MCHB-HRSA-24-105-(US8)-CMMP-final-rev.pdf

U.S. Department of Health and Human Services

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2024

Maternal and Child Health Bureau

Office of Policy and Planning

Center for Maternal and Child Health Medicaid Partnerships Funding Opportunity Number: HRSA-24-105

Funding Opportunity Type(s): New

Assistance Listing Number: 93.110

Application Due Date: July 10, 2024 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: April 26, 2024

Maura Dwyer Public Health Analyst, Office of Policy and Planning Call: 301-443-0830 Email: mdwyer@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:mdwyer@hrsa.gov

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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: Center for Maternal and Child Health Medicaid Partnerships

Funding Opportunity Number: HRSA-24-105

Assistance Listing Number: 93.110

Due Date for Applications: July 10, 2024

Purpose: The purpose of this program is to strengthen collaboration between state Medicaid, Children’s Health Insurance Program (CHIP), and Title V Maternal and Child Health Services Block Grant (Title V) programs and advance innovative strategies that improve outcomes for maternal and child health (MCH) populations.

Program Objective(s): • Increase understanding of Medicaid and CHIP systems, policies, language, and financing approaches among state Title V programs.

• Increase understanding of MCH populations’ needs, disparities, and public health/Title V strategies among state Medicaid and CHIP programs.

• Foster new partnerships and strengthen existing relationships between Medicaid, CHIP, and Title V programs.

Eligible Applicants: These types of domestic organizations may apply:

• Public or private

• Community-based

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• Tribal (governments, organizations)1

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

Anticipated FY 2024 Total Available Funding:

$2,000,000

Estimated Number and Type of Award(s):

Up to 1: new cooperative agreement

Estimated Annual Award Amount:

Up to $2,000,000 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:

Denise Boyer Grants Management Specialist Division of Grants Management Operations, OFAM Email: DBoyer@hrsa.gov

Program issues or technical assistance:

Maura Dwyer Public Health Analyst, Office of Policy and Planning, Maternal and Child Health Bureau Email: MDwyer@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.

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).

mailto:DBoyer@hrsa.gov mailto:MDwyer@hrsa.gov http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf https://www.hrsa.gov/grants/apply-for-a-grant/prepare-your-application

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Technical Assistance

We have scheduled the following webinar:

Thursday, May 23, 2024 3 – 5 p.m. ET Weblink: https://hrsa-gov.zoomgov.com/j/1608528765?pwd=cW5YaDF3L3AwUnBlYlR0OTQvRDBvZz09

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

Call-In Number: 1-833-568-8864 Meeting ID: 06541694

We will record the webinar. You can access the recording here.

https://hrsa-gov.zoomgov.com/j/1608528765?pwd=cW5YaDF3L3AwUnBlYlR0OTQvRDBvZz09 https://hrsa-gov.zoomgov.com/j/1608528765?pwd=cW5YaDF3L3AwUnBlYlR0OTQvRDBvZz09 https://www.hrsa.gov/grants/find-funding?search=&status=All&bureau=248

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Table of Contents

I. PROGRAM FUNDING OPPORTUNITY DESCRIPTION

1. PURPOSE

2. BACKGROUND

II. AWARD INFORMATION

1. TYPE OF APPLICATION AND AWARD

2. SUMMARY OF FUNDING

III. ELIGIBILITY INFORMATION

1. ELIGIBLE APPLICANTS

2. COST SHARING 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: PAGE LIMIT WORKSHEET

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I. Program Funding Opportunity Description

1. Purpose

This notice announces the opportunity to apply for funding under the Center for Maternal and Child Health Medicaid Partnerships program.

The purpose of the Center for Maternal and Child Health Medicaid Partnerships is to strengthen collaboration between state Medicaid, Children’s Health Insurance Program (CHIP), and Title V Maternal and Child Health Services Block Grant (Title V) programs and advance innovative financing strategies that improve outcomes and reduce health disparities for maternal and child health (MCH) populations.2 The award recipient will build knowledge and shared priorities between state Medicaid, CHIP, and Title V programs and provide one-to-one, state-specific3 tailored capacity-building assistance directly to state Medicaid, CHIP, and Title V programs to support MCH.

Support will include: (1) engaging state Title V, Medicaid, and CHIP programs to identify shared priorities and foster a common understanding of needs, opportunities, and best practices; (2) one-to-one, state-specific, tailored assistance to advance MCH financing; (3) support the development of innovative collaborative models leveraging HRSA, CHIP, and Medicaid funding, and (4) one-to-one capacity-building assistance to advance interagency agreements required by statute.4

Program Goals:

• Increase development, expansion, implementation, and monitoring of policies and practices to improve eligibility, coverage, access, and quality of care for MCH populations.

• Formalize policies and accountability mechanisms that guide and sustain coordination between state Medicaid, CHIP, and Title V programs.

• Support uptake of innovative payment models for MCH populations at the state level, specifically collaborative models between HRSA, CHIP, and Medicaid funding.

• Maximize resources to scale and sustain changes that improve Medicaid and CHIP eligibility, coverage, access, and quality of care for MCH populations.

2 “Maternal and child health” is a general term that refers to mothers, infants, children, children and youth with special health care needs, and their families.

3 For purposes of brevity, throughout this NOFO, the term “State” includes “States” which operate Medicaid programs – these are each of the 50 States, the District of Columbia and the U.S. territories of Puerto Rico, Guam, American Samoa, the Virgin Islands, and the Northern Mariana Islands.

4 Section 1902(a)(11) of Title XIX requires State Medicaid agencies to enter into Interagency Agreements with state Title V agencies. Also note that Section 509(a)(2) of Title V of the Social Security Act cites the need to promote “coordination at the Federal level of activities authorized under this title [Title V] and under title XIX….”

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ssa.gov%2FOP_Home%2Fssact%2Ftitle19%2F1902.htm&data=05%7C02%7CEHazzard%40hrsa.gov%7Ca42afa2b54564e186dbc08dc0e2c7028%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638400831217604224%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=udk0lx7h%2B0TLa9Y5l4negkSr1qJQi9ixcHMDQn8VmvQ%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ssa.gov%2FOP_Home%2Fssact%2Ftitle05%2F0509.htm&data=05%7C02%7CEHazzard%40hrsa.gov%7Ca42afa2b54564e186dbc08dc0e2c7028%7C14b77578977342d58507251ca2dc2b06%7C0%7C0%7C638400831217604224%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=9L4CXRAlocLo3razYlQiDGX9PN16E%2F%2BhV8C%2FZZD9JZM%3D&reserved=0

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2. Background

The Center for Maternal and Child Health Medicaid Partnerships is authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act).

The Maternal and Child Health Bureau’s (MCHB) mission is to improve the health and well-being of America’s mothers, children, and families. We carry out our mission by taking a life-course approach to our work and focus on:

• Women/maternal health

• Perinatal/infant health

• Child health

• Adolescent health

• Children with special health care needs

Recent data show opportunities for improvement in overall health outcomes, as well as significant and persistent health disparities, among these populations. Rates of maternal mortality and severe maternal morbidity are high in the U.S.5,6 And according to provisional Vital Statistics data, U.S. Infant mortality rates increased in 2022 for the first time in two decades.7

Maternal and infant health outcomes such as maternal mortality, infant mortality, preterm birth, and low birth weight show significant disparities by race, ethnicity, and geography.8 Health disparities among adolescents persist, with rates of risk factors and outcomes such as substance use, depression, suicide, and experience of violence varying based on factors including race, ethnicity, gender, education, income, disability, geographic location (for example, rural or urban), and sexual orientation.9,10 Similarly, the prevalence and impact of special health care needs among children and youth varies by race, ethnicity, socioeconomic status, and geography.11

The Title V, CHIP, and Medicaid programs share a common goal to improve the health of the MCH population. Medicaid greatly improves the health and health care of MCH populations12—serving over 25 million children, including disproportionately higher

5 Tikkanen, Roosa, Munira Z. Gunja, Molly FitzGerlad, and Laurie Zephyrin. “Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries.” The Commonwealth Fund, November 18, 2020. https://doi.org/10.26099/411v- 9255.

6 Federally Available Data (FAD) Resource Document (hrsa.gov) 7 Vital Statistics Rapid Release, Number 33 (November 2023) (cdc.gov) 8 Federally Available Data (FAD) Resource Document (hrsa.gov) 9 https://www.cdc.gov/healthyyouth/disparities/index.htm 10 https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf 11 Ghandour RM, Hirai AH, Kenney MK. (2022) Children and Youth with Special Health Care Needs: A Prof ile. Pediatrics, 149(7):e20210561500.

12 Kusma JD, Raphael JL, Perrin JM, Hudak ML. Committee on Child Health Financing. (2023) Medicaid and the Child’s Health Insurance Program: Optimization to Promote Equity in Child and Young Adult Health. Pediatrics, 152(5):e2023064088.

https://doi.org/10.26099/411v-9255 https://doi.org/10.26099/411v-9255 https://mchb.tvisdata.hrsa.gov/Admin/FileUpload/DownloadContent?fileName=FadResourceDocument.pdf&isForDownload=False https://www.cdc.gov/nchs/data/vsrr/vsrr033.pdf https://mchb.tvisdata.hrsa.gov/Admin/FileUpload/DownloadContent?fileName=FadResourceDocument.pdf&isForDownload=False https://www.cdc.gov/healthyyouth/disparities/index.htm https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf

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percentages of children from racial and ethnic minority communities.13 Medicaid covers more than 40% of all births14 and almost half of children with special health care needs.13 CHIP provides health coverage to eligible children in families with incomes too high to qualify for Medicaid but too low to afford private coverage. As of December 2023, over seven million children were enrolled in CHIP.15 HRSA’s Title V MCH Services Block Grant provides grants to states and jurisdictions to improve the health of an estimated 60 million women and children annually, including children with special health care needs, through a wide range of MCH programming. Given the broad reach of these three programs, Medicaid, CHIP, and Title V are vital for improving health outcomes and reducing disparities for MCH populations. States with collaborative and innovative partnerships between Title V, CHIP, and Medicaid programs have driven improvements in MCH outcomes.

Effective coordination between Title V, CHIP, and Medicaid systems can also be instrumental in reducing health disparities. There is significant geographic variation in Medicaid and CHIP eligibility and duration of coverage, covered services, quality of care standards, and payment models.16 There are also racial and ethnic disparities in the use of Medicaid and CHIP benefits.17,18,19,20 Title V’s statutory mission is to improve the health of all women and children and provides significant flexibility to states in determining what services to provide. States can use Title V funding to test innovative programs, expand providers (e.g., training community-based doulas), and otherwise support strategies that may be sustained through Medicaid and CHIP reimbursement pathways. Title V funding can also be used to support medical services and fill gaps in services for those who are ineligible or unable to pay for health insurance. Title V MCH programs also provide outreach and facilitate enrollment of Medicaid and CHIP-eligible children and pregnant women.21 Title V, CHIP, and Medicaid can expand their reach and effectiveness in supporting MCH through collaborative efforts to identify gaps in service, develop opportunities to increase or maintain access, and reduce barriers to accessing services.

About MCHB and Strategic Plan

13 Child and Adolescent Health Measurement Initiative. (2022) National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved 12/21/2023 from Home (childhealthdata.org).

14 https://www.cdc.gov/nchs/data/databriefs/db468.pdf 15 December 2023 Medicaid and CHIP Enrollment Snapshot 16 Medicaid and CHIP Eligibility and Enrollment Policies as of January 2021 Findings from a 50-State Survey - Report

- 9659 | KFF

17 Donohue JM, Cole ES, James CV. (2022) The US Medicaid Program Coverage, Financing Reforms, and Implications for Health Equity. JAMA, 328(11):1085-1099.doi:10.1001/jama.2022.14791 18 Wallace J, Lollo A, Duchowny KA, Lavallee M. Ndumele CD. (2022) Disparities in Health Care Spending and Utilization Among Black and White Medicaid Enrollees. JAMA Health Forum, 3(6):e221398.

19 Robers ET, Kwon Y, Hames AG. (2023) Racial and Ethnic Disparities in Health Care Use and Access Associated with Loss of Medicaid Supplemental Insurance Eligibility Above the Federal Poverty Level. JAMA Intern Med.

183(6):534-543.doi:10.1001/jamainternmed.2023.0512.

20 Race and Ethnicity of the National Medicaid and CHIP Population in 2020 21 https://amchp.org/resources/collaborations-between-state-title-v-maternal-and-child-health-programs-and-medicaid/ https://www.childhealthdata.org/ https://www.cdc.gov/nchs/data/databriefs/db468.pdf https://www.medicaid.gov/media/174636 https://www.kff.org/report-section/medicaid-and-chip-eligibility-and-enrollment-policies-as-of-january-2021-findings-from-a-50-state-survey-report/ https://www.kff.org/report-section/medicaid-and-chip-eligibility-and-enrollment-policies-as-of-january-2021-findings-from-a-50-state-survey-report/ https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/2020-race-etncity-data-brf.pdf https://amchp.org/resources/collaborations-between-state-title-v-maternal-and-child-health-programs-and-medicaid/ https://amchp.org/resources/collaborations-between-state-title-v-maternal-and-child-health-programs-and-medicaid/

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

MCHB.

II. Award Information

1. Type of Application and Award

Application type(s): 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:

• Assisting in the planning, development, and administration of this project.

• Monitoring and supporting the development and implementation of the work plan.

• Meeting at least monthly with award recipient virtually to discuss ongoing work, address challenges and areas of concern, and share best practices.

• Reviewing and supporting the development and distribution of reports, issue briefs, publications, trainings, or other products partially or fully funded under the cooperative agreement.

• Participating and providing subject matter expertise in meetings, committees, conference calls, and working groups related to the cooperative agreement and its projects.

• Coordinating with award recipient to identify opportunities to facilitate MCHB leadership interaction with stakeholders.

• Assisting in the establishment of cooperative and collaborative relationships between award recipient and HRSA partners, staff, and subject matter experts as needed to carry out the project.

• Leveraging resources across HRSA to develop synergies in programs, identify opportunities to address health disparities, strengthen existing projects, and avoid duplication of efforts.

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

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

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• Developing products that are timely, accurate and fact-based. These products cannot contain opinions and/or judgements and will not and cannot be used for lobbying purposes.

• Collaborating with other HRSA program award recipients to coordinate and leverage training, technical assistance, and information sharing.

• Collaborating with at least 35 state Medicaid, CHIP, Title V, and other key MCH stakeholder partnerships over the period of performance.

• Meeting with the HRSA project officer at the start of the award and throughout the entire period of performance to review current strategies and ensure projects, products, and goals align with HRSA priorities.

• Communicating in a timely manner with the HRSA project officer. This includes meeting at least monthly with the HRSA project officer for status check-ins and participating in progress report reviews.

• Working closely with the HRSA project officer to update the work plan and implement any proposed new activities.

• Being flexible and responsive to shifting priorities and implementation contexts and appropriately modifying policy initiatives and/or materials.

• Planning for HRSA leadership and staff to participate in Center for Maternal and Child Health Medicaid Partnerships-funded convenings, conferences and other relevant events.

• Consulting with the HRSA project officer before scheduling meetings or conferences at which the HRSA project officer’s or other HRSA subject matter experts’ attendance may be appropriate.

• Providing the HRSA project officer with any materials produced under this cooperative agreement to review and provide advisory input. Review should start as part of the concept development and continue through subsequent drafts and final products.

2. Summary of Funding

We estimate $2,000,000 will be available each year to fund 1 recipient. You may apply for a ceiling amount of up to $2,000,000 annually (reflecting direct and indirect costs).

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

Support beyond the first budget year will depend on:

• Appropriation of funds

• Satisfactory progress in meeting the project’s objectives

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

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Additional funding may become available at HRSA’s discretion, but this is not guaranteed. Recipient may request supplemental funding at any point in their period of performance to address unique activities that are connected to, but not duplicative of, the funded scope of work. HRSA may choose to support such supplemental projects if funding is available and allocable, the request is reasonable and allowable, sufficient time remains in the budget period to approve the request, and the activities are aligned with HRSA priorities and are not duplicative of work performed by HRSA or other HRSA-funded recipients.

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

If you have 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

These types of domestic organizations may apply:

• Public or private

• Community-based, or

• Tribal (governments, organizations)22

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

22 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).

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 https://www.ecfr.gov/current/title-42/section-51a.3

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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-24-105 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 are responsible for reviewing all information that relates to this NOFO.

2. Content and Form of Application Submission

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

Application Page Limit The total number of pages that count toward the page limit shall be no more than 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.

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-24-105 workspace application package, it may count toward the page limit.

Applications must be complete and validated by Grants.gov under HRSA-24-105 before the deadline.

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/

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Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

• When you submit your application, you certify that you and your principals23 (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.24

• If you cannot certify this, you must include an explanation in Attachments 9-12:

Other Relevant Documents.

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

Program Requirements and Expectations The Center for Maternal and Child Health Medicaid Partnerships aims to optimize MCH populations’ health and well-being by strengthening collaboration between state Medicaid, CHIP, and Title V programs and advancing innovative financing strategies for MCH. The successful award recipient will assemble a team of individuals/organizations with collective expertise in providing national-level and state-specific support to states, assuring significant and meaningful experience across the team with state Medicaid and CHIP programs as well as Title V programs. MCHB anticipates that the successful recipient will collaborate across individuals/organizations to build a team that has the requisite expertise for this project. Successful recipients will use their collective expertise and experience working directly with state Title V, CHIP, and Medicaid to support states in strengthening Title V, CHIP, and Medicaid partnerships, identifying shared goals, and executing policies and activities that improve coverage, access, and quality of MCH care. The award recipient will be expected to work directly, one-to-one, with state Title V, CHIP, and Medicaid program staff to help execute financing initiatives including developing and implementing state plan, waiver, and managed care contract language. At least 35 collaborations will be undertaken as a result of the Center’s work throughout the period of performance.

For the purposes of this funding opportunity, the recipient is expected to provide direct, tailored support to state Title V and/or Medicaid programs to address all population domains. The award recipient is expected to:

• Build knowledge and shared priorities among state Medicaid, CHIP, and Title V programs.

o Within 4 months of the start of the award, develop a detailed 5-year workplan for convening and engaging state Medicaid, CHIP, and Title V staff together from at least 35 states through activities such as annual convenings and/or

23 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).

24 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

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learning communities. Within six months of the start of the award, assess the current state of partnership, knowledge, and need across states.

o Engage and convene state Title V, CHIP, and Medicaid staff to:

Understand the underlying legislative/regulatory authorities for each and be aware of the strategies that each uses to improve the health of MCH populations.

Build shared language and translate terminology across each program.

Identify shared priorities and goals.

Increase understanding of opportunities, gaps, roles, and responsibilities between state Medicaid, CHIP, and Title V.

Share innovative financing approaches, best practices, tools and templates, and emerging issues.

o Craft and execute a plan to continue to support collaboration outside of convenings between state Title V, CHIP, and Medicaid programs.

o Develop materials each year to advance collaboration, communication, and information sharing across all states such as:

Briefing documents and/or other resources and engagements to translate changes or opportunities in Medicaid and CHIP policy into a clear “how-to” guidance for states.

A repository of Medicaid state plan and waiver language that advances outcomes for or otherwise supports MCH populations.

o Incorporate the engagement and input of community members, including those with lived experience, to inform the development of shared priorities.

o Develop a data collection mechanism to track performance measures and report annually on the progress of knowledge building between state Title V, CHIP, and Medicaid.

• Provide direct, state-specific, tailored support to state Title V, CHIP, and Medicaid programs to advance innovative financing strategies and improve access to quality care among MCH populations.

o Develop and implement a selection process to identify and engage states for one-on-one, tailored support to state Title V, CHIP, and Medicaid programs.

The selection process should consider how to include states at different levels of current engagement, coordination, and collaboration across Title V, CHIP, and Medicaid programs.

o Build joint state Title V, CHIP, and Medicaid program capacity to identify and act on innovative financing approaches including (but not limited to):

Adopting policies to expand eligibility and simplify enrollment.

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Testing novel initiatives with Title V funding and sustaining successful approaches with Medicaid funding.

Braiding Title V, CHIP, and Medicaid funding to achieve patient-centered strategies.

Enhancing covered benefits, such as home visiting, group prenatal care, doulas, and social determinant of health approaches.

Implementing alternative models of care and payment arrangements.

Building quality improvement and performance measurement or other requirements into managed care contracting to advance the state’s Title V priorities.

o Provide hands-on support to advance state-specific priorities and help states execute financing initiatives. This may include, but is not limited to:

Support collaborations among at least 7 Title V, CHIP, and Medicaid programs per year.

Create collaborations that leverage Title V funding to provide start-up resources and support for new approaches, workforce training, and other capacity that can, if successful, be sustained by Medicaid and

CHIP.

Develop example Medicaid state plan, amendment, waiver, and managed care contract language, and other resources states need to execute financing strategies that advance Title V/Medicaid/CHIP shared priorities.

Provide consultation to identify opportunities, best practices, and address barriers.

Facilitate introductions, engagement, and relationship building between Title V, CHIP, and Medicaid to advance state-specific needs.

o Develop materials each year to share lessons learned from one-to-one state consultations with other states, including guides and templates.

o Develop a data collection mechanism to track performance measures and report annually on the progress of tailored support to states.

• Provide one-to-one, direct support to improve interagency agreements and related processes, practices, and/or activities that guide coordination between state Title V and Medicaid programs.

o Develop and implement a selection process to identify and engage states to update interagency agreements (IAAs) between state Title V and Medicaid.

Selection process should consider how to include states at different levels of current engagement, coordination, and collaboration across Title V and Medicaid programs.

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o Provide hands-on support directly to state Title V and Medicaid programs to update interagency agreements and increase consistency, accountability, and coordination, as well as address MCH priorities.

o Develop and disseminate materials each year to build state capacity to improve consistency, accountability, and coordination through interagency agreements. This may include, but is not limited to:

A template for interagency agreements available to all state Title V and Medicaid programs.

Exemplar interagency agreements.

o Develop a data collection mechanism to track performance measures and report annually on the progress of tailored support to states.

• Ensure Sustainability beyond Funding Period o Propose a plan for project sustainability after the period of federal funding ends, focusing on key elements of the project (e.g., those that have been effective in improving practices and outcomes and reducing disparities for MCH populations) to be sustained and key stakeholders to be engaged.

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

• Performance Measurement: recipients are expected to measure and track progress on program goals and objectives outlined in the Purpose Section.

o This includes Discretionary Grants Information System (DGIS) measures, including Health Equity, Technical Assistance (including recipient satisfaction), Partnerships and Collaboration, Guidelines and Policy, Engagement of Persons with Lived Experience, Knowledge Change, and Products and Publications. For more information on these measures, please see the Reporting section.

o Monitoring: recipients are expected to track project-related processes, activities, and milestones, and use data to identify actual or potential challenges to implementation.

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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

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

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 o Briefly describe the purpose of the proposed project.

Organizational Information -- Corresponds to Section V’s Review Criterion 5:

Resources/Capabilities

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o Briefly describe your mission, structure, and scope of current activities.

Explain how these elements all contribute to the organization’s ability to carry out the program requirements and meet program expectations.

o Discuss the expertise of staff who will be assigned to this project as it relates to the scope of this project. Describe your proposed staff’s roles and include a project organizational chart as Attachment 6.

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

o Describe the collective experience and expertise of the team of collaborating individuals/organizations in providing national-level and state-specific support to states; state Medicaid, CHIP, and Title V programs; supporting interagency collaboration, such as interagency agreements; and providing customized support and creating tools and materials for wide dissemination. If applicable, provide evidence of success in prior initiatives and any lessons learned.

o Describe your organization’s capacity and relevant experience supporting the writing, drafting, and updating of interagency agreements for state Title V and Medicaid programs.

Need – Corresponds to Section V’s Review Criterion 1: Need o Outline trends in outcomes among MCH populations at the national level and the implications for collaboration of state Title V, CHIP, and Medicaid programs.

o Identify the challenges and opportunities related to improving collaboration between state Medicaid, CHIP, and Title V programs and how your organization is equipped to help address them.

o Describe existing shared priorities among state Medicaid, CHIP, and Title V programs and opportunities for new shared priorities. Explain why cross-agency collaboration between these state programs is needed and how you will foster this collaboration.

This section will help reviewers understand whom you will serve with the proposed project.

Approach – Corresponds to Section V’s Review Criterion 2: Response o Tell us how you’ll address the stated needs and meet the program requirements and expectations described in this NOFO. Approaches should encompass all 5 years of the project and identify the outcomes you expect to achieve by the end of the period of performance.

o Discuss how you plan to identify and engage states, and:

build knowledge and identify shared priorities, HRSA-24-105 CMMP 14 provide direct, tailored support to state Medicaid, CHIP, and Title V programs, Build at least 7 collaborations per year, and advance state Title V/Medicaid IAAs.

o Provide specific, measurable, attainable, realistic, time-bound, inclusive, and equitable (e.g., SMARTIE) objectives for each proposed project goal.

o Identify and describe partners you plan to leverage or collaborate with to support this project and your methods for development of effective strategies for ongoing partner outreach, collaborations, and clear communication. Include specific strategies for outreach and collaboration efforts to involve patients, families, and communities.

o Describe strategies for ongoing training, promoting collaboration, and sharing information among Title V, Medicaid, and CHIP staff. Describe how you will expand the capacity of state Medicaid, CHIP, and Title V agencies to advance MCH financing initiatives given their limited bandwidth amidst multiple state agency priorities. Include how you will build knowledge, skills, partnerships, and resources, and support states in completing essential tasks to advance these initiatives.

o Include a plan to distribute reports, products, or project outputs to target audiences, and promote their use.

o Propose a plan for project sustainability after the period of federal funding ends. HRSA encourages recipients to sustain key elements of their projects (for example, strategies and interventions which have been effective in improving policies/practices and have led to improved outcomes for the priority population). An update on sustainability efforts will be required with submission of each annual progress report.

o Describe how you will incorporate the engagement and feedback of, and support and strengthen ongoing Title V, CHIP, and state Medicaid program connections to, community members and people with lived experience to understand and align their needs and priorities to state priorities.

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

Impact o Describe the activities or steps you will use to achieve each of the objectives during the period of performance, including how you will evolve and/or add new activities in later years of the period of performance.

o Use a timeline that includes each activity and identifies who is responsible for each. As needed, identify how key stakeholders will help

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plan, design, and carry out all activities. The work plan and timeline should cover the entire 5-year period of performance.

Resolution of Challenges – Corresponds to Section V’s Review Criterion 2:

Response 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.

Evaluation and Technical Support Capacity – Corresponds to Section V’s Review Criteria 3: Evaluative Measures and 5: Resources/Capabilities o Provide a performance measurement plan that demonstrates how you will, if awarded, fulfill the expectations and requirements for performance measurement 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 required and/or proposed measures outlined in the Program Requirements and Expectations Section and plans for the timely collection and reporting of all measures. Recipients should also provide a plan for collecting and reporting the number of individuals impacted by an implemented policy, where feasible.

Describe your capacity to collect and manage data in a way that allows for good data quality, accurate and timely monitoring, and performance measurement. Include a description of the available resources (for example, organizational profile, collaborative partners, staff skills and expertise, budget), systems, key processes you will use for monitoring and performance measurement (for example, data sources, data collection methods, frequency of collection, data management software) and how results will be shared with HRSA.

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

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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.

As required by the Further Consolidated Appropriations Act, 2024 (P.L. 118-47), Division D, Title II, § 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 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 will not count toward the page limit.

Clearly label each attachment. Upload attachments into the application. Reviewers will not 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 will comply with federal standards related to recording personnel costs.

Attachment 3: Biographical Sketches of Key Personnel (Do not 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 have not hired yet, include a letter of commitment from that person with the biographical sketch.

https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.307

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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 Section B does not 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 and/or Charts

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 (Does not count towards the page limit)

If your organization is a non-profit, you need to attach proof. We will accept any of the following:

• A copy of a current tax exemption certificate from the IRS.

• A letter from your state's tax department, attorney general, or another state official saying that your group is a non-profit and that none of your net earnings go to private shareholders or others.

• A certified copy of your certificate of incorporation. This document must show that your group is a non-profit.

• Any of the above for a parent organization. Also include a statement signed by an official of the parent group that your organization is a non-profit affiliate.

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Attachments 9–12: Other Relevant Documents (no more than 12)

Include any other documents that are relevant to the application. This may include letters of support, which are not required for eligibility. Letters must show a commitment to the project/program (in-kind services, dollars, staff, space, equipment).

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.25

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.