Healthy Start Site

In this section, the grantee may expand the accordion menu to view the following details:

• Instructions

Detail sheet

In this section, the grantee must answer the following question:

Project Name

• The grantee may enter the Project Name in NCPR, and it prepopulates to subsequent NCCPRs and PPERs. The field remains editable in NCCPRs and PPERs.

Project name

Street Address

• This is a required field, and the grantee must enter the Street Address of the organization.
• The following validation will display on the data entry box: Provide a response for this field

 Street Address

City

• This is a required field, and the grantee must enter the City name of the organization.
• The following validation will display on the data entry box: Provide a response for this field

City name

State:

• This is a required field, and the grantee must select the organization State from the drop-down menu.
• The following validation displays on the state dropdown box: Provide a response for this field

State dropdown

Zip Code:

• This is a required field, and the grantee must enter the organization Zip Code.
• This field will only accept 5 digit numeric entry and the following validation will display on the data entry box: Enter a 5 digit Zip Code.

 Zip code

Are HS services provided at the primary location?

• This is a required field with Yes/No radio buttons, and the following validation displays on the radio buttons: Provide a response for this field

Primary location

Select the state(s) in this organization’s service area:

• This is a required field, and the grantee must select one or more states indicating what state(s) are included in their organization’s service area from the drop-down menu. For example, If the service area covers seven counties across two states, the grantee must select both states from the dropdown menu.

state selection

Service area for this organization primarily defined by:

• This is a required field, and the following validation displays on the radio buttons: Provide a response for this field
• The grantee must select one of the following options using the radio buttons and their selection informs the menu for the next questions:
  • County
  • Census Tract
  • Zip Code
• The grantees will have access to only one mode of reporting: County, ZIP Code, or Census Tract; it is not possible to select more than one type of service area.

Service area

Please select the all the counties covered by this organization’s service area. (Select all that apply)

• This field will be disabled by default and will become enabled and required if the grantee has selected County or Census Tract in Service area for this organization primarily defined by field above.
• The following validation will display on the data entry box: Provide a response for this field
• The grantee must click on Add/Edit Counties link to open a modal window to select the counties in the grantee’s service area.
• The modal window will display Counties data for the State(s) selected in Select the state(s) in this organization’s service area

Note: Add/Edit Counties link will be enabled if the grantee has selected County or Census Tract in Service area for this organization primarily defined by.

County selection

Please select all Census Tracts covered by this organization’s service area (Select all that apply)

• This field will be disabled by default and will become enabled and required if the grantee has selected Census Tract in Service area for this organization primarily defined by field and have selected the counties in Please select all the names of all of the counties covered by this organization’s service area.
• The following instruction text will display under the census tract question in parenthesis:
  • Counties must be entered in the field above before selecting the census tracts.
• The following validation will display on the data entry box: Provide a response for this field
• The grantee must click on Add/Edit Census Tract link to open a modal window to select the counties in the grantee’s service area.
• The modal window will display Census Tract data for the State(s) selected in Select the state(s) in this organization’s service area field, and their corresponding Counties selected in Please select all the names of all of the counties covered by this organization’s service area question for grantee to make the selection.

Note: Add/Edit Census Tract link will be enabled if the grantee has selected Census Tract in Service area for this organization primarily defined by field.

Census Tracts

Please select all the ZIP codes covered by this organization’s service area (Select all that apply)

• This field will be disabled by default and will become enabled and required if the grantee has selected Zip Code in Service area for this organization primarily defined by field above.
• The following validation will display on the data entry box: Provide a response for this field
• The grantee must click on Add/Edit Zip Codes link to open a modal window to select the counties in the grantee’s service area.
• The modal window Codes data for the State(s) selected in Select the state(s) in this organization’s service area

Note: Add/Edit Zip Codes link will be enabled if the grantee has selected Zip Codes in Service area for this organization primarily defined by field.

Select zip code

Please check all services provided

• This is a required field, and the grantee must check all the services from the available checkbox options that are provided across its service area. For example, if HS Site 1 provides doula services and HS Site 2 provides care to incarcerated persons, the grantees must indicate that these services are provided by their grantee organization.
• The following validation will display on the checkboxes: Provide a response for this field

 Select all services provided

In this section, the grantee must enter the following information for each site.

Project Manager Name

• This is a required field, and the grantee must enter the project manager name for the site. The following validation will display on the data entry box: Provide a response for this field

Project Name

• This is a required field, and the grantee must enter the project name for the site. The following validation will display on the data entry box: Provide a response for this field

• The grantee must enter the name that identifies the site where Healthy Start services are delivered (for example, "Healthy Start for Babies"). If there is no site-level name, the grantee can enter the Grantee Primary Organization name entered in Section 1.

Street Address 

• This is a required field, and the grantee must enter the street address of the site. The following validation will display on the data entry box: Provide a response for this field

City

• This is a required field, and the grantee must enter the city of the site. The following validation will display on the data entry box: Provide a response for this field

State

• This is a required field, and the grantee must enter the state of the site. The following validation will display on the data entry box: Provide a response for this field

Zip Code

• This is a required field, and the grantee must enter the zip code of the site. This field will only accept 5 digit numeric entry and the following validation will display on the data entry box: Enter a 5 digit Zip Code

+Add Row: Grantee must click this button to add another site.

x Delete: Grantee must click this to delete a site.

section 2

The grantee must click on Save or Save and Continue buttons before navigating away from this form to ensure all data entered is saved successfully.

• The Save button will save the validated information captured in the form and the grantee will remain on the same form.
• The Save and Continue button will save the validated information and the grantee will navigate to the next form.
• The Go to Previous Form button will navigate the grantee to the previous form without saving any previously unsaved information.