Division of State and Community Health (DSCH)

The work of all Maternal and Child Health Bureau divisions, programs, and staff is in support of the Bureau’s Strategic Plan (2003-2007) for meeting the needs of the maternal and child health populations of the United States and its Jurisdictions. The Bureau focuses—through leadership, performance, and accountability—on accomplishment of five over-arching goals: 1) Provide National Leadership for Maternal and Child Health; 2) Promote an Environment that Supports Maternal and Child Health; 3) Eliminate Health Barriers and Disparities; 4) Improve the Health Infrastructure and Systems of Care, and 5) Assure Quality of Care. The Bureau’s progress—or accountability—toward goal achievement is reported annually.

The Division of State and Community Health (DSCH) is one of five divisions of the HRSA’s MCHB. DSCH provides national leadership, direction, and administrative oversight for the Title V MCH Services Block Grant Program, the State Systems Developments Initiative (SSDI) and the Association of Maternal and Child Health Programs’ Cooperative Agreement. The Division is the Federal Government’s primary liaison with each of the 59 States’ and jurisdictions’ MCH programs.

MCH Services Block Grant Program (Title V)
Enacted in 1935 as a part of the Social Security Act, the Title V MCH Services Block Grant program is the Nation’s oldest Federal-State partnership. For over 70 years, the MCH Block Grant has provided a foundation for ensuring the health of the Nation’s mothers and children. Today, State MCH agencies, which are usually located within a State health department, apply for and receive a formula grant each year.

Every $4 of Federal Title V money received must be matched by at least $3 of State and/or local money. This “match” results in there being more than $5 billion annually available for MCH programs at the State and local level. At least 30 percent of Title V Federal funds is earmarked for preventive and primary care services for children, and at least 30 percent is earmarked for services for children with special health care needs.

Title V MCH Block Grant requirements include:

• Reducing infant mortality and incidence of handicapping conditions among children;
• Increasing the number of children appropriately immunized against disease;
• Increasing the number of children in low-income households who receive health assessments and follow-up diagnostic and treatment services;
• Providing and ensuring access to comprehensive perinatal care for women; preventive and child care services; comprehensive care, including long-term care services for children with special health care needs; and rehabilitation services for blind and disabled children under 16 years of age who are eligible for Supplemental Security Income (SSI); and
• Facilitating the development of comprehensive, family-centered, community-based, culturally competent, coordinated systems of care for children with special health care needs and their families.

Division responsibilities for liaison with the 59 States and Jurisdictions in this program include:

• Preparation of grant application guidance documents for the States;
• Clarification of application and reporting requirements;
• Review, negotiation, and approval of grant applications from States;
• Support of technical assistance and consultation related to Title V; and
• Management and supervision of a national, web-based information and data system (Title V Information System (TVIS)) for the Title V MCH Services Block Grant program, which is accessible on the World Wide Web at: https://perfdata.hrsa.gov/mchb/mchreports.
  
  Title V Information System
  Every year, each State provides an application and annual report to the Division on the status of its maternal and child health. The Division compiles the data and makes them available to everyone via the new TVIS’s online searchable database at https://perfdata.hrsa.gov/mchb/mchreports. State-by-State, as well as regional and national composite data, can be searched, viewed, and printed. Data include annual expenditures, numbers served, national performance and outcome measures, State-defined performance measures, Health Status Indicators, Health Systems Capacity Indicators and the frequency of public access of State MCH toll-free phone lines. Data also include statistics on infant mortality, prenatal care, childhood immunizations, and other measures of how well the Nation is caring for the health of its mothers and children. (The TVIS’s database can also be reached through the official MCHB site: www.mchb.hrsa.gov.)

State Systems Development Initiative
SSDI, launched in 1993, complements the Title V MCH Block Grant Program.  The purpose of the SSDI projects is to assure that the Title V agencies have access to policy and program relevant information and data.  SSDI assists State Agency MCH and Children with Special Health Care Needs (CSHCN) programs in the building of State and community infrastructure.  SSDI projects aid the Title V agencies with their ongoing MCH Needs Assessments, determining performance and outcome measures, and the setting of State priorities.  The efforts of the SSDI projects results in comprehensive, community-based systems of care for the population groups that include preventive and primary care services for pregnant women, mothers, and infants; preventive and primary care services for children, and services for CSHCN.

Title V Programs Work to:

• Reduce the number of infants who die before their first birthday to no more than 4.5 in one thousand births.
• Prevent mental retardation, neurological problems and other serious effects caused by metabolic disorders, such as PKU (phenylketonuria), through screenings at birth and early intervention and treatment.
• Assure that high-risk pregnant women and their infants are delivered at hospitals that can provide them with the appropriate level of care.
• Immunize infants and children against serious preventable illnesses including Measles, Mumps, Rubella, Polio, Diptheria, Tetanus, Pertussis, Haemophilus Influenza, and Hepatitis B.
• Reduce the number of children and adolescents who die or sustain serious injuries from motor vehicle crashes.
• Assure that every infant, child, adolescent, and child with special health care needs has a “medical/health home.”
• Increase the number of children who receive dental services.

For more information, contact the DSCH at 301-443-2204.