B-308128, Abstinence Education: Applicability of Section 317P of the Public Health Service Act, October 18, 2006

B-308128 Oct 18, 2006 Jump To VIEW DECISION DOWNLOADS RELATED PAGES GAO CONTACTS Highlights Section 317P(c)(2) of the Public Health Service Act, 42 U.S.C. 247b-17(c)(2) (2000), requires educational and prevention materials prepared and used by the Secretary of Health and Human Services (HHS) and HHS grantees, among others, to contain medically accurate information on condom effectiveness when such materials are specifically designed to address sexually transmitted diseases. Section 317P(c)(2) would apply to educational materials prepared and used by recipients of federal abstinence education grants, depending upon the substantive content of those materials. We recommend that HHS reexamine its position that section 317P(c)(2) does not apply to materials prepared and used by abstinence education grantees and adopt measures to ensure that, where applicable, abstinence education materials funded through federal abstinence education grants comply with this requirement. View Decision B-308128, Abstinence Education: Applicability of Section 317P of the Public Health Service Act, October 18, 2006 B-308128 October 18, 2006 The Honorable Michael O. Leavitt Secretary of Health and Human Services Subject: Abstinence Education: Applicability of Section 317P of the Public Health Service Act Dear Mr. Secretary: In responding to a congressional request on federal abstinence education grant programs, we identified a legal matter that requires the attention of the Department of Health and Human Services (HHS). In this regard, section 317P(c)(2) of the Public Health Service Act[1] requires certain educational materials to contain medically accurate information about condom effectiveness. HHS believes that this statute does not apply to materials prepared and used by recipients of federal abstinence education grants. As discussed below, we conclude that this requirement would apply to abstinence education materials prepared and used by federal grant recipients, depending upon the substantive content of those materials. We did not assess any particular abstinence education materials for compliance with section 317P(c)(2) and, therefore, reach no conclusions regarding statutory violations. However, in light of our conclusion, we recommend that HHS reexamine its position and adopt measures to ensure that, where applicable, abstinence education materials comply with this requirement. BACKGROUND As you know, HHS supports efforts to provide abstinence education primarily through grants to states, local communities, and private organizations under three programs. First, under section 510 of the Social Security Act,[2] HHS makes formula grants to states for the provision of abstinence education, targeting those most likely to have children out-of-wedlock. In addition, under section 1110 of the Social Security Act,[3] HHS awards community-based grants through a competitive process to public and private entities for the purpose of creating an environment that supports postponing sexual activity until marriage.[4] Grants may be used to support before and after school programs, adult and peer mentoring, and parent education groups.[5] Through the adolescent family life program established by Title XX of the Public Health Service Act,[6] HHS also makes competitive grants to public and private nonprofit organizations, including community, school, and faith-based organizations, to facilitate abstinence education. The state formula and community-based grant programs are administered by the Administration for Children and Families (ACF) within HHS and the adolescent family life program is administered by the Office of Population Affairs, which is located in the Office of the Secretary. Section 510(b)(2) of the Social Security Act defines –abstinence education— for purposes of the state formula grant program, effectively requiring grantees to meet eight criteria;[7] annual appropriations acts and program announcements have extended these criteria to the community-based and adolescent family life program grants as well.[8] Three of these criteria focus on the physical consequences of sexual activity, and one explicitly references sexually transmitted diseases. Specifically, abstinence education for which federal funds may be provided must (1) have as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity; (2) teach that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems; and (3) teach that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects.