The Texas Title V application financial forms (2, 3a, and 3b) were prepared in collaboration with the Department of State Health Services (DSHS), Funds Coordination and Management Branch (FCMB) and the Community Health Improvement (CHI) Division fiscal oversight team to provide a complete  set of FY 22 budget and expenditure data. Field Notes have been added to provide additional detail to individual form cells as needed. Expenditure information and budget planning is coordinated through ongoing communication and monthly meetings between DSHS and the Health and Human Services Commission (HHSC) budget and program personnel. The expenditures listed do not include agency indirect allocations. Title V is the payer of last resort, by legislation, and services listed by the state reflect services not covered or reimbursed through another provider. In FY22, the Maternal and Child Health Section (MCHS) continued efforts to identify new opportunities to collaborate with other agency programs and other agencies in the HHSC system to build upon existing efforts that serve mothers, infants, children, and youth.

Federal Expenditures noted in Form 2 amounted to $36,711,955 and reflect 42.3% of funds expended for preventive and primary care for children ($15,552,629), 39.8% for Children with Special Health Care Needs ($14,638,264), and 10% expended for Title V Administrative Costs ($3,671,195). There were no notable changes in expenditures from the previously completed fiscal year. Population-based and public health systems programs continued to be a focus. Non-federal MCH expenditures totaled $40,208,728, per the state required match.

The Texas Title V block grant budgeted federal amount of $36,711,955 for FY24 is consistent with the state’s federal allocation per Notice of Award totals. The Department of State Health Services (DSHS) commitment of state general revenue for FY24 remains limited to the Texas Maintenance of Effort (MOE) requirement of $40,208,728. The Title V program makes good faith efforts to comply with spending at least 30% of the federal allotment for preventive and primary services for children and at least 30% for services for children with special health care needs. The Texas Title V program funding supports accountants within the DSHS Budget Office whose primary responsibilities are to set-up detailed accounting and financial practices in managing the Texas Title V budget. These accountants work closely with financial analysts within the Community Health Improvement Division (CHI) and Maternal and Child Health Section (MCHS) to establish internal controls to monitor expenditures and federal fund budgets. Financial reports are prepared monthly to confirm compliance with the 30% - 30% requirement.

The CHI Division and Title V program leadership reviews reports, provides feedback, and adjusts service delivery (as needed) to maintain required spending proportions. The same rigorous monitoring process is in place to comply with the 10% cap on administrative expenditures (budgeted at $3,671,195). Texas’ block grant budget form calculation methodologies for represent an accurate reflection of state and federal fund expenditures for the 30/30/10 requirement. For FY24, the projected budget shows $15,972,553 of the federal Title V awarded funds are specifically marked for preventive and primary care for children while $13,256,499 are budgeted for children with special health care needs. These dollar amounts, based on the projected FY24 federal allocation, allows Texas to remain in compliance with federal requirements. The MCHS continues to partner with Health and Human Services Commission on the direct service efforts for prenatal health and dental services, child health and dental services for Children with Special Health Care Needs direct service care. Monthly meetings allow for ongoing budget monitoring and planning to support the direct care needs of the Texas MCH populations served though Title V.

Texas receives other federal, state, and private grants related to women and children, including the DHHS Rape Prevention and Education (RPE) Program, Pregnancy Risk Assessment Monitoring System (PRAMS), the State Systems Development Initiative (SSDI), National Violent Death Registry grant, Universal Newborn Hearing Screening and Intervention, and Texas Early Hearing Detection and Intervention (EHDI) State Programs. Additionally, Texas is a recipient of the State, Local, Territorial, and Tribal (SLTT) Partnership Programs to Reduce Maternal Deaths due to Violence Grant from HHS, and the Preventing Maternal Deaths: Supporting Maternal Mortality Review Committees grant from the Centers for Disease Control and Prevention (CDC).

Texas Title V is planning for implementation of new efforts and continuing impactful existing efforts to address the national and state performance measures identified through the five-year needs assessment process and ongoing evaluations.