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Updated March 7, 2018
Maternal and Child Health (MCH) Services Block Grant
The Maternal and Child Health (MCH) Services Block
Grant is a federal-state partnership program that aims to
improve the health of low-income pregnant women,
mothers, and children. In addition, the program aims to
connect low-income families with other services and
programs, such as Medicaid and the State Children's Health
Insurance Program (CHIP). The MCH Services Block
Grant program is administered by the Maternal and Child
Health Bureau (MCHB) of the Health Resources and
Services Administration (HRSA) in the Department of
Health and Human Services (HHS). The program is
authorized under Title V of the Social Security Act of 1935
(SSA; P.L. 74-121).
The MCH Services Block Grant program has three
components: (1) block grants to states, (2) the Special
Projects of Regional and National Significance (SPRANS)
program, and (3) the Community Integrated Service
Systems (CISS) program.
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The block grants to states program is a block grant within
the MCH Services Block Grant that provides formula-based
grants to enable states to undertake a number of activities
that, among other things, aim to ensure that quality health
care is provided to mothers and children, particularly to
those with low incomes or limited availability of care.
Block grants to states are awarded to all 50 states, the
District of Columbia, and eight jurisdictions (referred to
collectively as states). The eight jurisdictions are American
Samoa, Federated States of Micronesia, Guam, Marshall
Islands, Northern Mariana Islands, Palau, Puerto Rico, and
the U.S Virgin Islands.
Block grants may be used by states to provide and to
assure [that] mothers and children (in particular those with
low income or with limited availability of health services)
[have] access to quality maternal and child health services
(SSA, §501(a)(1)(A)). States determine the actual services
provided under the block grant. For example, a state may
provide medical services in sectors where public and
private health insurers offer limited coverage options, such
as coverage for dental and durable medical equipment (e.g.,
wheelchairs and oxygen equipment).
Individual state allocations are determined by a formula that
compares the proportion of low-income children in a state
with the total number of low-income children within all
states. Specifically, the first $422 million of the amount
appropriated is distributed to each state based on the
amount the state received under the consolidated maternal
and child health programs in 1983. Any funds above that
amount are distributed based on the number of children in
each state who are at or below 100% of the federal poverty
level (FPL) as a proportion of the total number of children
at or below 100% of the FPL for all states. The 2018 FPL
for a family of four is $25,100.
States are required to use at least 30% of their block grant
allocations for the population of children with special health
care needs (CSHCNS), 30% for services for preventive and
primary care services for children, and 40% for services for
either of these groups or for other appropriate maternal and
child health activities (SSA, §504(d)). However, states may
use no more than 10% of their federal allocations for
administrative costs. CSHCNs are infants and children who
have or are at risk of having a disability, chronic
illness/condition, or educational/behavioral issue.
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SinPlcamic* (SP kANS)
The SPRANS program is a set-aside that provides
competitive grants for research and training programs and
services related to maternal and child health, and CSHCNS.
SPRANS grants are awarded to (1) public or nonprofit
private institutions of higher learning that train health care
and maternal and child health personnel, and (2) public or
nonprofit private organizations or institutions of higher
learning that conduct maternal and child health research.
SPRANS funds may be used for genetic disease testing,
counseling, and information development and
dissemination programs; for grants relating to hemophilia
without regard to age; for the screening of newborns for
sickle cell anemia and other genetic disorders; and for
follow-up services. Generally, the priority for funding
SPRANS projects is determined by HRSA; however,
Congress has sometimes provided specific directives for
certain programs, including set-asides. For example,
Congress provided SPRANS set-aside funds for oral health
($5.24 million), epilepsy ($3.63 million), sickle cell ($2.99
million), and fetal alcohol syndrome ($0.48 million) in
FY2017.
The CISS program is a set-aside that provides competitive
grants to support development and expansion of a variety of
service delivery strategies. CISS grants are awarded to
public and private organizations or institutions.
CISS funds may be used for home visitation, integrated
service delivery systems, services to rural populations,
outpatient and community-based services for CSHCNs, and
increased participation of obstetricians and pediatricians
under Medicaid and the Title X Family Planning program.
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