WH-AST-26-003 NAVIGATE.pdf

General

U.S. Department of Health and Human Services

Office on Women’s Health

Notice of Funding Opportunity NAVIGATE Reproductive Center of Excellence (Network for Assessment, Validation, Innovation, Guidance, Access, Treatment and Evaluation)

Opportunity Number

WH-AST-26-003

Application Due Date July 24, 2026

Technical Assistance Webinar Date June 29, 2026

Table of Contents

SUMMARY

A. ELIGIBILITY INFORMATION

1. Eligible Applicants

2. Application Responsiveness Criteria

3. Cost Sharing or Matching

B. PROGRAM DESCRIPTION

1. Expectations for Recipients

2. Federal Involvement in the Project

3. Eligibility criteria for project participants

4. Required Alignment with OASH Mission and Agency Priorities

C. AWARD INFORMATION

D. APPLICATION CONTENTS AND FORMAT

1.Format of the Application

2. Content

E. SUBMISSION REQUIREMENTS AND DATES

1. Obtaining an Application Package

2. Required Registrations

3. Submission Instructions

4. Other Submission Requirements

F. APPLICATION REVIEW INFORMATION

1. Responsiveness Review

2. Merit Review Criteria Merit Review Scoring Criteria

3. Merit Review and Selection Process

4. Review of Risk Posed by Applicant

G. AWARD NOTICES

H. AWARD REQUIREMENTS AND ADMINISTRATION

1. Administrative and National Policy Requirements

2. Program Specific Terms and Conditions

3. Award Closeout

4. Lobbying Prohibitions

5. Non-Discrimination Requirements

6. Smoke- and Tobacco-free Workplace

7. Acknowledgement of Funding

8. HHS Rights to Materials and Data

9. Trafficking in Persons

10. Efficient Spending

11. Whistleblower Protection

12. Health Information Technology (IT) Interoperability

13. Certain telecommunications and video surveillance services or equipment

14. Human Subjects Protection

15. Research Integrity

16. Reporting

• Describe accomplishments and progress toward project purpose/strategies/ interventions and quantify measurable outcomes as defined in the Work Plan

• Summarize the status of the project’s staffing situation

• Describe the role and activities of each partnering organization

• Describe accomplishments, current or anticipated problems, changes, and progress on the evaluation plan

I. CONTACTS

J. OTHER INFORMATION

1. Application Checklist

2. Acronyms

3. Glossary

4. Object Class Descriptions and Required Justifications

5. Considerations in Recipient Plans for Oversight of Federal Funds

6. Financial Assistance General Certifications and Representations

BASIC INFORMATION

Opportunity Title NAVIGATE Reproductive Center of Excellence (Network for Assessment, Validation, Innovation, Guidance, Access, Treatment and Evaluation)

Program Office Office on Women’s Health Application Submission and Format

Electronic application submitted via Grants.gov ONLY. Opportunity Number

WH-AST-26-003

Award Type Grant

Application Deadline July 24, 2026

Announcement Type Initial

Technical Assistance Webinar Date June 29, 2026

Assistance Listing

93.088 Advancing System

Improvements for Key Issues in Women's Health

Technical Assistance Webinar Details Visit the OWH website at:

https://womenshealth.gov/about-us/work-us/funding-opportunities

Eligible Applicants (see Section A.1 for full details)

Executive Order 12372 does apply to this NOFO (see section E.3.D)

Estimated Total Funding Available $500,000 (with required organizational matching)

Estimated Period of Performance (months) 24 months

• 12-month first budget period

• 12-month second budget period

Optional competitive third year Estimated Number of Awards

Anticipated Award Date September 30, 2026

Anticipated Award Funding Range up to $500,000 (with required organizational matching)

Anticipated Project Start Date September 30, 2026

QUESTIONS?

Additional contact information in Section G https://womenshealth.gov/about-us/work-us/funding-opportunities https://womenshealth.gov/about-us/work-us/funding-opportunities

SUMMARY

The Office of the Assistant Secretary for Health (OASH) Office on Women’s Health (OWH) announces the anticipated availability of funds for Fiscal Year (FY) 2026 grants under the authority of section 229 of the Public Health Service (PHS) Act (42 U.S.C. § 237a), section 1703(a) of the PHS Act (42 U.S.C. § 300u-2(a)), and all of the authorities under Title XVII of the Public Health Service Act, as amended, pertaining to the mission of the Office on Women’s Health.” 73 Fed. Reg. 62995 (Oct 2008).

This notice solicits applications from organizations with demonstrated experience in the prevention, diagnosis, and treatment of reproductive health conditions, which may include polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome or PCOS), endometriosis, uterine fibroids, infertility, pelvic inflammatory disease (PID), reproductive-age endocrine disorders, or recurrent miscarriage. Through this cooperative agreement, selected organizations will be recognized and elevated as a Center of Excellence, building on their existing expertise to strengthen the translation of evidence into practice, enhance and standardize root-cause care pathways, expand workforce training, and improve health outcomes for women.

OWH encourages 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 application complies with all requirements and instructions.

The Office of the Assistant Secretary for Health (OASH) Grants and Acquisitions Management Division (GAM) will administer this competition.

All activities proposed in the application and budget narrative must align with applicable law, including but not limited to statutes, executive orders, federal regulations, and applicable judicial holdings. Accordingly, discretionary awards shall not be used to fund, promote, encourage, subsidize, or facilitate: racial preferences or other forms of racial discrimination by the recipient, including activities where race or intentional proxies for race will be used as a selection criterion for employment or program participation; denial by the recipient of the sex binary in humans, or the belief that sex is a chosen or mutable characteristic; illegal immigration; or any other initiatives that compromise public safety. If an application does not align, the application will not receive funding to the extent permitted by law and applicable court orders.

We encourage you to review all program requirements, eligibility information, application format and submission instructions, and other content of this notice to ensure your application complies with all requirements.

A. ELIGIBILITY INFORMATION

1. Eligible Applicants You must meet all of the eligibility requirements in order for us to review your application.

a. Eligible Entities

Eligible organizations include:

Any public or private (profit or 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. Community-based organizations, faith-based organizations and American Indian/Alaska Native/Native American (AI/AN/NA) organizations are eligible to apply.

Examples of eligible Organizations include:

• State Governments

• U.S. territories

• 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 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

• Private institutions of higher education

• For profit organizations, including small businesses.

Nonprofit organizations may be required to provide evidence of tax-exempt status. When projects involve the collaborative efforts of more than one organization or require the use of services or facilities not under the direct control of the applicant, written assurances of specific support or agreements may be required from the affected parties.

b. PD/PI Eligibility

There is no restriction on an individual’s eligibility to be Project Director (PD)/Principal Investigator (PI) on an application. However, we will not make an award with a PD/PI who has an active government-wide exclusion, suspension, or debarment recorded in SAM.gov.

We expect that throughout the period of performance the PD/PI will be involved in, and have substantial knowledge about, all aspects of the project. Although your organization may recognize co-PD/PIs on team-managed projects, we recognize only a single PD/PI who will be responsible for the programmatic aspects of the project.

c. Other Considerations Submitting Multiple Applications

You may submit more than one application, but each application must be for a distinctly different project.

If you submit multiple applications for the same project, we will accept only the last application submitted a Grants.gov timestamp that is before the due date and time. We will disqualify all other versions of the application. See Section F.1.b for all disqualification factors.

Submitting an Application as a Group or Consortium

For any given project, we will only make an award to a single eligible entity. More than one entity may choose to work together on a project under this opportunity, but only one entity may submit the application. If awarded, that entity will be the award recipient and will be responsible for conducting the project.

The other entities may participate in the project, if awarded, and would be responsible to the recipient for their respective roles, typically as subrecipients.

Groups may form a consortium, partnership, or other legally recognized entity for the purpose of applying for this opportunity and carrying out any awarded project. The resulting entity must exist and be legally recognized when it applies and must have an active registration in SAM.gov.

We will conduct a risk assessment on the applying entity (Section F.4) prior to making any award.

Eligibility Documentation

We do not require you to submit documentation of your eligibility (e.g., proof of 501(c)(3) status as determined by the Internal Revenue Service or an authorizing tribal resolution) when you submit your application. It is important that your organization is correctly classified in your SAM registration (Section E.2.a).

During our review of your application, we might request additional documentation to support your eligibility. This request means only that your application is under review and not that you will receive an award.

More specific information on the type of documentation that we might request specific to this opportunity appears in Section E.4.b.

Application Disqualification

We will disqualify applications that fail to meet the eligibility, responsiveness, formatting, and submission requirements (Sections F.1.b) prior to conducting merit review. Disqualified applications will not undergo further review.

We will notify disqualified applicants at the end of the competition when we announce the award recipients.

2. Application Responsiveness Criteria We will review your application to determine whether it meets the responsiveness criteria below.

If your application does not meet the responsiveness criteria, we will disqualify it from the competition; we will not review it beyond the initial screening.

The responsiveness criteria are as follows:

You must identify in the first paragraph of your project narrative at least one leading reproductive condition (e.g., polyendocrine metabolic ovarian syndrome [PMOS], endometriosis, uterine fibroids, infertility, pelvic inflammatory disease [PID], reproductive-age endocrine disorders, or recurrent miscarriage) that your Center of Excellence will seek to prevent, diagnose, and treat. You may focus on one or multiple reproductive conditions, but you must state at least one to be responsive.

3. Cost Sharing or Matching

Applicants are required to provide non-federal cost sharing or matching contributions equal to at least 100 percent of the total federal funds requested over each 12-month period of the project.

Matching contributions may be provided through:

• Cash contributions;

• Third-party in-kind contributions;

• Institutional investments that directly support implementation of the project.

All matching contributions must:

• Be verifiable from the recipient’s records;

• Not be included as contributions for any other federally assisted project or program;

• Be necessary and reasonable for accomplishment of project objectives;

• Be allowable under applicable federal cost principles; and

Applicants must clearly describe:

• The source and type of all matching contributions;

• The methodology used to determine the value of in-kind contributions;

• How matching funds will support sustainability and long-term integration of the Center’s activities; and

• Any commitments from institutional or external partners.

Applicants are strongly encouraged to demonstrate institutional commitment through investments that support sustainability beyond the federal project period, including integration into clinical operations, workforce development infrastructure, electronic medical record systems, community partnerships, and dissemination activities.

Matching contributions that substantially exceed the minimum requirement may be considered as evidence of organizational commitment and sustainability capacity; however, cost sharing will not be evaluated independently of overall programmatic merit.

Federal funds from other awards may not be used for any portion of this project.

B. PROGRAM DESCRIPTION

The Office of the Assistant Secretary for Health (OASH), Office on Women’s Health (OWH) announces the anticipated availability of funds for Fiscal Year (FY) 2026 grants under the authority of section 229 of the Public Health Service (PHS) Act (42 U.S.C. § 237a), section 1703(a) of the PHS Act (42 U.S.C. § 300u-2(a)), and all of the authorities under Title XVII of the Public Health Service Act, as amended, pertaining to the mission of the Office on Women’s Health.” 73 Fed. Reg. 62995 (Oct 2008).

The primary focus of OASH is to lead Americans toward healthier lives by promoting health and well-being across the lifespan. Projects funded through this NOFO will guide timely diagnosis and coordinated care for women’s reproductive health. NAVIGATE frames as a network hub that connects assessment, validated clinical pathways, innovation, and site-level guidance to improve access, streamline treatment, and rigorously evaluate outcomes across settings.

This cooperative agreement will recognize, strengthen, and expand a high-performing program already doing meaningful work in the prevention, diagnosis, and treatment of leading reproductive conditions, which may include polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome or PCOS), endometriosis, uterine fibroids, infertility, pelvic inflammatory disease (PID), reproductive-age endocrine disorders, or recurrent miscarriage. Through this partnership with HHS, the recipient organization will be elevated to a Center of Excellence, building on its established clinical expertise and root-cause diagnostic framework to deepen the translation of the latest evidence to patient care, enhance and standardize care pathways, and address gaps in provider training to improve health outcomes for women.

Background

Reproductive conditions such as PMOS, endometriosis, uterine fibroids, recurrent miscarriage, endocrine disorders, and infertility cause significant morbidity and prolonged diagnostic delays.

Fragmented care, variable clinical practice, and gaps in provider training perpetuate poor outcomes for women across the reproductive lifespan. Conventional approaches have often focused on suppressing normal physiology to manage symptoms rather than identifying and treating the underlying conditions driving reproductive dysfunction. NAVIGATE addresses these gaps by centering a root-cause approach to reproductive health, one that identifies underlying conditions contributing to reproductive dysfunction and treats them to restore the body’s natural functions. NAVIGATE centralizes best practice development within this framework, operationalizes standard restorative pathways, and embed navigation supports to reduce delays and streamline multidisciplinary care.

MAHA Priority Alignment: The Center aligns with Make America Healthy Again (MAHA) priorities by targeting prevention and early diagnosis of reproductive health conditions through a root-cause approach; advancing evidence-based clinical practice and restoring reproductive function; promoting patient-centered care and generating scalable interventions for system-wide adoption.

1. Expectations for Recipients

Goals: The goal of this project is to reduce diagnostic delay and improve care coordination for leading reproductive conditions using a root-cause clinical framework. The recipient organization will enhance and expand existing evidence-based clinical pathways for prioritized conditions including polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome or PCOS), endometriosis, uterine fibroids, endocrine disorders, recurrent miscarriage, or infertility. The organization will strengthen clinician training through a scalable curriculum and competency assessments grounded in root-cause clinical principles, expand patient-centered navigation and education resources, and rigorously evaluate clinical and patient-reported outcomes.

Organizational Capacity: The selected organization brings multidisciplinary research, clinical leadership, prior programmatic experience in reproductive health, Electronic Medical Record (EMR)/data capabilities, and established partnerships with clinical sites. The organization will demonstrate expertise in or commitment to adopting root-cause treatment approaches, including cycle-based diagnostics and individualized treatment planning.

Program Activities and Timeline: Building on existing infrastructure, the selected organization will formalize governance and refine and expand clinical pathway development and curriculum.

Training rollout and expanded pilot implementation will proceed with systematic data collection.

Throughout the project period, the organization will continuously review and improve program activities based on data and feedback, conduct a rigorous evaluation, and disseminate a finalized toolkit and implementation guide.

Staffing and Organizational Chart: Core staff include a Center Director (clinical lead), Program Manager, Clinical Pathways Lead, Data & Evaluation Analyst, and a Training Coordinator. The multidisciplinary team structure reflects the integrative nature of root-cause care and may include cycle charting educators, nurses, patient navigators, registered dietitians and nutritional experts, and lifestyle coaches. Roles combine existing institutional FTE and target new hires to support pathway development, implementation, and evaluation.

Program Components: Root-cause clinical pathways will include diagnostic algorithms that utilize cycle charting and tracking, interpreted analogously to an ECG to identify hormone patterns and cycle abnormalities, alongside targeted laboratory testing, ultrasound protocols, and EMR templates timed to a woman’s hormone cycle. Pathways may address polyendocrine metabolic ovarian syndrome (PMOS, formerly known as polycystic ovary syndrome or PCOS), endometriosis, uterine fibroids, endocrine disorders, recurrent miscarriage, or infertility.

Patient navigation will offer education in cycle awareness and charting, care coordination, and linkage to community resources. Navigation materials will empower women with knowledge of their own menstrual cycles, optimal timing for interventions, and the use of cycle changes as biofeedback to assess treatment efficacy. Pilot implementations will integrate workflows and telehealth where appropriate.

Evaluation Plans: A mixed-methods evaluation will measure provider uptake, time-to-diagnosis, symptom and functional outcomes, patient satisfaction, and access metrics. Data sources include EMR extracts, patient-reported outcome surveys, and qualitative interviews.

Quarterly monitoring will inform rapid-cycle improvements.

Dissemination and Scaling Strategy: The selected organization will disseminate findings and resources widely so that other programs can benefit, including through a freely available toolkit, webinars, conference presentations, and peer-reviewed publications. The selected organization will also offer hands-on technical assistance and adapt its training materials to support adoption of the approach across health systems and professional networks, drawing on existing relationships and platforms where possible.

Sustainability Plans: Recipients are expected to develop a sustainability plan describing how the program will continue after the award period ends. This plan should outline the steps the organization will take to maintain and support the program's core activities without federal funding.

Risk Management and Mitigation: The organization will identify potential challenges upfront and have a clear plan for addressing them.

Partnerships: NAVIGATE will formalize partnerships with primary care, OB/GYN, restorative medicine clinics, and patient advocacy groups.

Letters of Support & Appendices: Appendices will include MOUs, letters from pilot sites and community partners, job descriptions, CVs for key personnel, a detailed timeline/and evaluation instruments.

Critical Milestones:

1. Program governance is in place or strengthened, partnership agreements are signed, and key personnel are confirmed in their roles.

2. Enhanced clinical pathways are completed and training curriculum is piloted.

a. SMART goals identified to measure progress.

3. The expanded pilot is launched, and baseline data collection is initiated.

4. The final evaluation is completed, the toolkit is published, and the organization finalizes and commits to a dissemination and sustainability plan.

Overall Intended Impact: The ultimate goal of this project is to improve health outcomes for women living with chronic reproductive health conditions. By reducing the time it takes to receive an accurate diagnosis and expanding access to root-cause approaches to care, this project aims to diagnose and treat the underlying causes of reproductive illness rather than managing symptoms alone. Women served through this project will receive more timely, targeted, and effective treatment, resulting in meaningful improvements in their health, quality of life, and long-term wellbeing. The project will also produce a practical, tested toolkit and training program that extends these benefits beyond the funded site and creates lasting change in how reproductive health conditions are diagnosed and treated.

2. Federal Involvement in the Project If you receive an award, we will encourage you to seek the advice and opinion of federal staff when problems arise. However, you would be responsible for making sound programmatic and administrative judgments. The responsibility for operating decisions will be yours and does not shift to HHS, OASH, or OWH.

Awards will be in the form of cooperative agreements with the recipient. Cooperative agreements are a form of assistance that allows for substantial involvement between federal program office and the recipient during the project period. Substantial programmatic involvement from OWH may include:

• Providing prior approval for change of time that Key Personnel are dedicated to the project and for replacement of Key Personnel. Key Personnel includes those individuals who will oversee essential technical, professional, managerial, and support functions and/or assume responsibility for assuring the validity and quality of your organization’s program.

• Assisting the awardee to establish, review, and update priorities for activities conducted under the auspices of this cooperative agreement and outlined within the applicant's Work Plan.

• Serving as a resource to provide programmatic support during the implementation of the project by participating in the design of the activities and contributing with subject matter expertise.

• Identification of other organizations with whom the awardee may be asked to develop cooperative and collaborative relationships and partnerships.

• Collaborating on the development of measures, methods, and materials to be tested or used.

• Assisting the awardee to monitor the progress of the project, which includes but is not limited to collecting, reporting and analyzing data and required comprehensive reporting during the period of performance.

3. Eligibility criteria for project participants You must not restrict participation in the project on the basis of race, color, national origin, religion, sex, disability, age, or another protected characteristic (See Section H.5).

4. Required Alignment with OASH Mission and Agency Priorities The recipients of this award must implement any funds awarded under this NOFO to effectuate program goals and agency priorities in accordance with the Priorities of the Office of the Assistant Secretary for Health (available online at: https://health.gov/priorities), and when authorized by law according to the OWH statute, regulations, legislative mandates, and additional program guidance. Funded activities must advance and support OASH’s mission to improve the health and well-being of Americans.

The recipients must demonstrate ongoing compliance with these priorities, in all programs that are authorized to advance them, through program design, implementation, reporting, and evaluation. Failure to meaningfully align funded activities with the applicable requirements may result in corrective action, additional reporting requirements, or other actions consistent with federal grant regulations found at 2 C.F.R. Part 200 and the terms and conditions of this award (including termination pursuant to 2 C.F.R. 200.340(a)(4) for no longer effectuating program goals or agency priorities).

C. AWARD INFORMATION

Budget period(s)

We will fund awards in annual increments (budget periods) over two budget periods for a total period of performance up to two (2) years with an optional competitive third year, although we may approve shorter periods of performance. Recipients will be required to submit a non-competing continuation application for each budget period for the second and third years. We anticipate offering a competing continuation for a third year for the purpose of providing funding to support selected recipients as they transition projects to sustainability.

Budget periods may also vary from the estimate indicated above due to timing of award issuance or other administrative factors. 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. Funding for all approved budget periods after the first is generally the same as the initial award amount and may be subject to any offset with funds unused in a previous budget period.

D. APPLICATION CONTENTS AND FORMAT

1.Format of the Application You must prepare your application using the forms and information described in this NOFO. The official online application package on Grants.gov contains all necessary forms and guidance for preparing an application. This package includes but is not limited to:

https://health.gov/priorities

• Full Text of the NOFO

• Standard forms (required) and their instructions o SF-424 Application for Federal Assistance o SF-424A Budget Information for Non-Construction Programs o SF-LLL Disclosure of Lobbying Activities o Project Abstract Summary

• Sample templates, if available.

In addition to the four standard forms in the application package, your application will consist of 3 sections of materials you prepare:

1. Project Narrative

2. Appendices to the Project Narrative

3. Budget Package.

We strongly encourage you to read all instructions for the application format and content to avoid disqualification of your application. An application checklist is available in Section J.1.

a. Project Narrative – Formatting Following the formatting instructions below will help ensure that your application is readable for review process. Acceptable electronic file formats are in Section E.3.a.

Names of Individuals

We encourage you to use individuals’ full names (first, middle, last) on the standard forms and any other documents such as résumés/curricula vitae/biographical sketches to distinguish them for verification in the SAM exclusion records. Delays may result in award processing if full names are not provided.

You should avoid submitting personally identifiable information such as personal contact information (e.g., home address and telephone number) on résumés/curricula vitae/biographical sketches. Do not submit social security numbers.

If you receive an award, only one Project Director/Principal Investigator (PD/PI) will be named on the award documents. (Section A.1.b) Avoid using a placeholder or honorary PD/PI. If you have not hired an individual to be the PD/PI, you should name an interim PD/PI, and your application should clearly identify that person as such.

We typically expect the PD/PI to be named on the SF-424 in box 8.f. Avoid naming Project writers in box 8.f unless they have the expertise to respond to technical questions about the proposed project in a timely manner.

Identify other personnel who are essential or key to the execution of the proposed project clearly in your project narrative.

If you receive an award, a request for a change in PD/PI or key personnel under any circumstance requires prior approval of the grants management officer before becoming effective. We may disallow any costs incurred as a result of that change prior to our approval. See Section H.1.c.

Page Formatting

If you submit documents that do not conform to the following instructions, GAM will disqualify your application during the review process (SectionF.1.b).

Use an easily readable typeface, such as Times New Roman or Arial.

Use a 12-point font.

Use an 8.5” X 11” page size. Any other size page (e.g., A4, legal) will disqualify your application.

You must double-space the Project Narrative pages, or we will disqualify your application. You may single-space tables or use alternate fonts, but you must ensure the tables are easy to read.

Do not number pages or include a table of contents. Our grants management system will generate page numbers once your application is complete.

You must submit your application in the English language and in terms of U.S. dollars (2 C.F.R. 200.211) - https://www.ecfr.gov/current/title-2/section-200.111.

Page Limits

Your project narrative and appendices must adhere to these page limits.

The page limits do not include the budget package (Section D.2.c)

The page limits do not include the required forms (SF-424, SF-424A, SF-LLL, and the Project Abstract Summary)

If your application exceeds the specified page limits when printed on 8.5” X 11” page, we will not review your application further.

We encourage you to print out your application before submitting it to ensure that it is within the page limits and is easy to read. Do not reduce pages to fit multiple pages on a single sheet to avoid exceeding the page limitation.

Do not hyperlink documents or sites outside of your application to augment your application. Reviewers will not be permitted to follow links to external content during their assessment of your application. The one exception to this is a link to your internal controls as part of your budget package (Section D.2.c.3).

Page Limit

Project Narrative _____ 25 pages ____ https://www.ecfr.gov/current/title-2/section-200.111

Project Narrative plus Appendices ____ 50 pages _____

Labeling Proprietary Information

Proprietary information includes patentable ideas, trade secrets, privileged or confidential commercial or financial information, the disclosure of which may harm the applicant.

You should include proprietary information in your application only to the extent that it is essential to the reviewers’ understanding of the project. Proprietary information should not appear in your Project Abstract Summary.

If your application contains proprietary information, you should clearly label the top of the first page of the project narrative. For example, Contains proprietary or confidential information that [Your Organization Name] requests not be released to persons outside the government, except for purposes of review and evaluation.

Awarded applications are subject to release under the Freedom of Information Act (FOIA) with redactions as the FOIA statute permits.

b. Appendices to the Project Narrative – Formatting Your appendices should include any specific items outlined in Section D.2.b. 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/biographical sketches, organizational charts, tables, Memoranda of Agreement (MOAs) or Letters of Commitment (LOCs) may have formatting common to those documents, so long as the pages are easy to read. For example, resumes, MOAs and LOCs may be single-spaced.

You must upload all of your appendices as a single, consolidated file in the Attachments section of your Grants.gov application. You must use an acceptable file format (Section E.3.a). We strongly encourage you to convert your file(s) to PDF format before uploading and review them to ensure accurate conversion.

Your Project Narrative plus the Appendices may not exceed the total number of pages for the application (Section D.1.a).

c. Budget Package - Formatting 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 an 8.5” x 11” page. You must use an acceptable file format (Section E.3.a). We do not accept Excel or other similar spreadsheet formats.

The application page limit does not include the SF-424A or the budget narrative (including budget tables).

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

2. Content

a. Project Narrative - Content The Project Narrative is the most important part of your application. We will use it as the primary basis to determine whether your project merits an award. The project narrative should provide a clear and concise description of your project. We recommend that your project narrative includes the following components with the requested information. Labeling the sections accordingly will help the reviewers find information quickly.

Successful proposals should include the following:

1. A clearly defined reproductive health focus area or set of conditions that demonstrates the applicant’s understanding of diagnostic gaps, fragmentation of services, and barriers to timely treatment for women across the lifespan.

2. A comprehensive clinical implementation strategy describing how the applicant will:

o Develop and operationalize root-cause clinical pathways;

o Improve early detection and diagnostic accuracy;

o Integrate multidisciplinary care models;

o Incorporate navigation and referral coordination; and o Expand access to root-cause reproductive healthcare services.

3. A robust provider training plan that includes:

o Continuing education approaches and Competency-based learning;

o Clinical decision-support tools;

o Cross-disciplinary provider engagement; and

4. A data collection, evaluation, and quality improvement strategy that includes:

o Baseline and outcome measures;

o Continuous quality improvement methods;

o Patient reported outcomes;

o Clinical and operational performance indicators; and o Methods for assessing implementation effectiveness and scalability.

5. A dissemination and sustainability strategy describing how successful models, pathways, tools, and lessons learned will be shared broadly, adapted for replication, sustained after the federal funding period, and integrated into institutional and health system operations.

6. Organizational capacity and readiness including:

o Demonstrated expertise in women’s health or reproductive health;

o Existing clinical partnerships;

o Data and evaluation infrastructure; and o Capacity to implement a multi-component Center of Excellence model.

7. A realistic project timeline and implementation plan with measurable milestones, deliverables, staffing structure, and clearly defined roles and responsibilities.

8. A sustainability and systems-change approach demonstrating how the Center will create durable improvements in reproductive healthcare delivery, provider practice, patient outcomes, and institutional integration beyond the period of federal support.

b. Appendices to the Project Narrative – Content All items described in this section will count toward the total page limit of your application. You must submit them as a single electronic file uploaded to the Attachments section of your Grants.gov application.

Samples and optional forms/templates for some of these items are located under the Related Documents tab for this NOFO on Grants.gov.

Your application should include the following appendices:

• Work Plan

Your Work Plan should reflect, and be consistent with, the Project Narrative and Budget Narrative, and must cover all years of period of performance. However, each year’s activities should be fully attainable in one budget year. You may propose multi-year activities, as well as activities that build upon each other, but each phase of the project must be discreet and attainable within a single budget year. Your Work Plan should include a statement of the project’s overall goal, anticipated outcome(s), key objectives, and the major tasks, action steps, or products that will be pursued or developed to achieve the goal and outcome(s). For each major task of each year, action step, or product, your work plan should identify the timeframes involved (including start and end-dates), and the lead person responsible for completing the task.

• Memoranda of Agreement (MOA) and/or Letters of Commitment (LOC) from

Partners, Sub-recipient Organizations, and Agencies, as Applicable

Signed MOAs, if available at the time of submission, should be submitted for each partner and include specific roles, responsibilities, resources, and contributions of partner(s) to the project. If the applicant is unable to submit signed MOAs, the applicant should submit an unsigned MOA(s).

Otherwise, signed LOCs may be submitted for each partner and must detail the specific role and resources that will be provided, or activities that will be undertaken, in support of the project. The organization’s expertise, experience, and access to the targeted population(s) should also be described in the LOC. LOCs should be followed by fully-executed MOAs.

Fully-executed MOAs will be required within 30 days following the issuance of any award made under this announcement.

Letters of commitment are not the same as letters of support. Letters of support are letters that are general in nature that speak to the writer’s belief in the capability of an applicant to accomplish a goal/task. Letters of support also may indicate an intent or interest to work together in the future. Letters of support may be included as part of an application.

• Organizational Chart

Include an organizational chart that reflects the management structure for the project and demonstrates where the project resides within the greater organization.

• Curriculum Vitae/Résumé/Biographical Sketches for Key Project Personnel

You must submit with your application curriculum vitae and/or résumés of the Project Director/Principal Investigator and all other Key Personnel you have identified in your application. Key Personnel includes those individuals who will oversee the technical, professional, managerial, and support functions and/or assume responsibility for assuring the validity and quality of your organization’s program. This includes at a minimum Project Director/Principal Investigator. You should use full names (first, middle, last) on these documents to distinguish them for verification in the System for Award Management exclusion records. You should use the formatting common to those documents. (See https://grants.nih.gov/grants/forms/biosketch.htm for templates and sample biographical sketches.)

• References Cited

You should include your references cited in your project narrative. You may use any standard format that you chose as long as it will clearly lead the reader to your source of the information or data.

c. Budget Package - Content A complete budget package consists of the following required components:

• SF-424A “Budget Information Non-Construction Programs”

• Budget narrative with detailed justification by cost category/object class, and

• Plan for oversight of federal funds.

You should include supporting documentation for your budget (e.g., a copy of your approved indirect cost rate) as part of the budget package, not as part of your appendices to the project https://grants.nih.gov/grants/forms/biosketch.htm narrative. There is no page limit for the budget package contents. If you are recommended for an award, you may be asked to provide additional information about your budget package.

Throughout your budget package, “Federal resources” refers only to the funds you are requesting from the program office for this project. “Non-federal resources” refers to any funds outside of this NOFO (federal and non-federal). Funds from federal projects and/or grant programs typically are not eligible as cost share for other federal projects and/or grant programs. It is your responsibility to confirm with other federal agencies whether funds you receive from them are eligible resources to apply to your proposed project.

1. Standard Form SF-424A

You must enter the project budget according to the directions provided with the standard form.

You must provide costs by object class category for the first 12 months (i.e., first budget period) of the proposed project using Section B, box 6 of SF-424A. If the estimated period of performance is 12 months or less, this will be your total budget request for the entire project.

"Federal resources" refers only to the funds for which you are applying under this NOFO. "Non-federal resources" refers to any funds outside of this NOFO (federal and non-federal).

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

If there is a discrepancy between your SF-424A and budget narrative and justification, we will rely on the narrative and justification to determine the final amounts.

2. Budget Narrative with Justification

Your budget narrative must include a detailed line-item budget and must include calculations for all costs and activities by the “object class categories” identified on SF-424A. You must provide a detailed justification for the costs by object class. The object class budget organizes your proposed costs into a set of defined categories.

Use the guidelines in Section J.4 for preparing the detailed object class budget.

Budget Periods

Your budget narrative must describe the first budget period in detail. For each proposed cost for the first budget period, provide a justification that includes explanatory text and line-item detail.

You should describe how you derived your categorical costs. Your justification should show the necessity and reasonableness of the proposed costs for the project.

For subsequent budget years in an anticipated multi-year period of performance, 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 period, provide a detailed justification explaining these changes.

Funding levels for all approved budget periods after the first are generally the same as the initial award amount and are subject to an offset with funds unused in the previous budget period.

Carryover of unobligated funds from one budget period to the next requires prior approval.

Determining Proposed Costs

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.

Proposed costs must adhere to the cost principles described in 2 C.F.R. §200.416. We have provided additional information on the most common cost categories for applications for OASH awards in Section J.4.

Budget calculations must include estimation methods, quantities, unit costs, and other similar quantitative detail sufficient to verify the calculations. Carefully review Funding Restrictions (below) for specific information regarding allowable, unallowable, and restricted costs.

Describing Federal and Non-federal Share

Both federal and non-federal resources (if applicable) must be detailed and justified in the budget narrative. “Federal resources” refers only to the funds for which you are applying under this NOFO. “Non-federal resources” refers to any funds outside of this NOFO (federal and non-federal).

If matching or cost sharing is required or offered voluntarily, you must include a detailed listing of any funding sources identified in box 18 of SF-424 (Application for Federal Assistance).

Indirect Costs

Indirect costs must be consistent with the Federal Agency Acceptance of Negotiated Indirect Rates regulation. (2 C.F.R. § 200.414 (c)(1)).

Funding Restrictions

The following restrictions apply to costs you may propose and be awarded.

Pre-Award Costs

Pre-award costs are NOT allowed. Pre-award costs (2 C.F.R. § 200.458) are those incurred prior to the effective date of the Federal award directly pursuant to the negotiation and in anticipation of the Federal award where such costs are necessary for efficient and timely performance of the scope of work.

Salary Rate Limitation

Each year’s appropriations act limits the salary rate that you may charge to the grants and cooperative agreements that we award. You must not use award funds to pay the salary of an individual at a rate in excess of Federal Executive Pay Scale Executive Level II.

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRd41a10959e1acab/section-200.416 https://www.ecfr.gov/current/title-2/section-200.414 https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E/subject-group-ECFRed1f39f9b3d4e72/section-200.458

As of January 2026, the Executive Level II maximum salary is $228,000. This amount reflects an individual’s base salary exclusive of fringe benefits and any income that an individual working on the award project may be permitted to earn outside of the duties to the applicant organization. This salary rate limitation also applies to subawards/subcontracts under an HHS/OASH award.

An example of the application of this limitation for an individual devoting 50% of their time to this award is broken down below:

Salary Rate Limitation

Individual’s actual base full-time salary $350,000 with 50% of time devoted to project, i.e., 0.5 FTE

Direct salary ($350,000 x 0.5) = $175,000

Fringe (25% of salary) = $43,750

Total = $218,750

Individual’s base full-time salary adjusted to Executive Level II:

$225,700 with 50% of time devoted to the project

Direct salary ($225,700 x 0.5) = $112,850

Fringe (25% of salary) = $28,212.50

Total amount allowed = $141,062.50

Appropriate salary rate limits will apply as required by law.

Vehicle Purchase

We will not approve a vehicle purchase at the time of award even when included in your application. You must obtain prior approval before the purchase of a mobile health unit or any other vehicle with award funds. A request for prior approval must include a detailed justification of the need for the vehicle that includes an analysis of comparing purchase, lease, and other alternatives. Equipment purchases are subject to transfer to another federal project or sale at the end of the period of performance (2 C.F.R. § 200.313(e)).

Construction Costs

We will not approve construction costs. This includes major improvements to or significant renovations of facilities.

3. Plan for Recipient Oversight of Federal Award Funds

You must include a plan for oversight of federal award funds which describes:

• how your organization will provide oversight of federal funds and how award activities and partner(s) will adhere to applicable federal award and programmatic regulations.

https://www.ecfr.gov/current/title-2/part-200/section-200.313#p-200.313(e) https://www.ecfr.gov/current/title-2/part-200/section-200.313#p-200.313(e)

Include identification of risks specific to your project as proposed and how your oversight plan addresses these risks.

• the organizational systems that demonstrate effective control over and accountability for…