Title V was amended by the Omnibus Budget Reconciliation Act of 1981 (OBRA ’81).
In 1981, seven previously separate grants were consolidated into a “block” of funding. This allowed the funds to more broadly address a variety of health needs of mothers and children. The Title V MCH Block Grant was the first Block Grant.
- The MCH Block Grant became a major funding source to support a variety of programs, services, and capacity-building activities. It is not a single program.
- MCH Block Grant was designed to address the health of pregnant women, infants, children (including adolescents), children with special health care needs, women of childbearing age, and their families using a family-centered care approach.
- OBRA ’81 authorized set-aside funds (15% of the federal appropriation of the Block Grant) for Special Projects of Regional and National Significance (SPRANS).
Title V was again amended by the Omnibus Budget Reconciliation Act of 1989 (OBRA ’89).
- This amendment introduced stricter requirements for accountability of the use of funds and for state planning and reporting.
- It added a requirement that States conduct activities to “improve the health of all mothers and children”, emphasizing that there are no eligibility requirements to qualify for services paid with Title V funds.
- OBRA ’89 gave States flexibility to develop solutions to meet state and local needs.
- It defined a second set-aside for discretionary funding – Community Integrated Service Systems (CISS).
In 1998, the Abstinence Education Grant Program was added as Section 510 to Title V. This program is administered separately from the Block Grant.
The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program was added as Section 511 of Title V, as amended by the Patient Protection and Affordable Care Act of 2010. This program is administered separately from the Block Grant.