Cite as: U.S. Department of Health and Human
Services. 2008. State MCH-Medicaid Coordination:
of Title V and Title XIX Interagency Agreements
This document was developed for the U.S. Department
of Health and Human Services (HHS), Health Resources
and Services Administration (HRSA), Maternal
and Child Health Bureau (MCHB) under a contract
with Georgetown University.
D. Interagency Agreements (IAAs)
Web Page and Resources
A central goal
of public health is to identify causes of ill
health and to
develop actions to reduce these causes…Interagency
partnerships give a
sense of order to the issues. In maternal and
child health, each issue, in
a sense, is everybody’s business and thus
the various “bodies” need to be
involved in the resolution.
-- Vince L. Hutchins, M.D., M.P.H.
Celebrating Events, delivered at the
Anniversary meeting of The Association for
Maternal and Child Health, March 18, 1985
The Maternal and Child Health (MCH) Services
Block Grant and Medicaid, authorized by Title
V and Title XIX of the Social Security Act (SSA),
serve complimentary purposes and goals.
Coordination and partnerships between the two
programs greatly enhance their respective
abilities, increase their effectiveness, and
guard against duplication of effort. Such coordination
is the result of a long series of legislative
decisions that mandate the two programs to work
together. Interagency Agreements (IAAs), required
by both Title V and Title XIX legislation,
can serve as a key factor in ensuring coordination
and mutual support between the two agencies
(or divisions within an agency) that administer
the two programs.
This publication, now in its second edition,
serves as a tool to provide technical assistance
to State Title V and Medicaid agencies in achieving
successful and required coordination
between their programs, updating seminal work
carried out by the Association of Maternal and
Child Health Programs (AMCHP) in the first edition.
The document begins with a review of
the Federal legislation regarding Title V/Title
XIX IAAs and a summary of how States have
incorporated this legislation and other components
into their IAAs. It continues by presenting
recommended components and methodologies in
developing new IAAs and a “model”
IAA as a
template for States. Finally it highlights “promising
practices” being carried out by States
have developed successful partnerships through
This document is available both in print and
online (with additional electronic resources)
and Child Health Library
State MCH-Medicaid Coordination:
Chapter I of the report serves
as an overview, consisting of:
- A background on Title V, Title XIX, and
partnerships between the two programs.
- An overview of the importance of interagency
Chapter II provides an overview
of the current statutes, regulations, and Federal
regarding Title V and Title XIX collaboration,
focusing on the requirements set forth for Title
and Title XIX agencies.
Chapter III summarizes individual
State interagency agreements (IAAs), focused
components common to the majority of these documents
- A discussion of the documents reviewed and
the scope/limitations of the materials
- An explanation of the review components
used in analyzing the IAAs and examples of
State IAAs that either differ greatly from
or reflect the norm.
- State-by-state analysis of the IAAs based
on specific key components with references
the summary charts included in Chapter V.
Chapter IV focuses on an analysis
of IAA components as well as “best practices”
specific States of varying characteristics (e.g.,
geographic location, economic status of population
served, and racial/ethnic diversity of population)
and consists of:
- An analysis of components that are often
found in successful IAAs.
- Explanations of the importance of each
IAA component and what additional factors
should be considered when drafting new IAAs.
- A “model” IAA that can be modified
by States as a technical assistance tool in
drafting of future IAAs.
- A discussion of methodologies employed
by the Title V agencies in forging meaningful
partnerships with Medicaid.
- Specific examples of the partnership process
and motivating factors as well as problems
and difficulties encountered.
Chapter V presents the State-by-State
summary charts compiled as the basis of analysis
- An explanation of the charts.
- Detailed summaries of the IAAs for each
State based on each of the review components.
- Highlighted text where specific IAA sections
either differ greatly from or reflect the
with cross references back to a more detailed
analysis in Chapter Two.
- Additional State-specific information,
such as contact information, Web sites of
agencies, and links to full-text versions
of each IAA analyzed.
Interagency Agreement (IAA) Web Page and Resources
This publication and additional electronic
resources are available through the MCH Library
site at http://www.mchlibary.info/IAA. This
electronic “toolkit” includes:
- Links to the full-text document.
- Each IAA reviewed (in PDF and/or Word versions,
- Links to background print resources, to
State agencies profiled, and to Web sites
maintain data on State contacts, Title V and
Medicaid agencies, and MCH hotline
- A database of the State IAAs, searchable
by State, region, and keyword.
- An online glossary of terms and links to
glossaries used by Title V and Title XIX