State Mental Health Authorities (SMHA) administer federal funds that support first episode psychosis (FEP) programs in every State and U.S. territory. SMHAs are state governmental agencies designed to ensure the delivery of services to individuals with mental health conditions. Typically, SMHAs coordinate and directly operate mental health services (e.g., direct psychiatric treatment, supports for housing, employment and education) and allocate funds to community providers for mental health services not provided by the SMHA. This study investigated whether there is a relationship between the level of SMHA involvement with FEP programs and patient outcomes in those programs. Results show diversity in level of oversight and involvement of SMHA with funded FEP programs. Analyses suggest that higher levels of SMHA involvement is associated with greater patient improvement, such as reduction in symptoms and increased social and role functioning.