State Implementation of the Preventive Health and Health Services Block Grant

Testimony was given concerning the implementation of the preventive health and health services block grant in 13 States. GAO visited these States to determine: (1) the States' acceptance of their expanded management role under the block grant; (2) funding trends in State preventive health programs between 1981 and 1983; (3) changes in State preventive health services since block grant implementation; and (4) perceptions about the block grant from different State officials and interest groups. GAO found that, under the block grant program, States have had to make only minimal changes in their organizations and the structure of their service-provider networks, and they have been taking their expanded management role seriously. Trends in total expenditures for program areas supported with preventive health block grant funds varied considerably among the States, but the impact of Federal funding reductions was lessened by ongoing outlays from prior categorical awards and changes in State funding. Almost all State officials liked the increased flexibility provided by the block grants and the reduced administrative requirements and viewed block grants as a more desirable way to fund preventive health services than the prior categorical approach. However, about half of the interest group members interviewed tended to view the block grant method as a less desirable funding approach and believed that the changes the States have made have adversely affected the individuals or organizations which they represent. Both interest groups and State officials felt that the Federal funding reductions that accompanied the block grant tended to diminish its advantages.