Federal Funds
Fiscal Years 2002-2009 Obligations, Disbursements, and Expenditures for Selected Organizations Involved in Health-Related Activities Gao ID: GAO-10-533R May 28, 2010This report responds to Congress' request for information on federal funds provided for fiscal years 2002 through 2009 to selected organizations involved in health-related activities and their affiliates: Advocates for Youth, the Guttmacher Institute, the International Planned Parenthood Federation, the Planned Parenthood Federation of America, the Population Council, and the Sexuality Information and Education Council of the United States. Specifically, Congress requested that GAO identify the amount of federal funds provided to the selected organizations and their affiliates for each of fiscal years 2002 through 2009 and the sources of these federal funds (for example, family planning grants authorized under Title X of the Public Health Service Act). Congress also asked us to provide information on expenditures of federal funds reported by these organizations and their affiliates. For this report, GAO identified (1) reported obligations and disbursements of federal funds that the Department of Health and Human Services (HHS) and the United States Agency for International Development (USAID) provided directly to the selected organizations and their affiliates, and (2) expenditures of federal funds reported by organizations and their affiliates in instances in which an organization or an affiliate met the Office of Management and Budget audit threshold and submitted an audit report. Expenditures included both funds provided directly by HHS, USAID, and other federal entities such as the U.S. Department of Housing and Urban Development, and funds provided indirectly to the organizations or their affiliates, such as funds through the Medicaid program. This information updates GAO's May 16, 2003, report that provided information on fiscal year 2001 expenditures of federal funds by the organizations and their affiliates.
In summary, for the period of fiscal years 2002 through 2009, HHS and USAID reported obligating about $217 million and $347 million, respectively, to the selected organizations and their affiliates GAO reviewed, and disbursing about $188 million and $319 million, respectively, in accordance with these obligations. The selected organizations and their affiliates GAO reviewed reported spending a total of about $967 million in federal funds. This includes funds provided directly by HHS and USAID and federal funds provided indirectly, such as from federal grants to states that in turn provide the funds to these organizations. HHS and USAID reviewed a draft of this report and provided technical comments, which GAO incorporated as appropriate.
GAO-10-533R, Federal Funds: Fiscal Years 2002-2009 Obligations, Disbursements, and Expenditures for Selected Organizations Involved in Health-Related Activities
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GAO-10-533R:
United States Government Accountability Office:
Washington, DC 20548:
May 28, 2010:
Congressional Requesters:
Subject: Federal Funds: Fiscal Years 2002-2009 Obligations,
Disbursements, and Expenditures for Selected Organizations Involved in
Health-Related Activities:
This report responds to your request for information on federal funds
provided for fiscal years 2002 through 2009 to selected organizations
involved in health-related activities and their affiliates:[Footnote
1] Advocates for Youth, the Guttmacher Institute,[Footnote 2] the
International Planned Parenthood Federation, the Planned Parenthood
Federation of America, the Population Council, and the Sexuality
Information and Education Council of the United States. Specifically,
you requested that we identify the amount of federal funds provided to
the selected organizations and their affiliates for each of fiscal
years 2002 through 2009 and the sources of these federal funds (for
example, family planning grants authorized under Title X of the Public
Health Service Act).[Footnote 3] You also asked us to provide
information on expenditures of federal funds reported by these
organizations and their affiliates. For this report, we identified (1)
reported obligations and disbursements[Footnote 4] of federal funds
that the Department of Health and Human Services (HHS) and the United
States Agency for International Development (USAID) provided directly
to the selected organizations and their affiliates,[Footnote 5] and
(2) expenditures[Footnote 6] of federal funds reported by
organizations and their affiliates in instances in which an
organization or an affiliate met the Office of Management and Budget
audit threshold and submitted an audit report.[Footnote 7]
Expenditures included both funds provided directly by HHS, USAID, and
other federal entities such as the U.S. Department of Housing and
Urban Development, and funds provided indirectly to the organizations
or their affiliates, such as funds through the Medicaid
program.[Footnote 8] This information updates our May 16, 2003, report
that provided information on fiscal year 2001 expenditures of federal
funds by the organizations and their affiliates.[Footnote 9]
To obtain information on federal funds obligated for and disbursed to
the selected organizations and their affiliates, the federal agencies
that provided the funds, and the source of the funding, we interviewed
officials from the federal agencies and from the organizations
included in our prior work about federal funding data. We determined
that HHS and USAID could provide data on obligations and disbursements
of federal funds they provided directly to the selected organizations
and their affiliates from their audited financial accounting systems:
the Payment Management System and the Phoenix System, respectively.
[Footnote 10] We asked HHS and USAID to provide obligation and
disbursement data for each of federal fiscal years 2002 through 2009.
These data did not include federal funds provided indirectly to the
organizations, such as from HHS grants to states that in turn provided
the funds to these organizations and USAID funding provided to other
entities that in turn provided the funds to the organizations in our
review. Additionally, for federal fiscal years 2002 through 2005,
complete obligation and disbursement data for awards made through
USAID's overseas-based missions were not available. As a result,
obligations and disbursements in this report may understate the actual
amount of federal funds provided to the selected organizations and
their affiliates. For HHS, the department provided data by the agency
or office that awarded the funds as well as by HHS program.[Footnote
11] For USAID, the agency provided general categories of health
activities associated with about 90 percent of their obligations. We
reviewed current audit opinions on the Payment Management System and
the Phoenix System and determined that data from these systems were
sufficiently reliable for our purposes.
To obtain information on reported expenditures of federal funds by the
selected organizations and their affiliates for fiscal years 2002
through 2009, we reviewed the expenditure information contained in
publicly available audit reports submitted in accordance with the
Single Audit Act, as amended, and implementing guidance of the Office
of Management and Budget, Circular A-133.[Footnote 12] These audit
reports include expenditures of federal funds that HHS agencies and
offices and USAID provided both directly and indirectly to the
selected organizations and their affiliates, as well as expenditures
of funds provided directly and indirectly by federal agencies other
than HHS and USAID, such as the Department of Housing and Urban
Development, which provided grants totaling about $4.1 million to
Planned Parenthood affiliates who reported such expenditures during
the period of our review. The audit reports also included information
on the HHS program through which funding was provided; they did not
include comparable information for USAID. We did not obtain data on
expenditures of federal funds by organizations or their affiliates
that did not submit such audit reports, for example, organizations
that did not meet the audit threshold. As a result, expenditures in
this report may understate the actual amount of federal funds the
selected organizations and their affiliates spent. The expenditure
information in these audit reports was independently audited and we
determined that the data were sufficiently reliable for our purposes.
In addition to the limitations described previously, agencies reported
obligations and disbursements by federal fiscal year while the
organizations and their affiliates reported expenditures by their
varying fiscal years, so these amounts are not comparable and cannot
be totaled. Further, disbursement and expenditure amounts cannot be
combined together because funds disbursed by an agency are then spent
by an organization; combining the two would result in counting the
funds twice.
We conducted our work from June 2009 through May 2010 in accordance
with all sections of GAO's Quality Assurance Framework that were
relevant to our objective. The framework requires that we plan and
perform the engagement to obtain sufficient and appropriate evidence
to meet our stated objectives and to discuss any limitations in our
work.
In summary, for the period of fiscal years 2002 through 2009,
* HHS and USAID reported obligating about $217 million and $347
million, respectively, to the selected organizations and their
affiliates we reviewed, and disbursing about $188 million and $319
million, respectively, in accordance with these obligations.
* The selected organizations and their affiliates we reviewed reported
spending a total of about $967 million in federal funds. This includes
funds provided directly by HHS and USAID and federal funds provided
indirectly, such as from federal grants to states that in turn provide
the funds to these organizations.
HHS and USAID reviewed a draft of this report and provided technical
comments, which we incorporated as appropriate. In addition, we
incorporated more detailed USAID data on obligations by activity
category that USAID provided after receiving the draft report for
review.
Background:
The six selected organizations and their affiliates operate within the
United States and internationally and engage in health-related
activities such as providing information regarding reproductive health
and administering services related to the prevention and treatment of
human immunodeficiency virus/acquired immunodeficiency syndrome
(HIV/AIDS).
* Advocates for Youth is a nonprofit organization located in
Washington, D.C. that promotes adolescent reproductive and sexual
health programs and policies in the United States and abroad.
According to the organization, in 2008, Advocates for Youth worked
with more than 28,000 professionals who provided information and
assistance to over 9.5 million teens around the world to help them
make decisions about their sexual health.
* The Guttmacher Institute is a nonprofit organization with offices in
New York City and Washington, D.C. and provides information on sexual
activity, contraception, abortion, and childbearing. According to the
organization, it seeks to improve sexual and reproductive health in
the United States and worldwide through an interrelated program of
social science research, policy analysis, and public education. The
organization also supports U.S. and international research and
publications.
* The International Planned Parenthood Federation is a family health
care organization headquartered in London and registered as a charity
in the United Kingdom. The organization has six regional offices,
including a Western Hemisphere regional office located in the United
States. As of December 2009, the federation reported it had 152
autonomous member associations operating in 163 countries. According
to the organization, it works through its member associations to
promote access to reproductive health services, abortion services, and
services related to the prevention and treatment of HIV/AIDS.
* The Planned Parenthood Federation of America, with national offices
in New York City and Washington, D.C., is a national nonprofit
organization that provides support services to 89 affiliates that
operate 850 health care centers across the country.[Footnote 13]
Planned Parenthood affiliates are separately incorporated and
independent organizations with their own boards of directors and
financial autonomy. According to the organization, each year, Planned
Parenthood health centers provide reproductive health care--including
routine exams and screenings, contraception, abortion care, and
testing and treatment for sexually transmitted infections--to 3
million patients.
* The Population Council is an international nonprofit research
organization with headquarters in New York City. According to the
organization, it seeks to improve reproductive health around the
world; conducts biomedical, social science, and public health
research; and helps build research capacities in developing countries.
As of January 2010, its New York headquarters supported a global
network of 17 regional and country offices, which conduct research in
over 50 countries.
* The Sexuality Information and Education Council of the United States
is a nonprofit organization with offices in New York City and
Washington, D.C. According to the organization, it promotes
comprehensive education on and access to information about human
sexuality and conducts advocacy on issues pertaining to sexual and
reproductive rights.
During most of the period of our review, what has become known as the
"Mexico City Policy" was in effect. This policy required foreign
nongovernmental organizations to agree as a condition of their receipt
of federal funds for family planning activities that such
organizations would neither perform nor actively promote abortion as a
method of family planning in other nations. This policy was revoked in
January 2009.[Footnote 14]
Federal Funds HHS and USAID Reported Obligating for and Disbursing to
Selected Organizations:
For fiscal years 2002 through 2009, HHS reported that its agencies and
offices--primarily the Health Resources and Services Administration--
obligated about $217 million for and disbursed about $188 million to
the selected organizations and their affiliates. Over the same period,
USAID reported obligating about $347 million for and disbursing about
$319 million to the selected organizations and their affiliates for
health activities such as HIV/AIDS and family planning and
reproductive health.
Federal Funds HHS Reported Obligating for and Disbursing to Selected
Organizations:
For fiscal years 2002 through 2009, HHS reported obligating about $217
million for and disbursing about $188 million to the selected
organizations and their affiliates (see table 1 for obligations and
table 2 for disbursements).[Footnote 15]
Table 1: Federal Funds HHS Reported Obligating for Selected
Organizations, Fiscal Years 2002-2009:
Organization: Advocates for Youth;
2002: $1.5 million;
2003: $1.2 million;
2004: $0.9 million;
2005: $0.9 million;
2006: $1.1 million;
2007: $1.1 million;
2008: $1.1 million;
2009: $1.1 million;
Total: $8.9 million.
Organization: Guttmacher Institute;
2002: $1.2 million;
2003: $1.4 million;
2004: $1.1 million;
2005: $0.9 million;
2006: $0.5 million;
2007: $0.4 million;
2008: $0.8 million;
2009: $1.1 million;
Total: $7.4 million.
Organization: International Planned Parenthood Federation[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Planned Parenthood Federation of America[B];
2002: $16.2 million;
2003: $15.6 million;
2004: $18.0 million;
2005: $17.6 million;
2006: $17.5 million;
2007: $15.8 million;
2008: $17.6 million;
2009: $19.4 million;
Total: $137.7 million.
Organization: Population Council;
2002: $6.0 million;
2003: $6.5 million;
2004: $8.6 million;
2005: $6.3 million;
2006: $7.3 million;
2007: $7.6 million;
2008: $8.7 million;
2009: $9.9 million;
Total: $60.9 million.
Organization: Sexuality Information and Education Council of the
United States;
2002: $0.3 million;
2003: $0.2 million;
2004: $0.2 million;
2005: $0.2 million;
2006: $0.3 million;
2007: $0.3 million;
2008: $0.3 million;
2009: $0.3 million;
Total: $1.9 million.
Organization: Total;
2002: $25.2 million;
2003: $24.9 million;
2004: $28.8 million;
2005: $25.9 million;
2006: $26.6 million;
2007: $25.2 million;
2008: $28.4 million;
2009: $31.8 million;
Total: $216.7 million.
Source: GAO analysis of HHS data.
Notes: This table provides, for federal fiscal years 2002 through
2009, the amounts HHS reported obligating directly for the six
organizations and their affiliates in our review, including 21
affiliates of the Planned Parenthood Federation of America.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] HHS did not report obligating funds for the International Planned
Parenthood Federation or its member associations in federal fiscal
years 2002 through 2009.
[B] Includes amounts HHS reported obligating for affiliates of the
Planned Parenthood Federation of America.
[End of table]
Table 2: Federal Funds HHS Reported Disbursing to Selected
Organizations, Fiscal Years 2002-2009:
Organization: Advocates for Youth;
2002: $0.0 million[A];
2003: $1.1 million;
2004: $1.3 million;
2005: $1.1 million;
2006: $0.7 million;
2007: $0.9 million;
2008: $1.2 million;
2009: $1.1 million;
Total: $7.3 million.
Organization: Guttmacher Institute;
2002: 0.0 million[A];
2003: $1.0 million;
2004: $1.2 million;
2005: $0.8 million;
2006: $1.0 million;
2007: $1.1 million;
2008: 0.6 million;
2009: $1.0 million;
Total: $6.7 million.
Organization: International Planned Parenthood Federation[B];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Planned Parenthood Federation of America[C];
2002: $6.1 million;
2003: $14.7 million;
2004: $16.1 million;
2005: $17.0 million;
2006: $18.0 million;
2007: $18.0 million;
2008: $16.3 million;
2009: $16.9 million;
Total: $123.1 million.
Organization: Population Council;
2002: $1.4 million;
2003: $4.2 million;
2004: $7.1 million;
2005: $7.2 million;
2006: $5.0 million;
2007: $6.9 million;
2008: $7.7 million;
2009: $9.6 million;
Total: $49.2 million.
Organization: Sexuality Information and Education Council of the
United States;
2002: $0.3 million;
2003: $0.2 million;
2004: $0.2 million;
2005: $0.2 million;
2006: $0.3 million;
2007: $0.3 million;
2008: $0.2 million;
2009: 0.0;
Total: $1.6 million.
Organization: Total;
2002: $7.9 million;
2003: $21.2 million;
2004: $25.9 million;
2005: $26.3 million;
2006: $25.0 million;
2007: $27.2 million;
2008: $25.9 million;
2009: $28.6 million;
Total: $187.8 million.
Source: GAO analysis of HHS data.
Notes: This table provides the amount HHS reported disbursing in
accordance with obligations for federal fiscal years 2002 through 2009
directly to the six organizations and their affiliates in our review,
including 19 affiliates of the Planned Parenthood Federation of
America.
The term disbursement refers to amounts paid by federal agencies, in
cash or cash equivalents, to satisfy government obligations.
Disbursements may not add to totals due to rounding.
[A] Disbursements of less than $50,000 rounded to zero. HHS reported
disbursing about $3,000 to Advocates for Youth and about $6,000 to the
Guttmacher Institute in federal fiscal year 2002.
[B] HHS did not report disbursing funds to the International Planned
Parenthood Federation or its member associations in federal fiscal
years 2002 through 2009.
[C] Includes amounts HHS reported disbursing to affiliates of the
Planned Parenthood Federation of America.
[End of table]
Tables 3 and 4 provide information on the amounts HHS reported
obligating for and disbursing to the six selected organizations and
their affiliates in our review, by HHS awarding agency or office. The
largest amounts obligated and disbursed--about $132 million and $118
million, respectively--were provided through HHS's Health Resources
and Services Administration (HRSA).[Footnote 16] This funding was
provided predominantly through an HHS program for family planning
services.[Footnote 17]
Table 3: Federal Funds HHS Reported Obligating for Selected
Organizations, by Awarding Agency or Office, Fiscal Years 2002-2009:
Agency or office: Centers for Disease Control and Prevention;
2002: $2.8 million;
2003: $2.3 million;
2004: $2.2 million;
2005: $2.3 million;
2006: $2.3 million;
2007: $2.5 million;
2008: $3.9 million;
2009: $4.5 million;
Total: $22.8 million.
Agency or office: Health Resources and Services Administration;
2002: $15.2 million;
2003: $14.7 million;
2004: $16.7 million;
2005: $16.6 million;
2006: $16.7 million;
2007: $15.4 million;
2008: $17.2 million;
2009: $19.2 million;
Total: $131.8 million.
Agency or office: National Institutes of Health;
2002: $6.8 million;
2003: $7.5 million;
2004: $9.3 million;
2005: $6.7 million;
2006: $7.3 million;
2007: $7.2 million;
2008: $7.1 million;
2009: $7.8 million;
Total: $59.6 million.
Agency or office: Office of the Secretary;
2002: $0.3 million;
2003: $0.4 million;
2004: $0.5 million;
2005: $0.2 million;
2006: $0.2 million;
2007: $0.2 million;
2008: $0.2 million;
2009: $0.3 million;
Total: $2.5 million.
Agency or office: Total;
2002: $25.2 million;
2003: $24.9 million;
2004: $28.8 million;
2005: $25.9 million;
2006: $26.6 million;
2007: $25.2 million;
2008: $28.4 million;
2009: $31.8 million;
Total: $216.7 million.
Source: GAO analysis of HHS data.
Notes: This table provides, for federal fiscal years 2002 through
2009, the amounts HHS reported obligating directly for the six
organizations and their affiliates, including 21 affiliates of the
Planned Parenthood Federation of America, by HHS agency or office. HHS
did not report obligating funds for the International Planned
Parenthood Federation or its member associations during the period of
our review.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[End of table]
Table 4: Federal Funds HHS Reported Disbursing to Selected
Organizations, by Awarding Agency or Office, Fiscal Years 2002-2009:
Agency or office: Centers for Disease Control and Prevention;
2002: $0.4 million;
2003: $2.3 million;
2004: $2.4 million;
2005: $2.4 million;
2006: $2.3 million;
2007: $2.1 million;
2008: $2.7 million;
2009: $3.1 million;
Total: $17.6 million.
Agency or office: Health Resources and Services Administration;
2002: $6.0 million;
2003: $13.8 million;
2004: $15.3 million;
2005: $15.5 million;
2006: $17.0 million;
2007: $17.4 million;
2008: $15.9 million;
2009: $16.7 million;
Total: $117.6 million.
Agency or office: National Institutes of Health;
2002: $1.4 million;
2003: $4.8 million;
2004: $7.8 million;
2005: $7.8 million;
2006: $5.4 million;
2007: $7.4 million;
2008: $7.2 million;
2009: $8.5 million;
Total: $50.4 million.
Agency or office: Office of the Secretary;
2002: 0.0[A];
2003: $0.3 million;
2004: $0.4 million;
2005: $0.5 million;
2006: $0.3 million;
2007: $0.3 million;
2008: $0.2 million;
2009: $0.2 million;
Total: $2.1 million.
Agency or office: Total;
2002: $7.9 million;
2003: $21.2 million;
2004: $25.9 million;
2005: $26.3 million;
2006: $25.0 million;
2007: $27.2 million;
2008: $25.9 million;
2009: $28.6 million;
Total: $187.8 million.
Source: GAO analysis of HHS data.
Notes: This table provides the amount HHS reported disbursing in
accordance with obligations for federal fiscal years 2002 through 2009
directly to the six organizations and their affiliates, including 19
affiliates of the Planned Parenthood Federation of America. HHS did
not report disbursing funds to the International Planned Parenthood
Federation or its member associations during the period of our review.
The term disbursement refers to amounts paid by federal agencies, in
cash or cash equivalents, to satisfy government obligations.
Disbursements may not add to totals due to rounding.
[A] Disbursements of less than $50,000 rounded to zero. The Office of
the Secretary reported disbursing about $15,000 in federal fiscal year
2002 to the selected organizations and their affiliates.
[End of table]
Federal Funds USAID Reported Obligating for and Disbursing to Selected
Organizations:
For fiscal years 2002 through 2009, USAID reported obligating about
$347 million for and disbursing about $319 million to the selected
organizations and their affiliates (see table 5 for obligations and
table 6 for disbursements).[Footnote 18] According to USAID, this
funding was for health activities such as HIV/AIDS and family planning
and reproductive health.[Footnote 19] In addition to the funding
presented in tables 5 and 6, USAID reported shipping contraceptive
commodities, including condoms, valued at approximately $7.6 million
to affiliates of the International Planned Parenthood Federation
during the period of our review.
Table 5: Federal Funds USAID Reported Obligating for Selected
Organizations, Fiscal Years 2002-2009:
Organization: Advocates for Youth[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Guttmacher Institute[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: International Planned Parenthood Federation;
2002: $18.7 million;
2003: $13.6 million;
2004: $6.0 million;
2005: $11.2 million;
2006: $6.3 million;
2007: $10.6 million;
2008: $9.4 million;
2009: $17.9 million;
Total: $93.9v.
Organization: Planned Parenthood Federation of America[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Population Council;
2002: $28.6 million;
2003: $23.9 million;
2004: $30.1 million;
2005: $34.6 million;
2006: $34.2 million;
2007: $31.6 million;
2008: $27.1 million;
2009: $43.1 million;
Total: $253.3 million.
Organization: Sexuality Information and Education Council of the
United States[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Total;
2002: $47.4 million;
2003: $37.6 million;
2004: $36.0 million;
2005: $45.8 million;
2006: $40.6 million;
2007: $42.2 million;
2008: $36.5 million;
2009: $61.1 million;
Total: $347.1 million.
Source: GAO analysis of USAID data.
Notes: This table provides, for federal fiscal years 2002 through
2009, the amounts USAID reported obligating directly for the six
organizations in our review. Obligations for the International Planned
Parenthood Federation represent funding for nine of its member
associations.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
For federal fiscal years 2002 through 2005, complete obligation data
for awards made through the agency's overseas-based missions were not
available.
Obligations may not add to totals due to rounding.
[A] USAID did not report obligating funds for Advocates for Youth, the
Guttmacher Institute, the Planned Parenthood Federation of America or
its affiliates, or the Sexuality Information and Education Council of
the United States in federal fiscal years 2002 through 2009.
[End of table]
Table 6: Federal Funds USAID Reported Disbursing to Selected
Organizations, Fiscal Years 2002-2009:
Organization: Advocates for Youth[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Guttmacher Institute[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: International Planned Parenthood Federation[B];
2002: $10.8 million;
2003: $12.5 million;
2004: $12.0 million;
2005: $9.9 million;
2006: $9.3 million;
2007: $9.6 million;
2008: $11.8 million;
2009: $10.4 million;
Total: $86.2v.
Organization: Planned Parenthood Federation of America[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Population Council;
2002: $8.3 million;
2003: $23.0 million;
2004: $34.1 million;
2005: $30.4 million;
2006: $36.6 million;
2007: $29.6 million;
2008: $37.1 million;
2009: $33.7 million;
Total: $232.9 million.
Organization: Sexuality Information and Education Council of the
United States[A];
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Total;
2002: $19.1 million;
2003: $35.5 million;
2004: $46.1 million;
2005: $40.3 million;
2006: $45.9 million;
2007: $39.2 million;
2008: $48.9 million;
2009: $44.1 million;
Total: $319.1 million.
Source: GAO analysis of USAID data.
Notes: This table provides the amount USAID reported disbursing in
accordance with obligations for federal fiscal years 2002 through 2009
directly to the six organizations in our review. Disbursements to the
International Planned Parenthood Federation represent funding to nine
of its member associations.
The term disbursement refers to amounts paid by federal agencies, in
cash or cash equivalents, to satisfy government obligations.
For federal fiscal years 2002 through 2005, complete disbursement data
for awards made through the agency's overseas-based missions were not
available.
Disbursements may not add to totals due to rounding.
[A] USAID did not report disbursing funds to Advocates for Youth, the
Guttmacher Institute, the Planned Parenthood Federation of America or
its affiliates, or the Sexuality Information and Education Council of
the United States in federal fiscal years 2002 through 2009.
[B] USAID also reported that it shipped contraceptive commodities
valued at $2.4 million, $2.1 million, $1.3 million, $0.3 million, $0.3
million, $0.4 million, $0.7 million, and $0.1 million to affiliates of
the International Planned Parenthood Federation in federal fiscal
years 2002 through 2009, respectively. These amounts are not
disbursements reported from USAID's Phoenix System and are not
reflected in the table.
[End of table]
Expenditures of Federal Funds Reported by Selected Organizations:
For fiscal years 2002 through 2009, the selected organizations and
their affiliates in our review reported total expenditures of about
$967 million in federal funds provided directly and indirectly (see
table 7).[Footnote 20] More than one-third of this amount, about $342
million, was reported as expenditures from an HHS program for family
planning services.[Footnote 21] Nearly all (about $942 million) of the
reported expenditures were from programs administered by HHS and
USAID;[Footnote 22] the remaining $25 million in reported expenditures
were primarily from programs administered by the U.S. Department of
Housing and Urban Development, the U.S. Department of Agriculture, and
the U.S. Department of Justice.
Table 7: Organizations' Reported Expenditures of Federal Funds, Fiscal
Years 2002-2009:
Organization: Advocates for Youth;
2002: $0.8 million;
2003: $1.6 million;
2004: $1.3 million;
2005: $1.4 million;
2006: $0.7 million;
2007: $0.8 million;
2008: $1.1 million;
2009: $1.1 million;
Total: $8.7 million.
Organization: Guttmacher Institute;
2002: $1.7 million;
2003: $2.2 million;
2004: $1.7 million;
2005: $1.9 million;
2006: $2.1 million;
2007: $1.9 million;
2008: $1.2 million;
2009: 0.0;
Total: $12.7 million.
Organization: International Planned Parenthood Federation[A];
2002: $1.3 million;
2003: $1.0 million;
2004: $1.6 million;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $3.9 million.
Organization: Planned Parenthood Federation of America[B];
2002: $94.5 million;
2003: $88.5 million;
2004: $86.7 million;
2005: $93.7 million;
2006: $100.0 million;
2007: $97.6 million;
2008: $96.2 million;
2009: 0.0;
Total: $657.1 million.
Organization: Population Council;
2002: $37.9 million;
2003: $39.8 million;
2004: $37.1 million;
2005: $41.6 million;
2006: $40.5 million;
2007: $43.2 million;
2008: $44.4 million;
2009: 0.0;
Total: $284.3 million.
Organization: Sexuality Information and Education Council of the
United States;
2002: 0.0;
2003: $0.3 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.3 million.
Organization: Total;
2002: $136.2 million;
2003: $133.3 million;
2004: $128.4 million;
2005: $138.6 million;
2006: $143.2 million;
2007: $143.5 million;
2008: $142.9 million;
2009: $1.1 million;
Total: $967.1 million.
Source: GAO analysis.
Notes: This table provides, for fiscal years 2002 through 2009, the
amount of federal funds selected organizations and their affiliates,
including affiliates of the Planned Parenthood Federation of America
and the U.S.-based Western Hemisphere regional office of the
International Planned Parenthood Federation, reported spending in
audit reports submitted and available as of the end of federal fiscal
year 2009.
The term expenditure refers to the actual spending of money, also
known as an outlay.
Organizations based in the United States with expenditures of federal
funds of $500,000 or more ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on organizations' 12-
month fiscal years, which vary.
Expenditures may not add to totals due to rounding.
[A] Amounts reflect expenditures of federal funds reported by the U.S.-
based Western Hemisphere regional office of the International Planned
Parenthood Federation. Other regional offices and member associations
of the International Planned Parenthood Federation that are not based
in the United States are not subject to the Office of Management and
Budget audit reporting requirement.
[B] Includes expenditures reported by 85 affiliates of the Planned
Parenthood Federation of America. Planned Parenthood Federation of
America and its affiliates are separate entities from the U.S.-based
Western Hemisphere regional office of the International Planned
Parenthood Federation.
[End of table]
Agency Comments:
We provided a draft of this report to HHS and USAID for comment, and
we also provided relevant excerpts of the draft to the organizations
discussed in the report. USAID provided written comments, which appear
in enclosure V. USAID stated that it could provide more detailed data
than we had reported in the draft report. USAID had not provided these
detailed data before we sent the draft for review. However, after
receiving the draft report for review, USAID provided additional data
on the specific amounts of obligations for health activities
associated with about 90 percent of the amount USAID reported
obligating for the selected organizations during the period of our
review. In response, we revised the report to acknowledge that USAID
could provide such detailed data and also incorporated the detailed
data into the report in enclosure II.
USAID also commented that when the "Mexico City Policy" required
foreign nongovernmental organizations to certify that they would not
perform or actively promote abortion as a method of family planning as
a condition for receiving U.S. federal family planning assistance, no
USAID funds were obligated for the International Planned Parenthood
Federation in London, which did not agree to abide by the policy.
In addition, HHS, USAID, and some of the organizations discussed in
the report provided technical comments which we incorporated as
appropriate.
As agreed with your offices, unless you publicly announce its contents
earlier, we plan no further distribution of this report until 30 days
from its issue date. At that time, we will send copies of this report
to the Secretary of Health and Human Services and the Administrator of
USAID. The report will also be available at no charge on GAO's Web
site at [hyperlink, http://www.gao.gov]. If you or your staff have any
questions about this report, please contact me at (202) 512-7114 or
crossem@gao.gov. Contact points for our Offices of Congressional
Relations and Public Affairs may be found on the last page of this
report. Kim Yamane, Assistant Director; Tom Moscovitch; and Teresa Tam
made major contributions to this report.
Signed by:
Marcia Crosse:
Director, Health Care:
Enclosures - 5:
List of Requesters:
The Honorable John Boehner:
Republican Leader:
House of Representatives:
The Honorable Sam Brownback:
The Honorable John Cornyn:
The Honorable Jim DeMint:
The Honorable James Inhofe:
The Honorable David Vitter:
United States Senate:
The Honorable Joe Barton:
Ranking Member:
Committee on Energy and Commerce:
House of Representatives:
The Honorable Paul Ryan:
Ranking Member:
Committee on the Budget:
House of Representatives:
The Honorable Todd Akin:
The Honorable Michelle Bachmann:
The Honorable Roscoe Bartlett:
The Honorable Marsha Blackburn:
The Honorable Paul Broun:
The Honorable Vern Buchanan:
The Honorable John Fleming:
The Honorable Trent Franks:
The Honorable Scott Garrett:
The Honorable Phil Gingrey:
The Honorable Duncan Hunter:
The Honorable Walter Jones:
The Honorable Jim Jordan:
The Honorable Steve King:
The Honorable Doug Lamborn:
The Honorable Kenny Marchant:
The Honorable Pete Olson:
The Honorable Ron Paul:
The Honorable Mike Pence:
The Honorable Joe Pitts:
The Honorable Steve Scalise:
The Honorable Chris Smith:
The Honorable Lamar Smith:
House of Representatives:
[End of section]
Enclosure I:
Amounts the Department of Health and Human Services Reported
Obligating for Selected Organizations, by Program and Awarding Agency
or Office, Fiscal Years 2002-2009:
This enclosure provides, for fiscal years 2002 through 2009, the
amounts the Department of Health and Human Services (HHS) reported
obligating for Advocates for Youth, the Guttmacher Institute, the
Planned Parenthood Federation of America and its affiliates, the
Population Council, and the Sexuality Information and Education
Council of the United States by HHS program and awarding agency or
office, in descending order by total obligations.[Footnote 23] HHS did
not report obligating any funds for the International Planned
Parenthood Federation or its affiliates for the period of our review.
The HHS program with the largest amount of obligations--about $123
million or about 57 percent of total HHS obligations--was a grant
program, family planning services, authorized under Title X of the
Public Health Service Act.
Table 8: Federal Funds HHS Reported Obligating for Advocates for
Youth, by HHS Program and Awarding Agency or Office, Fiscal Years 2002-
2009:
Program title and number Agency or office[A]: Centers for Disease
Control and Prevention_Investigations and Technical Assistance
(93.283) Centers for Disease Control and Prevention:
2002: $0.4 million;
2003: $0.4 million;
2004: $0.7 million;
2005: $0.7 million;
2006: $0.9 million;
2007: $0.9 million;
2008: 0.0;
2009: $0.3 million;
Total: $4.3 million.
Program title and number Agency or office[A]: Acquired
Immunodeficiency Syndrome (AIDS) Activity (93.118) Centers for Disease
Control and Prevention:
2002: $0.8 million;
2003: $0.6 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $1.4 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Support Comprehensive School Health Programs to Prevent the Spread
of Human Immunodeficiency Virus (HIV) and Other Important Health
Problems (93.938) Centers for Disease Control and Prevention:
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.7 million;
2009: $0.7 million;
Total: $1.3 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Improve the Health Status of Minority Populations (93.004) Office
of the Secretary, Office of Minority Health.
2002: 0.0;
2003: 0.0;
2004: $0.1 million;
2005: $0.1 million;
2006: 0.0;
2007: 0.0;
2008: $0.2 million;
2009: $0.2 million;
Total: $0.7 million.
Program title and number Agency or office[A]: HIV Prevention
Activities_Non-governmental Organization Based (93.939) Centers for
Disease Control and Prevention.
2002: $0.3 million;
2003: $0.2 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.5 million.
Program title and number Agency or office[A]: State and Territorial
and Technical Assistance Capacity Development Minority HIV/AIDS
Demonstration Program (93.006) Office of the Secretary, Office of
Minority Health.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: $0.2 million;
2008: 0.0;
2009: 0.0;
Total: $0.2 million.
Program title and number Agency or office[A]: Community Programs to
Improve Minority Health Grant Program (93.137) Office of the
Secretary, Office of Minority Health.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: $0.1 million;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Centers for Research and
Demonstration for Health Promotion and Disease Prevention (93.135)
Centers for Disease Control and Prevention.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Support State-Based Safe Motherhood and Infant Health Initiative
Programs (93.946) Centers for Disease Control and Prevention.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Total;
2002: $1.5 million;
2003: $1.2 million;
2004: $0.9 million;
2005: $0.9 million;
2006: $1.1 million;
2007: $1.1 million;
2008: $1.1 million;
2009: $1.1 million;
Total: $8.9 million.
Source: GAO analysis of HHS data.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds HHS reported obligating for Advocates for Youth, by HHS
program, in descending order by total obligations.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[End of table]
Table 9: Federal Funds HHS Reported Obligating for the Guttmacher
Institute, by HHS Program and Awarding Agency or Office, Fiscal Years
2002-2009:
Program title and number Agency or office[A]: Child Health and Human
Development Extramural Research (93.865)[B] National Institutes Of
Health:
2002: $0.8;
2003: $1.0;
2004: $0.9;
2005: $0.7;
2006: $0.3;
2007: 0.0;
2008: $0.3;
2009: $0.6;
Total: $4.5.
Program title and number Agency or office[A]: Family Planning_Service
Delivery Improvement Research Grants (93.974)[C] Health Resources And
Services Administration:
2002: $0.0;
2003: $0.4;
2004: $0.3;
2005: $0.2;
2006: $0.2;
2007: $0.4;
2008: $0.4;
2009: $0.5;
Total: $2.5.
Dollars in millions: Program title and number Agency or office[A]:
Family Planning_Services (93.217)[C] Health Resources And Services
Administration:
2002: $0.4;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.4.
Dollars in millions: Program title and number Agency or office[A]:
Family Planning_Personnel Training (93.260)[C] Health Resources And
Services Administration:
2002: $0.0[D];
2003: $0.0[D];
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0[D].
Program title and number Agency or office[A]: Total;
2002: $1.2;
2003: $1.4;
2004: $1.1;
2005: $0.9;
2006: $0.5;
2007: $0.4;
2008: $0.8;
2009: $1.1;
Total: $7.4.
Source: GAO analysis of HHS data.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds HHS reported obligating for the Guttmacher Institute, by
HHS program, in descending order by total obligations.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] Reflects totals for HHS programs 93.864 and 93.865, which were
combined in 2003.
[C] This program is administered by the Office of Population Affairs
under the Office of Public Health and Science in HHS, but is funded
through appropriations for the Health Resources and Services
Administration.
[D] Obligations of less than $50,000 rounded to zero. HHS reported
obligating about $13,000 in fiscal year 2002 and about $13,000 in
fiscal year 2003 for a program supporting family planning personnel
training.
[End of table]
Table 10: Federal Funds HHS Reported Obligating for the Planned
Parenthood Federation of America and Affiliates, by HHS Program and
Awarding Agency or Office, Fiscal Years 2002-2009:
Program title and number Agency or office[A]: Family Planning_Services
(93.217)[B] Health Resources And Services Administration:
2002: $13.2 million;
2003: $14.0 million;
2004: $14.1 million;
2005: $15.9 million;
2006: $16.2 million;
2007: $14.7 million;
2008: $16.0 million;
2009: $18.2 million;
Total: $122.1 million.
Program title and number Agency or office[A]: Family
Planning_Personnel Training (93.260)[B] Health Resources And Services
Administration:
2002: $1.1 million;
2003: $0.2 million;
2004: $2.0 million;
2005: $0.1 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $3.4 million.
Program title and number Agency or office[A]: HIV Prevention
Activities_Non-governmental Organization Based (93.939) Centers for
Disease Control and Prevention.
2002: $0.9 million;
2003: $0.9 million;
2004: 0.0;
2005: 0.0;
2006: 0.0[C];
2007: 0.0;
2008: $0.7 million;
2009: $0.5 million;
Total: $3.1 million.
Program title and number Agency or office[A]: Acquired
Immunodeficiency Syndrome (AIDS) Activity (93.118) Centers for Disease
Control and Prevention;
2002: $0.1 million;
2003: 0.0;
2004: $0.9 million;
2005: $0.9 million;
2006: $0.7 million;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $2.6 million.
Program title and number Agency or office[A]: AIDS Education and
Training Centers (93.145) Health Resources and Services Administration;
2002: $0.5 million;
2003: $0.1 million;
2004: $0.4 million;
2005: $0.4 million;
2006: $0.3 million;
2007: 0.0;
2008: $0.3 million;
2009: $0.3 million;
Total: $2.2 million.
Program title and number Agency or office[A]: Centers for Disease
Control and Prevention_Investigations and Technical Assistance
(93.283) Centers for Disease Control and Prevention;
2002: 0.0[C];
2003: 0.0;
2004: 0.0[C];
2005: 0.0;
2006: $0.1 million;
2007: $0.8 million;
2008: 0.0;
2009: 0.0;
Total: $0.9 million.
Program title and number Agency or office[A]: Adolescent Family
Life_Demonstration Projects (93.995) Office of the Secretary, Office
of Population Affairs;
2002: $0.3 million;
2003: 0.0;
2004: $0.3 million;
2005: $0.1 million;
2006: $0.1 million;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.9 million.
Program title and number Agency or office[A]: Epidemiologic Research
Studies of Acquired Immunodeficiency Syndrome (AIDS) and Human
Immunodeficiency Syndrome (HIV) Infection in Selected Population
Groups (93.943) Centers for Disease Control and Prevention.
2002: 0.0;
2003: 0.0;
2004: $0.2 million;
2005: $0.3 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.5 million.
Program title and number Agency or office[A]: Family Planning_Service
Delivery Improvement Research Grants (93.974)[B] Health Resources And
Services Administration;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.2 million;
2009: $0.3 million;
Total: $0.5 million.
Program title and number Agency or office[A]: Adolescent Family Life
Research Grants (93.111) Office of the Secretary, Office of Population
Affairs;
2002: 0.0;
2003: $0.4 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.4 million.
Program title and number Agency or office[A]: Grants to Provide
Outpatient Early Intervention Services with Respect to HIV Disease
(93.918) Health Resources and Services Administration;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: $0.3 million;
2008: 0.0;
2009: 0.0;
Total: $0.3 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Support State-Based Safe Motherhood and Infant Health Initiative
Programs (93.946) Centers for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0[C];
2007: 0.0;
2008: $0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Health Care and Other
Facilities (93.887) Health Resources and Services Administration;
2002: 0.0;
2003: 0.0;
2004: $0.1 million;
2005: $0.1 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: HIV Prevention Programs
for Women (93.015) Office of the Secretary;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: $0.1 million;
Total: $0.1 million.
Program title and number Agency or office[A]: Special Projects of
National Significance (93.928) Health Resources and Services
Administration;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Consolidated Health
Centers (Community Health Centers, Migrant Health Centers, Health Care
for the Homeless, Public Housing Primary Care, and School Based Health
Centers) (93.224) Health Resources and Services Administration;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Trans-NIH Research
Support (93.310) National Institutes of Health.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Child Health and Human
Development Extramural Research (93.865) National Institutes of Health.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: $0.1 million;
Total: $0.1 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Improve the Health Status of Minority Populations (93.004) Office
of the Secretary, Office of Minority Health.
2002: 0.0;
2003: $0.1 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: State and Territorial
and Technical Assistance Capacity Development Minority HIV/AIDS
Demonstration Program (93.006) Office of the Secretary, Office of
Minority Health;
2002: 0.0;
2003: 0.0;
2004: $0.1 million;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: HIV Demonstration,
Research, Public and Professional Education Projects (93.941) Centers
for Disease Control and Prevention.
2002: 0.0;
2003: 0.0;
2004: 0.0[C];
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0[C].
Program title and number Agency or office[A]: Public Health and Social
Services Emergency Fund (93.003) Health Resources and Services
Administration.
2002: 0.0[C];
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0[C].
Program title and number Agency or office[A]: Total;
2002: $16.2 million;
2003: $15.6 million;
2004: $18.0 million;
2005: $17.6 million;
2006: $17.5 million;
2007: $15.8 million;
2008: $17.6 million;
2009: $19.4 million;
Total: $137.7 million.
Source: GAO analysis of HHS data.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds HHS reported obligating for the Planned Parenthood
Federation of America and 21 affiliates, by HHS program, in descending
order by total obligations.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] This program is administered by the Office of Population Affairs
under the Office of Public Health and Science in HHS, but is funded
through appropriations for the Health Resources and Services
Administration.
[C] Obligations of less than $50,000 rounded to zero. HHS reported
obligating about $30,000 in fiscal year 2006 through a program
supporting HIV prevention activities at nongovernmental organizations;
about $1,000 in fiscal year 2002 and $34,000 in fiscal year 2004
through a program supporting investigations and technical assistance;
about $34,000 in fiscal year 2006 for a program supporting state-based
safe motherhood and infant health initiatives; about $19,000 in fiscal
year 2004 for HIV research and education; and about $19,000 in fiscal
year 2002 for public health and social service emergencies.
[End of table]
Table 11: Federal Funds HHS Reported Obligating for the Population
Council, by HHS Program and Awarding Agency or Office, Fiscal Years
2002-2009:
Program title and number Agency or office[A]: Child Health and Human
Development Extramural Research (93.865)[B] National Institutes Of
Health:
2002: $4.6 million;
2003: $5.1 million;
2004: $5.5 million;
2005: $2.8 million;
2006: $2.5 million;
2007: $2.9 million;
2008: $2.5 million;
2009: $2.8 million;
Total: $28.7 million.
Program title and number Agency or office[A]: Allergy, Immunology and
Transplantation Research (93.855) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: $2.4 million;
2007: $2.6 million;
2008: $2.5 million;
2009: $3.0 million;
Total: $10.4 million.
Program title and number Agency or office[A]: Oral Disease and
Disorders Research (93.121) National Institutes of Health;
2002: 0.0;
2003: $0.5 million;
2004: $1.4 million;
2005: $1.4 million;
2006: $1.6 million;
2007: $1.0 million;
2008: $1.1 million;
2009: $0.6 million;
Total: $7.7 million.
Program title and number Agency or office[A]: HIV Demonstration,
Research, Public and Professional Education Projects (93.941) Centers
for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: $0.3 million;
2007: 0.0;
2008: $1.0 million;
2009: $2.8 million;
Total: $4.0 million.
Program title and number Agency or office[A]: Microbiology and
Infectious Diseases Research (93.856) National Institutes of Health;
2002: $1.2 million;
2003: $0.8 million;
2004: $0.8 million;
2005: $1.3 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $4.0 million.
Program title and number Agency or office[A]: Aging Research (93.866)
National Institutes of Health;
2002: $0.2 million;
2003: $0.2 million;
2004: 0.0;
2005: $0.1 million;
2006: $0.1 million;
2007: $0.4 million;
2008: $0.4 million;
2009: $0.4 million;
Total: $1.6 million.
Program title and number Agency or office[A]: Environmental Health
(93.113)[C] National Institutes Of Health;
2002: 0.0;
2003: 0.0;
2004: $0.3 million;
2005: $0.3 million;
2006: $0.3 million;
2007: $0.2 million;
2008: 0.0;
2009: 0.0;
Total: $1.2 million.
Program title and number Agency or office[A]: HIV Prevention
Activities_Health Department Based (93.940) Centers for Disease
Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.9 million;
2009: 0.0;
Total: $0.9 million.
Program title and number Agency or office[A]: Centers for Disease
Control and Prevention_Investigations and Technical Assistance
(93.283) Centers for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: $0.5 million;
2008: 0.0;
2009: 0.0;
Total: $0.5 million.
Program title and number Agency or office[A]: Acquired
Immunodeficiency Syndrome (AIDS) Activity (93.118) Centers for Disease
Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: $0.2 million;
2005: $0.3 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.4 million.
Program title and number Agency or office[A]: Trans-NIH Research
Support (93.310) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.3v;
2009: $0.1 million;
Total: $0.4 million.
Program title and number Agency or office[A]: National Institutes of
Health Acquired Immunodeficiency Syndrome Research Loan Repayment
Program (93.936) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: $0.2 million;
2005: 0.0;
2006: $0.1 million;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.4 million.
Program title and number Agency or office[A]: Kidney Diseases, Urology
and Hematology Research (93.849) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: $0.2 million;
2005: $0.2 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.3 million.
Program title and number Agency or office[A]: Trans-NIH Recovery Act
Research Support (93.701) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: $0.3 million;
Total: $0.3 million.
Program title and number Agency or office[A]: Drug Abuse and Addiction
Research Programs (93.279) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.1 million;
2009: 0.0;
Total: $0.1 million.
Program title and number Agency or office[A]: Total;
2002: $6.0 million;
2003: $6.5 million;
2004: $8.6 million;
2005: $6.3 million;
2006: $7.3 million;
2007: $7.6 million;
2008: $8.7 million;
2009: $9.9 million;
Total: $60.9 million.
Source: GAO analysis of HHS data.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds HHS reported obligating for the Population Council, by
HHS program, in descending order by total obligations.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] Reflects totals for HHS programs 93.864 and 93.865, which were
combined in 2003.
[C] Reflects totals for HHS programs 93.113 and 93.894, which were
combined in 2006.
[End of table]
Table 12: Federal Funds HHS Reported Obligating for the Sexuality
Information and Education Council of the United States, by HHS Program
and Awarding Agency or Office, Fiscal Years 2002-2009:
Program title and number Agency or office[A]: Centers for Disease
Control and Prevention_Investigations and Technical Assistance
(93.283) Centers for Disease Control and Prevention.
2002: $0.2 million;
2003: $0.1 million;
2004: $0.2 million;
2005: $0.2 million;
2006: $0.3 million;
2007: $0.3 million;
2008: 0.0;
2009: 0.0;
Total: $1.2 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Support Comprehensive School Health Programs to Prevent the Spread
of HIV and Other Important Health Problems (93.938) Centers for
Disease Control and Prevention.
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.3 million;
2009: $0.3 million;
Total: $0.5 million.
Program title and number Agency or office[A]: Preventive Health
Services_Sexually Transmitted Diseases Control Grants (93.977) Centers
for Disease Control and Prevention.
2002: $0.1 million;
2003: $0.1 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.2 million.
Program title and number Agency or office[A]: Total;
2002: $0.3 million;
2003: $0.2 million;
2004: $0.2 million;
2005: $0.2 million;
2006: $0.3 million;
2007: $0.3 million;
2008: $0.3 million;
2009: $0.3 million;
Total: $1.9 million.
Source: GAO analysis of HHS data.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds HHS reported obligating for the Sexuality Information
and Education Council of the United States, by HHS program, in
descending order by total obligations.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[End of table]
[End of section]
Enclosure II:
Amounts the United States Agency for International Development:
Reported Obligating for Selected Organizations, by Activity Category,
Fiscal Years 2002-2009:
This enclosure provides, for fiscal years 2002 through 2009, the
amounts the United States Agency for International Development (USAID)
reported obligating for the International Planned Parenthood
Federation and its affiliates and the Population Council, by activity
category, in descending order by total obligations.[Footnote 24] USAID
did not report obligating funds for the Planned Parenthood Federation
of America or its affiliates, the Guttmacher Institute, Advocates for
Youth, or the Sexuality Information and Education Council of the
United States for the period of our review. Activity categories were
provided by USAID and were identified by USAID officials. USAID
identified individual categories of health activities for about 90
percent of its obligations. The remaining 10 percent was identified as
nonhealth and unknown/unspecified activities. The health activity
category with the largest amount of obligations--about $144 million or
about 41 percent of total USAID obligations--was Family Planning and
Reproductive Health.
Table 13: Federal Funds USAID Reported Obligating for Selected
Organizations, by Activity Category, Fiscal Years 2002-2009:
Activity category: Family planning/reproductive health;
2002: $22.0 million;
2003: $13.0 million;
2004: $12.7 million;
2005: $15.5 million;
2006: $17.8 million;
2007: $17.3 million;
2008: $17.5 million;
2009: $27.8 million;
Total: $143.6 million.
Activity category: HIV/AIDS;
2002: $15.4 million;
2003: $18.8 million;
2004: $20.9 million;
2005: $22.6 million;
2006: $20.2 million;
2007: $14.0 million;
2008: $11.8 million;
2009: $17.5 million;
Total: $141.2 million.
Activity category: Other health[A];
2002: $5.0 million;
2003: $1.8 million;
2004: $2.3 million;
2005: $3.0 million;
2006: $2.5 million;
2007: $3.1 million;
2008: $2.1 million;
2009: $6.3 million;
Total: $26.0 million.
Activity category: Unknown/unspecified[B];
2002: $4.0 million;
2003: $0.2 million;
2004: $0.2 million;
2005: $0.1 million;
2006: 0.0;
2007: $4.8 million;
2008: $1.0 million;
2009: $7.5 million;
Total: $17.8 million.
Activity category: Nonhealth[C];
2002: $1.0 million;
2003: $3.8 million;
2004: 0.0;
2005: $4.6 million;
2006: 0.0;
2007: $3.0 million;
2008: $3.8 million;
2009: 0.0;
Total: $16.2 million.
Activity category: Avian flu;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.3 million;
2009: $2.0 million;
Total: $2.3 million.
Activity category: Total;
2002: $47.4 million;
2003: $37.6 million;
2004: $36.0 million;
2005: $45.8 million;
2006: $40.6 million;
2007: $42.2 million;
2008: $36.5 million;
2009: $61.1 million;
Total: $347.1 million.
Source: GAO analysis of USAID data.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds USAID reported obligating for the International Planned
Parenthood Federation and nine of its affiliates and the Population
Council, by activity category, in descending order by total
obligations. USAID did not report obligating funds for the Planned
Parenthood Federation of America or its affiliates, the Guttmacher
Institute, Advocates for Youth, or the Sexuality Information and
Education Council of the United States for the period of our review.
The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future.
Obligations may not add to totals due to rounding.
[A] Other health includes funds for maternal health, child health,
nutrition, and other infectious diseases, including malaria and
tuberculosis.
[B] Unknown/unspecified includes funds for broader development
purposes than health. Information on the activity category for which
the funds were obligated is not available in Phoenix.
[C] Nonhealth includes funds for general development assistance
activities other than health, including, for example, economic growth,
education, democracy and governance, climate change and environment,
and agriculture.
[End of table]
[End of section]
Enclosure III:
Expenditure Amounts Reported by Selected Organizations, by Department
of Health and Human Services Program and Awarding Agency or Office,
Fiscal Years 2002-2009:
This enclosure provides, for fiscal years 2002 through 2009, the
expenditures of federal funds that Advocates for Youth, the Guttmacher
Institute, the Planned Parenthood Federation of America and its
affiliates, and the Population Council reported, by Department of
Health and Human Services (HHS) program and awarding agency or
office.[Footnote 25] This enclosure does not contain a table for the
Sexuality Information and Education Council of the United States, but
this organization reported spending $304,503 in fiscal year 2003 for
an HHS program, Cooperative Agreements to Support Comprehensive School
Health Programs to Prevent the Spread of HIV and Other Important
Health Problems, awarded through the Centers for Disease Control and
Prevention. The International Planned Parenthood Federation did not
report spending HHS funds for the period of our review.[Footnote 26]
This enclosure does not contain expenditures of federal funds from
agencies other than HHS. The HHS program under which the organizations
and their affiliates reported the largest expenditures--about $342
million or 35 percent of total reported expenditures for HHS programs--
was a grant program, family planning services, authorized under Title
X of the Public Health Service Act.
Table 14: Advocates for Youth's Reported Expenditures of Federal Funds
by HHS Program and Awarding Agency or Office, Fiscal Years 2002-2009:
Program title and number Agency or office[A]: Cooperative Agreements
to Support Comprehensive School Health Programs to Prevent the Spread
of HIV and Other Important Health Problems (93.938) Centers for
Disease Control and Prevention;
2002: $0.4 million;
2003: $0.5 million;
2004: $0.4 million;
2005: $0.2 million;
2006: $0.2 million;
2007: $0.3 million;
2008: $0.4 million;
2009: $0.3 million;
Total: $2.7 million.
Program title and number Agency or office[A]: HIV Demonstration,
Research, Public and Professional Education Projects (93.941) Centers
for Disease Control and Prevention;
2002: $0.3 million;
2003: $0.8 million;
2004: $0.7 million;
2005: $0.9 million;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $2.7 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Support State-Based Safe Motherhood and Infant Health Initiative
Programs (93.946) Centers for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: $0.1 million;
2007: $0.4 million;
2008: $0.6 million;
2009: $0.6 million;
Total: $1.7 million.
Program title and number Agency or office[A]: Cooperative Agreements
to Improve the Health Status of Minority Populations (93.004) Office
of the Secretary, Office of Minority Health;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0[B];
2006: $0.2 million;
2007: $0.2 million;
2008: $0.2 million;
2009: $0.2 million;
Total: $0.7 million.
Program title and number Agency or office[A]: Centers for Disease
Control and Prevention_Investigations and Technical Assistance
(93.283) Centers for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: $0.2 million;
2005: $0.2 million;
2006: $0.1 million;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.6 million.
Program title and number Agency or office[A]: HIV Prevention
Activities_Non-governmental Organization Based (93.939) Centers for
Disease Control and Prevention;
2002: $0.2 million;
2003: $0.2 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.3 million.
Program title and number Agency or office[A]: Total;
2002: $0.8 million;
2003: $1.5 million;
2004: $1.3 million;
2005: $1.4 million;
2006: $0.7 million;
2007: $0.8 million;
2008: $1.1 million;
2009: $1.1 million;
Total: $8.7 million.
Source: GAO analysis.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds that Advocates for Youth reported spending for HHS
programs in descending order by total expenditures.
The term expenditure refers to the actual spending of money, also
known as an outlay.
Organizations based in the United States with expenditures of federal
funds of $500,000 or more ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on the organizations' 12-
month fiscal years, which vary. Advocates for Youth's fiscal year end
date is March 31.
Expenditures may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] Expenditures of less than $50,000 rounded to zero. Advocates for
Youth reported spending about $12,000 in 2005 for a program supporting
cooperative agreements to improve the health status of minority
populations.
[End of table]
Table 15: Guttmacher Institute's Reported Expenditures of Federal
Funds by HHS Program and Awarding Agency or Office, Fiscal Years 2002-
2009:
Program title and number Agency or office[A]: Child Health and Human
Development Extramural Research (93.865)[B] National Institutes Of
Health;
2002: $0.3 million;
2003: $0.7 million;
2004: $0.6 million;
2005: $0.7 million;
2006: $0.8 million;
2007: $0.6 million;
2008: $0.1 million;
2009: 0.0;
Total: $3.8 million.
Program title and number Agency or office[A]: Family Planning_Service
Delivery Improvement Research Grants (93.974)[C] Health Resources And
Services;
2002: $0.6 million;
2003: $0.6 million;
2004: $0.2 million;
2005: $0.2 million;
2006: $0.2 million;
2007: $0.4 million;
2008: $0.5 million;
2009: 0.0;
Total: $2.7 million.
Program title and number Agency or office[A]: Total;
2002: $0.8 million;
2003: $1.3 million;
2004: $0.8 million;
2005: $0.9 million;
2006: $1.0 million;
2007: $0.9 million;
2008: $0.7 million;
2009: 0.0;
Total: $6.6 million.
Source: GAO analysis.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds that Guttmacher Institute reported spending for HHS
programs, in descending order by total expenditures.
The term expenditure refers to the actual spending of money, also
known as an outlay.
Organizations based in the United States with expenditures of federal
funds of $500,000 or more ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on the organizations' 12-
month fiscal years, which vary. The Guttmacher Institute's fiscal year
end date is December 31.
Expenditures may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] Reflects totals for HHS programs 93.864 and 93.865, which were
combined in 2003.
[C] This program is administered by the Office of Population Affairs
under the Office of Public Health and Science in HHS, but is funded
through appropriations for the Health Resources and Services
Administration.
[End of table]
Table 16: The Planned Parenthood Federation of America and Affiliates'
Reported Expenditures of Federal Funds by Top 10 HHS Programs and
Awarding Agency or Office, Fiscal Years 2002-2009:
Program title and number Agency or office[A]: Family Planning_Services
(93.217)[B] Health Resources And Services Administration;
2002: $48.7 million;
2003: $45.5 million;
2004: $42.0 million;
2005: $50.4 million;
2006: $53.5 million;
2007: $49.0 million;
2008: $53.0 million;
2009: 0.0;
Total: $342.1 million.
Program title and number Agency or office[A]: Maternal and Child
Health Services Block Grant to the States (93.994) Health Resources
and Services Administration;
2002: $9.4 million;
2003: $9.5 million;
2004: $10.0 million;
2005: $9.5 million;
2006: $10.4 million;
2007: $9.2 million;
2008: $9.3 million;
2009: 0.0;
Total: $67.4 million.
Program title and number Agency or office[A]: Social Services Block
Grants (93.667) Administration for Children and Families;
2002: $8.8v;
2003: $7.2 million;
2004: $7.3 million;
2005: $8.4 million;
2006: $11.6 million;
2007: $10.8 million;
2008: $9.5 million;
2009: 0.0;
Total: $63.7 million.
Program title and number Agency or office[A]: Temporary Assistance for
Needy Families (93.558) Administration for Children and Families;
2002: $8.6v;
2003: $6.5 million;
2004: $9.9 million;
2005: $9.5 million;
2006: $7.9 million;
2007: $9.1 million;
2008: $9.6 million;
2009: 0.0;
Total: $61.2 million.
Program title and number Agency or office[A]: Medical Assistance
Program (Medicaid) (93.778) Centers for Medicare and Medicaid Services;
2002: $1.7v;
2003: $2.6 million;
2004: $2.0 million;
2005: $1.4 million;
2006: $2.3 million;
2007: $2.5 million;
2008: $2.5 million;
2009: 0.0;
Total: $15.0 million.
Program title and number Agency or office[A]: HIV Prevention
Activities_Health Department Based (93.940) Centers for Disease
Control and Prevention;
2002: $2.1 million;
2003: $1.3 million;
2004: $1.4 million;
2005: $1.4 million;
2006: $2.1 million;
2007: $2.0 million;
2008: $1.4 million;
2009: 0.0;
Total: $11.9 million.
Program title and number Agency or office[A]: Preventive Health
Services_Sexually Transmitted Diseases Control Grants (93.977) Centers
for Disease Control and Prevention;
2002: $2.2 million;
2003: $0.6 million;
2004: $1.4 million;
2005: $1.4 million;
2006: $1.7 million;
2007: $1.7 million;
2008: $1.5 million;
2009: 0.0;
Total: $10.4 million.
Program title and number Agency or office[A]: HIV Care Formula Grants
(93.917) Health Resources and Services Administration;
2002: $1.3 million;
2003: $1.3 million;
2004: $1.3 million;
2005: $1.7 million;
2006: $1.9 million;
2007: $1.7 million;
2008: $0.4 million;
2009: 0.0;
Total: $9.5 million.
Program title and number Agency or office[A]: Cooperative Agreements
for State-Based Comprehensive Breast and Cervical Cancer Early
Detection Programs (93.919) Centers for Disease Control and Prevention;
2002: $1.3 million;
2003: $1.7 million;
2004: $1.5 million;
2005: $0.8 million;
2006: $0.3 million;
2007: $0.3 million;
2008: $1.2 million;
2009: 0.0;
Total: $7.0 million.
Program title and number Agency or office[A]: HIV Prevention
Activities_Non-governmental Organization Based (93.939) Centers for
Disease Control and Prevention;
2002: $1.1 million;
2003: $0.8 million;
2004: $0.5 million;
2005: $1.1 million;
2006: $1.2 million;
2007: $0.7 million;
2008: $0.4 million;
2009: 0.0;
Total: $5.7 million.
Program title and number Agency or office[A]: Total;
2002: $85.2 million;
2003: $77.0 million;
2004: $77.4 million;
2005: $85.6 million;
2006: $93.0 million;
2007: $87.1 million;
2008: $88.7 million;
2009: 0.0;
Total: $593.9 million.
Source: GAO analysis.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds that the Planned Parenthood Federation of America and
its affiliates reported spending on 10 HHS programs that together
accounted for more than 90 percent of the total HHS funds the
organization and its affiliates reported spending over the period of
our review, in descending order by total expenditures. The remaining
funding was reported by the organization and its affiliates as
expenditures from HHS programs such as Centers for Disease Control and
Prevention_Investigations and Technical Assistance (93.283), HIV
Emergency Relief Projects Grants (93.914), Preventive Health and
Health Services Block Grants (93.991), Injury Prevention and Control
Research and State and Community Based Programs (93.136), Consolidated
Health Centers (93.224), Grants to Provide Outpatient Early
Intervention Services with Respect to HIV Disease (93.918), Health
Disparities in Minority Health (93.100), Adolescent Family
Life_Demonstration Projects (93.995), Family Planning_Personnel
Training (93.260), and Emergency Medical Services for Children
(93.127).
The term expenditure refers to the actual spending of money, also
known as an outlay.
Organizations based in the United States with expenditures of federal
funds of $500,000 or more ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on the organizations' 12-
month fiscal years, which vary.
Expenditures may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] This program is administered by the Office of Population Affairs
under the Office of Public Health and Science in HHS, but is funded
through appropriations for the Health Resources and Services
Administration.
[End of table]
Table 17: The Population Council's Reported Expenditures of Federal
Funds by Top 10 HHS Programs and Awarding Agency or Office, Fiscal
Years 2002-2009:
Program title and number Agency or office[A]: Child Health and Human
Development Extramural Research (93.865)[B] National Institutes Of
Health;
2002: $4.5 million;
2003: $4.5 million;
2004: $5.4 million;
2005: $3.5 million;
2006: $3.2 million;
2007: $2.7 million;
2008: $3.3 million;
2009: 0.0;
Total: $27.1 million.
Program title and number Agency or office[A]: Microbiology and
Infectious Diseases Research (93.856) National Institutes of Health;
2002: $1.3 million;
2003: $1.3 million;
2004: $1.1 million;
2005: $1.2 million;
2006: $0.6 million;
2007: $0.9 million;
2008: $0.1 million;
2009: 0.0;
Total: $6.6 million.
Program title and number Agency or office[A]: Oral Disease and
Disorders Research (93.121);
National Institutes of Health;
2002: 0.0;
2003: $0.2 million;
2004: $1.0 million;
2005: $1.2 million;
2006: $1.6 million;
2007: $0.9 million;
2008: $1.4 million;
2009: 0.0;
Total: $6.4 million.
Program title and number Agency or office[A]: Allergy, Immunology and
Transplantation Research (93.855) National Institutes of Health;
2002: 0.0;
2003: 0.0;
2004: 0.0[C];
2005: $0.1 million;
2006: $1.0 million;
2007: $1.7 million;
2008: $3.1 million;
2009: 0.0;
Total: $6.0 million.
Program title and number Agency or office[A]: HIV Demonstration,
Research, Public and Professional Education Projects (93.941) Centers
for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: $0.1 million;
2005: $0.2 million;
2006: $0.3 million;
2007: $0.4 million;
2008: $0.6 million;
2009: 0.0;
Total: $1.6 million.
Program title and number Agency or office[A]: Aging Research (93.866)
National Institutes of Health;
2002: $0.1 million;
2003: $0.2 million;
2004: $0.1 million;
2005: $0.1 million;
2006: $0.1 million;
2007: $0.3 million;
2008: $0.4 million;
2009: 0.0;
Total: $1.3 million.
Program title and number Agency or office[A]: Environmental Health
(93.113) National Institutes of Health;
2002: $0.1 million;
2003: 0.0;
2004: $0.1 million;
2005: $0.2 million;
2006: $0.3 million;
2007: $0.5 million;
2008: 0.0[C];
2009: 0.0;
Total: $1.2 million.
Program title and number Agency or office[A]: Kidney Diseases, Urology
and Hematology Research (93.849) National Institutes of Health;
2002: 0.0[C];
2003: 0.0;
2004: 0.0;
2005: $0.1 million;
2006: $0.1 million;
2007: 0.0[C];
2008: 0.0;
2009: 0.0;
Total: $0.3 million.
Program title and number Agency or office[A]: Global AIDS (93.067)
Centers for Disease Control and Prevention;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: $0.3 million;
2009: 0.0;
Total: $0.3 million.
Program title and number Agency or office[A]: Total;
2002: $6.0 million;
2003: $6.2 million;
2004: $7.9 million;
2005: $6.7 million;
2006: $7.2 million;
2007: $7.5 million;
2008: $9.2 million;
2009: 0.0;
Total: $50.7 million.
Source: GAO analysis.
Notes: This table provides, for fiscal years 2002 through 2009, the
federal funds that the Population Council reported spending on 10 HHS
programs that together accounted for more than 98 percent of the total
HHS funds the organization reported spending over the period of our
review, in descending order by total expenditures. Two of the 10
programs--93.864 and 93.865--were combined in 2003 and are shown as
one row in this table. The remaining funding was reported by the
organization as expenditures from HHS programs such as Mental Health
Research Grants (93.242) and Diabetes, Digestive, and Kidney Diseases
Extramural Research (93.847).
The term expenditure refers to the actual spending of money, also
known as an outlay.
Organizations based in the United States with expenditures of federal
funds of $500,000 or more ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on the organizations' 12-
month fiscal years, which vary. The Population Council's fiscal year
end date is December 31.
Expenditures may not add to totals due to rounding.
[A] This column lists the title of the program as listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009),
its corresponding CFDA number, and the HHS agency or office
administering the program.
[B] Reflects totals for HHS programs 93.864 and 93.865, which were
combined in 2003.
[C] Expenditures of less than $50,000 rounded to zero. The Population
Council reported spending about $29,000 in 2004 for a program
supporting allergy, immunology, and transplantation research; about
$32,000 in 2008 on a program supporting environmental health research;
and about $5,000 and $40,000 in 2002 and 2007, respectively, on a
program supporting kidney disease, hematology, and urology research.
[End of table]
[End of section]
Enclosure IV:
Expenditures Reported by Selected Organizations for Funding Provided
by the United States Agency for International Development, Fiscal
Years 2002-2009:
This enclosure provides, for fiscal years 2002 through 2009, the
expenditures of federal funds that Advocates for Youth, the Guttmacher
Institute, the International Planned Parenthood Federation, the
Planned Parenthood Federation of America and its affiliates, and the
Population Council reported for funding provided by the United States
Agency for International Development (USAID) in the audit reports we
reviewed.[Footnote 27] Data presented in table 18 for the
International Planned Parenthood Federation represents expenditures
reported by the U.S.-based Western Hemisphere regional office of the
organization; the organization's other regional offices and member
associations--with the exception of the Planned Parenthood Federation
of America--are not based in the United States and are not subject to
the audit reporting requirements. This enclosure does not contain
expenditures of federal funds from agencies or offices other than
USAID. The organization that reported spending the largest amount of
USAID funds during the period of our review--about $233 million in
total--was the Population Council.
Table 18: Organizations' Reported Expenditures of Federal Funds
Provided by USAID, Fiscal Years 2002-2009:
Organization: Advocates for Youth;
2002: 0.0;
2003: $0.1 million;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.1 million.
Organization: Guttmacher Institute;
2002: $0.8 million;
2003: $0.9 million;
2004: $0.9 million;
2005: $1.0 million;
2006: $1.0 million;
2007: $1.0 million;
2008: $0.5 million;
2009: 0.0;
Total: $6.1 million.
Organization: International Planned Parenthood Federation[A];
2002: $1.3 million;
2003: $1.0 million;
2004: $1.6 million;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $3.9 million.
Organization: Planned Parenthood Federation of America[B];
2002: $0.8 million;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: $0.8 million.
Organization: Population Council;
2002: $31.7 million;
2003: $33.6 million;
2004: $29.1 million;
2005: $34.7 million;
2006: $33.1 million;
2007: $35.6 million;
2008: $35.1 million;
2009: 0.0;
Total: $233.0 million.
Organization: Sexuality Information and Education Council of the
United States;
2002: 0.0;
2003: 0.0;
2004: 0.0;
2005: 0.0;
2006: 0.0;
2007: 0.0;
2008: 0.0;
2009: 0.0;
Total: 0.0.
Organization: Total;
2002: $34.7 million;
2003: $35.4 million;
2004: $31.6 million;
2005: $35.8 million;
2006: $34.1 million;
2007: $36.6 million;
2008: $35.7 million;
2009: 0.0;
Total: $243.8 million.
Source: GAO analysis.
Notes: This table provides, for fiscal years 2002 through 2009, the
amount of federal funds provided by USAID that Advocates for Youth,
the Guttmacher Institute, the International Planned Parenthood
Federation, the Planned Parenthood Federation of America, and the
Population Council reported spending in audit reports submitted and
available as of the end of federal fiscal year 2009. The Sexuality and
Information Council of the United States did not report spending any
funding provided by USAID during the period of our review.
The term expenditure refers to the actual spending of money, also
known as an outlay.
Organizations based in the United States with expenditures of federal
funds of $500,000 or more ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on organizations' 12-
month fiscal years, which vary.
Expenditures may not add to totals due to rounding.
[A] Amounts reflect expenditures of federal funds reported by the U.S.-
based Western Hemisphere regional office of the International Planned
Parenthood Federation. Other regional offices and member associations
of the International Planned Parenthood Federation that are not based
in the United States are not subject to the Office of Management and
Budget audit reporting requirement.
[B] Amounts represent expenditures of federal funds reported by an
affiliate of the Planned Parenthood Federation of America.
[End of table]
[End of section]
Enclosure V:
Comments from the United States Agency for International Development:
USAID:
From The American People:
U.S. Agency for International Development:
1300 Pennsylvania Avenue, NW:
Washington, DC 20523:
[hyperlink, http://www.usaid.gov]
May 13 2010:
Marcia Crosse:
Director, Health Care:
U.S. Government Accountability Office:
Washington, DC 20548:
Dear Ms. Crosse:
I am pleased to provide the U.S. Agency for International
Development's (USAID) formal response to the GAO draft correspondence
titled "Federal Funds: Fiscal Years 20022009 Obligations,
Disbursements, and Expenditures for Selected Organizations Involved in
Health”Related Activities" (GAO-10-533R).
The enclosed USAID comments are provided for incorporation with this
letter as an appendix to the final correspondence.
Thank you for the opportunity to respond to the GAO draft
correspondence and for the courtesies extended by your staff in the
conduct of this review.
Sincerely,
Signed by:
Drew W. Luten:
Senior Deputy Assistant Administrator:
Bureau for Management:
Enclosure: a/s:
USAID Comments On Draft GAO Correspondence No. GAO-10-533R:
The U.S. Agency for International Development (USAID) is pleased to
offer its comments to the GAO draft correspondence titled Federal
Funds: Fiscal Years 2002-2009 Obligations, Disbursements, and
Expenditures for Selected Organizations Involved in Health ”Related
Activities (GAO-10-533R). The report comes at an important time as the
Obama Administration has made health a high priority within U.S.
foreign assistance through development of the Global Health Initiative
and USAID is playing a central role in shaping the strategy and
implementation planning.
The draft GAO correspondence includes data on USAID funding to
selected organizations and their affiliates. As you are aware,
Congress appropriates funds to USAID under a number of different
funding accounts. USAID's accounting system, called Phoenix, tracks
obligations and disbursements made by USAID by funding account. Some
funding accounts are directed for specific health activity categories,
while other funding accounts are appropriated for multiple development
activities that could include health. The discussion on pp.2-3
regarding the level of detail available in Phoenix suggests that USAID
is not able to identify the specific amounts of funding associated
with the different funding categories. We respectfully submit that
this is not an accurate statement.
We have undertaken additional analysis of the data tables we provided
to the GAO and are able to identify all the obligations and
disbursements to the Population Council and the International Planned
Parenthood Federation (IPPF) member associations by funding account.
In addition, for this particular set of data, we are able to identify
the categories of health for which the funds were obligated for 90
percent of the funding. Specifically, our analysis indicates funds
were obligated for the following activity categories: 41 percent for
HIV/AIDS activities, 41 percent for family planning activities, 7
percent for other health activities, 1 percent for avian flu
activities, 5 percent for non-health activities, and 5 percent
unspecified activities. Funding included under the unspecified
category could have been used for multiple activities, including
health activities. These data were provided to the report team on May
10, 2010.
During the period January 2001 through January 2009, the "Mexico City
Policy" was in effect. The Mexico City Policy required foreign non-
governmental organizations to certify that they would not perform or
actively promote abortion as a method of family planning as a
condition for receiving USAID family planning assistance. The London-
based IPPF publicly refused to accept the conditions of the policy,
and no USAID funds were obligated to IPPF/London during this period.
IPPF member associations operate as independent legal entities and
some member associations took a different view from IPPF/London.
USAID/Washington, in concert with our field missions, is gathering
additional information on assistance to IPPF member associations
during the period covered by this GAO report.
[End of section]
Footnotes:
[1] In this report, we refer to an affiliate as an organization that
is associated with another as a subordinate, subsidiary, or member.
Affiliates of the selected organizations we reviewed operate
separately, may be separate legal entities from the parent
organization, and may be funded directly as well as indirectly from
federal agencies.
[2] Formerly the Alan Guttmacher Institute.
[3] 42 U.S.C. § 300 et seq.
[4] The term obligation refers to a definite commitment by a federal
agency that creates a legal liability to make payments immediately or
in the future. Agencies incur obligations, for example, when they
award grants or contracts to private entities. The term disbursement
refers to amounts paid by federal agencies, in cash or cash
equivalents, to satisfy government obligations.
[5] GAO identified HHS and USAID as the source of more than 90 percent
of expenditures of federal funds reported by the organizations and
their affiliates in fiscal year 2001. See GAO, Federal Funds: Fiscal
Year 2001 Expenditures by Selected Organizations Involved in Health-
Related Activities, [hyperlink,
http://www.gao.gov/products/GAO-03-527R] (Washington, D.C.: May 16,
2003).
[6] The term expenditure refers to the actual spending of money, also
known as an outlay.
[7] Organizations based in the United States with expenditures of
federal funds of $500,000 or more ($300,000 or more prior to 2004)
annually are required to have either a single audit or program-
specific audit in accordance with the Single Audit Act, as amended, 31
U.S.C. §§ 7501-7507, and implementing guidance of the Office of
Management and Budget, Circular A-133.
[8] Medicaid is a joint federal-state program authorized under Title
XIX of the Social Security Act that finances health care for certain
categories of low-income individuals, including children, persons with
disabilities, and persons who are elderly.
[9] [hyperlink, http://www.gao.gov/products/GAO-03-527R].
[10] We also determined that USAID could report values of
contraceptive commodities shipments, including condoms, that were
provided to the organizations. This information was not available
through USAID's Phoenix System but could be provided separately.
[11] HHS programs correspond to the title of the program listed in the
Catalog of Federal Domestic Assistance (CFDA): www.cfda.gov (2009).
[12] Organizations report expenditures over varying 12-month fiscal
years. We obtained publicly available audit reports from the Federal
Audit Clearinghouse Web site (http://harvester.census.gov/fac/) that
were available as of the end of federal fiscal year 2009.
[13] The Planned Parenthood Federation of America is a member
association of the International Planned Parenthood Federation but is
a separate entity from the International Planned Parenthood
Federation's U.S.-based Western Hemisphere Regional Office. In this
report we present information for the Planned Parenthood Federation of
America and its affiliates separately from the International Planned
Parenthood Federation and its member associations. The number of
affiliates and health care centers is accurate as of January 21, 2010.
[14] 74 Fed. Reg. 4903 (Jan. 28, 2009).
[15] According to HHS officials, it is possible for disbursements to
be greater than obligations in any given fiscal year, as disbursements
do not need to occur in the same year in which the funds were
obligated.
[16] The funding includes obligations and disbursements under a
program for family planning services authorized under Title X of the
Public Health Service Act, which is administered by the Office of
Population Affairs under the Office of Public Health and Science in
HHS, but is funded through appropriations for HRSA.
[17] See enclosure I for additional information on obligations by HHS
program.
[18] According to USAID officials, it is possible for disbursements to
be greater than obligations in any given fiscal year, as disbursements
do not need to occur in the same year in which the funds were
obligated.
[19] See enclosure II for additional information on obligations by
USAID activity categories.
[20] Organizations reported expenditures over varying 12-month fiscal
years that did not always align with the federal fiscal year.
[21] This program is authorized under Title X of the Public Health
Service Act. See enclosure III for information on reported
expenditures by HHS program.
[22] See enclosure IV for information on reported expenditures for
funding provided by USAID.
[23] Tables 8 through 12 provide the total amounts HHS reported
obligating for fiscal years 2002 through 2009 by HHS program in
descending order by total obligations. HHS programs are identified by
program title and number as listed in the Catalog of Federal Domestic
Assistance (CFDA): www.cfda.gov (2009).
[24] Table 13 provides the total amounts USAID reported obligating for
fiscal years 2002 through 2009, by activity category, in descending
order by total obligations.
[25] Tables 14 and 15 present the amounts Advocates for Youth and the
Guttmacher Institute reported spending for fiscal years 2002 through
2009, by HHS program, in descending order by total expenditures.
Tables 16 and 17 present the amounts the Planned Parenthood Federation
of America and its affiliates and the Population Council reported
spending for fiscal years 2002 through 2009, by the 10 HHS programs
that together accounted for more than 90 percent of each
organization's total expenditures of HHS funds, in descending order by
total expenditures. Organizations based in the United States with
expenditures of federal funds of $500,000 or more ($300,000 or more
prior to 2004) annually are required to have either a single audit or
program-specific audit in accordance with the Single Audit Act, as
amended, 31 U.S.C. §§ 7501-7507, and implementing guidance of the
Office of Management and Budget, Circular A-133. Amounts are reported
on organizations' 12-month fiscal years, which vary. We obtained
publicly available audit reports from the Federal Audit Clearinghouse
Web site (http://harvester.census.gov/fac/) that were available as of
the end of federal fiscal year 2009.
[26] The U.S.-based Western Hemisphere regional office of the
International Planned Parenthood Federation submitted audit reports
during the period of our review, but did not report spending federal
funds through HHS programs.
[27] Organizations based in the United States with expenditures of
federal funds of $500,000 ($300,000 or more prior to 2004) annually
are required to have either a single audit or program-specific audit
in accordance with the Single Audit Act, as amended, 31 U.S.C. §§ 7501-
7507, and implementing guidance of the Office of Management and
Budget, Circular A-133. Amounts are reported on organizations' 12-
month fiscal years, which vary. We obtained publicly available audit
reports from the Federal Audit Clearinghouse Web site
(http://harvester.census.gov/fac/) that were available as of the end
of federal fiscal year 2009. The Sexuality and Information Council of
the United States did not report spending any funding provided by
USAID during the period of our review.
[End of section]
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