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OIG: ACA Prevention Fund Grantees May Be Violating Anti-Lobbying Statutes

By Amy Lotven

Updated Story

HHS’ Office of Inspector General is asking CDC to ensure that the grantees of a community prevention program funded with health reform law money are not violating anti-lobbying statutes, saying that grantees’ quarterly reports suggest some funding may have been used for “inappropriate lobbying activities.” OIG also raises concerns that the Centers for Disease Control and Prevention may have encouraged the behavior by posting confusing guidance on its website for the Communities Putting Prevention to Work (CPPW) grantees, echoing GOP congressional concerns that grant money may have been inappropriately used for lobbying on school beverage and public smoking issues.

CDC agrees with IG of the need to clarify this issue with its grantees and is moving aggressively to do so,” a CDC spokesperson tells Inside Health Policy in an email. “The agency has already refined and reinforced its guidance with grantees in light of recent legislation from Congress, conducted new project officer training, and has undertaken a broad education of CDC leadership and program staff on the issue.”

A GOP congressional aide tells Inside Health Policy that several staffers had raised concerns about the grant funding, and says that additional congressional oversight and other activities should be expected. The report calls into question not only the $120 million in CPPW grants, but larger amounts of funding that have been distributed, the aide says. The aide also says that the report highlights government management issues that should be of concern to both parties.
The OIG says in a June 29 letter to CDC Director Thomas Frieden that the review was initiated after OIG received allegations from congressional staff concerning potentially inappropriate use of funds by the certain grantees, and specifically that grantees may be violating anti-lobbying statutes. OIG subsequently reviewed the quarterly reports from the grantees and met with officials from CDC, the CPPW program and the Office of the General Counsel. “We are concerned that some statements in those reports may reflect inappropriate lobbying activities using CPPW grant funds,” OIG writes. “Our review also indicated that this may have originated from a lack of clear guidance — or even conflicting information — from CDC to CPPW grantees concerning the anti-lobbying restrictions.”

The OIG’s letter also comes in the wake of a May 2 letter from Sen. Susan Collins (R-ME) to HHS Secretary Kathleen Sebelius requesting information on the activities reported by various CPPW grantees that indicated funding was being used for policymaking even though the use of federal funding to lobby at the state or federal level has been prohibited since 2002.

For example, the letter notes that the California Department of Public Health, which received a $2.2 million grant, reported that funds would be used to advance policy making. She also raised concerns about funding that went toward analyzing state legislative proposals that would levy taxes and remove certain beverages from middle and elementary schools.

The letter also noted that King County, Washington reported as a description of its activities the fact that County Board of Health “adopted changes to code on smoking in public places and places of employment that closed loopholes in the existing code, and passed a resolution encouraging no-smoking policies in multi-family housing…”

Collins in her letter stressed that since she is a “ strong supporter of wellness and prevention effort…I am eager to ensure that these important programs are operating within the law and that any misuses of funds are quickly addressed.” “The actual or perceived misuse of wellness and prevention funding has the potential of eroding support for these programs,” she wrote.

Collins also found it especially troubling that CDC’s official guidance to grantees appears to include an expectation that the funds should be used for prevention and wellness strategies that result in changes state and local policies and law. “If true, without express authorization by Congress, CDC would be guiding its grantees to potentially violate federal law, exposing them to hefty civil penalties for each violation,” she writes.
The OIG also found that CDC’s information — as well as non-CDC resource material posted on the CDC website — “appear to authorize, or even encourage, grantees to use grant funds for impermissible lobbying.” Furthermore, OIG says, “grantee activity reports posted online make troubling assertion that, on their face, raise the possibility that these anti-lobbying provisions were violated.”

OIG notes, however, that it is possible that the grantees were describing activities accomplished before the grants were awarded, or that were achieved by other entities or with other, non-federal funds. However, OIG, adds, the fact that the grantees are reporting favorably about the lobbying is of concern, and may indicate a faulty understanding of the funding prohibitions.

OIG calls for CDC do the following: review its guidance and other materials posted on its Web site; clarify any misleading statements about lobbying activities; train CDC employers; and provide updated and more detailed guidance to grantees on how to avoid violating anti-lobbying provisions. OIG says guidance should also inform grantees about new lobbying restrictions included in the FY 2012 HHS Appropriations bill.

The group non-partisan group Cause of Action has also cited concerns about the potentially anti-lobbying violations by the CPPW grantees. On March 16, COA wrote a letter to Attorney General Eric Holder asking him to “launch a comprehensive investigation” into the use of taxpayer money to influence public officials in favor of “anti-soda” or “anti-tobacco” policies.

In an emailed response to Inside Health Policy, Cause of Action says: “While it is a positive step for the OIG to review and clarify CDC materials, the real issue here is that it has taken Congressional attention for the OIG to do their job. If the CDC had been properly overseeing its grant awards and the use of taxpayer dollars by their grantees, there would be no need for Congress to intervene.

“In terms of accountability, is it too little too late for the funds that have already been used for lobbying purposes? Moving forward, we expect the OIG to monitor the implementation of the proposals in its June 29 letter and bring proper oversight to HHS, as taxpayers deserve a government that ensures proper use of their money,” COA adds. — Amy Lotven (alotven@iwpnews.com)

Editor’s note: This updated version includes comment from the CDC.