Abstract: | Section 314(d) of P. L. 89749, (1966), the Partnershipfor Health Act, combined nine categorical health grants intoone block grant for health. The impact of section 314(d), according to data gathered forthis study, can be summarized as follows: the block grant increasedthe administrative flexibility of state health officials; statehealth planning agencies generally did not have a major influenceon the block grant; state health planning agencies located ingovernors' offices had less influence over the block grant thanthose located in state health departments; Congress did notsignificantly increase expenditures for the block grant; nationalinfluence was increased by creating health programs that couldpotentially have been made part of the block grant; and theblock grant did not generally result in a reordering of spendingpriorities. The best explanation for the unspectacular effect of combiningseveral categorical grants into one block grant was that, withoutnew resources, the substantial (and welcome) new administrativeflexibility given state officials was insufficient to producean important substantive reordering of program priorities. |