[]{.mark}

[]{.mark}

**U.S. Department of Health and Human Services**

**Health Resources and Services Administration**

*Maternal and Child Health Bureau*

*Genetic Services Branch*

*Division of Services for Children with Special Health Needs*

***Regional Genetic and Newborn Screening Services***

*New Competition*

*HRSA-06-065*

**Catalog of Federal Domestic Assistance (CFDA) #93.110**

**PROGRAM GUIDANCE**

Fiscal Year 2006

Letter of Intent Due Date: December 7, 2005

**Application Due Date: January 13, 2006**

**Release Date: November 17, 2005**

**Date of Issuance: November 17, 2005**

Michele A. Lloyd-Puryear, MD, PhD

Chief, Genetic Services Branch

Telephone: 301/443-1080

Fax: 301/443-8604

*Authority: Section 501(a) (2) of the Social Security Act; 42 U.S.C.
701(a) (2) and Title XI, Sections 1109 and 1110 of the Public Health
Service Act, 42 U.S.C. 300b-8 and 9.*

**Executive Summary**

The purpose of this grant activity is to fund a new initiative to
support: national and regional collaborative activities to address the
infrastructure needs of state-based newborn screening programs.

Newborn screening in the United States is a public health program aimed
at the early identification of conditions for which early and timely
interventions can lead to the elimination or reduction of associated
mortality and morbidity. This screening takes place within the context
of a newborn screening system and involves the following components:
screening, follow-up, diagnosis, management, education and evaluation.

The importance of ensuring that results of newborn screens are shared
with the child's medical home is critical and involves a partnership at
each step of the newborn screening system process. The program's
efficiency and effectiveness has depended upon the smooth integration of
sample collection, laboratory testing, follow-up, diagnosis, timely
treatment, and tracking of outcomes. This grant activity focuses on the
follow-up component of newborn screening. The selected applicant is
eligible for one (1) year of funding.

**Table of Contents**

Funding Opportunity Description [2](#funding-opportunity-description)

Purpose [2](#purpose)

Project Activities [2](#project-activities)

Project Descriptions [2](#project-descriptions)

**Project 1: National Collaborative Activities** 6

**Project 2: Regional Collaborative Activities**
[2](#project-2-regional-collaborative-activities-1)

Integrated Child Health Information Systems
[2](#__RefHeading___Toc116463705)

Educational Initiative [2](#ii.-educational-initiative)

Newborn Screening Laboratory Test Performance Initiatives
[2](#iii.-newborn-screening-laboratory-test-performance-initiatives)

Background [2](#background)

Award Information [2](#award-information)

Type of Award [2](#type-of-award)

Summary of Funding [2](#summary-of-funding)

Eligible Applicants [2](#eligible-applicants)

Cost-Sharing/Matching [2](#cost-sharingmatching)

Other [2](#other)

Application Materials [2](#application-materials)

Content and Form of Application Submission
[2](#content-and-form-of-application-submission)

Application Format Requirements [2](#application-format-requirements)

Application Format [2](#application-format)

Application Face Page [2](#application-face-page)

Table of Contents [2](#table-of-contents)

Application Checklist [2](#application-checklist)

Budget Information [2](#budget-information)

Budget Justification [2](#budget-justification)

Assurances [2](#assurances)

Certifications [2](#certifications)

Project Abstract [2](#project-abstract)

Program Narrative [2](#program-narrative)

Appendices [2](#appendices)

Submission Dates and Times [2](#submission-dates-and-times)

Intergovernmental Review [2](#intergovernmental-review)

Funding Restrictions [2](#funding-restrictions)

Other Submission Requirements [2](#other-submission-requirements)

Application Review Information [2](#application-review-information)

Review Criteria [2](#review-criteria)

Review and Selection Process [2](#review-and-selection-process)

Anticipated Announcement and Award Dates
[2](#anticipated-announcement-and-award-dates)

Award Administration Information [2](#award-administration-information)

Award Notices [2](#award-notices)

Administrative and National Policy Requirements
[2](#administrative-and-national-policy-requirements)

Post Award Reporting [2](#post-award-reporting)

Performance Review [2](#__RefHeading___Toc116463741)

Agency Contacts [2](#agency-contacts)

Other Information [2](#other-information)

Tips for Writing a Strong Application [2](#__RefHeading___Toc116463744)

Appendix 1 [2](#__RefHeading___Toc116463745)

Appendix 2 [2](#__RefHeading___Toc116463746)

Appendix 3 43

Appendix 4 [2](#appendix-4)

Appendix 5 [2](#__RefHeading___Toc116463749)

# Funding Opportunity Description

## Purpose

Social Security Act, Section 501(a) (2); 42 U.S.C. 701(a) (2) and Title
XI, Section 1109 and 1110 of the Public Health Service Act, 42 U.S.C.
300b-8 and 9. The amendments to the Public Health Service Act with
respect to children's health may be cited as the ''Children's Health Act
of 2000". Title XXVI of the Children's Health Act of 2000 is entitled,
"Screening for Heritable Disorders".

This announcement solicits applications for Regional Genetic and Newborn
Screening Services (Activity Code: U22, Heritable Disorders, CFDA
#93.110).

The purpose of this grant activity is to fund an initiative to support
national and regional collaborative activities to address the
infrastructure needs of state-based newborn screening programs.

## Project Activities {#project-activities .unnumbered}

Applicants that represent national and regional collaborative activities
are invited to submit applications in response to this guidance.
National activities must address one or more of the project activities
listed below under *"Project 1".* The regional activities must address
one (1) or more of the project activities listed under "*Project 2*."
The regional activities are grouped by the three (3) project foci:
*Integrated Child Health Information Systems* (three \[3\] project
activities); *Educational Initiatives* (one \[1\] project activity),
and/or *Laboratory Test Performance* (seven \[7\] project activities).
Specific information on the project activities is provided under
"**Project Descriptions"** on page [7](#project-descriptions).

### Project 1: National Collaborative Activities {#project-1-national-collaborative-activities .Style-Heading-3-+-Bold}

[Project Activities]{.underline}

i.  Pilot Studies

ii. Guidance Materials

iii. National Plan For Educational Programs

### Project 2: Regional Collaborative Activities {#project-2-regional-collaborative-activities .Style-Heading-3-+-Bold}

> [Project Foci and Activities]{.underline}

i.  Integrated Child Health Information Systems

-   Pilot 1, 2 and/or 3

iv. Educational Initiatives

v.  Laboratory Test Performance

-   Projects 1 to 7

Each proposed project activity included in an application will be
reviewed as a separate proposal within the application. Hence, each
proposal must include all the guidance requirements for an application,
to include narrative, budget, budget justification, staffing plan and
personnel requirements. Project activity proposals must be able to
"stand-alone".

**NOTE:** Funding is for 1 (one) year. To minimize the burden on
applicants, the narrative, budget, budget justification, staffing plan
and personnel requirements for each project activity that is being
proposed must not exceed ten (10) pages; and appendices for each project
activity that is being proposed must not exceed ten (10) pages. The
total pages for the applications must not exceed 80 pages.

Applications, whether submitted electronically or on paper, that exceed
the specified limits (80 pages or approximately 10 MB, or that exceed 80
pages when printed by HRSA) will be deemed non-compliant. All
non-compliant applications will be returned to the applicant without
further consideration.

## Project Descriptions {#project-descriptions .unnumbered}

### Project 1: National Collaborative Activities {#project-1-national-collaborative-activities-1 .Style-Heading-3-+-Bold}

The national collaborative activity is expected to outline a project
proposal to address one or more of the following activities:

1.  Develop, in coordination with relevant health professional
    organizations and lay advocacy organizations, practice guidance
    materials (e.g., ACTion sheets, diagnostic algorithms) for primary
    care professionals for the management and treatment of infants
    identified through newborn screening programs. This activity should
    include pilot studies for existing follow-up and treatment
    guidelines for the diagnosis and management of genetic conditions
    identified through newborn screening programs. These guidelines
    should be accompanied by culturally and linguistically appropriate
    materials for patients and their families.

2.  Develop, in coordination with relevant health professional
    organizations and lay advocacy organizations, practice guidance
    materials (ACTion sheets, diagnostic algorithms) for primary care
    professionals for management of genetic conditions other than those
    related to newborn screening. These materials should be accompanied
    by culturally and linguistically appropriate materials for patients
    and their families.

3.  Develop and implement, in coordination with relevant health
    professional and lay advocacy organizations, a national plan to
    address primary care professionals' education about newborn
    screening and genetics. The plan should utilize existing tools such
    as Genetics through the Primary Care Lens
    ([www.genetests.org](http://www.genetests.org/) or
    [www.genetictools.org](http://www.genetictools.org/)) and be
    provided in a variety of formats and forums that are accessible to
    appropriate primary care professionals.

### Project 2: Regional Collaborative Activities {#project-2-regional-collaborative-activities-1 .Style-Heading-3-+-Bold}

This grant activity focuses on the follow-up component of newborn
screening. Newborn screening in the United States is a public health
program aimed at the early identification of conditions for which early
and timely interventions can lead to the elimination or reduction of
associated mortality and morbidity. This screening takes place within
the context of a newborn screening system and involves the following
components: screening, follow-up, diagnosis, management, evaluation, and
education.

It is important to ensure that the results of newborn screens are shared
with the child's medical home. A partnership at each step of the newborn
screening process with the medical home is critical to the improvement
of health outcomes. The program's efficiency and effectiveness has
depended upon the smooth integration of sample collection, laboratory
testing, follow-up, diagnosis, timely treatment, and tracking of
outcomes.

Applicants are expected to submit a proposal to strengthen newborn
screening follow-up using one or more of the three (3) project foci
which are listed below: **Integrated Child Health Information Systems**;
**Educational Initiatives**; or **Newborn Screening Laboratory Test
Performance Initiatives**. Collaborative efforts between states within a
region are encouraged.

*i. Integrated Child Health Information
Systems*[]{#__RefHeading___Toc116463705 .anchor}

Children's health and health services can be improved by the timely
provision of accurate and comprehensive information. MCHB and the
American Academy of Pediatrics co-sponsored a Newborn Screening Task
Force that issued a report in August 2000, supporting the integration of
newborn screening information. In response to these recommendations,
MCHB has established a partnership with the Public Health Informatics
Institute to develop a body of knowledge and resources to support State
public health programs as they build the infrastructure to ensure an
effective newborn screening follow-up program (see the list of resources
on page [38](#resources)).

In particular, applicants should use the self-assessment checklist in
the "Framework for Integrating Child Health Information Systems"
(Framework) as applicable to inform their project.  The checklist will
assist the project manager in assessing which of the principles and core
functions are incorporated into their integrated information system and
where they need to be focusing their efforts. The self-assessment
checklist is available at: <http://www.phii.org/Files/CHISchecklist.pdf>

The complete "Framework for Integrating Child Health Information
Systems" which includes an introduction and background to the
development of the Framework and a list of the principles, core
functions and performance measures is available at:
<http://www.phii.org/Files/CHISframework.pdf> and additional information
is available at:\
<http://www.phii.org/CoreFunctions.html>

Using information systems should facilitate follow-up programs and
processes by providing accurate and timely information, increasing and
facilitating communication between the private healthcare system and
public health agency components of the newborn screening program, as
well as within the public health agency, and facilitating the tracking
of the infant through the system to ensure that services (diagnosis,
treatment, and management) are delivered in a timely manner. The
ultimate goal is the accessibility of comprehensive health data (Child
Health Profile) to the medical home.

Applicants focusing on integrated information systems to strengthen
their follow-up program are expected to outline project proposals to
address one or more of the following activities:

1.  Develop and implement a pilot project to determine how many
    providers (i.e., in primary care clinical settings, emergency rooms,
    and newborn screening follow-up programs) would report using a Child
    Health Profile (web-based or other) to access an integrated child
    health information system while the patient was being seen. In
    addition, the proposal should outline how the applicant will
    determine if access to this information led to providing additional
    service referrals of the patient/client; and provided information
    useful for the care of the patient/client and/or the newborn
    screening program.

> Integration of disparate data to create useful information resources
> and design considerations for more effective clinical data collection
> systems at the point-of-care should be addressed. Applicants are
> encourage to take advantage of The National Center of Medical Home
> Initiatives for Children with Special Healthcare Needs
> \<[http://www.medicalhomeinfo.org](http://www.medicalhomeinfo.org/)\>
> to identify existing groups and/or committees that have shared goals
> and an invested interest in newborn screening follow-up to help in the
> continued development of integrated child health information systems
> in concert with the medical home.

4.  Develop and implement a pilot study to evaluate how the integrated
    information system increases the timeliness and universality of
    newborn screening within two (2) or more States within a region.
    This study is to determine if use of an integrated child health
    information system, i.e. Child Health Profile (web-based or other),
    is a feasible tool for quality improvement efforts. Adequate
    monitoring includes defining the population of infants as a focus,
    monitored linkage to birth records, awareness of testing performed
    on babies who have moved out of the States' jurisdiction, may have
    been transferred out of State after birth, or may have been tested
    by other laboratories including military or alternative private
    laboratories (that may have received a request for supplemental
    screening that included the program mandated tests).

5.  Develop and implement a pilot study to evaluate the follow-up system
    for newborn screening using the integrated information system.
    Components of the evaluation should include as a minimum: (1) time
    from birth to diagnosis (may include as components, time from birth
    to specimen collection, time from collection to receipt in
    laboratory, time from laboratory report to diagnosis, and time from
    birth to treatment initiated, if appropriate), (2) process for
    monitoring disposition for all cases, (3) collection and evaluation
    of confirmatory biochemical data where appropriate, and (4) a
    process for identifying reasons for cases lost to follow-up and late
    to diagnosis with documentation of corrective actions taken to
    ensure that the problem does not reoccur.

### Additional Requirements

The applicant should represent a regional collaborative effort and work
with States nation-wide that have operational integrated child health
information systems to identify projects for funding. Such projects
should support enhanced tracking of infants identified with out-of-range
or invalid screening results by newborn screening programs to provide or
support follow-up activities in their regions.

All project proposals should use a logic model (see list of resources
[[38]{.mark}](#resources)) to formulate questions to be answered with
data from their integrated child health information system to address
operational aspects of their work as well as the effectiveness of their
follow-up program. The application should address how States can
translate the questions into data analyses, and use them to improve
service efficiency, effectiveness, and impact. States should document in
what ways and to what degree these efforts require or have resulted in a
change to the culture of the organization.

Project proposals should consider the use of the following performance
measures and health systems capacity indicators.

+------+---------------------------------------------------------------+
| Mate |                                                               |
| rnal |                                                               |
| And  |                                                               |
| C    |                                                               |
| hild |                                                               |
| He   |                                                               |
| alth |                                                               |
| Serv |                                                               |
| ices |                                                               |
| \--  |                                                               |
| T    |                                                               |
| itle |                                                               |
| V    |                                                               |
| B    |                                                               |
| lock |                                                               |
| G    |                                                               |
| rant |                                                               |
| Pro  |                                                               |
| gram |                                                               |
| Guid |                                                               |
| ance |                                                               |
| And  |                                                               |
| F    |                                                               |
| orms |                                                               |
| for  |                                                               |
| the  |                                                               |
| T    |                                                               |
| itle |                                                               |
| V    |                                                               |
| Ap   |                                                               |
| plic |                                                               |
| atio |                                                               |
| n/An |                                                               |
| nual |                                                               |
| Re   |                                                               |
| port |                                                               |
|      |                                                               |
| (see |                                                               |
| list |                                                               |
| of   |                                                               |
| r    |                                                               |
| esou |                                                               |
| rces |                                                               |
| [    |                                                               |
| 38]( |                                                               |
| #res |                                                               |
| ourc |                                                               |
| es)) |                                                               |
+------+---------------------------------------------------------------+
|      | Health "Systems Capacity" Indicator                           |
+------+---------------------------------------------------------------+
| #0   | The ability of States to assure that the Maternal and Child   |
| 9(A) | Health program and Title V agency have access to policy and   |
|      | program relevant information and data. (Form 19)              |
+------+---------------------------------------------------------------+
|      | National Performance Measures                                 |
+------+---------------------------------------------------------------+
| #01  | The percent of newborns who are screened and confirmed with   |
|      | condition(s)                                                  |
|      |                                                               |
|      | mandated by their State-sponsored newborn screening programs  |
|      | (e.g.                                                         |
|      |                                                               |
|      | phenylketonuria and hemoglobinopathies) who receive           |
|      | appropriate follow up as defined by their State.              |
+------+---------------------------------------------------------------+
| #12  | Percentage of newborns who have been screened for hearing     |
|      | before hospital discharge.                                    |
+------+---------------------------------------------------------------+

+------+---------------------------------------------------------------+
| Per  |                                                               |
| form |                                                               |
| ance |                                                               |
| Meas |                                                               |
| ures |                                                               |
| for  |                                                               |
| In   |                                                               |
| tegr |                                                               |
| ated |                                                               |
| C    |                                                               |
| hild |                                                               |
| He   |                                                               |
| alth |                                                               |
| Inf  |                                                               |
| orma |                                                               |
| tion |                                                               |
| Sys  |                                                               |
| tems |                                                               |
| (IC  |                                                               |
| HIS) |                                                               |
|      |                                                               |
| (see |                                                               |
| list |                                                               |
| of   |                                                               |
| r    |                                                               |
| esou |                                                               |
| rces |                                                               |
| on   |                                                               |
| [    |                                                               |
| 38]( |                                                               |
| #res |                                                               |
| ourc |                                                               |
| es)) |                                                               |
+------+---------------------------------------------------------------+
|      | Newborn Hearing Screening Follow-up                           |
+------+---------------------------------------------------------------+
| PM 6 | Percent of children who did not pass initial hearing          |
|      | screening AND who are enrolled in/referred to an early        |
|      | intervention or other appropriate program OR found not to     |
|      | have hearing loss by 6 months of age.                         |
+------+---------------------------------------------------------------+
|      | N: From the denominator, number of records of children who    |
|      | were found [not]{.underline} to have hearing loss OR found to |
|      | have hearing loss and were enrolled in/referred to an early   |
|      | intervention or other appropriate program within 6 months of  |
|      | age.                                                          |
|      |                                                               |
|      | D: Total number of resident live births occurring in the      |
|      | jurisdiction during a specified time interval (mm/dd/yyyy -   |
|      | mm/dd/yyyy) who did not pass their initial hearing screening. |
+------+---------------------------------------------------------------+

+------+---------------------------------------------------------------+
|      | Newborn Dried Blood Spot Screening Follow-Up                  |
+------+---------------------------------------------------------------+
| PM   | Percent of children with out-of-range congenital              |
| 7A   | hypothyroidism screening results, who have been diagnosed AND |
|      | are under appropriate management by 21 days of birth. (NOTE:  |
|      | Appropriate management means the child is either in the NICU  |
|      | or has entered into a system of health care.)                 |
+------+---------------------------------------------------------------+
|      | N: From the denominator, number of records of children who    |
|      | have been diagnosed and are under appropriate management by   |
|      | 21days of birth.                                              |
|      |                                                               |
|      | D: Total number of resident live births occurring in the      |
|      | jurisdiction during a specified time interval (mm/dd/yyyy -   |
|      | mm/dd/yyyy) with out-of-range congenital hypothyroidism       |
|      | screening results.                                            |
+------+---------------------------------------------------------------+
| PM   | Percent of children with hemoglobin screening results         |
| 7B   | suggesting either Sickle Cell Anemia, Sickle C Disease or     |
|      | Beta Thalassemia, who have been evaluated and are under       |
|      | appropriate management by 2 months of age.                    |
+------+---------------------------------------------------------------+
|      | N: From the denominator, number of records of children who    |
|      | have been evaluated and are under appropriate management by 2 |
|      | months of age.                                                |
|      |                                                               |
|      | D: Total number of resident live births occurring in the      |
|      | jurisdiction during a specified time interval (mm/dd/yyyy -   |
|      | mm/dd/yyyy) with hemoglobin screening results suggesting      |
|      | either Sickle Cell Anemia, Sickle C Disease or Beta           |
|      | Thalassemia.                                                  |
+------+---------------------------------------------------------------+

Awardees will work with the Federal project officer and the Newborn
Screening Informatics Practice Network/ Child Health Information System
Collaborative (New Competition HRSA-06-066) to develop products for
dissemination that can be adapted by other States and/or regions, to
include publication in peer reviewed journals.

#### ii. Educational Initiative {#ii.-educational-initiative .unnumbered}

Education of parents and providers is an important component of the
newborn screening system, and is especially crucial to follow-up. This
second project focus includes the establishment of educational
initiatives for parents and primary health care providers, including
prenatal providers, to increase their knowledge and understanding of
newborn screening programs.

Proposals should be based on an established need identified by the
Program Evaluation and Assessment Scheme (PEAS)
(<http://genes-r-us.uthscsa.edu/>) as applicable. The PEAS tool was
created to aid state newborn screening programs in their process of
evaluation and assessment, with emphasis on the follow-up component. The
tool was developed through a cooperative agreement between the National
Newborn Screening and Genetics Resource Center (NNSGRC) at the
University of Texas Health Science Center in San Antonio and MCHB.

The PEAS tool indicates that education must be considered as an
essential element of the newborn screening system and a comprehensive
educational plan must be in place that addresses professional, consumer,
and policy-maker education.

The activities proposed should use existing validated materials,
including the U.S. Department of Health and Human Services (DHHS)
produced newborn screening brochure and information for providers and
parents:
(<http://mchb.hrsa.gov/programs/genetics/committee/nbsbrochure.htm>;
<http://mchb.hrsa.gov/programs/genetics/committee/parentsguide.htm>;
and, <http://mchb.hrsa.gov/programs/genetics/committee/hpguide.htm>);
the materials developed through the Genetics through the Primary Care
Lens project ([www.genetests.org](http://www.genetests.org/)) and the
ACTion sheets developed by the Regional Genetic and Newborn Screening
Collaboratives \-- National Coordinating Center
([www.acmg.org](http://www.acmg.org/)). In the plan for the use and
distribution of these materials, the regional applicant should have
collaborative working relationships with parents, consumers and
educational resource personnel. Educational products should be adaptable
in other Regions and must be culturally and linguistically appropriate
for health care providers, parents and other consumers. Materials for
parents and the general public should be at the appropriate literacy
level for a broad audience. [Grant funds will not support the
development of new materials.]{.underline}

The educational plan should address either prenatal or birthing
facilities; parent and consumer education; counseling for newly
diagnosed newborns and must be based in part on use of the PEAS tool.

An Education Plan includes:

-   A comprehensive, written education plan that is readily accessible
    and developed with representative newborn screening consumers and
    other stakeholder input.

-   Education needs identified through stakeholder input as a basis for
    program development.

-   A strategy for dissemination of educational materials.

-   A method of evaluating the materials used for cultural, linguistic
    and literacy level.

-   A method for systematic monitoring of disseminated materials.

-   A mechanism for monitoring educational impact through changes in
    knowledge, attitudes, and/or behavior.

-   A method for systematic review and updating the materials.

-   A method for systematic review and updating program.

-   Attention to adequate and qualified staffing for educational
    services.

#### iii. Newborn Screening Laboratory Test Performance Initiatives {#iii.-newborn-screening-laboratory-test-performance-initiatives .unnumbered}

This third project focus is to establish a regional/National project to
assess newborn screening laboratory test performance. The
regional/National proposal must be coordinated with the Regional Genetic
and Newborn Screening Collaboratives \-- National Coordinating Center.
Proposals must include methods for rigorous analysis of outcomes of
screen positive cases in order to improve laboratory screening and the
positive predictive value of screening tests. Improving laboratory
performance decreases the capacity that would be needed for follow-up
(i.e., by the decrease in the number of false positives).

Proposals should be based on an established need identified by the
Program Evaluation and Assessment Scheme (PEAS)
(<http://genes-r-us.uthscsa.edu/>) as applicable. The PEAS tool was
created to aid state newborn screening programs in their process of
evaluation and assessment, with emphasis on the follow-up component. The
tool was developed through a cooperative agreement between the National
Newborn Screening and Genetics Resource Center (NNSGRC) at the
University of Texas Health Science Center in San Antonio and MCHB.

Proposed projects should address one or more of the following
activities:

1.  Examine the uniformity of the selected panels of conditions within a
    region and consider approaches to achieving uniformity if it does
    not exist;

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6.  Examine the screening turn around times and devise strategies to
    optimize the time intervals from specimen collection to result
    reporting;

7.  Examine the spectrum of screening methods used by the participating
    laboratories; the cutoff values set by the labs and when there are
    differences in cutoff values, the reasons for them; and if and how
    the variance in cutoffs impact on false-positive/false-negative
    rates and quality of testing;

-   As a subset, on cutoff values for the region/Nation for premature
    and small for gestational age infants with specific endocrine
    disorders, such as: congenital hypothyroidism and congenital adrenal
    hyperplasia.

8.  Examine the false-positive/false-negative rates for each screening
    method among the participating laboratories and identify approaches
    to decrease the false-positive/false-negative rates;

9.  Enhance comparability of performance among the screening
    laboratories within the region/Nation by reviewing cutoff values and
    processes and consider the possible use of common cutoff values and
    laboratory processes and develop a plan for consensus;

10. Determine the positive predictive values for the screened conditions
    and strategies for improvement;

11. Conduct a study of unexplained infant deaths in the region/Nation by
    reviewing post-mortem examination and laboratory findings and review
    of infants' newborn screening results.

## Background

##### The Maternal & Child Health Bureau 

The Maternal and Child Health Bureau (MCHB) is a component of the Health
Resources and Services Administration (HRSA) within the U.S. Department
of Health and Human Services (DHHS).

##### MCHB Mission Statement

The mission of MCHB is to provide national leadership in partnership
with key stakeholders, to reduce disparities, assure the availability of
quality care, and strengthen the Nation's maternal and child health
(MCH) infrastructure in order to improve the physical and mental health,
safety, and well-being of the MCH population -- all women, infants,
children, adolescents and their families, including fathers and children
with special health care needs.

##### History and Purpose

The Children\'s Bureau was established in 1912. In 1935, the U.S.
Congress enacted Title V of the Social Security Act, which authorized
the Maternal and Child Health Services programs and provided a
foundation and structure for assuring the health of American mothers and
children. 

##### Block and Discretionary Grants

When the Title V program was converted to a block grant in 1981, seven
categorical programs were consolidated into a single block grant and
increased emphasis on planning, accountability, and systems development
at both the Federal and State levels. It also called for increased
leadership and programmatic responsibilities at the Federal level,
especially in the area of national policy development and policy
coordination. *Appendix 1: Core Public Health Services Delivered by MCH
Agencies* is a schematic diagram of how these activities are linked.

##### Discretionary Grants

###### Special Projects of Regional and National Significance (SPRANS) 

In 1981, Congress authorized funding for Special Projects of Regional
and National Significance as part of the MCH Block Grant. Approximately
15 percent of MCH Block Grant funds are set aside for programs in the
following general categories: MCH research; MCH training; genetic
disease testing, counseling and information dissemination; Hemophilia
diagnostic and treatment centers; and other special projects to improve
maternal and child health.

###### State Maternal and Child Health Early Childhood Comprehensive Systems Grant Program (SECCS)

The SECCS program was launched in 2003 to assist States and territories
in the planning, development and implementation of collaborations and
partnerships to support families and communities raise children that are
healthy and ready to learn at school entry. The SECCS program provides
opportunities for State Maternal and Child Health (MCH) agencies to
engage in Statewide, cross-agency early childhood systems development
planning and implementation activities that address the five critical
components of early childhood systems development: 1. Access to Health
Insurance and Medical Homes; 2. Mental Health and Social-Emotional
Development; 3. Early Care and Education/Child Care; 4. Parenting
Education; and, 5. Family support.

###### MCHB State Systems Development Initiative (SSDI)

The SSDI was launched in 1993 to facilitate the development of State
level infrastructure, which would, in turn, support the development of
systems of care at the community level. The SSDI Program was designed to
complement the Title V Maternal and Child Health Block Grant Program and
to combine the efforts of State MCH and CSHCN Agencies. In general, SSDI
is to assist State Agency MCH and CSHCN programs in the building of
State and community infrastructure that results in comprehensive,
community-based systems of care for all children and their families.

###### Genetic Services Branch Programs 

Genetic Services Branch programs are structured to facilitate the early
identification of individuals with heritable conditions and integrate
them into systems of care that are comprehensive, accessible, available,
affordable, acceptable, population and community-based, culturally
appropriate and family-centered and to increase knowledge of the genetic
contribution to health and disease upon which services are developed.
The Branch has three overarching areas of programmatic focus: **Newborn
Screening Infrastructure and Services**; **Delivering Genetic
Services**; and, **Translational Genetics**.

###### Heritable Disorders Program

In FY 2004 and FY 2005, Congress appropriated \$2 million to establish
the Heritable Disorders Program authorized under Title XI (Sections
1109, 1110, and 1111) of the Public Health Service Act, 42 U.S.C.
300b-8, 9 and 10.

These amendments to the Public Health Service Act, commonly referred to
by the short title, "Children's Health Care Act of 2000 -- Title XXVI
'Screening for Heritable Disorders'," established the Heritable
Disorders Program. The Heritable Disorders Program, under Sections 1109
and 1110, authorizes the Secretary, through grants to "a State, or a
consortium of two or more States or political subdivisions of States" to
"enhance, improve, or expand the ability of States and local public
health agencies to provide screening, counseling or health care services
to newborns and children having or at risk for heritable disorders" and
"to evaluate the effectiveness of screening, counseling or health care
services in reducing the morbidity and mortality caused by heritable
disorders in newborns and children."

This program was established to improve the access to newborn screening
and genetic services for medically underserved populations and to
enhance such activities as: screening, follow-up services; augmentation
of capacity needs: training, education; subspecialty linkage, expansion
of long term follow-up activities; strengthening of linkage to medical
homes; strengthening of linkage to tertiary care; strengthening of
genetic counseling services; and enhancement of communication/education
to families and health practitioners and other forms of information
sharing.

Under Section 1111, the "Child Health Care Act of 2000" establishes an
Advisory Committee on Heritable Disorders in Newborns and Children
(Advisory Committee). The Advisory Committee=s purpose is to "provide to
the Secretary advice and recommendations concerning the grants and
projects authorized under Sections 1109; provide technical information
for the development of policies; and priorities for the administration
of these grants".

###### Regional Genetic and Newborn Screening Collaboratives 

The purpose of the **Regional Genetic and Newborn Screening
Collaboratives** is to enhance and support the genetic and newborn
screening capacity of States across the Nation by undertaking a regional
approach to determine and resolve the needs and maldistribution of
genetic resources. These grants are expected to improve the health of
children and their families by moving genetic medicine into public
health and health care services. The seven regions identified are as
follows:

Region 1: [New England Regional Genetics Group]{.underline}, including
Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, and
Vermont

Region 2: [New York-Mid-Atlantic Consortium for Genetic and Newborn
Screening Services]{.underline}, including District of Columbia,
Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, and
West Virginia

Region 3: [Southeast Regional Genetics Group]{.underline}, including
Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina,
Puerto Rico, South Carolina, Tennessee, and the US Virgin Islands.

Region 4: [Great Lakes Genetics Collaborative]{.underline}, including
Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin.

Region 5: [Heartland Regional Genetics and Newborn Screening
Collaborative]{.underline}, including Arkansas, Iowa, Kansas, Missouri,
North Dakota, Nebraska, Oklahoma, and South Dakota.

Region 6: [Mountain States Regional Collaborative Center]{.underline},
including Arizona, Colorado, Montana, New Mexico, Texas, Utah, and
Wyoming.

Region 7: [Western States Genetic Services Collaborative]{.underline},
including Alaska, California, Hawaii, Nevada, Oregon, Washington, and US
Pacific Basin.

###### Regional Genetic and Newborn Screening Collaboratives \-- National Coordinating Center

The **Regional Genetic and Newborn Screening Collaboratives \-- National
Coordinating Center** is at the American College of Medical Genetics
(ACMG). ACMG offers genetics resources for genetic service providers,
primary care professionals, MCH health professionals, the public health
community, government policy makers, and consumers.

The NCC supports the Regional Genetic and Newborn Screening
Collaboratives' projects in their coordination and implementation
efforts and provides a community forum between the Regional
Collaborative projects, MCHB and other relevant organizational entities
to identify and prioritize issues of importance to the genetics and
newborn screening community; specifically, regarding the utilization of
genetic services at the National, State, and community levels.

# Award Information

## Type of Award

Funding will be provided in the form of cooperative agreements.

##### Federal responsibilities include, but are not limited to:

-   Participation, as appropriate, in meetings conducted during the
    period of the cooperative agreement.

-   Ongoing review and approval of activities and procedures to be
    established and implemented for accomplishing the proposed project.

-   Review and approval of project information prior to dissemination.

-   Review of information on project activities.

-   Assistance with the establishment of contacts with Federal and State
    agencies, MCHB grant projects, and other community-based contacts
    that may be relevant to the project's mission and referrals to these
    agencies.

-   Assistance in the establishment of State, Federal, and community
    partnerships, collaborations, and cooperation that may be necessary
    for carrying out the project.

##### Grantee responsibilities include:

-   Ongoing review of activities and procedures to be established and
    implemented for accomplishing the scope of work.

-   Ongoing communication and collaboration with the Federal granting
    agency, i.e. Federal Project Officer.

-   Ensuring the Federal project officer reviews and approves project
    information prior to dissemination.

-   Working with the Federal project officer to review information on
    project activities.

-   Establishing contacts that may be relevant to the project's mission
    such as Federal and State agencies, MCHB grant projects, to include
    the National Newborn Screening and Genetics Resource Center (NNSGRC)
    and other contacts, such as the Public Health Informatics Institute
    (PHII), that may be relevant to the project's mission.

[]{.mark}

## Summary of Funding

Funding will be provided for one (1) year during Federal FY 2006.
Approximately \$1,500,000 is expected to be available in 2006 to fund
eight (8) or more cooperative agreements for direct and indirect costs.

Applicants should indicate whether they are applying for *Project 1* or
*Project 2*; and which projects listed under the three (3) activities
(as noted below) the applicant will be addressing.

####### Project 1: National Collaborative Activities 

-   Pilot Studies

-   Guidance Materials

-   National Plan For Educational Programs

####### Project 2: Regional Collaborative Activities

-   Integrated Child Health Information Systems:

Pilot 1, 2 and/or 3

-   Educational Initiatives

-   Laboratory Test Performance:

Projects 1 to 7

[If additional resources are made available for the Heritable Disorders
Program during FY 2006, for purposes of continuity and efficient use of
funds during a limited time period the additional funds will be used to
support these national and regional collaborative
activities.]{.underline}

# Eligibility Information

## Eligible Applicants

Project 1: 42 CFR Part 51a.3 (a), any public or private entity,
including an Indian tribe or tribal organization (as those terms are
defined at 25 U.S.C. 450b), faith based and community organization is
eligible to apply for this Federal funding opportunity. Any applicant
that can serve in a national capacity to coordinate services among the
regional collaborative activities funded under Project 2 is eligible to
apply

Project 2: 42 CFR Part 51a.3 (a), any public or private entity,
including an Indian tribe or tribal organization (as those terms are
defined at 25 U.S.C. 450b), faith based and community organization is
eligible to apply for this Federal funding opportunity. Applicant must
be based within the identified region it will serve and be part of a
collaborative network of public health program entities responsible for
genetic and/or newborn screening and services in at least four (4)
different States. Applicants that fail to show that they are based
within the identified region it will serve and be part of a
collaborative network of public health program entities responsible for
genetic and/or newborn screening and services in at least four (4)
different States will not be considered.

## Cost-Sharing/Matching

Matching or cost sharing is not required; however applicants are
encouraged to indicate funds from other sources contributed to this
effort, including in-kind resources. The inclusion of
cost-sharing/matching or the lack thereof will have no bearing on either
eligibility or scoring.

## Other 

The national and regional applicants may submit applications for one (1)
or more of the proposed projects. Application requests exceeding the
ceiling award amount of \$300,000 will not be considered. Each
application may include one or more project activities as described in
*Section I: Funding Opportunity Description* (see page
[6](#project-activities))*.*

# Application and Submission Information

## Address to Request Application Package

###  Application Materials

Applicants must submit proposals using Form PHS-5161-1. These forms
contain additional general information and instructions for applications
for grant applications, proposal narratives, and budgets. These forms
may be obtained from the following sites by:

a)  Downloading from <http://www.hrsa.gov/grants/forms.htm>

or

b)  Contacting the HRSA Grants Application Center at:

> The Legin Group, Inc.
>
> Attn: Maternal and Child Health Bureau
>
> Program Announcement No. HRSA-06-065
>
> CFDA #93.110
>
> 901 Russell Avenue, Suite 450
>
> Gaithersburg, MD 20879
>
> Telephone: 877-477-2123

[[HRSAGAC@hrsa.gov]{.underline}](mailto:HRSAGAC@hrsa.gov)

Instructions for preparing portions of the application that must
accompany Form PHS-5161-1 appear in the "Application Format" section
below.

## Content and Form of Application Submission

### Application Format Requirements

If applying on-line, the total size of all uploaded files may not exceed
the equivalent of 80 pages when printed by HRSA, approximately 10 MB.
This 80-page limit includes the single abstract which addresses all
project activities submitted in the application; project and budget
narratives for each project activity, attachments, appendices and
letters of commitment and support.

If applying on paper, the entire application may not exceed 80 pages in
length (project narrative, budget, budget justification, staffing plan
and personnel requirements for each project activity that is being
proposed must not exceed ten (10) pages; and appendices for each project
activity that is being proposed must not exceed ten double-spaced (10)
pages). Applicants may apply for more than one (1) project activity in
which case the cumulative narrative, budget, budget justification,
staffing plan and personnel requirements may not exceed 40 double-spaced
pages; same for appendices). Appendices should include only supportive
information.

Applications, whether submitted electronically or on paper, that exceed
the specified limits (80 pages or approximately 10 MB, or that exceed 80
pages when printed by HRSA) will be deemed non-compliant. All
non-compliant applications will be returned to the applicant without
further consideration.

##### Number of Copies (Paper Applications only)

Submit one (1) original and two (2) unbound, single-sided copies of the
application.

##### Font 

Use an easily readable serif typeface, such as Times Roman, Courier, or
CG Times. The text and table portions of the application must be
submitted in not less than 12 point and 1.0 line spacing. Applications
not adhering to 12 point font requirements may be returned.

##### Paper Size and Margins

For scanning purposes, submit the application on 8 ½" x 11" white paper.
Margins must be at least one (1) inch at the top, bottom, left and right
of the paper. Left-align text.

##### Numbering 

Number the pages of the application sequentially from page 1 (face page)
to the end of the application, including charts, figures, tables, and
appendices.

##### Applicant Identification

Include the name of the applicant on each page.

##### Section Headings

Put all section headings flush left in bold type.

### Application Format

Applications for funding must consist of the following documents in the
following order:

#### Application Face Page 

The SF 424 entitled, "Application for Federal Assistance" included in
Form PHS-5161-1 is the face page for the application. Prepare this page
according to the instructions included in Form PHS-5161-1. The Catalog
of Federal Domestic Assistance Number (CFDA) is 93.110.

##### DUNS Number {#duns-number .unnumbered}

All applicant organizations are required to have a Data Universal
Numbering System (DUNS) number in order to apply for a grant from the
Federal government. The DUNS number is a unique nine-character
identification number provided by the commercial company, Dun and
Bradstreet. There is no charge to obtain a DUNS number. Information
about obtaining a DUNS number can be found at
[http://www.hrsa.gov/grants/preview/dunsccr.htm](http://www.hrsa.gov/grants/preview/dunsccr.htm )
or call 1-866-705-5711. Please include the DUNS number next to the OMB
Approval Number on the application face page. Applications will not be
reviewed without a DUNS number.

Additionally, the applicant organization will be required to register
with the Federal Government's Central Contractor Registry (CCR) in order
to do electronic business with the Federal Government. Information about
registering with the CCR can be found
at[http://www.hrsa.gov/grants/preview/dunsccr.htm](http://www.hrsa.gov/grants/preview/dunsccr.htm ).

#### Table of Contents

Provide a Table of Contents for the remainder of the application
(including appendices), with page numbers.

#### Application Checklist 

The checklist and instructions are included in Form PHS-5161-1.

#### Budget Information

Budget information and forms are included in Form PHS-5161-1.

#### Budget Justification

**Use the following instructions to complete the budget justification.**
Do [not]{.underline} use the directions included in Form PHS-5161-1.

Each individual proposed project activity included in the application
must include a narrative that explains the amounts requested for each
line in the budget. **The budget justification should specifically
describe how each item will support the achievement of proposed
objectives.**

The budget period and project period for this announcement is for ONE
(1) year. Line item information must be provided to explain the costs
entered in Form PHS-5161-1. **The budget justification must clearly
describe each cost element and explain how each cost contributes to
meeting the project activity's objectives/goals.** Be very careful about
showing how each item in the "other" category is justified. The budget
justification MUST be concise. Do NOT use the justification to expand
the project narrative.

Include the following in the budget justification for each project
activity:

a)  *Personnel Costs:* Personnel costs should be explained by listing
    each staff member who will be supported from funds, name (if
    possible), position title, percent full time equivalency, annual
    salary, and the exact amount requested for each project year which
    mainly covers indirect cost.

b)  *Indirect Costs:* Indirect costs are those costs incurred for common
    or joint objectives which cannot be readily identified but are
    necessary to the operations of the organization, e.g., the cost of
    operating and maintaining facilities, depreciation, and
    administrative salaries. If an organization applying for an
    assistance award does not have an indirect cost rate, the applicant
    may wish to obtain one through HHS's Division of Cost Allocation
    (DCA). Visit DCA's website at:
    [[http://rates.psc.gov/]{.underline}](http://rates.psc.gov/) to
    learn more about rate agreements, the process for applying for them,
    and the regional offices that negotiate them.

c)  *Fringe Benefits:* List the components that comprise the fringe
    benefit rate, for example health insurance, taxes, unemployment
    insurance, life insurance, retirement plan, tuition reimbursement.
    The fringe benefits should be directly proportional to that portion
    of personnel costs that are allocated for the project.

d)  *Travel:* List travel costs according to local and long distance
    travel. For local travel, the mileage rate, number of miles, reason
    for travel and staff member/consumers completing the travel should
    be outlined. The budget should also reflect the travel expenses
    associated with participating in meetings and other proposed
    trainings or workshops.

e)  *Equipment:* List equipment costs and provide justification for the
    need of the equipment to carry out the program's goals. Extensive
    justification and a detailed status of current equipment must be
    provided when requesting funds for the purchase of computers and
    furniture items.

f)  *Supplies:* List the items that the project will use. In this
    category, separate office supplies from medical and educational
    purchases. Office supplies could include paper, pencils, and the
    like; medical supplies are syringes, blood tubes, plastic gloves,
    etc., and educational supplies may be pamphlets and educational
    videotapes. Remember, they must be listed separately.

g)  *Subcontracts:* To the extent possible, all subcontract budgets and
    justifications should be standardized, and contract budgets should
    be presented by using the same object class categories contained in
    Form PHS-5161-1 (Budget Information: Section B - Budget Categories).
    Provide a clear explanation as to the purpose of each contract, how
    the costs were estimated, and the specific contract deliverables.

h)  *Other:* Put all costs that do not fit into any other category into
    this category and provide an explanation of each cost in this
    category. In some cases, grantee rent, utilities and insurance fall
    under this category if they are not included in an approved indirect
    cost rate.

#### Staffing Plan and Personnel Requirements

Applicants must present a staffing plan and provide a justification for
each project activity that includes education and experience
qualifications and rationale for the amount of time being requested for
each staff position. Position descriptions that include the roles,
responsibilities, and qualifications of proposed project staff must be
appended to the application. Copies of biographical sketches for any key
employed personnel that will be assigned to work on the proposed project
must also be appended. Applicants must complete *Appendix 2: Key
Personnel.*

#### Assurances

The assurances are included in Form PHS-5161-1.

#### Certifications

Certifications are included in Form PHS-5161-1.

#### Project Abstract

Use *Appendix 4:  Form 6 - MATERNAL & CHILD HEALTH DISCRETIONARY GRANT
PROJECT ABSTRACT FOR FY 2006* to complete this requirement.  Submit
*Form 6* with the application and to the EHB separately. Keywords are
listed in *Appendix 5*.

NOTE: Applicants must provide one (1) abstract that includes/summarizes
all project activities addressed in the application.

#### Program Narrative

**Use the following instructions to complete the program narrative.** Do
[not]{.underline} use the directions included in Form PHS-5161-1.

The national and regional applicants may submit one (1) or more project
activity proposal(s) listed in I.1.A. Project Descriptions (see page
[7](#project-descriptions)). Each project activity proposed will be
reviewed on its own merits. Hence, each project activity proposed within
an application must include all the requirements listed below, in
addition to the required budget, budget justification, staffing plan and
personnel requirements. This section provides a comprehensive framework
and description of all aspects of each proposed project activity. It
should be succinct, self-explanatory and well organized so that
reviewers can understand the proposed project.

Applicants must address the following program requirements:

-   Describe how the proposed project(s) will be responsive to the
    legislative authority (Section 501(a) (2) of the Social Security
    Act, the Maternal and Child Health Federal Set-Aside Program:
    Special Projects of Regional and National Significance (SPRANS) (42
    U.S.C. 701 (a) (2)) Title XI, Section 1110 of the Public Health
    Service Act, 42 U.S.C. 300b-10).

-   Describe how the proposed project(s) are responsive to the needs of
    the Regional Collaboratives.

-   Describe assurances to avoid duplication of effort with the Regional
    Collaboratives and knowledge of efforts by other organizational
    entities in activities proposed.

-   Describe a dissemination plan, where appropriate, that includes
    publication in peer reviewed journals.

-   Describe the mechanism that will be used to bring together
    individuals and organizations with appropriate expertise to address
    the specific public health problems as they relate to this
    initiative, to include face-to-face interaction and distance
    technology, such as teleconferences, webcasts and e-mail
    communication.

-   Provide a work plan, which includes each activity to be accomplished
    within the scope of the project, the timeline to achieve each
    activity, and the identified responsible staff.

Use the following section headers:

##### Introduction

This section should briefly describe the purpose of the proposed
project. Applicants must summarize the relationship of their project to
the Regional Collaborative's goals and objectives and identify which of
their program objectives and/or sub-objectives relate to the goals of
the Healthy People 2010 initiative.

Copies of Healthy People 2010 may be obtained from the Superintendent of
Documents or downloaded at the Healthy People 2010 website:
<http://www.health.gov/healthypeople/document/>

##### Needs Assessment

This section outlines the needs of the applicant's community and/or
organization. The target population and its unmet health needs must be
described and documented in this section. Demographic data should be
used and cited whenever possible to support the information provided.
This section should help reviewers understand the community and/or
organization that will be served by the proposed project.

##### Methodology

Propose methods that will be used to meet each of the
previously-described program requirements and expectations in this grant
announcement.

##### Work Plan

For each project activity proposed in the application, applicants should
describe the activities or steps that will be used to achieve each of
the activities proposed in the methodology section. In *Appendix F: Work
Plan* include a table or other format that clearly describes the
individual Work Plan for each project activity and contains the
following information:

-   Project Goals

-   Project's measurable objectives

-   Activities undertaken to accomplish the objectives of the project

-   Who will participate and/or will benefit from the activities

-   Specific resources allocated to each activity

-   How the applicant will know change has happened, i.e. long-term,
    short-term outcomes

-   What the applicant will use to gather this information, i.e. data
    source and collection strategy

-   What point in time the applicant will use to gather this
    information, i.e. time period

##### Resolution of Challenges

Discuss challenges that are likely to be encountered in designing and
implementing the activities described in the Work Plan, and approaches
that will be used to resolve such challenges.

##### Evaluation and Technical Support Capacity

Applicants should describe current experience, skills, and knowledge,
including individuals on staff, materials published, and previous work
of a similar nature.

##### Organizational Information

Applicants should provide information on their organization's current
mission and structure, scope of current activities, and an
organizational chart, and describe how these all contribute to the
ability of the organization to conduct the program requirements and meet
program expectations for each project activity.

The applicant should describe their capacity to collect and report the
data required in the discretionary grant performance measures (*Appendix
3: Part 1 - Detail Sheets; Appendix 4: Part 2 -- Financial and
Demographic Data Elements*) on an on-going basis.

[]{.mark}

+---------------------------------+------------------------------------+
| **ADDITIONAL NARRATIVE          |                                    |
| GUIDANCE**                      |                                    |
|                                 |                                    |
| In order to ensure that the     |                                    |
| Review Criteria are fully       |                                    |
| addressed, this box provides a  |                                    |
| "cross-walk" between the        |                                    |
| *Program Narrative* outlined    |                                    |
| above and the **Review          |                                    |
| Criteria** provided below.      |                                    |
+---------------------------------+------------------------------------+
| *x. Program Narrative*          | **1.** **Review Criteria**         |
| ([24](#program-narrative))      | ([32](#review-criteria))           |
+---------------------------------+------------------------------------+
| A. Introduction                 | A. Need                            |
+---------------------------------+------------------------------------+
| B. Needs Assessment             | B. Response                        |
+---------------------------------+------------------------------------+
| C. Methodology                  | C. Evaluative Measures             |
+---------------------------------+------------------------------------+
| D. Work Plan                    | B. Response & D. Impact            |
+---------------------------------+------------------------------------+
| E. Resolution of Challenges     | B. Response                        |
+---------------------------------+------------------------------------+
| F. Evaluation and Technical     | E. Resources/Capabilities          |
| Support Capacity                |                                    |
+---------------------------------+------------------------------------+
| G. Organizational Information   | E. Resources/Capabilities          |
+---------------------------------+------------------------------------+
| []{.mark}                       | F. Support Requested -- the budget |
|                                 | section should be sufficient to    |
|                                 | allow reviewers to determine the   |
|                                 | reasonableness of the requested    |
|                                 | support                            |
+---------------------------------+------------------------------------+

#### Appendices

Provide the following items for each project activity in the guidance to
complete the content of the application. Note that these items are
supplementary in nature, and are not intended to be a continuation of
the project narrative. Be sure each appendix is clearly labeled.

####### Appendix A: Tables, Charts, etc.

Includes materials and/or other information which provide further
details about the proposal.

####### Appendix B: Job Descriptions for Key Personnel

Keep each to one page in length as much as is possible. Item 6 in the
Program Narrative section of Form PHS-5161-1 provides some guidance on
items to include in a job description.

####### Appendix C: Biographical Sketches of Key Personnel

Include biographical sketches for persons occupying the key positions
described in *Appendix 2*, not to exceed two pages in length. In the
event that a biographical sketch is included for an identified
individual who is not yet hired, please include a letter of commitment
from that person with the biographical sketch.

####### Appendix D: Project specific Letters of Agreement and/or Description(s) of Proposed/Existing Contracts

Provide any documents that describe working relationships between the
applicant organization and other agencies and/or programs cited in the
proposal. Documents that confirm actual or pending contractual
agreements should clearly describe the roles of the subcontractors and
any deliverable. Letters of agreements must be dated.

####### Appendix E: Project Organizational Chart

Provide a one-page figure that depicts the organizational structure of
the project, including subcontractors and other significant
collaborators.

####### Appendix F: Work Plan

Provide the following information that can be presented in a table or
any other format that clearly describes the work plan. Include the
following information:

-   Project Goals

-   Project's measurable objectives

-   Activities undertaken to accomplish the objectives of the project

-   Who will participate and/or will benefit from the activities

-   Specific resources allocated to each activity

-   How the applicant will know change has happened, i.e. long-term,
    short-term outcomes

-   What the applicant will use to gather this information, i.e. data
    source and collection strategy

-   What point in time the applicant will use to gather this
    information, i.e. time period

####### Appendix G: Other Relevant Documents

Include here any other documents that are relevant to the application,
including letters of support. Letters of support must be dated.

[]{.mark}

Include only letters of support which specifically indicate a commitment
to the project/program (in-kind services, dollars, staff, space,
equipment, etc.) Letters of agreements and support must be dated. List
all other support letters on one page.

## Submission Dates and Times

##### Notification of Intent to Apply

An applicant is eligible to apply even if no *Letter of Intent* is
submitted. Receipt of *Letters of Intent* will not be acknowledged.

The *Letter of Intent* will be used by HRSA/MCHB to inform applicants of
a pre-application conference call. Applicants must indicate whether they
are applying for *Project 1* or *Project 2*; and which projects listed
under the three (3) activities (as noted below) the applicant will be
addressing.

### Project 1: National Collaborative Activities  {#project-1-national-collaborative-activities-3 .Style-Heading-3-+-Bold}

[Project Activities]{.underline}

i.  Pilot Studies

```{=html}
<!-- -->
```
vi. Guidance Materials

vii. National Plan for Educational Programs

### Project 2: Regional Collaborative Activities {#project-2-regional-collaborative-activities-3 .Style-Heading-3-+-Bold}

> [Project Foci and Activities]{.underline}

i.  Integrated Child Health Information Systems:

-   Pilot 1, 2 and/or 3

viii. Educational Initiatives

ix. Laboratory Test Performance:

-   Projects 1 to 7

This letter should be sent by **December 7, 2005**, by mail or fax to:

Division of Independent Review

HRSA Grants Application Center

Program Announcement No. HRSA-06-065

The Legin Group, Inc.

901 Russell Ave., Suite 450

Gaithersburg, MD 20879

Fax: 877-477-2345

##### B. Application Due Date {#b.-application-due-date .unnumbered}

The due date for applications under this grant announcement is **January
13, 2006** at **5:00 P.M. ET.**

Applications will be considered as meeting the deadline if they are
either:

a)  Received on or before the due date; or

b)  Post marked or E marked on or before the due date, and received in
    time for the Independent Review Committee review.

The Chief Grants Management Officer (CGMO) or a higher level designee
may authorize an extension of published deadlines when justified by
circumstances such as acts of God (e.g. floods or hurricanes),
widespread disruptions of mail service, or other disruptions of
services, such as a prolonged blackout. The authorizing official will
determine the affected geographical area(s).

###### Electronic Submission

Applications must be submitted by **5:00 P.M. ET**. **To ensure that
applicants have adequate time to follow procedures and successfully
submit the application, we recommend applicants start submission no
later than noon on the due date.** Applications submitted electronically
will be time/date stamped electronically, which will serve as receipt of
submission.

###### Paper Submission

Upon receipt of a paper application, the Grants Application Center (GAC)
will mail an acknowledgement of receipt to the applicant organization's
Program Director.

In the event that questions arise about meeting the application due
date, applicants must have a legibly dated receipt from a commercial
carrier or the U.S. Postal Service. Private metered postmarks will not
be accepted as proof of timely mailing.

###### Late applications

Applications which do not meet the criteria above are considered late
applications. HRSA shall notify each late applicant that its application
will not be considered in the current competition.

## Intergovernmental Review

This program is not subject to the provisions of Executive Order 12372,
as implemented by 45 CFR Part 100.

## Funding Restrictions

The national and regional collaborative applicants responding to this
announcement may request funding for a project period of up to one (1)
year, at no more than \$300,000 per year for the total of all project
activities.

## Other Submission Requirements

##### Electronic Submission

HRSA STRONGLY encourages applicants to submit applications online via
the HRSA Electronic Handbooks (EHB).

To register and/or log-in to prepare the application, go to:

<https://grants.hrsa.gov/webexternal/login.asp>.

Each individual in the organization who will work on the application
must register online.

For more detailed information about the online application and how to
get started, go to MCHB Critical Highlights at:

<https://performance.hrsa.gov/mchb/mchreports/criticalhighlights.asp>.

**For assistance in using HRSA EHB, call 877-Go4-HRSA (877-464-4772)
between 9:00 a.m. to 5:30 p.m. ET or e-mail:** <callcenter@hrsa.gov>.

The new online application and reporting system has been implemented
during FY 2005 for MCHB grantees. Ultimately, this system will provide
grantees with information from previous years, including budget and
services data. There are several features of the online system that are
designed to ease the reporting burden on grantees:

a)  Since electronic submissions are saved to a central database,
    applicants will not need to resubmit the same information year after
    year. In subsequent years, data previously submitted will be
    accessed and displayed.

```{=html}
<!-- -->
```
c)  When the same item is requested on multiple forms, applicants will
    only be required to enter the item once. The system will insert the
    data to the appropriate fields on subsequent forms. This reduces the
    need for redundant data entry.

d)  The system has built-in checks to help improve the quality of
    reported data, including features that guard against data entry or
    calculation errors. For example, the system checks to ensure that
    budget totals match across financial forms, and alerts the applicant
    when errors are detected. Similarly, the online system helps ensure
    that performance data reported fall within valid ranges. It also
    automatically calculates performance indicators using raw numerator
    and denominator (where applicable), thus sparing the grantee the
    need to calculate these indicators and ensuring against mathematical
    errors.

e)  For grant reviewers, the system will provide quick access to
    submitted data, as data will be automatically transmitted to the
    HRSA database, and those data can be accessed immediately thereafter
    by program management. Compared to the paper submission process, lag
    time will be greatly reduced.

Form PHS-5161-1 must be completed online. Required *MCHB Financial and
Demographic Data Elements (Appendix 3)* must also be completed online.
Application narratives, spreadsheets and other supporting supplemental
documents are to be completed off line and attached to the online
application. In subsequent years, grantees will also be required to
report on selected performance measures (*Appendix 4*). Applicants will
be prompted to complete these required forms online as part of the
application process.

##### Formal Submission of the Electronic Application 

Applications completed online are considered formally submitted when the
Authorizing Official electronically submits the application to HRSA.
However, to complete the submission requirements, a hard-copy of the
Application for Federal Assistance (SF-424 Face Sheet) that is included
in Form PHS-5161-1 must be printed, signed, and submitted to the HRSA
Grants Application Center. The Application for Federal Assistance
(SF-424 Face Sheet) can be printed from the online application.

**The signed hard-copy of the Application for Federal Assistance (SF-424
Face Sheet) must be sent to the HRSA Grants Application Center at the
address below, and received by HRSA by no later than five days after the
January 13, 2006 due date:**

HRSA Grants Application Center

The Legin Group, Inc.

Attn: *Regional Genetic and Newborn Screening Services*

Program Announcement No. HRSA-06-065

CFDA #93.110

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

Telephone: 877-577-2123

Applications will be considered as having met the deadline if: (1) all
parts of the online application are noted as COMPLETE on the Application
Forms Status menu, (2) the application has been submitted electronically
by the organization's Authorizing Official to HRSA on or before the
deadline date and time, and (3) the signed Application for Federal
Assistance (SF-424 Face Sheet) is received by HRSA no later than five
days after the deadline date.

**REMINDER:** Only applicants who apply online are permitted to forego
hard-copy submission of all application forms EXCEPT the signed
Application for Federal Assistance (SF-424 Face Sheet).

##### Paper Submission

Applicants who choose to submit a paper application should send the
original and two (2) copies of the application to:

[]{.mark}

HRSA Grants Application Center

The Legin Group, Inc.

Attn: *Regional Genetic and Newborn Screening Services*

Program Announcement No. HRSA-06-065

CFDA #93.110

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

Telephone: 877-577-2123

Whether you submit electronically or via paper, please understand that
we will not consider additional information and/or materials submitted
after your initial application. You must therefore ensure that all
materials are submitted together, whether electronically or on paper.

# Application Review Information

## Review Criteria

Procedures for assessing the technical merit of grant applications have
been instituted to provide for an objective review of applications and
to assist the applicant in understanding the standards against which
each application will be judged. Critical indicators have been developed
for each review criterion to assist the applicant in presenting
pertinent information related to that criterion and to provide the
reviewer with a standard for evaluation. Review criteria are outlined
below with specific detail and scoring points and will be applied to
each proposed project activity submitted.

Applications from the national and regional collaborative applicant may
consist of one (1) or more proposed project activity(ies). Each proposed
project activity submitted as part of an application, will be reviewed
separately based on its own merit. Review Criteria are used to review
and score project activity proposals. Each proposal for a project
activity must address all six (6) review criteria listed below:

##### NEED (10 points)

The extent to which the application describes the problem and associated
contributing factors to the problem as required in the funding
opportunity description on page [6](#funding-opportunity-description)
and under the application and submission information section on page
[20](#application-and-submission-information).

##### RESPONSE (30 points)

The extent to which the proposed project responds to the "Purpose"
included in the program description as required in the funding
opportunity description on page [6](#funding-opportunity-description)
and under the application and submission information section on page
[20](#application-and-submission-information). The clarity of the
proposed goals and objectives and their relationship to the identified
project. The extent to which the activities described in the application
are capable of addressing the problem and attaining the project
objectives.

##### EVALUATIVE MEASURES (5 points)

The effectiveness of the method proposed to monitor and evaluate the
project results as required in the funding opportunity description on
page [6](#funding-opportunity-description) and under the application and
submission information section on page
[20](#application-and-submission-information). Evaluative measures must
be able to assess 1) to what extent the program objectives have been met
and 2) to what extent these can be attributed to the project.

##### IMPACT (20 points)

The extent and effectiveness of plans for dissemination of project
results and/or the extent to which project results may be national in
scope and/or degree to which the project activities are replicable,
and/or the sustainability of the program beyond the Federal funding as
required in the funding opportunity description on page
[6](#funding-opportunity-description) and under the application and
submission information section on page
[20](#application-and-submission-information).

##### RESOURCES/CAPABILITIES (30 points)

The extent to which project personnel are qualified by training and/or
experience to implement and carry out the projects as required in the
funding opportunity description on page
[6](#funding-opportunity-description) and under the application and
submission information section on page
[20](#application-and-submission-information). The capabilities of the
applicant organization, and quality and availability of facilities and
personnel to fulfill the needs and requirements of the proposed project.
For competing continuations, past performance will also be considered.

##### SUPPORT REQUESTED (5 points)

The reasonableness of the proposed budget in relation to the objectives,
the complexity of the activities, and the anticipated results as
required in the funding opportunity description on page
[6](#funding-opportunity-description) and under the application and
submission information section on page
[20](#application-and-submission-information).

## Review and Selection Process

The Division of Independent Review is responsible for managing objective
reviews within HRSA. Applications competing for Federal funds receive an
objective and independent review performed by a committee of experts
qualified by training and experience in particular fields or disciplines
related to the program being reviewed. In selecting review committee
members, other factors in addition to training and experience may be
considered to improve the balance of the committee, e.g., geographic
distribution, race/ethnicity, and gender.

Each reviewer is screened to avoid conflicts of interest and is
responsible for providing an objective, unbiased evaluation based on the
review criteria noted above. The committee provides expert advice on the
strengths of each application to program officials responsible for final
selections for award.

[]{.mark}

## Anticipated Announcement and Award Dates

The announcement and award date for the grants funded under this
guidance is **June 1, 2006.**

# Award Administration Information

## Award Notices

Each applicant will receive written notification of the outcome of the
objective review process, including a summary of the expert committee's
assessment of the application's merits and weaknesses, and whether the
application was selected for funding. Applicants who are selected for
funding may be required to respond in a satisfactory manner to
"conditions" placed on their application before funding can proceed.
Letters of notification do not provide authorization to begin
performance. The Notice of Grant Award (NGA), which is signed by the
Grants Management Officer and is sent to the applicant agency's
Authorized Representative, is the authorizing document. It will be sent
prior to the start date of **June 1, 2006.**

## Administrative and National Policy Requirements

Successful applicants must comply with the administrative requirements
outlined in 45 CFR Part 74 or 45 CFR Part 92, as appropriate.

##### Public Policy Issuance

###### Healthy People 2010

Healthy People 2010 is a national initiative led by HHS that sets
priorities for all HRSA programs. The initiative has two major goals:
(1) to increase the quality and years of a healthy life; and (2)
eliminate our country's health disparities. The program consists of 28
focus areas and 467 objectives. HRSA has actively participated in the
work groups of all the focus areas, and is committed to the achievement
of the Healthy People 2010 goals.

###### Smoke-Free Environment

The Public Health Service strongly encourages all award recipients to
provide a smoke-free workplace and to promote the non-use of all tobacco
products. Further, Public Law 103-227, the Pro-Children Act of 1994,
prohibits smoking in certain facilities (or in some cases, any portion
of a facility) in which regular or routine education, library, day care,
health care or early childhood development services are provided to
children.

###### Cultural Competence

In order to assure access and cultural competence, it is expected that
projects will involve individuals from the populations to be served in
the planning and implementation of the project. MCHB\'s intent is to
ensure that project interventions are responsive to the cultural and
linguistic needs of special populations, that services are accessible to
consumers, and that the broadest possible representation of culturally
distinct and historically under represented groups is supported through
programs and projects sponsored by MCHB.

###### Family Participation

It is expected that projects will retain the family centered approach to
which MCHB is committed. This approach recognizes that the family is the
constant in a child\'s life, while service systems and their attendant
personnel fluctuate. It facilitates family/professional collaboration at
all levels of care, including program development, implementation,
policy formation and evaluation. Family-centered care ensures that
services and support systems are flexible, accessible, and comprehensive
in responding these family-identified needs.

## Post Award Reporting

Successful applicants who applied by *Paper Submission*
([30](#paper-submission)) will be required, within 120 days of the
Notice of Grant Award, to register in HRSA's Electronic Handbooks (EHBs)
and electronically complete the program specific data forms that appear
in *Appendices 3 and 4* of this guidance.  This requires the provision
of budget breakdowns in the financial forms based on the grant award
amount, the project abstract and other grant summary data, and
objectives for the performance measures.

The successful applicant under this guidance must comply with audit
requirements of Office of Management and Budget (OMB) Circular A-133.
Information on the scope, frequency, and other aspects of the audits can
be found on the Internet at
[www.whitehouse.gov/omb/circulars](http://www.whitehouse.gov/omb/circulars).

Grantees must submit a Payment Management System Quarterly Report. The
reports identify cash expenditures against the authorized funds for the
grant. Failure to submit the report may result in the inability to
access grant funds. Submit report to the:

Division of Payment Management

DPM/FMS/PSC/ASAM/HHS

PO Box 6021

Rockville, MD 20852

Telephone: 301-443-1660

Grantees must submit a Financial Status Report (FSR) within 90 days of
the end of each grant year. The report is an accounting of expenditures
under the project that year.

##### Program Monitoring

MCHB views program accountability, including monitoring, assessment, and
evaluation, as an important tool for ongoing program improvement. All
MCHB supported programs must, at minimum monitor program activities and
report annually on MCHB performance measures.

##### Performance Measures

The Government Performance and Results Act (GPRA), Public Law 103-62,
requires that each Federal program establish performance measures that
can be reported as part of the budgetary process, thus linking funding
decisions with performance and reviewing related outcome measures to see
if there were improved outcomes for the target population.

In FY 2003, MCHB's performance measures for discretionary grants were
approved by the Office of Management and Budget (OMB). MCHB must include
these measures in its annual reports to Congress on the actual
performance achieved by its programs compared to that proposed in the
performance plan. Program activities, as measured by these performance
measures, should have a collective contributory effect to positively
impact the outcome measures for the target population.

###### MCHB Performance Measures

MCHB has established the following performance measures for which both
***Project 1: National Collaborative Activities*** and ***Project 2:
Regional Collaborative Activities*** are responsible for:

-   PM03 (*Appendix 3* on page 42)

-   Forms: 1, 2, 4, 6, and 7 (*Appendix 4* on page 45)

Grantees are not responsible for establishing and achieving individual
program performance targets, grantees are expected to collect and
annually report program data to MCHB that addresses specified
performance measures. This data collection and reporting is essential to
MCHB\'s efforts to assess program-wide performance and progress towards
achieving national performance measure objectives and for the required
national evaluation.

Potential applicants for this initiative should be advised that MCHB\'s
data reporting requirements may change in the coming year. GPRA requires
the establishment of measurable goals for Federal programs that can be
reported as part of the budgetary process, thus linking funding
decisions with performance. Performance measures for States have already
been established under the block grant provisions of Title V.
Performance measures for other MCHB-funded grant programs were
established and approved by the Office of Management and Budget (OMB).

**4. Performance Review**

[]{#__RefHeading___Toc116463741 .anchor}

HRSA's Office of Performance Review (OPR) serves as the agency's focal
point for reviewing and enhancing the performance of HRSA funded
programs within communities and States. On a regularly scheduled basis,
HRSA grantees are required to participate in a performance review of
their HRSA funded program(s) by a review team from one of the ten OPR
regional divisions. Grantees should expect to participate in a
performance review at some point during their project period. When a
grantee receives more than one HRSA grant, each of the grantee's HRSA
funded programs will be reviewed during the same performance review.

The purpose of performance review is to improve the performance of HRSA
funded programs. Through systematic pre-site and on-site analysis, OPR
works collaboratively with grantees and HRSA Bureaus/Offices to measure
program performance, analyze the factors impacting performance, and
identify effective strategies and partnerships to improve program
performance, with a particular focus on outcomes. Upon completion of the
performance review, grantees are expected to prepare an Action Plan that
identifies key actions to improve program performance as well as
addresses any identified program requirement issues. Performance reviews
also provide direct feedback to the agency about the impact of HRSA
policies on program implementation and performance within communities
and States.

For additional information on performance reviews, please visit:
<http://www.hrsa.gov/performancereview>.

# Agency Contacts

Applicants may obtain additional information regarding business,
administrative, or fiscal issues related to this grant announcement by
contacting:

Theda Duvall

Lead Grants Management Specialist

HRSA/Division of Grants Management Operation

5600 Fishers Lane, Room 11A-16

Rockville, MD 20857

Telephone: 301-443-3414

E-mail: tduvall@hrsa.gov

Additional information related to the overall program issues by
contacting:

Michele A. Lloyd-Puryear, MD, PhD

Chief, Genetic Services Branch

HRSA/Maternal and Child Health Bureau

5600 Fishers Lane, Room 18A-19

Rockville, MD 20857

Telephone: 301-443-1080

Fax: 301-443-8604

E-Mail: CDiener@hrsa.gov

# Other Information

##### Resources

-   The American Academy of Family Physicians\' Annual Clinical Focus
    (ACF) <http://www.aafp.org/x25023.xml>.

-   CDC's Centers of Excellence for Birth Defects Prevention Research:
    <http://www.cdc.gov/ncbddd/bd/research.htm>.

-   Child Health Act of 2000, Title XXVI---Screening For Heritable
    Disorders, is available on pages 2203-2205 at:
    <http://a255.g.akamaitech.net/7/255/2422/29nov20040936/www.gpoaccess.gov/serialset/cdocuments/sd106-30/pdf/pl106-310.pdf>.

-   Clear Health Communications:
    <http://www.pfizerhealthliteracy.com/whatis.html>

-   Connections Community of Practice assists public health agencies
    with strategies and planning for integrating information systems
    essential to improving the health of children by facilitating
    peer-to-peer knowledge sharing and problem solving among its 18
    participating public health agencies throughout the country.
    <http://phii.org/ConnectionsCOP.html>.

-   Developing an effective dissemination plan:
    <http://www.ncddr.org/du/products/dissplan.html>.

-   "Framework for Integrating Child Health Information Systems"
    provides an introduction and background to the development of the
    Framework and a list of the principles, core functions and
    performance measures is available at:
    <http://www.phii.org/Files/CHISframework.pdf> . The self-assessment
    checklist is available at:
    <http://www.phii.org/Files/CHISchecklist.pdf>. For additional
    information, <http://www.phii.org/CoreFunctions.html>.

-   "Genetics through a Primary Care Lens" website provides background
    information, teaching cases, and links to other resources, to
    facilitate teaching about genetics in primary care settings.
    [http://www.genetests.org](http://www.genetests.org/).

-   Issue Focus: Integrating Child Health Information Systems, J Public
    Health Management Practice, 2004, November (Suppl). Summarizes the
    unique informational needs of children's health care and recent
    progress toward developing integrated child health information
    systems, with particular emphasis on public health activities.
    <http://phii.org/resources.html>.

-   Logic Model Development Guide:
    <http://www.wkkf.org/Pubs/Tools/Evaluation/Pub3669.pdf>.

-   The National Center of Medical Home Initiatives for Children with
    Special. This site provides information related to all of the
    activities of the National Center, including the \"Every Child
    Deserves a Medical Home\" Training Program, Screening Initiatives
    and a variety of resources developed by the AAP and/or other
    collaborating organizations.
    [http://www.medicalhomeinfo.org](http://www.medicalhomeinfo.org/).

-   National Newborn Screening and Genetics Resource Center (resources
    section): <http://genes-r-us.uthscsa.edu/resources.htm>.

-   Newborn screening brochure and information for providers and parents
    produced by the U.S. Department of Health and Human Services (DHHS):
    <http://mchb.hrsa.gov/programs/genetics/committee/nbsbrochure.htm>;
    <http://mchb.hrsa.gov/programs/genetics/committee/parentsguide.htm>;
    and, <http://mchb.hrsa.gov/programs/genetics/committee/hpguide.htm>.

-   Serving the Family From Birth to the Medical Home: A Report from the
    Newborn Screening Task Force Convened in Washington DC, May 10-11,
    1999, Pediatrics, Volume 106, Number 2, August 2000, Supplement is
    available upon request from HRSA Information Center by phone:
    Toll-Free Number: 888-Ask HRSA or on-line, at:
    <http://www.ask.hrsa.gov/Instructions.cfm>. The Inventory Code
    Number is: MCHM065.

-   Title V Information System (Title V IS) electronically captures data
    from annual Title V Block Grant applications and reports submitted
    by all 59 U.S. States, Territories, and Jurisdictions and provides
    information on key measures of maternal and child health in the
    United States, at:
    [http://www.mchdata.net](http://www.mchdata.net/).

-   Maternal And Child Health Services \-- Title V Block Grant Program
    Guidance And Forms for the Title V Application/Annual Report
    <ftp://ftp.hrsa.gov/mchb/blockgrant/bgguideforms.pdf>.

-   Regional Genetic and Newborn Screening Collaboratives \-- National
    Coordinating Center and the American College of Medical Genetics:
    [www.acmg.net](http://www.acmg.net/).

# Tips for Writing a Strong Application

[]{#__RefHeading___Toc116463744 .anchor}

**Include DUNS Number.** Applications will not be reviewed without a
DUNS number. To obtain a DUNS number, access
[www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or call
1-866-705-5711. Please include the DUNS number next to the OMB Approval
Number on the application face page.

**Keep your audience in mind.** Reviewers will use only the information
contained in the application to assess the application. Be sure the
application and responses to the program requirements and expectations
are complete and clearly written. Do not assume that reviewers are
familiar with the applicant organization. Keep the review criteria in
mind when writing the application.

**Start preparing the application early**. Allow plenty of time to
gather required information from various sources.

**Follow the instructions in this guidance carefully.** Place all
information in the order requested in the guidance. If the information
is not placed in the requested order, the application may receive a
lower score.

**Be brief, concise, and clear.** Make your points understandable.
Provide accurate and honest information, including candid accounts of
problems and realistic plans to address them. If any required
information or data is omitted, explain why. Make sure the information
provided in each table, chart, attachment, etc., is consistent with the
proposal narrative and information in other tables.

**Be organized and logical**. Many applications fail to receive a high
score because the reviewers cannot follow the thought process of the
applicant or because parts of the application do not fit together.

**Be careful in the use of appendices.** Do not use the appendices for
information that is required in the body of the application. Be sure to
cross-reference all tables and attachments located in the appendices to
the appropriate text in the application.

**Carefully proofread the application.** Misspellings and grammatical
errors will impede reviewers in understanding the application. Be sure
pages are numbered (including appendices) and that page limits are
followed. Limit the use of abbreviations and acronyms, and define each
one at its first use and periodically throughout application.

**Print out and carefully review an electronic application**. If
submitting electronically, print out the application before submitting
it to ensure appropriate formatting and adherence to page limit
requirements.

**Appendix 1**[]{#__RefHeading___Toc116463745 .anchor}

![](media/image1.wmf){width="6.33125in" height="8.452083333333333in"}

**Appendix 2**[]{#__RefHeading___Toc116463746 .anchor}

Key Personnel

**SUPPLEMENT TO SECTION F of SF 424A**

+------------------+-----------+------------+------------+-----------+
| NAME AND         | ANNUAL    | NUMBER OF  | PERCENTAGE | TOTAL     |
| POSITION/ TITLE  | SALARY    | MONTHS FOR | TIME       | FUNDS     |
|                  |           | BUDGET     |            | REQUESTED |
+------------------+-----------+------------+------------+-----------+
|                  | \(1\)     | \(2\)      | \(3\)      | \(4\)     |
+------------------+-----------+------------+------------+-----------+
|                  | \$        |            | \%         | \$        |
+------------------+-----------+------------+------------+-----------+
| FRINGE BENEFIT   | Total     |            |            | \$        |
|                  |           |            |            |           |
| (Rate )          |           |            |            |           |
+------------------+-----------+------------+------------+-----------+

Appendix 3

Maternal and Child Health Bureau

Discretionary Grant Performance Measures

PART 1 -

Detail Sheets

+-----------------------------------+-----------------+-----------------+
| **03 PERFORMANCE MEASURE**        | The percent of  |                 |
|                                   | completed MCHB  |                 |
| **Goal 1: Provide National        | supported       |                 |
| Leadership for MCHB**             | projects        |                 |
|                                   | publishing      |                 |
| **(Strengthen the MCH knowledge   | findings in     |                 |
| base and support scholarship      | peer-reviewed   |                 |
| within the MCH community)**       | journals.       |                 |
|                                   |                 |                 |
| **Level: Grantee**                |                 |                 |
|                                   |                 |                 |
| **Category: Information           |                 |                 |
| Dissemination**                   |                 |                 |
+-----------------------------------+-----------------+-----------------+
| **GOAL**                          | To increase the |                 |
|                                   | number of study |                 |
|                                   | findings from   |                 |
|                                   | research        |                 |
|                                   | projects that   |                 |
|                                   | are published   |                 |
|                                   | in              |                 |
|                                   | peer-reviewed   |                 |
|                                   | journals.       |                 |
+-----------------------------------+-----------------+-----------------+
|                                   |                 |                 |
+-----------------------------------+-----------------+-----------------+
| **MEASURE**                       | The percent of  |                 |
|                                   | completed MCHB  |                 |
|                                   | supported       |                 |
|                                   | projects        |                 |
|                                   | publishing      |                 |
|                                   | findings in     |                 |
|                                   | peer-reviewed   |                 |
|                                   | journals.       |                 |
+-----------------------------------+-----------------+-----------------+
|                                   |                 |                 |
+-----------------------------------+-----------------+-----------------+
| **DEFINITION**                    | **Numerator:**  |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | Number of       |                 |
|                                   | completed       |                 |
|                                   | projects        |                 |
|                                   | publishing main |                 |
|                                   | study findings  |                 |
|                                   | in              |                 |
|                                   | peer-reviewed   |                 |
|                                   | journals no     |                 |
|                                   | later than 3    |                 |
|                                   | years following |                 |
|                                   | completion in a |                 |
|                                   | cohort year.    |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | *               |                 |
|                                   | *Denominator:** |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | Total number of |                 |
|                                   | completed       |                 |
|                                   | projects in a   |                 |
|                                   | cohort year.    |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | **Units:** 100  | **Text:**       |
|                                   |                 | Percent         |
+-----------------------------------+-----------------+-----------------+
|                                   | A completed     |                 |
|                                   | project means   |                 |
|                                   | that the        |                 |
|                                   | funding period  |                 |
|                                   | has ended and   |                 |
|                                   | the final       |                 |
|                                   | report has been |                 |
|                                   | submitted by    |                 |
|                                   | the grantee.    |                 |
|                                   |                 |                 |
|                                   | Cohort year is  |                 |
|                                   | defined as      |                 |
|                                   | projects        |                 |
|                                   | completed in a  |                 |
|                                   | given fiscal    |                 |
|                                   | year. Each      |                 |
|                                   | cohort year     |                 |
|                                   | will be         |                 |
|                                   | collected for   |                 |
|                                   | three years.    |                 |
+-----------------------------------+-----------------+-----------------+
|                                   |                 |                 |
+-----------------------------------+-----------------+-----------------+
| **HEALTHY PEOPLE 2010 OBJECTIVE** | Related to Goal |                 |
|                                   | 1: Improve      |                 |
|                                   | access to       |                 |
|                                   | comprehensive,  |                 |
|                                   | high-quality    |                 |
|                                   | health care     |                 |
|                                   | services        |                 |
|                                   | (Objectives     |                 |
|                                   | 1.1- 1.16).     |                 |
+-----------------------------------+-----------------+-----------------+
|                                   |                 |                 |
+-----------------------------------+-----------------+-----------------+
| **DATA SOURCE(S) AND ISSUES**     | Attached data   |                 |
|                                   | collection form |                 |
|                                   | will be sent    |                 |
|                                   | annually to     |                 |
|                                   | grantees after  |                 |
|                                   | the funding     |                 |
|                                   | period for 3    |                 |
|                                   | years.          |                 |
|                                   |                 |                 |
|                                   | Some            |                 |
|                                   | preliminary     |                 |
|                                   | information may |                 |
|                                   | be gathered     |                 |
|                                   | from mandated   |                 |
|                                   | project final   |                 |
|                                   | reports.        |                 |
+-----------------------------------+-----------------+-----------------+
|                                   |                 |                 |
+-----------------------------------+-----------------+-----------------+
| **SIGNIFICANCE**                  | To be           |                 |
|                                   | successful, MCH |                 |
|                                   | information     |                 |
|                                   | must reach      |                 |
|                                   | professionals   |                 |
|                                   | who are         |                 |
|                                   | delivering      |                 |
|                                   | services,       |                 |
|                                   | developing      |                 |
|                                   | programs and    |                 |
|                                   | making policy   |                 |
|                                   | in order to     |                 |
|                                   | ensure that the |                 |
|                                   | latest          |                 |
|                                   | evidence-based, |                 |
|                                   | scientific      |                 |
|                                   | knowledge is    |                 |
|                                   | applied in      |                 |
|                                   | practice and    |                 |
|                                   | policy          |                 |
|                                   | development.    |                 |
|                                   | Peer reviewed   |                 |
|                                   | journals are    |                 |
|                                   | considered one  |                 |
|                                   | of the best     |                 |
|                                   | methods for     |                 |
|                                   | distributing    |                 |
|                                   | new knowledge   |                 |
|                                   | because of      |                 |
|                                   | their wide      |                 |
|                                   | circulation and |                 |
|                                   | rigorous        |                 |
|                                   | standard of     |                 |
|                                   | review.         |                 |
+-----------------------------------+-----------------+-----------------+

DATA COLLECTION FORM FOR DETAIL SHEET #03

**LIST OF PUBLICATIONS RELATED TO THE RESEARCH PROJECT FUNDED OR**

**CO-FUNDED BY MCHB**

FUNDED PROJECT
#:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROJECT TITLE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRINCIPAL INVESTIGATOR:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

GRANTEE/INSTITUTION:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(At the time the research was conducted)

TYPE OF PROJECT: Research \_\_\_\_ Training \_\_\_\_\_\_ Programmatic
\_\_\_\_\_\_\_

**LIST OF PUBLICATIONS**

**Produced by or for the Funded Project**

Please attach a reprint of listed article(s) to this form

TITLE OF THE ARTICLE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

JOURNAL:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

VOLUME: \_\_\_\_\_\_ NUMBER: \_\_\_\_\_\_\_\_ SUPPLEMENT:
\_\_\_\_\_\_\_YEAR:\_\_\_\_\_\_PAGE:\_\_\_\_\_\_

######## Appendix 4

Maternal and Child Health Bureau

Discretionary Grant Performance Measures

PART 2 -

Financial and Demographic Data Elements

**FORM 1**

**MCHB PROJECT BUDGET DETAILS FOR FY \_\_\_\_\_\_\_**

**1. MCHB GRANT AWARD AMOUNT** \$\_\_\_\_\_\_\_\_\_**\_**

**2. UNOBLIGATED BALANCE** \$\_\_\_\_\_\_\_\_\_**\_**

**3. MATCHING FUNDS** (Required: Yes \[ \] No \[ \] If yes, amount)
\$\_\_\_\_\_\_\_\_\_\_

> A. Local funds \$\_\_\_\_\_\_\_

B.  State funds \$\_\_\_\_\_\_\_

C.  Program Income \$\_\_\_\_\_\_\_

D.  Applicant/Grantee Funds \$\_\_\_\_\_\_\_

> E. Other funds \$\_\_\_\_\_\_\_

**4. OTHER PROJECT FUNDS** (Not included in 3 above)
\$\_\_\_\_\_\_\_\_\_\_

> A. Local funds \$\_\_\_\_\_\_\_

B.  State funds \$\_\_\_\_\_\_\_

C.  Program Income (Clinical or Other) \$\_\_\_\_\_\_\_

D.  Applicant/Grantee Funds (includes in-kind) \$\_\_\_\_\_\_\_

> E. Other funds (including private sector, e.g., \$\_\_\_\_\_\_\_
>
> Foundations)

**5**. **TOTAL PROJECT FUNDS** (Total lines 1 through 4)
\$\_\_\_\_\_\_\_\_\_\_

**6. FEDERAL COLLABORATIVE FUNDS**

(Source(s) of additional Federal funds contributing to the project)

> Other MCHB Funds (Do not repeat grant funds from Line 1)
>
> 1\) SPRANS \$\_\_\_\_\_\_\_\_
>
> 2\) CISS \$\_\_\_\_\_\_\_\_
>
> 3\) SSDI \$\_\_\_\_\_\_\_\_
>
> 4\) Abstinence Education \$\_\_\_\_\_\_\_\_
>
> 5\) Healthy Start \$\_\_\_\_\_\_\_\_

6)  EMSC \$\_\_\_\_\_\_\_\_

7)  Bioterrorism \$\_\_\_\_\_\_\_\_

8)  Traumatic Brain Injury \$\_\_\_\_\_\_\_\_

9)  State Title V Block Grant \$\_\_\_\_\_\_\_\_

10) Other \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_

> Other HRSA Funds

1)  HIV/AIDS \$\_\_\_\_\_\_\_\_

2)  Primary Care \$\_\_\_\_\_\_\_\_

3)  Health Professions \$\_\_\_\_\_\_\_\_

4)  Other \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_

> Other Federal Funds

1)  CMS \$\_\_\_\_\_\_\_\_

2)  SSI \$\_\_\_\_\_\_\_\_

3)  Agriculture (WIC/other) \$\_\_\_\_\_\_\_\_

4)  ACF \$\_\_\_\_\_\_\_\_

5)  CDC \$\_\_\_\_\_\_\_\_

6)  SAMHSA \$\_\_\_\_\_\_\_\_

7)  NIH \$\_\_\_\_\_\_\_\_

8)  Education \$\_\_\_\_\_\_\_\_

> Other: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_
>
> \$\_\_\_\_\_\_\_\_
>
> [\_]{.underline} \$\_\_\_\_\_\_\_\_

**7. TOTAL COLLABORATIVE FEDERAL FUNDS**
\$[\_\_\_\_\_\_\_\_]{.underline}

**INSTRUCTIONS FOR COMPLETION OF FORM 1**

**MCH BUDGET DETAILS FOR FY \_\_\_\_**

Line 1. Enter the amount of the Federal MCHB grant award for this
project.

Line 2. Enter the amount of carryover from the previous year's award, if
any (the unobligated balance).

Line 3. Indicate if matching funds are required by checking the
appropriate choice. If matching funds are required, enter the total
amount of the matching funds received or committed to the project. List
the amounts by source on lines 3A through 3D as appropriate. Do not
include "overmatch" funds. Any additional funds over and above the
amount required for matching purposes should be reported in Line 4.
Where appropriate, include the dollar value of in-kind contributions.

Line 4. Enter the amount of other funds received for the project, by
source on Lines 4A through 4E, specifying amounts from each source. Do
not include those amounts included in Line 3 above. Also include the
dollar value of in-kind contributions.

Line 5. Enter the sum of lines 1 through 4

Line 6. Line 6. Enter the amount of other Federal funds received on the
appropriate lines (A.1 through C.9) other than the MCHB grant award for
the project. Such funds would include those from other Departments,
other components of the Department of Health and Human Services, or
other MCHB grants or contracts.

Line 6C.1. Enter only project funds from the Center for Medicare and
Medicaid Services. Exclude Medicaid reimbursement, which is considered
Program Income and should be included on Line 3C or 4C.

If lines 6A.10, 6B.4, or 6C.9 are utilized, specify the source(s) of the
funds in the order of the amount provided, starting with the source of
the most funds. If more space is required, add a footnote at the bottom
of the page showing additional sources and amounts.

Line 7. Enter the sum of Lines 6A.1 through 6C.9.

> **NOTE: MCHB Training Grants must fill out Section "V. Detailed
> Budget" of the currently approved HRSA-6025 in addition to this
> form.**

**FORM 2**

**PROJECT FUNDING PROFILE**

<table style="width:100%;">
<colgroup>
<col style="width: 1%" />
<col style="width: 11%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
</tr>
<tr class="odd">
<td><strong>1</strong></td>
<td><p><u>MCHB Grant</u></p>
<p><u>Award</u> <u>Amount</u></p>
<p><em>Line 1, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="even">
<td><strong>2</strong></td>
<td><p><u>Unobligated Balance</u></p>
<p><em>Line 2, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="odd">
<td><strong>3</strong></td>
<td><p><u>Matching Funds</u></p>
<p><u>(If required)</u></p>
<p><em>Line 3, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="even">
<td><strong>4</strong></td>
<td><p><u>Other Project Funds</u></p>
<p><em>Line 4, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="odd">
<td><strong>5</strong></td>
<td><p><u>Total Project Funds</u></p>
<p><em>Line 5, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="even">
<td><strong>6</strong></td>
<td><p><u>Total Federal Collaborative Funds</u></p>
<p><em>Line 7, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
</tbody>
</table>

**INSTRUCTIONS FOR THE COMPLETION OF FORM 2**

**PROJECT FUNDING PROFILE**

**Instructions:**

Complete all required data cells. If an actual number is not available,
use an estimate. Explain all estimates in a footnote.

The form is intended to provide at a glance funding data on the
estimated budgeted amounts and actual expended amounts of an MCH
project.

> For each fiscal year, the data in the columns labeled Budgeted on this
> form are to contain the same figures that appear on the Application
> Face Sheet and Lines 1 through 7 of Form 1. The lines under the
> columns labeled Expended are to contain the actual amounts expended
> for each grant year that has been completed.

**FORM 4**

**PROJECT BUDGET AND EXPENDITURES**

**By Types of Services**

**FY \_\_\_\_\_ FY \_\_\_\_\_**

**[TYPES OF SERVICES]{.underline} [Budgeted]{.underline}
[Expended]{.underline} [Budgeted]{.underline} [Expended]{.underline}**

**I. [Direct Health Care Services]{.underline}** \$ \$ \$ \$
[\_\_\_\_\_\_\_\_\_]{.underline}

> (Basic Health Services and Health
>
> Services for CSHCN.)

**II. [Enabling Services]{.underline}** \$ \$ \$ \$
[\_\_\_\_\_\_\_\_\_\_]{.underline}

> (Transportation, Translation,

Outreach, Respite Care, Health

> Education, Family Support Services,

Purchase of Health Insurance,

> Case Management and Coordination
>
> with Medicaid, WIC, and Education.)

**III.** **[Population-Based Services]{.underline}** \$ \$ \$
\$\_\_\_\_\_\_\_\_\_\_\_

> (Newborn Screening, Lead Screening,
>
> Immunization, Sudden Infant Death
>
> Syndrome Counseling, Oral Health,
>
> Injury Prevention, Nutrition, and

Outreach/Public Education.)

**IV.** **[Infrastructure Building Services]{.underline}** \$ \$ \$ \$
[\_\_\_\_\_\_\_\_\_\_\_]{.underline}

> (Needs Assessment, Evaluation, Planning,
>
> Policy Development, Coordination,
>
> Quality Assurance, Standards Development,
>
> Monitoring, Training, Applied Research,

Systems of Care and Information Systems.)

**V. TOTAL \$ \$ \$ \$ [\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

**INSTRUCTIONS FOR THE COMPLETION OF FORM 4**

**PROJECT BUDGET AND EXPENDITURES BY TYPES OF SERVICE**S

Complete all required data cells. If an actual number is not available,
make an estimate. Please explain all estimates in a footnote.
Administrative dollars should be allocated to the appropriate level(s)
of the pyramid on lines I, II, II or IV. If an estimate of
administrative funds use is necessary, one method would be to allocate
those dollars to Lines I, II, III and IV at the same percentage as
program dollars are allocated to Lines I through IV.

Note: Lines I, II and II are for projects providing services. If grant
funds are used to build the infrastructure for direct care delivery,
enabling or population-based services, these amounts should be reported
in Line IV (i.e., building data collection capacity for newborn hearing
screening).

Line I [Direct Health Care Services]{.underline} - enter the budgeted
and expended amounts for the appropriate fiscal year completed and
budget estimates only for all other years.

> **Direct Health Care Services** are those services generally delivered
> one-on-one between a health professional and a patient in an office,
> clinic or emergency room which may include primary care physicians,
> registered dietitians, public health or visiting nurses, nurses
> certified for obstetric and pediatric primary care, medical social
> workers, nutritionists, dentists, sub-specialty physicians who serve
> children with special health care needs, audiologists, occupational
> therapists, physical therapists, speech and language therapists,
> specialty registered dietitians. Basic services include what most
> consider ordinary medical care, inpatient and outpatient medical
> services, allied health services, drugs, laboratory testing, x-ray
> services, dental care, and pharmaceutical products and services. State
> Title V programs support - by directly operating programs or by
> funding local providers - services such as prenatal care, child health
> including immunizations and treatment or referrals, school health and
> family planning. For CSHCN, these services include specialty and
> sub-specialty care for those with HIV/AIDS, hemophilia, birth defects,
> chronic illness, and other conditions requiring sophisticated
> technology, access to highly trained specialists, or an array of
> services not generally available in most communities.

Line II [Enabling Services]{.underline} - enter the budgeted and
expended amounts for the appropriate fiscal year completed and budget
estimates only for all other years.

> **Enabling Services** allow or provide for access to and the
> derivation of benefits from, the array of basic health care services
> and include such things as transportation, translation services,
> outreach, respite care, health education, family support services,
> purchase of health insurance, case management, coordination of with
> Medicaid, WIC and educations. These services are especially required
> for the low income, disadvantaged, geographically or culturally
> isolated, and those with special and complicated health needs. For
> many of these individuals, the enabling services are essential - for
> without them access is not possible. Enabling services most commonly
> provided by agencies for CSHCN include transportation, care
> coordination, translation services, home visiting, and family
> outreach. Family support activities include parent support groups,
> family training workshops, advocacy, nutrition and social work.

Line III [Population-Based Services]{.underline} - enter the budgeted
and expended amounts for the appropriate fiscal year completed and
budget estimates only for all other years.

> **Population Based Services** are preventive interventions and
> personal health services, developed and available for the entire MCH
> population of the State rather than for individuals in a one-on-one
> situation. Disease prevention, health promotion, and statewide
> outreach are major components. Common among these services are newborn
> screening, lead screening, immunization, Sudden Infant Death Syndrome
> counseling, oral health, injury prevention, nutrition and
> outreach/public education. These services are generally available
> whether the mother or child receives care in the private or public
> system, in a rural clinic or an HMO, and whether insured or not.

Line IV [Infrastructure Building Services]{.underline} - enter the
budgeted and expended amounts for the appropriate fiscal year completed
and budget estimates only for all other years.

> **Infrastructure Building Services** are the base of the MCH pyramid
> of health services and form its foundation. They are activities
> directed at improving and maintaining the health status of all women
> and children by providing support for development and maintenance of
> comprehensive health services systems and resources including
> development and maintenance of health services standards/guidelines,
> training, data and planning systems. Examples include needs
> assessment, evaluation, planning, policy development, coordination,
> quality assurance, standards development, monitoring, training,
> applied research, information systems and systems of care. In the
> development of systems of care it should be assured that the systems
> are family centered, community based and culturally competent.

Line V [Total]{.underline} -- enter the total amounts for each column,
budgeted for each year and expended for each year completed.

> **FORM 6**

**MATERNAL & CHILD HEALTH DISCRETIONARY GRANT**

**PROJECT ABSTRACT**

**FOR FY\_\_\_\_**

**PROJECT:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**I. PROJECT IDENTIFIER INFORMATION**

1\. Project Title:

> 2\. Project Number:

3\. E-mail address:

**II. BUDGET**

1\. MCHB Grant Award \$\_\_\_\_\_\_\_\_\_\_\_\_\_

(Line 1, Form 2)

2\. Unobligated Balance \$\_\_\_\_\_\_\_\_\_\_\_\_\_

(Line 2, Form 2)

3\. Matching Funds (if applicable) \$\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Line 3, Form 2)

4\. Other Project Funds \$\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Line 4, Form 2)

5\. Total Project Funds \$\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Line 5, Form 2)

**III. TYPE(S) OF SERVICE PROVIDED (Choose all that apply)**

\[ \] Direct Health Care Services

> \[ \] Enabling Services
>
> \[ \] Population-Based Services
>
> \[ \] Infrastructure Building Services

IV. **PROJECT DESCRIPTION OR EXPERIENCE TO DATE**

> A. Project Description

1.  Problem (in 50 words, maximum):

2.  Goals and Objectives: (List up to 5 major goals and time-framed
    objectives per goal for the project)

> Goal 1:

Objective 1:

Objective 2:

Goal 2:

Objective 1:

Objective 2:

Goal 3:

Objective 1:

Objective 2:

Goal 4:

Objective 1:

Objective 2:

Goal 5:

Objective 1:

Objective 2:

3.  Activities undertaken to meet project goals

4.  Specify the primary *Healthy People 2010* objectives(s) (up to
    three) which this project addresses:

> a\.
>
> b\.
>
> c\.

5\. Coordination (List the State, local health agencies or other
organizations involved in the project and their roles)

6\. Evaluation (briefly describe the methods which will be used to
determine whether process and outcome objectives are met)

B.  Continuing Grants ONLY

```{=html}
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```
1.  Experience to Date (For continuing projects ONLY):

2\. Website URL and annual number of hits

V.  **KEY WORDS**

    **VI. ANNOTATION**

> **INSTRUCTIONS FOR THE COMPLETION OF FORM 6**

**PROJECT ABSTRACT**

**NOTE:** All information provided should fit into the space provided in
the form. The completed form should be no more than 3 pages in length.
Where information has previously been entered in forms 1 through 5, the
information will automatically be transferred electronically to the
appropriate place on this form.

**Section I -- Project Identifier Information**

Project Title: List the appropriate shortened title for the project.

Project Number: This is the number assigned to the project when funded,
and will, for new projects, be filled in later.

E-mail address: Include electronic mail addresses

**Section II -- Budget -** These figures will be transferred from Form
1, Lines 1 through 5.

**Section III - Types of Services -** Indicate which type(s) of services
your project provides, checking all that apply (consistent with Form 5)

**Section IV -- Program Description OR Current Status (DO NOT EXCEED THE
SPACE PROVIDED)**

> A. New Projects only are to complete the following items:

1.  A brief description of the project and the problem it addresses such
    as preventive and primary care services for pregnant women, mothers,
    and infants; preventive and primary care services for children; and
    services for Children with Special Health Care Needs.

2.  Up to 5 goals of the project, in priority order. Examples are: To
    reduce the barriers to the delivery of care for pregnant women, to
    reduce the infant mortality rate for minorities and "services or
    system development for children with special healthcare needs." MCHB
    will capture annually every project's top goals in an information
    system for comparison, tracking, and reporting purposes; you must
    list at least 1 and no more than 5 goals. For each goal, list the
    two most important objectives. The objective must be specific (I.e.,
    decrease incidence by 10%) and time limited (by 2005).

3.  List the primary Healthy people 2010 goal(s) that the project
    addresses.

4.  Describe the programs and activities used to attain the goals and
    objectives, and comment on innovation, cost, and other
    characteristics of the methodology, proposed or are being
    implemented. Lists with numbered items can be used in this section.

5.  Describe the coordination planned and carried out, in the space
    provided, if applicable, with appropriate State and/or local health
    and other agencies in areas(s) served by the project.

6.  Briefly describe the evaluation methods that will be used to assess
    the success of the project in attaining its goals and objectives.

    B.  For continuing projects ONLY:

    ```{=html}
    <!-- -->
    ```
    1.  Provide a brief description of the major activities and
        accomplishments over the past year (not to exceed 200 words).

    2.  Provide website and number of hits annually, if applicable.

**Section V \-- Key Words**

> Key words describe the project, including populations served. Choose
> key words from the included list.

**Section VI -- Annotation**

> Provide a three- to five-sentence description of your project that
> identifies the project's purpose, the needs and problems, which are
> addressed, the goals and objectives of the project, the activities,
> which will be used to attain the goals, and the materials, which will
> be developed.

**FORM 7**

**DISCRETIONARY GRANT PROJECT**

**SUMMARY DATA**

1.  **Project Service Focus**

> \[ \] Urban/Central City \[ \] Suburban \[ \] Metropolitan Area (city
> & suburbs)
>
> \[ \] Rural \[ \] Frontier \[ \] Border (US-Mexico)

2.  **Project Scope**

> \[ \] Local \[ \] Multi-county \[ \] State-wide
>
> \[ \] Regional \[ \] National

3.  **Grantee Organization Type**

> \[ \] State Agency

\[ \] Community Government Agency

\[ \] School District

\[ \] University/Institution Of Higher Learning (Non-Hospital Based)

\[ \] Academic Medical Center

\[ \] Community-Based Non-Governmental Organization (Health Care)

\[ \] Community-Based Non-Governmental Organization (Non-Health Care)

\[ \] Professional Membership Organization (Individuals Constitute Its
Membership)

\[ \] National Organization (Other Organizations Constitute Its
Membership)

\[ \] National Organization (Non-Membership Based)

\[ \] Independent Research/Planning/Policy Organization

\[ \] Other
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

4.  **Project Infrastructure Focus** (from MCH Pyramid) if applicable

\[ \] Guidelines/Standards Development And Maintenance

\[ \] Policies And Programs Study And Analysis

\[ \] Synthesis Of Data And Information

\[ \] Translation Of Data And Information For Different Audiences

\[ \] Dissemination Of Information And Resources

\[ \] Quality Assurance

\[ \] Technical Assistance

\[ \] Training

\[ \] Systems Development

\[ \] Other

**5. Products and Dissemination**

  -------------------------------------------------------- --------------
  **PRODUCTS**                                             **NUMBER**

  Peer reviewed Journal Article                            

  Book/Chapter                                             

  Report/Monograph                                         

  Presentation                                             

  Doctoral Dissertation                                    

  Other:                                                   
  -------------------------------------------------------- --------------

**Appendix 5**[]{#__RefHeading___Toc116463749 .anchor}

**Keywords**

**for Projects Funded by the**

**U.S. Maternal and Child Health Bureau (MCHB)**

A list of keywords used to describe MCHB-funded projects follows. Please
choose from this list when selecting terms to classify your project.

Please note that this list is constantly under development: new terms
are being added and some terms are being deleted. Also, this list is
currently being revised so that it will match more closely the approved
list of keywords in the MCH Thesaurus. In the meantime, however, this
list can be used to help select keywords to describe MCHB-funded
projects.

If no term on this list adequately describes a concept, which you would
like to convey, please select a term, which you think is appropriate,
and include it in your list of keywords.

![](media/image2.png){width="6.25in" height="0.10416666666666667in"}

2010 Express

Abstinence

Abstinence Education

Abstinence-Only Education

Access to Health Care

Adolescent Health Programs

Adolescent Nutrition

Adolescent Parents

Adolescent Pregnancy

Adolescent Pregnancy Prevention

Adolescent Risk Behavior Prevention

Adolescents

Adolescent Transition

Adolescents with Disabilities

Advocacy

African Americans

African American Families and Children

Agricultural Safety

AIDS

AIDS Prevention

Alaska Natives

Alcohol

American Academy of Pediatrics

American Association of Health Plans

American College of Obstetricians and Gynecologists

American Public Health Association

Amniocentesis

Anemia

Anticipatory Guidance

Appalachians

Arthritis

Asian Language Materials

Asians

Asthma

Attachment

Attachment Behavior

Attention Deficit Disorder

Audiology

Audiometry

Audiovisual Materials

Automated Auditory Brainstem Response

Baby Bottle Tooth Decay

Battered Women

Behavior Disorders

Behavioral Pediatrics

Benefit Package

Bereavement

Bicycle Helmets

Bicycle Safety

Bilingual Services

Biochemical Genetics

Blindness

Blood Pressure Determination

Body Composition

Bonding

Brain Injuries

Breast Pumps

Breastfeeding

Bronchopulmonary Dysplasia

Bullying

Burns

Cambodians

Capitation

Care Coordination

Caregivers

Case Management

Cerebral Palsy

Character Development

Chelation Therapy

Child Abuse

Child Abuse Prevention

Child Care

Child Care Centers

Child Care Health Consultants

Child Care Workers

Child Morbidity

Child Mortality

Child Neglect

Child Nutrition

Child Sexual Abuse

Childhood Cancer

Children with Special Health Care Needs

Child Death Review

Chronic Illnesses and Disabilities

Cleft Lip

Cleft Palate

Clinical Genetics

Clinical Risk Groups

Clinics

Coalition Building

Cocaine

Cochlear Implant

Collaboration

Collaborative Office Rounds

Communicable Diseases

Communication Disorders

Communication Systems

Community

Community Based Health Education

Community Based Health Services

Community Based Preventive Health

Community Development

Community Health Centers

Community Integrated Service System

Community Participation

Community Partnerships

Community Systems Integration

Compliance

Comprehensive Primary Care

Computer Linkage

Computer Systems

Computers

Conferences

Congenital Abnormalities

Congenital Hearing Loss

Congenital Hypothyroidism

Consortia

Continuing Education

Continuity of Care

Cost Effectiveness

Counseling

County Health Agencies

Cranio-facial Conditions

Cross System Strategies

CSHCN Screener

Cultural and Linguistic Competence

Cultural Diversity

Cultural Competence

Cultural Sensitivity

Curricula

Cystic Fibrosis

Cytogenetics

Data Analysis

Data Collection

Data Systems

Databases

Deafness

Decision Making Skills

Delayed Development

Dental Sealants

Dental Treatment of Children with Disabilities

Depression

Developmental Disabilities

Developmental Evaluation

Developmental Screening

Diagnosis

Diarrhea

Dietitians

Dispute Resolution

Dissemination

Distance Education

Divorce

DNA Analysis

Down Syndrome

Drowning

Early Childhood Caries

Early Childhood Development

Early Childhood Education

Early Childhood and Family Environment

Early Intervention

Electronic Bulletin Boards

Electronic Mail

Eligibility Determination

Emergency Medical Services for Children

Emergency Medical Technicians

Emergency Room Personnel

Emotional Disorders

Emotional Health

Employee Assistance Programs

Employers

Employment of Parent

Enabling Services

Enteral Nutrition

EPSDT

Erythrocyte Protoporphyrin

Ethics

Evoked Otoacoustic Emissions

Failure to Thrive

Families

Family Centered Health Care

Family Centered Health Education

Family Characteristics

Family Environment

Family Financial Security and Socio-Emotional Development of Children

Family Focus Groups

Family Medicine

Family Participation

Family Planning

Family Professional Collaboration/Partnerships

Family Relations

Family Support Case Management

Family Support Programs

Family Support Services

Family to Family Health Information Centers

Family Violence Prevention

Farm Workers

Fathers

Feeding Disorders

Fetal and Infant Mortality Review

Fetal Alcohol Effects

Fetal Alcohol Syndrome

Financing

Food Preparation in Child Care

Formula

Foster Care

Foster Children

Foster Homes

Foster Parents

Fragile X Syndrome

Genetic Counseling

Genetic Disorders

Genetic Screening

Genetic Services

Genetics Education

Gestational Weight Gain

Glucose Intolerance

Governors

Grief

Gynecologists

Hawaiians

Head Start

Health Care Coverage

Health Care Financing

Health Care Reform

Health care utilization

Health Education

Health Insurance

Health Insurance Enrollment in Child Care

Health Maintenance Organizations

HP 2010 for CSHCN

HP 2010 for CSHCN State Implementation

Health Professionals

Health Promotion

Health Supervision

Healthy Communities

Healthy Mothers Healthy Babies Coalition

Healthy People 2010

Healthy Start Initiative

Healthy Tomorrows Partnership for Children

Hearing Disorders

Hearing Loss

Hearing Screening

Hearing Tests

Hemoglobinopathies

Hemophilia

Hepatitis B

Hispanics

Hispanic Access to Health Care

Hispanic Families and Children

HIV

Hmong

Home Health Services

Home Visiting for At Risk Families

Home Visiting Programs

Home Visiting Services

Homeless Persons

Hospitals

Hygiene

Hyperactivity

Hypertension

Identification

Illnesses in Child Care

Immigrants

Immunization

Incarcerated Women

Incarcerated Youth

Individual Education Plan (IEP)

Indian Health Service

Indigence

Individualized Family Service Plans

Infant Health Care

Infant Morbidity

Infant Mortality

Infant Mortality Review Programs

Infant Nutrition

Infant Screening

Infant Temperament

Infants

Information Networks

Information Services

Information Sources

Information Systems

Information System Integration

Injuries

Injury Prevention

Intensive Care

Interagency Cooperation

Interdisciplinary Collaboration

Interdisciplinary Strategies

Interdisciplinary Teams

Internship and Residency

Intubation

Iron Deficiency Anemia

Iron Supplements

Juvenile Rheumatoid Arthritis

Laboratories

Lactose Intolerance

Language Barriers

Language Disorders

Laotians

Lead Poisoning

Lead Poisoning Prevention

Lead Poisoning Screening

Leadership Development

Leadership Training

Learning Disabilities

Legal Issues

Life Support Care

Literacy

Local Health Agencies

Local MCH Programs

Low Birth weight

Low Income Population

Lower Birth weight

Males

Managed Care

Managed Care Organization

Managed Competition

Marijuana

Marital Conflict

Maternal and Child Health Bureau

Maternal Nutrition

MCH Research

Media Campaigns

Medicaid

Medicaid Managed Care

Medical Genetics

Medical History

Medical Home

Medical Necessity

Mental Health

Mental Health Services

Mental Retardation

Metabolic Disorders

Mexicans

Micronesians

Migrant Health Centers

Migrants

Minority Families

Minority Groups

Minority Health Professionals

Mobile Health Units

Molecular Genetics

Morbidity

Mortality

Motor Vehicle Crashes

Multiple Births

Myelodysplasia

National CSHCN Survey

National Information Resource Centers

National Programs

Native Americans

Needs Assessment

Neonatal Intensive Care

Neonatal Intensive Care Units

Neonatal Mortality

Neonates

Network Development

Networking

Neurological Disorders

New Freedom Initiative

Newborn Screening

Newborn Screening Education

Nurse Midwives

Nurses

Nutrition

Obstetricians

Occupational Therapy

One Stop Shopping

Online Databases

Online Systems

Oral Health

Organic Acidemia

Organization and Delivery of Health Services

Organizational Self Assessment

Otitis Media

Out-of-Wedlock Sexual Activity

Outreach

P. L. 99-457

Pacific Islanders

Pain

Paraprofessional Education

Parent and Professional Collaboration

Parent Education

Parent Education Programs

Parent Networks

Parent Professional Communication

Parent Support Groups

Parent Support Services

Parental Stressors

Parental Visits

Parenteral Nutrition

Parenting Skills

Parents

Partnerships

Patient Education

Patient Education Materials

Pediatric Advanced Life Support Programs

Pediatric Dentistry

Pediatric Intensive Care Units

Pediatric Nurse Practitioners

Pediatricians

Peer Counseling

Peer Support Programs

Perinatal Health

Periodontal

Periodontal Disease

Phenylketonuria

Physical Disabilities

Physical Therapy

Pneumococcal Infections

Poisons

Poison Control Center

Policy Initiatives

Positive Youth Development

Preconception Care

Pregnant Adolescents

Pregnant Women

Prematurity

Prenatal Care

Prenatal Diagnosis

Prenatal Screening

Preschool Children

Preterm Birth

Preventive Health Care

Preventive Health Care Education

Primary Care

Primary Care Providers

Professional Education in Adolescent Health

Professional Education in Behavioral Pediatrics

Professional Education in Breastfeeding

Professional Education in Chronic Illnesses and Disabilities

Professional Education in Communication Disorders

Professional Education in CSHN

Professional Education in Cultural Sensitivity

Professional Education in Dentistry

Professional Education in Developmental Disabilities

Professional Education in EMSC

Professional Education in Family Medicine

Professional Education in Genetics

Professional Education in Lead Poisoning

Professional Education in MCH

Professional Education in Metabolic Disorders

Professional Education in Nurse Midwifery

Professional Education in Nursing

Professional Education in Nutrition

Professional Education in Occupational Therapy

Professional Education in Physical Therapy

Professional Education in Primary Care

Professional Education in Psychological Evaluation

Professional Education in Pulmonary Disease

Professional Education in Social Work

Professional Education in Violence Prevention

Program Integration

Provider Participation

Psychological Evaluation

Psychological Problems

Psychosocial Services

Public Awareness Campaign

Public Health Academic Programs

Public Health Education

Public Health Nurses

Public Policy

Public Private Partnership

Puerto Ricans

Pulmonary Disease

Quality Assurance

Recombinant DNA Technology

Referrals

Regional Programs

Regionalized Care

Regulatory Disorders

Rehabilitation

Reimbursement

Repeat pregnancy prevention

Research

Residential Care

Respiratory Illnesses

Retinitis Pigmentosa

Rheumatic Diseases

Risk Adjustment

Risk Reduction

RNA Analysis

Robert Wood Johnson Foundation

Runaways

Rural Population

Safety in Child Care

Safety Seats

Sanitation in Child Care

School Age Children

School-Based Health Centers

School Dropouts

School Health Programs

School Health Services

School Nurses

School Mental Health Services

School Safety

Schools

Screening

Seat Belts

Self Esteem

Sensory Impairments

Service Coordination

Sex Roles

Sexual Behavior

Sexuality Education

Sexually Transmitted Diseases

Shaken Infant Syndrome

Siblings

Sickle Cell Disease

Sleep Disorders

Smoking During Pregnancy

Social Marketing

Social Skills Instruction

Social Work

Socio-Emotional Development and Maternal and Child Health Services
Delivery

Socio-Emotional Development Assessment

Socio-Emotional Development and Medical Home

Southeast Asians

Spanish Language Materials

Special Education Programs

Specialized Care

Specialized Child Care Services

Speech Disorders

Speech Pathology

Spina Bifida

Spouse Abuse

Standards of Care

State Health Agencies

State Health Insurance Programs (S-CHIP)

State Health Officials

State Legislation

State Programs

State Staff Development

State Systems Development Initiative

Stress

Substance Abuse

Substance Abuse Prevention

Substance Abuse Treatment

Substance Abusing Mothers

Substance Abusing Pregnant Women

Substance Exposed Children

Substance Exposed Infants

Sudden Infant Death Syndrome

Suicide

Supplemental Security Income Program

Support Groups

Surveys

Systems of Care

Tay Sachs Disease

Technical Assistance for CSHCN

Technology Dependence

Teleconferences

Telemedicine

Television

Teratogens

Terminally Ill Children

Tertiary Care Centers

Thalassemias

Third Party Payers

Title V Programs

Toddlers

Training

Transportation

Trauma

Traumatic Brain Injury

Tuberculosis

Twins

Underinsurance

Underserved

Uninsured

Unintentional Injuries

University Affiliated Programs

Urban Population

Urinary Tract Infections

Usher Syndrome

Vietnamese

Violence

Violence Prevention

Vision Screening

Vocational Training

Von Willebrand Disease

Waiver 1115

Welfare Reform and Child Development

Welfare to Work

Well Baby Care

Well Child Care

WIC

Women with Congenital Bleeding Disorders

Wraparound Services

Youth Development Assets

Youth Risk Behaviors

Youth in Transition

Youth with Special Health Care Needs