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Maternal and Child Health: Block Grant Funds Should Be Distributed More Equitably

HRD-92-5 Published: Apr 02, 1992. Publicly Released: Apr 02, 1992.
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Highlights

Pursuant to a congressional request, GAO analyzed the current Maternal and Child Health (MCH) Services Block Grant allocation formula, focusing on: (1) the development of equity standards to reflect the states' comparative needs; (2) the extent that the present MCH funding allocation adheres to such standards; (3) the creation of alternative formulas to distribute MCH funds more equitably; and (4) ways to phase in new formulas with minimum disruption to services.

Recommendations

Matter for Congressional Consideration

Matter Status Comments
Congress should adopt an MCH formula that improves equity for both intended beneficiaries and state taxpayers by distributing funding among the states according to three factors: (1) the concentration of children at risk; (2) the costs of providing health care services; and (3) the states' ability to finance maternal and child health services from state resources. In adopting a redesigned MCH formula, Congress will need to strike a balance between those two equity standards. GAO weighing of those two concerns in its example of a new allocation formula demonstrates one way in which Congress' preferences could be implemented.
Closed – Not Implemented
Congress has taken no action on this recommendation.
Congress may wish to determine the way in which the MCH formula would apply to grants to the U.S. insular areas. One way to implement such grants is to fund future levels by the MCH grant percentages that the areas currently receive. Another alternative would be to distribute MCH funds on the basis of each insular area's percentage of total U.S. population.
Closed – Not Implemented
Congress has taken no action on this recommendation.
A redesigned MCH formula would mean changes for the states, both in the standards for receiving MCH funding and in the amounts received. Congress may wish to consider determining the rate and the way in which those changes would be implemented. Central to this issue would be a choice between holding MCH allocations at the current level or raising them so that no state experiences a reduction in its present level of funding.
Closed – Not Implemented
Congress has taken no action on this recommendation.

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Topics

Block grantsChild care programsCommunity health servicesDisadvantaged personsstate relationsFunds managementGrant administrationGrants to statesHealth care servicesPrenatal careChild health services