Community Health Centers:

Administration of Grant Awards Needs Strengthening

HRD-92-51: Published: Mar 18, 1992. Publicly Released: Mar 30, 1992.

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Mark V. Nadel
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Pursuant to a congressional request, GAO reviewed Bureau of Health Care Delivery and Assistance (BHCDA) policies and procedures for awarding community health center grants, focusing on: (1) the amount determination process; (2) the award process for grants to national associations; and (3) whether grantees may use funds to pay for dues to national associations.

GAO found that BHCDA: (1) deviated from legislative and agency grant requirements concerning competitive awards, funding levels, and application reviews; (2) did not award grants competitively, contrary to Public Health Service policy; (3) did not fund grant awards on the basis of the differences between costs and revenues; (4) did not notify the Department of Health and Human Services (HHS) or Congress that it had continually awarded grants for less than the standard 12 months; (5) lacks an adequate review process to allow the final decisionmaker to adequately consider independent reviews required to protect against bias in the award process; and (6) reduced its control over grantee funds by indirectly providing additional funds to a national association through member grantees' dues.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: Among other actions, BPHC now has a policy to award all community and migrant health center grants competitively and has taken action to ensure the integrity of the review process.

    Recommendation: To help ensure that health center grants are made fairly and objectively, and are consistent with pertinent laws, policies, and regulations, the Secretary of Health and Human Services should direct the Assistant Secretary for Health to take steps to make sure that BHCDA fully complies with all laws, policies, and regulations regarding grant awards.

    Agency Affected: Department of Health and Human Services


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