Opportunity Information: Apply for HRSA 14 006
Apply for HRSA 14 006
- The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Reducing Loss to Follow up after Failure to Pass Newborn Hearing Screening" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.251 Universal Newborn Hearing Screening.
- This funding opportunity was created on Oct 30, 2013 and posted on Oct 28, 2013.
- Applicants must submit their applications by Dec 27, 2013. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $8,700,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $250,000.00 in funding.
- The number of recipients for this funding is limited to 35 candidate(s).
- Eligible applicants include: Others (see text field entitled Additional Information on Eligibility for clarification).
- Eligibility for this funding opportunity is limited to those current grantees/awardees with project periods ending March 31, 2014 and the one State, South Dakota, which does not have HRSA Federal funds to support its newborn hearing screening program at this time.
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Opportunity Summary:
The Reducing Loss to Follow up after Failure to Pass Newborn Hearing Screening grant opportunity (HRSA 14-006) is a discretionary grant from the Health Resources and Services Administration (HRSA) under CFDA 93.251, the Universal Newborn Hearing Screening and Intervention Program. It focuses on a specific and persistent gap in newborn hearing screening systems: infants who do not pass the initial physiologic hearing screening before leaving the newborn nursery, but then do not receive timely diagnostic follow-up or whose follow-up outcome is never properly documented. The central purpose is to push states beyond broad program support and toward targeted, measurable interventions that produce demonstrable improvements in follow-up rates and documentation quality.
The problem this funding targets is typically described as loss to follow up and loss to documentation (LTF/D). In practical terms, LTF/D includes infants who were referred from the birth screen (did not pass) but are later missing from the system as confirmed diagnostic results, completed rescreens, or documented outcomes. HRSA notes that LTF/D decreased by 10 between 2009 and 2011 (the latest annual data available at the time of the announcement), but emphasizes that further progress is needed. The performance expectation laid out in the notice is a continued reduction, with a goal of at least a 5-per-year decrease in LTF/D for each year from 2014 through 2017. Applications are therefore expected to show how proposed activities will directly drive down LTF/D using clear metrics, timely data review, and a structured improvement approach.
A defining feature of the opportunity is its emphasis on quality improvement (QI) methodology rather than one-time outreach or general education efforts. States are expected to build or re-energize an organized stakeholder team to lead the work and keep it accountable. At a minimum, that team must include the state EHDI coordinator as the lead, a pediatric audiologist, a parent of a child with hearing loss, a representative from the early intervention program, and a data specialist. Applicants are expected to establish a meeting schedule and use standard QI tools: create an aim statement, identify change strategies, and run Plan-Do-Study-Act (PDSA) cycles to test changes on a small scale, learn from the results, and then expand or "spread" successful practices across the broader system. The underlying message is that reducing LTF/D requires system redesign and iterative testing, not just reminding families to come back.
Data collection and ongoing performance monitoring are built into the grant expectations. Recipients must use timely data, including data reported to CDC and other relevant datasets, to continuously review whether interventions are producing system-wide improvements. That implies applicants should be ready to strengthen workflows around data capture, reporting from audiology providers, linkages between hospitals, audiology clinics, and early intervention, and routine analysis that can identify where infants are being lost (for example, breakdowns at discharge, referral handoffs, appointment scheduling, contact information quality, provider reporting delays, or missing documentation even when care occurred). Results are expected to be shared back out with appropriate stakeholders so the improvement effort remains visible and coordinated.
Funding details indicate a total estimated funding amount of $8.7 million with an expected 35 awards and an award ceiling of $250,000. There is no cost sharing or matching requirement listed. The opportunity was posted October 28, 2013, with an application deadline of December 27, 2013, and it was archived February 25, 2014. Eligibility is narrow and largely limited to existing grantees whose project periods were ending March 31, 2014, plus South Dakota, which at the time did not have HRSA federal funds supporting its newborn hearing screening program. In effect, this was designed as a continuation and improvement push for jurisdictions already running EHDI programs, with a strong focus on measurable reductions in missed follow-up and missing documentation after a failed newborn hearing screen.
Frequently Asked Questions (FAQs)
What is the "Reducing Loss to Follow up after Failure to Pass Newborn Hearing Screening" grant (HRSA 14-006)?
HRSA 14-006 is a discretionary grant opportunity from the Health Resources and Services Administration (HRSA) under CFDA 93.251, the Universal Newborn Hearing Screening and Intervention Program. It targets a specific gap in newborn hearing screening systems: infants who do not pass the initial physiologic hearing screening before leaving the newborn nursery, but then do not receive timely diagnostic follow-up or whose follow-up outcome is not properly documented.
What problem is this grant designed to address?
The grant focuses on reducing loss to follow up and loss to documentation (LTF/D). LTF/D generally includes infants who were referred from the birth screen (did not pass) but are later missing from the system as confirmed diagnostic results, completed rescreens, or documented outcomes.
What does LTF/D mean in practical terms for newborn hearing screening programs?
In practical terms, LTF/D refers to infants who fail (or do not pass) the initial newborn hearing screening and then do not show up in program data as having completed the next steps (such as diagnostic testing or rescreening), or whose outcomes are not captured and documented even if follow-up care occurred.
What is the central purpose of the HRSA 14-006 funding?
The central purpose is to move states beyond broad program support and toward targeted, measurable interventions that produce demonstrable improvements in follow-up rates and documentation quality after a newborn does not pass the initial hearing screening.
How does HRSA define success or performance expectations for this grant?
HRSA emphasizes continued reductions in LTF/D and sets an expectation that applicants will pursue measurable improvements. The notice describes a goal of at least a 5-per-year decrease in LTF/D for each year from 2014 through 2017.
What prior trend in LTF/D does the funding notice mention?
The notice states that LTF/D decreased by 10 between 2009 and 2011 (based on the latest annual data available at the time of the announcement), while emphasizing that further progress is still needed.
What types of approaches are emphasized in HRSA 14-006?
A defining feature of this opportunity is its emphasis on quality improvement (QI) methodology rather than one-time outreach or general education efforts. The intent is to reduce LTF/D through system redesign and iterative testing, not simply by reminding families to return.
What specific QI methods are applicants expected to use?
Applicants are expected to use standard QI tools and practices, including creating an aim statement, identifying change strategies, and running Plan-Do-Study-Act (PDSA) cycles to test changes on a small scale, learn from results, and then spread successful practices across the broader system.
Is a stakeholder team required as part of the grant approach?
Yes. States are expected to build or re-energize an organized stakeholder team to lead the improvement work and maintain accountability.
Who must be included on the stakeholder team at a minimum?
At a minimum, the stakeholder team must include: the state EHDI coordinator (as the lead), a pediatric audiologist, a parent of a child with hearing loss, a representative from the early intervention program, and a data specialist.
Are applicants expected to establish a meeting schedule for the stakeholder team?
Yes. Applicants are expected to establish a meeting schedule for the stakeholder team as part of running an organized and accountable QI effort.
What role does data play in this grant?
Data collection and ongoing performance monitoring are built into the grant expectations. Recipients must use timely data to continuously review whether interventions are producing system-wide improvements, and to support clear metrics and structured improvement work.
What data sources are mentioned in the grant description?
The opportunity references using timely data including data reported to the CDC and other relevant datasets to monitor performance and assess whether interventions are working.
What kinds of system breakdowns might applicants analyze to reduce LTF/D?
The notice implies applicants should be prepared to identify where infants are being lost in the process, such as breakdowns at discharge, referral handoffs, appointment scheduling, contact information quality, provider reporting delays, or missing documentation even when care occurred.
Does the grant expect improvements in documentation as well as follow-up?
Yes. The grant is explicitly concerned with both loss to follow up and loss to documentation, meaning the effort must improve timely diagnostic follow-up and the completeness/quality of documented outcomes in the system.
Are recipients expected to share results with stakeholders?
Yes. Results are expected to be shared with appropriate stakeholders so the improvement effort remains visible, coordinated, and aligned with system-wide goals.
What is the total estimated funding amount for this opportunity?
The total estimated funding amount is $8.7 million.
How many awards were expected under HRSA 14-006?
The opportunity anticipated approximately 35 awards.
What is the maximum award amount (award ceiling)?
The award ceiling is $250,000.
Is cost sharing or matching required?
No. The opportunity states that there is no cost sharing or matching requirement listed.
When was the opportunity posted and what was the application deadline?
The opportunity was posted on October 28, 2013, and the application deadline was December 27, 2013.
What does it mean that the opportunity was "archived"?
The notice indicates the opportunity was archived on February 25, 2014, meaning it is no longer an active/open funding opportunity as presented in that announcement.
Who was eligible to apply for HRSA 14-006?
Eligibility was narrow and largely limited to existing grantees whose project periods were ending March 31, 2014, plus South Dakota (which, at that time, did not have HRSA federal funds supporting its newborn hearing screening program).
Was this grant intended for new jurisdictions that were not already operating EHDI programs with HRSA support?
Based on the eligibility description, it was primarily designed for existing grantees nearing the end of their project periods, with South Dakota included as a specific exception noted in the announcement.
How is this opportunity different from broad program support for EHDI?
The opportunity is framed as a continuation and improvement push focused on targeted, measurable interventions. Instead of general support, it emphasizes demonstrable reductions in missed follow-up and missing documentation after an infant does not pass the initial newborn hearing screening.
What is the role of the state EHDI coordinator in this grant?
The state EHDI coordinator is expected to serve as the lead of the stakeholder team guiding the quality improvement work to reduce LTF/D.
What is the expected improvement approach over time?
The grant expects an iterative approach: test changes using PDSA cycles, learn from results, and then expand or spread effective practices across the system, while monitoring metrics and timely data to confirm system-wide improvement.
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