Arkansas Title V Maternal and Child Health Services Block Grant

2026 Application/2024 Annual Report

 

 

III.B.  Overview of the State

III.B.1.  State Description

 

Arkansas is in the southern region of the U.S. It covers an area of 53,178 square miles and is organized into 75 counties. Arkansas borders six other states (Missouri, Oklahoma, Texas, Tennessee, Louisiana, Mississippi). The Mississippi River forms the state borders to Tennessee and Mississippi in the east.

 

Geography:  Of the 75 counties in the state, 62 are considered rural (83%), with 41% of residents living in rural areas compared to 14% in the U.S. The capital and largest city is Little Rock. Major population areas are Fort Smith, Hot Springs, Jonesboro, Pine Bluff, and Texarkana, Northwest Arkansas (Fayetteville, Springdale, Rogers, and Bentonville), and Little Rock/North Little Rock. The county with the highest population is Pulaski County, where Little Rock is located. Benton County had the greatest increase (40%) between 2010 and 2023. Phillips County decreased from 22,000 to 15,000, representing the largest decrease (31%). (Source: U.S. Census population estimates) (Map Source: 2021 Rural Profile of Arkansas)

Counties in the Mississippi Delta are especially rural and poor. They have high concentrations of minority populations, especially African American. Counties along the state’s western border are mountainous and rural. The population of immigrant Hispanic families from Central and South America is high in these counties. Arkansas and Hawaii are home to the largest groups of Marshallese Islanders living outside of the Marshallese Islands.

 

Population: According to the U.S. Census Quick Facts, Arkansas is home to 3,088,354 residents. Arkansas’s population is primarily White (78.4%) with African American (15.6%) secondary. Other groups are Hispanic/Latino (9.2%), two or more races (2.54%), Asian (1.9%), American Indian/Alaska Native (1.1%), and Native Hawaiian and other Pacific Islander (0.5%). Of the total population, 18% are aged 65 and over, 23% are under age 18, and 5.9% children under are age five.

 

Marital Status:  In 2023, there were 1,232,871 households in Arkansas (U.S. Census Bureau, ACS), 29.5% of which had children under age 18 in the home. There were 345,922 female-headed households with no husband present, of which 68,833 had children under the age of 18. Children growing up in single-parent families typically do not have the same economic or human resources available as those growing up in two-parent families. Compared with children in married-couple families, children raised in single-parent households are more likely to drop out of school, to become a teen parent, and to experience a divorce in adulthood.

 

Economy: The average family income in Arkansas is $58,773 per year. This is 25% lower than the U.S. average of $78,538. Arkansas’ Gross Domestic Product (GDP) was $165,220 billion in 2022, representing 0.61% of the national GDP and making Arkansas the 35th largest state economy. Arkansas’s per-capita GDP in 2019 was $43,394.00, which was $21,847.00 lower than the national figure. However, the 2019 per-capita GDP was a 2.5% increase over 2016. The state’s GDP declined to $129 billion in 2022. Prior to 2020, the GDP had increased each year since 2009. (Federal Reserve Bank of St. Louis. Total gross domestic products for Arkansas. 2020)

 

The U.S. Census Bureau reports the majority (58.1%) of Arkansans ages 16 and older are in the civilian labor force. (Source: U.S. Census Quick Facts) Arkansas ranks 39th in business environment, which includes new business openings and the rate of patents for new inventions. Arkansas ranks 22nd in economic growth, determined by the growth of the young population in the state, growth by migration, and increased GDP. The disparity in earnings per job between rural and urban areas remains significant, with urban residents earning on average 19% more than rural residents.

 

Unemployment: Arkansas’s unemployment rate remained steady at 3.6% as of December 2024, meaning that 50,500 individuals are unemployed. This rate is a third of Arkansas’s pandemic unemployment of 10.1% in April 2020.  Arkansas’s unemployment rate is lower than the national average of 4.1% and the state ranks 20th for lowest level of unemployment, along with Delaware, Georgia, Mississippi, and Missouri. (Source: Bureau of Labor Statistics)

Employment:  Arkansas ranks in the bottom third of the nation for women's employment, earnings, poverty, and opportunity (Status of Women, 2018). Women ages 16 and older who work full-time, year-round have median annual earnings of $32,000, which is 0.80 cents on the dollar compared with men who work the same. Hispanic women earn just 0.51 cents for every dollar earned by white men. If the pay between employed women and men in comparable positions were the same, the poverty rate would be reduced by almost half and poverty among employed single mothers would drop by more than half.

Poverty: Arkansas’s prevalence of poverty continues to be high. With 15.7% of people below Federal Poverty Level (FPL), Arkansas is the state with the 7th highest prevalence in the U.S. In 2023, 20.9% of Arkansas’s children under the age of 18 lived in poverty compared to 16% in the U.S. The situation is worse for children under the age of five: 22.7% live in poverty compared to 16.8% nationally. Across the U.S. approximately 15.7% of children ages 5-17 live in poverty, but 20.3% of children in this age group in Arkansas live in poverty. (Source: U.S. Census Bureau, 2023) In the Coastal Plains and Delta regions of Arkansas, 36% of children live in poverty.

Poverty is statistically linked to negative outcomes for children, from low birthweight and poor nutrition in infancy to increased risk of academic failure, emotional distress, and teen pregnancy. Access to food, adequate shelter, and transportation are limited for many Arkansans. Almost one-quarter (24.2%) of Arkansas children experience food insecurity, with greatest concentration along the eastern and southern portions of the state. (Source: Feeding America)

Education:  Education levels in Arkansas are lower than the U.S. average for both high school and bachelor’s level degrees or higher. Approximately 88.6% of Arkansans ages 25 or older finished high school or an equivalent exam compared to 89.4% nationwide. The discrepancy is wider between those who have a bachelor’s degree: 25.1% of Arkansans ages 25 or older possess a bachelor’s degree compared to 35% in the same group in the U.S. overall.

Housing. In Arkansas, 13.2% of occupied housing units have at least one of the following problems - lack of complete kitchen facilities, lack of plumbing facilities, overcrowding, or severely cost-burdened occupants, compared to 16.8% in the U.S. (America’s Health Rankings [AHR] 2017-2021). Eight of 10 mothers with children who are homeless reported domestic violence (AHR, 2019). Additionally, six of 10 people in families experiencing homelessness are 18 years or less and 2.8% of public-school students in Arkansas lack a fixed, regular, and adequate nighttime residence compared to 2.4% in the U.S.

Social Risk Factors of Health: The rural regions have higher rates of obesity, food insecurity, and child poverty than urban areas. Forty percent (40%) of Arkansas adults are classified as obese, and 37.9% of children aged 10-17 years are overweight or obese. Arkansas has the highest percentage of food insecurity (18.9%) in the nation (AHR, 2024 Annual Report). The disparity in earnings per job between rural and urban areas remains great, with urban residents earning on average 20% more than rural residents. Arkansas has 14 rural counties with “persistent poverty” and “persistent child poverty”. Persistent child poverty is defined as having child (<18 years old) poverty rates of at least 20% in all the following sources: 1980, 1990, and 2000 decennial censuses, and 2007-2011 American Community Survey 5-year average. Each of the risk factors noted here contributes to significant health challenges.

 

Arkansas ranked 42nd of 49 states (49 being the worst) in the nation for maternal mortality in 2018-2022 (2024 Health of Women and Children Report). Findings from Arkansas Maternal Mortality Review Committee (AMMRC) revealed that 95% of pregnancy-related deaths from 2018-2021 were preventable.  Black non-Hispanic women were 1.2 times as likely to die as White non-Hispanic women.

 

African Americans tend to have poor health outcomes in comparison to whites, and this is especially true for maternal mortality. In the U.S., African American women are much more likely to die of pregnancy or childbirth-related causes than white women. Maternal mortality rates for African American women in Arkansas mirror those for African American women in the U.S.; African American women are 1.7 times more likely to die in the perinatal period than white women (HRSA Federally Available Data, NVSS 2018-2022). Additionally, life expectancy is lowest for African Americans born in the Delta Region of Arkansas (2023 Arkansas Red County Report).

 

Access to Medical Care. Eight out of ten Arkansas women ages 18-44 in Arkansas reported having one or more people they think of as their personal doctor or health care provider. Between 2021 and 2022, 81.8% of women reported having a usual source of care, slightly higher than the U.S. at 78.1%. (America’s Health Rankings Health of Women and Children [AHR HWC], 2024)

 

Access to Dental Care. In 2022, 60.8% of women ages 18-44 reported visiting the dentist or dental clinic within the past year compared to 64.1% in the U.S. (AHR HWC, 2024). In 2024, Arkansas had 45.3 general dentists and advanced practice dental therapists per 100,000 population (U.S. = 65.8), ranking them 48th in the nation (AHR, 2024).

 

Health Professional Shortage: Of the 75 counties in the state, 62 are considered rural (83%) and 51 (68%) have Health Professional Shortage Areas (HPSAs) (Arkansas State Health Assessment 2020). The primary care physician (PCP) ratio in rural versus urban areas is 1:1.8 (73 PCPs per 100,000 people vs. 133 PCPs per 100,000 people), indicating a great need for the provision of primary healthcare in these HPSAs with limited or no access to preventive services. The HPSAs are mostly distributed in Southeast (SE), Southwest (SW), Northeast (NE) and Northwest (NW) Arkansas (Arkansas State Health Assessment 2020). Arkansas is a rural state in which limited access to healthcare is a primary factor in delays for diagnosis and treatment.

 

Continuity of Insurance. In 2022, the percentage of children ages 0-18 in Arkansas and across the U.S. with health insurance of any type was 94% (AHR HWC, 2024). In 2022-2023, the percentage of continuously insured children aged 0-17 in Arkansas whose health plan has either no or reasonable out-of-pocket costs, offers benefits or covered services that meet the children’s needs, and allows them to see health care providers (2-year estimate) (68.8%) was higher than the national average (66.5%) (AHR HWC, 2024).

 

Although the percentage of women ages 19-44 who are not covered by private or public health insurance has declined since 2019, more women in Arkansas (12.0%) are uninsured compared to women across the U.S. (10.9%) (AHR HWC, 2024).

Life Expectancy: Arkansas ranked 45th in the nation for average life expectancy (CDC, 2021). In 2021, life expectancy was 72.5 years compared to 76.4 years nationally. Arkansas women had a higher life expectancy of 75.6 years (46th lowest in the nation), compared to men at 69.7 years (44th in the nation). Benton County (northwest) had the longest life expectancy: 78.2 years. Phillips County (eastern) had the shortest life expectancy: 67.2 years. (Source: Health Statistics Branch, Arkansas Department of Health, 2023)

 

This difference in life expectancy reflects the impact that the social risk factors of health noted above can have on the health of a population. COVID-19 had a large impact on life expectancy, with an estimated drop in life expectancy of 2.7 years between 2019 and 2021 across the U.S. The drop was especially felt among African American men.

 

Mortality: In 2022, Arkansas ranked 42nd in the nation for premature death, the leading causes of which are chronic diseases, COVID-19, and unintentional injuries. Unintentional injury is the fourth leading cause of death in the state. Accidents are the number one killer of Arkansans between the ages of 1-44 and the ages of 1-14.

 

In 2022, the total number of infant and child deaths (ages 0-17) in Arkansas was 453. Of those, 172 cases were eligible for review. The most common causes of infant and child deaths include unintentional accidents such as motor vehicle related injuries, poisoning or overdose, accidental drowning, and fire related injuries. (2024 Infant and Child Death Review)

 

 

Heart disease, cancer, chronic lung disease, stroke, Alzheimer’s disease, diabetes, and kidney disease are the leading causes of death associated with chronic disease. The state’s high rates of chronic disease can be linked to lack of physical activity combined with very high rates of obesity, high blood pressure, and tobacco use. In 2023, death from influenza and pneumonia was the 12th most common cause of death in Arkansas.

 

 

 

From 2018-2021, Arkansas had 141 pregnancy-associated deaths. This represents a pregnancy-associated mortality ratio of 97.6 deaths per 100,000 live births. For all pregnancy-associated deaths, Black non-Hispanic women were 1.8 times as likely to die compared to White non-Hispanic women.

Infections and disorders of the cardiovascular system were the leading causes of pregnancy-related deaths. The top underlying causes were infections, cardiomyopathy, cardiovascular conditions, hypertensive disorders of pregnancy, hemorrhage, and mental health conditions.

For pregnancy-related deaths, women ages 35 and older have the highest mortality ratio, which was 4.9 times the mortality ratio of women younger than 25 years

old. Black non-Hispanic women were 1.2 times as likely to die compared to White non-Hispanic women.

 

In Arkansas, African Americans have higher rates of infant mortality compared to Whites or Latinos. The infant mortality rate for African Americans in 2021 was 15.0 compared to 7.4 for whites and 5.2 for Latinos. The infant mortality rate is the annual number of babies per 1,000 live births who die before their first birthday. In 2021, 309 babies died in Arkansas before their first birthday. Arkansas had the 2nd highest infant mortality rate in the country at 8.6 deaths per 1,000 live births (Source: CDC. Infant Mortality Rates by State. 2021).

 

The leading causes of neonatal death in Arkansas are birth defects, prematurity, problems with the pregnancy, and complications of the placenta, cord and membranes. The leading causes of post-neonatal death are SIDS and birth defects. Additional numbers for 2021 show Arkansas ranked 6th highest in preterm birth rate (12.04 per 1,000) and 8th in low birthweight rate (9.52 per 1,000).   

 

Health Rankings: According to America’s Health Rankings (2024 Annual Report and 2024 Health of Women and Children Report), Arkansas ranks 48th in overall health and 50th in health of women and children. The range of measures rank unfavorably when compared to other states. With 50 being the worst and one being the best, Arkansas ranks:

• 45th – adult obesity in women
• 49th – teen births
• 49th – physical inactivity in adult women
• 49th – adult women who smoke
• 49th – infant mortality
• 46th – child mortality
• 39th – low birthweight live births
• 36th – childhood immunizations
• 48th – adverse childhood experiences
• 42th – maternal mortality
• 42th – diabetes in adult women

 

Arkansas ranks 45th in child well-being, which has four domains: health, education, economic well-being, and community and family. Within these domains, Arkansas ranks 46th in community and family, 47th in health, 46th in economic well-being, and 36th in education (Kids Count Data Book, 2024).

 

Teen Pregnancy Rate: Rates continue to decline, but not as fast as the national average.  Arkansas continues to have one of the highest teen birth rates in the country, ranking 49th in 2023 (CDC WONDER). The rates are being driven by 18–19 years old and two-thirds are unintended pregnancies.

 

According to the most recent AHR report, Arkansas has had one of the highest teen birth rates in the country among females ages 15 to 19 since 2014 (2019-k). Although the teen birth rate dropped from 40 live births per 1,000 females ages 15 to 19 to 24 live births per 1,000 females ages 15 to 19 from 2014 to 2023, rates in other states dropped as well, leaving Arkansas with the highest rate across the U.S. Although teen birth rates are falling in the state and across the country, Arkansas rates remain at least 67% higher than national rates.

 

In Arkansas, as across the U.S., the majority of teen births are among individuals aged 18 to 19. Rates among this age group have been declining for more than 10 years in both Arkansas and the nation; however, as noted above, rates in Arkansas remain significantly higher than those in the U.S.: 46 live births per 1,000 females ages 18 to 19 in Arkansas compared to 25 live births per 1,000 females ages 18 to 19 in the U.S.

 

In 2023, almost 400 (16%) of the teen births were teens who were already mothers (Kids Count Data Center, 2023). Across the U.S., this is true for 14% of the teen births. Teen pregnancy and childbearing can have significant and lifelong impacts on the mother and child. Teen mothers are more likely to drop out of high school, have difficulty getting and keeping a job, and live in poverty. Children of teen mothers are more likely to have lower school achievements and drop out of school, increasing the difficulty of finding employment and continuing the cycle of poverty. The state’s Maternal, Infant, and Early Childhood Home Visiting Program - MIECHV annually assesses the number of households containing an enrollee who is pregnant and under age 21 as a demographic measure. In both 2023 and 2024, the program served 197 (10.8% and 11.7% of total served, respectively) households with an enrollee who was pregnant and under age 21.

                                                                                                                    Challenges: Arkansas has unique challenges that impact the health status of its MCH population. Availability of and accessibility to health care and preventive health services varies widely in Arkansas. Central Arkansas is relatively urban and well supplied with health services for women and children. However, even in these counties, low-income families experience barriers in access to care. Other regions are rural, and many are medically underserved as defined by the HRSA.

People in rural Arkansas have greater difficulty getting the health care services they need, in part due to cost. In general, 13.9% of Arkansans report that they were not able to see a doctor in the past 12 months due to the cost, compared to 11.6% in the U.S. In rural counties, more than 20% of residents were not able to see a doctor due to the cost. In 2023, 12.4% of working-age Arkansas adults have no health insurance, a slight increase from 11.9% in the previous year (Small Area Health Insurance Estimates, 2022). In addition to cost, a shortage of health care services available is also a limiting factor.

The number of physician practices and birthing hospitals are not adequately dispersed throughout rural areas in Arkansas. See the Health Care Delivery Systems Section on page 27.

Arkansas also has some of the highest maternal and infant mortality rates in the nation and ranks among the poorest states for the number of counties identified as maternity care deserts. As rural labor and delivery units continue to face closures due to financial and workforce challenges, the need for a solution to the problem of resource allocation among facilities serving high-risk mothers and infants only increases.

The AMMRC 2024 Legislative Report noted that between 2018 and 2021, Arkansas had 141 pregnancy-associated deaths, or the equivalent of 97.6 pregnancy-associated deaths per 100,000 live births. Furthermore, the AMMRC determined that 95% of these deaths were considered preventable. Among the most common causes of pregnancy-related deaths were infections, cardiomyopathy, cardiovascular conditions, hypertensive disorders of pregnancy, hemorrhage, and mental health conditions.

Furthermore, access to basic food, shelter, and transportation is limited for many Arkansans. In 2023, there were 9,267 homes in the state lacking complete plumbing and 15,143 without kitchens. More than 12,993 homes were without phone service and 75,556 were without a method of transportation. As a result, families are limited in their ability to connect with others or access necessary goods and services.

Strengths: Despite these challenges, Arkansas’s healthcare delivery improved because of the Medicaid expansion, which was vital to the health of the state’s MCH population. Many previously uninsured Arkansas women and children were able to enroll in a healthcare plan.

As of 2022, 1,540,376 (88.1%) people between the ages of 18-64 were enrolled in health care coverage. According to Small Area Health Insurance Estimates (SAHIE, 2022), 793,842 women (90%) ages 18-64 were insured with 88,269 (10%) women remaining uninsured. Ninety-five percent (679,863) of the total number of children (718,865) under 19 were insured.

No other state has experienced a more rapid decline in its number of uninsured residents. The uninsured level fell from 16% in 2013 to 12% in 2023. Arkansas’s Medicaid expansion efforts have been in the form of the Private Option, which allows Medicaid to fund private insurance companies for families at or below 138% of the Federal Poverty Level (FPL). The 1115 Medicaid Waiver that funded family planning services for women up to 250% of the FPL ended in December 2013.

MMRC reviewed 141 pregnancy-associated deaths from 2018-2021. Of the 141 cases, 59 cases were pregnancy-related, which represents a ratio of 40.9 deaths per 1000,000 live births. Ninety-five percent of pregnancy-related deaths were considered preventable.

Based upon these findings, MMRC submitted recommendations for patients and families, providers, facilities, systems, and communities. The recommendations prompted the Governors’ Office to pilot a campaign aimed at improving maternal health, in March 2024.

As a result of the pilot campaign, the Healthy Moms, Healthy Babies Bill 213 passed during the 2025 legislative session. This bill changed policies relating to pregnancy and postpartum care by unbundling global payment, increasing provider reimbursements, and expanding access to telemedicine. This bill also improves pregnancy outcomes by empowering community health workers and ensuring Medicaid coverage for expectant mothers.

 

Another notable strength is the Newborn Screening (NBS) Program, which is located within the ADH Family Health Branch. The ADH NBS program is the only agency responsible for statewide newborn screening services, which include follow up actions for abnormal, borderline, inconclusive or indeterminate screening results for inborn conditions.

 

Act 192 of 1967 required that all newborns be screened for phenylketonuria. Since then, the screening program has expanded to include more than 30 genetic disorders using the blood spot card, as well as two point-of-care tests, hearing screening and critical congenital heart disease, totaling 35 core disorders. In 2024, the Newborn Screening (NBS) program served approximately 34,343 babies and their families born in Arkansas, with 94.7% of newborns screened for genetic disorders.

 

1. Total number of births for CY2024: 34,343
2. Total number of samples received for CY2024: 39,518
3. Total number of tests performed for CY2024: 382,754
4. Number confirmed cases: 92
5. Number referred for treatment: 92

 

The NBS monthly timeliness data consists of three key data points: 1) time of birth to time of collection, 2) time of collection to time of receipt in the lab, and 3) time of receipt in the lab to report all results. The 2024 NBS Quality Improvement report indicated the average time calculated to be 172 hours, which is just over the target goal of 168 hours (7 days).

 

In 2024, a total of 33 birthing hospitals plus Arkansas Children’s Hospital submitted 39,518 specimens to the NBS lab within 48 hours of collection. Specimen submission to the NBS lab must be within 48 hours to meet the goal of 80%. The yearly comparison report of all birthing facilities and Arkansas Children's Hospital had an average of 86%, which exceeded the 80% goal.

 

Defined Roles/Responsibilities and Targeted Interest: The Arkansas’s Title V MCH Block Grant Program relies on shared leadership between ADH’s Family Health Branch and the Arkansas Department of Human Services (DHS) Children’s Special Services (formerly Children with Special Health Care Needs) to execute services statewide. The state Title V MCH leadership team makes program and policy decisions and ensures alignment across the programs and agencies. Designated Title V MCH staff manage state-level program and policy work and provide technical assistance and oversight to the local Title V grantees. (Section VI: ADH and CSS Organizational Charts)

The Title V MCH and CSS administrators, along with MCH partners and ADH staff, utilize various methods to determine the importance, value, and priority of competing factors that impact health services delivery. The Title V program receives input and advice from partners, stakeholders, and other organizations. The overall goal of Arkansas's MCH program is to improve health outcomes. Supporting that goal are five priority areas:

 

1. Strengthen core services: Family Planning, Prenatal Care, WIC Program, Immunizations, and Home Visiting.
2. Develop more effective population-based approaches: prevent injuries, reduce infant mortality, increase physical activity, and improve oral health.
3. Communicate public health value and societal contribution: economic development, public awareness, and benefits of prevention.
4. Secure adequate human and financial resources: workforce needs and training and funding acquisition.
5. Increase departmental effectiveness and accountability: strengthen leadership, management systems, information technology, data use, and accountability.

Cross-cutting these areas is an emphasis on community engagement, partnerships, and policy development. The overall theme is to strengthen and improve traditional public health clinical services while focusing on program development, engaging more in public awareness and policy development, and retooling administrative processes to work more effectively and efficiently. The public is engaged through ADH’s Hometown Health Initiative (HHI), a community-driven process that empowers local communities to take ownership of health problems by working to identify and implement solutions.

 

The intricate roles of statewide coordinated services target the health interests of at-risk and vulnerable populations regardless of race, ethnicity, or national origin. Therefore, reducing health differences throughout the state continues to be a major ADH focus.

Multiple initiatives impact the state’s Title V directives. All the highest priority services are provided in all 75 counties. High-priority services not provided through ADH’s Local Health Units are organized through ADH’s Central Office such as newborn metabolic and hearing screening, school health, and home visiting programs. Secondary services include basic preventive services that local health care systems may not have the capacity to provide, especially maternity care.

The ADH’s Office of Health Disparities Elimination (OHDE) provides leadership in improving health outcomes for at-risk populations as defined by MCH programming. The OHDE serves as the ADH’s coordinating office for consultative services and training in cultural and linguistic competency, coordination, partnership building, program development and implementation, and related efforts to address the needs of underrepresented populations. This office promotes the integration of Culturally and Linguistically Appropriate Services (CLAS) within health programs.

 

The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program gives pregnant women and families with children ages 0 to 5 years old, particularly those considered at-risk, the necessary resources and skills to raise children who are physically, socially, and emotionally healthy and ready to learn. MIECHV implements voluntary, evidence-based and/or promising approach programs that best meet the needs of these children and their communities. From September 2023 through September 2024, the MIECHV program served 1,683 households, which included 535 pregnant women, 1,114 female caregivers, and 34 male caregivers. The total number of enrolled children served was 1,794, consisting of 938 female children and 856 male children.

ADH Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) facilitates a unique surveillance ability to find syphilis exposures during pregnancy and link them with health outcomes of pregnant women and infants through at least 2 years of age. SET-NET responds to the impact of syphilis on mothers and newborns, ensuring timely public health interventions to reduce adverse outcomes.

 

 

 

The UAMS Women and Infant Health Service Line – WISL provides comprehensive and high-risk maternity care to low-income women. The physician examines patients, reviews record, develops plans of care and answers questions for other health care providers in the clinic. Outpatient services include:

• Nursing Services
• Laboratory Services
• Physician Services
• Telephone and/or Telemedicine Consultation Services

 

Service Delivery: The Arkansas DHS houses programs that are important to improve MCH health in the state. DHS’s Division of Medical Services (DMS) administers the Medicaid Program, which serves approximately two-thirds of children in the state. Most children are covered based on income eligibility through ARKids First A or B, depending on income level. Medicaid funds 41% of births in Arkansas and in the nation in 2023. Out of the 35,264 births in Arkansas in 2023, 14,450 were paid by Medicaid.

Transitioning from pediatric to adult care is a priority of ADH for all youth and young adults in Arkansas, including those with disabilities, chronic health conditions, or other needs. The Arkansas Department of Human Services (DHS) is also home to the state’s Title V CSS program in the Division of Developmental Disabilities Services (DDS). ADH’s Title V Director is working to improve collaboration with this division, which includes maintaining an important partnership with the Division’s Medical Director. Services for CSS are closely associated with specialty services of the University of Arkansas for Medical Sciences (UAMS) Department of Pediatrics. The Division also supports the state's early intervention program (Part C), known as First Connections.

As the only medical school in the state, UAMS plays a critical role in Arkansas's health care system. Development of the UAMS College of Public Health in 2001 led to stronger links between state health-engaged agencies and the university system. UAMS’s pediatrics and obstetrics/gynecology departments partner with ADH to provide direct care to women and children and to carry out initiatives to improve systems of care.

Arkansas Children’s Hospital (ACH) in Little Rock plays an important role in the health care system. It is one of the largest children's hospitals in the U.S., attracting patients from around the region, other states, and other countries. The hospital provides most of the pediatric critical care in the state. The hospital’s administration is also committed to involvement in community and state level public health concerns such as infant mortality, injury prevention, home visiting, and school health initiatives.

Specific State Efforts: ADH disseminated the updated 2024-2029 ADH Strategic Plan, which supports two of the MCH priority areas: 1) women and maternal health and 2) youth tobacco use. Below are strategies addressed in the ADH Strategic Plan that align with the MCH NPMs.

 

Women and Maternal Health

• Strengthen the quality of care provided to women before and during pregnancy by their medical providers and/or the healthcare system.
• Increase the number of women accessing prenatal care and the frequency by which they access it.

 

Youth Tobacco Use

• Increase the number of groups that ADH Tobacco Prevention and Cessation Program (TPCP) has an active partnership with and increase the number of outreach/intervention projects conducted with these partners.

 

As noted in the Executive Summary, Arkansas was selected to receive a $17 million grant over 10 years for participants in Medicaid and the Children’s Health Insurance Program. This Transforming Maternal Health – TMaH model utilizes a whole-person approach to pregnancy, childbirth and postpartum care that addresses mothers’ physical, mental health, and social needs. The TMaH model also seeks to reduce differences in access and treatment and improve outcomes and experiences for mothers and newborns. DHS will lead the coordination of this project.

 

During the 2025 legislative session, bills were passed to promote the health and well-being of mothers, infants, and children.

• ACT 123 (Food Security): Ensures that all public-school students receive free school breakfast regardless of their family income beginning 2025-2026 school year.
• ACT 140 (Maternal Health): Healthy Moms, Healthy Babies changed Medicaid regulations to make prenatal care much more accessible in areas of the state that have been designated as maternal care deserts, because of a lack of obstetricians.

• Establishes presumptive eligibility for pregnant women who apply for Medicaid, which allows immediate prenatal care, while they’re waiting for a full application to be processed.
• Authorizes Medicaid to reimburse doulas and community health workers for visits to the pregnant woman’s home if the visit is related to prenatal or postpartum care.
• Authorize Medicaid coverage for office visits, laboratory fees, tests ordered by a physician, blood work, remote monitoring, fetal nonstress tests and glucose monitoring to detect possible gestational diabetes. Self-measurement blood pressure devices will be covered also.

• Act 138: Empowers certified midwives to make hospital admissions and sign birth or death certificates.
• ACT 965 (Maternal/Infant): Establishes the certified community-based doula certification act; to certify birth/postpartum doulas in this state to improve maternal and infant outcomes.
• ACT 868 (Maternal/Infant): Creates a comprehensive statewide system of care (Maternal Outcomes Management System (MOMS) to address maternal health research and resources; inclusive of establishing grant program for birthing and delivery hospitals.