- Download entire printer-friendly PDF (PDF; 7.12 MB)
- Introduction (PDF; 2.00 MB)
- Chapter 1: Overview of Title V and Title XIX (PDF; 2.13 MB)
- Chapter 2: Federal Legislation, Regulations, and Policy (PDF; 821 KB)
- Chapter 3: Analysis of State Title V/Title XIX Interagency Agreements (PDF; 888 KB)
- Chapter 4: Development of Successful IAAs and Promising Practices (PDF; 880 KB)
- Chapter 5: Summaries of State Title V/Title XIX Interagency Agreements (PDF; 1.35 MB)
- Appendices (PDF; 1.35 MB)

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

Purpose. 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.
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- The MCH Navigator has compiled learning opportunities to support the development of IAAs. See MCH-Medicaid Coordination: Training Brief.
- The National Academy for State Health Policy has developed Strengthening the Title V-Medicaid Partnership: Strategies to Support the Development of Robust Interagency Agreements between Title V and Medicaid.
This toolkit consists of:
- A link to the printer-friendly version of the publication (PDF) as well as PDFs of each chapter
- Full-text versions of all current IAAs and the 36 original IAAs used to develop the environmental scan
- A searchable database of key components of State IAAs based on the 36 original IAAs in the environmental scan
- Resources for writing/revising your State IAA
- Links to additional resources
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.
Collection of Historic and Seminal IAAs
2024 Application/2022 Annual Reports Full-Text State IAAs
These documents were collected from the MCH Title V Block Grant FY 2022 Application/FY 2020 Annual Reports.
- Alabama. Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Public Health (ADPH) (32 pp., signed 2023). Includes Attachments:
- ADPH Financial Services Non-clinic Immunization Cost Budge, 10/1/15 - 9/30/2019 (1 pp.)
- EPSDT Care Coordination, Oct - Dec 20218 (1 pp.)
- EPSDT Care Coordination Report for Non-CHIP Recipients, Oct 1 - Dec 31, 2018 (4 pp.)
- Alabama Medicaid Agency Business Associate Addendum (4 pp., signed 2020)
- Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Rehabilitation Services (ADRS) (9 pp., signed 2009).
- Alaska. Interagency Memorandum of Agreement between the State of Alaska, Department of Health and Social Services, Division of Public Health (DPH), Section of Women's Children's and Family Health (WCFH), and the Division of Health Care Services (DHCS), Medicaid Program (4 pp., signed 2023).
- American Samoa. Cooperative Agreement between The American Samoa Department of Health and Child Health Title V Program and the American Samoa Medicaid State Agency (3 pp., signed 2018).
- Arizona. Memorandum of Agreement between the Arizona Department of Health Services and Arizona Health Care Cost Containment System (13 pp., signed 2023).
- Arkansas. Memorandum of Agreement and Inter-Agency Agreement between the Arkansas Department of Human Services (OHS), Division of Medical Services (OMS) as the State Medicaid Agency, the OHS Division of Developmental Disabilities Services (DDS), and the Arkansas Department of Health (ADH) (23 pp. unsigned 2021). Includes Attachments:
- Attachment A, Early Intervention Data (2 pp.)
- Business Associate Agreement between Arkansas Department of Human Services and Arkansas Department of Health (6 pp. ND).
- California. Standard Agreement Amendment between Department of Health Care Services and California Department of Health. (20 pp., signed 2013).
- Colorado. State of Colorado Interagency Agreement Short From between Department of Health Care Policy and Financing and Department of Public Health Environment, April 1, 2022 through June 30, 2023 (1 pp.), includes Attachment: Exhibit 2A, Statement of Work (49 pp).
- Connecticut. Memorandum of Understanding (Data Share Agreement) By and Between State of Connecticut Department of Social Services and State of Connecticut Department of Public Health (8 pp., signed 2022).
- Delaware. Memorandum of Understanding #18-374 Between The Delaware Department of Health and Social Services Division of Public Health and The Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance to Improve Coordination and Outcomes for Programs Impacting Women, Infants and Children (8 pp., signed 2018).
- District of Columbia. Memorandum of Understanding Between the District of Columbia Department of Health and the Department of Health Care Finance (13 pp., signed 2022).
- Federated States of Micronesia. Not eligible for the Title V-Medicaid IAA.
- Florida. Memorandum of Agreement between the State of Florida Agency for Health Care Administration and the State of Florida Department of Health. (6 pp. signed 2023).
- 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 2017).
- 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 Understanding Between Hawaii State Department of Human Services and Department of Health, (5 pp., signed 2021).
- Idaho. Memorandum of Understanding Between Idaho Department of Health and Welfare Division of Public Health and Division of Medicaid and Division of Welfare (4 pp., signed 2023).
- Illinois. Interagency Agreement between the Department of Public Health and the Department of Healthcare and Family Services (6 pp., signed 2023).
- Indiana. Memorandum of Understanding Between the Indiana Family and Social Services Administration (FSSA) and the Indiana State Department of Health (IHCP) (58 pp., signed 2022)
- Iowa. 59 pp.). Includes:
- Contract Declaration and Execution (2 pp. signed 2016),
- Section 1: Special Terms (8 pp.), includes Attachment A, Attachment B, Attachment C, Attachment D,
- Second Amendment to the Maternal and Child Health Omnibus Contract,, (pp. 9, signed 2017),
- Fourth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 9, signed 2018)
- Fifth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 7, unsigned)
- Sixth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 9, unsigned)
- Eighth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 6, digitally signed 2021)
- Kansas. (11 pp.). Includes:
- 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 (5 pp., signed 2016)
- [Code of Federal Regulations] Title 42, Public Health (2 pp.)
- Intra-agency Agreement between the Division of Health Care Finance and the Division of Public Health of the Kansas Department of Health and Environment Implementing Maternal Mortality Review (4 pp., signed 2019)
- Kentucky. Commonwealth of Kentucky Contract (2 pp.); Memorandum of Agreement between Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Medicaid Services, Division of Policy and Operations and Department for Public Health (27 pp., signed 2022).
- Louisiana. (19 pp.) Louisiana Department of Health Memorandum of Understanding Between Office of Public Health, Bureau of Family Health (Title V) and Bureau of Health Services Financing (Title XIX and XXI) (5 pp., signed 2017). Includes:
- Appendix A (1 pp.), Appendix B Data Sharing Agreement (8 pp. signed 2015), Addendum A (2 pp.), and Addendum B (1 pp.).
- Maine. Memorandum of Understanding The Department of Health and Human Services, Maine Center for Disease Control and Prevention, Maternal and Child Health Program (Maine CDC) and The Department of Health and Human Services Office of MaineCare Services (OMS) (4 pp., signed 2020).
- Maryland. Cooperative Agreement between Maryland State Department of Health, Title XIX Medicaid Agency, Title V Maternal and Child Health Agency,Family Planning Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). (16 pp., signed 2020).
- Massachusetts. Commonwealth of Massachusetts Interdepartmental Service Agreement Form (17 pp. signed 2021) includes Attachment A, Terms of Performance and Justifications; and B, Budget. (2 copies of same agreement, one signed by 'Buyer', one signed by 'Seller').
- Michigan. Excerpted from Michigan Medicaid State Plan, in Attachment 4.16A, Section F. Medical Assistance and Title V Projects. (7 pp.)
- Medicaid State Plan is an agreement between the State of Michigan and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (1 pp., 2022) [document is numbered 1 of 2 pp., page 2 omitted or missing]
- Minnesota. State of Minnesota Interagency Memorandum of Understanding, Minnesota Department of Health and Minnesota Department of Human Services (4 pp., signed 2017).
- Mississippi. (69 pp.) Includes Memorandum of Understanding By and Between the Division of Medicaid and Mississippi Department of Health with Notary page.
- Missouri. Memorandum of Agreement between Missouri Department of Health and Senior Services; Missouri Department of Social Services, Children's Division; and the Office of Administration, Children's Trust Fund (58 pp., signed 2021).
- Montana. Intra-Agency Agreement between the Early Childhood and Family Support Division and the Health Resources Division of the Montana Department of Public Health and Human Services (6 pp., Signed 2023).
- Nebraska. Inter-Agency Protocol: Titles V, XIX, and XXI (4 pp., signed, 2015).
- Nevada. Interlocal Contract Between Public Agencies (State of Nevada Department of Health and Human Services, Division of Public and Behavioral Health – Title V Maternal and Child Health, Bureau of Child, Family and Community Wellness, and Division of Health Care Financing and Policy) (8 pp. signed 2021), includes Attachment A, Scope of Work and Deliverables.
- New Hampshire. State of New Hampshire, Department of Health And Human Services: Intra-Agency Agreement between the Maternal and Child Health and Special Medical Services Sections, and the Office of Medicaid Services Relative to Joint Planning, Coordination and Improvement of Health Programs Under Title V and Title XIX, November 22, 2017 (13 pp., signed, 2018).
- New Jersey. Interagency Letter of Agreement between the State of New Jersey Department of Health and Department of Human Services, Division of Medical Assistance and Health Services (4 pp., signed 2019). [Note: Report is only 4 pages, p. 3 is missing]
- New Mexico. Memorandum of Agreement Between New Mexico Department of Health and New Mexico Human Services Department (5 pp., signed 2021).
- New York. Intra-Agency Agreement as of August 18, 2020 by the New York State Department of Health Office of Health Insurance Programs and Office of Public Health (2 pp., signed).
- North Carolina. (127 pp.) Intra-Departmental Memorandum of Agreement between North Carolina Department of Health and Human Services— Division of Health Benefits and Division of Public Health (signed 2023).
- North Dakota. Memorandum of Understanding between North Dakota Department of Human Services and North Dakota Department of Health (10 pp., signed, 2020).
- Northern Mariana Islands. Commonwealth of the Northern Mariana Islands Title V–Title XIX Agreement (1 pp., signed, 2023).
- Ohio. (106 pp.) Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (8 pp., signed 2021), includes Attachments: A through J.
- Oklahoma. (129 pp.) Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (signed 2019), includes Schedules A-G.
- Oregon. Memorandum of Understanding between Oregon’s Title XIX and Title XXI Medicaid Program, Title V Maternal Child and Adolescent Health Program, and Title V Children and Youth with Special Health Needs Program (19 pp., signed 2018).
- Palau. Not eligible for Medicaid.
- Pennsylvania. Memorandum of Understanding between the Department of Health (Title V Maternal and Child Health Service Block Grant) and Department of Human Services (Title XIX Medicaid, or Medical Assistance in Pennsylvania (5 pp., signed 2019).
- Puerto Rico. Agreement between the Puerto Rico Department of Health (PR Title V Services Program and Medicaid Office) the Puerto Rico Health Insurance Administration (7 pp., signed, 2020).
- Republic of the Marshal Islands. Not eligible for Medicaid.
- Rhode Island. State of Rhode Island Interagency Agreement between Executive Office of Health and Human Services and Department of Health for Participation in the Rhode Island Medicaid Program (24 pp., signed, 2016).
- South Carolina. (54 pp.) Agreement between South Carolina Department of Health and Environmental Control and South Carolina Department of Health and Human Services (54 pp. signed 2018).
- South Dakota. Memorandum of Understanding between the South Dakota Department of Health and the South Dakota Department of Social Services (4 pp., 2022).
- Tennessee (59 pp.) Cover letter for Title V/Medicaid Interagency Agreements (1 pp, signed 2023). Includes:
- Interagency Agreement between the State of Tennessee Department of Finance and Administration Division of TennCare and Department of Health for the provision of Eligibility (25 pp. digitally signed 2021), includes Interagency Agreement Summary, Attachment A
- Texas. Health and Human Services Commission and Department of State Health Services: Memorandum of Understanding (3 pp., signed 2020).
- United States Virgin Islands. Memorandum of Understanding between The Virgina Islands Department of Health Maternal and Child Health/Children with Special Health Care Needs Program and The Virgin Islands Department of Human Services Medical Assistance Program through The Virgin Islands Department of Property and Procurement (8 pp., signed 2022)
- Utah. Utah Department of Health Memorandum of Agreement (know as, MCH-CSHCN Medicaid MOA) between Medicaid and Health Financing and Family Health and Preparedness (4 pp., 2022).
- Vermont. Department of Vermont Health Access and Vermont Department of Health Intra-Governmental Agreement for the Administration of Services under Vermont's Global Commitment to Health Demonstration Waiver (18 pp., signed 2017).
- Virginia. Memorandum of Understanding Between the Department of Medical Assistance Services and the Virginia Department of Health (50 pp., signed 2016), includes Attachments 1 and 2.
- Washington. (19 pp.) Washington State Health Care Authority and Department of Health, Interagency Agreement (signed 2023);
- West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., unsigned).
- Wisconsin. Memorandum of Understanding Between the Department of Health Services/Division of Medicaid Services and Division of Public Health (4 pp., signed 2022).
- 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; Biblio No.WY1_1].
2023 Application/2021 Annual Reports Full-Text State IAAs
These documents were collected from the MCH Title V Block Grant FY 2022 Application/FY 2020 Annual Reports.
- Alabama. Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Public Health (ADPH) (7 pp., signed 2020). Includes Attachments:
- ADPH Financial Services Non-clinic Immunization Cost Budge, 10/1/15 - 9/30/2019 (1 pp.)
- EPSDT Care Coordination, Oct - Dec 20218 (1 pp.)
- EPSDT Care Coordination Report for Non-CHIP Recipients, Oct 1 - Dec 31, 2018 (4 pp.)
- Alabama Medicaid Agency Business Associate Addendum (4 pp., signed 2020)
- Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Rehabilitation Services (ADRS) (9 pp., signed 2009).
- Alaska. Interagency Memorandum of Agreement between the State of Alaska, Department of Health and Social Services, Division of Public Health (DPH), Section of Women's Children's and Family Health (WCFH), and the Division of Health Care Services (DHCS), Medicaid Program (4 pp., signed 2019).
- American Samoa. Cooperative Agreement between The American Samoa Department of Health and Child Health Title V Program and the American Samoa Medicaid State Agency (3 pp., signed 2018).
- 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. Memorandum of Agreement and Inter-Agency Agreement between the Arkansas Department of Human Services, Division of Medical Services, Division of Developmental Disabilities Services and the Arkansas Department of Health (ADH) (15 pp. unsigned 2021). Includes Attachments:
- Attachment A, Early Intervention Data (2 pp.)
- Business Associate Agreement between Arkansas Department of Human Services and Arkansas Department of Health (6 pp. ND).
- California. Standard Agreement Amendment between Department of Health Care Services and California Department of Health. (2 pp., signed 2013). Includes attachments:
- Exhibit A A1, Scope of Work (4 pp.)
- Exhibit F, HIPPA Business Associate Addendum (14 pp.).
- Colorado. State of Colorado Interagency Agreement Short From between Department of Health Care Policy and Financing and Department of Public Health Environment, April 1, 2022 through June 30, 2023 (1 pp.), includes Attachment: Exhibit 2A, Statement of Work (46 pp).
- Connecticut. Memorandum of Understanding (Data Share Agreement) By and Between State of Connecticut Department of Social Services and State of Connecticut Department of Public Health (6 pp., signed 2017).
- Delaware. Memorandum of Understanding #18-374 Between The Delaware Department of Health and Social Services Division of Public Health and The Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance to Improve Coordination and Outcomes for Programs Impacting Women, Infants and Children (8 pp., signed 2018).
- District of Columbia. Memorandum of Understanding Between the District of Columbia Department of Health and the Department of Health Care Finance (13 pp., signed 2015). Note: Earlier version: 8 pp., signed 2020/2021 under 2022 Application/2020 Annual Reports.
- Federated States of Micronesia. Not eligible for the Title V-Medicaid IAA.
- Florida. Memorandum of Agreement between the State of Florida Agency for Health Care Administration and the State of Florida Department of Health. (12 pp. signed 2017). Note: Earlier version: 11 pp., signed 2019 under 2022 Application/2020 Annual Reports.
- 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 2017).
- 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 Understanding Between Hawaii State Department of Human Services and Department of Health, (5 pp., signed 2021).
- Idaho. Memorandum of Understanding Between Idaho Department of Health and Welfare Division of Public Health and Division of Medicaid and Division of Welfare (4 pp., signed 2022).
- Illinois. Interagency Agreement between the Department of Public Health and the Department of Healthcare and Family Services (6 pp., signed 2022).
- Indiana. Memorandum of Understanding Between the Indiana Family and Social Services Administration (FSSA) and the Indiana State Department of Health (IHCP) (8 pp., digitally signed 2022)
- Iowa. (34 pp.). Includes:
- Contract Declaration and Execution (2 pp. signed 2016),
- Section 1: Special Terms (8 pp.), includes Attachment A, Attachment B, Attachment C, Attachment D,
- Second Amendment to the Maternal and Child Health Omnibus Contract,, (pp. 9, signed 2017),
- Fourth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 9, signed 2018)
- Fifth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 7, unsigned)
- Sixth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 9, unsigned)
- Eighth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 6, digitally signed 2021)
- Kansas. (11 pp.). Includes:
- 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 (5 pp., signed 2016)
- [Code of Federal Regulations] Title 42, Public Health (2 pp.)
- Intra-agency Agreement between the Division of Health Care Finance and the Division of Public Health of the Kansas Department of Health and Environment Implementing Maternal Mortality Review (4 pp., signed 2019)
- Kentucky. Commonwealth of Kentucky Contract (2 pp.); Memorandum of Agreement between Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Medicaid Services, Division of Policy and Operations and Department for Public Health (26 pp., signed 2020).
- Louisiana. (19 pp.) Louisiana Department of Health Memorandum of Understanding Between Office of Public Health, Bureau of Family Health (Title V) and Bureau of Health Services Financing (Title XIX and XXI) (5 pp., signed 2017). Includes:
- Appendix A (1 pp.), Appendix B Data Sharing Agreement (8 pp. signed 2015), Addendum A (2 pp.), and Addendum B (1 pp.).
- Maine. Memorandum of Understanding The Department of Health and Human Services, Maine Center for Disease Control and Prevention, Maternal and Child Health Program (Maine CDC) and The Department of Health and Human Services Office of MaineCare Services (OMS) (4 pp., signed 2020).
- Maryland. Cooperative Agreement between Maryland State Department of Health, Title XIX Medicaid Agency, Title V Maternal and Child Health Agency,Family Planning Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). (16 pp., signed 2020).
- Massachusetts. Commonwealth of Massachusetts Interdepartmental Service Agreement Form (9 pp. signed 2021) includes Attachment A, Terms of Performance and Justifications; and B, Budget. (2 copies of same agreement, one signed by 'Buyer', one signed by 'Seller').
- Michigan. Excerpted from Michigan Medicaid State Plan, in Attachment 4.16A, Section F. Medical Assistance and Title V Projects. (7 pp.)
- Medicaid State Plan is an agreement between the State of Michigan and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (1 pp., 2022) [document is numbered 1 of 2 pp., page 2 omitted or missing]
- Minnesota. State of Minnesota Interagency Memorandum of Understanding, Minnesota Department of Health and Minnesota Department of Human Services (3 pp., signed 2017).
- Mississippi. (68 pp.) Includes Memorandum of Understanding By and Between the Division of Medicaid and Mississippi Department of Health with Notary page.
- Missouri. Memorandum of Agreement between Missouri Department of Health and Senior Services; Missouri Department of Social Services, Children's Division; and the Office of Administration, Children's Trust Fund (signed 2021).
- Montana. Intra-Agency Agreement between the Early Childhood and Family Support Division and the Health Resources Division of the Montana Department of Public Health and Human Services (6 pp., Signed 2022).
- Nebraska. Inter-Agency Protocol: Titles V, XIX, and XXI (4 pp., signed, 2015).
- Nevada. Interlocal Contract Between Public Agencies (State of Nevada Department of Health and Human Services, Division of Public and Behavioral Health – Title V Maternal and Child Health, Bureau of Child, Family and Community Wellness, and Division of Health Care Financing and Policy) (8 pp. signed 2021), includes Attachment A, Scope of Work and Deliverables.
- New Hampshire. State of New Hampshire, Department of Health And Human Services: Intra-Agency Agreement between the Maternal and Child Health and Special Medical Services Sections, and the Office of Medicaid Services Relative to Joint Planning, Coordination and Improvement of Health Programs Under Title V and Title XIX, November 22, 2017 (13 pp., signed, 2018).
- New Jersey. Interagency Letter of Agreement between the State of New Jersey Department of Health and Department of Human Services, Division of Medical Assistance and Health Services (5 pp., signed 2019). [Note: Report is only 4 pages, p. 3 is missing]
- New Mexico. Memorandum of Agreement Between New Mexico Department of Health and New Mexico Human Services Department (5 pp., signed 2021).
- New York. Intra-Agency Agreement as of August 18, 2020 by the New York State Department of Health Office of Health Insurance Programs and Office of Public Health (2 pp., signed).
- North Carolina. (126 pp.) Intra-Departmental Memorandum of Agreement between North Carolina Department of Health and Human Services— Division of Health Benefits and Division of Public Health (2 pp., signed 2022).
- North Dakota. Memorandum of Understanding between North Dakota Department of Human Services and North Dakota Department of Health (10 pp., signed, 2020).
- Northern Mariana Islands. Commonwealth of the Northern Mariana Islands Title V–Title XIX Agreement (1 pp., signed, 2020).
- Ohio. (106 pp.) Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (8 pp., signed 2021), includes Attachments: A through J.
- Oklahoma. (127 pp.) Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (signed 2019), includes Schedules A-G.
- Oregon. Memorandum of Understanding between Oregon’s Title XIX and Title XXI Medicaid Program, Title V Maternal Child and Adolescent Health Program, and Title V Children and Youth with Special Health Needs Program (19 pp., signed 2018).
- Palau. Not eligible for Medicaid.
- Pennsylvania. Memorandum of Understanding between the Department of Health (Title V Maternal and Child Health Service Block Grant) and Department of Human Services (Title XIX Medicaid, or Medical Assistance in Pennsylvania (5 pp., signed 2019).
- Puerto Rico. Agreement between the Puerto Rico Department of Health (PR Title V Services Program and Medicaid Office) the Puerto Rico Health Insurance Administration (7 pp., signed, 2020).
- Republic of the Marshal Islands. Not eligible for Medicaid.
- Rhode Island. State of Rhode Island Interagency Agreement between Executive Office of Health and Human Services and Department of Health for Participation in the Rhode Island Medicaid Program (3 pp., signed, 2020).
- South Carolina. (54 pp.) Agreement between South Carolina Department of Health and Environmental Control and South Carolina Department of Health and Human Services (29 pp. signed 2018).
- South Dakota. Memorandum of Understanding between the South Dakota Department of Health and the South Dakota Department of Social Services (4 pp., 2022).
- Tennessee (56 pp.) Cover letter for Title V/Medicaid Interagency Agreements (1 pp, signed 2022). Includes:
- Interagency Agreement between the State of Tennessee Department of Finance and Administration Division of TennCare and Department of Health for the provision of Eligibility (25 pp. digitally signed 2021), includes Interagency Agreement Summary, Attachment A
- Texas. Health and Human Services Commission and Department of State Health Services: Memorandum of Understanding (3 pp., signed 2020).
- United States Virgin Islands. Memorandum of Understanding between The Virgina Islands Department of Health Maternal and Child Health/Children with Special Health Care Needs Program and The Virgin Islands Department of Human Services Medical Assistance Program through The Virgin Islands Department of Property and Procurement (8 pp., signed 2022)
- Utah. Utah Department of Health Memorandum of Agreement (know as, MCH-CSHCN Medicaid MOA) between Medicaid and Health Financing and Family Health and Preparedness (6 pp., 2018).
- Vermont. Department of Vermont Health Access and Vermont Department of Health Intra-Governmental Agreement for the Administration of Services under Vermont's Global Commitment to Health Demonstration Waiver (17 pp., signed 2017).
- Virginia. Memorandum of Understanding Between the Department of Medical Assistance Services and the Virginia Department of Health (50 pp., signed 2016), includes Attachments 1 and 2.
- Washington. (23 pp.) Washington State Health Care Authority and Department of Health, Interagency Agreement (signed 2018);
- West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2022).
- Wisconsin. Memorandum of Understanding Between the Department of Health Services/Division of Medicaid Services and Division of Public Health (4 pp., signed 2022).
- 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; Biblio No.WY1_1].
2022 Application/2020 Annual Reports Full-Text State IAAs
These documents were collected from the MCH Title V Block Grant FY 2023 Application/FY 2020 Annual Reports.
- Alabama. Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Public Health (ADPH) (7 pp., signed 2020). Includes Attachments:
- ADPH Financial Services Non-clinic Immunization Cost Budge, 10/1/15 - 9/30/2019 (1 pp.)
- EPSDT Care Coordination, Oct - Dec 20218 (1 pp.)
- EPSDT Care Coordination Report for Non-CHIP Recipients, Oct 1 - Dec 31, 2018 (4 pp.)
- Alabama Medicaid Agency Business Associate Addendum (4 pp., signed 2020)
- Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Rehabilitation Services (ADRS) (9 pp., signed 2009).
- Alaska. Interagency Memorandum of Agreement between the State of Alaska, Department of Health and Social Services, Division of Public Health (DPH), Section of Women's Children's and Family Health (WCFH), and the Division of Health Care Services (DHCS), Medicaid Program (4 pp., signed 2019).
- American Samoa. Cooperative Agreement between The American Samoa Department of Health and Child Health Title V Program and the American Samoa Medicaid State Agency (3 pp., signed 2018).
- 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. Memorandum of Agreement and Inter-Agency Agreement between the Arkansas Department of Human Services, Division of Medical Services, Division of Developmental Disabilities Services and the Arkansas Department of Health (ADH) (15 pp. unsigned 2021). Includes Attachments:
- Attachment A, Early Intervention Data (2 pp.)
- Business Associate Agreement between Arkansas Department of Human Services and Arkansas Department of Health (6 pp. ND).
- California. Standard Agreement Amendment between Department of Health Care Services and California Department of Health. (2 pp., signed 2013). Includes attachments:
- Exhibit A A1, Scope of Work (4 pp.)
- Exhibit F, HIPPA Business Associate Addendum (14 pp.).
- Colorado. State of Colorado Interagency Agreement Short From between Department of Health Care Policy and Financing and Department of Public Health Environment, July 1, 2021 through June 30, 2023 (1 pp.), includes Attachment: Exhibit 2A, Statement of Work (44 pp).
- Connecticut. Memorandum of Understanding (Data Share Agreement) By and Between State of Connecticut Department of Social Services and State of Connecticut Department of Public Health (6 pp., signed 2017).
- Delaware. Memorandum of Understanding #18-374 Between The Delaware Department of Health and Social Services Division of Public Health and The Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance to Improve Coordination and Outcomes for Programs Impacting Women, Infants and Children (8 pp., signed 2018).
- District of Columbia. Memorandum of Understanding Between the District of Columbia Department of Health and the Department of Health Care Finance (8 pp., signed 2020/2021).
- Federated States of Micronesia. Not eligible for the Title V-Medicaid IAA.
- Florida. Memorandum of Agreement between the State of Florida Agency for Health Care Administration and the State of Florida Department of Health. (11 pp. signed 2019). Includes Attachments:
- I-A, Line Item Expenditures (3 pp.)
- II-Exhibit A, Certified Nursing Assistant Registry (2 pp.)
- II-Exhibit B, Children's Multidisciplinary Assessment Team Medical Eligibility Determinations (4 pp.)
- II-Exhibit C, Family Planning Waiver Services (2 pp.); II-Exhibit D, Healthy Start Program (2 pp.)
- II-Exhibit E, Medicaid Early Intervention Services Early Steps Program (2 pp.)
- II-Exhibit F, Medical Foster Care (2 pp.)
- II-Exhibit G, Preadmission Screening and Resident Review (3 pp.)
- III. Business Associate Agreement (4 pp. signed 2019).
- 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 2017).
- 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 Understanding Between Hawaii State Department of Human Services and Department of Health, (5 pp., signed 2021).
- Idaho. Memorandum of Understanding Between Idaho Department of Health and Welfare Division of Public Health and Division of Medicaid and Division of Welfare (4 pp., signed 2021).
- Illinois. Interagency Agreement between the Department of Public Health and the Department of Healthcare and Family Services (9 pp., signed 2020), includes Attachment A, Healthcare and Family Services (HFS) Reports.
- Indiana.
Memorandum of Understanding Between the Indiana Family and Social Services Administration (FSSA) and the Indiana State Department of Health (IHCP) (45 pp., digitally signed 2019), includes:
- Appendices Summary; Appendix 1, Prenatal and Postnatal Medicaid Claims; Appendix 2, IHCP Enrollees; Appendix 3, Eligibility for MA & TANF; Appendix 4, Eligibility for MA & TANF; Appendix 5, MA Ages 0-18; Appendix 6., Refugee Exchange; Appendix 7, Blood Lead Data Match (2-way); Appendix 8, ISDH / FSSA Data Exchange.
- Iowa. (90 pp.). Includes:
- Contract Declaration and Execution (2 pp. signed 2016),
- Section 1: Special Terms (50 pp.), includes Attachment A, Attachment B, Attachment C, Attachment D,
- Second Amendment to the Maternal and Child Health Omnibus Contract,, (pp. 9, signed 2017),
- Fourth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 9, signed 2018)
- Fifth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 7, unsigned)
- Sixth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 9, unsigned)
- Eighth Amendment to the Maternal and Child and Adolescent Health Omnibus Contract (pp. 6, digitally signed 2021)
- Kansas. (11 pp.). Includes:
- 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 (5 pp., signed 2016)
- [Code of Federal Regulations] Title 42, Public Health (2 pp.)
- Intra-agency Agreement between the Division of Health Care Finance and the Division of Public Health of the Kansas Department of Health and Environment Implementing Maternal Mortality Review (4 pp., signed 2019)
- Kentucky. Commonwealth of Kentucky Contract (2 pp.); Memorandum of Agreement between Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Medicaid Services, Division of Policy and Operations and Department for Public Health (26 pp., signed 2020).
- Louisiana. (19 pp.) Louisiana Department of Health Memorandum of Understanding Between Office of Public Health, Bureau of Family Health (Title V) and Bureau of Health Services Financing (Title XIX and XXI) (5 pp., signed 2017). Includes:
- Appendix A (1 pp.), Appendix B Data Sharing Agreement (8 pp. signed 2015), Addendum A (2 pp.), and Addendum B (1 pp.).
- Maine. Memorandum of Understanding The Department of Health and Human Services, Maine Center for Disease Control and Prevention, Maternal and Child Health Program (Maine CDC) and The Department of Health and Human Services Office of MaineCare Services (OMS) (4 pp., signed 2020).
- Maryland. Cooperative Agreement between Maryland State Department of Health, Title XIX Medicaid Agency, Title V Maternal and Child Health Agency,Family Planning Program, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). (16 pp., signed 2020).
- Massachusetts. Commonwealth of Massachusetts Interdepartmental Service Agreement Form (9 pp. signed 2021) includes Attachment A, Terms of Performance and Justifications; and B, Budget. (2 copies of same agreement, one signed by 'Buyer', one signed by 'Seller').
- Michigan. Excerpted from Michigan Medicaid State Plan, in Attachment 4.16A, Section F. Medical Assistance and Title V Projects. (10 pp.)
- Medicaid State Plan is an agreement between the State of Michigan and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (1 pp., 2020) [document is numbered 1 of 2 pp., page 2 omitted or missing]
- Minnesota. State of Minnesota Interagency Memorandum of Understanding, Minnesota Department of Health and Minnesota Department of Human Services (3 pp., signed 2017).
- Mississippi. (36 pp.) Includes Memorandum of Understanding By and Between the Division of Medicaid and Mississippi Department of Health with Notary page (5 pp., signed 2018), includes multiple Data Use Agreements (Attachments A through E).
- Missouri. Memorandum of Agreement between Missouri Department of Health and Senior Services; Missouri Department of Social Services, Children's Division; and the Office of Administration, Children's Trust Fund ( signed 2020).
- Montana. Intra-Agency Agreement between the Early Childhood and Family Support Division and the Health Resources Division of the Montana Department of Public Health and Human Services (6 pp., Signed 2020).
- Nebraska. Inter-Agency Protocol: Titles V, XIX, and XXI (4 pp., signed, 2015).
- Nevada. Interlocal Contract Between Public Agencies (State of Nevada Department of Health and Human Services, Division of Public and Behavioral Health – Title V Maternal and Child Health, Bureau of Child, Family and Community Wellness, and Division of Health Care Financing and Policy) (8 pp. signed 2021), includes Attachment A, Scope of Work and Deliverables.
- New Hampshire. State of New Hampshire, Department of Health And Human Services: Intra-Agency Agreement between the Maternal and Child Health and Special Medical Services Sections, and the Office of Medicaid Services Relative to Joint Planning, Coordination and Improvement of Health Programs Under Title V and Title XIX, November 22, 2017 (13 pp., signed, 2018).
- New Jersey. Interagency Letter of Agreement between the State of New Jersey Department of Health and Department of Human Services, Division of Medical Assistance and Health Services (5 pp., signed 2019). [Note: Report is only 4 pages, p. 3 is missing]
- New Mexico. Memorandum of Agreement Between New Mexico Department of Health and New Mexico Human Services Department (7pp., signed 2021).
- New York. Intra-Agency Agreement as of August 18, 2020 by the New York State Department of Health Office of Health Insurance Programs and Office of Public Health (2 pp., signed).
- North Carolina. (143 pp.) Intra-Departmental Memorandum of Agreement between North Carolina Department of Health and Human Services— Division of Health Benefits and Division of Public Health (1 pp., signed 2021). Includes:
- Amendment #5, Intra-Departmental Memorandum of Agreement #30014 between Department of Health and Human Services, Division of Health Benefits and Department of Health and Human Services, Division of Public Health (2 pp., signed 2020).
- Amendment #3, Intra-Departmental Memorandum of Agreement #30014 between Department of Health and Human Services, Division of Health Benefits and Department of Health and Human Services, Division of Public Health (2 pp., signed 2019).
- Intra-Departmental Memorandum of Agreement (Amendment) between North Carolina Department of Health and Human Services, Division of Medical Assistance and the Human Services, Division of Public Health (14 pp., signed 2017), includes Exhibits 1-2.
- Intra-Departmental Memorandum of Agreement between North Carolina Departments of Health and Human Services, Division of Medical Assistance and the Division of Public Health, Contract #30014 (124 pp., signed 2014) includes Attachments A-W.
- North Dakota. Memorandum of Understanding between North Dakota Department of Human Services and North Dakota Department of Health (10 pp., signed, 2020).
- Northern Mariana Islands. Commonwealth of the Northern Mariana Islands Title V–Title XIX Agreement (1 pp., signed, 2020).
- Ohio. (112 pp.) Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (8 pp., signed 2019), includes Attachments: A through J.
- Oklahoma. (127 pp.) Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (120 pp., signed 2011), includes Schedules A-G. Also includes:
- Amendment Ten Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (6 pp., signed 2018)
- Amendment Eleven Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (1 pp., signed 2019)
- Oregon. Memorandum of Understanding between Oregon’s Title XIX and Title XXI Medicaid Program, Title V Maternal Child and Adolescent Health Program, and Title V Children and Youth with Special Health Needs Program (19 pp., signed 2018).
- Palau. Not eligible for Medicaid.
- Pennsylvania. Memorandum of Understanding between the Department of Health (Title V Maternal and Child Health Service Block Grant) and Department of Human Services (Title XIX Medicaid, or Medical Assistance in Pennsylvania (5 pp., signed 2019).
- Puerto Rico. Agreement between the Puerto Rico Department of Health (PR Title V Services Program and Medicaid Office) the Puerto Rico Health Insurance Administration (7 pp., signed, 2020).
- Republic of the Marshal Islands. Not eligible for Medicaid.
- Rhode Island. State of Rhode Island and Providence Plantations Interagency Agreement between Executive Office of Health and Human Services and Department of Health for Participation in the Rhode Island Medicaid Program (24 pp., signed, 2016), includes Attachments A through E, Form 1 and Form 2– unsigned.
- South Carolina. (25 pp.) Master Data Sharing Agreement between South Carolina Department of Health and Environmental Control and South Carolina Department of Health and Human Services (13 pp. signed 2018), includes Appendix A (7 pp., signed 2018) and Appendix B (5 pp., signed 2018).
- South Dakota. Memorandum of Understanding between the South Dakota Department of Health and the South Dakota Department of Social Services (3 pp., 2020).
- Tennessee. (80 pp.) Cover letter for Title V/Medicaid Interagency Agreements (1 pp, signed 2021)
- Grant Agreement between the State of Tennessee Department of Finance and Administration Division of TennCare and Department of Health for the provision of Women's Health and Infant Mortality Reduction Initiatives (29 pp. digitally signed 2021), includes Interagency Grant Agreement Cover Sheet, Attachments A-C
- Interagency Agreement between the State of Tennessee Department of Finance and Administration Division of TennCare and Department of Health for the provision of Eligibility (25 pp. digitally signed 2021), includes Interagency Agreement Summary, Attachment A
- Interagency Agreement between the State of Tennessee Department of Finance and Administration Division of TennCare and Department of Health for the provision of Early Periodic Screening, Diagnosis, and Treatment Services and the Community Health Access and Navigation in Tennessee Program (25 pp. digitally signed 2021), includes Interagency Agreement Summary, Attachments 1 and 2.
- Texas. Health and Human Services Commission and Department of State Health Services: Memorandum of Understanding (3 pp., signed 2020).
- United States Virgin Islands. Memorandum of Understanding between The Virgina Islands Department of Health Maternal and Child Health/Children with Special Health Care Needs Program and The Virgin Islands Department of Human Services Medical Assistance Program through The Virgina Islands Department of Property and Procurement (5 pp. document marked as DRAFT)
- Utah. Utah Department of Health Memorandum of Agreement (know as, MCH-CSHCN Medicaid MOA) between Medicaid and Health Financing and Family Health and Preparedness (6 pp., 2018).
- Vermont. Department of Vermont Health Access and Vermont Department of Health Intra-Governmental Agreement for the Administration of Services under Vermont's Global Commitment to Health Demonstration Waiver (17 pp., signed 2017).
- Virginia. Memorandum of Understanding Between the Department of Medical Assistance Services and the Virginia Department of Health (60 pp., signed 2016), includes Attachments 1 and 2.
- Washington. (105 pp.) Washington State Health Care Authority and Department of Health, Interagency Agreement, Amendment 3 (5 pp., signed 2018), and;
- Restated and Amended Interagency Agreement Between State of Washington Health Care Authority and Department of Health (12 pp., signed 2017), including Exhibit A, Statement of Work
- Interagency Agreement Amendment between the Washington State Health Care Authority and Washington Uniform Business Identifier (3 pp., signed 2019), includes Exhibit A, Statement of Work for Genetic Counseling Services .
- Interagency Agreement Between State of Washington Health Care Authority and Department of Health (7 pp., signed 2012, includes Exhibit A, Genetic Counseling Services Statement of Work.
- Contract Amendment between State of Washington Health Care Authority to change the contract manager's name, all other conditions remain the same (3 pp., signed 2019), includes Exhibit A-1, Statement of Work.
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (8 pp., signed 2019), includes Exhibit A, Statement of Work.
- Maternal Infant Health Interagency Agreement Between State of Washington Health Care Authority and Department of Health (13 pp., signed 2018).
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (6 pp., no signature), includes Exhibit A, Statement of Work.
- Mutual Information Sharing Agreement for Confidential Information or Limited Dataset(s) Between State of Washington Department of Health and Washington State Health Care Authority-Medicaid Program (14 pp., 2019), includes 1 page showing a digital history of signatures.
- Data Share Agreement ProvderOne and PRISM, between the State of Washington Health Care Authority and the State of Washington Department of Social and Health Services (2 pp., signed 2016)
- Data Share Agreement ProvderOne and PRISM, between the State of Washington Health Care Authority and the State of Washington Department of Social and Health Services (16 pp., signed 2016)
- Data Share Agreement Amendment between the State of Washington Health Care Authority and Washington Uniform Business Identifier (2 pp., digitally signed 2020) [pages 3-5 are missing]
- Data Share Agreement between the State of Washington Health Care Authority and the State of Washington Department of Health (14 pp., signed 2018)
- West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2021).
- Wisconsin. Memorandum of Understanding Between the Department of Health Services/Division of Medicaid Services and Division of Public Health (11 pp., digitally signed 2020), includes Exhibit I, Subprograms, and Exhibit II, Activities Section.
- 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; Biblio No.WY1_1].
2021 Application/2019 Annual Reports Full-Text State IAAs
These documents were collected from the MCH Title V Block Grant FY 2021 Application/FY 2019 Annual Reports.
- Alabama. Memorandum of Understanding between the Alabama Medicaid Agency and the Alabama Department of Public Health (8 pp., signed 2019).
- Alaska. Interagency Memorandum of Agreement between the Section of Public Health (DPH), Section of Women's Children's and Family Health (WCFH), and the Division of Health Care Services (DHCS), Medicaid Program (4 pp., signed 2019).
- American Samoa. Letter explaining the state of Medicaid.
- Cooperative Agreement between American Samoa Medicaid State Agency, the American Samoa Department of Health (DOH), and the Maternal and Child Health (MCH) Title V Program (3 pp., signed 2018)
- 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).
- These documents may also support Data-Sharing Request/Agreement between Arizona Department of Health Services, Public Prevention Services, Division of Public Health, Office of Women's and Children's Health and Provider(s), Arizona Department of Economic Security (10 pp., unsigned 2000).
- Arkansas. Memorandum of Agreement and Inter-Agency Agreement between the Arkansas Department of Health (ADH) and the Arkansas Department of Human Services (14 pp. unsigned 2017).
- California. California Department of Health Block Grant Funding to the Department of Health Care Services. (30 pp., signed 2019) Includes:
- Exhibit A, B, Contract Request, Justification for Contracting Out Services, multiple Agreement Summaries and Standard Agreements.
- Colorado. Agreement Amendment No. 4 (45 pp., signed 2020). Includes: Exhibit A-2, Statement of Work (42 pp., signed 2019).
- This amendment references the [Colorado] Interagency Agreement (18 pp., unsigned) and the [Colorado] HIPAA Business Associate Interagency Memorandum of Understanding (9 pp., unsigned) used in the 2008 environmental scan.
- Connecticut. Memorandum of Understanding (Data Share Agreement) By and Between State of Connecticut Department of Social Services and State of Connecticut Department of Public Health (6 pp., signed 2017).
- Delaware. Memorandum of Understanding #18-374 Between The Delaware Department of Health and Social Services Division of Public Health and The Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance to Improve Coordination and Outcomes for Programs Impacting Women, Infants and Children (8 pp., signed 2018).
- District of Columbia. Memorandum of Understanding (MOU) Between the District of Columbia Department of Health’s, (DC Health), Community Health Administration, (CHA), and the Department of Health Care Finance (DHCF) (8 pp., unsigned).
- Federated States of Micronesia. Not eligible for Medicaid.
- FSM is not eligible for the Title V-Medicaid and Medicare Programs and Special Children’s Health Insurance Program (CHIP).
- 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."
- The latest IAA from Florida is [Florida] Cooperative Agreement for the Health Start Coordinated Care System for Pregnant Women and Infants between the Agency for Health Care Administration and the Department of Health (4 pp., signed 2001).
- State of Florida Agency for Health Care Administration Memorandum of Understanding No. AA348 (8 pp., signed 2017). Four additional pages in Attachment 1 (FMMIS Data File Variables).
- 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 2017).
- 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 Understanding Between Hawaii State Department of Human Services and Department of Health, July _, 2019 through June 30, 2025 (4 pp., unsigned). [stamped as a draft]
- 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 Division of Welfare (4 pp., signed 2020).
- Illinois. Intergovernmental Agreement between the Department of Public Health and the Department of Healthcare and Family Services (9 pp., signed 2020).
- This document appears to update Agreement Between Illinois Department of Public Aid and Illinois Department of Human Services - Office of Family Health Regarding the Maternal and Child Health Program (10 pp., signed 2000) and
- This document appears to support Intergovernmental Agreement between the Illinois Department of Public Aid and the Board of Trustees of the University of Illinois Regarding the Division of Specialized Care for Children (9 pp., signed 2004).
- Indiana. Memorandum of Understanding Between the Indiana State Department of Health and the Indiana Family and Social Services Administration (43 pp., electronically signed 2017).
- Iowa. Contract Declaration and Execution (50pp., signed 2016). Includes:
- Second Amendment, (pp. 9, signed 2017),
- Fourth Amendment (pp. 9, signed 2018),
- Fifth Amendment, to the Maternal and Child Health Omnibus Contract-Between the Iowa Department of Human Services (Agency), and Iowa Department of Public Health (Contractor).(pp. 7, unsigned).
- 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 (5 pp., signed 2016), [Code of Federal Regulations] (2pp.), Intra-agency Agreement between the Division of Health Care Finance and the Division of Public Health of the Kansas Department of Health and Environment Implementing Maternal Mortality Review (4pp., signed 2019). (total pp., 11).
- Kentucky. Memorandum of Understanding between Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Medicaid Services (DMS), Division of Policy and Operations (“the First Party”) and Department for Public Health (DPH) (25 pp., signed 2020).
- Louisiana. Louisiana Department of Health Memorandum of Understanding Between Office of Public Health, Bureau of Family Health (Title V) and Bureau of Health Services Financing (Title XIX and XXI) (5 pp., signed 2017). Includes: Appendix A, Appendix B Data Sharing Agreement (signed 2015), Addendum A, and Addendum B.
- Maine. Memorandum of Understanding The Department of Health and Human Services, Maine Center for Disease Control and Prevention, Maternal and Child Health Program (Maine CDC) and The Department of Health and Human Services Office of MaineCare Services (OMS) (4 pp., signed 2020).
- Maryland. Cooperative Agreement between Maryland State Department of Health (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 2020).
- 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 (3 pp., signed, 2020).
- Michigan. Excerpted from Michigan Medicaid State Plan. In Attachment 4.16A, see Section F. Medical Assistance and Title V Projects. (22 pp.)
- Medicaid State Plan is an agreement between the State of Michigan and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (1 pp., 2020) [document is numbered 1 of 2 pp., no p. 2 omitted or missing from MI]
- Minnesota. State of Minnesota Interagency Memorandum of Understanding, Minnesota Department of Health and Minnesota Department of Human Services (3 pp., signed 2017).
- Mississippi. (68 pp.) Includes Memorandum of Understanding By and Between the Division of Medicaid and Mississippi Department of Health with Notary page.
- Missouri. Memorandum of Agreement between Missouri Department of Health and Senior Services; Missouri Department of Social Services, Children's Division; and the Office of Administration, Children's Trust Fund ( signed 2020).
- Montana. Intra-Agency Agreement between the Early Childhood and Family Support Division and the Health Resources Division of the Montana Department of Public Health and Human Services (6 pp., Signed 2020).
- Nebraska. Inter-Agency Protocol: Titles V, XIX, and XXI (4 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: Intra-Agency Agreement between the Maternal and Child Health and Special Medical Services Sections, and the Office of Medicaid Services Relative to Joint Planning, Coordination and Improvement of Health Programs Under Title V and Title XIX, November 22, 2017 (13 pp., signed, 2018). [Note: signed in 2017, and 2018]
- New Jersey. Interagency Letter of Agreement between the State of New Jersey Department of Health and Department of Human Services, Division of Medical Assistance and Health Services (5 pp., signed 2019).
- New Mexico. Memorandum of Agreement Between New Mexico Department of Health and New Mexico Human Services Department (7 pp., signed 2017).
- New York. Intra-Agency Agreement Between the New York State Department of Health Office of Health Insurance Programs and Office of Public Health (2 pp., signed 2019).
- 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). Includes:
- Amendment #5, Intra-Departmental Memorandum of Agreement#30014 between Department of Health and Human Services, Division of Health Benefits and Department of Health and Human Services, Division of Public Health (2 pp., signed 2020).
- Intra-Departmental Memorandum of Agreement between North Carolina Department of Health and Human Services, Division of Medical Assistance and the Human Services, Division of Public Health (14 pp., signed 2017).
- Northern Mariana Islands. Commonwealth of the Northern Mariana Islands Title V–Title XIX Agreement (1 pp., signed, 2020).
- Ohio. Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (8 pp., signed 2019). Includes:
- Attachments: A through G.
- Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (92 pp., includes Contract and all Amendments, final signature dated 2020).
- Oregon. Memorandum of Understanding between Oregon’s Title XIX and Title XXI Medicaid Program, Title V Maternal Child and Adolescent Health Program, and Title V Children and Youth with Special Health Needs Program (19 pp., signed 2018).
- Palau. Not eligible for Medicaid.
- Pennsylvania. Memorandum of Understanding between the Department of Health (Title V Maternal and Child Health Service Block Grant) and Department of Human Services (Title XIX Medicaid, or Medical Assistance in Pennsylvania (5 pp., signed 2019).
- Puerto Rico. Agreement between the PR Department of Health (Medicaid office and PR MCAH) and the PR Health Insurance Administration (7 pp., signed, 2020).
- Republic of the Marshal Islands. Not eligible for Medicaid.
- [RMI does not have Medicaid services. We have our own local insurance.]
- Rhode Island. State of Rhode Island and Providence Plantations Interagency Agreement between Executive Office of Health and Human Services and Department of Health for Participation in the Rhode Island Medicaid Program (24 pp., signed, 2016). Includes Attachments A through E, Form 1, and Form 2, unsigned.
- South Carolina. Contract between South Carolina Department of Health and Environmental Control and South Carolina Department of Health and Human Services (25 pp., signed 2018). Includes Appendix A (7 pp., signed 2018) and Appendix B (5 pp., signed 2018).
- This document perhaps supercedes or supplements Memorandum of Agreement between South Carolina Department of Health and Environmental Control and State Budget and Control Board, Office of Research and Assistance to Link Maternal and Child Health Data Files for Public Health Research, Evaluation, and Surveillance (12 pp., unsigned, 2004).
- South Dakota. Memorandum of Understanding between South Dakota Department of Social Services and South Dakota Department of Health (4 pp., 2020)
- 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). Includes:
- Includes a cover page (dated 2019)
- Appendices A through E.
- Texas. Health and Human Services Commission and Department of State Health Services: Memorandum of Understanding (3 pp., signed 2020).
- United States Virgin Islands. Cover letter indicates USVI Title V/Title XIX Interagency Agreement revision and submitted for review and is expected to be approved in the second quarter of fiscal year 2021.
- Utah. Utah Department of Health Memorandum of Agreement Between Medicaid and Health Financing and Family Health and Preparedness (6 pp., 2018).
- Vermont. Department of Vermont Health Access and Vermont Department of Health Intra-Governmental Agreement for the Administration of Services Under Vermont's Global Commitment to Health Demonstration Waiver (17 pp., signed 2017).
- Virginia. Memorandum of Understanding Between the Department of Medical Assistance Services and the Virginia Department of Health (60 pp., signed 2016).
- Includes Scope of Work, Appendices and Attachments.
- Washington. Restated and Amended Interagency Agreement Between State of Washington Health Care Authority and Department of Health (22 pp., signed 2017). Also includes the following documents:
- Contract Amendment between State of Washington Health Care Authority and Contractor for Medicaid Genetics Counseling Services (3 pp., signed 2017)
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (7 pp., signed 2012)
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (8 pp., signed 2019)
- Maternal Infant Health Interagency Agreement Between State of Washington Health Care Authority and Department of Health (23 pp., signed 2018).
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (10 pp.)
- Interagency Agreement between State of Washington Health Care Authority and Contractor for Trauma Informed Approaches (TIA) Services (22 pp., signed 2019)
- Mutual Information Sharing Agreement for Confidential Information or Limited Dataset(s) Between State of Washington Department of Health and Washington State Health Care Authority-Medicaid Program (45 pp., signed 2017).
- Data Share Agreement between State of Washington Health Care Authority, the State of Washington Department of Social and Health Services, and the Sate of Washington Department of Health for ProviderOne and PRISM (16 pp., signed 2016)
- Data Share Agreement between State of Washington Health Care Authority and Department of Health for Maternal Mortality Review ( 16 pp., signed 2018)
- West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2020).
- West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2018).
- Included a cover letter.
- West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2018).
- Wisconsin. State of Wisconsin, Department of Health Services: Memorandum of Understanding Between the Department of Health Services/Division of Medicaid Services and Division of Public Health (11 pp., signed 2020).
- 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; Biblio No.WY1_1].
2020 Application/2018 Annual Reports Full-Text State IAAs
These documents were collected from the MCH Title V Block Grant FY 2020 Application/FY 2018 Annual Reports.
- Alabama. 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). Includes:
- 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 (WCFH), and the Division of Health Care Services (DHCS), Medicaid Program (4 pp., signed 2019).
- American Samoa. Letter explaining the state of Medicaid.
- Cooperative Agreement between American Samoa Medicaid State Agency, the American Samoa Department of Health (DOH), and the Maternal and Child Health (MCH) Title V Program (3 pp., signed 2018)
- 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).
- These documents may also support Data-Sharing Request/Agreement between Arizona Department of Health Services, Public Prevention Services, Division of Public Health, Office of Women's and Children's Health and Provider(s), Arizona Department of Economic Security (10 pp., unsigned 2000).
- Arkansas. Memorandum of Agreement and Inter-Agency Agreement between the Arkansas Department of Health (ADH) and the Arkansas Department of Human Services (14 pp.unsigned 2017).
- California. California Department of Health Block Grant Funding to the Department of Health Care Services. (30 pp., signed 2019) Includes:
- Exhibit A, B, Contract Request, Justification for Contracting Out Services, multiple Agreement Summaries and Standard Agreements.
- Colorado. Agreement Amendment No. 2 (4 pp., signed 2019). Includes: Exhibit A-2, Statement of Work (44 pp., signed 2019).
- This amendment references the [Colorado] Interagency Agreement (8 pp., unsigned) and the [Colorado] HIPAA Business Associate Interagency Memorandum of Understanding (9 pp., unsigned) used in the 2008 environmental scan.
- Connecticut. Memorandum of Understanding (Data Share Agreement) By and Between State of Connecticut Department of Social Services and State of Connecticut Department of Public Health (6 pp., signed 2017).
- Delaware. Memorandum of Understanding #18-374 Between The Delaware Department of Health and Social Services Division of Public Health and The Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance to Improve Coordination and Outcomes for Programs Impacting Women, Infants and Children (8 pp., signed 2018).
- District of Columbia. Memorandum of Understanding (MOU) Between District of Columbia Department of Health and The Department of Health Care Finance, October 1, 2018 through September 30, 2019 (7 pp., signed 2018). Includes:
- Memorandum of Understanding (MOU) Between District of Columbia Department of Health and The Department of Health Care Finance, October 1, 2019 through September 30, 2024 (5 pp., unsigned draft).
- Federated States of Micronesia. Not eligible for Medicaid.
- FSM is not eligible for the Title V-Medicaid and Medicare Programs and Special Children’s Health Insurance Program (CHIP).
- 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."
- The latest IAA from Florida is [Florida] Cooperative Agreement for the Health Start Coordinated Care System for Pregnant Women and Infants between the Agency for Health Care Administration and the Department of Health (4 pp., signed 2001).
- State of Florida Agency for Health Care Administration Memorandum of Understanding No. AA348 (8 pp., signed 2017). Four additional pages in Attachment 1 (FMMIS Data File Variables).
- 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 2017).
- 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 Understanding Between Hawaii State Department of Human Services and Department of Health, July _, 2019 through June 30, 2025 (4 pp., unsigned). [stamped as a draft]
- 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 2019).
- Illinois. Intergovernmental Agreement between the Department of Public Health and the Department of Healthcare and Family Services (9 pp., signed 2017).
- This document appears to update Agreement Between Illinois Department of Public Aid and Illinois Department of Human Services - Office of Family Health Regarding the Maternal and Child Health Program (10 pp., signed 2000) and
- This document appears to support Intergovernmental Agreement between the Illinois Department of Public Aid and the Board of Trustees of the University of Illinois Regarding the Division of Specialized Care for Children (9 pp., signed 2004).
- Indiana. Memorandum of Understanding Between the Indiana State Department of Health and the Indiana Family and Social Services Administration (43 pp., electronically signed 2017).
- Iowa. Contract Declaration and Execution (50pp., signed 2016). Includes:
- Second Amendment, (pp. 9, signed 2017),
- Fourth Amendment (pp. 9, signed 2018),
- Fifth Amendment, to the Maternal and Child Health Omnibus Contract-Between the Iowa Department of Human Services (Agency), and Iowa Department of Public Health (Contractor).(pp. 7, unsigned).
- 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 (5 pp., signed 2016), [Code of Federal Regulations] (2pp.), Intra-agency Agreement between the Division of Health Care Finance and the Division of Public Health of the Kansas Department of Health and Environment Implementing Maternal Mortality Review (4pp., signed 2019). (total pp., 11).
- Kentucky. Commonwealth of Kentucky Contract (2 pp.), Intra-agency Agreement: Memorandum of Agreement (MOA) between the Commonwealth of Kentucky and the Department for Public Health (42 pp., signed 2018).
- Louisiana. Louisiana Department of Health Memorandum of Understanding Between Office of Public Health, Bureau of Family Health (Title V) and Bureau of Health Services Financing (Title XIX and XXI) (5 pp., signed 2017). Includes: Appendix A, Appendix B Data Sharing Agreement ( signed 2015), Addendum A, and Addendum B.
- Maine. Cover page states that Maine’s current IAA is outdated and they have initiated planning meetings to begin formalizing a new version. Current version in place: Memorandum of Understanding Between the Office of Maine Care Services and the Division of Family Health within the Maine Center for Disease Control (8 pp., signed 2009).
- 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 (3 pp., signed, 2019).
- Michigan. Excerpted from Michigan Medicaid State Plan. In Attachment 4.16A, see "Section F. Medical Assistance and Title V Projects. (21 pp.)
- Medicaid State Plan is an agreement between the State of Michigan and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (1 pp., 2019) [document is numbered 1 of 2 pp., no p. 2 omitted or missing from MI]
- Minnesota. State of Minnesota Interagency Memorandum of Understanding, Minnesota Department of Health and Minnesota Department of Human Services (3 pp., signed 2017).
- Mississippi. Memorandum of Understanding By and Between the Division of Medicaid and Department of Health (5 pp., signed 2018). Includes multiple Data Use Agreements (Attachments A through E.
- Missouri. Cover letter states IAA's have no current challenges and MOU's (Memorandum of Understanding) as listed below is same documentation submitted with the FFY19 application. Includes:
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the [Missouri] Department of Health, Bureau of Special Health Care Needs, Head Injury Program (8 pp., signed 2001)
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the [Missouri] Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Administrative Case Management, Healthy Children and Youth Program (HCY) (5 pp., stamped and signed 1997). This document is the same at that used in the 2008 environmental scan.
- Title 19 -- Department of Health, Division 40 -- Division of Maternal, Child and Family Health, Chapter 61 -- Licensing Rules for Family Day Care Homes: Proposed Amendment (2 pp., signed, 1997).
- Memorandum of Agreement between the Missouri Department of Social Services, Children's Division and the Missouri Department of Health and Senior Services, Bureau of Genetics and Healthy Childhood (3 pp., signed 2014). Includes business associate agreement as Attachment A (5pp.).
- Excluded from this compiled document, but assumed to supplement the current IAA:
- Interagency Agreement between the Missouri Department of Health and the Missouri Department of Social Services: Well Child Outreach (3 pp., stamped and signed 1997).
- Cooperative Agreement between the Missouri Department of Social Services, Division of Medical Services and the Missouri Department of Health, Bureau of Special Health Care Needs, Head Injury Program: Non-Emergency Medical Transportation (5 pp., signed 2000).
- Cooperative Agreement between the [Missouri] Department of Social Services and the Department of Health relating to Administration of the Medicaid Home and Community-Based Services Waiver for Targeted Individuals with Physical Disabilities (10 pp., signed 2001).
- 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 (4 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: Intra-Agency Agreement between the Maternal and Child Health and Special Medical Services Sections, and the Office of Medicaid Services Relative to Joint Planning, Coordination and Improvement of Health Programs Under Title V and Title XIX, November 22, 2017 (13 pp., signed, 2018). [Note: signed in 2017, and 2018]
- New Jersey. Interagency Letter of Agreement between the State of New Jersey Department of Health and Department of Human Services, Division of Medical Assistance and Health Services (5 pp., signed 2019).
- New Mexico. Memorandum of Agreement Between New Mexico Department of Health and New Mexico Human Services Department (7 pp., signed 2017).
- New York. Intra-Agency Agreement Between the New York State Department of Health Office of Health Insurance Programs and Office of Public Health (2 pp., signed 2019).
- 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). Includes:
- Amendment #3, Intra-Departmental Memorandum of Agreement#30014 between Department of Health and Human Services, Division of Health Benefits and Department of Health and Human Services, Division of Public Health (2 pp., signed 2019).
- Intra-Departmental Memorandum of Agreement between North Carolina Department of Health and Human Services, Division of Medical Assistance and the Human Services, Division of Public Health (14 pp., signed 2017).
- Cooperative Agreement between North Dakota Department of Health and North Dakota Department of Human Services (8 pp.) [A note states document contains working notes and is marked 'DRAFT']
- Northern Mariana Islands. Commonwealth of the Northern Mariana Islands Title V–Title XIX Agreement (1 pp., signed, 2016).
- Ohio. Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (7 pp., signed 2018). Includes:
- Attachments: A through G.
- Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (116 pp., includes Contract and all Amendments, final signature dated 2019).
- Oregon. Memorandum of Understanding between Oregon’s Title XIX and Title XXI Medicaid Program, Title V Maternal Child and Adolescent Health Program, and Title V Children and Youth with Special Health Needs Program (19 pp., signed 2018).
- Palau. Not eligible for Medicaid.
- Pennsylvania. Memorandum of Understanding between the Department of Health (Title V Maternal and Child Health Service Block Grant) and Department of Human Services (Title XIX Medicaid, or Medical Assistance in Pennsylvania (5 pp., signed 2019).
- 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.
- [RMI does not have Medicaid services. We have our own local insurance.]
- Rhode Island. State of Rhode Island and Providence Plantations Interagency Agreement between Executive Office of Health and Human Services and Department of Health for Participation in the Rhode Island Medicaid Program (24 pp., signed, 2016). Includes Attachments A through E, Form 1, and Form 2, unsigned.
- South Carolina. Contract between South Carolina Department of Health and Environmental Control and South Carolina Department of Health and Human Services (25 pp., signed 2018). Includes Appendix A (7 pp., signed 2018) and Appendix B (5 pp., signed 2018).
- This document perhaps supercedes or supplements Memorandum of Agreement between South Carolina Department of Health and Environmental Control and State Budget and Control Board, Office of Research and Assistance to Link Maternal and Child Health Data Files for Public Health Research, Evaluation, and Surveillance (12 pp., unsigned, 2004).
- 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 (4 pp., 2014)
- 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). Includes:
- Includes a cover page (dated 2019)
- Appendices A through E.
- Texas. Health and Human Services Commission and Department of State Health Services: Memorandum of Understanding (3 pp., signed 2015).
- United States Virgin Islands. Cover letter indicates USVI Title V/Title XIX Interagency Agreement revision and submitted for review. Includes:
- Current agreement, 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).
- Interagency Agreement Between the USVI Department of Human Services Medical Assistance Program and the USVA Department of Health Maternal and Child Health/Children with Special Health Care Needs Program (6 pp., unsigned 2017).
- Utah. Utah Department of Health Memorandum of Agreement Between Medicaid and Health Financing and Family Health and Preparedness (6 pp., 2018).
- Vermont. Department of Vermont Health Access and Vermont Department of Health Intra-Governmental Agreement for the Administration of Services Under Vermont's Global Commitment to Health Demonstration Waiver (17 pp., signed 2018).
- Virginia. Memorandum of Understanding Between the Department of Medical Assistance Services and the Virginia Department of Health (60 pp., signed 2016).
- Includes Scope of Work, Appendices and Attachments.
- Washington. Restated and Amended Interagency Agreement Between State of Washington Health Care Authority and Department of Health (22 pp., signed 2017). Also includes the following documents:
- Contract Amendment between State of Washington Health Care Authority and Contractor for Medicaid Genetics Counseling Services (3 pp., signed 2017)
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (7 pp., signed 2012)
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (8 pp., signed 2019)
- Maternal Infant Health Interagency Agreement Between State of Washington Health Care Authority and Department of Health (23 pp., signed 2018).
- Interagency Agreement Between State of Washington Department of Health and Washington State Health Care Authority (10 pp.)
- Interagency Agreement between State of Washington Health Care Authority and Contractor for Trauma Informed Approaches (TIA) Services (22 pp., signed 2019)
- Mutual Information Sharing Agreement for Confidential Information or Limited Dataset(s) Between State of Washington Department of Health and Washington State Health Care Authority-Medicaid Program (45 pp., signed 2017).
- Data Share Agreement between State of Washington Health Care Authority, the State of Washington Department of Social and Health Services, and the Sate of Washington Department of Health for ProviderOne and PRISM (16 pp., signed 2016)
- Data Share Agreement between State of Washington Health Care Authority and Department of Health for Maternal Mortality Review ( 16 pp., signed 2018)
- West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2019).
- West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2018).
- Included a cover letter.
- West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2018).
- Wisconsin. State of Wisconsin, Department of Health Services: Memorandum of Understanding Between the Department of Health Services/Division of Medicaid Services and Division of Public Health (10 pp., signed 2018).
- 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; Biblio No.WY1_1].
2019 Application/2017 Annual Reports Full-Text State IAAs
These documents were collected from the MCH Title V Block Grant FY 2019 Application/FY 2017 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.
- Cooperative Agreement between American Samoa Medicaid State Agency and the American Samoa Department of Health Maternal and Child Health Title V Program (3 pp., unsigned)
- 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:
- Memorandum of Agreement and Inter-Agency Agreement Between the Arkansas Department of Health and the Arkansas Department of Human Services (3 pp. signed 2010).
- Interagency Agreement Between Arkansas Department of Health and Division of Medical Services for Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (8 pp. signed 1995).
- Amendment to Interagency Agreement Between Arkansas Department of Health and Division of Medical Services Arkansas Department of Human Services Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (1p. signed 1995).
- These documents may also support Data-Sharing Request/Agreement between Arizona Department of Health Services, Public Prevention Services, Division of Public Health, Office of Women's and Children's Health and Provider(s), Arizona Department of Economic Security (10 pp., unsigned 2000).
- Memorandum of Agreement between the Arkansas Department of Human Services, Division of Medical Services (DMS) as the State Medicaid Agency and the Arkansas Department of Health (ADH) (14 pp., unsigned 2017).
- California. Includes:
- Contract Request (2 pp., signed 2012).
- Exhibit A: Additional Provisions (15 pp.).
- Exhibit B: HIPAA Business Associate Addendum (11 pp.).
- Colorado. Includes:
- Agreement Amendment No. 3 and Exhibit A-2, Statement of Work (inclusive, 38 pp.).
- This amendment references the [Colorado] Interagency Agreement (8 pp., unsigned) and the [Colorado] HIPAA Business Associate Interagency Memorandum of Understanding (9 pp., unsigned) used in the 2008 environmental scan.
- Agreement Amendment No. 1 (4 pp., signed) and Exhibit A-1, Statement of Work (39 pp.).
- Connecticut. Memoranda of Agreement Between The Department of Public Health and Department of Social Services (13pp, signed 2011)
- Cover letter (10p., Signed 2014)
- Contract Face Sheet (11 p., stamped "Fully Executed").
- State of Connecticut Memorandum of Understanding between the Department of Public Health and Department of Social Services (12 pp., signed 2014).
- It appears to supplement or supercede State of Connecticut: Memorandum of Understanding between the Department of Public Health and the Department of Social Services Regarding Data Exchanges (10 pp., unsigned [2005]) and [State of Connecticut:] Memorandum of Understanding between Department of Public Health and (Name of Managed Care Organization) (4 pp., unsigned [no date]).
- Memorandum of Understanding (Data Share Agreement) By and Between State of Connecticut Department of Social Services and State of Connecticut Department of Public Health (6 pp., signed 2017).
- 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).
- Memorandum of Understanding #18-374 Between The Delaware Department of Health and Social Services Division of Public Health and The Delaware Department of Health and Social Services Division of Medicaid and Medical Assistance to Improve Coordination and Outcomes for Programs Impacting Women, Infants and Children (8 pp., signed 2018).
- 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).
- Memorandum of Agreement Between Department of Health and The Department of Health Care Finance and DC Public Schools (12 pp., signed 2014).
- Federated States of Micronesia. Not eligible for Medicaid.
- FSM is not eligible for the Title V-Medicaid and Medicare Programs and Special Children’s Health Insurance Program (CHIP).
- 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."
- The latest IAA from Florida is [Florida] Cooperative Agreement for the Health Start Coordinated Care System for Pregnant Women and Infants between the Agency for Health Care Administration and the Department of Health (4 pp., signed 2001).
- State of Florida Agency for Health Care Administration Memorandum of Understanding No. AA348 (8 pp., signed 2017). Four additional pages in Attachment 1 (FMMIS Data File Variables).
- 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).
- 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 2017).
- 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.
- Memorandum of Agreement between Department of Human Services and Department of Health (6 pp., signed 2015). States “this document is being updated.”
- Memorandum of Agreement Between Family Services Division, Department of Health and Med-Quest Division, Department of Human Services (1 page, signed).
- 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).
- 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 2018).
- Illinois. Intergovernmental Agreement between the Department of Public Health and the Department of Healthcare and Family Services (9 pp., signed 2015).
- This document appears to update Agreement Between Illinois Department of Public Aid and Illinois Department of Human Services - Office of Family Health Regarding the Maternal and Child Health Program (10 pp., signed 2000) and
- This document appears to support Intergovernmental Agreement between the Illinois Department of Public Aid and the Board of Trustees of the University of Illinois Regarding the Division of Specialized Care for Children (9 pp., signed 2004).
- 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.
- Memorandum of Understanding Between the Indiana State Department of Health and the Indiana Family and Social Services Administration (43 pp., electronically signed 2017).
- Iowa. Contract Declaration and Execution (50pp., Signed 2016)
- Second Amendment to the Maternal and Child Health Omnibus Contract-Between the Iowa Department of Human Services Agency and Iowa Department of Public Health Contractor (18 pp., signed 2018).
- 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)
- 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 (9 pp., signed 2016).
- Kentucky. Commonwealth of Kentucky Purchase Order: Preventive Health Services FY17 (35 pp., Signed 2016).
- Commonwealth of Kentucky Purchase Order: Preventive Health Services (43 pp., signed 2018).
- 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.
- Louisiana Department of Health Memorandum of Understanding Between Office of Public Health, Bureau of Family Health (Title V) and Bureau of Health Services Financing (Title XIX and XXI) (6 pp., signed 2017).
- Data Sharing Agreement Louisiana Department of Health and Hospitals, Bureau of Health Services Financing, and Office of Public Health, and Office of Behavioral Health (13 pp., signed 2015).
- Maine. PHN Office / Division Project Work Plan. (10pp., Signed 2016).
- Includes a cover page signed by in 2016
- Cover page states that Maine’s current IAA is outdated and they have initiated planning meetings to begin formalizing a new version.
- Old version attached: Memorandum of Understanding Between the Office of Maine Care Services and the Division of Family Health within the Maine Center for Disease Control (8 pp., 2009).
- 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.
- Medicaid State Plan is an agreement between the State of Michigan and the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (2 pp., 2017).
- Includes Contract Between the Michigan Department of Social Services and the Michigan Department of Public Health as Attachment A from 1980).
- 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.
- State of Minnesota Interagency Memorandum of Understanding, Minnesota Department of Health and Minnesota Department of Human Services (3 pp., signed 2017).
- 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.
- Data Use Agreement Attachment B (13 pp., signed 2017). [Note: Double-check this one].
- Missouri. Includes:
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Prenatal Case Management and/or Service Coordination for Pregnant Women (8 pp. stamped and signed 2001). This document is the same at that used in the 2008 environmental scan.
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the [Missouri] Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Administrative Case Management, Healthy Children and Youth Program (HCY) (5 pp., stamped and signed 1997). This document is the same at that used in the 2008 environmental scan.
- Title 19 -- Department of Health, Division 40 -- Division of Maternal, Child and Family Health, Chapter 61 -- Licensing Rules for Family Day Care Homes: Proposed Amendment (2 pp., signed, 1997).
- Memorandum of Agreement between the Missouri Department of Social Services, Children's Division and the Missouri Department of Health and Senior Services, Bureau of Genetics and Healthy Childhood (3 pp., signed 2014). Includes business associate agreement as Attachment A.
- Excluded from this compiled document, but assumed to supplement the current IAA:
- Interagency Agreement between the Missouri Department of Health and the Missouri Department of Social Services: Well Child Outreach (3 pp., stamped and signed 1997).
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal Child and Family Health, Bureau of Special Health Care Needs: Head Injury Program (9 pp., signed, 2001).
- Cooperative Agreement between the Missouri Department of Social Services, Division of Medical Services and the Missouri Department of Health, Bureau of Special Health Care Needs, Head Injury Program: Non-Emergency Medical Transportation (5 pp., signed 2000).
- Cooperative Agreement between the [Missouri] Department of Social Services and the Department of Health relating to Administration of the Medicaid Home and Community-Based Services Waiver for Targeted Individuals with Physical Disabilities (10 pp., signed 2001).
- 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).
- 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 (13 pp., signed, 2018). [Note: signed in 2017, and 2018 – double-check]
- 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.
- Memorandum of Agreement Between New Mexico Department of Health and New Mexico Human Services Department (7 pp., signed 2017).
- New York. Letter highlighting the requirements of HRSA (3 pp., signed 2016).
- Intra-Agency Agreement Between the New York State Department of Health Office of Health Insurance Programs and Office of Public Health (2 pp., signed 2017).
- 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)
- This document appears to supercede Memorandum of Understanding between the Division of Medical Assistance and the Division of Public Health, [North Carolina] Department of Health and Human Services (52 pp., signed 2003).
- 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) (138 pp., signed 2017).
- 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).[possible typo? 2003]
- 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 through G -- 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 Methodology Guide (p26)
- Includes:
- Interagency Agreement Between the Ohio Department of Medicaid and The Ohio Department of Health (7 pp., signed 2018).
- Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (116 pp., including purchase order, signed 2011).
- This document supercedes [Oklahoma] Memorandum of Agreement (4 pp., signed 2004).
- Oregon. State of Oregon Intergovernmental Agreement (37 pp., includes cover and document return statement, signed 2014).
- This document supercedes [Oregon] Intergovernmental Agreement [and Amendment] (10 pp., singed 1995 and 2000).
- Memorandum of Understanding Between Oregon’s Title XIX and Title XXI Medicaid Program, Title V Maternal Child and Adolescent Health Program, and Title V Children and Youth with Special Health Needs Program (19 pp., signed 2018).
- 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).
- Memorandum of Understanding Among the Pennsylvania Department of Health and The Pennsylvania Department of Human Services (2 pp., not signed). [also no signature blocks and stamped as a draft].
- 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.
- [RMI does not have Medicaid services. We have our own local insurance.]
- 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., not signed, 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.
- This document perhaps supercedes or supplements Memorandum of Agreement between South Carolina Department of Health and Environmental Control and State Budget and Control Board, Office of Research and Assistance to Link Maternal and Child Health Data Files for Public Health Research, Evaluation, and Surveillance (12 pp., unsigned, 2004).
- 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; Biblio No. SD1_1_2008].
- Includes:
- Memorandum of Understanding Between South Dakota Department of Health and South Dakota Department of Health Services (p5, signed 2015)
- This document supercedes Joint Powers Agreement between South Dakota Department of Social Services, Office of Medical Services and South Dakota Department of Health, Division of Health and Medical Services (3 pp., no date).
- 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 (55 pp., signed 2015).
- Includes:
- 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 (dated 2018).
- 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).
- Utah Department of Health Memorandum of Agreement Between the Medicaid and Health Financing and Family Health and Preparedness (6 pp., 2018).
- Vermont. Intra-Governmental Agreement for the Delivery of Services Under Vermont's Global Commitment to Health Demonstration Waiver (13 pp., signed 2006).
- Department of Vermont Health Access and Vermont Department of Health Intra-Government Agreement (17 pp., signed 2017).
- Virginia. Includes:
- Master Interagency/Business Associate Agreement; Privacy and Security of Protected Health Information DRAFT (5 pp., unsigned, no date).
- Scope of Work (39 pp., unsigned, no date).
- Extensive attachments and exhibits, including the VA APCD Data Submission Manual (40 pp., 2013).
- These documents appear to supercede Interagency Agreement Between Virginia Department of Medical Assistance Services and Virginia Department of Health (55 pp., unsigned, no date).
- Memorandum of Understanding Between the Department of Medical Assistance Services and the Virginia Department of Health (60 pp., signed 2016).
- Includes Scope of Work.
- Washington. Contract Amendment: Children with Special Health Care Needs (27 pp., signed 2013).
- This document perhaps amends [Washington] Statement of Work: Interlocal Agreement [Exhibit A, B7, C, E, and F7] (33 pp., unsigned with "track changes," no date).
- Maternal Infant Health Interagency Agreement Between State of Washington Health Care Authority and Department of Health (23 pp., signed 2018).
- Restated and Amended Interagency Agreement Between State of Washington Health Care Authority and Department of Health (24 pp., signed 2017).
- Mutual Information Sharing Agreement for Confidential Information or Limited Dataset(s) Between State of Washington Department of Health and Washington State Health Care Authority-Medicaid Program (67 pp., signed 2017). [Note: might want to revisit and double check this one].
- 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).
- West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2018).
- Included a cover letter.
- West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2018).
- Wisconsin. State of Wisconsin, Department of Health Services: Memorandum of Understanding between the Department of Health Services (DHS)/Division of Health Care Access and Accountability (sic) and Division of Public Health (DPH) (22 pp., signed 2016).
- This document appears to supercede [Wisconsin] Memorandum of Understanding: Title V, WIC, Title XIX and Title XXI (7 pp., signed 2000).
- Memorandum of Understanding Between the Department of Health Services/Division of Medicaid Services and Division of Public Health (10 pp., signed 2018).
- 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; Biblio No.WY1_1].
2018 Application/2016 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:
- Memorandum of Agreement and Inter-Agency Agreement Between the Arkansas Department of Health and the Arkansas Department of Human Services (3 pp. signed 2010).
- Interagency Agreement Between Arkansas Department of Health and Division of Medical Services for Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (8 pp. signed 1995).
- Amendment to Interagency Agreement Between Arkansas Department of Health and Division of Medical Services Arkansas Department of Human Services Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (1p. signed 1995).
- These documents may also support Data-Sharing Request/Agreement between Arizona Department of Health Services, Public Prevention Services, Division of Public Health, Office of Women's and Children's Health and Provider(s), Arizona Department of Economic Security (10 pp., unsigned 2000).
- California. Includes:
- Contract Request (2 pp., signed 2012).
- Exhibit A: Additional Provisions (15 pp.).
- Exhibit B: HIPAA Business Associate Addendum (11 pp.).
- Colorado. Includes:
- Agreement Amendment No. 3 and Exhibit A-2, Statement of Work (inclusive, 38 pp.).
- This amendment references the [Colorado] Interagency Agreement (8 pp., unsigned) and the [Colorado] HIPAA Business Associate Interagency Memorandum of Understanding (9 pp., unsigned) used in the 2008 environmental scan.
- Connecticut. Memoranda of Agreement Between The Department of Public Health and Department of Social Services (13pp, signed 2011)
- Cover letter (10p., Signed 2014)
- Contract Face Sheet (11 p., stamped "Fully Executed").
- State of Connecticut Memorandum of Understanding between the Department of Public Health and Department of Social Services (12 pp., signed 2014).
- It appears to supplement or supercede State of Connecticut: Memorandum of Understanding between the Department of Public Health and the Department of Social Services Regarding Data Exchanges (10 pp., unsigned [2005]) and [State of Connecticut:] Memorandum of Understanding between Department of Public Health and (Name of Managed Care Organization) (4 pp., unsigned [no date]).
- 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."
- The latest IAA from Florida is [Florida] Cooperative Agreement for the Health Start Coordinated Care System for Pregnant Women and Infants between the Agency for Health Care Administration and the Department of Health (4 pp., signed 2001).
- 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).
- This document appears to update Agreement Between Illinois Department of Public Aid and Illinois Department of Human Services - Office of Family Health Regarding the Maternal and Child Health Program (10 pp., signed 2000) and
- This document appears to support Intergovernmental Agreement between the Illinois Department of Public Aid and the Board of Trustees of the University of Illinois Regarding the Division of Specialized Care for Children (9 pp., signed 2004).
- 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:
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Prenatal Case Management and/or Service Coordination for Pregnant Women (8 pp. stamped and signed 2001). This document is the same at that used in the 2008 environmental scan.
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the [Missouri] Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Administrative Case Management, Healthy Children and Youth Program (HCY) (5 pp., stamped and signed 1997). This document is the same at that used in the 2008 environmental scan.
- Title 19 -- Department of Health, Division 40 -- Division of Maternal, Child and Family Health, Chapter 61 -- Licensing Rules for Family Day Care Homes: Proposed Amendment (2 pp., signed, 1997).
- Memorandum of Agreement between the Missouri Department of Social Services, Children's Division and the Missouri Department of Health and Senior Services, Bureau of Genetics and Healthy Childhood (3 pp., signed 2014). Includes business associate agreement as Attachment A.
- Excluded from this compiled document, but assumed to supplement the current IAA:
- Interagency Agreement between the Missouri Department of Health and the Missouri Department of Social Services: Well Child Outreach (3 pp., stamped and signed 1997).
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal Child and Family Health, Bureau of Special Health Care Needs: Head Injury Program (9 pp., signed, 2001).
- Cooperative Agreement between the Missouri Department of Social Services, Division of Medical Services and the Missouri Department of Health, Bureau of Special Health Care Needs, Head Injury Program: Non-Emergency Medical Transportation (5 pp., signed 2000).
- Cooperative Agreement between the [Missouri] Department of Social Services and the Department of Health relating to Administration of the Medicaid Home and Community-Based Services Waiver for Targeted Individuals with Physical Disabilities (10 pp., signed 2001).
- 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)
- This document appears to supercede Memorandum of Understanding between the Division of Medical Assistance and the Division of Public Health, [North Carolina] Department of Health and Human Services (52 pp., signed 2003).
- 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 Methodology Guide (p26)
- Includes:
- Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (116 pp., including purchase order, signed 2011).
- This document supercedes [Oklahoma] Memorandum of Agreement (4 pp., signed 2004).
- Oregon. State of Oregon Intergovernmental Agreement (37 pp., includes cover and document return statement, signed 2014).
- This document supercedes [Oregon] Intergovernmental Agreement [and Amendment] (10 pp., singed 1995 and 2000).
- 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.
- This document perhaps supercedes or supplements Memorandum of Agreement between South Carolina Department of Health and Environmental Control and State Budget and Control Board, Office of Research and Assistance to Link Maternal and Child Health Data Files for Public Health Research, Evaluation, and Surveillance (12 pp., unsigned, 2004).
- 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; Biblio No. SD1_1_2008].
- Includes:
- Memorandum of Understanding Between South Dakota Department of Health and South Dakota Department of Health Services (p5, signed 2015)
- This document supercedes Joint Powers Agreement between South Dakota Department of Social Services, Office of Medical Services and South Dakota Department of Health, Division of Health and Medical Services (3 pp., no date).
- Includes:
- 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:
- Master Interagency/Business Associate Agreement; Privacy and Security of Protected Health Information DRAFT (5 pp., unsigned, no date).
- Scope of Work (39 pp., unsigned, no date).
- Extensive attachments and exhibits, including the VA APCD Data Submission Manual (40 pp., 2013).
- These documents appear to supercede Interagency Agreement Between Virginia Department of Medical Assistance Services and Virginia Department of Health (55 pp., unsigned, no date).
- Washington. Contract Amendment: Children with Special Health Care Needs (27 pp., signed 2013).
- This document perhaps amends [Washington] Statement of Work: Interlocal Agreement [Exhibit A, B7, C, E, and F7] (33 pp., unsigned with "track changes," no date).
- 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 Accountability (sic) and Division of Public Health (DPH) (22 pp., signed 2016).
- This document appears to supercede [Wisconsin] Memorandum of Understanding: Title V, WIC, Title XIX and Title XXI (7 pp., signed 2000).
- 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; Biblio No.WY1_1].
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:
- Memorandum of Agreement and Inter-Agency Agreement Between the Arkansas Department of Health and the Arkansas Department of Human Services (3 pp. signed 2010).
- Interagency Agreement Between Arkansas Department of Health and Division of Medical Services for Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (8 pp. signed 1995).
- Amendment to Interagency Agreement Between Arkansas Department of Health and Division of Medical Services Arkansas Department of Human Services Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (1p. signed 1995).
- These documents may also support Data-Sharing Request/Agreement between Arizona Department of Health Services, Public Prevention Services, Division of Public Health, Office of Women's and Children's Health and Provider(s), Arizona Department of Economic Security (10 pp., unsigned 2000).
- California. Includes:
- Contract Request (2 pp., signed 2012).
- Exhibit A: Additional Provisions (15 pp.).
- Exhibit B: HIPAA Business Associate Addendum (11 pp.).
- Colorado. Includes:
- Agreement Amendment No. 3 and Exhibit A-2, Statement of Work (inclusive, 38 pp.).
- This amendment references the [Colorado] Interagency Agreement (8 pp., unsigned) and the [Colorado] HIPAA Business Associate Interagency Memorandum of Understanding (9 pp., unsigned) used in the 2008 environmental scan.
- Connecticut. Memoranda of Agreement Between The Department of Public Health and Department of Social Services (13pp, signed 2011)
- Cover letter (10p., Signed 2014)
- Contract Face Sheet (11 p., stamped "Fully Executed").
- State of Connecticut Memorandum of Understanding between the Department of Public Health and Department of Social Services (12 pp., signed 2014).
- It appears to supplement or supercede State of Connecticut: Memorandum of Understanding between the Department of Public Health and the Department of Social Services Regarding Data Exchanges (10 pp., unsigned [2005]) and [State of Connecticut:] Memorandum of Understanding between Department of Public Health and (Name of Managed Care Organization) (4 pp., unsigned [no date]).
- 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."
- The latest IAA from Florida is [Florida] Cooperative Agreement for the Health Start Coordinated Care System for Pregnant Women and Infants between the Agency for Health Care Administration and the Department of Health (4 pp., signed 2001).
- 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).
- This document appears to update Agreement Between Illinois Department of Public Aid and Illinois Department of Human Services - Office of Family Health Regarding the Maternal and Child Health Program (10 pp., signed 2000) and
- This document appears to support Intergovernmental Agreement between the Illinois Department of Public Aid and the Board of Trustees of the University of Illinois Regarding the Division of Specialized Care for Children (9 pp., signed 2004).
- 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:
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Prenatal Case Management and/or Service Coordination for Pregnant Women (8 pp. stamped and signed 2001). This document is the same at that used in the 2008 environmental scan.
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the [Missouri] Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Administrative Case Management, Healthy Children and Youth Program (HCY) (5 pp., stamped and signed 1997). This document is the same at that used in the 2008 environmental scan.
- Title 19 -- Department of Health, Division 40 -- Division of Maternal, Child and Family Health, Chapter 61 -- Licensing Rules for Family Day Care Homes: Proposed Amendment (2 pp., signed, 1997).
- Memorandum of Agreement between the Missouri Department of Social Services, Children's Division and the Missouri Department of Health and Senior Services, Bureau of Genetics and Healthy Childhood (3 pp., signed 2014). Includes business associate agreement as Attachment A.
- Excluded from this compiled document, but assumed to supplement the current IAA:
- Interagency Agreement between the Missouri Department of Health and the Missouri Department of Social Services: Well Child Outreach (3 pp., stamped and signed 1997).
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal Child and Family Health, Bureau of Special Health Care Needs: Head Injury Program (9 pp., signed, 2001).
- Cooperative Agreement between the Missouri Department of Social Services, Division of Medical Services and the Missouri Department of Health, Bureau of Special Health Care Needs, Head Injury Program: Non-Emergency Medical Transportation (5 pp., signed 2000).
- Cooperative Agreement between the [Missouri] Department of Social Services and the Department of Health relating to Administration of the Medicaid Home and Community-Based Services Waiver for Targeted Individuals with Physical Disabilities (10 pp., signed 2001).
- 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)
- This document appears to supercede Memorandum of Understanding between the Division of Medical Assistance and the Division of Public Health, [North Carolina] Department of Health and Human Services (52 pp., signed 2003).
- 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 Methodology Guide (p26)
- Includes:
- Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (116 pp., including purchase order, signed 2011).
- This document supercedes [Oklahoma] Memorandum of Agreement (4 pp., signed 2004).
- Oregon. State of Oregon Intergovernmental Agreement (37 pp., includes cover and document return statement, signed 2014).
- This document supercedes [Oregon] Intergovernmental Agreement [and Amendment] (10 pp., singed 1995 and 2000).
- 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.
- This document perhaps supercedes or supplements Memorandum of Agreement between South Carolina Department of Health and Environmental Control and State Budget and Control Board, Office of Research and Assistance to Link Maternal and Child Health Data Files for Public Health Research, Evaluation, and Surveillance (12 pp., unsigned, 2004).
- 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; Biblio No. SD1_1_2008].
- Includes:
- Memorandum of Understanding Between South Dakota Department of Health and South Dakota Department of Health Services (p5, signed 2015)
- This document supercedes Joint Powers Agreement between South Dakota Department of Social Services, Office of Medical Services and South Dakota Department of Health, Division of Health and Medical Services (3 pp., no date).
- Includes:
- 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:
- Master Interagency/Business Associate Agreement; Privacy and Security of Protected Health Information DRAFT (5 pp., unsigned, no date).
- Scope of Work (39 pp., unsigned, no date).
- Extensive attachments and exhibits, including the VA APCD Data Submission Manual (40 pp., 2013).
- These documents appear to supercede Interagency Agreement Between Virginia Department of Medical Assistance Services and Virginia Department of Health (55 pp., unsigned, no date).
- Washington. Contract Amendment: Children with Special Health Care Needs (27 pp., signed 2013).
- This document perhaps amends [Washington] Statement of Work: Interlocal Agreement [Exhibit A, B7, C, E, and F7] (33 pp., unsigned with "track changes," no date).
- 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 Accountability (sic) and Division of Public Health (DPH) (22 pp., signed 2016).
- This document appears to supercede [Wisconsin] Memorandum of Understanding: Title V, WIC, Title XIX and Title XXI (7 pp., signed 2000).
- 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; Biblio 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.
- 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:
- Memorandum of Agreement and Inter-Agency Agreement Between the Arkansas Department of Health and the Arkansas Department of Human Services (3 pp. signed 2010).
- Interagency Agreement Between Arkansas Department of Health and Division of Medical Services for Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (8 pp. signed 1995).
- Amendment to Interagency Agreement Between Arkansas Department of Health and Division of Medical Services Arkansas Department of Human Services Family Planning, Immunization, Maternity and Infant, and Sexually Transmitted Disease Services (1p. signed 1995).
- These documents may also support Data-Sharing Request/Agreement between Arizona Department of Health Services, Public Prevention Services, Division of Public Health, Office of Women's and Children's Health and Provider(s), Arizona Department of Economic Security (10 pp., unsigned 2000).
- California. Includes:
- Contract Request (2 pp., signed 2012).
- Exhibit A: Additional Provisions (15 pp.).
- Exhibit B: HIPAA Business Associate Addendum (11 pp.).
- Colorado. Includes:
- Agreement Amendment No. 2 and Exhibit A-2, Statement of Work (inclusive, 34 pp., signed 2015).
- This amendment references the [Colorado] Interagency Agreement (8 pp., unsigned) and the [Colorado] HIPAA Business Associate Interagency Memorandum of Understanding (9 pp., unsigned) used in the 2008 environmental scan.
- Connecticut. Includes:
- Cover letter (1 p., signed 2014).
- Contract Face Sheet (1 p., stamped "Fully Executed").
- State of Connecticut Memorandum of Understanding between the Department of Public Health and Department of Social Services (2 pp., signed 2014).
- It appears to supplement or supercede State of Connecticut: Memorandum of Understanding between the Department of Public Health and the Department of Social Services Regarding Data Exchanges (10 pp., unsigned [2005]) and [State of Connecticut:] Memorandum of Understanding between Department of Public Health and (Name of Managed Care Organization) (4 pp., unsigned [no date]).
- 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 Department of Health and the Department of Health Care Finance and DC Public Schools. (12 pp., signed, 2014).
- 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."
- The latest IAA from Florida is [Florida] Cooperative Agreement for the Health Start Coordinated Care System for Pregnant Women and Infants between the Agency for Health Care Administration and the Department of Health (4 pp., signed 2001).
- Georgia. Interagency Master Agreement between the Georgia Department of Community Health and the Georgia Department of Human Resources for Services in Support of the Medicaid Program for the State of Georgia (32 pp., signed 2004).
- This document appears to be a signed version of the original IAA used in the 2008 environmental scan.
- 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 (3 pp., signed 2015).
- This document updates the original IAA used in the 2008 environmental scan.
- Illinois. Intergovernmental Agreement between the Department of Public Health and the Department of Healthcare and Family Services (9 pp., signed 2015).
- This document appears to update Agreement Between Illinois Department of Public Aid and Illinois Department of Human Services - Office of Family Health Regarding the Maternal and Child Health Program (10 pp., signed 2000) and
- This document appears to support Intergovernmental Agreement between the Illinois Department of Public Aid and the Board of Trustees of the University of Illinois Regarding the Division of Specialized Care for Children (9 pp., signed 2004).
- 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 Declarations and Execution (22 pp. with a 2 pp. amendment, amendment signed 2014). This document appears to supercede the following documents:
- Cooperative Agreement Between the Iowa Department of Human Services and the University of Iowa On Behalf of Child Health Specialty Clinics (14 pp., unsigned 2004).
- Iowa Department of Human Services and Iowa Department of Public Health EPSDT Program (7 pp., unsigned 2004).
- Iowa Department of Human Services and Iowa Department of Public Health Outreach (5 pp., unsigned 2004).
- Kansas. State of Kansas State Plan Implementing the Provision of Health Care to Persons Eligible for Services Under Titles V, XIX, and XXI of the Social Security Act DRAFT (19 pp., unsigned, 2015).
- This document updates the original IAA used in the 2008 environmental scan.
- Kentucky. Commonwealth of Kentucky Purchase Order: Preventive Health Services FY15-16 (20 pp. Unsigned, but appears to be a printout from a state contract processing system, 2014).
- This document updates the original IAA used in the 2008 environmental scan.
- Louisiana. Department of Health and Hospitals Intra-Departmental Agreement between Office of Public Health (Title V) and Bureau of Health Services Financing (Title XIX) (17 pp., signed 1990).
- This document is the same at that used in the 2008 environmental scan.
- Maine. Memorandum of Understanding between the Bureau of Medical Services and the Bureau of Health, Public Health Nursing. (4 pp., signed 2005).
- 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, 2015).
- 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:
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Prenatal Case Management and/or Service Coordination for Pregnant Women (8 pp. stamped and signed 2001). This document is the same at that used in the 2008 environmental scan.
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the [Missouri] Department of Health, Division of Maternal, Child and Family Health, Bureau of Family Health: Administrative Case Management, Healthy Children and Youth Program (HCY) (5 pp., stamped and signed 1997). This document is the same at that used in the 2008 environmental scan.
- Title 19 -- Department of Health, Division 40 -- Division of Maternal, Child and Family Health, Chapter 61 -- Licensing Rules for Family Day Care Homes: Proposed Amendment (2 pp., signed, 1997).
- Memorandum of Agreement between the Missouri Department of Social Services, Children's Division and the Missouri Department of Health and Senior Services, Bureau of Genetics and Healthy Childhood (3 pp., signed 2014). Includes business associate agreement as Attachment A.
- Excluded from this compiled document, but assumed to supplement the current IAA:
- Interagency Agreement between the Missouri Department of Health and the Missouri Department of Social Services: Well Child Outreach (3 pp., stamped and signed 1997).
- Cooperative Agreement between the [Missouri] Department of Social Services, Division of Medical Services and the Department of Health, Division of Maternal Child and Family Health, Bureau of Special Health Care Needs: Head Injury Program (9 pp., signed, 2001).
- Cooperative Agreement between the Missouri Department of Social Services, Division of Medical Services and the Missouri Department of Health, Bureau of Special Health Care Needs, Head Injury Program: Non-Emergency Medical Transportation (5 pp., signed 2000).
- Cooperative Agreement between the [Missouri] Department of Social Services and the Department of Health relating to Administration of the Medicaid Home and Community-Based Services Waiver for Targeted Individuals with Physical Disabilities (10 pp., signed 2001).
- 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., unsigned, no date).
- 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 (3 pp., unsigned, but stated updated 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 2009).
- 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. Medicaid/EPSDT - Title V Action Plan: New York State Department of Health (3 pp., unsigned, no date).
- This document is the same at that used in the 2008 environmental scan.
- 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)
- This document appears to supercede Memorandum of Understanding between the Division of Medical Assistance and the Division of Public Health, [North Carolina] Department of Health and Human Services (52 pp., signed 2003).
- 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, 2015).
- Ohio. Attachment A -- Maternal and Child Health Interagency Agreement between the Ohio Department of Medicaid and the Ohio Department of Health (6 pp., unsigned, no date).
- This document possibly supports Interagency Agreement between the Ohio Department of Job and Family Services and the Ohio Department of Health (11 pp., unsigned, 2003).
- Oklahoma. Interagency Agreement between the Oklahoma Health Care Authority and the Oklahoma Department of Human Services (110 pp., including purchase order, signed 2011).
- This document supercedes [Oklahoma] Memorandum of Agreement (4 pp., signed 2004).
- Oregon. State of Oregon Intergovernmental Agreement (37 pp., includes cover and document return statement, signed 2014).
- This document supercedes [Oregon] Intergovernmental Agreement [and Amendment] (10 pp., singed 1995 and 2000).
- 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 (45 pp., unsigned, no date).
- This document perhaps supercedes or supplements Rhode Island Department of Health, Division of Family Health: Medicaid/EPSDT Administrative Activities (12 pp, signed 1995) and Memorandum of Agreement between the Department of Human Services, RI Department of Health, and RI Health Center Association Regarding the: Rhode Island Family Resource Counselor Program (12 pp., signed 2004).
- 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.
- This document perhaps supercedes or supplements Memorandum of Agreement between South Carolina Department of Health and Environmental Control and State Budget and Control Board, Office of Research and Assistance to Link Maternal and Child Health Data Files for Public Health Research, Evaluation, and Surveillance (12 pp., unsigned, 2004).
- 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 (4 pp., 2014) [Previously added to IAA collection; Biblio 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 (26 pp., unsigned 1991).
- 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 (28 pp., signed 2001).
- Vermont. Intra-Governmental Agreement for the Delivery of Services Under Vermont's Global Commitment to Health Demonstration Waiver (13 pp., signed 2015).
- Virginia. Includes:
- Master Interagency/Business Associate Agreement; Privacy and Security of Protected Health Information DRAFT (5 pp., unsigned, no date).
- Scope of Work (39 pp., unsigned, no date).
- Extensive attachments and exhibits, including the VA APCD Data Submission Manual (40 pp., 2013).
- These documents appear to supercede Interagency Agreement Between Virginia Department of Medical Assistance Services and Virginia Department of Health (55 pp., unsigned, no date).
- Washington. Contract Amendment: Children with Special Health Care Needs (9 pp., signed 2013).
- This document perhaps amends [Washington] Statement of Work: Interlocal Agreement [Exhibit A, B7, C, E, and F7] (33 pp., unsigned with "track changes," no date).
- West Virginia. West Virginia Department of Health and Human Resources: Agreement between Bureau for Medical Services and Bureau for Public Health (7 pp., signed, 2015).
- Wisconsin. State of Wisconsin, Department of Health Services: Memorandum of Understanding between the Department of Health Services (DHS)/Division of Health Care Access and Accountability (sic) and Division of Public Health (DPH) (22 pp., signed 2015).
- This document appears to supercede [Wisconsin] Memorandum of Understanding: Title V, WIC, Title XIX and Title XXI (7 pp., signed 2000).
- 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; Biblio No.WY1_1].
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).
* 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:
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
- Glossary of Title V/Title XIX Terms. This list of terms related to Title V and Title XIX is not meant to be comprehensive, but to serve as an introductory quick-reference.
- Title V and Medicaid: Compared (at a glance). Highlights of the Title V and Medicaid programs are presented to aid in obtaining a clearer view of each program's mandates, requirements, foci, and strengths.
- Title V and Medicaid: Methods of Coordination. There are many common strategies in which Title V works with Medicaid to increase access to care. These strategies can be organized in terms of the four-tiered MCH Pyramid of Health Services.
- Title V and Medicaid: Legislation. Summary of Requirements for Title V and Title XIX Coordination | Overarching Federal Legislation, Regulations, and Policy.
- Title V and Medicaid Resources. Links to additional websites and electronic documents to aid in understanding Title V, Medicaid, and how the two programs can coordinate successfully.
Page Name: State MCH-Medicaid Coordination Toolkit: Title V and Title XIX Interagency Agreements
Author: John Richards, M.A., AITP, NCEMCH 2008, Updated January 2011, July 2013, September 2015, July 2016, July 2017, July 2018, June 2019