Notice2022-28559
Request for Information: Healthy Start Initiative: Eliminating Disparities in Perinatal Health (Healthy Start)
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
January 4, 2023
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
HRSA's Maternal and Child Health Bureau, Division of Healthy Start and Perinatal Services seeks the perspectives of Healthy Start grantees, community members, people with lived experience, health care providers, community health workers, birthing people, parents, and other members of the public to inform future Healthy Start program development.
Full Text
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<title>Federal Register, Volume 88 Issue 2 (Wednesday, January 4, 2023)</title>
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[Federal Register Volume 88, Number 2 (Wednesday, January 4, 2023)]
[Notices]
[Pages 357-358]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-28559]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Request for Information: Healthy Start Initiative: Eliminating
Disparities in Perinatal Health (Healthy Start)
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice of request for information.
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SUMMARY: HRSA's Maternal and Child Health Bureau, Division of Healthy
Start and Perinatal Services seeks the perspectives of Healthy Start
grantees, community members, people with lived experience, health care
providers, community health workers, birthing people, parents, and
other members of the public to inform future Healthy Start program
development.
DATES: Submit comments no later than February 3, 2023.
ADDRESSES: Submit comments by email to <a href="/cdn-cgi/l/email-protection#19545a515b517c78756d71604a6d786b6d59716b6a78377e766f"><span class="__cf_email__" data-cfemail="ca8789828882afaba6bea2b399beabb8be8aa2b8b9abe4ada5bc">[email protected]</span></a>
(subject line Healthy Start Request for Information [RFI]). Submit
comments by mail to Mia Morrison, MPH, Maternal and Child Health
Bureau, Health Resources and Services Administration, 5600 Fishers
Lane, Room 18N-15, Rockville, MD 20857.
FOR FURTHER INFORMATION CONTACT: Mia Morrison, MPH, Supervisory Public
Health Analyst, Maternal and Child Health Bureau, Division of Healthy
Start and Perinatal Services, HRSA, 5600 Fisher Lane, 18N15, Rockville,
MD 20852. Phone: 301-443-2521. Email: <a href="/cdn-cgi/l/email-protection#9df0f0f2efeff4eef2f3ddf5efeefcb3faf2eb"><span class="__cf_email__" data-cfemail="a2cfcfcdd0d0cbd1cdcce2cad0d1c38cc5cdd4">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: HRSA's Healthy Start Initiative: Eliminating
Disparities in Perinatal Health (Healthy Start) program is authorized
by 42 U.S.C. 254c-8 (section 330H of the Public Health Service Act).
Healthy Start is a community-based program dedicated to reducing
disparities in maternal and infant health. HRSA provides Healthy Start
grants to communities with infant mortality rates at least 1.5 times
the U.S. national average and with high rates of adverse perinatal
outcomes (e.g., low birthweight, preterm birth, maternal morbidity, and
mortality). Healthy Start programs serve individuals of reproductive
age, pregnant and post-partum people, fathers/partners, and infants
from birth through 18 months.
HRSA currently funds 101 Healthy Start grantees in 35 states, the
District of Columbia and Puerto Rico, to improve health outcomes
before, during, and after pregnancy and reduce racial/ethnic
differences in rates of infant death and adverse perinatal outcomes by:
(1) improving access to quality health care and services for parents,
birthing people, infants, children, and families through outreach, care
coordination, health education, and linkage to health insurance; (2)
strengthening the health workforce, specifically those individuals
responsible for providing direct services; and (3) building healthy
communities and ensuring ongoing, coordinated comprehensive services
are provided in the most efficient manner through effective service
delivery.
In addition, HRSA funds the Supporting Healthy Start Performance
Project to provide grantees with technical assistance and training in
order to achieve the goals of the Healthy Start program. Through
Healthy Start investments, HRSA has also expanded access to doula care
and invested in communities to improve infant health equity by
developing data-driven systems level strategies addressing social and
structural determinants of health. More information about the portfolio
of Healthy Start programs is available online at: https://
mchb.hrsa.gov/about-us/divisions/division-healthy-start-perinatal-
services-
dhsps#:~:text=Our%20division%3A,between%20racial%20and%20ethnic%20groups
.
Unacceptably high rates of infant and maternal mortality persist in
communities across the country, with notable inequities by race and
ethnicity. HRSA seeks to accelerate the elimination of inequities in
birth outcomes in communities served by Healthy Start.
Responses: HRSA is seeking input from the public on the following
topics related to the design, implementation, and evaluation of the
Healthy Start program. A response to each question is not required. All
partners and interested parties are welcome and encouraged to respond
(e.g., Healthy Start grantees, community members, people with lived
experience, health care professionals, etc.)
Program Design and Implementation
(1) Provide input on the types and mix of services (direct \1\,
enabling \2\ or public health services and systems \3\) and program
activities (including strategies that address social and structural
determinants of health) that could accelerate Healthy Start's impact on
decreasing racial/ethnic disparities in maternal and infant mortality
and morbidity. In your response, include examples of innovative
services or strategies that a Healthy Start grantee could elect to
implement and how the effectiveness of these interventions could be
measured.
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\1\ Direct Services--Direct services are preventive, primary, or
specialty clinical services to pregnant women, infants, and children
where funds are used to reimburse or fund providers for these
services through a formal process similar to paying a medical
billing claim or managed care contracts.
\2\ Enabling Services--Enabling services are non-clinical
services (i.e., not included as direct or public health services)
that enable individuals to access health care and improve health
outcomes. Enabling services include, but are not limited to case
management, care coordination, referrals, translation/
interpretation, transportation, eligibility assistance, health
education for individuals or families, environmental health risk
reduction, health literacy, and outreach.
\3\ Public Health Services and Systems--Public health services
and systems are activities and infrastructure to carry out the core
public health functions of assessment, assurance, and policy
development, and the 10 essential public health services. Examples
include the development of standards and guidelines, needs
assessment, program planning, implementation, and evaluation, policy
development, quality assurance and improvement, workforce
development, and population-based disease prevention and health
promotion campaigns for services such as newborn screening,
immunization, injury prevention, safe-sleep education and anti-
smoking.
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(2) Propose criteria and/or methods for defining applicant project
area and target population \4\ in order to ensure that Healthy Start
programs are serving populations and communities with the highest rates
of infant and maternal mortality and morbidity, including communities
with the highest racial/ethnic disparities. If applicable to your
[[Page 358]]
response, propose criteria for reviewing Healthy Start grant
applications with overlapping geographic areas.
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\4\ Definition of project area and target population from the
fiscal year (FY) 2019 Healthy Start Initiative Notice of Funding
Opportunity (HRSA-19-049): A project area must represent a
reasonable and logical catchment area, but the defined areas do not
have to be contiguous. The target population is the population that
you will serve within your geographic project area.
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(3) Provide recommendations on implementing Healthy Start programs
with rural populations and underserved populations experiencing
disproportionate adverse maternal and infant health outcomes (e.g.,
American Indian/Alaskan Native). In your response, describe whether
potential Healthy Start applicants would benefit from the ability to
apply for tiered funding (i.e., flexibility to serve fewer participants
for programs with small numbers of residents within their catchment
area).
(4) Provide recommendations on the most effective period to enroll
Healthy Start participants (i.e., pre-conception, prenatal, postpartum)
and how long services should be offered to have the greatest impact on
improving maternal and infant health outcomes.
(5) Provide input on the engagement of fathers in Healthy Start
programs and recommendations for types of activities and programming.
When possible, provide examples of successful community-based
fatherhood initiatives (non-Healthy Start examples are welcome).
(6) Provide recommendations for increasing retention of community
health workers in Healthy Start programs.
(7) Provide recommendations on culturally responsive approaches for
providing Black, American Indian, Alaskan Native, and border
populations with maternal and child health education, support
navigating resources, and linkages to clinical services including
doula, prenatal, well-woman, and pediatric care.
(8) Provide recommendations for strengthening engagement of
birthing people, fathers, families, and people with lived experience in
Healthy Start program design, implementation, and evaluation.
Data and Evaluation of Healthy Start Programs
(9) Provide recommendations on the relevance of the current Healthy
Start measures pertaining to the key challenges and inequities
experienced in your community and priority population: (a) Which
current measures are useful for evaluating program impact and why? (b)
Which current measures are not useful for evaluating program impact and
why? (c) Are there additional/new measures that would support Healthy
Start program evaluation (if applicable provide examples and a
rationale)? (For a list of current Healthy Start measures, see page 20
of the Healthy Start Initiative: Eliminating Disparities in Perinatal
Health Notice of Funding Opportunity at <a href="https://grants.hrsa.gov/2010/Web2External/Interface/Common/EHBDisplayAttachment.aspx?dm_rtc=16&dm_attid=d3c378a4-b07d-48e5-ab36-38f05a7eeb48">https://grants.hrsa.gov/2010/Web2External/Interface/Common/EHBDisplayAttachment.aspx?dm_rtc=16&dm_attid=d3c378a4-b07d-48e5-ab36-38f05a7eeb48</a>).
(10) HRSA currently provides an optional Healthy Start database to
grantees (i.e., CAREWare) <a href="https://healthystartepic.org/healthy-start-implementation/careware-for-healthy-start/">https://healthystartepic.org/healthy-start-implementation/careware-for-healthy-start/</a>) free of charge. Provide
input on the essential and preferred components of an ideal Healthy
Start data system. Would there be an advantage to having one system
that all grantees are required to use? Would there be any
disadvantages?
Respondents may also provide additional comments or recommendations
that are not specifically linked to the questions above. All responses
may, but are not required to, identify the individual's name, address,
email, telephone number, professional or organizational affiliation,
background, or area of expertise (e.g., program participant, family
member, clinician, community health worker, researcher, Healthy Start
Director, etc.), and topic/subject matter. Information obtained as a
result of this RFI may be used by HRSA on a non-attribution basis for
program planning. Comments in response to this RFI may be made publicly
available, so respondents should bear this in mind when making
comments. HRSA will not respond to any individual comments.
Special Note to Commenters
Whenever possible, respondents are asked to draw their responses
from lived experience and/or objective, empirical, and actionable
evidence and to cite this evidence within their responses. This RFI is
issued solely for information and planning purposes; it does not
constitute a Request for Proposal, applications, proposal abstracts, or
quotations. This RFI does not commit the government to contract for any
supplies or services or make a grant or cooperative agreement award.
Further, HRSA is not seeking proposals through this RFI and will not
accept unsolicited proposals. HRSA will not respond to questions about
the policy issues raised in this RFI. Responders are advised that the
U.S. government will not pay for any information or administrative
costs incurred in response to this RFI; all costs associated with
responding to this RFI will be solely at the interested party's
expense. Not responding to this RFI does not preclude participation in
any future procurement or program, if conducted.
Diana Espinosa,
Deputy Administrator.
[FR Doc. 2022-28559 Filed 1-3-23; 8:45 am]
BILLING CODE 4165-15-P
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