The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving access to health care by strengthening the health care workforce, building healthy communities, and achieving health equity.

Healthy Start programs are funded at three different levels and are expected to impact the health of women, infants, children, and their families in different ways.1

“Healthy Start Is” Video

This 5 minute video features Healthy Start project directors from around the country describing the essence of the Healthy Start program by finishing the sentence “Healthy Start is…” Grantees can use this video to introduce Healthy Start to community partners, show it at community meetings, or post it on their websites.

This video is also available with audio descriptions.

Level 1: Community-Based Healthy Start

  • Intended to have an effect at the individual level
  • Program awards up to $750,000 annually to serve a minimum of 500 participants per year
  • Support the implementation of essential HS program activities needed to achieve five approaches of the HS Model

Level 2: Enhanced Services Healthy Start

  • Intended to have an effect at the community level and thereby drive collective impact
  • Program awards up to $1.2 million per year to serve a minimum of 800 participants per year
  • Support the implementation of the essential HS program activities needed to achieve the five approaches, and engage in additional services and activities, such as FIMR, PPOR, and/or MMMR

Level 3: Leadership and Mentoring Healthy Start

  • Intended to have an effect at the community level and thereby drive collective impact
  • Program awards up to $2 million per year to serve a minimum of 1,000 participants per year
  • Support the implementation of the essential HS program activities needed to achieve the five approaches, and engage in additional services and activities, such as FIMR, PPOR, and/or MMMR.
  • Support the provision of expanded maternal and women’s health services and supports the development of a place-based initiative that will serve as the backbone or hub organization for achieving collective impact.
  • Serve as a resource site for state, regional, and national action in support of other HS grantees and organizations working to improve perinatal outcomes through program and policy development
  • Participate with other Level 3 Leadership and Mentoring HS grantees to support the Healthy Start Performance Project (EPIC) and lead in the development and implementation of a HS Collaborative Innovation and Improvement Network (HS CoIIN)

Resources

 

Healthy Start Infographic (1 page):

Healthy Start Infographic with Timeline (2 pages):

     

History of the Healthy Start Program

1989 President George H. W. Bush creates the interagency White House Task Force to Reduce Infant Mortality with representatives from the Departments of Health and Human Services, Housing and Urban Development, Education, Commerce, and the CDC.
1989 Healthy Start is one of 18 proposals submitted to the White House Task Force to Reduce Infant Mortality.
1991 Healthy Start begins with a goal to reduce infant mortality by 50% in 5 years. Fifteen sites with infant mortality rates 1.5 to 2.5 times higher than the national average are selected to conduct demonstration projects.
1991 These programs were funded to be innovative, community-driven projects tasked with reducing infant mortality and improving the health and well-being of women, infants, and their families. Projects are based on one of nine intervention models: community consortia, coordinated care/case management, outreach and client recruitment, family resource centers, enhanced clinical services, risk prevention/reduction, facilitating services, training and education, and adolescent services.
1994 Seven sites are added to the Healthy Start program as “special projects.”
1997 Forty sites are added to the Healthy Start program with the intention that they will replicate the model of the original programs by conducting outreach, case management, and health education, and developing community consortia.
 1998  National Healthy Start Association is founded.
1999 Nineteen sites focused on the elimination of racial and ethnic disparities in perinatal health are added to the Healthy Start program.
2000 Healthy Start is Authorized by Congress as part of the Children’s Health Act.
2000 Kotelchuck and Fine: Healthy Start Initiative: Strategic Assessment & Policy Options (2000) makes 38 recommendations for strengthening the program. Federal and local leadership are re-balanced.
2002 After multiple rounds of funding, there are 96 federally-funded Healthy Start sites.
2002 Healthy Start 2.0 scope evolves to focus on preconception health, developmental focus through age 2 years, screening for maternal depression, father involvement, and consumer voice, in addition to comprehensive health services.
2008 Healthy Start Re-authorization Act is enacted.
2010 After four rounds of expansion and changes to funding, there are 105 Healthy Start sites located in 39 states, Puerto Rico, and the District of Columbia.
2012 Healthy Start 3.0 focused on five pillar approaches: Improve women’s health; Promote quality services; Strengthen family resilience; Achieve Collective Impact; and Increase accountability through quality improvement, performance monitoring, and evaluation.
2013 The Secretary’s Advisory Committee on Infant Mortality (SACIM) issues recommendations and a framework for a national strategy to reduce infant mortality and reaffirms need for continued federal investment in Medicaid; Title Vl MCH Services Block Grant; Healthy Start; Title X Family Planning Program; Community Health Centers; Maternal, Infant, Early Childhood Home Visiting (MIECHV) Program, and WIC.
2014 One-hundred Healthy Start programs in rural, urban, and border areas are funded by HRSA, in 37 states and the District of Columbia.
2016 Twenty-fifth anniversary of the federal Healthy Start Initiative.

HRSA Resources

Sources

Kotelchuck, M. (2012). MGH Center for Child and Adolescent Health Research and Policy/ Harvard Medical School Secretary’s Advisory Committee on Infant Mortality “Reflections on the History of the Healthy Start Initiative.”

National Healthy Start Association (2015). Healthy Start Initiative.

National Healthy Start Association. (2010). Federal Healthy Start Initiative: A national network for effective home visitation and family support services.

NHSA, Saving our Nation’s Babies, The Impact of the Federal Healthy Start Initiative. 2nd Edition, First Edition published 2011.

GovTrack

Report of the Secretary’s Advisory Committee on Infant Mortality (SACIM): Recommendations for HHS Action and Framework for a National Strategy.  (2013).

Division of Healthy Start and Perinatal Services, Health Resources and Services Administration, Department of Health and Human Services. (2015). Orientation webinar for healthy start frontline staff.

Healthy Start Initiative: Eliminating Disparities in Perinatal Health FOA issued Feb 14, 2014 (HRSA -14-121, HRSA-14-120, HRSA14-122).