Michigan’s Title V Maternal and Child Health (MCH) program supports critical MCH programming and services across the state. Its overarching goal is to improve the health and well-being of mothers, infants, children, and adolescents including children with special health care needs (CSHCN). The Michigan Department of Health and Human Services (MDHHS) administers the Title V block grant through the Division of Maternal and Infant Health (DMIH). The Children’s Special Health Care Services (CSHCS) Division serves as the Title V CSHCN program. The Division of Child and Adolescent Health (DCAH) oversees the Local MCH (LMCH) Program which provides Title V funding to local health departments (LHDs). Collectively, the DMIH, DCAH, and CSHCS Division provide leadership on MCH programs and policies, including oversight of program-specific work and statewide multisystem collaboratives, as discussed throughout this application.

Michigan’s Fiscal Year (FY) 2026-2030 state priorities were determined by the five-year needs assessment completed in 2025. The assessment identified needs for preventive and primary care services for women, mothers, infants, children, and services for CSHCN. MCH partners, local grantees, and individuals representing the Title V population domains were engaged in the process. Based on the needs assessment, the new Title V state priorities are:

• Improve the quality and accessibility of respectful care before, during, and after pregnancy.
• 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.
• Maintain access to and information about contraceptives and reproductive health.
• 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.

In response to Title V requirements, 16 total National Performance Measures (NPMs) and State Performance Measures (SPMs) were chosen to align with the priority needs and are discussed below by population domain. The needs assessment also identified three key “pillars” across population domains:

• Advance strategies so all children and families can flourish.
• Foster collaboration to strengthen coordinated systems.
• Engage and elevate family and community voices.

State action plans for NPMs and SPMs in Section III.E. include information on objectives, strategies, metrics, partnerships, family engagement, and program planning and improvement. A summary of each NPM and SPM is presented below.

Women/Maternal Health

The first goal in this domain is to increase the percent of women who attended a postpartum checkup within 12 weeks after giving birth and received recommended care components. In 2022, 90.2% of Michigan mothers reported postpartum checkups, but only 82.0% reported visits included all recommended components (MI PRAMS). Michigan’s strategies to improve postpartum care include increasing the number of CenteringPregnancy sites; utilizing the Philips Pregnancy+ smart app to increase awareness of the importance of postpartum visits; implementing a postpartum module in the High Touch, High Tech Pregnancy Checkup app; and partnering with Home Visiting to support women in accessing postpartum care.

The second goal in this domain is to support women during the perinatal period which includes decreasing the percent of women with a recent live birth who experienced racial/ethnic discrimination while getting healthcare during pregnancy, delivery, or at postpartum care. Nearly 10% of Michigan mothers reported perinatal care discrimination in 2021, with 23.2% of non-Hispanic Black mothers reporting racial discrimination during care (MI PRAMS). A key objective is to increase the number of doulas on the Michigan Doula Registry and provide training and technical assistance to the doula workforce. MDHHS will also work to increase the number of birthing hospitals participating in the Michigan Alliance for Innovation on Maternal Health and partner with Regional Perinatal Quality Collaboratives on quality improvement and community engagement initiatives.

The third goal is to increase the percent of women who had a dental visit during pregnancy. Michigan has seen a rebound in women receiving preventive dental care during pregnancy from a low of 40.7% in 2020 to 48.7% in 2022 (MI PRAMS). Objectives to increase dental visits include increasing the number of medical and dental providers trained to treat and refer pregnant women and increasing the number of pregnant women who receive oral health education and services.

The fourth goal in this domain is to increase the percent of women 18-49 years of age who used most or moderately effective contraception during the last time they had sexual intercourse. In 2022, 65.1% of Michigan women who reported using any contraception at last intercourse used moderately or most effective forms (Michigan Behavioral Risk Factor Surveillance System, 2022). Strategies to support women’s health will include expanding access to free and low-cost contraceptive services for uninsured and underinsured individuals and maintaining a high level of client satisfaction with the experience of care.

Perinatal/Infant Health

The first perinatal/infant health goal is to increase A) the percent of infants who are ever breastfed and B) percent of children, ages 6 months through 2 years, who were breastfed exclusively for 6 months. While breastfeeding rates have increased in Michigan, exclusivity rates still fall short of state goals. In Michigan, 86.7% of infants are ever breastfed (2022) and 26.4% are exclusively breastfed through six months (National Immunization Survey; NSCH 2022-2023). To increase breastfeeding rates, MDHHS will offer an online breastfeeding course for health care providers, support access to breastfeeding support professionals and peer counseling, promote training that addresses common challenges and complications with breastfeeding, and work to normalize and support breastfeeding.

The second goal is to increase infant safe sleep practices, including the four aspects of 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 placed to sleep without soft objects or loose bedding, and D) Percent of infants room-sharing with an adult during sleep. In 2022, 150 sleep-related infant deaths occurred in Michigan (Centers for Disease Control and Prevention Sudden Unexpected Infant Death Case Registry, 2010 to 2022, Michigan Public Health Institute, 2025). Sleep-related infant deaths are a leading type of death for infants aged 1-12 months old (2020-2023 Michigan Resident Infant Death File, Division for Vital Records & Health Statistics, MDHHS). MDHHS strategies include supporting local safe sleep activities; engaging family and community voices; providing training and resources for providers, including an online course for birthing hospital staff; promoting the infant safe sleep guidelines to families; and promoting protective factors, such as smoking cessation and breastfeeding, as well as evidence-based programs, such as home visiting and doulas.

Child Health

Michigan continues to focus on increasing the percentage of children who have a preventive dental visit. The percentage of Michigan children ages 1-17 who receive preventive dental care in the previous year has been stable over the period 2016-2017 (78.5%) to 2021-2022 (78.3%). In 2021-2022, the gap between non-Hispanic White (78.9%) and non-Hispanic Black (75.7%) shrank to its lowest level since 2016-2017 (National Survey of Children’s Health). A key objective in Michigan’s Title V plan is to increase the number of students who receive preventive dental screenings in a school-based dental sealant program. MDHHS will administer the SEAL! Michigan program and focus on improving access to care. MDHHS will also work with Detroit Public Schools Community District to increase dental screenings and sealants.

A second goal is to increase the percentage of children less than 72 months of age who receive a venous lead confirmation testing within 30 days of an initial elevated capillary test. Between 2010 and 2024, the percentage of children aged 6 and under in Michigan with blood lead levels >3.5 μg/dL decreased from 10.9% to 4.1% (MDHHS). Confirming elevated capillary results with a venous test is key to facilitating follow up especially as some communities still experience higher rates of lead poisoning. Progress has been made, with a rise in venous confirmation testing within 30 days of an initial elevated capillary test from 16.1% in 2013 to 42.3% in 2023 (MDHHS). To continue to make progress, Michigan will increase blood lead testing for children at 1, 2, and 4 years of age through provider education activities, especially in high-risk communities; improve notification to health care providers of patients’ blood lead levels and follow-up testing needs; partner with agencies to provide audience-specific lead exposure education; and conduct family engagement to improve educational strategies and nursing case management.  

MDHHS is working to increase the percent of children who have completed the combined 7-vaccine series by age 24 months. The estimated percentage of children in this age group who received all age-appropriate recommended vaccines was 63.7% in December 2024, a decline from pre-COVID coverage of 69.8% (Michigan Care Improvement Registry). Strategies to increase vaccination rates include provider training, updating pediatric vaccine materials, partnering with I Vaccinate to promote timely vaccination through media campaigns, increasing vaccine confidence statewide, and providing local health departments with county-specific vaccination data.

Michigan will work on activities to increase the percent of children who have a medical home, which is a new universal Title V measure. Over the period 2016-2017 (49.2%) to 2022-2023 (48.4%), there has been no significant trend in Michigan for children ages 0-17 receiving care in a medical home setting. However, as of 2022-2023 there is a significant difference between non-Hispanic White (53.7%) and non-Hispanic Black children (31.0%) receiving care in a medical home (NSCH). MDHHS is convening a Medical Home for Children advisory group that includes parents, providers, payors such as Medicaid, and other systems partners. An environmental scan and system gap analysis will be completed to inform targeted strategies to improve medical home access.

Adolescent Health

The first goal in this domain is to decrease the percentage of adolescents who are bullied or who bully others. After dropping to 24.4% in 2021, the percentage of Michigan adolescents reporting being bullied rose to 29.9% in 2023, the first observed increase since 2015 (Youth Risk Behavior Survey). Key objectives for MDHHS are to work with secondary schools to implement bullying prevention initiatives; implement the Michigan Model for Health social emotional health module; provide training and professional development for schools on laws, policies, and best practices to prevent bullying; and support students’ mental health through the Handle with Care initiative.

A second goal is to increase the percent of adolescents 13 to 18 years of age who have received a completed series of recommended vaccines. As of September 2024, 73.1% of adolescents ages 13 through 17 years were current with immunizations, but that percentage dropped to 43.3% when HPV series completion was included (MCIR). However, Michigan has improved the percentage of adolescents receiving at least one dose of the HPV vaccine. To support adolescent health, MDHHS will provide adolescent vaccine-focused materials for providers and communities, partner with Michigan’s Immunization Coalition to better engage families and communities, build relationships with School Wellness Programs, and work with internal and external partners including Oral Health to increase timely HPV vaccinations.

Children with Special Health Care Needs (CSHCN)

A goal is to increase the percentage of adolescents with special health care needs who receive services necessary to make transitions to adult health care. In Michigan, 21.8% of CYSHCN reported they received services necessary to transition to adult health care, which is slightly better than the US at 17.8% (NSCH, 2021-2022). To improve transitions to adult care, efforts will include implementing the Youth with Epilepsy requiring Support (YES) Demonstration Project grant; implementing a Michigan Health Care Transition framework to support clinics, youth, and families; utilizing the Medicaid Health Plan contract and compliance review to improve transition for youth; and implementing the annual Assessment of Health Care Transition Activities.

Another goal is to increase the percentage of parents/caregivers who are able to get appointments for their child with a specialist as soon as needed. In 2023, 84.0% of parents/caregivers indicated getting an appointment as soon as needed (Consumer Assessment of Healthcare Providers and Systems). Improving access to healthcare is a goal of CSHCS, which helps to cover the costs of specialist medical care and treatment. Strategies to increase access to high-quality services include offering program benefits to reduce financial burdens for CSHCS-eligible families, improving access to respite, assessing the pediatric subspeciality workforce, and using the local health department accreditation process to ensure CSHCS families receive high-quality, accessible care.

A third goal is to decrease the percentage of adolescents with special health care needs who are bullied or who bully others. Since 2019-2020, Michigan children with special healthcare needs have consistently been twice as likely to report having been bullied than children without special health care needs. In 2022-23, 55.7% of CSHCN reported having been bullied, compared to 26.8% of non-CSHCN (NSCH). MDHHS will implement the CSHCS Bullying Prevention Initiative and collaborate with parents and other systems partners on bullying prevention to support students’ mental health.

The last goal aligns with the national work on medical home to increase the percentage of children with special health care needs who have a medical home. Since 2019-2020 children with special health care needs have consistently been less likely than children without special health care needs to receive care in a medical home, with 39.8% of CSHCN and 51.3% of non-CSHCN reporting receiving care in a medical home in 2022-2023. This is driven in part by differences in receiving needed referrals (86.4% of non-CSCHN vs. 70.3% of CSHCN) and effective care coordination (78.5% of non-CSHCN vs. 49.6% of CSHCN) (NSCH, 2022-23). Michigan’s plan includes expanding the Children’s Multi-Disciplinary Specialty (CMDS) Clinic model, implementing the Children with Medical Complexity (CMC) Targeted Case Management (TCM) clinic model, and creating and implementing a coordinated approach to family engagement to increase knowledge of medical home.