Healthy Marriage and Responsible Fatherhood Initiative
Further Progress Is Needed in Developing a Risk-Based Monitoring Approach to Help HHS Improve Program Oversight Gao ID: GAO-08-1002 September 26, 2008Strengthening marriages and relationships in low-income families has emerged as a national strategy for enhancing the well-being of children. The Deficit Reduction Act of 2005 (DRA) appropriated $150 million in discretionary grants each year from 2006 through 2010 to implement the Healthy Marriage and Responsible Fatherhood Initiative. To provide insight into how these programs are being implemented and monitored, GAO is reporting on (1) how the Department of Health and Human Services (HHS) awarded grants and the types of organizations that received funding; (2) what activities and services grantees are providing, including those for domestic violence victims; (3) how HHS monitors and assesses program implementation and use of funds; and (4) how program impact is measured. GAO surveyed grantees, interviewed HHS staff, reviewed HHS records and policy, and visited several programs.
Operating under a deadline that allowed HHS 7 months to award grants, HHS shortened its existing process to award Healthy Marriage and Responsible Fatherhood grants to public and private organizations. During this process, HHS did not fully examine grantees' programs as described in their applications, including the activities they planned to offer, and this created challenges and setbacks for grantees later as they implemented their programs. For example, some grantees told us that they were informed that certain activities were not permitted months into program implementation even though HHS had approved these same activities described in their grant applications. The Healthy Marriage and Responsible Fatherhood programs provide similar activities, but their focus and target populations differ. Healthy Marriage programs are more likely to provide marriage and relationship activities, while Responsible Fatherhood programs are more likely to provide parenting skills. Additionally, both programs serve low-income and minority groups, but Healthy Marriage grantees are more likely to target teenaged youth, and Responsible Fatherhood grantees are more likely to target incarcerated parents. Both programs' grantees reported that they refer domestic violence victims to specialists in their communities. HHS uses methods that include site visits and progress reports to monitor grantees, but it lacks mechanisms to identify and target grantees that are not in compliance with grant requirements or are not meeting performance goals, and it also lacks clear and consistent guidance for performing site monitoring visits. Moreover, HHS's ability to readily identify which grantees are not in compliance or not meeting goals is hindered because it currently lacks uniform performance indicators and a computerized management information system that would enable HHS to more efficiently track key information on individual grantees. HHS told us that it is in the process of developing a management information system and has submitted uniform performance indicators for review. HHS has established a rigorous research agenda to gauge the long-term impact of healthy marriage and responsible fatherhood activities on diverse, low-income populations. HHS is sponsoring three multiyear impact evaluations of the Healthy Marriage program and one of the Responsible Fatherhood program.
RecommendationsOur 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: Team: Phone:GAO-08-1002, Healthy Marriage and Responsible Fatherhood Initiative: Further Progress Is Needed in Developing a Risk-Based Monitoring Approach to Help HHS Improve Program Oversight
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Report to the Chairman, Subcommittee on Income Security and Family
Support, Committee on Ways and Means, House of Representatives:
United States Government Accountability Office:
GAO:
September 2008:
Healthy Marriage And Responsible Fatherhood Initiative:
Further Progress Is Needed in Developing a Risk-Based Monitoring
Approach to Help HHS Improve Program Oversight:
GAO-08-1002:
GAO Highlights:
Highlights of GAO-08-1002, a report to the Chairman, Subcommittee on
Income Security and Family Support, Committee on Ways and Means, House
of Representatives.
Why GAO Did This Study:
Strengthening marriages and relationships in low-income families has
emerged as a national strategy for enhancing the well-being of
children. The Deficit Reduction Act of 2005 (DRA) appropriated $150
million in discretionary grants each year from 2006 through 2010 to
implement the Healthy Marriage and Responsible Fatherhood Initiative.
To provide insight into how these programs are being implemented and
monitored, GAO is reporting on (1) how the Department of Health and
Human Services (HHS) awarded grants and the types of organizations that
received funding; (2) what activities and services grantees are
providing, including those for domestic violence victims; (3) how HHS
monitors and assesses program implementation and use of funds; and (4)
how program impact is measured. GAO surveyed grantees, interviewed HHS
staff, reviewed HHS records and policy, and visited several programs.
What GAO Found:
Operating under a deadline that allowed HHS 7 months to award grants,
HHS shortened its existing process to award Healthy Marriage and
Responsible Fatherhood grants to public and private organizations.
During this process, HHS did not fully examine grantees‘ programs as
described in their applications, including the activities they planned
to offer, and this created challenges and setbacks for grantees later
as they implemented their programs. For example, some grantees told us
that they were informed that certain activities were not permitted
months into program implementation even though HHS had approved these
same activities described in their grant applications.
The Healthy Marriage and Responsible Fatherhood programs provide
similar activities, but their focus and target populations differ.
Healthy Marriage programs are more likely to provide marriage and
relationship activities, while Responsible Fatherhood programs are more
likely to provide parenting skills. Additionally, both programs serve
low-income and minority groups, but Healthy Marriage grantees are more
likely to target teenaged youth, and Responsible Fatherhood grantees
are more likely to target incarcerated parents. Both programs‘ grantees
reported that they refer domestic violence victims to specialists in
their communities.
HHS uses methods that include site visits and progress reports to
monitor grantees, but it lacks mechanisms to identify and target
grantees that are not in compliance with grant requirements or are not
meeting performance goals, and it also lacks clear and consistent
guidance for performing site monitoring visits. Moreover, HHS‘s ability
to readily identify which grantees are not in compliance or not meeting
goals is hindered because it currently lacks uniform performance
indicators and a computerized management information system that would
enable HHS to more efficiently track key information on individual
grantees. HHS told us that it is in the process of developing a
management information system and has submitted uniform performance
indicators for review.
HHS has established a rigorous research agenda to gauge the long-term
impact of healthy marriage and responsible fatherhood activities on
diverse, low-income populations. HHS is sponsoring three multiyear
impact evaluations of the Healthy Marriage program and one of the
Responsible Fatherhood program.
Figure: Domestic Violence Materials Distributed by Various Grantees:
This figure is a picture of a selection of domestic violence materials
distributed by various grantees.
[See PDF for image]
Source: GAO photo.
[End of figure]
What GAO Recommends:
GAO recommends that HHS employ a risk-based approach to monitoring
grantees and conducting grantee site visits, using its planned
management information system and information from both progress
reports and performance indicators to help identify those grantees at
risk of not meeting performance goals or not in compliance with grant
requirements. HHS also should create clear, consistent guidance and
policy for monitoring Healthy Marriage and Responsible Fatherhood
grantees. HHS is in the process of developing a risk-based approach to
monitoring, but disagreed that they lacked clear, consistent monitoring
guidance. GAO believes that its recommendations remain valid.
To view the full product, including the scope and methodology, click on
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-1002]. For more
information, contact Kay Brown at (202) 512-7215 or brownke@gao.gov.
[End of section]
Contents:
Letter:
Results in Brief:
Background:
HHS Awarded Grants to a Range of Public and Private Organizations, but
the Awards Process Contributed to Challenges for Some Grantees:
Programs Offer a Range of Similar Activities, but Their Focus and
Target Populations Differ:
HHS Has a Program Monitoring System, but Lacks Mechanisms to Identify
and Target Grantees Not in Compliance with Grant Requirements or Not
Meeting Performance Goals:
HHS Has Long-term Research Underway Intended to Assess Program Impact:
Conclusions:
Recommendations for Executive Action:
Agency Comments and Our Evaluation:
Appendix I: Objective, Scope, and Methodology:
Appendix II: Grantee Selection Criteria:
Appendix III: States and Territories with Grantees That Provide Direct
Services to Participants as of February 2008:
Appendix IV: Curricula Being Used by Healthy Marriage and Responsible
Fatherhood Grantees and Frequency of Use:
Appendix V: Comments from the Department of Health and Human Services:
Appendix VI: GAO Contact and Staff Acknowledgments:
Table:
Table 1: Allowable Activities as Described in DRA:
Figures:
Figure 1: Breakdown of DRA Funds for the Healthy Marriage and
Responsible Fatherhood Initiative, Fiscal Year 2007:
Figure 2: Activities Provided by Healthy Marriage and Responsible
Fatherhood Grantees:
Figure 3: Examples of Curricula Used by Healthy Marriage and
Responsible Fatherhood Grantees:
Figure 4: Domestic Violence Materials Distributed by Various Grantees:
Figure 5: Grantee Target Populations:
Figure 6: Examples of Recruitment Materials Used by Healthy Marriage
and Responsible Fatherhood Grantees:
Figure 7: Methods of Notifying Participants of Voluntary Participation
in Programs:
Figure 8: HHS Healthy Marriage and Responsible Fatherhood Impact
Research Studies:
Abbreviations:
BSF: Building Strong Families:
DRA: Deficit Reduction Act of 2005:
GED: General Educational Development:
HHS: Department of Health and Human Services:
Initiative: Healthy Marriage and Responsible Fatherhood Initiative:
MSF-IP: Marriage and Family Strengthening Grants for Incarcerated and
Re- entering Fathers and Their Partners:
SHM: Supporting Healthy Marriage:
TANF: Temporary Assistance for Needy Families:
United States Government Accountability Office:
Washington, DC 20548:
September 26, 2008:
The Honorable Jim McDermott:
Chairman:
Subcommittee on Income Security and Family Support:
Committee on Ways and Means:
House of Representatives:
Dear Mr. Chairman:
Strengthening marriages and relationships in low-income families has
emerged as a national strategy for enhancing the well-being of
children. With the passage of the Deficit Reduction Act of 2005 (DRA),
Congress appropriated $150 million in discretionary grants each year
from 2006 through 2010 to implement the Healthy Marriage and
Responsible Fatherhood Initiative (Initiative). The Initiative
represents an unprecedented financial commitment by the federal
government to support marriage and fatherhood programs. The focus of
the Healthy Marriage program is to encourage the formation and
maintenance of two-parent households through healthy marriage promotion
activities, while the focus of the Responsible Fatherhood program is to
strengthen the role of the father in a child's life. The Initiative
supports two goals under Temporary Assistance for Needy Families
(TANF), the federally funded block grant that funds programs designed
to help needy families achieve self-sufficiency. The goals are to
prevent and reduce the incidence of out-of-wedlock pregnancies and to
encourage the formation and maintenance of two-parent families. To
implement the Initiative, the Department of Health and Human Services
(HHS) competitively awarded grants to various organizations to support
a broad range of activities to promote healthy marriage and responsible
fatherhood. To address domestic violence concerns, DRA required all
grantees to consult with a domestic violence expert and to include
information on how they will address domestic violence issues in their
grant applications to HHS. It also required that participation by
individuals in the program be voluntary.
To gain insight into how these programs are being implemented, you
asked that we determine (1) how HHS awarded grants and the types of
organizations that received funding; (2) what activities and services
grantees are providing, including those for domestic violence victims;
(3) how HHS monitors and assesses program implementation and use of
funds, and (4) how program impact is measured.
To respond to these questions, we conducted a web-based survey of all
122 Healthy Marriage and 94 Responsible Fatherhood grantees that
provide direct services to program participants, asking them to provide
information about various aspects of their programs including the
characteristics of their organization, services they offered, curricula
used, and their process and procedures for identifying domestic
violence.[Footnote 1] Of the 216 grantees to whom we sent our survey,
211 responded for a response rate of 98 percent. Throughout this report
survey results are based on the number of grantees responding to a
particular question. Additionally, to obtain more in-depth information
about services marriage and fatherhood grantees are providing, we
visited 14 grantees in Washington, Oklahoma, New Mexico, Indiana,
Oregon, and the District of Columbia. On 2 of these visits, we
accompanied HHS staff responsible for monitoring grantees. We selected
grantees to achieve variation in geographic location, type of grant
awarded, award amount, services, organization type, and the programs'
target populations. In addition, we conducted telephone interviews with
organizations that were awarded grants to provide technical assistance
to grantees, and help organizations develop fatherhood programs.
Moreover, to understand the criteria HHS used to award grants and the
manner in which HHS monitors and assesses program implementation, we
randomly selected 40 Healthy Marriage and Responsible Fatherhood
grantee case files to review.[Footnote 2] In this review, we examined
several documents, including applications, semiannual progress and
financial reports, grantee selection panel score sheets, and
correspondences between grantees and agency officials. To determine how
program impact is measured, we interviewed organizations that have
received contracts to conduct impact evaluations of Healthy Marriage
and Responsible Fatherhood interventions and assessed their
methodological approach to measuring impact. We also interviewed HHS
officials about the uniform, program-wide performance indicators under
development and surveyed grantees about how they measure program
performance. We conducted this performance audit from July 2007 to
September 2008, in accordance with generally accepted government
auditing standards. Those standards require that we plan and perform
the audit to obtain sufficient and appropriate evidence to provide a
reasonable basis for our findings and conclusions based on our audit
objectives. We believe that the evidence obtained provides a reasonable
basis for our findings and conclusions based on our audit objectives.
For additional information on our scope and methodology, see appendix
I.
Results in Brief:
Operating under a deadline that allowed HHS 7 months to award grants,
HHS shortened its process to award grants to public and private
organizations on time. Under DRA, which was passed in February 2006,
HHS had to award the grants by the end of September 2006. Within that
time frame, HHS had to write and publicize the grant announcements,
develop criteria for selecting grantees, and convene panels to review
and score the more than 1,650 applications for funding it received.
After the applications were reviewed and scored, HHS awarded grants to
a diverse set of grantees--216 public, private, and nonprofit
organizations that provided direct services to participants--based on a
range of criteria, including the grantees' approach to recruiting and
retaining participants and strategy to address issues of domestic
violence. However, HHS did not fully examine grantees' programs as
proposed in grantee applications, including the activities they planned
to offer, and this contributed to challenges for some grantees when
implementing their programs. For example, during our site visits, 5 out
of 14 grantees told us that even though they had received approval from
HHS to implement their program as outlined in their grant applications,
HHS informed them after they had begun serving participants that
certain activities were not permitted under the grant legislation.
Healthy Marriage and Responsible Fatherhood programs offer a range of
similar activities, but their focus and target populations differ. Both
Healthy Marriage and Responsible Fatherhood programs offer activities
and services related to marriage and relationship skills, parenting,
and economic stability, but according to our survey, Healthy Marriage
programs are more likely to provide marriage and relationship services,
whereas Responsible Fatherhood programs are more likely to focus on
parenting skills. For example, 94 percent of Healthy Marriage grantees
reported that they provide activities related to marriage and
relationships, compared to 55 percent of Responsible Fatherhood
grantees. On the other hand, 92 percent of Responsible Fatherhood
grantees report that they provide activities related to parenting
compared to 47 percent of Healthy Marriage programs. Additionally,
grantees from both programs reported that they refer domestic violence
victims to specialists in their communities. By making referrals to
domestic violence specialists in their communities, both Healthy
Marriage and Responsible Fatherhood programs attempt to ensure that
victims of domestic abuse receive services. Almost all grantees in both
programs said they include domestic violence awareness as part of their
programs and, according to our survey, have protocols in place for
detecting and responding to signs of domestic violence. For example,
grantees from both programs told us they have specific classroom
sessions devoted to helping couples identify the signs of unsafe and
unhealthy relationships. The services offered by the two grant programs
are targeted to a range of groups, however, Healthy Marriage programs
were more likely to target high school and teenaged youths, and
Responsible Fatherhood programs were more likely to target incarcerated
fathers. According to our survey, grantees inform individuals that
their participation in the programs is voluntary through a range of
methods, including verbal and written notification.
HHS uses multiple methods to monitor grantees' programs; however it
lacks mechanisms to identify and target grantees that are not in
compliance with grant requirements or are not meeting performance
goals. To monitor Healthy Marriage and Responsible Fatherhood grantees,
HHS uses a combination of site visits, phone calls, e-mails, and
progress reports, but these tools are not used strategically to help
identify problems grantees are experiencing. Our review of grantee case
files found documentation of grantees that were not meeting performance
targets, such as participant recruitment goals, or not in compliance
with grant requirements, such as providing only those services allowed
under the grant. However, HHS did not always give priority to these
grantees for site visits or other monitoring activities, which was
further confirmed during our interviews with grantees. Instead, HHS
told us that the decision of which grantees to visit and in what order
was left to the discretion of individual HHS staff, and monitoring site
visits were scheduled based on staff preferences. When HHS conducted a
site visit, we found that HHS staff lacked specific and clear guidance
on how to conduct visits, and therefore the length and types of issues
reviewed and documentation examined varied depending on who conducted
the visit. For example, on some monitoring site visits, HHS staff
observed grantees providing services and in other instances, staff did
not. Finally, although HHS maintains paper files for each of the
grantees, the breadth and detail of these files vary considerably. HHS
told us that they plan to implement a computerized management
information system in fall 2008 which would enable it to more
efficiently track key information on individual grantees and combine
grantee communications and performance data. According to HHS, the
first phase of the web-based management information system has been
completed. HHS also told us that it currently is in the process of
developing uniform performance indicators that will eventually be part
of its planned management information system. These performance
indicators have been developed and are currently under review by the
Office of Management and Budget.
HHS has established a rigorous research agenda to gauge the long-term
impact of healthy marriage and responsible fatherhood activities on
diverse, low-income populations. HHS is sponsoring three multiyear
impact evaluations of the Healthy Marriage program and one of the
Responsible Fatherhood program. These evaluations will assess the
effectiveness of marriage and fatherhood programs on low-income
populations who traditionally have not been the focus of such studies.
Using a research design that compares study participants that received
marriage and fatherhood services to similar participants that did not,
the researchers will be able to compare the groups and measure any
differences resulting from their participation in the programs. One
study is assessing the impact of healthy marriage promotion activities
on low-income, unmarried couples around the time of the birth of a
child using data collected at three stages of participants' lives. This
study will examine a range of outcomes, including whether marriage
services improved marital relationships, changed couples' attitudes
toward marriage, reduced marital instability, and improved child well-
being. Studies such as these often are difficult and take time to
complete, but are considered the best method for assessing program
impact. Results from these studies will not be available until after
fiscal year 2010, when the current appropriation for the Healthy
Marriage and Responsible Fatherhood Initiative expires, but HHS
officials note that the results may help inform future policy
decisions.
To provide better program oversight, we are recommending that the
Secretary of HHS employ a risk-based approach to monitoring grantees
and conducting grantee site visits, using its planned management
information system and information from progress reports and
performance indicators to help identify those grantees at risk of not
meeting performance goals or not in compliance with grant requirements.
HHS also should create clear, consistent guidance and policy for
monitoring Healthy Marriage and Responsible Fatherhood grantees.
Background:
Welfare reform in 1996 made sweeping changes to the national welfare
policy, including a new emphasis on marriage as an area of societal and
governmental concern. With the passage of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996, which established the
Temporary Assistance for Needy Families (TANF) program, Congress wrote
into law that marriage is the foundation of a successful society and
promotes the interests of children. Congress was, in part, prompted to
address this issue because of what it deemed a "crisis in our Nation"
in the rate of pregnancies and births to unmarried women. In the
legislation, Congress cited the negative consequences to children that
result from these pregnancies and births, including greater risk for
child abuse and neglect, higher rates of poverty, and lower educational
aspirations.
TANF was reauthorized under the Deficit Reduction Act of 2005 (DRA),
and signed into law in February 2006. DRA appropriated $150 million a
year for 5 years in discretionary grants for the Healthy Marriage and
Responsible Fatherhood Initiative (Initiative).[Footnote 3] While the
Initiative was established as part of TANF, the nation's welfare
program, it does not impose income limits for program participants.
However, HHS designated a few priority groups for funding under the
Initiative, including incarcerated fathers and low-income, unwed,
expectant or new parents. In structuring the Initiative, HHS created
two distinct grant programs--one relating to Healthy Marriage and one
to Responsible Fatherhood--but with common aims. The Healthy Marriage
program is aimed at encouraging the formation and maintenance of two-
parent households to improve child well-being through healthy marriage
promotion, and the Responsible Fatherhood program is designed to
strengthen the role of the father as a means of promoting child well-
being, specifically within the context of marriage. HHS has stressed
that the overarching Initiative is not designed to encourage couples to
stay in unhealthy marriages.
In the legislation, Congress prescribed the "allowable" activities for
the Initiative (see table 1). Given the broadness of these allowable
activities, HHS developed examples of services grantees could provide,
such as providing after-school programs for high school students and
marriage education courses that incorporate information on financial
literacy. Although providing services to victims of domestic violence
is not an allowable activity (see table 1), organizations were required
by DRA to describe in their grant application how their programs or
activities would "address" issues of domestic violence, and commit in
their application to consult with experts in domestic violence in
developing their programs and activities. The DRA also required that
organizations describe in their application what they would do to
ensure and how they would inform individuals that participation in
programs is voluntary.
Table 1: Allowable Activities as Described in DRA:
Allowable activities;
Healthy Marriage: * Public advertising campaigns on the value of
marriage and the skills needed to increase marital stability and
health;
* Education in high schools on the value of marriage, relationship
skills, and budgeting;
* Marriage education, marriage skills, and relationship skills
programs, that may include parenting skills, financial management, and
job and career advancement, for nonmarried, pregnant women and
nonmarried, expectant fathers;
* Premarital education and marriage skills training for engaged couples
and for couples or individuals interested in marriage;
* Marriage enhancement and marriage skills training programs for
married couples;
* Divorce reduction programs that teach relationship skills;
* Marriage mentoring programs that use married couples as role models
and mentors in at-risk communities;
* Programs to reduce the disincentives to marriage in means-tested aid
programs, if offered in conjunction with any activity described above;
Responsible Fatherhood: * Activities to promote marriage or sustain
marriage through activities such as:
- counseling, mentoring, and disseminating of information about the
benefits of marriage and dual-parent involvement for children;
- relationship skills education;
- disseminating of information on the causes of domestic violence and
child abuse;
and:
- skills-based marriage education and financial planning;
* Activities to promote responsible parenting through activities such
as:
- counseling, mentoring, and mediation, and dissemination of
information about good parenting practices;
and:
- skills-based parenting education, encouragement of child support
payments, and other methods;
* Activities to foster economic stability by helping fathers improve
their economic status;
* Activities to promote responsible fatherhood such as the development,
promotion, and distribution of a media campaign to encourage the
appropriate involvement of parents in the life of their child that are
conducted through a contract with a nationally recognized, nonprofit,
fatherhood promotion organization.
Source: Deficit Reduction Act of 2005, Pub. L. No. 109-171.
[End of table]
In fiscal year 2007 most of the funding, approximately $113 million,
was used to support Healthy Marriage and Responsible Fatherhood
demonstration grants, while the remaining funds were used for research,
technical assistance, administrative costs, and other TANF-related
activities (see fig. 1).
Figure 1: Breakdown of DRA Funds for the Healthy Marriage and
Responsible Fatherhood Initiative, Fiscal Year 2007:
This figure is a pie graph showing a breakdown of DRA funds for the
healthy marriage and responsible fatherhood initiative, during fiscal
year 2007.
Healthy Marriage Grants: 50%;
Responsible Fatherhood grants: 25%;
Marriage and Fatherhood Research: 12%;
Technical Assistance to Grantees: 7%;
Other: 4%;
Administrative Overhead: 2%.
[See PDF for image]
Source: Analysis of budget information provided by HHS.
Note: "Other" includes 1 percent for Tribal TANF child welfare
expenditures and the remainder for TANF-related activities.
[End of figure]
As part of the agency's overall research agenda, HHS has sponsored
several impact evaluations of its programs. These evaluations are
considered to be the best method of determining the extent to which the
program, rather than other factors, is causing specific participant
outcomes. Impact evaluations, which are awarded through a competitive
bid process to experienced research firms, often are complex, multiyear
studies that can be difficult and costly to undertake and require
particular attention to both study planning and execution. Moreover,
maintaining proper incentives to obtain and sustain the participation
of populations that do not have financial and familial stability can be
challenging. In previous work, we found that HHS has established a
rigorous research agenda that regularly evaluates how well its programs
are working.[Footnote 4] In particular, HHS has a diverse research
agenda focused on TANF that includes research on strategies to help low-
income individuals gain self-sufficiency.[Footnote 5]
HHS Awarded Grants to a Range of Public and Private Organizations, but
the Awards Process Contributed to Challenges for Some Grantees:
HHS awarded grants to a range of public and private organizations, but
its awards process later contributed to challenges for these grantees.
HHS shortened its awards process to meet a deadline specified in
legislation that allowed 7 months to award grants. HHS awarded grants
to a diverse set of grantees that provided direct services to program
participants in 47 states, the District of Columbia, and American
Samoa. However, as part of its awards process, HHS did not fully
examine grantees' programs as described in grantee applications,
including the activities they planned to offer, contributing to
challenges for some grantees as they were implementing their programs.
HHS Shortened Its Existing Awards Process to Meet DRA Deadline for
Awarding Grants:
HHS shortened its process to award grants by the end of the fiscal year
(September 30). Under DRA, which became law in February 2006, HHS had
to award grants in 7 months. Within this time frame, HHS had to perform
several tasks related to the awards process. Specifically, HHS staff
said they developed the grant announcements and the criteria for
selecting grantees under tight time constraints and limited the amount
of time organizations could apply for grants to fewer than the 60 days
recommended in HHS's policy manual. HHS officials, who told us they had
not expected that more than 1,650 organizations would apply for
funding, hired The Dixon Group, a management consulting firm, to
receive applications, locate grant application reviewers, and assist
with reviewer training.[Footnote 6] At the same time The Dixon Group
was receiving applications, they also were selecting peer reviewers.
Approximately 600 peer reviewers served on 40 to 50 review panels for 4
weeks during July and August. While the grant announcements stated that
grant application reviewers should be experts, HHS allowed peer review
of the applications and The Dixon Group and HHS characterized graduate
students, professors, and practitioners as peer reviewers. Further,
because individuals who were experts in the field of marriage and
fatherhood applied for the grants, it limited the pool of available
expert reviewers. We reviewed several of the resumes of the peer
reviewers and found that while most had experience as federal
reviewers, their professional and volunteer experiences were not always
directly relevant to marriage and fatherhood services. For example, one
peer reviewer had experience in nursing and another listed experience
as a social studies teacher.
To determine which organizations would receive funding, HHS developed
guidance that outlined a five-part criteria for most grants, with each
criterion worth a specific amount of points. Reviewers scored
organizations' applications using the guidance provided by HHS and by
judging how well the applicant responded to each criterion. For
example, a major criterion was the applicant's "approach," worth 40
points. For this criterion, applicants were asked to describe their
approach to recruiting and retaining participants, their proposed
activities, and time frames for accomplishing specific milestones.
Applicants also were required to demonstrate that their proposed
activities were consistent with the needs of their target population
and that the rationale for the approach was based on the demonstrated
effectiveness of similar activities. Finally, under their approach
section, applicants also had to describe how they planned to address
issues of domestic violence and ensure voluntary participation. For the
"organizational profile" criterion, worth 20 points, organizations had
to provide information that demonstrated their qualifications to serve
participants, including organizational charts, financial statements,
resumes, letters of support, and the qualifications of partnering
organizations. As part of other criteria, applicants were asked to
provide a budget and budget justification, and information on how they
proposed to measure the outcomes of their programs. Applicants could
receive up to 5 bonus points if they demonstrated prior experience in
developing, implementing, or managing skills-based marriage or
fatherhood education programs. See appendix II for a table of the
criteria used for each type of grant.
The peer reviewers used these criteria to score applicants, and HHS
ranked the applications based on the scores. With some exceptions,
applications that received the highest scores were awarded grants. HHS
made exceptions to ensure, among other things, that grants were
geographically distributed and reflected a diversity of target
populations and communities served.
In September 2006, HHS began notifying grantees of their awards, but
experienced a setback when they had to reconvene review panels to
rescore 31 applications. When scoring some applications, some reviewers
incorrectly gave applicants zero points for the "approach" section.
According to the grant announcements, if applicants failed to discuss
how they would inform individuals that program participation was
voluntary, as well as discuss specific issues relating to domestic
violence issues, they would receive no points for the "approach"
criterion. HHS discovered that reviewers had incorrectly interpreted
whether applicants satisfied this portion of the "approach" criterion,
and after clarifying the criteria, required that they rereview the
applications.[Footnote 7]
HHS Awarded Grants to a Diverse Set of Grantees:
HHS awarded grants to a diverse set of grantees that included 216
different organizations--122 were Healthy Marriage and 94 were
Responsible Fatherhood demonstration grants that provided direct
services to program participants in 47 states, the District of
Columbia, and American Samoa (see app. III). In responding to our
survey, grantees selected multiple categories to describe their
organizational type. The majority--89 percent of the grantees--
classified themselves as nonprofits. However, faith-based, for-profit,
and private organizations also received funding. Awards for Healthy
Marriage demonstration grants ranged from $225,000 to $2.4 million, and
awards for Responsible Fatherhood demonstration grants were for smaller
amounts, ranging from $188,000 to $1 million.
Over two-thirds of our survey respondents indicated that their
organization had prior experience related to healthy marriage or
responsible fatherhood activities. This experience included providing
workshops for couples and singles, parenting classes, and relationship
workshops for high school students. Some of these organizations also
provided a broader array of other services to the community, such as
mental health services and counseling services, and substance abuse
treatment. Also, at least a dozen of the grantees had provided
abstinence services and some Healthy Marriage grantees were previous
recipients of grants from HHS for related purposes, including healthy
marriage curriculum development and fostering healthy marriage within
underserved communities.
HHS's Grant Awards Process Contributed to Challenges Grantees Had
Implementing Programs:
HHS's grant awards process contributed to challenges grantees later
faced implementing their programs. HHS was able to announce grant
awards by September 30; however HHS did not fully examine grantees'
programs as described in grantee applications. Specifically, we found
during 5 of our 14 site visits that grantees, whose program activities
had initially been approved by HHS, were later told that those same
activities were not allowed under the conditions of their award. For
example, during a site visit, one grantee reported that it proposed
providing services to unmarried couples in its application and was
doing so until HHS informed them that these services were not allowed
under the conditions of their award. Another grantee told us that it
was providing General Educational Development (GED) education as part
of its Healthy Marriage program, but was later notified that the
activity was not allowed. These grantees were well into program
implementation when they were told to discontinue certain activities.
One grantee we visited said it engaged in activities that were not
allowable under the grant for a full year before being informed by HHS
that the activities were not permissible. The grantee told us that it
would have benefited from more timely review and feedback from HHS. In
another case, HHS told a grantee that it would have to extend the
length of its workshops for participants from 60 minutes to 90 minutes
to 8 hours, even though the grant application noted that short,
workshops would be provided.[Footnote 8] To implement this change, the
grantee said it would likely incur additional expenses, such as paying
facilitators for extra time and spending more for rental space.
HHS told us that it received more applications than expected and this
was the first time it awarded these grants. HHS also said it had
learned from this experience.
Programs Offer a Range of Similar Activities, but Their Focus and
Target Populations Differ:
While the range of activities offered and populations served by Healthy
Marriage and Responsible Fatherhood programs' grantees are similar,
their focus and target populations differ. Both programs offer a range
of similar activities, but a greater percentage of marriage programs
provided activities related to marriage and relationship skills and a
larger percentage of fatherhood programs provided parenting skills.
Grantees for both programs reported that they refer domestic violence
victims to specialists when appropriate. Additionally, while both
programs target such groups as minority and low-income populations,
Healthy Marriage grantees are more likely to target high school or
teenaged youths, and Responsible Fatherhood grantees are more likely to
target incarcerated parents.
Both Programs Offer a Range of Similar Activities and Refer Domestic
Violence Victims to Specialists When Appropriate, but They Differ in
Which Activities They Offer Most Frequently:
Both programs offer a range of similar activities, and grantees from
both programs said they refer victims of domestic violence to
specialists in their communities when appropriate (see fig. 2).
However, according to our survey, while both programs offer many
similar activities, Healthy Marriage programs focus more on those
related to marriage and relationship services, whereas Responsible
Fatherhood programs are more likely to focus on providing services
teaching parenting skills. Specifically, 94 percent of Healthy Marriage
grantees, compared to 55 percent of Responsible Fatherhood grantees,
reported offering marriage and relationship activities. During our
visits to several Healthy Marriage grantees, we often observed
activities related to marriage and relationships. For example, we
observed a Healthy Marriage workshop where couples took quizzes to
determine how well they knew one another and then participated in a
discussion about commitment, chemistry, and compatibility. Conversely,
92 percent of Responsible Fatherhood grantees, compared to 47 percent
of Healthy Marriage grantees, reported in our survey that they provide
services related to teaching parenting skills. For example, a
Responsible Fatherhood grantee program we visited included in its
curriculum parenting skills training, such as lessons on a child's
developmental needs and how to communicate with children of different
ages. In addition, Responsible Fatherhood grantees were more likely
than Healthy Marriage grantees to report that they focused on providing
programs with specific services to help participants achieve economic
stability, including assistance with finding a job. Healthy Marriage
grantees also reported that they focus on economic stability
activities, but to a lesser extent than Responsible Fatherhood
programs. According to HHS, Healthy Marriage grantees can provide these
services only within the context of allowed activities (see table 1).
For example, Healthy Marriage grantees might discuss financial issues
as part of marriage and relationship skills. Depending on the
conditions of the award, grantees might provide more than one of the
services or activities listed in figure 2.
Figure 2: Activities Provided by Healthy Marriage and Responsible
Fatherhood Grantees:
This figure is a combination bar showing activities provided by healthy
marriage and responsible fatherhood grantees. The X axis represents
allowable activities, and the Y axis represents percentage.
Allowable activities: Economic stability;
Healthy marriage: 37;
Responsible fatherhood: 58.
Allowable activities: Divorce reduction;
Healthy marriage: 37;
Responsible fatherhood: 13.
Allowable activities: Marriage & Relationship Education for High
Schools Students;
Healthy marriage: 45;
Responsible fatherhood: 18.
Allowable activities: Education on the Benefits of Marriage;
Healthy marriage: 16;
Responsible fatherhood: 8.
Allowable activities: Marriage & Relationship Skills;
Healthy marriage: 94;
Responsible fatherhood: 55.
Allowable activities: Marriage enhancement for|married couples;
Healthy marriage: 69;
Responsible fatherhood: 27.
Allowable activities: Marital Mentoring;
Healthy marriage: 42;
Responsible fatherhood: 11.
Allowable activities: Pre-marital education;
Healthy marriage: 70;
Responsible fatherhood: 24.
Allowable activities: Promoting Responsible Parenting;
Healthy marriage: 47;
Responsible fatherhood: 92.
Allowable activities: Public Advertising Campaigns;
Healthy marriage: 59;
Responsible fatherhood: 25.
[See PDF for image]
Source: GAO analysis of Healthy Marriage and Responsible Fatherhood
grantees' responses to survey.
[End of figure]
Both Healthy Marriage and Responsible Fatherhood grantee programs offer
services for varying lengths of time and in various settings. Some
programs have one intensive session in a lecture setting, while others
offer classroom settings that are more interactive and may be offered
for 1 or 2 hours 1 night a week for up to 17 weeks. One grantee program
we visited offered marriage workshops to participants at weekend
retreats with paid lodging, and two Responsible Fatherhood programs we
visited included optional home visits by staff. In addition, some
grantees run advertisements or sponsor advertising campaigns that
discuss the importance of healthy marriage and responsible fatherhood.
For example, one advertising campaign designed a billboard that read "a
diamond isn't the only thing that should last forever."
According to our survey, the majority of grantees--98 percent--deliver
their services through classroom instruction using a curriculum (see
fig. 3). Many survey respondents said they developed and used their own
curriculum (41 percent of Healthy Marriage and 47 percent of
Responsible Fatherhood respondents). For example, one grantee we
visited said it developed its own Spanish-language curriculum because
the few existing Spanish-language curricula for Responsible Fatherhood
programs did not meet the specific needs of the Latino population the
grantee served. Other grantees adapt commercially available curricula
to meet the needs of participants. The most-commonly-used, commercially
available curriculum was the Prevention and Relationship Enhancement
Program. This curriculum focuses on identifying strengths and
weaknesses of a marriage, improving communication skills, and
increasing the connection between the partners. Technical assistance
providers make information about curricula available to grantees on
their Web site. A list of curricula used by multiple grantees is in
appendix IV.
Figure 3: Examples of Curricula Used by Healthy Marriage and
Responsible Fatherhood Grantees:
This figure is a picture of different examples of curricula used by
health marriage and responsible fatherhood grantees.
[See PDF for image]
Source: GAO photo.
[End of figure]
Most grantees--about 93 percent--reported in our survey that they
include information on domestic violence in their programs. For
example, several grantees modified their curriculum to include a
discussion of domestic violence with participants. One survey
respondent noted that it leads a discussion on domestic violence issues
that helps participants self-identify and understand domestic violence.
During our site visits, some Healthy Marriage grantees told us that
they focus on the characteristics of a healthy relationship. In
addition to discussing topics related to relationship health and
domestic violence awareness, grantees also distribute informational
materials about domestic violence (see fig. 4). For example, during a
site visit to a Healthy Marriage grantee, we observed classroom
instructors distributing pamphlets on recognizing signs of domestic
violence. Handouts include state Directories of Domestic Violence
Support Services; handbooks for domestic violence victims, and victims'
rights; and pamphlets on topics ranging from "recipes for safety" to
the characteristics of an abusive relationship.
Figure 4: Domestic Violence Materials Distributed by Various Grantees:
This figure is a picture is domestic violence materials distributed by
various grantees.
[See PDF for image]
Source: GAO photo.
[End of figure]
Additionally, most grantees reported in our survey that they have
protocols for how staff should handle instances where program
participants may be victims of domestic violence, and many grantees
train their staff on identifying signs of domestic violence, as well as
on teaching program participants the signs of unhealthy relationships.
Moreover, most grantees reported that they consult with domestic
violence organizations and refer potential domestic violence victims to
them. For example, one grantee we visited told us that it consulted
with two different domestic violence organizations when designing its
Responsible Fatherhood program. The domestic violence organizations
helped the grantee develop part of a workshop related to domestic
violence and also presented information to program participants. During
our site visits, grantees also told us they refer program participants
to domestic violence specialists when appropriate. For example, one of
the grantees we visited said that when it encountered a potential
domestic violence situation, it held a joint meeting with a caseworker,
domestic violence expert, and a family services coordinator.
Collectively they determined the appropriate referral for the person.
The DRA does not include domestic violence services as an allowed
activity, but does require that programs have in place mechanisms for
addressing domestic violence.
Programs Focus Services on Different Target Populations:
Healthy Marriage and Responsible Fatherhood grantee programs focus on
providing services to different populations, but they both target low-
income and minority populations. According to our survey, 58 percent of
Healthy Marriage and 52 percent of Responsible Fatherhood grantees
target low-income individuals, and 39 percent of Healthy Marriage and
36 percent of Responsible Fatherhood grantees target minorities (see
fig. 5). Healthy Marriage grantee programs target high school or
teenaged youths at higher rates than Responsible Fatherhood grantee
programs, in part, because education in high schools is one of the
Healthy Marriage program's allowed activities. On the other hand,
Responsible Fatherhood programs target incarcerated parents, typically
fathers, because HHS designated a portion of the program's funding for
this population. Both grantee programs allow men and women to
participate in their programs--even though the Responsible Fatherhood
programs were created specifically to target men, they are both open to
men and women. An administrative complaint was filed by a legal
advocacy organization centering on whether women have equal access to
the program and subsequently HHS reminded grantees that the Responsible
Fatherhood programs are open to eligible men and women.[Footnote 9]
Figure 5: Grantee Target Populations:
This figure is a combination bar graph showing grantee target
populations. The X axis represents the target population, and the Y
axis represents the percentage of grantees who target. One bar
represents health marriage, and the other responsible fatherhood.
Target population: High school students/youths;
Healthy marriage: 43;
Responsible fatherhood: 8.
Target population: Singles;
Healthy marriage: 13;
Responsible fatherhood: 4.
Target population: Unmarried couples;
Healthy marriage: 44;
Responsible fatherhood: 17.
Target population: Co-habitating unmarried couples;
Healthy marriage: 11;
Responsible fatherhood: 13.
Target population: Married couples;
Healthy marriage: 30;
Responsible fatherhood: 14.
Target population: Parents;
Healthy marriage: 42;
Responsible fatherhood: 84.
Target population: Low income;
Healthy marriage: 58;
Responsible fatherhood: 52.
Target population: Incarcerated persons;
Healthy marriage: 9;
Responsible fatherhood: 31.
Target population: Minorities;
Healthy marriage: 39.22;
Responsible fatherhood: 36.
Target population: Other;
Healthy marriage: 6;
Responsible fatherhood: 30.
[See PDF for image]
Source: GAO analysis of Health Marriage and Responsible Fatherhood
grantees' responses to survey.
[End of figure]
Grantees use a variety of methods to attract participants to the
program. According to our survey, grantees rely heavily on word of
mouth, but they also attract participants through educational handouts
and brochures, referrals, and advertisements such as promotion
campaigns (see fig. 6). For example, one grantee we visited, which
targets Latinos, indicated that while it advertises through a variety
of methods including community-based advertising, radio, and door-to-
door recruiting, it had difficulty attracting participants. Some
grantees told us they devised numerous incentives to better retain
participants. For example, one grantee we visited told us it provides
food and child care at each session, transportation subsidies, and Wal-
Mart and Babies R Us gift cards once participants completed the
program.
Figure 6: Examples of Recruitment Materials Used by Healthy Marriage
and Responsible Fatherhood Grantees:
This figure is a picture of examples of recruitment materials used by
healthy marriage and responsible fatherhood grantees.
[See PDF for image]
Source: GAO photo.
[End of figure]
Participation in the Healthy Marriage and Responsible Fatherhood
programs must be voluntary as required by DRA, and according to our
survey, grantees used a variety of methods to inform participants that
participation was voluntary. Specifically, 95 percent of survey
respondents indicated they provide verbal notification that
participation is voluntary, while 89 percent indicated that they
provide written notification (see fig. 7).
Figure 7: Methods of Notifying Participants of Voluntary Participation
in Programs:
This figure is a combination bar graph showing methods of notifying
participants of voluntary participation in programs. The X axis
represents the delivery method, and the Y axis represents percentage of
survey responses. One bar represents healthy marriage, and the other
represents responsible fatherhood.
Delivery method: Verbal notification;
Healthy Marriage: 95;
Responsible Fatherhood: 94.
Delivery method: Written notification;
Healthy Marriage: 84;
Responsible Fatherhood: 95.
Delivery method: Sign in sheet;
Healthy Marriage: 70;
Responsible Fatherhood: 64.
Delivery method: Waiver form;
Healthy Marriage: 53;
Responsible Fatherhood: 57.
Delivery method: Web site;
Healthy Marriage: 47;
Responsible Fatherhood: 37.
Delivery method: Posted notification;
Healthy Marriage: 33;
Responsible Fatherhood: 37.
Delivery method: Other;
Healthy Marriage: 49;
Responsible Fatherhood: 46.
[See PDF for image]
Source: GAO analysis of Healthy Marriage and Responsible Fatherhood
grantees' responses to survey.
[End of figure]
HHS Has a Program Monitoring System, but Lacks Mechanisms to Identify
and Target Grantees Not in Compliance with Grant Requirements or Not
Meeting Performance Goals:
HHS has a program monitoring system, but it lacks the mechanisms to
identify and target grantees not in compliance with grant requirements
or not meeting performance goals. HHS uses multiple tools to monitor
grantee programs, such as site visits and reviews of reports submitted
by grantees. However, HHS lacks specific guidance for conducting
monitoring site visits. Moreover, HHS's ability to target grantees in
need of assistance is hindered by the lack of an effective Management
Information System.
HHS Uses Multiple Tools to Monitor Grantees:
To monitor Healthy Marriage and Responsible Fatherhood grantee
performance, HHS uses multiple tools including a combination of phone
calls, e-mails, grantee progress reports, and site visits. HHS also
reviews grantee Single Audit Act reports.[Footnote 10] HHS is
responsible for monitoring the 216 Healthy Marriage and Responsible
Fatherhood grantees and according to our survey; almost all grantees
reported some contact from HHS staff.[Footnote 11] According to the
grantees we visited, HHS staff contact them at least once a month.
Grantees said that HHS staff typically contact them to notify them of
opportunities for technical assistance, address errors or issues that
arise during review of required programmatic and financial progress
reports, and to notify them of upcoming events. In addition, some
grantees also initiate communication with HHS to ask questions
regarding policy, to request approval for certain activities, or to
request budget modifications.
Semiannually, HHS requires grantees to submit both programmatic and
financial progress reports, which, among other things, provide HHS with
updates on grantees' progress toward meeting performance goals that
grantees established for themselves in their applications, as well as
provide information on grantees' compliance with domestic violence and
other HHS policies. For example, some grantees report to HHS on the
number of participants they expect to serve. Some grantees also may
report on the types of activities and participant satisfaction with
programs or services as well as changes in participant behavior before
and after programs. They also may report on any problems they may be
experiencing, including recruiting challenges. Because grantees can set
their own program goals and establish their own measures for these
goals, there is considerable variation among the information being
collected. Financial progress reports contain information, such as
financial statements, that allow HHS to track the use of grant funds.
HHS also monitors grantees' use of funds by tracking grantees' draw
down of funds. Specifically, HHS also is able to compare financial
progress reports submitted by grantees with reports from the HHS
electronic grant payment management system to monitor grantees'
withdrawal of funds. For example, if HHS observes that a grantee has
not withdrawn funds according to its schedule, they will contact the
grantee to determine the reason the grantee has not been withdrawing
funds. For grantees that received federal funds in excess of $500,000,
HHS monitors and reviews audit reports in accordance with the Single
Audit Act. According to HHS, its review of grantee Single Audit Act
reports covers compliance with audit standards, completeness,
timeliness, and other audit considerations.
As part of HHS's on-site monitoring, at least one HHS staff member will
interview grantee staff, review program documents, and in some
instances observe programs in operation. For example, when we
accompanied HHS during two grantee site visits in March of this year,
HHS and one of the grantees discussed challenges the grantee was
experiencing with recruiting participants. HHS discovered that the
grantee, whose target population included a rural district, was
struggling to meet its goal for the number of participants it initially
believed it would serve. The HHS official referred the grantee for
technical assistance in order to help it improve participant
recruitment and retention. HHS officials told us that monitoring site
visits was a priority for them and their goal was to visit all grantees
within the first 3 years of the award period. As of August 2008, HHS
told us that approximately 84 percent of grantees had received a site
visit from HHS since September of 2006, when the programs were first
funded. Our survey results confirmed that HHS had visited most of the
grantees in the first 2 years.[Footnote 12]
HHS Lacks Guidance for Conducting Site Visits and Other Monitoring
Activities:
HHS staff lack specific guidance for conducting site visits and other
monitoring activities, according to our interviews with HHS staff,
visits and interviews with grantees, and file reviews. As a result, the
length and types of issues reviewed and documentation examined by HHS
during site visits varied depending on who conducted the visit. HHS
officials told us that staff responsible for monitoring are to use the
legislation, grant announcements, and site visit protocol as guidance
to monitor grantee performance. Although legislation and grant
announcements provide some general guidance, they do not specifically
define what is permitted under each allowed activity. For example, the
grant announcement lists marriage education as an allowed activity for
some grantees, but does not specifically describe what marriage
education activities are permitted under the grant. We also found the
site visit protocol provided by HHS was limited to a checklist of
topics for HHS to cover during grantee site visits. The checklist did
not detail the process, the criteria for conducting monitoring site
visits, or the key items to be examined, leaving each monitoring staff
member the discretion to determine what information to gather and how
best to gather it. Moreover, we found other inconsistencies in how HHS
conducts monitoring visits. For example, during some monitoring site
visits, HHS staff observed grantees providing services while in other
instances they did not. According to HHS officials, HHS staff are
required only to observe services if the timing of the visit coincides
with services, but they are not required to schedule monitoring site
visits to coincide with sessions. Because some HHS officials do not
observe grantees providing services, they cannot confirm that the
services are in fact being provided or that the funding is being spent
as intended.
The lack of sufficient guidance from HHS may have led HHS staff to
inconsistently apply HHS policy among some grantees. For example,
through our interviews and file review, we found that some monitoring
staff members allowed several Healthy Marriage and Responsible
Fatherhood grantees to use incentives to retain program participants,
while others were told they were not permitted to use similar
incentives. From our review of grantee files, we found instances where
HHS staff worked with grantees to adjust or lower the goals they
developed for themselves to meet second-year targets. Other grantees
who did not meet their year-1 performance goals were not permitted to
adjust their performance targets. In another example, HHS officials
told us that abstinence education was not allowable under the Healthy
Marriage program, but we observed during our site visits and review of
grantee data several Healthy Marriage grantees operating programs that
focused on abstinence education.
HHS's Ability to Target Grantees Not in Compliance with Grant
Requirements or Not Meeting Performance Goals Is Hindered by the Lack
of an Effective Management Information System:
The lack of an effective management information system that captures
key information on individual grantees hinders HHS's ability to
appropriately identify which grantees are not in compliance with grant
requirements or are not meeting performance goals. Although it
maintains paper files on each grantee, the breadth and detail in these
files vary considerably. For example, some HHS staff keep very detailed
logs on grantees, while others maintain minimal records. Moreover, the
information in these files is not always used to target grantees in
need of assistance or to identify how grantees are using their funds.
For example, one grantee used grant funds to provide marriage education
services not allowed under its grant to participants. Although
information such as how grantees are using their funds should be
contained in the files, the grantee in this instance was notified
months after initiating services that the program was not allowed,
causing the grantee to use alternative sources of funding to provide
services. Moreover, through our case studies, we found instances where
grantees did not receive timely feedback on progress reports, documents
that are part of the files HHS maintains on individual grantees. These
files provide an early alert to problems grantees may be experiencing
and could potentially identify grantees at risk of not meeting
performance goals. Despite HHS having this information, some grantees
told us that they did not receive timely feedback from HHS, causing
them setbacks in implementing program activities.
Without an effective management information system, HHS has not been
able to take a strategic approach to conducting grantee site visits and
other monitoring activities. Although HHS told us that grantees
experiencing challenges should receive priority for site visits, our
review of a random sample of grantee files showed that several grantees
were having difficulty recruiting participants, yet HHS did not always
give them priority for on-site review. Moreover, during our site
visits, some grantees told us they were experiencing difficulty meeting
participation goals or recruiting the number of participants they
indicated to HHS they would serve through their program. These grantees
also were not targeted specifically for on-site monitoring.
Specifically, the decision of which grantees to visit and in what order
was left to the discretion of HHS staff, according to HHS officials.
Because grantees that were experiencing challenges did not always
receive priority for monitoring site visits and these site visits were
scheduled based on HHS staff scheduling preferences, we found that
monitoring was not always based on grantee risk or need.
HHS told us it is in the process of developing a database that will
help it standardize and combine grantee communications and performance
information. According to HHS, the first phase of the web-based
management information system has been completed. The system is
designed to replace the paper files and, according to HHS, will
considerably reduce or eliminate inconsistencies in HHS's
recordkeeping. The management information system will capture
performance indicators developed by the grantee and submitted
semiannually in grantee programmatic progress reports, such as
grantees' progress toward meeting participant recruitment goals and
changes in participant behavior. The new system should allow HHS to
better manage and search for grantee information, upload grantee
communications, and track data from grantee programmatic progress
reports. It is not clear, however, when HHS will be able to include
uniform performance indicators that it plans to collect from individual
grantees. HHS officials told us that performance indicators have been
developed, but are pending implementation while they are currently
under review by the Office of Management and Budget. HHS said it
anticipates having grantees begin collecting data in autumn or early
winter of 2008, the start of the third year of funding for the 5-year
initiative. According to HHS, the uniform performance indicators will
eventually be part of its planned management information system.
HHS Has Long-term Research Underway Intended to Assess Program Impact:
HHS has four multiyear studies of marriage and fatherhood programs
underway that are intended to assess the impact of the programs on
various populations and understudied groups, the final results of which
are expected between 2011 and 2013. Funded partially by the DRA, HHS
awarded contracts to three organizations--RTI International;
Mathematical Policy Research; and MDRC--that competitively bid to
conduct the evaluations, which run over several years and across
several marriage or fatherhood programs.[Footnote 13] Two of the impact
studies will exclusively follow grantees funded under the Healthy
Marriage and Responsible Fatherhood Initiative, while the other two
studies will follow a mix of grantees and healthy marriage programs not
funded under the Initiative. In all cases, the programs being studied
primarily offer participants skills-based marriage or fatherhood
education. The primary focus of HHS's research is to determine the
impact, if any, marriage and fatherhood programs have on couples,
families, and fathers as a result of participation in the programs.
Impact evaluations are the strongest method for assessing the efficacy
of a program because they allow for a comparison between similar groups
that differ only with respect to whether they received a service or
"treatment." However, they often are difficult and expensive to conduct
because they take years to complete and it often is difficult to retain
enough participants to produce meaningful results. Prior research has
focused on the impact of marriage services on middle-income families
and couples. A review of the literature, sponsored by HHS, on the
overall impact of marriage and relationship programs found that, on
average, middle-income couples receiving services showed increased
relationship satisfaction and improved communication skills. HHS's
research agenda represents the first major federal effort to study the
impact of healthy marriage and responsible fatherhood programs on low-
income populations and is part of a wider body of research being
developed by HHS.[Footnote 14]
Two of the three healthy marriage studies--the Building Strong Families
(BSF) and the Supporting Healthy Marriage (SHM) evaluations--focus on
low-income couples who are expecting or have recently had a child. The
BSF is following 5,103 low-income unmarried couples across seven
marriage programs around the time of the birth of a child using data
collected at three stages of participants' lives. The SHM study is
examining the effects of healthy marriage programs on 6,860 married
couples across eight marriage programs. The third healthy marriage
study--the Community Healthy Marriage Initiative--expands its focus
beyond specific target populations to entire communities: the
initiative is comparing couples in three different geographic
communities with federally funded healthy marriage programs--
Milwaukee, Wisconsin; Dallas, Texas; and St. Louis, Missouri--with
three demographically similar communities--Cleveland, Ohio; Ft. Worth,
Texas; and Kansas City, Missouri--where there are no federally funded
healthy marriage programs. The study, which involves 4,200
participants, will explore whether the presence of intensive healthy
marriage programs promotes changes in attitudes and behavior toward
marriage in the communities being studied. In addition to the three
healthy marriage evaluations, HHS also is funding an impact evaluation
of Responsible Fatherhood programs. The National Evaluation of the
Responsible Fatherhood, Marriage and Family Strengthening Grants for
Incarcerated and Re-entering Fathers and Their Partners (MFS-IP) began
in 2006, when the first year of Responsible Fatherhood funds became
available, and is currently enrolling participants. The MFS-IP, much
like the three marriage studies, will explore changes in couple quality
and changes in attitudes toward marriage. In addition, the MFS-IP will
assess changes in outcomes for employment and economic stability, in
line with the parameters of activities allowed under the legislation
for Responsible Fatherhood grantees (see fig. 8).
Figure 8: HHS Healthy Marriage and Responsible Fatherhood Impact
Research Studies:
This figure is a diagram showing HHS healthy marriage and responsible
fatherhood impact research studies.
[See PDF for image]
Source: Data provided by HHS.
[A] The official title of this Impact Study is "The National Evaluation
of the Responsible Fatherhood, Marriage and Family Strengthening Grants
for Incarcerated and Re-entering Fathers and Their Partners."
[End of figure]
For all four studies, evaluators will collect outcome data for the
couples participating in programs at various stages of the study and
then compare the results against groups of couples who did not
participate in the programs. Because the two groups are, by nature of
the study design, similar in every major respect, any differences
between the two groups can be attributed to the program. The evaluators
for the four studies differed on the methods they used to create these
two groups. Two of the four studies, the BSF and the SHM, randomly
assign couples to either a group that receives services (the
experimental group) or group that does not (the control group). The
other two studies are quasi-experimental. This type of study uses
methods other than random assignment to create a comparison group, such
as selecting a set of individuals who have similar characteristics to
the group receiving the program services under study.
To compare these groups in the four studies over time, the evaluators
are conducting surveys and interviews, generally 1 year and 3 years
after participating in a program, in order to gauge couples' and
families' outcomes. The surveys ask questions about how couples are
communicating after participating in a program; whether they are using
the skills they learned in the program; and how they would rate,
overall, the quality of their relationship since participating in the
program. The evaluators also will administer the same surveys to the
couples not participating in Healthy Marriage or Responsible Fatherhood
programs in order to make comparisons between the two groups. For
example, the BSF study will examine a range of outcomes, including
whether marriage services improved marital relationships, reduced
marital instability, and improved child well-being.
In general, we found the evaluations to be well-designed and rigorous,
however, there are inherent difficulties presented by the Community
Healthy Marriage Initiative, which assesses the impact of healthy
marriage programs on entire geographic areas. Specifically, it may be
difficult to find and study true comparison communities. One positive
feature of the study is the collection of baseline data for each of the
participating communities; however, it is difficult to determine if the
contractors have captured and controlled for the important variables
needed to match the communities. In addition, it will be difficult to
determine if changes in the community stem from Healthy Marriage
program services or some other factors.
Conclusions:
Marriage and fatherhood programs have emerged as a national strategy
for improving the well-being of children. The federal government has
committed $150 million annually for 5 years for these programs and
provided for an evaluation the Healthy Marriage and Responsible
Fatherhood Initiative to determine how well the Initiative is working
for low-income populations. While HHS has made an effort to visit
nearly all of the programs in their first 2 years of operations, absent
mechanisms for detecting grantee compliance and performance issues,
some grantees did not receive monitoring and technical assistance soon
enough and had to make modifications to their program well into
implementation. Moreover, effective monitoring was hampered by a lack
of an effective management information system that captures key
information, including uniform performance indicators for grantees, and
the lack of consistent and clear monitoring guidance. Without an
effective monitoring system or clear and consistent monitoring
guidance, grantees may continue to be at risk of noncompliance with HHS
policy or of not meeting performance requirements.
Recommendations for Executive Action:
In order to improve monitoring and oversight of Healthy Marriage and
Responsible Fatherhood grantees, we are recommending that the Secretary
of HHS:
* employ a risk-based approach to monitoring grantees and conducting
grantee site visits, using its planned management information system
and information from both progress reports and uniform performance
indicators to help identify those grantees at risk of not meeting
performance goals or not in compliance with grant requirements; and:
* create clear, consistent guidance and policy for monitoring Healthy
Marriage and Responsible Fatherhood grantees.
Agency Comments and Our Evaluation:
We provided a draft of this report to HHS for its comments; these
appear in appendix V. In its comments, HHS concurred with our
recommendation that it employ a risk-based approach to monitoring using
its planned management information system and performance indicators to
help identify grantees for monitoring, saying these tools would further
enhance oversight and monitoring efforts currently underway. In its
comments, HHS states that it has already developed and implemented this
portion of the recommendation, including developing a customized
approach to prioritizing site visits and technical assistance. However,
HHS caveats that only the first phase of its web-based management
information system has been completed and that performance indicators
that would help them identify those grantees at risk, are still
awaiting approval by OMB. A fully implemented management information
system with performance indicators in place will further enhance HHS's
ability to monitor grantees based on risk.
HHS disagreed with the portion of our recommendation that HHS lacks
specific guidance for conducting monitoring site visits. In its
comments, HHS stated that it developed a clear, comprehensive, and
thorough protocol and trained project officers on the critical and
essential items that must be covered during grantee site visits. As we
stated in our report, this protocol was limited to a checklist of
topics to be covered during the site visit and did not describe the
process to be followed or criteria to be used to monitor grantees.
Moreover, the lack of clarity in this protocol may have contributed to
the inconsistencies in how site visits were administered by HHS staff,
as noted in our report.
HHS also stated in its response that fiscal oversight or monitoring a
grantee's fiscal compliance can be used as an alternative mechanism to
confirm whether grantees are providing services or spending funds as
the grant intended. While we agree that monitoring grantee's fiscal
compliance is essential, HHS's comments do not change our view that
observing activities is critical to confirming that grantees are
actually providing services as intended by the grant.
Finally, HHS commented on our finding that some grantees were operating
programs focused on abstinence education. HHS stated that it is
impermissible to use Deficit Reduction Act (DRA) funding for abstinence
education, however, grantees may use funding from other sources to
provide abstinence education through programs separate from the Healthy
Marriage and Fatherhood programs. We visited one such program whose
staff told us that they used DRA funding to support their abstinence
education program and that abstinence education was not provided as a
single lesson, but was the focus of the entire curriculum.
HHS also provided technical changes to a draft of the report, which we
incorporated into the report as appropriate.
As agreed with your office, unless you publicly announce its contents
earlier, we plan no further distribution of this report until 30 days
after its issue date. At that time, we will send copies of this report
to the Honorable Michael O. Leavitt, Secretary of Health and Human
Services, relevant congressional committees, and other interested
parties. In addition, the report will be available at no charge on
GAO's Web site at [hyperlink, http://www.gao.gov]. Please contact me on
(202) 512- 7215 if you or your staff have any questions about this
report. Contact points for our offices of Congressional Relations and
Public Affairs may be found on the last page of this report. Key
contributors to this report are listed in appendix VI.
Sincerely yours,
Signed by:
Kay E. Brown:
Director, Education, Workforce, and Income Security Issues:
[End of section]
Appendix I: Objective, Scope, and Methodology:
To gain insight into how Healthy Marriage and Responsible Fatherhood
programs are being implemented, we were asked to report on (1) how the
Department of Health and Human Services (HHS) awarded grants and the
types of organizations that received funding; (2) the activities and
services grantees are providing, including those for domestic violence
victims; (3) the manner in which HHS monitors and assesses program
implementation and use of funds; and (4) how program impact is
measured.
To address the objectives, we conducted a Web-based survey of 122
Healthy Marriage and 94 Responsible Fatherhood grantees asking them to
provide information about various aspects of their programs. We
received a response rate of 98 percent. We also visited 14 grantees in
Washington, Oklahoma, New Mexico, Indiana, Oregon, and the District of
Columbia. In addition, we conducted telephone interviews with
organizations that provide technical assistance to grantees and help
other organizations develop fatherhood programs. To further understand
the criteria HHS used to award grants and the manner in which HHS
monitors and assesses program implementation, we reviewed 50 grantee
case files, 40 randomly and 10 deliberately selected, examining
documents such as applications, semiannual progress and financial
reports, grantee selection panel score sheets, and correspondences
between the grantees and agency officials. To determine how program
impact is measured, we interviewed organizations that received
contracts to conduct impact evaluations of Healthy Marriage and
Responsible Fatherhood interventions and assessed their methodological
approach to measuring impact.
Survey of Marriage and Fatherhood Programs:
To address all of our objectives, we conducted a Web-based survey of
all 216 demonstration grantees that provided direct services to
participants, 122 Healthy Marriage and 94 Responsible Fatherhood
grantees.[Footnote 15] We asked grantees about various aspects of their
programs, including the characteristics of their organization, services
they offered, experience providing similar services, curricula used,
their process and procedures for identifying domestic violence, staff
training; and any evaluations the grantees were conducting on their
own. In order to identify respondents for our survey, we obtained lists
of grantees and contact information from HHS's Administration for
Children and Families and their Office of Grants Management. We
compared the two lists to compile the most accurate list of grant
recipients and contact information. In some cases, we contacted the
organization directly to determine the appropriate contact person and
obtain updated information. Of the 216 grantees contacted, 211 provided
information, for a response rate of 98 percent. The survey data was
collected from February 2008 to April 2008.
Because this was not a sample survey, it has no sampling errors.
However, the practical difficulties of conducting any survey may
introduce errors, commonly referred to as nonsampling errors. For
example, difficulties in interpreting a particular question, sources of
information available to respondents, or entering data into a database
or analyzing them can introduce unwanted variability into the survey
results. We took steps in developing the questionnaire, collecting the
data, and analyzing them to minimize such nonsampling error. For
example, prior to launching our survey, we worked with social science
survey specialists to develop the questionnaire and minimize error. We
tested the content and format of the questionnaire with multiple
grantees prior to administering the survey to address issues such as
differences in question interpretation, and differences in data
tracking. We conducted 10 survey pretests. As a result of our pretests,
we changed survey questions as appropriate and tested those changes
with grantees that participated in our original pretests. Further, the
final pretests were performed using the Web-based survey tool, which
checked for accuracy and usability. To ensure grantees responded to the
survey, we sent e-mail reminders and conducted follow-up telephone
calls with nonrespondents. Since this was a Web-based survey,
respondents entered their answers directly into the electronic
questionnaire, eliminating the need to key data into a database,
minimizing error. We used content coding, computer edits, and
independent analysts to assess the reliability of the information
collected.
Site Visits to 14 Grantees:
To gather information to respond to all of these questions, we visited
14 grantees--9 Healthy Marriage grantees and 5 Responsible Fatherhood
grantees--in Washington, Oklahoma, New Mexico, Indiana, Oregon, and the
District of Columbia. We selected grantees to achieve variation in
geographic location, type of grant awarded, award amount, services,
organization type, program curriculum, and the programs' target
populations. During each site visit we asked the grantees about the
grant application process and their programs, including accessibility
of funds, services provided, guidance and communication with HHS, and
challenges the grantees experienced. During seven of these site visits,
we observed the implementation of marriage and fatherhood services.
Further, we also observed HHS staff in the process of conducting two
grantee site visits. In analyzing our site visit interviews we arrayed
and analyzed narrative responses thematically. The site visits were
conducted from December 2007 through April 2008.
File Review:
Further, to learn about the criteria used to award grants and HHS's
monitoring activities, we conducted a review of 50 grantee case files
out of the total 229 grants awarded in September 2006. We conducted a
simple random sample of 40 Healthy Marriage and Responsible Fatherhood
grantee case files--28 Healthy Marriage grantees and 12 Responsible
Fatherhood grantees. We also deliberately selected and reviewed an
additional 10 grantee case files; the team deliberately reviewed case
files for 1 technical assistance grantee, 6 grantees that assist other
organizations with developing fatherhood programs, and 3 grantees we
visited. During the case file review, we examined documents contained
in the grantee's case file including, the grantee's original and
continuation application, semiannual progress and financial reports,
grantee selection panel score summary sheets, correspondences between
the grantee and agency officials, and site visit reports. We reviewed
the documents to assess HHS's compliance with its grants policy manual
and to understand how HHS monitors use of funds. We also reviewed
Single Audit Reports for the selected sample of grantees. To facilitate
the case file review, we developed a data collection instrument to
record specific information for each case file reviewed. We used
content coding to analyze the qualitative information from our data
collection instrument. We conducted our review on-site at HHS's
Administration for Children and Families.
Review of Internal HHS Documents and Interviews with HHS Officials:
We also reviewed the HHS grant selection criteria included in the grant
announcements and HHS's internal guidance on grant selection processes
which we compared to the selection of Healthy Marriage and Responsible
Fatherhood grant recipients. In addition to these reviews, we
interviewed HHS and the contractor responsible for hiring reviewers and
organizing the review panels.
To determine how HHS measures program impact, we collected survey
instruments, design papers, and program guidelines for each of the four
impact evaluations underway in order to assess their methodological
soundness. In addition, we interviewed HHS staff responsible for
overseeing the contractors responsible for the impact evaluations. To
gauge how HHS is monitoring the progress of grantees, we interviewed
HHS staff regarding its process for monitoring grantees, including
guidance used and staff training provided to determine how HHS monitors
and assesses program implementation and use of funds.
Interviews with Experts:
To identify critical components that should be included in services
provided by grantees, we interviewed multiple experts in the areas of
marriage, fatherhood, and domestic violence. We also interviewed
grantees and contractors that were not direct providers of healthy
marriage and responsible fatherhood services but received funding under
the Healthy Marriage and Responsible Fatherhood Initiative to provide
technical assistance to demonstration grantees, conduct research, and
help other organizations develop fatherhood programs.
We conducted this performance audit from July 2007 to September 2008,
in accordance with generally accepted government auditing standards.
Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe that
the evidence obtained provides a reasonable basis for our findings and
conclusions based on our audit objectives.
[End of section]
Appendix II: Grantee Selection Criteria:
Criteria: Approach;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 40;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 40;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): 35;
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 40;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): 40;
Score values: Healthy Marriage Resource Center (1 grant awarded): 45.
Criteria: Staff and position data;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): [Empty];
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): [Empty];
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): [Empty];
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): [Empty];
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): 20;
Score values: Healthy Marriage Resource Center (1 grant awarded): 15.
Criteria: Results and benefits expected;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): [Empty];
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): [Empty];
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): [Empty];
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): [Empty];
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): 15;
Score values: Healthy Marriage Resource Center (1 grant awarded): .
Criteria: Objectives and need for assistance;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 10;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 10;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): 15;
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 10;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): 15;
Score values: Healthy Marriage Resource Center (1 grant awarded): .
Criteria: Budget and budget justification;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 15;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 15;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): 15;
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 15;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): 10;
Score values: Healthy Marriage Resource Center (1 grant awarded): 20.
Criteria: Organizational profile;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 20;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 20;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): 20;
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 20;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): [Empty];
Score values: Healthy Marriage Resource Center (1 grant awarded): 20.
Criteria: Evaluation;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 15;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 15;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): 15;
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 15;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): [Empty];
Score values: Healthy Marriage Resource Center (1 grant awarded):
[Empty].
Criteria: Experience (bonus points);
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 5;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 5;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): [Empty];
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 5;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): [Empty];
Score values: Healthy Marriage Resource Center (1 grant awarded):
[Empty].
Criteria: Total score possible;
Score values: Healthy Marriage Demonstration Grants (122 grants
awarded): 105;
Score values: Promoting Responsible Fatherhood Grants (94 grants
awarded): 105;
Score values: National Fatherhood Capacity-Building Grants (1 grant
awarded): 100;
Score values: Promoting Responsible Fatherhood Community Access (5
grants awarded): 105;
Score values: Healthy Marriage/ Responsible Fatherhood Research
Initiative (3 grants awarded): 100;
Score values: Healthy Marriage Resource Center (1 grant awarded): 100.
Source: Healthy Marriage and Responsible Fatherhood grant
announcements.
[End of table]
[End of section]
Appendix III: States and Territories with Grantees That Provide Direct
Services to Participants as of February 2008:
State or territory: Alabama;
Number of Healthy Marriage grantees: 2;
Number of Responsible Fatherhood grantees: 0;
Total: 2.
State or territory: Alaska;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: American Samoa;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 0;
Total: 1.
State or territory: Arizona;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 1;
Total: 4.
State or territory: Arkansas;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 1;
Total: 2.
State or territory: California;
Number of Healthy Marriage grantees: 10;
Number of Responsible Fatherhood grantees: 9;
Total: 19.
State or territory: Colorado;
Number of Healthy Marriage grantees: 6;
Number of Responsible Fatherhood grantees: 3;
Total: 9.
State or territory: Connecticut;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 2;
Total: 2.
State or territory: Delaware;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: District of Columbia;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 3;
Total: 3.
State or territory: Florida;
Number of Healthy Marriage grantees: 10;
Number of Responsible Fatherhood grantees: 3;
Total: 13.
State or territory: Georgia;
Number of Healthy Marriage grantees: 4;
Number of Responsible Fatherhood grantees: 3;
Total: 7.
State or territory: Hawaii;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: Idaho;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: Illinois;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 2;
Total: 5.
State or territory: Indiana;
Number of Healthy Marriage grantees: 5;
Number of Responsible Fatherhood grantees: 2;
Total: 7.
State or territory: Iowa;
Number of Healthy Marriage grantees: 2;
Number of Responsible Fatherhood grantees: 1;
Total: 3.
State or territory: Kansas;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 0;
Total: 1.
State or territory: Kentucky;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 1;
Total: 4.
State or territory: Louisiana;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 2;
Total: 2.
State or territory: Maine;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 1;
Total: 2.
State or territory: Maryland;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 4;
Total: 7.
State or territory: Massachusetts;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 0;
Total: 1.
State or territory: Michigan;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 6;
Total: 9.
State or territory: Minnesota;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 4;
Total: 4.
State or territory: Mississippi;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 0;
Total: 1.
State or territory: Missouri;
Number of Healthy Marriage grantees: 5;
Number of Responsible Fatherhood grantees: 1;
Total: 6.
State or territory: Montana;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 2;
Total: 2.
State or territory: Nebraska;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 0;
Total: 0.
State or territory: Nevada;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 0;
Total: 0.
State or territory: New Hampshire;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: New Jersey;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: New Mexico;
Number of Healthy Marriage grantees: 5;
Number of Responsible Fatherhood grantees: 1;
Total: 6.
State or territory: New York;
Number of Healthy Marriage grantees: 4;
Number of Responsible Fatherhood grantees: 7;
Total: 11.
State or territory: North Carolina;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 1;
Total: 4.
State or territory: North Dakota;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 0;
Total: 0.
State or territory: Ohio;
Number of Healthy Marriage grantees: 7;
Number of Responsible Fatherhood grantees: 3;
Total: 10.
State or territory: Oklahoma;
Number of Healthy Marriage grantees: 2;
Number of Responsible Fatherhood grantees: 1;
Total: 3.
State or territory: Oregon;
Number of Healthy Marriage grantees: 2;
Number of Responsible Fatherhood grantees: 1;
Total: 3.
State or territory: Pennsylvania;
Number of Healthy Marriage grantees: 6;
Number of Responsible Fatherhood grantees: 5;
Total: 11.
State or territory: Rhode Island;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: South Carolina;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: South Dakota;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 2;
Total: 2.
State or territory: Tennessee;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 2;
Total: 3.
State or territory: Texas;
Number of Healthy Marriage grantees: 15;
Number of Responsible Fatherhood grantees: 6;
Total: 21.
State or territory: Utah;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 0;
Total: 1.
State or territory: Vermont;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: Virginia;
Number of Healthy Marriage grantees: 3;
Number of Responsible Fatherhood grantees: 2;
Total: 5.
State or territory: Washington;
Number of Healthy Marriage grantees: 2;
Number of Responsible Fatherhood grantees: 1;
Total: 3.
State or territory: West Virginia;
Number of Healthy Marriage grantees: 0;
Number of Responsible Fatherhood grantees: 1;
Total: 1.
State or territory: Wisconsin;
Number of Healthy Marriage grantees: 5;
Number of Responsible Fatherhood grantees: 1;
Total: 6.
State or territory: Wyoming;
Number of Healthy Marriage grantees: 1;
Number of Responsible Fatherhood grantees: 0;
Total: 1.
State or territory: Total;
Number of Healthy Marriage grantees: 122;
Number of Responsible Fatherhood grantees: 94;
Total: 216.
Source: GAO analysis of HHS-provided data.
Note: These data represent Healthy Marriage and Responsible Fatherhood
demonstration grantees only.
[End of table]
[End of section]
Appendix IV: Curricula Being Used by Healthy Marriage and Responsible
Fatherhood Grantees and Frequency of Use:
Name of curriculum: ORG Designed[A];
Number of Healthy Marriage grantees using curriculum: 44;
Number of Responsible Fatherhood grantees using curriculum: 37.
Name of curriculum: Prevention and Relationship Enhancement Program
(PREP)[A];
Number of Healthy Marriage grantees using curriculum: 41;
Number of Responsible Fatherhood grantees using curriculum: 12.
Name of curriculum: PREPARE/ENRICH[A];
Number of Healthy Marriage grantees using curriculum: 28;
Number of Responsible Fatherhood grantees using curriculum: 6.
Name of curriculum: 24/7[A];
Number of Healthy Marriage grantees using curriculum: 2;
Number of Responsible Fatherhood grantees using curriculum: 21.
Name of curriculum: Practical Application of Intimate Relationship
Skill (PAIRS)a;
Number of Healthy Marriage grantees using curriculum: 19;
Number of Responsible Fatherhood grantees using curriculum: 3.
Name of curriculum: Premarital Interpersonal Choices & Knowledge
(PICK)/ a.k.a. How to Avoid Marrying a Jerk or Jerkette[A];
Number of Healthy Marriage grantees using curriculum: 18;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Focus and Re-focus[A];
Number of Healthy Marriage grantees using curriculum: 11;
Number of Responsible Fatherhood grantees using curriculum: 2.
Name of curriculum: Nurturing Fathers;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 11.
Name of curriculum: Connections;
Number of Healthy Marriage grantees using curriculum: 10;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: Love's Cradle;
Number of Healthy Marriage grantees using curriculum: 8;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: WAIT[A];
Number of Healthy Marriage grantees using curriculum: 8;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: LoveU2;
Number of Healthy Marriage grantees using curriculum: 6;
Number of Responsible Fatherhood grantees using curriculum: 2.
Name of curriculum: Family Wellness;
Number of Healthy Marriage grantees using curriculum: 7;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Fragile Families[A];
Number of Healthy Marriage grantees using curriculum: 3;
Number of Responsible Fatherhood grantees using curriculum: 5.
Name of curriculum: Mastering the Magic of Love;
Number of Healthy Marriage grantees using curriculum: 5;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Inside Out Dads;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 5.
Name of curriculum: Loving Couples Loving Children;
Number of Healthy Marriage grantees using curriculum: 5;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: STEP[A];
Number of Healthy Marriage grantees using curriculum: 3;
Number of Responsible Fatherhood grantees using curriculum: 2.
Name of curriculum: Ten Great Dates;
Number of Healthy Marriage grantees using curriculum: 3;
Number of Responsible Fatherhood grantees using curriculum: 2.
Name of curriculum: Responsible Fatherhood;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 4.
Name of curriculum: Active Relationships;
Number of Healthy Marriage grantees using curriculum: 3;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Basic Training for Couples;
Number of Healthy Marriage grantees using curriculum: 3;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: Fatherhood Development;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 3.
Name of curriculum: Quenching the Fathers Thirst;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 3.
Name of curriculum: Smart Steps for Stepfamilies;
Number of Healthy Marriage grantees using curriculum: 3;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: Eight Habits of Successful Marriages;
Number of Healthy Marriage grantees using curriculum: 2;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Relationship Enhancement;
Number of Healthy Marriage grantees using curriculum: 2;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Bringing Baby Home;
Number of Healthy Marriage grantees using curriculum: 2;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: Choosing the Best;
Number of Healthy Marriage grantees using curriculum: 2;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: Power of Two;
Number of Healthy Marriage grantees using curriculum: 2;
Number of Responsible Fatherhood grantees using curriculum: 0.
Name of curriculum: Preparing for Successful Fathering;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 2.
Name of curriculum: Effective Black Parenting;
Number of Healthy Marriage grantees using curriculum: 0;
Number of Responsible Fatherhood grantees using curriculum: 2.
Name of curriculum: Building Blocks for Successful Relationships and
Parenting;
Number of Healthy Marriage grantees using curriculum: 1;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Financial Literacy;
Number of Healthy Marriage grantees using curriculum: 1;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: LINKS;
Number of Healthy Marriage grantees using curriculum: 1;
Number of Responsible Fatherhood grantees using curriculum: 1.
Name of curriculum: Married and Loving It;
Number of Healthy Marriage grantees using curriculum: 1;
Number of Responsible Fatherhood grantees using curriculum: 1.
Source: GAO analysis of Healthy Marriage and Responsible Fatherhood
grantees' responses to survey.
Note: These data are from our survey question regarding curricula and
include data from the options listed and those provided in the optional
write-in box. In addition to these curricula listed, 59 grantees
provided the name of a curriculum that only 1 grantee reported using.
[A] Denotes curricula listed in survey question. Others provided in
written responses by grantees.
[End of table]
[End of section]
Appendix V: Comments from the Department of Health and Human Services:
Department Of Health & Human Services:
Office Of The Secretary:
Assistant Secretary for Legislation:
Washington, DC 20201:
September 17, 2008:
Kay E. Brown:
Director:
Education, Workforce, and Income Security:
Government Accountability Office:
441 G Street NW:
Washington, DC 20548:
Dear Ms. Brown:
Enclosed are the Department's comments on the U.S. Government
Accountability Office's (GAO) draft report entitled: "Healthy Marriage
and Responsible Fatherhood Initiative: Risk- Based Monitoring Would
Help Improve Program Oversight" (GAO-08-1002).
The Department appreciates the opportunity to review and comment on
this report before its publication.
Sincerely,
Jennifer R. Luong:
for:
Vincent J. Ventimiglia, Jr.:
Assistant Secretary for Legislation:
Attachment:
Department Of Health & Human Services:
Administration For Children And Families:
Office of the Assistant Secretary, Suite 600:
370 L'Enfant Promenade, S.W.:
Washington, D.C. 20447:
September 16, 2008:
To: Vincent J. Ventimiglia, Jr.:
Assistant Secretary for Legislation:
From: Daniel C. Schneider:
Acting Assistant Secretary for Children and Families
Subject: Government Accountability Office (GAO) Draft Report Titled,
"Healthy Marriage and Responsible Fatherhood Initiative: Risk-Based
Monitoring Would Help HHS Improve Program Oversight" (GAO-08-1002)
Attached are comments of the Administration for Children and Families
on the above-referenced GAO draft report.
Should you have questions or need additional information, please
contact Robin McDonald, Director, Division of State Territory TANF
Management, at (202) 401-5587.
Attachment:
Comments Of The Administration For Children And Families On The
Government Accountability Office's Draft Report Titled, "Healthy
Marriage And Responsible Fatherhood Initiative: Risk- Based Monitoring
Would Help HHS Improve Program Oversight" (GAO-08-1002):
The Administration for Children and Families (ACF) appreciates the
opportunity to comment on the Government Accountability Office's draft
report. ACF is responding to GAO's recommendations as well as other
critical items mentioned in the report.
GAO Recommendations:
In order to improve monitoring and oversight of Healthy Marriage and
Responsible Fatherhood grantees, we are recommending that the Secretary
of HHS:
* Employ a risk-based approach to monitoring grantees and conducting
grantee site visits, using its planned management information system
and information from both progress reports and uniform performance
indicators to help identify those grantees at risk of not meeting
performance goals or not in compliance with grant requirements, and
* Create clear, consistent guidance and policy for monitoring Healthy
Marriage and Responsible Fatherhood grantees.
ACF General Comments:
To the extent that ACF's Office of Family Assistance has been proactive
in implementing the GAO recommendations prior to the report's findings,
ACF requests that these measures be incorporated in the overview
section of the report.
ACF Comments on heading, "What GAO Found":
* First paragraph, first sentence, "HHS adapted its existing process in
order to award Healthy Marriage and Responsible Fatherhood grants." –
The present language suggests that there was irregularity in the
process. Consistent with departmental protocol, HHS followed its
existing process; however, the prescribed timeframe was limited due to
the delay in signing the legislation in February 2006.
* Third paragraph – Please see "Pages 4-5, last paragraph, last
sentence –" on page 2 hereof for OFA's full comment.
ACF Comments on Full Report:
Page 1, paragraph 1, fifth and sixth sentences – While it is
appropriate to state that the HM/RF initiative supports two goals under
the Temporary Assistance for Needy Families (TANF) program, it should
be made clear that these are discretionary grant programs and are not
funded under the TANF block grant.
Page 2, second paragraph, first sentence and footnote 1 – It should be
noted that the Responsible Fatherhood Community Access grants provide
technical assistance, etc., to sub-awardees that provide direct
services. This means that there are several other organizations
providing direct services to grantees. ACF requests that footnote 1
included a statement to that effect. ACF also requests that the last
sentence of footnote 1 be changed to read, "Since making the initial
awards, 5 organizations have relinquished their grants, 6 were slated
for non-continuation of future funding, and 1 new grant was awarded."
Page 4, second paragraph – Performance data was not available until
April 2007, shortly before the period of this study. During that time,
ACF/OFA developed site-monitoring protocols and other tools and trained
FPOs to use them in preparation for their visits. Copies of the site
visit protocols were provided to GAO.
Before FPOs had the benefit of the semi-annual reports, ACF/OFA
launched a vigorous plan to conduct 50 percent of grantee site
monitoring visits by the end of the first budget year. In accordance
with the program announcements, the grantee programs had a 90-day start
up period, followed by program implementation. By the programs' mid-
budget year, the grantees had been operating, i.e., providing direct
services, for approximately 3 months.
Following the first semi-annual report, and subsequently the second,
ACF/OFA developed and implemented a more targeted, customized approach
to prioritizing site visits and technical assistance to enhance its
preliminary strategy of FPO oversight from the program's inception. An
initial performance assessment by the FPOs revealed that 30 grantees
were in need of high- intensity technical assistance. Each of those
grantees was placed on a Corrective Action Plan (CAP) with specific,
time-limited tasks to rectify program deficiencies. Technical
assistance teams were directed to provide customized, on-site and
follow-up TA to ensure grantee progress. These proactive corrective
measures resulted in most grantees (23) achieving or exceeding the 75
percent performance improvement targets, while 6 grantees were slated
for non-continuation of future funding and 1 grantee decided to
relinquish because of their inability to demonstrate adequate progress.
Pages 4-5, last paragraph, last sentence – Development of the first
phase of the web-based management information system (MIS) has been
completed and FPOs have been trained on its usage”well in advance of
the intended fall 2008 target deadline. This system is designed to
replace the paper files that GAO describes and will considerably reduce
or eliminate the inconsistencies described. Throughout its report, GAO
frequently cites as a deficiency HHS/ACF's lack of uniform performance
indicators. GAO was made aware during its interview with Federal staff
that such indicators require clearance from the Office of Management
and Budget (OMB), which can take at least 120 days for completion. ACF
is pleased to report these indicators have been submitted to OMB for
review. ACF anticipates final approval by the end of calendar year
2008.
Page 5, second paragraph (recommendations re: monitoring grantees
utilizing the MIS system) – As ACF has indicated in its prior comments,
ACF/OFA has undertaken implementation of a grant monitoring strategy
that prioritizes and provides targeted and customized technical
assistance to struggling grantees.
Page 5, second paragraph, last sentence – Suggest changing to read,
"Results from these studies will not be available until after the
current appropriation for the Healthy Marriage and Responsible
Fatherhood Initiative expires after Fiscal Year 2010."
Page 6, second paragraph – See "Page 1, paragraph 1, fifth and sixth
sentences –" on page 1 hereof for needed clarification of HM/RF's
relationship with TANF.
Page 6, footnote 2 – Change to: "The DRA restricted HHS to awarding no
more than $50 million each year for Responsible Fatherhood activities
and $2 million each year for coordination between Tribal TANF and child
welfare services."
Page 9, graph – ACF requests that GAO revise the reference to tribal
child welfare expenditures to reflect that these expenditures are
specifically authorized by the Deficit Reduction Act (DRA). These
expenses make up 1 percent of the total, and it may be helpful to
separate this out from "Other" so that this category is only 3 percent
instead of 4 percent.
Page 9, Note (below graph) – The last statement about 2007 money in
2006 contracts is for TANF-related activities (rapid response technical
assistance), so ACF does not believe the last statement is necessary as
it is covered in the first part of the sentence. As stated immediately
above, an additional 1 percent of this "Other" category is tribal TANF
child welfare services as specified in the DRA. ACF believes this
should either be labeled as a separate slice of the pie or listed first
in the note, as it is one of the activities explicitly allowed under
DRA.
Page 10, first paragraph – See first bullet on page 1 hereof.
Page 10, second paragraph – The length of time that program
announcements were posted was reduced to accommodate the shortened time
period between the signed legislation (February 2006) and award
deadline (September 30, 2006). Had this accommodation not occurred, the
grants would not have been awarded in a timely manner and HHS would
have risked loss of the first year's appropriation.
GAO lists "students" among the list of reviewer characterizations.
However, GAO does not clarify that "student" reviewers in this category
were at the graduate or professional level. No one under the age of 21
was permitted to serve as a peer reviewer.
Page 12, footnote 6 – OFA recommends revising the note to reflect that
one grantee was funded after the re-review, not several.
Additionally, the eight-hour curriculum mentioned on this page was a
requirement described in the program announcement. ACF recommends that
GAO include in footnote 7 a statement that reflects that all applicants
had advance knowledge of this requirement and are responsible for
assuring their compliance.
Page 19, bottom paragraph, last sentence – Suggest changing to read,
"An administrative complaint was filed with HHS's Office for Civil
Rights by a legal advocacy organization centering on whether women have
equal access to the program, and in April 2007, HHS reminded grantees
that the Responsible Fatherhood programs are open to all eligible men
and women, i.e., fathers or mothers."
Page 22, last paragraph – OFA disagrees that HHS lacks specific
guidance to conduct monitoring site visits. To the contrary, OFA
developed a clear, comprehensive, and thorough protocol and trained
FPOs on the critical and essential items that must be covered during
the site visits. Copies of the site visit protocols were provided to
GAO. As previously stated, ACF/OFA's proactive, comprehensive
performance assessment and corrective action resulted in most grantees
(23) achieving or exceeding specified performance improvement targets.
Further, because of their inability to demonstrate adequate progress, 6
grantees were slated for non-continuation of their funding for
subsequent years and 1 grantee decided to relinquish its grant.
Page 23, footnote 9 – Given the technical assistance conferences,
Webinars, phone calls, emails, correspondence, site visits and
teleconferences, ACF considers it unlikely that there were two grantees
that never received contact with Federal staff.
Page 25, top paragraph – GAO suggests that FPOs are unable to confirm
whether services are, in fact, being provided is directly related to
whether or not HHS can confirm whether funding is being spent as
intended. This is incorrect. Observing a class is only one of several
ways that HHS provides grant fiscal and programmatic oversight. ACF's
Office of Grants Management, as the fiscal agent for these
discretionary programs, has established reporting systems and protocols
for managing grantee's fiscal compliance. It is common for
discretionary grant programs that lack the funding resources to conduct
site visits.
Page 25, middle paragraph – Finally, GAO has not made a clear
distinction between what activities may be permissible under a
different funding stream from what is impermissible under DRA funding.
For example, there are several abstinence education organizations that
receive funding from the Community Based Abstinence Education (CBAE)
program”a separate discretionary grant program within ACF's Family and
Youth Services Bureau. These organizations are also receiving DRA funds
to conduct healthy marriage education. While the DRA-funded program may
not provide abstinence education, the organization itself, which
receives funds from both DRA and CBAE, may in fact do both abstinence
education and marriage education in separate programs.
Another factor that GAO would need to consider is that in Allowable
Activity #2, which targets high school students on the benefits of
marriage, healthy relationships, etc., may include a session that
refers to abstinence without running afoul of compliance with the DRA.
For example, a marriage grantee may conduct a 12-week marriage
education program, which includes a session on "Making Wise Choices in
Relationships." Including abstinence as one choice to consider does not
violate the DRA's prohibition.
Page 25, last paragraph, continuing to page 26 – Comments regarding the
MIS system and the uniform performance measures have been previously
addressed. On August 25, 2008, the notice of HHS/ACF's proposal of
uniform performance indicators was posted in the Federal Register. This
is the initial phase of OMB's clearance and approval process, which can
take a minimum of 120 days to complete.
Page 30 – While ACF disagrees with GAO's characterization of the
absence of mechanisms to detect and forestall grantee non-compliance,
ACF concurs that these tools would further enhance the diligent
oversight and monitoring currently underway. OFA, the program office
that administers the HM/RF programs, has already developed and
implemented the two recommendations listed in the report and will
continue to refine procedures, oversight, provision of technical
assistance, and compliance for the duration of the program.
[End of section]
Appendix VI: GAO Contact and Staff Acknowledgments:
GAO Contact:
Kay E. Brown, (202) 512-7215 or brownke@gao.gov:
Acknowledgments:
Sherri Doughty (Assistant Director) and Ramona L. Burton (Analyst-in-
Charge) managed all aspects of the assignment. Michelle Bracy, Melissa
Jaynes, and Chhandasi Pandya made significant contributions to this
report, in all aspects of the work. In addition, Cathy Hurley, Kevin
Jackson, Stuart Kaufman, and Luann Moy provided technical support in
design and methodology, survey research, and statistical analysis;
Daniel Schwimer provided legal support; and Jessica Orr assisted in the
message and report development.
[End of section]
Footnotes:
[1] In 2006, HHS awarded a total of 229 grants, of which 216 were
Healthy Marriage and Responsible Fatherhood demonstration grants that
provided direct services to participants. We surveyed all of these
grantees. We did not survey the remaining grantees: those that either
provided research or technical assistance, assisted organizations with
developing fatherhood programs, or relinquished their grants. Moreover,
we did not survey organizations that received money from grant
recipients to provide direct services, subawardees. Since making the
initial awards, 4 organizations have relinquished their grants, 1
organization had its grant terminated, and 1 new grant was awarded.
There are 6 organizations currently pending non-continuation of award
funds.
[2] We purposively selected 10 additional case files to review. They
were selected based on the types of assistance provided or were part of
our site visits.
[3] The DRA restricted HHS to awarding no more than $50 million each
year for Responsible Fatherhood activities and $2 million each year for
coordination between Tribal TANF and child welfare services.
[4] GAO, Program Evaluation: An Evaluation Culture and Collaborative
Partnerships Help Build Agency Capacity, GAO-03-454 (Washington, D.C.:
May 2, 2003).
[5] GAO, Welfare Reform: More Information Needed to Assess Promising
Strategies to Increase Parents' Incomes, GAO-06-108 (Washington, D.C.:
Dec. 2, 2005).
[6] According to HHS, they amended an existing Dixon Group contract to
include additional services relating to the Healthy Marriage and
Responsible Fatherhood Initiative.
[7] At least one organization received a grant after having its
application rescored.
[8] Grant announcements noted that participants of marriage education
services must receive a minimum of 8 hours of instruction delivered
over time, or the number of instructional hours and days commensurate
with the established guidelines required by the author of the
curriculum used.
[9] Eligible men include fathers, expectant fathers, and father figures
and eligible women include mothers.
[10] All nonfederal entities that expend $500,000 or more of federal
awards in a year are required to obtain an annual audit in accordance
with the Single Audit Act of 1996 and Office of Management and Budget
Circular A-133, "Audits of States, Local Governments and Non-Profit
Organizations." A single audit combines an annual financial statement
audit with additional audit coverage of federal funds. HHS receives an
audit reporting package for grantees that expend more than $500,000 or
more in federal awards from the Federal Audit Clearinghouse
administered by the Department of Commerce.
[11] All but 2 of 207 grantee respondents indicated they had contact
with HHS monitoring staff.
[12] When we surveyed grantees in February 2008, about 60 percent
reported receiving a site visit from HHS.
[13] Research is partially funded with DRA and other HHS funding.
[14] The wider body of HHS's research agenda includes four studies
running alongside the impact evaluations that will evaluate how the
marriage and fatherhood programs being studied for the impact
evaluation are being implemented. HHS also has awarded three grants
under the DRA to study Responsible Fatherhood curricula.
[15] While 229 grants were awarded, we only surveyed the 216
demonstration grantees that provided direct services to participants.
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