Community Health Centers

Administration of Grant Awards Needs Strengthening Gao ID: HRD-92-51 March 18, 1992

The Community and Migrant Health Center program helps obtain adequate health care for people who would otherwise be without it. In fiscal year 1990, Congress appropriated $530 million to support about 550 health center grantees under the program. In reviewing the Bureau of Health Care Delivery and Assistance's policies and procedures for awarding grants to health centers and national associations, GAO found that the Bureau has deviated from legislative and agency grant requirements concerning competitive awards, funding levels, and application reviews.

GAO found that BHCDA: (1) deviated from legislative and agency grant requirements concerning competitive awards, funding levels, and application reviews; (2) did not award grants competitively, contrary to Public Health Service policy; (3) did not fund grant awards on the basis of the differences between costs and revenues; (4) did not notify the Department of Health and Human Services (HHS) or Congress that it had continually awarded grants for less than the standard 12 months; (5) lacks an adequate review process to allow the final decisionmaker to adequately consider independent reviews required to protect against bias in the award process; and (6) reduced its control over grantee funds by indirectly providing additional funds to a national association through member grantees' dues.

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.

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