This report focuses on the MCH Services Block Grant, which receives the largest single appropriation under Title V. The MCH Services Block Grant is administered by the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA) in the Department of Health and Human Services (HHS). Goals

Title V of the Social Security Act established seven broad goals for the MCH Services Block Grant. Programs and Services

The primary use of funds under the MCH Services Block Grant, including formula grants to states, discretionary grants for Special Projects of Regional and National Significance (SPRANS), and discretionary grants for Community Integrated Services Systems (CISS), is to fill gaps in core public health services for low-income mothers and children. Title V programs, including the Maternal and Child Health Services Block Grant, serve women and children who are covered by public and private insurance, as well as those who have no insurance coverage. Use of Block Grant Funds

Block grants to states provide funding for core public health services provided by maternal and child health agencies. The four levels of services are infrastructure building, population-based, enabling, and direct health care, as illustrated in Figure 1 . Approximately 15% of MCH Services Block Grant funds are set aside for SPRANS programs. Strategies used include maternal and infant health home visiting; projects to increase participation of obstetricians and pediatricians in Title V and Medicaid; integrated maternal and child health service delivery systems; maternal and child health centers providing pregnancy services for women and preventive and primary care services for infants (up to one year) that operate under the direction of a not-for-profit hospital; maternal and child health projects to serve rural populations; and outpatient and community-based services programs for children with special health care needs who are primarily treated through inpatient institutional care. Of the amount appropriated, an estimated $550.8 million was for block grants to states (86%), $77.1 million was for SPRANS (12%), and $10.3 million was for CISS (2%). The President's budget requested $638.2 million for the program for FY2017. Funding for the MCH Services Block Grant is discretionary and subject to the annual appropriations process. Full-year appropriations for FY2017 have yet to be enacted. Program Participation and Maternal and Child Health Reporting at the State and National Levels

The MCH Services Block Grant has several reporting mechanisms required by law: first, the needs assessment, as discussed in a previous section of this report; second, an annual report, including program participation data, state maternal and child health measures, and state pediatric and family workforce measures; third, an independent audit must be performed every two years. HRSA, in turn, must report to Congress on the activities carried out under the SPRANS and CISS programs, in addition to providing a summary of state reports on block grant activities. Program Participation Data

In FY2014, 59 states and jurisdictions received MCH Services Block Grant Funding. Selected measures are presented in this report to provide readers with context on the maternal and child health issues that Congress has chosen to address through the MCH Services Block Grant. Although these and other indicators are referred to as outcome measures and performance indicators by HRSA, and improvement in these measures is an objective of Title V funding, it is important to note that Title V funding is only one component affecting these measures. Other federal and state programs and policies, including Medicaid, and WIC, as well as complex societal issues, also substantially affect the health and well-being of low-income children and their families.
The Maternal and Child Health (MCH) Services Block Grant program, authorized under Title V of the Social Security Act, is a flexible source of funds that states use to support maternal and child health programs. The program provides grants to states and territories to enable them to coordinate programs, develop systems, and provide a broad range of direct health services. In addition to block grants to states, the MCH Services Block Grant includes a set-aside for Special Projects of Regional and National Significance (SPRANS), and another set-aside for the Community Integrated Service Systems (CISS) program. The Maternal and Child Health Bureau of the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS) administers the block grant. The Maternal and Child Health Bureau of HRSA also receives funding for other maternal and child health programs authorized under both Title V of the Social Security Act and the Public Health Service Act, including maternal and infant home visiting and autism services.
The MCH Services Block Grant received an appropriation of $638.2 million in FY2016. Of that amount, an estimated $550.8 million was for block grants to states (86%), $77.1 million was for SPRANS (12%), and $10.3 million was for CISS (2%). The President's budget requested the same amount for the program in FY2017. Funding for the MCH Services Block Grant is discretionary and subject to the annual appropriations process. Full-year appropriations for FY2017 have yet to be enacted.
Title V programs, including the MCH Services Block Grant, serve women and children who are covered by public and private insurance, as well as those who have no insurance coverage. MCH Services Block Grant funds are distributed for the purpose of funding core public health services provided by maternal and child health agencies. These core services are often divided into four categories: infrastructure-building, population-based, enabling, and direct health care. A wide array of programs is supported in each of these categories, including newborn screening, health services for children with special health care needs, and immunization programs. Another main objective of the MCH Services Block Grant is to increase pediatric workforce capacity, and to link low-income children and families to other services and programs, such as Medicaid.
To receive MCH Services Block Grant funds, states are required to (1) conduct a needs assessment every five years; (2) provide an annual report, including program participation data, state maternal and child health measures, and state pediatric and family workforce measures; and (3) ensure that an independent audit is performed every two years. HRSA, in turn, must report to Congress on the activities carried out under the SPRANS and CISS programs, in addition to providing a summary of state reports on block grant activities.
This report provides MCH Services Block Grant background and funding information. It also includes selected program participation data. Selected maternal and child health indicators are presented to provide readers with context on issues that Congress has sought to address through MCH Services Block Grant funding. Although improvement in these measures is an objective of Title V funding, it is important to note that Title V funding is only one component affecting these measures. Other federal and state health and social services policies, as well as complex societal issues, substantially affect these measures and maternal and child health in general.