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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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