Free Maternal and Child Health Services in Every State: The Title V Block Grant

Since 1935—before Medicare, before Medicaid, before the creation of the Department of Health and Human Services itself—the federal government has been funding health services for mothers and children through Title V of the Social Security Act. The Title V Maternal and Child Health (MCH) Services Block Grant is the oldest continuously funded federal health program in the United States, and it remains one of the most important. With annual federal funding of approximately $800 million, matched by at least $3 in state and local funds for every $4 in federal funds, Title V supports a comprehensive array of maternal and child health services in every state, the District of Columbia, U.S. territories, and tribal communities.

Title V reaches an extraordinary breadth of the American population. In any given year, Title V-supported services touch the lives of approximately 59 million people—including 90% of all pregnant women and 98% of all infants in the United States. This reach is possible because Title V does not just fund direct clinical services; it also funds public health infrastructure, systems building, workforce development, and population-based services that benefit all mothers and children.

For individual families, Title V translates into tangible, lifesaving services: prenatal care for pregnant women who might otherwise go without it, newborn screening that detects treatable conditions before they cause permanent damage, childhood immunizations that prevent deadly diseases, lead poisoning prevention that protects developing brains, dental care for children who have no other source, and specialized care coordination for children with complex medical conditions.

Opportunity Snapshot

Services Funded by Title V

Title V is extraordinarily flexible in what it can fund, and states have significant latitude in how they allocate their block grant. The following categories represent the major types of services supported:

Prenatal and Maternal Health

Title V is a critical funding source for prenatal care services, particularly for women who are uninsured, underinsured, or in communities with limited access to obstetric care. Services include early and comprehensive prenatal care (medical exams, lab work, ultrasounds, monitoring for complications), high-risk pregnancy management, gestational diabetes screening and management, preeclampsia monitoring, prenatal nutrition counseling and referral to WIC, smoking cessation support during pregnancy, substance use screening and referral to treatment, mental health screening for perinatal depression and anxiety, breastfeeding education and lactation support, and postpartum care and follow-up.

In many states, Title V funds are used to support community health worker programs, nurse-midwifery services, and maternity care in rural areas where hospitals have closed their obstetric units. For women in these areas, Title V-funded services may be the only accessible source of prenatal care.

Newborn and Infant Health

Every baby born in the United States is screened for a panel of rare but serious metabolic, endocrine, and genetic conditions—a process that has saved or improved millions of lives since its inception. Title V provides significant funding for state newborn screening programs, including laboratory testing for conditions such as phenylketonuria (PKU), congenital hypothyroidism, sickle cell disease, cystic fibrosis, and hearing loss. Early detection of these conditions allows treatment to begin before irreversible damage occurs.

Additional infant health services supported by Title V include infant safe sleep education and crib distribution programs, home visiting programs for new families, sudden infant death syndrome (SIDS) prevention, immunization promotion and delivery, well-baby check-ups and developmental monitoring, breastfeeding support and lactation consultant access, and neonatal abstinence syndrome (NAS) follow-up for babies exposed to substances in utero.

Child and Adolescent Health

Title V funds a wide range of preventive and primary care services for children and adolescents, including childhood immunizations (completing recommended vaccination schedules), lead poisoning screening and follow-up, developmental screening and early intervention referral, vision and hearing screening, dental care and oral health prevention (sealants, fluoride), nutrition assessment and counseling, injury and violence prevention programs, adolescent reproductive health services, mental health screening and referral, and school-based health services.

Many states use Title V funds to support school health programs, community health worker outreach, and mobile health clinics that bring preventive services directly to underserved communities and schools.

Children and Youth with Special Healthcare Needs (CYSHCN)

Federal law requires that states spend at least 30% of their Title V allocation on services for children and youth with special healthcare needs—defined as children who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.

This mandatory set-aside funds an essential system of support for families raising children with complex conditions:

Care coordination: Dedicated care coordinators help families navigate the healthcare system, schedule appointments with multiple specialists, coordinate insurance authorizations, and ensure that all providers are communicating effectively. For a family whose child sees a neurologist, cardiologist, physical therapist, speech therapist, and developmental pediatrician, care coordination can be the difference between comprehensive care and chaos.

Family support: Parent-to-parent support networks, family training on medical procedures and equipment, respite care referrals, information on disability rights and educational entitlements, and connection to family support organizations.

Medical home promotion: Title V promotes the medical home model—a team-based approach to healthcare where a primary care provider coordinates all of a child’s care—ensuring that children with special needs have a consistent point of medical contact.

Transition planning: As children with special healthcare needs grow into adolescence and young adulthood, Title V funds transition services that help them move from pediatric to adult healthcare, from school to employment, and from dependence to maximum independence.

Specialty care access: In states where pediatric specialists are scarce, Title V may fund telemedicine networks, specialty clinic outreach, or subsidized travel to specialty centers.

How Title V Works With Other Programs

Title V does not operate in isolation. It is designed to complement and enhance other maternal and child health programs:

Medicaid: Title V and Medicaid are deeply interconnected. Title V often fills gaps in Medicaid coverage, funds services that Medicaid does not cover, supports outreach and enrollment for Medicaid-eligible families, and builds infrastructure that Medicaid relies on. Many state MCH programs are administered by the same agency that runs the state Medicaid program.

WIC (Women, Infants, and Children): Title V and WIC serve overlapping populations. Title V-funded providers frequently screen women and children for WIC eligibility and facilitate enrollment. WIC nutrition services complement the healthcare services funded by Title V.

CHIP (Children’s Health Insurance Program): Title V supports outreach and enrollment for CHIP, ensuring that eligible children are connected with health insurance coverage.

Vaccines for Children (VFC): Title V complements the VFC program by supporting immunization infrastructure, education, and tracking systems that ensure children receive recommended vaccinations.

Early Intervention (IDEA Part C): Title V-funded developmental screenings identify infants and toddlers who may benefit from early intervention services, and many states use Title V funds to support the early intervention system.

Who Benefits from Title V

Title V serves an astonishingly wide swath of the American population. In a given year:

• Approximately 2.5 million pregnant women benefit from Title V-supported prenatal care, screening, and education
• Over 4 million infants benefit from newborn screening, home visiting, and infant health services
• Over 30 million children benefit from immunizations, screenings, and preventive services
• Over 12 million children and youth with special healthcare needs benefit from care coordination, family support, and specialty access
• Approximately 59 million people total are reached by Title V-funded or Title V-supported services

The program does not operate through a single application process. Families often access Title V-funded services without knowing the name of the program—they simply receive prenatal care, get their baby screened, or take their child to a school health screening that happens to be funded by Title V.

How to Access Title V Services

Step 1: Contact your state MCH program. Every state has a Title V/MCH program, usually housed within the state health department. Visit the HRSA Maternal and Child Health Bureau website at mchb.hrsa.gov for state contacts, or call your state health department directly.

Step 2: Ask about available services. Describe your situation—whether you are pregnant, have a young child, have a child with special healthcare needs, or need preventive services. The state MCH program can direct you to funded providers and services in your area.

Step 3: Connect with local providers. Title V services are delivered through a variety of local providers including health departments, community health centers, hospital-based clinics, school health programs, and community organizations. Your state MCH program can tell you which providers in your area receive Title V funding.

Step 4: Access services. Services are available on a rolling basis throughout the year. Many services—such as immunizations, screenings, and well-child visits—are available during regular office hours. Some programs offer evening, weekend, and mobile clinic services to increase access.

For children with special healthcare needs: Contact your state’s Title V CYSHCN program directly. Every state has a dedicated CYSHCN program with staff who specialize in helping families navigate the complex service system for children with chronic and complex conditions. The National Center for Family/Professional Partnerships at familyvoices.org can help you find your state’s CYSHCN program.

The Impact of Title V

Over its nine-decade history, Title V has contributed to some of the most significant public health achievements in American history:

• Infant mortality has declined by more than 90% since Title V was established in 1935
• Maternal mortality has been dramatically reduced through improved prenatal care, skilled birth attendance, and emergency obstetric services
• Newborn screening identifies approximately 13,000 babies per year with conditions that can be treated before they cause permanent harm
• Immunization rates for children have reached historically high levels, preventing millions of cases of vaccine-preventable diseases
• Childhood lead poisoning has been reduced dramatically through screening, education, and environmental intervention

These outcomes reflect the combined impact of Title V and the many other maternal and child health programs it supports and complements. Title V’s unique contribution is its role as the foundational infrastructure—the program that builds and maintains the systems through which all other maternal and child health services are delivered.

Frequently Asked Questions

Do I need to be low-income to access Title V services? Not necessarily. While many Title V services target low-income populations, some services—such as newborn screening, immunizations, and public health education—are available to everyone regardless of income. For direct clinical services, states may use sliding-scale fees.

Can I get prenatal care through Title V if I do not have insurance? Yes. Title V is a major funding source for prenatal care for uninsured women. Contact your state MCH program to find funded prenatal care providers in your area.

How is Title V different from Medicaid? Medicaid is a health insurance program that pays for medical services for eligible individuals. Title V is a block grant that funds public health infrastructure, direct services, and systems building for maternal and child health. They complement each other—many families benefit from both.

Does Title V cover dental care for children? Many states use Title V funds to support children’s dental health services, including fluoride varnish, dental sealants, and dental screenings. Contact your state MCH program for available dental services.

What counts as a “special healthcare need”? A child with a special healthcare need has or is at increased risk for a chronic physical, developmental, behavioral, or emotional condition and requires health services beyond what children generally need. This includes conditions such as asthma, diabetes, ADHD, autism, cerebral palsy, congenital heart conditions, and many others.

How to Get Started

1. Visit mchb.hrsa.gov for state MCH program contacts
2. Contact your state health department and ask about maternal and child health services
3. Find your local community health center at findahealthcenter.hrsa.gov
4. For CYSHCN services, find your state program at familyvoices.org
5. Call 211 for maternal and child health referrals in your area

From the first prenatal visit to the last childhood immunization, from newborn screening to transition to adult healthcare, Title V is there—quietly, consistently, and effectively supporting the health of mothers and children across America. If you are pregnant, raising a child, or caring for a child with a special healthcare need, Title V-funded services in your state can help.