Healthy Start Initiative


The purpose of the Healthy Start (HS) program is to improve health outcomes before, during, and after pregnancy, and reduce racial/ethnic differences in rates of infant death and adverse perinatal outcomes. The HS program provides grants to high-risk communities with infant mortality rates at least 1.5 times the U.S. national average and high rates of other adverse perinatal outcomes (e.g., low birthweight, preterm birth, maternal morbidity and mortality). HS works to reduce the disparity in health status between the general population and individuals who are members of racial or ethnic minority groups.

General information about this opportunity
Last Known Status
Program Number
Federal Agency/Office
Health Resources and Services Administration, Department of Health and Human Services
Type(s) of Assistance Offered
B - Project Grants
Program Accomplishments
Fiscal Year 2020 In 2019, the Health Start program served over 59,000 participants.
Fiscal Year 2021 In 2020, the Healthy Start program served over 65,000 participants.
Fiscal Year 2022 The Healthy Start Program served approximately 72,000 women and children in FY 2021, in addition to nearly 4,800 men.
Public Health Service Act Title III, Part D, Section 330H, 42 U.S.C. 254C-8
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Not applicable.
Beneficiary Eligibility
Service area residents, particularly women and infants 0-18 months, in areas with significant perinatal health disparities.
Applicants should review the individual HRSA notice of funding opportunity issued under this Assistance Listing program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is required. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. HRSA requires all applicants to apply electronically through All qualified applications will be forwarded to an objective review committee. Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions
Award Procedure
All qualified applications will be forwarded to an objective review committee. Based on the recommendations of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions. Notification is made in writing by a Notice of Award.
Contact the headquarters or regional location, as appropriate for application deadlines
Approval/Disapproval Decision Time
From 120 to 180 days. Final decisions are made 4 to 6 months after receipt of applications
Not applicable.
After initial awards, annual noncompetitive awards may be made contingent upon the submission of noncompetitive applications/progress reports and availability of funds and a determination that continued funding would be in the best interest of the federal government.
How are proposals selected?
Evaluation criteria vary based on the grant/cooperative agreement program. Refer to criteria included in the notice of funding opportunity (NOFO) for each specific program.
How may assistance be used?
The Healthy Start (HS) program aims to reduce disparities in infant mortality and adverse perinatal outcomes by: 1) improving women’s health, 2) improving family health and wellness, 3) promoting systems change, 4) assuring impact and effectiveness. Healthy Start grantees continue to reduce high infant mortality rates (IMR) by assuring access to culturally competent, family-centered, and comprehensive health and social services to women, infants, and their families through a community-based participatory approach. Additionally, HS grantees foster systems integration, coordination, and collaboration to advance community change. HS grantees also coordinate and align with State Title V Maternal and Child Health Block Grant programs to promote cooperation, integration, and dissemination of information with statewide systems and with other community services funded under Title V. Funds may not be used to supplant currently funded activities/services.
What are the requirements after being awarded this opportunity?
Not applicable.
In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, nonfederal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503
Grantees are required to maintain grant accounting records 3 years after the date they submit the Federal Financial Report (FFR). If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formula is not applicable to this assistance listing.

Matching requirements are not applicable to this assistance listing.

MOE requirements are not applicable to this assistance listing.
Length and Time Phasing of Assistance
Refer to the notice of funding opportunity (NOFO). Awards are made annually, in accordance with the project period method of awarding grants. Payments are made through a Letter-of-Credit or Cash Demand System. Grantees drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.
Who do I contact about this opportunity?
Regional or Local Office
None/Not specified.
Headquarters Office
Lee Wilson, Director, Division of Healthy Start and Perinatal Services
5600 Fishers Lane, Room 18N25
Rockville, MD 20857 US
Phone: (301) 443-0543
Website Address
Financial Information
Account Identification
(Cooperative Agreements) FY 22$10,103,409.00; FY 23 est $8,976,296.00; FY 24 est $7,499,999.00; FY 21$4,012,679.00; FY 20$3,335,279.00; FY 19$4,299,858.00; FY 18$4,298,291.00; FY 17$109,028,547.00; FY 16$95,472,848.00; - (Project Grants) FY 22$109,423,129.00; FY 23 est $122,629,500.00; FY 24 est $160,895,000.00; FY 21$113,681,687.00; FY 20$111,722,142.00; FY 19$110,304,869.00; FY 18$98,676,104.00; -
Range and Average of Financial Assistance
(Cooperative Agreements) FY 22 act. $496,938 - $2,714,857. Average award $1,028,754 FY 23 est. $495,762 - $2,464,435. Average award $935,304 FY 24 est. $500,000-$2,465,000. Average award $1,250,000 (Grants) FY 22 act. $649,356-$1,144,121. Average award $1,083,397 FY 23 est. $783,868- $1,144,121, Average award $1,214,153 FY 24 est. $783,868-$1,144,121. Average award $1,593,020
Regulations, Guidelines and Literature
All HRSA awards are subject to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements at 45 CFR part 75. HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at
Examples of Funded Projects
Not applicable.