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Federal-State Partnership

The U.S. Maternal and Child Health (MCH) Program is a partnership among the federal government, states, and local communities to promote the health of children and youth, mothers, and families. The federal role in this partnership includes:

  • administration of the MCH Services block grants to the 50 states and nine U.S. jurisdictions;
  • administration of discretionary grants to various entities involved in MCH;
  • advocacy for MCH at the national level; and
  • development of partnerships with states, communities, public-private groups, and families to strengthen the MCH infrastructure, assure the availability and use of medical homes, and build knowledge and human resources for addressing MCH issues.

The ultimate purpose of the above activities is to assure continued improvement in the health, safety, and well-being of U.S. pregnant women, infants, children, adolescents, and their families: including women of reproductive age, fathers, and children and youth with special health care needs.

Legislative Background and Program Accountability

With adoption of Title V of the Social Security Act (SSA) in 1935, the Federal MCH Program evolved into a “Federal-State” partnership. Federal administration of the program was assigned to the Federal Children’s Bureau. Included in Title V of the SSA was authorization for grants-in-aid to states for MCH programs. In 1981, Federal legislation consolidated the Title V MCH programs and five other categorical health programs into the MCH Services Block Grant (MCH Block Grant), transforming the MCH Program into a “State-Federal” partnership. Because the U.S. Congress expressed concern about lack of information on how Title V funds were being used, amendments made to the MCH Block Grant in 1989 greatly strengthened program accountability. In 1990, the Federal Maternal and Child Health Bureau (MCHB), which now administers the MCH Block Grant Program at the Federal level, was established within the Health Resources and Services Administration, U.S. Department of Health and Human Services.

A crucial part of MCH Block Grant accountability is the responsibility of each recipient of the grant to submit an annual report/application on MCH services and issues to MCHB in July of each year. During most of the year, the most recent of these reports/applications and the Federal guidance for preparing them can be viewed from the Title V Information System’s website. As well, recent “State Snapshots” of MCH can be accessed from this same website.

Content of Maternal and Child Health Block Grant Reports/Applications

The Federal guidance specifies content to be included in each MCH Block Grant report/application, including information on eighteen National Performance Measures, from seven to 10 State Performance Measures, and multiple Health Systems Capacity Indicators and Health Status Indicators. Overall, the document is to include information on the need for:

  • Preventive and primary care services for pregnant women, mothers, and infants up to one year of age.
  • Preventive and primary care services for children and youth.
  • Services, including specialty and subspecialty care and family-centered, community-based, coordinated care for children and youth with special health care needs.

The guidance further specifies that MCH services be described according to the four levels of core public health MCH services:  direct services, enabling services, population-based services, and infrastructure-building services.

For information on children with special health care needs, visit Alabama's Department of Rehabilitation Services website.


a The Children’s Bureau was formed in 1912, became part of the U.S. Department of Labor, and was dismantled in 1969, when the MCH/Title V Program was moved to the U.S. Public Health Service. In 1982, the program, which by then was the MCH Block Grant Program, was moved to the U.S. Department of Health and Human Services.

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