Celebrating the 75th Anniversary of Title V

Special: Celebrating the 75th Anniversary of Title V

By Kathy Peppe, RN, MS

AMCHP Past President (1999-2001)


Let me take you back to the last two years of President Bill Clinton’s second term in office (1999-2001). Those years coincide with my presidency of AMCHP. That time in America was one of economic growth and wellbeing, low unemployment and relatively low inflation. Life was pretty good for the majority of Americans (although certainly the impoverished remained a huge concern) and most states then enjoyed fairly stable state budgets.


In this national climate, AMCHP and MCHB strived to strengthen the federal-state partnership to carry out the legislative requirements for Title V programs. Together, the bureau and AMCHP had already weathered many political storms and time was devoted to trying to forecast and anticipate future changes in the political climate and funding. At the federal level, MCHB concentrated on improving its administration, accountability and data/information systems, factors that later helped Title V survive unforeseen federal budget cuts and policy shifts. At the state level, we struggled to implement the federal requirements for measurability and data collection. We concentrated on interpreting the MCH Pyramid for program planning and budgeting and used the Title V Information System.


During my tenure as president, strengthening partnerships was the focus for AMCHP. We faced considerable turnover in MCH/CSHCN leadership in the states as well as within the association’s staff. We welcomed the opportunity to bring new faces into AMCHP leadership ranks and started a New Director Orientation and Mentoring Program that was well received. We sponsored the first-ever Capitol Hill briefing on adolescent health and SCHIP in partnership with the National Adolescent Health Information Center, and it was very well attended by congressional leaders and staffers. Our collaboration with the Women and Children’s Health Policy Center at Johns Hopkins University School of Public Health culminated with the 2001 release of CAST-5, a self-assessment tool for state Title V programs organized around core public health functions and essential maternal and child health services. We adopted position papers on Family Planning, Folic Acid and HIV counseling and testing. We completed an issue brief on oral health and another on CHIP outreach and unveiled the first ever AMCHP Annual Report to the membership at the 2000 annual meeting.


In partnership with the Senate leadership in 2000, AMCHP was successful in increasing the Title V Authorization level to $850 million; the appropriation level was then $709 million. And we also found the time to initiate a Public Health Branding Campaign in collaboration with the Public Health Foundation, NACCHO, ASTHO, ASPH, APHL and APHA. AMCHP also collaborated with a coalition of national partners and won passage of the Child Health Act of 2000. Our members helped craft the final language in key sections of the Healthy Start and Safe Motherhood provision of this Act and secured permanent authorization for the Healthy Start infant mortality prevention program. Also in 2000, AMCHP issued the Care Coordination Working Group’s report, Care Coordination for Children with Special Health Care Needs and their Families in the New Millennium.


And finally, we heaved a collective sigh of relief when we realized that none of the dire predictions for the inoperability of computer systems at the turn of the millennium materialized. Perhaps for that reason, we selected Using Data for Action: Leading Title V into the 21st Century as the theme for our 2000 annual meeting and had U.S. Surgeon General Dr. David Satcher as our keynote speaker.


One of my fondest memories as AMCHP president was providing the keynote address in 1999 to the U.S. Virgin Islands maternal and child health program annual staff meeting. My topic? Increasing family involvement in Title V programs through partnerships. What a setting in which to speak! Another thrill for me was in 2001 when I gave oral testimony before the House subcommittee on appropriations urging an increase in funding for Title V for FY 2002 to the $850 million authorization level. We weren’t successful but testifying is one memory I’ll never forget.


Throughout my involvement with AMCHP, I considered the late Dr. Vince Hutchins, former MCHB Director, to be my personal hero. He was a quiet, soft-spoken man who gave generously of his knowledge and political savoir-faire (not to mention survival skills), mentored and served as a role model for so many people throughout his career. He never tired of lending a helping hand, giving advice, connecting us to people who could help us get things done and he always gave a huge smile and welcoming hug. He was a champion of families, mothers and children and was never content with what is currently in place. Reaching and stretching to improve the future wellbeing for America’s mothers, children and families and children and youth with special health care needs is the legacy that Dr. Hutchins has left us to carry forward. May each of us do so with as much grace and humility as he did.