Background

Our work has repeatedly shown that mission fragmentation and program  overlap are widespread in the federal government. In 1998 and 1999, we  found that this situation existed in 12 federal mission areas, ranging from  agriculture to natural resources and environment. We also identified, in  1998 and 1999, 8 new areas of program overlap, including 50 programs for  the homeless that were administered by 8 federal agencies. These  programs provided services for the homeless that appeared to be similar.   For example, 23 programs operated by 4 agencies offered housing services,  and 26 programs administered by 6 agencies offered food and nutrition  services. Although our work indicates that the potential for inefficiency  and waste exists, it also shows areas where the intentional participation by  multiple agencies may be a reasonable response to a complex public  problem. In either situation, implementation of federal crosscutting  programs is often characterized by numerous individual agency efforts that  are implemented with little apparent regard for the presence of efforts of  related activities.
In our past work, we have offered several possible approaches for better  managing crosscutting programs—such as improved coordination,  integration, and consolidation—to ensure that crosscutting goals are  consistent; program efforts are mutually reinforcing; and, where  appropriate, common or complementary performance measures are used  as a basis for management. One of our oft-cited proposals is to consolidate  the fragmented federal system to ensure the safety and quality of food.
Perhaps most important, however, we have stated that the Results Act  could provide the Office of Management and Budget (OMB), agencies, and  Congress with a structured framework for addressing crosscutting  program efforts.  OMB, for example, could use the governmentwide  performance plan, which is a key component of this framework, to  integrate expected agency-level performance. It could also be used to more  clearly relate and address the contributions of alternative federal  strategies. Agencies, in turn, could use the annual performance planning  cycle and subsequent annual performance reports to highlight crosscutting  program efforts and to provide evidence of the coordination of those  efforts.
OMB guidance to agencies on the Results Act states that, at a minimum, an  agency’s annual plan should identify those programs or activities that are  being undertaken with other agencies to achieve a common purpose or  objective, that is, interagency and cross-cutting programs. This  identification need cover only programs and activities that represent a  significant agency effort.  An agency should also review the fiscal year 2003  performance plans of other agencies participating with it in a crosscutting  program or activity to ensure that related performance goals and indicators  for a crosscutting program are consistent and harmonious. As appropriate,  agencies should modify performance goals to bring about greater synergy  and interagency support in achieving mutual goals.
In April 2002, as part of its spring budget planning guidance to agencies for  preparing the President’s fiscal year 2004 budget request, OMB stated that  it is working to develop uniform evaluation metrics, or “common  measures” for programs with similar goals.  OMB asked agencies to work  with OMB staff to develop evaluation metrics for several major  crosscutting, governmentwide functions as part of their September budget  submissions.  According to OMB, such measures can help raise important  questions and help inform decisions about how to direct funding and how  to improve performance in specific programs.  OMB’s common measures  initiative initially focused on the following crosscutting program areas:  job training and employment,  health.
We recently reported that one of the purposes of the Reports Consolidation  Act of 2000 is to improve the quality of agency financial and performance  data.  We found that only 5 of the 24 CFO Act agencies’ fiscal year 2000  performance reports included assessments of the completeness and  reliability of their performance data in their transmittal letters.  The other  19 agencies discussed, at least to some degree, the quality of their  performance data elsewhere in their performance reports.

	Scope and Methodology

To address these objectives, we first defined the scope of each crosscutting  program area as follows:  Drug control focuses on major federal efforts to control the supply of  illegal drugs through interdiction and seizure, eradication, and arrests.
Family poverty focuses on major federal efforts to address the needs of  families in poverty through programs aimed at enhancing family  independence and well-being.  We focused on agencies that provide key  support and transition tools associated with the income, health, and  food support and assistance to poor families.
Financial institution regulation focuses on major federal efforts to  supervise and regulate depository institutions.  Supervision involves  monitoring, inspecting, and examining depository institutions to assess  their condition and their compliance with relevant laws and regulations.   Regulation of depository institutions involves making and issuing  specific regulations and guidelines governing the structure and conduct  of banking.
Public health systems focuses on major federal efforts to prevent and  control infectious diseases within the United States.
To identify the agencies involved in each area we relied on our previous  work and confirmed the agencies involved by reviewing the fiscal year 2001  Results Act performance report and fiscal year 2003 Results Act  performance plans for each agency identified as contributing to the  crosscutting program area.  To address the remaining objectives, we  reviewed the fiscal year 2001 performance reports and fiscal year 2003  performance plans and used criteria contained in the Reports  Consolidation Act of 2000 and OMB guidance.  The act requires that an  agency’s performance report include a transmittal letter from the agency  head containing, in addition to any other content, an assessment of the  completeness and reliability of the performance and financial data used in  the report. It also requires that the assessment describe any material  inadequacies in the completeness and reliability of the data and the actions  the agency can take and is taking to resolve such inadequacies.
OMB guidance states that agency annual plans should include a description  of how the agency intends to verify and validate the measured values of  actual performance. The means used should be sufficiently credible and  specific to support the general accuracy and reliability of the performance  information that is recorded, collected, and reported.
We did not include any changes or modifications the agencies may have  made to the reports or plans after they were issued, except in cases in  which agency comments provided information from a published update to  a report or plan.  Furthermore, because of the scope and timing of this  review, information on the progress agencies may have made in addressing  their management challenges during fiscal year 2002 was not yet available.
We did not independently verify or assess the information we obtained  from agency performance reports and plans.  Also, that an agency chose  not to discuss its efforts to coordinate in these crosscutting areas in its  performance reports or plans does not necessarily mean that the agency is  not coordinating with the appropriate agencies.
We conducted our review from September through November 2002, in  accordance with generally accepted government auditing standards.

	Agencies Involved in Crosscutting Areas Show Opportunities for Coordination

As shown in table 1, multiple agencies are involved in each of the  crosscutting program areas we reviewed.
The discussion of the crosscutting areas below summarizes detailed  information contained in the tables that appear in appendixes I through IV.

	Drug Control

Fourteen million Americans use illegal drugs regularly, and drug-related  illness, death, and crime cost the nation approximately $110 billion  annually. From 1990 through 1997, there were more than 100,000 drug- induced deaths in the United States.  Despite U.S. and Colombian efforts,  the illegal narcotics threat from Colombia continues to grow and become  more complex. From 1995 through 1999, coca cultivation and cocaine  production in Colombia more than doubled and Colombia became a major  supplier of the heroin consumed in the United States. Moreover, over time,  the drug threat has become more difficult to address.  ONDCP was  established by the Anti-Drug Abuse Act of 1988 to set policies, priorities,  and objectives for the nation's drug control program.  The Director of  ONDCP is charged with producing the National Drug Control Strategy,  which directs the nation's antidrug efforts and establishes a budget and  guidelines for cooperation among federal, state, and local entities.   ONDCP’s 2001 Annual Report discussed two strategic goals that pertain to  controlling the supply of drugs that enter the United States, including   (1) “shielding U.S. borders from the drug threat” and (2) “reducing the  supply of illegal drugs.”  ONDCP reported two performance goals under the  strategic goals—reduce the rate of illicit drug flow through transit zones  and reduce the shipment rate of illicit drugs from arrival zones and supply  zones.
For fiscal year 2001, all the agencies we reviewed—Justice, State,  Transportation, and Treasury—discussed coordination with other agencies  in the area of drug control, although the level of detail varied.  For example,  Transportation stated that the Coast Guard worked with ONDCP and  Customs to finalize an interagency study of the deterrent effect that  interdiction has on drug trafficking organizations.  Also, Justice reported  that it collaborated with Transportation to prosecute cases that relate to  maritime drug smuggling.  In contrast, State identified the lead and partner  agencies it coordinated with to accomplish its goals, but it did not discuss  specific coordination efforts.  None of the agencies distinguished between  coordination efforts that occurred in fiscal year 2001 and those that were  planned for fiscal year 2003.
None of the agencies reported having met all of their goals and measures  relating to drug control in fiscal year 2001.  Customs reported that it met  eight of its nine measures for seizures of cocaine, marijuana, and heroin.   Customs reported that it did not meet its target for number of marijuana  seizures.  State reported that it met the targets for its goal of increasing  foreign governments’ effectiveness in dissolving major drug trafficking  organizations and prosecuting and convicting major traffickers.  For the  other goal—increasing foreign governments’ effectiveness in reducing the  cultivation of coca, opium poppy, and marijuana—State did not meet two  of its four targets.  For its two measures, Transportation reported that it did  not establish a target for one, the amount of drugs that are seized or  destroyed at sea, and it did not meet its target for the other, the seizure rate  for cocaine that is shipped through the transit zone.  Justice reported that it  exceeded the target for one measure—number of priority drug trafficking  organizations dismantled or disrupted by the Drug Enforcement  Administration (DEA)—and did not meet one of two targets for the second  measure—the number of drug trafficking organizations dismantled by the  Federal Bureau of Investigation (FBI).
The four agencies we reviewed—Justice, State, Transportation, and  Treasury—provided explanations for not meeting their fiscal year 2001  goals that appeared reasonable.  For example, Customs which is under  Treasury stated that although it did not meet its target for the number of  marijuana seizures, it seized more pounds of marijuana in fiscal year 2001  than in any other year.  Customs stated that it believes that the number of  seizures dropped because of an overall increase in sizes of marijuana loads.   Furthermore, it stated that the heightened state of alert on the border  following the events of September 11, 2001, might have deterred the  entrance into the country of hundreds of smaller, personal-sized loads.   However, none of the agencies discussed strategies for achieving the unmet  goals and measures in the future.
According to their fiscal year 2003 performance plans, the agencies we  reviewed expected to make progress on goals similar to those established  for fiscal year 2001.  All of Treasury’s performance targets were adjusted to  reflect higher anticipated levels of performance.  Justice and State  reflected a mixture of higher and lower anticipated levels of performance.   Although its goals remained the same, Transportation had measures that  differed from those reported in fiscal year 2001.  Justice and Transportation  provided strategies that appear reasonably linked to achieving their goals  for fiscal year 2003.  For the goal of reducing the supply and use of drugs in  the United States, Justice stated that the nine Organized Crime Drug  Enforcement Task Force (OCDETF) teams would coordinate to develop a  national priority target list of the most significant drug and money  laundering organizations.  As drug organizations are dismantled and more  organizations are identified, the OCDETF teams will monitor their progress  and modify the target list.  To achieve its target for the amount of drugs  seized or destroyed at sea—Transportation stated that the Coast Guard will  (1) operate along maritime routes to deter attempts to smuggle drugs and  (2) finalize an interagency study that focuses on the deterrent impact that  interdiction has on drug trafficking organizations.  Customs did not discuss  any strategies for achieving its fiscal year 2003 goals.  State provided only  general statements about how it planned to achieve its fiscal year 2003  goals.
Justice, Transportation, and Treasury each commented on the overall  quality and reliability of its data.  For example, in its combined report and  plan, Justice states that to ensure that data contained in this document are  reliable, each reporting component was surveyed to ensure that the data  reported met the OMB standard for data reliability.  Data that did not meet  this standard were not included in the report and plan.  These agencies also  discussed the quality of specific performance data in their fiscal year 2001  performance reports to various degrees.  In its fiscal year 2001  performance report, Justice provided a discussion of data verification and  validation for each performance measure.  For example, for the measure of  drug trafficking organizations dismantled by the FBI, an FBI field manager  reviewed and approved data that were entered into the system and the data  were verified through the FBI’s inspection process.  Transportation  reported that it used data entry software to ensure data quality and  consistency by employing selection lists and logic checks.  Also,  Transportation stated that internal analysis and review of published data by  external parties helps identify errors.  Furthermore, Customs reported on  the completeness, reliability, and credibility of its performance data by  discussing how it verifies the data for each performance measure.  State  did not report on the completeness, reliability, and credibility of its  performance data.
While Justice, Transportation, and Treasury acknowledged shortcomings in  their performance data, they did not report steps to resolve or minimize  these shortcomings.  Justice reported one shortcoming which was the need  to improve its reporting system for one measure—number of priority drug  trafficking organizations dismantled or disrupted by DEA.  Transportation  stated that although data verification and validation occurs several times in  the data reporting process, a potential limitation to the accuracy of its data  could stem from data duplication and coding errors.  Customs reported  that while its data could be considered reliable, the data could be subject to  input errors or duplicative reporting not identified by reviewers.  State did  not report on shortcomings in its performance data.

	Family Poverty

Federal government agencies have major programs aimed at supporting  families classified as poor.  For example, HHS’s Temporary Assistance for  Needy Families (TANF) program makes $16.8 billion in federal funds  available to states each year. While TANF delegates wide discretion to the  states to design and implement the program, it does specify four broad  program goals that focus on children and families:  providing assistance to needy families so that children may be cared for  in their own homes or in the homes of relatives;  ending the dependence of needy parents on government benefits by  promoting job preparation, work, and marriage;  preventing and reducing the incidence of out-of-wedlock pregnancies;   encouraging the formation and maintenance of two-parent families.
In addition, Agriculture’s Food Stamp Program helps low-income  individuals and families obtain a more nutritious diet by supplementing  their incomes with food stamp benefits. Agriculture’s Food and Nutrition  Service and the states jointly implement the Food Stamp Program, which  provided about $15 billion in benefits to over 17 million low-income  individuals in the United States during fiscal year 2000.  In 1998, Congress  passed the Workforce Investment Act (WIA) to consolidate services of  many employment and training programs, mandating that states and  localities use a centralized service delivery structure—the one-stop center  system—to provide most federally funded employment and training  assistance.  We previously reported that several challenges, including  program differences between TANF and WIA and different information  systems used by welfare and workforce agencies, inhibit state and local  coordination efforts.  For example, different program definitions, such as  what constitutes work, as well as complex reporting requirements under  TANF and WIA hamper state and local coordination efforts. Though some  states and localities have found creative ways to work around these issues,  the differences remain barriers to coordination for many others. For  example, antiquated welfare and workforce information systems are often  not equipped to share data with each other, and as a result, sometimes one- stop center staff members have to enter the same client data into two  separate systems. Although HHS and Labor have each provided some  assistance to the states on how to coordinate services, available guidance  has not specifically addressed the challenges that many continue to face.   Moreover, HHS and Labor have not addressed differences in program  definitions and reporting requirements under TANF and WIA.  To address  the obstacles to coordination, we recommended that HHS and Labor work  together to develop ways to jointly disseminate information on how some  states and localities have taken advantage of the flexibility afforded to  them under TANF and WIA to pursue coordination strategies to address  some of these obstacles to coordination. We also recommended that HHS  and Labor, either individually or jointly, promote research that would  examine the role of coordinated service delivery on outcomes of TANF  clients.
The agencies we reviewed generally discussed in their performance reports  and plans their efforts to coordinate with other federal agencies on  programs that address family poverty.  Three major interagency task forces  bring all of the agencies we reviewed, plus others, together to coordinate  on such programs: (1) the Interagency Council on the Homeless, which  includes such federal entities as HUD, HHS, Agriculture, Commerce,  Education, Energy, Justice, Labor, Defense, Transportation, Veterans  Affairs, the Social Security Administration, the Federal Emergency  Management Agency, the General Services Administration, and the U.S.  Postal Service, (2) OMB’s Workforce Investment Act Committee, which  includes HUD, Labor, HHS, and Education, to address the nation’s  employment issues, and (3) the Workforce Excellence Network, which  comprises Education, HHS, and Labor, conducts two major national  conferences each year, in which Labor is able to “showcase” its best WIA  programs.  In addition, three of the five agencies we reviewed identified  individual coordination efforts outside these task forces and specified the  programs on which they coordinated.  For example, HHS’s ACF reported  that it works with Labor in Welfare-to-Work (WtW) and WIA efforts,  Transportation in their Access to Jobs program, Education in providing  education and training services, and HUD in providing housing assistance.   Agriculture and HHS’s CMS stated that they coordinated with other  agencies, but did not specify the agencies or the types of coordination  efforts.
The agencies we reviewed reported varied progress in achieving their fiscal  year 2001 goals and measures.  For example, CMS reported meeting two  goals, partially meeting one goal, and not meeting a fourth goal related to  family poverty.  For its goal of promoting self-sufficiency and asset  development, HUD reported meeting the targets for seven of its  performance indicators, missing or expecting to miss six targets, not  having enough data for one target, and establishing baselines for 4 of its 18  performance indicators.  Incomplete data prevented Agriculture, ACF, and  HUD from reporting on all of their measures.  For example, ACF was  unable to report on its progress for 18 of its 23 performance indicators  related to three of its goals linked to family poverty due to the time lag in  receiving and validating data from states, localities, and other program  partners.  However, ACF was able to report that it fell short in achieving its  targets for the 5 performance indicators related to two of its goals:  improving the quality of child care and the Head Start Health Status  program.
All of the agencies provided explanations that appeared reasonable for not  meeting their goals. For example, ACF reported that two factors  contributed to its failure to meet two of the three targets for its goal of  improving Head Start Health Status: (1) a high student turnover rate  hindered the students’ receipt of health care despite Head Start’s medical  referrals and (2) Medicaid’s inability to cover dental and mental health  treatment for Head Start students prevented them from receiving proper  care.  In addition, these agencies generally provided strategies that  appeared reasonably linked to achieving the unmet goals in the future.  For  example, Labor outlined strategies to address its two unmet goals relating  to higher wages for and retention of WtW participants in the workforce and  increasing the number of child care apprenticeship programs and  apprentices.  Specifically, Labor proposed making retention of WtW  participants more attractive by increasing grantees’ use of tax credits and  continuing the Pathways to Advancement pilot project, which subsidizes  employers, upgrades and advances current TANF “alumni,” and validates  data at the program level, among other strategies.
For their fiscal year 2003 plan, the agencies we reviewed generally set goals  similar to those established for fiscal year 2001, but increased the targets to  reflect anticipated higher levels of performance.  The exception to this  consistency was HUD, which reported that the draft of its updated strategic  plan for fiscal years 2000 through 2006 affected the fiscal year 2003  performance plan framework.  The new framework introduced eight  strategic goals, two of which addressed family poverty.  Objectives  included helping families in public and assisted housing make progress  toward self-sufficiency and become homeowners, ending chronic  homelessness in 10 years, and helping homeless individuals and families  move to permanent housing.  Four of the five agencies we reviewed— Agriculture, ACF, HUD, and Labor—provided reasonable strategies for  achieving at least one of their fiscal year 2003 goals related to family  poverty.  For example, Labor lists departmentwide means and strategies for  meeting all of its goals, most of which are to continue or improve  preexisting efforts.  Following the list, Labor describes eight significant  new or enhanced efforts in fiscal year 2003.  For its goal of having states  develop a baseline and methodology for measuring the immunization of 2- year-old children under Medicaid, CMS discusses time frames for the  development of each state’s baseline measure and reporting methodology,  but it does not describe specific strategies for how it intends to achieve its  targets for this area.
All of the agencies we reviewed addressed data quality issues in some form,  although the degree to which such issues were addressed varied.  Three of  the five agencies—Agriculture, HUD, and Labor—included a broad  statement at the beginning or end of their reports or plans stating that the  reported data were generally reliable.  Because all of the agencies we  reviewed rely on data from the states and other grantees to report on  performance for at least one of their goals, they reported on the difficulty  of obtaining quality data in a timely manner.  However, all of the agencies  reported that they have methods for reviewing the performance data for  consistency and completeness.  For example, CMS stated that it had built- in quality assurance checks, technical consultants, and a review of data by  CMS personnel.   In addition, the agencies generally acknowledged  shortcomings in the data and discussed steps they were taking to resolve or  minimize the shortcomings.  For example, HUD reported that it is  discontinuing or updating the 18 performance indicators we reviewed in its  fiscal year 2001 report because of its inability to address data reliability  issues and because the connection between the indicators and the outcome  measure was unknown, among other reasons.  For the estimated data, HUD  stated that accurate numbers would be reported in its fiscal year 2002  performance report if adjustments were necessary.

	Financial Institution Regulation

Financial regulation of depository institutions in the United States is a  highly complex system.  Federal responsibilities for regulation and  supervision are assigned to five federal regulators: FDIC, the Board of  Governors of the Federal Reserve System, NCUA, OCC, and OTS.  FDIC  is the primary federal regulator and supervisor for federally insured state- chartered banks that are not members of the Federal Reserve System and  for state savings banks whose deposits are federally insured.  The Board is  the federal regulator and supervisor for bank-holding companies and is the  primary federal regulator for state-chartered banks that are members of the  Federal Reserve System.  OCC is the primary regulator of federally  chartered banks or national banks.  OTS is the primary regulator of all  federal and state-chartered thrifts whose deposits are federally insured and  their holding companies.  NCUA is the primary federal regulator for credit  unions.
A primary objective of federal depository institution regulators is to ensure  the safe and sound practices and operations of individual depository  institutions through regulation and supervision.  Regulation of depository  institutions involves making and issuing specific regulations and guidelines  governing the structure and conduct of banking.   Supervision involves the  monitoring, inspecting, and examining of depository institutions to assess  their condition and their compliance with relevant laws and regulations.   Each federal depository regulator is responsible for its respective  institutions; for example, the Board examines and regulates state member  banks and OCC examines and regulates national banks.
Although the Board, FDIC, OCC, OTS, and NCUA are responsible for  specific depository institutions, all of the agencies have similar oversight  responsibilities for developing and implementing regulations, conducting  examinations and off-site monitoring, and taking enforcement actions for  those institutions that are under their respective purview.  To ensure that  depository institutions are receiving consistent treatment in examinations,  enforcement actions, and regulatory decisions, coordination among the  regulators is essential.  In 1979, Congress established the Federal Financial  Institutions Examination Council (FFIEC) to promote uniformity in the  supervision of depository institutions by the Board, FDIC, NCUA, OCC, and  OTS.  It is a formal interagency body empowered to prescribe uniform  principles, standards, and report forms for the federal examination of  financial institutions and to make recommendations to promote uniformity  in the supervision of financial institutions.
Generally, the performance reports and plans of the federal depository  institutions regulators discussed possible coordination on crosscutting  goals.  The performance reports and plans of FDIC, OCC, and OTS  described the types of coordination that they conduct with the other  regulators.  The Board’s 2002-2003 plan includes a section on interagency  coordination of crosscutting issues.  For instance, the section of the plan  entitled, “Interagency Coordination of Crosscutting Issues” stated that the  Board formally coordinates with other federal depository institutions  regulators through the FFIEC and its participation with the Results Act  Financial Institutions Regulatory Working Group, a coordinating  committee of the depository institution regulators to address and report on  issues of mutual concern.  The performance report and plan of NCUA did  not include any discussion of coordination efforts with the other federal  depository institution regulators.
In 2001 and 2002, the federal depository institution regulators jointly issued  guidance or regulations on a number of occasions.  For example, the  regulators often jointly issue guidance in areas such as the risks of  brokered and other rate-sensitive deposits, temporary balance sheet  growth, clarification on the accounting and reporting for loans held for  sale, and consumer privacy.  In addition, earlier this year, the federal  depository institution regulators jointly issued proposed regulations to  implement section 326 of the USA Patriot Act on customer identification.   In 2001, they jointly issued guidelines on safeguarding confidential  customer information.
On the basis of their fiscal year 2001 performance reports, all the federal  depository institution regulators reported they made progress in achieving  their fiscal year 2001 goals for the supervision and regulation function.  The  Board, FDIC, and OCC each reported meeting all of their goals except for  one related to the examinations of depository institutions that were due for  a safety and soundness examination in 2001.  However, each of the three  agencies provided a reasonable explanation for not achieving the goal.    FDIC was unable to examine 11 banks that were scheduled for an  examination for the following reasons:  some institutions merged or  converted their charters, some institutions moved into or changed their  capital categories requiring a change in examination intervals, and one  institution converted its information system.  The Board did not meet its  goal because it failed to complete 17 bank examinations, as required by  statute and on the basis of their financial condition in 2001, but the Board  provided an appropriate reason for the delay—scheduling problems with  state bank regulatory agencies.  The Board reported that it is implementing  a new scheduling system that will partially resolve these problems.  NCUA  reported it generally met its performance goals, although out of its four  strategic goals, it missed one out of five outcome goals for two and was  unable to report on most of the outcome goals for another. OTS reported  meeting all of its goals.
On the basis of their fiscal year 2003 performance plans, three of the five  federal depository institution regulators designed strategies to achieve  their performance goals that appear to be reasonable.  Similar to the fiscal  year 2001 performance reports, the performance goals focused on the  scheduling of examinations under specific time frames, enforcement  actions, and reviewing compliance with consumer protection statutes  relating to consumer financial transactions.  The Board’s performance plan  outlined strategies that appeared reasonably linked to achieving its goals  and objectives for promoting a safe, sound, competitive, and accessible  banking system.  For example, the Board’s plan proposed focusing on the  areas of highest risk, promoting sound risk management practices,  understanding and accommodating the effects of financial innovation and  technology, improving international banking and supervisory practices, and  refining and strengthening the foreign bank organizations program, among  other strategies.  The FDIC performance plan included a strategy for  achieving its planned performance goals that also appeared reasonable.   For example, FDIC plans to analyze examination-related data collected in  the System of Uniform Reporting of Compliance and Community  Reinvestment Act (CRA) Examination to determine whether it achieved  targeted performance levels during the reporting period.  In its  performance plan, OCC discussed strategies for each of its strategic goals.   OTS discussed general strategies, which were not clearly linked to  particular performance goals.
Of the five regulators, only the performance reports of OCC and OTS  commented on the completeness, reliability, and credibility of the data for  the supervision and regulation function.  OCC’s performance report for  fiscal year 2001 concluded the data were accurate for some of the  performance measurements used in the report.  In its fiscal year 2001  performance report, OTS concluded that the data for its performance  measures met standards for accuracy and auditability.  The performance  reports issued by the Board, FDIC, and NCUA did not discuss whether the  performance data for the supervision and regulation areas used in the  reports were complete, reliable, and credible.  None of their performance  reports commented on the potential shortcomings of these data.

	Public Health Systems

Broadly speaking, federal involvement in the area of public health systems  encompasses a mix of efforts to maintain the health of a diverse  population, such as directly providing health services, regulating  prescription drugs, or paying for medical services provided to the aged and  the needy.  In this report, we focused one aspect of the public health  system—federal efforts to prevent and control infectious diseases within  the United States.  The spread of infectious diseases is a public health  problem once thought to be largely under control. However, outbreaks over  the last decade illustrate that infectious diseases remain a serious public  health threat.  For example, foodborne disease in the United States  annually causes an estimated 76 million illnesses, 325,000 hospitalizations,  and about 5,000 deaths, according to the Centers for Disease Control and  Prevention (CDC).  The resurgence of some infectious diseases is  particularly alarming because previously effective forms of control are  breaking down. For example, some pathogens (disease-causing organisms)  have become resistant to antibiotics used to bring them under control or  have developed strains that no longer respond to the antibiotics.  The need  for concerted efforts to prevent such diseases is critical to reducing this  threat to the public.  We have previously reported on various aspects of  protecting public health, such as ensuring the vaccination of children  through the Vaccines for Children program and limitations in several of  CDC’s foodborne disease surveillance systems.
Agriculture and each of the five components of HHS we reviewed—CDC,  CMS, FDA, HRSA, and NIH—discussed in their performance reports and  performance plans coordination efforts with other agencies related to  preventing infectious diseases.  For example, CDC reported that it  coordinated with (1) Agriculture and FDA on its food safety programs,  (2) HRSA, CMS, FDA, and NIH, among others, on its immunization  objectives, and (3) NIH and FDA on the development of new diagnostic and  treatment tools and better vaccines for tuberculosis.  Also, Agriculture  reported that it coordinated with HHS and the Environmental Protection  Agency regarding the goal to protect the public health by reducing the  incidence of foodborne illnesses.  However, none of the agencies discussed  specific details about the coordination.
According to its combined fiscal year 2001 performance report and fiscal  year 2003 performance plan, NIH was the only agency that reported  achieving its public health systems goal—to develop new or improved  approaches for preventing or delaying the onset or progression of disease  and disability.  Agriculture, FDA, and CDC each reported missing some of  its performance targets.  In addition, CDC, CMS, and HRSA lacked data to  report on some or all of their performance goals for fiscal year 2001.  For  example, HRSA indicated that the performance data for its goal—increase  the proportion of the national AIDS education and training center (AETC)  interventions provided to minority health care providers—will not be  collected until February 2003.   Three agencies—CDC, FDA, and  Agriculture—provided explanations for not meeting a measure or goal that  appeared reasonable.  For example, FDA reported that it missed its  target—inspect 90 percent of high-risk domestic food establishments each  year—because the agency purposefully diverted resources for these  inspections to focus on the even greater threat of bovine spongiform  encephalopathy that was breaking out in Europe at the time.  None of these  agencies discussed strategies to achieve the unmet goals in the future.
For fiscal year 2003, HHS’s CDC, CMS, FDA, and HRSA, and Agriculture,  reported they expect to make progress on goals that were generally the  same as those they reported on in fiscal year 2001.  NIH developed two new  subgoals for its goal of developing new or improved approaches to  preventing or delaying the onset or progression of disease and disability,  but did not indicate targets for the new goals.  CDC developed a new goal  of conducting research to identify and assess community-based prevention  interventions.  HRSA plans to drop one of its goals—“increase the number  of minority health care and social service providers who receive training in  AETCs”—because measuring the percentage of training interventions  provided to minority health providers was determined to be a more  accurate and appropriate method to measure the program’s progress in  training health care providers.  CMS and HRSA reported that they expected  to achieve higher levels of performance for all of their targets.  CDC, FDA,  and Agriculture planned for a mixture of higher and lower levels of  performance in fiscal year 2003.
Agriculture and three of the five HHS components we reviewed discussed  strategies that appeared reasonably linked to achieving their fiscal year  2003 goals.  For example, Agriculture reported that its performance goal— create a coordinated national and international food safety risk  management system to ensure safety of U.S. meat and poultry—has a set of  specifically outlined strategies to follow in order to accomplish the goal,  including (1) develop national performance standards for ready-to-eat meat  and poultry items, (2) ensure food safety requirements are followed by  monitoring slaughter and process plants, and (3) increase reviews of  foreign inspection systems to ensure the safety of imported meat, poultry,  and egg products.  In contrast, NIH and HRSA did not discuss strategies for  achieving their fiscal year 2003 goals.
Agriculture and NIH commented on the overall quality and reliability of the  performance data in their fiscal year 2001 performance reports.  For  example, NIH progress toward meetings its goals was assessed by its GPRA  Assessment Working Group, which reviewed the performance data.  In  addition, CDC, CMS, and Agriculture discussed aspects of data quality for  each of their performance measures.   For example, CDC’s combined report  and plan addresses data verification and validation for each data source  corresponding to each goal.  FDA and HRSA discussed narrow aspects of  data quality for certain measures.
FDA and HRSA acknowledged shortcomings in their performance data and  reported steps to resolve or minimize those shortcomings.  For example,  FDA stated that existing public health data systems are not adequate to  provide accurate and comprehensive baseline data needed to draw direct  relationships between FDA’s regulatory activities and changes in the  number and types of foodborne illnesses that occur annually in the United  States.  Therefore, through coordination with CDC and Agriculture, FDA  reported developing an improved food safety surveillance program called  FoodNet.  HRSA reported limitations related to its HIV/AIDS data  collection efforts.  For example, the reporting system that holds the data  contains duplicate data about individuals that prevents accurate  conclusions from being made.  To minimize the limitations, HRSA reported  it allows grantees the option of participating in a client-level reporting  system.  CDC and CMS acknowledged shortcomings in their data but did  not discuss steps to minimize the shortcomings.  NIH and Agriculture did  not discuss any limitations to their performance data in the area of public  health systems.

	Concluding Observations

We have previously stated that the Results Act could provide OMB,  agencies, and Congress with a structured framework for addressing  crosscutting program efforts.  In its guidance, OMB clearly encourages  agencies to use their performance plans as a tool to communicate and  coordinate with other agencies on programs being undertaken for common  purposes to ensure that related performance goals and indicators are  consistent and harmonious.  We have also stated that the Results Act could  also be used as a vehicle to more clearly relate and address the  contributions of alternative federal strategies.  The President’s common  measures initiative, by developing metrics that can be used to compare the  performance of different agencies contributing to common objectives,  appears to be a step in this direction.
Some of the agencies we reviewed appear to be using their performance  reports and plans as a vehicle to assist in collaborating and coordinating  program areas that are crosscutting in nature.  Those that provided more  detailed information on the nature of their coordination provided greater  confidence that they are working in concert with other agencies to achieve  common objectives.  Other agencies do not appear to be using their plans  and reports to the extent they could to describe their coordination efforts  to Congress, citizens, and other agencies.
Furthermore the quality of the performance information reported—how  agencies explain unmet goals and discuss strategies for achieving  performance goals in the future, and overall descriptions of the  completeness, reliability, and credibility of the performance information  reported—varied considerably.  Although we found a number of agencies  that provided detailed information about how they verify and validate  individual measures, only 5 of the 10 agencies we reviewed for all the  crosscutting areas commented on the overall quality and reliability of the  data in their performance reports consistent with the requirements of the  Reports Consolidation Act.  Without such statements, performance  information lacks the credibility needed to provide transparency of  government operations so that Congress, program managers, and other  decision makers can use the information.

	Agency Comments and Our Evaluation

We sent drafts of this report to the respective agencies for comments. We  received comments from Agriculture, the Board, FDIC, HHS, HUD, Labor,  and Treasury, including OCC and OTS.  The agencies generally agreed with  our findings.  The comments we received were mostly technical and we  have incorporated them where appropriate.
Regarding drug control, Justice, through its Office of Legal Policy,  commented that, as of November 2002, Justice had formalized increased  cooperation with ONDCP on drug policy and operations.
Regarding public health systems, the NIH component of HHS commented  that the prevention goal GAO looked at is one of five goals that together  that give a comprehensive picture of the performance of NIH’s research  program.  Furthermore, NIH commented that there are many formal and  informal ways in which it coordinates its work in the prevention arena that  are not reflected in its performance plan.  For example, NIH cites the Next- Generation Smallpox Vaccine Initiative, an intradepartmental task force  consisting of representatives from the Office of Public Health Policy, CDC,  FDA, and NIH.  We acknowledge this limitation in the scope and  methodology section of the report.
Regarding family poverty, HUD commented that, although GAO’s review  focused on two of HUD’s eight goals, it believes all of its goals and many of  its indicators have an impact on family poverty.  We do not dispute HUD’s  assertion that many of its goal address family poverty broadly.  However,  we focused on the goals that appeared to be most directly related to the  scope we defined in our scope and methodology section.
Regarding financial institution regulation, FDIC commented that a lack of  specific reference in the performance report regarding the completeness,  reliability and credibility of the data should not lead to a negative inference.
We are sending copies of this report to the President, the Director of the  Office of Management and Budget, the congressional leadership, other  Members of Congress, and the heads of major departments and agencies.   In addition, the report will be available at no charge on the GAO Web site at  http:// www.gao.gov.
If you have any questions about this report, please contact me or Elizabeth  Curda on (202) 512-6806 or daltonp@gao.gov. Major contributors to this  report are listed in appendix V.

GAO Contact and Staff Acknowledgments

	GAO Contact

	Acknowledgments

In addition to the individual named above, the following individuals made  significant contributions to this report:  Steven J. Berke, Lisa M. Brown,  Amy M. Choi, Peter J. Del Toro, Nancy M. Eibeck, and Debra L. Johnson.

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Summary:
Why GAO Did This Study

GAO's work has repeatedly shown that mission fragmentation and program overlap are widespread in the federal government. Implementation of federal crosscutting programs is often characterized by numerous individual agency efforts that are implemented with little apparent regard for the presence and efforts of related activities. GAO has in the past offered possible approaches for managing crosscutting programs, and has stated that the Government Performance and Results Act could provide a framework for addressing crosscutting efforts. GAO was asked to examine the actions and plans agencies reported in addressing the crosscutting issues of drug control, family poverty, financial institution regulation, and public health systems. GAO reviewed the fiscal year 2003 performance plans for the major agencies involved in these issues.

What GAO Found

GAO did not independently verify or assess the information it obtained from agency performance reports and plans. On the basis of the reports and plans, GAO found the following: (1) Most agencies involved in the crosscutting issues discussed coordination with other agencies in their performance reports and plans, although the extent of coordination and level of detail provided varied considerably; (2) Most of the agencies we reviewed reported mixed progress in achieving their fiscal year 2001 goals--meeting some goals, missing others, or not reporting on progress. Some of the agencies that did not meet their goals provided reasonable explanations and/or strategies that appeared reasonably linked to meeting the goals in the future; and (3) The agencies GAO reviewed generally planned to pursue goals in fiscal year 2003 similar to those in 2001, although some agencies added new goals, dropped existing goals, or dropped goals altogether. Many agencies discussed strategies that appeared to be reasonably linked to achieving their fiscal year 2003 goals.