Texas strategically uses Title V funds to ensure statewide maternal and child health (MCH) needs are being addressed. The Department of State Health Services (DSHS) is Texas’ public health agency and improving the lives of women and children, including children with special needs, is a priority. The work of Title V is driven by State and National Performance Measures which are guided by the results of ongoing statewide needs assessments. Continual evaluation allows for flexibility in programming and responsiveness to emerging issues. Recent organizational changes to DSHS created the Community Health Improvement Division. This improved alignment between Title V and other DSHS Sections that focus on MCH, such as Health Promotion and Chronic Disease Prevention, Environmental Epidemiology and Disease Registries, and Vital Statistics. Title V also staffs over 90 personnel throughout the Texas Public Health Regions to identify local community needs and develop solutions for improvement. Finally, Title V ensures that a continual and comprehensive review of finances and programming is in place so that utilization of Title V MCH Block Grant funds is methodical and reflects the needs of Texas.