Since state Maternal and Child Health Services Block Grant applications represent the most comprehensive source of information about community and state needs assessment, policy development, and program assurance for the population of mothers and children, these documents have the potential to play a central role in state accountability to Congress and the Maternal and Child Health Bureau. To measure the validity of block grant applications as a reporting mechanism, we assessed the sensitivity of the applications from seven states to strategies for reducing infant mortality. We used the independent coding of infant mortality strategies from the Healthy Futures/Healthy Generations Program intensive evaluation as the standard. Overall, the sensitivity of the block grant applications was only 45%. Since the open-ended design of the block grant applications does not appear to reflect the extent of state activity in infant mortality reduction, a uniform application should be adopted that will facilitate clear and systematic reporting of state activities.