Maternal and Child Health Bureau

The Health Resources and Services Administration (HRSA), a principal operating sub-agency of the Department of Health and Human Services, administers federal grants supporting direct health care delivery, workforce development, and public health infrastructure across state health departments, community health centers, and health professions training institutions. HRSA operates as the federal government's primary grant-making vehicle for health access, health professions education, and maternal and child health programs, and does not conduct significant federal contract procurement.

HRSA's grant portfolio encompasses $21.05 billion in combined federal dollars obligated across 2,581 awards since 1954. Grant activity has declined sharply: 272 awards in 2022, 289 in 2023, 243 in 2024, 160 in 2025, and 4 awards year-to-date in 2026, with the most recent grant award dated September 2026. The portfolio comprises 665 distinct grant recipients, predominantly state health departments, local health authorities, and health professions training organizations.

Grant recipients are highly fragmented by both award count and federal dollars over the last five years. The five highest-volume recipients by award count—Tennessee Department of Health, Kansas Department of Health and Environment, Massachusetts Department of Public Health, Michigan Department of Health and Human Services, and Human Services Vermont Agency of—collectively hold 7 percent of recent awards. By federal dollars obligated over the same period, the top five recipients—Ohio Department of Health, Michigan Department of Health and Human Services, Indiana Department of Health, North Carolina Department of Health and Human Services, and Tennessee Department of Health—account for 7 percent of recent federal dollars. This fragmentation reflects HRSA's statutory mandate to distribute funds to state and local public health systems rather than concentrate resources among a small set of large recipients.

HRSA's assistance-type portfolio is dominated by Project Grants, which make up 98 percent of all awards (2,519 grants). Block Grants constitute 2 percent (56 awards), and Cooperative Agreements comprise less than 1 percent (6 awards). The Project Grant structure predominates because HRSA funds discrete, time-limited initiatives such as maternal health programs, primary care workforce scholarships, and rural health infrastructure rather than ongoing entitlements or shared collaborative projects.

Recent grant activity shows substantial volume decline in 2026; business development professionals should confirm whether this reflects a transitional funding cycle, budget constraints, or the timing of major program renewals before pursuing new opportunities.