GAO's federal duplication report cites problems in public health

Mar 3, 2011 (CIDRAP News) – In the first of an expected annual series of reports to Congress on duplication in federal government goals and activities, the US Government Accountability Office (GAO) cites problems in three areas of public health: food safety, biodefense, and communications.

Congress passed a law last year ordering the GAO to produce annual duplication reports as a tool to help it reduce the federal deficit. The GAO said its 345-page report, issued Mar 1, isn't meant to identify all areas of overlap but singles out 34 areas where agencies, offices, or initiatives have similar missions or where government functions are fragmented across several agencies.

The report also identified 47 other areas where actions by Congress could reduce operational costs or increase revenue.

In the first section of the report the GAO repeated its longstanding view that the fragmented food safety system has led to problems with oversight and coordination, along with inefficient use of resources. It pointed out that 15 federal agencies administer at least 30 food-related laws. It acknowledged that several factors are making food safety duties more complex, including the increasing proportion of imported food, consumers eating more raw food, and an aging population that is more susceptible to foodborne illnesses.

The GAO said the 2010 nationwide egg recall highlighted the fragmentation in the nation's food safety system.

Though President Obama's Food Safety Working Group released in July 2009 a set of findings that cut across different agencies, they aren't results-oriented and don't detail the resources that are needed to achieve recommended goals, the GAO asserted. The report said that though the food safety law passed in December strengthens part of the system and expands Food and Drug Administration (FDA) authority, it doesn't address the overall federal food safety system.

As a next step, the GAO recommends that the Office of Management and Budget and food safety agencies develop a performance plan that includes results-oriented goals, performance measures, and a discussion of strategies and resources.

In the past, Congress hasn't followed through on the GAO's suggestion to form a National Academy of Sciences panel to explore options for restructuring the nation's food safety system, such as forming a single food safety agency.

The GAO said it doesn't expect reducing fragmentation in federal food safety oversight to produce significant cost savings, but it said doing so may help avoid new costs. Though reorganization might cause short-term disruptions and transition costs, it could also result in a number of nonfinancial benefits, the group said.

In its assessment of the government's biodefense efforts, the GAO echoed other expert groups in pointing out that more than two dozen presidential appointees and numerous federal agencies have some responsibility for biodefense. "However, there is no individual or entity with responsibility, authority, and accountability for overseeing the entire biodefense enterprise," the group wrote.

Multiple federal agencies have biodefense responsibilities in each of four areas: threat awareness, prevention and protection, surveillance and detection, and response and recovery, according to the GAO. In the past, it has described fragmentation in biosurveillance activities.

The agency recommended that the Homeland Security Council consider establishing a focal point to coordinate all federal biodefense activities. It added that the nation's biodefense system would benefit from strategic oversight mechanisms—such as a national coordinator and strategy—to ensure efficient, effective, and accountable results.

On another public health issue, the GAO said the Department of Health and Human Services (HHS) needs a comprehensive strategy to better integrate the nation's public health information systems to enhance situational awareness and response activities.

The GAO credited HHS for its efforts over the past 10 years to improve the ability of public health departments to electronically collect and share information, which helps with early disease detection and response operations, but it said the efforts have lacked the strategic planning needed to achieve a unified electronic situational awareness capacity, as required by the Pandemic and All-Hazards Preparedness Act of 2006.

The most recent information enhancements from HHS and its public health partners have taken place in a stove-piped fashion, focusing on specific functions, the GAO reported. Without better planning, HHS risks spending more money on more fragmented efforts without reaching its mandated goal.

Many of the GAO's comments on communications parallel the findings of its December 2010 report on establishing an electronic public health network. HHS has stated that it will incorporate a strategy into its biennial implementation plan for the National Health Security Strategy, which it expects to release in early 2011.

See also:

Mar 1 GAO report

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