MCHB-HRSA-24-035-(U52)-EHDI-Network-Final-V3.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Maternal and Child Health Bureau

Division of Services for Children with Special Health Needs

Early Hearing Detection and Intervention National Network Funding Opportunity Number: HRSA-24-035

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listing Number: 93.251

Application Due Date: November 6, 2023 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

We won’t approve deadline extensions for lack of registration.

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

Issuance Date: August 8, 2023

Shelby Graves, MPH, CHES Public Health Analyst Division of Services for Children with Special Health Needs Call: 240-701-7500 Email: SGraves@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 280g-1(a)(Title III, § 399M(a) of the Public Health Service Act) mailto:SGraves@hrsa.gov

HRSA-24-035 EHDI National i

508 COMPLIANCE DISCLAIMER

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

SUMMARY

Funding Opportunity Title: Early Hearing Detection and Intervention National Network

Funding Opportunity Number: HRSA-24-035

Assistance Listing Number: 93.251

Due Date for Applications: November 6, 2023

Purpose: The Health Resources and Services Administration (HRSA) is accepting applications for the fiscal year (FY) 2024 for the Early Hearing Detection and Intervention (EHDI) National Network. The purpose of this program, which funds three national centers, is to advance EHDI systems of services so that deaf and hard-of-hearing (DHH) newborns, infants, and young children up to age 3 receive appropriate supports and timely services to improve language acquisition outcomes. The Network includes three national centers:

1. Implementation and Change Center (ICC),

2. Family Leadership in Language and Learning Center (FL3), and

3. Provider Education Center (PEC).1

Program Objective(s): Objectives for the EHDI National Network measure technical assistance and support to state/territory EHDI programs. The Individual Centers provide support around: implementation to meet

1 For the FY 2024 program cycle, the National Technical Resource Center will be re-named the Implementation and Change Center, and a Provider Education Center will also be funded.

http://www.hrsa.gov/ http://www.hrsa.gov/

HRSA-24-035 EHDI National ii state/territory benchmarks, family support, and provider education.

Eligible Applicants: You can apply if your organization is in the United States and is:

• Public or private

• Community-based

• Tribal (governments, organizations, as those terms are defined at 25 U.S.C. § 450b) o Native American tribal governments (federally recognized) are eligible.

o Native American tribal organizations (other than federally recognized tribal governments) are eligible.

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

Anticipated FY 2024 Total Available Funding:

$1,500,000

We’re issuing this notice to ensure that, should funds become available for this purpose, we can process applications and award funds appropriately. You should note that we may cancel this program notice before award if funds are not appropriated.

Estimated Number and Type of Award(s):

Up to 3 competing continuation or new cooperative agreement(s)

Estimated Annual Award Amount:

1. EHDI Implementation and Change Center, up to $750,000 per year/one award, subject to the availability of appropriated funds

2. Family Leadership in Language and Learning Center, up to $450,000 per year/one award, subject to the availability of appropriated funds

3. Provider Education Center, up to $300,000 per year/one award, subject to the availability of appropriated funds

HRSA-24-035 EHDI National iii

Cost Sharing or Matching Required:

No

Period of Performance: April 1, 2024 through March 31, 2029 (5 years)

Agency Contacts: Business, administrative, or fiscal issues:

Angela L. Love Grants Management Specialist Division of Grants Management Operations, OFAM Email: Alove1@hrsa.gov

Program issues or technical assistance:

Shelby Graves, MPH, CHES Public Health Analyst MCHB Division of Services for Children with Special Health Needs Email: SGraves@hrsa.gov

Application Guide

You (the applicant organization / agency) are responsible for reading and complying with the instructions included in this NOFO and in HRSA Application Guide (Application Guide). Visit HRSA’s How to Prepare Your Application page for more information.

Technical Assistance

We have scheduled the following webinar:

Thursday, August 24, 2023 3–4 p.m. ET Weblink: https://hrsa-gov.zoomgov.com/j/1604247757?pwd=YjExU3ozMzk2VzFBaG5nZGxVSlhSZz09

Attendees without computer access or computer audio can use the following dial-in information:

Call-In Number: 833 568 8864 | Participant Code: 43531347 Meeting ID: 160 424 7757

We will record the webinar.

mailto:Alove1@hrsa.gov mailto:SGraves@hrsa.gov http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application https://hrsa-gov.zoomgov.com/j/1604247757?pwd=YjExU3ozMzk2VzFBaG5nZGxVSlhSZz09 https://hrsa-gov.zoomgov.com/j/1604247757?pwd=YjExU3ozMzk2VzFBaG5nZGxVSlhSZz09

HRSA-24-035 EHDI National iv

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 OR 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. Attachments

3. 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

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

APPENDIX: GLOSSARY OF KEY TERMS AND PHRASES

HRSA-24-035 EHDI National 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Early Hearing Detection and Intervention (EHDI) National Network. The purpose of this program, which funds three national centers to conduct National Network and National Center activities, is to advance EHDI systems of services nationwide so that deaf and hard-of-hearing (DHH)2 newborns, infants, and young children up to age 3 receive appropriate supports and timely services to improve language acquisition outcomes. The three national centers are the Implementation and Change Center (ICC), the Family Leadership in Language and Learning Center (FL3), and the Provider Education Center

(PEC).3

Program Goal

HRSA funds a portfolio of coordinated programs to improve outcomes for DHH children:

the Early Hearing Detection and Intervention State/Territory Program (HRSA-24-036), the Early Hearing Detection and Intervention (EHDI) National Network (HRSA-24-035), and the Pediatric Audiology Competitive Supplement to Leadership Education in Neuro-developmental and Related Disabilities (LEND) Program (HRSA-21-042). Together, these programs ensure DHH infants and children up to age 3 are identified in a timely manner and appropriate follow-up services are received to optimize language, literacy, cognitive, social, and emotional development. When children are identified as DHH early and provided timely and appropriate intervention services, their outcomes improve in these areas.

The goal of the EHDI National Network is to improve outcomes for DHH children by establishing a network of three national technical assistance (TA) centers to provide coordinated support to state/territory EHDI programs (HRSA-24-036) and other EHDI system stakeholders at national, state, and local levels. Each national TA center will be conducted by one recipient. The three national TA centers are:

• Implementation and Change Center (ICC) will support state/territory EHDI programs using implementation science4 and change management5 methods to improve the EHDI system of services.

• Family Leadership in Language and Learning Center (FL3) will increase state capacity for family-to-family support, develop family leadership skills, and engage DHH adults as mentors to families across state/territory EHDI programs and other EHDI system stakeholders.

2 See appendix 3 For the FY 2024 program cycle, the National Technical Resource Center will be re-named the Implementation and Change Center, and a Provider Education Center will also be funded.

4 See appendix 5 See appendix

HRSA-24-035 EHDI National 2

• Provider Education Center (PEC) will improve confidence and training for health care and allied service professionals6 who screen, diagnose, and provide services to infants, children, and families interacting with the EHDI system.

While each national TA center has a distinct focus, all three recipients are expected to work together within the EHDI National Network to provide leadership to states and national, state, and local stakeholders through technical assistance and training (TA/T), policy analysis and assessment, partnership building, communication, dissemination, and evaluation.

Program Objectives

The recipient for each center is funded to collect, report, and achieve the following program objectives:

EHDI Network Objectives:

The three centers that receive funding under this opportunity are to collaborate as a network to report on the following objectives:

• Annually, provide TA/T to at least 25 state/territory EHDI programs (HRSA-24-

036) on activities that improve their EHDI system of services (for example, 1-3-6 benchmarks7, family engagement and support, language acquisition, etc.).

• By March 2029, using data from at least 25 state/territory EHDI programs (HRSA-24-036), report the ability to access, analyze, and implement activities using data describing language acquisition among DHH children up to age 3.

• By March 2029, using data from at least 25 state/territory EHDI programs, identify, analyze and report language acquisition outcomes for the population of 3-year-old DHH children.

Individual National Center Objectives:

Applications should propose a baseline and describe methods to reach the following by March 2029:

• Implementation and Change Center (ICC) o All state/territory EHDI programs (HRSA-24-036) engaged with the ICC will achieve their program objectives related to the 1-3-6 benchmarks and state/territory determined objectives.

o All state/territory EHDI programs (HRSA 24-036) receiving TA/T through the ICC will report improved partnership and coordination with Part C/Early Intervention program(s) at the state/territory or local level.

6 See appendix 7 The term “1-3-6 benchmarks” refers to the state-determined objectives referenced in the HRSA-24-036 NOFO

HRSA-24-035 EHDI National 3 o All state/territory EHDI programs (HRSA 24-036) engaged with the ICC will report implementing evidence-based and promising practices to improve language acquisition outcomes in DHH children up to age 3.

• Family Leadership in Language and Learning Center (FL3) o All state/territory EHDI programs (HRSA-24-036) engaged with the FL3 will achieve their program objectives related to family support.

o All state/territory EHDI programs (HRSA-24-036) receiving TA/T through the FL3 will report increased ability to engage families from underserved populations in the EHDI system.

o All state/territory EHDI programs (HRSA-24-036) engaged with the FL3 will report improved partnerships with individuals or organizations engaging in family-to-family support and DHH adult mentorship in the EHDI system.

• Provider Education Center (PEC) o All state/territory EHDI programs (HRSA 24-036) engaged with the PEC will report improved partnerships with providers and provider organizations serving children and families in the EHDI system.

o All state/territory EHDI programs (HRSA-24-036) receiving TA/T through the PEC will report improved confidence to communicate effectively with families who have DHH children, including information about timely follow up and enrollment in the Individuals with Disabilities Education Act (IDEA) Program for Infants and Toddlers with Disability Part C Program/Early Intervention (EI).

All providers receiving TA/T and resources through the PEC will report increased capacity to serve DHH children and their families.

For more details, see Program Requirements and Expectations.

2. Background

Authority

The Early Hearing Detection and Intervention State/Territory Program is authorized by 42 U.S.C. § 280g-1(a) (Title III, § 399M of the Public Health Service Act).

About MCHB and Strategic Plan

The HRSA 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:

HRSA-24-035 EHDI National 4

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

To learn more about MCHB and the bureau’s strategic plan, visit Mission, Vision, and Work | MCHB.

Health Equity

Health equity is “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.”8

Children and Youth with Special Health Care Needs Blueprint for Change

The Blueprint for Change: A National Framework for a System of Services for Children and Youth with Special Health Care Needs establishes a national agenda to ensure that every child gets the services he/she needs to play, go to school, and grow up to become a healthy adult. The Blueprint for Change outlines strategies in four critical areas that will strengthen the systems serving CYSHCN: health equity; quality of life and well-being for CYSHCN and their families; access to services; and financing of services.

The Blueprint for Change provides a framework to guide EHDI programs as they move towards tracking long-term developmental outcomes, including language acquisition for DHH children. This work requires partnering with families, those with lived experience, health care and other service providers, payers, and others in the field to build state and system-level capacity.

Learn more by reading the Blueprint for Change Pediatrics Supplement.

8 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.

https://mchb.hrsa.gov/about-us/mission-vision-work https://mchb.hrsa.gov/about-us/mission-vision-work https://publications.aap.org/pediatrics/issue/149/Supplement%207 https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf https://www.govinfo.gov/content/pkg/FR-2021-01-25/pdf/2021-01753.pdf

HRSA-24-035 EHDI National 5

Program Background

Approximately 1.8 of every 1,0009 U.S. newborns are documented as being identified early as congenitally deaf or hard-of-hearing (DHH). Children continue to be identified as DHH through early childhood and by kindergarten the prevalence more than doubles.10 Despite success in achieving near-universal newborn hearing screening rates, significant gaps remain, including timely diagnostic audiological evaluation, enrollment in IDEA Part C/Early Intervention (EI) services, and reducing loss to follow-up and documentation (LTF/D). Additional challenges include limited family engagement, DHH-specific support services,11 parent knowledge about availability and importance of EI,12 and pediatric provider knowledge of the 1-3-6 recommendations.13,14

When DHH children are identified early and provided timely and appropriate intervention services, they have better outcomes than children identified later in life—particularly in the areas of vocabulary development, receptive language, expressive language, and social-emotional development.15, 16, 17, 18, 19 Early identification and intervention play a critical role in kindergarten readiness and long-term academic outcomes, such as reading proficiency.20,21 To improve developmental outcomes for DHH children, state/territory EHDI systems must partner with early childhood systems and service providers to track long term outcomes for this population.

The Blueprint for Change emphasizes the value and importance of partnering with families and individuals with lived experience at all levels of care to improve family and child well-being and quality of life.22 The EHDI system of services relies on partnerships between families and providers where information provided to families is high quality, “accurate, comprehensive, up-to-date, and evidence-based,”23 and communicated in an appropriate, timely, culturally sensitive way. Meeting the needs of DHH children and their families requires improved communication among health and other allied service professionals. Families with DHH children also benefit from family-to-family support and DHH adult to family support services.

II. Award Information

1. Type of Application and Award

Application type(s): Competing Continuation, New

9 Centers for Disease Control and Prevention. (2022, September 29). 2020 Summary of Diagnostics Among Infants Not Passing Hearing Screening. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/ncbddd/hearingloss/2020-data/06-diagnostics.html 10 Watkin, P., & Baldwin, M. (2012). The longitudinal follow up of a universal neonatal hearing screen: The implications for confirming deafness in childhood. International Journal of Audiology, 51(7), 519–528.

https://doi.org/10.3109/14992027.2012.673237 11 Family Leadership in Language and Learning (2018). Needs Assessment Report. Retrieved from:

https://www.handsandvoices.org/fl3/resources/docs/HV-FL3_NeedsAssessment_19Jul2018_Final-opt.pdf.

12 United States Government Accountability Office Report to Congressional Requestors. (2011). Deaf and Hard of Hearing Children – Federal Support for Developing Language and Literacy. GAO-11-357 https://www.cdc.gov/ncbddd/hearingloss/2020-data/06-diagnostics.html https://doi.org/10.3109/14992027.2012.673237 https://www.handsandvoices.org/fl3/resources/docs/HV-FL3_NeedsAssessment_19Jul2018_Final-opt.pdf

HRSA-24-035 EHDI National 6

We will fund you via a cooperative agreement.

A cooperative agreement is like a grant in that we award money, but we are substantially involved with program activities.

Aside from monitoring and technical assistance (TA), we also get involved in these ways:

• Participating in the planning and development of project activities during the period of performance.

• Participating in routine meetings and regular communication with the recipient to assess progress in meeting the goals and objectives of this initiative.

• Continuously reviewing policies and procedures, activities, emerging issues, data, measures, and tools designed and implemented during the period of performance.

• Participating, when appropriate, in meetings, conference calls, and other sessions conducted during the period of performance, including but not limited to, advisory committee meetings, TA/T sessions, and learning collaborative sessions.

• Reviewing and editing, as appropriate, written documents developed by the recipient prior to submission for publication or public dissemination.

13 American Academy of Pediatrics (AAP) Early Hearing Detection and Intervention (EHDI) Pediatrician Perspectives:

Executive Summary. August 2018.

14 American Academy of Pediatrics (AAP) Early Hearing Detection and Intervention (EHDI) Pediatrician Perspectives:

Executive Summary. August 2018.

15 Yoshinaga-Itano C, Sedey AL, Wiggin M, Chung W. Early Hearing Detection and Vocabulary of Children With Hearing Loss. Pediatrics. 2017 Aug;140(2):e20162964. doi: 10.1542/peds.2016-2964. Epub 2017 Jul 8. PMID:

28689189; PMCID: PMC5595069.

16 Carren J. Stika, Laurie S. Eisenberg, Karen C. Johnson, Shirley C. Henning, Bethany G. Colson, Dianne Hammes Ganguly, Jean L. DesJardin, Developmental outcomes of early-identified children who are hard of hearing at 12 to 18 months of age, Early Human Development, Volume 91, Issue 1, 2015, Pages 47-55, ISSN 0378-3782, https://doi.org/10.1016/j.earlhumdev.2014.11.005.

17 Harris AB, Seeliger E, Hess C, Sedey AL, Kristensen K, Lee Y, Chung W. Early Identification of Hearing Loss and Language Development at 32 Months of Age. Journal of Otorhinolaryngology, Hearing and Balance Medicine. 2022;

3(4):8. https://doi.org/10.3390/ohbm3040008 18 Allen TE, Morere DA. Early visual language skills affect the trajectory of literacy gains over a 3-year period of time for preschool aged deaf children who experience signing in the home. PLoS One. 2020 Feb 27;15(2):e0229591. DOI:

10.1371/journal.pone.0229591 19 Tomblin, J. Bruce1; Harrison, Melody2; Ambrose, Sophie E.3; Walker, Elizabeth A.1; Oleson, Jacob J.4; Moeller, Mary Pat3. Language Outcomes in Young Children with Mild to Severe Hearing Loss. Ear and Hearing:

November/December 2015 - Volume 36 - Issue - p 76S-91S doi: 10.1097/AUD.0000000000000219 20 Jareen Meinzen-Derr, Susan Wiley, Wendy Grove, Mekibib Altaye, Marcus Gaffney, Ashley Satterfield-Nash, Alonzo T. Folger, Georgina Peacock, Coleen Boyle; Kindergarten Readiness in Children Who Are Deaf or Hard of Hearing Who Received Early Intervention. Pediatrics October 2020; 146 (4): e20200557. 10.1542/peds.2020-0557 21 Yoshinaga-Itano C, Sedey AL, Wiggin M, Chung W. Early Hearing Detection and Vocabulary of Children With Hearing Loss. Pediatrics. 2017 Aug;140(2):e20162964. doi: 10.1542/peds.2016-2964. Epub 2017 Jul 8. PMID:

28689189; PMCID: PMC5595069.

22 Coleman, C. L., Morrison, M., Perkins, S. K., Brosco, J. P., & Schor, E. L. (2022). Quality of Life and Well-being for Children and Youth with Special Health Care Needs and Their Families: A Vision for the Future. Pediatrics, 149 (Supplement 7). https://doi.org/10.1542/peds.2021-056150g 23 Early Hearing Detection and Intervention Act of 2017, Public Health Service Act, Title III, Section 399M (as added by P.L. 106-310, Sec. 702; as amended by P.L. 111-337 and P.L. 115-71. Retrieved from:

https://www.congress.gov/115/plaws/publ71/PLAW-115publ71.pdf https://doi.org/10.1016/j.earlhumdev.2014.11.005 https://doi.org/10.3390/ohbm3040008 https://doi.org/10.1542/peds.2021-056150g https://www.congress.gov/115/plaws/publ71/PLAW-115publ71.pdf

HRSA-24-035 EHDI National 7

• Participating with the recipient in the dissemination of project findings, best practices, and lessons learned, and in producing and jointly reviewing reports, articles, and/or presentations developed under this NOFO.

• Conducting site visits with the recipient during the period of performance.

• Assisting in the establishment of partnerships, collaboration, and cooperation that may be necessary to carry out the project, including other federal agencies or programs within HRSA.

• Monitoring performance measurement and evaluation data reported by recipients to track recipient progress, provide feedback to individual recipients, and assess (in an aggregate manner) whether the HRSA program is achieving intended program outcomes. HRSA and the recipients will work together after award to finalize the performance monitoring and accountability approach.

• Monitoring the extent to which the products and services provided by the recipients meet needs identified by stakeholders.

You must follow all relevant federal regulations and public policy requirements. Your other responsibilities will include:

• Meeting with the HRSA project officer at the time of the award to review the current strategies and ensure the project and goals align with HRSA priorities for this activity.

• Collaborating with HRSA personnel in the planning and development of project activities including developing policies and procedures; identifying measures and data; identifying emerging issues; revising the monitoring and evaluation plan to address emerging needs; developing strategies and tools; and identifying topics for advisory committee meetings, learning collaboratives, publications, and other materials produced.

• Producing and disseminating project findings through publishing articles, reports and/or presentations; and adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all products produced by HRSA awards (see Acknowledgement of Federal Funding in Section 2.2 of HRSA’s SF-424 Application Guide).

• Analyzing evidence-informed data, impact, and quality improvement (QI) data, and any relevant data trends.

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

• Leveraging existing products or resources to maximize efficiency and effectiveness and reduce duplication.

• Participating in meetings and conference calls with HRSA during the period of performance to provide regular updates on progress in meeting goals and objectives.

• Collaborating with state/territory EHDI program (HRSA-24-036) recipients to meet the goals and objectives of the program.

HRSA-24-035 EHDI National 8

• Collaborating with fellow EHDI National Centers (HRSA-24-035) and other federally funded entities from HRSA, the Centers for Disease Control and Prevention (CDC), and the Office of Special Education Programs (for example, National Center for a System of Services for CYSHCN, MCH Workforce Development Center, Newborn Screening State Priorities Program, Newborn Screening System Excellence Program, Family Engagement and Leadership in Systems of Care, Association of Maternal and Child Health Programs, Early Childhood Technical Assistance Center, Center for Parent Information and Resources, etc.).

2. Summary of Funding

We estimate $1,500,000 will be available each year to fund up to 3 recipients. You may apply for a ceiling amount of up to $750,000 for the EHDI ICC, up to $450,000 for the FL3, or up to $300,000 for the PEC annually (reflecting direct and indirect costs).

The period of performance is April 1, 2024, through March 31, 2029 (5 years).

This program notice depends on the appropriation of funds. If funds are appropriated for this purpose, we will proceed with the application and award process.

Support beyond the first budget year will depend on:

• Appropriation

• Satisfactory progress in meeting the project’s objectives

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

45 CFR part 75 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards applies to all HRSA awards.

If you’ve never received a negotiated indirect cost rate, you may elect to charge a de minimis rate of 10 percent of modified total direct costs (MTDC)*. You may use this for the life of the award. If you choose this method, you must use it for all federal awards until you choose to negotiate for a rate. You may apply to do so at any time. See Section 4.1.v. Budget Narrative in the Application Guide.

*Note: One exception is a governmental department or agency unit that receives more than $35 million in direct federal funding.

III. Eligibility Information

1. Eligible Applicants

You can apply if your organization is in the United States and is:

• Public or private

• Community-based https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75

HRSA-24-035 EHDI National 9

• Tribal (governments, organizations, as those terms are defined at 25 U.S.C. § 450b) o Native American tribal governments (federally recognized) are eligible.

o Native American tribal organizations (other than federally recognized tribal governments) are eligible.

2. Cost Sharing or Matching

Cost sharing or matching is not required for this program.

3. Other

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

• Exceeds the funding ceiling amount

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

Multiple Applications

You may only apply for funding as one of three EHDI National TA Centers:

Implementation and Change Center (ICC), Family Leadership in Language and Learning (FL3), or Provider Education Center (PEC). You must state which Center you are applying for clearly in your application. HRSA will not consider funding applicants that apply for funding as more than one National Center.

We will only review your last validated application before the Grants.gov due date.

Organizations have the ability to come together as a consortium to submit a joint application for one National Center. Each consortium member must demonstrate substantial involvement in the project and contribute significantly to the goals of the project. The roles and responsibilities of each consortium member must be clearly defined in a proposed Memorandum of Understanding/Agreement (MOU/A). The proposed MOU/A must be supported in writing by all consortium members and submitted as Attachment 10.

IV. Application and Submission Information

1. Address to Request Application Package

We require you to apply online through Grants.gov. Use the SF-424 workspace application package associated with this notice of funding opportunity (NOFO). Follow these directions: How to Apply for Grants. If you choose to submit using an alternative online method, see Applicant System-to-System.

Note: Grants.gov calls the NOFO “Instructions.”

https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/s2s/applicant-system-to-system.html

HRSA-24-035 EHDI National 10

Select “Subscribe” and enter your email address for HRSA-24-035 to receive emails about changes, clarifications, or instances where we republish the NOFO. You will also be notified by email of documents we place in the RELATED DOCUMENTS tab that may affect the NOFO and your application. You’re responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

Application Format Requirements Submit your information as the Application Guide and this program-specific NOFO state. Do so in English and budget figures expressed in U.S. dollars. There’s an Application Completeness Checklist in the Application Guide to help you.

Application Page Limit The total number of pages that count toward the page limit shall be no more than 60 pages when we print them. We won’t review any pages that exceed the page limit.

Using the pages within the page limit, HRSA will determine eligibility using Section III.

Eligibility Information of the NOFO.

These items don’t count toward the page limit:

• Standard OMB-approved forms you find in the NOFO’s workspace application package

• Abstract (standard form (SF) "Project_Abstract Summary”)

• Indirect Cost Rate Agreement

• Proof of non-profit status (if it applies)

If there are other items that don’t count toward the page limit, we’ll make this clear in Section IV.2.v Attachments.

If you use an OMB-approved form that isn’t in the HRSA-24-035 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-035 before the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals24 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project. That is, no federal department or agency has debarred, suspended, proposed for debarment, claimed you ineligible, or you have voluntarily excluded yourself from participating.

• If you fail to make mandatory disclosures, we may take an action like those in 45 CFR § 75.371. This includes suspending or debarring you.25

24 See definitions at eCFR :: 2 CFR 180.995 -- Principal. and eCFR :: 2 CFR 376.995 -- Principal (HHS supplement to government-wide definition at 2 CFR 180.995).

25 See also 2 CFR parts 180 and 376, 31 U.S.C. § 3354, and 45 CFR § 75.113.

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 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 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180/subpart-I/section-180.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376/subpart-I/section-376.995 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-180 https://www.ecfr.gov/current/title-2/subtitle-B/chapter-III/part-376 https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title31-chapter33&edition=prelim https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-B/section-75.113

HRSA-24-035 EHDI National 11

• If you can’t certify this, you must include an explanation in Attachment 11 Other Relevant Documents.

(See Section 4.1 viii “Certifications” of the Application Guide)

Program Requirements and Expectations You will apply for funding as one of the following EHDI National TA Centers:

Implementation and Change Center (ICC), Family Leadership in Language and Learning Center (FL3), or Provider Education Center (PEC). The three recipients are expected to complete collaborative Network Level activities as well as National Center Level activities. As a Network, the three National TA Centers will collaborate to strengthen the EHDI system to ensure that DHH children reach language acquisition up to age 3. Each national center also will provide TA/T, policy analysis and assessment, partnership building, communication, dissemination, evaluation, and leadership to state/territory EHDI programs (HRSA-24-036) and other EHDI system stakeholders at national, state, and local levels.

Respond to both Network Level and National TA Center Level requirements. Describe how activities relate to the specific National Center to which you are applying.

Network Level Activities

Regarding the structure of the Network, recipients are expected to:

• Actively collaborate with the other funded EHDI National TA Centers as part of the Network. This includes the following:

o Design and implement an evaluation plan and identify a shared set of measures to assess overall Network outcomes and impact. This should reflect the state/territory EHDI program objectives. This should also include methods to reach consensus and develop collective responses to report progress on Network objectives.

o Develop mechanisms to streamline data collection from state/territory EHDI programs (for example, reports, needs assessments, etc.) to reduce the burden of reporting for state/territory EHDI programs.

o Develop and implement a comprehensive plan for communication and coordination to ensure any entity seeking TA/T as described in this NOFO receives such TA/T, as appropriate.

o Convene an annual strategic planning meeting, including key stakeholders and federal staff.

• Design and implement a memorandum of understanding (MOU) with the other recipients under this NOFO within 3 months of the Notice of Award, which may include, but is not limited to, describing methods of communication and consensus building, specific roles for each National Center, decisions for data sharing, and mechanisms to ensure network accountability.

https://www.grants.gov/web/grants/view-opportunity.html?oppId=349418

HRSA-24-035 EHDI National 12

• Participate in a Network kick-off meeting at the beginning of Year 1 of the period of performance.

Regarding collaboration of the Network, recipients are expected to:

• Convene at minimum one annual learning community26 of state/territory EHDI programs to address their identified need to improve language acquisition.

Implementation science/change management techniques should be used. This could include, but is not limited to, the following:

o Increasing data capacity and interoperability of data systems o Improving training and educating health care and other allied service providers o Building partnerships with other EHDI stakeholder organizations and entities. Such entities could include early intervention, such as Part C, family-based organizations, provider organizations, etc.

o Strengthening mechanisms to engage families, including families who are traditionally underserved, in DHH adult-to-family services o Providing family-to-family supports and services across the EHDI system

• Facilitate information sharing and learning opportunities to address the needs identified by state/territory EHDI programs and other EHDI stakeholders, including family-based-organizations.

• Collect, analyze, and disseminate findings to the field from the state/territory EHDI programs, including, data analysis, statewide infrastructure plans, and other reports.

All National TA Center Level Activities

Each National TA Center will be required to implement the following activities throughout the period of performance.

Technical Assistance and Training (TA/T)

• Provide TA/T and education to all 59 state/territory EHDI programs, family-based organizations, health care and allied service professionals, EI providers, and other EHDI system stakeholders to maximize access to language acquisition for DHH children up to age 3.

o Each National Center should provide TA/T to all 59 state/territory EHDI programs, either individually or via Network activities, by the end of the period of performance.

26 See appendix

HRSA-24-035 EHDI National 13 o Individualized TA/T can be provided via coaching, mentoring, or individual consultation. Group TA/T can be provided via a variety of methods such as learning collaboratives, peer-to-peer learning opportunities, and skills training sessions.

• Increase outreach and TA/T efforts to all state/territory EHDI programs (HRSA- 24-036) particularly those measuring below the national averages for the 1-3-6 benchmarks and/or state/territory determined objectives.

• Develop topical resources for state/territory EHDI programs, stakeholders, and the broader EHDI community (for example, issue briefs, tools, toolkits, fact sheets, webinars, and publications), as needed.

Policy Analysis and Assessment

• Monitor, analyze, and report policy and program initiatives at the local, state/territory, and national level that could act as barriers and/or facilitators to implement best practices in state/territory EHDI programs. This should include the four critical areas in the Blueprint for Change (that is, health equity, well-being and quality of life, access to services, and financing of services).

• Identify and analyze promising and evidence-based/-informed practices, innovations, and measures for state/territory EHDI programs to achieve program objectives listed in HRSA-24-036, specific to your National Center.

Partnership Building

• Convene an advisory group, comprised of at least 25 percent of members who represent families of DHH children, families from underserved populations, family-based organizations, those with lived experience, or Deaf-led organizations.

• Facilitate collaborative efforts between state/territory EHDI programs and partners, including IDEA Part C programs, Early Intervention (EI) providers, family-based organizations, and early care and education programs such as Early Head Start, who share goals to improve access to language acquisition.

• Collaborate with individuals and organizations who historically serve underserved populations.

Communication and Dissemination

• Maintain a high-quality 508 compliant, public-facing, National Center website with an easy-to-navigate design. The website must link to the other National Centers’ websites to ensure straightforward information is made available and exchanged.

• Develop a plan to disseminate successful innovations, trainings, resources, and reports to all intended audiences.

HRSA-24-035 EHDI National 14

• Interface with external partners to ensure developed resources, tools, and trainings are disseminated through multiple and diverse platforms, for example, family-based organizations, DHH-led organizations, early intervention/Part C programs, etc. Information provided to families should be accurate, comprehensive, up-to-date, and evidence-based.

Evaluation

• Develop and implement a monitoring and evaluation plan to track progress to achieve project goals and objectives and contribute to continuous QI. These activities should be ongoing, and data must be discussed and shared regularly with HRSA project officer and staff. The plan should distinguish between various types of TA/T provided. The plan should include a logic model presenting your conceptual framework to achieve project goals and objectives.

o Specifically, track and evaluate national progress on the 1-3-6 benchmarks.

• Develop a mechanism to track requests throughout the duration of the project for TA/T and other requests received by recipient type (for example, EHDI Coordinator, Family Leader, other system stakeholders, etc.), topic, response to TA/T request, and the outcome after responding to these requests.

• Develop mechanisms to collect information and data from state/territory EHDI programs via the Network or individually, as appropriate.

• Use evaluation results and TA/T recipient feedback to inform program and stakeholder decisions, policies, procedures, and processes.

Individual National Center Activities

Implementation and Change Center (ICC)

• Implement methods that include implementation science strategies and change management approaches to promote policy and practice change within the EHDI system. Implementation should assist state/territory EHDI programs in all phases of their work outlined in HRSA-24-036 and align with Phase I (Planning), Phase II (Implementation and Building Sustainable Practices). Activities should include, but are not limited to:

o Supporting state/territory EHDI programs in systems mapping and needs assessment activities o Coaching state/territory EHDI programs in systems change or change management efforts o Assisting state/territory EHDI programs in developing mechanisms for formal communication, training and referrals, and data sharing agreements between EHDI programs and IDEA Part C Program at the local and/or state level

HRSA-24-035 EHDI National 15

• Develop a national framework that identifies, defines, and measures the EHDI system of services, including language acquisition outcome measures.

• Provide TA/T and evaluation support to state/territory EHDI programs in fulfilling grant requirements (for example, State/Territory Determined Objectives, 1-3-6 benchmarks, statewide needs assessment, Language Acquisition Priority Plan, etc.), throughout the period of state/territory EHDI performance.

• Design and implement onboarding resources/materials for new state EHDI Coordinators and project staff.

• Plan, host, and facilitate an annual grantee meeting for state/territory EHDI Coordinators and Family Leaders. This meeting should be co-hosted and facilitated with the FL3 Center.

• Conduct an independent evaluation of TA/T provided, using one or more qualified, independent evaluators.

Family Leadership in Language and Learning Center (FL3)

• Support new EHDI Coordinators/Project Directors and Family Leaders/engagement liaisons by providing an orientation to family support and engagement within the EHDI system.

• Plan, host, and facilitate an annual grantee meeting for state/territory EHDI Coordinators and Family Leaders. This meeting should be co-hosted and facilitated with the ICC.

Provider Education Center (PEC)

• Design and publish by the end of Year 1, an assessment and analysis of the confidence and capacity of health care and other service providers in caring for DHH children and their families throughout the EHDI system of services (for example, audiologists, pediatricians, nurse practitioners, hospital screeners, EI service coordinators, etc.).

• Develop recommendations and guidelines for providers to communicate with families about 1-3-6 recommendations and other developmental outcomes, with particular emphasis on access to language and language acquisition.

• Develop and implement mechanisms to engage and train providers in interdisciplinary training and networking experiences to encourage leadership opportunities for those working in EHDI systems.

Program-Specific Instructions Include application requirements and instructions from Section 4 of the Application Guide (budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract). Also include the following:

HRSA-24-035 EHDI National 16

i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form that you’ll find in the workspace application package. Don’t upload the abstract as an attachment or it may count toward the page limit. For information you must include in the Project Abstract Summary Form, see Section 4.1.ix of the Application Guide.

NARRATIVE GUIDANCE

The following table provides a crosswalk between the narrative language and where each section falls within the review criteria. Make sure you’ve addressed everything. We may consider any forms or attachments you reference in a narrative section during the merit review.

Narrative Section Review Criteria

Introduction Criterion 1: NEED

Organizational Information Criterion 5: RESOURCES/CAPABILITIES

Criterion 6: SUPPORT REQUESTED

Need Criterion 1: NEED

Criterion 2: RESPONSE

Approach Criterion 2: RESPONSE

Criterion 4: IMPACT

Work Plan Criterion 2: RESPONSE

Criterion 3: EVALUATIVE MEASURES

Criterion 4: IMPACT

Resolution of Challenges Criterion 2: RESPONSE

Evaluation and Technical Support Capacity

Criterion 2: RESPONSE

Criterion 3: EVALUATIVE MEASURES

Criterion 5: RESOURCES/CAPABILITIES

Budget Narrative Criterion 6: SUPPORT REQUESTED

ii. Project Narrative

This section must describe all aspects of the proposed project. Make it brief and clear.

Provide the following information in the following order. Please use the section headers.

This ensures reviewers can understand your proposed project.

Introduction -- Corresponds to Section V’s Review Criterion 1: Need

HRSA-24-035 EHDI National 17

Specify the national TA center you are applying for: Implementation and Change Center (ICC), Family Leadership in Language and Learning Center (FL3), or Provider Education Center (PEC) and briefly describe the purpose of the proposed project that is consistent with Program Requirements and Expectations.

Organizational Information -- Corresponds to Section V’s Review Criteria 5: Resources/Capabilities and 6: Support Requested

Succinctly describe your organization’s current mission, structure, and scope of current activities, and how these elements all contribute to the organization’s ability to implement the Program Requirements and Expectations. Include an organizational chart.

o Describe your organization’s capacity and expertise to provide TA/T including the scope of TA/T and activities your organization currently engages in and your experience managing collaborative federal awards at the national level.

o Describe how key project personnel and any consultants and subcontractors will be allocated and how these allocations are appropriate and adequate to achieve the project’s intended outcomes.

o Describe how the proposed project will benefit from a diversity of perspectives, including those of families, Deaf adults, educators, TA providers, health care professionals, researchers, and policy makers, among others, in its development and operation.

o Describe how the proposed project will encourage engagement from persons who are members of groups that have traditionally been underrepresented based on race, color, national origin, gender, age, or disability, as appropriate.

o For multiple organizations submitting one application as a consortium, identify the lead organization, describe the roles and responsibilities of each member of the consortium, and discuss how the consortium will operate.

Implementation and Change Center (ICC) o Describe your organization’s expertise in the following areas: public health systems, workforce development, systems change, implementation science, change management, and evaluation.

Family Leadership in Language and Learning Center (FL3) o Describe your organization’s expertise in supporting family leadership and engagement in EHDI systems of services and developing family leaders.

Provider Education Center (PEC)

HRSA-24-035 EHDI National 18 o Describe your organization’s expertise supporting health care and service providers to improve the system of services for DHH children and their families.

Need-- Corresponds to Section V’s Review Criteria 1: Need and 2: Response

This section will help reviewers understand the EHDI system of services and the overall needs that could be served by this proposed project. Use and cite data whenever possible to support the information provided.

o…