Federal Program Implementation in selected states is an in depth analysis in three states of political and structural factors which lead to differences in the implementation, administration and results of maternal and child health programs and in the use of budget flexibility provided in the block grant created under the partnership for health program in 1966. Systematic data across fifty states will also be examined. The states chosen for study are Michigan, Pennsylvania and Alabama. The maternal and child health programs chosen include Title V Crippled Children's and MCH programs, child health aspects of Medicaid, and Early Periodic Screening Diagnosis, and Treatment (EPSDT).