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FY 2023 Quality Improvement Fund - Maternal Health Frequently Asked Questions

Below are common questions and corresponding answers for the fiscal year (FY) 2023 Quality Improvement Fund – Maternal Health (QIF-MH) funding opportunity. HRSA will add new questions as necessary. The QIF-MH notice of funding opportunity is the primary guidance for your QIF-MH application. Refer to the QIF-MH technical assistance webpage often for updates.

 

On this page:

General Information

How can I access the QIF-MH NOFO and application package?

Follow the instructions below:

  • Go to Grants.gov
  • Search Grants using Opportunity Number HRSA-23-027
  • Click the Opportunity Number link (HRSA-23-027)
  • Click the Package tab (rightmost tab)
  • Under Actions, click on Preview
    • Click the Download Instructions gray bar for the NOFO
    • Click the links to view the forms to be submitted in Grants.gov
  • Click the APPLY button to use the Grants.gov Workspace to apply

(Added: 10/4/2022)

What is the purpose of the Health Center Quality Improvement Fund (QIF) funding?

QIF awards are to be used specifically to develop, pilot, and evaluate new, innovative models of care that can be scaled across the Health Center Program. QIF funding is designed to provide health centers of all sizes and geographic locations the opportunity to test innovations that increase health equity and may eventually benefit the entire Health Center Program.

(Added: 10/4/2022)

The QIF MH notice of funding opportunity focuses on racial/ethnic disparities in maternal health outcomes yet there are also disparities in maternal health outcomes for the underserved in rural areas. Does my population of focus have to include individuals from certain racial or ethnic groups? Is HRSA giving priority to applications that focus on certain populations?

In your QIF-MH application, you must propose innovations and activities that are tailored to your population of focus to address disparities in maternal health outcomes and barriers to maternal health care faced by individuals in your service area. There are no requirements for the racial or ethnic makeup of your population of focus. However, you must also describe service-area specific disparities in maternal health indicators by race and ethnicity and describe the impact service area geography has on the availability and accessibility of maternal health services. HRSA is not giving priority to applications that focus on any specific population. Applications will be evaluated and scored based on review criteria outlined in Section V of the NOFO.

(Added: 11/29/2022)

The QIF-MH notice of funding opportunity states that my proposed project must be innovative and evidence-informed. How can I demonstrate that my proposed project fulfills both requirements?

For the purposes of this funding opportunity, “evidence-informed” means that you start with evidence-based strategies or programs that have been shown to work in the past, and then adapt, build on, and/or tailor those strategies in innovative ways to best address barriers faced for your population of focus. You should use input from patients, community members, and community partners to inform your innovation(s).

You must provide a summary of the evidence-based resources used as the foundation for your proposal. Evidence-based resources are published evaluations or studies that have evidence in effectiveness, feasibility, reach, sustainability and transferability. You must also describe how your proposed innovation(s) addresses potential gaps in the evidence and/or builds upon the evidence base.

(Added: 11/29/2022)

Our health center recently implemented a maternal health innovation that we would now like to expand in scope and evaluate. Can we still apply?

Yes, you can apply for QIF-MH funding. However, in your QIF-MH application, you must describe how your proposed innovation differs from previously implemented approaches or strategies (e.g., addresses a newly identified need or barrier) and offers new or improved solutions to address clinical and social barriers to care. In addition, your application must describe how you used input from patients and community members who have experienced maternal health barriers and at least one community partner to develop and adapt your proposed innovation(s).

(Updated: 11/29/2022)

Will QIF-MH funding continue beyond the two-year period of performance?

No. This is a one-time funding opportunity with a two-year period of performance (August 1, 2023- July 31, 2025).

(Added: 10/4/2022)

Budget

How should I present my QIF-MH funding request on the budget form and budget narrative attachment?

All QIF-MH funding will be awarded at the start of the period of performance in FY 2023. You will request the total funding needed (i.e., maximum of $2,000,000) on the SF-424A form. You will show how you plan to use the funding in each year of the two-year period of performance in the Budget Narrative (e.g., Year 1 budget $1,250,000 + Year 2 budget $750,000 = $2,000,000 total). If you have budget-related questions, contact Grants Management Specialist Joi Grymes-Johnson, (301) 443-2632, JGrymes@hrsa.gov

(Added: 10/4/2022)

Should I include contractors in the Table of Personnel?

Yes. You must include all direct hire and contractual personnel that you propose to support with QIF-MH funding in the table of personnel. The annualized salary and FTE must be included, along with the federal amount requested. As required by the Consolidated Appropriations Act, 2022 (P.L. 117-103), Division H, § 202 none of the annualized salaries included in your proposal can exceed the salary of an Executive Level II (as of January 2022, Executive Level II salary is $203,700; updates for each year can be found in on the Office of Personnel Management’s Pay and Leave webpage). For more information, see the sample Budget Narrative on the QIF-MH technical assistance webpage.

(Added: 10/4/2022)

Allowed Use of Funds

Can I use QIF-MH funding to increase full time equivalents (FTEs) of existing personnel?

QIF-MH funding may be used to compensate personnel with a commensurate increase in FTE, in alignment with your existing written policies and procedures and 45 CFR §75.430. However, keep in mind that QIF-MH awards are one-time funding, and salaries may not exceed 100 percent FTE across all federal awards.

(Added: 10/4/2022)

Can I use QIF-MH funding to reimburse my health center for revenue lost when a provider is participating in a QIF-MH supported activity, such as participation in learning collaborative meetings?

No. You may not use QIF-MH funding to offset lost revenue or productivity. However, you may use QIF-MH funding to support a substitute provider who provides temporary clinical services in the absent provider’s place.

(Added: 10/4/2022)

Can I use QIF-MH funding for minor alteration and renovation (A/R) costs?

Yes. You may use funding for equipment purchases and minor A/R that directly support the implementation of your proposed innovation. You may request no more than $400,000 in total across the two-year period of performance for equipment purchases and minor A/R costs combined. An allowable minor A/R project must be a stand-alone project consisting of work in an existing site in-scope and required to modernize, improve, and/or reconfigure the interior arrangements or other physical characteristics of a facility that is necessary to implement the proposed innovation(s). For a minor A/R activity, the total federal and non-federal cost of the site-specific project must be less than $500,000, excluding the cost of moveable equipment. See the QIF-MH technical assistance webpage for guidance on the required minor A/R forms and attachments.

(Added: 10/4/2022)

Are stipends for patient and community member participation an allowable cost?

During the application process and throughout the period of performance, you must engage with a group of health center patients and community members who have experienced maternal health barriers. You will use input from this group of individuals to inform the planning and monitoring of the proposed innovation(s) as well as any adaptations you propose as part of your ongoing continuous quality improvement efforts. It is not required to engage the same group of patients throughout the entire period of performance.

Patient and community member participation may take on many different forms, including focus groups, participation in quality improvement activities, and direct engagement in the learning collaborative. Award recipients are allowed to offer incentive stipends to patients and community members who provide their input and feedback to support the project. If you include incentive stipends in your budget, you must provide a rationale as to why these stipends are reasonable and necessary for achieving project goals and outcomes.

(Added: 11/29/2022)

Applicable Components

How do I complete the SF-424 submitted in Grants.gov?

See the Application for Federal Assistance (SF-424) form instructions. The table includes information on how to respond to specific sections:

Application for Federal Assistance SF-424

Box Number Question Response
1 Type of Submission Application
2 Type of Application New
3 Date Received Completed automatically in Grants.gov
4 Applicant Identifier Enter your H80 number
5a, 5b Federal Entity Identifier,  Federal Award Identifier Leave blank
12 Funding Opportunity Number HRSA-23-027
14 Areas Affected by Project Leave Blank
15 Descriptive Title of Applicant’s project “Quality Improvement Fund - Maternal Health”
16 Congressional Districts Include the congressional district for your main site. The attachment is not required.
17 Proposed Project Start and End Dates The project period is August 1, 2023 to July 31, 2025.
18 Estimated Funding ($) Enter amount of QIF-MH funding requested in a. Federal box (up to $2 million)
19 Is Application Subject to Review Under Executive Order 12372 Process? Select a. if your state is included in the SPOC list (PDF - 332 KB).
If not, select b. Program is subject to E.O. 12372 but has not been selected by the State for review.

(Added: 10/4/2022)

If I have multiple sites that I plan to include in my QIF-MH project, do I list them all on the Project/Performance Site locations form?

No. Only include the primary service delivery site where your QIF-MH project will be implemented on the Project/Performance Site Locations form in Grants.gov.

(Added: 10/4/2022)

How do I determine if my QIF-MH project will require a change in scope? Can I make changes to my scope of project through the QIF-MH application?

The scope of project webpage provides technical assistance materials to help you evaluate your scope of project. In addition, the QIF-MH NOFO, Section IV.2.v Program-Specific Forms, contains information on scope adjustment and change in scope requests. If needed, you must request a change in scope (CIS) or scope adjustment outside of the QIF-MH application. Contact Health Center Engagement using the BPHC Contact Form (under the Program Monitoring H80 heading, select Change in Scope) for guidance in determining if a scope adjustment or formal CIS will be necessary.

(Added: 10/4/2022)

Do I need to complete an Equipment List form for each year in which I plan to use QIF-MH funds to purchase equipment?

No. Include all proposed equipment purchases on one form. As a reminder, equipment includes moveable items that are non-expendable, tangible personal property (including information technology systems) having a useful life of more than 1 year and a per-unit acquisition cost that equals or exceeds the lesser of the capitalization level established by the applicant for its financial statement purposes, or $5,000. Moveable equipment can be readily shifted from place to place without requiring a change in the utilities or structural characteristics of the space.

(Added: 10/4/2022)

How should I select evaluative measures for the innovation?

Your QIF-MH innovation(s) will be uniquely designed to meet the specific maternal health needs of your population of focus. You will select measures that best capture the outcomes or impacts of the activities you propose. You can use both quantitative and qualitative data to assess the impact of your project. Just as you will work with health center patients, community members and community partners to design your innovation(s), you will also work with these groups to determine which evaluative measures you will use to assess the success of the proposed innovation(s). As you engage with the HRSA-funded evaluation and learning contractor and other awarded health centers, you may decide to add or further adapt measures to best capture your outcomes. Each innovation must include at least one measure of patient experience and one measure of community engagement. You may choose to use or adapt evaluative measures from the following:

If you receive QIF-MH funding, you will work with the HRSA-funded coordination and evaluation center contractor. In addition to your self-selected measures, the contractor may require all award recipients to report on a set of core evaluative measures. Section VI.3 Reporting of the QIF-MH NOFO includes additional details on reporting of evaluative measures.

(Added: 10/4/2022)

How will QIF-MH award recipients engage with each other and the HRSA-funded coordination and evaluation center contractor?

Award recipients are expected to actively participate in collaborative learning and evaluation activities with other QIF-MH award recipients and the HRSA-funded coordination and evaluation center. In particular, award recipients must collect and share data with the coordination and evaluation center to support the ongoing evaluation of the effectiveness of QIF-MH innovations in achieving their intended outcomes, and, for those innovations that are successful, their scalability to other health centers. Award recipients may also be asked to support the coordination and evaluation center in efforts to disseminate findings.

(Added: 10/4/2022)

What are the expectations for community partnerships?

Community partners can offer a different perspective on maternal health barriers and may be able to address maternal health needs that fall outside of the health center’s scope of project. During the application process and throughout the period of performance, you must engage with community partners to identify barriers to maternal health and select and adapt innovation(s) to address those barriers. In your application you will describe how community partners contribute to your project. In Attachment 1: Letters of Partnership you will include at least one current (i.e., dated within the last 6 months), signed letter from a community partner describing how they will support your project.

(Added: 10/4/2022)

What are the expectations for health center patient and community member engagement during the application period and throughout the period of performance?

During the application process and throughout the period of performance, you must engage with a group of health center patients and community members who have experienced maternal health barriers. You will use input from this group of individuals to inform the planning and monitoring of the proposed innovation(s) as well as any adaptations you propose as part of your ongoing continuous quality improvement efforts. It is not required to engage the same group of patients throughout the entire period of performance.

(Added: 10/4/2022)

What is the purpose of the Project Plan Form and what should it include?

The Project Plan Form serves as an overview of your proposed project, including the barriers your project will address, the activities you will implement for each of your proposed innovation(s), and how you will evaluate their success. The Project Plan Form should be aligned with responses provided in the Project Narrative. For a complete list of required Project Plan Form components, see Section IV (Application and Submission Information) of the QIF-MH NOFO.

(Added: 10/4/2022)

Resources

What resources are available to support me in the development of this application?

Appendix C of the QIF-MH NOFO contains information on HRSA-funded maternal health programs that you may find useful to consult in the development of your application. In addition, the QIF-MH technical assistance webpage contains links to additional maternal health and quality improvement resources you may find helpful for application development.

(Added: 10/4/2022)

How should I use QIF-MH funding to implement evidence-informed strategies while also achieving innovation?

Your proposed innovation(s) should be evidence-informed, meaning that it is rooted in evidence-based strategies that are then tailored specifically to your health center and the needs of your population of focus. Evidence-based refers to resources that are published intervention evaluations or studies that have evidence in effectiveness, feasibility, reach, sustainability, and transferability. In the project narrative, you will document the evidence-based resources used to inform your proposed innovation(s). Your QIF-MH activities should build off evidence-based strategies in new and innovative ways to address the needs and barriers of your population of focus.

(Added: 10/4/2022)

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