Healthy Start Initiative

To eliminate disparities in perinatal infant and maternal health by: enhancing a community's health care infrastructure and service system and a State's infrastructure; and directing resources and interventions to improve access to, utilization of, and full participation in comprehensive perinatal and
women's health services, particularly for women and infants at higher risk for poor health outcomes.
Related Programs

Examples of Funded Projects

From pregnancy either to the next pregnancy or 2 years post delivery for the mother and infant, every Healthy Start project assures the availability of a core set of services and system building activities to the perinatal population in the project area.

Projects include a consortium, case management, outreach, health education, screening and referral for depression, collaboration with State Title V, a local health system action plan, and plans for sustainability.

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.

Office - Director, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services, Room 18-12, Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857.

Telephone: (301) 443-0543.
Website Address

Relevant Nonprofit Program Categories

Program Accomplishments

In FY 07, 102 projects were awarded to new and existing projects. It is estimated that 102 projects will be awarded in FY's 08 and 09.

Uses and Use Restrictions

Every Healthy Start project implements community-driven approaches to address infant mortality rates by reducing maternal behavioral and medical risk factors and promoting healthy outcomes for women and their families.

Beginning with prenatal care and continuing through the infant's second year of life, each community awarded funds assures the availability of a core set of services and activities for the perinatal population in their project area.

These services include case management, home visiting and links to health care and other needed services for mothers and their infants; direct outreach and peer mentoring by trained community members; screening and referral for perinatal/postpartum depression; and strong coordination with and access to substance abuse, domestic violence, mental health, early intervention, parenting and other critical services for high-risk women and families.

In addition, each Healthy Start project is required to have a community-based consortium composed of individuals and organizations and that includes women and families served by their project, to collaborate with their State Title V (MCH) Agency, and to implement a local health system action plan to improve the quality, cultural competence of and access to services and/or to address other problems in the local system of care.

Funds may not be used to supplant currently funded activities/services.

Eligibility Requirements

Applicant Eligibility

Urban and rural communities with significant disparities in perinatal health, and States with need to build their infrastructure/capacity to address and support those communities trying to achieve the goals of the Healthy Start program.

Eligible applicants are any public or private entity, including an Indian Tribe or tribal organization (as those terms are defined at 25 U.S.C.


Community-based organizations, including faith-based organizations are eligible to apply.

Beneficiary Eligibility

Service area residents, particularly women and infants in areas with significant perinatal health disparities.


Applicants should review the individual HRSA Guidance documents 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.

Aplication and Award Process

Preapplication Coordination

This program is eligible for coverage under E.O.

12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office of the official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.

Application Procedures

Grant applications and required forms for this program can be obtained from Please visit the Web site at to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator. The Associate Administrator has the authority to make final selections for awards.

Award Procedures

See specific program grant guidance.

Deadlines .


Public Health Service Act, Title III, Part D, Section 330H; 42 U.S.C. 254c-8.

Range of Approval/Disapproval Time

Final decisions are made approximately 166 days after receipt of applications.




After initial award, projects may be renewed annually up to the limit of the project period upon the submission and approval of a satisfactory continuation application.

Assistance Considerations

Formula and Matching Requirements

This program has no statutory formula or matching requirements.

Length and Time Phasing of Assistance

Project periods vary depending on specific grant announcement with non-competing continuation awards made on an annual basis for up to 5 years depending on satisfactory progress and subject to the availability of funds.

Post Assistance Requirements


Grantees are required to submit progress reports on an annual basis.

Financial status reports are required no later than 90 days after the end of each budget period.

Final financial status and progress reports are due 90 days after the end of a project period.


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.


All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved.

Financial Information

Account Identification



(Grants) FY 07 $96,660,615; FY 08 est $94,450,895; and FY 09 est $94,450,895.

Range and Average of Financial Assistance

$155,000 to $2,350,000; $974,653.

Regulations, Guidelines, and Literature

This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable.

Information Contacts

Regional or Local Office

Director, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services, Room 18-12, Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857. Telephone: (301) 443-0543.

Headquarters Office

Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch: 301-443-2385; Research and Training Branch: 301-443-3099; Government and Special Focus Branch: 301-443-3288.

Criteria for Selecting Proposals

See specific program grant guidance.

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