Report to the Chairman, Committee on 

the Judiciary, House of Representatives

United States Government Accountability Office

GAO 

February 2006 ENERGY 

EMPLOYEES 

COMPENSATION 

Adjustments Made to 

Contracted Review 

Process, But 

Additional Oversight 

and Planning Would 

Aid the Advisory 

Board in Meeting Its 

Statutory 

Responsibilities 

GAO-06-177 
Page i GAO-06-177 Energy Employees Compensation 

Letter 1

Summary of Findings 3 

Conclusions 5 

Recommendations for Executive Action 6 

Agency and Other Comments and Our Evaluation 6 

Appendix I Briefing Slides 10 

Appendix II Comments from the Department of Health & Human 

Services 48 

Appendix III Comments from S. Cohen & Associates 50 

Appendix IV GAO Contact and Staff Acknowledgments 52 

Related GAO Products 53 

Contents 
Page ii GAO-06-177 Energy Employees Compensation 

Abbreviations 

CDC Centers for Disease Control and Prevention 

EEOICPA Energy Employees Occupational Illness Compensation 

 Program Act 

FACA Federal Advisory Committee Act 

HHS Department of Health and Human Services 

NIOSH National Institute for Occupational Safety and Health 

OCAS Office of Compensation Analysis and Support 

ORAU Oak Ridge Associated Universities 

PGO Procurement and Grants Office 

SC&A Sanford Cohen & Associates 

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Page 1 GAO-06-177 Energy Employees Compensation 

February 10, 2006 

The Honorable F. James Sensenbrenner, Jr. 

Chairman 

Committee on the Judiciary 

House of Representatives 

Dear Mr. Chairman: 

For the last several decades, the Department of Energy and its 

predecessor agencies and contractors have employed thousands of 

individuals in secret and dangerous work in the atomic weapons industry. 

In 2000, Congress enacted the Energy Employees Occupational Illness 

Compensation Program Act to compensate those individuals who have 

developed cancer or other specified diseases related to on-the-job 

exposure to radiation and other hazards at these work sites. Under 

Subtitle B, determining the eligibility of claimants for compensation is a 

complex process, involving several federal agencies and a reconstruction 

of the historical evidence available. The Department of Labor must 

consider a claimant’s case based on records of his or her employment and 

work activities, which are provided by the Department of Energy. Labor 

considers the compensability of certain claims by relying on estimates of 

the likely radiation levels to which particular workers were exposed. 

These “dose reconstructions” are developed by the National Institute for 

Occupational Safety and Health (NIOSH) under the Department of Health 

and Human Services (HHS). NIOSH also compiles information in “site 

profiles” about the radiation protection practices and hazardous materials 

used at various plants and facilities, which helps complete the dose 

reconstructions. Because certain facilities are known to have exposed 

employees to radiation while keeping few records of individuals’ 

exposure, their employees have been designated under the law as 

members of a “special exposure cohort,” and their claims may be paid 

without individual dose reconstructions. The law also allows the Secretary 

of HHS to add additional groups of employees to the special exposure 

cohort. 

For quality control and to raise public confidence in the fairness of the 

claims process, the compensation act also created a citizen’s advisory 

board of scientists, physicians, and employee representatives—the 

President’s Advisory Board on Radiation and Worker Health. Members of 

the board serve part-time and the board has limited staff support. The 

United States Government Accountability Office

Washington, DC 20548 
Page 2 GAO-06-177 Energy Employees Compensation 

advisory board is tasked to review the scientific validity and quality of 

NIOSH’s dose reconstructions and advise the Secretary of HHS. The board 

has the flexibility to determine the scope and methodology for this review. 

In addition, the advisory board is tasked with reviewing NIOSH’s 

evaluation of petitions for special exposure cohort status and 

recommending whether such status should be granted. To facilitate the 

advisory board’s review, HHS awarded a 5-year $3 million contract to 

Sanford Cohen & Associates (SC&A) in October 2003 to perform a variety 

of tasks, such as examining selected site profiles and a sample of dose 

reconstructions. The contract awarded was an indefinite-delivery, 

indefinite-quantity type of contract, which establishes the basic terms of 

the contract but then allows the advisory board to develop specific task 

orders requiring the contractor to complete certain tasks within specified 

time frames and budgets. SC&A is to be reimbursed for its costs and 

receive an additional fixed fee. However, this effort has been marked by 

delays and higher than originally anticipated costs and some concerns 

over the roles of the federal officials assigned by the Secretary of HHS to 

oversee this work. Because citizen advisory bodies do not have direct 

authority to spend federal monies, the government is responsible for 

awarding and managing support contracts. Insofar as the charge of the 

advisory board has been not merely to advise but to review the scientific 

validity and quality of NIOSH’s work, there could potentially be a conflict 

of roles for agency officials responsible for the program under review if 

they also oversee the contract work or assist the advisory board. In 

addition, there are congressional concerns about whether the advisory 

board is using the contractor’s expertise as the board evaluates special 

exposure cohort petitions. 

There is another contractor—Oak Ridge Associated Universities 

(ORAU)—that also plays an important role in the Energy Employees 

Occupational Illness Compensation Program. In September 2002, NIOSH 

awarded a 5-year contract to ORAU to support NIOSH in performing its 

responsibilities related to the program, such as developing site profiles 

and performing dose reconstructions. About $70 million was originally 

allocated to this contract, but this figure had increased to over $200 

million by 2004. 

We assessed how well the advisory board’s review and the contracted 

work with SC&A are proceeding. We focused on three questions: (1) Are 

the roles of key federal officials involved in the review of NIOSH’s dose 

reconstructions sufficiently independent to assure the objectivity of the 

review? (2) Have the agency’s management controls and the advisory 

board’s oversight been sufficient to ensure that the contract to review site 
Page 3 GAO-06-177 Energy Employees Compensation 

profiles and dose reconstructions is adequately carried out? and (3) Is the 

advisory board using the contractor’s expertise in reviewing special 

exposure cohort petitions? 

To perform our review, we analyzed pertinent contract-related materials, 

including the contract; monthly progress reports submitted by the 

contractor; minutes of advisory board meetings; special exposure cohort 

regulations; and correspondence between the contractor, agency, and 

advisory board. In addition, we interviewed agency officials, contractor 

officials, and advisory board members, and also attended meetings of the 

advisory board. The scope of our work did not include examining NIOSH’s 

contract with ORAU. We conducted our review from March 2005 to 

November 2005 in accordance with generally accepted government 

auditing standards. On December 13, 2005, we briefed your office on the 

results of our work (see app. I). This report conveys the information 

provided at that briefing, as updated to reflect changes we made in 

response to comments received on a draft of this report. 

The roles of certain key federal officials initially involved in the advisory 

board’s review of the dose reconstructions may not have been sufficiently 

independent and actions were taken to replace these officials. 

Nonetheless, continued diligence by HHS is required to prevent such 

problems from recurring as new candidates are considered for these roles. 

Initially, the project officer assigned responsibility for reviewing the 

monthly progress reports and monitoring the technical performance of the 

contractor was also a manager of the NIOSH dose reconstruction program 

being reviewed. In addition, the designated federal officer for the advisory 

board, who is responsible for scheduling and attending board meetings, 

was the director of the dose reconstruction program being reviewed. In 

response to concerns about the appearance of conflicting roles, the 

director of NIOSH replaced both of these officials in December 2004 with a 

senior NIOSH official not involved in the NIOSH program under review. 

The contractor and members of the board told us that implementation of 

the contract improved after these replacements were made. With regard to 

structural independence, we found it appropriate that the contracting 

officers, who are responsible for managing the contract on behalf of the 

advisory board, have been federal officials with the Centers for Disease 

Control and Prevention (CDC), NIOSH’s parent agency. The contracting 

officers do not have responsibilities for the NIOSH program under review 

and are not accountable to its managers. Members of the advisory board 

helped facilitate the independence of the contractor’s work by playing the 

Summary of Findings 
Page 4 GAO-06-177 Energy Employees Compensation 

leading role in developing and approving the initial statement of work for 

the contractor and the independent cost estimate for the contract. 

The progress of the contracted review of NIOSH’s site profiles and dose 

reconstructions has been hindered by the complexity of the work. 

Specifically, in the first 2 years, the contractor spent almost 90 percent of 

the $3 million that had been allocated to the contract for a 5-year 

undertaking. Various adjustments have been made in the review approach 

in light of the identified complexities, which were not initially understood. 

However, further improvements could be made in the oversight and 

planning of the review process. First, the contractor’s expenditure levels 

were not adequately monitored by the agency in the initial months and the 

contractor’s monthly progress reports did not provide sufficient details on 

the level of work completed compared to funds expended. The monthly 

report for each individual task order was subsequently revised to provide 

more details but developing more integrated data across the various tasks 

could further improve the board’s ability to track the progress of the 

overall review. Second, while the advisory board has made mid-course 

adjustments to the contractor’s task orders and review procedures, the 

board has not comprehensively reexamined its long-term plan for the 

overall project. The board revised the task orders for the contractor 

several times, in part to reflect adjustments made as the board gained a 

deeper understanding of the needs of the project. Nonetheless, the board 

has not reexamined its original plan for the total number of site profile and 

dose reconstruction reviews needed, and the time frames and funding 

levels for completing them. Third, there is still a gap with regard to 

management controls for the resolution of the findings and 

recommendations that emerge from SC&A’s review. The advisory board 

developed a six-step resolution process to help resolve technical issues 

between the contractor and NIOSH, and this process uses matrices to 

track the findings and recommendations of the contractor and advisory 

board. However, NIOSH currently lacks a system for documenting that 

changes it agrees to make as part of this resolution process are 

implemented. 

With regard to reviewing special exposure cohort petitions, the advisory 

board has asked for and received the contractor’s assistance, expanded its 

charge, and acknowledged the need for the board to review the petitions 

in a timely manner. The board has reviewed eight petitions as of October 

2005, and the contractor assisted with six of these by reviewing the site 

profiles associated with the facilities. The contractor will play an 

expanded role by reviewing some of the other submitted petitions and 

NIOSH’s evaluation of those petitions and recommending to the advisory 
Page 5 GAO-06-177 Energy Employees Compensation 

board whether the petitioning group should be added to the special 

exposure cohort. The contractor will also develop procedures for the 

advisory board to use when reviewing petitions. While NIOSH is generally 

required by law to complete its review of a petition within 180 days of 

determining that the petition has met certain initial qualification 

requirements, the advisory board has no specified deadline for its review 

of petitions. However, the board has discussed the fact that special 

exposure cohort petition reviews have required more time and effort than 

originally estimated and that the advisory board needs to manage its 

workload in order to reach timely decisions. 

Credibility is essential to the work of the advisory board and the 

contractor, and actions were taken in response to initial concerns about 

the independence of federal officials in certain key roles. Nonetheless, it is 

important for HHS to continue to be diligent in avoiding actual or 

perceived conflicts of roles as new candidates are considered for these 

roles over the life of the advisory board. 

The advisory board’s review of site profiles and dose reconstructions has 

presented a steep learning curve for the various parties involved. These 

experiences have prompted the board to make various adjustments to the 

contractor’s work that are intended to better meet the needs of the review, 

such as the establishment of a formal six-step resolution process that 

increases transparency. Nonetheless, further improvements could be made 

to the oversight and planning of the contracted review. Even though the 

advisory board has made numerous midcourse adjustments to the work of 

the contractor, the board has not comprehensively reexamined its longterm plan for the project to determine whether the plan needs to be 

modified in light of the knowledge gained over the past few years. In 

addition, while the contractor’s monthly reports were modified to provide 

more detailed expenditure data, the lack of integrated and comprehensive 

data across the various tasks makes it more difficult for the advisory board 

to track the progress of the overall review or make adjustments to funding 

or deliverables across tasks. Finally, without a system to track the actions 

taken by NIOSH in response to the findings and recommendations of the 

advisory board and contractor, there is no assurance that any needed 

improvements are being made. 

Conclusions 
Page 6 GAO-06-177 Energy Employees Compensation 

We are making three recommendations to the Secretary of HHS. 

To assist the advisory board meet its statutory responsibilities, we 

recommend that the Secretary of HHS 

(1) direct the contracting and project officers to develop and share with 

the advisory board more integrated and comprehensive data on contractor 

spending levels compared to work completed and 

(2) consider the need for providing HHS staff to collect and analyze 

pertinent information that would help the advisory board comprehensively 

reexamine its long-term plan for assessing the NIOSH site profiles and 

dose reconstructions. 

To ensure that the findings and recommendations of the advisory board 

and the contractor are promptly resolved, we recommend that the 

Secretary of HHS direct the Director of NIOSH to establish a system to 

track the actions taken by the agency in response to these findings and 

recommendations and update the advisory board periodically on the status 

of such actions. 

We provided a draft of this report to HHS, the contractor, and all the 

members of the advisory board for comment. We received comments 

from HHS, the contractor, and four individual members of the advisory 

board. The comments from the four members of the board represent the 

views of these individuals and not an official position of the advisory 

board. HHS agreed with GAO’s recommendations to provide more 

integrated and comprehensive data to the advisory board and said that it 

will consider the need to provide staff to help the advisory board 

reexamine its overall plan for assessing NIOSH site profiles and dose 

reconstructions. With regard to the third recommendation, HHS stated 

that a system is already in place to track actions taken by the agency in 

response to advisory board recommendations in letters from the board to 

the Secretary of HHS. HHS added that matrices used in conjunction with 

the six-step resolution process outline the contractor’s concerns, NIOSH’s 

response, and the actions to be taken. However, we believe that these 

matrices do not provide sufficient closure with regard to tracking the 

actions NIOSH has actually implemented in response to advisory board 

and contractor findings and recommendations. For example, in some of 

the matrices, the advisory board has made numerous recommendations 

that NIOSH perform certain actions to resolve various issues, but there is 

Recommendations for 

Executive Action 

Agency and Other 

Comments and Our 

Evaluation 
Page 7 GAO-06-177 Energy Employees Compensation 

no system in place to provide assurance that these actions have in fact 

been taken. Thus, we continue to see a need for this recommendation. 

Some individual advisory board members who provided comments 

expressed concerns about our recommendations, although differing in 

their reasons. One individual board member expressed concern about the 

recommendations to provide more integrated and comprehensive data to 

the advisory board or to provide staff to help in reexamining the overall 

review plan, suggesting that these changes might not be very helpful. We 

still believe that these recommendations are necessary to ensure that the 

advisory board has more complete information to better oversee the 

review as well as a long-term plan for completing the review; hence we did 

not revise the recommendation. Another individual board member 

suggested that a system be established to track the advisory board’s 

recommendations rather than the contractor’s recommendations since it is 

these that should be of greater concern. While GAO believes it is 

important to track the resolution of the board’s recommendations, it also 

important to track the resolution of the contractor’s recommendations, 

and we therefore revised the wording of our recommendation to reflect 

this position. 

HHS, the contractor, and individual advisory board members took issue 

with statements in the report about the contractor being over budget and 

behind schedule. While they agreed with GAO’s assessment that the 

review process got off to a slow start, they thought that the report did not 

provide sufficient information about the various factors that complicated 

or led to an expansion of work for the contractor, the revisions to the 

contractor’s task orders, and the performance of the contractor with 

respect to the revised task orders. For example, commenters pointed out 

that in some instances, the contractor had to review a site profile more 

than once after NIOSH had revised the site profile to include additional 

information. Commenters added that the contractor’s work also had to 

shift to accommodate changing priorities. For instance, NIOSH’s 

increased reliance on using the site profiles to complete dose 

reconstructions prompted a shift in contractor priorities to devote more 

time and resources to site profile reviews than originally anticipated. The 

commenters added that since the task orders were revised, the contractor 

has been meeting the time frames and budgets specified in the task orders. 

We therefore revised the report to incorporate additional information on 

factors that complicated or led to an expansion in the work of the 

contractor, the revisions that were made to the task orders, and the 

contractor’s progress in meeting the terms of the revised task orders. 
Page 8 GAO-06-177 Energy Employees Compensation 

HHS, the contractor, and some of the individual members of the advisory 

board maintained that the advisory board has taken actions to reexamine 

and adjust its strategy for reviewing site profiles and dose reconstruction 

cases. For instance, HHS stated that during the advisory board’s meetings 

in 2005, the board regularly discussed the future of contract activities and 

altered the review schedule and scope of work several times. For 

example, the contractor was asked to perform site profile reviews for sites 

not originally anticipated in order to facilitate the advisory board’s review 

of related special exposure cohort petitions. Other commenters pointed 

out the board’s development of a six-step resolution process for use by 

NIOSH and the contractor to resolve differences on technical issues. We 

revised the report to more fully reflect actions taken by the advisory board 

to reexamine and adjust its strategy for the review. We also changed the 

report title to reflect changes made in the report in this regard. However, 

we continue to see a need for the advisory board to build on its actions by 

comprehensively reexamining whether its original long-term plan for the 

overall project is still appropriate. 

Several individual advisory board members commented that they remain 

concerned about the independence of the board and its contractor. 

Although acknowledging that replacement of the original officials 

appointed as the designated federal officer and project officer has helped 

reduce possible challenges to independence, the members pointed out that 

NIOSH officials remain involved in managing the contract and could still 

potentially influence the work of the contractor. These individual board 

members also emphasized that the board has no independent budgetary 

authority and that it relies on NIOSH to obtain funding. Our review 

suggests that the contractor has been able to demonstrate its 

independence during the review. For instance, our report notes that the 

contractor’s reports have criticized numerous aspects of NIOSH site 

profiles and dose reconstructions. Further, contractor officials told us 

that they believe relations with NIOSH are thoroughly professional and 

board members told us that they are satisfied with the information 

provided by the contractor. We acknowledge that the potential for 

impairment of the contractor’s efforts remains. In fact, our draft report 

concluded that there is a need for continued diligence in avoiding actual or 

perceived conflicts of roles as new candidates are considered for certain 

positions over the life of the advisory board. We have further highlighted 

this point in the final report. 
Page 9 GAO-06-177 Energy Employees Compensation 

HHS’s comments are provided in appendix II, and the contractor’s 

comments are provided in appendix III. HHS, the contractor, and 

individual board members also provided technical comments, which we 

have incorporated as appropriate. 

As arranged with your office, unless you publicly announce its contents 

earlier, we plan no further distribution of this report until 30 days from the 

issue date. At that time, we will send copies of this report to the Secretary 

of Health and Human Services, interested congressional committees, and 

other interested parties. We are also sending copies to the Chair and 

members of the advisory board. We will make copies available to others 

upon request. In addition, the report will be available at no charge on 

GAO’s Web site at http://www.gao.gov. 

If you have any questions about this report, please contact me at (202) 512-

7215. Contact points for our Offices of Congressional Relations and Public 

Affairs may be found on the last page of this report. GAO staff that made 

major contributions to this report are listed in appendix III. 

Sincerely yours, 

Robert E. Robertson 

Director, Education, Workforce, 

 and Income Security Issues 
Appendix I: Briefing Slides 

Page 10 GAO-06-177 Energy Employees Compensation 

Appendix I: Briefing Slides 

1

Energy Employees Compensation: Adjustments Made 

to Contracted Review Process, But Additional 

Oversight and Planning Would Aid the Advisory Board 

in Meeting Its Statutory Responsibilities

Briefing for Staff of

Congressman F. James Sensenbrenner, Jr.

Chairman, House Committee on the Judiciary

December 13, 2005
Appendix I: Briefing Slides 

Page 11 GAO-06-177 Energy Employees Compensation 

2

Introduction

• For the last several decades, the Department of Energy and its 

predecessor agencies and contractors have employed thousands of 

individuals in secret and dangerous work in the atomic weapons industry.

• The Energy Employees Occupational Illness Compensation Program Act 

(EEOICPA) of 2000 compensates individuals who have developed cancer 

or other specified diseases related to on-the-job exposure to radiation and 

other hazards at these work sites.

• Under Subtitle B, determining a claimant’s eligibility for compensation 

involves developing estimates of the likely radiation levels a worker was 

exposed to based on information such as exposure records. These

estimates are referred to as “dose reconstructions” and are developed by 

the National Institute for Occupational Safety and Health (NIOSH) under 

the Department of Health and Human Services (HHS).
Appendix I: Briefing Slides 

Page 12 GAO-06-177 Energy Employees Compensation 

3

Introduction (cont.)

• NIOSH also compiles information in “site profiles” about the radiation 

protection practices and hazardous materials used at various plants and 

facilities, which assist NIOSH in completing the dose reconstructions. 

• Employees at certain facilities were designated under the law as members 

of a “special exposure cohort” because it was believed that exposure 

records were insufficient and the reasonable likelihood was that the 

workers’ radiation exposure caused their cancers. Their claims are paid 

without completing exposure estimates.

• The law also allows the Secretary, HHS, to designate additional groups of 

employees as members of the special exposure cohort.
Appendix I: Briefing Slides 

Page 13 GAO-06-177 Energy Employees Compensation 

4

Introduction (cont.)

• For quality control and to raise public confidence in the fairness of the 

claims process, EEOICPA created a citizen’s advisory board of scientists, 

physicians, and employee representatives—the President’s Advisory Board 

on Radiation and Worker Health (advisory board). Members of board 

serve part-time, and the board has limited staff support.

• The advisory board is tasked with reviewing the scientific validity and 

quality of NIOSH’s dose reconstructions and advising the Secretary of 

HHS. The board has the flexibility to determine the scope and 

methodology for this review. In addition, the advisory board is tasked with 

reviewing NIOSH’s evaluation of petitions for special exposure cohort 

status and recommending whether such status should be granted. 

• To facilitate the advisory board’s review, HHS awarded a 5-year, $3-million 

contract to Sanford Cohen & Associates (SC&A) in October 2003 to

examine a sample of dose reconstructions and particular site profiles and 

to perform a variety of other tasks.
Appendix I: Briefing Slides 

Page 14 GAO-06-177 Energy Employees Compensation 

5

Introduction (cont.)

• NIOSH awarded a 5-year contract to Oak Ridge Associated Universities to 

assist NIOSH in developing site profiles and in performing dose 

reconstructions. Originally, about $70 million was allocated to the contract, 

but this figure had increased to over $200 million by 2004.
Appendix I: Briefing Slides 

Page 15 GAO-06-177 Energy Employees Compensation 

6

Key Questions

We focused our work on three questions:

• Are the roles of key federal officials involved in the review of NIOSH’s 

dose reconstructions sufficiently independent to assure the objectivity 

of the review?

• Have the agency’s management controls and the advisory board’s 

oversight been sufficient to ensure that the contract to review site 

profiles and dose reconstructions is adequately carried out?

• Is the advisory board using the contractor’s expertise in reviewing 

special exposure cohort petitions?
Appendix I: Briefing Slides 

Page 16 GAO-06-177 Energy Employees Compensation 

7

Scope and Methodology

We reviewed pertinent contract-related materials and correspondence among 

key officials and interviewed these officials to document their roles. We 

used the broad principles specified in various criteria, including those 

specified in the Federal Acquisition Regulation and Government Auditing 

Standards, to assess the independence of key officials’ roles.

We analyzed the contract provisions, including the specific task orders and 

monthly progress reports as well as the actions taken by officials to 

manage the contract. We assessed whether the management controls 

were adequate, considering criteria such as the Federal Acquisition 

Regulation.
Appendix I: Briefing Slides 

Page 17 GAO-06-177 Energy Employees Compensation 

8

Scope and Methodology (cont.)

We analyzed the special exposure cohort regulations and advisory board 

meeting minutes as well as interviewed key officials and attended advisory 

board meetings, to determine the process the advisory board has used and 

plans to use to evaluate petitions.

The scope of our work did not include examining the contract NIOSH awarded 

to Oak Ridge Associated Universities. 

We conducted this review from March 2005 through November 2005 in 

accordance with generally accepted government auditing standards.
Appendix I: Briefing Slides 

Page 18 GAO-06-177 Energy Employees Compensation 

9

Summary of Findings

• The roles of certain key federal officials initially involved in the 

review of dose reconstructions may not have been sufficiently 

independent and these officials were replaced. However, 

continued diligence by HHS is required to prevent such problems 

from recurring as new candidates are considered for these roles.

• The progress of the contracted review of site profiles and dose 

reconstructions has been hindered, largely by the complexity of 

the work. Some adjustments have been made, but further 

improvements could be made to the oversight and planning of the 

review.

• The advisory board is using the contractor’s work in reviewing 

special exposure cohort petitions and has acknowledged the need 

to review the petitions in a timely manner.
Appendix I: Briefing Slides 

Page 19 GAO-06-177 Energy Employees Compensation 

10

Background

Multiple Entities and Officials Involved in the Review of 

NIOSH’s Dose Reconstructions

Department of Health and 

Human Services

(HHS)

Secretary

Centers for Disease Control 

and Prevention

(CDC)

Advisory Board on Radiation

and Worker Health

National Institute for Occupational Safety and Health 

(NIOSH)

Designated federal officer (since 12/04)

Project officer (since 12/04)

Procurement and Grants Office 

(PGO)

Contracting officer

Office of Compensation Analysis and Support 

(OCAS)

Designated federal officer (prior to 12/04)

Project officer (prior to 12/04)

Contractor

Sanford Cohen and Associates

(SC&A)
Appendix I: Briefing Slides 

Page 20 GAO-06-177 Energy Employees Compensation 

11

Background

Roles of HHS and CDC

HHS

• The Secretary of HHS has overall responsibility for the advisory board, as 

delegated by the President, and is tasked by executive order with providing 

administrative services, funds, facilities, staff, and other necessary support 

services to assist the advisory board in carrying out its responsibilities. 

CDC

• NIOSH’s parent agency awarded the contract on behalf of the advisory 

board.

• A CDC Procurement and Grants Office (PGO) official serves as the

contracting officer.

• The contracting officer is responsible for administering and providing management of the contract on the advisory board’s behalf. This includes reviewing the monthly progress reports and paying the 

contractor for its approved costs.
Appendix I: Briefing Slides 

Page 21 GAO-06-177 Energy Employees Compensation 

12

Background (cont.)

Role of NIOSH

NIOSH

• The Office of Compensation Analysis and Support (OCAS) is responsible 

for preparing the site profiles and completing the dose reconstructions.

• NIOSH officials serve as the project officer for the contract and the 

designated federal officer for the advisory board.

• The project officer is responsible for reviewing the monthly progress 

reports and monitoring the technical performance of the contractor.

• The designated federal officer schedules and attends meetings of 

the advisory board. 
Appendix I: Briefing Slides 

Page 22 GAO-06-177 Energy Employees Compensation 

13

Background (cont.)

Roles of Advisory Board and Contractor

Advisory Board

• Required to (1) review the scientific validity and quality of NIOSH’s dose 

reconstructions and (2) review NIOSH’s evaluation of special exposure 

cohort petitions and recommend whether such status should be granted.

• Operates under Federal Advisory Committee Act (FACA) requirements 

such as conducting its meetings in public. 

Contractor - SC&A

• Under contract, assists the advisory board in meeting its statutory 

responsibilities by reviewing a sample of dose reconstructions and their 

associated site profiles and providing assistance with special exposure 

cohort petitions. 

• Provides monthly progress reviews to the contracting officer, project officer, 

and advisory board.
Appendix I: Briefing Slides 

Page 23 GAO-06-177 Energy Employees Compensation 

14

Background (cont.)

Contract Initiated in October 2003 for 5 years and $3 

Million Maximum

Task Orders for contractor now include:

• Dose Reconstructions

• Task 1: Review selected NIOSH-developed site profiles. 

• Task 2: Develop automated system to track NIOSH dose reconstruction 

cases.

• Task 3: Review NIOSH dose reconstruction procedures.

• Task 4: Review a sample of NIOSH dose reconstruction cases.

• Special Exposure Cohort Petitions

• Review NIOSH’s special exposure cohort petition procedures and individual 

petitions.

• Other

• Provide administrative (logistical) support to advisory board (monthly 

progress reports, attendance at advisory board meetings, etc.).
Appendix I: Briefing Slides 

Page 24 GAO-06-177 Energy Employees Compensation 

15

Finding 1 

Two Federal Officials Were Replaced to Protect 

Independence of Review

• Two officials were replaced by the Director of NIOSH because of concerns 

about the appearance of conflicting roles: 

• project officer

• designated federal officer

• Initially, certain officials performing key roles did not appear to be 

sufficiently independent of the review and actions were taken to replace 

these officials. Advisory board members and the contractor have said that 

the implementation of the contract has improved as a result. Nonetheless, 

continued diligence is required to prevent such problems from recurring as 

new candidates may be considered for these roles.

• The contracting officer is a CDC employee whose organization is 

independent of the NIOSH program under review.
Appendix I: Briefing Slides 

Page 25 GAO-06-177 Energy Employees Compensation 

16

Finding 1: Independence of Roles cont.

Two Federal Officials Were Replaced

Replacement of Project Officer

• In 2003-2004, the project officer also served as a NIOSH program 

manager of the program under review.

• In December, 2004, a senior NIOSH official, who does not have 

responsibilities for the program under review, took over this role.

Replacement of Designated Federal Officer

• In 2002-2004, the designated federal officer also served as the NIOSH 

director of the program under review.

• In December 2004, a senior NIOSH official, who does not have 

responsibilities for the program, took over this role.
Appendix I: Briefing Slides 

Page 26 GAO-06-177 Energy Employees Compensation 

17

Finding 1: Independence of Roles cont.

Other Officials Are Independent of the Program under 

Review

• The contracting officers have been CDC officials in the Procurement and 

Grants Office. They do not have responsibilities for the NIOSH program 

under review and are not accountable to its managers.

• Members of the advisory board played the leading role in developing and 

approving the initial statement of work for the contractor and the 

independent government cost estimate for the contract, actions which 

helped facilitate the independence of the contractor’s work.
Appendix I: Briefing Slides 

Page 27 GAO-06-177 Energy Employees Compensation 

18

Finding 2 

Adjustments Were Made to SC&A’s Review But Further 

Improvements in Oversight and Planning Could be Made

• The project officer did not adequately monitor contract spending relative to 

overall project performance in the initial months. More detailed expenditure 

data were subsequently provided to facilitate monitoring but developing 

more comprehensive data would be useful.

• While the advisory board has made various adjustments to the contractor’s 

task orders and work processes after the contractor encountered initial 

difficulties, the board has not comprehensively reexamined its long-term 

plan for the project. 

• Additionally, NIOSH lacks a process for documenting actions it has taken in 

response to the contractor’s findings that are reported to the advisory board 

and the advisory board’s recommendations to HHS.
Appendix I: Briefing Slides 

Page 28 GAO-06-177 Energy Employees Compensation 

19

Finding 2: Contract Monitoring

CDC Did Not Adequately Monitor Contract Spending 

Compared to Work Completed

• The contractor’s expenditure levels were not adequately monitored in the initial months. 

• Although the contractor’s reports indicated that costs were higher than anticipated, the project 

officer was caught by surprise in October 2004 when the contractor announced a need for work 

stoppage because expenditures on a specific task order had approached budget ceilings. The 

contracting officer noted that during this period the contractor’s reports did not reflect the actual 

percent of work completed, making it very difficult to identify the actual cost of performance. 

• Work was suspended on the site profile review task and a smaller task for several days in 

November until additional funds were authorized.

• Separate monthly progress reports are submitted for each task order. However, there is no 

single comprehensive report on overall contract performance, which could facilitate tracking the 

progress of the overall review or making strategic adjustments where needed.
Appendix I: Briefing Slides 

Page 29 GAO-06-177 Energy Employees Compensation 

20

Finding 2: Initial Task Orders

Initial Task Order Budgets and Schedules Proved 

Unrealistic

• Initial task orders called for the contractor to complete:

• 12 to 16 site profile reviews by February 2005 for $426,000

• 60 dose reconstruction reviews by August 2004 for $467,000

• These tasks cost more or took longer to complete than originally estimated.

• At the end of January 2005, the contractor had completed 2 site profile 

reviews and partially completed 2 others while spending $481,000.

• The contractor completed the first 60 dose reconstruction reviews by 

September 2005 while spending about $1.0 million. (According to

SC&A, the cost increase consisted of costs related to overall contract 

management, not to increased dose reconstruction review costs.)

• Overall, in the first 2 years, the contractor spent almost 90 percent of 

the $3 million allocated for a 5-year undertaking.
Appendix I: Briefing Slides 

Page 30 GAO-06-177 Energy Employees Compensation 

21

Finding 2: Initial Task Orders

Several Factors Hindered Contractor from Meeting 

Original Task Order Goals and Budgets

• Complexity of work was much greater than originally 

anticipated.

• Both the contractor and NIOSH officials involved in the review reported that reviews of site profiles and dose reconstructions have proven 

considerably more complex than originally anticipated; thus the original cost estimates for the project (based on very limited information and 

experience) were not realistic.

• Contractor encountered initial delays in obtaining information.

• The contractor's progress was initially hindered by substantial delays it encountered in obtaining necessary security clearances and access 

from NIOSH to various technical documents. These early 

implementation issues have generally been resolved, according to the 

contractor.
Appendix I: Briefing Slides 

Page 31 GAO-06-177 Energy Employees Compensation 

22

Finding 2: Task Order Revisions 

The Advisory Board Has Significantly Revised Major Task 

Orders during First 2 Fiscal Years

• Site profile review task modified 5 times

• Completion date extended from Feb. 2005 to Oct. 2005

• Number of site reviews reduced from 12-16 to 9

• Funding increased from $426,000 to $1.6 million

• Dose reconstruction review task modified 4 times

• Completion date extended from Aug. 2004 to Dec. 2005

• Number of reviews (60) remained constant

• Funding increased from $467,000 to $1 million

• Contractor has met these revised task order requirements.
Appendix I: Briefing Slides 

Page 32 GAO-06-177 Energy Employees Compensation 

23

Finding 2: Task Order Revisions (cont.)

Task Order Revisions In Part Reflect Board’s Changing 

Needs for Contractor Support As Operations Matured

• Board shifted more contractor resources to site profile reviews in response 

to NIOSH’s increased reliance on site profiles.

• Site profiles were originally seen as one of numerous resources to be used in 

developing dose reconstructions. However, as site profiles became the primary 

resource used by NIOSH, the advisory board wanted assurance that these site 

profiles were credible.

• NIOSH revisions to site profiles required the contractor to complete multiple 

reviews in some instances.

• For example, the contractor completed four reviews of the Mallinckrodt site 

profile as a result of NIOSH’s changes. NIOSH views the site profiles as “living 

documents” that can be added to as new information is identified or changes 

need to be made. In addition, as NIOSH worked to complete many of the site 

profiles within an 18-month time frame, many “loose ends” remained in the site 

profiles, according to the contractor. 
Appendix I: Briefing Slides 

Page 33 GAO-06-177 Energy Employees Compensation 

24

Finding 2: Task Order Revisions (cont.)

Task Order Revisions In Part Reflect Board’s Changing 

Needs for Contractor Support As Operations Matured 

(cont.)

• Board developed a six-step process for use by NIOSH 

and contractor to resolve their differences of views on 

technical issues. This process expanded the time and 

resources needed for reviews.

• Unanticipated site profile reviews (e.g., Iowa Army 

Ammunition Plant) were needed to facilitate the advisory 

board’s review of special exposure cohort petitions.
Appendix I: Briefing Slides 

Page 34 GAO-06-177 Energy Employees Compensation 

25

Finding 2: Next Steps for Board

While the Advisory Board Has Authorized Contractor 

Work for Fiscal Year 2006...

• Congress provided $4.5 million in fiscal year 2006 for 

use by, or in support of, the advisory board.

• The advisory board has authorized a new set of 

contractor reviews for fiscal year 2006. 

• An additional 6 site profile reviews, 60 dose 

reconstruction case reviews, and 6 special exposure 

cohort petition reviews.
Appendix I: Briefing Slides 

Page 35 GAO-06-177 Energy Employees Compensation 

26

Finding 2: Next Steps for Board (cont.)

... the Advisory Board Has Not Comprehensively 

Reassessed Its Long-Term Plan for the Project

• Contract with SC&A included estimates of total work to be performed:

• 22 site profile reviews: 5 per year in each of the first 3 years, 4 in the fourth year, and 3 in the fifth year

• 600 dose reconstruction reviews: 150 in each of the first 3 years, 100 cases the fourth year, and 50 the 

fifth year

• In August 2005, the designated federal officer pointed out that at the current rate of 

progress, the original plan to review a total of 600 dose reconstructions would 

require about 10 years to complete.

• But the advisory board has not comprehensively reexamined its original long-term 

plan for the project to determine if it needs to be modified.

• Total number of site profile reviews needed?

• Total number of dose reconstruction case reviews needed?

• Time frames for completion and funding levels required?
Appendix I: Briefing Slides 

Page 36 GAO-06-177 Energy Employees Compensation 

27

Finding 2: Tracking Process

NIOSH Lacks Processes to Track Actions Taken in 

Response to Contractor’s Findings and Board’s 

Recommendations

• The contractor’s reports have criticized various aspects of NIOSH’s site 

profiles and dose reconstructions, such as NIOSH’s failure to consider 

information provided by site experts in its site profiles and certain 

assumptions NIOSH used to calculate dose reconstructions.

• As part of the six-step resolution process, the contractor and NIOSH 

develop matrices that specify NIOSH’s response and any planned actions 

for each of the contractor’s findings and recommendations. In some 

matrices, space is provided for the board to recommend that NIOSH take 

certain actions to resolve issues. 

• However, there is no system in place to track NIOSH’s implementation of 

these actions or advisory board recommendations. Procedures for prompt 

resolution and implementation of audit findings and other reviews should 

be part of all federal agencies’ internal controls.
Appendix I: Briefing Slides 

Page 37 GAO-06-177 Energy Employees Compensation 

28

Finding 3 

The Advisory Board Is Using the Contractor’s Work in 

Reviewing Special Exposure Cohort Petitions

• The advisory board is using the contractor’s work in reviewing special 

exposure cohort petitions.

• A recent task order expands the contractor’s role for this facet of the 

board’s work. 

• A potentially large increase in the board’s petition review workload did not 

occur because many petitions did not meet initial qualification 

requirements.

• The advisory board has acknowledged the need to review the petitions in 

a timely manner.
Appendix I: Briefing Slides 

Page 38 GAO-06-177 Energy Employees Compensation 

29

Finding 3: Use of Contractor

The Advisory Board Is Using the Contractor’s Work in 

Reviewing Petitions

Advisory Board’s Efforts as of October 31, 2005:

• The advisory board has reviewed eight petitions representing five sites.

• For six of these petitions, the contractor reviewed the site profiles 

(though not the actual petitions associated with the named facilities).

• For the other two petitions, the advisory board did not request the 

contractor’s assistance.
Appendix I: Briefing Slides 

Page 39 GAO-06-177 Energy Employees Compensation 

30

Finding 3: Task Order

Recent Task Order Expands the Contractor’s Role in 

Reviewing Petitions

Specifics of the Task Order include:

• The contractor will review some of the submitted petitions and NIOSH’s 

evaluations of these petitions to recommend to the advisory board whether 

the petitioning group should be added to the special exposure cohort.

• The contractor will also develop the procedures for the advisory board to 

use when reviewing petitions.
Appendix I: Briefing Slides 

Page 40 GAO-06-177 Energy Employees Compensation 

31

Finding 3: Future Workload

A Potentially Large Increase in the Board’s Petition Review 

Workload Did Not Occur

• Many petitions did not meet the initial qualification requirements and 

thus did not need to be reviewed by the board.

• As of October 2005, NIOSH had determined that 18 of the submitted 

petitions did not meet the qualification requirements.

• The advisory board may have to review five to eight more petitions 

filed as of October 2005:

• One petition is ready for the advisory board to review. 

• NIOSH is completing its evaluation of four more petitions that will be 

sent to the board for review.

• NIOSH is assessing three other petitions to determine if they meet the 

qualification requirements.
Appendix I: Briefing Slides 

Page 41 GAO-06-177 Energy Employees Compensation 

32

Finding 3: Timeliness of Petition Reviews

The Advisory Board Has Acknowledged the Need for 

Timely Review of Petitions

• The number of new petitions that may be submitted and that may qualify 

for evaluation is unknown.

• While NIOSH is generally required by law to complete its review of a 

petition within 180 days of the petition’s being qualified, there is no 

specified time frame for the advisory board’s review of petitions.

• Nonetheless, the advisory board has discussed the fact that special 

exposure cohort petition reviews have required more time and effort to 

reach a recommended decision than originally estimated and that the 

advisory board needs to manage its workload in order to reach timely 

decisions.
Appendix I: Briefing Slides 

Page 42 GAO-06-177 Energy Employees Compensation 

33

Conclusions

Independence of Roles

• After concerns were raised about the independence of certain federal officials 

performing key roles, actions were taken to replace these officials.

• Credibility is essential to the work of the advisory board and the contractor. Thus, it 

is important to continue to be diligent in avoiding actual or perceived conflicts of 

roles as new candidates are considered for certain positions over the life of the 

advisory board. 

Management and Oversight of the Review of Site Profiles and Dose

Reconstructions

• The advisory board’s review has presented a steep learning curve for the various 

parties involved. Despite some adjustments, further improvements could be made:

• reassessing the long-term plan for the project

• integrating data on contractor expenditures

• tracking resolution of board and contractor findings and recommendations.
Appendix I: Briefing Slides 

Page 43 GAO-06-177 Energy Employees Compensation 

34

Conclusions (cont.)

Reassessing the long-term plan for the project 

• The advisory board has made numerous midcourse adjustments to the work of the 

contractor as operations have matured.

• It would thus be appropriate for the advisory board to comprehensively reexamine its 

long-term plan for the overall project to determine whether this plan needs to be 

modified. 

Integrated data on contractor expenditures

• Contractor’s monthly reports were modified to provide more detailed data for 

individual tasks on expenditures compared to work completed.

• However, the lack of integrated and comprehensive data across the various tasks 

makes it more difficult for the advisory board to track the progress of the overall 

review or make strategic adjustments to funding or deliverables across tasks.
Appendix I: Briefing Slides 

Page 44 GAO-06-177 Energy Employees Compensation 

35

Conclusions (cont.)

Tracking resolution of findings and recommendations

• The advisory board developed a six-step resolution process that uses matrices to 

track the findings and recommendations of the contractor and board. However, 

without a system for documenting the actions NIOSH has taken in response, there is 

no assurance that any needed improvements are being made.
Appendix I: Briefing Slides 

Page 45 GAO-06-177 Energy Employees Compensation 

36

Recommendations

To assist the advisory board meet its statutory responsibilities, we 

recommend that the Secretary of HHS:

• direct the contracting and project officers to develop and share with the 

advisory board more integrated and comprehensive data on contractor’s 

spending levels compared to work completed and 

• consider the need for providing HHS staff to collect and analyze pertinent 

information that would help the advisory board comprehensively reexamine its 

long-term plan for assessing the NIOSH site profiles and dose reconstructions.
Appendix I: Briefing Slides 

Page 46 GAO-06-177 Energy Employees Compensation 

37

Recommendations (cont.)

To ensure that the findings and recommendations of the advisory 

board and the contractor are promptly resolved, we recommend 

that the Secretary of HHS 

• direct the Director of NIOSH to establish a system to track the actions 

taken by the agency in response to these findings and 

recommendations and update the advisory board periodically on the 

status of such actions.
Appendix I: Briefing Slides 

Page 47 GAO-06-177 Energy Employees Compensation 

38

Related GAO Products

• Energy Employees Compensation: Even with Needed Improvements in Case 

Processing, Program Structure May Result in Inconsistent Benefit Outcomes. GAO04-516. Washington, DC: May 28, 2004.

• Energy Employees Compensation: Many Claims Have Been Processed, but Action 

Is Needed to Expedite Processing of Claims Requiring Radiation Exposure 

Estimates. GAO-04-958. Washington, DC: Sept.10, 2004.
Appendix II: Comments from the Department 

of Health & Human Services 

Page 48 GAO-06-177 Energy Employees Compensation 

Appendix II: Comments from the Department 

of Health & Human Services 
Appendix II: Comments from the Department 

of Health & Human Services 

Page 49 GAO-06-177 Energy Employees Compensation 
Appendix III: Comments from S. Cohen & 

Associates 

Page 50 GAO-06-177 Energy Employees Compensation 

Appendix III: Comments from S. Cohen & 

Associates 
Appendix III: Comments from S. Cohen & 

Associates 

Page 51 GAO-06-177 Energy Employees Compensation 
Appendix IV: GAO Contact and Staff 

Acknowledgments 

Page 52 GAO-06-177 Energy Employees Compensation 

Robert E. Robertson, (202) 512-7215 or robertsonr@gao.gov 

Andy Sherrill, Assistant Director; Margaret Armen, Richard Burkard, 

Susan Bernstein, Sandra Chefitz, Mary Nugent, and Robert Sampson made 

significant contributions to this report. 

Appendix IV: GAO Contact and Staff 

Acknowledgments 

GAO Contact: 

Staff 

Acknowledgements: 
Related GAO Products 

Page 53 GAO-06-177 Energy Employees Compensation 

Energy Employees Compensation: Many Claims Have Been Processed, 

but Action Is Needed to Expedite Processing of Claims Requiring 

Radiation Exposure Estimates. GAO-04-958. Washington, D.C.: Sept. 10, 

2004. 

Energy Employees Compensation: Even with Needed Improvements in 

Case Processing, Program Structure May Result in Inconsistent Benefit 

Outcomes. GAO-04-516. Washington, D.C.: May 28, 2004. 

Related GAO Products 

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