MCHB HRSA-24-050 (U7C) MHTRC-Final-v2.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

Maternal Health Training and Resource Center (MHTRC) Funding Opportunity Number: HRSA-24-050

Funding Opportunity Type(s): Competing Continuation, New

Assistance Listing Number: 93.110

Application Due Date: May 2, 2024 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: February 2, 2024

Lud Abigail Duchatelier-Jeudy, Ph.D., MPH Lead Public Health Analyst Maternal and Women’s Health Branch Call: 301-443-0625 Email: wellwomancare@hrsa.gov

See Section VII for a complete list of agency contacts.

Authority: 42 U.S.C. §701(a)(2) (Title V, § 501(a)(2) of the Social Security Act) mailto:wellwomancare@hrsa.gov

HRSA-24-050 MHTRC 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: Maternal Health Training and Resource Center

(MHTRC)

Funding Opportunity Number: HRSA-24-050

Assistance Listing Number: 93.110

Due Date for Applications: May 2, 2024

Purpose: The purpose of the Maternal Health Training and Resource Center (MHTRC) program is to support MCHB’s State Maternal Health Innovation (State MHI) grantees to implement strategies to improve maternal health and respond to the needs of populations impacted by maternal mortality and severe maternal morbidity. The Center will also provide limited support to the Maternal and Child Health Bureau’s (MCHB) recipients with the implementation of maternal health projects, innovations, and initiatives, where resources permit.

Program Objective(s): Support for MCHB’s Maternal Health Recipients The MHTRC will translate science into practice to support the State Maternal Health Innovation awardees to implement effective strategies and innovations that positively impact Maternal and Child Health (MCH) populations, especially those experiencing the greatest disparities. The MHTRC will strengthen state- and community-based comprehensive systems of care for maternal health.

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

HRSA-24-050 MHTRC ii

• Public or private

• Community-based

• Native American tribal governments 1

• Native American tribal organizations 2

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

Anticipated FY 2024 Total Available Funding:

$3,000,000

We are 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 one cooperative agreement

Estimated Annual Award Amount:

Up to $3,000,000 per award, subject to the availability of appropriated funds

Cost Sharing or Matching Required:

No

Period of Performance: September 30, 2024 through September 29, 2029 (5 years)

Agency Contacts: Business, administrative, or fiscal issues:

David Colwander Grants Management Specialist Division of Grants Management Operations, OFAM Email: DColwander@hrsa.gov

Program issues or technical assistance:

Lud Abigail Duchatelier-Jeudy, MPH PhD Lead Public Health Analyst Division of Healthy Start and Perinatal Services Maternal and Child Health Bureau Email: wellwomancare@hrsa.gov

1 For awards authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act), see also 42 CFR § 51a.3(a).

2 For awards authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act), see also 42 CFR § 51a.3(a).

mailto:DColwander@hrsa.gov mailto:wellwomancare@hrsa.gov

HRSA-24-050 MHTRC iii

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in this NOFO and in the 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, March 7, 2024 2 – 3:30 p.m. ET Weblink: https://hrsa-gov.zoomgov.com/j/1616996318?pwd=RFB0M2YyaDdEMERMSDNwQnRtNGVQU T09

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

Call-In Number: 1-833-568-8864 Meeting ID: 93095248

We will record the webinar. You can access the recording here 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/1616996318?pwd=RFB0M2YyaDdEMERMSDNwQnRtNGVQUT09 https://hrsa-gov.zoomgov.com/j/1616996318?pwd=RFB0M2YyaDdEMERMSDNwQnRtNGVQUT09 https://hrsa-gov.zoomgov.com/j/1616996318?pwd=RFB0M2YyaDdEMERMSDNwQnRtNGVQUT09 https://www.hrsa.gov/grants/find-funding?search=&status=All&bureau=248

HRSA-24-050 MHTRC 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 A: GLOSSARY OF KEY TERMS

APPENDIX B: PAGE LIMIT WORKSHEET

APPENDIX C: MATERNAL HEALTH TOPICS

APPENDIX D: MCHB’S MATERNAL HEALTH RECIPIENTS

HRSA-24-050 MHTRC 1

I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Maternal Health Training and Resource Center (MHTRC) program.

The purpose of this program is to support MCHB’s maternal health recipients, with a primary focus on the State Maternal Health Innovation (State MHI) program, to improve maternal health and to respond to the needs of populations impacted by maternal mortality and severe maternal morbidity (SMM). The MHTRC will also provide limited support to MCHB’s maternal health recipients with the implementation of maternal health projects, innovations, and initiatives in their respective states, where funds are available.

Program Goals The goals of the MHTRC are to improve maternal health by:

• Providing tailored technical assistance (TA), capacity-building assistance (CBA), and evaluation support services to recipients of MCHB’s maternal health programs to aid awardees in addressing the needs of maternal health for populations disproportionately impacted by maternal mortality and severe maternal morbidity (SMM).

• Establishing a national resource center that provides evidence-based strategies and guidance to improve maternal health, reduce maternal mortality and SMM, and advance health equity at the individual, interpersonal, community, and societal levels.

Program Objectives

The Program Objectives to be accomplished during the period of performance to support program goals, include:

Support for MCHB’s Maternal Health Recipients

• The MHTRC will translate science into practice to support the State MHI awardees to implement effective strategies and innovations that positively impact maternal and child health populations, especially those experiencing the greatest disparities.

• The MHTRC will strengthen state- and community-based comprehensive systems of care for maternal health.

For more details, see Program Requirements and Expectations.

HRSA-24-050 MHTRC 2

2. Background

The Maternal Health Training and Resource Center is authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act) which authorizes awards for Special Projects of Regional and National Significance (SPRANS) in MCH.

About MCHB and Strategic Plan

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

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

Goal 2: Achieve health equity for MCH populations.

Goal 3: Strengthen public health capacity and workforce for MCH.

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

The MHTRC addresses MCHB’s Goals 1, 2, and 3 by supporting states, Title V agencies, community organizations, healthcare professionals, and other key stakeholders to improve care for people who give birth.

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

Maternal Mortality and Severe Maternal Mortality Approximately 3.6 million women give birth in the United States each year.3 Despite advances in medical care and investments in improving access to care, rates of maternal mortality and SMM are high and have not improved. Over 800 women die each year in the United States from pregnancy-related causes.4 More than 25,000 women experience unintended outcomes of labor and delivery that result in significant short- or long-term consequences to their health.5 Significant disparities exist in maternal mortality, SMM, and other adverse outcomes, which vary by socio-economic

3 Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: Final data for 2021.

National Vital Statistics Reports; vol 72, no 1. Hyattsville, MD: National Center for Health Statistics. 2023.

DOI: https://dx.doi. org/10.15620/cdc:122047 4 Hoyert DL. Maternal Mortality Rates in the United States, 2021. March 2023. Available at:

https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/E-stat-Maternal-Mortality-Rates-2022.pdf .

Accessed 7/26/2023.

5 HRSA Federally Available Data (FAD) Resource Document. Release Version July 18, 2023. Available at https://mchb.tvisdata.hrsa.gov/Admin/FileUpload/DownloadContent?fileName=FadResourceDocument.pd f&isForDownload=False Accessed 7/26/2023.

https://mchb.hrsa.gov/about-us/mission-vision-work https://mchb.hrsa.gov/about-us/mission-vision-work https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/E-stat-Maternal-Mortality-Rates-2022.pdf https://mchb.tvisdata.hrsa.gov/Admin/FileUpload/DownloadContent?fileName=FadResourceDocument.pdf&isForDownload=False https://mchb.tvisdata.hrsa.gov/Admin/FileUpload/DownloadContent?fileName=FadResourceDocument.pdf&isForDownload=False

HRSA-24-050 MHTRC 3

factors such as race, ethnicity, age, geography, and income.6 7 As state agencies and community-based organizations continue to grapple with current trends in maternal health, the MHTRC will serve as a national resource center that provides evidence-based strategies to prevent and reduce maternal mortality and severe maternal morbidity.

Program History

In FY 2019, this award, previously named the Maternal Health Learning & Innovation Center (MHLIC), focused on creating learning opportunities for MCHB’s maternal health recipients to develop tools, resources, and approaches needed to improve maternal health. The MHLIC utilized existing, and developed new, training materials and curricula to deliver technical assistance to maternal health entities through “Implementation Coaches.” The MHLIC focused on engagement, innovation support, and policy as it worked with awardees to improve maternal health. A particular focus of their work was on addressing disparities. For more information about MHLIC, please visit:

https://maternalhealthlearning.org/.

This next round of funding will build on the work of the first MHLIC and continue to support MCHB’s State MHI and other maternal health recipients in improving maternal health.

II. Award Information

1. Type of Application and Award

Application types: Competing Continuation, New

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:

• Participate in the planning and development of project activities, including in-person or virtual meetings, during the period of performance;

• Participate in at least monthly project updates meetings and regular communication with the award recipient to assess progress in meeting the goals and objectives;

6 Hoyert 2023.

7 Chen J, Cox S, Kuklina EV, Ferre C, Barfield W, Li R. Assessment of Incidence and Factors Associated with Severe Maternal Morbidity after Delivery Discharge among Women in the US. JAMA Network Open.

2021. doi:10.1001/jamanetworkopen.2020.36148 https://maternalhealthlearning.org/

HRSA-24-050 MHTRC 4

• Review policies and procedures, activities, emerging issues, and tools designed and implemented during the period of performance;

• Review the evaluation plan, including progress to achieving proposed outcomes, data collected, and measures of success;

• Review and edit all written documents developed by the recipient prior to submission for publication or public dissemination. This includes any articles, abstracts, presentations, or other resource documents; and,

• Facilitate the establishment of partnerships for carrying out the project, including partnerships with other federal agencies or programs within HRSA or HHS.

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

• Complete all administrative data and performance measure reports, as designated by HRSA, in a timely fashion;

• Produce and disseminate project findings through publishing articles, reports, and/or giving presentations and adhere 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);

• Collaborate with state Title V programs and other HRSA funded programs including, but not limited to: State MHI, AIM, AIM-Community Care Initiative, Maternal Mental Health and Substance Use Disorders, and other HRSA award recipients that focus on improving maternal health;

• Develop and maintain a web-based clearinghouse that ensures public access to all tools and resources during the project period and beyond and provide HRSA with a copy of all documents in an electronic file format at the end of the project period;

• Convene and lead face-to-face meetings during the period of performance for HRSA’s maternal health award recipients; and

• Regularly communicate with HRSA Project Officers, who monitor State MHI recipients, in order to improve recipient performance towards improving maternal mortality and SMM outcomes.

2. Summary of Funding

We estimate approximately $3,000,000 to be available annually to fund one recipient.

You may apply for a ceiling amount of up to $3,000,000 annually (reflecting direct and indirect costs).

The period of performance is September 30, 2024, through September 29, 2029 (5 years).

HRSA-24-050 MHTRC 5

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, the Commonwealth of Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, or the Republic of Palau, and is:

• Public or private

• Community-based

• Native American tribal governments 8

• Native American tribal organizations 9

2. Cost Sharing or Matching

Cost sharing or matching is not required for this program.

8 For awards authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act), see also

9 For awards authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act), see also https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75

HRSA-24-050 MHTRC 6

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.

NOTE: Multiple applications from an organization are not allowed. However, organizations have the ability to come together as a consortium to submit a joint application for this cooperative agreement.

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-24-050 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 is an Application Completeness Checklist in the Application Guide to help you.

Application Page Limitation The total number of pages that count toward the page limit shall be no more than 50 pages when we print them. 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.

https://www.grants.gov/ https://www.grants.gov/applicants/grant-applications/how-to-apply-for-grants https://www.grants.gov/system-to-system/applicant-system-to-system/

HRSA-24-050 MHTRC 7

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.vi Attachments.

If you use an OMB-approved form that is not in the HRSA-24-050 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-25-050 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 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:

Other Relevant Documents.

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

Program Requirements and Expectations The successful applicant will support and guide MCHB’s maternal health recipients as they develop services, programs, innovations, and initiatives to advance maternal health.

This is not a planning grant.

Throughout the period of performance, the recipient will be responsible for providing the following activities to MCHB’s maternal health recipients:

10 See def initions at eCFR :: 2 CFR 180.995 -- Principal. and eCFR :: 2 CFR 376.995 -- Principal (HHS supplement to government-wide def inition at 2 CFR 180.995).

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://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-24-050 MHTRC 8

Maternal Health Recipients

MHTRC Activity

State Maternal Health Innovation Program

Training and Technical Assistance Capacity Building Assistance National Resource Center Partnership Building Policy Analysis Performance Measurement Program Evaluation Continuous Quality Improvement

Other Maternal Health Recipients (where applicable based on available funds and need)

Training and Technical Assistance National Resource Center Partnership Building Policy Analysis

1. Training and Technical Assistance

The MHTRC award recipient is expected to develop and facilitate TA, training, and educational materials for the State MHI recipients (State Maternal Health Innovation (MHI) Program | MCHB (hrsa.gov)) that are culturally relevant and reflect programmatic and scientific expertise. Training and TA should be available to MCHB’s other maternal health recipients where applicable.

• Provide training and TA to State MHI evaluators on key topics such as defining goals of local evaluation, collecting and analyzing data, incorporating evaluation findings, and designing and implementing a rigorous evaluation.

• Provide State MHI recipients with resources and strategies to engage in community action that supports the development, implementation, and/or evaluation of local, state, and maternal health systems-level initiatives, programs, and/or policies (i.e., Perinatal Periods of Risk (PPOR)).

• Serve as Subject Matter Experts (SMEs). A SME is defined as a “person with bona fide expert knowledge about what it takes to do a particular job.” These SMEs will provide (at no cost to the program recipient) in-depth virtual and/or on-site TA to an individual grant recipient or group of grant recipients, prioritizing the practical application of evidence-based practices targeting State MHI goals and performance measures.

• Deliver training and TA in a variety of formats, including:

o Individualized: The MHTRC is expected to provide individualized training and TA for recipients on one or more specific maternal health 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 MCHB’s maternal health award recipients, with particular focus on State MHI recipients.

https://mchb.hrsa.gov/programs-impact/programs/state-mhi#award-recipients https://mchb.hrsa.gov/programs-impact/programs/state-mhi#award-recipients

HRSA-24-050 MHTRC 9

MCHB’s maternal health recipients can request training and TA on any of the requirements/expectations outlined in the HRSA-19-107, HRSA- 22-149, HRSA-23-106, and HRSA-23-108 NOFOs.

Develop a mechanism to track requests for training, TA, and other requests received by State, topic, and the outcome after responding to these requests, for the duration of the project.

o Group: Group training and TA may include Web-based opportunities for MHI and other maternal health recipients such as live and pre-recorded webinars and eLearning modules, as well as in-person training sessions.

o Communities of Practice (CoPs): The recipient of the MHTRC is expected to facilitate CoPs activities for State MHI recipients.

CoPs are formed and facilitated on an ongoing basis (i.e., quarterly) to facilitate peer support across State MHI recipients to address strategic plan implementation and other program areas as identified and requested by the recipients.

CoPs will focus on sharing State MHI best practices and on creating new approaches to advance and improve maternal health.

CoPs will also focus on partnership engagement to support the creation, development, and implementation of innovative strategies for the State MHI recipients.

o Project Director Mentorship Program: The Project Director Mentorship Program provides peer-to-peer learning and mentoring support to State MHI Project Directors to improve organizational leadership and program performance. The recipient of the MHTRC award is expected to create a mentoring program for individual State MHI recipients and develop objectives and expected outcomes for the mentoring opportunities. The MHTRC recipient is also expected to develop curricula and training and facilitate peer-to-peer mentoring for Project Directors in State MHI programs.

2. Capacity Building Assistance

The MHTRC award recipient is expected to conduct an environmental scan to identify system-level gaps in maternal health care compared to the principles and strategies that are included in the individual State MHI recipients’ plans. This will be accomplished by:

• Assessment - Developing a mechanism to regularly consider emerging needs, trends and priorities that may influence implementation of the State MHI Program.

HRSA-24-050 MHTRC 10

• Analysis - Analyzing barriers and opportunities to successfully implementing the State MHI Program at the community and state levels.

• Access - Identifying and analyzing policies and programs (e.g., community/state-level policies, hospital/hospital system policies) intended to increase access to a well-functioning system of services for State MHI recipients.

• Advancement – Identifying and implementing strategies that will allow the State MHI recipients to advance/accelerate their programmatic, financial, operational, and organizational efforts to improve maternal health in their respective state.

Additionally, the MHTRC award recipient will be expected to engage fully with federal project officers during HRSA-led organizational site visits across the 5-year period of performance. A minimum of one (1) site visit is required per State MHI recipient, per five-year grant cycle. It is expected that an identified MHTRC staff member accompanies the assigned MCHB federal officer to each planned State MHI site visit, and that the staff member provides needed TA as a component of the visit.

3. National Resource Center

The MHTRC award recipient is expected to develop a 508-compliant, public-facing, freestanding website that can act as a repository of resources, publications, topical meetings, and newsletters. The MHTRC will be expected to:

• Create and execute a plan for the development of effective tools and strategies for ongoing training, outreach, collaborations, clear communication, and information-sharing.

• Host and store multi-media TA products and State MHI award recipient-developed tools.

• Develop, identify, and disseminate effective, evidence-informed resources (e.g., educational materials, issue briefs, tools, toolkits, fact sheets, curricula, webinars, and publications).

4. Partnership Building

The MHTRC award recipient is expected to provide meaningful support to and collaborate with key stakeholders, including people with lived-experience (i.e., pregnant and postpartum women) and their families, organizations that represent people with lived-experience, state and federal agencies, and clinical and non-clinical health care providers in all stages of the MHTRC program. The MHTRC will be expected to:

• Develop and sustain partnerships with relevant national maternal health organizations and key stakeholder groups.

o Stakeholder groups might include, but are not limited to: The American College of Obstetricians and Gynecologists; the American College of Nurse-

HRSA-24-050 MHTRC 11

Midwives; the Association of Women’s Health, Obstetric and Neonatal Nurses; Black Mamas Matter Alliance; National Maternal Mental Health Leadership Alliance; National Birth Equity Collaborative; National Perinatal Task Force; March of Dimes; Nurse Practitioners in Women’s Health; Society for Maternal-Fetal Medicine; American Academy of Family Physicians;

Telehealth Resource Centers; and the Association of Maternal and Child Health Programs.

• Develop and sustain partnerships with individuals and organizations that conduct outreach to medically underserved populations.

5. Policy Analysis

• Identify and examine policy and program initiatives at the local, state, and federal level to reduce maternal mortality and SMM.

• Engage with State MHI and other maternal health recipients to discuss and consider policies and issues that foster or hinder maternal health priorities.

6. Performance Measurement, Program Evaluation, and Continuous Quality Improvement (CQI)

The MHTRC Recipients will be expected to conduct the following activities:

• Performance Measurement: Measure and track program performance on key activities and program objectives.

o This includes Discretionary Grants Information System (DGIS) measures on Health Equity, TA, Partnerships and Collaboration, and Outreach and Education. For more information on these measures, please see the Reporting section.

o Recipients will also be expected to develop measures to capture and track program performance on:

# of individualized TA events

# of group TA events

# of eLearning modules developed

# of participants for each TA event

# of resources, toolkits, etc. developed through the MHTRC

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

# of Community of Practice activities

HRSA-24-050 MHTRC 12

o Proposed measures should be developed and approved by HRSA in the first 6 months.

• Program Evaluation: Program evaluations should assess ongoing processes and the progress towards the goals and objectives of the project.

o Conduct evaluations that include both process and outcome measures;

o Implement an internal continuous quality improvement program or other mechanism for routinely evaluating and improving quality of services provided;

o Utilize a management information system to monitor proposed scope of work; and o Engage key partners in the evaluation and performance measurement planning processes.

• Continuous Quality Improvement:

o The recipient of the MHTRC is expected to perform an evaluation of training and TA offerings provided to SMHI recipients that will contribute to quality improvement (QI) and support routinely evaluating and improving the quality of services provided.

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.

Narrative Section Review Criteria

Introduction Criterion 1: NEED

Organizational Information Criterion 5: RESOURCES/CAPABILITIES

HRSA-24-050 MHTRC 13

Narrative Section Review Criteria

Need Criterion 1: NEED

Approach Criterion 2: RESPONSE

Work Plan Criterion 2: RESPONSE Criterion 4: IMPACT

Resolution of Challenges Criterion 2: RESPONSE

Evaluation and Technical Support Capacity

Criterion 3: EVALUATIVE MEASURES

Criterion 5: RESOURCES/CAPABILITIES

Budget Narrative Criterion 6: SUPPORT REQUESTED

Program-Specific Narrative Section

Criterion 7: PROGRAM-SPECIFIC

CRITERIA

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 o Briefly describe the purpose of the proposed project that is consistent with Section I: Purpose.

Need -- Corresponds to Section V’s Review Criterion 1 o Provide a brief description of maternal mortality and SMM in the United States.

o Describe the process for identifying the types of TA and CBA needed by the State MHI program recipients in order to meet the Purpose of the programs.

Organizational Information -- Corresponds to Section V’s Review Criterion 5 o Briefly describe your mission, structure, and scope of current activities and how the MHTRC fits within these activities. Include a project organizational chart (Attachment 6).

o Describe your organization’s capacity and expertise to provide TA, CBA, training, and education on innovative, evidence-informed strategies to reduce maternal mortality and SMM. At a minimum, address the following:

HRSA-24-050 MHTRC 14

Describe the scope of TA, training, and educational activities your organization currently engages in.

Demonstrate a clear understanding of how to implement innovative, evidence-informed strategies to reduce maternal mortality and SMM that would align with HRSA’s program intent for the State MHI program.

Document your organization’s ability to effectively prepare, for an audience such as State MHI, guidance documents, TA documents, issue briefs, and resources using plain language.

Describe your experience managing collaborative awards at the national level, including examples of the extent to which activities were timely and completed in full.

o Discuss your ability, experience, and expertise in collaborating with experts and trainers in maternal health disparities, rural maternal health, tribal maternal health, and maternal health for populations who have been marginalized and/or live in geographically isolated areas. Use and cite data whenever possible to support the information provided.

o Discuss how you will follow the approved plan, account for federal funds, and record all costs to avoid audit findings.

o Describe how you will support MCHB’s maternal health program recipients to assess and improve the unique needs of the people who live in the community they serve.

Approach -- Corresponds to Section V’s Review Criterion 2

Propose methods that will be used to address the stated needs and meet each of the previously described expectations outlined in the Program Requirements and Expectations section of this NOFO, including (1) TA/comprehensive support for maternal health program award recipients; (2) CBA for award recipients; (3) Establishing a resource center that provides national guidance to reduce maternal mortality and SMM; (4) Partnership Building; (5) Policy Analysis; and (6) Performance Measurement, Program Evaluation, and Continuous Quality Improvement.

1. Training and Technical Assistance o Describe in detail your plan for successfully implementing all aspects of Technical Assistance as delineated in the Program Requirement and Expectations section.

HRSA-24-050 MHTRC 15

2. Capacity Building Assistance o Describe the process for identifying the types of CBA needed by the State MHI Program and other MCHB maternal health program award recipients.

o Describe the various methods you intend to use in order to deliver CBA and promote technology and information transfer to State MHI Program recipients; including in-person and remote TA.

3. National Resource Center o Describe plans for providing learning opportunities and information to State MHI and other MCHB maternal health program recipients who focus on improving maternal health, states, and key stakeholders on the identified maternal health topics (Appendix C).

o Fully describe plans for provision of resources, tools, curricula, dissemination of reports and all other aspects of serving as a National Resource Center as delineated in the Program Requirements and Expectations section.

4. Partnership Building o Describe in detail your plan for successfully facilitating Partnership Building as delineated in the Program Requirement and Expectations section.

5. Policy Analysis o Describe in detail your plan for successfully supporting Policy Analysis as delineated in the Program Requirement and Expectations section.

6. Performance Measurement, Program Evaluation, and Continuous Quality Improvement (CQI) o Describe in detail your plan for successfully conducting Performance Measurement, Program Evaluation, and CQI as delineated in the Program Requirement and Expectations section.

Work Plan -- Corresponds to Section V’s Review Criterion 2 and 4 o The work plan should be used as a tool to actively manage your program’s efforts in order to clearly describe technical assistance goals and objectives, measure progress, identify necessary changes, and quantify accomplishments. At a minimum, the work plan should include:

1) Statement of need or problem statement;

2) Goals and top priorities for technical assistance;

HRSA-24-050 MHTRC 16

3) Specific, time-framed, measurable objectives;

4) Key action steps;

5) Timeframe for completion;

6) Staff responsible;

7) Methods of evaluation and impact;

8) Proposed innovations; and

9) Potential obstacles/pitfalls to project implementation.

o Describe the activities or steps that you will use to achieve each of the objectives proposed during the entire period of performance in the Methodology section. Use a timeline that includes each activity and identifies responsible staff. As appropriate, identify meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities, including the extent to which these contributors might reflect the cultural, racial/ethnic, linguistic, and geographic diversity of populations and communities served.

o Describe how you will provide opportunities for technical assistance for persons who learn best via self-learning, in other languages, and through other learning/training methods.

o Include a plan for disseminating reports, products, and/or project outputs so key target audiences receive the project information.

Resolution of Challenges -- Corresponds to Section V’s Review Criterion 2 o Discuss challenges that you are likely to encounter in designing and carrying out the activities in the work plan. Explain approaches that you’ll use to resolve them.

o Discuss challenges related to partner organizations and identified resources and processes for resolving such issues.

o Provide information that shows an understanding of the challenges faced in providing training and technical assistance to a program covering multiple states addressing the needs of diverse communities and geographic landscapes.

Evaluation and Technical Support Capacity -- Corresponds to Section V’s Review Criterion 3 and 5

Provide a performance measurement and evaluation plan that demonstrates how you will, if awarded, fulfill the expectations and requirements for performance

HRSA-24-050 MHTRC 17

measurement and evaluation described in the Program Requirements and Expectations section. This plan should include the following:

• Monitoring: how you will track project-related processes, activities, and milestones, and use data to identify actual or potential challenges to implementation. Provide an initial list of measures (indicators, metrics) you will use to monitor progress.

• Performance Measurement: your plan for measuring and tracking program goals and objectives outlined in the Purpose Section. The plan should include proposed measures outlined in the Program Requirements and Expectations Section and plans for the timely collection and reporting of all measures.

• Program Evaluation: your program evaluation plans and methods for completing the activities outlined in the Program Requirements and Expectations section.

• Continuous Quality Improvement: Discuss your plans for using and incorporating information from performance measurement and evaluation to inform and improve processes and outcomes.

iii. Budget

The Application Guide directions may differ from those on Grants.gov.

Follow the instructions in Section 4.1.iv Budget of the Application Guide and any specific instructions listed in this section. Your budget should show a well-organized plan.

Reminder: The total project or program costs are all allowable (direct and indirect) costs used for the HRSA activity or project. This includes costs charged to the award and non-federal funds used to satisfy a matching or cost-sharing requirement (which may include MOE, if applicable).

Program Income

You must use any program income you generate from awarded funds for approved project-related activities. Use program income under the addition alternative (45 CFR § 75.307(e)(2)). Find post-award requirements for program income at 45 CFR § 75.307.

Specific Instructions

MHTRC requires the following:

As required by the Consolidated Appropriations Act, 2023 (P.L. 117-328), Division H, § 202, “None of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307 https://www.congress.gov/bill/117th-congress/house-bill/2617/text

HRSA-24-050 MHTRC 18

Executive Level II.” Effective January 2024, the salary rate limitation is $221,900. As required by law, salary rate limitations may apply in future years and will be updated.

iv. Budget Narrative

See Section 4.1.v. of the Application Guide.

v. Attachments

Provide the following attachments in the order we list them.

Most attachments count toward the application page limit. Indirect cost rate agreement and proof of non-profit status (if it applies) are the only exceptions. They won’t count toward the page limit.

Clearly label each attachment. Upload attachments into the application. Reviewers won’t open any attachments you link to.

Attachment 1: Work Plan

Attach the project’s work plan. Make sure it includes everything that Section IV.2.ii.

Project Narrative details If you’ll make subawards or spend funds on contracts, describe how your organization will document funds.

Attachment 2: Staffing Plan and Job Descriptions for Key Personnel (see Section 4.1. of the Application Guide)

Keep each job description to one page as much as possible. Include the role, responsibilities, and qualifications of proposed project staff. Describe your organization’s timekeeping process. This ensures that you’ll comply with federal standards related to recording personnel costs.

Attachment 3: Biographical Sketches of Key Personnel (Don’t count towards the page limit) Include biographical sketches for people who will hold the key positions you describe in Attachment 2. Keep it to two pages or less per person. Do not include personally identifiable information (PII). If you include someone you haven’t hired yet, include a letter of commitment from that person with the biographical sketch.

Attachment 4: Letters of Agreement, Memoranda of Understanding

Provide any documents that describe working relationships between your organization and other entities and programs you cite in the proposal. Documents that confirm actual or pending contracts or agreements should clearly describe the roles of the contractors and any deliverable. Make sure you sign and date any letters of agreement.

Attachment 5: For Multi-Year Budgets--5th Year Budget

After using columns (1) through (4) of the SF-424A Section B for a 5-year period of performance, you need to submit the budget for the 5th year as an attachment. SF-424A

HRSA-24-050 MHTRC 19

Section B doesn’t count in the page limit; however, any related budget narrative does count. See Section 4.1.iv of the Application Guide.

Attachment 6: Project Organizational Chart

Provide a one-page figure that shows the project’s organizational structure.

Attachment 7: Tables, Charts, etc.

Provide tables or charts that give more details about the proposal (for example, Gantt or PERT charts, flow charts).

Attachment 8: Proof of Non-profit Status (Doesn’t count towards the page limit)

Attachments 9-12: Other Relevant Documents (no more than 15) Include any other documents that are relevant to the application. This may include letters of support.

Letters must show a commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.).

3. Unique Entity Identifier (UEI) and System for Award Management (SAM)

A UEI is required to apply for this funding. You must register in the SAM.gov to receive your UEI.

You cannot use a DUNS number to apply. For more details, visit the following webpage:

General Service Administration’s UEI Update

After you register with SAM, maintain it. Keep your information updated when you have:

an active federal award, application, or plan that an agency is considering.12

When you register, you must submit a notarized letter naming the authorized Entity Administrator.

We will not make an award until you comply with all relevant SAM requirements. If you have not met the requirements by the time we’re ready to make an award, we will deem you unqualified and award another applicant.

If you already registered on Grants.gov, confirm that the registration is active and that the Authorized Organization Representative (AOR) has been approved.

To register in Grants.gov, submit information in two systems:

• System for Award Management (SAM) (SAM Knowledge Base)

• Grants.gov

Effective March 3, 2023, individuals assigned a SAM.gov Entity Administrator role must be an employee, officer, or board member, and cannot be a non-employee. This change

12 Unless 2 CFR § 25.110(b) or (c) exempts you f rom those requirements or the agency approved an exemption for you under 2 CFR § 25.110(d)).

https://www.gsa.gov/entityid https://sam.gov/content/home https://www.fsd.gov/gsafsd_sp?id=gsa_kb_view2&kb_id=f66d8e6cdb76d4100d73f81d0f9619c6 https://www.grants.gov/ https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.fsd.gov%2Fgsafsd_sp%3Fid%3Dkb_article_view%26sysparm_article%3DKB0017347&data=05%7C01%7CDDixon%40hrsa.gov%7C80dfe1e3c58a4e26cd0008db143e65c3%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638126030447564740%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=nnDr7%2B8Bn1g9416eowK4Vwfx%2BO2%2BuUP1Nlu9KkvZoa4%3D&reserved=0

HRSA-24-050 MHTRC 20

is to ensure entities are in control of who has permission to control roles within their entity.

Here’s what this means:

• Entity Administrators assigning roles to non-employees will only be able to assign a Data Entry role or lower.

• Any entities assigning Entity Administrator roles using an Entity Administrator Role Request Letter (formerly called “notarized letter”) will no longer be able to assign the Entity Administrator role to a non-employee.

• Entity Administrator roles assigned to non-employees will be converted to Data Entry roles. With a Data Entry role, non-employees can still create and manage entity registration data entry but cannot manage roles.

If you are an entity using a non-employee or if you are a non-employee working with an entity to manage registrations, please read (and share) more about this change on the BUY.GSA.gov blog to know what to expect.

For more details, see Section 3.1 of the Application Guide.

Note: Allow enough time to register with SAM and Grants.gov. We don’t grant application extensions or waivers if you fail to register in time.

4. Submission Dates and Times

Application Due Date Your application is due on May 2, 2024, at 11:59 p.m. ET. We suggest you submit your application to Grants.gov at least 3 calendar days before the deadline to allow for any unexpected events. See the Application Guide’s Section 8.2.5 – Summary of emails from Grants.gov.

5. Intergovernmental Review

The Maternal Health Training and Resource Center program must follow the…