Health Home for Children with Medically Complex Conditions

The “Health Home for Children with Medically Complex Conditions” grant is a planning grant offered by the Centers for Medicare & Medicaid Services (CMS) under the U.S. Department of Health and Human Services. This funding opportunity is designed to support states in developing a State Plan Amendment (SPA) under Section 1945A of the Social Security Act to establish a health home model for children with medically complex conditions. This model aims to provide high-quality, family-centered care coordination that spans a full range of pediatric medical services, including access to out-of-state providers when necessary. The primary objective of the grant is to assist states in the planning and design of a Medicaid health home program tailored for children with serious, long-term physical, mental, or developmental disabilities or diseases. Children under 21 who meet specific criteria, such as having one or more chronic conditions affecting multiple organ systems or a life-limiting illness or rare pediatric disease, are eligible under this program. States are encouraged to implement health home services that include comprehensive care management, transitional care, patient and family support, and integration with health information technology. The funding allows for a total of $5,000,000 to be distributed across up to 50 awardees, with each grantee eligible for a maximum of $100,000. The grant period spans up to 36 months from the award date. Awardees are selected through a new, limited competition, and applications are accepted quarterly on January 4, April 1, July 1, and October 1. Matching funds are required based on the state’s standard Medicaid matching rate. Eligible applicants include a wide range of government, nonprofit, and educational entities such as state, county, and tribal governments; independent and public institutions of higher education; school districts; public housing authorities; and nonprofits, including those with or without 501(c)(3) status. For-profit organizations and small businesses may also apply. Entities must not be receiving other federal funding for the same planning activities proposed under this grant. Applications must be submitted electronically via Grants.gov and must include several key components such as standard federal forms (SF-424, SF-424A/B, SF-LLL), a project narrative, a detailed budget and budget narrative, a business assessment of the organization, and supporting documentation such as resumes and job descriptions for key personnel. The project narrative should clearly address the program requirements, including stakeholder engagement, health IT integration if applicable, and a proposed timeline. Applicants are evaluated based on four main criteria: the clarity and feasibility of the project narrative, organizational capabilities, the proposed evaluation plan, and the alignment of the budget with program objectives. CMS retains the right to adjust funding based on performance and may engage in pre-award negotiations. Progress and financial reports are required throughout the grant period, and applicants must comply with a range of federal policies, including accessibility standards, audit requirements, and reporting under the Federal Funding Accountability and Transparency Act.