Funding Opportunity for Testing New Approaches to Prenatal Care

Recent Updates:

08/06 - Important reminders posted about the application process.
07/11 - Clarification document for Strong Start Amended FOA posted.
07/02 - Amended Funding Opportunity Announcement for Testing New Approaches to Prenatal Care and accompanying Fact Sheet now posted. New application deadline, August 9, 2012.
06/12 - Important updates posted about Letter of Intent and application deadlines

 

Overview

As part of the Strong Start campaign, CMS has released a funding opportunity announcement to reduce the frequency of premature births – medically defined as less than 37 weeks of gestation – in pregnant Medicaid beneficiaries. Under this initiative, the CMS Innovation Center will award up to $41.4 million through a competitive process to providers, States, and managed care organizations to achieve better care, improved health, and lower costs for pregnant Medicaid beneficiaries and their newborns.

The Strong Start funding opportunity is a four-year initiative to test and evaluate enhanced prenatal care interventions for women with Medicaid coverage who are at risk for having a preterm birth. The goal of the initiative is to determine if these approaches to care can impact the rate of preterm births, improve the health outcomes of pregnant women and newborns and decrease the anticipated total cost of medical care over the first year of life for children born to mothers in the Medicaid program.

 

Three options

This initiative will test three evidence-based maternity care service options in order to enhance the current care delivery, reduce disparities, and address the medical, behavioral, and psychosocial factors that may be present during pregnancy and contribute to preterm-related poor birth outcomes.

The Innovation Center will offer grant funding for three approaches:

  • Enhanced Prenatal Care through Centering/Group Visits – group prenatal care that incorporates peer-to-peer interaction in a facilitated setting for health assessment, education, and additional psycho-social support.
  • Enhanced Prenatal Care at Birth Centers – comprehensive prenatal care facilitated by teams of health professionals including peer counselors and doulas. Services include collaborative practice, intensive case management, counseling and psycho-social support.
  • Enhanced Prenatal Care at Maternity Care Homes – enhanced prenatal care including psychosocial support, education, and health promotion in addition to traditional prenatal care. Services provided will expand access to care, improve care coordination and provide a broader array of health services.  

Interested parties can propose to implement more than one approach, but only one option can occur at an individual practice.

 

Eligibility Criteria

The intent of this initiative is to engage with a wide variety of interested parties who have developed innovations to improve care, improve health, and lower costs for Medicaid women at risk for preterm births. Eligible applicants include:

  • Providers of obstetric care (for example, provider groups or affiliated providers and facilities)
  • States
  • Medicaid managed care organizations (MCOs)
  • Conveners in partnership with other applicants. The convener may be a direct applicant, or may convene and support other organizations to become applicants. Examples of conveners include States, associations of providers or other health service related organizations.  

Partnerships with public health organizations as well as multistate collaborations are encouraged to apply. All non-provider applicants must also include letters from their provider to demonstrate willingness and capacity to participate in this initiative.

All applications must be submitted electronically through grants.gov. Applicants are strongly encouraged to use the review criteria information provided in the “Application Review Information” section in the funding opportunity announcement, to help ensure that the proposal adequately addresses all the criteria that will be used in evaluating the proposals.  

 

Cooperative Agreement Structure

CMS will award, through a competitive process, a set of renewable one year cooperative agreements to eligible applicants. The Strong Start program will operate for three years, and there will be up to an additional one year beyond the last birth for data collection and submission. Up to $43.2 million will be available for this initiative. The number of awards will depend on the number of women that applicants can enroll. The Innovation Center intends to fund the cost of prenatal care for 30,000 Medicaid women in each of the three options, or care for 90,000 Medicaid women in total over three years.  

Funds will be awarded with consideration to:

  • Available funding
  • Geographic diversity
  • Quality of each application and the ability to meet the goals of the initiative

Each applicant should have the capacity to serve at least 500 pregnant Medicaid beneficiaries considered at-risk for a preterm birth each year. The Innovation Center will make awards to applicants that can ensure the availability and oversee the delivery of one or more of the three options to large numbers of pregnant Medicaid beneficiaries.

 

Important Links and Dates

Funding Opportunity Announcement (PDF) - CMS released an amended FOA on July 3, 2012 that provided further clarifications regarding the initiative.  Interested parties must submit an application by 5:00pm ET on Thursday, August 9, 2012.

Letter Of Intent to Apply - Those interested in applying to the Strong Start funding opportunity may complete this LOI by August 8, 2012. Submitting this LOI is optional and not required in order to submit a Strong Start application.

In an effort to connect applicants interested in partnering together and to address concerns from interested organizations that may not have enough pregnant women enrolled in Medicaid and CHIP to apply, CMS has created a platform for potential applicants who have submitted an LOI and want to participate. If organizations would like to use the platform, they will need to grant consent through the LOI form (or by an email to StrongStart@cms.hhs.gov for those who have already submitted an LOI) to have their information accessible in the platform and to gain access to the platform.

 

Important Reminders about the Application Process

The following reminders, while not inclusive, can help ensure a qualified application.

  • Applications must be submitted through grants.gov by 5:00pm ET on August 9, 2012. When submitting, download and use the current grant application package that was posted on July 3, 2012.
  • Ensure that you include all of the required sections of your application (See Appendix F: Application Check-off Cover Sheet). The required content includes:
    • Forms and mandatory documents: SF 424: Application for Federal Assistance; SF-424A: Budget Information; SF-424B: Assurances-Non-Construction Programs; SF-LLL: Disclosure of Lobbying Activities; Project Site Location Form(s); Project Abstract Summary
    • Letter(s) of agreement from provider partners (only for those applying as a State, MCO, or convener)
    • Cover Letter
    • Project Narrative
    • Work Plan and Timeline
    • Budget Narrative
  • Note that the Cover Letter, Work Plan and Timeline, and Letter(s) of Agreement should be submitted as separate PDF documents on an “Other Attachment Form.”
  • Ensure that your narrative sections (i.e. Project Narrative, Budget Narrative, and Work Plan and Timeline) are double-spaced in 12-point font and are no more than 40 double-spaced pages (to include the one page, single-spaced Project Abstract). Tables and charts may be single-spaced in 10-point font (including the Work Plan and Timeline if the Work Plan and/or Timeline are presented in a table or chart format). Letters of Agreement are not included in the page limit.
  •  All documents should be submitted in PDF format.

 

 

Additional Information

 

For more information, please see the Strong Start FAQ page or direct your questions to StrongStart@cms.hhs.gov.