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2100 Program Authorization and Services
Revision 26-2; Effective Sept. 1, 2026
Title V Maternal and Child Health Fee-for-Services Program Background
The purpose of the Maternal and Child Health (MCH) Services Title V Block Grant is to create federal and state partnerships. These partnerships provide direct services to low-income women and children who are not eligible for Medicaid, Children’s Health Insurance Program (CHIP), CHIP Perinatal or another payer source that covers these same services. Title V Maternal and Child Health Fee-for-Services (TVFFS) grantees provide services that:
- significantly reduce infant mortality,
- include comprehensive care for women before, during and after pregnancy and childbirth, and
- include preventive and primary care services for infants, children and adolescents.
Legal Authority
Through Title V of the Social Security Act (SSA) of 1935, the federal government pledged to support state efforts to improve the health of all mothers and children. The MCH Block Grant Program under Title V of the SSA was created in 1981 to consolidate multiple programs. These programs support a more comprehensive, coordinated approach to meeting states’ individual needs consistent with the applicable health status goals and national health objectives now identified in Healthy People 2030.
Within Texas, TVFFS operates within a framework articulated by the Texas Legislature and Texas Health and Human Services Commission (HHSC).
States are required to use awarded federal funds as follows:
- 30% for preventive or primary care services for children
- 30% for services for children with Special Health Care Needs
- Up to 10% on administrative costs
- Remaining funds to support other MCH populations, such as pregnant women and mothers
Funding Sources
TVFFS program services are funded by state general revenue and federal funds through the Title V MCH Block Grant. HHSC TVFFS funds are allocated through a competitive application process. After the funds are allocated, selected applicants negotiate contracts with HHSC to provide services.
2200 Definitions
Revision 26-2; Effective Sept. 1, 2026
The following words and terms, when used in this manual, have the following meanings:
Adjusted Gross Household Income – The gross household income before taxes, minus any allowable deductions. The adjusted gross household income is used to calculate the Federal Poverty Level (FPL) percentage.
Alternate Eligibility Screening Tool (AEST) – An HHSC-approved eligibility screening form substitute, such as in-house form or electronic form, that contains the required information for determining eligibility.
Applicant – A person who applies to receive TVFFS services.
Barrier to Care – A factor that hinders a person from receiving health care. For example, proximity or distance, lack of transportation, documentation requirements, and copayment amount can impact access to services.
Case Management – Relating to pregnant women, this means making sure they have access to quality prenatal, delivery and postpartum care. With respect to infants, children and adolescents, it means making sure they have access to quality preventive and primary care services.
Children’s Health Insurance Program (CHIP) – A program for children in families that earn too much money to qualify for Medicaid but can’t afford to buy private insurance.
CHIP Perinatal Program – A health insurance program that provides limited coverage during pregnancy and postpartum for women who don’t qualify for Medicaid and don’t have health insurance.
Children and Adolescents – People from their first birthday through their 21st year.
Client – A person who has been screened and determined to be eligible for the program.
Confidentiality – The state of keeping information private and not sharing it without permission.
Consultation – A service provided by a health care provider with expertise in a medical or surgical specialty.
Copayment or Copay – Money collected directly from clients for services.
Dental Services – Diagnostic, preventive and therapeutic dental services that are provided to an eligible client and are performed in a dental office or clinic.
Department of State Health Services (DSHS) – The agency responsible for public health in the state of Texas.
Dependent Care Deduction – The expense of providing care for a dependent. This expense must be both necessary for employment and incurred by an employed person. Allowable deductions are actual expenses, up to $200 per month for each child younger than two years and $175 per month for each child two years or older.
Diagnosis – The recognition of disease status determined by evaluating the client’s history, the disease process, and the signs and symptoms present. Determining the diagnosis may require some or all the following:
- microscopic – culture
- chemical – blood tests
- radiological examinations – X-rays
Diagnostic Services – Activities related to the diagnosis made by a physician or other health professional.
Family Planning Services – Educational or comprehensive medical activities that enable clients to freely determine the number and spacing of their children and select how this may be achieved.
Federal Poverty Level (FPL) – The set minimum amount of income that a family needs for food, clothing, transportation, shelter and other necessities. This level is determined by the Department of Health and Human Services. FPL varies per family size. The number is adjusted for inflation and reported annually in the Federal Poverty Guidelines. Public assistance programs, such as Medicaid, define eligibility income limits in terms of a percentage of FPL.
Fee-for-Service (FFS) – The payment mechanism for services that are reimbursed on a set rate per unit of service, also known as unit rate.
Fiscal Year – The state fiscal year is from Sept. 1 through Aug. 31. The federal fiscal year is from Oct. 1 through Sept. 30.
Grantee – A non-state entity that receives an award directly from the state awarding agency to carry out an activity under a state program. The term does not include subgrantees or subrecipients.
Gross Household Income – The total countable income of the household before taxes. Refer to Appendix I, Definition of Income.
Health and Human Services Commission (HHSC) – The Texas administrative agency established under Chapter 531, Texas Government Code, or its designee. HHSC manages programs that help families with food, health care, safety and disaster services.
Health Care Provider or Provider – A physician, physician assistant, nurse practitioner, clinical nurse specialist, certified nurse midwife, group of clinicians, federally qualified health center, family planning agency, health clinic, ambulatory surgical center, hospital ambulatory surgical center, laboratory or rural health center that provide healthcare services.
Medicaid – The Texas Medical Assistance Program, a joint federal and state program provided in Texas Human Resources Code Chapter 32 and subject to Title XIX of the Social Security Act, 42 USC Section 1396. The program reimburses for health care services delivered to low-income clients who meet eligibility guidelines.
Minor – Per the Texas Family Code, a minor is a person younger than 18 years of age who is not and has not been married or who has not had the disabilities of minority removed for general purposes, such as emancipated. In this policy manual, minor and child may be used interchangeably.
Nutritional Services – The provision of services to identify the nutritional status of a person and offer instruction. Instruction includes appropriate dietary information based on the client’s needs such as age, sex and health status. This may be provided to a person on a one-to-one basis or to a group of people.
Payor Source – Programs, benefits or insurance that pays for the service provided.
Prescription Drugs, Devices and Durable Supplies – Medically necessary pharmaceuticals and medical supplies that are capable of withstanding wear, which are needed for the treatment of a diagnosed condition.
Preventive Health Care – Services include, but are not limited to the following: immunizations, risk assessments, health histories and baseline physicals for early detection of disease and restoration to a previous state of health, and prevention of further deterioration or disability.
Program Income – Money collected directly by the grantee, subrecipient or provider for services provided under the grant award such as third-party reimbursements, Title XIX, private insurance, and client copay fees and donations.
Promotores or Community Health Worker (CHW) – A person who, with or without compensation, helps connect people in their community with health care and social services. A certified CHW is someone with current certification issued by DSHS.
Referral – The process of directing or redirecting a medical case or person to an appropriate specialist or agency for information, help or treatment.
Referral Agency – An agency that provides a service for a TVFFS client that the TVFFS grantee does not provide and is not a reimbursable TVFFS service.
Service Member – A member or former member of the state military forces or a component of the United States Armed Forces, including a reserve component. This includes active duty, reserve, and veterans of the United States Armed Forces as well as active and former members of the Texas National Guard and the Texas State Guard.
Subgrantee or Subrecipient – A non-state entity that receives a subaward from a pass-through entity to carry out part of a state program. It does not include a person that is a beneficiary of such a program. A subgrantee or subrecipient may also be a grantee of other state awards directly from a state awarding agency. Refer to the Texas Grant Management Standards.
Teledentistry – A health service delivered by a dentist or by a health professional acting under the delegation and supervision of a dentist. The providers act within the scope of the dentist's or health professional's license or certification to provide dental care to a patient at a different physical location than the dentist or health professional using telecommunications or information technology.
Telehealth – A health service, other than a telemedicine medical service or a teledentistry dental service, delivered by a health professional licensed, certified or otherwise entitled to practice in this state and acting within the scope of their license, certification or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology.
Telemedicine – A health care service delivered by a physician licensed in this state, or a health professional acting under the delegation and supervision of a physician licensed in this state and acting within the scope of the physician's or health professional's license to a patient at a different physical location than the physician or health professional using telecommunications or information technology.
Texas Resident – A person who lives within the geographic boundaries of Texas.
Transportation – Services that may be provided to transport a client to receive required health care services. Transportation could be provided by a private vehicle, public transportation, a project site vehicle or an emergency medical vehicle.
Unduplicated Client – A client who is counted only one time during the program’s fiscal year, regardless of the number of visits, encounters or services they receive, for each Title V program they participate in, which includes: Prenatal Medical, Prenatal Dental, Child Health and Child Dental. If a client participates in more than one Title V program, only their first visit of the fiscal year will be counted as an unduplicated client for each program they participate in.