United Sttes Government Accountbility Office Wshington, DC 20548 My 28, 2010 Congressionl Requesters Subject: Federl Funds: Fiscl Yers 2002-2009 Obligtions, Disbursements, nd Expenditures for Selected Orgniztions Involved in Helth-Relted Activities This report responds to your request for informtion on federl funds provided for fiscl yers 2002 through 2009 to selected orgniztions involved in helth-relted ctivities nd their ffilites: 1 Advoctes for Youth, the Guttmcher Institute, 2 the Interntionl Plnned Prenthood Federtion, the Plnned Prenthood Federtion of Americ, the Popultion Council, nd the Sexulity Informtion nd Eduction Council of the United Sttes. Specificlly, you requested tht we identify the mount of federl funds provided to the selected orgniztions nd their ffilites for ech of fiscl yers 2002 through 2009 nd the sources of these federl funds (for exmple, fmily plnning grnts uthorized under Title X of the Public Helth Service Act). 3 You lso sked us to provide informtion on expenditures of federl funds reported by these orgniztions nd their ffilites. For this report, we identified (1) reported obligtions nd disbursements 4 of federl funds tht the Deprtment of Helth nd Humn Services (HHS) nd the United Sttes Agency for Interntionl Development (USAID) provided directly to the selected orgniztions nd their ffilites, 5 nd (2) expenditures 6 of federl funds reported by orgniztions nd their ffilites in instnces in which n orgniztion or n ffilite met the Office of Mngement nd Budget udit threshold nd submitted n udit report. 7 Expenditures included both funds provided directly by HHS, USAID, nd other federl entities such s the U.S. Deprtment of Housing 1 In this report, we refer to n ffilite s n orgniztion tht is ssocited with nother s subordinte, subsidiry, or member. Affilites of the selected orgniztions we reviewed operte seprtely, my be seprte legl entities from the prent orgniztion, nd my be funded directly s well s indirectly from federl gencies. 2 Formerly the Aln Guttmcher Institute. 3 42 U.S.C. 300 et seq. 4 The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Agencies incur obligtions, for exmple, when they wrd grnts or contrcts to privte entities. The term disbursement refers to mounts pid by federl gencies, in csh or csh equivlents, to stisfy government obligtions. 5 GAO identified HHS nd USAID s the source of more thn 90 percent of expenditures of federl funds reported by the orgniztions nd their ffilites in fiscl yer 2001. See GAO, Federl Funds: Fiscl Yer 2001 Expenditures by Selected Orgniztions Involved in Helth-Relted Activities, GAO-03-527R (Wshington, D.C.: My 16, 2003). 6 The term expenditure refers to the ctul spending of money, lso known s n outly. 7 Orgniztions bsed in the United Sttes with expenditures of federl funds of $500,000 or more ($300,000 or more prior to 2004) nnully re required to hve either single udit or progrm-specific udit in ccordnce with the Single Audit Act, s mended, 31 U.S.C. 7501-7507, nd implementing guidnce of the Office of Mngement nd Budget, Circulr A-133.
nd Urbn Development, nd funds provided indirectly to the orgniztions or their ffilites, such s funds through the Medicid progrm. 8 This informtion updtes our My 16, 2003, report tht provided informtion on fiscl yer 2001 expenditures of federl funds by the orgniztions nd their ffilites. 9 To obtin informtion on federl funds obligted for nd disbursed to the selected orgniztions nd their ffilites, the federl gencies tht provided the funds, nd the source of the funding, we interviewed officils from the federl gencies nd from the orgniztions included in our prior work bout federl funding dt. We determined tht HHS nd USAID could provide dt on obligtions nd disbursements of federl funds they provided directly to the selected orgniztions nd their ffilites from their udited finncil ccounting systems: the Pyment Mngement System nd the Phoenix System, respectively. 10 We sked HHS nd USAID to provide obligtion nd disbursement dt for ech of federl fiscl yers 2002 through 2009. These dt did not include federl funds provided indirectly to the orgniztions, such s from HHS grnts to sttes tht in turn provided the funds to these orgniztions nd USAID funding provided to other entities tht in turn provided the funds to the orgniztions in our review. Additionlly, for federl fiscl yers 2002 through 2005, complete obligtion nd disbursement dt for wrds mde through USAID s oversesbsed missions were not vilble. As result, obligtions nd disbursements in this report my understte the ctul mount of federl funds provided to the selected orgniztions nd their ffilites. For HHS, the deprtment provided dt by the gency or office tht wrded the funds s well s by HHS progrm. 11 For USAID, the gency provided generl ctegories of helth ctivities ssocited with bout 90 percent of their obligtions. We reviewed current udit opinions on the Pyment Mngement System nd the Phoenix System nd determined tht dt from these systems were sufficiently relible for our purposes. To obtin informtion on reported expenditures of federl funds by the selected orgniztions nd their ffilites for fiscl yers 2002 through 2009, we reviewed the expenditure informtion contined in publicly vilble udit reports submitted in ccordnce with the Single Audit Act, s mended, nd implementing guidnce of the Office of Mngement nd Budget, Circulr A-133. 12 These udit reports include expenditures of federl funds tht HHS gencies nd offices nd USAID provided both directly nd indirectly to the selected orgniztions nd their ffilites, s well s expenditures of funds provided directly nd indirectly by federl gencies other thn HHS nd USAID, such s the Deprtment of Housing nd Urbn Development, which provided grnts totling bout $4.1 million to Plnned Prenthood ffilites who reported such expenditures during the period of our review. The udit reports lso included informtion on the HHS progrm through which funding ws provided; they did not include comprble informtion for USAID. We did not obtin dt on expenditures of federl funds by orgniztions or their 8 Medicid is joint federl-stte progrm uthorized under Title XIX of the Socil Security Act tht finnces helth cre for certin ctegories of low-income individuls, including children, persons with disbilities, nd persons who re elderly. 9 GAO-03-527R. 10 We lso determined tht USAID could report vlues of contrceptive commodities shipments, including condoms, tht were provided to the orgniztions. This informtion ws not vilble through USAID s Phoenix System but could be provided seprtely. 11 HHS progrms correspond to the title of the progrm listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009). 12 Orgniztions report expenditures over vrying 12-month fiscl yers. We obtined publicly vilble udit reports from the Federl Audit Cleringhouse Web site (http://hrvester.census.gov/fc/) tht were vilble s of the end of federl fiscl yer 2009. 2
ffilites tht did not submit such udit reports, for exmple, orgniztions tht did not meet the udit threshold. As result, expenditures in this report my understte the ctul mount of federl funds the selected orgniztions nd their ffilites spent. The expenditure informtion in these udit reports ws independently udited nd we determined tht the dt were sufficiently relible for our purposes. In ddition to the limittions described previously, gencies reported obligtions nd disbursements by federl fiscl yer while the orgniztions nd their ffilites reported expenditures by their vrying fiscl yers, so these mounts re not comprble nd cnnot be totled. Further, disbursement nd expenditure mounts cnnot be combined together becuse funds disbursed by n gency re then spent by n orgniztion; combining the two would result in counting the funds twice. We conducted our work from June 2009 through My 2010 in ccordnce with ll sections of GAO s Qulity Assurnce Frmework tht were relevnt to our objective. The frmework requires tht we pln nd perform the enggement to obtin sufficient nd pproprite evidence to meet our stted objectives nd to discuss ny limittions in our work. In summry, for the period of fiscl yers 2002 through 2009, HHS nd USAID reported obligting bout $217 million nd $347 million, respectively, to the selected orgniztions nd their ffilites we reviewed, nd disbursing bout $188 million nd $319 million, respectively, in ccordnce with these obligtions. The selected orgniztions nd their ffilites we reviewed reported spending totl of bout $967 million in federl funds. This includes funds provided directly by HHS nd USAID nd federl funds provided indirectly, such s from federl grnts to sttes tht in turn provide the funds to these orgniztions. HHS nd USAID reviewed drft of this report nd provided technicl comments, which we incorported s pproprite. In ddition, we incorported more detiled USAID dt on obligtions by ctivity ctegory tht USAID provided fter receiving the drft report for review. Bckground The six selected orgniztions nd their ffilites operte within the United Sttes nd interntionlly nd engge in helth-relted ctivities such s providing informtion regrding reproductive helth nd dministering services relted to the prevention nd tretment of humn immunodeficiency virus/cquired immunodeficiency syndrome (HIV/AIDS). Advoctes for Youth is nonprofit orgniztion locted in Wshington, D.C. tht promotes dolescent reproductive nd sexul helth progrms nd policies in the United Sttes nd brod. According to the orgniztion, in 2008, Advoctes for Youth worked with more thn 28,000 professionls who provided informtion nd ssistnce to over 9.5 million teens round the world to help them mke decisions bout their sexul helth. The Guttmcher Institute is nonprofit orgniztion with offices in New York City nd Wshington, D.C. nd provides informtion on sexul ctivity, contrception, bortion, nd childbering. According to the orgniztion, it seeks to improve sexul nd reproductive helth in the United Sttes nd worldwide through n interrelted progrm of socil science reserch, policy nlysis, nd public eduction. The orgniztion lso supports U.S. nd interntionl reserch nd publictions. 3
The Interntionl Plnned Prenthood Federtion is fmily helth cre orgniztion hedqurtered in London nd registered s chrity in the United Kingdom. The orgniztion hs six regionl offices, including Western Hemisphere regionl office locted in the United Sttes. As of December 2009, the federtion reported it hd 152 utonomous member ssocitions operting in 163 countries. According to the orgniztion, it works through its member ssocitions to promote ccess to reproductive helth services, bortion services, nd services relted to the prevention nd tretment of HIV/AIDS. The Plnned Prenthood Federtion of Americ, with ntionl offices in New York City nd Wshington, D.C., is ntionl nonprofit orgniztion tht provides support services to 89 ffilites tht operte 850 helth cre centers cross the country. 13 Plnned Prenthood ffilites re seprtely incorported nd independent orgniztions with their own bords of directors nd finncil utonomy. According to the orgniztion, ech yer, Plnned Prenthood helth centers provide reproductive helth cre including routine exms nd screenings, contrception, bortion cre, nd testing nd tretment for sexully trnsmitted infections to 3 million ptients. The Popultion Council is n interntionl nonprofit reserch orgniztion with hedqurters in New York City. According to the orgniztion, it seeks to improve reproductive helth round the world; conducts biomedicl, socil science, nd public helth reserch; nd helps build reserch cpcities in developing countries. As of Jnury 2010, its New York hedqurters supported globl network of 17 regionl nd country offices, which conduct reserch in over 50 countries. The Sexulity Informtion nd Eduction Council of the United Sttes is nonprofit orgniztion with offices in New York City nd Wshington, D.C. According to the orgniztion, it promotes comprehensive eduction on nd ccess to informtion bout humn sexulity nd conducts dvoccy on issues pertining to sexul nd reproductive rights. During most of the period of our review, wht hs become known s the Mexico City Policy ws in effect. This policy required foreign nongovernmentl orgniztions to gree s condition of their receipt of federl funds for fmily plnning ctivities tht such orgniztions would neither perform nor ctively promote bortion s method of fmily plnning in other ntions. This policy ws revoked in Jnury 2009. 14 Federl Funds HHS nd USAID Reported Obligting for nd Disbursing to Selected Orgniztions For fiscl yers 2002 through 2009, HHS reported tht its gencies nd offices primrily the Helth Resources nd Services Administrtion obligted bout $217 million for nd disbursed bout $188 million to the selected orgniztions nd their ffilites. Over the sme period, USAID reported obligting bout $347 million for nd disbursing bout $319 million to the selected orgniztions nd their ffilites for helth ctivities such s HIV/AIDS nd fmily plnning nd reproductive helth. 13 The Plnned Prenthood Federtion of Americ is member ssocition of the Interntionl Plnned Prenthood Federtion but is seprte entity from the Interntionl Plnned Prenthood Federtion s U.S.-bsed Western Hemisphere Regionl Office. In this report we present informtion for the Plnned Prenthood Federtion of Americ nd its ffilites seprtely from the Interntionl Plnned Prenthood Federtion nd its member ssocitions. The number of ffilites nd helth cre centers is ccurte s of Jnury 21, 2010. 14 74 Fed. Reg. 4903 (Jn. 28, 2009). 4
Federl Funds HHS Reported Obligting for nd Disbursing to Selected Orgniztions For fiscl yers 2002 through 2009, HHS reported obligting bout $217 million for nd disbursing bout $188 million to the selected orgniztions nd their ffilites (see tble 1 for obligtions nd tble 2 for disbursements). 15 Tble 1: Federl Funds HHS Reported Obligting for Selected Orgniztions, Fiscl Yers 2002-2009 Orgniztion 2002 2003 2004 2005 2006 2007 2008 2009 Totl Advoctes for Youth $1.5 1.2 0.9 0.9 1.1 1.1 1.1 1.1 8.9 Guttmcher Institute 1.2 1.4 1.1 0.9 0.5 0.4 0.8 1.1 7.4 Interntionl Plnned Prenthood Federtion 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Plnned Prenthood Federtion of Americ b 16.2 15.6 18.0 17.6 17.5 15.8 17.6 19.4 137.7 Popultion Council 6.0 6.5 8.6 6.3 7.3 7.6 8.7 9.9 60.9 Sexulity Informtion nd Eduction Council of the United Sttes 0.3 0.2 0.2 0.2 0.3 0.3 0.3 0.3 1.9 Totl 25.2 24.9 28.8 25.9 26.6 25.2 28.4 31.8 216.7 Source: GAO nlysis of HHS dt. Notes: This tble provides, for federl fiscl yers 2002 through 2009, the mounts HHS reported obligting directly for the six orgniztions nd their ffilites in our review, including 21 ffilites of the Plnned Prenthood Federtion of Americ. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. HHS did not report obligting funds for the Interntionl Plnned Prenthood Federtion or its member ssocitions in federl fiscl yers 2002 through 2009. b Includes mounts HHS reported obligting for ffilites of the Plnned Prenthood Federtion of Americ. 15 According to HHS officils, it is possible for disbursements to be greter thn obligtions in ny given fiscl yer, s disbursements do not need to occur in the sme yer in which the funds were obligted. 5
Tble 2: Federl Funds HHS Reported Disbursing to Selected Orgniztions, Fiscl Yers 2002-2009 Orgniztion 2002 2003 2004 2005 2006 2007 2008 2009 Totl Advoctes for Youth $0.0 1.1 1.3 1.1 0.7 0.9 1.2 1.1 7.3 Guttmcher Institute 0.0 1.0 1.2 0.8 1.0 1.1 0.6 1.0 6.7 Interntionl Plnned Prenthood Federtion b 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Plnned Prenthood Federtion of Americ c 6.1 14.7 16.1 17.0 18.0 18.0 16.3 16.9 123.1 Popultion Council 1.4 4.2 7.1 7.2 5.0 6.9 7.7 9.6 49.2 Sexulity Informtion nd Eduction Council of the United Sttes 0.3 0.2 0.2 0.2 0.3 0.3 0.2 0.0 1.6 Totl 7.9 21.2 25.9 26.3 25.0 27.2 25.9 28.6 187.8 Source: GAO nlysis of HHS dt. Notes: This tble provides the mount HHS reported disbursing in ccordnce with obligtions for federl fiscl yers 2002 through 2009 directly to the six orgniztions nd their ffilites in our review, including 19 ffilites of the Plnned Prenthood Federtion of Americ. The term disbursement refers to mounts pid by federl gencies, in csh or csh equivlents, to stisfy government obligtions. Disbursements my not dd to totls due to rounding. Disbursements of less thn $50,000 rounded to zero. HHS reported disbursing bout $3,000 to Advoctes for Youth nd bout $6,000 to the Guttmcher Institute in federl fiscl yer 2002. b HHS did not report disbursing funds to the Interntionl Plnned Prenthood Federtion or its member ssocitions in federl fiscl yers 2002 through 2009. c Includes mounts HHS reported disbursing to ffilites of the Plnned Prenthood Federtion of Americ. Tbles 3 nd 4 provide informtion on the mounts HHS reported obligting for nd disbursing to the six selected orgniztions nd their ffilites in our review, by HHS wrding gency or office. The lrgest mounts obligted nd disbursed bout $132 million nd $118 million, respectively were provided through HHS s Helth Resources nd Services Administrtion (HRSA). 16 This funding ws provided predominntly through n HHS progrm for fmily plnning services. 17 16 The funding includes obligtions nd disbursements under progrm for fmily plnning services uthorized under Title X of the Public Helth Service Act, which is dministered by the Office of Popultion Affirs under the Office of Public Helth nd Science in HHS, but is funded through ppropritions for HRSA. 17 See enclosure I for dditionl informtion on obligtions by HHS progrm. 6
Tble 3: Federl Funds HHS Reported Obligting for Selected Orgniztions, by Awrding Agency or Office, Fiscl Yers 2002-2009 Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Centers for Disese Control nd Prevention $2.8 2.3 2.2 2.3 2.3 2.5 3.9 4.5 22.8 Helth Resources nd Services Administrtion 15.2 14.7 16.7 16.6 16.7 15.4 17.2 19.2 131.8 Ntionl Institutes of Helth 6.8 7.5 9.3 6.7 7.3 7.2 7.1 7.8 59.6 Office of the Secretry 0.3 0.4 0.5 0.2 0.2 0.2 0.2 0.3 2.5 Totl 25.2 24.9 28.8 25.9 26.6 25.2 28.4 31.8 216.7 Source: GAO nlysis of HHS dt. Notes: This tble provides, for federl fiscl yers 2002 through 2009, the mounts HHS reported obligting directly for the six orgniztions nd their ffilites, including 21 ffilites of the Plnned Prenthood Federtion of Americ, by HHS gency or office. HHS did not report obligting funds for the Interntionl Plnned Prenthood Federtion or its member ssocitions during the period of our review. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. Tble 4: Federl Funds HHS Reported Disbursing to Selected Orgniztions, by Awrding Agency or Office, Fiscl Yers 2002-2009 Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Centers for Disese Control nd Prevention $0.4 2.3 2.4 2.4 2.3 2.1 2.7 3.1 17.6 Helth Resources nd Services Administrtion 6.0 13.8 15.3 15.5 17.0 17.4 15.9 16.7 117.6 Ntionl Institutes of Helth 1.4 4.8 7.8 7.8 5.4 7.4 7.2 8.5 50.4 Office of the Secretry 0.0 0.3 0.4 0.5 0.3 0.3 0.2 0.2 2.1 Totl 7.9 21.2 25.9 26.3 25.0 27.2 25.9 28.6 187.8 Source: GAO nlysis of HHS dt. Notes: This tble provides the mount HHS reported disbursing in ccordnce with obligtions for federl fiscl yers 2002 through 2009 directly to the six orgniztions nd their ffilites, including 19 ffilites of the Plnned Prenthood Federtion of Americ. HHS did not report disbursing funds to the Interntionl Plnned Prenthood Federtion or its member ssocitions during the period of our review. The term disbursement refers to mounts pid by federl gencies, in csh or csh equivlents, to stisfy government obligtions. Disbursements my not dd to totls due to rounding. Disbursements of less thn $50,000 rounded to zero. The Office of the Secretry reported disbursing bout $15,000 in federl fiscl yer 2002 to the selected orgniztions nd their ffilites. 7
Federl Funds USAID Reported Obligting for nd Disbursing to Selected Orgniztions For fiscl yers 2002 through 2009, USAID reported obligting bout $347 million for nd disbursing bout $319 million to the selected orgniztions nd their ffilites (see tble 5 for obligtions nd tble 6 for disbursements). 18 According to USAID, this funding ws for helth ctivities such s HIV/AIDS nd fmily plnning nd reproductive helth. 19 In ddition to the funding presented in tbles 5 nd 6, USAID reported shipping contrceptive commodities, including condoms, vlued t pproximtely $7.6 million to ffilites of the Interntionl Plnned Prenthood Federtion during the period of our review. Tble 5: Federl Funds USAID Reported Obligting for Selected Orgniztions, Fiscl Yers 2002-2009 Orgniztion 2002 2003 2004 2005 2006 2007 2008 2009 Totl Advoctes for Youth $0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Guttmcher Institute 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Interntionl Plnned Prenthood Federtion 18.7 13.6 6.0 11.2 6.3 10.6 9.4 17.9 93.9 Plnned Prenthood Federtion of Americ 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Popultion Council 28.6 23.9 30.1 34.6 34.2 31.6 27.1 43.1 253.3 Sexulity Informtion nd Eduction Council of the United Sttes 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Totl 47.4 37.6 36.0 45.8 40.6 42.2 36.5 61.1 347.1 Source: GAO nlysis of USAID dt. Notes: This tble provides, for federl fiscl yers 2002 through 2009, the mounts USAID reported obligting directly for the six orgniztions in our review. Obligtions for the Interntionl Plnned Prenthood Federtion represent funding for nine of its member ssocitions. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. For federl fiscl yers 2002 through 2005, complete obligtion dt for wrds mde through the gency s overses-bsed missions were not vilble. Obligtions my not dd to totls due to rounding. USAID did not report obligting funds for Advoctes for Youth, the Guttmcher Institute, the Plnned Prenthood Federtion of Americ or its ffilites, or the Sexulity Informtion nd Eduction Council of the United Sttes in federl fiscl yers 2002 through 2009. 18 According to USAID officils, it is possible for disbursements to be greter thn obligtions in ny given fiscl yer, s disbursements do not need to occur in the sme yer in which the funds were obligted. 19 See enclosure II for dditionl informtion on obligtions by USAID ctivity ctegories. 8
Tble 6: Federl Funds USAID Reported Disbursing to Selected Orgniztions, Fiscl Yers 2002-2009 Orgniztion 2002 2003 2004 2005 2006 2007 2008 2009 Totl Advoctes for Youth $0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Guttmcher Institute 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Interntionl Plnned Prenthood Federtion b 10.8 12.5 12.0 9.9 9.3 9.6 11.8 10.4 86.2 Plnned Prenthood Federtion of Americ 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Popultion Council 8.3 23.0 34.1 30.4 36.6 29.6 37.1 33.7 232.9 Sexulity Informtion nd Eduction Council of the United Sttes 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Totl 19.1 35.5 46.1 40.3 45.9 39.2 48.9 44.1 319.1 Source: GAO nlysis of USAID dt. Notes: This tble provides the mount USAID reported disbursing in ccordnce with obligtions for federl fiscl yers 2002 through 2009 directly to the six orgniztions in our review. Disbursements to the Interntionl Plnned Prenthood Federtion represent funding to nine of its member ssocitions. The term disbursement refers to mounts pid by federl gencies, in csh or csh equivlents, to stisfy government obligtions. For federl fiscl yers 2002 through 2005, complete disbursement dt for wrds mde through the gency s oversesbsed missions were not vilble. Disbursements my not dd to totls due to rounding. USAID did not report disbursing funds to Advoctes for Youth, the Guttmcher Institute, the Plnned Prenthood Federtion of Americ or its ffilites, or the Sexulity Informtion nd Eduction Council of the United Sttes in federl fiscl yers 2002 through 2009. b USAID lso reported tht it shipped contrceptive commodities vlued t $2.4 million, $2.1 million, $1.3 million, $0.3 million, $0.3 million, $0.4 million, $0.7 million, nd $0.1 million to ffilites of the Interntionl Plnned Prenthood Federtion in federl fiscl yers 2002 through 2009, respectively. These mounts re not disbursements reported from USAID s Phoenix System nd re not reflected in the tble. Expenditures of Federl Funds Reported by Selected Orgniztions For fiscl yers 2002 through 2009, the selected orgniztions nd their ffilites in our review reported totl expenditures of bout $967 million in federl funds provided directly nd indirectly (see tble 7). 20 More thn one-third of this mount, bout $342 million, ws reported s expenditures from n HHS progrm for fmily plnning services. 21 Nerly ll (bout $942 million) of the reported expenditures were from progrms dministered by HHS nd USAID; 22 the remining $25 million in reported expenditures were primrily from progrms dministered by the U.S. Deprtment of Housing nd Urbn Development, the U.S. Deprtment of Agriculture, nd the U.S. Deprtment of Justice. 20 Orgniztions reported expenditures over vrying 12-month fiscl yers tht did not lwys lign with the federl fiscl yer. 21 This progrm is uthorized under Title X of the Public Helth Service Act. See enclosure III for informtion on reported expenditures by HHS progrm. 22 See enclosure IV for informtion on reported expenditures for funding provided by USAID. 9
Tble 7: Orgniztions Reported Expenditures of Federl Funds, Fiscl Yers 2002-2009 Orgniztion 2002 2003 2004 2005 2006 2007 2008 2009 Totl Advoctes for Youth $0.8 1.6 1.3 1.4 0.7 0.8 1.1 1.1 8.7 Guttmcher Institute 1.7 2.2 1.7 1.9 2.1 1.9 1.2 0.0 12.7 Interntionl Plnned Prenthood Federtion 1.3 1.0 1.6 0.0 0.0 0.0 0.0 0.0 3.9 Plnned Prenthood Federtion of Americ b 94.5 88.5 86.7 93.7 100.0 97.6 96.2 0.0 657.1 Popultion Council 37.9 39.8 37.1 41.6 40.5 43.2 44.4 0.0 284.3 Sexulity Informtion nd Eduction Council of the United Sttes 0.0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.3 Totl 136.2 133.3 128.4 138.6 143.2 143.5 142.9 1.1 967.1 Source: GAO nlysis. Notes: This tble provides, for fiscl yers 2002 through 2009, the mount of federl funds selected orgniztions nd their ffilites, including ffilites of the Plnned Prenthood Federtion of Americ nd the U.S.-bsed Western Hemisphere regionl office of the Interntionl Plnned Prenthood Federtion, reported spending in udit reports submitted nd vilble s of the end of federl fiscl yer 2009. The term expenditure refers to the ctul spending of money, lso known s n outly. Orgniztions bsed in the United Sttes with expenditures of federl funds of $500,000 or more ($300,000 or more prior to 2004) nnully re required to hve either single udit or progrm-specific udit in ccordnce with the Single Audit Act, s mended, 31 U.S.C. 7501-7507, nd implementing guidnce of the Office of Mngement nd Budget, Circulr A-133. Amounts re reported on orgniztions 12-month fiscl yers, which vry. Expenditures my not dd to totls due to rounding. Amounts reflect expenditures of federl funds reported by the U.S.-bsed Western Hemisphere regionl office of the Interntionl Plnned Prenthood Federtion. Other regionl offices nd member ssocitions of the Interntionl Plnned Prenthood Federtion tht re not bsed in the United Sttes re not subject to the Office of Mngement nd Budget udit reporting requirement. b Includes expenditures reported by 85 ffilites of the Plnned Prenthood Federtion of Americ. Plnned Prenthood Federtion of Americ nd its ffilites re seprte entities from the U.S.-bsed Western Hemisphere regionl office of the Interntionl Plnned Prenthood Federtion. Agency Comments We provided drft of this report to HHS nd USAID for comment, nd we lso provided relevnt excerpts of the drft to the orgniztions discussed in the report. USAID provided written comments, which pper in enclosure V. USAID stted tht it could provide more detiled dt thn we hd reported in the drft report. USAID hd not provided these detiled dt before we sent the drft for review. However, fter receiving the drft report for review, USAID provided dditionl dt on the specific mounts of obligtions for helth ctivities ssocited with bout 90 percent of the mount USAID reported obligting for the selected orgniztions during the period of our review. In response, we revised the report to cknowledge tht USAID could provide such detiled dt nd lso incorported the detiled dt into the report in enclosure II. USAID lso commented tht when the Mexico City Policy required foreign nongovernmentl orgniztions to certify tht they would not perform or ctively promote bortion s method of fmily plnning s condition for receiving U.S. federl fmily plnning ssistnce, no USAID funds were obligted for the Interntionl Plnned Prenthood Federtion in London, which did not gree to bide by the policy. In ddition, HHS, USAID, nd some of the orgniztions discussed in the report provided technicl comments which we incorported s pproprite. 10
As greed with your offices, unless you publicly nnounce its contents erlier, we pln no further distribution of this report until 30 dys from its issue dte. At tht time, we will send copies of this report to the Secretry of Helth nd Humn Services nd the Administrtor of USAID. The report will lso be vilble t no chrge on GAO s Web site t http://www.go.gov. If you or your stff hve ny questions bout this report, plese contct me t (202) 512-7114 or crossem@go.gov. Contct points for our Offices of Congressionl Reltions nd Public Affirs my be found on the lst pge of this report. Kim Ymne, Assistnt Director; Tom Moscovitch; nd Teres Tm mde mjor contributions to this report. Mrci Crosse Director, Helth Cre Enclosures - 5 11
List of Requesters The Honorble John Boehner Republicn Leder House of Representtives The Honorble Sm Brownbck The Honorble John Cornyn The Honorble Jim DeMint The Honorble Jmes Inhofe The Honorble Dvid Vitter United Sttes Sente The Honorble Joe Brton Rnking Member Committee on Energy nd Commerce House of Representtives The Honorble Pul Ryn Rnking Member Committee on the Budget House of Representtives The Honorble Todd Akin The Honorble Michelle Bchmnn The Honorble Roscoe Brtlett The Honorble Mrsh Blckburn The Honorble Pul Broun The Honorble Vern Buchnn The Honorble John Fleming The Honorble Trent Frnks The Honorble Scott Grrett The Honorble Phil Gingrey The Honorble Duncn Hunter The Honorble Wlter Jones The Honorble Jim Jordn The Honorble Steve King The Honorble Doug Lmborn The Honorble Kenny Mrchnt The Honorble Pete Olson The Honorble Ron Pul The Honorble Mike Pence The Honorble Joe Pitts The Honorble Steve Sclise The Honorble Chris Smith The Honorble Lmr Smith House of Representtives 12
Enclosure I Amounts the Deprtment of Helth nd Humn Services Reported Obligting for Selected Orgniztions, by Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 This enclosure provides, for fiscl yers 2002 through 2009, the mounts the Deprtment of Helth nd Humn Services (HHS) reported obligting for Advoctes for Youth, the Guttmcher Institute, the Plnned Prenthood Federtion of Americ nd its ffilites, the Popultion Council, nd the Sexulity Informtion nd Eduction Council of the United Sttes by HHS progrm nd wrding gency or office, in descending order by totl obligtions. 1 HHS did not report obligting ny funds for the Interntionl Plnned Prenthood Federtion or its ffilites for the period of our review. The HHS progrm with the lrgest mount of obligtions bout $123 million or bout 57 percent of totl HHS obligtions ws grnt progrm, fmily plnning services, uthorized under Title X of the Public Helth Service Act. 1 Tbles 8 through 12 provide the totl mounts HHS reported obligting for fiscl yers 2002 through 2009 by HHS progrm in descending order by totl obligtions. HHS progrms re identified by progrm title nd number s listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009). 13
Enclosure I Tble 8: Federl Funds HHS Reported Obligting for Advoctes for Youth, by HHS Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl _Investigtions nd Technicl Assistnce (93.283) $0.4 0.4 0.7 0.7 0.9 0.9 0.0 0.3 4.3 Acquired Immunodeficiency Syndrome (AIDS) Activity (93.118) 0.8 0.6 0.0 0.0 0.0 0.0 0.0 0.0 1.4 Coopertive Agreements to Support Comprehensive School Helth Progrms to Prevent the Spred of Humn Immunodeficiency Virus (HIV) nd Other Importnt Helth Problems (93.938) 0.0 0.0 0.0 0.0 0.0 0.0 0.7 0.7 1.3 Coopertive Agreements to Improve the Helth Sttus of Minority Popultions (93.004) Office of the Secretry, Office of Minority Helth 0.0 0.0 0.1 0.1 0.0 0.0 0.2 0.2 0.7 HIV Prevention Activities_Non-governmentl Orgniztion Bsed (93.939) 0.3 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.5 Stte nd Territoril nd Technicl Assistnce Cpcity Development Minority HIV/AIDS Demonstrtion Progrm (93.006) Office of the Secretry, Office of Minority Helth 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.2 Community Progrms to Improve Minority Helth Grnt Progrm (93.137) Office of the Secretry, Office of Minority Helth 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.1 Centers for Reserch nd Demonstrtion for Helth Promotion nd Disese Prevention (93.135) 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 Coopertive Agreements to Support Stte-Bsed Sfe Motherhood nd Infnt Helth Inititive Progrms (93.946) 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 Totl 1.5 1.2 0.9 0.9 1.1 1.1 1.1 1.1 8.9 Source: GAO nlysis of HHS dt. Notes: This tble provides, for fiscl yers 2002 through 2009, the federl funds HHS reported obligting for Advoctes for Youth, by HHS progrm, in descending order by totl obligtions. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. This column lists the title of the progrm s listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009), its corresponding CFDA number, nd the HHS gency or office dministering the progrm. 14
Enclosure I Tble 9: Federl Funds HHS Reported Obligting for the Guttmcher Institute, by HHS Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Child Helth nd Humn Development Extrmurl Reserch (93.865) b Ntionl Institutes of Helth $0.8 1.0 0.9 0.7 0.3 0.0 0.3 0.6 4.5 Fmily Plnning_Service Delivery Improvement Reserch Grnts (93.974) c Helth Resources nd Services Administrtion 0.0 0.4 0.3 0.2 0.2 0.4 0.4 0.5 2.5 Fmily Plnning_Services (93.217) c Helth Resources nd Services Administrtion 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 Fmily Plnning_Personnel Trining (93.260) c Helth Resources nd Services Administrtion 0.0 d 0.0 d 0.0 0.0 0.0 0.0 0.0 0.0 0.0 d Totl 1.2 1.4 1.1 0.9 0.5 0.4 0.8 1.1 7.4 Source: GAO nlysis of HHS dt. Notes: This tble provides, for fiscl yers 2002 through 2009, the federl funds HHS reported obligting for the Guttmcher Institute, by HHS progrm, in descending order by totl obligtions. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. This column lists the title of the progrm s listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009), its corresponding CFDA number, nd the HHS gency or office dministering the progrm. b Reflects totls for HHS progrms 93.864 nd 93.865, which were combined in 2003. c This progrm is dministered by the Office of Popultion Affirs under the Office of Public Helth nd Science in HHS, but is funded through ppropritions for the Helth Resources nd Services Administrtion. d Obligtions of less thn $50,000 rounded to zero. HHS reported obligting bout $13,000 in fiscl yer 2002 nd bout $13,000 in fiscl yer 2003 for progrm supporting fmily plnning personnel trining. 15
Enclosure I Tble 10: Federl Funds HHS Reported Obligting for the Plnned Prenthood Federtion of Americ nd Affilites, by HHS Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Fmily Plnning_Services (93.217) b Helth Resources nd Services Administrtion $13.2 14.0 14.1 15.9 16.2 14.7 16.0 18.2 122.1 Fmily Plnning_Personnel Trining (93.260) b Helth Resources nd Services Administrtion 1.1 0.2 2.0 0.1 0.0 0.0 0.0 0.0 3.4 HIV Prevention Activities_Non-governmentl Orgniztion Bsed (93.939) 0.9 0.9 0.0 0.0 0.0 c 0.0 0.7 0.5 3.1 Acquired Immunodeficiency Syndrome (AIDS) Activity (93.118) 0.1 0.0 0.9 0.9 0.7 0.0 0.0 0.0 2.6 AIDS Eduction nd Trining Centers (93.145) Helth Resources nd Services Administrtion 0.5 0.1 0.4 0.4 0.3 0.0 0.3 0.3 2.2 _Investigtions nd Technicl Assistnce (93.283) 0.0 c 0.0 0.0 c 0.0 0.1 0.8 0.0 0.0 0.9 Adolescent Fmily Life_Demonstrtion Projects (93.995) Office of the Secretry, Office of Popultion Affirs 0.3 0.0 0.3 0.1 0.1 0.0 0.0 0.0 0.9 Epidemiologic Reserch Studies of Acquired Immunodeficiency Syndrome (AIDS) nd Humn Immunodeficiency Syndrome (HIV) Infection in Selected Popultion Groups (93.943) 0.0 0.0 0.2 0.3 0.0 0.0 0.0 0.0 0.5 Fmily Plnning_Service Delivery Improvement Reserch Grnts (93.974) b Helth Resources nd Services Administrtion 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.3 0.5 Adolescent Fmily Life Reserch Grnts (93.111) Office of the Secretry, Office of Popultion Affirs 0.0 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.4 Grnts to Provide Outptient Erly Intervention Services with Respect to HIV Disese (93.918) Helth Resources nd Services Administrtion 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.3 Coopertive Agreements to Support Stte-Bsed Sfe Motherhood nd Infnt Helth Inititive Progrms (93.946) 0.0 0.0 0.0 0.0 0.0 c 0.0 0.1 0.0 0.1 Helth Cre nd Other Fcilities (93.887) Helth Resources nd Services Administrtion 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.1 HIV Prevention Progrms for Women (93.015) Office of the Secretry 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 16
Enclosure I Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Specil Projects of Ntionl Significnce (93.928) Helth Resources nd Services Administrtion 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 Consolidted Helth Centers (Community Helth Centers, Migrnt Helth Centers, Helth Cre for the Homeless, Public Housing Primry Cre, nd School Bsed Helth Centers) (93.224) Helth Resources nd Services Administrtion 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 Trns-NIH Reserch Support (93.310) Ntionl Institutes of Helth 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 Child Helth nd Humn Development Extrmurl Reserch (93.865) Ntionl Institutes of Helth 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 Coopertive Agreements to Improve the Helth Sttus of Minority Popultions (93.004) Office of the Secretry, Office of Minority Helth 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.1 Stte nd Territoril nd Technicl Assistnce Cpcity Development Minority HIV/AIDS Demonstrtion Progrm (93.006) Office of the Secretry, Office of Minority Helth 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.1 HIV Demonstrtion, Reserch, Public nd Professionl Eduction Projects (93.941) 0.0 0.0 0.0 c 0.0 0.0 0.0 0.0 0.0 0.0 c Public Helth nd Socil Services Emergency Fund (93.003) Helth Resources nd Services Administrtion 0.0 c 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 c Totl 16.2 15.6 18.0 17.6 17.5 15.8 17.6 19.4 137.7 Source: GAO nlysis of HHS dt. Notes: This tble provides, for fiscl yers 2002 through 2009, the federl funds HHS reported obligting for the Plnned Prenthood Federtion of Americ nd 21 ffilites, by HHS progrm, in descending order by totl obligtions. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. This column lists the title of the progrm s listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009), its corresponding CFDA number, nd the HHS gency or office dministering the progrm. b This progrm is dministered by the Office of Popultion Affirs under the Office of Public Helth nd Science in HHS, but is funded through ppropritions for the Helth Resources nd Services Administrtion. c Obligtions of less thn $50,000 rounded to zero. HHS reported obligting bout $30,000 in fiscl yer 2006 through progrm supporting HIV prevention ctivities t nongovernmentl orgniztions; bout $1,000 in fiscl yer 2002 nd $34,000 in fiscl yer 2004 through progrm supporting investigtions nd technicl ssistnce; bout $34,000 in fiscl yer 2006 for progrm supporting stte-bsed sfe motherhood nd infnt helth inititives; bout $19,000 in fiscl yer 2004 for HIV reserch nd eduction; nd bout $19,000 in fiscl yer 2002 for public helth nd socil service emergencies. 17
Enclosure I Tble 11: Federl Funds HHS Reported Obligting for the Popultion Council, by HHS Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Child Helth nd Humn Development Extrmurl Reserch (93.865) b Ntionl Institutes of Helth $4.6 5.1 5.5 2.8 2.5 2.9 2.5 2.8 28.7 Allergy, Immunology nd Trnsplnttion Reserch (93.855) Ntionl Institutes of Helth 0.0 0.0 0.0 0.0 2.4 2.6 2.5 3.0 10.4 Orl Disese nd Disorders Reserch (93.121) Ntionl Institutes of Helth 0.0 0.5 1.4 1.4 1.6 1.0 1.1 0.6 7.7 HIV Demonstrtion, Reserch, Public nd Professionl Eduction Projects (93.941) 0.0 0.0 0.0 0.0 0.3 0.0 1.0 2.8 4.0 Microbiology nd Infectious Diseses Reserch (93.856) Ntionl Institutes of Helth 1.2 0.8 0.8 1.3 0.0 0.0 0.0 0.0 4.0 Aging Reserch (93.866) Ntionl Institutes of Helth 0.2 0.2 0.0 0.1 0.1 0.4 0.4 0.4 1.6 Environmentl Helth (93.113) c Ntionl Institutes of Helth 0.0 0.0 0.3 0.3 0.3 0.2 0.0 0.0 1.2 HIV Prevention Activities_Helth Deprtment Bsed (93.940) 0.0 0.0 0.0 0.0 0.0 0.0 0.9 0.0 0.9 _Investigtions nd Technicl Assistnce (93.283) 0.0 0.0 0.0 0.0 0.0 0.5 0.0 0.0 0.5 Acquired Immunodeficiency Syndrome (AIDS) Activity (93.118) 0.0 0.0 0.2 0.3 0.0 0.0 0.0 0.0 0.4 Trns-NIH Reserch Support (93.310) Ntionl Institutes of Helth 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.1 0.4 Ntionl Institutes of Helth Acquired Immunodeficiency Syndrome Reserch Lon Repyment Progrm (93.936) Ntionl Institutes of Helth 0.0 0.0 0.2 0.0 0.1 0.0 0.0 0.0 0.4 Kidney Diseses, Urology nd Hemtology Reserch (93.849) Ntionl Institutes of Helth 0.0 0.0 0.2 0.2 0.0 0.0 0.0 0.0 0.3 Trns-NIH Recovery Act Reserch Support (93.701) Ntionl Institutes of Helth 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.3 18
Enclosure I Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl Drug Abuse nd Addiction Reserch Progrms (93.279) Ntionl Institutes of Helth 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 Totl 6.0 6.5 8.6 6.3 7.3 7.6 8.7 9.9 60.9 Source: GAO nlysis of HHS dt. Notes: This tble provides, for fiscl yers 2002 through 2009, the federl funds HHS reported obligting for the Popultion Council, by HHS progrm, in descending order by totl obligtions. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. This column lists the title of the progrm s listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009), its corresponding CFDA number, nd the HHS gency or office dministering the progrm. b Reflects totls for HHS progrms 93.864 nd 93.865, which were combined in 2003. c Reflects totls for HHS progrms 93.113 nd 93.894, which were combined in 2006. 19
Enclosure I Tble 12: Federl Funds HHS Reported Obligting for the Sexulity Informtion nd Eduction Council of the United Sttes, by HHS Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 Progrm title nd number Agency or office 2002 2003 2004 2005 2006 2007 2008 2009 Totl _Investigtions nd Technicl Assistnce (93.283) $0.2 0.1 0.2 0.2 0.3 0.3 0.0 0.0 1.2 Coopertive Agreements to Support Comprehensive School Helth Progrms to Prevent the Spred of HIV nd Other Importnt Helth Problems (93.938) 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.3 0.5 Preventive Helth Services_Sexully Trnsmitted Diseses Control Grnts (93.977) 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.2 Totl 0.3 0.2 0.2 0.2 0.3 0.3 0.3 0.3 1.9 Source: GAO nlysis of HHS dt. Notes: This tble provides, for fiscl yers 2002 through 2009, the federl funds HHS reported obligting for the Sexulity Informtion nd Eduction Council of the United Sttes, by HHS progrm, in descending order by totl obligtions. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. This column lists the title of the progrm s listed in the Ctlog of Federl Domestic Assistnce (CFDA): www.cfd.gov (2009), its corresponding CFDA number, nd the HHS gency or office dministering the progrm. 20
Enclosure II Amounts the United Sttes Agency for Interntionl Development Reported Obligting for Selected Orgniztions, by Activity Ctegory, Fiscl Yers 2002-2009 This enclosure provides, for fiscl yers 2002 through 2009, the mounts the United Sttes Agency for Interntionl Development (USAID) reported obligting for the Interntionl Plnned Prenthood Federtion nd its ffilites nd the Popultion Council, by ctivity ctegory, in descending order by totl obligtions. 1 USAID did not report obligting funds for the Plnned Prenthood Federtion of Americ or its ffilites, the Guttmcher Institute, Advoctes for Youth, or the Sexulity Informtion nd Eduction Council of the United Sttes for the period of our review. Activity ctegories were provided by USAID nd were identified by USAID officils. USAID identified individul ctegories of helth ctivities for bout 90 percent of its obligtions. The remining 10 percent ws identified s nonhelth nd unknown/unspecified ctivities. The helth ctivity ctegory with the lrgest mount of obligtions bout $144 million or bout 41 percent of totl USAID obligtions ws Fmily Plnning nd Reproductive Helth. Tble 13: Federl Funds USAID Reported Obligting for Selected Orgniztions, by Activity Ctegory, Fiscl Yers 2002-2009 Activity ctegory 2002 2003 2004 2005 2006 2007 2008 2009 Totl Fmily plnning/ reproductive helth 22.0 13.0 12.7 15.5 17.8 17.3 17.5 27.8 143.6 HIV/AIDS 15.4 18.8 20.9 22.6 20.2 14.0 11.8 17.5 141.2 Other helth 5.0 1.8 2.3 3.0 2.5 3.1 2.1 6.3 26.0 Unknown/unspecified b 4.0 0.2 0.2 0.1 0.0 4.8 1.0 7.5 17.8 Nonhelth c 1.0 3.8 0.0 4.6 0.0 3.0 3.8 0.0 16.2 Avin flu 0.0 0.0 0.0 0.0 0.0 0.0 0.3 2.0 2.3 Totl 47.4 37.6 36.0 45.8 40.6 42.2 36.5 61.1 347.1 Source: GAO nlysis of USAID dt. Notes: This tble provides, for fiscl yers 2002 through 2009, the federl funds USAID reported obligting for the Interntionl Plnned Prenthood Federtion nd nine of its ffilites nd the Popultion Council, by ctivity ctegory, in descending order by totl obligtions. USAID did not report obligting funds for the Plnned Prenthood Federtion of Americ or its ffilites, the Guttmcher Institute, Advoctes for Youth, or the Sexulity Informtion nd Eduction Council of the United Sttes for the period of our review. The term obligtion refers to definite commitment by federl gency tht cretes legl libility to mke pyments immeditely or in the future. Obligtions my not dd to totls due to rounding. Other helth includes funds for mternl helth, child helth, nutrition, nd other infectious diseses, including mlri nd tuberculosis. b Unknown/unspecified includes funds for broder development purposes thn helth. Informtion on the ctivity ctegory for which the funds were obligted is not vilble in Phoenix. c Nonhelth includes funds for generl development ssistnce ctivities other thn helth, including, for exmple, economic growth, eduction, democrcy nd governnce, climte chnge nd environment, nd griculture. 1 Tble 13 provides the totl mounts USAID reported obligting for fiscl yers 2002 through 2009, by ctivity ctegory, in descending order by totl obligtions. 21
Enclosure III Expenditure Amounts Reported by Selected Orgniztions, by Deprtment of Helth nd Humn Services Progrm nd Awrding Agency or Office, Fiscl Yers 2002-2009 This enclosure provides, for fiscl yers 2002 through 2009, the expenditures of federl funds tht Advoctes for Youth, the Guttmcher Institute, the Plnned Prenthood Federtion of Americ nd its ffilites, nd the Popultion Council reported, by Deprtment of Helth nd Humn Services (HHS) progrm nd wrding gency or office. 1 This enclosure does not contin tble for the Sexulity Informtion nd Eduction Council of the United Sttes, but this orgniztion reported spending $304,503 in fiscl yer 2003 for n HHS progrm, Coopertive Agreements to Support Comprehensive School Helth Progrms to Prevent the Spred of HIV nd Other Importnt Helth Problems, wrded through the Centers for Disese Control nd Prevention. The Interntionl Plnned Prenthood Federtion did not report spending HHS funds for the period of our review. 2 This enclosure does not contin expenditures of federl funds from gencies other thn HHS. The HHS progrm under which the orgniztions nd their ffilites reported the lrgest expenditures bout $342 million or 35 percent of totl reported expenditures for HHS progrms ws grnt progrm, fmily plnning services, uthorized under Title X of the Public Helth Service Act. 1 Tbles 14 nd 15 present the mounts Advoctes for Youth nd the Guttmcher Institute reported spending for fiscl yers 2002 through 2009, by HHS progrm, in descending order by totl expenditures. Tbles 16 nd 17 present the mounts the Plnned Prenthood Federtion of Americ nd its ffilites nd the Popultion Council reported spending for fiscl yers 2002 through 2009, by the 10 HHS progrms tht together ccounted for more thn 90 percent of ech orgniztion s totl expenditures of HHS funds, in descending order by totl expenditures. Orgniztions bsed in the United Sttes with expenditures of federl funds of $500,000 or more ($300,000 or more prior to 2004) nnully re required to hve either single udit or progrm-specific udit in ccordnce with the Single Audit Act, s mended, 31 U.S.C. 7501-7507, nd implementing guidnce of the Office of Mngement nd Budget, Circulr A-133. Amounts re reported on orgniztions 12-month fiscl yers, which vry. We obtined publicly vilble udit reports from the Federl Audit Cleringhouse Web site (http://hrvester.census.gov/fc/) tht were vilble s of the end of federl fiscl yer 2009. 2 The U.S.-bsed Western Hemisphere regionl office of the Interntionl Plnned Prenthood Federtion submitted udit reports during the period of our review, but did not report spending federl funds through HHS progrms. 22