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FAQ: Enhancing Systems of Care for Children with Medical Complexity

Funding Opportunity NumbersHRSA-22-088 (Coordinating Center) and HRSA-22-098 (Demonstration Projects)

NOFO Technical Assistance

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

View the webinar recording.

When I try to apply for the grant, the Apply tab does not work.

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

Telephone: 1-800-518-4726 (International callers dial 606-545-5035)


View the webinar recording.


Is my program eligible for this funding mechanism?

Read information about the HRSA-22-098 and HRSA-22-088 programs, including who is eligible to apply, instructions on how to apply, the program goals and objectives, and the program requirements and expectations of successful applicants.

Are awards limited to one per state if there are multiple submissions from that state?

There is not a limitation on how many awardees can come from a single state.

Are previous Children with Medical Complexity (CMC) Collaborative Improvement and Innovation Network (CoIIN) project state team awardees qualified to apply?

Previous CMC CoIIN project state teams are eligible to apply for this program if they meet the eligibility requirements above.

Is there an age cut-off for this grant?

HRSA defines children with special health care needs (CSHCN) as those children who have, or are at an increased risk of, a chronic physical, developmental, behavioral, or emotional condition and require health care and related services of a type or amount beyond that required by children generally. Children with medical complexity, a subgroup of CSHCN, are children who are the most medically fragile and have the most intensive health care needs. For reference, the population of CSHCN served by state Title V Maternal and Child Health (MCH) Services Block Grant is inclusive of children and youth, ages one through 21 years.

Do the project services need to occur in a particular setting?

The NOFO does not specifically state where services need to be provided.


Will payments for subcontractors go through the awardee or directly to the subcontracts based on the submitted budget?

Payments to contractors/subrecipients must be made in accordance with the grant recipient’s organizational policies and procedures. Grant recipients must have in place an established and adequate procurement system with fully developed written procedures/policies for awarding and monitoring all contracts.

Are project contractors and subcontractors required to register in before the application is submitted? Does this mean anyone with a Memorandum of Understanding (MOU) needs to register in

Per page 30 of the SF-424 Application Guide, contractors/subrecipients must register in The registration must remain active during the application process as well as during the full grant period. The applicant organization is responsible for ensuring that the contractors/subrecipients are registered and continue to ensure that the registration remains active.

Would income obtained during the grant be utilized along with the grant monies or would it be utilized in place of the grant monies?

All program income generated as a result of the awarded funds must be used for approved project-related activities. Any program income earned by the recipient must be used under the addition or additive. You can find Post-Award requirements for the program income at 45 CFR 75.307. Treatment of program income, if generated by your organization, must be used or rolled back to support approved project activities.

Regarding Section IV, Item 6.5 (Funding Restrictions on Cash Stipends/Incentives), does this mean we cannot provide parental incentive for survey completion?

Grant funds cannot be used for cash stipends/monetary incentives. Incentives can be provided as long as they align with the NOFO and programmatic requirements. An example of an acceptable incentive is in the form of gift cards.

Program Requirements

Can you please elaborate on "Children with Medical Complexity"?

The definition of children and youth with special health needs and how children with medical complexity are characterized is on page 4 of the application guidance.

For previous CMC CoIIN activities/investments, is it preferred that these activities are built upon, or are new innovations also suitable?

This is a competitive application and we are looking at how well applicants respond to program requirements in this next iteration. We encourage novel and innovative projects.

How involved will the evaluation for the demonstration project need to be? Should we hire evaluators?

Pages 11-14 and 18-19 of the NOFO lists program requirements and expectations and what program recipients are expected to measure during the project. It is up to the organization to determine if their organization has the capacity to accomplish what is needed for the evaluation in house, or if they need to hire an evaluator. Some of the data collection and evaluation activities are listed below:

HRSA-22-098 – Demonstration Projects

Regarding models of care delivery, successful recipients will:

  1. Implement and evaluate evidence-informed models of care designed to optimize CMC’s health, general functioning/quality of life and family well-being
  2. Plan for evaluation of project activities including measurement of progress on the program objectives and any additional measures

Regarding data collection, successful recipients will:

  1. Conduct a health equity assessment of the CMC target population within the first year of the project to identify challenges and barriers these children and families face in accessing services in their current system of care
  2. Collect and analyze data to measure progress on the program objectives
  3. Collect and analyze data on additional measures (up to three additional measures is recommended)

HRSA-22-088 – Coordinating Center

Regarding training and technical assistance, the successful recipient will:

  1. Assist HRSA-22-098 recipients with the development, implementation, evaluation, and replicability/scalability of their models of care
  2. Assist HRSA-22-098 recipients with the collection of data to measure and evaluate the effectiveness and impact of their demonstration project

Regarding evaluation, the successful recipient will:

  1. Assist HRSA-22-098 recipients with the development and evaluation of additional measures specific to each demonstration project
  2. Evaluate the progress of the HRSA-22-098 recipients in meeting the goals and objectives of the program
  3. Evaluate the progress of the coordinating center in meeting the goals and objectives of the program

Will HRSA provide the health equity assessment framework or can an applicant select an assessment framework?

Applicants can select the health equity assessment framework.

For the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and the Pediatric Integrated Care Survey (PICS) requirements listed under the HRSA-22-098 objectives, are these collected in their entirety or only use the appropriate sections?

Program recipients would only need to collect data on the sections that are appropriate to measure the objectives.

Do applicants for the coordinating center need to be specific about what aspects of the demonstration projects they would be coordinating?

The NOFO identifies areas where the coordinating center will work with the demonstration projects, and applicants can respond with the specific activities that address where the NOFO is expecting the coordinating center to provide support to the demonstration projects.

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