oversight

Prevention and Public Health Fund: Activities Funded in Fiscal Years 2010 and 2011

Published by the Government Accountability Office on 2012-09-13.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                             United States Government Accountability Office

GAO                          Report to Congressional Requesters




September 2012
                             PREVENTION AND
                             PUBLIC HEALTH
                             FUND
                             Activities Funded in
                             Fiscal Years 2010 and
                             2011




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GAO-12-788
                                                 September 2012

                                                 PREVENTION AND PUBLIC HEALTH FUND
                                                 Activities Funded in Fiscal Years 2010 and 2011

Highlights of GAO-12-788, a report to
congressional requesters




Why GAO Did This Study                           What GAO Found
In March 2010, PPACA established the             For fiscal years 2010 and 2011, the Department of Health and Human Services
PPHF to provide for expanded and                 (HHS) allocated funds from the Prevention and Public Health Fund (PPHF) for 43
sustained national investment in                 activities in five agencies. These activities—which include HHS programs and
prevention and public health programs,           initiatives—were administered by HHS’s Agency for Healthcare Research and
including prevention research, health            Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Health
screenings, and immunization                     Resources and Services Administration (HRSA), Substance Abuse and Mental
programs. PPACA appropriated $500                Health Services Administration (SAMHSA), and the Office of the Secretary (OS).
million for fiscal year 2010, $750               Most of the $500 million available for fiscal year 2010 was allocated for activities
million for fiscal year 2011, and
                                                 administered by HRSA, and most of the $750 million available for fiscal year
additional amounts for future fiscal
                                                 2011 was allocated for activities administered by CDC (see fig.). HHS agencies
years to operationalize the PPHF.
                                                 funded individual projects with PPHF funds through grants, contracts, and
HHS allocates funding from the PPHF              interagency agreements.
for specific prevention and public
health activities administered by HHS            Prevention and Public Health Fund (PPHF) Allocations by HHS Agency, Fiscal Years 2010 and
agencies. The agencies, once funds               2011
are transferred to them, use the PPHF            FY 2010 ($500 million)                             FY 2011 ($750 million)
funds to support individual projects
through, for example, grants and
                                                                                                                                 3% HRSA
contracts. GAO was asked to provide
information on how PPHF funds were                                          HRSA                                                 SAMHSA
allocated for fiscal years 2010 and
2011. This report describes, for those                                      4% SAMHSA                                            3% OS
fiscal years, (1) the HHS agencies and
activities for which PPHF allocations                                       2% OS                                                2% AHRQ
were made, (2) the process and criteria
                                                                                                               12%
HHS used to allocate PPHF funds, and                                        1% AHRQ
(3) HHS reporting of the outcomes of
activities receiving PPHF funding. GAO
reviewed agency documents, including               54%                                                        81%                CDC
                                                             38%            CDC
budget justifications, funding
announcements, data on PPHF
allocations and awards of PPHF-
funded grants, contracts, and
interagency agreements; examined
agency websites; and interviewed HHS             Note: Percentages do not total to 100% due to rounding.
officials.
                                                 Because the PPHF was established midway through fiscal year 2010 and after
HHS provided technical comments on               the President had submitted the fiscal year 2011 budget request, for the fund’s
a draft of this report, which were               first 2 years HHS used an abbreviated process to allocate PPHF funds. Instead
incorporated as appropriate.                     of developing HHS-wide written criteria, HHS requested that its agencies
                                                 propose activities for PPHF funding based on language in the Patient Protection
                                                 and Affordable Care Act (PPACA) provision establishing the PPHF. According to
                                                 HHS, the proposed activities were also aligned with existing departmental
                                                 priorities.
                                                 HHS has relied on its agencies to establish performance measures and targets
                                                 and to track outcomes (the results) of the PPHF-funded activities. Agency
View GAO-12-788. For more information,
contact Katherine Iritani at (202) 512-7114 or
                                                 officials reported that for many activities, it is too early to report outcomes
iritanik@gao.gov.                                because many projects receiving PPHF funding in fiscal years 2010 and 2011
                                                 are multiyear projects or have not yet completed evaluations.
                                                                                                 United States Government Accountability Office
Contents


Letter                                                                                      1
               Background                                                                   3
               HHS Agencies and Activities for Which PPHF Funds Were
                 Allocated and Entities That Received PPHF Funding, Fiscal
                 Years 2010 and 2011                                                        7
               Process and Criteria for Allocating and Awarding PPHF Funds for
                 Fiscal Years 2010 and 2011                                               15
               HHS Reporting of Performance Measures, Targets, and Outcomes
                 of Activities and Projects Receiving PPHF Funding                        20
               Agency Comments                                                            22

Appendix I     Agency for Healthcare Research and Quality—Prevention and
               Public Health Fund Awards by Activity                                      24



Appendix II    Centers for Disease Control and Prevention—Prevention and
               Public Health Fund Awards by Activity                                      28



Appendix III   Health Resources and Services Administration—Prevention and
               Public Health Fund Awards by Activity                                      98



Appendix IV    Office of the Secretary—Prevention and Public Health Fund
               Awards by Activity                                                        112



Appendix V     Substance Abuse and Mental Health Services Administration—
               Prevention and Public Health Fund Awards by Activity                      117



Appendix VI    GAO Contact and Staff Acknowledgments                                     126




               Page i                             GAO-12-788 Prevention and Public Health Fund
Tables
         Table 1: PPACA Appropriations to the PPHF, Fiscal Years 2010-
                  2022                                                                 5
         Table 2: PPHF Allocations, by HHS Agency and Activity, Fiscal
                  Years 2010 and 2011                                                10
         Table 3: PPHF-Funded Awards by Funding Mechanism, Fiscal
                  Years 2010 and 2011                                                12
         Table 4: Types of Entities Eligible for PPHF-Funded Grants
                  Awarded in Fiscal Years 2010 and 2011                              13
         Table 5: Number of Funding Opportunity Announcements and
                  PPHF-Funded Grants, by Type of Grant, Fiscal Years 2010
                  and 2011                                                           14
         Table 6: HHS Process for Allocating and Awarding PPHF Funds,
                  Fiscal Years 2010 and 2011                                         18
         Table 7: Overall Performance Measures, Targets, and Outcome
                  Information for the Three Activities for Which HHS
                  Allocated the Most PPHF Funding, Fiscal Years 2010 and
                  2011                                                               21
         Table 8: FY 2010 Contracts, Clinical Preventive Services Task
                  Force                                                              25
         Table 9: FY 2011 Contracts, Clinical Preventive Services Task
                  Force                                                              25
         Table 10: FY 2011 Grants, Clinical Preventive Services Research             26
         Table 11: FY 2011 Contract, Clinical Preventive Services Research           27
         Table 12: FY 2010 Contract, Healthy Weight Practice-Based
                  Research Networks                                                  27
         Table 13: FY 2011 Grants, Community Transformation Grants
                  Program                                                            29
         Table 14: FY 2011 Contracts, Community Transformation Grants
                  Program                                                            32
         Table 15: FY 2011 Grants, Section 317 Immunization Program                  33
         Table 16: FY 2011 Contracts, Section 317 Immunization Program               37
         Table 17: FY 2010 Grants, National Public Health Improvement
                  Initiative                                                         39
         Table 18: FY 2010 Contracts, National Public Health Improvement
                  Initiative                                                         42
         Table 19: FY 2011 Grants, National Public Health Improvement
                  Initiative                                                         43
         Table 20: FY 2011 Contracts, National Public Health Improvement
                  Initiative                                                         46
         Table 21: FY 2010 Grants, Tobacco Prevention (Media and
                  Quitlines)                                                         47


         Page ii                             GAO-12-788 Prevention and Public Health Fund
Table 22: FY 2010 Contracts, Tobacco Prevention (Media and
        Quitlines)                                                         49
Table 23: FY 2011 Grants, Tobacco Prevention (Media and
        Quitlines)                                                         50
Table 24: FY 2011 Contracts, Tobacco Prevention (Media and
        Quitlines)                                                         52
Table 25: FY 2010 Grants, Epidemiology and Laboratory Capacity
        Grants                                                             53
Table 26: FY 2011 Grants, Epidemiology and Laboratory Capacity
        Grants                                                             56
Table 27: FY 2011 Contracts, Epidemiology and Laboratory
        Capacity Grants                                                    58
Table 28: FY 2011 Grants, Coordinated Chronic Disease Prevention
        Program                                                            59
Table 29: FY 2011 Contracts, Coordinated Chronic Disease
        Prevention Program                                                 62
Table 30: FY 2010 Grants, CDC Healthcare Surveillance and
        Statistics                                                         63
Table 31: FY 2010 Contracts, CDC Healthcare Surveillance and
        Statistics                                                         64
Table 32: FY 2011 Contracts, CDC Healthcare Surveillance and
        Statistics                                                         65
Table 33: FY 2010 Grants, ARRA: Communities Putting Prevention
        to Work                                                            66
Table 34: FY 2010 Contracts, ARRA: Communities Putting
        Prevention to Work                                                 67
Table 35: FY 2011 Grants, Environmental Public Health Tracking             68
Table 36: FY 2011 Contracts, Environmental Public Health
        Tracking                                                           70
Table 37: FY 2010 Grants, Public Health Workforce                          71
Table 38: FY 2010 Contracts, Public Health Workforce                       72
Table 39: FY 2011 Grants, Public Health Workforce                          73
Table 40: FY 2011 Contracts, Public Health Workforce                       74
Table 41: FY 2010 Grants, HIV/AIDS                                         75
Table 42: FY 2010 Contracts, HIV/AIDS                                      78
Table 43: FY 2011 Grants, Racial and Ethnic Approaches to
        Community Health (REACH)                                           79
Table 44: FY 2011 Contract, Racial and Ethnic Approaches to
        Community Health (REACH)                                           82
Table 45: FY 2011 Grants, Public Health Research                           83
Table 46: FY 2011 Contracts, Public Health Research                        84




Page iii                           GAO-12-788 Prevention and Public Health Fund
Table 47: FY 2010 Grants, Community Guide/Community
        Preventive Services Task Force                                     85
Table 48: FY 2010 Contracts, Community Guide/Community
        Preventive Services Task Force                                     85
Table 49: FY 2011 Grants, Community Guide/Community
        Preventive Services Task Force                                     86
Table 50: FY 2011 Contracts, Community Guide/Community
        Preventive Services Task Force                                     87
Table 51: FY 2011 Grants, Healthcare-Associated Infections                 88
Table 52: FY 2011 Contracts, Healthcare-Associated Infections              90
Table 53: FY 2011 Grants, Prevention Research Centers                      91
Table 54: FY 2011 Contracts, Workplace Wellness                            92
Table 55: FY 2011 Contracts, National Youth Fitness Survey                 92
Table 56: FY 2010 Grants, ARRA: Evaluation                                 93
Table 57: FY 2010 Contracts, ARRA: Evaluation                              94
Table 58: FY 2010 Contracts, ARRA: Media                                   95
Table 59: FY 2011 Contracts, Education and Outreach Campaign
        Regarding Preventive Benefits                                      96
Table 60: FY 2010 Contract, National Prevention Strategy                   96
Table 61: FY 2011 Contracts, National Prevention Strategy                  97
Table 62: FY 2011 Contracts, Promoting Obesity Prevention in
        Early Childhood Programs                                           97
Table 63: FY 2010 Grants, Primary Care Training and Enhancement            99
Table 64: FY 2010 Grants, Public Health Workforce Development             103
Table 65: FY 2011 Grants, Public Health Workforce Development             104
Table 66: FY 2010 Grants, Advanced Nursing Education                      105
Table 67: FY 2010 Grants, Nurse Managed Care Centers                      107
Table 68: FY 2010 Grants, State Health Workforce Development
        Grants for Primary Care                                           108
Table 69: FY 2010 Grants, HRSA Healthy Weight Collaborative               110
Table 70: FY 2010 Grant, Nutrition, Physical Activity, and Screen
        Time Standards in Child Care Settings                             111
Table 71: FY 2010 Contracts, Obesity Media Activities                     113
Table 72: FY 2011 Contracts, Obesity Media Activities                     113
Table 73: FY 2011 Contracts, Tobacco Prevention Media                     114
Table 74: FY 2010 Contracts, National Prevention, Health
        Promotion, and Public Health Council Planning                     115
Table 75: FY 2010 Contracts, President’s Council on Fitness,
        Sports, and Nutrition                                             115
Table 76: FY 2010 Contracts, Tobacco Cessation                            116
Table 77: FY 2010 Contract, Healthy Living Innovations Awards             116




Page iv                            GAO-12-788 Prevention and Public Health Fund
          Table 78: FY 2010 Grants, Primary and Behavioral Health Care
                  Integration                                                                   118
          Table 79: FY 2011 Grants, Primary and Behavioral Health Care
                  Integration                                                                   120
          Table 80: FY 2011 Grants, Screening, Brief Intervention, and
                  Referral to Treatment                                                         122
          Table 81: FY 2011 Contracts, SAMHSA Health Surveillance                               123
          Table 82: FY 2011 Grants, Suicide Prevention                                          124
          Table 83: FY 2011 Contract, Suicide Prevention                                        125


Figures
          Figure 1: PPHF Allocations by HHS Agency, Fiscal Years 2010 and
                   2011                                                                              8
          Figure 2: PPHF Key Event Timeline, Fiscal Years 2010 and 2011                             16




          Abbreviations

          AHRQ              Agency for Healthcare Research and Quality
          ASFR              Office of the Assistant Secretary for Financial Resources
          CDC               Centers for Disease Control and Prevention
          FOA               funding opportunity announcement
          GPRA              Government Performance and Results Act
          HHS               Department of Health and Human Services
          HRSA              Health Resources and Services Administration
          OS                Office of the Secretary
          PPACA             Patient Protection and Affordable Care Act
          PPHF              Prevention and Public Health Fund
          SAMHSA            Substance Abuse and Mental Health Services
                              Administration



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          Page v                                      GAO-12-788 Prevention and Public Health Fund
United States Government Accountability Office
Washington, DC 20548




                                   September 13, 2012

                                   The Honorable Orrin G. Hatch
                                   Ranking Member
                                   Committee on Finance
                                   United States Senate

                                   The Honorable Tom Coburn
                                   Ranking Member
                                   Permanent Subcommittee on Investigations
                                   Committee on Homeland Security and Governmental Affairs
                                   United States Senate

                                   In March 2010, the Patient Protection and Affordable Care Act (PPACA)
                                   established the Prevention and Public Health Fund (PPHF) to provide for
                                   expanded and sustained national investment in prevention and public
                                   health programs, such as prevention research, health screenings, and
                                   immunization programs. 1 PPACA appropriated $500 million to the fund for
                                   fiscal year 2010, $750 million for fiscal year 2011, a total of $3.75 billion
                                   for fiscal years 2012 through 2014, and $2 billion for fiscal year 2015 and
                                   each subsequent fiscal year. 2

                                   For each fiscal year since the passage of PPACA, the Department of
                                   Health and Human Services (HHS) has allocated PPHF funds—that is,
                                   established a plan for funding specific prevention and public health-
                                   related activities—for that year and then transferred funds from the PPHF
                                   to the appropriation accounts for the HHS agencies that administer these




                                   1
                                    Pub. L. No. 111-148, §§ 4002, 10401(b). 124 Stat. 119, 541, 974 (2010).
                                   2
                                    More recently, the Middle Class Tax Relief and Job Creation Act of 2012 amended this
                                   provision, reducing the annual amounts appropriated for the PPHF in fiscal years 2013-
                                   2021. Pub. L. No. 112-96, § 3205, 126 Stat. 156, 194.




                                   Page 1                                     GAO-12-788 Prevention and Public Health Fund
activities. 3 Once HHS has allocated and transferred PPHF funds, HHS
agencies use PPHF funding for individual projects to carry out the
activities through, for example, grant and contract awards. 4

You asked us to provide detailed information on the allocation of PPHF
funding for fiscal years 2010 and 2011, including how decisions were
made to allocate PPHF funding for specific HHS activities, the entities
receiving PPHF funding, and the outcomes—that is, the results—of those
activities. This report describes (1) the HHS agencies and activities for
which PPHF funding was allocated for fiscal years 2010 and 2011 and the
entities receiving PPHF funding, (2) the process and criteria HHS used to
allocate and award PPHF funds for fiscal years 2010 and 2011, and
(3) HHS reporting of the performance measures, targets, and outcomes
of activities and projects receiving PPHF funding.

To describe the HHS agencies and activities for which PPHF funding was
allocated and for which awards were made for fiscal years 2010 and
2011, we reviewed documents, such as budget justifications, funding
opportunity announcements, and data on PPHF allocations and recipients
of PPHF-funded grants, contracts, and interagency agreements provided
by HHS agencies. We also interviewed officials from the Office of the
Assistant Secretary for Financial Resources (ASFR) within the HHS
Office of the Secretary (OS), which is involved in the allocation of PPHF
funds, and HHS agencies and the OS (hereafter collectively referred to as


3
 Such activities include the Community Transformation Grants program and the National
Prevention Strategy. The Community Transformation Grants program, established under
PPACA and administered by HHS’s Centers for Disease Control and Prevention (CDC),
awards competitive grants to state and local governmental agencies and community-
based organizations for activities that reduce chronic disease rates, prevent the
development of secondary conditions, address health disparities, and develop a stronger
evidence base of effective prevention programming. Pub. L. No. 111-148, §§ 4201, 10403,
124 Stat. 564, 975 (2010). Because CDC refers to this program as the “Community
Transformation Grants program”, we use that name in referring to the program in this
report. The National Prevention Strategy was developed by the National Prevention
Council, which is composed of the heads of 17 federal agencies that consulted with
outside experts and stakeholders. The strategy, released in June 2011, includes actions
that public and private partners can take to help Americans stay healthy and fit.
4
 Throughout this report we use the following terms: “agency” to refer to agencies within
HHS and the Office of the Secretary; “activity” to refer to HHS programs and initiatives,
such as the National Prevention Strategy; “project” to refer to the specific grants,
contracts, or interagency agreements made by a given activity, such as grants for tobacco
prevention projects; and “award recipient” to refer to those awarded grants, contracts, and
cooperative agreements, such as a state or local government.




Page 2                                       GAO-12-788 Prevention and Public Health Fund
             HHS agencies) that administered activities that received PPHF funding in
             fiscal years 2010 and 2011. We summarized funding data HHS reported
             to us and did not independently verify the reported data. Through our
             review of the relevant documentation, our discussions with HHS officials,
             and quality control checks we performed on the data, we determined that
             the data provided were sufficiently reliable for our purposes. To describe
             the criteria and processes HHS used to allocate PPHF funds we
             interviewed HHS and agency officials who were knowledgeable about the
             decision-making process and reviewed available documentation,
             including HHS websites. When documentation of the criteria and
             processes was not available, we report HHS officials’ descriptions. To
             describe how HHS and agencies reported the performance measures,
             targets, and outcomes of activities and projects receiving PPHF funding,
             we reviewed HHS’s websites, budget justifications, and other documents
             and interviewed HHS and agency officials. We examined performance
             measures that HHS established for PPHF-funded activities, the targets
             set for those activities, and the available information from HHS on
             outcomes. For all three objectives we also examined relevant laws and
             other documents related to PPHF allocations and oversight.

             We conducted this performance audit from December 2011 to September
             2012 in accordance with generally accepted government auditing
             standards. Those standards require that we plan and perform the audit to
             obtain sufficient, appropriate evidence to provide a reasonable basis for
             our findings and conclusions based on our audit objectives. We believe
             that the evidence obtained provides a reasonable basis for our findings
             and conclusions based on our audit objectives.


             PPACA established the PPHF to provide for expanded and sustained
Background   national investment in prevention and public health programs to improve
             health and help restrain the rate of growth in private and public sector
             health care costs. 5 For this purpose, the Secretary of Health and Human
             Services is required to transfer amounts from the PPHF to HHS accounts
             to increase funding, over the fiscal year 2008 level, for programs
             authorized by the Public Health Service Act, “for prevention, wellness,
             and public health activities including prevention research, health
             screenings, and initiatives, such as the Community Transformation grant



             5
             Pub. L. No. 111-148, § 4002(a), 124 Stat. 541.




             Page 3                                     GAO-12-788 Prevention and Public Health Fund
program, the Education and Outreach Campaign Regarding Preventive
Benefits, and immunization programs.” 6 Within HHS, agencies including
the Agency for Healthcare Research and Quality (AHRQ), the Centers for
Disease Control and Prevention (CDC), the Health Resources and
Services Administration (HRSA), the Substance Abuse and Mental Health
Services Administration (SAMHSA), and the OS administer programs
authorized by the Public Health Service Act.

PPACA appropriated $5 billion to the PPHF for fiscal years 2010 through
2014, and $2 billion for each fiscal year thereafter. 7 In February 2012, the
Middle Class Tax Relief and Job Creation Act of 2012 8 amended PPACA,
reducing the amounts appropriated to the PPHF for fiscal years 2013
through 2021 by a total of $6.25 billion (see table 1).




6
 Pub. L. No 111-148, §§ 4002 (c), 10401(b), 124 Stat. 541, 974. Because CDC
refers to the “Community Transformation Grants program”, we use that name in
referring to the program in this report. PPACA provided for the implementation of
the Education and Outreach Campaign Regarding Preventive Benefits—a
national public-private partnership for a prevention and health promotion
outreach and education campaign to raise public awareness of health
improvement across the lifespan. Pub. L. No. 111-148, § 4004, 124 Stat. 544
(2010).
7
Pub. L. No. 111-148, § 4002(b), 124 Stat. 541.
8
Pub. L. No. 112-96, § 3205, 126 Stat. 156, 194.




Page 4                                  GAO-12-788 Prevention and Public Health Fund
Table 1: PPACA Appropriations to the PPHF, Fiscal Years 2010-2022

                                             PPACA         PPACA as amended
                                                    a                         b
                                        March 2010             February 2012              Decrease
    Fiscal year                         (in millions)             (in millions)        (in millions)
    2010                                         $500                         $500                   —
    2011                                           750                         750                   —
    2012                                        1,000                        1,000                   —
    2013                                        1,250                        1,000              $250
    2014                                        1,500                        1,000               500
    2015                                        2,000                        1,000             1,000
    2016                                        2,000                        1,000             1,000
    2017                                        2,000                        1,000             1,000
    2018                                        2,000                        1,250               750
    2019                                        2,000                        1,250               750
    2020                                        2,000                        1,500               500
    2021                                        2,000                        1,500               500
    2022 + annually                             2,000                        2,000                   —
                                                                                                      c
    Total fiscal years 2010-2022              $21,000                     $14,750            $6,250
Source: GAO analysis.
a
    Amounts appropriated by PPACA, Pub. L. No. 111-148, § 4002(b).
b
    Amounts appropriated by PPACA, as amended by Pub. L. No. 112-96, § 3205.
c
 $6.25 billion represents a 37 percent reduction of the amount appropriated to the PPHF for fiscal
years 2013 through 2021.


When appropriations are made available, an agency may obligate funds
through such actions as awarding discretionary grants, cooperative
agreements, 9 or contracts, or through entering into interagency
agreements. 10 For discretionary grants, 11 agencies announce the
availability of funds through a publicly available notice called a funding



9
 A cooperative agreement is an arrangement that has greater agency involvement than a
grant. For the purposes of this report, the term grant is used to mean both grants and
cooperative agreements. See 31 U.S.C. §§ 6304 (using grant agreements) and 6305
(using cooperative agreements).
10
  In this report we refer to the amount obligated under a grant, cooperative agreement,
contract, or interagency agreement as the “amount awarded.”
11
  Unlike a formula grant that is based on a precise formula specified in legislation, an
agency makes discretionary grant awards on the basis of a competitive process.




Page 5                                            GAO-12-788 Prevention and Public Health Fund
opportunity announcement. 12 The funding announcements provide
guidance on how to apply for available funding and often identify
restrictions on eligibility, such as limiting applicants to states, local
governments, tribal organizations, or academic institutions. Funding
opportunity announcements also indicate the type of grant award, such as
new, continuation, or supplemental. A new grant provides funding for a
project that is currently not receiving financial support, a continuation
grant provides additional funding for one or more budget periods to a
project that would otherwise end, and a supplemental grant increases
funding for an approved project during a current budget period.

An agency may also provide federal funding pursuant to a contract, a
legal instrument that establishes a binding relationship between the
agency and another entity for acquisition of property or services. 13
Agencies can also enter into interagency agreements to carry out projects
when, for example, another agency has expertise in an area or has
additional capacity to do the work.




12
  HHS agencies typically publically announce funding opportunities on www.grants.gov.
Each funding announcement is identified by a number assigned by the agency and
provides such information as the project purpose, eligibility, evaluation criteria, funding
preferences or priorities, and legislative authority. Funding opportunity announcements
may also be referred to as request for applications, program announcements, notices of
funding availability, or solicitations depending on the agency and type of program—we
refer to all types of funding announcements as funding opportunity announcements in this
report.
13
  See 31 U.S.C. § 6303. HHS agencies typically publically announce contract solicitations
on www.fbo.gov.




Page 6                                       GAO-12-788 Prevention and Public Health Fund
                         The Consolidated Appropriations Act, 2012 required HHS to establish a
                         website that provides information on the use of PPHF funds. Specifically,
                         it required HHS to post on a website specific information relating to use of
                         fiscal year 2012 PPHF funds. 14


                         HHS allocated PPHF funds for 43 activities in five HHS agencies—
HHS Agencies and         AHRQ, CDC, HRSA, OS, and SAMHSA—in the first 2 years of the fund. 15
Activities for Which     The majority of the $500 million in PPHF funding available for fiscal year
PPHF Funds Were          2010 was allocated for activities administered by HRSA, while the
                         majority of the $750 million in PPHF funding available for fiscal year 2011
Allocated and Entities   was allocated for activities administered by CDC (see fig. 1).
That Received PPHF
Funding, Fiscal Years
2010 and 2011




                         14
                           Pub. L. No. 112-74, § 220, 125 Stat. 786, 1085-6 (2011). The provision required HHS to
                         post on the PPHF website specific information on fiscal year 2012 PPHF funds including
                         information on the program or activity receiving funds (to be posted no later than the day
                         after the transfer is made), identification of each grant, cooperative agreement, or contract
                         with a value of $25,000 or more awarded using PPHF funds (to be posted no later than
                         5 days of the award), as well as annual and semiannual reporting requirements. The
                         President’s budget request for fiscal year 2013 requested that the PPHF reporting
                         requirements be rescinded, but as of May 25, 2012, legislation had not been introduced to
                         do so. The Consolidated Appropriations Act, 2012, also contained a provision specifically
                         prohibiting the use of PPHF funds for publicity or propaganda or other expenses related to
                         activities designed to influence the enactment of legislation, regulations, administrative
                         actions, or executive orders before Congress or state or local bodies. See Pub. L.
                         No. 112-74, § 503, 125 Stat. 1110.
                         15
                           According to HHS officials, an activity can consist of a single program, such as CDC’s
                         Community Transformation Grants program, or multiple programs, such as SAMHSA’s
                         Suicide Prevention activity, which consists of four suicide prevention programs.




                         Page 7                                       GAO-12-788 Prevention and Public Health Fund
Figure 1: PPHF Allocations by HHS Agency, Fiscal Years 2010 and 2011




Note: This figure summarizes HHS information on fiscal year (FY) 2010 and 2011 PPHF allocations
to activities administered by five HHS agencies—the Agency for Healthcare Research and Quality
(AHRQ), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services
Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA),
and the Office of the Secretary (OS). Percentages do not total to 100% due to rounding.


According to information provided by HHS, of the 43 activities for which
PPHF allocations were made for fiscal years 2010 and 2011, about half
(23 activities accounting for 72 percent of total fiscal year 2010 and 2011
allocations) received funding from regular (that is, non-PPHF)
appropriations; 16 the remainder (20 activities accounting for 28 percent of
total fiscal year 2010 and 2011 allocations) were funded solely from the
PPHF during those 2 fiscal years. In fiscal year 2010, the three activities
for which the largest PPHF allocations were made were:




16
  According to HHS, these 23 activities also received funding from HHS’s regular
appropriations in fiscal year 2010, 2011, or both. We use the term “regular appropriations”
to refer to funding that is a product of the annual budget and appropriations process.




Page 8                                         GAO-12-788 Prevention and Public Health Fund
•    HRSA’s Primary Care Training and Enhancement ($198.1 million),

•    CDC’s National Public Health Improvement Initiative 17 ($50.0 million),
     and

•    CDC’s ARRA: Communities Putting Prevention to Work ($36.4
     million).

In fiscal year 2011, the three activities for which the largest PPHF
allocations were made were funded by CDC:

•    Community Transformation Grants program ($146.3 million),

•    Section 317 Immunization program ($100.0 million), and

•    Coordinated Chronic Disease Prevention program ($51.7 million).

Activities for which the largest allocations were made in the three other
HHS agencies during this 2-year period included AHRQ’s support of the
U.S. Preventive Services Task Force, SAMHSA’s Primary and Behavioral
Health Care Integration, and OS’s Obesity Media Activities (see table 2).




17
  According to HHS officials, this activity was called Public Health Infrastructure in fiscal
year 2010.




Page 9                                         GAO-12-788 Prevention and Public Health Fund
Table 2: PPHF Allocations, by HHS Agency and Activity, Fiscal Years 2010 and 2011

                                                                                     Fiscal year 2010    Fiscal year 2011          Total
Agency and activity                                                                      (in millions)       (in millions) (in millions)
Centers for Disease Control and Prevention (CDC)
    Community Transformation Grants Program                                                        —               $146.3        $146.3
                                           a
    Section 317 Immunization Program                                                               —                100.0         100.0
                                                                b
    National Public Health Improvement Initiative                                               $50.0                40.2          90.2
                                                        a
    Tobacco Prevention (Media and Quitlines)                                                     14.5                50.0          64.5
                                                                    a
    Epidemiology and Laboratory Capacity Grants                                                  20.0                40.0          60.0
                                                                        a
    Coordinated Chronic Disease Prevention Program                                                 —                 51.7          51.7
                                                            a
    CDC Healthcare Surveillance and Statistics                                                   19.9                30.0          49.9
    ARRA: Communities Putting Prevention to Work                                                 36.4                  —           36.4
                                               a
    Environmental Public Health Tracking                                                           —                 35.0          35.0
                             a
    Public Health Workforce                                                                       7.5                25.0          32.5
             a
    HIV/AIDS                                                                                     30.4                  —           30.4
                                                                            a
    Racial and Ethnic Approaches to Community Health (REACH)                                       —                 25.0          25.0
                             a
    Public Health Research                                                                         —                 20.0          20.0
                                                                            a
    Community Guide/Community Preventive Services Task Force                                      5.0                 7.0          12.0
                                       a
    Healthcare-Associated Infections                                                               —                 11.8          11.8
                                   a
    Prevention Research Centers                                                                    —                 10.0          10.0
    Workplace Wellness                                                                             —                  9.3           9.3
    National Youth Fitness Survey                                                                  —                  6.0           6.0
    ARRA: Evaluation                                                                              4.0                  —            4.0
    ARRA: Media                                                                                   4.0                  —            4.0
    Education and Outreach Campaign Regarding Preventive Benefits                                  —                  2.0           2.0
    National Prevention Strategy                                                                  0.1                 1.0           1.1
    Promoting Obesity Prevention in Early Childhood Programs                                       —                  0.7           0.7
Agency subtotal                                                                                 191.8               610.9         802.7
Health Resources and Services Administration (HRSA)
                                                    a
    Primary Care Training and Enhancement                                                       198.1                  —          198.1
                                               a
    Public Health Workforce Development                                                          14.8                20.0          34.8
                                   a
    Advanced Nursing Education                                                                   31.4                  —           31.4
    Nurse Managed Care Centers                                                                   15.3                  —           15.3
    State Health Workforce Development Grants for Primary Care                                    5.8                  —            5.8
    HRSA Healthy Weight Collaborative and Activities                                              5.0                  —            5.0
                                                                                     a
    Nutrition, Physical Activity, and Screen Time Standards in Child Care Settings                0.3                  —            0.3
Agency subtotal                                                                                 270.7                20.0         290.7




                                                   Page 10                                 GAO-12-788 Prevention and Public Health Fund
                                                                                         Fiscal year 2010        Fiscal year 2011          Total
Agency and activity                                                                          (in millions)           (in millions) (in millions)
Substance Abuse and Mental Health Services Administration (SAMHSA)
                                                        a
    Primary and Behavioral Health Care Integration                                                       20.0                   35.0              55.0
                                                                   a
    Screening, Brief Intervention and Referral to Treatment                                                —                    25.0              25.0
                                  a
    SAMHSA Health Surveillance                                                                             —                    18.0              18.0
                         a
    Suicide Prevention                                                                                     —                    10.0              10.0
Agency subtotal                                                                                          20.0                   88.0            108.0
Office of the Secretary (OS)
    Obesity Media Activities                                                                              9.1                     9.1             18.2
    Tobacco Prevention Media                                                                               —                    10.0              10.0
    National Prevention, Health Promotion, and Public Health Council Planning                             1.0                      —               1.0
                                                               a
    President’s Council on Fitness, Sports, and Nutrition                                                 0.9                      —               0.9
    Tobacco Cessation                                                                                     0.9                      —               0.9
    Healthy Living Innovations Awards                                                                     0.1                      —               0.1
Agency subtotal                                                                                          12.0                   19.1              31.1
Agency for Healthcare Research and Quality (AHRQ)
                                              a
    Clinical Preventive Services Task Force                                                               5.0                     7.0             12.0
    Clinical Preventive Services Research                                                                  —                      5.0              5.0
    Healthy Weight Practice-Based Research Networks                                                       0.5                      —               0.5
Agency subtotal                                                                                           5.5                   12.0              17.5
Total PPHF allocations for all activities                                                             $500.0                 $750.0         $1,250.0
                                              Source: GAO analysis of HHS information.

                                              Notes: Total reported allocations from the PPHF in this table may not match—for example, they may
                                              be higher than—the total amounts awarded in grants or contracts (reported obligations) for each
                                              agency or activity. According to HHS officials, to carry out an activity, an agency may incur
                                              administrative expenses, including an agency’s internal costs associated with managing and
                                              overseeing grants and contracts, not reflected in award amounts. Further, to the extent that an
                                              appropriation has not identified a particular amount for a specific activity, an agency may reallocate
                                              unobligated funds from that activity to another during the course of a fiscal year.
                                              a
                                               In addition to PPHF funding, these 23 activities also received funding from regular appropriations.
                                              We use the term “regular appropriations” to refer to funding that is a product of the annual budget and
                                              appropriations process.
                                              b
                                              According to HHS officials, this activity was called Public Health Infrastructure in fiscal year 2010.


                                              For the 43 activities for which HHS allocated PPHF funds for fiscal years
                                              2010 and 2011, HHS agencies awarded grants and contracts, and
                                              entered into interagency agreements, with the majority of funding




                                              Page 11                                            GAO-12-788 Prevention and Public Health Fund
awarded through grants (see table 3). 18 The number of award recipients
for each activity ranged from 1 contractor for the AHRQ Healthy Weight
Practice-Based Research Networks to 110 grantees receiving PPHF
funding under HRSA’s Primary Care Training and Enhancement activity.
Recipients of PPHF funds were located in all 50 states, the District of
Columbia, and 8 U.S. territories. (See apps. I-V for listings of recipients of
PPHF funds and their locations.)

Table 3: PPHF-Funded Awards by Funding Mechanism, Fiscal Years 2010 and 2011

                                           Fiscal year 2010                   Fiscal year 2011
                                                          Amount                                 Amount
                                      Number of          awarded        Number of               awarded
 Funding mechanism                      awards       (in millions)        awards            (in millions)
 Grants                                       545             $416               663                 $463
 Contracts                                     66               52               154                  223
 Interagency agreements                        14               20                29                    41
 Total                                        625             $488               846                 $727
Source: GAO analysis of HHS information.

Notes: This table presents the total amounts of PPHF funding awarded (reported as obligations) by
HHS agencies through grants, contracts, and interagency agreements for fiscal years 2010 and 2011.
Total amounts awarded (reported obligations) in this table may not match—for example, they may be
lower than—the total amounts allocated for each fiscal year. According to HHS officials, to carry out
an activity, an agency may incur administrative expenses, including an agency’s internal costs
associated with managing and overseeing grants and contracts, not reflected in award amounts.
Further, to the extent that an appropriation has not identified a particular amount for a specific activity,
an agency may reallocate unobligated funds from that activity to another during the course of a fiscal
year.


PPHF-funded grants were awarded to state and local governments, tribal
organizations, academic institutions, as well as national organizations and
hospitals; eligibility for these awards was often limited to a certain type or
types of entity. Our review of 58 funding opportunity announcements for
PPHF-funded grants for fiscal years 2010 and 2011 found that state,
local, territory, or tribal governments were eligible for the most grant
opportunities in those years. While many funding opportunity


18
  Total amounts awarded (reported obligations) may not match—for example, they may
be lower than—the total amounts allocated from the PPHF for each fiscal year. According
to HHS, to carry out an activity, an agency may incur administrative expenses, including
an agency’s internal costs associated with managing and overseeing grants and
contracts, not reflected in award amounts. Further, to the extent that an appropriation has
not identified a particular amount for a specific activity, an agency may reallocate
unobligated funds from that activity to another during the course of a fiscal year.




Page 12                                               GAO-12-788 Prevention and Public Health Fund
                                                  announcements limited eligibility to one type of entity, others—including
                                                  the funding opportunity announcement for the Community Transformation
                                                  Grants program—listed multiple types of entities as eligible to apply for
                                                  the PPHF-funded grants (see table 4).

Table 4: Types of Entities Eligible for PPHF-Funded Grants Awarded in Fiscal Years 2010 and 2011

                                               Fiscal year 2010                              Fiscal year 2011                           Total
                                            Number of             Amount               Number of            Amount         Number of                 Amount
                                               funding           awarded                  funding          awarded            funding               awarded
Type of entity                            opportunities      (in millions)           opportunities     (in millions)     opportunities          (in millions)
Limited to state, local, territory,
                       a
or tribal governments                                 13                $125                      13            $228                    26              $353
Limited to academic institutions
                               b
or physician training programs                         4                 243                       5              41                     9               285
                                      c
Limited to national organizations                      2                     8                     6              15                     8                 23
                                          d                                                                                                 e
Not limited to one type of recipient                   5                   40                      8            168                    11                208
        f
Other                                                  0                     0                     4              10                     4                 10
                                                                                                                                            e
Total                                                 24                $416                      36            $463                   58               $879
                                                  Source: GAO analysis of HHS information.

                                                  Note: This table presents information on the types of entities eligible to receive PPHF funded grants
                                                  in fiscal years 2010 and 2011, including the total amounts of PPHF funding awarded (reported as
                                                  obligated) by HHS agencies as a result of grants for fiscal years 2010 and 2011. Rows and columns
                                                  may not total due to rounding.
                                                  a
                                                   Includes grant funding opportunities that were limited to state, local, tribal, or territorial governments,
                                                  or their bona fide agents, as well as tribal organizations and state partnerships such as a state
                                                  workforce investment board.
                                                  b
                                                  Includes grant funding opportunities that were limited to private and public educational institutions, as
                                                  well as hospitals and other organizations that train providers.
                                                  c
                                                   Includes grant funding opportunities that were limited to national, nonprofit, and public health
                                                  organizations.
                                                  d
                                                   Includes grant funding opportunities that were not limited to one type of entity—for example, multiple
                                                  types of entities, including state, local, or tribal governments as well as nonprofit organizations were
                                                  eligible to apply.
                                                  e
                                                   Two funding announcements supported projects in both fiscal years 2010 and 2011. We examined
                                                  58 unique funding announcements.
                                                  f
                                                   Includes funding opportunities limited to other types of organizations—for example, one that was
                                                  limited to prevention epicenters and one that was limited to publicly funded community mental health
                                                  and other community-based behavioral health agencies.


                                                  As reported by HHS, most PPHF-funded grants for fiscal years 2010 and
                                                  2011 were new grants, followed by supplemental and continuation grants
                                                  (see table 5).




                                                  Page 13                                                GAO-12-788 Prevention and Public Health Fund
Table 5: Number of Funding Opportunity Announcements and PPHF-Funded Grants, by Type of Grant, Fiscal Years 2010 and
2011

                                           Fiscal year 2010                                                   Fiscal year 2011
Type of grant in funding      Number of funding                                                   Number of funding
                         a
opportunity announcement          opportunities                Number of grants                       opportunities         Number of grants
New                                              17                                 419                           17                      202
Supplemental                                      7                                 126                           11                      218
Continuation                                      0                                     0                         10                      243
                                                                                                                       b
Total                                            24                                 545                           36                      663
                                      Source: GAO analysis of HHS funding opportunity announcements.

                                      Note: This table presents the types of PPHF funded grants based on a review of 58 funding
                                      opportunity announcements identified by HHS for fiscal years 2010 and 2011. Two funding
                                      announcements supported projects in both fiscal years 2010 and 2011.
                                      a
                                       A new grant provides funding for a project that is not currently receiving financial support, a
                                      continuation grant provides additional funding for one or more budget periods to a project for which
                                      financial support would otherwise end, and a supplemental grant increases funding for an approved
                                      project during a current budget period.
                                      b
                                       The number of funding opportunities for each type do not sum to the column total because two
                                      funding announcements were used to make both new and continuation awards in fiscal year 2011.
                                      We examined 58 unique funding announcements.


                                      HHS has not published a comprehensive list of agencies and activities for
                                      which PPHF funding was allocated and has not published a
                                      comprehensive list of all of the entities receiving PPHF funding in fiscal
                                      years 2010 and 2011; PPACA did not require HHS to do so. 19 For PPHF
                                      funding in fiscal year 2012, HHS established a website to provide
                                      information on activities supported from the PPHF, in response to
                                      provisions in the Consolidated Appropriations Act, 2012. 20 According to
                                      HHS officials, HHS does not plan to include information on activities




                                      19
                                        Some information on activities and award recipients was reported in numerous press
                                      releases about activities funded by the PPHF in fiscal years 2010 and 2011 and on HHS
                                      and agency websites. For example, HHS issued press releases announcing some PPHF-
                                      funded awards with hyperlinks listing projects funded by the PPHF. In addition, a HHS
                                      website shows PPHF funding amounts by state and type of effort, such as community
                                      prevention, clinical prevention, or research and data collection. See
                                      http://www.healthcare.gov/news/factsheets/2011/02/prevention02092011a.html
                                      (accessed Aug. 6, 2012).
                                      20
                                        According to HHS, this website will provide information on the fiscal year 2012 planned
                                      allocation of PPHF funds, funding opportunities, and the recipients of awards, with
                                      information to be posted as it becomes available. See
                                      http://www.hhs.gov/open/recordsandreports/prevention/ (accessed June 12, 2012).




                                      Page 14                                                      GAO-12-788 Prevention and Public Health Fund
                         funded in fiscal years 2010 and 2011 on this website, and as of May
                         2012, was still evaluating how it will use the website in fiscal year 2013.


                         HHS implemented an abbreviated process to allocate PPHF funds for
Process and Criteria     fiscal years 2010 and 2011 because of the timing when PPACA was
for Allocating and       enacted, according to HHS. PPACA was signed into law on March 23,
                         2010, 1 week before the midpoint of fiscal year 2010 and over a month
Awarding PPHF            after the President had released his fiscal year 2011 budget request. (See
Funds for Fiscal Years   fig. 2 for a timeline of key events.)
2010 and 2011




                         Page 15                               GAO-12-788 Prevention and Public Health Fund
Figure 2: PPHF Key Event Timeline, Fiscal Years 2010 and 2011




                                        Page 16                 GAO-12-788 Prevention and Public Health Fund
HHS implemented an abbreviated process for allocating PPHF funds for
fiscal years 2010 and 2011 due to the timing of PPACA in relation to the
budget formulation process for those years. 21 That is, because the
President’s budget request, along with agency justifications, had already
been submitted, HHS did not have the opportunity to lay out its plans for
how PPHF funds would be spent for fiscal years 2010 and 2011.
According to ASFR officials, for fiscal years 2012 and 2013 HHS
considered which activities to support with PPHF funding through the
annual budget formulation process. 22

In its abbreviated process, HHS requested proposals for PPHF funding
from agencies. HHS did not develop HHS-wide criteria for fiscal years
2010 and 2011; instead HHS instructed agencies to use activities cited in
the PPACA provisions establishing the PPHF as guidance for developing
proposals for activities for which HHS could allocate PPHF funding.
According to HHS, the proposed activities were also aligned with existing
departmental priorities. HHS then evaluated agency proposals and
allocated and transferred PPHF funds to the corresponding
appropriations accounts, guided in fiscal year 2011 by proposed
legislative language. Agencies then evaluated applications and selected
projects to fund with their available PPHF funds. Table 6 provides a
description of actions taken in each step for allocating and awarding
PPHF funds for fiscal years 2010 and 2011, as reported by HHS and
agency officials.




21
  Federal agencies typically begin developing their budget requests in the spring (or
earlier) each year, at least 9 months before the President submits his budget request to
Congress, and about 17 months before the start of the fiscal year to which the budget
requests pertains. For fiscal year 2010 that started on October 1, 2009, the President
released his budget request in February 2009, and agencies would have begun work on
their budgets in spring 2008. For fiscal year 2011, agencies would have begun work on
their budgets in spring 2009. As part of this budget and appropriations process for regular
appropriations, agencies prepare and submit materials (budget justifications) to
accompany the President’s budget that lay out their plans for how funds would be spent.
Because of the timing of PPACA, HHS did not have the opportunity to include PPHF funds
in its submissions for fiscal years 2010 and 2011.
22
  HHS’s congressional budget justifications for fiscal years 2012 and 2013 identified the
activities for which HHS proposed allocating PPHF funds in those years. According to
HHS, the department’s annual budget formulation process includes participation of the
Secretary’s Budget Council, which consists of the HHS Deputy Secretary, the Secretary-
appointed policy counselors, and other select leadership within the Office of the Secretary
who advise the Secretary on departmental issues, including the annual HHS budget.




Page 17                                      GAO-12-788 Prevention and Public Health Fund
Table 6: HHS Process for Allocating and Awarding PPHF Funds, Fiscal Years 2010 and 2011

Step                        HHS/Agency action
1. Agencies develop PPHF    In late March to early April 2010, HHS requested agencies to submit proposals for fiscal years 2010
   proposals                and 2011 PPHF funding. HHS officials reported that the shortened time frames did not allow for
                            development of HHS-wide written criteria for developing PPHF proposals. In lieu of HHS-wide criteria,
                            agencies were referred to the activities cited in PPACA related to PPHF funding as guiding principles
                            in developing agency proposals—specifically, that PPHF is “for programs authorized by the Public
                            Health Service Act, for prevention, wellness, and public health activities including prevention research,
                            health screenings, and initiatives, such as the Community Transformation grant program, the
                                                                                                                                a
                            Education and Outreach Campaign Regarding Preventive Benefits, and immunization programs.”
                            HHS also requested that agency proposals focus on existing programs or programs that could be
                            implemented in a short time frame. For example:
                            •    AHRQ officials reported using existing criteria for its Prevention and Care Management program,
                                 including improving primary care and clinical outcomes through health care redesign, clinical-
                                 community linkages, self-management support, integration of health information technology, and
                                 care coordination, to identify activities to propose for PPHF funding.
                            •    SAMHSA officials reported proposing funding for additional grants under existing activities,
                                 including additional grants for suicide prevention.
2. HHS allocates PPHF       After receiving proposals from agencies for fiscal year 2010 PPHF funding, HHS officials allocated and
   funds to agencies and    provided for the transfer of funds so that funds could be obligated before the end of the fiscal year. For
   activities               example, they did this by allocating PPHF funds for activities that had existing mechanisms in place for
                            implementation. In fiscal year 2010, HHS made the largest PPHF allocation for HRSA’s Primary Care
                            Training and Enhancement activity as part of an initiative to increase the nation’s supply of primary
                            care providers.
                            According to HHS officials, for allocation decisions for both fiscal years 2010 and 2011, HHS
                                                                                                 b
                            leadership, including members of the Secretary’s Budget Council, reviewed and evaluated PPHF
                            proposals, and developed final allocations. For fiscal year 2011, HHS also used proposed legislative
                            language as guidance for allocating PPHF funds.
3. Agencies select PPHF     In general, each agency administering activities for which PPHF allocations and transfers were made
   projects for funding     issued funding announcements and many agencies reported using their regular review process to
                            select project applications for PPHF funding. Agencies also reported using existing criteria—and in
                            some cases language from PPACA as additional criteria—to select grants and contracts. For example:
                            •    AHRQ officials reported that fiscal year 2010 and 2011 PPHF-funded grants and contracts, as
                                 well as non-PPHF awards, were competitively selected based on peer reviews and scoring.
                            •    CDC officials reported that the specific criteria used to evaluate proposals were tailored to each
                                 funding announcement—common rating criteria included demonstration of public health need;
                                 feasibility and effectiveness of activities, staffing plan, and budget; defined, measurable, and
                                 achievable goals; and efficient and effective use of resources. CDC officials reported that they
                                 also used language from PPACA as criteria for rating applications for PPHF funds for fiscal years
                                 2010 and 2011.
                            •    HRSA officials told us that they generally invest funding (including PPHF funds) in programs that
                                 have the potential of having a national impact. According to HRSA, individual projects, or grants,
                                 are selected using a competitive process, are independently reviewed, and generally reflect
                                 geographic distribution.
                                         Source: GAO summary of HHS information.
                                         a
                                          Because CDC refers to the “Community Transformation Grants program”, we use that name in
                                         referring to the program in this report.
                                         b
                                          The Secretary’s Budget Council consists of the HHS Deputy Secretary, the Secretary-appointed
                                         policy counselors, and other select leadership within the Office of the Secretary who advise the
                                         Secretary on departmental issues, including the annual HHS budget.




                                         Page 18                                          GAO-12-788 Prevention and Public Health Fund
As part of the abbreviated process HHS used for fiscal years 2010 and
2011, following the enactment of PPACA, HHS developed a PPHF
allocation plan then consulted with staff from the authorizing and
appropriations committees prior to transferring the funds. Specifically,
HHS told us that prior to transferring PPHF funds within HHS for fiscal
years 2010 and 2011, officials notified minority and majority staff from
authorizing and appropriations committees including: the House
Appropriations Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies; the Senate Appropriations
Subcommittee on Labor, Health and Human Services, Education, and
Related Agencies; the House Energy and Commerce Committee; and,
the Senate Committee on Health, Education, Labor and Pensions. In
addition, for fiscal year 2011, HHS told us that the department used
language for the proposed allocation in the fiscal year HHS
appropriation 23 as a guide for allocating the $750 million available from
the PPHF that year. HHS also reported consulting with the authorizing
and appropriations committees prior to executing the transfer of funds for
the fiscal year 2011 allocation.

For fiscal years 2010 and 2011, HHS did not formally solicit input from
outside stakeholders on the PPHF allocation process, according to HHS
officials. But HHS officials reported that a wide range of stakeholders,
including states, nonprofit organizations, community-based organizations,
and coalitions, proactively provided HHS and agencies with input on the
use of PPHF funds, which was considered by HHS leadership during the
decision-making process.




23
  156 Cong. Rec. S9026 (daily ed. Dec. 14, 2010) (section 4 of proposed S. Amdt. 4805
to H. R. 3082 provided that the explanatory statement by the Chairman of the Senate
Committee on Appropriations, which specified amounts to be transferred from the PPHF
to HHS agencies for specific activities administered by those agencies, was to have the
same effect with respect to the allocation of funds as if it were a joint explanatory
statement of a committee of conference) (the amendment was not agreed to and the
proposed language did not become law); 156 Cong. Rec. S9799 (explanatory statement
by the Chairman of the Senate Committee on Appropriations for proposed fiscal year 2011
HHS appropriation); S9849 (daily ed. Dec. 14, 2010 (portion of explanatory statement
providing for transfers from the PPHF)).




Page 19                                   GAO-12-788 Prevention and Public Health Fund
                     HHS has relied on its agencies to establish performance measures and
HHS Reporting of     targets and to track outcomes of PPHF activities. For the 23 activities for
Performance          which PPHF allocations were made and that received funding through
                     regular appropriations, performance measures, targets, and outcomes
Measures, Targets,   data were generally not specific to PPHF-funded projects, but applied to
and Outcomes of      the entire activity regardless of the funding source. For example,
Activities and       SAMHSA used both regular appropriations and PPHF funds for existing
                     activities, such as suicide prevention. Moreover, SAMHSA evaluates the
Projects Receiving   performance of the suicide prevention activities as a whole and does not
PPHF Funding         have separate performance measures for the PPHF-funded projects. For
                     individual projects receiving PPHF funding, performance measures were
                     frequently established in funding opportunity announcements.

                     HHS agency officials told us that it is too early to report outcomes for
                     many activities for which PPHF funding was allocated because many
                     projects receiving PPHF funding in fiscal year 2010, 2011, or both are
                     multiyear projects or have not yet completed project evaluations, and
                     outcomes have not been measured or reported. 24 For example, one
                     performance measure of HRSA’s Primary Care Training and
                     Enhancement activity—an activity that received PPHF funding in fiscal
                     year 2010—is the number of primary care physicians supported with
                     PPHF funding who complete their education; however, while data on the
                     number of individuals training to be physicians who are supported with
                     PPHF funding are available, outcome data on the numbers completing
                     their programs will not be available until fiscal year 2014, the year the first
                     cohort of physicians supported by fiscal year 2010 PPHF funding will
                     finish their training. Table 7 presents information on performance
                     measures and available information on targets and outcomes for the
                     three HHS activities for which the largest PPHF allocations were made for
                     fiscal years 2010 and 2011. Collectively, HHS allocated a total of
                     $198.1 million for fiscal year 2010 and $246.3 million for fiscal year 2011
                     for these three activities.



                     24
                       Agency officials said that some performance measures and outcomes for activities
                     receiving PPHF funding will be reported as part of their agencies’ routine Government
                     Performance and Results Act (GPRA) performance reporting. Pub. L. No. 103-62, 107
                     Stat. 285 (1993). GPRA, which was recently amended by the GPRA Modernization Act of
                     2010, requires agencies to establish outcome-oriented goals and performance indicators
                     to measure overall progress toward these goals. See Pub. L. No. 111-352, 124 Stat. 3866
                     (2011); GAO, Managing for Results: Opportunities for Congress to Address Government
                     Performance Issues, GAO-12-215R (Washington, D.C.: Dec. 9, 2011).




                     Page 20                                    GAO-12-788 Prevention and Public Health Fund
Table 7: Overall Performance Measures, Targets, and Outcome Information for the Three Activities for Which HHS Allocated
the Most PPHF Funding, Fiscal Years 2010 and 2011

Activity (agency) and PPHF
                                                                                             a
allocation amounts                  Performance measures, targets, and outcomes
Primary Care Training and           Under this activity, which includes HRSA’s Expansion of Physician Assistant Training program
Enhancement (HRSA)                  and Primary Care Residency Expansion program, HRSA performance measures and targets
Fiscal year 2010: $198.1 million    include the following:
                                    •    Number of physician assistants who complete their education supported by PPHF
                                         funding. (Target of 140 for fiscal year 2012.)
                                    •    Number of primary care physicians who complete their education supported by PPHF
                                         funding. (Target of 172 for fiscal year 2014.)
                                    According to HRSA, outcome data for these performance measure are not yet available,
                                    because students initially funded with PPHF funding in fiscal year 2010 will complete their
                                    training programs in fiscal years 2012 (physician assistants) and 2014 (physicians).
Community Transformation Grants     As of May 14, 2012, CDC had not finalized performance measures or targets for this activity.
Program (CDC)                       CDC’s draft performance measures, for which CDC estimated that targets will be available
Fiscal year 2011: $146.3 million    around October 2012, include the following:
                                    •   Number of people with increased access to smoke-free or tobacco-free environments in
                                        settings such as workplaces, restaurants, campuses, and outdoor places.
                                    •   Number of people with increased access to environments with healthy food or beverage
                                        options, including in schools, workplaces, and other community settings.
                                    •   Number of people with increased access to physical activity opportunities, including in
                                        schools, workplaces, and other community settings.
                                    •   Number of people with increased access to systems that support control of high blood
                                        pressure and of high cholesterol in health care and other community settings.
                                    CDC had not reported data on outcomes as of May 2012.
Section 317 Immunization Program    To ensure that children and adolescents are appropriately vaccinated, CDC performance
                                                                                                  b
(CDC)                               measures and targets for this activity include the following:
Fiscal year 2011: $100.0 million    •   Sustain immunization coverage in children 19-35 months of age for one dose of measles,
                                        mumps, and rubella vaccine. (Target of at least 90 percent for fiscal year 2011.)
                                    •   Achieve immunization coverage of at least 90 percent in children 19-35 months of age for
                                        at least four doses of pneumococcal conjugate vaccine. (Target of at least 87 percent for
                                        fiscal year 2011.)
                                    •   Achieve immunization coverage of at least 60 percent in children 19-35 months of age for
                                        two to three doses of rotavirus vaccine. (Target of at least 52 percent for fiscal year 2011.)
                                    •   Achieve or sustain immunization coverage of at least 70 percent in adolescents 13 to
                                        15 years of age for one dose Tdap (tetanus and diphtheria toxoids and acellular
                                        pertussis). (Target of at least 67 percent for fiscal year 2011.)
                                    •   Achieve or sustain immunization coverage of at least 70 percent in adolescents 13 to
                                        15 years of age for one dose meningococcal conjugate vaccine. (Target of at least
                                        66 percent for fiscal year 2011.)
                                    According to CDC, data on outcomes for fiscal year 2011 will be available by September 30,
                                    2012.
                                         Source: GAO analysis of HRSA and CDC information.




                                         Page 21                                             GAO-12-788 Prevention and Public Health Fund
                  a
                   Some of these targets are consistent with objectives in Health People 2020, which provides a
                  comprehensive set of 10-year national goals and objectives for improving the health of all Americans.
                  For example, Health People 2020 includes objectives to “increase tobacco-free environments in
                  schools” and to “achieve and maintain effective vaccination coverage levels for universally
                  recommended vaccines among young children.” For more information, see
                  http://www.healthypeople.gov/2020/about/default.aspx.
                  b
                   According to CDC, the targets reflect the impact of funding from both regular appropriations and
                  PPHF funds.


                  As of July 2012, information was available on some projects receiving
                  PPHF funding in fiscal years 2010 and 2011—for example, CDC posted
                  information on activities planned by individual projects funded by its
                  Community Transformation Grants program, which was initiated in late
                  fiscal year 2011. 25 At the same time, however, information on all fiscal
                  year 2010 and 2011 outcomes was not reported. 26


                  HHS reviewed a draft of this report and provided technical comments,
Agency Comments   which we incorporated as appropriate.


                  As arranged with your offices, unless you publicly announce its contents
                  earlier, we plan no further distribution of this report until 30 days after its
                  issue date. At that time, we will send copies of this report to the Secretary
                  of Health and Human Services and interested congressional committees.
                  In addition, the report will be available at no charge on the GAO website
                  at http://www.gao.gov.




                  25
                    See http://www.cdc.gov/communitytransformation/index.htm (accessed July 23,
                  2012).
                  26
                    For fiscal year 2012, HHS is required to report on PPHF-funded projects valued at
                  $25,000 or more. The Consolidated Appropriations Act, 2012 requires HHS to post on its
                  website semiannual reports summarizing the activities undertaken for each PPHF-funded
                  grant or contract of $25,000 or more (to be posted no later than 30 days after the end of
                  each 6-month period). Pub. L. No. 112-74, § 220, 125 Stat. 1085-1086. As of July 23,
                  2012, no semiannual reports had been posted on the website. See
                  http://www.hhs.gov/open/recordsandreports/prevention/ (accessed July 23, 2012).




                  Page 22                                           GAO-12-788 Prevention and Public Health Fund
If you or your staff have any questions regarding this report, please
contact me at (202) 512-7114 or iritanik@gao.gov. Contact points for our
Office of Congressional Relations and Public Affairs may be found on the
last page of this report. GAO staff who made key contributions to this
report are listed in appendix VI.




Katherine Iritani
Director, Health Care




Page 23                            GAO-12-788 Prevention and Public Health Fund
Appendix I: Agency for Healthcare Research
              Appendix I: Agency for Healthcare Research
              and Quality—Prevention and Public Health
              Fund Awards by Activity


and Quality—Prevention and Public Health
Fund Awards by Activity
              This appendix presents information on awards made by the Agency for
              Healthcare Research and Quality (AHRQ) for Prevention and Public
              Health Fund (PPHF) activities with funds allocated and transferred from
              the PPHF for fiscal years (FY) 2010 and 2011. For each AHRQ activity
              that received PPHF funding, tables 8 through 12 summarize information
              on awards made with those funds through grants and contracts for each
              fiscal year. 1 Award information was provided by the Department of Health
              and Human Services’ (HHS) Assistant Secretary for Financial Resources,
              AHRQ, or reported in the funding opportunity announcements (FOA) HHS
              identified as being associated with the activity and awards.

              The information presented in this appendix, including the purpose of the
              PPHF-funded activity, was obtained from HHS. Due to the large number
              of awards, we did not edit the award recipient information to correct
              typographical or grammatical errors, or clarify the information provided. In
              general, we reprinted the abbreviations and acronyms provided by HHS
              and the legislative authority cited in the FOA or otherwise provided by
              HHS. We did not independently verify the legislative authority. Totals in
              this appendix (reported obligations) may not match—for example, they
              may be lower than—the amounts in table 2 (reported allocations).
              According to HHS officials, to carry out an activity, an agency may incur
              administrative expenses, including an agency’s internal costs associated
              with managing and overseeing grants and contracts, not reflected in
              award amounts. Further, to the extent that an appropriation has not
              identified a particular amount for a specific activity, an agency may
              reallocate unobligated funds from that activity to another during the
              course of a fiscal year.

              Activity: Clinical Preventive Services Task Force

              The purpose of this activity is to support the U.S. Preventive Services
              Task Force (USPSTF), an independent panel of private-sector experts in
              prevention and primary care, including support for a Scientific Resource
              Center, a preventive medicine residency rotation program, staff support,
              and to develop and finalize updated evidence reports.




              1
               The tables present information on cooperative agreements with grants, and include
              information on interagency agreements with contracts.




              Page 24                                      GAO-12-788 Prevention and Public Health Fund
                                         Appendix I: Agency for Healthcare Research
                                         and Quality—Prevention and Public Health
                                         Fund Awards by Activity




                                         •     Fiscal year 2010: $5.0 million (2 contracts)

                                         •     Fiscal year 2011: $6.8 million (2 contracts)

Table 8: FY 2010 Contracts, Clinical Preventive Services Task Force

Recipient                                                    Purpose                                    State     Award (dollars)
ABT Associates, Inc.                                         Specialized Communications for USPSTF      MA             $4,000,000
Oregon Evidence-based Practice Center (EPC) for              USPSTF Reviews                             OR              1,010,937
USPSTF Reviews
Total (2 awards)                                                                                                       $5,010,937
                                         Source: GAO analysis of HHS information.




Table 9: FY 2011 Contracts, Clinical Preventive Services Task Force

Recipient                                                     Purpose                                   State     Award (dollars)
ABT Associates, Inc.                                          Specialized Communications for USPSTF     MA             $3,776,974
Oregon Evidence-based Practice Center (EPC) for               USPSTF Reviews                            OR              3,000,000
USPSTF Reviews
Total (2 awards)                                                                                                       $6,776,974
                                         Source: GAO analysis of HHS information.



                                         Activity: Clinical Preventive Services Research

                                         The purpose of this activity is to support integrated, multiproject research
                                         programs that will work with a well-defined, central research focus to
                                         contribute to addressing the research and implementation gaps identified
                                         as part of the development of the HHS National Prevention and National
                                         Quality Strategies.

                                         •     Fiscal year 2010: None

                                         •     Fiscal year 2011: $4.8 million (3 grants totaling $4.3 million and
                                               1 contract for $0.5 million)




                                         Page 25                                       GAO-12-788 Prevention and Public Health Fund
                                               Appendix I: Agency for Healthcare Research
                                               and Quality—Prevention and Public Health
                                               Fund Awards by Activity




Table 10: FY 2011 Grants, Clinical Preventive Services Research

Announcement                                                           Recipient                                   State     Award (dollars)
Research Centers for Excellence in Clinical Preventive                 University of North Carolina, Chapel Hill   NC             $1,500,000
Services (RFA-HS-11-005)                                               University of Colorado, Denver              CO              1,483,338
Purpose (award type): To support Research Centers for
Excellence in Clinical Preventive Services to conduct                  Northwestern University                     IL              1,365,757
research and development activities in order to generate               Total (3 awards)                                           $4,349,095
new knowledge and develop tools and resources to improve
health and health care through clinical preventive services.
Core infrastructure should include: training, education, and
robust dissemination capabilities, and may, in addition, focus
on the provision of specific methodologic support to the
Center. Each Research Center application must propose a
body of work addressing one of three programmatic areas:
(1) patient safety; (2) health equity; or, (3) health care
system implementation. (New)
Legislative Authority: 42 U.S.C. 299a(a), which authorizes
AHRQ to conduct and support research, support
demonstration projects, and disseminate information on
health care and on systems for the delivery of such care,
including activities with respect to clinical practice, including
primary care and practice-oriented research. See 42 U.S.C.
299a(a)4.
Eligibility: Public or non-profit private institution, such as a
university, college, or a faith-based or community-based
organization; Units of local or State government; Eligible
agencies of the Federal government; Indian/Native American
Tribal Government (Federally Recognized); Indian/Native
American Tribal Government (Other than Federally
Recognized); and Indian/Native American Tribally
Designated Organizations.
                                               Source: GAO analysis of HHS information.




                                               Page 26                                            GAO-12-788 Prevention and Public Health Fund
                                           Appendix I: Agency for Healthcare Research
                                           and Quality—Prevention and Public Health
                                           Fund Awards by Activity




Table 11: FY 2011 Contract, Clinical Preventive Services Research

Recipient                 Purpose                                                                  State           Award (dollars)
Abt Associates, Inc.      Technical assistance and evaluation of grant program.                    MD                     $484,986
Total (1 award)                                                                                                           $484,986
                                           Source: GAO analysis of HHS information.



                                           Activity: Healthy Weight Practice-Based Research Networks

                                           The purpose of this activity is to promote innovative efforts to improve the
                                           management of obese patients in primary care by (1) supporting the
                                           development and evaluation of scalable and sustainable linkages
                                           between primary care practices and community-based resources to
                                           support obesity treatment and management across the lifespan; and
                                           (2) creating an implementation guide on obesity management to be
                                           disseminated widely to diverse primary care settings that describes
                                           optimal processes for developing, assessing, and maintaining effective
                                           linkages with community-based programs.

                                           •     Fiscal year 2010: $0.5 million (1 contract)

                                           •     Fiscal year 2011: None

Table 12: FY 2010 Contract, Healthy Weight Practice-Based Research Networks

Recipient                                         Purpose                                                  State   Award (dollars)
Colorado Practice-based Research Network          To create a guide for primary care practices to build  CO               $489,063
(PBRN) Healthy Weight                             linkages with community based organizations in support
                                                  of healthy weight programs.
Total (1 award)                                                                                                           $489,063
                                           Source: GAO analysis of HHS information.




                                           Page 27                                      GAO-12-788 Prevention and Public Health Fund
Appendix II: Centers for Disease Control and
              Appendix II: Centers for Disease Control and
              Prevention—Prevention and Public Health
              Fund Awards by Activity


Prevention—Prevention and Public Health
Fund Awards by Activity
              This appendix presents information on awards made by the Centers for
              Disease Control and Prevention (CDC) for Prevention and Public Health
              Fund (PPHF) activities with funds allocated and transferred from the
              PPHF for fiscal years (FY) 2010 and 2011. For each CDC activity that
              received PPHF funding, tables 13 through 62 summarize information on
              awards made with those funds through grants and contracts for each
              fiscal year. 1 Award information was provided by HHS’s Assistant
              Secretary for Financial Resources, CDC, or reported in the funding
              opportunity announcements (FOA) HHS identified as being associated
              with the activity and awards.

              The information presented in this appendix, including the purpose of the
              PPHF-funded activity, was obtained from HHS. Due to the large number
              of awards, we did not edit the award recipient information to correct
              typographical or grammatical errors, or clarify the information provided. In
              general, we reprinted the abbreviations and acronyms provided by HHS
              and the legislative authority cited in the FOA or otherwise provided by
              HHS. We did not independently verify the legislative authority. Totals in
              this appendix (reported obligations) may not match—for example, they
              may be lower than—the amounts in table 2 (reported allocations).
              According to HHS officials, to carry out an activity, an agency may incur
              administrative expenses, including an agency’s internal costs associated
              with managing and overseeing grants and contracts, not reflected in
              award amounts. Further, to the extent that an appropriation has not
              identified a particular amount for a specific activity, an agency may
              reallocate unobligated funds from that activity to another during the
              course of a fiscal year.

              Activity: Community Transformation Grants Program

              The purpose of this activity is to support community-level efforts to reduce
              chronic diseases such as heart disease, cancer, stroke, and diabetes. By
              promoting healthy lifestyles, especially among population groups
              experiencing the greatest burden of chronic disease, these funded
              projects are designed to help improve health, reduce health disparities,
              and control health care spending.




              1
               The tables present information on cooperative agreements with grants, and include
              information on interagency agreements with contracts.




              Page 28                                        GAO-12-788 Prevention and Public Health Fund
                                                Appendix II: Centers for Disease Control and
                                                Prevention—Prevention and Public Health
                                                Fund Awards by Activity




                                                •    Fiscal year 2010: None

                                                •    Fiscal year 2011: $139.3 million (68 grants in three funding
                                                     announcements totaling $107.9 million and contracts totaling
                                                     $31.4 million)

Table 13: FY 2011 Grants, Community Transformation Grants Program

Announcements (3)                                             Recipient                                           State     Award (dollars)
 1. Public Prevention Health Fund: Community                  Texas State Dept of Health Services                 TX            $10,000,000
    Transformation Grants                                     Los Angeles County Health Services Dept             CA              9,848,011
    (CDC-RFA-DP11-1103PPHF11)
Purpose (award type): To create healthier                     New York State Dept of Health                       NY              8,391,881
communities by (1) building capacity to implement             NC State Dept/Hlth & Human Services                 NC              7,466,092
broad evidence and practice-based policy,
                                                              Public Health Institute                             CA              5,926,365
environmental, programmatic and infrastructure
changes, as appropriate, in large counties, and in            Illinois State Dept of Public Health                IL              4,781,121
states, tribes and territories, including in rural and        University of Wisconsin-Madison                     WI              4,700,000
frontier areas; and (2) supporting implementation of
such interventions in five strategic areas (1) tobacco-       South Carolina State Dept of Hlth/Env               SC              4,624,724
free living, (2) active living and healthy eating, (3) high   Minnesota State Dept of Health                      MN              3,603,724
impact evidence-based clinical and other preventive
services, (4) social and emotional wellness, and              Washington State Department of Health               WA              3,256,347
(5) healthy and safe physical environment. (New)              Massachusetts State Dept of Pub Health              MA              3,079,988
Legislative Authority: Sections 4002 and 4201 of              County/San Diego Health/Human Ser/Ag                CA              3,053,793
the Affordable Care Act.
                                                              Iowa State Dept of Public Health                    IA              3,007,856
Eligibility: Limited to state and local governmental
agencies, or their Bona Fide Agent or the equivalent,         Maryland State Dept of Hlth/Mtl Hygiene             MD              1,945,289
as well as, state and local nonprofit organizations,          WV State Dept Hlth/Human Rscs                       WV              1,883,603
federally recognized American Indian Tribes and
Alaska Native Villages, tribal organizations, and             Broward Regional Health Planning Council            FL              1,766,476
Urban Indian Health programs.                                 City of Philadelphia Public Health Dept             PA              1,547,297
                                                              New Mexico State Department of Health               NM              1,500,000
                                                              Maine State Dept/Health/Human Servs                 ME              1,318,301
                                                              Hennepin County Health and Human Services           MN              1,156,212
                                                              Austin Health and Human Services Department         TX              1,026,158
                                                              San Francisco Dept of Public Health                 CA                815,358
                                                              South Dakota State Dept of Health                   SD                812,383
                                                              Tacoma-Pierce County Health Department              WA                796,836
                                                              Montana State Dept/Pub Hlth & Human Srvs            MT                769,195
                                                              University of Rochester                             NY                733,703
                                                              Louisville Metro Department of Health               KY                721,594
                                                              OK City County Health Department                    OK                716,704
                                                              Mid-American Regional Council Comm. Services        MO                705,708




                                                Page 29                                          GAO-12-788 Prevention and Public Health Fund
                    Appendix II: Centers for Disease Control and
                    Prevention—Prevention and Public Health
                    Fund Awards by Activity




Announcements (3)              Recipient                                            State     Award (dollars)
                               Vermont Department of Health                         VT                621,760
                               Denver Health and Hospital Authority                 CO                610,345
                               Douglas County Health Department                     NE                510,199
                               My Brother’s Keeper                                  MS                500,000
                               Sault St. Marie Tribe of Chippewa Indians            MI                500,000
                               Houston City Health & Human Services                 TX                500,000
                               Operation Unite                                      KY                500,000
                               Louisiana State Dept of Hlth & Hospitals             LA                500,000
                               Austen Bioinnovation Institute In Akron              OH                500,000
                               Toyiabe Indian Health Project                        CA                500,000
                               New Jersey State Dept/Health/Senior Srvs             NJ                500,000
                               Great Lakes Inter-Tribal Council                     WI                499,982
                               Fresno County Department of Public Health            CA                499,695
                               Southeast Alaska Reg Hlth Consortium                 AK                499,588
                               Fairfax County Neighborhood And Comm. Srvcs          VA                499,559
                               Utah State Department of Health                      UT                499,366
                               Sierra Health Foundation                             CA                499,229
                               Cobb Public Health                                   GA                499,000
                               Confederated Tribes of the Chehalis Reservation      WA                498,663
                               Bernalillo County Office of Environmental Health     NM                497,353
                               Connecticut State Dept of Public Health              CT                493,891
                               Ventura County                                       CA                481,036
                               County of Kern Public Health Services Dept           CA                416,577
                               North Dakota State Department of Health              ND                370,684
                               Spectrum Health Hospitals                            MI                333,321
                               Stanislaus County Health Services Agency             CA                293,899
                               Lancaster General Health                             PA                233,577
                               Sophie Trettevick Indian Health Center               WA                218,929
                               Yukon-Kuskokwim Health Corporation                   AK                193,340
                               Public Health - Dayton And Montgomery County         OH                180,246
                               Ulkerreuil A. Klengar                                PW                147,106
                               Total (60 awards)                                                $103,552,064




                    Page 30                                        GAO-12-788 Prevention and Public Health Fund
                                           Appendix II: Centers for Disease Control and
                                           Prevention—Prevention and Public Health
                                           Fund Awards by Activity




Announcements (3)                                         Recipient                                        State     Award (dollars)
2. Public Prevention Health Fund: National                National Council of the Young Men’s Christian    IL             $1,300,000
    Dissemination and Support for Community               Association
    Transformation Grants                                 National REACH Coalition                         CA                900,000
    (CDC-RFA-DP11-1115PPHF11)
Purpose (award type): To support the efforts of the       American Lung Association                        DC                800,000
Community Transformation Grants program                   Community Anti-Drug Coalitions of America        VA                300,000
(CDC-RFA-DP11-1103PPHF11) by funding national
                                                          American Public Health Association               DC                300,000
network(s) of community-based organizations. Also to
support, disseminate and amplify successful program       Occidental College                               CA                300,000
models and activities as prescribed under statutory       Asian Pacific Partners for Empowerment,          CA                300,000
authority [Section 4201 (c) (5) of ACA]. (New)            Advocacy and Leadership
Legislative Authority: Sections 4002 and 4201 of
                                                          Total (7 awards)                                                $4,200,000
the Patient Protection and Affordable Care Act (ACA).
Eligibility: National network(s) of community based
organizations.
 3. Competitive Program Expansion Supplement for National Association of City/County Health                DC                140,000
     CDC-RFA-HM08-805: Strengthen and Improve            Officials
     the Nation’s Capacity through National, Non-
                                                         Total (1 award)                                                    $140,000
     profit, Professional Public Health Organizations to
     Increase Health Protection and Health Equity
     (CDC-RFA-HM08-8050402PHFF11)
Purpose (award type): To support the provision of
capacity building assistance to state, tribal, local and
territorial health departments that ensures
performance improvement and successful adoption of
best or promising practices to address key areas of
public health infrastructure investments. (Supplement)
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241
and 247b as amended. Funding is appropriated under
the Affordable Care Act (PL 111-148), Title IV,
Section 4002 (Prevention and Public Health Fund).
Eligibility: Limited to specific national, non-profit,
public health professional organizations funded
through the competitive funding opportunity
announcement CDC-RFA-HM08-805.
                                           Source: GAO analysis of HHS information.




                                           Page 31                                        GAO-12-788 Prevention and Public Health Fund
                                           Appendix II: Centers for Disease Control and
                                           Prevention—Prevention and Public Health
                                           Fund Awards by Activity




Table 14: FY 2011 Contracts, Community Transformation Grants Program

                                                                                                                              Award
Recipient                                Purpose                                                                State       (dollars)
ICF Macro, Inc                           TA and Training Contract                                               GA        $6,035,730
Research Triangle Institute              Community Transformation Grants – Evaluation Technical                 GA         5,835,132
                                         Assistance, Training Services, and Performance Monitoring
FHI Development 360 LLC                  Community Transformation Grants Program Evaluation – Enhanced          GA         5,396,166
                                         Evaluation Techniques
Four Seasons Environmental, Inc.         CDC Program Oversight & Implementation                                 GA         4,430,683
Research Triangle Institute              Social Media Contract                                                  GA         4,319,460
ICF Macro, Inc                           Modeling and Cost Benefit Analysis Contract                            GA         3,281,366
Global Evaluation & Applied Research     Extramural Staffing Contract                                           GA           678,033
Solutions (GEARS)
Deloitte Consulting, LLP                 CDC Program Oversight & Implementation                                 GA           477,725
Dell Services Federal Government, Inc.   CDC Program Oversight & Implementation                                 GA           375,000
Deloitte Consulting, LLP                 Project Management Contract Support                                    GA           200,000
Northrop Grumman                         Community Transformation Grants – Program Management                   GA           200,000
Deloitte Consulting, LLP                 CDC Program Oversight & Implementation                                 GA           103,286
Various – Emory University, JP Morgan    Contracts < $25K                                                       GA            19,489
Chase, Northrop Grumman
DOE IAA                                  CDC Program Oversight & Implementation                                 GA            12,000
Total                                                                                                                    $31,364,071
                                           Source: GAO analysis of HHS information.



                                           Activity: Section 317 Immunization Program

                                           The purpose of this activity is to provide funding for immunization
                                           operations and infrastructure necessary to implement a comprehensive
                                           immunization program at the federal, state, and local levels.

                                           •     Fiscal year 2010: None

                                           •     Fiscal year 2011: $99.8 million (73 grants in six funding
                                                 announcements totaling $46.5 million and contracts totaling
                                                 $53.3 million)




                                           Page 32                                        GAO-12-788 Prevention and Public Health Fund
                                              Appendix II: Centers for Disease Control and
                                              Prevention—Prevention and Public Health
                                              Fund Awards by Activity




Table 15: FY 2011 Grants, Section 317 Immunization Program

Announcements (6)                                     Recipient                                               State     Award (dollars)
1. Competitive Program Expansion Supplement National Association of City/County Health Officials              DC               $200,000
    for CDC-RFA-HM08-805: Strengthen                    Total (1 award)                                                        $200,000
    and Improve the Nation’s Capacity through
    National, Non-profit, Professional Public
    Health Organizations to Increase
    Health Protection and Health Equity
    (CDC-RFA-HM08-8050402PHFF11)
Purpose (award type): To support the provision
of capacity building assistance to state, tribal, local
and territorial health departments that ensures
performance improvement and successful
adoption of best or promising practices to address
key areas of public health infrastructure
investments. (Supplement)
Legislative Authority: Sections 301 and 317 of
the Public Health Service Act (PHS Act),
42 USC, 241 and 247b as amended. Funding is
appropriated under the Affordable Care Act
(PL 111-148), Title IV, Section 4002 (Prevention
and Public Health Fund).
Eligibility: Limited to specific national, non-profit,
public health professional organizations funded
through the competitive funding opportunity
announcement CDC-RFA-HM08-805.
2.   Prevention and Public Health Fund: Capacity      Arkansas State Dept of Health                           AR             $3,586,942
     Building Assistance to Strengthen Public         Kansas State Dept of Hlth and Environmnt                KS              3,115,885
     Health Immunization Infrastructure and
     Performance (CDC-RFA-IP11-1107PPHF11)            New York State Dept of Health                           NY              2,573,336
Purpose (award type): To assist Section 317           Massachusetts State Dept of Pub Health                  MA              2,570,827
grantees’ transitions into a health care
                                                      Colorado State Dept/Pub Hlth & Environmt                CO              1,800,000
environment that is being transformed by the
Affordable Care Act. (New)                            Washington State Department of Health                   WA              1,736,427
Legislative Authority: Sections 301 and 317 of        Connecticut State Dept of Public Health                 CT              1,611,744
the Public Health Service Act (PHS Act),
                                                      Alabama State Dept of Public Health                     AL              1,438,016
42 USC, 241 and 247b as amended and the
Patient Protection and Affordable Care Act            Missouri State Dept/Health & Senior Srv                 MO              1,397,940
(PL 111-148).
                                                      West Virginia State Dept Hlth/Human Rscs                WV              1,317,124
Eligibility: Limited to grantees that are currently
funded under funding announcement                     Maryland State Dept of Hlth/Mtl Hygiene                 MD              1,297,548
RFP IP08-803 because they have the necessary          Minnesota State Dept of Health                          MN              1,261,172
infrastructure in place to perform the activities
                                                      Maine State Dept/Health/Human Servs                     ME              1,256,896
required and have the experience needed to
successfully complete the required functions.         Michigan State Dept of Community Health                 MI              1,235,590
                                                      Arizona State Department of Hlth Srvcs                  AZ              1,162,818
                                                      Oklahoma State Department of Health                     OK              1,046,675
                                                      Georgia Department of Community Health                  GA              1,036,494
                                                      North Carolina State Dept/Hlth & Human Services         NC              1,023,484




                                              Page 33                                        GAO-12-788 Prevention and Public Health Fund
                                            Appendix II: Centers for Disease Control and
                                            Prevention—Prevention and Public Health
                                            Fund Awards by Activity




Announcements (6)                                    Recipient                                               State     Award (dollars)
                                                     Hawaii State Department of Health                       HI                933,189
                                                     Iowa State Dept of Public Health                        IA                900,000
                                                     New Jersey State Dept/Health/Senior Srvs                NJ                876,197
                                                     Vermont Department of Health                            VT                792,138
                                                     California Department of Public Health                  CA                765,000
                                                     Wisconsin Department of Health Services                 WI                756,548
                                                     Florida State Department of Health                      FL                718,920
                                                     South Carolina State Dept of Hlth/Env                   SC                654,034
                                                     Oregon State Public Health Division                     OR                639,590
                                                     Texas State Dept of Health Services                     TX                540,000
                                                     Nevada State Dept of Hlth/Human Svcs                    NV                539,989
                                                     Utah State Department of Health                         UT                515,979
                                                     Nebraska St Dept of Health & Human Servs                NE                492,300
                                                     Wyoming State Department of Health                      WY                485,906
                                                     Mississippi State Department of Health                  MS                484,195
                                                     Virginia State Dept of Health                           VA                452,061
                                                     Indiana State Department of Health                      IN                271,141
                                                     Ohio State Department of Health                         OH                252,275
                                                     North Dakota State Department of Health                 ND                226,418
                                                     Houston City Health & Human Services                    TX                134,842
                                                     Total (38 awards)                                                     $41,899,640
3. Enhanced Surveillance for New Vaccine             University of Rochester                                 NY               $201,220
    Preventable Disease (RFA-IP-11-010)              The Children’s Mercy Hospital                           MO                201,220
Purpose (award type): To establish surveillance
and evaluation sites that will collaborate as a      Cincinnati Children’s Hospital                          OH                201,220
larger network as the New vaccine Surveillance       Vanderbilt University Medical Center                    TN                201,220
Network to conduct multi-site and individual
                                                     Seattle Children’s Hospital                             WA                201,220
projects to assess the impact of new vaccines and
vaccine policies for diseases among children that    Total (5 awards)                                                       $1,006,100
are currently vaccine-preventable and those that
are potentially vaccine preventable in the future.
(New)
Legislative Authority: Sections 317(k)(1) of the
Public Health Service Act as amended
(42 U.S.C. 247b(k)(1)).




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Announcements (6)                                       Recipient                                              State     Award (dollars)
Eligibility: Eligible applicants include higher
education institutions, nonprofits, independent
school districts, housing authorities, faith-based,
community-based, and regional organizations,
Bona Fide agents, and state, county, city or
township, special districts, federally and
nonfederally recognized tribal, and U.S. territory or
possession governments. Entities must be states
(or bona fide agents to states), political
subdivisions of states, or other public or non-profit
private entities.
4. Patient Protection and Affordable Care Act           New York State Dept of Health                          NY               $409,254
     (ACA), Emerging Infections Programs (EIP),         California Department of Public Health                 CA                381,103
     Enhancing Epidemiology and Laboratory
     Capacity (CDC- RFA-CI10-00302PPHF11)               Minnesota State Dept of Health                         MN                328,791
Purpose (award type): The purpose of the                Georgia Department of Community Health                 GA                212,612
EIP-ACA cooperative agreement is to support
                                                        Connecticut State Dept of Public Health                CT                199,515
state and local health departments’ surveillance
infrastructure through enhancement of the               Colorado State Dept/Pub Hlth & Environmt               CO                191,878
epidemiology and laboratory capacity of the             Oregon State Public Health Division                    OR                167,139
existing EIP network. (Continuation)
                                                        Tennessee State Department of Health                   TN                162,890
Legislative Authority: Sections 301(a)
[42 U.S.C. 241(a)] and 317(k) (2) [42 U.S.C.            New Mexico State Department of Health                  NM                162,131
247b (k) (2)] of the Public Health Service Act,
                                                        Maryland State Dept of Hlth/Mtl Hygiene                MD                145,460
as amended and the Patient Protection and
Affordable Care Act (PPACA) (Public Law 111-            Total (10 awards)                                                     $2,360,773
148), Title IV, Sections 4002 and 4304
(Prevention and Public Health Fund).
Eligibility: Limited to health departments of states
(or bona fide agents) currently funded under
funding announcement CI10-003.
5. Patient Protection and Affordable Care Act           Georgia Department of Public Health                    GA               $253,635
     (ACA), Emerging Infections Programs (EIP)          CT ST Dept of Public Health                            CT                154,877
     (CI05-0026)
Purpose (award type): To provide continued              Total (2 awards)                                                        $408,512
support to Emerging Infections Programs.
(Continuation)
Legislative Authority: Sections 301(a)
[42 U.S.C. 241(a)], 317(k) (1) [42 U.S.C. 247b (k)
(1)], and 317 (k) (2) [42 U.S.C. 247b (k) (2)], as
amended.
Eligibility: Limited to state governments or their
bona fide agents.




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                                            Fund Awards by Activity




Announcements (6)                                     Recipient                                              State     Award (dollars)
6. Patient Protection and Affordable Care Act         Los Angeles County Health Services Dept                CA               $124,611
     Epidemiology and Laboratory Capacity for         Utah State Department of Health                        UT                 63,409
     Infectious Diseases (ELC) Building and
     Strengthening Epidemiology, Laboratory           New York City Health/Mental Hygiene                    NY                 39,963
     and Health Information Systems Capacity in       Maine State Dept/Health/Human Servs                    ME                 35,624
     State and Local Health Departments
     (CDC-RFA-CI10–101202PPHF11)                      Iowa State Dept of Public Health                       IA                 35,000
Purpose (award type): To enhance public health        Washington State Department of Health                  WA                 34,659
programs to improve health and help restrain the      Massachusetts State Dept of Pub Health                 MA                 32,450
rate of growth of health care costs through
building epidemiology, laboratory, and health         Arizona State Department of Hlth Srvcs                 AZ                 26,996
information systems capacity in state and local       NC State Dept/Hlth & Human Services                    NC                 26,798
public health departments. (Continuation)
                                                      South Carolina State Dept of Hlth/Env                  SC                 26,624
Legislative Authority: Sections 301(a)
[42 U.S.C. 241(a)] and 317(k) (2)                     Florida State Department of Health                     FL                 26,190
[42 U.S.C. 247b (k) (2)] of the Public Health         Houston City Health & Human Services                   TX                 26,000
Service Act, as amended and the Patient
Protection and Affordable Care Act (PL 111-148),      Wisconsin Department of Health Services                WI                 25,744
Title IV, Sections 4002 and 4304 (Prevention and      Tennessee State Department of Health                   TN                 23,943
Public Health Fund).
                                                      Alabama State Dept of Public Health                    AL                 23,340
Eligibility: Limited to 58 current Epidemiology
and Laboratory Capacity for Infectious Disease        Oklahoma State Department of Health                    OK                 17,016
Affordable Care Act state and local public health     City of Philadelphia Public Health Dept                PA                 17,000
department grantees or their bona fide agents of
funding announcement CI10-1012.                       Total (17awards)                                                        $605,367

                                            Source: GAO analysis of HHS information.




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Table 16: FY 2011 Contracts, Section 317 Immunization Program

Recipient                                                Purpose                                            State   Award (dollars)
Merck Sharp & Dohme Corp.                                Vaccine Supplies                                   GA          $20,523,444
Pfizer Inc.                                              Vaccine Supplies                                   GA            6,817,823
Sanofi Pasteur Inc.                                      Vaccine Supplies                                   GA            5,751,222
Glaxosmithkline LLC                                      Vaccine Supplies                                   GA            4,843,178
Merck Sharp & Dohme Corp.                                Vaccine Supplies                                   GA            4,413,348
Deloitte Consulting, LLP                                 Barcoding - Implementation Pilot for               GA            2,907,887
                                                         Two-Dimensional Vaccine Barcode Utilization
Glaxosmithkline LLC                                      Vaccine Supplies                                   GA            2,858,200
Four Seasons Environmental, Inc.                         CDC Program Oversight & Implementation             GA            2,149,345
Novartis Vaccines and Diagnostics, Inc.                  Vaccine Supplies                                   GA              565,969
Northrup Grumman Systems Corporation                     IIS-TIPS                                           GA              446,831
The Cadence Group, Inc.                                  PPHF project management                            GA              415,758
Carter Consulting, Inc.                                  VTrckS-IIS interface                               GA              410,363
Carter Consulting, Inc.                                  Billing Planning and Implementation - Technical GA                 340,952
                                                         Assistance Management of NCIRD funded grants
                                                         Support for the Education, Information, and
                                                         Partnership Branch (EIPB), Immunization
                                                         Services Division (ISD), National Center for
                                                         Immunization and Respiratory Diseases (NCIRD)
P3S Corporation                                          Evaluation of PCV 13 Vaccine - RBD Contractors     GA              263,017
Novartis Vaccines and Diagnostics, Inc.                  Vaccine Supplies                                   GA              190,861
P3S Corporation                                          Enhanced Pertussis Surveillance and Eval of        GA              164,044
                                                         Acellular VE
P3S Corporation                                          Strengthening the Evidence Base - MCV              GA               81,820
                                                         Evaluation - MVDB Contractors
Agilent Technologies, Applied Biosystems Bio-Rad         Contracts < $25K                                   N/A              73,165
Laboratories, Caliper Life Sciences, J P Morgan
Chase Bank, Roche Diagnostics Corporation
GSA Federal Telecommunication Service                    Evaluation Impact and Effectiveness of Rotavirus   GA               50,200
                                                         Vaccine
MA Biological Laboratory                                 Vaccine Supplies                                   GA               35,955
Southeast Scientific                                     Maintenance of 35 freezers                         GA               33,557
Goodwill Industries of North GA                          CDC Program Oversight & Implementation             GA               10,655
Total                                                                                                                   $53,347,594
                                          Source: GAO analysis of HHS information.




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Fund Awards by Activity




Activity: National Public Health Improvement Initiative

The purpose of this activity 2 is to systematically increase the capacity of
public health departments to detect and respond to public health events
requiring highly coordinated interventions to improve and/or sustain the
performance (efficiency/effectiveness) of public health organizations,
systems, practices, and essential services. It is intended to promote the
development, dissemination, and adoption of evidence-based practices.

•   Fiscal year 2010: $47.9 million (80 grants in two funding
    announcements totaling $46.4 million and three contracts totaling
    $1.5 million)

•   Fiscal year 2011: $40.2 million (80 grants in three funding
    announcements totaling $36.7 million and four contracts totaling
    $3.5 million)




2
According to HHS, this activity was called Public Health Infrastructure in fiscal year 2010.




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Table 17: FY 2010 Grants, National Public Health Improvement Initiative

                                                                                                                                  Award
Announcements (2)                                             Recipient                                             State       (dollars)
1. Strengthening Public Health Infrastructure for             California Department of Public Health                CA        $2,060,128
     Improved Health Outcomes (CDC-RFA-CD10-1011)             Florida State Department of Health                    FL         2,060,128
Purpose (award type): To support innovative changes
in key areas that improve the quality, effectiveness and      New York City Health/Mental Hygiene                   NY         2,060,128
efficiency of the public health infrastructure that will      Wisconsin Department of Health Services               WI         1,960,129
support the delivery of public health services and
                                                              Massachusetts State Dept of Pub Health                MA         1,960,128
programs as specified within the Affordable Care Act.
(New)                                                         Minnesota State Dept of Health                        MN         1,960,128
Legislative Authority: Sections 301 and 317 of the            North Carolina State Dept/Hlth & Human Services       NC         1,903,858
Public Health Service Act (PHS Act), 42 USC, 241 and
                                                              Oregon State Public Health Division                   OR         1,860,128
247b as amended. Funding is appropriated under the
Affordable Care Act (PL 111-148), Title IV, Section 4002      Los Angeles County Health Services Dept               CA         1,859,950
(Prevention and Public Health Fund).                          Cherokee Nation                                       OK         1,760,128
Eligibility: All 50 states, Washington D.C., 9 large local
health departments supporting cities with populations of      Maine State Dept/Health/Human Servs                   ME         1,758,786
1 million or more inhabitants, 5 U.S. Territories, 3 U.S.     Pacific Islands Health Officers Assn                  HI         1,660,128
Affiliated Pacific Islands and up to 7 federally recognized
                                                              New Jersey State Dept/Health/Senior Srvs              NJ         1,638,751
tribes (or their equivalent) with an established public
health department structure that provide public health        Tennessee State Department of Health                  TN         1,296,995
services.                                                     Nebraska St Dept of Health & Human Servs              NE         1,200,000
                                                              West Virginia State Dept Hlth/Human Rscs              WV         1,200,000
                                                              City of Philadelphia Public Health Dept               PA         1,118,493
                                                              Hawaii State Department of Health                     HI         1,100,000
                                                              Vermont Department of Health                          VT         1,100,000
                                                              Illinois State Dept of Public Health                  IL           400,000
                                                              Michigan State Dept of Community Health               MI           400,000
                                                              New York State Dept of Health                         NY           400,000
                                                              Pennsylvania State Dept of Health                     PA           400,000
                                                              Texas State Dept of Health Services                   TX           400,000
                                                              Georgia Department of Community Health                GA           399,836
                                                              Ohio State Department of Health                       OH           394,111
                                                              Colorado State Dept/Pub Hlth & Environmt              CO           300,000
                                                              Indiana State Department of Health                    IN           300,000
                                                              Maryland State Dept of Hlth/Mtl Hygiene               MD           300,000
                                                              Missouri State Dept/Health & Senior Srv               MO           300,000
                                                              Virginia State Dept of Health                         VA           300,000
                                                              Washington State Department of Health                 WA           299,981
                                                              Arizona State Department of Hlth Srvcs                AZ           289,586
                                                              Alabama State Dept of Public Health                   AL           200,000
                                                              Arkansas State Dept of Health                         AR           200,000



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                    Fund Awards by Activity




                                                                                                       Award
Announcements (2)                 Recipient                                              State       (dollars)
                                  Connecticut State Dept of Public Health                CT           200,000
                                  Idaho State Dept of Health and Welfare                 ID           200,000
                                  City of Chicago                                        IL           200,000
                                  Iowa State Dept of Public Health                       IA           200,000
                                  Kansas State Dept of Hlth and Environmnt               KS           200,000
                                  KY Cabinet for Health and Family Services              KY           200,000
                                  Louisiana State Dept of Hlth & Hospitals               LA           200,000
                                  Nevada State Dept of Hlth/Human Svcs                   NV           200,000
                                  Oklahoma State Department of Health                    OK           200,000
                                  Puerto Rico Department of Health                       PR           200,000
                                  South Carolina State Dept of Hlth/Env                  SC           200,000
                                  Houston City Health & Human Services                   TX           200,000
                                  Utah State Department of Health                        UT           200,000
                                  New Mexico State Department of Health                  NM           199,877
                                  Mississippi State Department of Health                 MS           199,585
                                  County of Maricopa                                     AZ           199,434
                                  Alaska State Department of Hlth-Soc Svcs               AK           100,000
                                  Alaska Native Tribal Health Consortium                 AK           100,000
                                  Southeast Alaska Reg Hlth Consortium                   AK           100,000
                                  American Samoa Department of Health                    AS           100,000
                                  Gila River Indian Community                            AZ           100,000
                                  Navajo Nation Division of Health                       AZ           100,000
                                  County/San Diego Health / Human Ser/Ag                 CA           100,000
                                  DC Department of Health                                DC           100,000
                                  Delaware State Dept of Hlth & Soc Srvs                 DE           100,000
                                  Federated States Micronesia                            FM           100,000
                                  Guam Department of Public Health-Soc Svc               GU           100,000
                                  Republic/Marshall Island Mnstry of Hlth                MH           100,000
                                  Montana State Dept/Pub Hlth & Human Srvs               MT           100,000
                                  Montana-Wyoming Tribal Leaders Council                 MT           100,000
                                  Commonwealth N Mariana Is Dept Pub Hlth                MP           100,000
                                  NH State Dept of Health and Human Sers                 NH           100,000
                                  Northwest Portland Area Indian Hlth Bd                 OR           100,000
                                  City of San Antonio Metro Health Dist                  TX           100,000
                                  Dallas County Dept/Hlth/Human Srvs                     TX           100,000
                                  Virgin Islands Department of Health                    VI           100,000




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                                                Fund Awards by Activity




                                                                                                                                                 Award
Announcements (2)                                                   Recipient                                                   State          (dollars)
                                                                    Wyoming State Department of Health                          WY             100,000
                                                                    Republic/Marshall Island Mnstry of Hlth                     MH             100,000
                                                                    Mille Lacs Band of Ojibwe Indians                           MN               99,866
                                                                    Rhode Island State Dept of Health                           RI               99,738
                                                                    Total (75 awards)                                                       $42,400,000
2.  Competitive Supplement to CDC-RFA-HM08-805:                     National Network of Public Health Institutes                LA           $1,000,000
    Strengthen and Improve the Nation’s Capacity                    American Public Health Association                          DC             750,000
    through National, Non-profit, Professional
    Public Health Organizations to Increase                         National Association of City/County Health Officials DC                    750,000
    Health Protection and Health Equity                             Public Health Foundation                                    DC             750,000
    (CDC-RFA-HM08-8050301SUPP10)
                                                                    Association of State and Territorial Health Officials       VA             750,000
Purpose (award type): To support the provision of
capacity building assistance to state, tribal, local                Total (5 awards)                                                         $4,000,000
and territorial health departments that ensures
successful adoption of best or promising practices to
address key areas of public health infrastructure
investments. (Supplement)
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241 and
247b as amended. Funding is appropriated under the
Affordable Care Act (PL 111-148), Title IV, Section 4002
(Prevention and Public Health Fund).
Eligibility: Limited to specific national, non-profit, public
health professional organizations funded through the
funding announcement CDC-RFA-HM08-805.
                                                Source: GAO analysis of HHS information.

                                                Note: In fiscal year 2010, this activity was referred to as Public Health Infrastructure.




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Table 18: FY 2010 Contracts, National Public Health Improvement Initiative

Recipient                          Purpose                                                                           State       Award (dollars)
Office of Personnal Management     Competencies necessary for Workforce                                              GA               $1,500,000
Deloitte Consulting, LLP           Business services support - Health Reform Implementation Office                   GA                  12,358
Northrop Grumman                   Support all aspects of full lifecycle application systems development GA                               7,000
                                   and maintenance on a variety of platforms including mainframe,
                                   client server, and web; architecture and infrastructure design to
                                   support enterprise application software services including
                                   hardware/software/network design and implementation; database
                                   design, application development and support; data management
                                   and security controls; quality assurance, test and control functions;
                                   and technical communication, consultation and information support.
Total (3 awards)                                                                                                                      $1,519,358
                                          Source: GAO analysis of HHS information.

                                          Note: In fiscal year 2010, this activity was referred to as Public Health Infrastructure.




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                                             Prevention—Prevention and Public Health
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Table 19: FY 2011 Grants, National Public Health Improvement Initiative

Announcements (3)                                        Recipient                                                State    Award (dollars)
1.  Public Prevention Health Fund: Strengthening         New York City Health/Mental Hygiene                      NY            $1,093,662
    Public Health Infrastructure for Improved Health     Florida State Department of Health                       FL             1,093,662
    Outcomes (CDC-RFA-CD10-101101PPHF11)
Purpose (award type): To provide support for             California Department of Public Health                   CA             1,093,662
accelerating public health accreditation readiness       NC State Dept/Hlth & Human Services                      NC             1,037,779
activities; to provide additional support for
                                                         Minnesota State Dept of Health                           MN               993,662
performance management and improvement
practices; and, for the development, identification      Wisconsin Department of Health Services                  WI               993,662
and dissemination of evidence-based policies and         Massachusetts State Dept of Pub Health                   MA               993,662
practices. (Supplement)
                                                         New Jersey State Dept/Health/Senior Srvs                 NJ               950,791
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241         Oregon State Public Health Division                      OR               893,662
and 247b as amended. Funding is appropriated             Los Angeles County Health Services Dept                  CA               893,598
under the Affordable Care Act (PL 111-148), Title IV,
Section 4002 (Prevention and Public Health Fund).        Cherokee Nation                                          OK               843,662
Eligibility: Limited to 76 official public health        Maine State Dept/Health/Human Servs                      ME               843,182
agencies that are current recipients of project grants
                                                         Tennessee State Department of Health                     TN               757,600
for Strengthening Public Health Infrastructure for
Improved Health Outcomes under funding                   City of Philadelphia Public Health Dept                  PA               664,213
opportunity CDC-RFA-CD10-1011.                           Nebraska St Dept of Health & Human Servs                 NE               657,600
                                                         West Virginia State Dept Hlth/Human Rscs                 WV               657,600
                                                         Hawaii State Department of Health                        HI               607,600
                                                         Vermont Department of Health                             VT               607,600
                                                         Pacific Islands Health Officers Assn                     HI               593,662
                                                         Pennsylvania State Dept of Health                        PA               500,000
                                                         New York State Dept of Health                            NY               500,000
                                                         Illinois State Dept of Public Health                     IL               500,000
                                                         Michigan State Dept of Community Health                  MI               500,000
                                                         Ohio State Department of Health                          OH               500,000
                                                         Texas State Dept of Health Services                      TX               500,000
                                                         Georgia Department of Community Health                   GA               499,738
                                                         Maryland State Dept of Hlth/Mtl Hygiene                  MD               400,000
                                                         Missouri State Dept/ Health & Senior Srv                 MO               400,000
                                                         Indiana State Department of Health                       IN               400,000
                                                         Washington State Department of Health                    WA               400,000
                                                         Colorado State Dept/Pub Hlth & Environmt                 CO               400,000
                                                         Arizona State Department of Hlth Srvcs                   AZ               400,000
                                                         Virgnia State Dept of Health                             VA               399,859
                                                         Arkansas State Dept of Health                            AR               300,000
                                                         City of Chicago                                          IL               300,000




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Announcements (3)             Recipient                                              State    Award (dollars)
                              Houston City Health & Human Services                   TX               300,000
                              Alabama State Dept of Public Health                    AL               300,000
                              County of Maricopa                                     AZ               300,000
                              Kansas State Dept of Hlth and Environmnt               KS               300,000
                              KY Cabinet for Health and Family Services              KY               300,000
                              Louisiana State Dept of Hlth & Hospitals               LA               300,000
                              Nevada State Dept of Hlth/Human Svcs                   NV               300,000
                              Idaho State Dept of Health and Welfare                 ID               300,000
                              Oklahoma State Department of Health                    OK               300,000
                              Utah State Department of Health                        UT               300,000
                              Connecticut State Dept of Public Health                CT               300,000
                              Iowa State Dept of Public Health                       IA               300,000
                              New Mexico State Department of Health                  NM               300,000
                              Puerto Rico Department of Health                       PR               300,000
                              South Carolina State Dept of Hlth/Env                  SC               300,000
                              Mississippi State Department of Health                 MS               299,585
                              County/San Diego Health / Human Ser/Ag                 CA               250,000
                              DC Department of Health                                DC               250,000
                              Delaware State Dept of Hlth & Soc Srvs                 DE               250,000
                              NH State Dept of Health and Human Sers                 NH               250,000
                              Northwest Portland Area Indian Hlth Bd                 OR               250,000
                              City of San Antonio Metro Health Dist                  TX               250,000
                              Alaska State Department of Hlth-Soc Svcs               AK               250,000
                              Rhode Island State Dept of Health                      RI               250,000
                              Navajo Nation Division of Health                       AZ               250,000
                              Alaska Native Tribal Health Consortium                 AK               250,000
                              American Samoa Department of Health                    AS               250,000
                              Federated States Micronesia                            FM               250,000
                              Guam Department of Public Health-Soc Svc               GU               250,000
                              Mille Lacs Band of Ojibwe Indians                      MN               250,000
                              Republic/Marshall Island Mnstry of Hlth                MH               250,000
                              Montana WY Tribal Leaders Council                      MT               250,000
                              MT State Dept/Pub Hlth & Human Srvs                    MT               250,000
                              Republic of Palau Ministry of Health                   PW               250,000
                              Southeast Alaska Reg Hlth Consortium                   AK               250,000
                              Dallas County Dept/Hlth/Human Srvs                     TX               249,998
                              Commonwealth N Mariana Is Dept Pub Hlth                MP               249,993




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                                               Fund Awards by Activity




Announcements (3)                                           Recipient                                               State   Award (dollars)
                                                            Wyoming State Department of Health                      WY             248,838
                                                            Gila River Indian Community                             AZ             100,000
                                                            Total (74 awards)                                                  $33,568,532
2. Competitive Program Expansion Supplement for National Association of City/County Health Officials                DC            $300,000
     CDC-RFA-HM08-805: Strengthen and Improve            Total (1 award)                                                          $300,000
     the Nation’s Capacity through National, Non-
     profit, Professional Public Health Organizations
     to Increase Health Protection and Health Equity
     (CDC-RFA-HM08-8050402PHFF11)
Purpose (award type): To support the provision of
capacity building assistance to state, tribal, local and
territorial health departments that ensures
performance improvement and successful adoption
of best or promising practices to address key areas
of public health infrastructure investments.
(Supplement)
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241
and 247b as amended. Funding is appropriated
under the Affordable Care Act (PL 111-148), Title IV,
Section 4002 (Prevention and Public Health Fund).
Eligibility: Limited to specific national, non-profit,
public health professional organizations funded
through the competitive funding opportunity
announcement CDC-RFA-HM08-805.
 3. Non-Competitive 12-month Cost Extension                 National Association of City/County Health Officials    DC            $999,400
     Supplement for CDC-RFA-HM08-                           American Public Health Association                      DC             464,400
     8050301SUPP10: Affordable Care Act (ACA):
     Capacity Building Assistance to Strengthen             Public Health Foundation                                DC             464,400
     Public Health Infrastructure and Performance           National Network of Public Health Institutes            LA             464,400
     (CDC-RFA-HM08-8050401PPHF11)
                                                            Association of State and Territorial Health Officials   VA             464,400
Purpose (award type): To support the provision of
capacity building assistance to state, tribal, local and    Total (5 awards)                                                    $2,857,000
territorial health departments that ensures
performance improvement and successful adoption
of best or promising practices to address key areas
of public health infrastructure investments.
(Supplement)
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241
and 247b as amended. Funding is appropriated
under the Affordable Care Act (PL 111-148), Title IV,
Section 4002 (Prevention and Public Health Fund).
Eligibility: Limited to specific national, non-profit,
public health professional organizations funded
under CDC-RFA-HM08-8030301SUPP10 funding
opportunity announcement.
                                               Source: GAO analysis of HHS information.




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Table 20: FY 2011 Contracts, National Public Health Improvement Initiative

Recipient                                 Purpose                                                       State      Award (dollars)
Deloitte Consulting, LLP                  National Public Health Improvement Initiative (NPHII)         GA              $1,751,979
                                          Implementation Support
Goodwill Industries of North Georgia      CDC Program Oversight & Implementation                        GA               1,407,000
Deloitte Consulting, LLP                  CDC Program Oversight & Implementation                        GA                 201,000
Total Solutions, Inc.                     Administrative Support                                        GA                 114,489
Total (4 awards)                                                                                                        $3,474,468
                                         Source: GAO analysis of HHS information.



                                         Activity: Tobacco Prevention (Media and Quitlines)

                                         The purpose of this activity is to raise awareness and shift key attitudes
                                         and beliefs about the harms of tobacco use and exposure to secondhand
                                         smoke in areas of the country with some of the highest rates of tobacco
                                         use prevalence.

                                         •     Fiscal year 2010: $14.1 million (46 grants in two funding
                                               announcements totaling $3.9 million and seven contracts totaling
                                               $10.2 million)

                                         •     Fiscal year 2011: $49.1 million (43 grants in two funding
                                               announcements totaling $5.0 million and 11 contracts totaling
                                               $44.1million)




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Table 21: FY 2010 Grants, Tobacco Prevention (Media and Quitlines)

Announcements (2)                                            Recipient                                      State     Award (dollars)
1. Patient Protection and Affordable Care Act: State         California Department of Public Health         CA               $240,173
     Supplemental Funding for Healthy Communities,           NC State Dept/Hlth & Human Services            NC                198,758
     Tobacco Prevention and Control, Diabetes Prevention
     and Control, and Behavioral Risk Factor Surveillance    New York State Dept of Health                  NY                150,543
     System (RFA-DP09-90101SUPP10)                           Florida State Department of Health             FL                145,380
Purpose (award type): To provide additional financial
                                                             Illinois State Dept of Public Health           IL                116,426
and programmatic assistance to strengthen the abilities
of States, the District of Columbia, and eligible U.S.       Pennsylvania State Dept of Health              PA                114,853
Territories to move towards implementing a plan to           Ohio State Department of Health                OH                109,388
reduce tobacco use through legislative, regulatory, and
educational arenas, as well as enhance and expand the        Texas State Dept of Health Services            TX                102,360
national network of tobacco cessation quitlines to           Michigan State Dept of Community Health        MI                101,296
significantly increase the number of tobacco users who
quit each year to reduce mortality and morbidity from        Georgia Department of Community Health         GA                100,573
tobacco use, and associated health care costs.               New Jersey State Dept/Health/Senior Srvs       NJ                 94,802
(Supplement)
                                                             Virginia State Dept of Health                  VA                 90,557
Legislative Authority: Sections 301, 307, 310, and 311
of the Public Health Service Act, as amended, and the        Washington State Department of Health          WA                 84,288
Comprehensive Smoking Education Act of 1984,                 Arizona State Department of Hlth Srvcs         AZ                 83,936
Comprehensive Smokeless Tobacco Health Education
Act of 1986, and the American Recovery and                   Massachusetts State Dept of Pub Health         MA                 83,924
Reinvestment Act of 2009 (Recovery Act)                      Indiana State Department of Health             IN                 83,048
[Public Law 111-5].
                                                             Tennessee State Department of Health           TN                 82,395
Eligibility: Eligibility is limited to state agencies, the
District of Columbia, and U.S. Territories that are          Missouri State Dept/ Health & Senior Srv       MO                 80,807
funded under funding announcement DP09-901.                  Maryland State Dept of Hlth/Mtl Hygiene        MD                 79,325
                                                             Wisconsin Department of Health Services        WI                 79,095
                                                             Minnesota State Dept of Health                 MN                 77,095
                                                             Alabama State Dept of Public Health            AL                 74,227
                                                             Colorado State Dept/Pub Hlth & Environmt       CO                 73,927
                                                             South Carolina State Dept of Hlth/Env          SC                 73,468
                                                             Louisiana State Dept of Hlth & Hospitals       LA                 73,112
                                                             KY Cabinet for Health and Family Services      KY                 72,033
                                                             Puerto Rico Department of Health               PR                 70,412
                                                             Oregon State Public Health Division            OR                 69,683
                                                             Oklahoma State Department of Health            OK                 68,970
                                                             Connecticut State Dept of Public Health        CT                 68,102
                                                             Iowa State Dept of Public Health               IA                 65,476
                                                             Arkansas State Dept of Health                  AR                 64,867
                                                             Kansas State Dept of Hlth And Environmnt       KS                 64,045
                                                             Utah State Department of Health                UT                 63,874
                                                             Nevada State Dept of Hlth/Human Svcs           NV                 63,169




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Announcements (2)                                               Recipient                                  State     Award (dollars)
                                                                New Mexico State Department of Health      NM                 60,340
                                                                West Virginia State Dept Hlth/Human Rscs   WV                 59,363
                                                                Nebraska St Dept of Health & Human Servs   NE                 59,244
                                                                Idaho State Dept of Health And Welfare     ID                 57,953
                                                                NH State Dept of Health And Human Sers     NH                 56,815
                                                                Delaware State Dept of Hlth & Soc Srvs     DE                 54,445
                                                                South Dakota State Dept of Health          SD                 54,180
                                                                Maine State Dept/Health/Human Servs        ME                 53,098
                                                                DC Department of Health                    DC                 53,080
                                                                Wyoming State Department of Health         WY                 52,800
                                                                Total (45 awards)                                         $3,825,705
2. Patient Protection and Affordable Health Care Act       Guam Department of Public Health-Soc Svc GU                       $50,000
    (Affordable Care Act): Pacific Islands Supplemental    Total (1 award)                                                   $50,000
    Funding for Five-Year US Affiliated Pacific Island
    Collaborative Performance Agreement for Tobacco
    Control, Diabetes Prevention and Control, and the
    Behavioral Risk Factor Surveillance System
    (RFA-DP09-90201SUPP10).
Purpose (award type): To strengthen Guam’s ability to
move towards implementing a comprehensive plan to
reduce tobacco use through legislative, regulatory, and
educational arenas, as well to contribute to the
enhancement and expansion of the national network of
tobacco cessation quitlines to significantly increase the
number of tobacco users who quit each year in order to
reduce mortality and morbidity from tobacco use, and
associated health care costs. (Supplement)
Legislative Authority: Section 301 (a), and 317 (k) (2) of
the Public Health Service Act, [42 U.S.C. section 241 (a)
and 247b (k) (2), as amended], and the Comprehensive
Smoking Education Act of 1984, Comprehensive
Smokeless Tobacco Health Education Act of 1986, and the
American Recovery and Reinvestment Act of 2009
(Recovery Act) [Public Law 111-5].
Eligibility: Limited to Guam, which was funded under
funding announcement DP09-902.
                                         Source: GAO analysis of HHS information.




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Table 22: FY 2010 Contracts, Tobacco Prevention (Media and Quitlines)

Recipient                                  Purpose                                                        State     Award (dollars)
Plowshare Group                            Develop and implement a comprehensive communication            GA             $8,080,000
                                           and marketing plan to deliver actionable tobacco prevention
                                           information, messages, and interventions to the identified
                                           audience segments.
MACRO                                      To provide health communications and integrated marketing GA                   1,050,000
                                           strategies and database support to the Health
                                           Communications Branch, Office on Smoking and Health,
                                           NCCDPHP.
Department of Health and Human Services    Plan, coordinate and deliver training and technical            MO                539,344
                                           assistance to state and community health department staff
                                           and partners to support the implementation of policies
                                           leading to tobacco prevention and cessation.
Plowshare Group                            Develop and implement a comprehensive communication            GA                347,044
                                           and marketing plan to deliver actionable tobacco prevention
                                           information, messages, and interventions to the identified
                                           audience segments.
Deloitte Consulting, LLP                   Business services support - Financial Management Office        GA                180,000
Deloitte Consulting, LLP                   Business services support - Health Reform Implementation       GA                 30,000
                                           Office
Deloitte Consulting, LLP                   Business services support - Health Reform Implementation       GA                 20,000
                                           Office
Total (7 awards)                                                                                                        $10,246,388
                                          Source: GAO analysis of HHS information.




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Table 23: FY 2011 Grants, Tobacco Prevention (Media and Quitlines)

Announcements (2)                                                  Recipient                                        State     Award (dollars)
1.  State Supplemental Funding for Healthy Communities,            California Department of Public Health           CA               $340,245
    Tobacco Prevention and Control, Diabetes Prevention            Texas State Dept of Health Services              TX                251,470
    and Control (CDC-RFA-DP09-9010201PPHF11)
Purpose: To provide additional financial and                       New York City Health/Mental Hygiene              NY                213,269
programmatic assistance to strengthen the abilities of             Florida State Department of Health               FL                205,000
states, the District of Columbia, and eligible U.S.
                                                                   Pennsylvania State Dept of Health                PA                162,708
Territories that were funded under Funding
Announcement DP09-901 to reduce tobacco use through                Ohio State Department of Health                  OH                154,966
legislative, regulatory, and educational arenas, as well as        Michigan State Dept of Community Health          MI                143,503
enhance and expand the national network of tobacco
cessation quitlines to significantly increase the number of        NC State Dept/Hlth & Human Services              NC                139,210
tobacco users who quit each year to reduce mortality and           Virginia State Dept of Health                    VA                128,289
morbidity from tobacco use, and associated health care
costs. (Supplement)                                                Washington State Department of Health            WA                119,408
Legislative Authority: Sections 301, 307, 310, and                 Arizona State Department of Hlth Srvcs           AZ                118,909
311 of the Public Health Service Act, as amended,                  Massachusetts State Dept of Pub Health           MA                118,894
and the Comprehensive Smoking Education Act of
1984, Comprehensive Smokeless Tobacco Health                       Indiana State Department of Health               IN                117,651
Education Act of 1986, and the American Recovery                   Tennessee State Department of Health             TN                116,726
and Reinvestment Act of 2009 (Recovery Act)
[Public Law 111-5].                                                Missouri State Dept/ Health & Senior Srv         MO                114,477
Eligibility: Eligibility is limited to State agencies, including   Maryland State Dept of Hlth/Mtl Hygiene          MD                112,377
the District of Columbia and U.S. Territories funded under         Wisconsin Department of Health Services          WI                112,051
announcement (DP09-901).
                                                                   Minnesota State Dept of Health                   MN                109,218
                                                                   Colorado State Dept/Pub Hlth & Environmt         CO                107,458
                                                                   Alabama State Dept of Public Health              AL                105,155
                                                                   Louisiana State Dept of Hlth & Hospitals         LA                103,575
                                                                   KY Cabinet for Health and Family Services        KY                102,279
                                                                   Puerto Rico Department of Health                 PR                 99,750
                                                                   Oregon State Public Health Division              OR                 98,711
                                                                   Oklahoma State Department of Health              OK                 97,707
                                                                   Connecticut State Dept of Public Health          CT                 96,478
                                                                   Iowa State Dept of Public Health                 IA                 92,758
                                                                   Arkansas State Dept of Health                    AR                 91,895
                                                                   Kansas State Dept of Hlth and Environmnt         KS                 91,379
                                                                   Utah State Department of Health                  UT                 91,130
                                                                   Nevada State Dept of Hlth/Human Svcs             NV                 90,099
                                                                   New Jersey State Dept/Health/Senior Srvs         NJ                 85,482
                                                                   West Virginia State Dept Hlth/Human Rscs         WV                 84,098
                                                                   Idaho State Dept of Health and Welfare           ID                 82,100
                                                                   NH State Dept of Health and Human Sers           NH                 80,488




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Announcements (2)                                              Recipient                                   State     Award (dollars)
                                                               Maine State Dept/Health/Human Servs         ME                 80,443
                                                               Hawaii State Department of Health           HI                 80,274
                                                               Rhode Island State Dept of Health           RI                 78,510
                                                               Montana State Dept/Pub Hlth & Human Srvs    MT                 77,939
                                                               Delaware State Dept of Hlth & Soc Srvs      DE                 77,285
                                                               Vermont Department of Health                VT                 75,365
                                                               Wyoming State Department of Health          WY                 74,800
                                                               Total (42 awards)                                          $4,923,529
2. Pacific Islands Supplemental Funding for Five-Year       Guam Department of Public Health-Soc Svc       GU                $50,000
     US Affiliated Pacific Island Collaborative Performance Total (1 award)                                                  $50,000
     Agreement for Tobacco Control, Diabetes Prevention
     and Control (CDC-RFA-DP09-9020302PPHF11)
Purpose (award type): To create additional tobacco
quitters, beyond what Guam has projected to achieve in
Recovery Act funded programs. (Supplement)
Legislative Authority: Sections 301, 307, 310, and 311
of the Public Health Service Act, as amended, and the
Comprehensive Smoking Education Act of 1984,
Comprehensive Smokeless Tobacco Health Education Act
of 1986, and the American Recovery and Reinvestment
Act of 2009 (Recovery Act) [Public Law 111-5].
Eligibility: Limited to Guam health department.
                                          Source: GAO analysis of HHS information.




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Table 24: FY 2011 Contracts, Tobacco Prevention (Media and Quitlines)

Recipient                            Purpose                                                              State     Award (dollars)
Plowshare Group, Inc.                CDC’s National Tobacco Prevention and Control Public Education       GA            $34,313,221
                                     Campaign
Plowshare Group, Inc                 CDC’s National Tobacco Prevention and Control Public Education       GA              3,330,978
                                     Campaign
Research Triangle Institute          Evaluation of the National Tobacco Prevention and Control Public     GA              2,935,310
                                     Education Campaign
Four Seasons Environmental, Inc.     CDC Program Oversight & Implementation                               GA                816,000
Macro International Inc.             Communication, Marketing, and Database Strategies, Services          GA                702,448
                                     and Support to the Office on Smoking and Health, Health
                                     Communications Branch
Northrop Grumman                     CDC Program Oversight & Implementation                               GA                584,000
HHS Program Support Center           CASU Tobacco Prevention Activities                                   GA                527,053
Deloitte Consulting, LLP             CDC Program Oversight & Implementation                               GA                344,355
North American Quitline Consortium   North American Quitline                                              GA                263,000
Deloitte Consulting, LLP             CDC Program Oversight & Implementation                               GA                250,000
Emory University                     TTAC – Competency Development Task 9                                 GA                 37,962
Total (11 awards)                                                                                                       $44,104,327
                                          Source: GAO analysis of HHS information.



                                          Activity: Epidemiology and Laboratory Capacity Grants

                                          The purpose of this activity is to enhance the ability of state, local, and
                                          territorial Epidemiology and Laboratory Capacity (ELC) and EIP grantees
                                          to strengthen and integrate capacity for detecting and responding to
                                          infectious diseases and other public health threats.

                                          •     Fiscal year 2010: $19.2 million (68 grants in two funding
                                                announcements)

                                          •     Fiscal year 2011: $40.0 million (68 grants in two funding
                                                announcements totaling $38.4 million and two contracts totaling
                                                $1.6 million)




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Table 25: FY 2010 Grants, Epidemiology and Laboratory Capacity Grants

Announcements (2)                                          Recipient                                         State     Award (dollars)
1. Patient Protection and Affordable Care Act,             California Department of Public Health            CA               $677,043
     Epidemiology and Laboratory Capacity for              Massachusetts State Dept of Pub Health            MA                598,230
     Infectious Diseases, Building and Strengthening
     Epidemiology, Laboratory and Health Information       Illinois State Dept of Public Health              IL                586,815
     Systems Capacity in State and Local Health            Texas State Dept of Health Services               TX                544,902
     Departments (CDC-RFA-CI10-1012)
                                                           Washington State Department of Health             WA                510,120
Purpose (award type): To assist state public health
agencies improve surveillance for, and response to,        Indiana State Department of Health                IN                493,938
infectious diseases and other public health threats by     Arkansas State Dept of Health                     AR                442,594
(1) strengthening epidemiologic capacity; (2) enhancing
laboratory practice; (3) improving information systems;    Florida State Department of Health                FL                423,403
and (4) developing and implementing prevention and         Alaska State Department of Hlth-Soc Svcs          AK                413,558
control strategies. (New)
                                                           Los Angeles County Health Services Dept           CA                412,980
Legislative Authority: Sections 301(a)
[42 U.S.C. 241(a)] and 317(k) (2) [42 U.S.C. 247b (k)      Iowa State Dept of Public Health                  IA                407,337
(2)] of the Public Health Service Act, as amended          Wisconsin Department of Health Services           WI                395,014
and the Patient Protection and Affordable Care Act
(PL 111-148), Title IV, Sections 4002 and 4304             KY Cabinet for Health and Family Services         KY                389,385
(Prevention and Public Health Fund).                       New York State Dept of Health                     NY                374,166
Eligibility: Limited to 58 state and local public health   Alabama State Dept of Public Health               AL                361,795
agencies grantees who received funding through the
Epidemiology and Laboratory Capacity for Infectious        Utah State Department of Health                   UT                352,662
Diseases funding announcement CI04-040.                    New Jersey State Dept/Health/Senior Srvs          NJ                346,382
                                                           New York City Health/Mental Hygiene               NY                340,392
                                                           Colorado State Dept/Pub Hlth & Environmt          CO                327,908
                                                           New Mexico State Department of Health             NM                326,168
                                                           Montana State Dept/Pub Hlth & Human Srvs          MT                312,811
                                                           Tennessee State Department of Health              TN                308,225
                                                           Delaware State Dept of Hlth & Soc Srvs            DE                307,243
                                                           Minnesota State Dept of Health                    MN                304,209
                                                           MS State Department of Health                     MS                302,720
                                                           Ohio State Department of Health                   OH                298,394
                                                           Rhode Island State Dept of Health                 RI                296,803
                                                           Louisiana State Dept of Hlth & Hospitals          LA                289,273
                                                           NC State Dept/Hlth & Human Services               NC                281,894
                                                           Maine State Dept/Health/Human Servs               ME                273,410
                                                           NH State Dept of Health And Human Sers            NH                266,217
                                                           Missouri State Dept/ Health & Senior Srv          MO                263,260
                                                           Kansas State Dept of Hlth and Environmnt          KS                259,936
                                                           Idaho State Dept of Health and Welfare            ID                254,056
                                                           Virginia State Dept of Health                     VA                251,035




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Announcements (2)                                         Recipient                                          State     Award (dollars)
                                                          Michigan State Dept of Community Health            MI                243,670
                                                          Hawaii State Department of Health                  HI                240,142
                                                          Oklahoma State Department of Health                OK                232,165
                                                          Maryland State Dept of Hlth/Mtl Hygiene            MD                231,600
                                                          South Carolina State Dept of Hlth/Env              SC                231,176
                                                          Georgia Department of Community Health             GA                223,117
                                                          Vermont Department of Health                       VT                219,273
                                                          Oregon State Public Health Division                OR                212,318
                                                          City of Philadelphia Public Health Dept            PA                183,688
                                                          Pennsylvania State Dept of Health                  PA                166,089
                                                          Wyoming State Department of Health                 WY                163,444
                                                          Puerto Rico Department of Health                   PR                156,230
                                                          Nebraska St Dept of Health & Human Servs           NE                148,500
                                                          Connecticut State Dept of Public Health            CT                145,694
                                                          South Dakota State Dept of Health                  SD                145,267
                                                          North Dakota State Department of Health            ND                138,776
                                                          City of Chicago                                    IL                136,789
                                                          Arizona State Department of Hlth Srvcs             AZ                117,120
                                                          West Virginia State Dept Hlth/Human Rscs           WV                 96,448
                                                          NV State Dept of Hlth/Human Svcs                   NV                 90,000
                                                          Houston City Health & Human Services               TX                 89,443
                                                          Republic of Palau Ministry of Health               PW                 84,773
                                                          DC Department of Health                            DC                 10,000
                                                          Total (58 awards)                                                $16,700,000
2. Patient Protection and Affordable Care Act             Minnesota State Dept Of Health                     MN               $322,544
    (PPACA); Emerging Infections Program (EIP);           Georgia Department of Community Health             GA                309,358
    Enhancing Epidemiology and Laboratory Capacity
    (U01) (RFA-CI-10-003)                                 Colorado State Dept/Pub Hlth & Environmt           CO                295,655
Purpose (award type): To support state and local          New Mexico State Department of Health              NM                256,398
health departments’ surveillance infrastructure through
                                                          Oregon State Public Health Division                OR                255,704
enhancement of the epidemiology and laboratory
capacity of the existing Emerging Infections Program      Connecticut State Dept of Public Health            CT                247,028
network. (New)                                            Maryland State Dept of Hlth/Mtl Hygiene            MD                230,728
                                                          New York State Dept of Health                      NY                202,009
                                                          California Department of Public Health             CA                198,869
                                                          Tennessee State Department of Health               TN                181,707




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Announcements (2)                                             Recipient                                     State     Award (dollars)
Legislative Authority: Sections 301(a) [42 U.S.C.             Total (10 awards)                                            $2,500,000
241(a)] and 317(k) (2) [42 U.S.C. 247b (k) (2)] of the
Public Health Service Act, as amended and the Patient
Protection and Affordable Care Act (PPACA) of 2010
(Public Law 111-148).
Eligibility: Limited to ten state health departments or
their bona fide agents also funded through the
Emerging Infections Program funding announcements
CI02-174 and CI05-026 in order to build upon the
existing Emerging Infections Program infrastructure,
capabilities, and activities.
                                            Source: GAO analysis of HHS information.




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Table 26: FY 2011 Grants, Epidemiology and Laboratory Capacity Grants

Announcements (2)                                          Recipient                                         State     Award (dollars)
1. Patient Protection and Affordable Care Act              Iowa State Dept of Public Health                  IA             $1,553,629
     Epidemiology and Laboratory Capacity for              Utah State Department of Health                   UT              1,483,303
     Infectious Diseases Building and Strengthening
     Epidemiology, Laboratory and Health Information       New York City Health/Mental Hygiene               NY              1,342,974
     Systems Capacity in State and Local Health            Indiana State Department of Health                IN              1,250,965
     Departments (CDC-RFA-CI10–101202PPHF11)
                                                           Michigan State Dept of Community Health           MI              1,088,593
Purpose (award type): To enhance public health
programs to improve health and help restrain the rate      Massachusetts State Dept of Pub Health            MA              1,073,121
of growth of health care costs through building            Wisconsin Department of Health Services           WI              1,053,518
epidemiology, laboratory, and health information
systems capacity in state and local public health          NC State Dept/Hlth & Human Services               NC              1,015,354
departments. (Continuation)                                Alabama State Dept of Public Health               AL                987,592
Legislative Authority: Public Health Service Act           Houston City Health & Human Services              TX                930,520
Sections 301(a) [42 U.S.C. 241(a)] and 317(k) (2)
[42 U.S.C. 247b (k) (2)], as amended and the Patient       Alaska State Department of Hlth-Soc Svcs          AK                927,070
Protection and Affordable Care Act (PL 111-148),           Texas State Dept of Health Services               TX                904,754
Title IV, Sections 4002 and 4304 (Prevention and
Public Health Fund).                                       West Virginia State Dept Hlth/Human Rscs          WV                901,911
Eligibility: Limited to 58 state and local public health   Minnesota State Dept of Health                    MN                860,220
departments (or their established bona fide agents) that   Florida State Department of Health                FL                814,429
were 2010 grantees of Epidemiology and Laboratory
Capacity for Infectious Diseases CI10-1012 funding         IL State Dept of Public Health                    IL                744,130
announcement.                                              New Mexico State Department of Health             NM                739,137
                                                           Los Angeles County Health Services Dept           CA                727,894
                                                           Colorado State Dept/Pub Hlth & Environmt          CO                725,559
                                                           Virginia State Dept of Health                     VA                694,767
                                                           Maine State Dept/Health/Human Servs               ME                692,911
                                                           Rhode Island State Dept of Health                 RI                666,375
                                                           Washington State Department of Health             WA                663,520
                                                           NH State Dept of Health and Human Sers            NH                654,040
                                                           Georgia Department of Community Health            GA                636,979
                                                           Kansas State Dept of Hlth and Environmnt          KS                633,447
                                                           Nebraska St Dept of Health & Human Servs          NE                622,123
                                                           Ohio State Department of Health                   OH                617,083
                                                           Vermont Department of Health                      VT                602,431
                                                           Arkansas State Dept of Health                     AR                575,549
                                                           Tennessee State Department of Health              TN                570,146
                                                           Mississippi State Department of Health            MS                558,601
                                                           KY Cabinet for Health and Family Services         KY                540,272
                                                           New Jersey State Dept/Health/Senior Srvs          NJ                507,324
                                                           NY State Dept of Health                           NY                487,947




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Announcements (2)                                                 Recipient                                      State     Award (dollars)
                                                                  MT State Dept/Pub Hlth & Human Srvs            MT                462,058
                                                                  NV State Dept of Hlth/Human Svcs               NV                461,153
                                                                  South Caronia State Dept of Hlth/Env           SC                459,589
                                                                  South Dakota State Dept of Health              SD                444,845
                                                                  Maryland State Dept of Hlth/Mtl Hygiene        MD                441,204
                                                                  Delaware State Dept of Hlth & Soc Srvs         DE                427,619
                                                                  Arizona State Department of Hlth Srvcs         AZ                422,586
                                                                  Oregon State Public Health Division            OR                414,936
                                                                  Connecticut State Dept of Public Health        CT                406,836
                                                                  Louisiana State Dept of Hlth & Hospitals       LA                398,630
                                                                  City of Philadelphia Public Health Dept        PA                355,230
                                                                  DC Department of Health                        DC                346,006
                                                                  Oklahoma State Department of Health            OK                295,015
                                                                  Puerto Rico Department of Health               PR                294,511
                                                                  Missouri State Dept/ Health & Senior Srv       MO                291,326
                                                                  Wyoming State Department of Health             WY                229,436
                                                                  Idaho State Dept of Health and Welfare         ID                228,448
                                                                  CA Department of Public Health                 CA                156,034
                                                                  Pennsylvania State Dept of Health              PA                159,835
                                                                  North Dakota State Department of Health        ND                108,848
                                                                  Republic of Palau Ministry of Health           PW                 69,283
                                                                  Hawaii State Department of Health              HI                 40,000
                                                                  City of Chicago                                IL                 38,383
                                                                  Total (58 awards)                                            $35,799,999
2. Patient Protection and Affordable Care Act,                    Minnesota State Dept of Health                 MN               $313,593
    Emerging Infections Programs, Enhancing                       Tennessee State Department of Health           TN                307,413
    Epidemiology and Laboratory Capacity
    (CDC-RFA-CI10-00302PPHF11)                                    New York State Dept of Health                  NY                300,477
Purpose (award type): To support state and local                  Connecticut State Dept of Public Health        CT                296,877
health departments’ surveillance infrastructure through
                                                                  Oregon State Public Health Division            OR                268,693
enhancement of the epidemiology and laboratory
capacity of the existing EIP network. (Continuation)              New Mexico State Department of Health          NM                254,826
Legislative Authority: Public Health Service Act                  Maryland State Dept of Hlth/Mtl Hygiene        MD                239,195
Sections 301(a) [42 U.S.C. 241(a)] and 317(k) (2)
                                                                  Georgia Department of Community Health         GA                235,911
[42 U.S.C. 247b (k) (2)], as amended and the Patient
Protection and Affordable Care Act (PPACA) (Public                Public Health Foundation Enterprises, Inc      CA                216,149
Law 111-148), Title IV, Sections 4002 and 4304                    Colorado State Dept/Pub Hlth & Environmt       CO                166,864
(Prevention and Public Health Fund).
Eligibility: Limited to state health department (or their         Total (10 awards)                                             $2,599,998
bona fide agents) grantees funded under funding
announcement CI10-003.
                                              Source: GAO analysis of HHS information.




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                                       Fund Awards by Activity




Table 27: FY 2011 Contracts, Epidemiology and Laboratory Capacity Grants

Recipient                         Purpose                                                       State            Award (dollars)
Booz Allen Hamilton Inc.          CDC Program Oversight & Implementation                        GA                    $1,400,000
Deloitte Consulting, LLP          CDC Program Oversight & Implementation                        GA                       200,000
Total (2 awards)                                                                                                      $1,600,000
                                       Source: GAO analysis of HHS information.



                                       Activity: Coordinated Chronic Disease Prevention Program

                                       The purpose of this activity is to establish or strengthen Chronic Disease
                                       Prevention and Health Promotion programs within state health
                                       departments, to provide leadership and coordination, support
                                       development, implementation, and evaluation of CDC funded Chronic
                                       Disease and Health Promotion programs. The focus is on the top five
                                       leading chronic disease causes of death and disability (i.e., heart disease,
                                       cancer, stroke, diabetes, and arthritis) and their associated risk factors.

                                       •     Fiscal year 2010: None

                                       •     Fiscal year 2011: $51.5 million (75 grants in three funding
                                             announcements totaling $49.8 million and two contracts totaling
                                             $1.7 million)




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Table 28: FY 2011 Grants, Coordinated Chronic Disease Prevention Program

Announcements (3)                                              Recipient                                        State     Award (dollars)
1. Prevention and Public Health Fund Coordinated               California Department of Public Health           CA             $1,915,243
     Chronic Disease Prevention and Health Promotion           Texas State Dept of Health Services              TX              1,509,549
     Program (CDC-RFA-DP09-9010301PPHF11)
Purpose (award type): To establish or strengthen               New York State Dept of Health                    NY              1,290,563
Chronic Disease Prevention and Health Promotion                Florida State Department of Health               FL              1,182,915
Programs within State Health Departments, to provide
                                                               ASTDHPPHE                                        DC              1,128,816
leadership and coordination, support development,
implementation and evaluation of CDC funded Chronic            Ohio State Department of Health                  OH                933,930
Disease Prevention and Health Promotion programs,              Pennsylvania State Dept of Health                PA                930,987
focusing on the top five leading chronic disease causes
of death and disability (e.g. heart disease, cancer, stroke,   NC State Dept/Hlth & Human Services              NC                911,104
diabetes, and arthritis) and their associated risk factors,    Georgia Department of Community Health           GA                898,871
in order to increase efficiency and impact of categorical
diseases and risk factor prevention programs, including,       Michigan State Dept of Community Health          MI                883,445
but not limited to heart disease, cancer prevention and        Arizona State Department of Hlth Srvcs           AZ                842,629
control, stroke, arthritis, diabetes, nutrition, physical
activity and obesity. (Supplement)                             Missouri State Dept/ Health & Senior Srv         MO                784,312
Legislative Authority: Sections 4002 of the Affordable         Mississippi State Department of Health           MS                778,962
Care Act and 301(a) and 317(k) (2) of the Public Health        Illinois State Dept of Public Health             IL                778,232
Service Act (PHS Act), 42 U.S.C. 241(a) and 247b (k)(2).
                                                               Tennessee State Department of Health             TN                775,664
Eligibility: Limited to States, District of Columbia and
Territorial (Puerto Rico and Virgin Islands) health            Louisiana State Dept of Hlth & Hospitals         LA                763,822
departments or their Bona Fide Agent. Eligibility is also      Virginia State Dept of Health                    VA                763,407
limited to grantees currently funded under DP09-901
Collaborative Chronic Disease, Health Promotion, and           Massachusetts State Dept of Pub Health           MA                757,121
Surveillance Program Announcement: Tobacco Control,            New Jersey State Dept/Health/Senior Srvs         NJ                748,849
Diabetes Prevention and Control, and Behavioral Risk
Factor Surveillance System, National Center for Chronic        KY Cabinet For Health and Family Services        KY                748,295
Disease Prevention and Health Promotion.                       Washington State Department of Health            WA                748,177
                                                               Alabama State Dept of Public Health              AL                715,499
                                                               Wisconsin Department of Health Services          WI                697,830
                                                               South Carolina State Dept of Hlth/Env            SC                690,357
                                                               Oklahoma State Department of Health              OK                682,853
                                                               Oregon State Public Health Division              OR                682,598
                                                               Maryland State Dept of Hlth/Mtl Hygiene          MD                673,446
                                                               Arkansas State Dept of Health                    AR                672,980
                                                               Colorado State Dept/Pub Hlth & Environmt         CO                672,949
                                                               New Mexico State Department of Health            NM                665,704
                                                               Minnesota State Dept of Health                   MN                651,463
                                                               Kansas State Dept of Hlth And Environmnt         KS                639,334
                                                               DC Department of Health                          DC                626,219
                                                               Indiana State Department of Health               IN                600,000
                                                               Iowa State Dept of Public Health                 IA                600,000




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Announcements (3)                                              Recipient                                      State     Award (dollars)
                                                               West Virginia State Dept Hlth/Human Rscs       WV                600,000
                                                               Nevada State Dept of Hlth/Human Svcs           NV                583,865
                                                               Connecticut State Dept of Public Health        CT                569,287
                                                               Rhode Island State Dept of Health              RI                559,000
                                                               Montana State Dept/Pub Hlth & Human Srvs       MT                554,321
                                                               Utah State Department of Health                UT                552,360
                                                               Maine State Dept/Health/Human Servs            ME                551,920
                                                               Nebraska St Dept of Health & Human Servs       NE                534,440
                                                               Idaho State Dept of Health And Welfare         ID                530,612
                                                               Delaware State Dept of Hlth & Soc Srvs         DE                505,981
                                                               North Dakota State Department of Health        ND                502,238
                                                               Puerto Rico Department of Health               PR                491,271
                                                               Vermont Department of Health                   VT                479,632
                                                               Alaska State Department of Hlth-Soc Svcs       AK                479,112
                                                               NH State Dept of Health and Human Sers         NH                463,729
                                                               South Dakota State Dept of Health              SD                453,480
                                                               Hawaii State Department of Health              HI                445,130
                                                               Wyoming State Department of Health             WY                411,507
                                                               Total (53 awards)                                            $38,614,010
2. Prevention and Public Health Fund Pacific Islands           Guam Department of Public Health-Soc Svc       GU               $213,280
    Coordinated Chronic Disease Prevention and Health
                                                               American Samoa Department of Health            AS                204,846
    Promotion Program (CDC-RFA-DP09-
    9020303PPHF-11)                                            Federated States Micronesia                    FM                207,868
Purpose (award type): To establish or strengthen               Republic/Marshall Island Mnstry of Hlth        MH                204,836
Chronic Disease Prevention and Health Promotion
                                                               Commonwealth N Mariana Is Dept Pub Hlth         MP               203,745
Programs within Territory Health Departments, to provide
leadership and coordination, support development,              Republic of Palau Ministry of Health           PW                199,599
implementation and evaluation of CDC funded Chronic            Total (6 awards)                                              $1,234,174
Disease Prevention and Health Promotion programs,
focusing on the top five leading chronic disease causes
of death and disability (e.g. heart disease, cancer, stroke,
diabetes, and arthritis) and their associated risk factors,
in order to increase efficiency and impact of categorical
diseases and risk factor prevention programs, including,
but not limited to heart disease, cancer prevention and
control, stroke, arthritis, diabetes, nutrition, physical
activity and obesity. (Supplement)
Legislative Authority: Sections 4002 of the Affordable
Care Act and 301(a) and 317(k) (2) of the Public Health
Service Act (PHS Act), 42 U.S.C. 241(a) and 247b (k)(2).




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Announcements (3)                                                Recipient                                       State     Award (dollars)
Eligibility: Limited to health departments of U.S.
Territories or their Bona Fide Agent, American Samoa,
Federated States of Micronesia, Guam, Marshall Islands,
Palau and Northern Mariana Islands. Eligibility is also
limited to Grantees currently funded under DP09-902
Affiliated Pacific Island Collaborative Performance
Agreement.
3. Nutrition, Physical Activity and Obesity Program              Massachusetts State Dept of Pub Health          MA               $900,137
    (CDC-RFA-DP08-805)
                                                                 Washington State Department of Health           WA                842,927
Purpose (award type): To improve healthful eating and
physical activity to prevent and control obesity and other       Iowa State Dept of Public Health                IA                782,031
chronic diseases by building and sustaining statewide            Rhode Island State Dept of Health               RI                735,819
capacity, and implementing population based strategies
                                                                 New Jersey State Dept/Health/Senior Srvs        NJ                726,377
and interventions. (New)
Legislative Authority: Section 317 (k)(2) of the Public          South Carolina State Dept of Hlth/Env           SC                695,145
Health Service Act, [42 U.S.C. section 247b(k)(2), as            Wisconsin Department of Health Services         WI                683,659
amended].
                                                                 California Department of Public Health          CA                657,358
Eligibility: State health departments and their bona fide
agents (this includes the District of Columbia, the              Nebraska St Dept of Health & Human Servs        NE                653,178
Commonwealth of Puerto Rico, the Virgin Islands, the             Texas State Dept of Health Services             TX                631,161
Commonwealth of the Northern Mariana Islands,
American Samoa, Guam, the Federated States of                    Georgia Department of Community Health          GA                597,369
Micronesia, the Republic of the Marshall Islands, and the        Arizona State Dept of Health                    AR                579,957
Republic of Palau).
                                                                 NH State Dept of Health and Human Sers          NH                445,500
                                                                 Utah State Department of Health                 UT                416,324
                                                                 Tennessee State Department of Health            TN                335,754
                                                                 Indiana State Department of Health              IN                317,304
                                                                 Total (16 awards)                                             $10,000,000
                                             Source: GAO analysis of HHS information.




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Table 29: FY 2011 Contracts, Coordinated Chronic Disease Prevention Program

Recipient                            Purpose                                                     State           Award (dollars)
Four Seasons Environmental           CDC Program Oversight & Implementation                      GA                   $1,490,000
Deloitte Consulting                  CDC Program Oversight & Implementation                      GA                      200,000
Total (2 awards)                                                                                                      $1,690,000
                                       Source: GAO analysis of HHS information.



                                       Activity: CDC Healthcare Surveillance and Statistics

                                       The purpose of this activity is to support the efforts of CDC programs
                                       including: Health Information Exchange, Enhancing Healthcare Data
                                       Access and Use and Health Service Research Capacity, National Health
                                       and Nutrition Examination Survey, Public Health Surveillance Program
                                       Office—National Center for Health Statistics Centers for Medicare and
                                       Medicaid Services Data Project, National Health Interview Survey,
                                       National Youth Fitness Survey, and Behavioral Risk Factor Surveillance
                                       System.

                                       •     Fiscal year 2010: $19.4 million (two grants in two funding
                                             announcements totaling $0.7 million and 12 contracts totaling
                                             $18.7 million)

                                       •     Fiscal year 2011: $29.5 million (13 contracts)




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Table 30: FY 2010 Grants, CDC Healthcare Surveillance and Statistics

Announcements (2)                                                          Recipient                       State      Award (dollars)
 1. American Recovery and Reinvestment Act of 2009:                Arkansas State Dept of Health           AR                $200,770
    Communities Putting Prevention to Work                         Total (1 award)                                           $200,770
    (CDC-RFA-DP09-912ARRA09)
Purpose (award type): To create healthier communities through
sustainable, proven, population-based approaches such as
broad-based policy, systems, organizational and environmental
changes in communities and schools. (New)
Legislative Authority: Section 311 and 317(k)(2) of the Public
Health Service Act, 42 U.S. Code 243 and 247b(k)2.
Eligibility: State and local health departments or bona fide
agencies, federally recognized tribal governments, regional area
Indian health boards, urban Indian organizations, and inter-tribal
councils. For this funding announcement, the term “states”
includes the 50 states, the Commonwealth of Puerto Rico, the
Virgin Islands, and the Commonwealth of the Northern Mariana
Islands, American Samoa, Guam, the Federated States of
Micronesia, the Republic of the Marshall Islands, and the
Republic of Palau.
 2. Cancer Prevention and Control Activities                          American Cancer Society               GA               $499,582
    (CDC-RFA-DP08-814)                                                Total (1 award)                                        $499,582
Purpose (award type): To assist with developing and
disseminating current national, state, and community-based
comprehensive information on cancer prevention, early
detection, diagnosis, treatment, and survivorship; developing and
disseminating professional education programs; promoting the
analysis and development of evaluation, surveillance and
research data, and its translation into public health messages,
practice and programs; and, facilitating the exchange of expertise
and coordination of programmatic efforts related to cancer
prevention and control among a variety of public, private, and
not-for-profit agencies at the national, state, tribal, territory and
community level. (New)
Legislative Authority: Sections 301(a), 317(k)(2) of the Public
Health Service Act, [42 U.S.C. 241(a) and 247b(k)(2)], as
amended.
Eligibility: National public and private nonprofit organizations
and faith based organizations.
                                            Source: GAO analysis of HHS information.




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Table 31: FY 2010 Contracts, CDC Healthcare Surveillance and Statistics

Recipient                      Purpose                                                                       State   Award (dollars)
US Census Bureau               Enhancing National Ambulatory Medical Care Survey (NAMCS) and                 MD          $5,782,500
                               National Hospital Ambulatory Medical Care Survey (NHAMCS) data on
                               preventive services through computerized collection of NAMCS and
                               NHAMCS data through induction interviews for providers.
US Census Bureau               Enhancing National Ambulatory Medical Care Survey (NAMCS) and                 MD           4,053,529
                               National Hospital Ambulatory Medical Care Survey (NHAMCS) data on
                               preventive services through computerized collection of NAMCS and
                               NHAMCS data through induction interviews for providers.
US Census Bureau               Conduct the National Health Interview Survey 2010 through data                MD           2,975,000
                               collection of approximately 64,000 assigned households using trained
                               National Health Interview Survey field representatives.
SciMetricka                    Demonstrating public health utility of health data sources through a          GA           1,976,536
                               2-yr research study to establish utility of healthcare surveillance
                               purposes of alternative health data sources
Agilex Technologies            Conduct a 2-year research study to estimate the relative or cumulative        GA             850,696
                               value of improvement in morbidity or deaths prevented by increasing
                               the use of clinical preventive services in entire populations
SciMetricka                    Demonstrating public health utility of health data sources through a          GA             745,000
                               2-yr research study to establish utility of healthcare surveillance
                               purposes of alternative health data sources
Buccaneer Computer Systems     Expand the analytic utility of CMS data for research at NCHS to support VA                   649,710
                               newly emerging health care reform priorities, and expand the availability
                               of CMS data for tracking the provision, use, effectiveness, and impact of
                               primary and secondary preventative healthcare services and
                               surveillance of selected health outcomes
Westat Inc.                    Provide services to complete all activities required for data collection at   MD             596,000
                               a primary sampling unit (PSU) component of the National Health and
                               Nutrition Examination Survey program during Partition 4 of the data
                               collection plan.
Deloitte Consulting, LLP       Business services support - Financial Management Office                       GA             499,982
Global Evaluation & Applied    Support for National Ambulatory Medical Care Survey (NAMCS) and               GA             296,472
Research Solutions             National Hospital Ambulatory Medical Care Survey (NHAMCS) through
                               data programming and processing tasks in conjunction with the
                               development, implementation, and maintenance of computerized data
                               collection systems for NAMCS and NHAMCS in the Division of Health
                               Care Statistics (DHCS)
Global Evaluation & Applied    Support for National Ambulatory Medical Care Survey (NAMCS) and               GA             217,500
Research Solutions             National Hospital Ambulatory Medical Care Survey (NHAMCS) through
                               data programming and processing tasks in conjunction with the
                               development, implementation, and maintenance of computerized data
                               collection systems for NAMCS and NHAMCS in the Division of Health
                               Care Statistics (DHCS)
Deloitte Consulting, LLP       Business services support - Health Reform Implementation Office               GA              61,235
Total (12 awards)                                                                                                       $18,704,160
                                          Source: GAO analysis of HHS information.




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Table 32: FY 2011 Contracts, CDC Healthcare Surveillance and Statistics

Recipient                                            Purpose                                               State      Award (dollars)
US Census Bureau, Demographic Surveys                NHIS Healthcare Reform Monitoring                     GA             $10,900,000
Division
US Census Bureau                                     Support Services for the National Health Care         MD              10,571,195
                                                     Surveys – Census
Agilex Technologies, Inc.                            States, Communities, and Health Information           GA               2,789,133
                                                     Exchanges for Prevention and Public Health
Research Triangle Institute                          Leveraging Beacon Communities’ Experience in          GA               1,417,390
                                                     Health Information Exchange for Public and
                                                     Population Health
Goodwill Industries of North Georgia                 CDC Program Oversight & Implementation                GA               1,050,000
Johns Hopkins University Applied Physics             Enhancing Healthcare Data Access and Use and          GA                 598,523
Laboratory                                           Health Service Research Capacity
Global Evaluation & Applied Research Solutions       Support Services for the National Health Care         MD                 531,795
(GEARS)                                              Surveys – GEARS
International Society for Disease                    Developing Business and Infrastructure                GA                 449,934
                                                     Requirements for Syndromic Surveillance using
                                                     Clinical Data from Health Information Exchanges
Social & Scientific Systems, Inc.                    Health Indicators Warehouse                           MD                 291,000
Systems Research and Applications Corporation        Support Services for the National Health Care         MD                 287,010
                                                     Surveys – SRA
Westat, Inc.                                         Trailer refurbishment                                 MD                 250,000
Westat, Inc.                                         Physical Activity and Fitness Feasibility Study       MD                 240,000
Deloitte Consulting, LLP                             CDC Program Oversight & Implementation                GA                 150,000
Total (13 awards)                                                                                                         $29,525,980
                                           Source: GAO analysis of HHS information.



                                           Activity: ARRA: Communities Putting Prevention to Work

                                           The purpose of this activity is to address two of the leading preventable
                                           causes of death and disability, obesity and tobacco use, through the
                                           locally driven initiative Communities Putting Prevention to Work.

                                           •     Fiscal year 2010: $35.0 million (nine grants in one funding
                                                 announcement totaling $29.0 million and eight contracts totaling
                                                 $6.0 million)

                                           •     Fiscal year 2011: None




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Table 33: FY 2010 Grants, ARRA: Communities Putting Prevention to Work

Announcement                                                            Recipients                               State     Award (dollars)
American Recovery and Reinvestment Act (Recovery Act):                  City of Chicago                          IL             $5,800,000
Communities Putting Prevention to Work: State Competitive               Pinellas County Health Dept              FL              4,350,000
Supplemental Funding for Behavioral Risk Factor Surveillance
System (CDC-RFA-DP09-90102-ARRA09)                                      Southern Nevada Health District          NV              3,800,000
Purpose (award type): To provide state health departments               County of Santa Clara                    CA              3,600,000
with resources to collect BRFSS baseline and follow up data
                                                                        NC State Dept/Hlth & Human Services      NC              3,200,000
from communities funded under Communities Putting
Prevention to Work funding announcement,                                Alabama State Dept of Public Health      AL              2,500,000
 CDC-RFA-DP09-912ARRA09. (Supplement)                                   Dekalb County Board of Public Health     GA              2,350,000
Legislative Authority: Sections 301, 307, 310, and 311 of the
                                                                        Arkansas State Dept of Health            AR              1,800,000
Public Health Service Act, as amended, and the
Comprehensive Smoking Education Act of 1984,                            South Carolina State Dept of Hlth/Env    SC              1,606,981
Comprehensive Smokeless Tobacco Health Education Act of                 Total (9 awards)                                       $29,006,981
1986, and the American Recovery and Reinvestment Act of
2009 (Recovery Act) Public Law 111-5.
Eligibility: Limited to 30 state health departments and the
District of Columbia that are funded under Communities
Putting Prevention to Work funding announcement,
CDC-RFA-DP09-912ARRA09.
                                           Source: GAO analysis of HHS information.




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Table 34: FY 2010 Contracts, ARRA: Communities Putting Prevention to Work

Recipient                        Purpose                                                               State      Award (dollars)
MACRO                            Training Resource Center for community action                         GA              $2,584,665
MACRO                            Support multiple evaluation components of the Communities             GA               1,748,195
                                 Putting Prevention to Work initiative in communities and states.
Northrop Grumman                 Software development, integration of applications, web                GA                 500,000
                                 development, and maintenance of the infrastructure to support
                                 systems. The contractor will provide systems support and studies
                                 for research activities related to public health practice and
                                 research.
Research Triangle Institute      Communities Putting Prevention to Work (CPPW) is to implement         GA                 398,900
                                 supportive policies, systems, and environments that will drive
                                 changes in behaviors to reduce risk factors, prevent/delay chronic
                                 diseases, promote wellness in children and adults, and provide
                                 positive sustainable health changes in communities.
McKing Consulting                Management Consultation and Technical Assistance Services in          GA                 349,993
                                 Support
                                 of the Nutrition, Physical Activity and Obesity Programs.
Research Triangle Institute      To customize a system dynamic evaluation model to project the  GA                        195,488
                                 impact policy, systems, and governmental changes in the
                                 approximately 44 Communities Putting Prevention to Work (CPPW)
                                 initiative and the 8 additional communities funded through the
                                 Affordable Care Act.
GMI & DESA JOINT VENTURE         Contribute to the national agenda for obesity prevention and control GA                  190,000
Northrop Grumman                 Support all aspects of full lifecycle application systems             GA                   9,000
                                 development and maintenance on a variety of platforms including
                                 mainframe, client server, and web; architecture and infrastructure
                                 design to support enterprise application software services including
                                 hardware/software/network design and implementation; database
                                 design, application development and support; data management
                                 and security controls; quality assurance, test and control functions;
                                 and technical communication, consultation and information support.
Total (8 awards)                                                                                                       $5,976,241
                                        Source: GAO analysis of HHS information.



                                        Activity: Environmental Public Health Tracking

                                        The purpose of this activity is to establish and maintain a nationwide
                                        tracking network to collect, integrate, analyze, and translate health and
                                        environmental data for use in public health practice and policy
                                        development. This activity is designed to build environmental public
                                        health surveillance (tracking) capacity in additional state and local health
                                        departments by enhancing infrastructure, data, partnerships, and
                                        workforce.




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                                             •   Fiscal year 2010: None

                                             •   Fiscal year 2011: $30.8 million (30 grants in five funding
                                                 announcements totaling $22.8 million and contracts totaling
                                                 $8.0 million)

Table 35: FY 2011 Grants, Environmental Public Health Tracking

Announcements (5)                                          Recipient                                         State     Award (dollars)
1.   National Environmental Public Health Tracking         Missouri State Dept/ Health & Senior Srv          MO             $1,100,000
     Program (CDC-RFA-EH09-907)                            New Mexico State Department of Health             NM              1,100,000
2. National Environmental Public Health Tracking
     Program-Network Implementation                        Oregon State Public Health Division               OR              1,100,000
     (CDC-RFA-EH11-1103)                                   Utah State Department of Health                   UT              1,100,000
Purpose (award type): To establish and maintain a          Wisconsin Department of Health Services           WI              1,100,000
nationwide tracking network to obtain integrated
health and environmental data and use it to provide        California Department of Public Health            CA              1,099,998
information in support of actions that improve the         New York State Dept of Health                     NY              1,099,995
health of communities. The program also aims to build
                                                           New York City Health/Mental Hygiene               NY              1,099,894
state and local public health capacity in the area of
environmental health surveillance. (New and                Washington State Department of Health             WA              1,099,121
Continuation)                                              Massachusetts State Dept of Pub Health            MA              1,073,968
Legislative Authority: Sections 311 and 317(k)(2) of
the Public Health Service Act, [42 U.S.C. Sections 243     Maryland State Dept of Hlth/Mtl Hygiene           MD              1,047,251
and 247b(k)(2)] as amended.                                Maine State Dept/Health/Human Servs               ME              1,004,719
Eligibility: For CDC-RFA-EH09-907, federally               Florida State Department of Health                FL                963,629
recognized or state-recognized American Indian/Alaska
Native tribal governments, state and local governments     Minnesota State Dept of Health                    MN                875,000
or their Bona Fide Agents, and political subdivisions of   South Carolina State Dept of Hlth/Env             SC                862,000
states; and for CDC-RFA-EH11-1103, state and local
                                                           Pennsylvania State Dept of Health                 PA                815,858
government health departments, or their Bona Fide
Agents, which were originally selected through a           New Jersey State Dept/Health/Senior Srvs          NJ                795,691
competitive award process under CDC Program                Vermont Department of Health                      VT                753,411
Announcement CDC-RFA-EH06-601 of 2006 –
National Environmental Public Health Tracking              Connecticut State Dept of Public Health           CT                722,000
Program- Network Implementation.                           NH State Dept of Health and Human Sers            NH                715,892
                                                           Louisiana State Dept of Hlth & Hospitals          LA                678,510
                                                           Colorado State Dept/Pub Hlth & Environmt          CO                656,802
                                                           Kansas State Dept of Hlth and Environmnt          KS                577,596
                                                           Iowa State Dept of Public Health                  IA                370,273
                                                           Total (24 awards)                                               $21,811,608




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Announcements (5)                                                 Recipient                                          State   Award (dollars)
3.    Non-Competitive 12-month Cost Extension                     Council of State and Territorial Epidemiologists   GA             $250,000
      Supplement for CDC-RFA-HM08-8050301SUPP10:                  Association of State and Territorial Health        VA              235,000
      Affordable Care Act (ACA): Capacity Building                Officials
      Assistance to Strengthen Public Health
      Infrastructure and Performance                              National Association of City/County Health         DC              150,400
      (CDC-RFA-HM08-8050401PPHF11)                                Officials
Purpose (award type): To support the provision of                 American Public Health Association                 DC              100,000
capacity building assistance to state, tribal, local and
                                                                  Total (4 awards)                                                  $735,400
territorial health departments that ensures performance
improvement and successful adoption of best or
promising practices to address key areas of public
health infrastructure investments. (Supplement)
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241 and
247b as amended. Funding is appropriated under the
Affordable Care Act (PL 111-148), Title IV, Section 4002
(Prevention and Public Health Fund).
Eligibility: Limited to specific national, non-profit, public
health professional organizations funded through the
competitive funding opportunity,
CDC-RFA-HM08-8030301SUPP10.
4.   National Environmental Public Health Tracking         Nat. Assoc. of Health Data Orgs.                          UT             $124,995
     Program National Association for Health Data          Total (1 award)                                                          $124,995
     Organizations (CDC-RFA-EH10-1003)
Purpose (award type): To continue a partnership with
the National Association of Health Data Organizations.
(Continuation)
Legislative Authority: Section 317(k) (2) of the Public
Health Service Act, [42 U.S.C Section 247b(k)(2)], as
amended.
Eligibility: Limited to the National Association of Health
Data Organizations.
5.   National Environmental Public Health Tracking          NAPHSIS                                                  MD             $125,000
     Program National Association for Public Health         Total (1 award)                                                         $125,000
     Statistics and Information Systems
     (CDC-RFA-EH10-1004)
Purpose (award type): To promote collaboration
among vital records, health statistics, and health
information systems professionals to provide
environmental and health data information to public
health practitioners, policy makers, and the public.
(Continuation)
Legislative Authority: Section 311 and 317 (k)(2) of
the Public Health Service Act, [42 U. S. C. Section 243
and 247b(k)(2)] as amended.
Eligibility: Limited to the National Association for Public
Health Statistics and Information Systems.
                                                Source: GAO analysis of HHS information.




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Table 36: FY 2011 Contracts, Environmental Public Health Tracking

Recipient                                          Purpose                                                      State   Award (dollars)
TKC Global                                         IT Support - TKC Global                                      GA           $1,489,663
Battelle                                           IT Support - Battelle IT                                     GA            1,260,000
Battelle memorial Institute                        IT Support - Battelle (DM)                                   GA              808,600
University of California, Berkeley                 Environmental Public Health Tracking Program                 CA              612,144
GSA/FAS/4TRE                                       Information technology, data management, and                 GA              574,869
                                                   support services for surveillance public health activities
Healthy Housing Solutions, Inc.                    Tobacco Control: Adoption, Health Impact                     GA              399,999
University of Illinois-Chicago                     Environmental Public Health Tracking Program                 IL              353,354
University of Medicine and Dentistry –             Environmental Public Health Tracking Program                 NJ              297,197
New Jersey
The Regents of The University of California        Environmental Public Health Tracking Program                 CA              292,318
GSA/FAS/4TRE                                       Development of a Climate Change Module to track              GA              263,895
                                                   predictors, responses and public health consequences
                                                   of climate
NASA                                               Return On Investment                                         GA              225,000
University of Pittsburgh                           Environmental Public Health Tracking Program                 PA              223,838
University of Utah                                 Academic Partners - Schools of Public Health                 UT              221,721
University of Pittsburgh                           Environmental Public Health Tracking Program                 PA              197,022
Booz Allen Hamilton Inc.                           GRASP                                                        GA              185,000
GSA/FAS/4TRE                                       Air Pollution and Respiratory Health Branch National         GA              154,225
                                                   Asthma Control Program Workgroups
SMITHKLINE BEECHAM CORPORATION                     Environmental Tracking                                       GA              153,607
Emory University                                   Field Test/Training Exercise                                 GA              146,394
PRR, Inc.                                          Health Marketing Communication                               GA               96,075
Various - Emory University, JP Morgan Chase, Contracts <$25K                                                    GA               65,101
Northrop Grumman
Total                                                                                                                        $8,020,022
                                              Source: GAO analysis of HHS information.



                                              Activity: Public Health Workforce

                                              The purpose of this activity is to help ensure a prepared, diverse,
                                              sustainable public health workforce. PPHF funding leverages critical
                                              workforce development activities supported with CDC’s core budget.




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                                               •     Fiscal year 2010: $ 4.7 million (four grants in one funding
                                                     announcement totaling $0.8 million and 17 contracts totaling
                                                     $3.8 million)

                                               •     Fiscal year 2011: $18.5 million (four grants in two funding
                                                     announcements totaling $4.7 million and 27 contracts totaling
                                                     $13.8 million)

Table 37: FY 2010 Grants, Public Health Workforce

Announcement                                                Recipient                                               State   Award (dollars)
Competitive Supplement to CDC-RFA-HM08-805:                 Council of State and Territorial Epidemiologists        GA            $335,000
Strengthen and Improve the Nation’s Capacity
                                                            Dekalb County Board of Public Health                    GA             250,000
through National, Non-profit, Professional
Public Health Organizations to Increase Health              Public Health Foundation                                DC             172,000
Protection and Health Equity                                Association of State and Territorial Health Officials   VA              75,000
(CDC-RFA-HM08-8050301SUPP10)
                                                            Total (4 awards)                                                      $832,000
Purpose (award type): To support the provision
of capacity building assistance to state, tribal, local
and territorial health departments that ensures
successful adoption of best or promising practices to
address key areas of public health infrastructure
investments. (Supplement)
Legislative Authority: Sections 301 and 317 of the
Public Health Service Act (PHS Act), 42 USC, 241
and 247b as amended. Funding is appropriated
under the Affordable Care Act (PL 111-148), Title IV,
Section 4002 (Prevention and Public Health Fund).
Eligibility: Limited to national, non-profit, and public
health professional organizations funded through the
competitive funding announcement
CDC-RFA-HM08-805.
                                               Source: GAO analysis of HHS information.




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Table 38: FY 2010 Contracts, Public Health Workforce

                                                                                                                              Award
Recipient                        Purpose                                                                      State         (dollars)
Office of Personnal Management   PHAP Management & Operations Support                                         GA          $1,700,860
Deloitte Consulting, LLP         Evaluation/Education/Curriculum Development (All Fellowships)                GA             912,705
Chickasaw Adv                    IT/informatics Nees/EIS Secure Website                                       GA             264,220
Deloitte Consulting, LLP         Evaluation/Education/Curriculum Development (All Fellowships)                GA             199,605
Chickasaw Adv                    Sr. Health Communication Specialist                                          GA             118,694
Chickasaw Adv                    Public Health Analyst (All Fellowships)                                      GA             116,274
Chickasaw Adv                    Public Health Advisor (PHPS)                                                 GA             107,192
Annual EIS Conference Support    Administrative and Logistical Support to the Public Health Apprentice        GA              70,000
                                 Program
Chickasaw Adv                    Health Comm Specialist I (All Fellowships)                                   GA              56,371
Chickasaw Adv                    Web Developer I (All Fellowships)                                            GA              54,428
Midtown Personnel                Administrative Assistant III (PHPS)                                          GA              42,148
Emory University                 Public Health Instructor                                                     GA              39,798
Chickasaw Adv                    Health Comm Specialist I (All Fellowships)                                   GA              37,079
Chickasaw Adv                    Health Comm Specialist II (All Fellowships)                                  GA              35,015
Deloitte Consulting, LLP         Business services support - Health Reform Implementation Office              GA              30,000
Deloitte Consulting, LLP         Web Developer II (All Fellowships)                                           GA              29,530
Chickasaw Adv                    Program Assistant (EIS)                                                      GA              14,564
Total (17 awards)                                                                                                         $3,828,483
                                           Source: GAO analysis of HHS information.




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Table 39: FY 2011 Grants, Public Health Workforce

                                                                                                                                     Award
Announcements (2)                                                   Recipient                                     State            (dollars)
1.    Association of Public Health Laboratories                Association of Public Health Laboratories          MD             $1,000,000
     Cooperative Agreement (CDC-RFA-HM10-1001)                 Total (1 award)                                                   $1,000,000
Purpose (award type): To enhance the work of public
health laboratories in the U.S. and abroad, to promote
quality public health laboratory practice, improve public
health laboratory infrastructure, strengthen the public
health laboratory system, and to develop a well-trained
public health laboratory workforce in the U.S. and globally.
Also, to ensure laboratory preparedness for emerging
infectious diseases or other biologic and chemical public
health threats, promote technology transfer to ensure up-
to-date technologies for the testing laboratory, and
enhance communication linkages between state and local
public health laboratories and the clinical laboratory testing
community. (New)
Legislative Authority: Sections 307 and 317(k)(2) of the
Public Health Service Act, [42 U.S.C. 242l and 247b (k)(2),
as amended].
Eligibility: Limited to the Association of Public Health
Laboratories.
2.    Non-Competitive 12-month Cost Extension                       Council of State And Territorial              GA             $3,096,706
      Supplement for CDC-RFA-HM08-8050301SUPP10:                    Epidemiologists
      Affordable Care Act (ACA): Capacity Building                  Association of State and Territorial Health   VA                412,920
      Assistance to Strengthen Public Health Infrastructure
                                                                    Officials
      and Performance (CDC-RFA-HM08-
      8050401PPHF11) and Competitive Program                        Public Health Foundation                      DC                172,000
      Expansion Supplement for CDC-RFA-HM08-805:                    Total (3 awards)                                             $3,681,626
      Strengthen and Improve the Nation’s Capacity
      through National, Non-profit, Professional Public
      Health Organizations to Increase Health Protection
      and Health Equity (CDC-RFA-HM08-
      8050402PHFF11)
Purpose (award type): To support the provision of
capacity building assistance to state, tribal, local and
territorial health departments that ensures performance
improvement and successful adoption of best or promising
practices to address key areas of public health
infrastructure investments. (Supplement)
Legislative Authority: Sections 301 and 317 of the Public
Health Service Act (PHS Act), 42 USC, 241 and 247b as
amended. Funding is appropriated under the Affordable
Care Act (PL 111-148), (Prevention and Public Health
Fund).
Eligibility: Limited to specific national, non-profit, public
health professional organizations also funded through the
funding opportunity CDC-RFA-HM08-80301SUPP10 and
the competitive funding opportunityCDC-RFA-HM08-805.
                                              Source: GAO analysis of HHS information.




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Table 40: FY 2011 Contracts, Public Health Workforce

Recipient                                 Purpose                                                          State    Award (dollars)
Scimetrika, LLC                           PHPS Field Residency and Expanded Training                       GA            $2,531,027
Emory University Southeastern Institute   Program Management Support – OPM IAA Strategic Human             GA             2,357,192
for Training and Evaluation               Resource Planning and Implementation to Improve Human
                                          Capital and Enterprise
Scimetrika, LLC                           Post EIS Practicum (PEP)                                         GA             1,759,097
Deloitte Consulting LLP                   Education and Evaluation Consultation for SEPDPO                 GA             1,641,587
                                          Fellowship Programs
Deloitte Consulting LLP                   Fellowship Management System                                     GA             1,361,629
Emergint Technologies, Inc.               IT Support for SEPDPO                                            GA               766,612
Chickasaw Advisory Services, LLC          E Learning Expansion (Training, Education and                    GA               739,599
                                          Communication Support)
Booz Allen Hamilton Inc.                  CDC Program Oversight & Implementation                           GA               500,000
Deloitte Consulting, LLP                  CIMS Task Order Fellowship Management System                     GA               205,000
DB Consulting Group, Inc.                 Workforce Enumeration Project                                    GA               197,222
Chickasaw Advisory Services, LLC          Contractor for Informatician Job Classification Project          GA               148,845
Emergint Technologies, Inc.               Online Learning Development                                      GA               142,196
Chickasaw Advisory Services, LLC          Management Analyst                                               GA               134,880
Total Solutions, Inc.                     Administrative Assistant                                         GA               126,917
Chickasaw Advisory Services, LLC          Web Developer/Master II                                          GA               124,937
Chickasaw Advisory Services, LLC          Half-time Health Communication Specialist II (1/2 time) (SW)     GA               124,937
Dell Services Federal Government, Inc.    IT Support                                                       GA               120,000
Chickasaw Advisory Services, LLC          Web Developer                                                    GA               116,858
Chickasaw Advisory Services, LLC          Health Communication Specialist I (MPR)                          GA               116,758
Chickasaw Advisory Services, LLC          Health Communication Specialist I (SN)                           GA               112,781
Chickasaw Advisory Services, LLC          Public Health Advisor                                            GA               111,165
Chalk And Wire                            Commercial software for assessment of learning outcome           GA                82,915
                                          (COTS Portfolio)
Corporate Temps Inc                       Administrative Assistant II                                      GA                79,738
Chickasaw Advisory Services, LLC          Program Assistant                                                GA                78,519
Chickasaw Advisory Services, LLC          Half-time Health Communication Specialist II                     GA                62,452
Ashlin Management Group, Inc.             Tech Support for SEPDPO                                          GA                28,954
Professional and Scientific Associates,   PSA Training Order - Emory University Southeastern Institute     GA                24,631
Inc.                                      for Training and Evaluation
Total (27 awards)                                                                                                       $13,796,447
                                          Source: GAO analysis of HHS information.




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                                                Activity: HIV/AIDS

                                                The purpose of this activity is to support demonstration projects to identify
                                                and implement a “combination approach” to enhance effective HIV
                                                prevention programming in hard-hit areas across the country. These
                                                efforts are designed to both supplement existing programs in these
                                                communities and help jurisdictions to better focus efforts on key at-risk
                                                populations and fulfill unmet needs.

                                                •    Fiscal year 2010: $ 29.2 million (88 grants in three funding
                                                     announcements totaling $21.6 million and six contracts totaling
                                                     $7.6 million)

                                                •    Fiscal year 2011: None

Table 41: FY 2010 Grants, HIV/AIDS

Announcements (3)                                            Recipient                                         State      Award (dollars)
1.   HIV/AIDS Surveillance: Enhancing Laboratory             California Department of Public Health            CA                $415,593
     Reporting (CDC-RFA-PS08-8020302SUPP10)                  Florida State Department of Health                FL                 400,000
Purpose (award type): To enable state and local
health departments to improve the reporting of HIV           New York City Health/Mental Hygiene               NY                 393,380
laboratory data from private and public laboratories to      New York State Dept of Health                     NY                 307,033
state and local health departments and CDC.
                                                             Maryland State Dept of Hlth/Mtl Hygiene           MD                 229,857
(Supplement)
Legislative Authority: Sections 317 and 318B of the          Virginia State Dept of Health                     VA                 200,000
Public Health Service Act (42 U.S.C. Sections 247b           Los Angeles County Health Services Dept           CA                 190,581
and 247c-2), as amended and the Patient Protection
                                                             Houston City Health & Human Services              TX                 184,076
and Affordable Care Act (PL 111-148), Title IV,
Section 4002 (Prevention and Public Health Fund).            DC Department of Health                           DC                 183,595
Eligibility: Limited to state and local territorial health   San Francisco Dept of Public Health               CA                 171,081
departments that are currently grantees under the
funding announcement PS08-802, HIV/AIDS                      New Jersey State Dept/Health/Senior Srvs          NJ                 169,050
Surveillance.                                                Texas State Dept of Health Services               TX                 142,681
                                                             Alabama State Dept of Public Health               AL                 136,711
                                                             City of Philadelphia Public Health Dept           PA                 136,330
                                                             Michigan State Dept of Community Health           MI                 135,438
                                                             Oklahoma State Department of Health               OK                 122,817
                                                             Minnesota State Dept of Health                    MN                 117,953
                                                             Arkansas State Dept of Health                     AR                 114,182
                                                             Washington State Department of Health             WA                 104,993
                                                             Utah State Department of Health                   UT                 104,114
                                                             Iowa State Dept of Public Health                  IA                 101,668
                                                             Louisiana State Dept of Hlth & Hospitals          LA                  97,517




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Announcements (3)                                           Recipient                                        State      Award (dollars)
                                                            Wisconsin Department of Health Services          WI                  96,639
                                                            Tennessee State Department of Health             TN                  93,161
                                                            Arizona State Department of Hlth Srvcs           AZ                  90,262
                                                            Massachusetts State Dept of Pub Health           MA                  89,268
                                                            South Carolina State Dept of Hlth/Env            SC                  87,900
                                                            Oregon State Public Health Division              OR                  82,180
                                                            Connecticut State Dept of Public Health          CT                  79,714
                                                            Mississippi State Department of Health           MS                  79,020
                                                            Nevada State Dept of Hlth/Human Svcs             NV                  75,576
                                                            KY Cabinet for Health and Family Services        KY                  72,899
                                                            Illinois State Dept of Public Health             IL                  72,489
                                                            Colorado State Dept/Pub Hlth & Environmt         CO                  68,390
                                                            Nebraska St Dept of Health & Human Servs         NE                  67,735
                                                            Maine State Dept/Health/Human Servs              ME                  60,000
                                                            Delaware State Dept of Hlth & Soc Srvs           DE                  51,218
                                                            Virgin Islands Department of Health              VI                  49,750
                                                            Alaska State Department of Hlth-Soc Svcs         AK                  41,909
                                                            Hawaii State Department of Health                HI                  41,848
                                                            Georgia Department of Community Health           GA                  35,431
                                                            Puerto Rico Department of Health                 PR                  29,565
                                                            Guam Department of Public Health-Soc Svc         GU                  25,000
                                                            Idaho State Dept of Health And Welfare           ID                  24,658
                                                            City of Chicago                                  IL                  16,941
                                                            American Samoa Department of Health              AS                   9,797
                                                            Total (46 awards)                                                $5,600,000
2.   Expanded Human Immunodeficiency Virus (HIV)            Alabama State Dept of Public Health              AL                $145,567
     Testing for Disproportionately Affected Populations
                                                            Arizona State Department of Hlth Srvcs           AZ                 145,567
     (CDC-RFA-PS10-10138)
Purpose (award type): To increase HIV testing               California Department of Public Health           CA                 145,567
opportunities for populations disproportionately affected   Los Angeles County Health Services Dept          CA                 145,567
by HIV; increase the proportion of HIV-infected persons
                                                            San Francisco Dept of Public Health              CA                 145,567
in these populations who are aware of their infection
and are linked to appropriate services; and identify        Connecticut State Dept of Public Health          CT                 145,567
strategies for leveraging resources to maximize the         DC Department of Health                          DC                 145,567
yield and sustainability of routine HIV screening
programs in healthcare settings. (New)                      Florida State Department of Health               FL                 145,567
Legislative Authority: Sections 301 and 318 of the          Georgia Department of Community Health           GA                 145,567
Public Health Service Act (42 U.S.C. Section 241 and        Illinois State Dept of Public Health             IL                 145,567
247c), as amended.




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Announcements (3)                                              Recipient                                       State      Award (dollars)
Eligibility: Limited to health department jurisdictions        City of Chicago                                 IL                 145,567
with at least 175 estimated combined AIDS diagnoses            Louisiana State Dept of Hlth & Hospitals        LA                 145,567
among Blacks/African Americans and Hispanics/
Latinos in 2007.                                               Maryland State Dept of Hlth/Mtl Hygiene         MD                 145,567
                                                               Massachusetts State Dept of Pub Health          MA                 145,567
                                                               Michigan State Dept of Community Health         MI                 145,567
                                                               Mississippi State Department of Health          MS                 145,567
                                                               Missouri State Dept/ Health & Senior Srv        MO                 145,567
                                                               New Jersey State Dept/Health/Senior Srvs        NJ                 145,567
                                                               New York State Dept of Health                   NY                 145,567
                                                               New York City Health/Mental Hygiene             NY                 145,557
                                                               NC State Dept/Hlth & Human Services             NC                 145,567
                                                               Ohio State Department of Health                 OH                 145,567
                                                               City of Philadelphia Public Health Dept         PA                 145,567
                                                               Hershey Milton S Medical Center                 PA                 145,567
                                                               Puerto Rico Department of Health                PR                 145,567
                                                               South Carolina State Dept of Hlth/Env           SC                 145,567
                                                               Tennessee State Department of Health            TN                 145,567
                                                               Texas State Dept of Health Services             TX                 145,567
                                                               Houston City Health & Human Services            TX                 145,567
                                                               Virginia State Dept of Health                   VA                 145,567
                                                               Total (30 awards)                                               $4,367,000
3.   Enhanced Comprehensive HIV Prevention                     New York City Health/Mental Hygiene             NY              $1,581,184
     Planning and Implementation for Metropolitan              Los Angeles County Health Services Dept         CA               1,059,407
     Statistical Areas Most Affected by HIV/AIDS
     (CDC-RFA-PS10-10181)                                      DC Department of Health                         DC                 946,403
Purpose (award type): To facilitate the development            City of Chicago                                 IL                 927,371
and implementation of Enhanced Comprehensive HIV
                                                               Georgia Department of Community Health          GA                 913,982
Prevention Plans (ECHPPs) for geographic areas most
affected by the HIV epidemic in order to reduce HIV risk       Florida State Department of Health              FL                 909,315
and incidence in those areas. (New)                            City of Philadelphia Public Health Dept         PA                 906,024
Legislative Authority: Sections 317(k)(2) and 318 of
                                                               Houston City Health & Human Services            TX                 891,108
the Public Health Service Act (42 U.S.C. Sections
247b(k)(2) and 247c), as amended, and Section 4002             San Francisco Dept of Public Health             CA                 887,968
of the Patient Protection and Affordable Care Act              Maryland State Dept of Hlth/Mtl Hygiene         MD                 878,896
(PL 111-148).
Eligibility: Limited to twelve (12) state and local            Texas State Dept of Health Services             TX                 850,016
governments or bona fide agencies/organizations in             Puerto Rico Department of Health                PR                 848,326
specific Metropolitan Statistical Areas or specified
                                                               Total (12 awards)                                              $11,600,000
Metropolitan Divisions that have the highest estimated
AIDS prevalence at the end of 2007.
                                             Source: GAO analysis of HHS information.




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Table 42: FY 2010 Contracts, HIV/AIDS

Recipient                               Purpose                                                         State       Award (dollars)
Scimetrika, LLC                         Comprehensive HIV Prevention through the evaluation of          NC               $3,164,520
                                        Enhanced Comprehensive HIV Prevention Planning and
                                        Implementation for Metropolitan Statistical Areas most
                                        affected by HIV
Manila Consulting Group, Inc            Web-based HIV behavioral trend analysis among men who           VA                3,106,740
                                        have sex with men (MSM)
Office of Clinical and Preventive       To utilize interagency resources to reduce the incidence        MD                1,000,000
Service Indian Health Services          and burden of HIV and other STDs and hepatitis in the
                                        AI/AN population
Professional & Scientific Assoc         Meeting & Conference Support for Consultation meetings for      VA                  203,865
                                        grantees of PS10-10181: “Enhanced Comprehensive HIV
                                        Prevention Planning and Implementation for Metropolitan
                                        Statistical Areas Most Affected by HIV/AIDS.”
Professional & Scientific Assoc         Meeting & Conference support for Consultation on                GA                  109,875
                                        Monitoring of CD4 and Viral Load Test Results In The
                                        National HIV Surveillance System
Northrop Grumman                        Support all aspects of full lifecycle application systems       GA                   40,500
                                        development and maintenance on a variety of platforms
                                        including mainframe, client server, and web; architecture
                                        and infrastructure design to support enterprise application
                                        software services including hardware/software/network
                                        design and implementation; database design, application
                                        development and support; data management and security
                                        controls; quality assurance, test and control functions; and
                                        technical communication, consultation and information
                                        support.
Total (6 awards)                                                                                                         $7,625,500
                                          Source: GAO analysis of HHS information.



                                          Activity: Racial and Ethnic Approaches to Community Health (REACH)

                                          The purpose of this activity is to serve as the cornerstone of CDC’s efforts
                                          to eliminate racial and ethnic disparities in health. REACH supports
                                          community coalitions that design, implement, evaluate, and disseminate
                                          community-driven strategies to eliminate health disparities in key health
                                          areas, such as heart disease, diabetes, breast and cervical cancer,
                                          immunization, asthma, hepatitis B, and infant mortality.

                                          •     Fiscal year 2010: None

                                          •     Fiscal year 2011: $24.6 million (43 grants in three funding
                                                announcements totaling $24.5 million and one contract totaling
                                                $0.1 million)



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Table 43: FY 2011 Grants, Racial and Ethnic Approaches to Community Health (REACH)

Announcements (3)                                 Recipient                                                  State     Award (dollars)
1.   Racial and Ethnic Approaches to              Public Health Institute                                    CA               $893,128
     Community Health across the US               Hildalgo Medical Services                                  NM                874,499
     (CDC-RFA-DP07-707)
Purpose (award type): To advance evidence-        University of Colorado At Denver And Hsc                   CO                865,189
and practice-based programs and culturally        University of Illinois At Chicago                          IL                852,874
based community practices to eliminate racial
                                                  Boston Public Health Commission                            MA                850,040
and ethnic health disparities through
implementation, evaluation, and dissemination     Medical University of South Carolina                       SC                850,001
of state of the art knowledge. (New)              University of Alabama at Birmingham                        AL                850,000
Legislative Authority: Section 301(a) and
                                                  University of California, Los Angeles                      CA                850,000
317(k) (2) of the Public Health Service Act,
42 U.S. Code 241(a) and 247b(k)2.                 University of Hawaii                                       HI                850,000
Eligibility: Public and private nonprofit         Genesee County Health Department                           MI                850,000
organizations; for profit organizations; small,
minority women-owned businesses;                  Institute for Urban Family Health                          NY                850,000
universities and colleges; hospitals;             Oklahoma State Department of Health                        OK                850,000
community-based and faith-based
                                                  Greater Lawrence Family Health Center, Inc                 MA                849,999
organizations; American Indian/Alaska Native
tribal governments and American                   Mount Sinai School of Medicine                             NY                849,999
Indian/Alaska Native tribally designated          Orange Co. Asian and Pacific Islander Community            CA                844,285
organizations; Alaska Native health               Alliance
corporations; Urban Indian health
organizations; tribal epidemiology centers;       New York University School of Medicine                     NY                844,248
state and local governments or their Bona         Khmer Health Advocates, Inc.                               CT                844,243
Fide agents, and political subdivisions of
states.                                           Southeast Chicago Development Commission                   IL                427,891
                                                  Seattle-King County Department of Public Health            WA                415,391
                                                  LA Biomedical Research Institute at Harbor                 CA                415,390
                                                  Special Services for Groups                                CA                415,390
                                                  City of Chicago                                            IL                415,390
                                                  Health Visions Midwest, Inc.                               IN                415,390
                                                  Center for Comm. Health, Education and Research            MA                415,390
                                                  Eastern Band of Cherokee Indians                           NC                415,390
                                                  YMCA of Greater Cleveland                                  OH                415,390
                                                  Choctaw Nation of Okahoma                                  OK                415,390
                                                  Virginia Commonwealth University                           VA                415,390
                                                  Inter-Tribal Council of MI                                 MI                415,390
                                                  West Virginia State Dept Hlth/Human Rscs                   WV                415,387
                                                  University of Arizona                                      AZ                412,890
                                                  Community Health Councils, Inc.                            CA                411,370
                                                  Wai’Anac District Health and Hosp. Board                   HI                402,075
                                                  To Our Children’s Future With Health, Inc                  PA                400,031
                                                  YMCA of Santa Clara Valley                                 CA                400,000



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Announcements (3)                               Recipient                                                   State     Award (dollars)
                                                Children’s Hospital Corporation                             MA                400,000
                                                Brooklyn Perinatal Network                                  NY                400,000
                                                Northern Arapaho Tribe                                      WY                397,808
                                                Vernon J. Harris East End Community H Center                VA                396,052
                                                Total (39 awards)                                                         $23,551,300
2.   Racial and Ethnic Approaches to              Schenectady Co. Public Health Services                    NY               $199,700
     Community Health for Communities             Total (1 award)                                                            $199,700
     Organized to Respond and Evaluate
     (REACH) (CDC-RFA-DP10-1014)
Purpose (award type): To support local
communities to strategically organize,
implement and evaluate evidence-based
policy, system, and environmental change
interventions that eliminate racial and ethnic
health disparities in chronic diseases. In
addition this announcement will support the
transition of communities from the analysis of
intervention results to the use of these results
in facilitating health equity and policy change.
(New)
Legislative Authority: Section 301(a) and
317(k) (2) of the Public Health Service Act,
42 U.S. Code 241(a) and 247b(k)2.
Eligibility: With the exception of current Racial
and Ethnic Approaches to Community Health
for Communities grantees, eligible applicants
include: nonprofit and for-profit organizations
(other than small business); small, minority
women-owned businesses; universities,
colleges and research institutions; hospitals;
community-based and faith-based
organizations; American Indian/Alaska native
tribal governments and American
Indian/Alaska native tribally designated
organizations; Alaska Native health
corporations; Urban Indian health
organizations; tribal epidemiology centers,
state and local governments or their Bona Fide
agents, and political subdivisions of states.




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Announcements (3)                                   Recipient                                                 State     Award (dollars)
3.   National Organizations that Serve Minority     Asian Pacific Partners For Empowerment, Advocacy And CA                    $250,000
     Communities Initiative to Share Racial and     Leadership
     Ethnic Approaches to Eliminate Health          Inter-Tribal Council of Michigan                          MI                250,000
     Disparities with Local Affiliates & Chapters
     (CDC-RFA-DP09-905)                             Joint Center For Political And Economic Studies           DC                250,000
Purpose (award type): To support national           Total (3 awards)                                                           $750,000
minority organizations to (1) disseminate
evidence-based strategies, tools and best
practices to their local affiliates and chapters;
and (2) to provide capacity-building technical
assistance to local affiliates and chapters to
address the growing health disparities among
their constituents. (New)
Legislative Authority: Section 301(a) and
317(k) (2) of the Public Health Service Act, 42
U.S. Code 241(a) and 247b(k)(2).
Eligibility: Limited to established national
nonprofit and Urban Indian health
organizations and federally recognized
American Indian/Alaska Native tribal
governments that can demonstrate experience
working in the health arena and specifically on
issues related to health disparities.
                                              Source: GAO analysis of HHS information.




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Table 44: FY 2011 Contract, Racial and Ethnic Approaches to Community Health (REACH)

Recipient                      Purpose                                                                     State    Award (dollars)
Planning Professionals, LTD.   Racial and Ethnic Health Disparities Action Institute (REHDAI) Workshop     GA               $98,792
Total (1 award)                                                                                                             $98,792
                                          Source: GAO analysis of HHS information.



                                          Activity: Public Health Research

                                          The purpose of this activity is to fund research projects through the ACA
                                          Prevention and Public Health Fund that investigate the effectiveness of
                                          public health services and systems in real world settings. The specific
                                          requirements for projects to be supported within this initiative are to
                                          (1) examine evidence-based practices related to prevention, with a
                                          particular focus on high-priority areas consistent with the National
                                          Prevention Strategy and Healthy People 2020, including comparisons of
                                          community-based public health interventions in terms of effectiveness
                                          and cost; (2) analyze the effective translation of interventions from
                                          academic settings to real world settings; and (3) identify effective
                                          strategies to organize, finance, or deliver public health services in real
                                          world community settings, including comparisons of state and local health
                                          department structures and systems in terms of effectiveness and cost.

                                          •     Fiscal year 2010: None

                                          •     Fiscal year 2011: $19.9 million (12 grants in three funding
                                                announcements totaling $11.5 million and 12 contracts totaling
                                                $8.4 million)




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Table 45: FY 2011 Grants, Public Health Research

Announcements (3)                                                    Recipient                                     State      Award (dollars)
1.   Public Health Prevention Fund: Streamlined                      Harvard Pilgrim Health Care                   MA              $1,544,184
     Surveillance for Ventilator-Associated Pneumonia:               Total (1 award)                                               $1,544,184
     Reducing Burden and Demonstrating Preventability
     (RFA-CK11-001010PPHF11)
Purpose (award type): To evaluate the performance
characteristics of streamlined ventilator associated
pneumonia and evaluate the extent to which it can be
prevented through adherence to process measures
outlined in the HHS Action Plan. (Supplement)
Legislative Authority: Section 307 of the Public Health
Service Act as amended (42 U.S.C. 242l).
Eligibility: Applicants selected as a Prevention Epicenter
under FOA CK 11-001.
2.   Preparedness and Emergency Response Research                    University of California, Berkeley            CA              $1,509,000
     Centers: A Public Health Systems Approach                       University of California, Los Angeles         CA               1,197,000
     (RFA-TP-08-001)
Purpose (award type): To fund research for promoting                 University of Minnesota                       MN               1,147,000
and enhancing the preparedness and emergency                         University of North Carolina, Chapel Hill     NC               1,147,000
response capabilities of the public health infrastructure at
                                                                     Total (4 awards)                                              $5,000,000
the federal, state, local, and tribal levels. (New)
Legislative Authority: Section 319F(d)(7) of the Public
Health Service Act, 42 U.S.C. 247d-6(d)(7).
Eligibility: Accredited Schools of Public Health, as required
by section 319F-2(d) of the Public Health Service Act. Only
schools accredited by the Council on Education for Public
Health are eligible
3.   Preparedness and Emergency Response Learning                    University of South Florida                   FL                $714,285
     Centers (CDC-RFA-TP10-100102CONT11)                             Johns Hopkins University                      MD                 714,286
Purpose (award type): To address legislative
requirements, as stated in section 319F(d) of the Public             University of Albany, SUNY                    NY                 714,286
Health Service (PHS) Act (42 USC § 247d-6(d), as part of             Columbia University                           NY                 714,286
a plan to improve the nation’s public health and medical
                                                                     University of Oklahoma                        OK                 714,286
preparedness and response capabilities for emergencies,
whether deliberate, accidental, or natural. (New)                    Texas A & M University                        TX                 714,286
Legislative Authority: Section 319F(d) of the Public                 University of Washington                      WA                 714,285
Health Service (PHS) Act (42 USC § 247d-6(d)).
                                                                     Total (7 awards)                                              $5,000,000
Eligibility: Accredited Schools of Public Health that
received their accreditation from the Council on
Education for Public Health.
                                             Source: GAO analysis of HHS information.




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Table 46: FY 2011 Contracts, Public Health Research

Recipient                                      Purpose                                                        State     Award (dollars)
Healthy Housing Solutions Inc                  Tobacco Control: Adoption, Health Impact and Cost of           GA             $2,210,000
                                               Smoke-Free Multi-Unit Housing Policies
Research Service, Hines VA Hospital            Evaluating the impact of a treatment intervention to reduce    GA              1,846,000
                                               Clostridium difficile transmission from asymptomatic C.
                                               difficile carriers in VA Community Living Centers
The Johns Hopkins University                   Center of Excellence for Measuring the Health and Social       GA              1,636,598
                                               Impacts of Changes in State Alcohol Prices
University of North Carolina at Chapel Hill    The Effectiveness of extending a “Consistent Care” program NC                    745,000
                                               aimed to prevent prescription drug overdoses
Washington State University                    A randomized controlled trial of proactive reporting by        WA                550,587
                                               prescription drug monitoring programs (PDMP)
ABT Associates Inc.                            A randomized controlled trial of proactive reporting by        MD                505,514
                                               prescription drug monitoring programs (PDMP)
Emergint Technologies, Inc.                    Promoting DVT/PE prevention through monitoring practices       GA                321,045
                                               and health outcomes
Goodwill Industries of North Georgia           CDC Program Oversight & Implementation                         GA                250,000
Lantana Consulting Group                       HL7 Implementation Guidance Development and                    GA                128,955
                                               Maintenance
Deloitte Consulting, LLP                       CDC Program Oversight & Implementation                         GA                100,000
Avaris Concepts, LLC                           Logistical support of the s-VAP workgroup meeting              GA                 54,998
Deloitte Consulting, LLP                       CDC Program Oversight & Implementation                         GA                 50,000
Total (12 awards)                                                                                                            $8,398,697
                                              Source: GAO analysis of HHS information.



                                              Activity: Community Guide/Community Preventive Services Task Force

                                              The purpose of this activity is to help people choose programs and
                                              policies to improve health and prevent disease in communities using the
                                              Community Guide, a free resource. The activity’s findings are used by
                                              partners at federal, state, and local levels within governments, health
                                              departments, worksites, community-based organizations, and elsewhere
                                              to guide and improve public health programs, policies, and research.

                                              •     Fiscal year 2010: $5.0 million (six grants in one funding
                                                    announcement totaling $2.2 million and six contracts totaling
                                                    $2.8 million)

                                              •     Fiscal year 2011: $6.0 million (six grants in one funding
                                                    announcement totaling $1.3 million and seven contracts totaling
                                                    $4.7 million)



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Table 47: FY 2010 Grants, Community Guide/Community Preventive Services Task Force

Announcement                                                      Recipient                                        State        Award (dollars)
Affordable Care Act: Capacity Building Assistance to              National Association of City/County Health       DC                 $500,000
Strengthen Public Health Infrastructure and                       Officials
Performance (CDC-RFA-HM08-8050301SUPP10)                          Association of State and Territorial Health      VA                  500,000
Purpose (award type): To expand funding                           Officials
announcement CDC-RFA-HM08-805 by supporting the
provision of capacity building assistance to state, tribal,       National Network of Public Health Institutes     LA                  450,000
local and territorial health departments that ensures             Public Health Foundation                         DC                  350,000
successful adoption of best or promising practices to
                                                                  National Association of Local Boards of Health   OH                  300,000
address key areas of public health infrastructure
investments. (Supplement)                                         Association of Maternal and Child Health         DC                  100,000
Legislative Authority: Sections 301 and 317 of the                Programs
Public Health Service Act (PHS Act), 42 USC, 241 and              Total (6 awards)                                                  $2,200,000
247b as amended. Funding is appropriated under the
Affordable Care Act (PL 111-148), Title IV, Section 4002
(Prevention and Public Health Fund).
Eligibility: Limited to specific national, non-profit, public
health professional organizations funded through the
competitive funding announcement
CDC-RFA-HM08-805.
                                                Source: GAO analysis of HHS information.




Table 48: FY 2010 Contracts, Community Guide/Community Preventive Services Task Force

                                                                                                                                        Award
Recipient                               Purpose                                                                         State         (dollars)
Dept of Energy/Oak Ridge Ops            Collection, Review & Analysis of Data                                           GA          $1,300,000
Westat                                  Community Guide Communication Technical Assistance and Support                  MD           1,054,685
Deloitte Consulting, LLP                Business services support - Financial Management Office                         GA             180,000
Chickasaw Advisory Services, LLC        Provide analytical epidemiology support                                         GA             122,500
Chickasaw Advisory Services, LLC        Provide analytical epidemiology support                                         GA             122,500
Deloitte Consulting, LLP                Business services support - Health Reform Implementation Office                 GA              20,000
Total (6 awards)                                                                                                                    $2,799,685
                                                Source: GAO analysis of HHS information.




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Table 49: FY 2011 Grants, Community Guide/Community Preventive Services Task Force

Announcement                                                Recipient                                               State    Award (dollars)
Non-Competitive 12-month Cost Extension                     Association of State and Territorial Health Officials   VA              $305,682
Supplement for CDC-RFA-HM08-                                Public Health Foundation                                DC               296,329
8050301SUPP10: Affordable Care Act (ACA):
Capacity Building Assistance to Strengthen                  National Association of City/County Health Officials    DC               266,821
Public Health Infrastructure and Performance                National Network of Public Health Institutes            LA               249,582
(CDC-RFA-HM08-8050401PPHF11)
                                                            National Association of Local Boards of Health          OH               165,449
Purpose (award type): To expand funding
announcement CDC-RFA-HM08-805 by                            Association of Maternal and Child Health Programs       DC                61,137
supporting the provision of capacity building               Total (6 awards)                                                      $1,345,000
assistance to state, tribal, local and territorial
health departments that ensures performance
improvement and successful adoption of best or
promising practices to address key areas of public
health infrastructure investments. (Supplement)
Legislative Authority: Sections 301 and 317 of
the Public Health Service Act (PHS Act), 42 USC,
241 and 247b as amended. Funding is
appropriated under the Affordable Care Act
(PL 111-148), Title IV, Section 4002 (Prevention
and Public Health Fund)
Eligibility: Eligibility is limited to specific national,
non-profit, public health professional organizations
funded through the funding announcement
CDC-RFA-HM08-8030301SUPP10.
                                                  Source: GAO analysis of HHS information.




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Table 50: FY 2011 Contracts, Community Guide/Community Preventive Services Task Force

Recipient                                 Purpose                                                    State      Award (dollars)
Cloudburst Consulting Group, INC.         Programmatic Management/ Intramural HR                     GA              $1,499,286
Department of Energy                      ORISE Fellows                                              GA               1,300,000
University of Manchester                  Low Complexity Community Guide Reviews                     GA                 886,350
Westat, Inc.                              Communications Support Contract                            GA                 629,976
Deloitte Consulting, LLP                  CDC Program Oversight & Implementation                     GA                 245,000
Chickasaw Advisory Services, LLC          Health Scientist                                           GA                  99,809
Deloitte Consulting, LLP                  CDC Program Oversight & Implementation                     GA                  35,000
Total (7 awards)                                                                                                     $4,695,421
                                      Source: GAO analysis of HHS information.



                                      Activity: Healthcare-Associated Infections (HAI)

                                      The purpose of this activity is to expand state prevention activities
                                      through funding to health departments that have already demonstrated
                                      successes and capacity to implement HAI prevention programs and to
                                      build upon advances made through Recovery Act investments. This
                                      program is designed to accelerate electronic reporting to detect HAIs at
                                      the state level by decreasing data entry burden. Electronic reporting will
                                      increase validation of data and the ability of states and healthcare
                                      facilities to measure the impact of prevention efforts.

                                      •     Fiscal year 2010: None

                                      •     Fiscal year 2011: $11.4 million (54 grants in two funding
                                            announcements totaling $9.4 million and four contracts totaling
                                            $2.0 million)




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Table 51: FY 2011 Grants, Healthcare-Associated Infections

Announcements (2)                                    Recipient                                             State       Award (dollars)
1.   Patient Protection and Affordable Care Act      Michigan State Dept of Community Health               MI                 $782,173
     Epidemiology and Laboratory Capacity for        Illinois State Dept of Public Health                  IL                  779,616
     Infectious Diseases Building and
     Strengthening Epidemiology, Laboratory and      California Department of Public Health                CA                  771,473
     Health Information Systems Capacity in State    Tennessee State Department of Health                  TN                  768,006
     and Local Health Departments
     (CDC-RFA-CI10-101202PPHF11)                     New York State Dept of Health                         NY                  621,473
Purpose (award type): To enhance public health       Massachusetts State Dept of Pub Health                MA                  521,473
programs that focus on improving health and          Oregon State Public Health Division                   OR                  426,523
helping restrain the rate of growth of health care
costs through building epidemiology, laboratory,     Florida State Department of Health                    FL                  421,472
and health information systems capacity in state     Colorado State Dept/Pub Hlth & Environmt              CO                  363,303
and local public health departments.
(Continuation)                                       Arizona State Department of Hlth Srvcs                AZ                  316,078
Legislative Authority: Public Health Service Act     Nevada State Dept of Hlth/Human Svcs                  NV                  296,516
Sections 301(a) [42 U.S.C. 241(a)] and 317(k) (2)    KY Cabinet for Health and Family Services             KY                  274,784
[42 U.S.C. 247b (k) (2)], as amended and the
Patient Protection and Affordable Care Act           Minnesota State Dept of Health                        MN                   71,474
(PL 111-148), Title IV, Sections 4002 and 4304       Mississippi State Department of Health                MS                   71,473
(Prevention and Public Health Fund).
                                                     Montana State Dept/Pub Hlth & Human Srvs              MT                   71,473
Eligibility: Limited to 58 state and local public
health departments or their established bona fide    NH State Dept of Health and Human Sers                NH                   71,473
agents that were 2010 grantees of Epidemiology       New Jersey State Dept/Health/Senior Srvs              NJ                   71,473
and Laboratory Capacity for Infectious Diseases
CI10-1012 funding announcement.                      New Mexico State Department of Health                 NM                   71,473
                                                     Ohio State Department of Health                       OH                   71,473
                                                     Pennsylvania State Dept of Health                     PA                   71,473
                                                     Virginia State Dept of Health                         VA                   71,473
                                                     Alabama State Dept of Public Health                   AL                   71,472
                                                     Alaska State Department of Hlth-Soc Svcs              AK                   71,472
                                                     Georgia Department of Community Health                GA                   71,472
                                                     Indiana State Department of Health                    IN                   71,472
                                                     Iowa State Dept of Public Health                      IA                   71,472
                                                     Kansas State Dept of Hlth and Environmnt              KS                   71,472
                                                     Maine State Dept/Health/Human Servs                   ME                   71,472
                                                     NC State Dept/Hlth & Human Services                   NC                   71,472
                                                     Oklahoma State Department of Health                   OK                   71,472
                                                     Wisconsin Department of Health Services               WI                   71,472
                                                     Arkansas State Dept of Health                         AR                   71,471
                                                     South Carolina State Dept of Hlth/Env                 SC                   71,252
                                                     Hawaii State Department of Health                     HI                   70,992
                                                     Connecticut State Dept of Public Health               CT                   69,980




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Announcements (2)                                         Recipient                                               State    Award (dollars)
                                                          Vermont Department of Health                            VT                67,236
                                                          Maryland State Dept of Hlth/Mtl Hygiene                 MD                66,852
                                                          Delaware State Dept of Hlth & Soc Srvs                  DE                66,760
                                                          Nebraska St Dept of Health & Human Servs                NE                66,300
                                                          Puerto Rico Department of Health                        PR                66,154
                                                          Washington State Department of Health                   WA                66,153
                                                          Rhode Island State Dept of Health                       RI                66,147
                                                          Missouri State Dept/ Health & Senior Srv                MO                66,121
                                                          South Dakota State Dept of Health                       SD                63,945
                                                          DC Department of Health                                 DC                63,342
                                                          West Virginia State Dept Hlth/Human Rscs                WV                62,760
                                                          Idaho State Dept of Health And Welfare                  ID                58,617
                                                          Utah State Department of Health                         UT                55,647
                                                          North Dakota State Department of Health                 ND                48,611
                                                          Louisiana State Dept of Hlth & Hospitals                LA                47,553
                                                          Wyoming State Department of Health                      WY                23,239
                                                                                                                                            a
                                                          Total (51 awards)                                                    $8,939,999
2.   Competitive Program Expansion Supplement             Council of State and Territorial Epidemiologists        GA              $290,000
     for CDC-RFA-HM08-805: Strengthen and                 National Association of City/County Health Officials DC                  100,000
     Improve the Nation’s Capacity through
     National, Non-profit, Professional Public            Association of State and Territorial Health Officials   VA               100,000
     Health Organizations to Increase Health              Total (3 awards)                                                        $490,000
     Protection and Health Equity
     (CDC-RFA-HM08-8050402PHFF11)
Purpose (award type): Support the provision of
capacity building assistance to state, tribal, local
and territorial health departments that ensures
performance improvement and successful
adoption of best or promising practices to address
key areas of public health infrastructure
investments. (Supplement)
Legislative Authority: Sections 301 and 317 of
the Public Health Service Act (PHS Act), 42 USC,
241 and 247b as amended. Funding is
appropriated under the Affordable Care Act
(PL 111-148), Title IV, Section 4002 (Prevention
and Public Health Fund).
Eligibility: Limited to specific national, non-profit,
public health professional organizations funded
through the competitive funding opportunity
announcement CDC-RFA-HM08-805.
                                                Source: GAO analysis of HHS information.
                                                a
                                                Column does not total due to rounding.




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Table 52: FY 2011 Contracts, Healthcare-Associated Infections

                                                                                                                               Award
Recipient                                                    Purpose                                              State      (dollars)
Science Applications International Corporation (SAIC)        National Healthcare Safety Network (NHSN)            VA       $1,065,693
                                                             development and infrastructure requirements for
                                                             surveillance of HAIs
Four Seasons Environmental, Inc.                             CDC Program Oversight & Implementation               GA          470,000
Lantana Consulting Group                                     HL7 Implementation Guidance Development and          GA          434,307
                                                             Maintenance
Avaris Concepts, LLC                                         DHQP’s State-based Training Activity & Resource      GA           50,000
                                                             Support (STARS) Training and Resource Initiative
Total (4 awards)                                                                                                           $2,020,000
                                           Source: GAO analysis of HHS information.



                                           Activity: Prevention Research Centers

                                           The purpose of this activity is to help alter the individual behaviors and
                                           community environmental factors that put people at risk for the leading
                                           causes of death and disability—chronic diseases, such as cancer, heart
                                           disease, and diabetes. Centers may also address risks for injury,
                                           infectious disease, mental health, global health, and the health effects of
                                           impairments such as deafness. The activity is designed to bridge gaps
                                           between research findings and the translation of those findings into public
                                           health practice and policy.

                                           •     Fiscal year 2010: None

                                           •     Fiscal year 2011: $10.0 million (15 grants in one funding
                                                 announcement)




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Table 53: FY 2011 Grants, Prevention Research Centers

Announcement                                                  Recipient                                        State    Award (dollars)
Health Promotion and Disease Prevention Research              University of Arizona                            AZ            $1,015,000
Centers (RFA-DP09-00103SUPP11)                                San Diego State University with (UCSD)           CA               965,000
Purpose (award type): To support a network of
Health Promotion and Disease Prevention Research              Morehouse School of Medicine                     GA               894,500
Centers that: (1) focus on the major causes of disease        NYU Medical Center                               NY               785,999
and disability, with an emphasis on underserved and
                                                              University of Rochester                          NY               744,501
minority populations; (2) improve public health practice
through a community-based participatory research              West Virginia University Research Corporation    WV               690,000
process; and (3) design, test, disseminate, or translate      Yale University                                  CT               615,000
effective public health programs at the state and
community levels. Funded centers will also function           University of South Florida                      FL               615,000
as a part of a networked environment to support and           Johns Hopkins University                         MD               615,000
advance health promotion and disease prevention
research and serve as a national resource for                 Boston University                                MA               615,000
developing and applying effective public health               University of New Mexico                         NM               615,000
programs at the state or community level. (New)
                                                              Case Western Reserve University                  OH               615,000
Legislative Authority: Section 1706 of the Public
Health Service Act (PHS Act), 42 U.S.C. 300u-5,               Oregon Health and Science University             OR               615,000
 as amended.                                                  University of Maryland                           MD               300,000
Eligibility: Accredited schools of public health and          Dartmouth College                                NH               300,000
accredited schools of osteopathy and accredited
schools of medicine that offer an accredited Preventive       Total (15 awards)                                             $10,000,000
Medicine Residency program. Osteopathy and medicine
schools in the process of obtaining accreditation for a
Preventive Medicine Residency program are also
eligible.
                                            Source: GAO analysis of HHS information.



                                            Activity: Workplace Wellness

                                            The purpose of this activity is to engage and recruit through a national
                                            organization, groups of 10-15 employers and lead them through the
                                            process of building a core workplace health program.

                                            •     Fiscal year 2010: None

                                            •     Fiscal year 2011: $9.2 million (six contracts)




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Table 54: FY 2011 Contracts, Workplace Wellness

Recipient                                Purpose                                                            State   Award (dollars)
Viridian Health Management               Worksite Wellness Program Contract                                 GA           $7,769,250
Research Triangle Institute              Program Evaluation                                                 GA              537,824
Carter Consulting, Inc.                  Management Consultation and Technical Assistance Services          GA              360,501
Deloitte Consulting, LLP                 CDC Program Oversight & Implementation                             GA              350,000
Dell Services Federal Government, Inc.   IT Support                                                         GA              100,000
Four Seasons Environmental, Inc.         CDC Program Oversight & Implementation                             GA               50,000
Total (6 awards)                                                                                                         $9,167,575
                                          Source: GAO analysis of HHS information.



                                          Activity: National Youth Fitness Survey

                                          The purpose of this activity is to gather data on physical activity and
                                          fitness in children and teens through the National Youth Fitness Survey.
                                          The survey is conducted by the National Center for Health Statistics, part
                                          of the Centers for Disease Control and Prevention.

                                          •     Fiscal year 2010: None

                                          •     Fiscal year 2011: $5.9 million (four contracts)


Table 55: FY 2011 Contracts, National Youth Fitness Survey

Recipient                                Purpose                                                       State        Award (dollars)
Westat                                   National Youth Fitness Survey Activities                      MD                $5,305,291
Westat                                   Trailer refurbishment                                         MD                   354,709
Four Seasons Environmental               CDC Program Oversight & Implementation                        GA                   210,000
Deloitte Consulting                      CDC Program Oversight & Implementation                        GA                    30,000
Total (4 awards)                                                                                                         $5,900,000
                                          Source: GAO analysis of HHS information.




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                                              Activity: ARRA: Evaluation

                                              The purpose of this activity is to support the Behavioral Risk Factor
                                              Surveillance System (BRFSS) in tracking health conditions and risk
                                              behaviors in the United States.

                                              •     Fiscal year 2010: $4.0 million (nine grants in one funding
                                                    announcement totaling $3.6 million and five contracts totaling
                                                    $0.4 million)

                                              •     Fiscal year 2011: None

Table 56: FY 2010 Grants, ARRA: Evaluation

Announcement                                              Recipient                                               State     Award (dollars)
Patient Protection and Affordable Care Act                Arkansas State Dept of Health                           AR               $892,025
(Affordable Care Act) State Competitive                   North Carolina State Dept/Hlth & Human Services         NC                772,104
Supplemental Funding for Behavioral Risk
Factor Surveillance System                                Alabama State Dept of Public Health                     AL                749,995
(CDC-RFA-DP09-90103-SUPP10)                               Pinellas County Health Dept                             FL                500,000
Purpose (award type): To provide State Health
                                                          Florida State Department of Health                      FL                326,905
Departments with resources to maintain previous
projections in sample size, enhance and expand            Georgia Department of Community Health                  GA                109,533
the utility of Behavioral Risk Factor Surveillance        Illinois State Dept of Public Health                    IL                 99,845
System, and support ongoing state-based public
health surveillance infrastructure. (Supplement)          Texas State Dept of Health Services                     TX                 75,148
Legislative Authority: Sections 301, 307, 310,            Dekalb County Board of Public Health                    GA                 61,000
and 311 of the Public Health Service Act, as              Total (9 awards)                                                       $3,586,555
amended, and the Comprehensive Smoking
Education Act of 1984, Comprehensive
Smokeless Tobacco Health Education Act of 1986,
and Patient Protection and Affordable Care Act
(Affordable Care Act).
Eligibility: All 50 states, the District of Columbia,
Puerto Rico and U.S. Virgin Islands. Eligibility for
the evaluation of Communities Putting Prevention
to Work component is limited to state health
departments in which a Communities Putting
Prevention to Work grantee resides within the state
health agency jurisdiction boundary.
                                              Source: GAO analysis of HHS information.




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Table 57: FY 2010 Contracts, ARRA: Evaluation

Recipient                                    Purpose                                                        State   Award (dollars)
Denali Corporation DBA Denali Technologies   BRFSS data evaluation                                          GA            $120,132
WESTAT                                       Fund the sampling and weighting of BRFSS data once it          GA             106,171
                                             has been collected by ARRA/CPPW communities through
                                             this point in time surveys.
Deloitte Consulting, LLP                     Business services support - Financial Management Office        GA              70,296
Northrop Grumman                             Support all aspects of full lifecycle application systems      GA              59,209
                                             development and maintenance on a variety of platforms
                                             including mainframe, client server, and web; architecture
                                             and infrastructure design to support enterprise application
                                             software services including hardware/software/network
                                             design and implementation; database design, application
                                             development and support; data management and security
                                             controls; quality assurance, test and control functions; and
                                             technical communication, consultation and information
                                             support.
Deloitte Consulting, LLP                     Business services support - Health Reform Implementation GA                    10,000
                                             Office
Total (5 awards)                                                                                                          $365,808
                                         Source: GAO analysis of HHS information.



                                         Activity: ARRA: Media

                                         The purpose of this activity is to provide enhanced media
                                         buying/placement support to the National Prevention Media Initiative to
                                         increase exposure of audiences to campaign messages in communities
                                         that received Communities Putting Prevention to Work awards. The goal
                                         of this activity is to achieve maximum additional exposure of existing/in-
                                         development creative campaign materials.

                                         •     Fiscal year 2010: $3.9 million (three contracts)

                                         •     Fiscal year 2011: None




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Table 58: FY 2010 Contracts, ARRA: Media

Recipient                                  Purpose                                                        State     Award (dollars)
CAMPBELL-EWALD COMPANY                     Advertising and marketing services for planning and           GA              $3,730,000
                                           execution of paid-media strategies in support of the National
                                           Prevention Media Initiative.
Department of Health and Human Services    Provide publication development and management, Web            MO                110,000
                                           development and maintenance, and other presentation and
                                           communication support
Deloitte Consulting, LLP                   Business services support - Health Reform Implementation       GA                 10,000
                                           Office
Total (3 awards)                                                                                                         $3,850,000
                                          Source: GAO analysis of HHS information.



                                          Activity: Education and Outreach Campaign Regarding Preventive
                                          Benefits

                                          The purpose of this activity is to support the Pharmacy Outreach Project
                                          to increase pharmacists’ capacity and interest in providing over-the-
                                          counter advice to patients with high blood pressure, especially
                                          encouraging medication adherence and the use of available preventive
                                          clinical services.

                                          •     Fiscal year 2010: None

                                          •     Fiscal year 2011: $1.8 million (four contracts)




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Table 59: FY 2011 Contracts, Education and Outreach Campaign Regarding Preventive Benefits

Recipient                                      Purpose                                                    State      Award (dollars)
Ogilvy Public Relations Worldwide Inc.         Communications Support for Pharmacists Partnership         GA              $1,696,945
                                               and Cardiovascular Disease Prevention Activities
Four Seasons Environmental, Inc.               CDC Program Oversight & Implementation                     GA                  70,000
Northrup Grumman Systems Corporation           CDC Program Oversight & Implementation                     GA                  15,000
Deloitte Consulting, LLP                       CDC Program Oversight & Implementation                     GA                  10,000
Total (4 awards)                                                                                                          $1,791,945
                                           Source: GAO analysis of HHS information.



                                           Activity: National Prevention Strategy

                                           The purpose of this activity is to guide our nation in the most effective and
                                           achievable way to improve health and well being; the National Prevention
                                           Strategy prioritizes prevention by integrating recommendations and
                                           actions across multiple settings to improve health and save lives.

                                           •     Fiscal year 2010: $0.01 million (one contract)

                                           •     Fiscal year 2011: $0.7 million (four contracts)


Table 60: FY 2010 Contract, National Prevention Strategy

Recipient             Purpose                                                                               State    Award (dollars)
Northrop Grumman      Support all aspects of full lifecycle application systems development and             GA               $14,500
                      maintenance on a variety of platforms including mainframe, client server, and web;
                      architecture and infrastructure design to support enterprise application software
                      services including hardware/software/network design and implementation; database
                      design, application development and support; data management and security
                      controls; quality assurance, test and control functions; and technical communication,
                      consultation and information support.
Total (1 award)                                                                                                              $14,500
                                           Source: GAO analysis of HHS information.




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Table 61: FY 2011 Contracts, National Prevention Strategy

Recipient                           Purpose                                                            State        Award (dollars)
Deloitte Consulting, LLP            Strategic & Tactical Planning, Workforce Development and           GA                 $529,525
                                    other Related Transformation Initiatives
Department of Energy                Research Participation Program                                     GA                   98,000
Deloitte Consulting, LLP            CDC Program Oversight & Implementation                             GA                   35,000
Goodwill Industries of North GA     CDC Program Oversight & Implementation                             GA                    5,000
Total (4 awards)                                                                                                          $667,525
                                         Source: GAO analysis of HHS information.



                                         Activity: Promoting Obesity Prevention in Early Childhood Programs

                                         The purpose of this activity is to encourage child care providers across
                                         the nation to adopt healthier policies and practices around physical
                                         activity and nutrition, including limiting screen time and supporting
                                         breastfeeding.

                                         •     Fiscal year 2010: None

                                         •     Fiscal year 2011: $0.7 million (seven contracts)


Table 62: FY 2011 Contracts, Promoting Obesity Prevention in Early Childhood Programs

Recipient                          Purpose                                                                  State   Award (dollars)
National Institutes of Health      CDC support for NCCOR coordinating and collaborating projects            GA            $200,000
McKing Consulting Corporation      Management Consultation and Technical Assistance                         GA             194,969
The Regents of the University of   Development of a comprehensive state policy evaluation for               CO             150,000
Colorado                           nutrition, physical activity and obesity (University of Colorado,
                                   Denver)
Department of Energy               Collaborative efforts to prevent obesity in early childhood              GA              93,031
FHI Development 360 LLC            ORISE: Nutrition and Physical Activity Research                          GA              80,001
Deloitte Consulting, LLP           CDC Program Oversight & Implementation                                   GA              28,000
Four Seasons Environmental, Inc.   CDC Program Oversight & Implementation                                   GA               2,000
Total (7 awards)                                                                                                          $748,001
                                         Source: GAO analysis of HHS information.




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Appendix III: Health Resources and Services
              Appendix III: Health Resources and Services
              Administration—Prevention and Public Health
              Fund Awards by Activity


Administration—Prevention and Public
Health Fund Awards by Activity
              This appendix presents information on awards made by the Health
              Resources and Services Administration (HRSA) for Prevention and Public
              Health Fund (PPHF) activities with funds allocated and transferred from
              the PPHF for fiscal years (FY) 2010 and 2011. For each HRSA activity
              that received PPHF funding, tables 63 through 70 summarize information
              on awards made with those funds through grants and contracts for each
              fiscal year. 1 Award information was provided by HHS’s Assistant
              Secretary for Financial Resources, HRSA, or reported in the funding
              opportunity announcements (FOA) HHS identified as being associated
              with the activity and awards.

              The information presented in this appendix, including the purpose of the
              PPHF-funded activity, was obtained from HHS. Due to the large number
              of awards, we did not edit the award recipient information to correct
              typographical or grammatical errors, or clarify the information provided. In
              general, we reprinted the abbreviations and acronyms provided by HHS
              and the legislative authority cited in the FOA or otherwise provided by
              HHS. We did not independently verify the legislative authority. Totals in
              this appendix (reported obligations) may not match—for example, they
              may be less than—the amounts in table 2 (reported allocations).
              According to HHS officials, to carry out an activity, an agency may incur
              administrative expenses, including internal costs associated with
              managing and overseeing grants and contracts, not reflected in award
              amounts. Further, to the extent that an appropriation has not identified a
              particular amount for a specific activity, an agency may reallocate
              unobligated funds from that activity to another during the course of a
              fiscal year.

              Activity: Primary Care Training and Enhancement

              The purpose of this activity is to support and develop primary care
              physician and physician assistant programs. The program deploys its
              resources to strengthen medical education for physician and physician
              assistants to improve the quantity, quality, distribution, and diversity of the
              primary care workforce.




              1
               The tables present information on cooperative agreements with grants, and include
              information on interagency agreements with contracts.




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                                            •    Fiscal year 2010: $197.5 million (110 grants in two funding
                                                 announcements)

                                            •    Fiscal year 2011: None


Table 63: FY 2010 Grants, Primary Care Training and Enhancement
                                                          a
Announcements (2)                               Recipient                                                    State   Award (dollars)
1.   Primary Care Residency Expansion           Children’s Hospital & Research Center at Oakland             CA           $3,840,000
     Program (HRSA-10-277)                      Children’s National Medical Center                           DC            3,840,000
Purpose (award type): To increase the
number of primary care physicians by            Boston Medical Center                                        MA            3,840,000
expanding enrollment in accredited primary      Baystate Medical Center                                      MA            3,840,000
care residency programs, including family
                                                The Ohio State University                                    OH            3,840,000
medicine, general internal, and general
pediatric medicine. The program funds           Johns Hopkins University                                     MD            3,839,998
resident support of $80,000 per resident per    University of North Carolina At Chapel Hill                  NC            3,715,684
year for a total of three years per resident.
(New)                                           Spectrum Health Hospitals                                    MI            3,490,659
Legislative Authority: Section 747 of the       Danbury Hospital                                             CT            3,360,000
Public Health Service Act (42 U.S.C. 293k),     Louisiana State University Health Science Center             LA            3,120,000
as amended by section 5301 of the Patient
Protection and Affordable Care Act              Regents of University of California                          CA            2,880,000
(Pub. L. 111-148), and section 4002 of the      Baystate Medical Center                                      MA            2,880,000
Patient Protection and Affordable Care Act
(Publ. L. 111-148).                             Bronx-Lebanon Hosp Ctr                                       NY            2,880,000
Eligibility: Public or nonprofit private        Bronx-Lebanon Hosp Ctr                                       NY            2,880,000
hospitals, schools of medicine or osteopathic   Kingsbrook Jewish Medical Center                             NY            2,880,000
medicine, or a public or private nonprofit
entity which the Secretary has determined is    Richmond Medical Center                                      NY            2,880,000
capable of carrying out such grants. An         The Reading Hospital And Medical Center                      PA            2,880,000
applicant must be accredited as a residency
training program in family medicine, general    Meharry Medical College                                      TN            2,880,000
internal medicine, and/or general pediatrics    Mount Auburn Hospital                                        MA            2,879,998
by the Accreditation Council for Graduate
Medical Education (ACGME) or by the             Variety Children’s Hospital dba Miami Children’s Hospital    FL            2,861,568
American Osteopathic Association (AOA).         University of Pennsylvania                                   PA            2,777,757
                                                Tulane University, School of Medicine                        LA            2,472,964
                                                Texas Tech University Health Sciences Center                 TX            1,920,001
                                                Regents of the University of California                      CA            1,920,000
                                                Catholic Healthcare West/St. Mary Medical Center             CA            1,920,000
                                                The Regents of the University of California, Los Angeles     CA            1,920,000
                                                Regents of the University of California                      CA            1,920,000
                                                The Regents of the University of California, San Francisco   CA            1,920,000
                                                The Regents of the University of California, San Francisco   CA            1,920,000




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                                a
Announcements (2)     Recipient                                                     State    Award (dollars)
                      Regents of the University of Colorado                         CO             1,920,000
                      University of Colorado Denver                                 CO             1,920,000
                      University of Florida                                         FL             1,920,000
                      The University of Illinois At Chicago                         IL             1,920,000
                      Central Iowa Hospital Corporation                             IA             1,920,000
                      Curators, University of Missouri on behalf of UMKC            MO             1,920,000
                      Curators, University of Missouri On Behalf of UMKC            MO             1,920,000
                      Cooper Health System D/B/A Cooper University Hospital         NJ             1,920,000
                      Cooper Health System D/B/A Cooper University Hospital         NJ             1,920,000
                      Newark Beth Israel Medical Center                             NJ             1,920,000
                      Newark Beth Israel Medical Center                             NJ             1,920,000
                      University of Medicine and Dentistry of New Jersey            NJ             1,920,000
                      St. Elizabeth Medical Center                                  NY             1,920,000
                      Crozer-Chester Medical Center                                 PA             1,920,000
                      Albert Einstein Healthcare Network                            PA             1,920,000
                      Children’s Hospital of Pittsburgh of the UPMC Health          PA             1,920,000
                      System
                      Medical University of South Carolina                          SC             1,920,000
                      The University of Texas Southwestern Medical Center At        TX             1,920,000
                      Dallas
                      Baylor College of Medicine                                    TX             1,920,000
                      Carilion Medical Center                                       VA             1,920,000
                      Community Health of Central Washington                        WA             1,920,000
                      Marshfield Clinic Research Foundation                         WI             1,920,000
                      Marshfield Clinic Research Foundation                         WI             1,920,000
                      Hennepin Healthcare System, Inc/Hennepin County               MN             1,918,827
                      Medical Center
                      Sisters of Charity Hospital                                   NY             1,912,499
                      Variety Children’s Hospital Doing dba Miami Children’s        FL             1,907,712
                      Hospital
                      Freeman Oak Hill Health System                                MO             1,907,712
                      University of Connecticut Health Center                       CT             1,890,723
                      University of Rochester                                       NY             1,887,125
                      Cincinnati Children’s Hospital Medical Center                 OH             1,872,024
                      Board of Trustees of Southern Illinois University             IL             1,869,763
                      New Hanover Regional Medical Center                           NC             1,795,571
                      Virginia Commonwealth University                              VA             1,585,520
                      University of Arkansas for Medical Sciences                   AR             1,520,001




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                                            Fund Awards by Activity




                                                           a
Announcements (2)                                Recipient                                                  State    Award (dollars)
                                                 University of Arkansas for Medical Sciences-Cancer         AR             1,520,001
                                                 Research Center
                                                 Montefiore Medical Center                                  NY             1,490,111
                                                 Yellowstone City & County Health Department/Riverstone     MT               960,003
                                                 Health
                                                 The Family Medicine Residency of Idaho, Inc.               ID               960,000
                                                 The Family Medicine Residency of Idaho, Inc.               ID               960,000
                                                 Idaho State University                                     ID               960,000
                                                 Swedish Covenant Hospital                                  IL               960,000
                                                 Community Hospitals Foundation                             IN               960,000
                                                 Univ. of Mass. Medical School                              MA               960,000
                                                 The Regents of the University of Michigan                  MI               960,000
                                                 Board of Regents, University of Nevada, Reno               NV               960,000
                                                 UMDNJ – Robert Wood Johnson Medical School                 NJ               960,000
                                                 UPMC Presbyterian Shadyside                                PA               960,000
                                                 Baylor Research Institute                                  TX               960,000
                                                 Texas Tech Univ Health Sciences Center                     TX               960,000
                                                 Providence St Peter Hospital                               WA               960,000
                                                 Group Health Cooperative                                   WA               960,000
                                                 University of Arkansas                                     AR               759,999
                                                 University of Arkansas for Medical Sciences-Cancer         AR               759,999
                                                 Research Center
                                                 Total (82 awards)                                                     $167,356,219
2.   Expansion of Physician Assistant            Riverside Community College District/Moreno Valley         CA            $2,117,808
     Training (EPAT) Program                     Campus
     (HRSA-10-278)                               The Research Foundation of SUNY                            NY             2,046,528
Purpose (award type): To increase student
enrollment in primary care Physician             University of Texas-Pan American                           TX             1,980,000
Assistant programs and graduates planning to     University of Washington                                   WA             1,980,000
practice primary care specialties. The
                                                 Lincoln Memorial University                                TN             1,900,800
program funds physician assistant student
stipends, educational expenses, reasonable       Grand Valley State University                              MI             1,791,720
living expenses and indirect costs for a total   Duke University Medical Center                             NC             1,320,000
of $22,000 per student, for a maximum of two
years per student, plus indirect costs. (New)    Samuel Merritt College                                     CA             1,232,000




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                                           Fund Awards by Activity




                                                             a
Announcements (2)                               Recipient                                                         State     Award (dollars)
Legislative Authority: Section 747 of the       Methodist University, Inc.                                        NC                1,188,000
Public Health Service Act (42 U.S.C. 293k),     Shenandoah University                                             VA                1,069,200
as amended by section 5301 of the Patient
Protection and Affordable Care Act              LeMoyne College                                                   NY                1,056,000
(Pub. L. 111-148), and section 4002 of the      The University of Toledo Health Science Campus                    OH                1,009,880
Patient Protection and Affordable Care Act
(Pub. L. 111-148).                              University of New England                                         ME                  990,000
Eligibility: Public or private academically     King’s College                                                    PA                  990,000
affiliated physician assistant training         University of Nebraska Medical Center                             NE                  924,000
programs that have as their objective the
education of individuals who, upon completion   Chatham University                                                PA                  880,000
of their studies in the program, will be        University of Colorado Denver                                     CO                  855,360
qualified to provide primary care medical
services with the supervision of a physician.   New York Institute of Technology                                  NY                  855,360
                                                Union College                                                     NE                  792,000
                                                University of Southern California                                 CA                  704,000
                                                Desales University                                                PA                  704,000
                                                Marywood University                                               PA                  704,000
                                                University of Utah                                                UT                  704,000
                                                Pace University                                                   NY                  660,000
                                                Miami Dade College Medical Center Campus                          FL                  641,520
                                                The Univ. of Oklahoma Health Sciences Center                      OK                  418,171
                                                State of Colorado for Red Rocks Community College                 CO                  399,495
                                                University of New Mexico Health Sciences Center                   NM                  204,239
                                                Total (28 awards)                                                                $30,118,081
                                           Source: GAO analysis of HHS information.
                                           a
                                            According to HRSA officials, applicants could submit applications for each accredited family
                                           medicine, general internal medicine, or general pediatric residency program in primary care provided
                                           by the institution, and could receive multiple awards.


                                           Activity: Public Health Workforce Development

                                           The purpose of this activity is to support the training of public health
                                           workers. Public health workers protect and improve the health of
                                           communities through education, disease prevention and health
                                           promotion, and monitoring, diagnosis, research, and provision of services
                                           to address community health problems.

                                           •     Fiscal year 2010: $14.8 million (24 grants in one funding
                                                 announcement)

                                           •     Fiscal year 2011: $20.0 million (32 grants in one funding
                                                 announcement)



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Table 64: FY 2010 Grants, Public Health Workforce Development

Announcement                                         Recipient                                                State     Award (dollars)
Public Health Training Centers Program               Regents of the University of California, Los Angeles     CA               $650,000
(HRSA-10-270)                                        University of South Florida                              FL                650,000
Purpose (award type): To improve the nation’s
public health system by strengthening the            Emory University                                         GA                650,000
technical, scientific, managerial, and leadership    The Regents of the Univ of Michigan                      MI                650,000
competence of the current and future public
                                                     University of Puerto Rico Medical Sciences Campus        PR                650,000
health workforce. A public health training center
plans, develops, operates, and evaluates             University of South Carolina                             SC                650,000
projects that are in furtherance of the goals        East Tennessee State Univ                                TN                650,000
established by the Secretary in the areas of
preventive medicine, health promotion and            University of Washington                                 WA                650,000
disease prevention, or improving access to and       Univ of Pittsburgh                                       PA                649,994
quality of health services in medically
underserved communities. (New)                       Trustees of Boston University, BUMC                      MA                649,977
Legislative Authority: Section 765 of the            The Research Foundation of SUNY                          NY                649,921
Public Health Service Act (42 U.S.C. 295),           The Regents of the University of California              CA                649,819
as amended by section 5206 of the Patient
Protection and Affordable Care Act                   The Univ of Texas Health Science Center At Houston       TX                649,801
(Pub. L. 111-148), and section 766 of the            The University of Oklahoma Health Sciences Center        OK                649,750
Public Health Service Act (42 U.S.C. 295a), and
section 4002 of the Patient Protection and           University of Colorado Denver                            CO                649,497
Affordable Care Act (Publ. L. 111-148).              UMDNJ-School of Public Health                            NJ                647,654
Eligibility: A Council on Education for Public       Arizona Board of Regents                                 AZ                647,637
Health (CEPH) accredited school of public
health or another public or nonprofit private        University of Kentucky Research Foundation               KY                647,307
institution accredited for the provision of          Univ of North Carolina at Chapel Hill                    NC                643,004
graduate or specialized training in public health.
                                                     The University of Georgia                                GA                630,032
                                                     Board of Regents of the University of Wisconsin System WI                  628,480
                                                     Trustees of Dartmouth College                            NH                618,734
                                                     Eastern Virginia Medical School                          VA                488,360
                                                     Indiana University                                       IN                129,267
                                                     Total (24 awards)                                                      $14,829,234
                                              Source: GAO analysis of HHS information.




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Table 65: FY 2011 Grants, Public Health Workforce Development

Announcement                                      Recipient                                                             State   Award (dollars)
Public Health Training Centers Program            Regents of the University of California, Los Angeles                  CA            $650,000
(HRSA-11-142)                                     University of South Florida                                           FL             650,000
Purpose (award type): To improve the
nation’s public health system by                  Emory University                                                      GA             650,000
strengthening the technical, scientific,          The Board of Trustees of the University of Illinois                   IL             650,000
managerial, and leadership competence of
                                                  University of Iowa                                                    IA             650,000
the current and future public health
workforce. A public health training center        The Regents of the University of Michigan                             MI             650,000
plans, develops, operates, and evaluates          Regents of the University of Minnesota                                MN             650,000
projects that are in furtherance of the goals                                                                   a
established by the Secretary in the areas of      Board of Regents of the University of Nebraska, UNMC                  NE             650,000
preventive medicine, health promotion and         University of South Carolina                                          SC             650,000
disease prevention, or improving access to
and quality of health services in medically       East Tennessee State University                                       TN             650,000
underserved communities. (New and                 University of Washington                                              WA             650,000
Continuation)                                                       a
                                                  Yale University                                                       CT             649,998
Legislative Authority: Section 765 of the
Public Health Service Act (42 U.S.C. 295),        University of Pittsburgh                                              PA             649,995
as amended by section 5206 of the Patient         University of Colorado Denver                                         CO             649,990
Protection and Affordable Care Act                                                          a
(Pub. L. 111-148), and section 766 of the         University of Alabama at Birmingham                                   AL             649,981
Public Health Service Act (42 U.S.C. 295a),       Trustees of Boston University, BUMC                                   MA             649,972
and section 4002 of the Patient Protection
and Affordable Care Act (Pub. L. 111-148).        The Regents of the University of California                           CA             649,905
Eligibility: A Council on Education for Public    The University of Texas Health Science Center at Houston              TX             649,819
Health (CEPH) accredited school of public         The Research Foundation of SUNY                                       NY             649,496
health or another public or nonprofit private
institution accredited for the provision of       Board of Regents of the University of Wisconsin System                WI             647,154
                                                                           a
graduate or specialized training in public        University of Florida                                                 FL             645,158
health.
                                                  Arizona Board of Regents                                              AZ             645,038
                                                  UMDNJ-New Jersey-School of Public Health                              NJ             644,441
                                                  The University of Oklahoma Health Sciences Center                     OK             642,064
                                                  University of Puerto Rico Medical Sciences Campus                     PR             640,879
                                                  University of North Carolina at Chapel Hill                           NC             639,004
                                                  The University of Georgia                                             GA             633,022
                                                  Trustees of Dartmouth College                                         NH             619,090
                                                                                            a
                                                  University of Massachusetts Amherst                                   MA             614,589
                                                  University of Kentucky Research Foundation                            KY             610,781
                                                  Eastern Virginia Medical School                                       VA             491,849
                                                  Indiana University                                                    IN             129,748
                                                  Total (32 awards)                                                                $19,951,973
                                             Source: GAO analysis of HHS information.
                                             a
                                                 Indicates new awards for five recipients, remainder are continuation awards.




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                                                Fund Awards by Activity




                                                Activity: Advanced Nursing Education

                                                The purpose of this activity is to build and enhance advanced nursing
                                                education programs, including grants to schools of nursing to accelerate
                                                the education of primary care advanced practice nurses.

                                                •     Fiscal year 2010: $31 million (26 grants in one funding
                                                      announcement)

                                                •     Fiscal year 2011: None

Table 66: FY 2010 Grants, Advanced Nursing Education

Announcement                                        Recipient                                                    State     Award (dollars)
Advanced Nursing Education Expansion                Florida State University                                     FL             $1,425,600
(HRSA-10-281)                                       University of Illinois at Chicago/The Board of Trustees of   IL              1,425,600
Purpose (award type): To increase the               the University of Illinois
number of students enrolled full time in
accredited primary care Nurse Practitioner          Michigan State University                                    MI              1,425,600
and Nurse Midwifery programs and to                 The University of Michigan-Flint                             MI              1,425,600
accelerate the graduation of part time
                                                    Daemen College                                               NY              1,425,600
students in such programs by encouraging
full time enrollment. The program provides          Pace University                                              NY              1,425,600
master’s, post master’s, and, on a limited          Case Western Reserve Univ                                    OH              1,425,600
basis, doctor of nursing practice students
with stipends, educational expenses, or             Medical Univ of South Carolina                               SC              1,425,600
other reasonable living expenses for                East Tennessee State University                              TN              1,425,600
$22,000 per year, for a maximum of two
years per student, plus indirect costs.             University of Texas Health Science Center at San Antonio     TX              1,425,600
(New)                                               Univ of Utah                                                 UT              1,425,600
Legislative Authority: Section 811(a)(1) of         The Pennsylvania State Univ                                  PA              1,335,840
the Public Health Service Act (42 U.S.C.
296j(a)(1), as amended by section 5308 of           College of St. Scholastica                                   MN              1,330,560
the Affordable Care Act (Pub. L. 111-148),          Wayne State University                                       MI              1,320,000
and section 4002 of the Patient Protection
and Affordable Care Act (Pub. L. 111-148).          Oregon Health & Science University                           OR              1,283,040
Eligibility: Collegiate schools of nursing,         Duke Univ School of Nursing                                  NC              1,276,000
academic health centers, and other private          Shenandoah Univ                                              VA              1,188,000
or public entities accredited by a national
nursing accrediting agency recognized by            Western Univ of Health Sciences                              CA              1,056,000
the Secretary of the U.S. Department of             Trustees of the Univ of Pennsylvania                         PA                950,400
Education that offer and have students
enrolled in a primary care nurse practitioner       West Virginia University Rsch Corporation                    WV                950,400
program and/or an accredited nurse-                 Georgia State Univ Research Foundation, Inc.                 GA                831,600
midwifery program.
                                                    Rutgers, The State University                                NJ                807,840
                                                    Univ of Oklahoma Health Sciences Center                      OK                807,840
                                                    Univ of Massachusetts Medical School                         MA                760,816




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               Administration—Prevention and Public Health
               Fund Awards by Activity




Announcement       Recipient                                                  State     Award (dollars)
                   Univ of Detroit Mercy                                      MI                760,320
                   University of Miami                                        FL                704,000
                   Total (26 awards)                                                        $31,044,256
               Source: GAO analysis of HHS information.



               Activity: Nurse Managed Care Centers

               The purpose of this activity is to support nurse managed clinics which
               improve access to primary care, enhance nursing practice by increasing
               the number of clinical teaching sites for primary care and community
               health nursing students, and develop electronic processes for
               establishing effective patient and workforce data collection systems.

               •     Fiscal year 2010: $14.8 million (10 grants in one funding
                     announcement)

               •     Fiscal year 2011: None




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                                             Administration—Prevention and Public Health
                                             Fund Awards by Activity




Table 67: FY 2010 Grants, Nurse Managed Care Centers

                                                                                                                                 Award
Announcement                                             Recipient                                                 State       (dollars)
Nurse Managed Health Clinics (HRSA-10-282)               Fair Haven Community Health Clinic, Inc.                  CT        $1,500,000
Purpose (award type): To support the                     University of Mississippi Medical Center                  MS         1,500,000
development and operation of Nurse-Managed
Health Clinics (NMHC) to: (1) improve access to          The University of Texas Medical Branch at Galveston       TX         1,500,000
comprehensive primary health care and/or wellness        University of Illinois at Chicago/The Board of Trustees   IL         1,499,995
services (disease prevention and health promotion)       of the University of Illinois
across the lifespan, (2) provide services in
                                                         Regents of the Univ of Michigan                           MI         1,498,577
medically underserved areas and/or for vulnerable
populations; (3) serve as clinical training sites for    University of Colorado, Denver                            CO         1,498,206
students in primary care and specifically, enhance       The Regents of the University of California, San          CA         1,497,320
nursing practice by increasing the number of             Francisco
structured clinical teaching sites for primary and
community health graduate nursing students; and          St. Mary’s Health Wagon, Inc.                             VA         1,493,634
(4) establish or enhance electronic processes for        Tides Center–Women’s Community Clinic                     CA         1,459,366
establishing effective patient and workforce data
collection systems. (New)                                East Tennessee State University                           TN         1,400,998
Legislative Authority: Section 330A-1 of the             Total (10 awards)                                                  $14,848,096
Public Health Service Act (42 U.S.C. 254c-1a)
as added by Section 5208 of the Patient Protection
and Affordable Care Act (Pub. L. 111-148), and
section 4002 of the Patient Protection and
Affordable Care Act (Pub. L. 111-148).
Eligibility: Nurse-managed health clinics (NMHC)
that are associated with an accredited school,
college, university, or department of nursing,
federally qualified health center or independent
nonprofit health or social services agency.
Applicants must provide primary care or wellness
services to vulnerable and/or underserved
populations.
                                             Source: GAO analysis of HHS information.



                                             Activity: State Health Workforce Development Grants for Primary Care

                                             The purpose of this activity is to provide support to states in expanding
                                             their health care workforce by enabling state partnerships (generally the
                                             State Workforce Investment Board) to complete comprehensive planning
                                             and to carry out activities leading to coherent and comprehensive health
                                             care workforce development strategies at the state and local levels, with
                                             particular emphasis on primary care.

                                             •     Fiscal Year 2010: $5.6 million (26 grants in two funding
                                                   announcements)

                                             •     Fiscal Year 2011: None


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                                               Administration—Prevention and Public Health
                                               Fund Awards by Activity




Table 68: FY 2010 Grants, State Health Workforce Development Grants for Primary Care

                                                                                                                                 Award
Announcements (2)                                        Recipient                                                  State      (dollars)
1.   State Health Care Workforce Planning Grants         California Department of Employment Development            CA         $150,000
     (HRSA-10-284)                                       Colorado Department of Public Health and Environment       CO          150,000
Purpose (award type): To enable State
partnerships to complete comprehensive health            Connecticut Employment & Training Commission               CT          150,000
care workforce development planning to address           Hawaii Department of Labor and Industrial Relations        HI          150,000
current and projected workforce demands within
                                                         Idaho Department of Labor                                  ID          150,000
the State. (New)
Legislative Authority: Section 5102 of the               Kansas Department of Commerce                              KS          150,000
Affordable Care Act; and section 4002 of the             Maine Jobs Council                                         ME          150,000
Patient Protection and Affordable Care Act,
                                                         Maryland Governor’s Workforce Investment Board             MD          150,000
Public Law 111-148.
Eligibility: Limited to eligible State partnerships      Montana State University                                   MT          150,000
(generally a State Workforce Investment Board)           NJ Department of Labor and Workforce                       NJ          150,000
that includes, or modifies the members to include,
at least one representative from each of the             New Mexico Department of Labor                             NM          150,000
following: health care employer, labor                   New York State Department of Labor                         NY          150,000
organization, a public 2-year institution of
                                                         University of North Dakota                                 ND          150,000
higher education, a public 4-year institution of
higher education, the recognized State federation        Alaska Department of Labor And Workforce Development,      AK          150,000
of labor, the State public secondary education           ESD
agency, the State P-16 or P-20 Council                   State of Ohio – Department of Health                       OH          150,000
(statewide assemblies of education, business, and
community leaders charged with developing                Pennsylvania Department of Labor & Industry                PA          150,000
strategies to better coordinate, integrate, and          University of Wisconsin –Madison                           WI          150,000
improve education for preschool through college
students), if such a council exists, and a               Nevada Dept of Employment, Training, and Rehabilitation    NV          149,999
philanthropic organization that is actively engaged      MN Department of Employment and Economic                   MN          149,599
in providing learning, mentoring, and work               Development
opportunities to recruit, educate, and train
individuals for, and retain individuals in, careers in   Wyoming Department of Workforce Services                   WY          149,396
health care and related industries.                      Commonwealth Corporation                                   MA          149,271
                                                         District of Columbia Department of Employment Services     DC          149,250
                                                         North Carolina Department of Commerce Division of          NC          144,595
                                                         Workforce Development
                                                         University of Vermont                                      VT          131,786
                                                         South Carolina Department of Employment and Workforce      SC          114,604
                                                         Total (25 awards)                                                   $3,688,500




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                                          Administration—Prevention and Public Health
                                          Fund Awards by Activity




                                                                                                                            Award
Announcements (2)                                   Recipient                                                  State      (dollars)
2.   State Health Care Workforce Implementation Virginia State Department of Health                            VA       $1,935,137
     Grants (HRSA-10-285)                             Total (1 award)                                                   $1,935,137
Purpose (award type): To enable State
partnerships to implement workforce development
plans or carry out activities as defined by the State
application in order to address current and
projected workforce demands within the
State.(New)
Legislative Authority: Section 5102 of the
Affordable Care Act; and section 4002 of the
Patient Protection and Affordable Care Act, Public
Law 111-148.
Eligibility: A State partnership shall have
(1) received a planning grant as specified under
subsection c of Section 5102, P.L. 111-148 and
completed all requirements of such grant; or
(2) completed a satisfactory application, including
a plan to coordinate with required partners and
complete the required activities during the two
year period of the implementation grant.
                                          Source: GAO analysis of HHS information.



                                          Activity: HRSA Healthy Weight Collaborative and Activities

                                          The purpose of this activity is to integrate primary care, public health, and
                                          the community by using quality improvement science to identify, test, and
                                          disseminate evidence-based interventions to prevent and treat obesity in
                                          children and families.

                                          •     Fiscal year 2010: $5.0 million (one grant in one funding
                                                announcement)

                                          •     Fiscal year 2011: None




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                                             Appendix III: Health Resources and Services
                                             Administration—Prevention and Public Health
                                             Fund Awards by Activity




Table 69: FY 2010 Grants, HRSA Healthy Weight Collaborative

Announcement                                             Recipient                                            State   Award (dollars)
Prevention Center For Healthy Weight                  National Initiative For Children’s Healthcare Quality   MA           $4,983,638
(HRSA-10-303)                                         Total (1 award)                                                      $4,983,638
Purpose (award type): To support a Prevention
Center for Healthy Weight (PC) to plan, implement,
and manage a nation-wide Healthy Weight
Collaborative (HWC) as well as recruit and support
communities and teams participating in the HWC.
The PC will also serve as a gateway to quality
information on the prevention and treatment of
overweight and obesity in the context of integration
of public and community health and primary care.
(New)
Legislative Authority: Title V, Section 501(a)(2)
Social Security Act (42 U.S.C. 701) and Section
4002 of the Patient Protection and Affordable Care
Act (P.L. 111-148).
Eligibility: Any public or private nonprofit entity,
including state and local government agencies,
institutions of higher education, and an Indian tribe
or tribal organization. Applicants must have at least
four years experience in the fields of quality
management, quality improvement, developing and
disseminating informational materials, and
providing training or technical assistance related to
the prevention and treatment of overweight and
obesity on a national level. The applicant should
have experience working with public health,
community-based organizations, primary care,
behavioral health, and academic institutions in
addressing these concerns. The Prevention Center
may be a consortium of organizations composed of
more than one eligible entity, but only one entity
can be the official applicant for funding. All other
organizations are members of the consortium or
partnership.
                                             Source: GAO analysis of HHS information.



                                             Activity: Nutrition, Physical Activity, and Screen Time Standards in Child
                                             Care Settings

                                             The purpose of this activity is to enhance the quality of out-of-home child
                                             care by supporting the state and local health departments, early care and
                                             education regulatory agencies, early care and education providers, and
                                             parents in their efforts to identify and promote healthy and safe early care.




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                                            Fund Awards by Activity




                                            •     Fiscal year 2010: $0.2 million (one grant in one funding
                                                  announcement)

                                            •     Fiscal year 2011: None


Table 70: FY 2010 Grant, Nutrition, Physical Activity, and Screen Time Standards in Child Care Settings

Announcement                                            Recipient                                            State    Award (dollars)
National Resource Center for Health and Safety          University of Colorado, Denver, College of Nursing   CO              $249,000
in Child Care Settings (HRSA-05-058)                    Total (1 award)                                                      $249,000
Purpose (award type): The National Resource
Center (NRC) In partnership with national experts
(American Academy of Pediatrics and American
Public Health Association), coordinates the
development, updating and promotion of voluntary
national evidence-based health and safety
standards for child care programs—commonly
referred to as Caring for Our Children.
(Supplement)
Legislative Authority: Title V, Section 501(a)(2-3)
Social Security Act (42 U.S.C. 701) and
Section 4002 of the Patient Protection and
Affordable Care Act (P.L. 111-148).
Eligibility: Supplemental funding to the National
Resource Center for Health and Safety in Child
Care, University of Colorado, Denver, College of
Nursing.
                                            Source: GAO analysis of HHS information.




                                            Page 111                                       GAO-12-788 Prevention and Public Health Fund
Appendix IV: Office of the Secretary—
              Appendix IV: Office of the Secretary—
              Prevention and Public Health Fund Awards by
              Activity


Prevention and Public Health Fund Awards
by Activity
              This appendix presents information on awards made by the Office of the
              Secretary (OS) for Prevention and Public Health Fund (PPHF) activities
              with funds allocated and transferred from the PPHF for fiscal years (FY)
              2010 and 2011. For each OS activity that received PPHF funding, tables
              71 through 77 summarize information on awards made with those funds
              through grants and contracts for each fiscal year. 1 Award information was
              provided by HHS’s Assistant Secretary for Financial Resources and OS
              officials.

              The information presented in this appendix, including the purpose of the
              PPHF-funded activity, was obtained from HHS. Due to the large number
              of awards, we did not edit the award recipient information to correct
              typographical or grammatical errors, or clarify the information provided. In
              general, we reprinted the abbreviations and acronyms provided by HHS.
              Totals in this appendix (reported obligations) may not match—for
              example, they may be lower than—the amounts in table 2 (reported
              allocations). According to HHS officials, to carry out an activity, an agency
              may incur administrative expenses, including an agency’s internal costs
              associated with managing and overseeing grants and contracts, not
              reflected in award amounts. Further, to the extent that an appropriation
              has not identified a particular amount for a specific activity, an agency
              may reallocate unobligated funds from that activity to another during the
              course of a fiscal year.

              Activity: Obesity Media Activities

              The purpose of this activity is to develop and execute innovative
              communication campaigns, including both print and online materials
              development for anti-obesity and healthy lifestyle initiatives.

              •   Fiscal year 2010: $9.1 million (one contract)

              •   Fiscal year 2011: $8.6 million (two contracts)




              1
               The tables present information on cooperative agreements with grants, and include
              information on interagency agreements with contracts.




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                                         Appendix IV: Office of the Secretary—
                                         Prevention and Public Health Fund Awards by
                                         Activity




Table 71: FY 2010 Contracts, Obesity Media Activities

Recipient                             Purpose                                                  State              Award (dollars)
Oglivy Public Relations               Develop strategic outreach plans                         NY                      $9,100,000
Total (1 award)                                                                                                        $9,100,000
                                         Source: GAO analysis of HHS information.




Table 72: FY 2011 Contracts, Obesity Media Activities

Recipient                              Purpose                                                 State              Award (dollars)
Oglivy Public Relations                Public awareness campaigns                              NY                      $5,993,740
Ad Council                             Public awareness campaigns                              NY                       2,650,000
Total (2 awards)                                                                                                       $8,643,740
                                         Source: GAO analysis of HHS information.



                                         Activity: Tobacco Prevention Media

                                         The purpose of this activity is to launch a mass-media countermarketing
                                         campaign to prevent youth initiation, promote cessation among adults,
                                         and change social norms, using social media initiatives, a website, and
                                         smart phone applications.

                                         •     Fiscal year 2010: None

                                         •     Fiscal year 2011: $10.1 million (12 contracts)




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                                         Appendix IV: Office of the Secretary—
                                         Prevention and Public Health Fund Awards by
                                         Activity




Table 73: FY 2011 Contracts, Tobacco Prevention Media

                                                                                                                           Award
Recipient                                       Purpose                                                     State        (dollars)
PlowShare Group Inc                             Smoking Cessation campaign                                  CT         $4,000,000
Aquilent                                        Web development                                             MD          2,052,116
Matthews Media Group                            Smoking Cessation campaign                                  MD          2,000,000
Aquilent                                        Web development                                             MD            494,224
American Independent Media                      Studio activities in support of tobacco related messaging   MD            425,000
Communication Training Analysis Corporation     Research and database                                       VA            298,939
Communication Training Analysis Corporation     Research and database                                       VA            229,960
Aquilent                                        Web development                                             MD            221,064
Intelligent Enterprise Solutions                Develop engine to syndicate content                         MD            200,000
Interagency Agreement with OASH                 Content support                                                           125,000
PSC                                             Various processing fees                                                    21,943
Web Training                                    Web training                                                                3,500
Total (12 awards)                                                                                                     $10,071,746
                                         Source: GAO analysis of HHS information.



                                         Activity: National Prevention, Health Promotion, and Public Health
                                         Council Planning

                                         The purpose of this activity is to support the National Prevention Council,
                                         including a national conference that will bring together individuals,
                                         agencies, organizations, and programs that are putting into practice
                                         activities that will advance prevention per the Healthy People 2020
                                         initiative.

                                         •     Fiscal year 2010: $1.1 million (one grant for $0.1 million 2 and three
                                               contracts totaling $1.0 million)

                                         •     Fiscal year 2011: None




                                         2
                                          HHS did not provide a funding announcement for this award. According to HHS officials,
                                         OS awarded $138,000 to the Association for Prevention Teaching Workshop for fiscal
                                         year 2010.




                                         Page 114                                      GAO-12-788 Prevention and Public Health Fund
                                              Appendix IV: Office of the Secretary—
                                              Prevention and Public Health Fund Awards by
                                              Activity




Table 74: FY 2010 Contracts, National Prevention, Health Promotion, and Public Health Council Planning

                                                                                                                                    Award
Recipient                                         Purpose                                                                 State   (dollars)
IQ Solutions, Inc.                                Contracts to support strategic planning within the Office of Public             $620,000
American Institutes For Research                  Health and Science, such as support for the National Prevention,                  66,000
                                                  Health Promotion, and Public Health Council and Advisory Group
National Opinion Research Center                  in section 4001 of the Affordable Care Act.                                      300,000
Total (3 awards)                                                                                                                  $986,000
                                              Source: GAO analysis of HHS information.



                                              Activity: President’s Council on Fitness, Sports, and Nutrition

                                              The purpose of this activity is to coordinate obesity activities, including the
                                              Let’s Move Ambassador Program; the President’s Active Lifestyle Awards
                                              Program; the Youth Empowerment Program, and support for a
                                              Leadership Development Series for the Council.

                                              •     Fiscal year 2010: $0.8 million (two contracts)

                                              •     Fiscal year 2011: None


Table 75: FY 2010 Contracts, President’s Council on Fitness, Sports, and Nutrition

                                                                                                                                    Award
Recipient                                                       Purpose                                                   State   (dollars)
National Initiative on Physical Fitness for Children and        Interagency agreements to coordinate obesity, including           $500,000
Youth with Disabilities (OPHS-10-239)                           the Let’s Move Ambassador Program; the President’s
Research Participation Program (OPHS-10-228)                    Active Lifestyle Awards Program; the Youth                         292,000
                                                                Empowerment Program, and support for a Leadership
                                                                Development Series for the Council.
Total (2 awards)                                                                                                                  $792,000
                                              Source: GAO analysis of HHS information.



                                              Activity: Tobacco Cessation

                                              The purpose of this activity is to implement tobacco cessation activities,
                                              such as reducing tobacco use among low social economic status women
                                              of childbearing age, reducing the impact of tobacco use on their children,
                                              and other outreach efforts.

                                              •     Fiscal year 2010: $0.7 million (three contracts)

                                              •     Fiscal year 2011: None



                                              Page 115                                        GAO-12-788 Prevention and Public Health Fund
                                         Appendix IV: Office of the Secretary—
                                         Prevention and Public Health Fund Awards by
                                         Activity




Table 76: FY 2010 Contracts, Tobacco Cessation

                                                                                                                               Award
Recipient                                                  Purpose                                                   State   (dollars)
Tobacco and Young, Low-SES Women Federal                   Contract and interagency agreements to implement                  $285,000
Collaboration Smoking Cessation and Prevention             tobacco cessation activities, such as reducing tobacco
Program (OPHS-10-213)                                      use among low social economic status women of
American Institutes for Research                           childbearing age, reducing the impact of tobacco use on            226,000
                                                           their children, and other outreach efforts.
LSES Women and Tobacco Collaborative                                                                                          150,000
Demonstration Project (OPHS-10-231)
Total (3 awards)                                                                                                             $661,000
                                         Source: GAO analysis of HHS information.



                                         Activity: Healthy Living Innovations Awards

                                         The purpose of this activity is to create a public challenge project that
                                         would address three health promotion areas: healthy weight, physical
                                         activity, and nutrition. Project funds were used to develop the website,
                                         market the challenge, coordinate the review process for 250 applications,
                                         develop a monthly report on the website analytics, and manage the
                                         logistics of bringing the challenge winners to Washington, D.C. to
                                         received an award (plaques) and present on their projects at a national
                                         conference. The contractor also developed a final report documenting the
                                         process and highlighting areas of improvement.

                                         •     Fiscal year 2010: $0.1 million (one contract)

                                         •     Fiscal year 2011: None


Table 77: FY 2010 Contract, Healthy Living Innovations Awards

Recipient                                                  Purpose                                      State         Award (dollars)
NORC at the University of Chicago                          Administer awards program                    MD                   $100,000
Total (1 award)                                                                                                              $100,000
                                         Source: GAO analysis of HHS information.




                                         Page 116                                        GAO-12-788 Prevention and Public Health Fund
Appendix V: Substance Abuse and Mental
              Appendix V: Substance Abuse and Mental
              Health Services Administration—Prevention
              and Public Health Fund Awards by Activity


Health Services Administration—Prevention
and Public Health Fund Awards by Activity
              This appendix presents information on awards made by the Substance
              Abuse and Mental Health Services Administration (SAMHSA) for
              Prevention and Public Health Fund (PPHF) activities with funds allocated
              and transferred from the PPHF for fiscal years (FY) 2010 and 2011. For
              each SAMHSA activity that received PPHF funding, tables 78 through 83
              summarize information on awards made with those funds through grants
              and contracts for each fiscal year. 1 Award information was provided by
              HHS’s Assistant Secretary for Financial Resources, SAMHSA, or
              reported in the funding opportunity announcements (FOA) HHS identified
              as being associated with the activity and awards.

              The information presented in this appendix, including the purpose of the
              PPHF-funded activity, was obtained from HHS. Due to the large number
              of awards, we did not edit the award recipient information to correct
              typographical or grammatical errors, or clarify the information provided. In
              general, we reprinted the abbreviations and acronyms provided by HHS
              and the legislative authority cited in the FOA or otherwise provided by
              HHS. We did not independently verify the legislative authority. Totals in
              this appendix (reported obligations) may not match—for example, they
              may be lower than—the amounts in table 2 (reported allocations).
              According to HHS officials, to carry out an activity, an agency may incur
              administrative expenses, including an agency’s internal costs associated
              with managing and overseeing grants and contracts, not reflected in
              award amounts. Further, to the extent that an appropriation has not
              identified a particular amount for a specific activity, an agency may
              reallocate unobligated funds from that activity to another during the
              course of a fiscal year.

              Activity: Primary and Behavioral Health Care Integration

              The purpose of this activity is to improve the physical health status of
              people with serious mental illnesses by supporting communities to
              coordinate and integrate primary care services in community mental
              health and other community-based behavioral health settings.




              1
               The tables present information on cooperative agreements with grants, and include
              information on interagency agreements with contracts.




              Page 117                                    GAO-12-788 Prevention and Public Health Fund
                                              Appendix V: Substance Abuse and Mental
                                              Health Services Administration—Prevention
                                              and Public Health Fund Awards by Activity




                                              •    Fiscal year 2010: $20.0 million (35 grants in two funding
                                                   announcements)

                                              •    Fiscal year 2011: $35.0 million (43 grants in two funding
                                                   announcements)

Table 78: FY 2010 Grants, Primary and Behavioral Health Care Integration

Announcements (2)                                         Recipient                                         State      Award (dollars)
1.   Grants for Primary and Behavioral Health Care        Community Mental Health Affiliates, Inc.          CT                $496,863
     Integration (SM-09-011)                              Asian Community Mental Health Board               CA                 496,863
Purpose (award type): To improve the overall
wellness and physical health status of people with        Glenn County Health Services Agency               CA                 496,863
serious mental illnesses by making available              Apalachee Center, Inc.                            FL                 496,863
coordinated primary care services in community
                                                          Coastal Behavioral Healthcare, Inc.               FL                 496,863
mental health and other community-based
behavioral health settings. SAMHSA expects that           Miami Behavioral Health Center, Inc.              FL                 496,863
people with serious mental illnesses will show            Heritage Behavioral Health Center, Inc.           IL                 496,863
improvement in their physical health status through
participation in the programs associated with this        St. Barnabas Hospital                             NY                 496,863
grant. PBHCI also includes a focus on providing           North Oklahoma County Mental Health Center        OK                 496,863
wellness education and support services. This grant
program supports SAMHSA’s Pledge for Wellness             Asian Counseling and Referral Services            WA                 496,863
10 by 10 Campaign to prevent and reduce early             Tarzana Treatment Centers, Inc.                   CA                 496,862
mortality among people with mental illness by
10 years over the next 10 years. It is projected that     Community Rehab Center (CRC), Inc.                FL                 496,862
better coordination and integration of primary and        LifeStream Behavioral Center                      FL                 496,862
behavioral health care should lead to outcomes such
                                                          Washtenaw Community Health Organization           MI                 496,862
as improved access to primary care services;
improved prevention, early identification and             Catholic Charities, Diocese of Trenton            NJ                 496,862
intervention to avoid serious health issues including     Weber Human Services                              UT                 496,862
chronic diseases; enhanced capacity to holistically
serve those with mental and/or substance use              Cobb County Community Services Board              GA                 496,825
disorders; and better overall health status of clients.   Community Health and Counseling Services          ME                 496,820
(New)
                                                          Kent Center for Human and Organizational          RI                 496,636
Legislative Authority: Section 520A of the Public
                                                          Development
Health Service Act, as amended.
Eligibility: Limited to publicly funded community         Postgraduate Center for Mental Health             NY                 496,372
mental health and other community-based                   County of San Mateo                               CA                 496,307
behavioral health agencies. For the purposes of this
                                                          Bronx Lebanon Hospital Center                     NY                 496,135
announcement, community mental health and other
behavioral health agencies are defined as the             Adult and Child Mental Health Center, Inc.        IN                 495,189
following: (1) an entity that meets applicable            Austin Travis County MH/MR Center                 TX                 494,900
licensing or certification requirements in the State in
which it is located; and (2) provides outpatient          Greater Cincinnati Behavioral Health Services     OH                 492,511
mental health and/or other behavioral health              Family Services, Inc.                             MD                 490,868
services for individuals with serious mental illness.
                                                          Downtown Emergency Services Center                WA                 482,394
                                                          Horizon House, Inc.                               PA                 481,562
                                                          South Carolina Department of Mental Health        SC                 471,654




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                                          Health Services Administration—Prevention
                                          and Public Health Fund Awards by Activity




Announcements (2)                                      Recipient                                          State     Award (dollars)
                                                       Community Healthlink, Inc.                         MA                460,690
                                                       Lakeside Behavioral Healthcare, Inc.               FL                448,343
                                                       Prestera Center for Mental Health Services, Inc.   WV                438,513
                                                       Trilogy, Inc.                                      IL                421,263
                                                       Alaska Island Community Services                   AK                296,836
                                                       Total (34 awards)                                                $16,403,620
2.   Training and Technical Assistance Center for    National Council for Community Behavioral            DC             $3,596,380
     Primary and Behavioral Health Care Integration Healthcare
     (TTA-PBHCI) (SM-10-011)                         Total (1 award)                                                     $3,596,380
Purpose (award type): To provide technical
assistance support for up to 30 additional grantees,
support a coordinated approach to address
workforce development issues affecting the
behavioral health service delivery community, and
promote the training and use of behavioral health
screening, brief intervention and referral for
treatment in primary care settings. (New)
Legislative Authority: Section 520A (SAMHSA)
and 330(1) (HRSA) of the Public Health Service Act,
as amended.
Eligibility: Eligible applicants are domestic public
and private nonprofit entities. For example, State
and local governments, federally recognized
American Indian/Alaska Native Tribes and tribal
organizations, urban Indian organizations, public or
private universities and colleges; and community-
and faith-based organizations may apply. Tribal
organization means the recognized body of any
AI/AN Tribe; any legally established organization of
American Indians/Alaska Natives which is controlled,
sanctioned, or chartered by such governing body or
which is democratically elected by the adult
members of the Indian community to be served by
such organization and which includes the maximum
participation of American Indians/Alaska Natives in
all phases of its activities. Consortia of tribal
organizations are eligible to apply, but each
participating entity must indicate its approval.
                                          Source: GAO analysis of HHS information.




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                                              Appendix V: Substance Abuse and Mental
                                              Health Services Administration—Prevention
                                              and Public Health Fund Awards by Activity




Table 79: FY 2011 Grants, Primary and Behavioral Health Care Integration

                                                                                                                                      Award
Announcements (2)                                               Recipient                                                 State     (dollars)
                                                                                                              a
1.   Grants for Primary and Behavioral Health Care              Capital Area Human Services District                      LA      $1,893,939
     Integration (SM-09-011)                                    Catholic Charities of Santa Clara County
                                                                                                                  a
                                                                                                                          CA       1,893,939
Purpose (award type): To improve the overall wellness                                                     a
and physical health status of people with serious mental        Highline West Seattle Mental Health                       WA       1,893,939
                                                                                                      a
illnesses by making available coordinated primary care          Norfolk Community Services Board                          VA       1,893,939
services in community mental health and other                                                                         a
                                                                San Francisco Department of Public Health                 CA       1,893,939
community-based behavioral health settings. (New and
                                                                                          a
Continuation)                                                   SouthCentral Foundation                                   AK       1,893,939
                                                                                                  a
Legislative Authority: Section 520A of the Public Health        Community Support Services Inc.                           OH       1,836,954
Service Act, as amended.                                                                                              a
                                                                Health and Hospital Corp of Marion County                 IN       1,834,412
Eligibility: Limited to publicly funded community mental
health and other community-based behavioral health              Apalachee Center, Inc.                                    FL        500,000
agencies. For the purposes of this announcement,                Asian Community Mental Health Board                       CA        500,000
community mental health and other behavioral health
agencies are defined as the following: (1) an entity that       Asian Counseling and Referral Services                    WA        500,000
meets applicable licensing or certification requirements in     Catholic Charities, Diocese of Trenton                    NJ        500,000
the State in which it is located; and (2) provides outpatient
                                                                Coastal Behavioral Healthcare, Inc.                       FL        500,000
mental health and/or other behavioral health services for
individuals with serious mental illness.                        Community Mental Health Affiliates, Inc.                  CT        500,000
                                                                Community Rehab Center (CRC), Inc.                        FL        500,000
                                                                Family Services, Inc.                                     MD        500,000
                                                                Glenn County Health Services Agency                       CA        500,000
                                                                Heritage Behavioral Health Center, Inc.                   IL        500,000
                                                                LifeStream Behavioral Center                              FL        500,000
                                                                Miami Behavioral Health Center, Inc.                      FL        500,000
                                                                North Oklahoma County Mental Health Center                OK        500,000
                                                                Tarzana Treatment Centers, Inc.                           CA        500,000
                                                                Washtenaw Community Health Organization                   MI        500,000
                                                                Community Health and Counseling Services                  ME        499,957
                                                                Postgraduate Center for Mental Health                     NY        499,510
                                                                County of San Mateo                                       CA        499,444
                                                                Bronx Lebanon Hospital Center                             NY        499,272
                                                                Cobb County Community Services Board                      GA        498,825
                                                                Adult and Child Mental Health Center, Inc.                IN        498,061
                                                                Austin Travis County MH/MR Center                         TX        498,037
                                                                St. Barnabas Hospital                                     NY        496,863
                                                                Kent Center for Human and Organizational                  RI        492,281
                                                                Development
                                                                Downtown Emergency Services Center                        WA        485,531
                                                                Community Healthlink, Inc.                                MA        484,964




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                                            Appendix V: Substance Abuse and Mental
                                            Health Services Administration—Prevention
                                            and Public Health Fund Awards by Activity




                                                                                                                                     Award
Announcements (2)                                                Recipient                                              State      (dollars)
                                                                 Greater Cincinnati Behavioral Health Services          OH         483,637
                                                                 Prestera Center for Mental Health Services, Inc.       WV         481,091
                                                                 South Carolina Department of Mental Health             SC         478,049
                                                                 Horizon House, Inc.                                    PA         467,609
                                                                 Lakeside Behavioral Healthcare, Inc.                   FL         455,033
                                                                 Trilogy, Inc.                                          IL         387,218
                                                                 Weber Human Services                                   UT         365,000
                                                                 Alaska Island Community Services                       AK         300,000
                                                                 Total (42 awards)                                              $31,405,382
2.   Continuation to the Training and Technical                  National Council for Community Behavioral              DC       $3,594,045
     Assistance Center for Primary and Behavioral Health         Healthcare
     Care Integration (TTA-PBHCI)(SM-10-011)                     Total (1 award)                                                 $3,594,045
Purpose (award type): To provide technical assistance
support for a coordinated approach to address workforce
development issues affecting the behavioral health
service delivery community, and promote the training and
use of behavioral health screening, brief intervention and
referral for treatment in primary care settings.
(Continuation)
Legislative Authority: Section 520A (SAMHSA) and
330(1) (HRSA) of the Public Health Service Act, as
amended.
Eligibility: Limited to the National Council for Community
Behavioral Healthcare (NCCBH), based on the Council’s
expertise and relationship with the PBHCI grantees.
                                            Source: GAO analysis of HHS information.
                                            a
                                             Indicates new awards for eight recipients, remainder are continuation awards.


                                            Activity: Screening, Brief Intervention, and Referral to Treatment

                                            The purpose of this activity is to implement screening, brief intervention,
                                            and referral to treatment services for adults in primary care and
                                            community health settings, for substance misuse and substance use
                                            disorders. This program is designed to expand/enhance the state and
                                            tribal continuum of care for substance misuse services and reduce
                                            alcohol and drug consumption and its negative health impact; increase
                                            abstinence and reduce costly health care utilization; and promote
                                            sustainability and behavioral health information technology.




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                                             Health Services Administration—Prevention
                                             and Public Health Fund Awards by Activity




                                             •     Fiscal year 2010: None

                                             •     Fiscal year 2011: $25.0 million (three grants in one funding
                                                   announcement)


Table 80: FY 2011 Grants, Screening, Brief Intervention, and Referral to Treatment

                                                                                                                             Award
Announcement                                           Recipient                                               State       (dollars)
Cooperative Agreements for Screening, Brief            North Carolina Department of Health and Human Services NC         $8,330,000
Intervention and Referral to Treatment (SBIRT)         State of Connecticut                                    CT         8,330,000
(TI-11-005)
Purpose (award type): To expand/enhance the            State of Indiana                                        IN         8,329,906
State/Tribe’s continuum of care to include             Total (3 awards)                                                 $24,989,906
universal, adult SBIRT services in primary
care and a mix of other community settings
(e.g., health centers, nursing homes, university
health centers, employee assistance and job
training sites, hospitals, emergency departments,
office-based practices and Military, Reserve and
Guard units) and supports clinically appropriate
services for persons at risk (asymptomatic) for, or
diagnosed with, a substance use disorder (SUD).
It also seeks to identify and sustain systems and
policy changes to increase access to treatment in
generalist and specialist settings. (New)
Legislative Authority: Section 509 of the Public
Health Service Act, as amended.
Eligibility: The immediate office of the Chief
Executive (e.g., Governor) in the States,
Territories, and District of Columbia; and the
highest ranking official and/or the duly authorized
official of a federally recognized American
Indian/Alaska Native Tribe or tribal organization.
                                             Source: GAO analysis of HHS information.



                                             Activity: SAMHSA Health Surveillance
                                             The purpose of this activity is to support a number of federal, state, local,
                                             and tribal governments, as well as researchers and nongovernmental
                                             organizations, to develop timely and credible data and statistical
                                             information to improve the quality and outcomes of services provided to
                                             individuals, families, communities, and tribal communities.

                                             •     Fiscal year 2010: None

                                             •     Fiscal year 2011: $17.9 million (seven contracts)




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                                       Appendix V: Substance Abuse and Mental
                                       Health Services Administration—Prevention
                                       and Public Health Fund Awards by Activity




Table 81: FY 2011 Contracts, SAMHSA Health Surveillance

                                                                                                                       Award
Recipient                             Purpose                                                         State          (dollars)
Westat                                DAWN Operations and Emergency room data collection              MD           $8,804,701
Manila Consulting                     Expansion of NREPP                                              VA            3,547,794
Synectics for Management Decisions    Expansion of Mental Health inventories                          VA            2,400,704
RTI International                     DAWN Analysis contract modification                             NC            1,503,561
The Mitre Corporation                 MITRE FFRDC                                                     VA              757,272
RTI International                     Analysis on NSDUH data system                                   NC              690,412
Manila Consulting                     SAMHSA Data Users Conference on prevention research             VA              200,000
Total (7 awards)                                                                                                  $17,904,444
                                       Source: GAO analysis of HHS information.



                                       Activity: Suicide Prevention

                                       The Garrett Lee Smith (GLS) Memorial Act authorizes SAMHSA to
                                       manage two significant youth suicide prevention programs and a resource
                                       center. The GLS State/Tribal Youth Suicide Prevention and Early
                                       Intervention Grant Program supports the development and
                                       implementation of youth suicide prevention and early intervention
                                       strategies involving public-private collaborations among youth-serving
                                       institutions. The GLS Campus Suicide Prevention program provides
                                       funding to institutions of higher education to prevent suicide and suicide
                                       attempts. The Suicide Prevention Resource Center (SPRC) develops
                                       effective strategies and best practices to ensure the field has access to
                                       the most crucial information.

                                       •     Fiscal year 2010: None

                                       •     Fiscal year 2011: $10.1 million (11 grants in four funding
                                             announcements totaling $10.0 million and one contract for
                                             $0.1 million)




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                                              Appendix V: Substance Abuse and Mental
                                              Health Services Administration—Prevention
                                              and Public Health Fund Awards by Activity




Table 82: FY 2011 Grants, Suicide Prevention

Announcements (4)                                                   Recipient                                 State     Award (dollars)
1.    State and Tribal Youth Suicide Prevention Grants              Pueblo of San Felipe - GLS States         NM             $1,440,000
      (SM-11-001)                                                   Muscogee Creek Nation - GLS States        OK              1,440,000
Purpose (award type): To support States and tribes in
developing and implementing statewide and/or tribal youth           Native American Rehabilitation Assn -     OR              1,440,000
suicide prevention and early intervention strategies, grounded      GLS States
in public/private collaboration. Such efforts must involve          Tohono O’Odham Nation - GLS States        AZ              1,440,000
public/private collaboration among youth serving institutions
                                                                    Total (4 awards)                                         $5,760,000
and agencies and should include schools, educational
institutions, juvenile justice systems, foster care systems,
substance abuse and mental health programs, and other
child and youth supporting organizations. (New)
Legislative Authority: The Garrett Lee Smith Memorial Act
(Section 520E-1 of the Public Health Service Act, as
amended).
Eligibility: (1) States (Including D.C. and the Territories);
(2) Federally recognized Indian tribes, tribal organizations (as
defined in the Indian Self-Determination and Educational
Assistance Act), or urban Indian organizations (as defined in
the Indian Health Care Improvement Act) that are actively
involved in the development and continuation of a tribal youth
suicide early intervention and prevention strategy; and
(3) Public or private non-profit organizations designated by a
State, federally recognized Indian tribe, tribal organization, or
urban Indian organization, to develop or direct the
State/tribal-sponsored youth suicide prevention and early
intervention strategy.
2. Campus Suicide Prevention Grants (SM-11-002)                     University of Puerto Rico Rio Piedras -   PR               $306,000
Purpose (award type): To assist colleges and universities in        GLS Campus
their efforts to prevent suicide attempts and completions and       Thomas Jefferson University - GLS         PA                306,000
to enhance services for students with mental and behavioral         Campus
health problems, such as depression and substance
use/abuse that put them at risk for suicide and suicide             University of Arizona - GLS Campus        AZ                306,000
attempts. (New)                                                     University of Alaska Anchorage - GLS      AL                306,000
Legislative Authority: The Garrett Lee Smith Memorial Act           Campus
(Section 520E-2 of the Public Health Service Act, as                Jackson State University - GLS Campus     MS                306,000
amended).
                                                                    Total (5 awards)                                         $1,530,000
Eligibility: Limited to institutions of higher education as a
statutory requirement (per Section 520E-2 of the Public
Health Service Act, as amended). Applicants from both public
and private institutions may apply, including State
universities, private four-year colleges and universities
(including those with religious affiliations), Minority Serving
Institutions of higher learning, and community colleges.
Entities that have previously been awarded a Campus
Suicide Prevention Grant are not eligible. SAMHSA is further
limiting the eligibility to applicants who have not previously
received an award in order to allow for a broader distribution
of the limited funds across campuses and universities.




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                                           Appendix V: Substance Abuse and Mental
                                           Health Services Administration—Prevention
                                           and Public Health Fund Awards by Activity




Announcements (4)                                                    Recipient                         State      Award (dollars)
3.   Program Supplement for the National Suicide Prevention Link2Health Solutions, Inc. - Suicide      NY              $1,705,000
     Lifeline (SM-11-003)                                   Hotline Supplement
Purpose (award type): To expand/enhance grant activities    Total (1 award)                                            $1,705,000
funded under the Cooperative Agreement for Networking,
Certifying, and Training Suicide Prevention Hotlines grant
announcement. Supplemental funding is being provided as a
result of increased demand and challenges posed by the
current economic environment. (Supplement)
Legislative Authority: Section 520A of the Public Health
Service Act, as amended.
Eligibility: Limited to the current grantee, Link2Health
Solutions, Inc.. The grantee was awarded the cooperative
agreement following a competitive application process.
4.   Program Supplement for the Suicide Prevention              Education Development Center, Inc.     MA                $999,993
     Resource Center (SPRC) (SM-11-014)
                                                                Total (1 award)                                          $999,993
Purpose (award type): To expand and enhance grant
activities funded under the Suicide Prevention Resource
Center (SPRC) grant announcement. This one-year
supplement to the SPRC is to expand and enhance the level
of support provided to the National Action Alliance for Suicide
Prevention. (Supplement)
Legislative Authority: Section 520C of the Public Health
Service Act, as amended.
Eligibility: Limited to the Education Development Center, Inc.
Eligibility for this one-year supplemental agreement is being
limited because SPRC is currently providing the infrastructure
for the Action Alliance and this is the most efficient and
effective way to accomplish the goals of advancing the
National Strategy for Suicide Prevention.
                                           Source: GAO analysis of HHS information.




Table 83: FY 2011 Contract, Suicide Prevention

Recipient                                                    Purpose                         State                Award (dollars)
Westover Consultants INC                                     Meeting support                 MD                          $110,656
Total (1 award)                                                                                                          $110,656
                                           Source: GAO analysis of HHS information.




                                           Page 125                                    GAO-12-788 Prevention and Public Health Fund
Appendix VI: GAO Contact and Staff
                  Appendix VI: GAO Contact and Staff
                  Acknowledgments



Acknowledgments

                  Katherine Iritani, (202) 512-7114 or iritanik@gao.gov
GAO Contact
                  In addition to the contact named above, Kim Yamane, Assistant Director;
Staff             George Bogart; Carolyn Garvey; Laurie Pachter; and Terry Saiki made
Acknowledgments   key contributions to this report.




(291001)
                  Page 126                             GAO-12-788 Prevention and Public Health Fund
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