Maternal, Child & Adolescent Health Division

Title V Maternal and Child Health Block Grant Executive Summary

California Snapshot

California is home to one out of every eight U.S. residents, making it the most populous state in the nation.¹ The state's economy is the largest in the U.S. and is the fifth largest in the world.² California has 58 counties that vary widely in size and population, include major metropolitan areas as well as rural and frontier counties; global centers for agriculture, the arts, culture, technology, and innovation; geography ranging from coastal areas and mountains to the desert; nine National Parks; an international border; and countless other unique characteristics. San Bernardino County covers more than 20,000 square miles and is the largest county in the U.S. by area, while San Francisco County has 810,202 residents in approximately 47 square miles, making it the most densely populated county in the state.³^,⁴^,⁵ Los Angeles-Long Beach-Anaheim is the second largest metropolitan area in the country with more than 9.6 million residents, while Alpine County has just 1,092 residents.

The California Title V Program Background

The mission of the California Department of Public Health (CDPH) is to advance the health and well-being of people and communities in California. The Maternal, Child and Adolescent Health (MCAH) Division is one of three divisions under the Center for Family Health (CFH) in CDPH. MCAH administers the Title V Maternal and Child Health Services Block Grant Program.

Title V supports a variety of programs and initiatives such as the Black Infant Health (BIH) Program and the Adolescent Family Life Program (AFLP). CDPH/MCAH funds and supports partnerships with state and local agencies, community-based organizations (CBO), and universities to drive programmatic efforts that improve the health of the MCAH population. CDPH/MCAH programs and initiatives serve California's populations and regions, providing resources, information, and data on physical, emotional, mental, and social health while recognizing the integral role that families play in the health of mothers, infants, children, and adolescents and engages in ongoing efforts to increase family involvement as an important aspect of its Title V work.

CDPH/MCAH uses Title V and other funding to support 61 Local MCAH programs, based in 58 counties and three cities, which differ widely by population, geography and socioeconomic factors. Local MCAH programs, located within the California Local Health Jurisdictions (LHJ), play a critical role in the collaborative development of priorities and strategies that drive the MCAH mission. CDPH/MCAH also strengthens the capacity of LHJs, communities and CBOs, and leverages the MCAH infrastructure provided by Title V to improve the health and well-being of women, infants, children and adolescents throughout the state.

Healthy Outcomes for All People: A Core Focus

Achieving healthy outcomes and well-being for all Californians means acknowledging and addressing areas for improvement. CDPH/MCAH programs connect families to economic, social and physical supports and services that can help mitigate the impact of poverty and limited health care access on their physical and mental/emotional health. CDPH/MCAH recognizes the need to listen to and learn from its population for program development and improvement, and to ensure that their needs are addressed.

Expansion to Address Mental Health and Maternal Mortality & Morbidity

CDPH/MCAH received new funding from the state legislature from the passage of “Future of Public Health" and “SB65 – The California Momnibus Act," enabling the expansion of the division to address the emerging essential issues of MCAH mental health and maternal mortality and morbidity.

Future of Public Health

CDPH/MCAH recently created the Community Resilience and Support Section (CORESS) and developed the MCAH Mental Health Initiative to address mental health within the broader Future of Public Health initiative to strengthen California's public health infrastructure. CORESS strengthens MCAH's capacity in supporting children and youth with special health care needs and broader maternal, child and adolescent mental health initiatives. The MCAH Mental Health Initiative builds on these efforts by advancing primary prevention strategies, promoting mental wellness, and fostering resilience through training, resources, and technical assistance for LHJs.

SB 65 – The CA Momnibus Act

CDPH/MCAH created the Adverse Pregnancy Outcomes Prevention (APOP) team to support the California Momnibus Act (SB 65). APOP works side by side with the surveillance team to promote health and address health disparities, inform and translate data into action, integrate community-informed prevention opportunities, and enhance the development of strategies to reduce preventable maternal mortality and morbidity.

Continued Public Health Workforce Challenges

Public health and health care continue to face challenges finding qualified professionals, including public health nurses and doctors, to fill vacancies both at the state and local level. These difficulties have affected MCAH programs and sectors serving MCAH populations, such as education, childcare, early intervention, and others. This is an ongoing issue that will require statewide efforts to address.

2025-2030 National Performance Measures, Priority Needs, Objectives and Focus Areas
CDPH/MCAH conducted a Title V statewide needs assessment from August 2023 through March 2025. The state needs assessment consisted of the following phases:

Local Needs Assessment Analysis (July – August 2024): All 61 LHJs completed a local need assessment from August 2023 – July 2024 which resulted in five emergent focus areas across our population health domains: Access to Quality Care & Services, Mental Health & Substance Use, Community Health Factors & Family Social Supports, Physical Health & Prevention, and Injury Prevention & Safe Environments. The state used the results of the local needs assessment and the five focus areas as the foundation of the state needs assessment. Domain activities are aligned by focus area in the California five-year action plan.
Statewide Population Data Scan (August– October 2024): CDPH/MCAH's Epidemiology Team created a data tool to scan MCAH Data Dashboards and other data sources. The team then extracted California rates for 60 indicators across Title V domains and calculated a priority score. CDPH/MCAH Domain Leads used the data tool to identify any state-level gaps that may have not been captured from the local-level needs assessment.
State-Level Partner Engagement (December 2024 – March 2025): CDPH/MCAH shared the draft five-year action plan priority need statements and strategies with statewide partners for input and feedback before finalizing the action plan.

CDPH/MCAH used the needs assessment to select the following priority need statements, HRSA National Performance Measures (NPMs), five-year objectives and focus areas for the state Title V Five-Year Action Plan. CDPH/MCAH has also identified focus areas that can benefit our five population health domains: women/maternal, perinatal/infant, child, adolescent, and children and youth with special health care needs (CYSHCN). More information can be found in the action plan and application narratives.

Women/Maternal

Priority Need: Advance healthy birth outcomes by supporting mothers to thrive through pregnancy and the postpartum period.

Focus Area(s):

Access to Quality Care & Services
Mental Health & Substance Use
Community Health Factors & Family Social Supports
Physical Health & Prevention
Injury Prevention & Safe Environments

Read Women/Maternal Application Narrative

Perinatal/Infant

Priority Need: Advance healthy birth outcomes by supporting mothers and families to have thriving infants.

Focus Area(s):

Access to Quality Care & Services
Community Health Factors & Family Social Supports
Physical Health & Prevention
Injury Prevention & Safe Environments

Read Perinatal/Infant Application Narrative

Child

Priority Need: Improve the physical and mental health and development of all children so they flourish and thrive.

Focus Area(s):

Access to Quality Care & Services
Mental Health & Substance Use
Physical Health & Prevention
Injury Prevention & Safe Environments

Read Child Application Narrative

Adolescent

Priority Need: Enhance strengths, skills and access to supports, ensuring all youth thrive.

Focus Area(s):

Access to Quality Care & Services
Mental Health & Substance Use
Physical Health & Prevention

Read Adolescent Application Narrative

Children and Youth with Special Health Care Needs (CYSHCN)

Priority Need 1: Improve access to supports and services for children and youth with special health care needs.
Priority Need 2: Increase engagement and build resilience among CYSHCN and their families.

Focus Area(s):

Access to Quality Care & Services
Mental Health & Substance Use
Community Health Factors & Family Social Supports

Read CYSHCN Application Narrative

Cross-Cutting & Systems Building

Priority Need 1: Increase knowledge and capacity of state and local MCAH workforce to improve maternal and child health outcomes.
Priority Need 2: Increase knowledge, skills and best practices regarding policy, systems and environmental change (PSE) practices among state and local MCAH workforce.

Read Application Narrative

How Federal Title V Funds Complement State-Supported MCH Efforts

As described in the previous section, Title V supports a wealth of activities in California. CDPH/MCAH oversees the administration of state and federal funds that align with Title V, ensuring effective support for key programs and initiatives aimed at improving the health of mothers, babies, children, adolescents and families in California.

CDPH/MCAH receives federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) funds and State General Funds to fund and support evidence-based and evidence-informed home visiting programs across the state through the California Home Visiting Program (CHVP). CHVP aims to uplift pregnant and newly parenting families by focusing on prevention and strength-based approaches to improve their social and health outcomes.

CDPH/MCAH receives Family and Youth Services Bureau, Personal Responsibility Education Program (PREP) funds to support comprehensive sexual health education for youth. This program complements and aligns with Title V adolescent health priority needs, programs and initiatives.

CDPH/MCAH receives federal Centers for Disease Control and Prevention funding to enhance the capacity for developing and implementing data-informed strategies to prevent pregnancy-related deaths and reduce disparities among disproportionately impacted populations. The grant supports improving data availability and quality to better identify and characterize pregnancy-related deaths and related health inequities. The grant complements California's Title V and state-funded surveillance efforts related to maternal morbidity and mortality.

CDPH/MCAH receives State General Funds for the California Momnibus Act that established the California Pregnancy-Associated Review Committee to identify and conduct reviews of pregnancy-related deaths, analyze common causes of Severe Maternal Morbidity, and make recommendations on strategies to prevent maternal mortality and morbidity and report on this work at least every three years.

CDPH/MCAH is committed to responding with adaptability and dedication to meet the needs of the various MCAH populations across the state. The Title V Maternal and Child Health Block Grant provides core funding to California that helps MCAH lead, fund, partner and support activities to meet its mission.

MCH Success Stories By Population Domain

Women/Maternal: CDPH/MCAH was accepted into the 2025-2027 National Academy for State Health Policy Advancing State Strategies to Address Maternity Care Deserts Policy Academy. Partners include California’s Medicaid department, Perinatal Quality Collaborative, and a managed care plan serving half of California’s counties. The team aims to understand the landscape of maternity service closures in regions with no or low facilities or providers with a focus on surveillance and ultimately mitigation strategies.

Perinatal/Infant: CDPH/MCAH partnered with the Centers for Disease Control and Prevention (CDC) and other divisions within the Center for Family Health–the Genetic Disease Screening Program and the Women, Infants and Children Program–to provide a recorded webinar on folate and pregnancy. The webinar titled “Choosing the right form of Folate for a Healthy Pregnancy: an Essential Guide” featured speakers from each division and CDC, who shared program highlights and contributions with over 400 essential partners statewide.

Child: CDPH/MCAH partnered with the CDPH Office of School Health to promote the health, wellness, and safety of school-aged children, their families, and communities. Through this partnership, CDPH participated in and promoted health education webinars, updated and disseminated clinical infectious disease guidance, created a state-wide epinephrine standing order for school use, elevated mental and behavioral health and wellness programs, and uplifted youth engagement and school-linked health opportunities.

Adolescent: CDPH/MCAH promoted local youth engagement by supporting 10 youths from across the state to serve as Adolescent Family Life Program Youth Advisors. One youth advisor, who was a past program participant, used her firsthand experience to inform program decisions, create youth-friendly social media posts and plan monthly group connections for young parents. Her experience and leadership were inspiring to other program participants.

CYSHCN: CDPH/MCAH administered the CYSHCN Innovation Grants, launched in 2022, to fund five local public health departments—San Francisco, Pasadena, Riverside, San Joaquin and Sutter—to develop and implement innovative strategies that enhance services and support for children and youth with special health care needs and their families. All five agencies are now moving toward the final stages of their projects.