Substance Abuse and Violence Prevention: Multiple Youth Programs Raise Questions of Efficiency and Effectiveness

Published by the Government Accountability Office on 1997-06-24.

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

                          United States General Accounting Office

GAO                       Testimony
                          Before the Subcommittee on Oversight and Investigations,
                          Committee on Education and the Workforce
                          House of Representatives

For Release on Delivery
Expected at 11:00 a.m.
Tuesday, June 24, 1997
                          SUBSTANCE ABUSE AND
                          VIOLENCE PREVENTION

                          Multiple Youth Programs
                          Raise Questions of
                          Efficiency and Effectiveness
                          Statement of Carlotta C. Joyner, Director
                          Education and Employment Issues
                          Health, Education, and Human Services Division

Substance Abuse and Violence Prevention:
Multiple Youth Programs Raise Questions of
Efficiency and Effectiveness
              Mr. Chairman and Members of the Committee:

              I am pleased to be here today to discuss our work on federal
              substance-abuse and violence-prevention programs for youths.

              Drug and alcohol abuse (substance abuse) and violence by youths are
              serious problems confronting our nation. After declining in the eighties,
              drug use rates among school-age youths increased between 1992 and 1995
              for more than 10 different types of drugs. For example, one study reported
              that the rate of marijuana use by eighth grade students more than
              doubled—from about 7 to about 16 percent—and the rate for twelfth
              graders rose from about 22 to about 35 percent. During this period, the
              rate of alcohol use remained above 70 percent for twelfth graders.1 The
              Congress found in 1994 that about 3 million thefts and violent crimes took
              place on or near school campuses each year—more than 16,000 incidents
              per school day.2 About one in five high school students regularly carried a
              firearm, knife, razor, club, or other weapon. The federal government, state
              and local governments, and private organizations have all responded to
              these problems by establishing and funding a wide range of programs and
              activities intended to reduce or prevent youth substance abuse and

              My testimony today, based on a number of studies we have issued, will
              focus on (1) the information available about substance-abuse and
              violence-prevention programs and the federal investment in them,
              (2) what is known about the effectiveness of federally funded programs in
              reducing youth substance abuse and violence, and (3) improving the
              federal effort by focusing more on accountability and results. (A list of
              related GAO products appears at the end of this testimony.) Although some
              of the data we present—for example, on programs and their funding—are
              from 1994 and 1995, the issues we are addressing have changed little since
              our work was done.

              In summary, our reviews have raised questions about the efficiency and
              effectiveness of the federal effort in this area. The system that has
              developed—of multiple federal programs dispursed among several
              agencies—has created the potential for inefficient service as well as
              difficulty for those trying to access the most appropriate services and
              funding sources. For example, we identified 70 federal programs that

                Monitoring the Future, National Institutes of Health, National Institute on Drug Abuse (Rockville, Md.:
               20 U.S.C. 7102 (3).

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             could have been used in fiscal year 1995 to provide substance-abuse
             and/or violence-prevention services for youths. These programs were
             located in 13 federal departments or other federal entities and had
             appropriations of about $2.4 billion. In addition, state, county, and local
             governments, as well as private sources provided billions of dollars for
             substance-abuse prevention and treatment efforts for adults and youths.

             Often, insufficient information exists on these programs’ performance.
             Although we identified some promising approaches for preventing
             substance abuse and violence, our work suggests that additional research
             is needed to further test these approaches’ effectiveness and their
             applicability to different populations in varied settings. In addition, a
             major information gap exists for federal decisionmakers who need to
             know the accomplishments of these individual federal programs and the
             combination of those programs.

             The Government Performance and Results Act of 1993 (GPRA) can move
             agencies toward a more integrated approach to meeting common goals
             and a greater emphasis on accountability and assessment of program
             results. This emphasis will require agencies not only to better document
             federal programs’ progress toward achieving their goals of preventing
             substance abuse and violence, but also to identify which service delivery
             approaches have been effective and encourage greater use of more
             effective models.

             Stemming the tide of youth drug use and violence is a high priority on the
Background   national policy agenda. For example, one of the five goals of the Office of
             National Drug Control Policy (ONDCP), created by the Congress in 1988 to
             lead the nation’s war on drugs, is to “educate and enable America’s youth
             to reject illegal drugs as well as alcohol and tobacco.”3 In addition, one of
             the National Education Goals, adopted by the Congress in 1994, is that “by
             the year 2000, all schools in America will be free of drugs, violence, and
             the unauthorized presence of firearms and alcohol, and will offer a
             disciplined environment that is conducive to learning.”4 In fiscal year 1994,
             $1.8 billion, 40 percent of the $4.4 billion federal budget authority for

              National Drug Control Strategy, 1997, ONDCP (Washington, D.C.).
              20 U.S.C. 5812 (7).

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                           substance-abuse prevention and treatment, was targeted to prevention
                           activities for adults and youths.5

Preventing Substance       The major goals of substance-abuse prevention programs are preventing
Abuse                      or eliminating drug and alcohol abuse and averting substance abuse-
                           related problems. Prevention activities vary and are directed at different
                           groups and delivered in multiple settings. For example, activities may

                       •   providing information and education to increase knowledge of substance
                           abuse and alternative drug-free lifestyles;
                       •   teaching skills to resist drug and alcohol influences, solve problems, and
                           make decisions;
                       •   developing interventions to control the sale and distribution of illegal
                           drugs; and
                       •   encouraging communities to implement responses to drug and alcohol

                           Activities may be directed toward

                       •   the general population to alter social, psychological, and environmental
                           factors that may inflence the prevalence and outcomes at the community
                       •   individuals or subgroups at risk of developing substance abuse behaviors
                           to reduce risk factors6 and enhance protective factors7 related to the onset
                           of use and the progression to abuse and dependence; or

                            In our report, Drug and Alcohol Abuse: Billions Spent Annually for Treatment and Prevention
                           Activities (GAO/HEHS-97-12, Oct. 8, 1996), we noted that ONDCP estimated total budget authority of
                           $4.7 billion for fiscal year 1996, but we did not analyze the percentage that was authorized for
                           treatment compared with prevention.
                            Reducing risk factors focuses on trying to lessen the negative effect of factors that impinge on one’s
                           life that have been shown or theorized to relate to drug and alcohol use. These factors include
                           availability of drugs and alcohol, community norms favorable to drug and alcohol use, extreme
                           economic deprivation, family history of problems with use, favorable parental attitudes and
                           involvement in problem use, early and persistent antisocial behavior, academic failure, alienation and
                           rebellion, and friends who engage in problem behavior.
                            Enhancement of protective factors focuses on increasing an individual’s resilience in dealing with
                           potentially high-risk situations (such as dysfunctional families, schools, and communities).
                           Researchers in substance abuse prevention have hypothesized that more resilient individuals are less
                           likely to engage in drug use. Optimism, empathy, insight, intellectual competence, self-esteem,
                           direction or mission, and determination and perseverance are seven major factors affecting youths’
                           resilience. The coping or life skills associated with these seven factors are emotional management
                           skills, interpersonal social skills, intrapersonal reflective skills, academic and job skills, ability to
                           restore self-esteem, planning and life skills, and problem-solving ability.

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                             •   individuals who use one or more drugs but who do not yet meet diagnostic
                                 criteria for a substance abuse disorder to interrupt the progression from
                                 use to abuse, addiction, and social dysfunction.

                                 Service delivery settings may include the classroom, peer support groups,
                                 the home, and the community, or a combination of these.

Preventing Violence              Schools use a wide variety of educational and noneducational approaches
                                 and programs to address violence. Many school-based violence-prevention
                                 programs operate under the premise that violence is a learned behavior. In
                                 general, these programs focus on primary prevention; that is, they seek to
                                 prevent violence before it occurs. Although school-based violence-
                                 prevention programs and strategies vary, most fall within three broad

                             •   Educational and curricula-based programs: These programs seek to teach
                                 students the skills to manage their behavior and resolve conflict
                                 nonviolently. Examples are programs that focus on conflict resolution or
                                 gang aversion.
                             •   Environmental modification: These programs focus on either the social or
                                 physical environment. Examples include after-school recreational and
                                 academic activities and metal detectors and gates limiting access to
                                 building entrances and exits.
                             •   School organization and management: These programs focus on
                                 establishing school discipline policies and procedures governing student
                                 behavior, creating alternative schools, and developing cooperative
                                 relationships with police and other government agencies.

                                 Multiple sources currently fund a wide variety of substance-abuse
Prevention Efforts               prevention and violence-prevention programs. The federal government,
Span Many Agencies               while a major investor in prevention programs, is just one of several
and Programs                     contributors. State and local governments, as well as the private sector,
                                 also contribute to the billions spent annually on prevention efforts. The
                                 current array of prevention services, however, does not constitute an
                                 integrated approach to substance abuse and violence problems, raising
                                 questions about overlapping services and duplication created by these
                                 many programs.

Multiple Federal Programs        The federal government funds a wide array of programs to prevent
With Many Similar Services       substance abuse and violence. For youths, many of these services are

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provided through programs targeted to delinquent youths or youths
considered at risk for delinquency or drug use.8 In our 1996 report on
delinquent and at-risk youths, we identified more than 131 programs
administered by 16 federal departments and other agencies.9 At that time,
we estimated that the amount of the federal appropriations for these
programs dedicated to at-risk and delinquent youths exceeded more than
$4 billion in fiscal year 1995.

Further analysis showed that 70 of the 131 programs were authorized to
provide either substance-abuse prevention or violence-prevention services
or both to the youths they served (see app. I).10 For example, 34 of these
programs may provide both types of prevention services. The 70
prevention programs we identified are administered by 10 federal
agencies, one presidential council, and a federal foundation. The
Departments of Health and Human Services (HHS), Justice, and Education
administer 48 of these programs—nearly 70 percent of all the programs.
The fiscal year 1995 appropriations for the prevention programs for youths
in these three departments totaled about $1 billion, about 42 percent of the
total federal appropriation of about $2.4 billion for all 70 programs.11

Although we have not fully examined these multiple programs, the
implications of having multiple, unintegrated substance-abuse and
violence-prevention programs might be similar to those for employment
training programs—an area we have examined. In fiscal year 1995, we
identified 163 federal employment training programs disbursed among 15
departments and agencies. We recently concluded that consolidating these
programs could probably reduce the cost of providing job training services
because of the efficiencies achieved by eliminating duplicative

 The term “at risk” can have different meanings in different contexts. We are using the term in a broad
sense to refer to youths who, due to certain characteristics or experiences, are statistically more likely
than other youths to encounter certain problems—legal, social, financial, educational, emotional, and
health—in the future.
 At-Risk and Delinquent Youth: Multiple Federal Programs Raise Efficiency Questions
(GAO/HEHS-96-34, Mar. 6, 1996).
  Our original analysis focused on 17 types of services or activities that programs could provide to
at-risk or delinquent youths. Of those, we identified five that focused on substance-abuse prevention or
violence prevention: conflict resolution, crime/violence intervention, focused activities (activities for
preventing juvenile delinquency by offering positive, alternative ways for youths to spend their time,
such as recreation and sports), gang intervention, and substance-abuse intervention. For the analysis
presented in this testimony, we did not update information about the appropriations.
  This is a conservative estimate because it is based on information for only 61 of the 70 programs; for
the remaining 9 programs, officials were unable to estimate the portion of total appropriations that
was dedicated to youths (ages 5 through 24).

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                      administrative activities. Furthermore, consolidating similar programs
                      could improve opportunities to increase service delivery effectiveness.12

Contributions From    State, county, and local governments also help fund substance-abuse and
Nonfederal Sources    violence-prevention programs. In fiscal year 1994, they reported spending
                      $1.6 billion in addition to the $4.4 billion federal budget authority for
                      substance-abuse prevention and treatment for adults and youths. Forty
                      percent of the federal funds and 12 percent of the state, county, and local
                      funds were targeted to prevention services. Total spending by state and
                      local governments, however, probably does exceed these reported

                      Comprehensive data on private funding of substance-abuse prevention
                      activities over time are sparse. For example, the National Drug and
                      Alcoholism Treatment Unit Survey (NDATUS), which compiled private
                      contributions from various sources, focused on treatment only.14 Data on
                      private donations from foundations, however, show that the top 25
                      contributors awarded $39.4 million in grants for substance-abuse
                      treatment and prevention programs for adults and youths during 1993 and
                      1994, the latest years for which grant data were available at the time of our
                      report. The grants ranged from $306,342 to about $18.5 million. These
                      grants were provided to nonprofit organizations in the United States and
                      abroad for substance-abuse treatment and prevention programs, including
                      counseling, education, residential care facilities, halfway houses, support
                      groups, family services, community programs, and services for children of
                      drug-dependent parents. Grants were also awarded for medical research
                      on substance abuse and media projects on substance-abuse prevention.
                      Population groups receiving the largest grant amounts were alcohol or
                      drug abusers, children and youths, women and girls, economically
                      disadvantaged individuals, offenders or ex-offenders, and minorities.

                      Our previous work has identified promising approaches for both
Effectiveness of      substance-abuse prevention and violence prevention. Evaluation research
Prevention Programs   provides some information about effective program models and their

                       Department of Labor: Challenges in Ensuring Workforce Development and Worker Protection
                      (GAO/T-HEHS-97-85, Mar. 6, 1997).
                        GAO/HEHS-97-12, Oct. 8, 1996.
                       Sponsored by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Office of
                      Applied Studies, NDATUS is a census of substance-abuse treatment units in the United States and the
                      U.S. territories.

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                           outcomes. But often less information is available on the effectiveness of
                           individual programs funded at the national, state, and local levels by the
                           federal government or by sets of such programs addressing similar goals.

Promising Program Models   Research on the effectiveness of substance-abuse and violence-prevention
Identified                 programs has identified promising approaches in both areas. Our recent
                           review of the literature on the effectiveness of substance-abuse prevention
                           programs identified two promising approaches for school-age youths.15
                           The first approach—referred to as the psychosocial approach—
                           emphasizes improving individuals’ drug-resistance skills and generic
                           problem-solving/decision-making skills and modifying attitudes and norms
                           that encourage drug use. The second approach—the comprehensive
                           approach—involves the coordinated use of multiple societal institutions,
                           such as family, community, and schools, for delivering prevention
                           programs. Both approaches have reduced student drug use as well as
                           strengthened individuals’ ability to resist drugs in both short- and longer
                           term programs.16 Although other approaches, such as information
                           dissemination, affective education, and alternatives to drug use, have been
                           used in previous programs, they have not shown consistent effectiveness
                           when used individually. They have been included, however, in promising
                           comprehensive approaches to prevention.

                           In our 1995 report on school safety, we described the characteristics of
                           promising school-based violence-prevention programs.17 These
                           characteristics are (1) a comprehensive approach, (2) an early start and
                           long-term commitment, (3) strong leadership and disciplinary policies,
                           (4) staff development, (5) parental involvement, (6) interagency
                           partnerships and community linkages, and (7) a culturally sensitive and
                           developmentally appropriate approach. For example, teaching students
                           early about making positive choices and linking school-based programs to
                           community groups, such as law enforcement or service agencies, are
                           approaches used by promising programs.

                            Drug Control: Observations on Elements of the Federal Drug Control Strategy (GAO/GGD-97-42,
                           Mar. 14, 1997).
                             Some of the most notable programs include (1) the Life Skills Training Prevention Program (using a
                           psychosocial approach), which showed that 44 percent less intervention participants reported use of
                           three drugs over a specified period of time, as compared with control group participants, and (2) the
                           Midwestern Prevention Project (using a comprehensive approach), also known as Project Star or
                           I-Star, which showed a 20- to 40-percent net reduction in the use of two drugs by school-age youths
                           over a 3-year period.
                            School Safety: Promising Initiatives for Addressing School Violence (GAO/HEHS-95-106, Apr. 25,

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                             We also identified four programs that have received national recognition
                             for their innovative approach to addressing school violence: the Anaheim
                             Union School District program in California, which stresses school
                             management and order issues; the Paramount, California, program in
                             which schools use an anti-gang curriculum to reduce gang membership
                             among students who participated in the program; a Dayton, Ohio, program
                             that provides students with social skills and anger-management training;
                             and a New York City program that uses conflict-resolution and peer-
                             mediation training to reduce student fighting.

                             Preliminary evaluations of these programs concluded that they showed
                             initial signs of success because student participants’ attitudes and
                             behaviors had changed. Reported participant changes included (1) new
                             attitudes toward violence and gang membership; (2) less disruptive
                             behavior, including fewer fights; and (3) less contact with the criminal
                             justice system. For example, public health officials have regarded New
                             York City’s Resolving Conflict Creatively Program as one of the most
                             promising violence-prevention programs. Early evaluation results of this
                             program showed that teachers observed less student name calling and
                             fewer verbal put-downs by students. Teachers also agreed that the
                             mediation program has helped students take more responsibility for
                             solving their own problems.

Additional Research          While our work has identified promising approaches, more and better
Needed on Effectiveness of   evaluation research is needed on program effectiveness. For example,
Program Approaches           regardless of the early positive results of certain substance-abuse
                             prevention approaches, experts suggest that additional research is needed
                             to better identify and understand the elements of effective prevention.
                             They say substantiating early program results through further research
                             and evaluation is important to advancing promising substance-abuse
                             prevention approaches. Examples of useful initiatives for future research
                             include determining the combination of approaches that yields the most
                             significant outcome results and assessing the approaches that work best
                             for different population groups.

                             We reached similar conclusions about violence-prevention programs.
                             While the early results of violence-prevention programs proved a useful
                             starting point, a general consensus exists that the methodological rigor of
                             these studies must be improved to determine program effectiveness. To
                             improve the usefulness of future evaluations, designing stronger impact or
                             effectiveness studies should be emphasized. Design issues requiring

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                        particular attention include sampling techniques, longitudinal assessment,
                        random assignment, and collection of data on impact and outcome

                        Conducting such evaluations, according to officials we interviewed,
                        depends on obtaining grants or private funds specifically for that purpose.
                        Fortunately, some agencies have now begun funding impact evaluations to
                        study the effectiveness of specific school-based interventions. For
                        example, the Centers for Disease Control and Prevention, the National
                        Institute of Justice, and the National Institute of Mental Health awarded 26
                        grants totaling approximately $28 million for this purpose during fiscal
                        years 1993 and 1994.

Information Generally   From a decision-making standpoint, what is needed—but often not
Lacking About Overall   available—is information about the overall effectiveness of a particular
Results of Federal      program. That is, to what extent are individual programs, such as the Safe
                        and Drug-Free Schools and Communities Act of 1994 program, achieving
Programs                the expected results? Information is needed about such programs because
                        decisions about appropriate funding levels and sources are made at the
                        program level. In addition, with accurate information about the overall
                        results of the federal programs addressing similar goals, such as
                        preventing substance abuse and violence, more effective use could be
                        made of those funds. First, inefficiencies in the use of funds, such as those
                        resulting from overlapping and duplicative programs, could be reduced
                        through retargeting or combining programs. Second, policymakers could
                        better ensure that the activities funded—in this case, the individual
                        program models used—are the ones most likely to achieve program goals.

                        GPRA  can be a useful mechanism for the Congress and federal agencies to
Increasing Emphasis     improve the combined federal effort against substance abuse and violence
on Accountability and   among youths. GPRA requires agencies to ask fundamental questions about
Program Results         their missions, their goals and objectives for achieving those missions,
                        how they will measure their performance, and how they will use
                        performance measurement information to improve their efforts. It forces
                        federal agencies to shift the focus from such traditional concerns as
                        staffing and activity levels to a single, overriding issue: results.

                        Specifically, GPRA directs agencies to consult with the Congress, obtain the
                        views of other stakeholders, and clearly define their missions. It also
                        requires agencies to establish long-term strategic goals as well as annual

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performance goals linked to the strategic goals. Agencies must then
measure their performance according to their goals and report to the
President and the Congress on their success. In addition to ongoing
performance monitoring, agencies are expected to identify performance
gaps in their programs and to use information from evaluation studies to
improve programs.

GPRA  requires that federal agencies develop strategic plans covering at
least 5 years and submit them to the Congress and the Office of
Management and Budget no later than September 30, 1997. These plans
must identify the agencies’ long-term strategic goals and describe how the
agencies intend to meet these goals through their activities and resources.
The plans are expected to reflect coordination with other federal agencies
that are trying to achieve similar strategic goals or have activities or
functions similar to theirs. Beginning with fiscal year 1999, federal
agencies are to use their strategic plans to prepare annual performance
plans. These performance plans are to include annual goals linked to the
activities described in budget presentations as well as the indicators the
agency will use to measure performance according to the results-oriented
goals. Agencies are subsequently to report each year on the extent to
which they meet their goals, provide an explanation regarding any goals
they did not meet, and describe the actions needed to meet any unmet

For substance-abuse and violence-prevention programs, this shift to a
focus on results can help bridge the gap between accurate data about
effective program models and the performance of individual federal
programs. For example, current research has identified aspects of
effective substance-abuse prevention programs and characteristics of
promising approaches for violence-prevention programs. This research,
however, often consists of one-time efforts, and the extent to which these
studies influence other programs’ design and service delivery is uncertain.
GPRA, on the other hand, provides an incentive for agency and program
personnel to systematically assess what is working in their programs and
expand or replicate those practices. GPRA also provides an early warning
system for identifying goals and objectives that are not being met so that
agency and program staff can replace ineffective practices with effective

Measuring how well programs are working can present a major challenge,
however, especially when funds are distributed through block grants—as
is the case with many of the programs we identified. For example, most of

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              the dollars distributed by HHS’ SAMHSA in fiscal year 1996—including the
              $1.2 billion to states for substance-abuse prevention and treatment
              services—was distributed through block grants.18 The agency faces the
              challenge of balancing the flexibility it affords states to set priorities on
              the basis of local need with its own need to hold the states accountable for
              achieving SAMHSA’s goals. Recognizing this challenge, HHS is transforming
              its SAMHSA block grants into Performance Partnership Grants (PPG). Under
              PPGs, the states and federal governments will negotiate an arrangement
              that identifies specific objectives and performance measures regarding
              outcomes, processes, and these outcomes’ capacity to be reached in 3 to 5
              years. This appears to be a promising strategy because it gives states more
              control over their funding decisions while encouraging them to accept
              greater accountability for results.

              The federal investment in youth substance-abuse and violence-prevention
Conclusions   programs is intended to help America’s youths avoid the harmful
              consequences, to themselves and society, of substance abuse and violent
              behavior. Although some of these individual federally funded efforts have
              shown value, concern still exists about the overall efficient use of federal
              funds and the effectiveness of the services they provide. An integrated,
              coordinated federal effort is lacking. Such an effort would consider the
              substantial investment by other levels of government and the private
              sector and have clear accountability for results. Better information is
              needed about which program approaches are most effective with which
              groups of youths in preventing substance abuse and violence. We also
              need such information to better link results to overall federal funding for
              programs. GPRA is an important tool for bridging this gap between
              knowledge about individual program approaches and federal funding for
              programs because it provides the needed accountability and an incentive
              for agencies to set measurable goals for their programs and to periodically
              assess progress toward those goals.

              Mr. Chairman, this concludes my prepared statement. I would be pleased
              to respond to any questions you or members of the Subcommittee may

               Substance Abuse and Mental Health: Reauthorization Issues Facing the Substance Abuse and Mental
              Health Services Administration (GAO/T-HEHS-97-135, May 22, 1997).

              Page 11                                                                    GAO/T-HEHS-97-166
Appendix I

Federal Substance-Abuse Prevention and
Violence-Prevention Programs for Youths

Dollars in millions
                                                                      Type of prevention assistance for which funds are
                                            Estimate of federal   Substance-
                                            funding for youths    abuse
Agency and program                          during FY 1995        prevention      Violence prevention         Both
Corporation for National and Community Service (three programs)
Foster Grandparent Program                  $67.8                 X
Retired and Senior Volunteer Program        35.7                                                              X
Volunteers in Service to America            13.7                                                              X
Subtotal                                    $117.2
Department of Agriculture (four programs)
4-H Youth Development                       63.0                                  X
Education—Cooperative Extension System
Children, Youth, and Families at Risk       10.0                                  X
Initiative—Cooperative Extension System
Partnerships Against Violence Network       Not available                                                     X
Youth Conservation Corps                    3.0                                   X
Subtotal                                    $76.0
Department of Defense (two programs)
Child Development and Youth                 8.0                                                               X
Programs—“At-Risk” Youth Program
Community Outreach Pilot Program            8.0                   X
Subtotal                                    $16.0
Department of Education (five programs)
Civic Education Program                     4.5                                   X
Drug-Free Schools and                       25.0                                                              X
Communities—National Programs
Family and Community Endeavor Schools       0.0                                   X
Grant Program
Safe and Drug-Free Schools, Part A, Subpart 441.0                                                             X
1, State Grants for Drug and Violence
School Dropout Demonstration Assistance     12.0                                  X
Subtotal                                    $482.5
Department of Health and Human Services (29 programs)
Center for Substance Abuse                  2.3                   X
Prevention—Public Education/Dissemination
Community Prevention Coalitions             Not available                                                     X
Demonstration Grant Program
Community Schools Youth Services and        10.0                                                              X
Supervision Program

                                            Page 12                                                     GAO/T-HEHS-97-166
                                             Appendix I
                                             Federal Substance-Abuse Prevention and
                                             Violence-Prevention Programs for Youths

Dollars in millions
                                                                            Type of prevention assistance for which funds are
                                             Estimate of federal        Substance-
                                             funding for youths         abuse
Agency and program                           during FY 1995             prevention      Violence prevention         Both
Demonstration Grant Program for Residential 2.0                                         X
Treatment for Women and Their Children
Demonstration Partnership Program            0.0                                                                    X
Demonstration Programs for High Risk Youth 65.2                         X
Drug Abuse Prevention for Runaway and        14.5                       X
Homeless Youth
Emergency Community Services Homeless        Not available                              X
Grant Program
Family and Community Violence Prevention     5.9                                                                    X
Family Support Center and Gateway            7.3                                                                    X
Demonstration Programs
Health Care for the Homeless Program         Not available              X
Health Services for Residents of Public      9.5                                                                    X
Indian Health Service—Alcohol and            66.1                       X
Substance Abuse Programs
Indian Youth Grant Program                   0.5                                                                    X
Injury Prevention and Control Research and   22.2                                       X
State Grant Projects
Maternal and Child Health Block Grant        Not available                              X
Services Program
Maternal and Child Health Block Grant        3.4                                                                    X
Services Program—Special Projects of
Regional and National Significance
Migrant Health Centers                       Not available              X
National Institute of Alcohol Abuse and      20.3                       X
Alcoholism—Research Programs
National Institute on Drug Abuse—Research    6.0                        X
National Youth Sports Program                12.0                                                                   X
Native American Programs                     Not available                              X
Runaway and Homeless Youth                   40.5                                       X
Programs—Basic Centers
Service Grant Program for Residential        1.3                                                                    X
Treatment for Pregnant and Postpartum
Social Services Block Grant                  Not available              X

                                             Page 13                                                          GAO/T-HEHS-97-166
                                              Appendix I
                                              Federal Substance-Abuse Prevention and
                                              Violence-Prevention Programs for Youths

Dollars in millions
                                                                             Type of prevention assistance for which funds are
                                              Estimate of federal        Substance-
                                              funding for youths         abuse
Agency and program                            during FY 1995             prevention      Violence prevention         Both
Substance Abuse Prevention and Treatment      Not available              X
Block Grant
Urban Indian Health Program                   5.8                        X
Youth Initiatives/Youth Gangs                 10.5                                                                   X
Youth Risk Behavior Surveillance System       1.4                        X
Subtotal                                      $306.7
Department of Housing and Urban Development (four programs)
4-H After-School Program/Demonstration        3.5                                                                    X
Youth Apprenticeship                          0.4                                        X
Youth Development Initiative                  10.0                                                                   X
Youth Sports/Public and Indian Housing        13.9                                                                   X
Drug Elimination Program
Subtotal                                      $27.8
Department of the Interior (one program)
Indian Child Welfare Act (Title II Grants)    23.8                                       X
Subtotal                                      $23.8
Department of Justice (14 programs)
Boot Camps, Part H                            0.0                                                                    X
Children’s Justice Act Discretionary Grants   0.0                                        X
for Native American Indian Tribes
Community Outreach Program                    0.3                                                                    X
Community Relations Service Initiatives       10.0                                       X
Edward Byrne Memorial State and Local Law 28.8                                                                       X
Enforcement Assistance
Programs—Discretionary Grant
Edward Byrne Memorial State and Local Law 48.5                                                                       X
Enforcement Assistance Programs—Formula
Gang-Free Schools and                         10.0                                                                   X
Communities—Community-Based Gang
Juvenile Justice and Delinquency              70.0                                                                   X
Prevention—Allocation to States (State
Formula Grants) Part B
Juvenile Justice and Delinquency              4.0                                        X
Prevention—Juvenile Mentoring, Part G

                                              Page 14                                                          GAO/T-HEHS-97-166
                                              Appendix I
                                              Federal Substance-Abuse Prevention and
                                              Violence-Prevention Programs for Youths

Dollars in millions
                                                                             Type of prevention assistance for which funds are
                                              Estimate of federal        Substance-
                                              funding for youths         abuse
Agency and program                            during FY 1995             prevention      Violence prevention         Both
Juvenile Justice and Delinquency Prevention 25.0                                                                     X
National Programs—Discretionary Grants,
Part C
Public Education on Drug Abuse                0.7                                                                    X
Title II: Part A—Concentration of Federal     0.2                                                                    X
Title V—Incentive Grants for Local            20.0                                                                   X
Delinquency Prevention Programs
Weed and Seed Program Fund                    Not available                                                          X
Subtotal                                      $217.5
Department of Labor (one program)
Job Training Partnership Act—Job Corps        1,099.5                                                                X
Subtotal                                      $1,099.5
Department of Transportation (one program)
Youth Impaired Driving Projects               1.4                                                                    X
Subtotal                                      $1.4
Department of Treasury (one program)
Gang Resistance Education and Training        16.2                                       X
Subtotal                                      $16.2
National Foundation on the Arts and Humanities (four programs)
Promotion of the Arts—Arts for Youth          0.4                                        X
Promotion of the Arts—Arts in Education-Art   5.8                                        X
Promotion of the Arts—Expansion Arts—Arts     0.3                                        X
Education Initiative
Promotion of the Arts—State and Regional      2.7                                        X
Subtotal                                      $9.2
President’s Crime Prevention Council (one program)
President’s Crime Prevention Council          1.5                                                                    X
Subtotal                                      $1.5
Total                                         $2,395.3

                                              Page 15                                                          GAO/T-HEHS-97-166
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(104894)      Page 16                                                   GAO/T-HEHS-97-166
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