Tag Archives: Nursing Workfroce Diversity

The Narrative Should Use the Headers the Funder Says It Should Use: HRSA’s Health Start Initiative (HSI)

A few days ago I was describing some of the weirder sections in HRSA’s Healthy Start Initiative: Eliminating Disparities in Perinatal Health (HSI) program to my fiancée, and between the time I started and the time she fell asleep I mentioned that a proposal’s disjointedness often comes not from the writer but from the RFP. Proposals aren’t written for humans; they’re written for bureaucrats. That’s true for most federal proposals, some state proposals, fewer local proposals, and least of all for reasonably unstructured foundation proposals.

Way back in 2012 we wrote “Upward Bound means more narrative confusion,” which described how that RFP “practically hide[s] the location of the material you’re supposed to respond to.” Today I’d like to talk about an exciting, sexy, related topic: HSI (which is due tomorrow). Like Upward Bound, it has two logical places that a moderately intelligent writer could use to structure the narrative: the first is on page 22 of the RFP, which says things like: “INTRODUCTION — Corresponds to Section V’s Review Criterion 1.”

Notice the language used: “Corresponds to Section V’s Review Criterion 1.” Review Criterion 1 starts on page 43, and it has very clear section headers that could be used to structure a fairly clean and clear proposal. I was tempted to use them and I bet a lot of other people have used them in the past, since HRSA put a simple but easily missed instruction on page 22: “Use the following section headers for the Narrative.”

That instruction should be and is the end of the debate. Because of it, anyone who uses the page 43 Review Criteria is doing it wrong. As always with grant writing, it may be possible to do it wrong and then get funded anyway, but you should always err on the side of obeying the RFP.

As you might imagine, we’ve had some… discussions… around this issue with clients. I’ll leave the nature of those discussions intentionally euphemistic, but in the meantime I will note that they should not have been as long or contentious as they were.

HRSA proposals are particularly finicky with narrative starts. The Nursing Workforce Diversity (NWD) Program, for example, has the same weird, bifurcated structure, in which the narrative beings on page 10 and the review criteria on page 21. It isn’t as monstrous as HSI—the final submission package is 65 pages max, as opposed to HSI’s 100 pages, and the RFP is correspondingly shorter—but it does the same confusing thing.

From a writer’s perspective, the (imperfect) solution is to write with the mandated narrative headers and then make sure that the response hits all the review criteria. If it doesn’t, pick up some of the language from the response and then use that as a jumping off section for a paragraph. For example, HSI has a review criterion that starts, “The extent to which the proposed quality improvement plan describes an ongoing/continuous overall management approach…” and you should answer it by saying, “The proposed project will implement a quality improvement plan describes an ongoing/continuous overall management approach by creating a database that will be used by CHWs to…”

That’s a nice thing to do for the reviewers, because it allows them to check the box and ideally give you the maximum number of points possible. It would be even smarter to make the narrative instructions and review criteria identical, but HRSA evidently isn’t yet that evolved—which makes our job harder. But if we wanted an easy job, we would have become lion tamers.