Opportunity Information: Apply for HRSA 14 104
Apply for HRSA 14 104
- 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 Feb 12, 2014 and posted on Feb 12, 2014.
- Applicants must submit their applications by Mar 24, 2014. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $3,503,082.00 to eligible and selected applicants.
- The number of recipients for this funding is limited to 15 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 August 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 grant opportunity "Reducing Loss to Follow up after Failure to Pass Newborn Hearing Screening" (HRSA-14-104) 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 common problem in newborn hearing screening systems: infants who do not pass the initial physiologic hearing screen before hospital discharge, but then do not receive timely diagnostic follow-up, or whose follow-up outcomes are never properly documented. The central intent of the funding is to push states beyond broad intentions and into specifically targeted, measurable interventions that demonstrably reduce loss to follow up and loss to documentation (often grouped as LTF/D). In other words, the program is not simply about screening newborns; it is about making sure failed screens reliably lead to appropriate next steps, and that the system can prove it through clean, timely data.
A key feature of the announcement is its explicit emphasis on quality improvement (QI) as the vehicle for change. Applicants are expected to use structured QI methods rather than isolated outreach or one-time fixes. That includes forming or reinvigorating a stakeholder team that meets regularly and drives the work, setting clear aims, testing changes in small cycles, learning from data, and then scaling what works across the broader system. The notice specifically calls for Plan-Do-Study-Act (PDSA) cycles, which signals that HRSA wants iterative testing and real-time learning, not just planning documents. The expectation is that the interventions will be concrete and measurable, and that progress will be continuously assessed using ongoing data review and analysis.
The performance motivation is also built into the announcement through a defined improvement target. The background notes that LTF/D dropped by 10 between 2009 and 2011 (the most recent annual data available at the time), and the stated goal is to achieve at least a 5-per-year reduction in LTF/D during the years 2014 through 2016. This frames the grant as a results-driven effort: the purpose is to generate measurable improvements in the number of infants who receive appropriate and timely follow-up after a failed screen, and to reduce the number of infants whose outcomes remain unknown because of documentation gaps.
The required team composition is another major element. States are expected to convene a multi-disciplinary group, at minimum including the state EHDI (Early Hearing Detection and Intervention) 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. This mix reflects the real-world handoffs in the EHDI process: screening in hospitals, diagnostic audiology, referral to early intervention, and the data infrastructure needed to track infants across those steps. The inclusion of a parent is not symbolic; it is meant to keep the work grounded in family experience, barriers to follow-up, and communication practices that affect whether families actually complete next steps.
Operationally, applicants are expected to establish a meeting schedule for the QI team and to produce a disciplined improvement plan. That plan should include an aim statement (a clear, time-bound improvement objective), identified change strategies (specific interventions to test), PDSA cycles to determine which changes produce improvement, and an approach to spread successful changes across the statewide system. The announcement also makes clear that data are not an afterthought. States are expected to collect and use CDC-related data and other relevant data in a timely manner, review it on an ongoing basis, analyze whether changes are producing system-wide improvements, and report results back to appropriate stakeholders. The overall message is that the system must be able to track infants from screening to diagnosis to intervention, and the state must be able to show that the redesigned processes are improving follow-up completion and documentation.
Eligibility is limited and targeted rather than open-ended. The opportunity is primarily for current HRSA grantees/awardees whose project periods were ending August 31, 2014, plus one specific state (South Dakota) that did not have HRSA federal funds supporting its newborn hearing screening program at that time. There is no cost sharing or matching requirement. The announcement listed an estimated total funding level of $3,503,082 and anticipated approximately 15 awards. The posting date was February 12, 2014, with an original (and final) closing date of March 24, 2014, and the opportunity was later archived on May 23, 2014.
Taken together, this grant opportunity is best understood as a system-improvement initiative for state EHDI programs, with a tight focus on reducing the number of infants who fall through the cracks after a failed newborn hearing screen. HRSA is asking states to use formal quality improvement methods, a cross-sector stakeholder team, and robust data practices to produce measurable, sustained reductions in loss to follow up and loss to documentation, so that more infants receive timely diagnostic evaluation and connection to early intervention services when needed.
FAQs: Reducing Loss to Follow up after Failure to Pass Newborn Hearing Screening (HRSA-14-104)
What is the HRSA-14-104 grant opportunity?
HRSA-14-104 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 funds state-level work focused specifically on reducing loss to follow up and loss to documentation (often grouped as LTF/D) after an infant does not pass the newborn hearing screen.
What problem is this funding meant to solve?
The grant targets a common breakdown in newborn hearing screening systems: infants who do not pass the initial physiologic hearing screening before hospital discharge but do not receive timely diagnostic follow-up, or whose follow-up outcomes are never properly documented. The intent is to reduce the number of infants who fall through the cracks and to ensure the system can prove follow-up and outcomes through clean, timely data.
Is this grant about increasing the number of newborns screened?
No. The focus is not on expanding screening itself. The central purpose is to make sure that failed screens reliably lead to appropriate next steps (diagnostic evaluation and connection to services when needed) and that follow-up and outcomes are documented so they are not counted as unknown.
What does "loss to follow up" mean in the context of this program?
In this opportunity, loss to follow up refers to infants who do not pass the newborn hearing screening but do not receive timely diagnostic follow-up afterward.
What does "loss to documentation" mean in the context of this program?
Loss to documentation refers to situations where follow-up may have occurred (or may not have), but the outcome is not properly recorded in the system. The result is that the infant's status remains unknown due to documentation gaps.
What is the main approach HRSA expects applicants to use?
HRSA explicitly emphasizes structured quality improvement (QI) as the vehicle for change. Applicants are expected to use formal QI methods, not isolated outreach or one-time fixes. The work is intended to be iterative, data-driven, and scalable across the statewide system.
Are Plan-Do-Study-Act (PDSA) cycles required or just suggested?
PDSA cycles are specifically called for in the announcement. This signals that HRSA expects iterative testing of changes, learning from real-time data, and then refining and scaling interventions that demonstrably improve follow-up and documentation.
What kinds of activities are expected under the quality improvement approach?
Based on the announcement description, expected activities include forming or reinvigorating a stakeholder team that meets regularly, setting clear aims, testing change strategies in small cycles, learning from ongoing data review and analysis, and spreading successful changes across the broader statewide system.
Is there a defined performance goal for improvement?
Yes. The announcement frames the effort as results-driven and states a goal of achieving at least a 5-per-year reduction in LTF/D during 2014 through 2016.
How is progress expected to be measured and managed?
States are expected to continuously assess progress through ongoing data review and analysis. The announcement emphasizes timely collection and use of CDC-related data and other relevant data, analysis of whether changes are producing system-wide improvements, and reporting results back to appropriate stakeholders.
Who is required to be on the project or QI stakeholder team?
At minimum, states are expected to convene a multi-disciplinary group that includes the state EHDI (Early Hearing Detection and Intervention) 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.
Why does the required team include a parent of a child with hearing loss?
The announcement indicates the parent role is meant to keep the work grounded in family experience, barriers to follow-up, and communication practices that influence whether families complete next steps after a failed screen.
What role does data play in the funded work?
Data are treated as core to the project rather than a secondary task. The state is expected to track infants from screening to diagnosis to intervention, use timely CDC-related and other relevant data, review and analyze data on an ongoing basis, and demonstrate that the redesigned processes are improving follow-up completion and documentation.
What is an "aim statement" in the improvement plan?
An aim statement is described as a clear, time-bound improvement objective. It is part of the disciplined improvement plan that guides what the team is trying to accomplish and by when.
What elements should be included in the improvement plan?
The announcement describes a plan that includes an aim statement, identified change strategies (specific interventions to test), PDSA cycles to determine which changes produce improvement, and an approach to spread successful changes across the statewide system.
Does the opportunity require a regular meeting schedule?
Yes. Applicants are expected to establish a meeting schedule for the QI team so the stakeholder group meets regularly and drives the work over time.
Who is eligible to apply for this grant?
Eligibility is limited. It is primarily for current HRSA grantees/awardees whose project periods were ending August 31, 2014, plus one specific state: South Dakota (which did not have HRSA federal funds supporting its newborn hearing screening program at that time).
Is there a cost sharing or matching requirement?
No. The announcement states there is no cost sharing or matching requirement.
How much funding was expected to be available?
The announcement listed an estimated total funding level of $3,503,082.
How many awards were anticipated?
The opportunity anticipated approximately 15 awards.
When was the opportunity posted and when was it due?
The posting date was February 12, 2014. The original (and final) closing date was March 24, 2014.
Is this opportunity still open?
No. The opportunity was later archived on May 23, 2014, and the closing date was March 24, 2014.
What is the larger program this grant sits under?
It is under CFDA 93.251, the Universal Newborn Hearing Screening and Intervention Program, and it is aligned with state EHDI system performance from screening through diagnosis and intervention.
What does HRSA mean by "moving beyond broad intentions"?
The announcement emphasizes specifically targeted, measurable interventions that demonstrably reduce LTF/D. In practical terms, it is not enough to state goals; applicants are expected to test concrete changes, measure results, and show sustained improvement through data.
What does "spread" mean in the context of this grant?
"Spread" refers to taking changes that prove effective in QI testing and scaling them across the broader statewide system so improvements are not limited to a single site or small pilot.
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