FAQ: Early Hearing Detection and Intervention State/Territory Program

Funding Opportunity Number: HRSA-24-036 (Competing Continuation, New)

Application technical assistance & preparation

Note for applicants: Please see the HRSA SF-424 Application Guide (PDF - 680 KB) for specific instructions on application formatting (for example, font size, margins, etc.).

Where can I find a recording of the NOFO Technical Assistance call?

View the webinar recording.

How do I resolve technical errors while preparing or submitting my application in Grants.gov?

For assistance with submitting the application in Grants.gov, contact Grants.gov 24 hours a day, 7 days a week, excluding federal holidays at:

Grants.gov Contact Center Telephone: 1-800-518-4726 (International callers dial 606-545-5035)

Email: support@grants.gov

View the webinar recording.

What needs to be completed prior to submission of the award application? 

An applicant’s SAM.gov and Grants.gov registrations and passwords must be current in order to submit an application to HRSA. Registrations in all systems may take up to one month to complete, so do not wait to activate or update accounts in these two systems.

Please note that a Unique Entity ID (UEI) is required to apply for this funding. You must register in the SAM.gov to receive your UEI. You cannot use a DUNS number to apply. For more details, visit the following webpage: General Service Administration's UEI Update.

When is the final deadline for applications? Is there a recommended timeline for submitting the application?

The final application deadline is Monday, November 6, at 11:59 p.m. ET. It is recommended to not wait until the last minute to submit an application in case there are issues.

Page 22 of the NOFO states: “We suggest you submit your application to Grants.gov at least 3 calendar days before the deadline to allow for any unexpected events.”

Please see HRSA’s page Understand our Policy on Late Submissions for additional information regarding application deadlines.

Attachments

Please outline the page limit guidance within the HRSA-24-036 NOFO, including which attachments count toward the page limit.

Page 8 of the NOFO states, “The total number of pages that count toward the page limit shall be no more than 60 pages when we print them (includes a 55-page limit for the EHDI State/Territory Base Program and a 5-page limit for EHDI Innovation additional funding materials, Attachment 9). We won’t review any pages that exceed the page limit.”

Per page 9 of the NOFO, these items don’t count toward the page limit:

Standard OMB-approved forms you find in the NOFO’s workspace application package 
Abstract (standard form (SF) "Project Abstract Summary”) 
Indirect Cost Rate Agreement 
Proof of non-profit status (if it applies)

All other documents will count toward the page limit, unless noted in the NOFO (see page 20, Section IV.2.v. Attachments). Please see page 40 of the HRSA SF-424 Application Guide (PDF - 680 KB) for additional information on application page limits.

Are letters of agreement, letters of support, and letters of intent required?

There are no requirements for letters of support, intent or agreement in the NOFO.

If you choose to include letters of support, intent or agreement, keep in mind the following. A letter of agreement is a document that describes working relationships between your organization and other entities and programs cited in the proposal. Documents that confirm actual or pending contractual or other agreements should clearly describe the roles of the contractors and any deliverable. If desired, you can include letters of support as attachments 10-15 (other relevant documents). Letters of support must be dated and specifically indicate a commitment to the project/program (in-kind services, dollars, staff, space, equipment, etc.)

Is Attachment 8: Proof of Non-profit Status required if we are not a non-profit?

Proof of non-profit status is required only if you are applying as a non-profit entity.

Please confirm we are submitting a work plan for 5 years, as well as a budget and budget narrative for 5 years.

Yes, please submit the required work plan, budget, budget narrative, and budget SF-424A for all 5 years of the award. For more information, see pages 20 and 21 of the NOFO.

Do we need to use a specific template for the biographical sketch attachment?

No, the NOFO does not require a specific template for the biographical sketch attachment. Per page 20 of the NOFO, the biographical sketch should not exceed two pages in length per person. You can find additional information about recommended narrative and attachment formatting within the HRSA SF-424 Application Guide (PDF - 680 KB) (pages 35-40).

Can you clarify what needs to be included in the work plan for Years 2-5 since Year 1 is a planning year?

Per page 17 of the NOFO, applicants must include a Work Plan as Attachment 1. The work plan must, “Describe the activities or steps that you will use to achieve each of the activities proposed during the entire period of Performance in the Approach section. Use a timeline that includes each activity and identifies responsible staff in each Phase of the proposed project.”

This means the work plan should include the activities required throughout the period of performance, Phase I (Planning), and Phase II (Implementation and Building Sustainable Practices). In other words, all activities for Years 1-5 should be included in the workplan.

Should we include bio sketches of personnel who play a significant role in our program, but who will not be paid directly by this award, within our application?

Per page 20 of the NOFO, applicants should include bio sketches of any key personnel listed in the applicant’s Staffing Plan and Job Descriptions for Key Personnel (Attachment 2).

Page 39 of the HRSA SF-424 Application Guide (PDF - 680 KB) includes the following clarification: “Key Personnel: The Principal Investigator/Project Director (PI/PD) and other individuals who contribute to the programmatic development or execution of a project or program in a substantive, measurable way, whether or not they receive salaries or compensation under the award.”

Is Attachment 6 (Tables, Charts, etc.) required?

Attachment 6 is not a requirement. There are no requirements for including tables, charts, etc., in your application.

Can we fit 2 or more letters of agreement on one page within Attachment 4 (Letters of Agreement, MOU, etc.)?

There are no formatting requirements within the NOFO and the HRSA SF-424 Application Guide (PDF - 680 KB) that would restrict applicants from fitting 2 or more letters of agreement on one page for Attachment 4.

Objectives

What year should be used to set baseline data? 

For the State Determined Objectives: By the end of Year 1, you are expected to collect and report baseline data (page 2).

For the 1-3-6 Benchmarks: New recipients will establish baseline data in Year 1. Continuing recipients will report the state/territory’s data from the 2021 CDC EHDI Hearing Screening and Follow-up Survey as baseline data in Year 1 (page 3).

Could you please provide clarification on the State/Territory Determined Objectives?

State/Territory Determined Objectives reflect the unique needs of your state/territory. In the application, propose at least one objective, including annual percent increases, in each area:

Strengthening the infrastructure to coordinate services across the statewide EHDI system for DHH children to improve language acquisition outcomes.
Providing family-to-family supports and services across the EHDI system, which could include DHH adult-to-family supports and services.

Please define the specific cohort of children for who we are meant to “identify, collect, and report baseline data on language acquisition outcomes.”

The population of 3-year-old DHH children includes all DHH children identified from all states/territories. The NOFO does not specify parameters for recipients to use for this objective. These should be set based on the data collected and analyzed from state/territory EHDI programs.

States have the flexibility to define the cohort of children for this requirement. This can be based on the needs of your state/locality/community and the needs of the DHH children in your state. For example, cohorts could include DHH children in geographic areas based on school districts, states, local health districts, counties, regional health districts, etc. Because HRSA recognizes this is a new objective, a planning year (Year 1) has been built into the NOFO to assist recipients in finalizing data elements.

When are we expected to disaggregate language acquisition data to identify and address disparities?

While there is an expectation to report baseline language acquisition outcomes, the NOFO states (page 3) that this is expected by the end of Year 5. The findings, analysis and proposed solutions (reported in the State Infrastructure Plan) should inform Phase II of the Project. Using the analysis from Phase I and the built-in flexibility for state/territory programs to assess the needs and capacity of their Program, some states/territories may be able to do this prior to Year 5.

For the language outcomes data referred to on page 3 of the NOFO, is the data to be reported meant to be individual level data or summary/aggregate outcome data for the population of 3-year-olds?

The NOFO does not specify the level of data to be reported. Personal Health Information (PHI) will not be shared with HRSA.

Early intervention and language acquisition

Why is there a focus on language acquisition/language outcomes for EHDI programs?

The EHDI legislation charges HRSA with developing and monitoring the “efficacy of statewide programs and systems for hearing screening of newborns, infants, and young children; prompt evaluation and diagnosis of children referred from screening programs; and appropriate educational, audiological, medical and communication (or language acquisition) interventions (including family support) for children identified as deaf or hard of hearing.”

HRSA supports a comprehensive, coordinated portfolio of programs to ensure children who are deaf and hard of hearing and their families receive appropriate supports and timely services including hearing screening, diagnosis and early intervention to improve language acquisition outcomes.

What are the variables that HRSA EHDI expects programs to collect?

We encourage applicants to speak to local, state, and national partners, and examine existing resources on EHDI and early intervention to inform the application and describe what is needed to move toward data collection and reporting for language acquisition outcomes for DHH children up to age 3.

The planning year (Year 1) is intended to allow recipients to convene partners at various levels of the EHDI system, identify the needs of the state/territory to move toward data collection and reporting for language acquisition outcomes for DHH children up to age 3. The goal is to identify the leaks in the pipeline and to develop and implement a plan to identify language acquisition outcomes.

What resources are available to assist us in supporting language acquisition outcomes for DHH children up to age 3?

We encourage applicants to speak to local, state, and national partners, and examine existing resources related to EHDI and early intervention collaboration. Successful state/territory EHDI grant recipients will be supported in this area throughout the project period.

What aspects of emergent language acquisition are expected to be reported upon, as reading and writing are within the ASHA definition as well?

The NOFO does not specify emergent language acquisition outcomes. The intent of the funding opportunity is to allow states the flexibility to explore the aspects of language acquisition that are currently measured and/or the elements that could be measured by engaging various partners who support DHH children in the state. Language and language acquisition are multi-faceted constructs that are inclusive for receptive, expressive, verbal and non-verbal forms of communication.

Optional EHDI Innovation Project

Who is eligible to apply to the Optional EHDI Innovation Project?

Anyone eligible to apply for the HRSA-24-035 NOFO is eligible to apply for the Optional EHDI Innovation Project.

Can a state apply for the $75,000 supplemental funding for Years 2-5 if they do not apply for Year 1?

No. The NOFO states that there is an opportunity for supplemental funding for Year 1 of the Project. Funding for this project is contingent on the availability of appropriated funds.

Does the one-time optional funding have to be taken and received in year 1? For example, could we use it year 3?

Optional funding is available for Year 1 and should be spent in the Year 1 budget period (April 1, 2024 – March 31, 2025).

Is the optional $75K only for one year? If so, do we provide a 1-year budget for the optional 75K?

Yes, the optional innovation project is for $75,000 and must be implemented during Year 1 of the project. See page 13 of the NOFO. Page 17 of the NOFO provides additional details on how to apply for the 1-year Optional EHDI Innovation Project:

To be considered for the optional project, submit a proposal including a description of the need and proposed methods, work plan, budget, and budget narrative for a 1-year activity to build state/territory-level data and measurement capacity to improve language acquisition outcomes for DHH children (page 17 of the NOFO).

If you apply for this optional project, the plan and budget should be included in Attachment 9 and should be no longer than 5 pages.

On what can I spend the innovation project funds?

The proposed project should be innovative and lend itself to a promising practice in advancing data collection and reporting language outcomes for children identified as DHH (see Page 17 in NOFO).

Optional projects could include (Page 13 in NOFO):

Building data system capacity and interoperability
Identifying measures, developing, and collecting language acquisition data

Could you clarify the timeline of the innovation award?

The Optional EHDI Innovation Project is a 1-year project. The innovation award is to be implemented during Year 1 of the project, April 1, 2024 – March 31, 2025.

If funded, we plan to contract out to complete our Optional EHDI Innovation Project. Our contractor has prepared a budget justification and related documentation. Do we need to include their budget justification and related documents within our Year 1 budget?

No. Please note that the NOFO requires separate budget attachments for the NOFO budget and the Optional EHDI Innovation Project.

Applicants competing for the Optional EHDI Innovation Project should submit their project details and budget as a separate attachment. Per Attachment 9 details on NOFO page 21, applicants must, “Provide a plan and budget for the Optional EHDI Innovation Project as described in Section IV: Narrative and Program Requirements and Expectations. The attachment may be up to 5 pages in length. Please include a separate budget using the SF-424A for this attachment.”

The HRSA SF-424 Application Guide (PDF - 680 KB) provides detailed instructions for the budget submission, including specific instructions for budgeting for contracts. Per page 30 of the HRSA SF-424 Application Guide (PDF - 680 KB), “Contractual/Subawards/Consortium/Consultant: Provide a clear explanation as to the purpose of each contract/subaward, how the costs were estimated, and the specific contract/subaward deliverables. You should not provide line item details on proposed contracts, rather you should provide the basis for your cost estimate for the contract. You are responsible for ensuring that your organization or institution has in place an established and adequate procurement system with fully developed written procedures for awarding and monitoring all contracts/subawards. Recipients must notify potential subrecipients that entities receiving subawards must be registered in SAM and provide the recipient with their UEI number (see 2 CFR part 25).”

In addition to providing a narrative with budget for the supplement/optional innovation project, do we need to complete an SF-424 and SF-424A for it?

Yes, please submit the SF 424A if you plan on applying for the Optional EHDI Innovation Project. On page 17 of the NOFO it states: To be considered for the optional project, submit a proposal (including a description of the need and proposed methods work plan, budget, and budget narrative for a 1-year activity to build state/territory-level data and measurement capacity to improve language acquisition outcomes for DHH children. The NOFO also states (on page 17): If you apply for this optional project, the plan and budget should be included in Attachment 9 and no longer than 5 pages.

On page 21 of the NOFO it states: Provide a plan and budget for the Optional EHDI Innovation Project as described in Section IV: Narrative and Program Requirements and Expectations. The attachment may be up to 5 pages in length. Please include a separate budget using the SF-424A for this attachment.

If we plan to apply for the Optional EHDI Innovation Project, do we complete the SFLLL for $310,000 or for $235,000?

Applicants do not need to submit any longer the assurances and certifications with the application in Grants.gov. It is done when applicants register in SAM.gov. This is why it is important to keep your SAM.gov registration current and accurate each year.

Family engagement

Please provide an explanation of the role of the "Family Engagement Liaison" referenced in Phase II.

Per page 12 of the NOFO, applicants are required to designate a point person to serve as a Family Engagement Liaison. This is described as, “your state/territory EHDI program’s family lead for support and engagement activities. This individual will also coordinate and communicate with the Family Leadership in Language and Learning Center about state/territory needs.”

Please refer to the NOFO’s Glossary of Key Terms for additional information on family engagement, family support, and possible family engagement and support activities (pages 33-34).

Can the Family Engagement Liaison be a program staff member? If contracted, do they have to be from a specific family-based organization?

The NOFO does not specify whether the Family Engagement Liaison needs to be employed by the Program or be under contract. As described in the NOFO, the Family Engagement Liaison should be the program’s family lead for support and engagement activities and coordinate with the FL3 Center about state/territory needs. If contracted, they do not have to belong to a specific family-based organization.

If funding is given to a family support organization, can they use that funding to send families to the Annual Early Hearing Detection and Intervention Coordinators meeting?

Funds given to a family support organization must support the organization’s ability to provide family support services to families with DHH children (page 19 of the NOFO). Please note that travel for the designated Family Leader to attend the annual grantee meeting hosted by the FL3/ICC centers must be supported by the EHDI Program and is not included in the mandatory minimum requirement of funds specified for family engagement and support.

The 20% of funding towards family engagement is initially listed under Phase II (Years 2-5). Will this be required in Year 1 as well?

The 20% towards family engagement applies to all 5 years of the grant. Please refer to the Budget Narrative section of the NOFO (pg.19-20). Specifically, page 19, which states, “At a minimum, use 20 percent* of your funds to support family engagement and family support activities.”

Are we expected to conduct family engagement and support activities throughout all 5 years of the grant (Years 1-5)?

Yes, programs are expected to conduct family engagement and support activities throughout the project period (Years 1-5).

Per page 19-20 of the NOFO, recipients must, “At a minimum, use 20 percent* of your funds to support family engagement and family support activities. Possible activities include: 1) providing funds to a statewide family-based organization(s) or program(s) that provide(s) family support services to families with DHH children; 2) conducting family engagement and family support activities within the state/territory EHDI Program if led by DHH adult consumers or families of DHH children; or 3) a combination of contracted and state/territory EHDI Program family engagement and support activities. Below is a list of possible activities:

Programs are also expected to budget for one Family Leader to attend the Annual EHDI Coordinator’s Grantee Meeting (page 20) and engage families within the advisory committee (page 10) throughout the project period (Years 1-5).

Programs and activities that provide direct family-to-family support services to parents and families with a child newly identified as DHH.
Programs and activities that provide direct DHH adult consumer-to-family support services to parents and families with a child newly identified as DHH.
Stipends to Family Leaders who have a DHH child to participate on the state/territory EHDI advisory committee.
Salary for Family Leaders who have a DHH child or DHH adult consumers to serve as a staff member for the EHDI Program conducting family engagement and family support.
Other family support activities, pending approval from HRSA.

Budget

The budget period is for five years, but the SF424A only allows applicants to enter four years of budgetary information. How can we supply the budget information for the fifth year in our application?

Per page 21 of the NOFO, you will submit the SF-424A Section B for the 5th year as a separate attachment (Attachment 7). Please see the HRSA SF-424 Application Guide (PDF - 680 KB) and page 22 of the NOFO for additional instructions.

If there are multiple applications from a state/territory, are the awards/funds ever split?

Per page 6 of the NOFO, there will only be one award per state and territory.

The SF-424 Application Guide indicates that “costs incurred by advisory councils or committees are unallowable unless authorized by law, the HHS awarding agency, or as an indirect cost where allocable to federal grants.” Is travel reimbursement for EHDI advisory committee meetings an allowable cost for the project?

Travel is an allowable expense as long as it aligns with the goals and objectives of the program. Please see the details related to Travel expenditures within the HRSA SF-424 Application Guide (PDF - 680 KB) (page 30):

“Travel: List travel costs according to local and long distance travel. For local travel, outline the mileage rate, number of miles, reason for travel and staff member/consumers completing the travel. The budget should also reflect the travel expenses (e.g., airfare, lodging, parking, per diem, etc.) for each person and trip associated with participating in meetings and other proposed trainings or workshops. Name the traveler(s) if possible, describe the purpose of the travel, provide number of trips involved, the destinations, and the number of individuals for whom funds are requested.”

Is it allowable to submit the new NOFO budget proposal with a lower indirect rate than what our formal document for indirect states?

Applicants can charge the grant less than what their indirect cost rate agreement indicates.

Other

Is it possible to fulfill the website requirement through a contracted site, rather than from our state/territory’s government website?

The NOFO does not require the state/territory EHDI program websites to be hosted on a state/territory government website.

What type of technical assistance can state/territory EHDI programs expect from the EHDI National Network (HRSA-24-035)?

The EHDI National Network (HRSA-24-035) funds three centers: Implementation and Change Center (ICC), Family Leadership in Language and Learning Center (FL3), and the Provider Education Center (PEC).

While each national TA center has a distinct focus, all three recipients are expected to work together within the EHDI National Network to provide leadership to states and national, state, and local stakeholders through technical assistance and training (TA/T), policy analysis and assessment, partnership building, communication, dissemination, and evaluation.

We encourage applicants to review the HRSA-24-035 NOFO to learn more about the technical assistance that will be provided to state/territory EHDI programs and stakeholders.

Are state/territory EHDI programs required to share all data, reports, and other relevant information with the EHDI National Network (HRSA-24-035)?

Per page 10 of the NOFO, “state/territory programs must report data to the Network, as needed or requested.” Page 11 of the NOFO specifically requests that programs “provide a statewide infrastructure plan to the EHDI National Network (HRSA-24-05).

We encourage programs to share relevant data, reports, and other information with the EHDI National Network, as needed or appropriate. During Year 1, grantees will work with the EHDI National Network to determine relevant data and information needs.

Could you expand on the review process and how reviewers are selected?

Page 25 of the NOFO describes the Review and Selection Process. The applications will be reviewed by an independent, objective review committee. HRSA uses the review process outlined below:

HRSA ensures that the objective review process is independent, efficient, effective, economical, and complies with the applicable statutes, regulations, and policies. Applications are reviewed by subject matter experts knowledgeable in health and public health disciplines for which support is requested. Review findings are advisory to HRSA programs responsible for making award decisions.

Reviewers are professionals with expertise and experience consistent with the HRSA mission and competitive program needs to address the availability and delivery of quality health care to all Americans.

Learn how to become a HRSA reviewer.

When will the successful applicant be announced? How far ahead of the April 1, 2024 project start date?

The project start date is April 1, 2024, and, if funding becomes available for this program, HRSA’s goal is to issue the award at least 15 days in advance of the project start date.

Can you expand on what you mean by maintaining a "508-compliant" website?

The HRSA-24-036 notice of funding opportunity (NOFO) requires recipients to maintain a high-quality, accessible, public-facing website. HRSA released a clarification notice regarding this requirement, which can be found within the “Related Documents” tab of the HRSA-24-036 posting Grants.gov.

The NOFO uses the term “508 compliant” to describe website accessibility standards (NOFO pages 13, 16). However, federal award recipients are required to adhere to Section 504 of the Rehabilitation Act, Part 84, to ensure accessible communications for people with disabilities.

For the purposes of the HRSA-24-036 NOFO, HRSA would like to clarify that recipients should adhere to Section 504 of the Rehabilitation Act, rather than section 508.

Date Last Reviewed:

October 2023

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