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93.926 HEALTHY START INITIATIVE

(Healthy Start)

FEDERAL AGENCY
HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

AUTHORIZATION
Public Health Service Act, Title III, Part D, Section 330H; 42 U.S.C. 254c-8.

OBJECTIVES
To eliminate disparities in perinatal infant and maternal health by: enhancing a community's health care infrastructure and service system and a State's infrastructure; and directing resources and interventions to improve access to, utilization of, and full participation in comprehensive perinatal and women's health services, particularly for women and infants at higher risk for poor health outcomes.

TYPES OF ASSISTANCE
Project Grants.

USES AND USE RESTRICTIONS
Every Healthy Start project implements community-driven approaches to address infant mortality rates by reducing maternal behavioral and medical risk factors and promoting healthy outcomes for women and their families. Beginning with prenatal care and continuing through the infant's second year of life, each community awarded funds assures the availability of a core set of services and activities for the perinatal population in their project area. These services include case management, home visiting and links to health care and other needed services for mothers and their infants; direct outreach and peer mentoring by trained community members; screening and referral for perinatal/postpartum depression; and strong coordination with and access to substance abuse, domestic violence, mental health, early intervention, parenting and other critical services for high-risk women and families. In addition, each Healthy Start project is required to have a community-based consortium composed of individuals and organizations and that includes women and families served by their project, to collaborate with their State Title V (MCH) Agency, and to implement a local health system action plan to improve the quality, cultural competence of and access to services and/or to address other problems in the local system of care. Funds may not be used to supplant currently funded activities/services.

Applicant Eligibility
Urban and rural communities with significant disparities in perinatal health, and States with need to build their infrastructure/capacity to address and support those communities trying to achieve the goals of the Healthy Start program. Eligible applicants are any public or private entity, including an Indian Tribe or tribal organization (as those terms are defined at 25 U.S.C. 450b). Community-based organizations, including faith-based organizations are eligible to apply.

Beneficiary Eligibility
Service area residents, particularly women and infants in areas with significant perinatal health disparities.

Credentials/Documentation
Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package.

Preapplication Coordination
This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office of the official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.

Application Procedure
Grant applications and required forms for this program can be obtained from Grants.gov. Please visit the Grants.gov Web site at www.grants.gov to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator. The Associate Administrator has the authority to make final selections for awards.

Award Procedure
See specific program grant guidance.

Deadlines
www.hrsa.gov.

Range of Approval/Disapproval Time
Final decisions are made approximately 166 days after receipt of applications.

Appeals
None.

Renewals
After initial award, projects may be renewed annually up to the limit of the project period upon the submission and approval of a satisfactory continuation application.

Formula and Matching Requirements
This program has no statutory formula or matching requirements.

Length and Time Phasing of Assistance
Project periods vary depending on specific grant announcement with non-competing continuation awards made on an annual basis for up to 5 years depending on satisfactory progress and subject to the availability of funds.

Reports
Grantees are required to submit progress reports on an annual basis. Financial status reports are required no later than 90 days after the end of each budget period. Final financial status and progress reports are due 90 days after the end of a project period.

Audits
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records
All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.

Account Identification
75-0350-0-1-550.

Obligations
(Grants) FY 07 $96,660,615; FY 08 es.t $94,450,895; and FY 09 est. $94,450,895.

Range and Average of Financial Assistance
$155,000 to $2,350,000; $974,653.

PROGRAM ACCOMPLISHMENTS
In FY 07, 102 projects were awarded to new and existing projects. It is estimated that 102 projects will be awarded in FY's 08 and 09.

REGULATIONS, GUIDELINES, AND LITERATURE
This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

Regional or Local Office
Director, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services, Room 18-12, Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-0543.

Headquarters Office
Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: 301-443-2385; Research and Training Branch: 301-443-3099; Government and Special Focus Branch: 301-443-3288.

Web Site Address
www.hrsa.gov

RELATED PROGRAMS
93.110, Maternal and Child Health Federal Consolidated Programs; 93.224, Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing Primary Care, and School Based Health Centers); 93.246, Health Centers Grants for Migrant and Seasonal Farmworkers.

EXAMPLES OF FUNDED PROJECTS
From pregnancy either to the next pregnancy or 2 years post delivery for the mother and infant, every Healthy Start project assures the availability of a core set of services and system building activities to the perinatal population in the project area. Projects include a consortium, case management, outreach, health education, screening and referral for depression, collaboration with State Title V, a local health system action plan, and plans for sustainability.

CRITERIA FOR SELECTING PROPOSALS
See specific program grant guidance.


General Services Administration
Office of Chief Acquisition Officer
Regulatory and Federal Assistance Division (VIR)