Meeting Emerging Needs

Rates of syphilis are rising across the country. Syphilis during pregnancy can cause adverse maternal and neonatal outcomes. These include stillbirth, miscarriage, infant death, and birth defects.

A recent Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC) noted that:

• Congenital syphilis cases in the United States have increased more than 10-fold since 2012. 

Of these:

• Roughly 90% are preventable with timely testing and treatment.
• In almost 40% of cases, mothers received no prenatal care during pregnancy

MCHB encourages using Title V Maternal and Child Health (MCH) Service Block Grant funds to support testing, diagnosis, and treatment of syphilis for pregnant women.

Read the January 2024 letter to state Title V agencies (PDF - 123 KB) from Associate Administrator Dr. Michael Warren to the MCHB Title V state agency colleagues. It encourages them to use Title V funding flexibilities to respond to the current rise in congenital syphilis.

Did you know that:

• Over 40% of all births are paid for by Medicaid and the Children's Health Insurance Program (CHIP)?
• And almost 7 million infants—nearly every newborn in the country—receive newborn screening through HRSA-administered maternal and child health programs? Many of these children access follow-up services through Medicaid and CHIP.

The waivers put in place during the COVID-19 pandemic to make sure people had Medicaid or Children's Health Insurance Program (CHIP) health coverage ended on March 31, 2023.

We are part of a larger HHS-wide effort to make sure those affected by the change are aware of it and what steps they can take to maintain coverage. Learn more and help MCH populations continue to receive health coverage.

The COVID-19 Public Health Emergency (PHE) ended on May 11, 2023. The federal government has taken significant steps to ensure all people have continued access to lifesaving protections.

COVID-19 vaccinations are safe and save lives. We encourage MCH populations to vaccinate. Our partner, MotherToBaby, offers educational resources on COVID-19 during pregnancy and breastfeeding.

Since the start of the COVID-19 pandemic, we have actively responded to the needs of MCH populations.

During the PHE, we:

Shifted how we provided health services and funded telehealth expansion.

• Programs such as our Title V MCH Program, Home Visiting, and Healthy Start trained the health workforce through remote training, provided remote home visiting services, and virtual education.
• Through the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act, we awarded new funding that builds infrastructure for telehealth and supports training health care workers to provide high-quality service through telehealth.

Supported vaccination, testing, and contact tracing to slow the spread of COVID-19.

• States could use Title V MCH Program funds to support activities including contact tracing, testing, direct patient care, and case management. Many of our programs provided education and information to encourage vaccine uptake to pregnant women, families, and youth.

Improved data collection to develop better interventions.

• We added COVID-19-related questions to the annual National Survey of Children's Health. We partnered with the U.S. Census Bureau Household Pulse survey to gather data to understand the pandemic's impact on telemedicine, preventive visits, and childcare. And the Pediatric Emergency Care Applied Research Network (PECARN) gathered data about children's admissions to emergency departments during the pandemic.
• We also initiated a longitudinal cohort study that will allow researchers to assess the long-term effects of COVID-19 on our Nation's children.

Partnered with federal agencies and national organizations to coordinate our response and help our grantees access resources for their clients.

• We hosted town halls, facilitated through the Association of Maternal and Child Health Programs (AMCHP). We issued joint letters with the Administration for Children and Families and with the Centers for Disease Control and Prevention to support our partners to better meet the needs of MCH Populations.
• Throughout the public health emergency, we worked to connect our grantees to other government offices' guidance and resources that involved topics such as children and youth with special health care needs, educational settings and safety, civil rights, and nutrition.

RSV is a common virus that affects the lungs and breathing passages. Virtually all children get an RSV infection by the time they are 2 years old. Most of the time RSV will cause a mild, cold-like illness, but it can also cause severe illness such as:

• Bronchiolitis (inflammation of the small airways in the lung)
• Pneumonia (infection of the lungs)

In late 2022, there was an increase in RSV infections as well as associated emergency department visits.

As a result, we did the following:

• HRSA MCHB Associate Administrator Michael Warren, M.D., M.P.H., FAAP, sent a letter to 30,000 partners encouraging them to promote flu and COVID-19 vaccines, as well as other prevention measures to reduce cases of respiratory illnesses and hospitalizations among children.
• HRSA invited grantees to attend an RSV-focused townhall. The townhall featured MCHB's Pediatric Pandemic Network leaders and reached over 200 children's hospital leaders, local emergency managers, public health leaders, and pediatric experts across the region. Our representatives took part in subsequent regional town halls.
• MCHB participated in daily Pediatric Surge Steering Committee meetings with other federal agencies to understand viral surveillance trends, to coordinate across federal agencies and manage the surge in pediatric respiratory illness. The group shared information and resources to support clinical and public health providers.

Since the state of emergency declaration in 2015, Flint, Michigan, and the surrounding community continue to experience ongoing health needs associated with the lead contaminated water supply, particularly among pregnant women and young children.

Prenatal lead exposure can impact fertility, the likelihood of miscarriage, pre-term birth, low birth weight, infant neurodevelopment, and gestational hypertension. In children, lead exposure can have long-term effects including developmental and cognitive delays, and behavioral disorders.

In 2017, MCHB awarded approximately $15 million to Genesee County Health Department to help minimize developmental delays among lead-exposed children up to age six years in Flint and the surrounding Genesee County area. The Genesee County Health Department oversees the county's MCHB-funded Healthy Start Program.

Zika virus infection during pregnancy can cause serious birth defects, especially affecting the neurological system. Children exposed to Zika virus prenatally meet the definition of children with special healthcare needs, regardless of whether they are symptomatic at birth.

Since 2019, there have been no confirmed Zika virus cases reported in the United States, but the virus remains a risk in other countries and territories throughout the world. We responded to this public health threat by:

• Ensuring Access to Comprehensive Services: We awarded $18 million to the Departments of Health of Puerto Rico, American Samoa and the United States Virgin Islands for the Zika Maternal and Child Health Services Program to ensure access to services and comprehensive medical homes for women, children and families affected by the virus.
• Enhancing Provider Education and Training on Caring for Children Exposed to Zika: We awarded a total of $1 million to existing Leadership Education in Neurodevelopmental and Other Related Disabilities (LEND) grantees at the University of Miami, Children's Hospital Los Angeles, and Trustees of Indiana University to implement the Health Professional Support Program for Children with/or At-Risk for Congenital Zika Virus Infection. This program provided workforce development and interdisciplinary clinical consultation to health professionals caring for children with Zika in Puerto Rico, American Samoa, and the U.S. Virgin Islands.
• Supporting Family Engagement: We awarded a total of $450,000 to the Puerto Rico Department of Health, Parent to Parent by Apoyo a Padres de Niños con Impedimentos, Inc. and Virgin Islands Advocacy, Inc. to implement the Optimizing Family Support Program for Children with/or At-Risk for Congenital Zika Virus Infection to support family engagement by providing information, education, and technical assistance. We also awarded $250,000 to Family Voices, Inc. for the National Center for Family/Professional Partnerships to expand training and assistance on family-to-family support, referral assistance, and distribution of Zika-specific, culturally appropriate information to families.

Children have unique needs in emergency situations. Our EMSC investments work to reduce childhood morbidity and mortality that result from severe illness or trauma. Funding supports improvements to medical services for children in each state.

• Adding child-appropriate equipment in ambulances and emergency departments
• Supporting programs to prevent pediatric injuries
• Providing training to EMTs, paramedics and other emergency medical care providers
• Developing educational materials to cover every aspect of pediatric emergency care

Reach out to our Pediatric Emergency Care Applied Research Network for high-quality, multi-center research studies and explore the EMSC Innovation and Improvement Center for how to optimize outcomes for children.

Launched in 2021 with funding from HRSA, the Regional Pediatric Pandemic Network is a national network of 10 children's hospitals and partners dedicated to improving pediatric disaster readiness.