Opportunity Information: Apply for HRSA 13 217
Apply for HRSA 13 217
- The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.110 Maternal and Child Health Federal Consolidated Programs.
- This funding opportunity was created on Dec 3, 2012 and posted on Dec 3, 2012.
- Applicants must submit their applications by Feb 8, 2013. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The number of recipients for this funding is limited to 1 candidate(s).
- Eligible applicants include: City or township governments Native American tribal organizations (other than Federally recognized tribal governments) County governments Special district governments Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education Independent school districts Others (see text field entitled Additional Information on Eligibility for clarification) State governments.
- As cited in 42 CFR Part 51 a.3(a), any public or private entity, including an Indian tribe or tribal organization (as those terms are defined at 25 U.S.C. 450b) is eligible to apply. Faith and community based organizations are also eligible.
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Opportunity Summary:
The National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs (Funding Opportunity Number HRSA-13-217) is a Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB) discretionary cooperative agreement intended to create a single, nationally focused center that helps children and youth with special health care needs (CYSHCN) obtain and keep adequate health insurance coverage and other financing supports needed to access both health and health-related services. The central idea is that insurance coverage alone is not always enough for this population; families often need help navigating benefits, filling gaps in coverage, and securing payment for services that are essential but inconsistently covered across states and payers. The Center is expected to work across national, state, and community levels, partnering with Title V Maternal and Child Health programs and a broad set of stakeholders to develop, promote, and spread practical strategies and policies that improve coverage adequacy and reduce financial burden on families.
This opportunity is grounded in MCHB's long-standing framework for improving systems of care for children with special health care needs, particularly the goal of family-centered, community-based, coordinated care. Progress is tracked through six core outcome measures, one of which focuses specifically on health insurance: whether CYSHCN have access to adequate private and/or public insurance and financing to pay for needed services. MCHB historically monitored this outcome using the National Survey of Children with Special Health Care Needs (administered in 2001, 2005/2006, and 2009/2010). While the data showed improvement over roughly a decade in the share of CYSHCN meeting the insurance outcome, the announcement highlights persistent disparities for underserved groups, particularly Hispanic and African American children, older youth, and children with the most significant functional limitations. At the same time, it notes a troubling trend in declining adequacy of coverage, especially among those with private insurance, meaning families may technically be insured but still face high out-of-pocket costs, limited benefits, or coverage exclusions that undermine access to care.
A major focus of the National Center is helping states and communities translate health reform into meaningful coverage for CYSHCN. The Affordable Care Act (ACA) is described as having already produced important gains, such as allowing young adults to remain on a parent's private plan until age 26. Even so, the announcement stresses that full ACA implementation does not automatically solve CYSHCN coverage problems. Certain essential health benefit categories may be limited in ways that matter disproportionately for CYSHCN, including habilitative services, behavioral health care, pediatric vision, and pediatric oral health. In addition, states have discretion in selecting benchmark plans that may not include the comprehensive scope of services CYSHCN need, which can shift costs to families and increase financial risk. The Center is also expected to address financing needs beyond traditional medical services, acknowledging that families often require supports like respite care or nutritional supplements that are vital to health and functioning but frequently not covered by standard insurance.
The required strategies for the Center are broad and systems-oriented. It must provide ongoing support and technical assistance to state Title V programs and their partners to maximize CYSHCN access to insurance and related services available through the ACA and other health care delivery and financing reforms. It must convene and engage federal, state, and community stakeholders to ensure that policy implementation efforts explicitly account for CYSHCN needs. A strong emphasis is placed on improving coordination among Title V, Medicaid, and the Children's Health Insurance Program (CHIP), especially around care coordination, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage, enrollment processes, and quality improvement. Another explicit responsibility is identifying and supporting policy and program initiatives at state and federal levels that reduce insurance and financing disparities affecting underserved CYSHCN populations. In parallel, the Center must monitor, analyze, and report on emerging federal and state trends including legislation, regulations, and policy proposals relevant to insurance and health care financing, so stakeholders have timely, usable information.
Operationally, the announcement envisions a Center that is both a technical assistance hub and a knowledge development and dissemination engine. Example activities include organizing multi-stakeholder state teams that bring together Title V agencies, families, Medicaid, private payers, and health professionals to implement and spread evidence-based models aimed at improving insurance adequacy and financing, particularly for groups experiencing disparities. The Center would deliver training and technical assistance on the ACA, broader health reform changes, Medicaid and CHIP policies, and evolving financing models as they relate to CYSHCN. It is also expected to create and distribute practical products such as policy briefs, chart books, toolkits, and issue papers tailored to multiple audiences including state Title V programs, families, state Medicaid leadership, federal partners, health plans, employers, national associations, and advocacy organizations. The Center must maintain a repository of relevant resources, provide direct information and assistance to stakeholders, and convene or participate in expert meetings and calls that advance improvements in coverage and financing.
The opportunity also places real weight on data and evidence. The Center is expected to train Title V programs on collecting, analyzing, and using both quantitative and qualitative data to demonstrate the impact of efforts to improve insurance and financing. It must also continuously build the evidence base by collecting and analyzing models and approaches that work for CYSHCN, including periodic reviews of peer-reviewed and non-peer-reviewed literature and relevant materials from other grantees, then translating those findings into actionable guidance. Finally, the Center must monitor progress on the health insurance core outcome and document its own impact, reinforcing that success is not only about producing resources but also about measurable improvements in access to adequate coverage and financing.
Administratively, this was a discretionary cooperative agreement with an expected single award (Expected Awards: 1) under CFDA 93.110 (Maternal and Child Health Federal Consolidated Programs). No cost sharing or matching was required. The posting date was December 3, 2012, with an original and final closing date of February 8, 2013, and an archive date of April 9, 2013. Award ceiling and floor were listed as 0 in the summary record, which typically indicates applicants needed to refer to the full announcement for budget expectations. Eligible applicants were broadly defined under 42 CFR Part 51a.3(a) to include any public or private entity, including Indian tribes or tribal organizations, and faith- and community-based organizations. The practical takeaway is that HRSA/MCHB wanted one well-positioned national entity to serve as the coordinating backbone for policy analysis, technical assistance, stakeholder engagement, and dissemination of proven financing strategies that help CYSHCN get not just coverage, but adequate, equitable, and sustainable access to the services that support health and daily functioning.
Frequently Asked Questions (FAQs)
What is this funding opportunity?
This opportunity is the National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs (CYSHCN), Funding Opportunity Number HRSA-13-217. It is a Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) discretionary cooperative agreement intended to establish a single, nationally focused center.
What is the purpose of the National Center?
The purpose is to help children and youth with special health care needs obtain and keep adequate health insurance coverage and other financing supports needed to access health and health-related services. The Center is intended to address the reality that having insurance coverage does not always mean families can access or afford needed services.
Who is the Center designed to help?
The Center focuses on children and youth with special health care needs (CYSHCN) and the systems that serve them, including families, state Title V Maternal and Child Health programs, Medicaid and CHIP agencies, and other stakeholders involved in coverage and financing.
Why does the announcement emphasize that "insurance coverage alone is not always enough" for CYSHCN?
The announcement highlights that families often need support navigating benefits, filling gaps in coverage, and securing payment for essential services that may be inconsistently covered across states and payers. Even when a child is insured, families may still face limited benefits, exclusions, or high out-of-pocket costs that reduce real access to care.
What types of financing needs beyond traditional medical services are mentioned?
The opportunity acknowledges that families may need financing supports for services and items that are vital to health and functioning but often not covered by standard insurance, such as respite care or nutritional supplements.
How does this opportunity relate to the MCHB framework for CYSHCN systems of care?
The announcement is grounded in MCHB's long-standing framework for improving systems of care for CYSHCN, including the goal of family-centered, community-based, coordinated care. Progress is tracked through six core outcome measures, including one focused on health insurance adequacy and financing.
What is the specific health insurance outcome measure referenced?
One of the six core outcome measures asks whether CYSHCN have access to adequate private and/or public insurance and financing to pay for needed services.
What data sources are cited for tracking insurance adequacy for CYSHCN?
MCHB historically monitored the insurance outcome using the National Survey of Children with Special Health Care Needs, administered in 2001, 2005/2006, and 2009/2010.
What trends or concerns about coverage adequacy are highlighted?
While the data showed improvement over roughly a decade in the share of CYSHCN meeting the insurance outcome, the announcement emphasizes persistent disparities for underserved groups and notes a troubling trend in declining adequacy of coverage, particularly among those with private insurance.
Which groups are identified as experiencing persistent disparities?
The announcement specifically identifies underserved groups with persistent disparities, including Hispanic and African American children, older youth, and children with the most significant functional limitations.
How is the Affordable Care Act (ACA) addressed in the opportunity?
The ACA is described as producing important gains, such as allowing young adults to remain on a parent's private plan until age 26. However, the announcement stresses that full ACA implementation does not automatically resolve coverage and financing problems for CYSHCN.
Why might ACA implementation still leave gaps for CYSHCN?
The announcement notes that certain essential health benefit categories may be limited in ways that disproportionately affect CYSHCN (for example, habilitative services, behavioral health care, pediatric vision, and pediatric oral health). It also notes state discretion in selecting benchmark plans, which may not include the comprehensive scope of services CYSHCN need.
What role do state benchmark plans play in coverage adequacy?
States have discretion in selecting benchmark plans. The announcement notes these plans may not include the full range of services needed by CYSHCN, potentially shifting costs to families and increasing financial risk.
Is the Center expected to work at the national level only?
No. The Center is expected to work across national, state, and community levels and partner with Title V programs and a broad set of stakeholders to develop, promote, and spread practical strategies and policies.
What kinds of partners and stakeholders is the Center expected to engage?
The Center is expected to convene and engage federal, state, and community stakeholders, including Title V agencies and their partners. Example stakeholder groupings mentioned include families, Medicaid, private payers, and health professionals, along with audiences such as health plans, employers, national associations, and advocacy organizations.
What are the core required functions of the Center?
Required functions include providing ongoing support and technical assistance to state Title V programs and partners; convening stakeholders to ensure policy implementation accounts for CYSHCN needs; improving coordination among Title V, Medicaid, and CHIP; identifying and supporting initiatives to reduce disparities; and monitoring and reporting on emerging federal and state trends relevant to insurance and health care financing.
What does the opportunity say about coordination among Title V, Medicaid, and CHIP?
The announcement places strong emphasis on improving coordination among Title V, Medicaid, and CHIP, especially around care coordination, EPSDT coverage, enrollment processes, and quality improvement.
What is EPSDT in the context of this announcement?
EPSDT is referenced as a key Medicaid-related area for coordination and improvement efforts (Early and Periodic Screening, Diagnostic, and Treatment).
What kinds of technical assistance and training are envisioned?
The Center is expected to deliver training and technical assistance related to the ACA and broader health reform changes, Medicaid and CHIP policies, and evolving financing models as they relate to CYSHCN.
What example implementation approach is described for states?
An example described is organizing multi-stakeholder state teams that bring together Title V agencies, families, Medicaid, private payers, and health professionals to implement and spread evidence-based models aimed at improving insurance adequacy and financing, particularly for groups experiencing disparities.
What types of resources and products is the Center expected to develop?
The Center is expected to create and distribute practical products such as policy briefs, chart books, toolkits, and issue papers tailored to multiple audiences.
Who are the intended audiences for the Center's products?
Audiences named in the announcement include state Title V programs, families, state Medicaid leadership, federal partners, health plans, employers, national associations, and advocacy organizations.
Is the Center required to maintain a resource repository?
Yes. The Center must maintain a repository of relevant resources, provide direct information and assistance to stakeholders, and convene or participate in expert meetings and calls that advance improvements in coverage and financing.
What is the Center expected to do regarding policy monitoring and trend analysis?
The Center must monitor, analyze, and report on emerging federal and state trends, including legislation, regulations, and policy proposals relevant to insurance and health care financing, to provide timely and usable information to stakeholders.
What does the announcement require regarding data and evidence?
The opportunity places significant emphasis on data and evidence. The Center is expected to train Title V programs on collecting, analyzing, and using quantitative and qualitative data to demonstrate the impact of efforts to improve insurance and financing.
How is the Center expected to build the evidence base?
The Center must continuously build the evidence base by collecting and analyzing models and approaches that work for CYSHCN. This includes periodic reviews of peer-reviewed and non-peer-reviewed literature and relevant materials from other grantees, and translating findings into actionable guidance.
How will the Center be expected to demonstrate impact?
The Center must monitor progress on the health insurance core outcome and document its own impact, emphasizing measurable improvements in access to adequate coverage and financing in addition to producing resources.
What type of award mechanism is this?
This was a discretionary cooperative agreement administered by HRSA/MCHB.
How many awards were expected?
The announcement anticipated a single award (Expected Awards: 1) to create one national center.
What is the CFDA number associated with this opportunity?
The CFDA number listed is 93.110 (Maternal and Child Health Federal Consolidated Programs).
Was cost sharing or matching required?
No cost sharing or matching was required.
Who was eligible to apply?
Eligible applicants were broadly defined under 42 CFR Part 51a.3(a) to include any public or private entity, including Indian tribes or tribal organizations, and faith- and community-based organizations.
What were the key dates for this funding opportunity?
The posting date was December 3, 2012. The original and final closing date was February 8, 2013. The archive date was April 9, 2013.
What was the award ceiling and floor?
The summary record listed the award ceiling and floor as 0, which typically indicates applicants needed to refer to the full announcement for budget expectations.
In plain terms, what "problem" is this Center trying to solve?
The Center is intended to reduce the gap between having coverage on paper and having coverage that is adequate in real life for CYSHCN. That includes addressing benefit limits, coverage exclusions, gaps across payers and states, and the financial burden families can face when essential services are not consistently covered.
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