Center For Mental Health Services
Community Mental Health Services Block Grant

(Dollars in thousands)

Authorizing Legislation - Section 1920 of the PHS Act

2005 Authorization Expired

Purpose and Method of Operation
The Community Mental Health Services Block Grant Program distributes funds to 59 eligible States and Territories through a formula, based upon specified economic and demographic factors. Applications for FY 2005 grants are due September 1, 2004. Applications must include an annual plan for providing comprehensive community mental health services to adults with a serious mental illness (SMI) and children with a serious emotional disturbance (SED). Major provisions of the current law include a maintenance of effort requirement for States and a provision that ensures that when the application of the formula results in lowered funding for a particular State, the allotment will not be less than that received in FY 1998.

The program's overall goal is to move care for adults with SMI and children with SED from costly and restrictive inpatient hospital care to the community. States and territories may expend Block Grant funds only to carry out the annual plan, to evaluate programs and services carried out under the plan, and for planning, administration, and educational activities related to providing services under the plan. The legislation provides a 5% set-aside for data collection, technical assistance, and evaluation which is retained by SAMHSA for these purposes.

Funds Distributed through Formula
95% of the funds allocated to the Block Grant program are distributed to States through a formula prescribed by the authorizing legislation. States are required to use the funds to carry out the annual Plan submitted with the Block Grant application. Factors used to calculate the allotments include total personal income; State population data by age groups (total population data for Territories); total taxable resources; and a cost of services index factor. Variation in allotments from FY 2004 is the result of the program increase and changes in the source data. Funds reached 972 subgrantees in FY 2002. The number of persons served by the mental health block grant funding is derived from the amount of Block Grant funding and the average Medicaid client cost for outpatient care:

FY 2003 FY 2004 FY 2005
Number of persons served 230,000 223,000 220,000
Average claimant cost $1,808 $1,850 $1,885

Transition to Performance Partnerships
The Children's Health Act of 2000 required the development and submission to Congress of a report on plans for transforming SAMHSA's two block grants into Performance Partnerships. The draft Report to Congress, which is in final review, includes:

· The flexibility that would be given to the States under the plan;
· The common set of performance measures that would be used for accountability;
· The definitions of the data elements to be used under the plan;
· The obstacles to implementation of the plan and the manner in which such obstacles would be resolved;
· The resources needed to implement the performance partnerships under the plan; and
· An implementation strategy, complete with recommendations for any necessary legislation.

The Children's Health Act provided the means for CMHS to fund State Date Infrastructure grants beginning in FY 2001. The States submitted the first set of data reports to CMHS in December 2002. Data submitted in December 2003 is being used to report on new GPRA measures. States are moving toward adopting common data and information technology standards, with a focus on improving information from the local provider sector.

5% Set-aside for Data Collection, Technical Assistance, and Evaluation
Five percent of the annual allocation of MHBG funds are designated for CMHS to assist the States and Territories in the development of their mental health systems through the support of technical assistance, data collection and evaluation activities. The table on the next page shows planned expenditure of set-aside funds.

Mental health block grant set-aside funding supports several critical survey activities, including the Survey of Mental Health Organizations, the Client/Patient Sample Survey and the Decision Support 2000+ Data Standards ($2.8 million total). $15.395 million supports several technical assistance efforts, including the National Technical Assistance Center, which provides assistance to State mental health agencies to improve the design, delivery, and evaluation of services; the Targeted Technical Assistance Project, which provides assistance to other stakeholders in State mental health systems; and the Technical Assistance Center for the Evaluation of Adult Mental Health Systems Change.

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