Restrictions on Abortion and Lobbying Activities in Family Planning Programs Need Clarification

Gao ID: HRD-82-106 September 24, 1982

In response to a congressional request, GAO reviewed the family planning program authorized by title X of the Public Health Service Act to determine whether title X funds have been used to finance lobbying activities or to support abortion-related activities.

GAO found no evidence that title X funds have been used either for abortions or to advise clients to have abortions. The Department of Health and Human Services (HHS) has held that these restrictions on the use of funds are applicable only to that part of a recipient's operation which is supported by title X. Title X recipients are allowed to carry out abortion-related activities if those activities are separate from the title X family planning services. This creates some public confusion on the matter. Congressional guidance may be needed if Congress does not want title X funds to go to organizations which provide abortions. However, family planning clinics need formal guidance on abortion-related matters. GAO found some variations in clinic practices that it believed were questionable, such as: (1) counseling practices which do not present alternatives to abortion; (2) abortion referral practices which may go beyond HHS referral policy; and (3) the use of educational materials which present barrier methods of contraception together with early abortion as a method of family planning in the event of failure. Title X recipients also need more specific guidance on lobbying activities. All of the recipients which GAO reviewed had incurred expenses that raised questions regarding adherence to federal restrictions. The organizations used program funds to pay dues to lobbying organizations and, in two cases, used small amounts of program funds to lobby themselves. To establish more specific guidance on lobbying, HHS has initiated action to amend the cost principles for grantees.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Franklin A. Curtis Team: General Accounting Office: Human Resources Division Phone: (202) 275-5451


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