Results of GAO Reviews of Family Planning Activities Under Title X of Public Health Service Act

Through the Department of Health and Human Services (HHS), the Federal Government provides funds for family planning service in several programs, the largest of which is title X. Although GAO has not comprehensively assessed the program's effectiveness, its work has shown that the program has not reached or effectively served many individuals in its target population beacuase of a lack of: (1) resources; (2) program coordination; (3) focus on high-risk groups, other than adolescents; and (4) client motivation to seek or to effectively use family planning services. GAO has identified several areas in which program improvements could reduce cost or enhance effectiveness and efficiency by: (1) streamlining the required level of services for clients and increasing grantee revenues through more aggressive fee collections; (2) consolidating and better coordinating the Federal programs that fund family planning services; (3) improving data collection efforts and grantee monitoring; (4) improving weaknesses in grant and contract award and management procedures; and (5) assuring that funds authorized for program implementation research are appropriately used. HHS has been responsive to GAO recommendations, but has not taken sufficient action to: (1) establish procedures for enrolling low-income persons, particularly welfare recipients, desiring family planning services; (2) ensure that grantees collect fees from persons able to pay; (3) help resolve conflicts in fee policies between title X and XX; (4) facilitate the coordination and evaluation roles of the Deputy Assistant Secretary for Population Affairs; (5) increase program audits of title X grantees; or (6) guide programatic and administrative activities of consolidated grantees.