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Michigan's Local Maternal Child Health Program

Michigan's Local Maternal Child Health Program

Program Overview 

Local Maternal Child Health (LMCH) funding is made available to all 45 local health departments to support the health of women, children, and families in communities across Michigan. Funding is made available through the Title V Maternal and Child Health (MCH) Services Block Grant to address national and state priority areas and/or a local MCH priority need identified through a needs assessment process. Local health departments complete an annual LMCH plan, which describes the jurisdiction's priority maternal and child health needs, the strategies/activities that will be used to address these needs, and the service categories from the MCH pyramid of services. Priority populations are women of childbearing age, mothers, infants, children ages 1-21 and their families, and children with special health care needs. The focus of local programming is to provide the priority populations with increased access to and the provision of gap-filling direct clinical services; enabling services such as health education, case management, and care coordination; public health services and systems like epidemiological support, workforce development, and health promotion campaigns; and interventions to address community specific MCH needs.

Legal Basis

Public Health Code, Public Act 368 of 1978, Part 23 Basic Health Services; Title V of the Social Security Act (SSA, P.L. 74-121, as amended; 42 U.S.C. §§701-709)

Program Effectiveness 

Local health departments are required to provide an annual year-end report that includes a summary of the fiscal year's activities, a brief description of any challenges and successes, and the number of individuals served and the amount of MCH funds expended. MCH funds provide critical gap-filling services at the local level and support public health infrastructure costs to deliver essential public health services. In FY 2024, the LMCH Program served approximately 147,000 individuals. 

  •  Title V of the Social Security Act of 1935 authorized funding for Maternal and Child Health (MCH) Services. The Title V MCH Block Grant is the nation's oldest federal-state partnership focused on improving the health of mothers, infants, and children, including children with special health care needs. Since its original authorization in 1935, Title V of the Social Security Act has been amended to reflect a continuing national focus on maternal and child health. In 2015, Title V was transformed to reflect updated performance measures, utilization of data-driven processes, and family engagement. In 2024, the Title V guidance introduced a revised performance measure framework and builds on/refines the reporting structure and vision outlined in previous editions. 

    Each State's health agency is responsible for the administration (or supervision of the administration) of programs carried out with allotments made to the State under Title V. In Michigan, the Title V MCH Block Grant supports a wide range of critical MCH programs and services across the state. The overarching goal is to improve the health and well-being of the state's mothers, infants, children, and adolescents-including children with special health care needs.

    Title V funding is allocated to each of Michigan's 45 local health departments (LHDs) through the Local Maternal Child Health (LMCH) program. Approximately one-third of the state's Title V funding supports the MCH work of these 45 LHDs across the state. LMCH funds are available to support one or more Title V national performance measures or state performance measures plus locally identified needs. Each LHD completes a work plan for every performance measure selected. The LMCH grants play an important role in building and sustaining LHD public health systems and supporting the delivery of needed programs and services.

  • The conceptual framework for services supported by the Title V Maternal and Child (MCH) Health Services Block Grant is envisioned as a pyramid with three tiers of services: direct, enabling, and public health services and systems. The three tiers align with the 10 MCH Essential Services. The 10 Essential Public Health Services (EPHS) framework was updated in 2020 and describes the public health activities that all communities should undertake.

    The Maternal Child Health (MCH) Pyramid of Services includes direct services (top), enabling services (middle), and public health services and systems (bottom) and serves as the MCH Working Framework for the Title V MCH Block Grant.

    Direct Services are preventive, primary, or specialty clinical services to individuals for which funds reimburse or provide payment to providers for services.

    Enabling Services are non-clinical services (i.e., not included as direct or public health services) that enable individuals to access health care and improve health outcomes.

    Public Health Services and Systems are activities and infrastructure to carry out the core public health functions of assessment, assurance, and policy development, and the 10 essential public health services.

    Reference: U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Title V Maternal and Child Health Services Block Grant to States Program. Guidance and forms for the Title V application/annual Report. Tenth Edition. OMB NO 0915-0172, Expires 12/31/2026, p.79; Title V Block Grant Guidance and Reporting Forms (hrsa.gov)

     

  • Every five years, states are required to perform a statewide MCH needs assessment to determine Title V health priorities for women, infants, and children, including children with special health care needs. States must identify 7-10 state priority needs and then link those needs with national performance measures or state performance measures. States must also choose a minimum of one federally defined national performance measure from each Title V population domain: women/maternal health; perinatal/infant health; child health; adolescent health; and children with special health care needs. Beginning in 2024, states must also report on two Universal Measures, Postpartum Visit and Medical home for Children and for CSHCN.

    State Priorities 2026-2030

    Through the most recent needs assessment process, Michigan assessed MCH population data, community needs and strengths, MCH system and program capacity, funding needs, and the potential to impact change. Based on the 2025 needs assessment findings, Michigan's Title V state priority needs are:

    • Improve the quality and accessibility of respectful care before, during, and after pregnancy. 
    • Maintain access to and information about contraceptives and reproductive health.
    • Expand parent and provider access to person-centered breastfeeding and infant safe sleep knowledge and support.
    • Expand awareness of and access to quality dental care for children and pregnant women.
    • Expand vaccination access and address reasons for vaccine hesitancy. 
    • Increase access to information, education, and testing for lead poisoning.
    • Expand awareness of and access to medical homes and improve care coordination through the medical home approach.
    • Partner with schools, parents, and the broader community to support students' mental health.
    • Improve the quality, accessibility, and coordination of care and resources for children with special health care needs. 

  • The federal Health Resources and Services Administration (HRSA) established 20 National Performance Measures (NPMs) across five population health domains for the Title V MCH Services Block Grant program. States can select the best combination of NPMs, including universal measures, and state-identified State Performance Measures (SPMs) to address each priority need based on the findings of the five-year needs assessment. States must select a minimum of one NPM in each population domain.

    Michigan's current performance measures are listed in the table below.

    Priority Area

    National Performance Measure (NPM)

    Postpartum Visit

    A) Percent of women who attend a postpartum checkup within 12 weeks after giving birth and B) Percent of women who attended a postpartum checkup and received recommended care components

    Perinatal Care Discrimination

    Percent of women with a recent live birth who experienced racial/ethnic discrimination while getting healthcare during pregnancy, delivery, or at postpartum care

    Breastfeeding

    A) Percent of infants who are ever breastfed and B) Percent of infants breastfed exclusively through 6 months

    Safe Sleep

    A) Percent of infants placed to sleep on their backs, B) Percent of infants placed to sleep on a separate approved sleep surface, C) Percent of infants room-sharing with an adult, and D) Percent of infants placed to sleep without soft objects or loose bedding

    Childhood Vaccination

    Percent of children who have completed the combined 7-vaccine series (4:3:1:3*:3:1:4) by age 24 months

    Bullying

    Percent of adolescents with and without special health care needs, ages 12 through 17, who are bullied or who bully others

    Transition

    Percent of adolescents with and without special health care needs, ages 12 through 17, who received services necessary to make transitions to adult health care

    Preventive Dental Visit

    A) Percent of women who had a dental visit during pregnancy and B) Percent of children, ages 1 through 17, who had a preventive dental visit in the past year

    Medical Home

    Percent of children with and without special health care needs, ages 0 through 17, who have a medical home

    Priority Area

    State Performance Measure (SPM)

    Childhood Lead Poisoning Prevention

    Percent of children less than 72 months of age who receive a venous lead confirmation testing within 30 days of an initial positive capillary test

    Adolescent Vaccination

    Percent of adolescents 13 to 18 years of age who have received a completed series of recommended vaccines (1323213* series)

    Medical Care & Treatment for CSHCN

    Percent of parents/caregivers who got appointments for their child with a specialist as soon as needed

    Contraceptive Use

    Percent of women 18 to 49 who used effective contraception during the last time they had sexual intercourse

  • LMCH Annual Plan

    Each year local health departments (LHDs) complete a Local Maternal Child Health (LMCH) Plan. The LMCH Plan reflects how LHDs will utilize LMCH funding. The LMCH Plan document describes the local health department's jurisdiction and MCH population; priority MCH issues the LHD will address; performance measure(s) the LHDs will address and the related goals and objectives; data relevant to objective/performance measure; evidence-based/informed/promising practice strategies; and activities the LHD will undertake to reach their objective(s) using LMCH funds. The LMCH Plan also describes the projected number of individuals the health department will serve along with the projected costs of providing those services. Local health departments are encouraged to select only one to two performance measures and delve deeper into the strategies to "move the needle" on MCH outcomes.


    LMCH Year-End Report

    At the end of the fiscal year, LHDs report on activities and progress toward achieving their objectives, the number of individuals served, and the total amount of funding expended. The health department is also asked to describe any challenges and successes they experienced in delivering services. The year-end report should only include activities and expenditures for which LMCH funds were used. MDHHS provides each LHD with a customized year-end report template based on their LMCH Annual Plan.

     

  • The LMCH Annual Plan and Year-End Report require relevant data for objectives and performance measures. The websites below are not an exhaustive list, but may be helpful when completing the LMCH Annual Plan and Year-End Report.


    Data and Surveillance Resources

  • The following resources may be helpful when creating workplans by national and state performance measures.


    Michigan Department of Health and Human Services Resources


    Title V Maternal and Child Health Block Grant Resources


    Other Resources