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H H S Department of Health and Human Services
Health Resources and Services Administration
Maternal and Child Health

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Title V Maternal and Child Health Services Block Grant Program

Enacted in 1935 as a part of the Social Security Act, the Title V Maternal and Child Health Program is the Nation’s oldest Federal-State partnership. For over 75 years, the Federal Title V Maternal and Child Health program has provided a foundation for ensuring the health of the Nation’s mothers, women, children and youth, including children and youth with special health care needs, and their families. Title V converted to a Block Grant Program in 1981.

Specifically, the Title V Maternal and Child Health program seeks to:

  1. Assure access to quality care, especially for those with low-incomes or limited availability of care;
  2. Reduce infant mortality;
  3. Provide and ensure access to comprehensive prenatal and postnatal care to women (especially low-income and at risk pregnant women);
  4. Increase the number of children receiving health assessments and follow-up diagnostic and treatment services;
  5. Provide and ensure access to preventive and child care services as well as rehabilitative services for certain children;
  6. Implement family-centered, community-based, systems of coordinated care for children with special healthcare needs; and
  7. Provide toll-free hotlines and assistance in applying for services to pregnant women with infants and children who are eligible for Title XIX (Medicaid).

The Maternal and Child Health Services Block Grant includes State Formula Block Grants, Special Projects of Regional and National Significance (SPRANS), and Community Integrated Service Systems (CISS) projects. Section 502 of the Social Security Act states that of the amounts appropriated, up to $600,000,000, 85% is for allocation to the States, and 15 % is for SPRANS activities. Any amount appropriated in excess of $600,000,000 is distributed as follows: 12.75% is for CISS activities; of the remaining amount, 85% is for allocation to the States, and 15% is to support SPRANS activities. Individual State allocations are determined by a formula which takes into consideration the proportion of the number of low-income children in a State compared to the total number of low-income children in the United States.

State Maternal and Child Health agencies (which are usually located within a State health department) apply for and receive a formula grant each year. In addition to the submission of a yearly application and annual report, State Title V programs are also required to conduct a State-wide, comprehensive Needs Assessment every five years. States and jurisdictions use their Title V funds to design and implement a wide range of Maternal and Child Health and Children with Special Health Care Need activities that address National and State needs.
Unique in its design and scope, the Maternal and Child Health Block Grant to States program:

  1. Focuses exclusively on the entire maternal and child health population;
  2. Encompasses infrastructure, population-based, enabling, and direct services for the maternal and child health population;
  3. Requires a unique partnership arrangement between Federal, State and local entities;
  4. Requires each State to work collaboratively with other organizations to conduct a State-wide, comprehensive Needs Assessment every 5 years;
  5. Based on the findings of the Needs Assessment, requires each State to identify State priorities to comprehensively address the needs of the MCH population and guide the use of the Maternal and Child Health Block Grant funds; and
  6. May serve as the payer of last resort for direct services for the maternal and child health population that are not covered by any other program.

SPRANS projects support research and training, genetics services and newborn screening, and treatments for sickle cell disease and hemophilia. CISS projects seek to increase local service delivery capacity and foster comprehensive, integrated, community service systems for mothers and children.

Title V Maternal and Child Health Block Grants to States

States and jurisdictions must match every $4 of Federal Title V money that they receive by at least $3 of State and/or local money. This “match” results in more than $6 billion being available annually for maternal and child health programs at the State and local levels. At least 30 percent of Federal Title V funds are earmarked for preventive and primary care services for children and at least 30 percent are earmarked for services for children with special health care needs. States and jurisdictions may spend no more than 10 percent of Federal Title V funds on their administrative costs. The level of expenditure for each State’s and jurisdiction’s maternal and child health programs must also equal the amount provided in 1989.

A total of 59 States and jurisdictions receive Title V Maternal and Child Health Block Grant funding. In fiscal year 2009, State Title V programs served over 39 million individuals. Among the individuals served were 2.5 million pregnant women, 4.1 million infants,
27.6 million children, and 1.9 million children with special health care needs.

The Maternal and Child Health Bureau has worked with the State Maternal and Child Health programs to build a data capacity at both Federal and State levels that supports the program’s performance and outcome measures. States and jurisdictions report annually on their program activities and their performance relative to 18 National Performance Measures, 9 Health Systems Capacity Indicators, 6 National Outcome Measures and
12 Heath Status Indicators. In addition, each State develops between 7 and 10 State Performance measures to address identified priorities and unique needs to the extent that these needs are not addressed by the National measures. Federal efforts have centered on the development of a client-based data system to more accurately capture the direct, enabling and population-based services that are provided by States.

Title V Information System

The Title V Information System (TVIS) electronically captures data from the annual Title V Maternal and Child Health Block Grant applications and reports. TVIS is a web-based, searchable database that captures key financial, program and performance/indicator data as reported by the State Title V Maternal and Child Health programs. State-by-State, as well as Regional and National composite data, can be searched, viewed, and printed. Other available information includes each State’s and jurisdiction’s five-year Needs Assessment, the narrative sections and data forms from each State’s and jurisdiction’s most recent application and annual report, and the contact information for each State’s and jurisdiction’s Title V Maternal and Child Health Director and Children with Special Health Care Needs Director.

Discretionary Grant Information System (DGIS)

The Discretionary Grant Information System (DGIS) electronically captures data from the nearly 900 discretionary grant awards made each year. Many of these grants are supported under the Title V Maternal and Child Health Block Grant Federal set-aside programs (SPRANS and CISS). The DGIS electronically captures annual financial, performance measure, program and abstract data for the Bureau’s discretionary grants. These data help assess the effectiveness of the programs and to ensure that quality health care is available to the Nation’s maternal and child health populations. Released in October 2004, the DGIS is a web-based system that allows grantees to report their data online to the Maternal and Child Health Bureau through the Health Resources and Services Administration’s Electronic Handbooks as part of the grant application and performance reporting processes. The data displayed in the financial data and performance reports are aggregated to report program data.

A clinician with a mother and infant patient

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