The primary purpose of this hearing was to enable committee members to question Government Accounting Office (GAO) personnel about the results of the GAO study of the implementation of the Maternal and Child Health (MCH) Black Grant. A background paper on the MCH block grant program is provided prior to the introduction of testimony concluding that the block grant is being carried out effectively at the state level and other testimony that maternal and child health services have suffered under block grant provisions. Testimony given before the committee also concerned: (1) the administrative structure of maternal and child health programs within the Department of Health and Human Services, funding issues, priorities for set-aside monies, and the need for a common database for assessing the effects of the block grant approach; (2) efforts of MCH block grant programs to improve the health of mothers and children, including children with chronic illness or disability; (3) results of a study by the Urban Institute of implementation of the MCH block grant by 18 states, indicating that states have remained committed to MCH services but have made changes in priority of programs; (4) the desire of county officials to be involved in the block grant planning process; (5) cuts in funding by states and the effect of inflation; and (6) the experiences of Arkansas, Colorado, Illinois, and New York with the MCH block grant. Positions of several concerned agencies and organizations are also included in the record. (RH)