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1 1 (June 7, 2024)

handle is hein.crs/govepfn0001 and id is 1 raw text is: Congres&on I Resedrch S4 infor inc I icc Ia ive d tate e 191 S June 7, 2024 Title V State Maternal and Child Health (MCH) Block Grants Over e Title V of the Social Security Act (SSA; P.L. 74-121, as amended; 42 U.S.C. §§701-709) permanently authorizes the Maternal and Child Health (MCH) Services Block Grant, which aims to improve the health of pregnant women, mothers, and children, particularly those with low-income or limited access to health services. The MCH Services Block Grant consists of three programs: (1) State MCH Block Grants, (2) Special Projects of Regional and National Significance (SPRANS), and (3) Community Integrated Service Systems (CISS). More information about each of these programs is available in CRS Report R48088, Maternal and Child Health Services Block Grant: Overview and Issuesfor Congress; this CRS In Focus covers the State MCH Block Grant program. Background The State MCH Block Grant program, often referred to in short as Title V, provides formula-based block grants to all 50 states and nine jurisdictions, which include American Samoa, District of Columbia, Federated States of Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico, and the U.S. Virgin Islands (collectively referred to hereinafter as states). This federal- state partnership aims to provide states the flexibility to address the unique health needs of its population of pregnant women, mothers, infants, and children, including children and youth with special health care needs (CYSHCN) and their families. The program is administered by the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS). Broadly, SSA Section 501 establishes the purpose of the State MCH Block Grant program as follows: to improve access to quality MCH services; reduce infant mortality and child morbidity; increase access to routine diagnostic, immunization, treatment, and rehabilitation services; provide prenatal, delivery, and postpartum support; and provide specialized care to CYSCHN and their families. Funding Federal funding for the overarching MCH Services Block Grant program is discretionary and subject to the annual appropriations process. Federal funding allocations across each of the three individual programs are determined by formula; the State MCH Block Grant program receives the remaining funds after CISS and SPRANS funds are reserved (§501(c)). Although federal funding levels have remained relatively flat over time, the proportion of total MCH Services Block Grant funds appropriated to the State MCH Block Grant program has declined, indicating that a greater proportion of these funds are appropriated to topic- specific grant programs, specifically SPRANS. Table 1 displays total State MCH Block Grant appropriations relative to the total MCH Services Block Grant appropriations from FY2020 to FY2024. Table I. Funding History: Federal Appropriations $ Millions State MCH Total MCH Proportion of Block Services Funds Allocated Fiscal Grant Block Grant to State MCH Year Funds Funds Block Grants 2020 $558.3 $687.7 81.2% 2021 $561.6 $710.6 79.0% 2022 $570.4 $733.0 77.8% 2023 $593.8 $816.2 72.8% 2024 $593.3 $813.7 72.9% Source: Compiled by CRS using data from HRSA's Budget Justifications; FY2024 data are from P.L. 118-47 and the Congressional Record, vol. 170, no. 51, book II, March 22, 2024, p. H 1887. Federal funds are allotted to individual states using a formula that considers (1) the amount of funds historically allocated to each state and (2) the proportion of low-income children in each state relative to the total number of low- income children nationwide (§502(c)). In the most recent available data in the Title V Information System (TVIS), FY2022, federal allotments to individual states ranged from $150,000 (Palau) to $39.6 million (California). States are required to match at least $3 for every $4 of federal block grant funds received (§503(a)). States must also maintain a level of contribution that is at or above the state's FY1989 level (§505(a)(4)). MCHB calculates total program funding by adding federal and state funds with local MCH funds, program income (e.g., health insurance reimbursements), and other federal funds (Figure 1). In FY2022, the State MCH Block Grant program funding totaled over $2.6 billion across all five funding sources. Figure I. State MCH Block Grant Funding Sources St te MCI H Funds $1,087.7m Federal Allocanton $556.8m Program Income $543.4m Other Funds $370.0m FY2022 Total Local MCH Funds $95.7m $2,653,617,499 Source: Figure created by CRS using data from HRSA's Title V Information System (TVIS); https://mchb.tvisdata.hrsa.gov/.

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