States Use Added Flexibility Offered by the Preventive Health and Health Services Block Grant

In response to a congressional request, GAO reviewed the progress made by 13 States in implementing the preventive health and health services block grant created by the Omnibus Budget Reconciliation Act of 1981.

GAO found that the States have been aided in implementing their block grants by outlays from prior categorical grants, which continued to provide substantial support for program operations into 1982. States have strived to maintain program continuity under the block grant but, as categorical funds diminished in 1983 and States reassessed their needs, they adjusted the level of support for individual programs. Where States had had considerable involvement in funding and administering the categorical programs, they tended to assign those areas higher priority and few service changes were made. However, where States previously had limited control, more changes emerged in program areas. As established State agencies implemented their expanded administrative responsibilities, program officials reported management improvements. Most State officials rated the block grant more flexible and desirable, whereas about half the interest groups expressed a preference for the categorical approach.