What GAO Found
In the summer of 2020, the Office of the Assistant Secretary for Public Affairs (ASPA) within the Department of Health and Human Services (HHS) worked with procurement offices within the Food and Drug Administration (FDA) and the National Institutes of Health (NIH) to solicit proposals and make awards to two firms in support of a COVID-19 public education campaign. The primary goals of the campaign, according to award documents, were sharing information on preventing the spread of COVID-19 and increasing vaccine acceptance. ASPA officials developed and led the campaign, while FDA and NIH staff oversaw the technical aspects of the contracting process.
- FDA awarded a nearly $15 million contract in September 2020 to Atlas Research, a consulting firm The award focused primarily on developing a series of public service announcements for multiple media channels. The announcements were to feature members of the entertainment industry and public health officials.
- NIH made a $250 million award in September 2020 to Fors Marsh Group, a consulting firm, which then developed multiple messages for the public on vaccine development and COVID-19 prevention. Messages were designed for television, radio, print and social media channels. Fors Marsh Group also designed the campaign’s theme and logo, We Can Do This (see figure).
HHS’s We Can Do This Web Page
In October 2020, following congressional inquiries and negative press coverage about the campaign, the then-Secretary of Health and Human Services convened a group of public health officials to ensure the campaign was serving important public health purposes. FDA terminated the Atlas Research contract in November 2020, following the HHS internal review. Fors Marsh Group has continued to work on the campaign.
ASPA paid for the two awards and other campaign costs with COVID-19 relief funds appropriated for the Centers for Disease Control and Prevention (CDC). Specifically, CDC and ASPA entered into a $300 million interagency agreement, initially funded with $100 million from the CARES Act and $200 million from the Paycheck Protection Program and Health Care Enhancement Act. HHS budget officials reported that the department subsequently identified a more appropriate funding source, and CDC adjusted its budget accounts to use only its CARES Act funds for the $300 million interagency agreement with ASPA.
Why GAO Did This Study
In response to the COVID-19 pandemic, HHS began a national public education campaign led by ASPA. Congressional committees and the media raised questions about the focus and timing of the campaign. There were also concerns that funds meant for CDC were used to pay for the effort.
The CARES Act includes a provision for GAO to report on the federal response to the pandemic. In addition, GAO was asked to conduct a review of the award process for the COVID-19 public education campaign, as well as its source of funding.
This report describes, among other issues: ASPA, FDA, and NIH’s roles in executing the COVID-19 public education campaign, and how ASPA paid for the campaign awards.
To conduct this work, GAO reviewed and analyzed inter-agency agreements, award files, related funding documents, and the products developed for the public education campaign; federal statutes and regulations; applicable agency guidance; and agency email communications about the campaign. GAO also interviewed relevant agency officials and contractors, and received written answers to questions regarding the funding used for the campaign.
GAO provided a draft of this report to HHS for review and comment. HHS stated that it appreciated the opportunity to review the draft, and had no comments.
For more information, contact Alyssa M. Hundrup at (202) 512-7114 or firstname.lastname@example.org.
- Veteran Suicide: VA Needs Accurate Data and Comprehensive Analyses to Better Understand On-Campus Suicides
September 9, 2020The Department of Veterans Affairs’ (VA) process for identifying on-campus suicides does not include a step for ensuring the accuracy of the number of suicides identified. As a result, its numbers are inaccurate. VA’s Veterans Health Administration (VHA) first started tracking on-campus veteran suicides in October 2017, and uses the results to inform VA leadership and Congress. GAO reviewed the data and found errors in the 55 on-campus veteran suicides VHA identified for fiscal years 2018 and 2019, including 10 overcounts (deaths that should not have been reported but were) and four undercounts (deaths that should have been reported but were not). Examples of Errors on the Department of Veterans Affairs’ (VA) List of 55 On-Campus Veteran Suicides for Fiscal Years 2018 and 2019 (as of September 2019) VA has taken some steps to address on-campus veteran suicides, such as issuing guidance and staff training. However, GAO found that the analyses informing these efforts are limited. Specifically, VHA requires root cause analyses—processes to determine what can be done to prevent recurrences of incidents—for some but not all on-campus veteran suicides. According to VHA officials, only 25 percent of on-campus suicides from October 2017 to April 2019 met the criteria for a root cause analysis. does not make use of all relevant information VA collects about these deaths, such as clinical and demographic data collected through other VA suicide prevention efforts. VHA officials said they could not link the different sources of information, but GAO found that selected medical facilities could do so. Without accurate information on the number of suicides and comprehensive analyses of the underlying causes, VA does not have a full understanding of the prevalence and nature of on-campus suicides, hindering its ability to address them. VA established suicide prevention as its highest clinical priority. In recent years, there have been reports of veterans dying by suicide on VA campuses—in locations such as inpatient settings, parking lots, and on the grounds of cemeteries. GAO was asked to review veteran deaths by suicide on VA campuses. This report examines (1) VA’s process to track the number of veterans that died by suicide on VA campuses, and (2) steps VA has taken to address these types of suicides. GAO reviewed the sources of information VHA uses to identify and analyze on-campus veteran suicides, VA and VHA strategic plans and policies related to suicide prevention and reporting, and federal internal control standards. GAO also interviewed VA and VHA central office officials, and officials from three medical facilities that GAO selected because they reportedly had on-campus veteran suicides between fiscal years 2018 and 2019. GAO is making three recommendations, including that VA improve its process to accurately identify all on-campus veteran suicides and conduct more comprehensive analyses of these occurrences. VA did not concur with one of GAO’s recommendations related to conducting root cause analyses. GAO continues to believe that this recommendation is valid, as discussed in the report. For more information, contact Debra A. Draper at (202) 512-7114 or email@example.com.
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- Federal Telework: Key Practices That Can Help Ensure the Success of Telework Programs
November 18, 2020The Telework Enhancement Act of 2010 (the act) defines telework as a work flexibility arrangement under which an employee performs the duties and responsibilities of their position and other authorized activities from an approved worksite other than the location from which the employee would otherwise work. GAO previously identified key practices in telework-related literature and guidelines that federal agencies should implement in ensuring successful telework programs. These key practices may be grouped under seven categories. Program planning. Consistent with a key practice GAO identified, agencies are required to have a telework managing officer. Other key practices related to planning for a telework program include establishing measurable telework program goals, and providing funding to meet the needs of the telework program. Telework policies. Agencies can help ensure their workforces are telework ready by establishing telework policies and guidance. To ensure that teleworkers are approved on an equitable basis, agencies should establish eligibility criteria, such as suitability of tasks and employee performance. Agencies should also have telework agreements for use between teleworkers and their managers. Performance management. Agencies should ensure that the same performance standards are used to evaluate both teleworkers and nonteleworkers. Agencies should also establish guidelines to minimize adverse impacts that telework can have on nonteleworkers. Managerial support. For telework programs to be successful agencies need support from top management. They also need to address managerial resistance to telework. Training and publicizing. Telework training helps agencies ensure a common understanding of the program. The act requires agencies to provide telework training to employees eligible to telework and to managers of teleworkers. Keeping the workforce informed about the program also helps. Technology. Agencies need to make sure teleworkers have the right technology to successfully perform their duties. To that end, agencies should assess teleworker and organization technology needs, provide technical support to teleworkers, and address access and security issues. Program evaluation. Agencies should develop program evaluation tools and use such tools from the very inception of the program to identify problems or issues. Agencies can then use this information to make any needed adjustments to their programs. GAO has previously reported instances where selected agencies faced challenges implementing telework programs that aligned with key practices. For example, three of four selected agencies did not require review or document their review of ongoing telework agreements. These reviews are important to provide assurance that the agreements reflect and support their current business needs. GAO also previously reported that managers at three of four selected agencies were not required to complete telework training before approving staff’s telework agreements. The training is important to ensure managers fully understood agency telework policy and goals before approving or denying requests to telework. Telework offers benefits to federal agencies as well as to the federal workforce. These include improving recruitment and retention of employees, reducing the need for costly office space, and an opportunity to better balance work and family demands. In addition, telework is a tool that agencies can use to help accomplish their missions during periods of disruption, including during the current COVID-19 pandemic. Congress has encouraged federal agencies to expand staff participation in telework, most recently by passing the Telework Enhancement Act of 2010 (the act). The act established requirements for executive agencies’ telework policies and programs, among other things. This statement provides key practices to help ensure the success of telework programs. The statement is based on GAO’s body of work on federal telework issued from July 2003 through February 2017. GAO has recently initiated two reviews related to federal telework. One is examining the extent to which agencies have used telework during the COVID-19 pandemic, including the successes and challenges agencies experienced. The second is reviewing agencies’ telework information technology infrastructure. For more information, contact Michelle B. Rosenberg at (202) 512-6806 or firstname.lastname@example.org.
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October 19, 2021What GAO Found The Internal Revenue Service (IRS) reported that the five investments GAO reviewed met most of the performance goals set by the agency for fiscal years 2019 and 2020. Specifically, IRS reported that most of the three investments in development were within 10 percent of performance goals, a variance the Office of Management and Budget considers not to be significant. An exception was the Customer Account Data Engine (CADE) 2, a program intended to modernize tax processing, that reportedly spent about 15 percent less than budgeted for 2020. For the two investments in operations and maintenance, IRS reported that for fiscal years 2019 and 2020 one investment met all five operational performance goals established by the agency, while the other met three of five goals in fiscal year 2019 and four of five in fiscal year 2020. While CADE 2 had lower reported costs than expected for 2020 and was within 10 percent of schedule goals for 2019 and 2020, its longer term performance and outlook are troubling. IRS began developing CADE 2 in 2009 to replace its 60-year-old Individual Master File (IMF)—IRS’s authoritative data source for individual tax account data. Since 2009, IRS has revised the program’s cost, schedule, and scope goals on numerous occasions, including seven times between 2016 and 2019. Accordingly, a key major program milestone for replacing selected IMF functions, known as transition state 2, has slipped 9 years—from 2014 to 2023. Further, CADE 2 is now expected to replace core functions of IMF, rather than the entire system. The CADE 2 delays and IRS’s continued use of IMF are troubling given, that IMF (1) is one of the oldest systems in the federal government; (2) has software written in an archaic language that IRS stated is no longer taught in school; and (3) is supported by a workforce with specialized skills that are increasingly harder to find. In June 2021, IRS reported that it planned to replace and fully retire IMF by 2030. Accordingly, IRS will continue to face IMF challenges for several more years. For its agency-wide modernization plan, IRS reported completing most of its activities intended for fiscal years 2019 and 2020 within cost and on or ahead of schedule. The updated plan identified 59 activities for completion in fiscal years 2019 and 2020. IRS reported that, by the end of fiscal year 2020, it had completed 54 of the 59 activities early or on schedule and the remaining five activities 3 to 7 months later than initially planned. Regarding cost, IRS reported that it spent $9 million less than the $300 million planned for fiscal year 2019 and $19.9 million less than the $271 million planned for fiscal year 2020. To respond to the pandemic, IRS took a number of information technology (IT)-related actions to maximize telework capabilities for its employees, including deploying IT equipment, such as laptops, and upgrading its network infrastructure bandwidth. For fiscal year 2020, IRS spent $104 million for these actions from emergency appropriations included in pandemic-related legislation. According to IRS officials, the long-term impact of sustaining an increased level of telework on the budget had not been determined. In contrast, IRS said the actions to maximize telework capabilities delayed plans for IT modernization and operations. 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GAO’s specific objectives were to (1) summarize IRS’s reported performance for selected IT investments, including CADE 2; (2) identify IRS’s reported progress in implementing its 2019 IT modernization plan; and (3) identify the IT-related actions IRS has taken to maximize telework and operate during the COVID-19 pandemic, and any impacts of those actions. GAO obtained IRS’s reported performance information for a nonprobability sample of five investments, and compared performance to agency targets. GAO also compared modernization activities that IRS reported completing to those identified in the agency’s 2019 IT modernization plan. Further, GAO reviewed agency documentation to identify reported IT actions taken to continue to operate during the pandemic and reported associated impacts. GAO also interviewed cognizant IRS officials. For more information, contact David B. Hinchman at (214) 777-5719 or email@example.com.
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