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Title V Block Grant Program has as a general purpose the improvement
of the health of all mothers and children in the nation, in keeping
with the national health objectives established by the Public Health
Service Act for the year 2010. The Block Grant Program has three components:
Formula Block Grants to 59 States and other political jurisdictions,
Special Projects of Regional and National Significance (SPRANS), and
Community Integrated Service Systems (CISS) Grants.
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Formula Block
Grants to 59 States and Jurisdictions
The specific purpose of the Title V Block Grants to the
States is the creation of federal-State partnerships to develop service
systems in our nation's communities that can meet the critical challenges
facing maternal and child health, including
- Significantly
reducing infant mortality
- Providing
comprehensive care for women before, during, and after pregnancy
and childbirth
- Providing
preventive and primary care services for children and adolescents
- Providing
comprehensive care for children and adolescents with special health
care needs
- Immunizing
all children
- Reducing adolescent
pregnancy
- Preventing
injury and violence
- Putting into
community practice national standards and guidelines (e.g., prenatal
care; healthy and safe child care; and health supervision of infants,
children, and adolescents)
- Ensuring access
to care for all mothers and children
- Meeting the
nutritional and developmental needs of mothers, children, and
families
The conceptual
framework for the Title V Block Grants to the States is illustrated
in the figure below. Once a State's maternal and child health (MCH)
priorities are determined, resources are allocated to activities
that specifically address those priorities. The collective efforts
of all States, in all levels of the pyramid, contribute to the national
health of mothers and children.
The performance of the activities within each of the pyramid levels,
collectively and individually, is measured by capacity, process, and
risk factor performance measures. Program capacity, which includes
delivery systems, workforce, policies, support systems, and other
infrastructure, measures the strength of the human and material resources
necessary to meet public health obligations. Process results are indicators
of activities, methods, and interventions that support the achievement
of outcomes (such as improved health status). Risk factor results
answer the questions, "Why should the State address this issue?" and
"What health benefits will this create?"
State Requirements
States prepare and transmit a standardized grant request
based on the Block Grant Guidance, a comprehensive resource book of
required application forms and submission guidelines. There are major
requirements in the application, including a Statewide needs assessment,
a plan for meeting the needs identified by that assessment, and other
specific items on which States must report.
The Title V Block Grant Program requires that every $4 of federal
Title V money must be matched by at least $3 of State and local money.
This "match" results in the availability of more than 2 billion additional
dollars for MCH programs annually at the State and local level. The
program also requires that a minimum of 30% of federal Block Grant
funds be used to support services for CSHCN and that a minimum of
30% of federal funds be used to provide preventive and primary care
services for children. The States may spend no more than 10% of federal
Title V funds on administrative costs. This partnership with the States
provided nearly $2.7 billion in FY 1997 for services and programs
at the State and local level.
State MCH programs, usually housed in each State's department of health,
meet their Title V Block Grant responsibilities through a wide range
of programs, with specific goals for
- Reducing morbidity
and mortality by assuring pregnant women, infants, children, and
adolescents full access to quality, community-based preventive
and primary care
- Developing
family-centered, coordinated, community-based systems of care
- Participating
in interagency coordination, especially with Medicaid; Women,
Infants, and Children (WIC) Supplemental Foods program;
Individuals with Disabilities in Education Act (IDEA); and other
children's health, education, and social services programs
- Providing
rehabilitative services to SSI recipients under age 16 who are
not covered by Medicaid
- Linking Title
V efforts to national year 2010 objectives
- Conducting
comprehensive needs assessments every 5 years and preparing annual
plans as part of a standardized application process
- Submitting
to MCHB State annual reports reviewing program developments, health
status and service data, and progress in meeting State and national
health objectives
Special Projects
of Regional and National Significance
Activities supported under Special Projects of Regional and
National Significance (SPRANS) include MCH research, training, genetic
services, hemophilia diagnostic and treatment centers, and MCH improvement
projects that support a broad range of innovative strategies. In
FY 1999, MCHB funded approximately 478 SPRANS grants, providing
a total of $102 million. In addition, $5 million in SPRANS funds
will support the Traumatic Brain Injury (TBI) Demonstration Grant
Program, which provides grants to States to implement systems that
ensure access to comprehensive and coordinated TBI services.
Community Integrated Service Systems
The Community Integrated Service Systems (CISS) program seeks
to reduce infant mortality and improve the health of mothers and
children by funding projects for the development and expansion of
integrated services at the community level. In FY 1999, 143 CISS
grants will be awarded, totaling $12 million.
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