FAQ: Healthy Start Initiative – Enhanced (HSE)

Funding Opportunity Numbers: HRSA 23-130 (New)

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 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.

Current Healthy Start and Catalyst for Infant Health Equity (Catalyst) recipients

Are current Healthy Start recipients eligible to apply to the HSE Notice of Funding Opportunity (NOFO)?

Yes. Eligible applicants include any domestic public or private entity. As noted on page 5 of the NOFO, domestic faith-based and community-based organizations, tribes, and tribal organizations are also eligible to apply. Recipients of Healthy Start Initiative: Eliminating Disparities in Perinatal Health (HRSA-19-049) are only eligible to apply for this grant if a new project area, not currently funded by your existing grant, is proposed.

Are current Catalyst recipients eligible to apply to the HSE NOFO?

Yes, although a current Catalyst recipient that is also a current Healthy Start recipient through HRSA-19-049 is only eligible to apply for this grant, if a new project area, not currently funded by your existing grant, is proposed.

Multiple applicants from a single state

How many Healthy Start and HSE awards will HRSA make per state?

As noted on page 33 of the NOFO, HRSA will award no more than 6 Healthy Start grants per state (i.e., awardees of HRSA -19-049 and HSE projects combined). A list of HRSA-19-049 recipients can be found online on the 2020 Healthy Start Grant Awards page.

Project area

Will HRSA fund more than one applicant proposing to serve the same project area?

Pages 8-9 of the NOFO indicate that if two applications receiving a fundable score propose to serve the same project area in full, HRSA will only consider the highest scoring application. If part of your project area overlaps with a project area proposed by another applicant, you must establish that there will be no overlap of population served or duplication in services provided. This includes recipients funded through Healthy Start Initiative: Eliminating Disparities in Perinatal Health (HRSA-19-049).

See page 9 of the NOFO for details on exceptions specific to American Indian/Alaskan Native (AI/AN) target populations and a situation where part of your proposed project area overlaps with a project area proposed by another applicant of HRSA-23-130.

Target population

Does the target population have to be defined by race/ethnicity?

As indicated on page 9 of the NOFO, your target population should be the group with the highest infant mortality rate (IMR) living in the project area.

Can an applicant propose more than one target population for the project area?

No. The target population is the population that you will serve within your project area. It should be the population with the highest rate of infant deaths (i.e., IMR). Please note that for an AI/AN primary target population, two applicants/recipients can propose to serve the same project area if the AI/AN population is the primary target population for one but not both of the two projects (a list of HRSA-19-049 recipients whose primary target population is AI/AN is available in Appendix E of the HRSA-23-130 NOFO). If two applicants propose the same project and the AI/AN population is the primary target for both, then only the highest scoring application will be considered.

Exceptions on serving more than target population are listed on page 9 of the NOFO.

Can an organization apply for this grant if its target population includes non-Hispanic whites and/or Hispanics?

Yes. As noted on page 9 of the NOFO, your target population should be the group with the highest IMR living in the project area.

Direct and enabling services

How many participants will HSE recipients serve annually?

Funded HSE projects will serve 650 participants annually: 450 participants through case management/care coordination and 200 participants through group-based education. Please reference pages 12-13 of the NOFO for additional information.

Community Consortia

Will an existing network be considered as a Community Consortium?

Yes. Community Consortia (formerly known as Community Action Networks or “CANs”) are intended to bring together various representatives across the community to address pressing issues and needs that may lead to poor perinatal health outcomes.

Can our existing Community Action Network serve as the Community Consortium for the proposed project area?

Yes. The existing Community Action Network may act as the Community Consortium. However, it must act on behalf of the proposed target population in the project area proposed for the HSE application.

Is there a minimum or maximum number of partners required in the Community Consortium?

No. It is expected that the Community Consortium will have representation from Title V, public health departments, hospitals, health centers under section 254b, State substance abuse agencies, and other significant sources of health care services. Other categories of partners can include: community leaders, representatives from service agencies, community-based organizations; state/non-profit organizations/faith-based organizations addressing housing, employment, education, transportation, and health care. For additional details on the composition of the Community Consortium please see pages 14-15 of the NOFO.

The Community Consortium plan

Our community has a plan to address perinatal outcomes and reduce infant deaths. Is a new plan required for HSE?

No. Recipients of HSE are to develop and submit a Community Consortium plan to address social determinants of health (SDOH) by June 30, 2024. If the recipient has an existing plan that meets the requirements in the NOFO, it can be submitted for review to your HRSA Project Officer. Plans should go beyond solely addressing barriers to clinical care and improving the local system of care. The plan should address the environmental, social, and economic conditions that contribute to disparities in perinatal outcomes. Plans are expected to be based upon the results of a community needs assessment and environmental scan that identifies and prioritizes SDOH causes of disparities in perinatal outcomes for the target population in the project area.

Is compensation to Community Consortium participants an allowable expense?

Yes. Page 22 of the NOFO asks that you state whether community members and/or HSE participants on the community consortium will be compensated for service provided.

Is there a required format/template for the Community Consortia plan?

No. HRSA does not require a specific format for the Community Consortia plan.

Budget

Can HSE funds be used to address participant needs such groceries, utility and rental assistance payments or income supplements?

No. As noted on page 24 of the NOFO, funds awarded under the Healthy Start Initiative - Enhanced NOFO cannot be used to provide in-kind benefits or cash payments (e.g., rental assistance payments, housing vouchers, income supplements, etc.).

Will HSE recipients be allowed to sub-contract with organizations that are providing in-kind benefits?

Yes, recipients may sub-contract with organizations that provide in-kind benefits. Recipients who plan to make sub-awards must describe how their organization will ensure proper use and documentation of funds.

Are applicants to submit a budget for the 5th year of the project only?

Applicants are to provide a 5-year budget for the proposed project. The NOFO directs applicants to include the 5th year budget as attachment 8 (see pages 24 and 26 of the NOFO).

Can HSE funds be used to purchase a vehicle?

Yes, the purchase of a vehicle is an allowable cost to support approved activities or programs of the grant.

Will funded organizations be allowed to combine HSE funding with non-federal sources of funding to implement planned activities?

Yes. There are no restrictions on use of non-federal funding to support implementation of HSE activities. HSE recipients may accept and use external funds to support implementation of their program components.

Are doulas counted toward the requirement that, 10% of award funds be dedicated to clinical services, as stated in the NOFO?

Doulas can be a part of the support team, or included as an addition to the services, but cannot be included in the 10%.

How do I designate my proposed project area as rural or urban?

If all or a majority of your target population resides in an urban area, you should designate your project as urban. If all or the majority of your target population resides in a rural area you should designate your project as rural, based on the results of the Rural Health Grants Eligibility Analyzer.