Affordable Care Act (ACA) Tribal Maternal, Infant, and Early Childhood Home Visiting Program

For eligible Tribes (or consortia of Tribes), Tribal Organizations, and Urban Indian Organizations, strengthen and improve maternal and child health programs, improve service coordination for at-risk communities, and identify and provide comprehensive evidence-based home visiting services to families
who reside in at-risk communities.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Program Accomplishments

Fiscal Year 2009: Not Applicable. Fiscal Year 2010: Approximately 15 grants will be awarded in FY 2010. Fiscal Year 2011: Number of grant awards for FY 2011 are not yet determined.

Uses and Use Restrictions

Assistance will be used to conduct a needs assessment that: considers community characteristics and the quality and capacity of existing home visiting programs and other supportive services; is coordinated with other relevant needs assessments; and involves community stakeholders as appropriate; collaborative planning efforts to address identified needs by developing capacity and infrastructure; providing high-quality, evidence-based home visiting services to pregnant women and families with young children aged birth to kindergarten entry; and conducting rigorous local evaluations that may include examining effectiveness of home visiting models in serving Tribal populations, adaptations of home visiting models for Tribal communities, or questions regarding implementation of infrastructure necessary to support evidence-based home visitation models in Tribal comm unties.

Costs of organized fund raising, including financial campaigns, endowment drives, solicitation of gifts and bequests, and similar expenses incurred solely to raise capital or obtain contributions, are unallowable.

Grant awards will not allow reimbursement of pre-award costs.

Construction and purchase of real property are not allowable activities or expenditures under this grant award.

The statute requires that grantees supplement and not supplant, funds from other HV initiatives.

Awards issued under this announcement are subject to the uniform administrative requirements and cost principles of 45 CFR Part 74 (Awards and Subawards to Institutions of Higher Education, Hospitals, Other Non-Profit Organizations, and Commercial Organizations), or 45 CFR Part 92 (Grants and Cooperative Agreements to State, Local, and Tribal Governments).

An application funded with the release of Federal funds through a grant award, does not constitute, or imply, compliance with Federal regulations.

Funded organizations are responsible for ensuring that their activities comply with all applicable Federal regulations.

Grantees are subject to the limitations set forth in 45 CFR Part 74.81 (Prohibition against profit), which states that, "...

no HHS funds may be paid as profit to any recipient even if the recipient is a commercial organization.

Profit is any amount in excess of allowable direct and indirect costs."

Grantees are also subject to the requirements of 45 CFR Part 87, Equal Treatment for Faith-Based Organizations: "Direct Federal grants, sub-award funds, or contracts under this ACF program shall not be used to support inherently religious activities such as religious instruction, worship, or proselytization.

Therefore, organizations must take steps to separate, in time or location, their inherently religious activities from the services funded under this program.

Regulations pertaining to the Equal Treatment for Faith-Based Organizations, which includes the prohibition against Federal funding of inherently religious activities, can be found at the HHS web site at:

A faith-based organization receiving HHS funds retains its independence from Federal, State, and local governments, and may continue to carry out its mission, including the definition, practice, and expression of its religious beliefs.

For example, a faith-based organization may use space in its facilities to provide secular programs or services funded with Federal funds without removing religious art, icons, scriptures, or other religious symbols.

In addition, a faith-based organization that receives Federal funds retains its authority over its internal governance, and it may retain religious terms in its organization"s name, select its board members on a religious basis, and include religious references in its organization"s mission statements and other governing documents in accordance with all program requirements, statutes, and other applicable requirements governing the conduct of HHS funded activities." Additional information on "Understanding the Regulations Related to the Faith-Based and Community Initiative" can be found at:

The Code of Federal Regulations (CFR) is available at

Awards issued under this announcement are subject to the requirements of Section 106 (g) of the Trafficking Victims Protection Act of 2000, as amended (22 U.S.C.


For the full text of the award term, go to

All funds are discretionary under this program.

Eligibility Requirements

Applicant Eligibility

Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organizations, as defined by Section 4 of the Indian Health Care Improvement Act, Public Law 94-437.

Beneficiary Eligibility

• Eligible families residing in at-risk American Indian/Alaskan Native communities in need of such services, as identified in a needs assessment
• Low-income eligible families
• Eligible families who are pregnant women under age 21
• Eligible families with a history of child abuse or neglect or have had interactions with child welfare services
• Eligible families with a history of substance abuse or need substance abuse treatment
• Eligible families that have users of tobacco products in the home
• Eligible families that are or have children with low student achievement
• Eligible families with children with developmental delays or disabilities
• Eligible families who, or that include individuals serving or formerly serving in the Armed Forces, including those with members who have had multiple deployments outside the US

Eligible family:
• A woman who is pregnant, and the father of the child if available, or
• A parent or primary caregiver of the child, including grandparents or other relatives and foster parents serving as the child s primary caregiver from birth until kindergarten entry, including a noncustodial parent with an ongoing relationship with, and at times provides physical care for the child.


Applicants should review the individual funding opportunity announcement issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. OMB Circular No. A-87 applies to this program.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is not applicable.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.


Application Procedures

OMB Circular No. A-102 applies to this program. OMB Circular No. A-110 applies to this program.

Award Procedures

Each application will be screened to determine whether it was received by the closing date and time and whether the requested amount exceeds the award ceiling. Applications that are designated as late or those with requests that exceed the award ceiling will be returned to the applicant with a notation that they were deemed non-responsive and will not be reviewed.

Applications competing for financial assistance will be reviewed and evaluated by objective review panels using the criteria described in the funding opportunity announcement. Each panel is made up of experts with knowledge and experience in the area under review. Generally, review panels are composed of three reviewers and one chairperson.

Results of the competitive objective review are taken into consideration by ACF in the selection of projects for funding; however, objective review scores and rankings are not binding and are one element of the decision-making process.

ACF may elect to not fund applicants with management or financial problems that would indicate an inability to successfully complete the proposed project. Applications may be funded in whole or in part. Successful applicants may be funded at an amount lower than that requested. ACF reserves the right to consider a preference to fund organizations serving emerging, unserved, or under-served populations, including those located in pockets of poverty, and to consider the geographic distribution of Federal funds in its funding decisions.

ACF may refuse funding for projects with what it regards as unreasonably high start-up costs for facilities or equipment, or for projects with unreasonably high operating costs. In addition, federal staff will conduct an administrative review of the applications and the results of the competitive review and will make recommendations for funding to the Acting Director, Office of Family Assistance (OFA). With the results of the competitive review and information from federal staff, the Acting Director of OFA, in consultation with Deputy Assistant Secretary and Inter-Departmental Liaison for Early Childhood Development, will make the final funding decisions.

Applications that are approved but unfunded may be held over for funding in the next funding cycle, pending the availability of funds, for a period not to exceed one year.


Contact the headquarters or regional office, as appropriate, for application deadlines.


Social Security Act, Title V, Section 511(h)(2)(A), as amended by Affordable Care Act (ACA), Section 2951, Public Law 111-148.

Range of Approval/Disapproval Time

From 60 to 90 days.


Not Applicable.


Not Applicable.

Assistance Considerations

Formula and Matching Requirements

This program has no statutory formula.
Matching requirements are not applicable to this program.
This program does not have MOE requirements.

Length and Time Phasing of Assistance

Grants (cooperative agreements) are generally awarded for a 5-year project period. In the first year of the project, grants will be awarded on a competitive basis. Pending successful completion of Year 1 activities, submission of a plan that meets requirements, and approval of this plan, applications will be considered on a noncompetitive continuation basis for Years 2 - 5 subject to availability of funds, satisfactory progress of the grantee, and a determination that continued funding would be in the best interest of the Federal Government. Grants will be awarded for 12-month budget periods with a 5-year project period.

Funds awarded to grantees under this program will be made available for expenditure through the end of the second succeeding fiscal year after award. Method of awarding/releasing assistance: lump sum.

Post Assistance Requirements


Grantees under this announcement will be required to submit performance progress and financial reports periodically throughout the project period.

Federal Financial Report (FFR) - Federal Cash Transaction Report.

Progress reports are not applicable.

At a minimum, grantees are required to submit the ACF-OGM SF-PPR, which consists of the ACF-OGM SF-PPR Cover Page and the Program Indicators-Attachment B.

No performance monitoring is required.


In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. None.


Awards issued under this program are subject to the uniform administrative requirements of 45 CFR Part 74 (Awards And Subawards To Institutions Of Higher Education, Hospitals, Other Nonprofit Organizations, And Commercial Organizations) or 45 CFR Part 92 (Grants And Cooperative Agreements To State, Local, And Tribal Governments).

Financial Information

Account Identification



(Project Grants) FY 09 $0; FY 10 est $3,000,000; FY 11 est $7,500,000 - Three percent of annual appropriations under Section 511(h)(2)(A) of Title V of the Social Security Act, as amended by Section 2951 of the Affordable Care Act (ACA) (Public Law 111-148) shall be reserved for purposes of making grants to eligible entities that are Indian Tribes (or a consortium of Indian Tribes), Tribal organizations, or Urban Indian Organizations. Tribes (or a consortium of Indian Tribes), Tribal Organizations, or Urban Indian Organizations are those defined by Section 4 of the Indian Health Care Improvement Act, Public Law 94-437.

Range and Average of Financial Assistance

The range is $100,000-$500,000.

Regulations, Guidelines, and Literature

Not Applicable.

Information Contacts

Regional or Local Office


Headquarters Office

Carol Gage Child Care Bureau, Office of Family Assistance, Administration for Children and Families, Department of Health and Human Services, 370 L Enfant Promenade, S.W. , Washington, District of Columbia 20447 Email: Phone: 202-690-6243 Fax: 202-690-5600

Criteria for Selecting Proposals

Applications will be evaluated based upon the criteria published in the funding opportunity announcement.

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