Among the most successful public health initiatives in U.S. history, HRSA's maternal and child health programs annually serve more than 34 million people.
HRSA administers a broad range of programs services to pregnant women, mothers, infants, children and their families — and children with special health care needs.
The largest of the programs, the Maternal and Child Health Services Block Grant, includes State Formula Block Grants, Special Projects of Regional and National Significance (SPRANS), and Community Integrated Service Systems (CISS) projects. Other vital missions include Universal Newborn Hearing Screening, Traumatic Brain Injury, Healthy Start, Sickle Cell Service Demonstrations, Family to Family Health Information Centers, Emergency Medical Services for Children, and autism.
Maternal and Child Health Services Block Grant Program
To reduce infant mortality, this program provides access to comprehensive prenatal and postnatal care for women; increases the number of children receiving health assessments and follow-up diagnostic and treatment; and provides access to preventive care (including immunizations) and rehabilitative services for children. States must spend 30 percent of their funding on children with special health care needs; 30 percent also must be spent on primary and preventive care for children.
This grant program supports federal and state partnerships that provide gap-filling maternal health services to more than 2.6 million women, and primary and preventive care to more than 27.8 million infants and children, including approximately 1 million children with special health care needs.
HRSA also administers the Maternal and Child Health Block Grant setaside programs of SPRANS and CISS.
SPRANS projects support research and training, genetics services and newborn screening, and treatments for sickle cell disease and hemophilia. CISS projects seek to increase local service delivery capacity and foster comprehensive, integrated, community service systems for mothers and children.
Healthy Start Program
Healthy Start provides services tailored to the needs of high-risk pregnant women, infants and mothers in communities with exceptionally high rates of infant mortality. Communities in the 38 states, the District of Columbia, and Puerto Rico served by Healthy Start have large minority populations, high rates of unemployment and poverty, and limited access to safe housing and medical providers. Healthy Start supports community-driven programs in these areas to reduce the prevalence of risk factors that contribute to infant mortality.
Since its inception in 1991, Healthy Start has served hundreds of thousands of families. In Healthy Start projects in 1998, first trimester entry into prenatal care by project participants was only 41.8 percent. By 2004, first-trimester entry into prenatal care had increased to 70 percent. From 2005-2006, 22 Healthy Start communities reported no infant deaths among program participants.
Other Maternal and Child Health Programs
- Universal Newborn Hearing Screening - HRSA provides funds to states to establish statewide programs for screening, diagnosis and intervention for infants with newborn hearing disorders.
- Traumatic Brain Injury - HRSA provides funds to states to improve access to health and other services for individuals with traumatic brain injury and their families. Grants support state efforts to develop an infrastructure capable of responding to and treating traumatic brain injuries.
- Emergency Medical Services for Children - This program is designed to reduce child and youth disability and death due to severe illness and injury. Emergency Medical Services for Children grants go to states, U.S. territories, the District of Columbia and schools of medicine to improve existing emergency medical services systems for treating children and to develop and evaluate procedures and protocols.
- Children with Autism and Epilepsy - HRSA award grants to improve health care and other services for young people with autism specturm disorders and other developmental disabilities. Funds also are used to conduct research and improve technical assistance to organizations that treat children with autism. Other grants assist young people with epilepsy or seizure disorders.
- Family-to-Family Health Information Centers - This program provides grants to family-run organizations to ensure that families have access to adequate information about health and community resources to allow informed decisions around their children's health care.
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- 1,128 health center grant recipients operate more than 8,500 community-based clinics in every state and territory, giving geographically isolated or economically distressed people access to preventive and primary health care.
- HRSA-supported health centers cared for about 20.2 million people in 2011, approximately two-thirds of whom are members of minority groups. Thirty-six percent have no health insurance; a third are children.
- One of every 15 people living in the U.S. relies on a HRSA-funded clinic for primary care.
- The National Hansen's Disease Program is the major source of direct patient care, clinician training and research in the field of Hansen's Disease and related leprous conditions.
- The Free Clinics Medical Malpractice Program insures physicians and other clinicians who contribute free health care services in the communities, relieving them of the burden of paying for private liability coverage.
The federal commitment to addressing maternal and child health can be traced first to the Children's Bureau (established in 1912) and then to Title V of the Social Security Act (enacted in 1935), which focuses on maternal and child health services. Title V converted to a Block Grant Program in 1981.