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HEALTH services project grants administered by the Public Health Service have increased dramatically in recent years. These "project grants" assist State and local public and nonprofit agencies to provide health services and carry out related planning, training, stud¬ ies, and demonstrations. They usually are awarded without requiring matching funds and in most programs upon the recommendation of

FEDERAL HEALTH SERVICES grants are again in a period of transition. These programs have experienced many changes since they were established on a continuing basis almost 50 years ago by the Social Security Act of 1935. The proposal of President Reagan in February 1981 that most of these activities be consolidated into "block grants" began a new phase of development. The initial action of the Congress on the President's proposal, that was completed in July 1981, indicated a willingness to approve some, but not all, of the proposed changes in direction and emphasis. Federal grants for the development and support of State and local health services have served many purposes. A primary aim of many was to stimulate and

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