U.S. Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health Bureau
Emergency Medical Services for Children Program
Emergency Medical Services for Children
State Partnership Grant (EMSCP)
Announcement Type: New and Competing Continuation
Announcement Number: HRSA-10—063
Catalog of Federal Domestic Assistance (CFDA) No. 93.127
PROGRAM GUIDANCE
Fiscal Year 2010
Application Due Date: January 29, 2010
Release Date: December 18, 2009
Date of Issuance: December 18, 2009
Tina Turgel, RN, BSN, RN-C
Nurse Consultant, Emergency Medical Services for Children Program
Telephone: (301) 443-5599
Fax: (301) 443-1296
Legislative Authority: Public Health Service Act, Title XIX, Section 1910
(42 U.S.C. 300w-9), as amended by sec. 415, P.L 105-392
Table of Contents
EXECUTIVE SUMMARY 1
I. Funding Opportunity Description 3
Purpose 3
Background 3
II. Award Information 10
1. Type of Award 10
2. Summary of Funding 10
III. Eligibility Information 10
1. Eligible Applicants 10
2. Cost Sharing/Matching 10
3. Other 10
IV. Application and Submission Information 11
1. Address to Request Application Package 11
2. Content and Form of Application Submission 11
i. Application Face Page 15
ii. Table of Contents 15
iii. Application Checklist 15
iv. Budget 15
v. Budget Justification 15
vi. Staffing Plan and Personnel Requirements 17
vii. Assurances 17
viii. Certifications 17
ix. Project Abstract 17
x. Program Narrative 18
xi. Program Specific Forms 20
xii. Attachments 20
3. Submission Dates and Times 21
4. Intergovernmental Review 21
5. Funding Restrictions 21
6. Other Submission Requirements 22
V. Application Review Information 22
1. Review Criteria 22
VI. Award Administration Information 24
1. Award Notices 24
2. Administrative and National Policy Requirements 24
3. Reporting 26
VII. Agency Contacts 28
VIII. Other Information 29
ix. Tips for Writing a Strong Application 29
APPENDIX A: HRSA ELECTRONIC SUBMISSION GUIDE 30
Appendix B: MCHB Administrative Forms and Performance Measures 52
EXECUTIVE SUMMARY
Emergency Medical Services for Children State Partnership Grant
We are pleased to provide you with the Emergency Medical Services for Children (EMSC) Guidance for the State Partnership Grant. Grant support is available from the Division of Child, Adolescent and Family Health (DCAFH), part of the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA) in the U.S. Department of Health and Human Services (DHHS). Please read the entire guidance carefully before completing the application.
The State Partnership grants are intended to solidify the integration of a pediatric focus within the state EMS system. State Partnership grants are required to work on EMSC-specific performance measures described in the narrative sections of this guidance. State governments and accredited schools of medicine are the only eligible applicants for funding under the EMSC Program. The involvement of the State MCH Program, State Office of EMS and the State Highway Traffic Safety Office is strongly encouraged because of the importance of linking EMSC activities with the system of care for children.
Qualified Applicants: State governments and accredited schools of medicine are the only eligible applicants for funding under the EMSC Program.
Number of Grants: 11
Funds per year: up to $130,000
Application Availability: December 18, 2009
Deadline: January 29, 2010
Award Date: March 1, 2010
Project Period: March 1, 2010 – February 28, 2013
Applicants may obtain additional information regarding business, administrative, or fiscal issues related to this grant announcement by contacting the Grants Management Specialist, Ms. Mickey Reynolds or Ms. Tya Renwick.
HRSA-10-063 1
Mail: HRSA Division of Grants Management Operations
Parklawn Building, Room 11A-02
5600 Fishers Lane
Rockville, Maryland 20857
Ms. Mickey Reynolds Ms. Tya Renwick
Grants Management Specialist Grants Management Specialist
Fax: (301) 443-6686
Technical assistance regarding this funding announcement may be obtained by contacting:
Mail: EMSC National Resource Center
8737 Colesville Road, 400
Silver Spring, MD 20910
Phone: (202) 476-4927
Fax: (202) 476-6845
Electronic Mail:
Applications must be submitted online by January 29, 2010 8:00pm ET.
HRSA-10-063 1
I. Funding Opportunity Description
Purpose
The mission of HRSA/MCHB is to provide national leadership and to work in partnership with States, communities, public-private partners, and families to strengthen the maternal and child health (MCH) infrastructure, assure the availability and use of medical homes, and build the knowledge and human resources, in order to assure continued improvement in the health, safety and well-being of the MCH population. The MCH population includes all America's women, infants, children, adolescents and their families, including fathers and children with special health care needs (CSHCN).
The Emergency Medical Services for Children (EMSC) Program assists States in expanding and improving State and local capability for reducing and ameliorating pediatric emergencies in the State. The EMSC Program takes special care to include children with special health needs, culturally distinct populations and historically underrepresented groups, including Native American/Alaska Natives, and Native Hawaiians. The EMSC Program also incorporates the use of existing research-based knowledge, state-of-the-art systems development approaches, and the experience and products of previous EMSC grantees in meeting program goals; and generates support from local public and private sources for sustainability of funded EMSC projects after Federal support terminates, through State legislative, regulatory, or policy changes or other means.
Through this competition, States are expected to work on specific performance measures described further in the narrative requirements.
State Partnership grants are intended to solidify the integration of a pediatric focus within the state EMS system. State governments and accredited schools of medicine are the only eligible applicants for funding under the EMSC Program. The involvement of the State MCH Program, State Office of EMS, and the State Highway Traffic Safety Office is strongly encouraged, because of the importance of linking EMSC activities with the system of care for children.
Background
The EMSC Program supports the development of capabilities within existing EMS systems. Ideally, EMSC is integrated within the EMS system, Maternal and Child Health system, and the general health care system.
The Emergency Medical Services for Children (EMSC) grant program is administered by the Department of Health and Human Services (DHHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). The program is authorized by the Public Health Service Act, Title XIX, Section 1910.
This Federal initiative evolved out of a growing recognition that children have unique needs in emergency situations -- needs that often vary from those of adults due to physiological, developmental and psychological differences.
Legislation passed by Congress in 1984, authorized the use of Federal funds to expand and improve emergency medical services for children in each State. Since 1984, 50 States, 5 territories and the District of Columbia, have received grants.
The goal of the EMSC program is to reduce child and youth morbidity and mortality resulting from severe illness or injury. The EMSC Program is intended to enhance the pediatric capability of EMS systems. “EMS” is here understood broadly to include the following components: prevention, prehospital EMS care, hospital based care, rehabilitation and reentry of the child into the community.
Definitions
The following definitions are provided as guidance for applicants:
· "Children" means youths from birth through age 18.
· “Cultural Competence” means a set of values, behaviors, attitudes, and practices within a system, organization, program, or among individuals that enables them to work effectively cross culturally. Further, it refers to the ability to honor and respect the beliefs, language, interpersonal styles and behaviors of individuals and families receiving services, as well as staff who are providing such services. Cultural competence is a dynamic, ongoing, developmental process that requires a long-term commitment and is achieved over time.
· Emergency Medical Services" or "EMS" means services used in responding to an adult or child's need for immediate medical care in order to prevent loss of life and to prevent aggravation of physiological or psychological illness or injury and disability by appropriate intervention at the very early stages of the event. However, the EMSC Program expands the view of emergency services to include primary prevention through rehabilitation activities.
· "Emergency Medical Services System" means an arrangement of personnel, facilities, and equipment for the effective and coordinated delivery of health care services in an appropriate geographical area, under emergency conditions (occurring either as a result of the patient's condition or of natural disasters or similar situations), and which has the authority and the resources to provide effective administration of the system. An "appropriate geographical area" means an area which is of sufficient size, population, and economic diversity so that an efficient and economically feasible EMS project can be established, taking into consideration existing medical service areas and health service areas. The EMS system is a continuum, encompassing primary prevention, prehospital and emergency department care, critical care and acute hospitalization, rehabilitation, and return to the community. All of these activities must be coordinated with the child's primary care provider or "medical home."
· "Family-Centered" includes the following key elements of care: maximum possible involvement of families in all phases of the EMSC continuum of care; clear and continuous communication between family members and the emergency care team; attention to the psychological needs of all family members; cultural competence of providers; consumer (parental) involvement in planning and needs assessment; organizational support for the formation of parent advocacy groups; and ongoing partnerships with such groups.
· “Performance Measures” refer to defined EMSC performance measures for State Partnership grantees (performance measures 71 through 80).
· "State" means one of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of Northern Mariana Islands.
Program Requirements of the Grantee
Partnership grants will fund activities that improve operational capacities to provide pediatric emergency care, and refine and institutionalize EMSC in a State. Applicants must address program requirements A, B, C, and D listed below. In addition to fulfilling these requirements, applicants may choose from other activities listed in “E” below.
A) Program Manager
Applicants are required to designate an EMSC Program Manager who will implement the Program requirements. An effective EMSC Program Manager should be able to build coalitions, manage projects, and provide leadership for EMSC initiatives. Some States have been successful in securing public or private funds to support an EMSC Manager position so that the entire grant may be used for program activities. Partnership grant funds may be used to support the EMSC Manager position. The person fulfilling this role should be identified in the grant application and a biosketch provided under key personnel.
B) Performance Measures
Successful applicants to the Partnership grant are required to report annually on all of the EMSC performance measures.
On October 31, 2009, the Office of Management and Budget (OMB) approved revisions to the Maternal and Child Health Bureau (MCHB) Performance Measures for Discretionary Grants (OMB number 0915-0298; expiration date 10/31/2012). A review of the performance measures and administrative forms for this discretionary grant program will be conducted and new national performance measures and administrative forms will be assigned.
Background Information on Performance Measures:
In response to the Government Performance and Results Act (GPRA), the Health Resources and Services Administration (HRSA) requires grantees to report on specific performance measures related to their grant-funded activities. The purpose of the Emergency Medical Services for Children (EMSC) State Partnership performance measures is to demonstrate national outcomes of the Program and to improve the delivery of emergency care services to children. Specifically, the set of measures will:
§ provide an ongoing, systematic process for tracking progress towards meeting the goals of the EMSC Program;
§ allow for continuous monitoring of the effectiveness of key pediatric components of the EMS system;
§ identify potential areas of performance improvement among the EMSC State Partnership grantees;
§ determine the extent to which the State is meeting established targets and standards; and
§ allow the EMSC Program to demonstrate its effectiveness and report progress to HRSA, Congress, and other stakeholders.
Summary of EMSC Performance MeasuresPERFORMANCE MEASURE 71 / The percent of prehospital provider agencies in the State/Territory that have on-line pediatric medical direction.
PERFORMANCE MEASURE 72 / The percent of prehospital provider agencies in the State/Territory that have off-line pediatric medical direction.
PERFORMANCE MEASURE 73 / The percent of patient care units in the State/Territory that have essential pediatric equipment and supplies.
PERFORMANCE MEASURE 74 / The percent of hospitals with an Emergency Department (ED) recognized through a statewide, territorial or regional standardized system that are able to stabilize and/or manage pediatric medical emergencies.
PERFORMANCE MEASURE 75 / The percent of hospitals with an Emergency Department (ED) recognized through a statewide, territorial or regional standardized system that are able to stabilize and/or manage pediatric traumatic emergencies.
PERFORMANCE MEASURE 76 / The percent of hospitals with an Emergency Department (ED) in the State/Territory that have written inter-facility transfer guidelines that cover pediatric patients and that contain all the components as per the implementation manual.
PERFORMANCE MEASURE 77 / The percent of hospitals with an Emergency Department (ED) in the State/Territory that have written inter-facility transfer agreements that cover pediatric patients.
PERFORMANCE MEASURE 78 / The adoption of requirements by the State/Territory for pediatric emergency education for the license/certification renewal of basic life support (BLS) and advanced life support (ALS) providers.
PERFORMANCE MEASURE 79 / The degree to which the State/Territory has established permanence of EMSC in the State/Territory EMS system.
PERFORMANCE MEASURE 80 / The degree to which the State/Territory has established permanence of EMSC in the State/Territory EMS system by integrating EMSC priorities into statutes/regulations.
Performance measures 71-77 identify and address gaps in the pediatric emergency care system to improve the quality and adequacy of pediatric emergency care. The Institute of Medicine’s Emergency Care for Children: Growing Pains report identified this as a key theme. For example, having on-line and off-line pediatric medical direction available at the scene of all emergencies for both BLS and ALS providers will help ensure that prehospital providers in the State/Territory have access to medical direction facilitating the provision of quality assessment and optimal care in pediatric emergencies. Prehospital providers also need the appropriate pediatric equipment to achieve optimal pediatric outcomes. In addition, the existence of a standardized categorization and/or designation system that recognizes hospitals capable of stabilizing and/or managing pediatric medical and trauma emergencies will help ensure that pediatric patients receive the appropriate care. Lastly, when a child’s needs are beyond those available at a receiving facility, interfacility transfer guidelines and agreements ensure appropriate and timely transfer of children to facilities with the resources and competencies to effectively treat pediatric emergencies.