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Affordable Care Act (ACA) Maternal, Infant, and Early Childhood Home Visiting Program

MIECHV
Number: 93.505
Agency: Department of Health and Human Services
Office: Health Resources and Services Administration

Program Information 

Program Number/Title (010):
93.505 Affordable Care Act (ACA) Maternal, Infant, and Early Childhood Home Visiting Program
Federal Agency (030):
Health Resources and Services Administration, Department of Health and Human Services
Authorization (040):
Social Security Act, Title V, Section 511 (42 U.S.C. §711), as added by Section 2951 of the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148).
Objectives (050):
The Maternal, Infant, and Early Childhood Home Visiting Program is designed : (1) to strengthen and improve the programs and activities carried out under Title V; (2) to improve coordination of services for at risk communities; and (3) to identify and provide comprehensive services to improve outcomes for families who reside in at risk communities. Voluntary evidence-based home visiting is the primary strategy to deliver services. A nurse, social worker, parent educator, or other paraprofessional regularly visits an expectant mother or father, new parent, or primary caregiver of a young child from birth to kindergarten entry to support and strengthen the parent-child relationship to improve the health, development and well-being for the child and family.
Types of Assistance (060):
Formula Grants; Project Grants
Uses and Use Restrictions (070):
1. Assistance can potentially be used for enhancing States’ infrastructure for improving coordination of services for at-risk communities and identifying and providing comprehensive services to improve outcomes for families who reside in at-risk communities, as well as for implementing State home visiting service programs. The statute reserves the majority of funding for the delivery of services through use of one or more evidence-based home visiting service delivery models. In addition, it supports continued innovation by allowing up to 25 percent of funding to support service delivery through promising approaches that do not yet qualify as evidence-based models. To ensure that the required statutory distribution is maintained, all MIECHV programs must demonstrate that they are being delivered in conformity with the approved service delivery models. This fidelity is demonstrated by programs that have the requisite designation and/or approval from a model developer to provide evidence-based home visiting services. MIECHV-funded programs must maintain the requisite designation and/or approval from the model developer while receiving MIECHV funding.

2. Restrictions: No more than 10% of the award amount may be spent on costs associated with administering the award. Funds made available to a grantee for a fiscal year shall remain available for expenditure by the grantee through the end of the second succeeding fiscal year after award. Funds that have not been expended during the period of availability will be deobligated and no longer available for use by the grantee.
Eligibility Requirements (080)
Applicant Eligibility (081):
Eligibility for funding is limited to a single application from each State, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, the Northern Mariana Islands, and American Samoa. The Governor has the responsibility and authority to designate which entity or group of entities will apply for and administer home visiting program funds on behalf of the State or US Territory.

Regardless of the entity or entities designated by the Governor, this application must contain the concurrence and signatures of the:

• Director of the State’s Title V agency;
• Director of the State’s agency for Title II of the Child Abuse Prevention and Treatment Act (CAPTA);
• The State’s child welfare agency (Title IV-E and IV-B), if this agency is not also administering Title II of CAPTA:
• Director of the State’s Single State Agency for Substance Abuse Services;
• The State’s Child Care and Development Fund (CCDF) Administrator;
• Director of the State’s Head Start State Collaboration Office, and
• The State’s Advisory Council on Early Childhood Education and Care authorized by 642B(b)(1)(A)(i) of the Head Start Act.


For those states that have elected not to participate in MIECHV, nonprofit organizations with an established record of providing early childhood home visiting programs or initiatives in a state or several states are eligible to apply to carry out programs in those states.
Beneficiary Eligibility (082):
• Eligible families residing in communities in need of such services, as identified in a State needs assessment
• Low-income eligible families
• Eligible families who are pregnant women under age 21
• Eligible families with a history of child abuse or neglect or have had interactions with child welfare services
• Eligible families with a history of substance abuse or need substance abuse treatment
• Eligible families that have users of tobacco products in the home
• Eligible families that are or have children with low student achievement
• Eligible families with children with developmental delays or disabilities
• Eligible families who, or that include individuals serving or formerly serving in the Armed Forces, including those with members who have had multiple deployments outside the US

Eligible family:
o A woman who is pregnant, and the father of the child if available, or
o A parent or primary caregiver of the child, including grandparents or other relatives and foster parents serving as the child's primary caregiver from birth until kindergarten entry, including a noncustodial parent with an ongoing relationship with, and at times provides physical care for the child.
Credentials/Documentation (083):
Applicants should review the individual HRSA funding opportunity announcement issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. OMB Circular No. A-87 applies to this program.
Application and Award Process (090)
Preapplication Coordination (091):
Preapplication coordination is required. Environmental impact information is not required for this program. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.
Application Procedures (092):
OMB Circular No. A-102 applies to this program. OMB Circular No. A-110 applies to this program. HRSA requires all applicants to apply electronically through Grants.gov.
Award Procedure (093):
Formula Grants: All qualified applications will be reviewed internally by grants management officials (business and financial review) and program staff (technical review) for eligibility, completeness, accuracy, and compliance with the requirements outlined in this announcement. The HRSA program official with delegated authority is responsible for final selection and funding decisions.

Competitive Grants: All qualified applications will be forwarded to an independent objective review committee. Based on the advice of the independent objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions.

Notification is made in writing by an electronic Notice of Award.
Deadlines (094):
Contact the headquarters or regional office, as appropriate, for application deadlines.
Range of Approval/Disapproval Time (095):
From 60 to 90 days. Contact the Headquarters or Regional Office as appropriate for application deadlines or view the specific funding opportunity announcement.
Appeals (096):
Not Applicable.
Renewals (097):
Formula funds are awarded on an annual basis.
Assistance Consideration (100)
Formula and Matching Requirements (101):
Statutory Formula: Formula funding is determined as follows:

i. The number of children under age five in families at or below 100% of the Federal poverty line in each state was obtained by using 2011 U.S. Census Bureau’s Small Area Income Poverty Estimate (SAIPE) data (available at http://www.census.gov/did/www/saipe/data/statecounty/data/2011.html).

ii. The percentage of children under age five in families at or below 100% of the Federal poverty line in the state, as compared to the number of such children nationally, was calculated.

iii. For each state, the percentage of children under age five in families at or below 100% of the Federal poverty line was multiplied by the total amount of funding available, (excluding the funding allocated for Puerto Rico, Guam, the Virgin Islands, the Northern Mariana Islands, and American Samoa. Because SAIPE data is not available for these jurisdictions, each was allocated a base amount of $1,000,000.

iv. This initial distribution, based on the percentage of children in poverty, was reviewed and proportionally modified to ensure a floor of the allocation provided in federal FY 2012 (excluding the funding provided for the Supporting Evidence Based Home Visiting Program).
This program has no matching requirements.
This program has MOE requirements, see funding agency for further details. Funds provided to an eligible entity receiving a grant shall supplement, and not supplant, funds from other sources for early childhood home visitation programs or initiatives (per the Social Security Act, Title V, § 511(f)). The grantee must agree to maintain non-Federal funding (State General Funds) for grant activities at a level which is not less than expenditures for such activities as of the most recently completed fiscal year.

For purposes of maintenance of effort/non-supplantation, home visiting is defined as an evidence-based program, implemented in response to findings from a needs assessment, that includes home visiting as a primary service delivery strategy (excluding programs with infrequent or supplemental home visiting), and is offered on a voluntary basis to pregnant women or children birth to age five targeting the participant outcomes in the legislation which include improved maternal and child health, prevention of child injuries, child abuse, or maltreatment, and reduction of emergency department visits, improvement in school readiness and achievement, reduction in crime or domestic violence, improvements in family economic self-sufficiency, and improvements in the coordination and referrals for other community resources and supports.
Length and Time Phasing of Assistance (102):
Funds awarded to an eligible entity for a fiscal year remain available for expenditure through the end of the second succeeding fiscal year after award. See the following for information on how assistance is awarded/released: Grantee drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.
Post Assistance Requirements (110)
Reports (111):
Performance Reports (DGIS Forms 1, 2, 4, and 6, Products and Publications. The HRSA MCHB Discretionary Grant Information System (DGIS) Forms 1, 2, 4 and 6, and Products and Publications reports are due within 120 days of the Notice of Award (NoA) issue date. For additional information about these forms, please visit: https://mchdata.hrsa.gov/dgisreports/AboutDGIS.aspx

Demographic, Service Utilization, and Benchmark Area-related Data Reporting (DGIS-HV Forms 1 and 2). Data for DGIS-HV Forms 1 and 2 (available online at http://mchb.hrsa.gov/programs/homevisiting/ta/resources/enrolleeschildrenform.pdf and http://mchb.hrsa.gov/programs/homevisiting/ta/resources/granteedefinedperformancemeasuresform.pdf) must be submitted by October 30 of each fiscal year. Grantees will provide demographic, service utilization and benchmark area-related data into DGIS. The demographic and service utilization data report will include: an unduplicated count of enrollees; selected characteristics by race and ethnicity; socioeconomic data; other demographics; numbers of enrolled from priority populations; and, service utilization across all models. The benchmark data report will include an update of data collected for all constructs within each of the six benchmark areas. The benchmark data report will also provide the following information: the name of the benchmark and construct; the performance measure; the operational definition; the measurement tool utilized; rationale for the measure; the reporting period value; and, the definition of improvement.

Grantees are required to submit progress and financial reports on the status of the project using the Electronic Handbooks System (https://grants.hrsa.gov/webexternal/home.asp). Refer to the specific funding opportunity announcement for further information. Submit a quarterly electronic Federal Financial Cash Transaction Report via the Payment Management System. The report identifies cash expenditures against the authorized funds for the grant. The Cash Transaction Reports must be filed within 30 days of the end of each quarter. Failure to submit the report may result in the inability to access award funds. Go to www.dpm.psc.gov for additional information. Successful applicants receiving funding will be required, within 90 days from the end of the project period, to electronically complete the program specific data forms. The requirement includes providing expenditure data for the final year of the project period, the project abstract and award summary data as well as final indicators/scores for the performance measures. A Financial Report is required within 90 days of the end of each budget period. The report is an accounting of expenditures under the project that year. It must be submitted on-line by grantees in the HRSA Electronic Handbooks system at https://grants.hrsa.gov/webexternal/home.asp. More specific information will be included in the award notice. It must be submitted on-line by grantees in the HRSA Electronic Handbooks system at https://grants.hrsa.gov/webexternal/home.asp.
Audits (112):
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.
Records (113):
Grantees are required to maintain grant accounting records 3 years after the date they submit the Federal Financial Report (FFR). If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.
Financial Information (120)
Obligations (122):
(Formula Grants) FY 12 $309,069,046; FY 13 est $344,510,947; and FY 14 est $344,510,947
Range and Average of Financial Assistance (123):
Formula (2013):
$1,000,000 – $11,234,549

Competitive (2013):
A Expansion – $1,461,377 - $8,910,423.
B. Nonprofit - $589,685 - $5,584,723.
Program Accomplishments (130):
Not Applicable.
Regulations, Guidelines, and Literature (140):
This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

HRSA awards are subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at http://www.hrsa.gov/grants.
Information Contacts (150)
Regional or Local Office (151) :
See Regional Agency Offices. Angela Odjidja-Boateng, JD, MHS ; Health Resources and Services Administration; Maternal and Child Health Bureau; 5600 Fishers Lane, 10-86; Rockville MD 20857; (301) 443-8932; aablorh-odjidja@hrsa.gov.
Headquarters Office (152):
Angela Odjidja-Boateng, JD, MHS, HRSA, 5600 Fishers Lane, 10-86,, Rockville, Maryland 20857 Email: aablorh-odjidja@hrsa.gov Phone: (301) 443-8932
Website Address (153):
http://mchb.hrsa.gov/programs/homevisiting/
Examples of Funded Projects (170):
Not Applicable.
Criteria for Selecting Proposals (180):
In FY2014, awards will be made on both a formula and competitive basis. All formula applications will be reviewed internally by grants management officials (business and financial review) and program staff (technical review) for eligibility, completeness, accuracy, and compliance with the requirements outlined in this announcement.

All competitive applications will be reviewed internally by grants management officials (business and financial review) and program staff (technical review) for eligibility, completeness, accuracy, and compliance with the requirements outlined in this announcement. All qualified applications will be forwarded to an independent objective review committee. Based on the advice of the independent objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions. See section V. Application Review Information of the relevant funding opportunity announcement.