oppHRSA-18-115-cfda93.504-cidHRSA-18-115-instructions.pdf

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Maternal and Child Health Bureau Division of Services for Children with Special Health Needs

Expansion of the Family-to-Family Health Information Centers

Funding Opportunity Number: HRSA-18-115

Funding Opportunity Type: New Catalog of Federal Domestic Assistance (CFDA) Number: 93.504

NOTICE OF FUNDING OPPORTUNITY

Fiscal Year 2018

Application Due Date: July 19, 2018

Ensure your SAM.gov and Grants.gov registrations and passwords are current immediately!

HRSA will not approve deadline extensions for lack of registration.

Registration in all systems, including SAM.gov and Grants.gov, may take up to 1 month to complete.

Issuance Date: May 21, 2018

LaQuanta Smalley, MPH, BSN, RN Public Health Analyst, Division of Services for Children with Special Health Needs Telephone: (301) 443-2372 Fax: (301) 443-2960 Email: LSmalley@hrsa.gov

Authority: Social Security Act, Title V, § 501(c) (42 U.S.C. § 701(c)), as amended by § 216 of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act of 2015 (P.L. 114-10), and § 50501 of the Bipartisan Budget Act of 2018 (P.L. 115-123).

mailto:LSmalley@hrsa.gov

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EXECUTIVE SUMMARY

The Health Resources and Services Administration (HRSA) is accepting applications for fiscal year (FY) 2018 for the Expansion of the Family-to-Family Health Information Centers (F2F HIC) Program. The purpose of this program is to provide information, education, technical assistance, and peer support to families of children and youth with special health care needs and the professionals who serve them. This program will fund one F2F HIC in each of the following five United States (U.S.) Territories - American Samoa, Guam, Puerto Rico, the Northern Mariana Islands and the U.S. Virgin Islands;

and up to three F2F HICs to serve American Indians/Alaska Natives.1

Funding Opportunity Title: Expansion of the Family-to-Family Health

Information Centers Funding Opportunity Number: HRSA-18-115 Due Date for Applications: July 19, 2018 Anticipated Total Annual Available FY 2018 Funding:

Up to $774,000

Estimated Number and Type of Awards: Up to eight grants Estimated Award Amount: Up to $96,750 per year dependent on the availability of appropriated funds Cost Sharing/Match Required: No Period of Performance: September 28, 2018 through

May 31, 2022 (Up to 3 years and 8 months)

1 Section 50501 of the Bipartisan Budget Act of 2018 (P.L. 115-123) provides authority and funding to develop Family-to-Family Health Information Centers in the U.S. Territories and to serve Indian tribes.

The term “Indian tribe” is defined in this statute as having the same meaning as in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603), which defines the term “Indian Tribe” as ”any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or group or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (85 Stat. 688), which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.” Accordingly, this NOFO will also refer to individuals of this population as American Indian and/or Alaska Native, as appropriate.

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Eligible Applicants: Eligible applicants for the Expansion of the Family-to-Family Health Information Centers program include any domestic public or private entity. Domestic faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply.

Eligibility for this funding opportunity is limited to applicants within the five United States Territories (American Samoa, Guam, Puerto Rico, the Northern Mariana Islands and the U.S.

Virgin Islands) and entities that will serve American Indian and/or Alaska Native tribes.

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

Application Guide

You (the applicant organization/agency) are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide, available online at http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf, except where instructed in this NOFO to do otherwise. A short video explaining the Application Guide is available at http://www.hrsa.gov/grants/apply/applicationguide/.

Technical Assistance

HRSA has scheduled the following technical assistance webinar:

Webinar

Day and Date: Tuesday, June 19, 2018 Time: 3 – 4 p.m. ET Call-In Number: 866-662-1955 Participant Code: 9336249 Web link: https://hrsa.connectsolutions.com/f2f_hic/

Playback information will be available at https://mchb.hrsa.gov/fundingopportunities/default.aspx http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/ https://hrsa.connectsolutions.com/f2f_hic/

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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/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. Program-Specific Forms

vi. Attachments

3. DUN AND BRADSTREET DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBER AND

SYSTEM FOR AWARD MANAGEMENT

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 AND OTHER PRE-AWARD ACTIVITIES

4. ANTICIPATED ANNOUNCEMENT AND AWARD DATES

VI. AWARD ADMINISTRATION INFORMATION

1. AWARD NOTICES

2. ADMINISTRATIVE AND NATIONAL POLICY REQUIREMENTS

3. REPORTING

VII. AGENCY CONTACTS

VIII. OTHER INFORMATION

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I. Program Funding Opportunity Description

1. Purpose

This notice solicits applications for the Expansion of the Family-to-Family Health Information Centers (F2F HICs) Program in U.S. Territories and for American Indians/Alaska Natives. The purpose of this program is to provide information, education, technical assistance, and peer support to families of children and youth with special health care needs (CYSHCN) and the professionals who serve them. This program will fund one F2F HIC in each of the following five U.S. Territories - American Samoa, Guam, Puerto Rico, the Northern Mariana Islands and the U.S. Virgin Islands;

and up to three F2F HICs to serve American Indians/Alaska Natives.

Program Goal The goal of the Expansion of the F2F HICs Program is to promote optimal health for CYSHCN by helping families and health professionals to partner in health care decision-making and facilitating access to cost-effective, quality health care.

Program Objectives:

The recipients will be responsible for collecting data on these objectives for the purposes of monitoring and evaluating the overall effectiveness of the program.

Baselines should be established for these measures within the first year of the award.

• By 2022, increase by 5 percent from baseline the number of families of CYSHCN and professionals who have received information, education, and/or training from F2F HICs.

• By 2022, increase by 5 percent from baseline the number of CYSHCN and families, particularly families from underrepresented and diverse communities, trained to partner at all levels of shared decision-making.

• By 2022, increase by 10 percent from baseline the number and type of territory/tribal/state agencies/programs and community-based organizations assisted in providing services/information to families of CYSHCN.

Program Requirements The F2F HICs are required to:

• Assist families of CYSHCN in making informed choices about health care in order to promote good treatment decisions, cost effectiveness and improved health outcomes;

• Provide information regarding the health care needs of, and resources available to, CYSHCN;

• Identify successful health care delivery models for CYSHCN;

• Develop, with representatives of health care providers, managed care organizations, health care purchasers, and appropriate territory/tribal/state

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agencies, a model for collaboration between families of CYSHCN and health professionals;

• Provide training and guidance regarding the care of CYSHCN;

• Conduct outreach activities to families of CYSHCN, health professionals, schools and other appropriate entities and individuals; and

• Staff centers with families of CYSHCN who have expertise in federal and territory/tribal/state public and private health care systems, and with health professionals.

In addition to the seven required activities listed above, the F2F HICs are expected to:

• Use evidence-based practices related to family-centered care to:

o Provide one-to-one, family-to-family, and peer-to-peer support;

o Help families navigate health care systems;

o Link families to resources and information;

o Connect families to other families for information and peer support;

o Provide outreach and training to families, particularly those from underrepresented and diverse communities, to learn how to partner with professionals, identify needs and strategies to obtain supports, and share decision-making at the individual and systems level;

o Train professionals to work with families with CYSHCN; and o Offer strategies/training to families to assume ongoing leadership and advisory roles in systems that serve CYSHCN.

• Develop partnerships with organizations serving CYSHCN and their families, especially in activities addressing disparities and emerging health trends.

Partnerships should include, but not be limited to: HRSA-funded state/territory Maternal and Child Health (MCH) Title V programs and other state/territory/tribal agencies and/or programs; other programs serving children such as early education and early intervention initiatives; primary care organizations; parent/family-led organizations; patient navigator programs; federal agencies, such as the Centers for Disease Control and Prevention (CDC), the Indian Health Service, Substance Abuse and Mental Health Services Administration; and other HRSA programs/award recipients. (To search for HRSA-funded programs in your community, visit https://datawarehouse.hrsa.gov/tools/findgrants.aspx)

• Use and promote evidence-based/informed practices that reflect cultural and linguistic competencies such as:

o Ensuring policies are in place to support culturally and linguistically competent practices;

o Demonstrating evidence of appropriate language access that has current, accurate and culturally/linguistically appropriate information and education for families, accounting for their health literacy levels; and o Engaging with cultural brokers and/or community health workers.

• Develop resources such as brochures, frequently asked questions and answers, webinars, web-based resources, or other resources for families and providers https://datawarehouse.hrsa.gov/tools/findgrants.aspx

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regarding the health care needs of CYSHCN and resources available in their territory/region/state.

• Identify and track changes in health care delivery including changes in territory/tribal/state law that impact families.

• Integrate the following Family/Professional Partnership Program principles throughout project policies and activities: (1) family-centered care, (2) cultural and linguistic competence, and (3) shared decision-making between families of CYSHCN, health professionals and appropriate territory/tribal/state and community organizations.

• Demonstrate and promote family leadership and connection to the territory/tribal/state systems of care for CYSHCN, through such activities as membership or involvement on territory/tribal-wide/state advisory councils, partnerships with entities such as departments of public health, education, social services, or housing.

• Collect, monitor, analyze, and report on data to: (1) measure the number and types of families served (e.g., race, ethnicity, language); (2) measure how effective F2F HICs have been in providing information, mentoring, and training to families and providers in engaging families of CYSHCN as they make informed health care decisions; and

(3) inform program development and service delivery.

Additional Program Information HRSA expects you to identify and apply to serve as an F2F HIC for one of two target areas: (1) a specific U.S. Territory - American Samoa, Guam, Puerto Rico, the Northern Mariana Islands or the U.S. Virgin Islands; or (2) American Indians/Alaska Natives .

You can only apply to one of the aforementioned areas. HRSA will make one award in each of the five U.S. Territories and up to three awards to serve American Indians/Alaska Natives.

You are expected to demonstrate and use a strengths-based approach that focuses on the strengths of the CYSHCN and families served.2 Also, it is expected that you will have personnel on staff who are capable of engaging directly with families of the population(s) to be served.

You may use until June 1, 2019, of the grant period to complete a planning process period that can be used to formalize stakeholder engagement and/or develop a data collection and implementation plan. If you choose to include a planning process period in your application, you will be expected to describe the planning activities and how the activities will enhance the ability to fully implement the program. You are expected to demonstrate that you can begin to fully implement the required activities no later than June 1, 2019.

If you wish to implement a planning process period, HRSA expects that the planning process period will include successful completion of the following activities:

2 King, S., Teplicky, R., King, G., & Rosenbaum, P. (2004). Family-Centered Service for Children With Cerebral Palsy and Their Families: A Review of the Literature. Seminars in Pediatric Neurology; 11(1):

78-86.

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• Securing formal documentation of engagement from diverse stakeholders who will participate in the implementation of this program, including letters of commitment and Memoranda of Understanding/Agreement

• Developing an implementation plan, including formalizing capacity to work with families of CYSHCN, identifying community resources, and developing dissemination/communication plans and training plans for families and health care providers

• Developing a data collection plan, including identifying baseline numbers of CYSHCN to be served and determining how data will be collected and analyzed

Target Area 1: U.S. Territories You are expected to identify which Territory you will serve. You are expected to be located and able to work directly in the Territory to which you are applying. You are expected to include a description of the specific issues regarding successful service delivery for CYSHCN in the Territory.

Target Area 2: American Indians/Alaska Natives Up to three (3) F2F HICs will be developed to serve the specific needs of American Indians/Alaska Natives.

You are expected to clearly describe the geographic area and the tribe(s) to be served.

To the extent possible, awards will be made so as not to duplicate coverage of an area or populations served by another tribal F2F HIC. You should describe how you will interact with the state F2F(s) that serve that area, so as not to duplicate services.

It is expected that you will clearly demonstrate knowledge of working with tribes and existing professional working relationships with the tribe(s) with whom you intend to work with. It is expected that you will also demonstrate knowledge and understanding of tribal leadership and governance systems. It is expected that you will demonstrate existing professional/working relationships with the American Indian/Alaska Native tribe(s) you seek to work with and you will provide documentation of these relationships.

In addition, it is preferred that the staffing plan include representation from both the community and the Tribal Chairman/Governor’s office.

2. Background

This program is authorized by the Social Security Act, Title V, §501(c) (42 U.S.C. § 701(c)), as amended by § 216 of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act of 2015 (P.L. 114-10), and §50501 of the Bipartisan Budget Act of 2018 (P.L. 115-123).

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Among U.S. children 0 -17 years of age, 14.2 million children have a special health care need.3 CYSHCN are those that have, or are at risk of having, a chronic physical, developmental, behavioral, or emotional condition and who require health and related services of a type or amount beyond that required by children generally.4 Studies demonstrate that engaging families as equal partners in their child’s health care decision-making reduces unmet health needs, problems with specialty referrals, out-of-pocket expenses and improves patient physical and behavioral function.5 Family engagement is defined as “patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system to improve health and health care.”6

Due to the growing numbers of CYSHCN and the complexity of their health care needs, CYSHCN may require a variety of services from multiple, diverse systems and often must access a number of different funding sources to pay for those services. A major challenge for families is accessing services in a system of care, which is often fragmented, that will adequately address their children’s needs.7 In many cases, there is a lack of available specialty services, and those that are available may not be coordinated with primary care or other community-based services. In addition, coverage for services may not be comprehensive. To meet all of the needs of their children, families of CYSHCN require an in-depth understanding of the health care system and options for health care. Unfortunately, there often is no clear, family-friendly, easily accessible, and objective source for this information. For many parents/families, the best sources of information are their peers – other families of CYSHCN whose extensive experiences with navigating the health care system can provide them with a wealth of relevant information and knowledge.

In order to help address the challenges for families in accessing care, the F2F HICs Program was developed to fill the gaps in information and support for families of CYSHCN and the providers who care for them. Originally funded through a Special Projects of Regional and National Significance (SPRANS) pilot program in 2005, and currently authorized and funded under Section 501(c)(1)(a) of the Social Security Act, the network of F2F HICs is a cornerstone of ongoing family engagement efforts. These centers are staffed by family members who have first-hand experience using health care services and programs for CYSHCN. This experience is used to provide support, patient-centered information, resources, and training to families and professionals around health issues faced by CYSHCN. Since the program’s inception in 2005, the network has grown from 29 to a total of 51 funded F2F HICs (one in each of the 50

3 Child and Adolescent Health Measurement Initiative. Data Resource Center for Child and Adolescent Health. 2016 National Survey of Children’s Health (NSCH) data query. Retrieved [09/19/17] from http://www.childhealthdata.org. CAHMI: http:/www.cahmi.org.

4 McPherson M., Arango P., Fox H. A new definition of children with special health care needs. Pediatrics.

1998; 102: 137-140.

5Smalley et al. (2014). Family perceptions of shared decision-making with health care providers: Results of the National Survey of CSHCN, 2009-2010. doi: 10.1007/s10995-013-1365-z.

6 Carman, K.L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013).

Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223-231.

7Huang, Z. J., Kogan. M.D., Yu, S. M., & Strickland, B. (2005). Delayed or forgone care among children with special health care needs: An analysis of the 2001 National Survey of Children with Special Health Care Needs. Ambulatory Pediatrics, 5, 60-67.

http://www.childhealthdata.org/ http://www.cahmi.org/

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states and the District of Columbia), and the centers have more than quadrupled the number of families served. Data collected from June 1, 2016 to May 31, 2017 revealed that F2F HICs provided outreach and information to 929,444 families and 341,390 professionals and served a total of 184,002 families and 85,556 health professionals through individualized assistance and/or training from an F2F HIC.

F2F HICs have worked with American Indian/Alaska Native populations through outreach activities, trainings, and workshops for tribal organizations. F2F HICs have also worked with U.S. Territories by providing training and support to other HRSA-funded programs.

The F2F HIC program was recently re-authorized and expanded to create centers to address the specific needs of families of CYSHCN in the U.S. Territories of American Samoa, Guam, Puerto Rico, the Northern Mariana Islands and the U.S. Virgin Islands, as well as for American Indian/Alaska Native families of CYSHCN. This program expansion is intended to address the unique circumstances that these families face, including physical barriers (geographic isolation to availability of providers) and cultural approaches regarding provision of health care for CYSHCN.

F2F HICs seek to address health inequities and meet the needs of diverse families of CYSHCN by disseminating culturally competent materials and resources in multiple languages, conducting outreach to culturally diverse communities, partnering with non-profit groups that represent the interest and needs of ethnic and cultural minorities, providing support groups and subcontracting with members of specific communities to coordinate trainings.

F2F HICs fill a critical need for reliable information and support for all families with CYSHCN. Additionally, they serve as an important complement to, and resource for, other HRSA-funded programs that support direct health care service delivery or system infrastructure, such as HRSA-funded MCH Title V, and other programs that serve families with condition-specific health care needs.

For additional information about existing centers, please visit http://www.fv-ncfpp.org/f2fhic/find-a-f2f-hic/.

II. Award Information

1. Type of Application and Award

Types of applications sought: New.

HRSA will provide funding in the form of a grant.

2. Summary of Funding

HRSA expects approximately $774,000 to be available annually to fund up to eight recipients. You may apply for a ceiling amount of up to $96,750 total cost (includes both direct and indirect, facilities and administrative costs) per year. The period of http://www.fv-ncfpp.org/f2fhic/find-a-f2f-hic/ http://www.fv-ncfpp.org/f2fhic/find-a-f2f-hic/

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performance is September 28, 2018 through May 31, 2022 (3 years and 8 months).

Funding beyond the first year is dependent on the availability of appropriated funds for the Expansion of the F2F HICs Program in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

The awards to serve American Indians/Alaska Natives will reflect a consideration of geographic distribution in order to prevent duplication of service areas.

All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles and Audit Requirements at 45 CFR part 75.

III. Eligibility Information

1. Eligible Applicants

Eligible applicants for the Expansion of the F2F HICs program include any domestic public or private entity. Domestic faith-based and community-based organizations, tribes, and tribal organizations are eligible to apply. Eligibility for this funding opportunity is limited to applicants within the five U.S. Territories (American Samoa, Guam, Puerto Rico, the Northern Mariana Islands and the U.S. Virgin Islands) and entities that will serve American Indian and/or Alaska Native tribes.

2. Cost Sharing/Matching

Cost sharing/matching is not required for this program.

3. Other

HRSA will consider any application that exceeds the ceiling amount non-responsive and will not consider it for funding under this notice.

HRSA will consider any application that fails to satisfy the deadline requirements referenced in Section IV.4 non-responsive and will not consider it for funding under this notice.

NOTE: Multiple applications from an organization are not allowable. You can only apply to one of the aforementioned target areas: (1) U.S. Territories or (2) American Indians/Alaska Natives. The application must clearly identify the target area.

If for any reason (including submitting to the wrong funding opportunity number or making corrections/updates) an application is submitted more than once prior to the application due date, HRSA will only accept your last validated electronic submission, under the correct funding opportunity number, prior to the Grants.gov application due date as the final and only acceptable application.

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=4d52364ec83fab994c665943dadf9cf7&ty=HTML&h=L&r=PART&n=pt45.1.75

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IV. Application and Submission Information

1. Address to Request Application Package

HRSA requires you to apply electronically. HRSA encourages you to apply through Grants.gov using the SF-424 workspace application package associated with this NOFO following the directions provided at http://www.grants.gov/applicants/apply-for-grants.html.

HRSA recommends that you supply an email address to Grants.gov on the grant opportunity synopsis page when accessing this notice of funding opportunity (NOFO) (also known as “Instructions” on Grants.gov) or workspace application package. This allows Grants.gov to email organizations in the event HRSA changes and/or republishes the NOFO on Grants.gov before its closing date. Responding to an earlier version of a modified notice may result in a less competitive or ineligible application.

Please note you are ultimately responsible for reviewing the For Applicants page for all information relevant to desired opportunities.

2. Content and Form of Application Submission

Section 4 of HRSA’s SF-424 Application Guide provides instructions for the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract. You must submit the information outlined in the Application Guide in addition to the program-specific information below. You are responsible for reading and complying with the instructions included in HRSA’s SF-424 Application Guide except where instructed in the NOFO to do otherwise. You must submit the application in the English language and in the terms of U.S. dollars (45 CFR § 75.111(a)).

See Section 8.5 of the Application Guide for the Application Completeness Checklist.

Application Page Limit The total size of all uploaded files may not exceed the equivalent of 80 pages when printed by HRSA. The page limit includes the abstract, project and budget narratives, attachments, and letters of commitment and support required in the Application Guide and this NOFO. Standard OMB-approved forms that are included in the workspace application package do not count in the page limit. Indirect Cost Rate Agreement and proof of non-profit status (if applicable) do not count in the page limit. We strongly urge you to take appropriate measures to ensure your application does not exceed the specified page limit.

Applications must be complete, within the specified page limit, and validated by Grants.gov under the correct funding opportunity number prior to the deadline to be considered under this notice.

Debarment, Suspension, Ineligibility, and Voluntary Exclusion Certification

1) The prospective recipient certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, https://www.grants.gov/ http://www.grants.gov/applicants/apply-for-grants.html http://www.grants.gov/applicants/apply-for-grants.html https://www.grants.gov/web/grants/applicants.html

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declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

2) Failure to make required disclosures can result in any of the remedies described in 45 CFR § 75.371, including suspension or debarment. (See also 2 CFR parts 180 and 376, and 31 U.S.C. 3321).

3) Where the prospective recipient is unable to attest to the statements in this certification, an explanation shall be included in Attachments 9-15: Other Relevant Documents.

See Section 4.1 viii of HRSA’s SF-424 Application Guide for additional information on all certifications.

Program-Specific Instructions In addition to application requirements and instructions in Section 4 of HRSA’s SF-424 Application Guide (including the budget, budget narrative, staffing plan and personnel requirements, assurances, certifications, and abstract), include the following:

i. Project Abstract See Section 4.1.ix of HRSA’s SF-424 Application Guide.

ii. Project Narrative This section provides a comprehensive framework and description of all aspects of the proposed project. It should be succinct, self-explanatory and well organized so that reviewers can understand the proposed project.

Successful applications will contain the information below. Please use the following section headers for the narrative:

INTRODUCTION -- Corresponds to Section V’s Review Criterion # 1 Need

• This section should briefly describe the purpose and goals of the proposed project including a discussion of CYSHCN and their needs. The application should clearly identify the proposed target area: (1) U.S. Territory or (2) American Indians/Alaska Natives. If you plan to serve American Indians/Alaska Natives, you should clearly describe the geographic area and American Indian/Alaska Native tribes to be served. You should concisely describe the problem, summarize the proposed intervention, and summarize the anticipated benefits of the project to the territory/tribe(s), HRSA, and a national network of F2F HICs. The project should clearly demonstrate that families of CYSHCN are partners in decision-making at all levels of care.

NEEDS ASSESSMENT -- Corresponds to Section V’s Review Criteria #1 Need and #4 Impact

• This section should describe the identified population of families of CYSHCN to be served by the proposed project. The description should include the territory’s/tribe’s Maternal and Child Health (MCH)/CYSHCN community and their partners, socio-cultural determinants of health, health disparities, and document the identified population’s unmet needs related to the program http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf http://www.hrsa.gov/grants/apply/applicationguide/sf424guide.pdf

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purpose. Examples of partners could include territory/tribal/state agencies, other programs serving children and families such as early education and early intervention initiatives, primary care organizations, parent/family led organizations, federal agencies, and HRSA-funded programs. HRSA expects that applications proposing to serve in a Territory will include a description of the specific issues regarding successful service delivery to CYSHCN in the Territory. HRSA expects that applications proposing to serve American Indians/Alaska Natives will demonstrate knowledge and understanding of Tribal leadership and governance systems of the tribe(s) to be served.

• Demographic data, including geographic, economic, racial/ethnic and linguistic data, should be included and cited whenever possible to support the information provided. Data can be both quantitative and qualitative. Relevant data from current/past activities, the National Survey for Children’s Health (NSCH), HRSA-funded MCH Title V Block Grant activities supporting CYSHCN and other sources can be used. Please discuss any relevant contributing factors and barriers in the territory/tribe(s)/state(s) that the project will work to overcome.

Also, discuss any needs of the territory/tribe(s)/state(s) as they relate to health insurance, and improving the health literacy of those who are currently insured.

• Include a description of the process for engaging key stakeholders in the needs assessment process including the CYSHCN program under the HRSA-funded MCH Title V Block Grant, families and members of the identified communities/population group. Other stakeholders could include community and faith-based organizations, Tribal councils/governments, and representatives from underrepresented and diverse communities.

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

In this section, propose methods that will be used to meet each of the project goals and objectives. You should propose methods that address the following:

• Required activities (please refer to page 1 for the full description) related to: 1) assisting families to make informed choices; 2) providing information; 3) identifying successful health care delivery models; 4) developing models for collaborations; 5) providing training and guidance; 6) conducting outreach activities; and 6) staffing by families and health professionals.

• Additional activities (please refer to pages 2-3 for the full description) addressing the following: 1) evidence-based practices; 2) partnerships; 3) cultural and linguistic competency; 4) development of resources; 5) identification of changes in health care delivery that impact families; 6) integration of Family/Professional Partnership program values; 7) demonstration of family leadership; and 8) collection, monitoring, analysis and reporting on data, including program objectives as outlined on page 1.

• If you wish to implement a planning period, you should describe how the proposed activities will enhance the ability of your organization to fully implement

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the program. HRSA expects that the planning period will consist of the following activities:

o Securing formal documentation of engagement from diverse stakeholders to implement this program including letters of commitment and Memoranda of Understanding/Agreement o Developing an implementation plan, including formalizing capacity to work with families of CYSHCN, identifying community resources, and/or developing dissemination/communication plans and training plans for families and health care providers o Developing a data collection plan, including identifying baseline numbers of CYSHCN served and determining how data will be collected and analyzed

In addition, you should address how you will achieve the following in your response:

• Identifying meaningful support and collaboration with key stakeholders in planning, designing, and implementing all activities including development of the proposal, including the extent to which these contributors reflect the cultural, racial/ethnic, linguistic, and geographic diversity of the populations and communities served. HRSA expects that applications for Target Area 2 (American Indians/Alaska Natives) will demonstrate existing professional/working relationships with the American Indian/Alaska Native tribe(s) you plan to work with, and applications will include documentation of these relationships. HRSA expects that for Target Area 2 (American Indians/Alaska Natives), you will demonstrate how your organization will collaborate with the F2F HIC(s) that also serve in your identified geographic area.

• Implementing activities that have a focus on overall health for CYSHCN (as defined by HRSA).8 For example, if you are a family organization with a history of funding that is condition-specific or related to the education, mental health or developmental disabilities sectors, evidence of activities that address health for the broad CYSHCN population should be included in their application. Likewise, if you plan to represent a primary medical focus, you should provide information about how families with questions in other sectors, for example, mental health or educational, will be served or referred to appropriate services.

• Implementing activities that demonstrate and use a strengths-based approach that focuses on the strengths of the CYSHCN and the families served.

• Implementing a plan for promoting the F2F HIC as a resource to serve families in the Territory/Tribe(s). You could address this activity through partnerships with health clinics, mental and behavioral health groups, providers, community groups, and others.

• Implementing a plan for project sustainability after the period of federal funding ends. HRSA expects the recipient to sustain key elements of the project, e.g., strategies or services and interventions, which have been effective in improving

8McPherson, M., Arango, P., Fox, H., Lauver, C., McManus, M., Newacheck, P. W., et al. (1998). A new definition of children with special health care needs. Pediatrics, 102(1 pt 1), 137-140.

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practices and those that have led to improved outcomes for the identified population.

• Designing activities to achieve results that will have territory/tribal and/or national level impact and/or are replicable in other settings.

• Implementing a plan to ensure that project results will be effectively disseminated to key stakeholder audiences including HRSA-funded MCH Title V, families, providers, policy makers, other federal programs, and members of the identified communities/population groups.

WORK PLAN -- Corresponds to Section V’s Review Criteria #2 Response, #3 Evaluative Measures, and #4 Impact

Describe the activities or steps you will use to achieve each of the core activities proposed in the methodology. Clearly link the proposed activities to the project goals and objectives. The application should show compelling evidence that such plans are supported and can be accomplished and sustained throughout the proposed period of performance.

• Clearly describe an approach that is specific, measurable, attainable, realistic, and time-bound (SMART). Use a time line, time allocation table, graph, or chart that includes each activity and identifies responsible staff and partners, proposed outcome, intended impact, and how you will measure the activity’s outcome and impact.

• Provide evidence of partnerships by including a letter of commitment (LOC) or memorandum of understanding/agreement (MOU/MOA) between your organization and partnering organizations. LOCs or MOU/MOAs must be included as part of Attachment 4 of the application.

o HRSA expects applications for Target Area 2 (American Indians/Alaska Natives) will include an LOC, MOU or MOA with the Tribal council/government for the American Indian/Alaska Native tribe(s) you plan to serve and/or documentation of working relationships with the American Indian/Alaska Native tribe(s) you plan to serve.

o HRSA expects applications for Target Area 2 (American Indians/Alaska Natives) will describe relationships to existing F2F HICs in the state(s) that fall within the project’s identified geographical area.

• Report on the number of partnerships and demonstrate partner involvement in activities via the project work plan. Examples of partners include, but need not be limited to the following: HRSA-funded MCH Title V programs and other territory/tribal/state agencies/programs; child-focused programs, primary care organizations; parent/family-led organizations; patient navigator programs;

federal agencies; and HRSA programs/award recipients.

• Provide a logic model within Attachment 1 of the application. Refer to Section VIII (Other Information) of this NOFO for information on developing a logic model.

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Applications lacking a complete and well-conceived evaluation protocol or plan to develop the evaluation protocol may not be funded.

RESOLUTION OF CHALLENGES -- Corresponds to Section V’s Review Criterion #2 Response

• Discuss challenges that you are likely to encounter in designing and implementing the activities described in the work plan, and approaches that you will use to resolve such challenges.

EVALUATION AND TECHNICAL SUPPORT CAPACITY -- Corresponds to Section V’s Review Criterion #3 Evaluative Measures

Describe the activities or steps you will take to implement the evaluation activities by the end of the period of performance.

• Project-level evaluation methodology should be specific and related to the stated goals, objectives, and priorities of the project. The evaluation plan should include mechanisms to determine if families felt the services provided them the information, skills and support about health care and the health care system to make informed choices about health care that promote good treatment decisions, cost effectiveness and improved health outcomes, and to better find and access community services.

• You should propose a plan to collect, analyze, and report on information that measures how F2F HICs disseminate information, mentor, and train families and professionals to enable families of CYSHCN to make informed health care decisions or, if you have a planning process period in your application, discuss how you will develop the plan to collect, analyze, and report on information that measures how F2F HICs disseminate information, mentor and train families and professionals to enable families of CYSHCN to make informed health care decisions. This information should be collected by conducting follow-up with the families and professionals served through the project. All funded F2F HICs will report this data to HRSA or the National Center for Family/Professional Partnerships to be aggregated periodically throughout the year. Data should include:

o The number of families who have been provided:

Information via direct one-on-one contact through an in person contact or by telephone (unduplicated number - only including initial and not repeat contacts);

Educational material via listservs, conferences, printed materials, newsletters, or other mechanisms; and

Training via presentations during conference sessions, workshops and other activities.

o The increase in the number of families with CYSHCN who partner in decision making as a result of services/mentoring/training/education from the F2F HICs. Data should be captured both on the individual level (e.g., families receiving one-to-one assistance to partner in decisions related to their child) and the systems level (e.g., families who partner in

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decision making with both local and territory/tribal/state service systems such as HRSA-funded MCH Title V, the Indian Health Service, and Medicaid).

o Models of successful service delivery for CYSHCN.

o The types of information on activities related to outreach and education to help families navigate health care systems (including mental and behavioral health systems) and promote health literacy.

• Applications should clearly present an evaluation plan that contains:

(1) strategies to identify/use appropriate data sources and collect and analyze data that will measure outcomes/impact of the project; (2) strategies to collect, analyze, and track data to measure outcomes/impact as it relates to different socio-cultural groups (e.g., race, ethnicity, language); (3) mechanisms to monitor and evaluate the efficiency of the proposed project activities/process; and (4) an explanation of how the data will be used to inform and improve the quality of program development and service delivery. Describe any data collection tools to be used (e.g., surveys, database) and key elements of those tools that will be used in the evaluation strategy.

• You should describe the data collection and calculation methods to meet the objectives of the program, specifically:

o By 2022, increase by 5 percent from baseline the number of families of CYSHCN and professionals who have received information, education, and/or training from F2F HICs.

o By 2022, increase by 5 percent from baseline the number of CYSHCN and families, particularly families from underrepresented and diverse communities, trained to partner at all levels of shared decision-making.

o By 2022, increase by 10 percent from baseline the number and type of territory/tribal/state agencies/programs and community-based organizations assisted in providing services/information to families of

CYSHCN.

ORGANIZATIONAL INFORMATION -- Corresponds to Section V’s Review Criterion # 5 Resources/Capabilities

• Provide information on your organization’s current mission and structure; fiscal, administrative, and managerial viability; and scope of current activities.

• Describe the organization’s proven and successful leadership role in activities undertaken related to the functions of F2F HICs and proposed activities.

• Provide information that demonstrates how the program meets the requirement of being a family (of CYSHCN) staffed organization. If your organization is a university or other type of organization, family staff must have equal decision-making authority for the F2F HICs project and a memorandum of understanding/agreement between the your organization and the staff must be included in Attachment 4 of the application. Describe how these all contribute to the ability of your organization to conduct the program requirements and meet program expectations.

o HRSA expects that applications will have personnel, in the staffing plan, HRSA-18-115 15 who are capable of engaging directly with families of the population(s) to be served.

o HRSA prefers applications for Target Area 2 (American Indians/Alaska Natives) to include representation from both the community and the Tribal Chairman/Governor’s office.

• Provide an organizational chart (a one-page figure that depicts the organizational structure of the project, including subcontractors and other significant collaborators) and include it as Attachment 5 of the application.

• Describe the staffing plan, which includes current experience, expertise, skills, and knowledge of staff, contractors, and partners; data collection capabilities;

and previous work and materials. Include a description of the existing available resources (staff, funds, related projects, in-kind contributions) and supports available at the community, territory/tribal/state, regional and/or national levels to support/carry out your project.

• Provide information on the organization’s resources and capabilities to support provision of culturally and linguistically competent health literacy services proposed for the project. Any relevant contracts must specify tasks, activities, duties, and timelines.

• Describe the organization’s capacity to manage federal funds. You must demonstrate existing and effective fiscal, administrative and management systems.

• Include a staffing plan and job descriptions for key faculty/staff in Attachment 2 (Staffing Plan and Job Descriptions). Biographical sketches must be included in Attachment 3, and, at minimum, contain the following elements: (1) related employment history with a summary of job responsibilities and (2) educational background. Biographical sketches must also contain information regarding the faculty/staff personal experience with CYSHCN, if applicable.

• Address how the proposal builds upon your organization’s previous accomplishments and reflects documented success in working collaboratively with families, territory/tribal/state and community programs and health agencies for CYSHCN, including existing F2F HICs, HRSA-funded MCH Title V and other relevant organizations.

NARRATIVE GUIDANCE

To ensure that you fully address the review criteria, this table provides a crosswalk between the narrative language and where each section falls within the review criteria.

Narrative Section Review Criteria Introduction (1) Need

Needs Assessment (1) Need and (4) Impact

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Methodology (2) Response and (4) Impact

Work Plan (2) Response, (3) Evaluative Measures, and

(4) Impact

Resolution of Challenges (2) Response

Evaluation and Technical Support Capacity

(3) Evaluative Measures

Organizational Information (5) Resources/Capabilities

Budget and Budget Narrative (below)

(6) Support Requested – the budget section should include sufficient justification to allow reviewers to determine the reasonableness of the support requested.

iii. Budget

See Section 4.1.iv of HRSA’s SF-424 Application Guide. Please note: the directions offered in the SF-424 Application Guide may differ from those offered by Grants.gov.

Follow the instructions included in the Application Guide and the additional budget instructions provided below. A budget that follows the Application Guide will ensure that, if HRSA selects the application for funding, you will have a well-organized plan, and by carefully following the approved plan can avoid audit issues during the implementation phase.

Reminder: The Total Project or Program Costs are the total allowable costs (inclusive of direct and indirect costs) incurred by the recipient to carry out a HRSA-supported project or activity. Total project or program costs include costs charged to the award and costs borne by the recipient to satisfy a matching or cost-sharing requirement, as applicable.

iv. Budget Narrative See Section 4.1.v. of HRSA’s SF-424 Application Guide.

In addition, the Expansion of the F2F HICs program requires the following:

• Award-related Meetings: You should include sufficient funding to support one (1) F2F HIC staff to attend an annual technical assistance meeting and participation in monthly/quarterly conference calls.

FOR PACIFIC ISLAND TERRITORIES ONLY: This is a program requirement that can be further negotiated with HRSA after an award is made.

• Access Accommodations: You should include the cost of access accommodations as part of your project’s budget. This includes sign language interpreters; plain language and health literate print materials in alternate formats (including…