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FAQ: Maternal Mental Health and Substance Use Disorder (MMHSUD) Program

Funding Opportunity Number: HRSA-23-085

Estimated Number and Type of Award(s): HRSA expects to fund up to 14 awards in the form of cooperative agreements.

Estimated Annual Award Amount: The award will be funded up to $750,000 per award per year during the five-year project period. Funding beyond the first year is subject to the availability of appropriated funds for the MMHSUD Program in subsequent fiscal years, satisfactory progress, and a decision that continued funding is in the best interest of the Federal Government.

Period of Performance: The period of performance is September 30, 2023, through September 29, 2028 (5 years).

Application due date: Friday, June 2, 2023, at 11:59 p.m. ET.


Who is eligible to apply?
Eligible applicants are States, Indian Tribes, and Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act) (25 U.S.C. § 5304)).
Are US territories eligible to apply as a state?
Yes. Per Section 2(f) of the PHS Act, 42 U.S.C. § 201(f), the definition of state includes, in addition to the 50 States, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the Virgin Islands, American Samoa, and the Trust Territory of the Pacific Islands
Can a State University apply for this funding?
This Notice of Funding Opportunity (NOFO) is open to states, tribes and tribal organizations as outlined by the legislative authority. A State University may be eligible to apply for this funding if it has legislative authority to serve as a trustee of the state. If your state academic institution meets this requirement, be sure to include the necessary documentation as part of your application.
How can health networks be eligible to apply?
Hospital health networks themselves are not eligible to apply for this program. However, health networks can still support the implementation of the program by encouraging and supporting State Government agencies, tribes, or tribal organizations within their state to apply. This can include sharing how the health network can assist with implementation if a grant is awarded.
Can existing Screening and Treatment for Maternal Mental Health and Substance Use Disorders programs apply for the funding? Or is the funding limited to new programs?
This funding is not limited to new programs. States, Indian Tribes, and Tribal organizations may establish a new or enhance existing state, tribal, or regional networks that expand health care provider capacity to assess, treat, and refer pregnant and postpartum people with behavioral health concerns.


How much funding can I apply for?
You may apply for a ceiling amount of up to $750,000, annually per year. The ceiling amount you may request depends on the Total Number of Women of Reproductive Age within the State or Tribal Area(s). See the following table.
Total Number of Women of Reproductive Age Within the State or Tribal Area(s) Annual Funding Amount
≤200,000 Up to $500,000
≥200,000 Up to $750,000


How is Women of Reproductive Age defined?
Women of reproductive age is defined as women 15-44 years of age.
What data sources can I use to determine the number of Women of Reproductive age in my state?
The 2020 population estimates from the US Census Bureau for women 15-44 years of age by state (and some counties) are available from CDC WONDER (CDC WONDER) or March of Dimes Peristats. Population estimates for women 15-44 years of age for tribal areas can be calculated from U.S. Census Bureau My Tribal Area.
Who is the target audience for this funding?
The target audience for the MMHSU Program is front-line healthcare providers and practices that serve pregnant and postpartum individuals. HRSA is looking to fund applications that work directly with these providers to provide workforce training and support for screening and treatment of maternal mental health and substance use disorder.
Is the Project Narrative needed or it sufficient to just answer the question in NOFO?
A project narrative is necessary when submitting an application, as it is a required component of this NOFO. It should provide a comprehensive description of all aspects of the proposed project and be organized in alignment with the sections and format outlined on pages 11-16 of the NOFO. The narrative should be concise, self-explanatory, and consistent with forms and attachments.
Will HRSA determine what screening tool to use for mental health and substance use or can the state choose their own method of screening.
HRSA will not prescribe the selection of screening tools; applicants must include their proposed tools in the application. However, when submitting your application, it's important to propose evidence-based, trauma-informed, and culturally and linguistically appropriate screening tools. If your proposal is awarded, the final decision on screening modalities will be made through collaborative discussion and review with the project officer. The recipient will work with the project officer to finalize the screening tools and protocols to be used. Keep in mind that as a cooperative agreement, the recipient does not have the final say on program implementation. Therefore, submitting a comprehensive and evidence-based proposal outlining the screening tools and protocols for pregnant and postpartum individuals is crucial.
Will only one Grant be awarded per state? Or can one State receive multiple awards?
The MMHSUD program aims to expand its reach and impact. If multiple applications are received from the same state, HRSA will review and fund the highest-rated proposal that aligns with the program's goals. It is important to note that the final decision on awards will be based on the quality of the proposals and their ability to meet the program's objectives.
Does HRSA provide templates for Attachment 5 or can we use our own?
HRSA does not provide specific templates for Attachment 5. An applicant should draft their own templates for Letters of Agreement, Memoranda of Understanding, and/or contracts. However, it is important to ensure that all required elements are included in the letter and that it meets the requirements outlined in the NOFO.
Within the Needs Assessment section, are all Health Professional Shortage Areas (HSPAs) to be referenced (primary care, mental health, facility) or should applicants just focus on one in particular (e.g., mental health HSPAs)?
The NOFO provides guidance on the needs assessment section. It is important to provide a clear picture of what you are planning to implement in your application. If denoting all HSPAs will provide a clearer picture, then that may be the direction to take. However, it is ultimately up to the applicant to determine how they want to enhance their program within the guidelines of the NOFO.
Does the term "psychiatric consultation" require direct patient care services to be provided as part of this program, or can it refer primarily to provider-to-provider consultation services in which a psychiatrist provides consultation to frontline maternity care providers?
This program focuses on provider-to-provider consultation and training. Grant recipients are not required to provide direct services, but frontline healthcare providers who receive consultation and training may provide treatment to pregnant and postpartum individuals. Consultation may be provided in-person or remotely by various healthcare providers, including nurse practitioners, nurse midwives, obstetrician-gynecologists, pediatricians, psychiatrists, mental health care providers, and primary care clinicians.
How does HRSA defines "medically underserved" areas? Are there specific criteria those areas have to meet?
The term ‘‘medically underserved area’’ has the meaning given the term ‘‘medically underserved community’’ in section 799B(6) of the Public Health Service (PHS) Act (42 U.S.C. § 295p(6)). Section 799B(6) of the PHS Act defines the term ‘‘medically underserved community’’ as an urban or rural area or population that— (A) is eligible for designation under section 332 of the PHS Act as a health professional shortage area; (B) is eligible to be served by a migrant health center under section 329 of the PHS Act, a community health center under section 330 of the PHS Act, a recipient under section 330(h) of the PHS Act (relating to homeless individuals), or a recipient under section 340A of the PHS Act (relating to residents of public housing); (C) has a shortage of personal health services, as determined under criteria issued by the Secretary under section 1861(aa)(2) of the Social Security Act (relating to rural health clinics); or (D) is designated by a State Governor (in consultation with the medical community) as a shortage area or medically underserved community.
Is there a significant difference between this new HRSA grant program and the prior Maternal Depression and Related Behavioral Disorder (MDRBD) program?
This new grant program has several differences from the previous one. Firstly, the name has been changed. Secondly, the eligibility criteria have been expanded to include Indian Tribes and Tribal Organizations in addition to States. Thirdly, there is now a requirement for cost sharing or match funding which was not required before. Fourthly, the program includes up to four (4) funding priority points. Lastly, the MMHSUD is tiered funding; ceiling amount is based on the number of women of reproductive age within the State or Tribal Area(s).
Are there any unique expectations for states with existing MDRBD funding with this NOFO?
This is a new funding opportunity, and there are no unique expectations for state who currently have MDRBD grant funding. Each application will be evaluated based on the review criteria outlined in this NOFO, and the merits of the application will be reviewed scored accordingly.
For a new program starting with no history of service, would they be considered for funding?
Program history is not a requirement, and all organizations are encouraged to submit an application, if they meet the eligibility criteria found in page 6 of the NOFO. The application should be succinct, self-explanatory, consistent with forms and attachments, and organized in alignment with the sections and format provided so that reviewers can understand the proposed project.
Is it possible to find out which government entity in my state might be applying for this grant and to reach out to collaborate with them?
You should connect with your state's Department of Public Health or Title V Maternal and Child Health (MCH) Block Grant Directors. These individuals are well-informed about funding opportunities. You can send an email inquiring if someone in their organization is responding to this NOFO and expressing interest in collaborating. The names and contact information the Title V MCH Block Grant Directors can be found on the Association of Maternal and Child Health Programs (AMCHP) website.

Data requirements

What are the data collection and reporting requirements and measures?
Page 29 of the NOFO provides a list of all the DGIS Performance Reports awardees are required to report on (Core 3; Financial Forms 1, 6, and 7; Capacity Building 1, 4, 6, and 8; Women’s/Maternal Health 4; Training 15; and Products and Publications) and a link to the reporting package that shows all of the forms. Please note, Financial Form 2 is no longer required. In addition, the purpose section of the NOFO (pages 1 and 2) lists four objectives that awardees will be expected to track and report on. The first two program objectives will be reported on the DGIS Training Form 15 and the second two objectives will be reported on in a separate program report, such as a Non-competing Progress Report or a separate Request for Information. The DGIS Training Form 15 can be found at the forms link in the “Forms for Program-Specific Measures” section under the “Division of Workforce Development” link.
Is the collection of client-level screening data required?
Page 29 of the NOFO provides a list of the DGIS Performance Reports and a link to where the reporting package (which includes the forms) can be found. The DGIS Training 15 form includes one question regarding screening that is optional, so programs can choose whether to report screening data. The DGIS Training 15 form can be found at the forms link in the “Forms for Program-Specific Measures” section under the “Division of Workforce Development” link.
Besides the DGIS performance measures, are their other reporting measures we need to address in the application?
Page 1 of the NOFO lists the program objectives. Please follow the narrative guidance in the NOFO to be sure you fully address the review criteria. The table on Page 11 of the NOFO shows how the narrative sections crosswalk with the review criteria sections.


Is the personnel salary cap per role, or for all roles combined?
The Executive Level II cap is per role, not combined.
Is cost sharing and/or matching required for this NOFO?
This funding opportunity requires not less than 10% non-federal matching funds in years 1-5.
Can HRSA share additional information about the requirements and/or limitations of cost sharing?
This funding opportunity requires not less than 10% non-federal matching funds in years 1-5. The budget justification/narrative should clearly describe how the matching requirement will be met in each year of the 5-year period of performance. Refer to page 6 of the NOFO for examples of possible sources to meet the 10% non-federal cost sharing/matching requirement.
How does HRSA want the cost sharing to show in the budget? Is there a special format?
Cost sharing should be reflected in the SF-424A Line-Item Budget and Budget Narrative.
Does HRSA have an indirect cost rate agreement? If so, can applicants receive a copy?
If your organization does not have an indirect costs rate, you may wish to obtain one through HHS’s Program Support Center (PSC). Visit PSC’s Indirect Cost Negotiations website.
Does HRSA require specific budget form for the 5-year budget, or can applicants use their own?
Applicants must use the SF-424A Line-Item Budget.
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