What exactly is a grant?

It’s one of the federal programs that the states use to finance the costs of health care. When a state gets a federal grant — the Community Health Centers Fund — it must pay about half the cost of its care — in this instance, an average amount of $1.25 for medical care for an entire family and $1.35 for a single adult. The rest is given back in matching funds to local communities. State health departments are only allowed to use a block grant to cover 90 percent.

How can a state choose which grants it will use?

Each state is allowed to choose which health care projects to fund. These funds, called community grant funding, are administered by the state-run Community Development Block Grant Programs. These are administered by different federal agencies:

Health and Human Services



The federal government provides a block grant for each state’s health department, which determines what projects the health department will fund. These are very flexible grants, so it can be difficult to identify a particular project as appropriate. The federal government allows several types of local funding. It also provides a grant to a state’s health departments if the state is able to use grant funding to cover half of the costs of a health care project.

For instance, the Obama Administration in 2010 awarded $8.55 million to the state of Texas to fund a statewide expansion of the State Children’s Health Insurance Program for low-income children. Some other projects may benefit from a matching grant of $3,000. Because it’s the federal government’s responsibility to determine the amount of the federal block grant for each state, it can make the decisions on what projects get dollars. Most of these projects do not involve health care benefits.

But, this grant can also include services for families, if federal funds permit it.

Can states choose local grants to fund?

Yes — these can be used to fund health care benefits for local programs. For instance, the Obama Administration awarded $8.5 million to Texas to fund a statewide expansion of the Health and Human Services Department’s child care initiative.

What happens if a state cannot reach a funding agreement?

If a state cannot reach an agreement with the federal government to use its block-grant funds on a particular project, it can request a grant from another grant program. This is often done when there is not enough community funding to fund a specific project. For instance, when the Obama Administration awarded Texas