Healthy Start Initiative
The purpose of this grant program is to improve perinatal health outcomes and reduce racial and ethnic disparities in perinatal health outcomes by using community-based approaches to service delivery, and to facilitate access to comprehensive health and social services for women, infants, and their families. HS grants are provided to communities with rates of infant mortality at least 1? times the U.S. national average and high rates for other adverse perinatal outcomes (e.g., low birthweight, preterm birth, maternal morbidity and mortality) in order to address the needs of high-risk women and their families before, during, and after pregnancy.
General information about this opportunity
Last Known Status
Health Resources and Services Administration, Department of Health and Human Services
Type(s) of Assistance Offered
B - Project Grants
Title III, Part D, Section 330H of the Public Health Service Act, (42 U.S.C.254c-8)
Who is eligible to apply/benefit from this assistance?
Eligible Project Area All applicants applying for funding under this grant notice must identify themselves as serving an urban, rural, or border community project area. A project area is defined as a geographic community in which the proposed services are to be implemented. A project area must represent a reasonable and logical catchment area, but the defined areas do not have to be contiguous. A map of the proposed project area must be included in the application. Urban - Territory, population, and housing units located within an urbanized area (UA) or an urban cluster (UC), which has: o a population density of at least 1,000 people per square mile; and o surrounding census blocks with an overall density of at least 500 people per square mile. Rural - To determine whether the Census tract or County for your proposed project area is defined as a rural area (RA), visit the webpage Rural Health Grants Eligibility Analyzer(http://datawarehouse.hrsa.gov/RuralAdvisor/ruralhealthadvisor.aspx?ruralByAddr=1) and enter the project area address. US/Mexico Border - Border communities are those communities located within 62 miles/100 kilometers of the U.S./Mexico border. In order to be considered for Border Community funding, the project area and the target population to be served both have to reside within 62 miles/100 kilometers of the U.S./Mexico border. Eligible Target Population The target population is the population that the applicant will serve within their geographic project area and will determine their eligibility. The target population may range from a single racial/ethnic group to the entire project area population. The project area for which the applicant is applying and the proposed target population within that project area must be clearly identified to confirm eligibility. Eligibility Factors Demonstrating Need HRSA/MCHB must be able to verify submitted data with the appropriate state/local government agency responsible for vital statistics. Border community applicants that cannot provide this verifiable data may use the other indicators specified in the second section below. Project data for the eligibility factors for all applicants must be included in the application's transmittal letter and in the needs assessment section of the submitted application. The existing racial/ethnic disparities in these or other perinatal indicators should also be described in the needs assessment section of the application. Applications that do not provide this information, in the manner described within this notice of funding opportunity (NOFO), will be considered ineligible and the application will be returned without review. An applicant's target population within their proposed project area must meet the following verifiable criteria using the smallest statistical level of verifiable data available -- not to be any larger than a combination of counties (e.g. a city project should not report county-level data).HRSA-14-020, Urban and Rural Communities Using verifiable three-year average data for calendar years 2007 through 2009, the proposed project area for communities which meet the urban or rural community definition must meet the following indicators from the list below. The 2007-2009 combined three-year infant mortality rate (IMR, infant deaths per 1,000 live births over three years) must be equal to or more than 9.9 deaths per 1,000 live births (1.5 times the national average) AND there must be 20 or more infant deaths over the three years for the targeted population. If the combined 2007-2009 number of infant deaths are less than (<)20, then to be eligible the following must be met: o The 2007-2009 three-year average low birthweight (LBW) is equal to or more than 12.3% (1.5 times the national average) AND there must be 100 or more LBW births in the targeted population for the three-year period, 2007 to 2009 OR The 2007-2009 preterm births (PTB) is equal to or more than 18.6% (1.5 times the national average) AND there must be 100 or more PTB births in the targeted population for the period, 2007 to 2009 For Levels 2 and 3, if the combined 2007-2009 IMR is less than 9.9 deaths per 1,000 live births, then to be eligible the following must be met: o The applicant must demonstrate a 20% decrease in IMR in their target population for 2005-2009 (five-year combined average) and discuss how they were a significant contributor to this reduction AND meet at least one of the following criteria: The 2007-2009 three-year average low birthweight (LBW) is equal to or more than 12.3% (1.5 times the national average) AND there must be 100 or more LBW births in the targeted population for the three-year period, 2007 to 2009 OR The 2007-2009 preterm births (PTB) is equal to or more than 18.6% (1.5 times the national average) AND there must be 100 or more PTB births in the targeted population for the period, 2007 to 2009 US/Mexico Border Communities Using verifiable three-year average data for 2007 through 2009, the proposed target population for project areas which meet the border community definition (i.e., within 62 miles of the U.S./Mexico border) must have at least 1,000 births for the three year period and meet at least three (3) indicators from the list below. If vital statistics are not available from state/local government agencies, border community applicants can use other verifiable data. o Percentage of women of childbearing age with diabetes is 3.1% or more; o Percentage of women of childbearing age who are obese is 31.8% or more; o Percentage of pregnant women entering prenatal care in the first trimester is less than 80%; o Percentage of births to women who had no prenatal care is greater than 2%; o Percentage of births to women who smoke is greater than 20%; o Percentage of children 0-2 years old with a completed schedule of immunization is less than 60%; o Percentage of children under 18 years of age with family incomes below the Federal Poverty Level exceeded 25% for 2010. If more recent verifiable poverty data is available, please provide this data and identify year and source; o Percent of infants born large for gestational age (LGA) is 9.4 or greater.
Service area residents, particularly women and infants in areas with significant perinatal health disparities.
Applicants should review the individual HRSA notice of funding opportunity issued under this CFDA 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?
Preapplication coordination is required. An environmental impact statement is required for this listing. An environmental impact assessment is required for this listing. 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. 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.
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 Grants.gov.
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. 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
Final decisions are made approximately 166 days after receipt of applications.
After initial award, projects may be renewed annually up to the limit of the project period upon the submission and approval of a satisfactory progress report.
How are proposals selected?
See the notice of funding opportunity to obtain specific program grant guidance.
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) promoting quality services, 3) strengthening family resilience, 4) achieving collective impact, and 5) increasing accountability through quality improvement, performance monitoring, and evaluation. 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 and increase collective impact. 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?
2) Performance Report(s). The Health Resources and Services Administration (HRSA) has modified its reporting requirements for SPRANS projects, CISS projects, and other grant programs administered by the Maternal and Child Health Bureau (MCHB) to include national performance measures that were developed in accordance with the requirements of the Government Performance and Results Act (GPRA) of 1993 (Public Law 103-62). This Act requires the establishment of measurable goals for Federal programs that can be reported as part of the budgetary process, thus linking funding decisions with performance. Performance measures for States have also been established under the Block Grant provisions of Title V of the Social Security Act, the MCHB’s authorizing legislation. Performance measures for other MCHB-funded grant programs have been approved by the Office of Management and Budget and are primarily based on existing or administrative data that projects should easily be able to access or collect. 1. Performance Measures and Program Data To prepare successful applicants for their reporting requirements, the listing of MCHB administrative forms and performance measures for this program can be found at: https://perf-data.hrsa.gov/mchb/DgisApp/FormAssignmentList/H49_2.HTML. 2. Performance Reporting Successful applicants receiving grant funds will be required, within 120 days of the Notice of Award (NoA), to register in HRSA’s Electronic Handbooks (EHBs) and electronically complete the program specific data forms that appear for this program at: https://perf-data.hrsa.gov/mchb/DgisApp/FormAssignmentList/H49_2.HTML. This requirement entails the provision of budget breakdowns in the financial forms based on the grant award amount, the project abstract and other grant summary data as well as providing objectives for the performance measures. Performance reporting is conducted for each grant year of the project period. Grantees will be required, within 120 days of the NoA, to enter HRSA’s EHBs and complete the program specific forms. This requirement includes providing expenditure data, finalizing the abstract and grant summary data as well as finalizing indicators/scores for the performance measures. 3. Project Period End Performance Reporting Successful applicants receiving grant funding will be required, within 90 days from the end of the four years and nine months project period, to electronically complete the program specific data forms that appear for this program at: https://perf-data.hrsa.gov/mchb/DgisApp/FormAssignmentList/H49_2.HTML. The requirement includes providing expenditure data for the final year of the project period, the project abstract and grant summary data as well as final indicators/scores for the performance measures.
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
Project periods vary depending on specific grant notice with non-competing continuation awards made on an annual basis for up to 5 years depending on satisfactory progress and subject to the availability of funds. 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
Director, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services, Room 13-91, Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-0543.
David de la Cruz, Director, Division of Healthy Start and Perinatal Services
5600 Fishers Lane, Room 18N29
Rockville, MD 20857 US
(Cooperative Agreements) FY 18$4,298,291.00; FY 19 est $4,298,306.00; FY 20 est $4,298,306.00; FY 17$109,028,547.00; FY 16$95,472,848.00; - (Project Grants) FY 18$98,676,104.00; FY 19 est $109,211,989.00; FY 20 est $109,313,964.00; -
Range and Average of Financial Assistance
(Cooperative Agreements) FY 18 $299,979-$2,000,000. Average award $716,382 FY 19 $299,994-$2,000,000. Average award $716,384 FY 20 est. $299,994-$2,000,000. Average award $716,384 (Grants) FY 18 $304,144-$1,898,600. Average award $986,761 FY 19 $8,901-$1,070,000. Average award $1,092,120 FY 20 est. $8,901-$1,070,000. Average award $1,093,140
Regulations, Guidelines and Literature
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 http://www.hrsa.gov/grants.
Examples of Funded Projects