States Have Made Few Changes in Implementing the Alcohol, Drug Abuse, and Mental Health Services Block Grant

As part of a continuing series on the implementation of block grants, GAO reviewed the progress made by States in implementing the alcohol, drug abuse, and mental health (ADAMH) services block grant.

GAO found that, although Federal appropriations for ADAMH services decreased as States began to implement the block grant, the decreases were offset by increased State funds and categorical awards. Five of the States reviewed showed increases in total program support after adjustments for inflation. GAO found that there were no major changes in program administration because, before the enactment of the block grant, many ADAMH services were jointly funded and administered by States and the Federal Government. None of the States reviewed changed policies relating to client eligibility and most States continued to fund the same service provider network. Some service providers experienced a variety of program changes; however, GAO determined that these were the result of changes in community needs and total funding. GAO found that States typically assigned administrative responsibilities under the block grant to offices which had administered related programs prior to block grant enactment. States carried out their increased responsibilities by establishing program requirements, monitoring grantees, providing technical assistance, and audit funds. GAO found that interest groups were generally satisfied with their level of access to State officials, but many believed that changes made by States adversely affected individuals or organizations that they represented. While most State officials viewed the block grant as more desirable than the prior approach, about half of the interest groups viewed the block grant as less desirable.