Family Planning Clinics Can Provide Services at Less Cost but Clearer Federal Policies Are Needed
HRD-81-68
Published: Jun 19, 1981. Publicly Released: Jun 19, 1981.
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Highlights
In fiscal year 1980, the Department of Health and Human Services (HHS) spent about $375 million for family planning services and contraceptive supplies through several different programs. GAO reviewed several aspects of the family planning program authorized by the Public Health Service Act.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should reassess whether the Deputy Assistant Secretary for Population Affairs needs to administer all of the HHS family planning programs which provide for or authorize grants or contracts. |
Closed – Not Implemented
|
Congress has not addressed this recommendation in the more than 4 years that have passed since it was made. This recommendation was included in the GAO 1984 Annual Report and will be included in the 1985 Report. While GAO thought that it might be addressed in the 1985 reauthorization hearings, there are currently no plans for such hearings. |
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct HHS regional offices to ensure that title X funded clinics establish fee scales and collect fees in accordance with title X regulations. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Bureau of Community Health Services to revise its family planning guidelines to clarify clinics' options to tailor education requirements to client status and circumstances. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should take steps to resolve the differences between titles X and XX programs regarding eligibility for free and subsidized family planning service. If necessary, appropriate proposals should be prepared to achieve this. |
Closed – Not Implemented
HHS believes that eligibility criteria for family planning services under title XX should be made at the state level. Title XX has been included in the Block Grant Program.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should formally define program implementation research in consultation with the House Committee on Energy and Commerce and the Senate Committee on Labor and Human Resources. |
Closed – Not Implemented
HHS believes that it is already providing Congress the necessary information on the type and results of research it supports.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Bureau of Community Health Services to revise its family planning guidelines to establish routine revisit policies in line with the American College of Obstetricians and Gynecologists' standards and recommendations. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should clarify the responsibilities of the Deputy Assistant Secretary for Population Affairs and instruct component agencies to cooperate with the Deputy to put the Deputy in a better position to coordinate all of the HHS family planning activities. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Bureau of Community Health Services to work with centers to prepare guidance on venereal disease screening appropriate for family planning projects. Such guidance should enable projects to decide, in consultation with state and local health authorities, whether to routinely test all clients or to apply criteria for selective testing. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Bureau of Community Health Services to revise its family planning guidelines to eliminate the proposed provision for routine gonorrhea screening and the existing requirement and recommendation for anemia screening and provide that clinics screen based on medical necessity or local conditions. Clinics desiring to screen all clients routinely should be required to justify the need to HHS. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should more closely monitor clinic practices to identify routine visits or medical services that are in excess of those required or recommended and deny federal financial participation under the title X, Medicaid, Social Services, and other programs for those activities unless they are appropriately justified. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should direct the Deputy Assistant Secretary for Population Affairs and the Office of Family Planning to refine existing management informations systems to provide data and performance efficiency indicators suited to family planning clinic operations. HHS should build on existing automated systems, and it should include, for example, objective and measurable standards for: (1) accurately counting workload; (2) reporting retention levels and degree of contraceptive protection provided; (3) total cost of providing services; (4) monitoring fee collections; and (5) the extent to which women served are priority target populations. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
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Topics
Reproductive health careCollection proceduresContraceptionDisadvantaged personsEligibility criteriaHealth care cost controlHealth care servicesManagement information systemsProgram managementTest facilities