NOFO_MP-CPI-23-004.pdf

U.S. Department of Health and Human Services

Office of Minority Health

Notice of Funding Opportunity: Healthy Families Community-Based Perinatal Health Initiative

Opportunity Number: MP-CPI-23-004

Application Due Date:

07/18/2023 at 6:00 PM Eastern

OVERVIEW

FEDERAL AGENCY NAME

The Office of the Assistant Secretary for Health, Office of Minority Health

FUNDING OPPORTUNITY TITLE

Healthy Families Community-Based Perinatal Health Initiative

ACTION

Notice

ANNOUNCEMENT TYPE

Initial G (Grant)

FUNDING OPPORTUNITY NUMBER

MP-CPI-23-004

ASSISTANCE LISTING NUMBER AND PROGRAM:

93.137 , Community Programs to Improve Minority Health

DATES

Application Deadline: 07/18/2023 by 6:00 PM Eastern.

Technical Assistance Webinar: 06/01/2023 at 3:00 PM Eastern.

EXECUTIVE SUMMARY

The Office of Minority Health announces the availability of funds for Fiscal Year (FY) 2023 under the authority of 42 U.S.C. § 300u-6 (Section 1707 of the Public Health Service Act).

The Healthy Families Community-Based Perinatal Health Initiative (COPHI) is intended to develop innovative models for integrating community-based maternal support services (COMSS) into perinatal systems of care.

OMH announces the availability of $10,000,000 to support up to 10 awards, ranging from $975,000 to $1,250,000 annually for a project period of up to four years with the possibility of an optional competitive fifth year for transition to sustainability.

OMH expects recipients’ innovative models will improve pregnant and post-partum people's health outcomes and reduce racial and ethnic disparities.

The Office of the Assistant Secretary for Health (OASH) encourages all applicants to review all program requirements, eligibility information, application format and submission information, evaluation criteria, and other information in this funding announcement to ensure that their applications comply with all requirements and instructions.

Table of Contents

OVERVIEW

FEDERAL AGENCY NAME

FUNDING OPPORTUNITY TITLE

ACTION

ANNOUNCEMENT TYPE

FUNDING OPPORTUNITY NUMBER

ASSISTANCE LISTING NUMBER AND PROGRAM:

DATES

EXECUTIVE SUMMARY

A. Program Description

1. Background

2. Expectations for Funded Projects

B. FEDERAL AWARD INFORMATION

1. Legal Authority

2. Award Information

C. ELIGIBILITY INFORMATION

1. Eligible Applicants

2. Cost Sharing or Matching

3. Other - Application Responsiveness Criteria

4. Application Disqualification Criteria

D. APPLICATION AND SUBMISSION INFORMATION

1. Address to Request Application Package

2. Content and Form of Application Submission

3. Application Content

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

5. Submission Dates and Times

6. Intergovernmental Review

7. Funding Restrictions

8. Other Submission Requirements

E. APPLICATION REVIEW INFORMATION

1. Criteria

2. Review and Selection Process

3. Review of Risk Posed by Applicant

4. Final Award Decisions, Anticipated Announcement, and Federal Award Dates

F. FEDERAL AWARD ADMINISTRATION INFORMATION

1. Federal Award Notices

2. Administrative and National Policy Requirements

3. Program Specific Terms and Conditions

4. Closeout of Award

5. Lobbying Prohibitions

6. Non-Discrimination Requirements

7. Smoke- and Tobacco-free Workplace

8. Acknowledgement of Funding

9. HHS Rights to Materials and Data

10. Trafficking in Persons

11. Efficient Spending

12. Whistleblower Protection

13. Health Information Technology (IT) Interoperability

14. Prohibition on certain telecommunications and video surveillance services or equipment. 43

15. Human Subjects Protection

16. Research Integrity

17. Reporting

G. CONTACTS

1. Administrative and Budgetary Requirements

2. Program Requirements

3. Electronic Submission Requirements

H. OTHER INFORMATION

1. Awards under this Announcement

2. Application Elements

I. SUPPLEMENTARY MATERIALS

1. Acronyms

2. Considerations in Recipient Plans for Oversight of Federal Funds

3. Financial Assistance General Certifications and Representations

4. Disparity Impact Statements

5. Glossary

6. References

A. Program Description The Office of Minority Health announces the availability of funds for Fiscal Year (FY) 2023 under the authority of 42 U.S.C. § 300u-6 (Section 1707 of the Public Health Service Act).

The Office of Minority Health (OMH) is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities. Through its demonstration projects, OMH supports the identification of effective approaches for improving health outcomes with the goal of promoting dissemination and sustainability of these approaches.

OMH intends projects funded under the Healthy Families Community-Based Perinatal Health Initiative (COPHI) to develop innovative models for integrating community-based maternal support services (COMSS) into perinatal systems of care. COMSS are social and supportive services that address social determinants of health (SDOH), such as health literacy; pregnancy, childbirth, and parenting education; cultural and linguistic diversity; exposure to trauma, housing; food; and transportation. Trained individuals, such as doulas and community health workers (CHWs), provide these services during pregnancy, labor and delivery and after delivery.

Integrating COMSS into perinatal systems of care will ultimately improve pregnant and post-partum people's health outcomes and reduce racial and ethnic disparities.

1. Background

Recent studies indicate that community-based maternal support services (COMSS) are associated with improved pregnant and post-partum people health outcomes.1 Trained individuals, such as doulas and community health workers (CHWs), provide these services during pregnancy, labor and delivery and after delivery.

CMS noted considerable racial disparities exist, with Black and American Indian/ Alaskan Native (AI/AN) women are three and two times more likely, respectively, to die from pregnancy-related complications than non-Hispanic White women. Hispanic women also experience higher rates of severe maternal morbidity.8,9 As noted in a report published by the Health & Human Services (HHS) Office of Assistant Secretary for Planning and Evaluation, one in three pregnancy-related deaths occur between one week and one year after childbirth. The post-partum period is critical for recovering from childbirth, addressing complications of delivery, ensuring mental health, managing infant care, and transitioning from obstetric to primary care. 10 Disparities in pregnant and post-partum people reflect high barriers to care for minority populations. Hospital and obstetric department closures, gaps in insurance coverage, and workforce shortages in rural communities have led to a lack of access to high-quality maternal health services and contributed to these maternal health disparities.2

The evidence demonstrates that using COMSS has an associated reduction in maternal and infant mortality and morbidity rates.1,2 Overall, when doulas are present during birth, the risk of cesarean section is decreased by 39 percent.3,5 A systematic review found that women with continuous support during labor were more likely to have a spontaneous vaginal birth and less likely to report negative feelings about their childbirth experience.3The report also noted that during labor, individuals provided with continuous support were less likely to use pain medication or epidural anesthesia and had a lower rate of vacuum or forceps-assisted birth.

Evidence also suggests that doulas are associated with shorter labors, on average about a 40-minute reduction, and higher Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores for infants at birth.2,5 Additionally, evidence supports that using CHWs in primary care reduced hospital stays by 65 percent and doubled the rate of patient satisfaction.6

Births by caesarean section increased to about 32 percent of all U.S. births last year, continuing what has been a small but steady increase over the past 25 years, according to a new report from the National Center for Health Statistics. There are potential cost savings in reducing the overall cesarean birth rate. Vaginal birth after cesarean birth (VBAC) rates hover at 10 percent, with most women experiencing a repeat cesarean birth.7The savings associated with avoiding the first cesarean section can also be compounded over a person’s entire childbearing years. The same is true for reducing preterm birth and the long-term costs associated with infant care, particularly in the first year of life. In a theoretical model of 1.8 million women, the approximate number of nulliparous women giving birth annually, it was postulatedthat if COMSS were included in all first births, there would be markedly improved outcomes in the first and second births of this theoretical cohort. Each community-based maternal support service potentially saves up to $530 per delivery.4

Ultimately, opportunities exist to increase the utilization of COMSS in minority populations.

The integration of medical, social and supportive services has proven beneficial in assuring a continuum of care and improving health outcomes. Adequately addressing social determinants of health, such as housing, food, and transportation, will increase the likelihood of adherence to perinatal medical care plans. Incorporating the voice of the community-based workforce in the development of programs and policies is critical for engaging groups trained in providing needed social and supportive services to pregnant and post-partum people.

2. Expectations for Funded Projects

We seek to support projects that will develop and implement innovative models for integrating COMSS into perinatal systems of care. We expect recipients to tailor their approach to local contexts and priorities. We strongly encourage recipients to engage community-based organizations CB), community members, COMSS providers (e.g., doulas and CHWs), and perinatal medical providers.

OMH expects recipients of awards under this initiative to develop a demonstration project that includes public, private, and community partnerships that will:

a. Develop and implement the COMMS integration model

The demonstration project should develop policy and/or program interventions to integrate COMSS into a perinatal system of care. The demonstration project should provide equitable opportunities for all provider types and representatives of the geographic community of focus to participate in the development and implementation of the innovative COMSS integration model. The model should include methods for assessing COMSS needs for pregnant and post-partum individuals and infants included in the demonstration project. The model also should ensure that both COMSS and perinatal medical services are accessible and available in a complementary manner. However, costs of medical services are unallowable under this funding opportunity.

b. Establish a Collaborative Partnership to Support Integration of COMSS

We expect recipients’ collaborative partnerships to support the development, implementation, and evaluation of the integrated COMSS model within the geographic community of focus. The collaborative partnership should include organizations that cover each of the following categories:

i. Community-based organizations (CBOs) providing social and supportive services that address SDOH (i.e., COMSS).

ii. CBOs with experience in case management coordination and physical and mental health promotion for high-risk populations

iii. Medical organizations (e.g., safety net providers, teaching hospital, or other medical providers).

An organizational partner may fill one or two of the types of roles above for the project.

Recipient should engage COMSS providers (e.g., doulas and CHWs) at all stages in the development, implementation, and evaluation of the integrated COMSS model.

Also, recipients should partner with additional organizations, as needed, to ensure capacity to conduct evaluation activities.

c. Integrate Healthy People 2030 and other measures into the development of the COMSS Integration model

We strongly encourage recipients also to incorporate Healthy People 2030 measures and resources for pregnancy, childbirth, and maternal mental health, such as:

(1) MICH-04 – Reduce maternal death;

(2) MICH-06 – Reduce cesarean births among low-risk women with no prior births;

(3) MICH-02 – Reduce the rate of infant deaths;

(4) MICH-07 – Reduce preterm births;

(5) MICH-08 – Increase the proportion of women who receive early and adequate prenatal care;

(6) MICH-D01 – Increase the proportion of women who get screened for postpartum depression;

(7) MIHC-09 – Increase abstinence from alcohol among pregnant women;

(8) MICH-11 – Increase abstinence form illicit drugs among pregnant women.

d. Implement a process and outcomes evaluation

We expect recipients to assess the impact of the COMSS integration model by implementing a process and outcomes evaluation. Recipients should develop public, private, and community partnerships to support the development of the evaluation plan and related data collection and analysis. The process and outcomes evaluation should assess whether the COMSS integration model was implemented as planned, whether it reached the community of focus, and its impact on health outcomes for the community of focus.

We expect recipients to identify and collect data on outcome measures to demonstrate the effectiveness of the innovative perinatal health system that fully integrates COMSS with perinatal medical services. This should include measures for assessing the impact of perinatal health system on SDOH in areas such as health literacy; pregnancy, childbirth, and parenting education; cultural and linguistic diversity; and exposure to trauma.

e. Identify, utilize, and disseminate best practices

We expect recipients to document and share project findings and results (e.g., best practices, lessons learned, process successes, and challenges) with the population served, the general public, and other parties interested in project results. Recipients should publish the findings and results in scholarly articles or brief reports, including baseline and post-intervention data for the chosen process and outcome measures. Publications should include a description of the COMSS integration model and its impact on maternal health and infant health outcomes and health disparities within the geographic areas served by the project. When published, the article should be freely, immediately, and equitably accessible to the public.

f. Develop a disparity impact statement

Recipients are expected to develop a disparity impact statement (DIS) during the project period using local data to identify populations at highest risk for health disparities relative to this initiative. Additional information and links to resources are available in Section I.2.

B. FEDERAL AWARD INFORMATION

1. Legal Authority

42 U.S.C. § 300u-6 (Section 1707 of the Public Health Service Act)

2. Award Information

We intend to make funds available for competing G (Grant) awards.

We will fund awards in annual increments and generally for a period of performance up to 4 year(s), although we may approve shorter periods of performance. Budget periods may also vary from the estimate indicated below due to timing of award issuance or other administrative factors.

Recipients will be required to submit a non-competing continuation application for each budget period after the first. Funding for all approved budget periods beyond the first is generally level with the initial award amount and is contingent upon the availability of funds, satisfactory progress of the project, adequate stewardship of Federal funds, and the best interests of the Government.

We anticipate offering a competing continuation for an additional budget period for the purpose of providing funding to support selected recipients in transitioning successful projects to sustainability. Funding available for this addition budget period is not guaranteed at all nor expected to be at the same level of previous budget periods.

Award Information

Estimated Federal Funds Available $10,000,000

Anticipated Number of Awards 10

Award Ceiling (Federal Funds including indirect costs) $1,250,000 per budget period

Award Floor (Federal Funds including indirect costs) $975,000 per budget period

Anticipated Start Date 09/30/2023

Estimated Period of Performance Not to exceed 4 year(s)

Anticipated Initial Budget Period Length 12 months

Type of Award Grant

Type of Application Accepted Electronic via Grants.gov ONLY unless an exemption is granted.

C. ELIGIBILITY INFORMATION

1. Eligible Applicants

Any public or private nonprofit entity located in a State (which includes one of the 50 United States, District of Columbia, Commonwealth of Puerto Rico, U.S. Virgin Islands, Commonwealth of the Northern Mariana Islands, American Samoa, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of the Marshall Islands) is eligible to apply for an award under this announcement.

Private non-profit institutions of higher education are eligible to apply.

Faith-based organizations and American Indian/Alaskan Native/Native American (AI/AN/NA) organizations that are public or non-profit private entities are eligible to apply.

Public or non-profit community-based organizations (CBOs) are eligible to apply.

Examples of eligible Organizations include:

State governments

County governments

City or township governments

Special district governments

Independent school districts

Public and State controlled institutions of higher education

Native American tribal governments (Federally recognized)

Public housing authorities/Indian housing authorities

Native American tribal organizations (other than Federally recognized tribal governments)

Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education

Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education

2. Cost Sharing or Matching

You are not required to provide cost sharing or matching in your proposed budget. If you voluntarily include cost sharing in your application, you must include in your budget narrative a non-Federal sources justification as described in Section D.3.b.1.t or your application will be disqualified (Section C.4.k). Voluntary cost sharing is not expected for research applications.

During the merit review of an application, cost sharing will only be considered in the overall review of the adequacy of the total proposed budget (Federal and non-Federal share) to support the project proposed.

Applications including cost sharing or matching, whether required or voluntary, that result in an award will include the cost sharing or matching commitment on the notice of award at the level proposed in the application. See Section D.3.b.1.s. Any change in the responsibility to provide cost sharing or matching at that level will require prior approval of the grants management officer.

Cost-Sharing or Matching may include any in-kind contributions necessary to the execution of the proposed project (45 C.F.R. § 75.306).

3. Other - Application Responsiveness Criteria

There are no Other - Application Responsiveness Criteria.

4. Application Disqualification Criteria

If you successfully submit an application, the OASH Grants and Acquisitions Management (GAM) Division will determine whether your application is eligible according to section C.1 Eligible Applicants. If we determine your application fails to meet the criteria described below, we will disqualify it, that is, we will not review it and will give it no further consideration.

a. You must submit your application electronically via https://grants.gov/ (unless an exemption was granted by the grants management officer 2 business days prior to the deadline) by the date and time indicated in Section D.5 of this announcement.

b. If you successfully submit multiple applications from the same organization for the same project, we will only review the last application received by the deadline.

c. You must complete the required forms in the application package: SF-424, SF-424A, SF-LLL, and Project Abstract Summary (Section D.2.a).

d. Your application must be submitted in the English language and must be in terms of U.S. dollars (45 C.F.R. § 75.111(a)).

e. Your Project Narrative section of the application must be double-spaced, on the equivalent of 8 ½ ” x 11” page size, with 1” margins on all sides (top, bottom, left and right) and font size not less than 12 points (Section D.2.a).

f. Your Project Narrative must not exceed 30 pages. The following items do not count toward the Project Narrative page limit: all required forms, including SF-424, SF-424A, SF-LLL, Project Abstract Summary, and Budget Narrative (including budget tables)(Section D.2.a).

g. Your total application (i.e., the Project Narrative plus Appendices) must not exceed 50 pages. The following items do not count toward the Project Narrative page limit: all required forms, including SF-424, SF-424A, SF- LLL, Project Abstract Summary, and Budget Narrative (including budget tables)(Section D.2.a).

h. Your Federal funds request including indirect costs must not be above the maximum indicated in Award Ceiling (Section B.2).

i. Your Federal funds request including indirect costs must not be below the Minimum indicated in Award Floor, if any (Section B.2).

j. Your application must meet the Other - Application Responsiveness Criteria outlined above (Section C.3).

k. If your application includes cost sharing (voluntary or required, Section C.2), you must include in your budget narrative a non-federal sources justification.

https://grants.gov/

D. APPLICATION AND SUBMISSION INFORMATION

1. Address to Request Application Package

You may obtain an application package electronically by accessing Grants.gov at https://www.grants.gov/. You can find it by searching on the Assistance Listing (formerly CFDA) number shown on page 1 of this funding opportunity announcement. If you have problems accessing the application or difficulty downloading, contact:

OASH Grants and Acquisitions Management Division

Phone: 240-453-8822

Email: OASH_Grants@hhs.gov

2. Content and Form of Application Submission

a. Application Format

Your application must be prepared using the forms and information provided in the online application package. This includes but is not limited to:

SF-424 Application for Federal Assistance SF-424A Budget Information for Non-Construction Programs SF-LLL Disclosure of Lobbying Activities Project Abstract Summary

We encourage individuals to use their full name (first, middle, last) on the Standard Forms and other documents such as résumés/curricula vitae/biographical sketches to distinguish them for verification in the System for Award Management exclusion records. Delays may result in award processing if full names are not provided.

Only one Project Director/Principal Investigator (PD/PI) will be named on any resulting award.

You should clearly identify the individual in that role in your application. This individual should be the person who will be responsible for the programmatic aspects of the project if an award is made. A placeholder PD/PI is strongly discouraged because this may not present a clear picture for the review. Furthermore, once an award is issued a request for a change in PD/PI requires prior approval of the grants management officer (45 C.F.R. § 75.308(c)(1)(ii-iii)).

The Project Narrative, and total application including appendices, must adhere to the page limit indicated in Application Disqualification Criteria listed in Section C.4. The page limit does not include the Budget Narrative (including budget tables), required forms, assurances, and certifications as described in the Application Disqualification Criteria.

You must double-space the Project Narrative pages.

Your application must be submitted in the English language and must be in the terms of U.S.

dollars (45 C.F.R. § 75.111(a)) https://www.grants.gov/ mailto:OASH_Grants@hhs.gov

You should use an easily readable typeface, such as Times New Roman or Arial. You must use 12-point font. You may single-space tables or use alternate fonts but you must ensure the tables are easy to read.

Please do not number pages or include a table of contents. Our grants management system will generate page numbers once your application is complete. If your application exceeds the specified page limits for the Project Narrative or Project Narrative plus Appendices (Section C.4(f)-(g)) when printed on 8.5” X 11” paper as determined by OASH/GAM, the application will not be reviewed further. We recommend you print out your application before submitting electronically to ensure that it is within the page limits and is easy to read.

b. Appendices Format

Your appendices should include any specific documents outlined in Section D.3.c, under the heading “Appendices” in the Application Content section of this announcement. Your documents should be easy to read. You should use the same formatting specified for the Project Narrative.

However, documents such as résumés/curricula vitae, organizational charts, tables, or letters of commitment may use formatting common to those documents, but the pages must be easy to read. All of your appendices must be uploaded as a single, consolidated file in the Attachments section of your Grants.gov application.

c. Project Abstract Summary Format

You must complete the Project Abstract Summary form provided in the application package. The abstract will be used to provide reviewers with an overview of the application and will form the basis for the application summary in grants management and program summary documents.

Furthermore, if your project is funded, HHS will publish the abstract from your form on TAGGS.hhs.gov and USASpending.gov. The abstract may also appear on the program office website or other government website. Therefore, do not include sensitive or proprietary information in your abstract.

d. Budget Narrative Format

The Budget Narrative should use the formatting required of the Project Narrative for the explanatory text. Budget tables may be single-spaced but should be laid out in an easily-readable format and within the printable margins of the page.

3. Application Content

Successful applications will contain the following information:

a. Project Narrative Content

The Project Narrative is the most important part of the application because it will be used as the primary basis to determine whether your project meets the minimum requirements for an award under this announcement. The Project Narrative should provide a clear and concise description of your project. We recommend that your project narrative includes the following components:

1) Statement of Need; 2) Project Plan; 3) Evaluation Plan; 4) Organizational Capability; and 5) Dissemination Plan.

1. Statement of Need

Describe in this section, in both quantitative and qualitative terms, the nature and scope of the specific need and geographic area(s) the project is designed to address. Provide details on how the project will potentially affect the pregnant and post-partum people served and other interested stakeholders as identified. Focus your statement of need on the specific aspects of the gaps and barriers related to the impact of the project on improving access and availability of COMSS through an innovative model that integrates COMSS into a perinatal system of care.

Describe how your proposed intervention will serve underserved and disadvantaged populations, including racial/ethnic minorities and limited English proficient populations, incorporating the National Standards for Culturally and Linguistically Appropriate Services (CLAS) as appropriate.

2. Project Plan

a. Goals, Objectives, and Outcomes

Describe in this section your project’s proposed goal(s) and major objectives. Objectives should be specific, measurable, achievable, realistic, time-bound, inclusive, and equitable (SMARTIE).

Goals should be ambitious and achievable in the project's time-frame/period of performance.

SMARTIE objectives should include baseline data and quantifiable time-frames for achievement. Your goals, objectives and outcomes should link to the activities described in your Project Approach section and Work Plan appendix.

Clearly identify the measurable outcome(s) that will result from the project, and provide specific, quantified estimates of expected outcome(s). We will not fund any project that does not include measurable outcomes connected to the selected policies and practices being addressed.

A “measurable outcome” is an observable end-result that describes how a particular intervention benefits program participants. It demonstrates the “impact” of the COMSS integration model.

For example, a change in provider’s knowledge, skill, attitude, awareness, or behavior regarding the COMSS coverage. A measurable outcome is not a measurable output, such as: the number of policies; the number of partners committed; or the number of health measures.

Describe how you envision the project will benefit the future of the field at large. Consider the benefits to the field of health systems analysis, health policy research, health disparities, evidence-based policies, and interventions for racial and ethnic minorities and other underserved populations.

b. Proposed Approach

Provide a clear and concise description of the approach to plan, develop and implement an innovative model that integrates COMSS into a perinatal system of care. Your proposal should detail the nature of the activities to be undertaken, how they address system gaps and identified issues, and how they will assist in achieving the overall project goals and objectives. Explain the rationale for your approach and activities. Clarify why these specific activities were selected (e.g., has this approach been successful in other settings or does the research suggest this direction). Provide specifics about the intervention strategies, expected outcomes, and barriers for all anticipated years of the award.

Identify planned or existing public, private, and community partnerships to support the development and implementation of the COMSS integration model, data collection, and evaluation. Explain your rationale for selecting these partners and describe their anticipated contribution to the project. Also, describe how you will engage in partnership(s) with the types of organizations described in Section A.2.a above.

Identify any major barriers anticipated and how your project will be able to overcome those barriers. This should include anticipated barriers at any stage of project development, implementation, or evaluation.

c. Work Plan

Provide a summary of activities, supported by specific details in the work plan in your appendices, and how they will assist in achieving the project goals and objectives over the anticipated project period. We encourage but do not require you to use the Work Plan template provided in the application package (See Section C.1.b ). Your activities should clearly relate to and work toward your SMARTIE goals and objectives. You should also describe the method that you will use to monitor and track progress on the project's tasks and objectives. Describe the approach you will use for leveraging existing partnerships and establishing new partnerships to achieve proposed project activities.

3. Evaluation Plan

Describe the methods you will use to evaluate whether the project achieves its measurable outcome(s) and assess and evaluate the impact of activities you propose. Submit a detailed logic model that demonstrates linkages between the objectives, inputs, activities, outputs, outcomes, and impacts, as described below in Appendices (See Section C.1.b). Describe your approach for collecting baseline, measurable targets, interim and post-intervention processes, time-frames, and outcome measures. Describe how you will measure and report on the outcomes of the project, including how you will use process and outcome evaluation techniques to analyze the goals and objectives of the initiative.

Identify the individuals/organizations responsible for evaluation activities and that individual/organization’s qualifications. Provide a compelling rationale for your approach to ensuring evaluator independence. Describe both the quantitative and qualitative tools and techniques that you will employ to measure the outcome(s) and how you will identify and document the “lessons learned.” This should include a plan for statistical analysis and how you will overcome any potential obstacles to data collection. The evaluation plan should describe specific methods and indicators to:

measure the change in access to COMSS through the proposed COMSS integration model.

monitor and document key project outcome(s), linked, as appropriate and relevant to Healthy People 2030 measures and resources, such as MICH-02, MICH-04, MICH-06, MICH-07, MICH-08, MICH-09, and MICH-11 and MICH-D01.

determine whether the identified need(s) for the project were addressed.

Your description should include detail of the validity and reliability of the proposed measures or indicators.

4. Organizational Capability

Describe your organization’s capability and capacity to successfully implement the proposed project, including implementation readiness and ability to demonstrate impact within the project period. Describe how your organization (or the particular division of a larger agency which will have responsibility for this project) is organized, the nature and scope of its work, and the capabilities it possesses. Your description should include capabilities of the organization not included elsewhere in the project narrative, such as any current or previous relevant experience and/or the record of the project team in preparing cogent and useful reports, publications, and other products. Include an organizational chart in your appendices (See Section C.b.4) showing the relationship of the project to the current organization.

You should clearly delineate the roles and responsibilities of project staff and partners and how they will contribute to achieving the project’s objectives and outcomes. Describe areas of expertise for key personnel as supported by vitae or biographical sketches for key project personnel submitted in the Appendices. Key personnel include the Principal Investigator/Project Director (PI/PD) and Evaluator for the project. Identify any additional key personnel whose contributions are essential to the project. You should describe the qualifications, competing time commitments, and related ongoing projects of all key personnel.

Specify who would have day-to-day responsibility for key tasks such as: leadership of project;

monitoring the project’s ongoing progress; preparation of reports; and communications with other partners and OMH. Also describe the approach that will be used to monitor and track progress on the project’s tasks and objectives. Clearly identify the individual who will serve as the PI/PD and that individual’s qualifications, competing time commitments, and related ongoing projects. We expect that throughout the award period the PI/PD will have involvement in and substantial knowledge about all aspects of the project.

You should describe the collaborative partnership(s) which will support project activities. You should describe the role and makeup of partners intended to be involved in completing specific tasks. Describe the anticipated level of effort and responsibilities of each partner in completing programmatic activities. Commitment of the partners should be supported by memoranda of agreement or letters of commitment, if available, in your appendices. (Section D.3.c).

Describe your organization’s skills, experience, capability, or capacity for forming, managing, engaging, and partnering with organizations in the implementation of health-related projects.

Also include information about any contractors and/or consultants that will have a secondary role(s) in implementing the project and achieving project goals.

5. Dissemination Plan

Describe the method you will use to disseminate the project's results and findings on time and in easily understandable formats to the population served, the general public, and other parties interested in using the project results. In addition to traditional forms of dissemination such as scholarly articles in peer review journals, we encourage you to propose innovative approaches to informing those who might be interested in using the results of your project. Consider how your results, including baseline, target, time frame, and outcome data for the chosen pregnant and post-partum people's health measures may inform practice, service delivery, program development, and/or policymaking. Dissemination efforts should focus on assisting those you may replicate your project. Also, it should include a description of the model for integrating COMSS into a perinatal system of care and its impact on maternal health and infant health outcomes and health disparities within the geographic area(s) of focus. All relevant findings and products may be posted on an HHS/OMH- sponsored website as determined by HHS/OMH. See also Section F.9.

b. Budget Narrative Content

You must complete the required budget forms and submit a budget narrative with detailed justification as part of your application. You must enter the project budget on the Budget Information Non-construction Programs standard form (SF-424A) according to the directions provided with this standard form. The budget narrative consists of a detailed line-item budget that includes calculations for all costs and activities by "object class categories" identified on the SF-424A and justification of the costs.

Project budget calculations must include estimation methods, quantities, unit costs, and other similar quantitative detail sufficient to verify the calculations. If matching or cost sharing is required, you must include a detailed listing of any funding sources identified in box 18 of the SF-424 (Application for Federal Assistance). You must state the method you are selecting for your indirect cost rate. See Indirect Costs (Section D.3.b.1.o)) for further information. If you are providing in-kind contributions of any type or value, including costs otherwise covered by your indirect cost rate, you must identify those costs, and you should, as appropriate, include the value of the in-kind contribution as proposed cost-sharing (voluntary or required ) (45 C.F.R. § 75.306).

Please be sure to carefully review Section D.7 Funding Restrictions for specific information regarding allowable, unallowable, and restricted costs.

You must provide an object class category budget using Section B, box 6 of the SF-424A for the first year of the proposed project. For awards with an anticipated period of performance of one year or less, this will be the budget request for the entire project. Provide a budget justification, which includes explanatory text and line-item detail, for the entire first year of the proposed project. The budget narrative should describe how the categorical costs are derived. Discuss the necessity, reasonableness, and allocation of the proposed costs.

For subsequent budget years in an anticipated multi-year project, provide a summary narrative and line-item budget for each year beyond the first. For categories or items that differ significantly from the first budget year, provide a detailed justification explaining these changes.

Do not include costs beyond the first budget period in the object class budget in box 6 of the SF- 424A or box 18 of the SF-424; the amounts entered in these sections should only reflect the first budget period.

Your budget narrative should justify the overall cost of the project as well as the proposed cost per activity, service delivered, and/or product. For example, the budget narrative should define the amount of work you have planned and expect to perform, what it will cost, and an explanation of how the result is cost effective. If you are proposing to provide services to clients, you should describe how many clients you expect to serve, the unit cost of serving each client, and how this is cost effective.

Use the following guidelines for preparing the detailed object class budget required by box 6 of the SF-424A. The object class budget organizes your proposed costs into a set of defined categories outlined below. Both federal and non-federal resources (if applicable) must be detailed and justified in the budget narrative. "Federal resources" refers only to the HHS/OASH funds for which you are applying under this NOFO. "Non-federal resources" are all other non- HHS/OASH federal and non-federal resources. We recommend you present budget amounts and computations in a columnar format: first column, object class categories; second column, federal funds requested; third column, non-federal resources; and last column, total budget.

Object Class Federal Funds Requested

Non-federal Resources

Total Budget

Personnel $100,000 $25,000 $125,000

Subrecipient/contract and consultant detailed costs should all be included in those specific line items, not in the overall project object class line items. For example, subrecipient travel should be included in the Contractual line item not in Travel. Subrecipient/contract and consultant activities must be described in sufficient detail to describe accurately the project activities that each will conduct.

1. Object Class Descriptions and Required Justifications

a. Personnel Description

Costs of staff salaries and wages, excluding benefits.

b. Personnel Justification

Clearly identify the PD/PI, if known at the time of application. Provide a separate table for personnel costs detailing for each proposed staff person: the title; full name (if known at time of application), time commitment to the project as a percentage or full-time equivalent: annual salary and/or annual wage rate; federally funded award salary; non-federal award salary, if applicable; and total salary. No salary rate may exceed the statutory limitation in effect at the time you submit your application (see D.7.2) Funding Restrictions, Salary Rate Limitation for details). Do not include the costs of consultants, personnel costs of delegate agencies, or of specific project(s) and/or businesses to be financed by the applicant. Contractors and consultants should not be placed under this category.

Position Title and

Full Name

Percent Time

Annual Salary

Federally-funded Salary

Non-federal Salary

Total Project Salary

Project Director, John K. Doe

50% $100,000 $50,000 $0 $50,000

Data Assistant, Susan R.

Smith

10% $30,000 $3,000 $3,000

c. Fringe Benefits Description

Costs of employee fringe benefits unless treated as part of an approved indirect cost rate.

d. Fringe Benefits Justification Provide a breakdown of the amounts and percentages that comprise fringe benefit costs such as health insurance, Federal Insurance Contributions Act (FICA) taxes, retirement insurance, and taxes.

e. Travel Description Costs of travel by staff of the applicant organization only. Do not include travel costs for subrecipients or contractors under this object class.

f. Travel Justification For each trip proposed for applicant organization staff only, show the date of the proposed travel, total number of traveler(s); travel destination; duration of trip; per diem; mileage allowances, if privately owned vehicles will be used; and other transportation costs and subsistence allowances. Do not include travel costs for subrecipients or contractors under this object class.

g. Equipment Description Equipment means tangible personal property (including information technology systems) having a useful life of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established by the non- Federal entity for financial statement purposes, or $5,000. (Acquisition cost means the cost of the asset including the cost to ready the asset for its intended use.

Acquisition cost for equipment, for example, means the net invoice price of the equipment, including the cost of any modifications, attachments, accessories, or auxiliary apparatus necessary to make it usable for the purpose for which it is acquired. Acquisition costs for software includes those development costs capitalized in accordance with generally accepted accounting principles (GAAP). Ancillary charges, such as taxes, duty, protective in transit insurance, freight, and installation may be included in or excluded from the acquisition cost in accordance with the non- Federal entity’s regular accounting practices.) See 45 C.F.R. § 75.2 for additional information.

h. Equipment Justification For each type of equipment requested you must provide a description of the equipment; the cost per unit; the number of units; the total cost; and a plan for use of the equipment in the project; as well as a plan for the use, and/or disposal of, the equipment after the project ends. An applicant organization that uses its own definition for equipment should provide a copy of its policy, or section of its policy, that includes the equipment definition; include this with your Budget Narrative file.

Reference the policy in this justification and include the policy copy in your Budget Narrative file (not your appendices).

i. Supplies Description

Costs of all tangible personal property other than those included under the Equipment category. This includes office and other consumable supplies with a per-unit cost of less than $5,000.

j. Supplies Justification Specify general categories of supplies and their costs. Show computations and provide other information that supports the amount requested.

k. Contractual Description

Costs of all contracts or subawards for services and goods except for those that belong under other categories such as equipment, supplies, construction, etc. Include third-party evaluation contracts, if applicable, and contracts or subawards with subrecipient organizations (with budget detail), including delegate agencies and specific project(s) and/or businesses to be financed by the applicant. This line item is not for individual consultants.

l. Contractual Justification

Demonstrate that all procurement transactions will be conducted in a manner to provide, to the maximum extent practical, open, and free competition. Recipients and subrecipients are required to use 45 C.F.R. § 75.329 procedures and must justify any anticipated procurement action that is expected to be awarded without competition and exceeds the simplified acquisition threshold fixed by 41 U.S.C. § 134 and currently set at $250,000. Recipients may be required to make pre-award review and procurement documents, such as requests for proposals or invitations for bids, independent cost estimates, etc., available to HHS/OASH.

Whenever you intend to transfer a substantive part of the project effort to another entity (including non-employee individuals), you must provide a detailed budget and budget narrative for each subrecipient/contractor, by title/name, along with the same supporting information referred to in these instructions. If you plan to select the subrecipients/contractors post-award and a detailed budget is not available at the time of application, you must provide information on the nature of the work to be transferred, the estimated costs, and the process for selecting the subrecipient/contractor.

m. Other Description

Enter the total of all other costs. Such costs, where applicable and appropriate, may include but are not limited to: consultants; insurance; professional services (including audit charges); space and equipment rent; printing and publication; training, such as tuition and stipends; participant support costs including incentives, staff development costs; and any other costs not addressed elsewhere in the budget.

n. Other Justification

Provide computations, a narrative description, and a justification for each cost under this category.

o. Indirect Costs Description

Total amount of indirect costs. This category has one of two methods that you may select. You may only select one and must clearly identify that selection in your submitted budget.

Your organization currently has an indirect cost rate approved by the Department of Health and Human Services (HHS) or another cognizant federal agency. You should enclose a copy of the current approved rate agreement in your Budget Narrative file. If you request a rate that is less than allowed, your authorized representative must submit a signed acknowledgement that the organization is accepting a lower rate than allowed.

Per 45 C.F.R. § 75.414 (f) Indirect (F&A) costs, “any non-Federal entity [i.e., applicant] that has never received a negotiated indirect cost rate, … may elect to charge a de minimis rate of 10% of modified total direct costs (MTDC) which may be used indefinitely. As described in § 75.403, costs must be consistently charged as either indirect or direct costs, but may not be double charged or inconsistently charged as both. If chosen, this methodology once elected must be used consistently for all Federal awards until such time as a non-Federal entity chooses to negotiate for a rate, which the non-Federal entity may apply to do at any time.”

The de minimis rate method only applies if you have never received an approved negotiated indirect cost rate from HHS or another cognizant federal agency. If you are waiting for approval of an indirect cost rate, you may request the 10% de minimis rate. If you choose this method, costs included in the indirect cost pool must not be charged as direct costs to the award.

Indirect costs on Federal awards for training are limited to a fixed rate of eight percent of MTDC exclusive of tuition and related fees, direct expenditures for equipment, and subawards in excess of $25,000 (45 C.F.R. § 75.414 (c)(1)(i)).

p. Indirect Costs Justification

Provide the calculation for your indirect costs total, i.e., show each line item included in the base, the total of these lines, and the application of the indirect rate.