvement and Innovation Network 3.0 (HV CoIIN 3.0) through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. The goal of this program is to disseminate and scale up1 the most effective practices and interventions identified under the Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN) 2.0 and to research the development of specific tools and resources to advance quality improvement practices within the MIECHV Program.

The objectives of the program are to:

1) Identify, manage, and execute the scaling up of interventions to at least 30 state recipients and 300 local implementing agencies (LIAs);

2) Refine and test a new set of evidence-informed change strategies using accepted evaluation methodologies and the MIECHV Program performance measures;

3) Further refine the health equity framework1 and parent leadership toolkit developed in HV CoIIN 2.0 and support the integration of the health equity and parent leadership principles across all activities; and

4) Assist MIECHV recipients and LIAs in building their capacity to use continuous quality improvement (CQI) as a tool for ongoing program monitoring and improvement.

Funding Opportunity Title: Home Visiting Collaborative Improvement and

Innovation Network 3.0 (HV CoIIN 3.0)

Funding Opportunity Number: HRSA-22-081 Due Date for Applications: April 6, 2022 Anticipated Total Annual Available FY 2022 Funding:

$1,300,000

Estimated Number and Type of Award(s):

Up to one (1) cooperative agreement

Estimated Annual Award Amount: Up to $1,300,000 per year

1 https://hv-coiin.edc.org/content/health-equity-new-topic-workstream http://hv-coiin.edc.org/ http://hv-coiin.edc.org/ http://hv-coiin.edc.org/ http://hv-coiin.edc.org/ http://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting https://hv-coiin.edc.org/content/health-equity-new-topic-workstream

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Cost Sharing/Match Required: No Period of Performance: September 1, 2022 through

August 31, 2027 (5 years) Eligible Applicants: Eligible applicants include domestic public and private entities. Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply.

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, except where instructed in this NOFO to do otherwise. Visit HRSA’s How to Prepare Your Application page at https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application for more information.

Technical Assistance

A technical assistance webinar for this funding opportunity will be provided. You are encouraged to participate. The webinar will: (1) help prepare you to submit an application; (2) highlight key requirements; and (3) offer you an opportunity to ask questions.

HRSA has scheduled following technical assistance:

Webinar

Day and Date: Wednesday, January 26, 2022 Time: 2 – 3:30 p.m. ET Call-In Number: 1-833-568-8864 Participant Code: 24887386 Weblink: HVCOIIN TA Webinar

HRSA will record the webinar and make it available at:

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

http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://hrsa-gov.zoomgov.com/j/1602771949?pwd=UElOQy9uMzhwcHlPT3dZRVVWR0xBdz09 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 MANAGEMENT (SAM)

4. SUBMISSION DATES AND TIMES

5. INTERGOVERNMENTAL REVIEW

6. FUNDING RESTRICTIONS

V. APPLICATION REVIEW INFORMATION

1. REVIEW CRITERIA

2. REVIEW AND SELECTION PROCESS

3. ASSESSMENT OF RISK

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

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VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX: GLOSSARY OF SELECTED TERMS

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Home Visiting Collaborative Improvement and Innovation Network 3.0 (HV CoIIN 3.0).

The goal of this program is to disseminate and scale up2 the most effective practices and interventions identified under the Home Visiting Collaborative Improvement and Innovation Network (HV CoIIN) 2.0 and to research the development of specific tools and resources to advance quality improvement practices within the MIECHV Program.3

The objectives of this program are to:

1) Plan, manage, and execute the scale up of interventions tested and found to be effective in HV CoIIN 2.0 to at least 30 state recipients and 300 local implementing agencies (LIAs).4 These interventions include strategies to alleviate maternal depression, support families impacted by Intimate Partner Violence (IPV), promote developmental screening and linkage to services, increase breastfeeding initiation and duration, complete age-appropriate well child care visits, improve the recruitment and retention of home visiting staff, and develop parent leadership within continuous quality improvement (CQI) efforts;

2) Refine and test a new set of evidence-informed change strategies using accepted evaluation methodologies, such as rapid Plan-Do-Study-Act5 cycles, in alignment with best practices in home visiting implementation, emerging innovations, and the MIECHV Program performance measures6;

3) Further refine the health equity framework7 and parent leadership toolkit8 developed in HV CoIIN 2.0 and support the integration of the health equity and parent leadership in CQI principles across all HV CoIIN 3.0 scale up and new topic CQI activities; and

4) Assist MIECHV recipients and LIAs in building their capacity to use CQI as a tool for ongoing program monitoring and improvement, utilizing coaching and peer-to-peer learning networks to ensure sustainability.

For more details, see Program Requirements and Expectations.

2 Barker et al: A Framework for Scaling up Health Interventions. 2016.

3 Definitions of key terms can be found in the APPENDIX 4 https://hv-coiin.edc.org/ 5 http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx 6 https://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting/performance-reporting-and-evaluation-resources 7 https://hv-coiin.edc.org/content/health-equity-new-topic-workstream. Note: Framework will be posted when developed.

8 https://hv-coiin.edc.org/content/parent-leadership-toolkit http://hv-coiin.edc.org/ http://hv-coiin.edc.org/ http://hv-coiin.edc.org/ http://hv-coiin.edc.org/ http://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx https://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting/performance-reporting-and-evaluation-resources https://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting/performance-reporting-and-evaluation-resources https://hv-coiin.edc.org/content/health-equity-new-topic-workstream https://hv-coiin.edc.org/content/parent-leadership-toolkit

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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

This program addresses all goals within MCHB’s strategic plan.

• The program aims to assure high quality and equitable health services (Goal 1) by accelerating the improvement of home visiting through the dissemination and scale up of proven CQI practices.

• The program aims to achieve health equity for MCH populations (Goal 2) through the integration and scaling of a health equity framework developed and tested in HV CoIIN 2.0, designed specifically to address social determinants of health in home visiting and advance equity utilizing a CQI lens.

• The program intends to strengthen public health capacity and workforce (Goal 3) by supporting capacity building, leadership, and technical mastery of CQI methods across both state recipient and LIA staff.

• The program aims to maximize impact through leadership, collaborative partnership, and stewardship (Goal 4) by continuously tracking and monitoring program outcomes over the course of program implementation to inform program improvement and future allocation of resources.

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

About this Program This program is authorized by 42 U.S.C. § 711(h)(3) (Title V, § 511(h)(3) of the Social Security Act), as added by the Patient Protection and Affordable Care Act, § 2951.)

The overall purpose of the HV CoIIN has been to more quickly and consistently produce positive health and development outcomes for families served by home visiting and other early childhood service agencies in underserved communities across the country utilizing proven CQI methodologies.9 This announcement supports an effort to advance effective scaling of proven practices, build the knowledge base around new topic areas, and strengthen MIECHV recipient

9 Additional information about activities completed as part of HV CoIIN 1.0 and HV CoIIN 2.0 can be found by visiting https://hv-coiin.edc.org/ https://mchb.hrsa.gov/about https://hv-coiin.edc.org/

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and LIA capacity to sustain gains achieved through increased CQI knowledge and skills.

The MIECHV Program responds to the diverse needs of children and families in underserved communities and provides an opportunity for collaboration and partnership at the federal, state, and community levels to improve health and development outcomes for young children and their families through evidence-based home visiting programs. The MIECHV Program offers a useful platform to expand collaborative quality improvement projects.

All MIECHV recipients collect data on six statutorily mandated benchmark areas:

1) improved maternal and newborn health;

2) prevention of child injuries, child abuse, neglect, or maltreatment, and reduction of emergency department visits;

3) improvement in school readiness and achievement;

4) reduction in crime or domestic violence;

5) improvements in family economic self-sufficiency; and

6) improvements in the coordination and referrals for other community resources and supports.

Recipients have established performance measurement plans that include standardized measures associated with the benchmark areas and each of 19 applicable constructs (such as breastfeeding, screening for depression, screening for developmental delays, primary caregiver educational attainment, etc.) to be monitored for improvement. Recipients are required to submit service utilization and socio-demographic data as well as program performance data annually, in accordance with their performance measurement plans. MIECHV demographic and benchmark performance measures can be found here.

The capacity to collect valid data across a wide range of program areas has created an opportunity for recipients and LIAs to have timely data available for the purposes of improvement. In addition to defining performance accountability requirements, MIECHV Program statute encourages the use of data-driven quality improvement methods that may result in better care and outcomes for families served. Recipients are required to submit CQI plans on an annual basis.

HRSA/MCHB has funded CQI activities in support of MIECHV recipients and their LIAs through HV CoIIN since 2012. The HV CoIIN provides MIECHV recipients and LIAs the assistance needed to build their internal capacity to use CQI as a mechanism to improve MCH outcomes. Through the HV CoIIN, teams learn and use the Breakthrough Series (BTS) collaborative model. The BTS collaborative model involves topic selection, faculty recruitment, enrollment of participating organizations and teams, learning sessions, and action periods. The participating teams use the Model for Improvement, including rapid testing, to carry out the improvement work. Teams also build their capacity to collect and use data as a key part of the measurement system that includes process and outcome measures by topic area.

The HV CoIIN 1.0 brought together 12 MIECHV recipients and 35 LIA teams to seek collaborative learning, perform rapid testing for improvement, and share best practices to close the gap between what we know works and what we do on the ground to http://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting/home-visiting-program-technical-assistance/performance-reporting-and-evaluation-resources http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx https://hv-coiin.edc.org/sites/hv-coiin.edc.org/files/HV%20CoIIN%20Information%20Resource%202017_0.pdf?

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improve outcomes for families of young children. The HV CoIIN 1.0 targeted four MIECHV Program outcomes: (1) improved rates of initiation and duration of breast feeding; (2) improved screening and surveillance of developmental delays as well as the referral of clients to appropriate services; (3) improved screening, referral, and service provision for maternal depression; and (4) improved family engagement (a topic for innovation which covered enrollment, frequency of visits and length of program participation). The HV CoIIN 1.0 established an aim for each of the four HV CoIIN topics, and used the Model for Improvement,10 which includes small tests of change (known as Plan-Do-Study-Act or PDSA cycles) to assist LIAs with testing and implementation of evidence-based or informed practices recommended by expert faculty. For each of the four topic areas, the HV CoIIN tracked individual agency and overall progress using standardized outcomes and process measures for each target area.

The most recent 5-year cooperative agreement for HV CoIIN 2.0 (September 1, 2017 – August 31, 2022), used the BTS model for the development of change packages on new topics based on additional MIECHV performance measures, emerging issues, and best practices in home visiting implementation. The new topics included: 1) completion of age-appropriate well child care services; 2) support for women impacted by IPV; 3) improvements in the recruitment and retention of home visiting staff; and 4) the development of a health equity framework utilizing CQI as the mechanism of improvement. A topic that was not new to the HV CoIIN, but received considerable new investments of time and effort, was the involvement of parents as leaders in CQI. In order to facilitate greater parent collaboration in CQI activities, a Parent Leadership Toolkit11 was developed and all teams were encouraged to have family members on their CoIIN teams. HV CoIIN 2.0 also engaged with scale up experts to identify methods most appropriate to the home visiting environment and the interventions being scaled.

The goal of scale up efforts were to build on the successes of HV CoIIN 1.0. MIECHV teams from 25 states across more than 250 LIAs were brought together in the previously tested topic areas of developmental screening, exclusive breastfeeding, maternal depression and a new topic area of IPV.

Notably, HV CoIIN 2.0 developed a framework to support MIECHV recipients to advance health equity. Recommendations in the HV CoIIN health equity framework are meant to be flexible, feasible, and actionable. The framework is being tested utilizing a 15-month (3/2021 – 7/2022) BTS collaborative model. In addition to the health equity framework, measures and refined tests of change will be published and disseminated across other MIECHV-funded home visiting programs.

This funding opportunity seeks to sustain and build upon the learning and developments of the HV CoIIN 1.0 and HV CoIIN 2.0. Through continued scaling and peer learning, the capacity for data-driven performance improvement activities for additional MIECHV recipients and their LIAs will be strengthened. This opportunity also seeks to expand the health equity efforts spearheaded in HV CoIIN 2.0 to refine and scale quality

10 http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx 11 https://hv-coiin.edc.org/content/parent-leadership-toolkit https://hv-coiin.edc.org/content/parent-leadership-toolkit

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improvement practices to address social determinants of health and advance health equity.

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 cooperative agreement. A cooperative agreement is a financial assistance mechanism where HRSA anticipates substantial involvement with the recipient during performance of the contemplated project.

HRSA program involvement includes:

• Providing the expertise of MCHB personnel as participants in the planning and development of the project;

• Participating in all aspects of the HV CoIIN scale up and new topic activities, including but not limited to, o identifying additional topic areas for targeted improvement, o reviewing and planning for the project, o facilitating collaboration and peer learning among MIECHV recipients and LIAs, and o facilitating involvement of expert faculty and partner organizations

(such as, for example, model developers);

• Reviewing aims, activities, and tools to be established and implemented to accomplish the goals of the project;

• Identifying HHS, HRSA, and MCHB priorities that relate to the ongoing efforts of the project;

• Participating, as appropriate, in regular conference calls, meetings and webinars to be conducted during the period of performance;

• Reviewing and editing, as appropriate, written documents developed by the recipient, including documentation of pre-work and learning sessions;

• Co-authoring articles and publications as appropriate; and

• Participating with the recipient in the dissemination of project findings, best practices, and lessons learned from the HV CoIIN scale up, and in producing and jointly reviewing reports, articles, and/or presentations developed under this funding opportunity announcement.

The cooperative agreement recipient’s responsibilities include:

• Planning and implementing a successful scale up of HV CoIIN following the BTS model. Activities should include using the common measurements and change packages of interventions across the topics while adapting to and anticipating challenges to scale up;

• Planning and implementing peer learning networks;

• Responding to HRSA priorities and initiatives that correspond to project

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activities;

• Refining and testing of new change packages integrated and linked to the MIECHV performance measures, emerging innovations, as well as evidence-based home visiting implementation best practices;

• Refining and implementing the health equity framework;

• Integrating parent leaders at all levels of program oversight and implementation;

• Completing all activities proposed in the workplan;

• Participating in face-to-face meetings and conference calls with HRSA conducted during the period of the cooperative agreement;

• Ensuring that lessons learned and promising approaches are distributed regularly to home visiting and early childhood partners; and

• Collaborating with HRSA on ongoing review of activities, procedures and budget items, information/publication prior to dissemination, contracts and interagency agreements.

2. Summary of Funding

HRSA estimates approximately $1,300,000 to be available annually to fund one (1) recipient. You may apply for a ceiling amount of up to $1,300,000 total cost (includes both direct and indirect, facilities and administrative costs) per year.

The period of performance is September 1, 2022 through August 31, 2027 (5 years).

Funding beyond the first year is subject to the availability of appropriated funds for the MIECHV Program in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

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 public and private entities. Domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply.

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 of $1,300,000 per year

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

NOTE: Multiple applications from an organization are not allowable.

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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HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, before the Grants.gov application due date as the final and only acceptable application.

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-22-081 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 80 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-22-081, it may count against the page limit. Therefore, we strongly recommend you only use Grants.gov workspace 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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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 80 will not be read, evaluated, or considered for funding.

Applications must be complete, within the maximum specified page limit, and validated by Grants.gov under HRSA-22-081 before 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. § 3354).

3) If you are unable to attest to the statements in this certification, you must include an explanation in Attachments 8-15: Other Relevant Documents.

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

Program Requirements and Expectations

The recipient is expected to achieve aims in four areas: new topic COIIN, scale up, training and technical assistance, and health equity framework. Specific aims to be achieved in each of these areas are discussed below.

New Topic CoIIN The recipient is expected to help achieve the following activities of the new topic CoIIN beginning in Year 1 through Year 5:

a) Follow the Institute for Health Care Improvement Breakthrough Series12 methodology similar to that used by HV CoIIN 2.013 to develop, refine, and test three to five new evidence-informed change packages over the course of the cooperative agreement. Detailed information on these processes are available on the HV CoIIN’s website at http://hv-coiin.edc.org/.

b) Use accepted evaluation methodologies, such as the Model for Improvement14 and rapid Plan-Do-Study-Act (PDSA)15 Cycles to improve program outcomes.

c) Continue to strengthen leadership and expertise in CQI efforts and support innovation among cohorts of MIECHV recipients and LIA teams.

12 The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003.

13 https://hv-coiin.edc.org/content/hv-coiin-20-fact-sheets https://hv-coiin.edc.org/content/hv-coiin-20-fact-sheets 14 Associates in Process Improvement, The Improvement Guide, Jossey-Bass, 1996.

15 http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx 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 http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx http://hv-coiin.edc.org/ https://hv-coiin.edc.org/content/hv-coiin-20-fact-sheets https://hv-coiin.edc.org/content/hv-coiin-20-fact-sheets http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx

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d) Spread the efforts of the new topic CoIINs to other LIAs within the participating states.

e) Integrate parent leadership and health equity principles across new topic areas.

The following outcomes are expected in Years 4–5:

a) MIECHV recipients and LIAs participating in HV CoIIN 3.0 adopt and sustain the new collaborative improvement and innovation interventions and practices shown to be effective, such that their findings can be spread to additional LIAs within the participating states.

b) A new set of playbooks for the topics tested is available.

c) Publications highlighting key lessons learned are produced.

Scale Up Activities The recipient is expected to help achieve the following activities of the scale up program16, based on the lessons learned from prior HV CoIIN efforts. These activities are to begin in Year 1 and continue through Year 5.

a) Take the lessons learned from the two cohorts of MIECHV recipients and LIAs funded under scale up activities in HV CoIIN 2.0 and replicate the cohorts’ performance among additional MIECHV recipients and LIAs.

b) Demonstrate a general familiarity with content of the HV CoIIN 2.0 that will conclude August 31, 2022 (for up-to-date information on the HV CoIIN 2.0 activities and outcomes visit: https://hv-coiin.edc.org/). This content includes a basic understanding of scale up methods and the individual playbook/ toolkits for each of the following HV CoIIN 2.0 topics: 1) alleviating maternal depression, 2) promoting early child development as well as identifying related delays and linking families to services, 3) increasing initiation and duration of breastfeeding,

4) completion of age-appropriate well child care services, 5) improving staff recruitment and retention, 6) building parent leadership in CQI, and 7) integrating the health equity framework.

c) Select MIECHV Scale Up teams made up of MIECHV recipients and LIAs for participation in scale up activities including assessing readiness for implementation, and identifying the target of the scale up activities, the specific goals expected to be achieved and evaluated, and the timeframe for the effort.

d) Develop an initial scale up plan using appropriate “behavior change support models” (e.g., Campaign, Extension Agency, Collaboratives)17 that take into account what infrastructure enhancements MIECHV recipients and LIAs will need to make in order to achieve the scale up aim.

e) Conduct at least three successive 12–18 month-long cohorts of participation.

This includes a Scale Up Steering Committee of key advisors, coaches, and experts who provide coaching on quality improvement to participating teams.

f) Execute, evaluate, and refine the plan with CQI methods in place, to obtain information from those involved in the scale up, such that timely adjustments in the process are possible. This may include the development of a data dashboard

16 https://ssir.org/articles/entry/unleashing_large_scale_change https://ssir.org/articles/entry/unleashing_large_scale_change 17 McCannon J, Massoud MR, Alyesh AZ. Many Ways to Many: A brief compendium of networked learning methods. Stanford Social Innovation Review, 2016.

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that allows for ongoing monitoring and sharing of regularly collected data.

The following outcomes are expected in years 3–5 of the scale up phase:

• By the end of Year 5, at least 30 MIECHV recipients and 300 LIAs have implemented ideas demonstrating improvement and are included in the scale up activities.

• Results from the initial scale up activities are available to inform the next cohort of HV CoIIN 3.0 teams. They will provide the foundation for the development of materials that can serve as a resource to support the scale up of proven strategies to additional LIA sites and MIECHV recipients.

• Publications highlighting lessons learned are produced.

• MIECHV recipients and LIAs have built the capacity to sustain and institutionalize

CoIIN activities and associated home visiting innovations.

Training and Technical Assistance (TA) During Years 1–5, the recipient is expected to assist MIECHV recipients and LIAs in building their capacity to use CQI as a tool for ongoing program monitoring and improvement.

The recipient is expected to provide training and TA to MIECHV recipients and LIAs on topics such as:

• The Breakthrough Series and Model for Improvement;

• The CoIIN model, processes and activities;

• Spread and scale up methods and best practices;

• Data collection and oversight;

• CQI leadership competencies and skills;

• Development of financial and programmatic plans for sustaining CQI activities and outcome results; and

• Using coaching and peer-to-peer learning networks to ensure sustainability.

The following outcomes are expected in years 4–5 of the scale up phase:

• CQI is used as a tool for ongoing program monitoring and improvement by the majority of MIECHV recipients and LIAs.

• MIECHV recipients are skilled and adept at supporting LIAs in scale up activities across funded communities.

Health Equity and Parent Leadership Principles The recipient is to further refine the health equity framework and parent leadership toolkit developed in HV CoIIN 2.0 to support the integration of the health equity and parent leadership principles across all HV CoIIN 3.0 scale and new topic CQI activities.

The following outcomes are expected in years 3–5 of the scale up phase:

• Key components of the health equity framework are included in each new topic and scale up topic areas.

• Health equity and parent leadership are fully integrated across all team CQI activities for ongoing program improvement.

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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:

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. Please use the guidance below. It is most current and differs slightly from that in Section 4.1.ix of HRSA’s SF-424 Application Guide.

Provide a summary of the application in the Project Abstract box using 4,000 characters or less. Because the abstract is often distributed to provide information to the public and Congress, prepare this so that it is clear, accurate, concise, and without reference to other parts of the application. It must include a brief description of the proposed project including the needs to be addressed, the proposed services, and the population group(s) to be served. If the application is funded, your project abstract information (as submitted) will be made available to public websites and/or databases including USAspending.gov.

Provide the information below in the Project Abstract field:

Project Director Name Address Contact Phone Numbers (Voice, Fax) EMail Address Web Site Address, if applicable

Annotation: Provide a three-to-five-sentence description of your project that identifies the project’s goal(s), a description of the needs that are addressed, and the activities used to attain the goals.

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

Methodology (2) Response

Work Plan (2) Response and (4) Impact http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.usaspending.gov/

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Narrative Section Review Criteria

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures and

(5) Resources/Capabilities

Organizational Information (5) Resources/Capabilities

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

Describe the purpose of the proposed project and identify project goals and objectives.

You are expected to exhibit a strong understanding of:

• The MIECHV Program generally and early childhood systems linkages,

• Home Visiting CoIIN 1.0/2.0 activities and outcomes,

• MIECHV performance measurement and CQI requirements including CQI plan development and implementation among MIECHV recipients,

• The Breakthrough Series (BTS) Collaborative18and frameworks for scale including but not limited to the Institute for Healthcare Improvement (IHI)’s Framework for Scale Up19,

• Principles and practices of adult learning and peer learning,

• The application of CQI to public health settings, and

• Parent leadership in CQI and the integral role of health equity in CQI.

NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criterion (1) Need

Outline ways of assessing the needs as well as the strengths with respect to quality improvement capacity of states and territories. Describe how you will assess MIECHV recipient and LIA readiness to participate in scale up activities

18http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforA chievingBreakthroughImprovement.aspx 19 http://www.ihi.org/resources/Pages/IHIWhitePapers/PlanningforScaleWhitePaper.aspx http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx http://www.ihi.org/resources/Pages/IHIWhitePapers/PlanningforScaleWhitePaper.aspx

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related to the seven topic areas of focus20 and in new home visiting improvement and innovation topic areas.

Data should be used and cited whenever possible to support the information provided. Clear, concrete, and concise language is highly valued.

METHODOLOGY -- Corresponds to Section V’s Review Criterion (2) Response

Propose methods that will be used to address the stated needs and meet each of the previously described program requirements and expectations in this NOFO.

Primarily, a methodology for using the findings and technical content of the current HV CoIIN, i.e., the “playbooks or toolkits” of the seven HV CoIIN topics, to take the breakthrough performance of previously tested topics to scale with at least 30 MIECHV recipients and 300 LIAs by the end of Year 5.

New Topic CoIINs

With the understanding that these activities are to begin in Year 1 and continue through Year 5, develop plans and timelines for how you will fulfill all of the program requirements by addressing the items listed below.

Describe your plan for identifying New Topic CoIINs and developing teams, and how:

• Three to five new topics will be identified using MIECHV performance measures, emerging issues, and best practices in home visiting implementation.

• Cohorts of teams made up of MIECHV recipients and LIA teams will be identified. Each cohort will participate for 12–18 months.

• The BTS Model21 and Model of Improvement22 will be implemented.

Describe your plan for training and technical assistance which includes:

• Selecting the HV CoIIN 3.0 experts, advisors, coaches, and other roles to advise MIECHV and LIA teams in collaborative efforts to test and implement change ideas. These advisors will assist the HV CoIIN 3.0 Teams on defining their aim, choosing actions to accelerate improvement, testing the changes they make and tracking progress of selected measures.

• Facilitating HV CoIIN 3.0 Teams, and supporting and coaching each cohort of teams. This may include: Using adult learning principles and distance learning best practices in virtual or in-person learning sessions and

20 Topics include: alleviating maternal depression, promoting early child development as well as identifying related delays and linking families to services, increasing initiation and duration of breastfeeding, completion of age-appropriate well child care services, improving staff recruitment and retention, building parent leadership in CQI, and health equity framework

21http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelfo rAchievingBreakthroughImprovement.aspx 22 http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx http://www.ihi.org/resources/Pages/IHIWhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchievingBreakthroughImprovement.aspx

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training activities for HV CoIIN 3.0 participants, and conducting monthly calls/or webinars to facilitate communication across HV CoIIN 3.0 Teams.

• Developing and maintaining a web-based platform and a data dashboard to facilitate online collaboration and learning activities for HV CoIIN 3.0 Teams’ participants.

Describe your measurement strategies and how:

• The HV CoIIN 3.0 experts, advisors, and coaches will assess change ideas and key driver diagrams. The experts, advisors, and coaches will support the development of SMART23 goals and measures to reach the HV CoIIN 3.0 program aims.

• An information system will regularly collect periodic progress reports, analyze and display data from HV CoIIN 3.0 Teams.

Describe how lessons learned will be spread to additional LIAs within the participating states, and documents, findings, and other resources will be disseminated to all MIECHV recipients and LIAs.

Scale Up With the understanding that these activities are to begin in Year 1 and continue through Year 5, develop plans and timelines for how you will fulfill all of the program requirements by addressing the items listed below.

Describe your plan for scale up that includes:

• Identifying a Scale Up Steering Committee and key advisors, experts, and coaches.

• Selecting MIECHV Scale Up teams made up of MIECHV recipients and LIAs for participation in scale up activities including readiness for implementation. The team might include supervisors from LIAs, home visitor(s), data/CQI manager(s), parent(s), client(s), and model developers/TA leaders.

• Identifying the scale up methodology.24

• Conducting three to five successive 12–18 month-long cohorts of participation.

• Incorporating the parent leadership in CQI and health equity framework into team planning.

23 SMART Goals—SMART goals are goals that are Specific, Measurable, Achievable, Relevant, and time-phased.

24 https://ssir.org/articles/entry/unleashing_large_scale_change

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Describe your measurement plan and how:

• A central information system will be developed to collect, monitor and display performance data, key indicators and graphs (e.g., data dashboard).

• The key specific and measureable aims of the scale up effort will be developed and monitored.

Describe your plan for TA which includes:

• Providing assistance and coaching on quality improvement to participating teams to build capacity to guide and mentor LIAs, provide feedback to new teams, and establish accountability.

• Provide peer-to-peer opportunities for learning and sharing of lessons learned.

Describe your communication plan and how the team will build awareness broadly and consistently about scale up activities across the MIECHV Program.

Training and TA Describe a plan for providing training and guidance to the MIECHV recipients and LIAs, which includes:

• Developing an ongoing training program on running BTS Collaboratives, developing CQI skills, and understanding scale up methods. This includes providing an overview of the findings and technical content of the HV CoIIN 2.0 (for up-to-date information on the HV CoIIN 2.0 activities and outcomes visit: https://hv-coiin.edc.org/).

• Sponsoring a peer learning exchange system on home visitation and quality improvement.

Describe the plan for supporting the refinement of the health equity framework and parent leadership in CQI toolkit, and integration of the health equity and parent leadership principles across all HV CoIIN 3.0 scale up and new topic CQI activities.

WORK PLAN -- Corresponds to Section V’s Review Criteria (2) Response and

(4) Impact

Describe the steps that will be used to achieve each of the activities proposed for the entire period of performance in the Methodology section. Scale up, new topic activities, training and capacity building, and incorporating health equity principles are expected to take place across Years 1–5 of the project. Use a timeline that includes each activity and identifies responsible staff. As appropriate, identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities. Indicate the extent to which these contributors might reflect the cultural, racial, linguistic, and geographic diversity of the populations and communities to be served.

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The work plan should closely correspond to the needs assessment and other activities described in the program narrative. The action steps are those activities that you will undertake to implement the proposed project and provide a basis for evaluating the program. The work plan should include all 5 years, be broken out by year, and include goals, objectives, and action steps proposed for the entire period of performance.

Describe plans for dissemination of project results, and the extent to which project results may be national in scope, and the degree to which the proposed project activities are replicable, and the sustainability of the program beyond the federal funding.

In addition to a narrative, you may display this information in a table format that includes objectives/sub-objectives listed in measurable terms, methodology/activities, resources and personnel responsible for program activity, time/milestones, and evaluation measures/process outcomes (Attachment 1).

Logic Models

Submit a logic model for designing and managing the project (Attachment 1). A logic model is a one-page diagram that presents the conceptual framework for a proposed project and explains the links among program elements. While there are many versions of logic models, for the purposes of this notice, the logic model should summarize the connections between the:

• Goals of the project (e.g., reasons for proposing the intervention, if applicable);

• Assumptions (e.g., beliefs about how the program will work and support resources. Base assumptions on research, best practices, and experience.);

• Inputs (e.g., organizational profile, collaborative partners, key personnel, budget, other resources);

• Target population (e.g., the individuals to be served);

• Activities (e.g., approach, listing key intervention, if applicable);

• Outputs (i.e., the direct products of program activities); and

• Outcomes (i.e., the results of a program, typically describing a change in people or systems).

Although there are similarities, a logic model is not a work plan. A work plan is an “action” guide with a time line used during program implementation; the work plan provides the “how to” steps. You can find additional information on developing logic models at the following website:

https://www.acf.hhs.gov/sites/default/files/documents/prep-logic-model-ts_0.pdf.

https://www.acf.hhs.gov/sites/default/files/documents/prep-logic-mo…