HealthySteps Expansion April 2026

HealthySteps April 2026 EXPANSION
Request for Applications
Grant Procurements
(On-Line Submission Required)
Statewide Financial System (SFS) Identifier- MH253026
2026

New York State Office of Mental Health (OMH)
SECTION 1. Programmatic Information
A. Introduction and Background
The New York State (NYS) Office of Mental Health (OMH) announces the availability of funds
to support the expanded implementation of HealthySteps (HS).i It is anticipated that OMH will
make up to 381 awards across the state, contingent upon availability of funding. This funding is
specifically designated for new sites, with the goal to expand the capacity of pediatric and
family medicine practices to implement HealthySteps, prioritizing statewide access across
counties without existing HealthySteps sites2 as well as at risk areas as determined by higher
percent of births covered by Medicaid or self-pay. The combined total of these awards will be
up to $18,420,462 distributed over five (5) years (See Section 1.F Operating Funds).
In 2016, OMH first awarded HealthySteps funding to pediatric primary care practices, and since
that time, comprehensive services have been provided to tens of thousands of young children
and their families across New York State as part of the program.
This Request for Applications (RFA) will provide the opportunity to expand this reach to even
more children and their families throughout NYS as we continue to work towards enhancing
protective factors to foster childhood resiliency, promoting a trauma-informed approach to care,
screening for depression of birthing persons, and addressing the deleterious effects of the
social determinants of mental health for children and families.
This RFA, part of New York State's historic investment to strengthen the mental health system
and drastically reduce the number of individuals with unmet mental health needs throughout
the state, clearly demonstrates OMH's ongoing commitment to primary prevention and the
health and well-being of the youngest New Yorkers. The goal is to ultimately promote an
intentional focus on prevention activities by identifying and implementing evidence-based
programs and data-informed strategies that are universally accessible.
HealthySteps is an evidence-based program that delivers dyadic services to both young
children (0-3 years) and their families in a pediatric healthcare setting, which is non-
stigmatizing and offers universal access. Pediatricians often serve as the initial point of contact
for new caregivers. Typically, an infant has seven (7) well-child visits within the first year of life,
often occurring before families have contact with any other service system. This early access
allows the youngest children to integrate mental health and physical well-being at a critical time
in brain development. It also allows the HealthySteps Specialist to support the healthcare team
in promoting the child's developmental, social-emotional, and behavioral health. A
HealthySteps Specialist uses a two-generation approach to promote well-being and to address
concerns about challenging behaviors, developmental delays, caregiver mental health, and
family needs such as food and housing instability. The HealthySteps model offers the ability to
1 Qualified sites that partner to share 1 FTE HealthySteps Specialist (see Sections 1.D and 1.E) will count
as one of the 38 awards, although each of those sites will receive one award of an adjusted amount as
described in Section 1.F.
2 Refer to Table 3. County-based distribution of existing (E) OMH supported NYS HealthySteps sites plus
Onboarding sites awarded (A) from the OMH HealthySteps RFAs in June 2022, November 2022, June
2023, August 2024, or June 2025.
Page 1

New York State Office of Mental Health (OMH)
instill preventative efforts through anticipatory guidance, which may enhance positive outcomes
and prevent future mental health challenges.
The HealthySteps model's preventative efforts are promoted through a HealthySteps
Specialist, a professional with expertise in child development who partners with families during
well-child visits as part of the primary care team. The HealthySteps Specialist fulfills a variety of
roles: Serving as a liaison between the child and family and the healthcare team, offering
screenings and support that the physician may lack time to address, including feeding,
behavior, sleep, attachment, depression, social determinants of health, and adjusting to the
complexities of caring for a newborn child. The HealthySteps Specialist also provides families
with parenting/caregiver guidance, support between pediatric visits, referrals, and care
coordination, all the while ensuring that the child and family's needs are identified, addressed,
and ultimately met.
Evidence-Based
National Evaluation of HealthyStepsii clearly demonstrates that this evidence-
based program has shown significant positive outcomes for the child, the family,
and the practice/provider. The original findings are supported by subsequent
conclusions, as outlined in the HealthySteps Evidence Summary 2023 Final.iii
These findings continue to support both the immediate and longitudinal benefits of
this model.
Child
* "Children were more likely to attend all of the first 10 recommended well-child visits
and were twice as likely to attend specific visits and for visits to be on time."
* "Children were up to 1.6x more likely to receive timely vaccinations and 1.4x more
likely to be up to date on vaccinations by age 2."
* "Continuity of care was significantly better for both total and well-child visits and
families were nearly twice as likely to remain with the practice through 20 months."
* "Children were 8x more likely to receive a developmental assessment and had
significantly higher rates of developmental and other nonmedical referrals."
* "Children were 23% less likely to visit the emergency room for injuries in a 1-year
period."
Family
* "Families were 24% less likely to place newborns on their stomachs to sleep,
reducing SIDS risk."
* "Families were significantly less likely to report harsh punishments (yelling, spanking
with hand) and severe discipline (face slap, spanking with objects)."
* "Families were significantly more likely to share picture books and play with their
infants daily."
Page 2

New York State Office of Mental Health (OMH)
* "Families were significantly more likely to notice behavioral cues and provide age-
appropriate nurturing."
* "Families demonstrated a significantly better understanding of infant development."
Practice/Provider
* "Families were significantly more likely to report practice staff went out of the way for
them, that they relied on practice staff for advice (rather than a friend or relative), and
that they received needed emotional support".
* "Families rated their provider as more competent and caring and were significantly
more likely to believe that the health plan cared about them and to recommend their
clinic to a friend or family member."
* "Physicians reported significantly higher satisfaction with HealthySteps and that they
felt emotionally supported by the HealthySteps Specialist."
Trauma-Informed Care
* Trauma can have long-term effects on a person's emotional, mental, and physical
well-being, including the ability to cope, sense of safety, and everyday life.
Traumatized individuals, particularly those who were exposed to adverse childhood
experiences, are at increased risk for social and behavioral problems as well as
physical health challenges. Trauma can lead to changes in brain chemistry and
structure, resulting in symptoms such as anxiety, depression, and PTSD, and can
even cause physical damage to the brain.iv
* Pediatric and family medicine practices are on the front lines of caring for children
and supporting families. They serve a critical role in early identification, education,
and response to childhood trauma.
The following are six key principlesv of a trauma-informed approach for health care
organizations:
* "Safety - Throughout the organization, patients and staff feel physically and
psychologically safe";
* "Trustworthiness and transparency - Decisions are made with transparency, and with
the goal of building and maintaining trust";
* "Peer support - Individuals with shared experiences are integrated into the
organization and viewed as integral to service delivery";
* "Collaboration and mutuality - Power differences - between staff and clients and
among organizational staff - are leveled to support shared decision-making";
* "Empowerment, voice, and choice - Patient and staff strengths are recognized, built
on, and validated - this includes a belief in resilience and the ability to heal from
trauma"; and
Page 3

New York State Office of Mental Health (OMH)
* "Humility + Responsiveness - Biases and stereotypes (e.g., based on race, ethnicity,
sexual orientation, age, geography) and historical trauma are recognized and
addressed."
According to the National Child Traumatic Stress Network,vi "the following elements are
important to consider when creating trauma-informed integrated healthcare systems:
* Creating a trauma-informed office.
* Involving and engaging family in program development, implementation, and
evaluation.
* Promoting child and family resilience, enhancing protective factors, and addressing
parent/caregiver trauma.
* Enhancing staff resilience and addressing secondary traumatic stress.
* Assessing trauma-related somatic and mental health issues.
* Providing coordinated, integrated care across child- and family- service systems."
HealthySteps sites are encouraged to implement trauma-informed principles within their
practice. The Office of Mental Health's New York State Trauma-Informed Network and
Resource Center (NYS TINRC)vii and Project TEACHviii are two projects that provide
training, information and resources on this topic.
NYS TINRC's goal is to make New York more trauma-informed, which assists people to
heal and thrive. It promotes learning around trauma, trauma-responsive practices, and
well-being.
To meet this goal, the NYS TINRC supports the following:
* Connection and collaboration for those who are interested in trauma-informed
practices.
* Support for organizations and communities in becoming trauma-informed.
* Training to advance implementation of trauma-informed practices in organizations.
* A trauma and resilience-informed approach to prevention and wellness promotion.
The NYS TINRC is open to individuals, organizations, and communities across the state.
HealthySteps sites are encouraged to both register and sign up for the NYS TINRC
Newsletterix to receive up-to-date information about trainings and resources.
For many children and families, adverse childhood experiences (ACEs - defined below) *
and trauma are all too common." More than two-thirds of children reported at least one
(1) traumatic event by age 16."x
*Adverse Childhood Experiences (ACEs) are potentially stressful or traumatic events that occur
during childhood (ages 0-17). xiACEs are often reflective of abuse, neglect, household instability,
and/or dysfunction. Research supports that when a child experiences a traumatic event, their
capacity to cope may be overwhelmed by strong negative emotions and physical reactions.xii
Without intervention, exposure to frequent traumatic adversities can lead to prolonged activation
of the stress-response system, also known as toxic stress.xiii Toxic stress from ACEs has been
Page 4

New York State Office of Mental Health (OMH)
linked to organic changes in brain development, consequently impacting attention, behavior,
decision-making, and how the body responds to future stressors.xiv xv xvi
While not required, it is recommended that sites incorporate the ACEs questionnaire into
their practice if staff are trained in a trauma-informed approach. For caregivers, their
answers to the ACEs questionnaire will provide information to the HealthySteps Specialist
on any trauma history and encourage opportunities to help build family resiliency through
targeted support and education and linkages to supports and services. The HealthySteps
National Office provides resourcesxvii to support sites in implementing ACEs screening
into practice.
B. Target Population/Eligibility Criteria
OMH will first prioritize NYS counties that do not currently have a HealthySteps site and then
prioritize at risk areas as determined by higher percent of births covered by Medicaid or self-pay.
This will support OMH's commitment to provide universal access to prevention opportunities and
to ensure equity and the reduction of disparities in access, quality and treatment outcomes for
marginalized and underserved populations.
The target population of the HealthySteps program is children ages 0-3 years and their families
seen in pediatric and/or family medical practices. HealthySteps sites are required to serve ages
0-3 years; up to age 5 is optional.
C. Key Events/Timeline
Activity Date
Release RFA 4/28/26
Practices submit questions due date 5/19/26
Post Q&A 6/11/26
Application Submission Deadline -
7/2/26
1:00 PM EST
Anticipated Notification of Awards 7/30/26
Anticipated earliest contract start date 1/1/2027
D. Eligible Applicants
Eligible applicants are pediatric, or family medical practices located in New York State whose
population includes children ages 0-3 years and deliver or have the potential to deliver well-child
visits in the pediatric or family medicine setting. (This includes but is not limited to: Federally
Qualified Health Centers, American Indian Health Programs in New York State, Rural Health
Centers, Community Health Centers).
Each applicant must be applying to become a new HealthySteps site. Sites that are listed on the
HealthySteps Practice Directory xviii at the time of application, or have accepted or anticipate
funding from the OMH HealthySteps RFAs released in June 2022, November 2022, June 2023,
August 2024, or June 2025 are not eligible to apply. However, organizations with a current site
are eligible to apply to establish a new site/s at different and/or additional locations under this
RFA.
Page 5

New York State Office of Mental Health (OMH)
Each applicant must have a minimum panel size (i.e., caseload) of 100 children ages 0-3 years.
Each practice location must submit a separate and complete application.
Considerations for small practices.
Small practices have the option to apply in partnership with another practice as described in
Strategies to Deliver HealthySteps to Children and Families in Rural and Small Pediatric Primary
Care Practices. xix For small practices that plan to partner, the minimum combined panel size of
children ages 0-3 years is 100 and the maximum allowable combined panel size is 2,000.
Each site will be required to submit its own unique application, and if awarded, the funding as
outlined in Section 1.F. will be divided evenly between both sites. Each practice must
individually meet the eligibility requirements and attest to providing each of the program
requirements.
Partnering practices cannot be from separate independent practices and must be part of
the same healthcare system3 or partnering practices must participate in the same
integrated provider network. All partnering practices must both submit their unique
applications concurrently.
Prequalification is required for all not-for-profit organizations seeking grant funding from New York
State. Please see Section 2. Administrative Information, D. SFS Prequalification Requirement,
and Section 2.E. Vendor Registration, Prequalification and Training Resources for Not-for-Profits.
for additional Prequalification Information.
E. Program Requirements
As noted in the introduction, the purpose of these funds is to support the expanded
implementation of the HealthySteps program. As part of this funding, each applicant will be
required to attest to complying with each of the following fourteen (14) program requirements. The
Attestation process will be facilitated/completed in the New York Statewide Financial System
(SFS). If you are unable to attest to any component of the program requirements, please note that
your application will be automatically disqualified.
E-1. HealthySteps Specialist (HSS):
Sites will be required to maintain and fill one (1) full-time equivalent (FTE) HealthySteps
Specialist position throughout the duration of this funding. At minimum, the HealthySteps
Specialist must hold a bachelor's degree (although a master's degree is preferred). HS
Specialists are frequently social workers with mental health training, psychologists, early
childhood educators, and/or nurses with experience in early childhood development. We
highly recommend that a practice hire a candidate with a mental health background
(ideally infant and early childhood mental health or infant and early childhood
3 For the purposes of the RFA, a healthcare system is defined as a healthcare entity that operates
multiple practices or sites and/or a medical institution with different physical addresses/practices under
one legal name.
Page 6

New York State Office of Mental Health (OMH)
development). Mental health professionals are well-suited for the position due to their
clinical training, skills related to reflective practice, and the ability to provide consultation
and care coordination. It is preferred that the HealthySteps Specialist have a master's or
doctoral level degree and is a licensed behavioral health professional. Please note that
the degree and credentials of HealthySteps Specialist and the ability to bill for their
services will have implications for future reimbursement and sustainability beyond the
term of this grant. See Resources for Hiring and Orientation.xx
Within six (6) months of the contract, each site will be required to identify and/or hire a
qualified individual as the HealthySteps Specialist. This position is required to be
budgeted as a full-time equivalent staff member of the designated site and cannot be
subcontracted to another agency. For the purposes of this RFA, no more than two (2)
part-time individuals can combine effort to meet the duties of the one (1) FTE
HealthySteps Specialist position.
"The National Office requires that a HS Specialist is expected to participate in team-
based well-child visits in-person, as an integrated member of the care team." xxi (Tiers
and Core Components - HealthySteps)
The HealthySteps Specialist is a required, integrated member of the clinic team.
Therefore, this position must be maintained for the duration of this contract. In the event
of a HealthySteps Specialist vacancy, the site is solely responsible for the recruitment,
orientation, and training of a qualified candidate to fulfill the HealthySteps Specialist role.
All staff vacancies and fills must be reported to the OMH within thirty (30) days of status
change.
Considerations for small practices that plan to partner:
To address the unique needs of small practices, the full-time equivalent HealthySteps
Specialist position can be shared between two (2) sites within the same healthcare
system. This could mean one full-time individual splits their time at two sites, OR two
part-time individuals cover two sites. No more than two (2) part-time individuals can
combine effort to meet the duties of the one (1) FTE HealthySteps Specialist position.
The HealthySteps program has flexibility and innovative solutions that can assist smaller
practices. As stated previously, for small practices that plan to partner, the minimum
combined panel size of children ages 0-3 years is 100 and the maximum allowable
combined panel size is 2,000.
As described in Strategies to Deliver HealthySteps to Children and Families in Rural and
Small Pediatric Primary Care Practicesxxii "Flexible scheduling requires the participating
sites to attempt to schedule well-child visits for children birth to three on certain days of
the week (or potentially less difficult, only scheduling visits for families needing Tier 3
services on certain days of the week) and the ability for HealthySteps Specialist to split
time between sites that are in geographic proximity. This will also require office
administrative staff to understand the HealthySteps Specialist's schedule and how to
book visits."
In addition, the use of telehealth solutions may facilitate access to HealthySteps
Page 7