Position Statement on Mental Health Block Grant Formula

The U.S. Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have proposed a change in the wage proxy used to determine state-by-state allocations under the substance abuse and mental health performance partnership block grants.

Congress has imposed a one-year moratorium on such a change. The appropriations committees of the U.S. House and Senate included language in the conference report accompanying recently-enacted FY 1998 SAMHSA appropriations legislation charging the authorizing committees of jurisdiction, SAMHSA, and the substance abuse and mental health services communities with implementing a consensus policy regarding block grant formulas, whether through legislation or existing administrative authority. Failure to resolve the issue will bar any future increases in the block grants.

In light of the significant impact that any formula decision will have on many state mental health agencies, the National Association of State Mental Health Program Directors (NASMHPD) requests that SAMHSA play an active and immediate leadership role in addressing this issue. SAMHSA should create a forum for dialogue which solicits and incorporates input from states affected by formula decisions and encourages creative approaches to resolving the issue. In particular, SAMHSA should seek to develop a resolution that minimizes the impact of any formula decision on the people served by state mental health agencies. In supporting this effort, NASMHPD commits to work collaboratively with SAMHSA and in partnership with the National Association of State Alcohol and Drug Abuse Directors (NASADAD) to facilitate a resolution.

In order to advocate effectively during the approaching FY 1999 appropriations cycle in Congress, NASMHPD further encourages SAMHSA to convene a working group of state mental health and substance abuse directors representing agencies that support a range of formula options, with the goal of developing proposals for SAMHSA to present to Congressional authorizing committees by March 1. That working group should (1) review and consider the historical context of the block grant formula; and (2) actively explore options that would ensure that all states are held harmless from any negative impact on the capacity of state mental health agencies to provide services to people with mental illnesses.

The National Association of State Mental Health Program Directors (NASMHPD) represents the public mental health service delivery system serving 6.1 million people annually in all 50 states and 5 territories.