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Transforming Pediatrics for Early Childhood (TPEC) FAQs

Our proposal plans to focus on a specific city or county for placement of Early Childhood Development (ECD) experts. Does this meet program requirements?

HRSA does not specify a minimum geographic scope for the award. Rather, the program aims to spread the approach of ECD expert integration, to have a greater footprint within a state, territory, or tribal area, and to address state-level barriers to more sustained and widespread uptake. As noted on pages 24-25 of the Notice of Funding Opportunity (NOFO), applications will be assessed on the feasibility of achieving meaningful expansion across the period of performance and their potential for state-level impact.

We want to work with a network of practices within a region that includes more than one state. Is this eligible for funding?

HRSA does not require a specific geographic scope for the award. Applications may propose to reach more than one state in a regional approach. Applications will still be assessed on their understanding of the needs across each area of the jurisdiction, the ability to fulfill expectations of achieving more widespread expansion of ECD experts and addressing state-level barriers, and the potential for state-level impact.

Applicants should also consider the special consideration described on pages 26-27 of the NOFO. HRSA may select only one entity to implement the program in a particular state, territory, jurisdiction, or tribal area.

Is there a minimum number of pediatric practices to engage as partners for placing ECD experts?

HRSA does not require a minimum or expected number of practice partners at any phase of the project. The reviewers will consider how well the proposed approach achieves program goals, addresses practice and community needs (as articulated in the application), and substantially increases the number of ECD experts placed in pediatric practices in communities with the greatest need during the period of performance. Applications should clearly provide the rationale for the proposed approach, and detail how it will meet the program expectations and promote sustainability beyond the period of this award.

How should we interpret the requirement that pediatric practice partners must serve a high percentage of P–5 populations who are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) or are uninsured, as defined in the NOFO?

HRSA provides a definition of “high percentage” on page 8 of the NOFO. The intent of the definition is to give guidance that ensures program reach to populations who are eligible for Medicaid or CHIP or are uninsured, and to communities with the greatest need. However, HRSA recognizes that health systems, practice demographics, population distribution, and other contextual factors vary across states, territories, and tribal areas. Applicants may interpret the “high percentage” to apply at the level of individual practice service population, the service population across the cohort of practices to be engaged, or coverage of the total possible service population within the state or jurisdiction. All applications should make clear the needs and service population characteristics within their jurisdiction, and the proposed strategy to engage pediatric practices that serve Medicaid or CHIP-eligible and uninsured P–5 populations and reach communities with the greatest need.

Who is the recipient of the Early Childhood Developmental Health System (ECDHS): Evidence to Impact Center award (HRSA-22-091), and what is the expected relationship between that entity and award recipients under Transforming Pediatrics for Early Childhood (TPEC; HRSA-22-141)?

The recipient for the ECDHS: Evidence to Impact Center has not yet been identified, and will be awarded concurrently with the TPEC awards. Among other responsibilities, the Evidence to Impact Center will provide national leadership, training, technical assistance (TA), and coordination to the state-level resource hubs supported under the TPEC program. This includes establishing a suite of supports in Year 1 to help TPEC awardees advance their program goals, and maintaining and delivering supports throughout the period of performance. See the NOFO for HRSA-22-091 for more detail about expected activities. HRSA expects TPEC award recipients to participate in TA activities offered by the Evidence to Impact Center and to collaborate with the Center on data and evaluation efforts. After award, HRSA will facilitate connections between recipients under both awards.

Must pediatric practice partners be led by pediatricians? In my state, most children receive primary care services from family medicine practitioners or at Federally Qualified Health Centers.

No, practices do not have to be led by pediatricians or serve only pediatric patients. HRSA defines pediatric practices broadly to include a range of settings in which young children receive primary health care services, with a focus on patient-centered medical homes and similar settings. Services may be delivered by a range of medical professionals, including pediatricians, primary care or family medicine practitioners, nurse practitioners, physician assistants, or community health workers.

Can this be an expansion of existing work or does this have to be a new program?

Efforts under this award may be new or build on existing initiatives. Awards may support the initiation of ECD services in practices that do not currently offer them and/or build the capacity of practices to expand and improve the quality of existing ECD services.

Can community-based agencies or health systems apply, or is this NOFO geared more towards state- and tribal-based agencies?

Any domestic public or private entity may apply. HRSA expects recipients to have or form partnerships that address state-level infrastructure and barriers, but this does not limit potentially successful applicants to state and tribal-based agencies. Page 9 of the NOFO states: “HRSA encourages applications that are from, or propose strong partnerships with, the organizations listed in Appendix D in order to successfully engage pediatric practices and support state-level infrastructure required for effective program implementation.” See pages 11-12 for additional expectations related to partnerships and project activities.

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