The Division of Finance and Account within the Mississippi State Department of Health is responsible for all fiscal management at the agency including the Maternal and Child Health Block Grant. MSDH staff uses the financial management system called MAGIC. MAGIC is Mississippi State Government’s Enterprise Resource Planning (ERP) solution. MAGIC is the statewide accounting and procurement system of record, encompassing Finance (accounting, budgeting, grants management) and Logistics (procurement, fleet management, inventory management).

The Title V federal funding, in conjunction with non-federal state monies and other federal funds, are obligated and expended to support Mississippi’s priority needs and Title V requirements. Approximately one-third of Title V funding supports Children and Youth with Special Health Care Needs (CYSHCN) and an additional one-third supports the MCH work of departments across the state. The remaining one-third of Title V funding supports other critical MCH priorities such as regional perinatal care systems, lead poisoning prevention, oral health, infant safe sleep and breastfeeding initiatives, reproductive health, infant and maternal mortality reduction strategies, health equity initiatives, and PRAMS.

The Maternal and Child Health Finance Director oversees all MCH budget expenditures. Computer generated cumulative expenditures, transaction listings and spending/receipt plans are available in electronic format for all MCH programs. This information can be accessed by both central and regional office staff. Contract agencies are also audited frequently. MCH program staff provides site visits and program monitoring at contract agencies in order to assure compliance with the contract's scope of services. The Mississippi State Department of Health adheres to the policies and procedures developed by the Department of Finance and Administration. These policies can be found on the Department of Finance and Administration website and pertain to the multiple financial functions of the State.

The budget for Mississippi's Title V MCH Block Grant application was developed by MSDH Health Services in cooperation with the Office of Health Administration, Finance and Accounts. The total program for FY 2019 was $16,936,581 of which $9,235,413 (52 percent) is Title V and $7,701,168 (48 percent) is match provided in-kind by the applicant. Sources of match funds are state funds, Medicaid earnings (as allowed by the MCH Bureau), and other Third Party earnings.

Pregnant Women and Infants

Services for pregnant women and infants are budgeted as follows for FY 2019: $2,770,624 for federal funds (30 percent of the total federal award); $2,544,250for non-federal funds (37 percent of total non-federal funds).

Child and Adolescent Health

The goal of the Child Health Program is to integrate services across agency boundaries for children and families to improve availability and accessibility of services and; to improve child health outcomes and quality of life. The Adolescent Health Services Program provides technical assistance, educational resources and training opportunities for healthcare providers and community partners as they assess the needs to develop implement and evaluate health programs serving adolescents in their communities.

Services for the Child and Adolescent Health program are budgeted as follows for FY 2019: $2,770,624 for federal funds (30 percent of the total federal award), $2,293,975 for non-federal funds (33 percent of total non-federal funds).

Children with Special Health Care Needs

The mission of the Children's Medical Program (CYSHCN) is to develop a statewide system of care for children and youth with special health care needs (CYSHCN) and their families, using resources of the Mississippi State Department of Health, University Medical Center, community health care providers, community agencies and other available resources.  CYSHCN strives to identify barriers and gaps in current health care systems for CYSHCN and assists with resolution.

In past years the program has provided direct care services to CYSHCN and their families. During the 2015-2016 year, the program experienced a reduction in program earnings.  This reduction was due to CYSHCN and their families having greater access to specialty care services and health insurance, which decreased the need for services at Blake Clinic.  Effective, fall 2015, the Blake Clinic will discontinue direct care services and place emphasis on providing supportive services such as family-centered care coordination, travel reimbursement and respite care services.  The program now focuses on infrastructure building and other linkage to care services through increased parental involvement, provider partnerships and other stakeholders.

Services for children with special health care needs are budgeted as follows for FY 2019: $2,770,624 for federal funds (30 percent of the total federal award), $2,088,333 for total non-federal funds (30 percent of total non-federal funds).

Administrative Costs

Administrative costs are budgeted at $923,541, which is 10 percent of the total federal grant award. This amount does not exceed the allowable 10 percent of the total Title V MCH Block Grant as mandated in OBRA 1989.

Maintenance of Effort

The level of state funds provided for match for FY 2018 is greater than the State's "maintenance of effort" level, i.e., the total amount of State funds expended for maternal and child health program in FY 1989.

Matching funds for the Title V MCH Block Grant are identified by listing all direct program costs which have been paid from non-federal sources. These expenses include travel, medicine, medical services, clinical, and lab supplies. Funds used to match Medicaid or other grants are deducted.

All salary and non-salary charges for the CSHCN program are identified by budget. The agency time study provides a report of the value of staff time paid from state or county funds. Time coded to Family Health, Family Planning, Maternity, Perinatal High Risk Management and other Maternal and Child Health efforts is used to match the pregnant women, mothers, and infants’ category. Time coded to Child Health, Oral Health, and School Nurse is used to match the children and adolescent category.

MSDH decided to no longer provide maternity services in late 2016-2017. We anticipate a reduction in state funds and program income. The reduction would be a direct result of no longer providing these services as well as boundaries and regional changes to staff and locations.

Mississippi’s Maternal and Child Health Block Grant financial management plan assures compliance with the Title V fiscal requirements.

Mississippi state law requires all State agencies to submit a provisional budget request for the coming fiscal year that outlines proposed expenditures for the administration, operation and maintenance of programs. In addition, The Mississippi State Department of Health has an internal budget process for all offices within MSDH.  Budget guidelines are prepared annually by the Department of Finance and Administration. The budget request is approved and signed by authorizing officials. A working program budget is then developed for each program/office.

The Title V block grant 2019-2020 budget application projections will provide funds for maternal and child health (MCH) services, primary care for children and adolescents, and preventive and maintenance services to children and youth with special health care needs (CYSHCN). Preventive and primary care services include policy and procedural oversight, regional health department (RHD) agreements, pharmacy and laboratory testing, newborn screening and referral for follow up, and reducing health disparities and risk factors. Other services provided include population-based maternal and child health systems coordination, e.g. cross-coordination of providers, specialists, school systems, government agencies, and community partners.

Calculation methodologies for the Block Grant budget forms represent an accurate reflection of expenditures of state and federal funds for the 30/30/10 requirement The state share for MCH services will continue to be met. Expenditures for FY2020 are expected to utilize the full allocation of funding.