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Title V Maternal & Child Health Block Grant
     Federal Grants Management
The MCH Block Grant is authorized under the Omnibus Budget Reconciliation Act (OBRA) of 1981 and codified at 42 USC 701-709.  The authorizing statute offers evidence of the congressional intent to provide substantial flexibility relative to a State’s needs. 
There are, however, certain restrictions.  The funds may NOT be used for:
  1. inpatient services, other than inpatient services provided to children with special health care needs or to high-risk pregnant women and infants and such other inpatient services as the Secretary may approve; 
  2. cash payments to intended recipients of health services; 
  3. the purchase or improvement of land, the purchase, construction, or permanent improvement (other than minor remodeling) of any building or other facility, or the purchase of major medical equipment; 
  4. satisfying any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds;
  5. roviding funds for research or training to any entity other than a public or nonprofit private entity; or 
  6. ayment for any item or service (other than an emergency item or service) furnished  
    • by an individual or entity during the period when such individual or entity is excluded from providing service under the Maternal and Child Health Act or Title XVIII (Medicare), Title XIX (Medicaid) or Title XX (Services for Families, Children, Aged or Disabled) of the Social Security Act pursuant to section 42 U.S.C. 1320a-7, 42 U.S.C. 1320a-7a, 42 U.S.C. 1320c-5, or 42 U.S.C. 1395u(j)(2) of the Social Security Act; or
    • at the medical direction or on the prescription of a physician during the period when the physician is excluded from providing services in the Maternal and Child Health program or Title XVIII (Medicare), Title XIX (Medicaid) or Title XX (Services for Families, Children, Aged and Disabled) of the Social Security Act pursuant to 42 U.S.C. Section 1320a-7, 42 U.S.C. Section 1320a-7a, 42 U.S.C. Section 1320-5, or 42 U.S.C. 1395u(j)(2) of the Social Security Act and when the person furnishing such item or service knew or had reason to know of the exclusion (after a reasonable time period after reasonable notice has been furnished to the person).


This and other block grants are implemented by the U.S. Department of Health and Human Services (HHS).  The Office of Management and Budget (OMB) permits federal agencies more flexibility with block grants, i.e. States are not required to apply the uniform administrative and cost provisions required of other federal grants.  Instead, OMB instructs agencies to allow States to use “equivalent procedures of their own” to administer the programs.  Accordingly, HHS promulgated separate block grant regulations published at 45 CFR 96 giving States broad latitude for this and other HHS block grant programs. 
In the absence of separate written fiscal and administrative requirements for block grants, Nebraska follows OMB’s Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, or more simply the Uniform Grants Guidance, implemented at 2 CFR part 200.  This Guidance streamlined and co-located requirements from the prior OMB Circulars A-21, A-87, A-110, A-122, A-89, A-102, A-133, and A-50.  HHS adapted OMB’s final guidance with certain amendments.  The implementing regulations are located in 45 CFR part 75. 
Compliance with the federal grants management policies (statutory and regulatory) flows down to subrecipients of Nebraska’s Title V MCH Block Grant, i.e. in subawards to local organizations for community-based projects. Here are the reporting worksheets for the current subawards.
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