~ MCAH Action ~ Protecting and Improving the Health of California’s Families
California Maternal, Child, and Adolescent Health Directors
Invest in the health of California’s mothers, children and families today to build a strong and
prosperous work force for tomorrow and reduce future health care costs.
What is the Maternal, Child and
Adolescent Health Program (MCAH)?
Since 1935, Title V of the Social Security Act has
provided funding for states to deliver public health
services to improve the health, safety and well-being
of mothers and children, including children with
special health care needs. California’s Maternal Child
and Adolescent Health (MCAH) Program works with
local MCAH programs in all 58 California counties
and the cities of Berkeley, Pasadena, and Long
Beach to provide these services.
The health systems and services funded by the MCAH
program enable early identification and treatment of
health risks that result in preterm birth, birth defects,
chronic disease and other problems that left
undiagnosed and untreated, increase costs for health
care, education and social services.
The California MCAH Program uses scientific
evidence-based methods to develop, target, and
evaluate its programs and maintain and improve its
population-based data systems. Partners include
nationally recognized public health and medical
experts in health care and university settings; local
health jurisdiction programs and other State and
Federal programs.
Using ongoing surveillance and survey data, the CA
MCAH program continuously assesses the health
and needs of the MCAH population to identify new
and continuing issues, inform program design,
identify areas of greatest need, and identify
opportunities to invest resources for optimal public
health impact. Every five years, in close collaboration
with local health jurisdictions and other stakeholders,
MCAH synthesizes this information into a
comprehensive statewide needs assessment to
identify emerging issues and update public health
priorities.
What does the MCAH Program do?
Investing in MCAH Programs saves money

Saved $131 million in 2010 in California alone
because fewer babies were born premature,
saving an average of $60,0001 per preterm
birth. Efforts to reduce preterm birth are
paying off with the rate declining from 10.5%
in 2000 to 9.8% in 2011.

$5.19 is saved in reduced health costs for
every $1 spent on programs improving the
health of women with diabetes before they get
pregnant, preventing costly complications in
both mothers and babies.2

$4 is saved for every $1 spent3 on public
expenditures for family planning, thus helping
women to achieve their childbearing goals,
while also saving public dollars.

$1.1 billion annual savings to taxpayers. Had
CA continued 1991 teen birth rate of 71 births
per 1,000, we would have had an additional
52,685 births in 2008. CA’s success in
reducing teen births represents a total annual
savings to society of $4.5 billion.4
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Improves birth outcomes and the health of
our babies
 Black Infant Health Program (BIH) uses case
management and a group-based approach to
improve the health of pregnant and mothering
Black women and improve birth outcomes.
 Breastfeeding Program promotes and supports
public health and health care efforts to make
breastfeeding the normal method of infant feeding
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in California as it provides proven benefits to the
mother, infant, and society.
California Perinatal Quality Care Collaborative
(CPQCC) monitors quality indicators of hospital care
for infants in Neonatal Intensive Care Units and works
with hospitals to improve perinatal outcomes.
Comprehensive Perinatal Services Program
provides nutrition, psychosocial and health education
services, in addition to obstetrical care for pregnant
women eligible for Medi-Cal.
Fetal and Infant Mortality Review Program
examines contributing factors to fetal and infant deaths
and implements necessary actions to prevent these
deaths.
Perinatal Substance Use Prevention promotes
perinatal substance use screening, assessment, and
referral to treatment for pregnant women through
partnerships and collaborations.
Regional Perinatal Programs of California work with
hospitals and healthcare providers to promote access
to risk-appropriate care for pregnant women and their
infants.
Sudden Infant Death Syndrome (SIDS) Program
educates parents, families, and child care providers on
how to reduce the risk of SIDS and help families and
others deal with the tragedy of SIDS.
Reduces death and disease and improves
the health of our moms
 California Diabetes and Pregnancy Program
works with providers and community liaisons to
promote improved outcomes for high-risk pregnant
women with pre-existing diabetes and those who
develop it.
 California Maternal Quality Care Collaborative
(CMQCC) investigates causes of increased
pregnancy-related morbidity and mortality that have
Medi-Cal spending $106,923,000 on the 5.6% of
births affected by gestational hypertension
disorders5 and $105,956,000 on the 4.6% of births
affected by hemorrhage6, and disseminates best
obstetrical practices to save lives and reduce costs.
 Nutrition and Physical Activity Initiative
integrates and coordinates healthy eating and
physical activity promotion within MCAH and local
public health and health care programs.
 Preconception Health and Health Care works
with local programs to improve the health of
women before they get pregnant and offers
resources, tools and best practices for individuals,
providers, and communities on
everywomancalifornia.org
Reduces deaths and chronic diseases and
improves the health of our children
 California Early Childhood Comprehensive
Systems is funded by a federal grant to create a
comprehensive early childhood system for access
to medical homes, mental health and socialemotional development, early care and education,
parent education, and family support services.
 Childhood Injury Prevention Program provides
assistance and training to local MCAH programs to
integrate injury prevention into programs, policy
and outreach activities
 Oral Health Program ensures oral health needs of
pregnant women, mothers, and children, especially
within low-income families, are met by expanding
access to dental care and preventive services.
Improves adolescent sexual and
reproductive health and reduces teen
pregnancy
 Adolescent Family Life Program (AFLP)
provides case management, home visitation, and
health education to pregnant and parenting teens
and their families and raises community awareness
of the problem of adolescent pregnancy in 35 local
health jurisdictions.
 Personal Responsibility and Education
Program (PREP) funds community organizations
to educate high-risk and vulnerable adolescents on
both abstinence and contraception by replicating
evidence-based program models that have been
proven to change behavior or reduce pregnancy
among youth.
 Information and Education Program (I&E) funds
educational programs that emphasize primary
prevention to enhance knowledge, attitudes and skills
of adolescents and young men and women of
childbearing age to make responsible decisions
relevant to sexual and reproductive behavior.
Programs and services to women, infants and
children have been cut and reduced as a
result of budget cuts over the last 7 years
Total MCAH Funding has Declined
State Fiscal Years 2007-08 through 2012-13
(dollars in thousands)
$140,000
$133,558
$130,000
$130,152
$120,000
$110,000
$100,000
SGF +Title V + Title XIX
$90,000
$77,454
$74,767 $75,365 $70,900
$80,000
$70,000
Title V + Title XIX
$60,000
$50,000
$40,000
2007-08
2008-09
2009-10
2010-11
2011-12
2012-13
 State General Funds (SGF) for CA MCAH first
reduced by 10% in State Fiscal Year (SFY) 2008-09
($4.6M), were totally eliminated in SFY 2009-10
($40M).
 Federal Title V funding for CA has dropped from
$47.9M in 2005 to $41.1M 2012, while CA’s
population grew from 35.3 to 37.3M. Due to
sequestration, a 2013 funding drop to $39.1M has
been proposed.
 $10 million in matching Title XIX funds were lost due
to reduction in SGF for MCAH.
 Local MCAH, AFLP and BIH programs have been cut
or reduced services since their budgets and
expenditures were cut 30%-60% since the reduction
of SGF and matching Federal Title XIX Funds from
FY 2008 and 2009.
 $20.4M was eliminated FY 2009-2010 from the State
SGF budget for the MCAH Domestic Violence
Program.
 Local general funds for MCAH programs continue to
be reduced or eliminated.
 Federal, State, and local funding cuts are impacting
the ability of MCAH programs to serve California’s
families while the demand for services continues
rising.
Institute of Medicine (IOM). Report Brief: Preterm Birth: Causes, Consequences, and Prevention. Washington, D.C., National Academies Press, 2006. http://www.iom.edu/reports/2006/preterm-birth-causesconsequences-and-prevention.aspx, accessed June 19, 2013. NOTE – 2005 costs were adjusted for inflation to 2012 dollars
2
Scheffler RM, Feuchtbaum LB, Phibbs CS. Prevention: the cost-effectiveness of the California Diabetes and Pregnancy Program. Am J Public Health 1992;82:168–75
3
Frost, Jennifer J., DrPH et al. The Impact of Publicly Funded Family Planning Clinic Services on Unintended Pregnancies and Government Cost Savings. Journal of Health Care for the Poor and Underserved 19 (2008):
778–796. http://www.guttmacher.org/pubs/09_HPU19.3Frost.pdf, accessed May 1, 2009
4
Constantine NA, Jerman P and Nevarez CR. No Time for Complacency: Teen Births in California. 2010 Spring Update. Berkeley, CA: Public Health Institute, 2010.
5
Pourat N, Martinez AE, Jones, JM, Gregory KD, Korst L, Kominski GF. Costs of Gestational Hypertensive Disorders in California: Hypertension, Preeclampsia, and Eclampsia. Los Angeles (CA): UCLA Center for Health
Policy Research; 2013.
6
Pourat N, Martinez AE, McCullough, JC, Gregory KD, Korst L, Kominski GF. Costs of Maternal Hemorrhage in California. Los Angeles (CA): UCLA Center for Health Policy Research; 2013.
Institute of Medicine (IOM). Report Brief: Preterm Birth: Causes, Consequences, and Prevention. Washington, D.C., National Academies Press, 2006. http://www.iom.edu/reports/2006/preterm-birth-causes-consequences-andprevention.aspx, accessed June 19, 2013. NOTE – 2005 costs were adjusted for inflation to 2012 dollars
2
Scheffler RM, Feuchtbaum LB, Phibbs CS. Prevention: the cost-effectiveness of the California Diabetes and Pregnancy Program. Am J Public Health 1992;82:168–75
3
Frost, Jennifer J., DrPH et al. The Impact of Publicly Funded Family Planning Clinic Services on Unintended Pregnancies and Government Cost Savings. Journal of Health Care for the Poor and Underserved 19 (2008): 778–796.
http://www.guttmacher.org/pubs/09_HPU19.3Frost.pdf, accessed May 1, 2009
4
Constantine NA, Jerman P and Nevarez CR. No Time for Complacency: Teen Births in California. 2010 Spring Update. Berkeley, CA: Public Health Institute, 2010.
5
Pourat N, Martinez AE, Jones, JM, Gregory KD, Korst L, Kominski GF. Costs of Gestational Hypertensive Disorders in California: Hypertension, Preeclampsia, and Eclampsia. Los Angeles (CA): UCLA Center for Health Policy Research;
2013.
6
Pourat N, Martinez AE, McCullough, JC, Gregory KD, Korst L, Kominski GF. Costs of Maternal Hemorrhage in California. Los Angeles (CA): UCLA Center for Health Policy Research; 2013.