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Q & A with Dr. Charles Homer About Navigating the Recovery Act and CHIPRA Pediatric Healthcare Funding Opportunities

October 2009

NICHQ Offers Expertise on Recovery Act and CHIPRA Pediatric Healthcare Funding Opportunities

With the passage earlier this year of the American Recovery and Reinvestment Act of 2009 (the “stimulus bill”) and the Child Health Insurance Program Reauthorization Act (CHIPRA), new funds have become available for several pediatric healthcare and quality topics and approaches.  NICHQ is very excited about the opportunities these grants will provide for innovation and the advancement of children’s healthcare quality.  Below, Dr. Charles Homer answers questions about some of the funding opportunities currently open for proposals. 

What are some of the funding areas targeted by Recovery Act and CHIPRA funding opportunities related to quality of children’s health care?

Requests for proposals have gone out on quite a few topics. 

·    The CDC has issued two RFPs (one at the state and one at the community level) under the Communities Putting Prevention to Work initiative, which addresses obesity prevention;
·    AHRQ is currently looking for grant applications around the comparative effectiveness of specific medical tests, devices, therapies and other interventions in the treatment of conditions ranging from arthritis to autism, as well as evaluations of primary care practices that have undergone or are undergoing the transformation to medical homes; 
·    CMS has set aside $100 million for demonstration programs to improve quality for children’s health care.

Funds were also appropriated to support the adoption and meaningful use of electronic health records; so far, RFPs have been issued to create state or regional extension programs to assist practices in adopting health IT, and to states to support the development and refinement of health information exchange capabilities (

What organizations are eligible for funding?

The RFPs vary on who is eligible for support:

·    The obesity-related RFPs aim to provide resources to states and communities, but other organizations will be needed as partners to provide technical expertise. 
·    State Medicaid, CHIP agencies or consortiums of such state programs are the only entities permitted to apply for the CMS Quality Demonstration programs. These entities MUST partner with others, such as providers and those experienced in data collection and assessment.
·    AHRQ’s comparative effectiveness program generally targets research entities—universities, teaching hospitals or non-profit research organizations—working in partnership with delivery organizations. The Transforming Primary Care funding announcement, specifically, must include partnership with medical practices or community health centers that have already achieved substantial “transformative” changes.

What size grants will be awarded?

AHRQ’s Clinical and Health Outcomes Initiative in Comparative Effectiveness grants may not exceed $10 million in total costs over three years.  CMS will issue no more than 10 grants for a total of $100 million. At the other end of the funding spectrum, the Transforming Primary Care grants will top out at $300,000 per year over two years.

Our practice is in the process of becoming a patient centered medical home, but we are unsure if we meet the standard of “transformational change” that the Transforming Primary Care opportunity is seeking.  What indicators should we be looking for?

AHRQ is cognizant that transformational change doesn’t happen overnight.  They are, however, looking to evaluate and learn from practices that are further along in the transformative process.  As stated, eligible applicants should have begun the change process at least a year before applying for funding, and have some definite outcomes to indicate that their system of care has changed.  Be aware, however, that this RFP does not want to study incremental system change.  In a recent technical assistance conference call, AHRQ representatives told potential applicants that 12 – 18 months was a reasonable time frame for an eligible transformation to have occurred.

What types of organizational partnerships do you see arising from these funding opportunities?

Few single organizations—even organizations as vast as state governments or universities—have the full range of expertise required to undertake the work specified in these RFP’s, or find that their capabilities are not enhanced through external partners.  Moreover, several of the the RFP’s themselves express preference or requirement for partnerships.

Communities and states targeting obesity may seek assistance in engaging other sectors—including health providers—by partnering with groups who have long worked with providers both in improving their clinical practice and in engaging in promoting community change.

State Medicaid and CHIP programs are required to partner with state or national external associations or organizations including providers, foundations, academic institutions, and other state agencies.  The RFP points to statewide quality partnerships as one model for such partnership programs, including those with expertise in quality standards, measurement, reporting and improvement.

Research organizations seeking to assess transformation will need to partner with practices and systems that deliver care. They may also want to partner with groups such as NICHQ that have helped dozens of practices go through the transformation process, and also have created measures of process and outcome commonly used in medical home transformation.

Some of NICHQ’s greatest project successes have come from our diverse partnerships with both public and private organizations. In mobilizing health care response to the childhood obesity epidemic, we have worked with partners like BlueCross BlueShield of Massachusetts, HRSA and, most recently, the Robert Wood Johnson Foundation.  NICHQ also partners with states across the country on projects including perinatal care, Medicaid and Title V, and care for children with chronic illnesses.  In addition, we have successfully assisted primary care systems as they move to a patient-centered medical home philosophy of care. 

These partnerships have led to dynamic programs with lessons that can be applied to other communities across the country.  For more information about our projects, past and present, please see our website. If you are interested to learn how a partnership with NICHQ could strengthen your proposed initiative, please feel free to email us with any questions.

When should our organization begin crafting our proposals?

Now!  Many of these grant programs have very short application timelines, as the federal government seeks to get this new funding to communities in need.  If you haven’t already begun thinking about how your organization can take part in these exciting new opportunities, I would encourage you to take some time and read through the grant requirements very soon. (,, The funds are almost all one-time opportunities, and we at NICHQ would love to see our friends take part so that together we can create a world in which all children receive the high quality healthcare they need!

Download this Q & A in PDF format.


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