GEORGETOWN UNIVERSITY

Toolkit

State MCH-Medicaid Coordination Toolkit: Title V and Title XIX Interagency Agreements

Title V and Title XIX logoPurpose. This toolkit supplements an environmental scan of State Interagency Agreements (IAAs) of Title V and Medicaid programs and supports the report: State MCH-Medicaid Coordination: A Review of Title V and Title XIX Interagency Agreements, 2nd edition. It includes access to the final report, full-text, current IAAs (collected from the MCH Title V Block Grant FY 2016 Application/FY 2014 Annual Reports) and the 36 IAAs used in the scan, a searchable database, recommendations, and additional resources

Background. Title V programs complement Medicaid in many ways, including (1) providing gap-filling services to enrollees, (2) assisting in the identification of potentially eligible beneficiaries, and (3) creating an infrastructure in communities to ensure that the capacity exists to support the delivery of quality health care services for women and children.

A key factor in assuring coordination and mutual support can be the Interagency Agreement (IAA), required in both Title V and Title XIX legislation, between the State agencies (or divisions within a State agency) that administer the two programs.

Contact John Richards for additional information on this project.

NEW

This toolkit consists of:

Report: Printer-Friendly Version

U.S. Department of Health and Human Services. 2008. State MCH-Medicaid Coordination: A Review of Title V and Title XIX Interagency Agreements (2nd edition). Click More to download PDFs.

2017 Application/2015 Annual Reports Full-Text State IAAs

These documents were collected from the MCH Title V Block Grant FY 2017 Application/FY 2015 Annual Reports.

  • Alabama. Includes:
    •  Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Public Health (4 pp., signed 2002; this document was used in the 2008 IAA environmental scan).
    • Alabama Medicaid Agency Medicaid Outstationed Worker Procedures for Alabama Department of Public Health Sites (6 pp.,unsigned).
    • Provider Agreement Between the Alabama Medicaid Agency and Alabama Department of Rehabilitation Services (8 pp., signed 2009).
  • Alaska. Interagency Memorandum of Agreement between the Section of Public Health (DPH), Section of Women's Children's and Family Health (ECFH), and the Division of Health Care Services (DHCS), Medicaid Program (3 pp., signed 2015).
  • American Samoa. Letter explaining the state of Medicaid.
  • Arizona. Arizona Health Care Cost Containment System Data Sharing Agreement: Data Sharing of Blood Lead Level Data between the Arizona Health Care Cost Containment System and the Arizona Department of Health Services Offices of Environmental Health (6 pp., signed 2013).
  • Arkansas. Includes:
  • California. Includes:
    • Contract Request (2 pp., signed 2012).
    • Exhibit A: Additional Provisions (15 pp.).
    • Exhibit B: HIPAA Business Associate Addendum (11 pp.).
  • Colorado. Includes:
  • Connecticut. Memoranda of Agreement Between The Department of Public Health and Department of Social Services (13pp, signed 2011)
  • Delaware. State of Delaware Department of Health and Social Services: Intra-Departmental Cooperative Agreement Related to Maternal and Child Health Services (5 pp., signed 1993).
  • District of Columbia. Memorandum of Agreement Between the Department of Health Care Finance and the District Department of Health Administration Data Sharing Agreement (6 pp., not signed).
  • Federated States of Micronesia. Not eligible for Medicaid.
  • Florida. Per the state Block Grant Application/Report, "The Department of Health’s Maternal and Child Health Section is working with the Office of General Counsel to draft a current Inter-Agency Agreement between the Department and the Agency for Health Care Administration, Florida’s Medicaid Agency."
  • Georgia.Interagency Agreement Between the Georgia Department of Public Health and the Georgia Department of Community Health for Title V and Title XIX Coordination (11pp., signed 2016)
  • Guam. Memorandum of Agreement between the Department of Public Health and Social Services, Division of Public Health/Bureau of Family Health and Nursing Services and the Department of Public Health and Social Services, Division of Public Welfare (3 pp., signed 2015).
  • Hawaii. Memorandum of Agreement between Department of Human Services and Department of Health (6 pp., electronically signed).
    • This document updates the original IAA used in the 2008 environmental scan.
  • Idaho. Memorandum of Understanding between Idaho Department of Health and Welfare, Division of Public Health and Division of Medicaid and Department of Welfare (4 pp., signed 2016).
  • Illinois. Intergovernmental Agreement between the Department of Public Health and the Department of Healthcare and Family Services (9 pp., signed 2015).
  • Indiana. Memorandum of Understanding between Indiana State Department of Health and Indiana Office of Medicaid Policy and Planning for Data Sharing (28 pp., signed 2003).
    • This document was used in the environmental scan.
  • Iowa. Contract Declaration and Execution (50pp., Signed 2016)
  • Kansas. Intra-agency Agreement between the Division of Health Care Finance and the Division of Public Health of the Kansas Department of Health and Environment for Implementing the Provision of Health Care to Persons Eligible for Services Under Titles V, XIX, and XXI of the Social Security Act (19 pp., Not signed)
  • Kentucky. Commonwealth of Kentucky Purchase Order: Preventive Health Services FY17 (35 pp., Signed 2016).
  • Louisiana. Department of Health and Hospitals Intra-Departmental Agreement between Office of Public Health (Title V) and Bureau of Health Services Financing (Title XIX) (4 pp., signed 1990).
    • This document omits the data sharing Agreement included in the 2015 version.
    • This document is the same at that used in the 2008 environmental scan.
  • Maine. PHN Office / Division Project Work Plan. (10pp., Signed 2016).
    • Includes a cover page signed by in 2016
  • Maryland. Cooperative Agreement between Maryland State Department of Health and Mental Hygiene (Title XIX) Medicaid Agency, (Title V) Maternal and Child Health Agency, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). (16 pp., signed 2015).
    • This document updates the original IAA used in the 2008 environmental scan.
  • Massachusetts. Interagency Agreement (IAA) between Title V Agency and Medicaid (Title XIX), Massachusetts Department of Public Health, Bureau of Family Health and Nutrition and MassHealth (2 pp., signed, 2016).
  • Michigan. [Michigan Title V/Title XIX Interagency Agreement] (10 pp., unsigned 1995. Partial document).
    • This document is the same at that used in the 2008 environmental scan.
  • Minnesota. State of Minnesota Interagency Memorandum of Understanding (5 pp., signed 2003).
    • This document is the same at that used in the 2008 environmental scan.
  • Mississippi. Includes:
    • Mississippi Division of Medicaid: Data Use Agreement (8 pp., signed 2015). Includes data file (2013) as Attachment A.
    • Cover letter (1 pp., signed 2012).
    • Computer Matching and Privacy Protection Act Agreement between the Social Security and the State of Mississippi (12 pp., signed 2012). Includes security controls as Attachment C, notice of breach (Attachment D), certificate of return or destruction of confidential data (Attachment E), and Memorandum of Understanding between the Division of Medicaid in the Office of the Governor, State of Mississippi and the Mississippi State Department of Health (Maternal and Infant Vital Records Data (Attachment F. singed, 2014).
    • Attachment F seems to supplement the original IAA used in the 2008 environmental scan.
  • Missouri. Includes:
  • Montana. Intra-Agency Agreement between the Public Health and Safety Division, the Health Resources Division, and the Human and Community Services Division of the Montana Department of Public Health and Human Services (6 pp., Signed 2016).
  • Nebraska. Inter-Agency Protocol: Titles V, XIX, and XXI (3 pp., signed, 2015).
    • This document updates the original IAA used in the 2008 environmental scan.
  • Nevada. Memorandum of Agreement between Division of Public and Behavioral Health (DPBH) -- Bureau of Child, Family and Community Wellness (BCF&CW) Title V Maternal and Child Health (MCH) Program and Division of Health Care Financing and Policy (DHCF) -- Title XIX Medicaid (4 pp., Signed 2015).
  • New Hampshire. State of New Hampshire, Department of Health And Human Services: Agreement between the New Hampshire Division of Public Health Services and the New Hampshire Division of Human Services Relative to Joint Planning, Coordination and Improvement of Health Programs Under Title V, Title X, Title XIX and WIC/CSFP (11 pp., signed, 1993 in document; 1 p. signed cover sheet, 1994, is appended).
  • New Jersey. Memorandum of Understanding (MOU) between the New Jersey Department of Health and Senior Services and the New Jersey Department of Human Services, Division of Medical Assistance and Health Services: "Administration of Maternal Child Block Grant Programs" (8 pp., signed 2005).
  • New Mexico. State of New Mexico Human Services Department Medical Assistance Division Provider Participant Agreement (6 pp., signed 2003).
    • This document is the same at that used in the 2008 environmental scan.
  • New York. Letter highlighting the requirements of HRSA (3 pp., signed 2016).
  • North Carolina. Intra-Departmental Memorandum of Agreement between NC Department of Health and Human Services (DHHS) Division of Medical Assistance (DMA) and NC Department of Health and Human Services (DHHS) Division of Public Health (DPH) (124 pp., signed 2014)
  • North Dakota. Cooperative Agreement between North Dakota Department of Human Services and North Dakota Department of Health and Primary Care Office/Primary Care Association (9 pp., signed, 20013).
    • This document is the same at that used in the 2008 environmental scan.
  • Northern Mariana Islands. Commonwealth of the Northern Mariana Islands Title V-Title XIX Agreement (1 pp., signed, 2016).
  • Ohio. Attachment A -- Maternal and Child Health Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (108 pp., Signed 2015).
    • Includes:
      • Ohio Department of Health Administrative Claiming Methadology Guide (p26)
  • Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (116 pp., including purchase order, signed 2011).
  • Oregon. State of Oregon Intergovernmental Agreement (37 pp., includes cover and document return statement, signed 2014).
  • Palau. Not eligible for Medicaid.
  • Pennsylvania. Includes:
    • Cover letter (2 pp., xxx).
    • Memorandum of Understanding among Pennsylvania Department of Education, Pennsylvania Department of Public Welfare, Pennsylvania Department of Labor and Industry, Pennsylvania Department of Health (17 pp., signed 1999).
    • Commonwealth of Pennsylvania Governor's Office Executive Order (5 pp., unsigned 1998).
    • Memorandum of Understanding for a Shared Agenda for Youth and Young Adults with Disabilities. Two versions: Version 1 (2 pp., stamped 2006 and signed) and Version 2 (3 pp., signed, no date).
  • Puerto Rico. Agreement between the PR Department of Health (Medicaid office and PR MCAH) and the PR Health Insurance Administration (10 pp., signed, 2015).
  • Republic of the Marshal Islands. Not eligible for Medicaid.
  • Rhode Island. State of Rhode Island and Providence Plantation Interagency Agreement between Executive Office of Health and Human Services and Department of Health for Participation in the Rhode Island Medicaid Program (24 pp., draft version).
  • South Carolina. Contract between South Carolina Department of Health and Human Services and South Carolina Department of Health and Environmental Control for the Purchase and Provision of Medicaid Services (23 pp., signed 2014). Includes extensive appendices.
  • South Dakota. Joint Powers Agreement between South Dakota Department of Social Services, Division of Medical Services and South Dakota Department of Health, Division of Health and Medical Services (7 pp., 2014) [Previously added to IAA collection; Bilbio No. SD1_1_2008].
  • Tennessee. Medicaid/Title V Agreement: Tennessee Department of Health: 1. Bureau of Health Services, 2. Bureau of Health Systems Development, 3. Bureau of Medicaid, and 4. Tennessee Department of Finance and Administration (27 pp., unsigned 1991).
    • Includes a cover page
  • Texas. Health and Human Services Commission and Department of State Health Services: Memorandum of Understanding (3 pp., signed 2015).
  • United States Virgin Islands. Statement of Agreement to Ensure Maximum Collaboration and Utilization of the Needs Program Under the Virgin Islands State Plan for Medical Assistance, Title XIX of the Social Security Act (13 pp., signed, 1995).
  • Utah. Memorandum of Agreement: Utah Department of Health, Division of Health Care Financing and Division of Community and Family Health Services (39 pp., signed 2013).
  • Vermont. Intra-Governmental Agreement for the Delivery of Services Under Vermont's Global Commitment to Health Demonstration Waiver (13 pp., signed 2006).
  • Virginia. Includes:
  • Washington. Contract Amendment: Children with Special Health Care Needs (27 pp., signed 2013).
  • West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2016).
  • Wisconsin. State of Wisconsin, Department of Health Services: Memorandum of Understanding between the Department of Health Services (DHS)/Division of Health Care Access and Acountability (sic) and Division of Public Health (DPH) (22 pp., signed 2016).
  • Wyoming. Intra-Agency Agreement between the Public Health Division and the Division of Healthcare Financing of the Wyoming Department of Health (7 pp., signed, 2013) [Previously added to IAA collection; Bilbio No.WY1_1].

2016 Application/2014 Annual Reports Full-Text State IAAs

These documents were collected from the MCH Title V Block Grant FY 2016 Application/FY 2014 Annual Reports.

IAAs Used in the Environmental Scan. These IAAs were used to develop the report, State MCH-Medicaid Coordination: A Review of Title V and Title XIX Interagency Agreements (2nd edition), and supplemental materials (e.g., the IAA database, resources for writing/revising your State IAA).

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 Alabama
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 Kansas
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 North Dakota
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 Arizona
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 Kentucky
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 Ohio
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 California
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 Louisiana
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 Oklahoma
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 Colorado*
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 Maryland
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 Oregon
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 Connecticut*
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 Michigan
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 Rhode Island*
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 Florida
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 Minnesota
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 South Carolina
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 Georgia
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 Mississippi
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 South Dakota*
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 Hawaii
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 Missouri*
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 Utah
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 Idaho
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 Nebraska
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 Virginia
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 Illinois*
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 New Mexico
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 Washington
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 Indiana
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 New York
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 Wisconsin
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 Iowa*
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 North Carolina
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 Wyoming

* Indicates that the PDF is made up of several individual IAAs developed within the State

Database of State IAAs

The State IAAs used in the environmental scan have been summarized as they correspond to the Code of Federal Regulations. See a Summary of All State IAAs or use the following fields alone or in combination to search the database:

Keyword:

State/Region:


(regions are listed at the end of the alphabetical state listing)

 

Resources for Writing/Revising Your State IAA

Use the following resources to begin the process of developing or reworking a State Title V/Title XIX IAA:

  • State Intake Form: This document outlines a "model" IAA for States to begin the process of updating or creating a new IAA. Use this document to become familiar with the components of successful IAAs. Once you have reviewed this document, you will be ready to use the "Model IAA" below.
  • Model IAA: Copy and paste text from this document to add to you current IAA or to create a new document using a framework that follows the Code of Federal Regulations and "promising practices" examples from other States.

Additional Resources