collection and monitoring of grantees; improving procedures for grants and contracts awards; and ensuring the appropriate use of funds authorized for program implementation research. GAO indicated that these improvements could reduce costs or enhance the effectiveness and efficiency of Title X.


In 2004, the Office of Grants Management and Policy, under the direction of the Assistant Secretary for Administration and Management, conducted a review of the family planning grant program pre-award activities, which include selection of instruments, development of the program announcement, solicitation of applications, review of applications, and monitoring of post-award activities (Office of Grants Management and Policy, Assistant Secretary for Administration and Management, 2004). The evaluation focused on how the program complied with HHS regulations and policies, whether the pre-award process effectively maximized competition, and whether post-award administration was adequate.

Results of the evaluation identified areas for improved compliance, such as utilizing the system more fully, improving filing of communication with grantees, and standardizing the maintenance and organization of grant files. In terms of competition, it was recommended that term limits for grant application reviewers be established, that supplemental requests across regions be reviewed to ensure objectivity, and that OPA review practices to ensure that competition is maximized. Several recommendations were also made in the area of post-award administration, including forwarding copies of site visit reports, as well as the protocols used and the documentation provided, to the grants office for inclusion in the official grant file; developing a post-award monitoring instrument to record contact with grantees; verifying and documenting that appropriate financial monitoring is conducted; and developing a mechanism to verify that organizations eligible for new or continuation grants are up to date with applicable audit requirements. Some additional recommendations outside of the main focus areas were also made, such as establishing a specific amount of time a reviewer could serve under the same program. The protocol used to conduct program reviews of grantees was identified as a best practice.


In 2005, the Research Triangle Institute (RTI) provided a review of evaluations relevant to the Title X program to assess evaluation activities, determine evaluation needs and topics, and identify approaches to guide future evaluations (RTI International, 2005a,b). After identifying

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