MCHB-HRSA-24-038-(UF5)-SHSPP-Final.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Maternal and Child Health Bureau

Division of Healthy Start and Perinatal Services

Supporting Healthy Start Performance Project

Funding Opportunity Number: HRSA-24-038

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listing Number: 93.926

Application Due Date: December 29, 2023 Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

We will not approve deadline extensions for lack of registration.

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

Issuance Date: September 29, 2023

Kristal Dail, MPH Public Health Analyst, Division of Healthy Start and Perinatal Services Call: 301-287-0236 Email: kdail@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. § 254c-8 (Title III, § 330H of the Public Health Service Act) mailto:kdail@hrsa.gov

HRSA-24-038 SHSPP 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: Supporting Healthy Start Performance Project

Funding Opportunity Number: HRSA-24-038

Assistance Listing Number: 93.926

Due Date for Applications: December 29, 2023

Purpose: The purpose of the Supporting Healthy Start Performance Project (SHSPP) is to provide training and technical assistance to support Healthy Start (HS), Healthy Start Initiative - Enhanced (HSE), and Catalyst for Infant Health Equity grant recipients in improving their service delivery, meeting outcome measures, and building program capacity to work with community partners to improve health and social service systems to reduce maternal and infant health disparities.

Program Objective(s): By May 31, 2029, the SHSPP will:

• Increase the number of grant recipients provided with training and technical assistance on implementation strategies to increase fair access to quality community-based services.

• Increase the number of training materials and resources on perinatal health topics for grant recipients.

• Increase opportunities for peer-to-peer learning and information sharing among grant recipients.

• Increase the number of grant recipients who receive training and technical assistance on data collection and data use for quality https://www.grants.gov/web/grants/view-opportunity.html?oppId=346219 https://www.grants.gov/web/grants/view-opportunity.html?oppId=334421

HRSA-24-038 SHSPP ii improvement, performance monitoring, and local evaluation.

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

• Public or private;

• Community-based; and/or

• Tribal (governments, organizations).

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

Anticipated FY 2024 Total Available Funding:

Supporting Healthy Start Performance Project:

$3,500,000

SHSPP TA Enhancement: Up to $800,000

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):

Supporting Healthy Start Performance Project: Up to 1 competing continuation, new cooperative agreement

SHSPP TA Enhancement (Optional): Recipient may receive additional funding for TA Enhancement, subject to the availability of appropriated funds.

Estimated Annual Award Amount:

Up to $3,500,000 per award for the Supporting Healthy Start Performance Project, subject to the availability of appropriated funds

Up to $800,000 for the SHSPP TA Enhancement, subject to the availability of appropriated funds

Cost Sharing or Matching Required:

No

HRSA-24-038 SHSPP iii

Period of Performance: Supporting Healthy Start Performance Project:

June 1, 2024 through May 31, 2029 (5 years)

SHSPP TA Enhancement:

June 1, 2024 through May 31, 2029 (5 years)

Agency Contacts: Business, administrative, or fiscal issues:

David Colwander Grants Management Specialist Division of Grants Management Operations, OFAM Health Resources and Services Administration Call: 301-443-7858 Email: Dcolwander@HRSA.gov

Program issues or technical assistance:

Kristal Dail, MPH Public Health Analyst, Division of Healthy Start and Perinatal Services Maternal and Child Health Bureau Call: 301-287-0236 Email: kdail@hrsa.gov

Rochelle Logan, DrPH, MPH, CHES Supervisory Public Health Analyst, Division of Healthy Start and Perinatal Services Maternal and Child Health Bureau Call: 240-381-5834 Email: rlogan@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.

mailto:Dcolwander@HRSA.gov mailto:kdail@hrsa.gov mailto:rlogan@hrsa.gov http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application

HRSA-24-038 SHSPP iv

Technical Assistance

We have scheduled the following webinar:

Tuesday, October 17, 2023 1:00 – 3:00. p.m. ET Weblink: https://hrsa-gov.zoomgov.com/j/1603453343?pwd=UmgzRk5NZFd2NlVOMDRFWFFkbSs5dz09

Attendees without computer access or computer audio can use the following dial-in information: Call-In Number: 1 833 568 8864 Meeting ID: 20958161

We will record the webinar, which will be available at:

https://mchb.hrsa.gov/fundingopportunities/default.aspx https://hrsa-gov.zoomgov.com/j/1603453343?pwd=UmgzRk5NZFd2NlVOMDRFWFFkbSs5dz09 https://hrsa-gov.zoomgov.com/j/1603453343?pwd=UmgzRk5NZFd2NlVOMDRFWFFkbSs5dz09 https://mchb.hrsa.gov/fundingopportunities/default.aspx

HRSA-24-038 SHSPP v

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 A: PAGE LIMIT WORKSHEET

APPENDIX B: GLOSSARY

APPENDIX C: HEALTH PROMOTION TOPICS

HRSA-24-038 SHSPP 2

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Supporting Healthy Start Performance Project (SHSPP). The purpose of the SHSPP is to provide training and technical assistance (TA) to support grant recipients in improving their service delivery, meeting outcome measures, and building program ability to work with community partners to improve health and social service systems to reduce maternal and infant health disparities. These grant recipients include those funded under the following programs: Healthy Start (HS), Healthy Start Enhanced (HSE), and Catalyst for Infant Health Equity (Catalyst).

To carry out these activities, the SHSPP recipient will serve as the Healthy Start Technical Assistance and Support Center (TASC)1. As the TASC, the SHSPP will aid in strengthening the implementation of HS grant recipient activities by providing ongoing training and TA to grant recipients.

The HS, HSE, and Catalyst programs have an increased emphasis on addressing social determinants of health (SDOH)2 to improve disparities in maternal and infant health outcomes. Training and TA strategies provided by the SHSPP are expected to acknowledge and respond to SDOH affecting HS grant recipients across the country.

Program Goal:

The goal of the SHSPP is to strengthen the ability of grant recipients in their implementation of strategies and programs that improve perinatal outcomes by increasing equitable access to quality community-based services.

Program Objectives The objectives to be carried out during the period of performance include:

By May 31, 2029, the SHSPP will:

• Increase the number of grant recipients provided with training and technical assistance on implementation strategies to increase fair access to quality community-based services.

• Increase the number of training materials and resources on perinatal health topics for grant recipients.

• Increase opportunities for peer-to-peer learning and information sharing among grant recipients.

1 The TASC operates the Healthy Start EPIC Website. The Healthy Start EPIC website is an online database where grant recipients can access training, consultation, and technical resources to support the implementation of each program.

2 https://www.cdc.gov/about/sdoh/index.html https://www.grants.gov/web/grants/view-opportunity.html?oppId=346219 https://www.grants.gov/web/grants/view-opportunity.html?oppId=334421 https://www.grants.gov/web/grants/view-opportunity.html?oppId=334421 https://healthystartepic.org/about-hs-epic-center/services/ https://healthystartepic.org/about-hs-epic-center/services/ https://www.cdc.gov/about/sdoh/index.html

HRSA-24-038 SHSPP 3

• Increase the number of grant recipients who receive training and technical assistance on data collection and data use for quality improvement, performance monitoring, and local evaluation.

For more details on the program requirements and expectations to support and monitor the program goals and objectives, see Program Requirements and Expectations.

The FY24 Healthy Start competition (HRSA-24-033) includes a new expectation for HS projects to provide group-based prenatal/postpartum health and parenting education, which can lead to positive perinatal outcomes. The purpose of the enhancement is to further advance efforts around reducing maternal and infant health disparities. The optional SHSPP TA Enhancement seeks to provide additional, more focused support to build HS capacity around group-based interventions for FY24 HS recipients, as well as HSE and Catalyst recipients.

The SHSPP TA Enhancement activities may include but are not limited to the following:

(1) Assessment of recipient needs

(2) One-on-one TA to HS projects

(3) Identifying best practices

(4) Support in the implementation of group-based health and education programs

Note: the recipient may be asked to submit a revised budget and workplan for enhancement activities at the time funding is made available, based on the needs of grant recipients for SHSPP TA Enhancement. Proposed activities should be consistent with those listed in Section V’s Review Criteria within the Review and Selection Process section, on page 29 and Attachment 9 Project Narrative.

2. Background

Authority

The Supporting Healthy Start Performance Project is authorized by 42 U.S.C. § 254c-8 (Title III, § 330H of the Public Health Service Act).

Infant Mortality, Perinatal Health, and Social Determinants of Health

Approximately four million births occur each year in the U.S.3 While most women have a safe pregnancy and deliver a healthy infant, there are persistently higher rates of infant mortality and maternal morbidity among Black and American Indian/Alaska Native populations. The highest infant mortality rates in the country are among Black infants and AI/AN infants (10.38 and 7.68 infant deaths per 1,000 live births in 2020, respectively), with rates that are significantly higher than that of White infants (4.40 infant deaths per 1,000 live births in 2020).4

3 https://www.cdc.gov/nchs/fastats/births.htm 4 https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-05.pdf https://www.cdc.gov/nchs/fastats/births.htm https://www.cdc.gov/nchs/data/nvsr/nvsr71/nvsr71-05.pdf

HRSA-24-038 SHSPP 4

Excess non-Hispanic Black and non-Hispanic AI/AN infant deaths are those that occur due to higher mortality rates compared to non-Hispanic White infants, and can be referred to as deaths attributable to disparity or deaths that need to be prevented to achieve equity. Each year, approximately 3,500 more infant deaths occur due to higher mortality rates among non-Hispanic Black and non-Hispanic AI/AN infants than White infants5.

Inequities in access to health promoting resources such as education, employment, and health care contribute to racial/ethnic disparities in perinatal health and infant death.

Research suggests a correlation between individual outcomes and health disparities across racial groups, indicating that they are shaped by interpersonal, institutional, community, and policy factors such as racism, providers’ cultural competence, access to quality health care, neighborhood quality, and economic and housing opportunities.6 Several social determinants of health frameworks (for example, National Birth Equity Framework,7 Vital Conditions for Well-Being,8 and Healthy People 20309) have been developed to help communities, medical and public health professionals, and others better understand and address the multiple factors that contribute to disparate health outcomes.

The Healthy Start Initiative Since its start as a demonstration project in 1991, HS has provided grants to communities with infant mortality rates at 1.5 times the U.S. national average and with high rates of other adverse perinatal outcomes (for example, low birthweight, preterm birth, maternal morbidity, and mortality). The purpose of HS is to reduce infant mortality rates and improve perinatal outcomes, focusing on project areas with average annual rates of infant mortality that are high or above the national average. HS uses a community-based approach to deliver direct and enabling services that facilitate access to health care and community services. HS works to eliminate the disparities in health status between the general population and individuals who are members of racial and ethnic minority groups.

5 Excess Infant Deaths is a statistical term used in public health to refer to infant deaths that occur due to higher mortality rates than non-Hispanic White infants and can be referred to as deaths attributable to disparity or deaths that need to be prevented to achieve equity in infant mortality rates. Excess deaths are calculated by multiplying excess death rates by the number of births (for example, [Black IM rate – White IM rate] X Black births).

6 National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Community-Based Solutions to Promote Health Equity in the United States; Baciu A, Negussie Y, Geller A, et al., editors. Communities in Action:

Pathways to Health Equity. Washington (DC): National Academies Press (US); 2017 Jan 11. 3, The Root Causes of Health Inequity. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425845 7 https://www.marchofdimes.org/professionals/mom-and-baby-action-network.aspx 8 https://winnetwork.org/vital-conditions 9 https://health.gov/healthypeople/priority-areas/social-determinants-health https://www.ncbi.nlm.nih.gov/books/NBK425845 https://www.marchofdimes.org/professionals/mom-and-baby-action-network.aspx https://winnetwork.org/vital-conditions https://health.gov/healthypeople/priority-areas/social-determinants-health

HRSA-24-038 SHSPP 5

Currently, HRSA funds HS programs in 101 communities across 35 states and the District of Columbia.

Healthy Start Initiative – Enhanced

Launched in 2023, the purpose of HSE is to improve health outcomes before, during, and after pregnancy and reduce the well-documented racial/ethnic differences in rates of infant death and adverse perinatal outcomes. HSE is intended to support projects in diverse communities and populations (for example, rural, urban, non-Hispanic Black, American Indian/Alaskan Native [AI/AN]) experiencing the greatest disparities in maternal and infant health outcomes).

Catalyst for Infant Health Equity

The purpose of the Catalyst for Infant Health Equity program is to support the implementation of existing action plans that apply data-driven policy and innovative systems strategies to reduce IM disparities and prevent excess infant deaths.

Recipients are expected to implement action plans that address the social determinants of health (that is, environmental, social, and economic conditions), and/or the structural determinants of health (for example, institutions, systemic barriers, policies) that contribute to disparities in IM.

Healthy Start Technical Assistance and Support Center (TASC)

The recipient of the SHSPP will be expected to serve as the TASC and provide training, technical assistance, and support to the HS, HSE, and Catalyst grant recipients.

This notice of funding opportunity (NOFO) aims to address some of the lessons learned from previous periods of performance of the HS, HSE, and Catalyst programs, including the need to:

• Support grant recipients in planning, implementing, and measuring program activities through evidence-based services and best practices.

• Promote effectiveness, consistency, and quality of content in grant recipient services and program activities used for grant recipients, participants, and community partners.

• Strengthen the grant recipients’ workforce through effective professional development techniques that ensure knowledge, skills, and competencies.

The SHSPP TA Enhancement will provide additional TA to build HS capacity around group-based interventions. Examples of enhancement activities include but are not limited to providing an assessment of grantee needs, one-on-one TA to HS projects, identifying best practices, and providing support in the implementation of group-based health and education programs across HS, HSE, and Catalyst recipient programs.

HRSA-24-038 SHSPP 6

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:

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 | MCHBhttps://mchb.hrsa.gov/about-us/mission-vision-work.

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.

In addition to the usual monitoring and technical assistance (TA) provided directly to award recipients, HRSA program involvement will include:

• Having experienced HRSA personnel available as participants in the planning and development of the project, including participation in and planning of any meetings conducted as part of project activities

• Participating, as appropriate, in conference calls, meetings, training, and TA sessions that are conducted during the period of the cooperative agreement

• Coordinating the partnership and communication with federally funded maternal health programs and other federal entities that may be relevant for the successful completion of tasks and activities identified in the approved scope of the cooperative agreement

• Conducting ongoing review of the establishment and implementation of activities, procedures, measures, and tools for accomplishing the goals of the cooperative agreement https://mchb.hrsa.gov/about-us/mission-vision-work https://mchb.hrsa.gov/about-us/mission-vision-work https://mchb.hrsa.gov/about-us/mission-vision-work

HRSA-24-038 SHSPP 7

• Reviewing and providing input on written documents, including information and materials for the activities conducted through the cooperative agreement, prior to submission for publication or public dissemination

• Participating with the award recipient in the dissemination of project findings, best practices, and lessons learned from the project

• Providing consultation regarding the collection of information and administrative data designated by HRSA

In addition to adhering to all applicable federal regulations and public policy requirements, the cooperative agreement recipient’s responsibilities will include:

• Adhering to HRSA guidelines pertaining to acknowledgement and disclaimer on all products produced by HRSA award funds, per page 26 of the HRSA SF-424 Application Guide

• Providing the federal project officer with the opportunity to review and discuss any publications, audiovisuals, and other materials produced, as well as meetings planned, through this cooperative agreement. Such review should start at the time of concept development and include review of drafts and final products prior to dissemination

• Completing activities proposed in response to the Program Requirements and Expectations section of this notice of funding opportunity

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

• Consulting with the federal project officer when scheduling any meetings that pertain to the scope of the cooperative agreement and at which the project officer’s attendance would be appropriate (as determined by the project officer)

• Collaborating with HRSA on ongoing review of activities, procedures, budget items, contracts, and sub-awards

• Leveraging existing products or resources developed by the previously funded entity, as well as internal and external resources, to maximize the TA Center’s efficiency and effectiveness

• Convening and leading a minimum of eight face-to-face annual meetings during the period of performance for participating grant recipients. As appropriate, meetings should include agencies that administer block grant programs under Title V of the Social Security Act to promote cooperation, integration, and dissemination of information with Statewide systems and with other community services funded under the Maternal and Child Health Block Grant.

https://www.hrsa.gov/sites/default/files/hrsa/grants/sf424-application-guide.pdf https://www.hrsa.gov/sites/default/files/hrsa/grants/sf424-application-guide.pdf

HRSA-24-038 SHSPP 8

• Participating in evaluation activities provided by the designated HRSA evaluation contractor, if applicable

• Completing all administrative data and performance measure reports, as designated by HRSA and in a timely manner

• Supporting HRSA’s efforts to advance identified priorities for the MCH population related to addressing perinatal outcomes

2. Summary of Funding

We estimate $3,500,000 will be available each year to fund one recipient. You may apply for a ceiling amount of up to $3,500,000 annually (reflecting direct and indirect costs). In addition, up to $800,000 is expected to be available annually to fund a SHSPP TA Enhancement project. You may apply for a ceiling amount of up to $800,000 annually in additional funding for the SHSPP TA Enhancement.

Type of Award Estimated Number of Awards

Estimated Amount of Award per Grantee

Anticipated Total Availability of Funds

Supporting Healthy Start Performance Project

1 $3,500,000 $3,500,000

SHSPP TA Enhancement (optional)

1 Up to $800,000

Up to $800,000

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

The period of performance is June 1, 2024, through May 31, 2029 (5 years). Funding beyond the first year is subject to the availability of appropriated funds for the Supporting Healthy Start Performance Project and the SHSPP TA Enhancement in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

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.

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-24-038 SHSPP 9

III. Eligibility Information

1. Eligible Applicants

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

• Public or private;

• Community-based; and or

• Tribal (governments, organizations).

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

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

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.”

Select “Subscribe” and enter your email address for HRSA-24-038 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.

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-24-038 SHSPP 10

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. The page limit for the optional SHSPP TA Enhancement is 10 pages* and includes the project narrative, budget narrative, and other descriptive information as described under Attachment 9.

Supporting Healthy Start Performance Project

60 pages

SHSPP TA Enhancement 10 pages *does not count in the 60-page limit

We will not 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 do not 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 do not count toward the page limit, we’ll make this clear in Section IV.2.v Attachments.

If you use an OMB-approved form that is not in the HRSA-24-038 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-038 before the deadline.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals10 (for example, program director, principal investigator) can participate in receiving award funds to carry out a proposed project. That is, no federal department or

10 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).

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

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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.11

• If you cannot certify this, you must include an explanation in Attachment 12-15:

Other Relevant Documents.

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

Program Requirements and Expectations The recipient of the SHSPP will act as the Healthy Start Technical Assistance Support Center (TASC). As the HS TASC, the SHSPP recipient should bring innovative ideas to advance the goals outlined in the HS, HSE, and Catalyst programs, to include strategies to support providing direct and enabling services for participants, setting up, and maintaining a community consortium, and implementing action plans on SDOH.

Training and Technical Assistance

Specifically, the SHSPP is expected to provide training and technical assistance to grant recipients, using a SDOH centered approach, on the following:

• Recruitment and retention of HS and HSE participants who live within the grant recipients’ selected project area.

• Preventive screening services and prenatal care (for example, providing and/or contracting for wellness visits, prenatal/postpartum care and screening for maternal depression, intimate partner violence, sexually transmitted infections, diabetes, hypertension etc.).

• Referrals and linkages to clinical care and support services.

• Addressing SDOH using warm hand-offs in transferring care.

• Navigation support to keep participants in clinical care and maintain connection to services addressing SDOH.

• Case management/care coordination services for women of reproductive age and fathers/partners.

• Development and implementation of group-based health and parenting education classes.

• Health promotion, education, and prevention activities aimed at increasing family health and wellness and promoting best perinatal health outcomes.

11 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://healthystartepic.org/about-hs-epic-center/services/ https://healthystartepic.org/about-hs-epic-center/services/ 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

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• Accessing preventive health services, behavioral health care, and other specialty services.

• Development and submission of Community Consortium plans and action plans to address SDOH.

• Implementing systems-level changes/actions to address SDOH and reduce racial/ethnic disparities.

• Supporting programs in developing Specific, Measurable, Attainable, Realistic, Timely, Inclusive, and Equitable (SMARTIE) objectives.

• Strengthening the grant recipient workforce through effective professional development techniques that ensure knowledge, skills, and competencies.

Grant recipients can request training and technical assistance on any of the requirements/expectation of recipients outlined in the NOFOs for the HS, HSE, and Catalyst programs.

The SHSPP is expected to provide training and technical assistance on the above grant recipient activities through one or more of the modalities listed below:

• Individualized Training and Technical Assistance: The SHSPP is expected to provide individualized training and TA for grant recipients on one or more specific health promotion topics (Appendix C) to strengthen the implementation of program goals. Individualized training and TA support may be provided virtually and/or on-site to support the specific needs of grant recipients. Individualized training and TA support should be designed to address unique factors that inform SDOH within each grantee’s service area.

• Group Training and Technical Assistance: Group Training and TA may include Web-based opportunities for grant recipients such as live and pre-recorded webinars, eLearning modules as well as in person training sessions.

• Communities of Practice (CoPs): The recipient of the SHSPP is required to facilitate Community of Practice activities for HS and HSE grant recipients. These activities may focus on peer support across HS and HSE projects, sharing of best practices in partnership engagement, plan implementation, and creation of new knowledge.

• Project Director Mentorship Program: The Project Director Mentorship Program provides peer-to-peer learning and mentoring support to HS and HSE Project Directors to improve organizational leadership and program performance.

The award recipient of the SHSPP award is expected to create a mentoring program for individual HS and HSE grant recipients and develop objectives and expected outcomes for the mentoring opportunities. The SHSPP award recipient is also expected to develop curricula and training and facilitate peer-to-peer

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mentoring for project directors in HS and HSE programs (for example, HS grant recipient with 90 percent retention of HS participants providing mentoring to HS grant recipient with 40 percent retention of HS participants).

The SHSPP recipient is expected to contract or hire individuals to serve as a Subject Matter Experts (SMEs). A SME12 is defined as a “person with bona fide expert knowledge about what it takes to do a particular job.” SMEs will provide free, in-depth virtual and/or on-site technical assistance to an individual grant recipient or group of grant recipients, with an eye toward practical application of evidence-based practices targeting HS, HSE, and Catalyst goals and performance measures. SMEs must be available to provide technical assistance on the health promotion topics listed in Appendix C.

Healthy Start EPIC Website13

The Healthy Start EPIC website is an online database where grant recipients can access training, consultation, and technical resources to support the implementation of each program. The recipient of the SHSPP is expected to ensure the Healthy Start EPIC website:

• Acts as an up-to-date repository of technical assistance tools and resources outlining best practices on specific health education topics.

• Provides a mechanism for grant recipients to request individualized training and TA support to achieve HS, HSE, and Catalyst program goals.

• Provides access to recordings of past training and TA offerings for on-demand use by grant recipients, as needed.

CAREWare14 for Healthy Start and Healthy Start Enhanced

CAREWare is a free, electronic health and social support services information system available at no cost to HS and HSE grant recipients to meet their data collection and reporting requirements.

12 https://www.directives.doe.gov/terms_definitions/subject-matter-expert-sme 13 https://healthystartepic.org/ 14 https://healthystartepic.org/healthy-start-implementation/careware-for-healthy-start/ https://www.directives.doe.gov/terms_definitions/subject-matter-expert-sme https://healthystartepic.org/ https://healthystartepic.org/healthy-start-implementation/careware-for-healthy-start/

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SHSPP is expected to provide support to HS and HSE grant recipients using CAREWare through the following activities:

• Provide technical support to facilitate access to and utilization of the CAREWare system. Collaborate with the system developer/owner, jProg, to remedy technical issues. Technical support may include resources such as a help desk, dedicated support email address, and/or phone number, user guides, and instruction manuals, among others.

• Provide training and TA to grant recipients as needed to build their ability to collect and report data using CAREWare.

• Gather system enhancement requirements with HRSA/DHSPS partners. Work with jProg to implement enhancements to meet the required reporting needs of grant recipients and to improve system performance. This includes reports/tools that generate annual/semi-annual performance measures, quarterly Healthy Start Monitoring and Evaluation Data System (HSMED) compliant files, and updated grant recipient data collection forms, among others.

• Conduct regular, ongoing project management meetings with the DHSPS CAREWare lead to develop annual workplans for CAREWare enhancement, provide status updates on open activities, and discuss technical assistance requests/resolutions.

• Support recipients who would like to transition their data to CAREWare by providing demonstrations of the system, conducting training, and assisting in transition planning.

Convening of Grant Recipients

The SHSPP award recipient will be expected to convene and lead a minimum of eight face-to-face and/or virtual meetings during the period of performance for HS, HSE and Catalyst grant recipients. Meetings include but are not limited to Regional Grant Recipient Meetings, Conversations with the Division Webinar, All Grant Recipient Meeting. As appropriate, meetings should include agencies that administer block grant programs under Title V of the Social Security Act in order to promote cooperation, integration, and dissemination of information with Statewide systems and with other community services funded under the Maternal and Child Health Block Grant.

Site Visits

The SHSPP award recipient will be expected to attend and collaborate with federal project officers during HRSA-led organizational site visits across the 5-year period of performance, as applicable.

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Community-Based Consortium

The SHSPP award recipient will be expected to form its own community-based consortium of individuals and organizations, which include grant recipients, state agencies responsible for administering block grant programs under title V of the Social Security Act, community-based organizations, participants and former participants of project services, public health departments, hospitals, health centers under section 254b15 and State substance abuse agencies. The consortium will inform technical assistance offerings, standardized tools for grant recipients, Communities of Practice, topics for grant recipient convenings and other activities and products as appropriate.

Communications and Tracking

The recipient of the SHSPP is expected to provide regular updates on technical assistance offerings and requests at a frequency established by the DHSPS. These updates should include:

• Detailed descriptions of training and TA offerings (to include, but not limited to, webinars, communities of practice, targeted series, etc.) that will be provided to grant recipients, at least 1 month prior to the scheduled offering date.

• Access to materials used during training and TA offerings, such as PowerPoint slides, informational tools, and fact sheets.

• Summary of attendees for each training and TA offering, to include recipient name and staff role in the program.

• Synopsis of training and TA evaluations from recipients’ post-training and TA offerings, at least 1 month following the offering date.

The recipient of the SHSPP is expected to develop a mechanism to track training and TA requests, as well as a process for following up on those requests. This mechanism should capture:

• The number of requests for individualized and/or group training and TA by topic, state, region, and recipient monthly.

• Standard Operating Procedures (SOPs) or workflows for the training and TA process, to include action steps during each phase.

15 “Health centers under section 254b” is a reference to health centers receiving funding or designation under 42 U.S.C. 254b (section 330 of the Public Health Service Act), and which include an entity that serves a population that is medically underserved, or a special medically underserved population comprised of migratory and seasonal agricultural workers, people experiencing homelessness, and residents of public housing, by providing primary care and other resources and supports under this authority.

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The recipient of the SHSPP is expected to provide reports on key MCH topics to the DHSPS, as requested.

Reporting

The SHSPP award recipient will report on the following performance measures:

• # of individualized technical assistance events

• # of group technical assistance events

• # of eLearning modules developed

• # of participants for each technical assistance event, by grantee, participant type

• # of resources, toolkits, etc. developed through the SHSPP

• # of opportunities created to foster peer-to-peer exchange through the mentorship program

• # of Community of Practice activities

Quality Improvement The recipient of the SHSPP is expected to perform an evaluation of training and technical assistance offerings provided to HS, HSE, and Catalyst grantees that will contribute to quality improvement (QI) and support routinely evaluating and improving the quality of services provided. The program performance evaluation should monitor ongoing processes and the progress towards the goals and objectives of the project.

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:

i. Project Abstract

Use the Standard OMB-approved Project Abstract Summary Form that you’ll find in the workspace application package. Do not 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.

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Narrative Section Review Criteria

Introduction (1) Need

Organizational Information (5) Resources/Capabilities

Need (1) Need

Approach (2) Response and (4) Impact

Work Plan (2) Response and (4) Impact

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures and

(5) Resources/Capabilities

Budget Narrative (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

• Briefly describe the purpose of the proposed project that is consistent with

Section I: Purpose

You must state for which you are applying:

o Supporting Healthy Start Performance Project; OR o Supporting Healthy Start Performance Project with SHSPP TA

Enhancement

You must apply for the Supporting Healthy Start Performance Project in order to apply for the SHSPP TA Enhancement

Organizational Information -- Corresponds to Section V’s Review Criterion 5 Resources/Capabilities

• 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 support the development and management of the SHSPP. Include a project organizational chart as Attachment 5.

• Describe your organization’s current experience, skills, and knowledge in providing training and TA on community-based maternal and child health programs including individuals on staff, materials published, and previous

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work of a similar nature. Include experiences related to supporting data-driven initiatives that support improvement in perinatal health outcomes.

• Describe project personnel, including proposed partners that will be engaged to fulfill the needs and requirements of the proposed project. Include relevant training, qualifications, expertise, and experience of staff to implement and carry out this project. Include a staffing plan and job descriptions for key personnel in Attachment 2, and biographical sketches of key personnel in Attachment 3.

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

• Provide a brief description of perinatal outcomes in communities with excess infant deaths and high rates of infant mortality, beyond what is included in the Background section. Discuss how you would support grant recipients in addressing these issues in their communities.

• Describe challenges and barriers that grant recipients may meet when participating in the HS, HSE, and Catalyst programs.

• Describe the major technical assistance, training, and education needs for grant recipients to effectively take part in the HS, HSE, and Catalyst programs.

• This section should help reviewers understand the overall needs that could be served by the proposed project.

Approach -- Corresponds to Section V’s Review Criteria 2 Response and 4 Impact

• Propose effective, innovative, and feasible methods that will be used to address the stated needs and meet each of the previously described expectations for the SHSPP as outlined in the Program Requirements and Expectations. Proposed approaches should name the outcomes you expect to achieve by the end of the period of performance, May 31, 2029.

• Provide Specific, Measurable, Achievable, Realistic, Time-bound, Inclusive, and Equitable (SMARTIE) objectives for each of the project goal and objectives listed in the Purpose section.

• Describe the process for identifying the types of training and TA needed for grant recipients.

• Describe a plan to provide training and TA to HS and HSE grant recipients specifically on preventive screening services and prenatal care (for example, providing and/or contracting for wellness visits, prenatal/postpartum care and screening for maternal depression, intimate partner violence, sexually transmitted infections, diabetes, and hypertension)

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• Describe your plan to support recruitment and retention of HS and HSE participants who live within the grantee selected community service area.

• Propose a plan to provide individualized training and TA on one or more specific health promotion topics (Appendix C) to strengthen the implementation of HS, HSE, and Catalyst programs.

• Describe how you propose to deliver group technical assistance.

• Describe your plan for supporting seamless use and dissemination of existing tools and resources that have been created to date by the current SHSPP recipient and maintaining the Healthy Start EPIC Website as outlined in the Program Requirements and Expectations.

• Describe how you will plan, host, facilitate, and evaluate meetings for grant recipients, to include but not limited to regional grant recipient meetings, annual grant recipient meetings, and Conversations With the Division.

• Describe how you will form and maintain a community-based consortium of individuals and organizations, as described in the Program Requirements and Expectations. Include frequency of meetings as well as proposed activities for the group.

• Describe how you will provide technical support to facilitate access to and use of the CAREWare system. Describe how you will collaborate with the CAREWare system developer/owner, jProg, to remedy technical issues.

• Describe your plan to provide regular updates on technical assistance offerings and requests to the DHSPS, as detailed in the Program Requirements and Expectations.

Work Plan -- Corresponds to Section V’s Review Criteria 2 Response and 4 Impact.

• Describe the activities or steps that you will use to achieve each of the objectives proposed during the entire period of performance in the Approach section. Use a timeline that includes each activity and names responsible staff.

• Identify meaningful support and collaboration with key stakeholders, including those with lived experience, in planning, designing, and implementing all activities, including developing the application.

• Submit a work plan in table format as Attachment 1, to include your activities that respond to the Program Requirements and Expectations section of this

NOFO.

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Resolution of Challenges -- Corresponds to Section V’s Review Criterion 2 Response

• Discuss challenges that you are likely to meet in designing and implementing the activities described in the work plan, and approaches that you will use to…