BLOCK GRANTS FOR PUBLIC HEALTH

The Reagan administration proposed in 1981 the creation of several grants to replace categorical grant programs to the states. The idea behind this proposal was to transfer authority and responsibility to the states, thereby reducing the role of the federal government as a funder, relieving states of some federal regulatory burden and saving money by reducing administrative costs. Congress acted on this proposal in the summer of 1981 and consolidated fifty-seven categorical programs into several block grants. The two most significant block grants for state public health systems were the Maternal and Child Health Block Grant (MCHBG) and the Preventive Health and Health Services Block Grant (PHHSBG).

In Federal Fiscal Year (FFY) 1999, the core PHHSBG was funded nationally at $150 million. Additional funds earmarked specifically for rape prevention education were subsequently added to this core amount and distributed via a formula to all states. The primary areas of activity for the core PHHSBG included chronic disease prevention and control, emergency medical services in rural areas, and community health education efforts. States are required to develop plans, report activities, and target these activities to identify high-need populations. Flexibility inherent in this block grant allows states to address health problems specific to their state, as long as these activities also address the national health objectives for the nation contained in Healthy People 2010. Funded program areas included cardiovascular disease prevention, injury prevention, increasing good nutrition choices and physical activity, and prevention of tobacco use by youth.

The Maternal and Child Health program was authorized under Title V of the Social Security Act of 1935. The actions taken by Congress in 1981 created block grant amendments for Federal Fiscal Year (FFY) 1982 (October 1, 1981–September 30, 1982). These amendments increased states' roles in determining activities and added programs under Title V to create the MCHBG.

The MCHBG is focused on improving and protecting the health of all mothers and children. States have the ability to determine their needs within prescribed categories of activities. These planned activities must be consistent with national health objectives established by the Secretary of the U.S. Department of Health and Human Services (e.g., Healthy People 2010 ). Programs have been developed to address several areas, which include preventing deaths, illnesses, and disabilities; assuring access to quality health care; and providing community-based health services to children with special needs. It is estimated that over 20 million women, children, and youth received services under the MCHBG in FFY 1999. Programs funded by the MCHBG include prenatal care, services for children with special health care needs, newborn screening for metabolic errors, childhood lead-poisoning prevention, and sudden infant death syndrome prevention.

Frank S. Bright

(see also: Maternal and Child Health Block Grant; Newborn Screening; Prevention Block Grant; Sudden Infant Death Syndrome [SIDS] )

Bibliography

Association of Maternal and Child Health Programs. "Frequently Asked Questions about Title V." Available at http://www.amchp.org/titlev/questions.htm.

Centers for Disease Control and Prevention. "Preventive Health and Health Services Block Grant." Available at http://www.cdc.gov/nccdphp/prevbloc.htm.

Public Law 97–35, August 13, 1981. Title XIX: Health Services and Facilities, Subtitle A-Block Grants, 95 Stat, 535–542.