Federal Fiscal Year (FY) 22 Expenditures, including Title V Maternal and Child Health Services Block Grant, State appropriations, and other grant funding, demonstrate NYS’s commitment to providing supports and services to NYS’s women, children, and families. The State Allocation Plan is described in Section 504, Use of Allotment of Funds, and Section 505, Application for Block Grant Funds.

Expenditures, reflected in Form 2, confirm that NYS has continued to comply with the 30%-30%-10% requirements, as specified in Section 504(d) and Section 505(a)(3). The scope and comprehensiveness of services for NYS’s Maternal and Child Health population are fully outlined and described in the FY 2022 report and FY 2024 application.

Title V Maternal and Child Health Service Block Grant funds supported primary and preventive health care services and infrastructure to continue to achieve the objectives for each State Priority in NYS’s Title V State Action Plan. Initiatives. Programs, such as the Comprehensive Adolescent Pregnancy Prevention, ACT for Youth Center for Community Action, and Family Planning Program, promote primary and preventive health care, preconception and interconception health, and physical, social, and emotional health and wellness for all individuals served. Programs such as the School Based Health Center program ensure access to health care for children and adolescents, also focusing on reproductive and behavioral health. The Lead Poisoning Prevention Program provides identification and follow-up for children at risk for or with high blood lead levels. Title V Maternal and Child Health Services Block Grant funding is provided to NYS’s Regional Perinatal Centers to ensure all pregnant women and newborns have access to high quality, appropriate level of perinatal care to improve birth outcomes. The School Based Dental Sealant Program promotes improved oral health for NYS’s highest risk population. Programs that support specific populations, such as the American Indian Health Program, Maternal and Infant Community Health Collaboratives (which was renamed to the Perinatal and Infant Community Health Collaborative), and Migrant and Seasonal Farmworker Health, engage populations in health care across the life course. Title V Maternal and Child Health Services Block Grant funds supported monitoring of the Family Planning Program, School Based Health Centers, and School Based Dental Sealant programs to ensure services are provided in accordance with State and Federal requirements where applicable. Title V Maternal and Child Health Services Block Grant funds also support efforts to update NYS’s standards for perinatal regionalization and efforts to identify and address those factors that result in maternal mortality and morbidity.

Title V Maternal and Child Health Services Block Grant funds, in conjunction with state and other federal funds, supports a rich tapestry of programs and initiatives developed to support NYS’s Title V State Action Plan, and assist NYS to address the needs of women, children and families, including the overarching priority to promote health equity. NYS’s Part C of the Individuals with Disabilities Education Action (also known as the Early Intervention Program) funding supports the administration of one of the largest Early Intervention Program in the nation. Grants such as Maternal, Infant, and Early Childhood Hove Visiting support evidence-based home visiting and efforts to engage women and families into health insurance, interconception health, breastfeeding, parenting support, and a range of other supports and services. Funding provided through the Personal Responsibility Education Program and Pregnancy Assistance Fund allows an expansion of adolescent programming to support the growth and development of children and adolescents. The Health Resources and Services Administration Universal Newborn Hearing Screening and the Center for Disease Control and Prevention’s Early Hearing Detection and Intervention Surveillance grant augments the statewide newborn hearing screening program and supports enhanced efforts to track newborns lost to follow-up services. NYS leverages the Perinatal Quality Collaborative grant to support efforts to improve the quality of care provided to women and newborns in NYS’s perinatal hospitals. in the goal of NYS’s Rape Prevention and Education program is to decrease sexual violence and promoting healthy relationships among NYS’s adolescents and young adults.

Supports and services to NYS’s Children and Youth with Special Health Care Needs and their families are an essential component of NYS’s Title V services. Through the Children and Youth with Special Health Care Needs Support Services funding is provided for medical assessment of children with suspected health issues where there is no other source of financial support. Although all primary and preventive health care programs provide services to Children and Youth with Special Health Care Needs, NYS’s Title V Program also oversees services specifically designed to serve Children and Youth with Special Health Care Needs and their families. For example, Title V Maternal and Child Health Services Block Grant funds support forty-eight county Local Health Departments and the five counties served by the NYC Department of Health and Mental Hygiene (NYCDOHMH) to provide information and referral services to Children and Youth with Special Health Care Needs and their families. This funding supports staff in Local Health Departments to respond to inquiries by families related to issues such as insurance coverage, assistance with services, family support and needed items for their Children and Youth with Special Health Care Needs. Support is provided to NYS’s Wadsworth Center Laboratory that administers the statewide Newborn Metabolic Screening Program as well as specialty centers for individuals with genetic diseases and disabilities. NYS’s Lead Poisoning Prevention Program focuses on environmental changes as well as identifying and supporting potentially lead poisoned children and their families. Programs such as NYS’s School Based Health Centers provide services to children, including Children and Youth with Special Health Care Needs that can result in decreased absenteeism, improved school performance, and better health outcomes. As stated in NYS’s application, NYS’s Title V Maternal and Child Health Services Block Grant program continues to focus improving supports and services for Children and Youth with Special Health Care Needs and their families. Information obtained from Children and Youth with Special Health Care Needs and their families will assist NYS’s Title V Program to improve and enhance supports and services for Children and Youth with Special Health Care Needs in the coming years.

To calculate data on priority populations served by group (pregnant women, infants under one year of age, children ages 1-21 years, Children and Youth with Special Health Care Needs and others) and by level of the Maternal and Child Health pyramid (direct health care services, enabling services, and population and infrastructure services), program managers provide information based on actual data collected from each program or provide an estimate for each of these categories. These data are compiled for Forms 3a and 3b. Expenditure reports are generated for the appropriate period and distributions by population and pyramid level are then calculated. NYS does not provide direct health care services using Title V funding except for limited funding through the Children and Youth with Special Health Care Needs Support Services. A rich health care coverage and service system in NYS results in very limited expenditures through Children and Youth with Special Health Care Needs Supports and Services NYS’s direct care expenses remain less than 1%.

NYS’s commitment to the Maternal and Child Health population is evidenced by the substantial State appropriation that is devoted to supports and services for NYS’s women, children, including Children and Youth with Special Health Care Needs and families. Differences in state and local contributions from prior years are evident as NYS continues to promote enrollment into health insurance coverage for all New Yorkers, as well as to maximize the use of other state and federal fund sources to enhance services for the Maternal and Child Health population.

Overall, the actual expenditures for FY 22 appear less than originally projected. This is because multiple Maternal and Child Health grants are spent in the same time period due to the two-year spending period. Each award value remains fully obligated and will be fully dispersed by the liquidation deadline at the end of each year.

NYS’s FY 22 application reflected a budget of over $21 million in Program Income, but actual expenditures were more than anticipated. This is likely related to the timing of the reporting by Local Health Departments rather than an actual increase in income.

NYS continues to be committed to identifying additional resources to serve NYS’s Maternal and Child Health population. NYS’s Title V Program has been very successful in accessing additional funding to develop the comprehensive system that currently exists in NYS and a myriad of other grants support NYS’s efforts to improve outcomes of all women, infants, and children, including Children and Youth with Special Health Care Needs and families across NYS.

This Federal Fiscal Year (FY) 2024 budget reflects NYS’s commitment to Title V Maternal and Child Health Services Block Grant programs and services. NYS will continue to use FY 2024 Title V funds to support the implementation of NYS’s Title V State Action Plan. Title V Maternal and Child Health Services Block Grant funds, in addition to State appropriation, Federal Medical Assistance Program, and federal grant funds will continue to support programs and initiatives across all domains as described in the application section. This includes the development of substantial data analyses and reports to guide NYS’s services for the Maternal and Child Health population. Support for efforts such as maternal and infant mortality and morbidity surveillance and quality improvement efforts to avoid these devastating outcomes is a priority. Enhancing NYS’s efforts to identify those factors that result in maternal mortality and morbidity and addressing those factors will continue to be of importance in NYS’s Title V Maternal and Child Health Services Block Grant program. NYS’s Title V Maternal and Child Health Services Block Grant will continue interagency efforts to address maternal depression.

NYS will continue to move towards a greater understanding of comprehensive health, development, morbidity, and health disparities, social-emotional development in children and adolescents, and will promote and support efforts to ensure all NYS’s children have the opportunity for healthy development. Information obtained through systems/care mapping has been used to develop enhanced systems for Children and Youth with Special Health Care Needs and their families. The Title V Program is increasing its investment in the Local Health Department Children and Youth with Special Health Care Needs program to provide more support to local staff who can connect with and support Children and Youth with Special Health Care Needs and their families. The Title V Program will also continue to invest in three regional technical assistance centers at the state’s University Centers of Excellence in Developmental Disabilities. In NYS, the University Centers of Excellence in Developmental Disabilities are the Westchester Institute for Human Development in Valhalla, Rose F. Kennedy Center at Montefiore Medical Center in New York City, and the Strong Center for Developmental Disabilities at the University of Rochester. These entities are federally designated by Health Resources and Services Administration and established federally through a competitive application process to work with people with disabilities, family members, state and local government agencies, and community providers in projects that provide training, technical assistance, service, research, and information sharing. This investment will continue to assist NYS’s Title V Maternal and Child Health Services Block Grant program to improve and enhance supports and services for Children and Youth with Special Health Care Needs and their families.

Overall efforts will continue to provide supports and services for children and adolescents, with a significant focus on physical activity and nutrition, social-emotional development, School Based Health Centers and School Based Dental programs, evidence-based home visiting services, oral health services, services for Children and Youth with Special Health Care Needs, and many other supports and services discussed throughout NYS’s application. Paramount to the plan is the promotion of health equity for all across the life course.

Financially, the Title V Administrative budget of $2.8 million remains below the 10% limit for these costs. As in prior years, the NYS share for Maternal and Child Health services will continue to be considerable and will more than meet the requirements for state match. Expenditures for FY24 are expected to utilize the full allocation of $38,909,810. NYS continues to be fully committed to the health and wellness of all New Yorkers and will move forward in the comprehensive work as outlines in the Title V State Action Plan.