[Federal Register Volume 81, Number 87 (Thursday, May 5, 2016)]
[Notices]
[Pages 27145-27146]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-10514]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Providing Support for the Collaborative Improvement and 
Innovation Network (CoIIN) To Reduce Infant Mortality

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of a single-award deviation from competition 
requirements for providing support for the Collaborative Improvement 
and Innovation Network (CoIIN) to Reduce Infant Mortality.

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SUMMARY: HRSA announces the award of an extension in the amount of 
$3,000,000 for the Providing Support for the Collaborative Improvement 
and Innovation Network (CoIIN) to Reduce Infant Mortality cooperative 
agreement. The purpose of the CoIIN is to develop and disseminate 
evidence-based interventions to reduce infant mortality across states 
in Regions I, II, III, VII, VIII, IX, and X by planning, implementing, 
and managing regional CoIINs; providing technical assistance to CoIIN 
teams to improve approaches to address infant mortality in their 
respective regions through the understanding of

[[Page 27146]]

quality improvement concepts, tools, and techniques; and assisting 
regional CoIIN participants and stakeholders in understanding the 
process for sustaining and continuing project strategies after the 
Federal period of support. The extension will permit the National 
Institute for Children's Health Quality, Inc. (NICHQ), the cooperative 
agreement awardee, during the budget period of 9/30/2016-9/29/2017, to 
complete activities.

SUPPLEMENTARY INFORMATION: 
    Intended Recipient of the Award: National Institute for Children's 
Health Quality, Inc.
    Amount of Non-Competitive Awards: $3,000,000.
    Period of Supplemental Funding: 9/30/2016-9/29/2017.
    CFDA Number: 93.110.

    Authority:  Special Projects of Regional and National 
Significance (SPRANS); Social Security Act, Title V, Sec.  501(a)(2-
3); 42 U.S.C. 701 (a)(2-3).

    Justification: The National Institute for Children's Health 
Quality, Inc. (NICHQ), as part of the cooperative agreement, oriented 
and trained CoIIN participants on quality improvement processes and 
related principles and practices; planned and conducted regularly 
scheduled learning sessions and monthly action period calls for each 
strategy team; provided technical assistance to state strategy teams on 
how to track progress of chosen quality improvement aims through the 
use of real-time data; and provided an internet-based collaborative 
workspace for monthly/quarterly/annual reporting of qualitative and 
quantitative topic-specific and common measures of progress. In project 
year 2, NICHQ received approval to add Regions IV, V, and VI to the 
scope of work. As such, NICHQ has developed a CoIIN to reduce infant 
mortality that includes all 59 states and jurisdictions and focuses on 
six common state-driven strategies (safe sleep, smoking cessation, 
preconception and interconception care, perinatal regionalization, 
prevention of pre/early term birth, and social determinants of health). 
NICHQ provides ongoing technical assistance to these six strategy teams 
dedicated to improving infant mortality by focusing on the strategy 
topics and to state personnel to implement CoIIN strategies. NICHQ has 
used the Institute for Healthcare Improvement's (IHI) Breakthrough 
Series Model for Improvement where strategy teams commit to working 
over a period of 12-18 months, alternating between learning sessions 
and action periods. During the entire collaborative cycle, teams are 
connected through a virtual, on-line community and are expected to 
upload and share their results (i.e., data submission/reporting) as 
well as encouraged to conduct peer-to-peer sharing/mentoring.
    The recipient continues to make significant progress. However, the 
project experienced significant delays due to factors beyond the 
grantee's control. Startup delays included developing state personnel 
and systems capacity to monitor and implement activities to improve 
infant mortality. Also, orientation to the CoIIN methodology/approach 
took longer than anticipated as states and jurisdictions reported 
competing priorities. Further, states needed additional technical 
assistance and capacity building related to data collection and 
submission as there were several state and/or local level barriers to 
obtaining the data needed for activity and outcome measures which 
required resolution at the state level. Though some states were able to 
begin collecting data in August 2015, some activity and/or outcome 
measures are unavailable until at least 6-8 weeks after the end of the 
data collection period due to state policies/procedures.
    MCHB found similar delays in its CoIIN pilot that concluded one 
year after this CoIIN cooperative agreement began. An analysis of the 
pilot data showed that applying the IHI method to state public health 
systems rather than clinical settings required an additional 6-8 months 
to meet the quality improvement aims and show measurable improvements 
in infant mortality and birth outcomes. NICHQ must continue activities 
beyond the original project period (9/30/2013-9/29/2016) to achieve the 
additional months of state action and learning sessions with 
accompanying data submissions.

FOR FURTHER INFORMATION CONTACT: Vanessa Lee, MPH, Division of Healthy 
Start and Perinatal Services, Maternal and Child Health Bureau, Health 
Resources and Services Administration, 5600 Fishers Lane, Room 18N84, 
Rockville, MD 20852, Phone: (301) 443-9992, Fax: (301) 594-0878, Email: 
[email protected].

    Dated: April 29, 2016.
James Macrae,
Acting Administrator.
[FR Doc. 2016-10514 Filed 5-4-16; 8:45 am]
 BILLING CODE 4165-15-P