Nationally, we found that the states reported $15 billion in DSH payments to hospitals, with about 23% of this amount paid to institutes for mental disease. The states with the largest DSH programs are California, New York, New Jersey, and Texas. Utilizing the estimates made by Coughlin et al. for FY 1997, we estimate that 11 states retained DSH funds: California, Connecticut, Georgia, Indiana, Kentucky, Massachusetts, Mississippi, Missouri, North Carolina, Rhode Island, and Texas. The amounts retained by the 11 states represented 15% of federal DSH payments. If we assume that only the federal share of DSH payments represents new money to facilities, “new” DSH payments would total $8.3 billion.