Appendices
Appendix A: Title V and Title XIX Resources
Appendix B: List of Abbreviations
Appendix C: Glossary
Appendix D: Supplemental Figures
Appendix E: Document Development
Appendix
A: Title V and Title XIX Resources
The following recent resources
provide additional information and are available
electronically.
Title V/Title XIX
Coordination
Association of Maternal and Child Health Programs.
2005. AMCHP Fact Sheet: Working Together –
The Relationship Between MCH Title V and Medicaid.
2005. Washington, DC: Association of Maternal
and Child Health Programs. Available at http://www.amchp.org/aboutamchp/publications/web/working-together-mch-and-medicaid.php.
Webcast.
Enhancing Partnerships Between Title V, Medicaid,
and Local Health Departments Through EPSDT.
Title V
Association of Maternal and Child Health Programs.
The
Title V Block Grant.
U.S. Department of Health and Human Services,
Health Resources and Services Administration,
Maternal and Child Health Bureau. Maternal
and Child Health Services Title V Block Grant
Program: Guidance and Forms for the Title V
Application/Annual Report (Expires
May 31, 2009).
U.S. Department of Health and Human Services,
Health Resources and Services Administration,
Maternal and Child Health Bureau. Understanding
Title V of the Social Security Act: A Guide
to the Provisions of the Federal Maternal and
Child Health Block Grant.
Title XIX/Medicaid
American Academy of Pediatrics and National
Association of Children’s Hospitals. State-by-State
Medicaid Fact Sheets. July 2005.
Centers for Medicare and Medicaid Services.
Medicaid:
A Brief Summary.
Centers for Medicare and Medicaid Services.
State
Medicaid Manual.
.
Kaiser Commission on Medicaid and the Uninsured.
2006. Deficit
Reduction Act of 2005: Implications for Medicaid.
Washington, DC: Kaiser Commission on Medicaid
and the Uninsured.
Appendix B: List of Abbreviations
The following list of abbreviations are those
used throughout this document and are commonly
used in the field. A glossary of select terms
follows this list.
ACF: Administration for Children
and Families
AMCHP: Association of Maternal
and Child Health Programs
BBA: Balanced Budget Act
BIPA: Benefits Improvement
and Protection Act
BPHC: Bureau of Primary Health
Care
CDC: Centers for Disease Control
and Prevention
CFR: Code of Federal Regulations
CISS: Community Integrated
Service Systems
CMS: Centers for Medicare and
Medicaid Services
CSHCN: Children with Special
Health Care Needs
CYP: Children and Youth Projects
EPSDT: Early and Periodic Screening,
Diagnostic and Treatment
DSH Payments: Disproportionate
Share Hospital Payments
FFP: Federal Financial Participation
FPL: Federal Poverty Level
FQHC: Federally Qualified Health
Center
FMAP: Federal Medical Assistance
Percentage
GU: Georgetown University
HHS: U.S. Department of Health
and Human Services
HIPAA: Health Insurance Portability
and Accountability Act
HMO: Health Maintenance Organization
HRSA: Health Resources and
Services Administration
IAA: Interagency Agreement
MCH: Maternal and Child Health
MCHB: Maternal and Child Health
Bureau
MCO: Managed Care Organization
MIC: Maternal and Infant Care
NCHS: National Center for Health
Statistics
NPM: National Performance Measure
OBRA: Omnibus Budget Reconciliation
Act
PHS: Public Health Service
PIC: Partnership in Communication
Interorganizational Workgroup
SCHIP: State Children’s
Health Insurance Program
SIDS: Sudden Infant Death Syndrome
SPM: State Performance Measure
SPRANS: Special Projects of
Regional and National Significance
SSA: Social Security Act
SSI: Supplemental Security
Income
TANF: Temporary Assistance
for Needy Families
Title V IS (TVIS): Title V
Information System
WIC: Women, Infants, and Children
Program
Appendix
C: Glossary
The following list of terms related to Title
V and Title XIX is not meant to be comprehensive,
but to serve as an introductory quick-reference.
For more information, see the (1) the Glossary
of the Title V Guidance at http://www.mchdata.net;
(2) the Medicaid Glossary (in English and Spanish)
at http://www.cms.hhs.gov/glossary; and/or (3)
the MCH Leadership Skills Training Institute
Glossary at http://www.soph.uab.edu/mch-leadership/resources.htm.
Beneficiary: A person who
is eligible for and enrolled in a Medicaid or
similar program.
Block Grant: Also known as
a “formula grant,” a transfer of
a capped amount of Federal funds to States and/or
local governments for broad purposes such as
health. A block grant usually gives States larger
discretion on how the funds are to be used.
Categorical Eligibility: Medicaid’s
policy of providing services to individuals
in specified groups (e.g., children, senior
citizens, persons with disabilities).
Categorically Needy: Specified
groups of Medicaid beneficiaries who qualify
for basic benefits. These groups include pregnant
women and infants (1) with incomes at or below
133 percent of the FPL (who States participating
in Medicaid are required to cover); and (2)
with incomes between 133-185 percent of the
FPL (who States participating in Medicaid have
the option to cover).
Centers for Medicare and Medicaid Services
(CMS): [Formerly Health Care Financing
Administration (HCFA)]. The agency under the
U.S. Department of Health and Human Services
that administers Medicare, Medicaid, and SCHIP.
Online at http://www.cms.hhs.gov.
Children’s Health Insurance Program
: SEE State Children’s Health
Insurance Program.
Children with Special Health Care Needs
(CSHCN): Individuals from birth through
age 21 who have health problems requiring more
than routine and basic care
Community Integrated Service Systems
(CISS) Discretionary Grants: Seek to
reduce infant mortality and improve the health
of mothers and children – including those
living in rural areas and those with special
health care needs – by funding projects
for the development and expansion of integrated
services at the community level. Such projects
include health home visiting programs; projects
to increase participation of health care providers
under Title V and Title XIX programs; integrated
MCH service delivery systems; MCH centers providing
pregnancy, preventive, and primary care services;
MCH projects to serve rural populations; and
outpatient and community-based services programs
for CSHCN.
Discretionary Grant: An award
of money or supplies by the Federal government,
usually awarded through a competitive review
process.
Disproportionate Share Hospital (DSH)
Payments: Additional payments to hospitals
that serve large populations of patients with
low incomes.
Early and Periodic Screening, Diagnostic,
and Treatment (EPSDT) Services: States
must provide periodic screenings to identify
physical (including vision, hearing and dental)
and mental conditions, to Medicaid-eligible
children under age 21. State Title V and Medicaid
agencies are required to participate in coordination
of EPSDT services.
Entitlement Program: A program
(such as Medicaid and Medicare) that requires
the Federal government to provide a specified
service to identified persons. Spending is determined
through the program’s eligibility criteria,
not by a specific level of funding.
Federal Financial Participation (FFP):
Federal matching funds paid to States to cover
Medicaid services or administrative costs.
Federal Medical Assistance Percentage
(FMAP): Also know as the “Federal
Medicaid matching rate,” it is the share
that the Federal government provides for Medicaid
services or administration dependant on a State’s
per capita income. While it varies from 50-83
percent, it averages to 57 percent across the
States.
Federal Poverty Level (FPL):
The definition of poverty used as the income
standard for certain categories of beneficiaries.
The current HHS Poverty Guidelines and related
materials are available online at http://aspe.hhs.gov/poverty.
Federally Qualified Health-Center (FQHC)
Services: FQHC Services are primary
and other ambulatory care services provided
by community health centers and migrant health
centers receiving grants under section 330 of
the Public Halth Service Act, certain tribal
organizations, and FQHC Look-Alikes. States
are requied to include services provided by
FQHCs in their basic Medicaid benefit package
as well as benchmark benefit packages.
Financial Eligibility: Medicaid’s
policy of providing services to individuals
with limited income. Financial eligibility varies
by State and category.
Formula Grant: SEE Block Grant.
Health Insurance Portability and Accountability
Act (HIPAA): Requires State Medicaid
programs to use national codes for electronic
transmission of information related to health
claims and to have a Medicaid Management Information
System (MMIS).
Health Maintenance Organization (HMO):
A plan that provides health care from specific
doctors and/or hospitals within a set plan.
Interagency Agreement (IAA):
A binding agreement between two or more agencies
(or divisions within a single agency) that specify
the roles and responsibilities of the participating
agencies. IAAs can serve as a major resource
in coordinating activities and providing mutual
support between the agencies.
Managed Care Organization (MCO):
A type of Managed Care Entity (MCE) that provides
certain benefits to Medicaid beneficiaries for
a monthly capitation payment for each beneficiary
as set forth in a State contract.
Medicaid: The Federal/State
program that pays for medical assistance for
certain individuals and families with low incomes.
Assists States in providing medical long-term
care to people who meet defined eligibility
requirements.
Medical Assistance: Payment
for services covered under a State’s Medicaid
program.
Medically Needy: Beneficiaries
who qualify for Medicaid coverage because of
high medical expenses.
Performance Measure: A description
of a specific health need, that when addressed
will improve that health outcome in a defined
place and time frame.
Population Based Services:
Preventive services developed for the entire
population rather than for beneficiaries in
an individual basis.
Prepaid Inpatient Health Plan (PIHP):
A health plan that provides less than
comprehensive inpatient services on an at-risk
reimbursement basis.
Presumptive Eligibility Period:
The time period between when a provider determines
that a beneficiary’s income does not exceed
the eligibility threshold until a formal eligibility
determination is made by the State Medicaid
agency.
Preventive Services: Those
that are aimed at reducing health problems,
disease, or personal risk factors for such conditions.
Risk Factors: Scientifically
established direct and indirect causes of morbidity
and mortality.
Social Security Act (SSA):
Full
text of Title V and Title XIX of the SSA
are available online.
Special Projects of Regional and National
Significance (SPRANS) Grants: Activities
under SPRANS include MCH research; training
grants; genetic disease testing, counseling,
and information dissemination; hemophilia diagnostic
and treatment centers; and other special MCH
improvement projects that support a broad range
of innovative strategies.
State: In this document, State
refers to the 50 States, the District of Columbia,
and the 9 political jurisdictions.
Supplemental Security Income (SSI):
A Federal entitlement program that provides
monetary assistance to specific beneficiaries.
In most States (with the exception of Section
209(b) States), SSI beneficiaries are also eligible
for Medicaid.
State Children’s Health Insurance
Program (SCHIP): A Federal-State matching
health care block grant program for uninsured
low-income children. Children who are eligible
for Medicaid are not eligible for SCHIP, although
States can administer SCHIP through their Medicaid
programs.
Temporary Assistance for Needy Families
(TANF): A Federal block grant program
that provided matching funds and services to
States for low-income families with children.
Title V: Enacted by Congress
in 1935 as part of the Social Security Act,
the only legislation to promote and improve
the health of all mothers and children. Title
V authorized the creation of the MCH programs,
providing the infrastructure to achieve this
mission.
Title XIX: Enacted by Congress
in 1965 as part of the Social Security Act,
the legislation that authorizes the Medicaid
program that pays for medical assistance for
certain individuals and families with low incomes
who meet defined eligibility requirements.
Appendix
D: Supplemental Figures
Supplemental Figure 1:
The MCH Pyramid of Health Services
Supplemental Figure 2:
Recent Title V Block Grant Appropriations
Fiscal Year |
Appropriation |
1993 |
$664,534,000 |
1994 |
$687,034,000 |
1995 |
$683,950,000 |
1996 |
$678,034,000 |
1997 |
$681,000,000 |
1998 |
$681,079,404 |
1999 |
$699,777,000 |
2000 |
$710,000,000 |
2001 |
$714,230,000 |
2002 |
$731,615,000 |
2003 |
$729,965,000 |
2004 |
$729,800,000 |
2005 |
$723,900,000 |
2006 |
$693,000,000 |
Source: The Association of Maternal and Child
Health Programs, Recent Funding History for
the Title V Maternal and Child Health Block
Grant.
Supplemental Figure 3:
Coverage for Personal Health Care Spending
[D]
Appendix
E: Document Development
The first edition of 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 cooperative agreement
with the Association of Maternal and Child Health
Programs (AMCHP).
This edition was 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.
An Expert Panel provided review of the entire
document:
Christopher Dykton, M.A., Science Applications
International Corporation
Catherine Hess, M.S.W., National Academy for
State Health Policy
Kay Johnson, M.P.H., Ed.M., Johnson Consulting
Group
Neva Kaye, B.S., National Academy for State
Health Policy
Several Title V directors reviewed Chapters
Three and Four:
Jane Borst, Iowa Department of Public Health
Carlos Cano, M.D., Maternal and Family Health
Administration, District of Columbia
Linda Hale, R.N., BSN, EMT, Wisconsin Department
of Health and Family Services
Richard Nugent, M.D., Arkansas Department of
Health and Human Services
Valerie J. Ricker, M.S.N., M.S., Division of
Family Health, Maine
David Suttle, M.D., Office of Family Health
Services, Commonwealth of Virginia
Karen Trierweiler, Office of Maternal and Child
Health, Colorado
Several staff, faculty, and researchers from
the Maternal and Child Health Bureau and Georgetown
University served as additional reviewers and
content/health education experts.
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