a

GAO

United States Government Accountability Office

Report to the Chairman, Subcommittee on 

Oversight of Government Management, the 

Federal Workforce, and the District of 

Columbia, Committee on Homeland Security 

and Governmental Affairs, U.S. Senate

October 2005 RESULTS-ORIENTED 

GOVERNMENT

Practices That Can 

Help Enhance and 

Sustain Collaboration 

among Federal 

Agencies

GAO-06-15
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

www.gao.gov/cgi-bin/getrpt?GAO-06-15.

To view the full product, including the scope 

and methodology, click on the link above. 

For more information, contact Bernice 

Steinhardt at (202) 512-6543 or 

steinhardtb@gao.gov. 

Highlights of GAO-06-15, a report to the 

Chairman, Subcommittee on Oversight of 

Government Management, the Federal 

Workforce, and the District of Columbia, 

Committee on Homeland Security and 

Governmental Affairs, U.S. Senate 

October 2005

RESULTS-ORIENTED GOVERNMENT

Practices That Can Help Enhance and 

Sustain Collaboration among Federal 

Agencies 

Collaboration can be broadly defined as any joint activity that is intended to 

produce more public value than could be produced when the organizations 

act alone. Agencies can enhance and sustain their collaborative efforts by 

engaging in the eight practices identified below. Running throughout these 

practices are a number of factors such as leadership, trust, and 

organizational culture that are necessary elements for a collaborative 

working relationship: 

 

• define and articulate a common outcome; 

• establish mutually reinforcing or joint strategies; 

• identify and address needs by leveraging resources; 

• agree on roles and responsibilities; 

• establish compatible policies, procedures, and other means to operate 

across agency boundaries; 

• develop mechanisms to monitor, evaluate, and report on results; 

• reinforce agency accountability for collaborative efforts through agency 

plans and reports; and 

• reinforce individual accountability for collaborative efforts through 

performance management systems. 

GAO has previously reported that GPRA, with its focus on strategic planning,

the development of long-term goals, and accountability for results, provides 

a framework Congress, OMB, and executive branch agencies can use to 

consider the appropriate mix of long-term strategic goals and strategies 

needed to identify and address issues that cut across agency boundaries. In 

addition, to provide a broader perspective on the federal government’s goals 

and strategies to address issues that cut across agencies, we previously 

recommended that (1) OMB develop a governmentwide performance plan as 

required by GPRA and (2) Congress consider amending GPRA to require a 

governmentwide strategic plan. 

OMB, through the PMA, has emphasized improving government performance 

through governmentwide and agency-specific initiatives. One of these 

focuses specifically on improving coordination, but only between the 

Departments of Veterans Affairs and Defense for health programs and 

systems. However, many other areas that cut across agency boundaries 

would benefit from greater OMB focus and attention, including information 

sharing for homeland security, which GAO recently designated as a high-risk 

area. OMB has also used its PART diagnostic tool to determine, among other 

things, whether individual programs duplicate other efforts and if agencies 

coordinate and collaborate effectively with related programs. The PART 

tool provides general guidance for assessing effective program coordination 

and collaboration, but does not discuss practices for enhancing and 

sustaining collaboration, such as those described and illustrated in this 

report. 

The federal government faces a 

series of challenges in the 21st

century that will be difficult, if not 

impossible, for any single agency to 

address alone. Many issues cut 

across more than one agency and 

their actions are not well 

coordinated. Moreover, agencies 

face a range of barriers when they 

attempt to work collaboratively. 

This report identifies key practices 

that can help enhance and sustain 

agency collaboration. GAO also 

considered how the Government 

Performance and Results Act 

(GPRA) and the Office of 

Management and Budget (OMB) 

address collaboration among 

agencies. To illustrate these 

practices, we selected the Healthy 

People, wildland fire management, 

and Departments of Veterans 

Affairs and Defense’s health 

resource sharing collaborations. 

What GAO Recommends

GAO recommends that the Director 

of OMB focus on additional 

programs in need of collaboration 

and promote the practices in this 

report. Options include expanding 

the focus on collaboration in the 

President’s Management Agenda 

(PMA) and supplementing the 

Program Assessment Rating Tool 

(PART) guidance with information 

about these practices. OMB agreed 

with this recommendation. 

Agencies involved in the 

collaborations provided technical 

comments, which we incorporated 

as appropriate. 
Page i GAO-06-15 Results-Oriented Government 

Letter 1

Results in Brief 4 

Background 6 

Key Practices That Can Help Enhance and Sustain Collaboration 

among Federal Agencies 10 

GPRA and OMB’s Management Tools Offer Opportunities to Foster 

Greater Collaboration among Federal Agencies 26 

Conclusions 29 

Recommendation for Executive Action 30 

Agency Comments and Our Evaluation 30 

Appendix I Scope and Methodology 32 

Appendix II Federal Collaborative Efforts We Reviewed 35 

Appendix III GAO Contact and Staff Acknowledgments 38 

Table Table 1: Federal Collaborative Efforts We Reviewed 35 

Contents 
Page ii GAO-06-15 Results-Oriented Government 

Abbreviations 

CDC Centers for Disease Control and Prevention 

DOD Department of Defense 

DOE Department of Energy 

FDA Food and Drug Administration 

GPRA Government Performance and Results Act of 1993 

HHS Department of Health and Human Services 

ICS Incident Command System 

NIFC National Interagency Fire Center 

NIH National Institutes of Health 

OMB Office of Management and Budget 

OPM Office of Personnel Management 

PART Program Assessment Rating Tool 

PMA President’s Management Agenda 

SES Senior Executive Service 

USDA U.S. Department of Agriculture 

VA Department of Veterans Affairs 

VISN Veterans Integrated Service Network 

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reproduce this material separately. 
Page 1 GAO-06-15 Results-Oriented Government 

October 21, 2005 

The Honorable George V. Voinovich 

Chairman 

Subcommittee on Oversight of Government Management, 

 the Federal Workforce, and the District of Columbia 

Committee on Homeland Security and Governmental Affairs 

United States Senate 

Dear Mr. Chairman: 

Achieving results for the nation increasingly requires that federal agencies 

work together. From combating terrorism, monitoring infectious diseases, 

and responding to natural disasters, the federal government faces a series 

of challenges in the 21st century that will be difficult, if not impossible, for 

any single agency to address alone. Taking into account the nation’s longrange fiscal challenges, the federal government must identify ways to 

deliver results more efficiently and in a way that is consistent with its 

multiple demands and limited resources. 

Our work has shown that many issues cut across more than one agency 

and their actions are not well coordinated. Examples include the 

following: 

• Four years after the 9/11 terrorist attacks the federal government’s efforts 

to achieve interoperable communications among emergency responders at 

all levels of government have been hampered in part by an inadequate 

level of interagency collaboration.1, 2

 1

GAO, Project SAFECOM: Key Cross-Agency Emergency Communications Effort 

Requires Stronger Collaboration, GAO-04-494 (Washington, D.C.: Apr. 16, 2004) and 

Homeland Security: Management of First Responder Grant Programs and Efforts to 

Improve Accountability Continue to Evolve, GAO-05-530T (Washington, D.C.: Apr. 12, 

2005). 

2

For the purpose of this report we use the term “collaboration” broadly to include 

interagency activities that others have variously defined as “cooperation,” “coordination,” 

“integration,” or “networking.” We have done so since there are no commonly accepted 

definitions for these terms and we are unable to make definitive distinctions between these 

different types of interagency activities. The background section contains a more complete 

definition of collaboration as used in this report. 

United States Government Accountability Office

Washington, DC 20548 
Page 2 GAO-06-15 Results-Oriented Government 

• No overall strategy integrates the threat-reduction and nonproliferation 

programs of the Department of Defense (DOD), Department of Energy 

(DOE), and others, and the agencies’ implementation of very similar 

programs has not always been well coordinated. In particular, there is no 

governmentwide guidance delineating the roles and responsibilities of 

agencies managing border security programs. According to DOD and DOE 

officials managing these programs, agencies’ roles are not well delineated 

and coordination could be improved.3

We have also reported that agencies face a range of barriers when they 

attempt to collaborate with other agencies.4

 One such barrier stems from 

missions that are not mutually reinforcing or that may even conflict, 

making reaching a consensus on strategies and priorities difficult. Another 

significant barrier to interagency collaboration is agencies’ concerns about 

protecting jurisdiction over missions and control over resources. Finally, 

interagency collaboration is often hindered by incompatible procedures, 

processes, data, and computer systems. Instead, federal agencies carry out 

programs in a fragmented, uncoordinated way, resulting in a patchwork of 

programs that can waste scarce funds, confuse and frustrate program 

customers, and limit the overall effectiveness of the federal effort. 

To help agencies overcome these barriers, and in response to your request, 

this report identifies key practices that can help enhance and sustain 

federal agency collaboration, along with illustrative examples from select 

agencies. We also considered our prior work on how the Government 

Performance and Results Act of 1993 (GPRA)5

 can be used to identify 

opportunities for improved collaboration among federal agencies and on 

the role played by the Office of Management and Budget (OMB)—as the 

focal point for overall management in the executive branch agencies—in 

providing leadership and direction to federal agencies’ collaborative 

efforts. 

 3

GAO, Weapons of Mass Destruction: Nonproliferation Programs Need Better Integration, 

GAO-05-157 (Washington, D.C.: Jan. 28, 2005). 

4

GAO, Managing for Results: Barriers to Interagency Coordination, GAO/GGD-00-106

(Washington, D.C.: Mar. 29, 2000). 

5

Pub. L. No. 103-62, 107 Stat. 285 (1993). Under GPRA, federal agencies are required to 

develop strategic plans, performance plans, and performance reports that set long-term and 

annual goals along with the means for accomplishing the goals and report on achieving 

them. 
Page 3 GAO-06-15 Results-Oriented Government 

To meet these objectives, we reviewed the relevant literature, including 

our prior reports, and interviewed experts in the area of collaboration. On 

the basis of these sources, we identified eight broad practices that can 

facilitate greater collaboration among federal agencies. We also identified 

areas where federal agencies are engaged in collaborative efforts. 

Although achieving results may involve the collaborative efforts of both 

federal and nonfederal partners, for the purpose of this work we focused 

on the practices that federal agencies can employ.6

To illustrate these practices, we selected three areas where federal 

agencies have developed substantial ongoing collaborations: Healthy 

People 2010—a long-standing effort to develop and track public health 

objectives for the nation, wildland fire management,7

 and health resource 

sharing between the Department of Veterans Affairs (VA) and DOD at 

selected locations. We selected these areas based on expert views and our 

prior work indicating that collaboration was taking place in the area. The 

examples presented in this report are intended to be illustrative. 

Therefore, we did not seek to show how the agencies in each of the three 

collaborative areas engaged in every practice. In addition, because the 

focus of our work was to identify practices for effective collaboration, we 

did not assess whether the examples of collaboration practices we 

highlighted resulted in improved agency performance in the three areas. 

To obtain perspectives on the practices we identified, we interviewed 

officials and reviewed documents from the federal agencies involved in 

the three collaborative efforts —VA, DOD, and the Departments of 

Agriculture (USDA), Education, Health and Human Services (HHS), and 

the Interior. In addition, we visited selected locations from among these 

agencies that were involved in sharing resources with each other. We also 

interviewed nonfederal stakeholders involved in the collaborative efforts 

we selected. 

Appendix I provides a more detailed description of our scope and 

methodology. 

 6

For factors that enhance regional collaboration across federal, state, and local entities see 

GAO, Homeland Security: Effective Regional Coordination Can Enhance Emergency 

Preparedness, GAO-04-1009 (Washington, D.C.: Sept. 15, 2004). 

7

In prior GAO work on wildland fire management, we defined coordination as an activity 

that takes place among federal agencies and collaboration as an activity that occurs among 

federal and nonfederal partners. In this report we do not distinguish between the two 

terms. For further explanation see footnote 2. 
Page 4 GAO-06-15 Results-Oriented Government 

We conducted our work from May 2004 through August 2005 in offices in 

the Washington, D.C. metropolitan area; Boise, Idaho; Louisville and Fort 

Knox, Kentucky; Pensacola, Florida; and Sacramento and Fairfield, 

California, in accordance with generally accepted government auditing 

standards. 

Collaboration can be broadly defined as any joint activity that is intended 

to produce more public value than could be produced when organizations 

act alone. Agencies can enhance and sustain their collaborative efforts by 

engaging in the practices identified below: 

• Define and articulate a common outcome. VA Gulf Coast Health Care 

System and the Naval Hospital Pensacola, for example, collaborated on 

building a new joint ambulatory care clinic in order to improve the quality, 

access, and efficiency of health care delivery for their respective 

populations. 

• Establish mutually reinforcing or joint strategies designed to help 

align activities, core processes, and resources to achieve a common 

outcome. VA and DOD, for example, developed a joint strategic plan for 

health resource sharing that discusses strategies such as developing joint 

guidelines and policies and providing joint training. 

• Identify and address needs by leveraging resources to support the 

common outcome and, where necessary, opportunities to leverage 

resources. For example, the National Interagency Fire Center (NIFC), in 

Boise, Idaho, identifies and allocates federal firefighting resources from 

different agencies as needed to suppress wildland fires. 

• Agree on roles and responsibilities, including leadership. Officials at 

the VA Northern California Health Care System and at Travis Air Force 

Base, for example, jointly developed a charter that specified the respective 

roles and responsibilities of an executive management team as well as a 

charter for a working group for health resource sharing. 

• Establish compatible policies, procedures, and other means to 

operate across agency boundaries, including compatible standards and 

data systems, and communicate frequently to address such matters as 

cultural differences. Federal agencies with wildland fire management 

responsibilities developed an interagency handbook that defines the 

common standards, policies, and procedures they are to use in wildland 

fire operations. 

• Develop mechanisms to monitor, evaluate, and report on the 

results of the collaborative effort. HHS holds periodic progress reviews to 

assess the status of achieving Healthy People 2010 objectives. The results 

of these reviews are publicly reported on the Healthy People website. 

Results in Brief 
Page 5 GAO-06-15 Results-Oriented Government 

• Reinforce agency accountability for collaborative efforts by using 

strategic and annual performance plans to establish complementary goals 

and strategies and by using performance reports to account for results. 

The Forest Service has a goal in its fiscal year 2004-2008 strategic plan, 

“Reduce the risk from catastrophic wildland fire,” that complements the 

interagency goals contained in the 10-year strategy for reducing wildland 

fire risk. 

• Reinforce individual accountability for collaborative efforts through 

performance management systems by identifying competencies related to 

collaboration and setting performance expectations for collaboration. 

Interior evaluates the performance of its senior executives, in part, on 

their ability to successfully collaborate with customers, partners, and 

stakeholders. 

For a number of these practices, it is critical to involve nonfederal 

partners, key clients, and stakeholders in decisionmaking. Additionally, 

running throughout these practices are a number of factors such as 

leadership, trust, and organizational culture that are necessary elements 

for a collaborative relationship. 

We have previously reported that GPRA, with its focus on strategic 

planning, the development of long-term goals, and accountability for 

results, provides a framework that Congress, OMB, and executive branch 

agencies can use to consider the appropriate mix of long-term strategic 

goals and strategies needed to identify and address crosscutting federal 

goals. For example, we have previously recommended that OMB could 

provide a broader perspective on the federal government’s goals and 

strategies to address issues that cut across different federal agencies, 

including redundancy and other inefficiencies in how the government does 

its business, by fully implementing the GPRA requirement to develop a 

governmentwide performance plan. Moreover, we recommended Congress 

amend GPRA to require a governmentwide strategic plan to provide a 

framework for identifying long-term goals and strategies for addressing 

crosscutting issues. 

OMB, through the President’s Management Agenda (PMA), has 

emphasized improving government performance through governmentwide 

and agency-specific initiatives. OMB has established “standards for 

success” for the initiatives and rates agencies’ progress toward meeting 

these standards. Among the PMA initiatives, only one focuses specifically 

on improving coordination—coordination of VA and DOD programs and 

systems. However, many other areas that cut across agency boundaries 

would benefit from greater OMB focus and attention, including 
Page 6 GAO-06-15 Results-Oriented Government 

information sharing for homeland security which we recently designated 

as a high-risk area.8

 OMB has also used the Program Assessment Rating 

Tool (PART), a diagnostic tool consisting of questions designed to provide 

a consistent approach to rating federal programs. To determine whether 

programs are achieving results, PART assesses, among other things, 

whether programs are duplicative of other efforts—federal, state, local, 

and private—and whether agencies coordinate and collaborate effectively 

with related programs. The PART tool provides general guidance for 

assessing effective program coordination and collaboration, but does not 

discuss any practices for enhancing and sustaining collaboration, such as 

those described and illustrated in this report. 

We recommend that the Director of OMB continue to encourage 

interagency collaboration by identifying additional programs in need of 

greater collaboration to achieve common outcomes and promoting the 

collaboration practices identified in this report. Options for encouraging 

interagency collaboration include expanding the PMA initiatives and 

associated standards for success to include a greater focus on 

collaboration and supplementing the PART guidance with information 

about the collaboration practices in this report. 

We provided a draft of this report to the Director of OMB for comment. 

OMB’s Counsel to the Deputy Director for Management responded orally 

that OMB agreed with the recommendation. We also provided relevant 

sections of a draft of this report to the agencies involved in the three 

collaboration efforts—VA, DOD, USDA, HHS, and the Departments of 

Education and the Interior. They offered technical suggestions, which we 

incorporated as appropriate. 

Although there is no commonly accepted definition for collaboration, for 

the purpose of this report we define it as any joint activity by two or more 

organizations that is intended to produce more public value than could be 

produced when the organizations act alone.9

 For example, joint activities 

can range from occasional meetings between middle-management 

employees in which the existing division of labor of the respective 

agencies is reaffirmed to the more structured joint law enforcement teams 

 8

GAO, High-Risk Series: An Update, GAO-05-207 (Washington, D.C.: January 2005). 

9

See E. Bardach, Getting Agencies to Work Together: The Practice and Theory of 

Managerial Craftsmanship (Washington, D.C.: Brookings Institution, 1998). 

Background 
Page 7 GAO-06-15 Results-Oriented Government 

operating over a long period of time.10 In contrast, absent effective 

collaboration, routine interagency meetings can be dutifully attended 

without having any substantive information communicated, joint 

agreements reached among the agencies, or agreements implemented. 

Although, according to this definition, collaboration can involve federal 

and nonfederal governmental organizations as well as nongovernmental 

organizations, this report focuses on the actions federal agencies can take 

to improve collaboration. 

To illustrate practices that can enhance and sustain collaboration among 

federal agencies, we selected three federal collaborative efforts—Healthy 

People 2010, wildland fire management, and VA and DOD health resource 

sharing—in which federal agencies work across agency lines to achieve 

common outcomes. Appendix II provides additional information on these 

three efforts. 

Healthy People 2010, a federal effort led by HHS and involving a number of 

other federal agencies, is a set of national public health objectives, with 

associated indicators to measure progress, which are revisited every 10 

years. These objectives are intended to cover the most significant 

preventable threats to health and support two broad national goals—(1) 

increasing the quality and years of healthy life and (2) eliminating health 

disparities. The Healthy People objectives are divided among 28 focus 

areas. In this report we looked at two focus areas that involved multiple 

federal agencies—Nutrition and Overweight, and Disability and Secondary 

Conditions. The goal of the Nutrition and Overweight focus area is to 

promote health and reduce chronic disease associated with diet and 

weight. The Food and Drug Administration (FDA) and National Institutes 

of Health (NIH) are colead agencies for the Nutrition and Overweight 

focus area. The goal of the Disability and Secondary Conditions focus area 

is to promote the health of people with disabilities, prevent secondary 

conditions, and eliminate disparities between people with and without 

disabilities in the U.S. population. The Centers for Disease Control and 

Prevention (CDC) and the Department of Education’s National Institute on 

Disability and Rehabilitation Research are colead agencies for Disability 

and Secondary Conditions. Since it was established in 1979, Healthy 

 10As Bardach maintains, if successfully done, occasional meetings by which participants 

agree upon their respective responsibilities increase public value. To successfully manage 

such agreement requires participants working together collaboratively. 

Federal Collaborative 

Efforts We Reviewed 

Healthy People 2010 
Page 8 GAO-06-15 Results-Oriented Government 

People has engaged a diverse group of stakeholders throughout the 

country, including public and private organizations. 

Wildland fires contribute to ecological health in forests and rangelands by 

maintaining plant species diversity, limiting the spread of insects and 

disease, and promoting new growth, among other things. However, past 

management practices, including a concerted federal policy in the 20th 

century of suppressing fires to protect communities and ecosystem 

resources, unintentionally resulted in steady accumulation of dense 

vegetation that fuels large, intense, wildland fires than can have 

catastrophic effects on ecosystems and nearby communities. Federal 

agencies responsible for wildland fire management (wildland fire 

agencies) include the Forest Service at USDA and the Bureau of Indian 

Affairs, Bureau of Land Management, Fish and Wildlife Service, and 

National Park Service at Interior. 

The first single comprehensive federal wildland fire policy for USDA and 

Interior was established in 1995 in response to the prior year’s fire season 

with its 34 fatalities.11 The 1995 policy is based on several guiding 

principles including interagency cooperation—in particular, “fire 

management planning, preparedness, suppression, fire use, monitoring, 

and research will be conducted on an interagency basis with the 

involvement of all parties.” Interagency collaboration in the area of fire 

suppression, however, predated this 1995 federal policy. For example, the 

Bureau of Land Management and the Forest Service established a joint 

coordination center at Boise, Idaho, in 1965. This center has since evolved 

into the current NIFC, housing the five wildland fire agencies along with 

the National Weather Service, Department of Commerce; Office of Aircraft 

Services, Department of the Interior; United States Fire Administration, 

Department of Homeland Security; and the National Association of State 

Foresters. A series of catastrophic wildland fires in 2000 resulted in the 

wildland fire agencies and their partners developing a long-term, 

collaborative approach for reducing wildland fire risk and the reviewing 

and updating of the 1995 federal wildland fire policy. The collaborative 

approach and update are the basis for the current wildland fire 

management policy and practice. 

 11U.S. Department of the Interior and U.S. Department of Agriculture, Federal Wildland 

Fire Management Policy and Program Review: Final Report (Washington, D.C.: Dec. 18, 

1995). 

Wildland Fire Management 
Page 9 GAO-06-15 Results-Oriented Government 

VA operates one of the nation’s largest health care systems. Of the 7.4 

million total enrollees in fiscal year 2004, VA obligated $28.4 billion to 

provide care to 5.2 million total patients, which included veterans and 

eligible nonveterans. Currently, health care is provided through 157 VA 

hospitals and nearly 900 outpatient clinics nationwide. DOD spends about 

$30.4 billion on health care for over 9.1 million beneficiaries, including 

active-duty personnel and retirees, and their dependents. Most DOD health 

care is provided at more than 530 Army, Navy, and Air Force military 

treatment facilities worldwide, supplemented by civilian providers. While 

both agencies have distinct missions—the VA focuses on providing 

benefits to veterans and their families and DOD focuses on maintaining 

the combat readiness of the military—both provide health care services. 

To encourage sharing of federal health resources between VA and DOD, in 

1982 Congress passed the Veterans’ Administration and Department of 

Defense Health Resources Sharing and Emergency Operations Act (the 

“Sharing Act”).12 Previously, VA and DOD health care facilities, many of 

which are colocated or in close geographic proximity, operated virtually 

independently of each other. The Sharing Act authorizes VA medical 

centers and military treatment facilities to become partners and enter into 

sharing agreements to buy, sell, and barter medical and support services. 

The intent of the law was not only to remove legal barriers, but also to 

encourage VA and DOD to engage in health resource sharing to more 

effectively and efficiently use federal health resources. 

Additional legislation was passed in 2002 to encourage and foster VA and 

DOD health resource sharing. Under the Bob Stump National Defense 

Authorization Act for Fiscal Year 2003, VA and DOD were required, among 

other things, to develop a joint strategic plan and incorporate the joint 

goals and strategies into the respective departments’ strategic and 

performance plans that are required under GPRA. VA and DOD were also 

required to establish a high-level interagency committee to develop and 

implement collaborative efforts and to establish a joint incentive program 

to provide incentives for implementing, funding, and evaluating creative 

health resource sharing initiatives. VA and DOD are each required to make 

a minimum contribution of $15 million from each department’s 

appropriations each year for four years to fund the joint program,13 the 

Joint Incentive Fund Program. Proposals for funding for either onetime 

 12Pub. L. No. 97-174, 96 Stat. 70 (May 4, 1982); House Report 97-72; Senate Report 97-137. 

13Pub. L. No. 107-314, §721, 116 Stat. 2458, 2589-2595 (Dec. 2, 2002). 

VA and DOD Health Resource 

Sharing 
Page 10 GAO-06-15 Results-Oriented Government 

investments or recurring operations must be jointly developed by VA and 

DOD. To ensure continuity of operations, projects involving recurring 

costs must be self-sustaining and the incentive funds can be used for no 

more than two years for operational costs. 

We have pointed out that VA and DOD health resource sharing faces longstanding barriers, including incompatible computer systems that affect the 

exchange of patient health information, inconsistent reimbursement and 

budgeting policies, and burdensome agreement approval processes.14 OMB 

has also singled out VA and DOD resource sharing for increased attention 

through its PMA initiative. Nonetheless, our work has also shown that at 

specific sites, VA and DOD are actively involved in health resource sharing 

activities.15 For this work, we reviewed health resource sharing at three of 

those sites, covering the Army, Navy, and Air Force. See appendix I for a 

complete list of the VA and DOD sites we visited. 

Drawing from the literature we reviewed, the experts we interviewed, and 

our prior work, we identified eight key practices that can help federal 

agencies enhance and sustain their collaborative efforts. The federal 

collaborative efforts we reviewed helped further refine the practices and 

provided a wide variety of concrete illustrations of how the practices can 

apply in different federal agency contexts. 

While collaboration among federal agencies can take many different 

forms, the practices generally consist of two or more agencies 

• defining and articulating a common outcome; 

• establishing mutually reinforcing or joint strategies to achieve the 

outcome; 

• identifying and addressing needs by leveraging resources; 

• agreeing upon agency roles and responsibilities; 

• establishing compatible policies, procedures, and other means to operate 

across agency boundaries; 

• developing mechanisms to monitor, evaluate, and report the results of 

collaborative efforts; 

 14GAO, Opportunities for Congressional Oversight and Improved Use of Taxpayer Funds: 

Budgetary Implications of Selected GAO Work, GAO-04-649 (Washington, D.C.: May 7, 

2004). 

15GAO, VA and DOD Health Care: Resource Sharing at Selected Sites, GAO-04-792

(Washington D.C.: July 21, 2004). 

Key Practices That 

Can Help Enhance 

and Sustain 

Collaboration among 

Federal Agencies 
Page 11 GAO-06-15 Results-Oriented Government 

• reinforcing agency accountability for collaborative efforts through agency 

plans and reports; and 

• reinforcing individual accountability for collaborative efforts through 

agency performance management systems. 

For a number of these practices, it is also critical to involve nonfederal 

partners, key clients, and stakeholders in decision making. Additionally, 

agencies can strengthen their commitment to work collaboratively by 

articulating their agreements in formal documents, such as a 

memorandum of understanding, interagency guidance, or an interagency 

planning document, signed by senior officials in the respective agencies. 

Running throughout these eight practices are a number of factors such as 

leadership and trust that are necessary elements for a collaborative 

working relationship. These factors are established, sustained, and 

reinforced through that relationship, thereby fostering a collaborative 

culture.16

To overcome significant differences in agency missions, cultures, and 

established ways of doing business, collaborating agencies must have a 

clear and compelling rationale to work together. The compelling rationale 

for agencies to collaborate can be imposed externally through legislation 

or other directives or can come from the agencies’ own perceptions of the 

benefits they can obtain from working together. In either case, the 

collaborative effort requires agency staff working across agency lines to 

define and articulate the common federal outcome or purpose they are 

seeking to achieve that is consistent with their respective agency goals and 

mission. Moreover, the development of a common outcome takes place 

over time and requires sustained resources and commitment. 

Following the authority provided in the Sharing Act, a number of VA and 

DOD facilities have collaborated to achieve their common goals. VA Gulf 

Coast Health Care System and the Naval Hospital Pensacola, for example, 

collaborated to build a new joint ambulatory care clinic to improve the 

quality, access, and efficiency of health care delivery for their respective 

 16We identified a series of useful practices and implementation steps for mergers and 

organizational transformation that address a number of these same areas such as 

leadership and culture. See GAO, Results-Oriented Cultures: Implementation Steps to 

Assist Mergers and Organizational Transformations, GAO-03-669 (Washington, D.C.: July 

2, 2003). 

Define and Articulate the 

Common Outcome 
Page 12 GAO-06-15 Results-Oriented Government 

populations. The VA wanted to expand its medical facilities and increase 

the type of medical services available in the area, as most beneficiaries 

who needed specialty care were transported by the VA to Biloxi, 

Mississippi, or New Orleans, Louisiana, adding to the cost of care.17 The 

Navy, with several aging medical facilities, was facing a demand for 

services from a growing population of retirees and students from the 

cryptology school on the naval base. Over the course of nearly a year, 

officials from the VA Gulf Coast Health Care System and the Naval 

Hospital Pensacola, who had already shared medical services in the past, 

agreed to build a joint ambulatory care center to provide closer and 

expanded services as a way of improving access for both VA and Navy 

populations. This agreement was formalized in a concept paper signed by 

the director of VA Gulf Coast Health Care System and the Commanding 

Officer of the Naval Hospital Pensacola. 

USDA and Interior’s current collaboration in managing wildland fires 

stemmed from the catastrophic wildland fires of 2000. The fires prompted 

the President to request that the Secretaries of USDA and the Interior 

develop a response to severe wildland fires, reduce their effects, and 

ensure sufficient firefighting resources in the future.18 Additionally, the 

conference committee report accompanying the fiscal year 2001 Interior 

appropriations act directed the Secretaries to work with the relevant 

Governors to develop a 10-year strategy for reducing wildland fire risk.19

The Departments’ response and conference committee direction resulted 

in the National Fire Plan that included a collaborative approach for a 10-

 17The VA facilities in Biloxi and New Orleans are both over 100 miles from the VA 

Pensacola Outpatient Clinic. 

18U.S. Department of the Interior and U.S. Department of Agriculture, Managing the 

Impact of Wildfires on Communities and the Environment: A Report to the President In 

Response to the Wildfires of 2000 (Washington, D.C.: Sept. 8, 2000). 

19U.S. House of Representatives, Making Appropriations for the Department of the 

Interior and Related Agencies for the Fiscal Year Ending September 30, 2001, and for 

Other Purposes, Report 106-914 (Sept. 29, 2000). 
Page 13 GAO-06-15 Results-Oriented Government 

year strategy and implementation plan to reduce the risk of catastrophic 

wildland fires.20

The fires in 2000 also led to a review of the 1995 federal fire policy, which 

concluded that while the policy was sound and appropriate, the 

implementation was incomplete, particularly where it involved 

“collaboration, coordination, and integration across agency jurisdiction 

and across different disciplines.”21 As a result of the review, as well as 

studies by the National Academy of Public Administration and GAO, USDA 

and Interior established the Wildland Fire Leadership Council in 2002 to 

provide leadership and oversight in implementing the National Fire Plan 

and the federal fire policy. This interagency council, comprised of senior 

USDA and Interior officials, federal, state, tribal, and county 

representatives, including the heads of the five wildland fire agencies, 

meets regularly to foster policy coordination and the resolution of 

interagency differences. 

In the case of the Healthy People initiative, federal agencies, along with 

state and local government agencies and nongovernmental organizations, 

came together voluntarily to collaborate because they shared an overall 

commitment to and responsibility for health promotion and disease 

prevention. Recognizing that progress in improving the nation’s health 

required the active participation and leadership of this diverse array of 

organizations, the collaboration has grown to over 600 organizations since 

it began in 1988. Officials from several federal agencies with public health 

responsibilities worked together to review and update as necessary the 

Healthy People objectives. For example, the CDC, along with the 

Department of Education’s National Institute on Disability and 

Rehabilitation Research, worked together to assess current public health 

conditions and concluded that the health and well-being of people with 

 20U.S. Department of the Interior, U.S. Department of Agriculture, and Western Governors’ 

Association, A Collaborative Approach for Reducing Wildland Fire Risks to Communities 

and the Environment: 10 Year Comprehensive Strategy (Washington, D.C.: August 2001); 

and U.S. Department of the Interior, U.S. Department of Agriculture, and Western 

Governors’ Association, A Collaborative Approach for Reducing Wildland Fire Risks to 

Communities and the Environment: 10-Year Comprehensive Strategy, Implementation 

Plan (Washington, D.C.: May 2002). 

21U.S. Department of the Interior, U.S. Department of Agriculture, Department of Energy, 

Department of Defense, Department of Commerce, U. S. Environmental Protection Agency, 

Federal Emergency Management Agency, and National Association of State Foresters, 

Review and Update of the 1995 Federal Wildland Fire Management Policy (Washington, 

D.C.: January 2001). 
Page 14 GAO-06-15 Results-Oriented Government 

disabilities was an issue that could be better represented in the Healthy 

People 2010 agenda. Scientific and technological advances, societal 

attitudes, and labor market changes had redefined the extent to which 

physical or mental conditions are disabling,22 and such changes should also 

be reflected in the public health system. As a result of this collaborative 

review, “Disability and Secondary Conditions” was included as a new 

focus area for Healthy People 2010. The goal for this new focus area is to 

“promote the health of people with disabilities, prevent secondary 

conditions, and eliminate disparities between people with and without 

disabilities.” Specific objectives for this focus area include (1) establishing 

a standardized operational definition for disability and collecting 

information on people with disabilities, thereby enabling government 

policymakers, researchers, and clinicians to make better-informed 

decisions; (2) eliminating disparities in employment between working-age 

adults with and without disabilities; and (3) increasing the proportion of 

children and youth with disabilities in regular education programs. 

In defining and articulating a common outcome, where appropriate, 

federal agencies should involve nonfederal partners, key clients, and 

stakeholders. In doing so, federal agencies can better address their 

interests and expectations and gain their support in achieving the 

objectives of the collaboration. In developing the Healthy People 2010 

objectives, HHS included as partners nonfederal organizations such as 

state and local public health, mental health, and environmental agencies; 

professional health groups; and health and recreation organizations. In 

addition, HHS solicited public comments and invited individuals from 

academia, businesses, the faith community, health care providers, 

advocacy groups and community-based organizations, and nonprofit or 

voluntary agencies to attend public meetings to discuss the proposed 

Healthy People 2010 objectives. 

To achieve a common outcome, collaborating agencies need to establish 

strategies that work in concert with those of their partners or are joint in 

nature. Such strategies help in aligning the partner agencies’ activities, 

core processes, and resources to accomplish the common outcome. 

 22We also reported on how these changes have affected the ability of people with 

disabilities to work. See GAO, SSA Disability: Program Redesign Necessary to Encourage 

Return to Work, GAO/HEHS-96-62 (Washington, D.C.: Apr. 24, 1996) and SSA Disability: 

Other Programs May Provide Lessons for Improving Return-to-Work Efforts, GAO-01-153

(Washington, D.C.: Jan. 12, 2001). 

Establish Mutually 

Reinforcing or Joint 

Strategies 
Page 15 GAO-06-15 Results-Oriented Government 

Federal agencies have developed mutually reinforcing strategies to 

accomplish the Healthy People 2010 goal for the nutrition and overweight 

focus area—to promote health and reduce chronic diseases associated 

with diet and weight. For example, USDA, in collaboration with HHS, 

updates the Dietary Guidelines for Americans that provides advice on 

good dietary habits and serves as the basis for federal food and nutrition 

education programs.23 One of FDA’s strategies to achieve this goal is to 

require that food labels provide information to consumers that will assist 

them in planning healthful diets. And one of NIH’s strategies towards this 

goal was to promote the use of their evidence-based guidance for treating 

overweight conditions and obesity—Clinical Guidelines on the 

Identification, Evaluation, and Treatment of Overweight and Obesity in 

Adults: The Evidence Report.

24

VA and DOD, on the other hand, have developed joint strategies. As 

required by the Bob Stump National Defense Authorization Act for Fiscal 

Year 2003, VA and DOD’s Joint Executive Council, comprised of senior 

leadership and staff involved in health and benefit activities from both 

agencies, developed a joint strategic plan for the delivery of benefits and 

services.25 The plan identifies strategies for accomplishing each of six 

strategic goals. The strategies include developing joint guidelines and 

policies for the delivery of high-quality care and assurance of patient 

safety, and providing joint training in multiple disciplines. 

In the area of wildland fire management, federal agencies have involved 

nonfederal partners, key clients, and stakeholders in the development of 

joint strategies to achieve their common goal of preventing and 

suppressing wildland fires. In the aftermath of a series of wildland fires in 

2000, the President directed the Secretaries of USDA and the Interior to 

identify short-term strategies for responding to severe wildland fires. 

Subsequently, the conference committee report accompanying the fiscal 

year 2001 appropriations act directed the Secretaries to work with 

 23The dietary guidelines have been jointly issued every 5 years since 1980. For the most 

recent guidelines see U.S. Department of Health and Human Services and U.S. Department 

of Agriculture, Dietary Guidelines for Americans 2005 (Washington, D.C.: 2005). 

24National Institutes of Health, Clinical Guidelines on the Identification, Evaluation, and 

Treatment of Overweight and Obesity in Adults: The Evidence Report, NIH Publication 

No. 98-4083 (Bethesda, Md.: September 1998). 

25Pub. L. 107-314 and Department of Veterans Affairs and Department of Defense, 

Department of Veterans Affairs and Department of Defense Joint Strategic Plan, Fiscal 

Year 2005 (Washington, D.C.: December 2004). 
Page 16 GAO-06-15 Results-Oriented Government 

Governors of the affected states on a long-term strategy to deal with 

wildland fires. Moreover, the Secretaries were directed to engage the 

Governors in a “collaborative structure to cooperatively develop” a 

comprehensive strategy with the states as “full partners in the planning, 

decision-making and implementation” of such strategy. Serving as a 

conduit for a broad range of nonfederal stakeholders, the Western 

Governors’ Association, in collaboration with USDA and Interior, 

developed a 10-year comprehensive strategy and implementation plan that 

includes a number of actions that are to be carried out in concert. For 

example, the Wildland Fire Leadership Council, National Association of 

State Foresters, and National Association of Counties are jointly 

responsible for assessing “the training, equipment, safety awareness of, 

and services provided by rural, volunteer, and other firefighters that work 

in the wildland-urban interface.” 

Collaborating agencies should identify the human, information technology, 

physical, and financial resources needed to initiate or sustain their 

collaborative effort. Collaborating agencies bring different levels of 

resources and capacities to the effort. By assessing their relative strengths 

and limitations, collaborating agencies can look for opportunities to 

address resource needs by leveraging each others’ resources, thus 

obtaining additional benefits that would not be available if they were 

working separately. 

Wildland fire agencies collaborate to quickly identify and address resource 

needs for suppressing wildland fires. According to NIFC, no single agency 

is capable of providing the resources needed to respond to especially large 

fires or to multiple concurrent fires. NIFC monitors the occurrence of 

wildland fires and coordinates and mobilizes wildland firefighting 

resources nationally to suppress those fires. Local and regional federal fire 

centers unable to meet personnel, equipment, and supply needs contact 

NIFC in Boise, Idaho. In response, NIFC provides certain resources and 

requests others from the closest available federal agency. For example, 

NIFC could request firefighting resources, including aircraft, personnel, 

telecommunications equipment, and ground and air transportation for 

equipment and supplies, from the Forest Service, Bureau of Indian Affairs, 

Fish and Wildlife Service, and the National Park Service to respond to an 

incident on land under the jurisdiction of the Bureau of Land Management. 

In the three cases we examined of VA and DOD health resource sharing, 

the agencies each had the incentive to work collaboratively to share 

facilities, medical supplies, and skilled medical personnel, enabling them 

Identify and Address 

Needs by Leveraging 

Resources 
Page 17 GAO-06-15 Results-Oriented Government 

to leverage resources. For example, in 1996 the Ireland Army Community 

Hospital at Fort Knox entered into an agreement with the Louisville VA 

Medical Center in which VA would provide primary care services for 

active duty military personnel and their families. In return, the Army 

provided VA with space, supplies, and equipment for a new outpatient 

clinic for VA patients and agreed to fill some prescriptions for VA patients. 

As a VA official noted, in a time of tight resources, there is an incentive for 

the VA and the Army to be partners, enabling them to accomplish their 

respective missions. 

In another example, the VA Northern California Health Care Systems and 

the David Grant Medical Center at Travis Air Force Base established a 

joint dialysis clinic that expanded services and increased the number of 

VA and Air Force patients served. Prior to the opening of the joint clinic, 

the medical center made its dialysis clinic available on an emergency basis 

to the VA, which lacked its own dialysis facilities. The VA sent its northern 

California patients to private physicians in the area at a higher cost. With a 

growing demand for dialysis services, the VA and Air Force worked 

collaboratively to develop and submit a proposal to the national Joint 

Incentive Fund for a joint clinic. This joint proposal was subsequently 

awarded funding, enabling an expansion of the dialysis facility to serve 

both DOD and VA patients. 

Collaborating agencies should work together to define and agree on their 

respective roles and responsibilities, including how the collaborative effort 

will be led. In doing so, agencies can clarify who will do what, organize 

their joint and individual efforts, and facilitate decisionmaking. Committed 

leadership by those involved in the collaborative effort, from all levels of 

the organization, is also needed to overcome the many barriers to working 

across agency boundaries. 

The five federal agencies with wildland fire management responsibilities 

jointly developed and update the Interagency Standards for Fire and Fire 

Aviation Operations—an operations handbook that defines the roles and 

responsibilities for all personnel engaged in managing wildland fire 

operations, regardless of agency affiliation. For example, according to the 

handbook, the Incident Commander for a wildland fire is responsible for 

all incident activities, including developing the fire management strategy 

and tactics, and ordering, deploying, and releasing resources. The Incident 

Commander is supported by an Incident Command Staff that may include 

a safety officer, information officer, operations section chief, planning 

section chief, logistics section chief, finance section chief, and a liaisons 

Agree on Roles and 

Responsibilities 
Page 18 GAO-06-15 Results-Oriented Government 

officer.26 In addition to specifying the roles and responsibilities, the 

interagency handbook also identifies the qualifications required for each 

position. For each wildland fire incident, staff meeting these qualifications 

are assigned to these roles, regardless of the agency for which they work. 

The VA and the Air Force in Northern California specified the roles and 

responsibilities for health resource sharing in two joint charters. These 

charters define a jointly staffed management structure for resource 

sharing—the Executive Management Team and the Joint Initiatives 

Working Group. One charter defines the roles and responsibilities of the 

Executive Management Team in determining the workload and fiscal 

implications of the sharing agreements, providing a dispute resolution 

system for the collaborative effort, and setting policy for sharing 

agreements and joint ventures. The other defines the roles and 

responsibilities of the Joint Initiatives Working Group for making 

recommendations to the Executive Management Team on sharing 

opportunities, reimbursement methodologies, facility and space 

considerations, and staffing personnel requirements. These charters have 

helped sustain the collaborative effort, despite routine rotations of DOD 

staff to other military installations. 

The leadership continuity provided by VA partners has also helped to 

sustain collaborative efforts in the face of periodic changes in DOD 

leadership. At the three local sites we visited, VA and DOD officials we 

spoke with said that it was important to have committed VA individuals 

who had a common understanding of both the VA and military 

environment and resource needs. One official said such individuals are 

instrumental in initiating and sustaining the collaboration for resource 

sharing. 

 26The Incident Command System (ICS), the onsite management system, provides a common 

organizational structure, procedures, and standards for agencies responding to wildland 

fires. This ICS system has since been adopted nationally as the National Incident 

Management System by the Department of Homeland Security to be utilized for all 

emergencies including terrorism, floods, and hurricanes. The ICS system has also been 

adopted by other countries, such as Canada, Australia, and New Zealand. 
Page 19 GAO-06-15 Results-Oriented Government 

To facilitate collaboration, agencies need to address the compatibility of 

standards, policies, procedures, and data systems that will be used in the 

collaborative effort. Furthermore, as agencies bring diverse cultures to the 

collaborative effort, it is important to address these differences to enable a 

cohesive working relationship and to create the mutual trust required to 

enhance and sustain the collaborative effort. Frequent communication 

among collaborating agencies is another means to facilitate working 

across agency boundaries and prevent misunderstanding. 

The Interagency Standards for Fire and Fire Aviation Operations

handbook mentioned previously also specifies common standards, 

operational policies, and procedures used for wildland fire operations. The 

interagency handbook includes standards for training and firefighting 

equipment as well as policies and procedures for developing a response to 

wildland fire, aviation operations, and communications. For example, the 

handbook specifies the standards for the chemicals used to suppress 

wildland fires, such as long-term retardants, suppressant foam, and water 

enhancers. It also establishes policies and procedures for the safe 

application of aerial and ground suppressants in a way that does not harm 

the ecosystem. 

The interagency Wildland Fire Leadership Council was established by 

USDA and Interior to facilitate collaboration across agency boundaries by 

providing leadership and the consistent implementation of wildland fire 

management goals and policy. The council deals with national policy 

issues, such as nationwide resource allocation and prioritization that cut 

across the different federal agencies. One official noted that the council 

members are the ultimate authority within their departments for wildland 

fire management. As such, they can negotiate and set wildland fire 

management policy for their respective departments. Council members are 

to ensure their respective agency’s disparate interests, missions, and 

multiple responsibilities are not adversely affected by policy decisions the 

council makes collectively. While the council meets several times a year, 

Establish Compatible 

Policies, Procedures, and 

Other Means to Operate 

across Agency Boundaries 
Page 20 GAO-06-15 Results-Oriented Government 

council staff—coordinators from both USDA and Interior—communicate 

more frequently and serve as liaisons to the various agencies.27

Collaborating agencies may also need to find common ground while still 

satisfying their respective operating needs. For example, in discussing 

where to locate the new joint ambulatory care clinic, VA and DOD at 

Pensacola had to overcome differences in their respective security 

standards. VA officials had expressed concern about their beneficiaries’ 

access to medical facilities located on military bases during periods of 

heightened security. Navy officials wanted the new clinic to be within 

walking distance from the Center for Cryptology so students attending the 

school could have easy access. At the same time, the Navy had concerns 

that easy access to the base could expose the cryptology school, which is a 

top secret facility, to unauthorized individuals. To address differences in 

security standards, the VA and the Navy agreed to install a security fence 

around the new clinic, creating an enclave within the naval base with a 

separate entrance that is accessible from a public highway. 

The ability to work collaboratively requires mutual trust among the 

respective parties—a shared belief that the partners will carry out their 

part of the joint agreement. Experts in collaboration and agency officials 

involved in all three efforts we examined—Healthy People 2010, VA and 

DOD health resource sharing, and wildland fire management—mentioned 

trust as a key to enhancing and sustaining collaborative efforts. Trust can 

be fostered in a variety of ways. For example, officials at NIFC suggested 

that trust among staff from the different wildland fire agencies was 

fostered through joint activities that provided opportunities for face-toface interaction, such as interagency training and national or regional 

conferences. Trust can also be a function of shared interest or background 

in an area. In the case of NIFC, although staff have different agency 

affiliations, most of them have field experience fighting fires. 

Fostering an interagency culture, according to NIFC staff we interviewed, 

can help facilitate collaborative efforts across agency boundaries and 

 27Staffing for the Wildland Fire Leadership Council at USDA is under the Forest Service’s 

National Coordinator for the National Fire Plan, while staffing at Interior is under the 

Office of Wildland Fire Coordination. These two offices are also responsible for 

coordinating with the other federal agencies and nonfederal partners, such as the Federal 

Emergency Management Agency, U.S. Geological Survey, National Governors Association, 

Intertribal Timber Council, National Association of State Foresters, and National 

Association of Counties. 
Page 21 GAO-06-15 Results-Oriented Government 

enhances a cohesive working relationship among staff from the different 

federal agencies with wildland fire responsibilities. For example, the 

agencies at NIFC reinforce a common interagency culture by hiring staff 

who have had experience and feel comfortable working in an interagency 

environment. An interagency environment, according to one official, is 

reinforced at NIFC in a variety of ways, including staff wearing a common 

interagency badge and co-location of staff by functional areas rather than 

by agency, reflecting the integrated staffing. 

Federal agencies engaged in collaborative efforts need to create the means 

to monitor and evaluate their efforts to enable them to identify areas for 

improvement. Reporting on these activities can help key decision makers 

within the agencies, as well as clients and stakeholders, to obtain feedback 

for improving both policy and operational effectiveness. 

To monitor and report on the status of achieving the Healthy People 2010 

objectives, HHS holds progress reviews in which the federal agencies with 

lead responsibilities for a focus area report on the progress towards 

achieving the objectives. Other federal agencies that do work related to 

the focus area also participate in these meetings. The agencies discuss the 

data trends, barriers to achieving the objectives, strategies undertaken to 

overcome barriers, and alternative approaches to attain further progress. 

A summary report of the progress review, including contact information, is 

made available to the public through the Healthy People website. 

Additionally, HHS conducts a midcourse review to assess the status of the 

overall Healthy People objectives and identify the significant health trends 

and gaps in preventive health issues. As the midcourse review could result 

in the modification of the Healthy People 2010 objectives, the proposed 

revisions to the objectives will be made available for public comment.28

Federal wildland fire agencies assess fire operations through “after action” 

reviews. According to interagency policy and standards, after each 

wildland fire incident, the wildland fire agencies should conduct reviews 

with personnel from different agencies along functional areas—for 

example, the incident management team and smokejumpers (firefighters 

 28The 30-day public comment period for the proposed midcourse review revisions was held 

from August 15, 2005, through September 15, 2005, with the final revisions to be issued in 

2006. Additionally, according to NIH officials, HHS uses a publicly available online 

database, DATA2010, to monitor and report on the status of achieving the Healthy People 

objectives. 

Develop Mechanisms to 

Monitor, Evaluate, and 

Report Results 
Page 22 GAO-06-15 Results-Oriented Government 

who use parachutes to get to the fire).29 As part of these reviews, personnel 

who worked on the incident discuss the strengths and weaknesses of the 

operations and determine what can be learned from it. Personnel assess 

what was planned, what actually happened, why, and what can be done to 

improve wildland fire management. Managers should address such aspects 

as the initial assessment of resource requirements, safety and welfare of 

personnel, fire suppression operations, and administrative responsibilities. 

According to federal wildland fire management policy, these after action 

reviews are then used to modify fire management plans. 

Wildland fire agencies also plan to evaluate their overall joint activities, 

although these evaluations have not yet been conducted. Under the 

Interagency Strategy for the Implementation of Federal Wildland Fire 

Management Policy, USDA and Interior agreed to conduct fire 

management reviews approximately every 4 years to provide information 

for improving both policy and operational effectiveness.30 According to the 

interagency strategy, these evaluations will be consistent with GPRA 

requirements and agency strategic plans. 

A focus on results, as envisioned by GPRA, implies that federal programs 

contributing to the same or similar results should collaborate to ensure 

that goals are consistent and, as appropriate, program efforts are mutually 

reinforcing. Federal agencies can use their strategic and annual 

performance plans as tools to drive collaboration with other agencies and 

partners and establish complementary goals and strategies for achieving 

results. Such plans can also reinforce accountability for the collaboration 

by aligning agency goals and strategies with those of the collaborative 

efforts. Accountability for collaboration is reinforced through public 

reporting of agency results. 

USDA, a stakeholder for the Nutrition and Overweight focus area of 

Healthy People 2010, uses its strategic plan to reinforce its commitment to 

support key Healthy People 2010 objectives. The main goal for the 

Nutrition and Overweight focus area in Healthy People 2010 is to “Promote 

 29Smokejumpers conduct after action reviews after each mission rather than a single 

review at the end of the wildland fire incident. 

30U.S. Department of Agriculture and U.S. Department of the Interior, Interagency Strategy 

for the Implementation of Federal Wildland Fire Management Policy, June 20, 2003. This 

policy was approved by the departments on April 21, 2004. 

Reinforce Agency 

Accountability for 

Collaborative Efforts 

through Agency Plans and 

Reports 
Page 23 GAO-06-15 Results-Oriented Government 

health and reduce chronic disease associated with diet and weight.” To 

track progress towards that goal, Healthy People developed seven 

objectives related to food and nutrient intake, such as fruit intake and total 

fat intake. A goal in USDA’s strategic plan for fiscal years 2002-2007 is to 

contribute to reductions in obesity of the American public consistent with 

the goals of Healthy People 2010. Specifically, one of the performance 

measures in USDA’s strategic plan is to promote healthier eating habits 

and lifestyles, setting as a goal for 2007, as a partner with HHS, “to take 

actions to encourage a reduction in overweight and obesity such that adult 

obesity will be no greater than 20% and child and adolescent overweight 

will be no greater than 8%.”31

Federal agencies involved in wildland fire management have goals in their 

strategic plans that are compatible with those of the National Fire Plan’s 

10-year comprehensive strategy to reduce the wildland fire risk to 

communities and the environment. In its fiscal year 2003-2008 strategic 

plan, Interior makes specific reference to the National Fire Plan and the 

10-year comprehensive strategy. Additionally, the plan describes strategies 

that include restoring fire-adapted ecosystems and reducing hazardous 

fuels through collaboration, consistent with the 10-year comprehensive 

strategy. Similarly, the Forest Service, also making specific reference to 

the 10-year comprehensive strategy, has a compatible goal—“Reduce the 

risk from catastrophic wildland fire”—in its strategic plan for fiscal years 

2004-2008. 

High-performing organizations use their performance management 

systems to strengthen accountability for results, specifically by placing 

greater emphasis on fostering the necessary collaboration both within and 

across organizational boundaries to achieve results.32 Within the federal 

government, the Office of Personnel Management (OPM) and OMB now 

require such emphasis under the new performance-based pay system for 

agency senior executives. Under this system, agencies are to hold 

executives accountable for, among other things, collaboration and 

teamwork across organizational boundaries to help achieve goals by 

requiring the executives to identify programmatic crosscutting, and 

 31Note that while USDA set these percentage targets to be achieved by 2007, Healthy People 

2010 has set targets of 15 and 5 percent, respectively, to be achieved by 2010. 

32GAO, Results-Oriented Cultures: Creating a Clear Linkage between Individual 

Performance and Organizational Success, GAO-03-488 (Washington, D.C.: Mar. 14, 2003).

Reinforce Individual 

Accountability for 

Collaborative Efforts 

through Performance 

Management Systems 
Page 24 GAO-06-15 Results-Oriented Government 

partnership-oriented goals through the performance expectations in their 

individual performance plans. 

As a first step in reinforcing individual accountability for collaborative 

efforts, agencies set expectations for senior executives for collaboration 

within and across organizational boundaries in their individual 

performance plans. For example, as part of its Senior Executive Service 

(SES) performance management system, Interior, one of the agencies 

involved in wildland fire management, requires all of its senior executives 

to incorporate in their individual performance plans a competency related 

to collaboration—“Building Collaboration and Partnerships with 

Customers/Partners/Stakeholders.” Specifically, for this competency, 

senior executives are to communicate, consult, and cooperate with 

customers, partners, and stakeholders to ensure that Interior’s missions 

and programs effectively empower citizens in the support of conservation. 

According to an Interior official, Interior’s bureaus have the flexibility to 

cascade the required senior executive competency related to collaboration 

to their non-SES employees’ individual performance plans. 

In addition, we have recommended that agencies have senior executives 

identify specific programmatic crosscutting goals that would require 

collaboration to achieve in their individual performance plans.33 To this 

end, HHS holds all senior executives accountable for the crosscutting 

“One-HHS” program objectives that relate to their job responsibilities.34

For example, NIH senior executives are to cascade the One-HHS program 

objectives into their individual performance plans, as appropriate. One of 

these program objectives is to “improve the quality of health care” by 

improving the coordination, communication, and application of health 

research results. To meet this objective, an NIH senior executive, who is 

the agency’s colead for the Healthy People 2010 Nutrition and Overweight 

focus area, set an expectation in her individual performance plan to 

enhance health care quality and treatment through the coordination and 

translation of nutrition sciences, obesity, and physical activity research 

and policy-related activities, through collaborative and coordinated 

interagency activities at the federal and other levels. Further, NIH is 

 33GAO, Human Capital: Senior Executive Performance Management Can Be 

Significantly Strengthened to Achieve Results, GAO-04-614 (Washington, D.C.: May 26, 

2004). 

34The One-HHS management and program objectives reflect the goals and priorities of the 

Secretary of HHS for the department. 
Page 25 GAO-06-15 Results-Oriented Government 

beginning to cascade the One-HHS program objectives to all NIH 

employees through their individual performance plans. 

In addition, we have recommended that agencies have senior executives 

name the relevant internal or external organizations with which they 

would collaborate to reinforce a focus across organizational boundaries.35

To this end, a senior executive at Interior’s Bureau of Land Management 

set an expectation in his individual performance plan to assure that 

interagency fire program policies and operational changes are made in 

collaboration with interagency partners and stakeholders. In his selfassessment for the year, the senior executive named the Fire Director for 

the USDA Forest Service. The National Wildfire Coordinating Group, an 

interagency activity coordinating group, tasked the executive and the Fire 

Director to develop an interagency implementation strategy for the federal 

wildland fire management policy. By closely collaborating with other 

federal agencies and state representatives, the senior executive and the 

USDA Fire Director designed a strategy that was approved for 

implementation by the Wildland Fire Leadership Council last year. 

High-performing organizations include results-oriented goals in individual 

performance plans (or performance agreements) to encourage senior 

executives to work collaboratively across traditional organizational 

boundaries or “silos.” We reported in October 2000 that the Veterans 

Health Administration’s Veterans Integrated Service Network (VISN) 

headquartered in Cincinnati implemented performance agreements that 

focused on patient services for the entire VISN and were designed to 

encourage the VISN’s medical centers to work collaboratively.36 In 2000, 

the VISN Director had a performance agreement with “care line” directors 

for patient services, such as primary care, medical and surgical care, and 

mental health care. In particular, the mental health care line director’s 

performance agreement included improvement goals related to mental 

health for the entire VISN. To make progress towards these goals, this care 

line director had to work across each of the VISN’s four medical centers 

with the corresponding care line managers at each medical center. As part 

of this collaboration, the care line director needed to establish consensus 

among VISN officials and external stakeholders on the strategic direction 

for the services provided by the mental health care line across the VISN; 

 35GAO-04-614. 

36GAO, Managing for Results: Emerging Benefits From Selected Agencies’ Use of 

Performance Agreements, GAO-01-115 (Washington, D.C.: Oct. 30, 2000). 
Page 26 GAO-06-15 Results-Oriented Government 

develop, implement, and revise integrated clinical programs to reflect that 

strategic direction for the VISN; and allocate resources among the centers 

for mental health programs to implement these programs. 

GPRA, with its focus on strategic planning, the development of long-term 

goals, and accountability for results, provides a framework that Congress, 

OMB, and executive branch agencies can use to consider the appropriate 

mix of long-term strategic goals and strategies needed to identify and 

address federal goals that cut across agency boundaries. For example, we 

have previously reported that the strategic and annual performance 

planning processes under GPRA provide opportunities for federal agencies 

to identify other agencies addressing related outcomes, and coordinate 

with these agencies to ensure that program goals are complementary; 

strategies are mutually reinforcing; and, as appropriate, common 

performance measures are used. 

OMB, as the focal point for overall management in the executive branch, 

plays a key role in aligning the federal government’s resources and 

activities. To better manage the accomplishment of crosscutting policy 

goals, we have recommended that OMB fully implement the GPRA 

requirement to develop a governmentwide performance plan.37 A 

governmentwide performance plan could provide a broader perspective of 

the federal government’s goals and strategies to address issues that cut 

across different federal agencies, including redundancy and other 

inefficiencies in how the government does its business. 

Moreover, we have recommended Congress amend GPRA to require a 

governmentwide strategic plan to provide a framework for identifying 

long-term goals and strategies for addressing crosscutting issues. A 

strategic plan for the federal government, along with key national 

indicators to assess the government’s performance, could provide an 

additional tool for governmentwide reexamination of existing programs, 

as well as proposals for new programs. If fully developed, a 

governmentwide strategic plan can potentially provide a cohesive 

perspective on the long-term goals of the federal government and provide 

a much-needed basis for fully integrating, rather than merely coordinating, 

a wide array of federal activities. 

 37GAO, Results-Oriented Government: GPRA Has Established a Solid Foundation for 

Achieving Greater Results, GAO-04-38 (Washington, D.C.: Mar. 10, 2004). 

GPRA and OMB’s 

Management Tools 

Offer Opportunities to 

Foster Greater 

Collaboration among 

Federal Agencies 
Page 27 GAO-06-15 Results-Oriented Government 

In addition to the role it could play in implementing GPRA, OMB could 

also use its PMA (President’s Management Agenda) and PART (Program 

Assessment Rating Tool) tools to foster greater federal agency 

collaboration. According to OMB, the PMA was implemented to remedy 

long-standing federal agency management and performance challenges. 

The PMA consists of five governmentwide initiatives—strategic 

management of human capital, competitive sourcing, improved financial 

performance, expanded electronic government, and budget and 

performance integration. For each initiative, OMB has established goals or 

“standards for success,” and OMB rates agencies’ status each quarter in 

achieving the goals and making progress toward them. Additionally, the 

PMA has nine agency-specific initiatives such as privatization of military 

housing and reform of food aid programs, which OMB also rates 

quarterly.38

Among the governmentwide initiatives in the PMA is the strategic 

management of human capital. One of the standards for success for this 

initiative is having performance appraisals and award programs for all 

members of the SES and managers, as well as most of the workforce, that 

effectively align with agency mission, goals, and outcomes and hold them 

accountable for results. In addition, as stated earlier, high-performing 

organizations can place greater emphasis on fostering necessary 

collaboration to achieve results through their performance management 

systems for all levels of employees. OMB and OPM have recognized this 

strategic use of performance management and require SES members to be 

held accountable for collaboration and teamwork across organizational 

boundaries.39 However, the PMA standards do not include a similar focus 

on collaboration and teamwork for managers and the rest of the 

workforce, and thus miss an opportunity to reinforce to agencies that their 

performance management systems are strategic tools to strengthen 

accountability for results. 

One of the nine agency-specific initiatives focuses on improving 

coordination of VA and DOD programs and systems to allow for the 

seamless transition and continuity of care of beneficiaries from active duty 

 38OMB, “The President’s Management Agenda, Fiscal Year 2002” (Washington, D.C.: August 

2001). See also GAO, Management Reform: Assessing the President’s Management 

Agenda, GAO-05-574T (Washington, D.C.: Apr. 21, 2005). 

39Executive Performance and Accountability Regulations, 69 Fed. Reg. 45548 (July 29, 2004) 

(codified at 5 C.F.R. pts. 430, 1330). 
Page 28 GAO-06-15 Results-Oriented Government 

to veteran status. Apart from this case, however, our work has shown that 

many issues cut across more than one agency and their actions are not 

well coordinated. Therefore, such issues would benefit from the greater 

attention and focus that PMA could provide. For example, information 

sharing for securing the homeland is a governmentwide effort involving 

multiple federal agencies, including OMB; DOD; the Departments of 

Homeland Security, Justice, and State; and the Central Intelligence 

Agency. We have recently highlighted this issue as a high-risk area in need 

of broad-based transformation in order to facilitate information sharing 

among and between government entities and the private sector.40 To do 

this will require an extraordinary level of collaboration among the federal, 

state, and local governments and the private sector. 

OMB developed PART as a diagnostic tool meant to provide a consistent 

approach to assessing federal programs during the executive budget 

formulation process. PART covers four broad topics for all programs 

selected for review: (1) program purpose and design, (2) strategic 

planning, (3) program management, and (4) program results. In 

conducting PART assessments of federal agency programs, OMB 

considers, among other things, whether the program coordinates and 

collaborates effectively with related programs and whether duplication 

exists. In addition, consistent with our recommendation, OMB has begun 

to use the PART framework to conduct assessments of groups of 

programs in similar areas that cut across agency boundaries.41 The PART 

tool provides general guidance for assessing effective program 

coordination and collaboration: to demonstrate effective collaboration, 

agencies need to provide evidence of collaborative efforts “leading to 

meaningful actions in management and resource allocation”—for example, 

a joint grant announcement, planning documents, or performance goals. 

However, while these are important steps, as OMB recognizes, such 

evidence alone does not demonstrate that meaningful collaboration has 

occurred. 

 40GAO-05-207. 

41See GAO, Performance Budgeting: Observations on the Use of OMB’s Program 

Assessment Rating Tool for the Fiscal Year 2004 Budget, GAO-04-174 (Washington, D.C.: 

Jan. 30, 2004). A follow-up report, scheduled to be issued in October 2005, examines the 

effects the PART recommendations have on agency operations and program results, the 

relationship between PART and GPRA, and congressional involvement in the PART 

process. 
Page 29 GAO-06-15 Results-Oriented Government 

Agency officials from each of the case study agencies we interviewed 

agreed that OMB could play an effective role in fostering greater 

collaboration among federal agencies. Some officials we interviewed 

indicated that the PMA and PART tools were appropriate vehicles for 

sharing the practices in this report. For example, an official stated that for 

VA and DOD resource sharing, being singled out as a PMA initiative 

provided a high level of visibility to the issue—the additional attention 

they have received by having a higher-level entity such as OMB focus on 

the issue has been helpful in directing leadership attention and resources. 

Furthermore, some officials stated that it would be helpful to have more 

expanded criteria for assessing collaboration than the existing guidance 

provided by OMB for its PART assessments. 

As the challenges of the 21st century grow, it will become increasingly 

important for Congress, OMB, and executive agencies to consider how the 

federal government can maximize performance and results through 

improved collaboration. Our prior work has shown that many issues cut 

across more than one agency and their actions are not well coordinated. In 

this report, we identify key practices that can help enhance and sustain 

collaboration among federal agencies. We also describe how select 

agencies’ collaboration efforts to address common goals reflect one or 

more of these practices. The specific ways in which the case agencies 

implemented the practices may not be appropriate for adoption by other 

federal agencies seeking to improve their collaboration. Nevertheless, the 

practices themselves can be adapted to address the specific collaboration 

challenges each agency faces. 

The strategic, annual, and performance planning processes under GPRA 

provide a means for agencies to ensure that their goals for crosscutting 

programs complement those of other agencies; program strategies are 

mutually reinforcing; and, as appropriate, common performance measures 

are used and they place greater emphasis on collaboration in agency 

performance management systems. Furthermore, as we have 

recommended, governmentwide strategic and annual planning approaches 

led by OMB could aid in improving collaboration across agency lines. 

OMB has a central role in overseeing the management of federal agencies 

and has used its role to promote results-oriented management practices. 

Under its PMA initiatives, OMB has highlighted an agency-specific 

initiative—coordination of VA and DOD programs and systems—for 

improvement. However, this is only one of a number of areas that OMB 

could be focusing on to improve coordination among federal agencies. 

Conclusions 
Page 30 GAO-06-15 Results-Oriented Government 

Moreover, given the problems we have previously identified with 

interagency coordination and collaboration, OMB could bring greater 

agency attention to improving collaboration by creating a governmentwide 

PMA initiative related to coordination and collaboration akin to its other 

five governmentwide initiatives. Furthermore, OMB does not specifically 

emphasize collaboration in its standards for successful strategic human 

capital management. In its PART program, OMB has also highlighted 

effective coordination as one of its assessment criteria. But it does not rely 

on sufficient information to assess the effectiveness of the collaboration 

nor has OMB offered information on practices that could assist agencies in 

enhancing their capacity to coordinate and collaborate effectively. OMB 

could, therefore, complement its existing efforts by looking to the 

practices in this report as additional evidence of collaboration or to help 

diagnose why collaborative efforts have not produced desired results. 

We recommend that the Director of OMB continue to encourage 

interagency collaboration by focusing attention on additional areas in need 

of greater collaboration to achieve common outcomes and promoting the 

collaboration practices identified in this report. Options for doing this 

could involve 

• expanding the PMA initiatives and standards to include either an 

additional governmentwide initiative focused on improving collaboration 

across federal agencies or additional agency initiatives focused on specific 

areas in need of improved collaboration; 

• expanding the standards for the PMA’s strategic management of human 

capital initiative to reflect the need for agencies to hold individuals 

accountable, through their performance management systems, for 

coordinating and collaborating within and across organizational 

boundaries in order to help the agencies achieve their mission, goals, and 

outcomes; and 

• supplementing the PART guidance on interagency coordination with 

information about the collaboration practices in this report. 

We provided a draft of this report to the Director of OMB for comment. 

OMB’s Counsel to the Deputy Director for Management responded orally 

that OMB agreed with the recommendation. We also provided relevant 

sections of a draft of this report to the agencies involved in the three 

collaboration efforts—VA, DOD, USDA, HHS, and the Departments of 

Education and the Interior. They offered technical suggestions which we 

incorporated as appropriate. 

Recommendation for 

Executive Action 

Agency Comments 

and Our Evaluation 
Page 31 GAO-06-15 Results-Oriented Government 

We are sending copies of this report to other interested congressional 

committees. We are also sending copies to the Director of OMB. We will 

make copies available to others upon request. In addition, this report is 

available at no charge on the GAO website at http://www.gao.gov. 

If you or your staff have any questions about this report, please contact me 

at (202) 512-6543 or at steinhardtb@gao.gov. Contact points for our Offices 

of Congressional Relations and Public Affairs may be found on the last 

page of this report. Key contributors to this report are listed in appendix 

III. 

Sincerely yours, 

Bernice Steinhardt 

Director, Strategic Issues 
Appendix I: Scope and Methodology 

Page 32 GAO-06-15 Results-Oriented Government 

To identify key practices that can help enhance and sustain collaboration 

as well as federal agency collaborative efforts that illustrate these 

practices, we reviewed academic literature and prior GAO and 

Congressional Research Service reports. In addition, we interviewed 

experts in coordination, collaboration, partnerships, and networks from 

the National Academy of Public Administration, the IBM Center for The 

Business of Government, and the University of California, Berkeley. 

Although achieving results may involve the collaborative efforts of both 

federal and nonfederal partners, for the purpose of this work we focused 

on the practices that federal agencies can employ. 

Using our literature review and interviews, we derived a set of practices 

that we believe can help enhance and sustain federal agency collaborative 

efforts. After examining the various approaches, frameworks, and models 

that have been used to describe collaboration practices, we derived from 

that material a set of practices that are consistent with results-oriented 

performance management and agency requirements under the 

Government Performance and Results Act of 1993. Therefore, we do not 

consider our categorization of the practices for collaborative efforts to be 

definitive and recognize that alternative categorizations of practices could 

be developed and additional practices included. 

While we generally believe that the application of as many of these 

practices as possible increases the likelihood of effective collaboration, 

we also recognize that there is a wide range of situations and 

circumstances in which agencies work together. Consequently, in some 

cases the judicious adoption of even a few practices may be sufficient for 

effective collaboration while in other cases the adoption of all these 

practices may not be sufficient to guarantee an effective working 

relationship. 

To illustrate, and to also help refine these practices, we selected three 

areas where federal agencies have developed ongoing collaborations: 

Healthy People 2010—a long-standing effort to develop and track public 

health objectives for the nation, wildland fire management, and health 

resource sharing between Veterans Affairs (VA) and the Department of 

Defense (DOD). We selected these areas based on expert views and our 

prior work indicating that substantial collaboration was taking place. We 

selected examples from among the three collaborative efforts that, in our 

judgment, most clearly illustrated and supported the practices we 

identified. Therefore, agencies other than those cited for a particular 

practice may, or may not, be engaged in the same practice. As the 

objectives of this work were to identify practices that can help enhance 

Appendix I: Scope and Methodology 
Appendix I: Scope and Methodology 

Page 33 GAO-06-15 Results-Oriented Government 

and sustain such collaboration, we did not assess whether the examples of 

collaboration practices we highlighted resulted in improved performance 

in these three areas. 

For our review, we selected two Healthy People 2010 focus areas—

“Disability and Secondary Conditions” and “Nutrition and Overweight”—

that involve substantial collaboration among the Department of Health and 

Human Services (HHS), which leads this initiative, and non-HHS agencies. 

The Department of Education’s National Institute on Disability and 

Rehabilitation Research coleads the Disability and Secondary Conditions 

focus area with HHS’s Centers for Disease Control and Prevention (CDC). 

While HHS’s Food and Drug Administration (FDA) and National Institutes 

of Health (NIH) colead the Nutrition and Overweight focus area, with the 

CDC’s National Center for Health Statistics providing the majority of data 

for assessing progress toward attaining the Nutrition and Overweight 

objectives, the U.S. Department of Agriculture (USDA) provides most of 

the food and consumption data. 

To obtain perspectives on the practices being used by the federal agencies 

involved in Healthy People 2010, we reviewed literature on Healthy People 

and met with officials from the National Academy of Public Administration 

and the Robert Wood Johnson Foundation. We interviewed federal 

officials from the Office of Disease Prevention and Health Promotion at 

HHS who coordinate this effort. We also interviewed federal officials from 

USDA’s Agriculture Research Service, Center for Nutrition Policy and 

Promotion, and Food and Nutrition Service; HHS’s FDA, CDC, and NIH; 

and the Department of Education’s National Institute on Disability and 

Rehabilitation Research. 

We judgementally selected and interviewed officials from three state 

health agencies that differed in their approaches to healthy people 

initiatives—Iowa Division of Administration, Pennsylvania Bureau of 

Health Planning, and the California Department of Health Services—to 

obtain nonfederal perspectives on the federal collaborative efforts to 

develop Healthy People 2010. 

To obtain perspectives on the practices used by VA and DOD to share 

health resources, we reviewed our prior reports and met with officials 

from VA’s Resource Sharing Office and DOD’s DOD-VA Program 

Coordination Office. We also spoke with VA and DOD staff and reviewed 

agency documents they provided at the specific sites we visited in 

California, Florida, and Kentucky covering the Air Force, Navy, and Army 

respectively. In California, we visited the VA McClellan outpatient clinic in 
Appendix I: Scope and Methodology 

Page 34 GAO-06-15 Results-Oriented Government 

Sacramento and the David Grant Medical Center at Travis Air Force Base. 

In Florida, we visited the VA Outpatient Clinic, Naval Hospital, and Corry 

Station Branch Medical Clinic—all in Pensacola. In Kentucky, we visited 

the Louisville VA Medical Center, the VA Community Based Outpatient 

Clinic in Standiford Field, and Ireland Army Community Hospital in Fort 

Knox. 

To obtain perspectives on the practices being used by the federal agencies 

involved in wildland fire management, we reviewed our prior reports and 

documents we obtained from these agencies. We interviewed officials 

from the Office of the National Fire Plan Coordinator at the Forest Service 

and the Office of Wildland Fire Coordination at the Department of the 

Interior. We also visited the National Interagency Fire Center (NIFC) at 

Boise, Idaho, and interviewed NIFC staff from six federal agencies—the 

Bureau of Land Management, Bureau of Indian Affairs, Fish and Wildlife 

Service, and National Park Service of the Department of the Interior; the 

Forest Service of USDA; and the National Weather Service of the 

Department of Commerce. While at NIFC, we also interviewed staff from 

Interior’s Office of Aviation Services. To obtain a perspective from 

stakeholders on federal interagency collaboration, we interviewed 

representatives from the Western Governors’ Association and the National 

Association of State Foresters. 

We conducted our work from May 2004 through August 2005 in offices in 

the Washington, D.C. metropolitan area; Boise, Idaho; Louisville and Fort 

Knox, Kentucky; Pensacola, Florida; and Sacramento and Fairfield, 

California, in accordance with generally accepted government auditing 

standards. 
Appendix II: Federal Collaborative Efforts We 

Reviewed 

Page 35 GAO-06-15 Results-Oriented Government 

Table 1: Federal Collaborative Efforts We Reviewed 

Federal 

collaborative effort Description 

Key federal agencies, partners, and 

stakeholders 

Healthy People 

2010 

The Healthy People 2010 initiative provides a comprehensive set of 

national disease prevention and health promotion objectives to be 

achieved over a 10-year period along with indicators to measure 

progress. 

First issued in 1979 in Healthy People: The Surgeon General’s Report 

on Health Promotion and Disease Prevention, and updated in 1990, 

the Healthy People 2010 initiative is the third time that HHS has 

developed 10-year Healthy People objectives for the nation. 

The Healthy People 2010 objectives are designed to achieve two 

overarching goals—(1) increase quality and years of healthy life and 

(2) eliminate health disparities. The 467 objectives are organized 

around 28 focus areas, such as access to quality health services, 

cancer, medical product safety, and physical activity and fitness. 

The Disability and Secondary Condition focus area comprises 13 

objectives to “promote the health of people with disabilities, prevent 

secondary conditions, and eliminate disparities between people with 

and without disabilities in the U.S. population.” This focus area was 

included as a new area for Healthy People 2010. 

The Nutrition and Overweight focus area comprises 18 objectives to 

“promote health and reduce chronic disease associated with diet and 

weight.” Nutrition has been included as a focus area in the Healthy 

People initiative since its inception in 1979. 

The Healthy People initiative is led by 

HHS. HHS uses a broad consultation 

process in the development of the 

objectives involving state and territorial 

public health, mental health, substance 

abuse, and environmental agencies; 

and national professional, advocacy, 

and business sector organizations. 

HHS designated lead and colead 

federal agencies for each of the 28 

focus areas. Additionally each focus 

area has a work group comprising 

representatives from both federal and 

nonfederal partners. 

CDC and the Department of 

Education’s National Institute on 

Disability and Rehabilitation Research 

are the two colead agencies for the 

Disability and Secondary Conditions 

focus area. Work group members 

include representatives from the 

Department of Commerce and the 

Social Security Administration as well 

as HHS agencies, such as the 

Administration for Children and 

Families, Indian Health Service, and 

Substance Abuse and Mental Health 

Services Administration. 

FDA and NIH are the two colead 

agencies for the Nutrition and 

Overweight focus area. While the 

CDC’s National Center for Health 

Statistics provides the majority of the 

data to track the achievement of 

objectives in this area, USDA is also a 

partner in this effort. Work group 

members for this focus area also 

include representatives from other HHS 

agencies—such as the Administration 

on Aging, CDC, Indian Health Services, 

and Health Resources and Services 

Administration—and the Department of 

Education. 

Appendix II: Federal Collaborative Efforts 

We Reviewed 
Appendix II: Federal Collaborative Efforts We 

Reviewed 

Page 36 GAO-06-15 Results-Oriented Government 

Federal 

collaborative effort Description 

Key federal agencies, partners, and 

stakeholders 

VA and DOD health 

resource sharing 

In 1982, Congress passed the “Sharing Act” to promote cost-effective 

use of health care resources and efficient delivery of care.a

Specifically, Congress authorized VA medical centers and DOD 

military treatment facilities to enter into sharing agreements with each 

other to buy, sell, and barter medical and support services. In 2002, 

Congress passed additional legislation to encourage and foster health 

resources sharing between VA and DOD. For example, VA and DOD 

were required to establish a high-level joint committee for developing 

and establishing collaborative efforts; develop a joint strategic plan; 

provide start-up funds for sharing projects; and fund resource-sharing 

demonstration projects.b

VA and DOD sharing activities fall into three categories: 

1. national sharing initiatives designed to lower costs and provide 

better access to goods and services by purchasing nationally 

rather than by individual facilities; 

2. joint-venture sharing agreements aimed at reducing costs by 

pooling resources, for example to build a new facility or jointly use 

an existing facility; and 

3. local sharing agreements pertaining to inpatient and outpatient 

care, ancillary services—such as diagnostic and therapeutic 

radiology, dental care, and specialty care—and other support 

services such as administration and management, research, 

education and training, patient transportation, and laundry. 

VA and DOD 

Wildland fire 

management 

Federal fire agencies use the interagency 2001 Federal Wildland Fire 

Management Policy and the National Fire Plan to manage wildland 

fires.c

 The 2001 federal fire policy provides the broad policy 

foundation for federal fire management programs and activities, 

including those under the National Fire Plan. 

The 2001 federal fire policy contains nine guiding principles for the 

management of wildland fires including: firefighter and public safety is 

the first priority in every fire management activity; standardization of 

policies and procedures among federal agencies is an ongoing 

objective; and federal, state, tribal, local, interagency, and 

international coordination and cooperation are essential. 

The National Fire Plan comprises various documents including—(1) a 

September 2000 report from the Secretaries of Agriculture and the 

Interior to the President in response to the wildland fires of 2000,d

 

(2) a conference committee report accompanying the fiscal year 2001 

appropriations act,e

 and (3) a 10-year comprehensive strategy and 

implementation plan for reducing fire risks.f

The National Fire Plan addresses five key issues: (1) firefighting 

resources and personnel, (2) rehabilitation and restoration, 

(3) hazardous fuels reduction, (4) community assistance, and 

(5) accountability. 

The five federal agencies with wildland 

fire responsibilities are the Forest 

Service at USDA; Bureau of Indian 

Affairs, Bureau of Land Management, 

Fish and Wildlife Service, and National 

Park Service at the Department of the 

Interior. The Federal Emergency 

Management Agency is also involved 

to the extent that wildland fires at the 

urban interface may involve buildings. 

Key nonfederal stakeholders include 

the Western Governors’ 

Association/National Governors 

Association, National Association of 

State Foresters, National Association of 

Counties, and the Intertribal Timber 

Council. 

Source: GAO analysis of agency documents. 

a

Veterans’ Administration and Department of Defense Health Resources Sharing and Emergency 

Operations Act, Pub. L. No. 97-174, 96 Stat. 70 (May 4, 1982). 
Appendix II: Federal Collaborative Efforts We 

Reviewed 

Page 37 GAO-06-15 Results-Oriented Government 

b

Bob Stump National Defense Authorization Act of 2003, Pub. L. No. 107-314, §721-22, 116 Stat. 

2458, 2589-98 (Dec. 2, 2002). 

c

U.S. Department of the Interior, U.S. Department of Agriculture, Department of Energy, Department 

of Defense, Department of Commerce, U.S. Environmental Protection Agency, Federal Emergency 

Management Agency, and National Association of State Foresters, Review and Update of the 1995 

Federal Wildland Fire Management Policy (Washington, D.C.: January 2001). 

d

U.S. Department of the Interior and U.S. Department of Agriculture, Managing the Impact of Wildfires 

on Communities and the Environment: A Report to the President In Response to the Wildfires of 2000

(Washington, D.C.: Sept. 8, 2000). 

e

U.S. House of Representatives, Making Appropriations for the Department of the Interior and Related 

Agencies for the Fiscal Year Ending September 30, 2001, and for Other Purposes, Report 106-914 

(Washington, D.C.: Sept. 29, 2000). 

f

U.S. Department of the Interior, U.S. Department of Agriculture, Western Governors’ Association, A 

Collaborative Approach for Reducing Wildland Fire Risks to Communities and the Environment: 10-

Year Comprehensive Strategy (Washington, D.C.: August 2001); and U.S. Department of the Interior, 

U.S. Department of Agriculture, Western Governors’ Association, A Collaborative Approach for 

Reducing Wildland Fire Risks to Communities and the Environment: 10-Year Comprehensive 

Strategy, Implementation Plan (Washington, D.C.: May 2002). 
Appendix III: GAO Contact and Staff 

Acknowledgments 

Page 38 GAO-06-15 Results-Oriented Government 

Bernice Steinhardt, (202) 512-6543 

Thomas M. Beall, Mallory B. Bulman, Elizabeth H. Curda, Patricia A. 

Dalton, Bertha Dong, Martin H. De Alteriis, Janice C. Latimer, Benjamin T. 

Licht, Allen C. Lomax, William A. McKelligott, Michael L. Rose, and Lisa R. 

Shames made major contributions to this report. In addition, Aditi Shah 

Archer, Cynthia A. Bascetta, Michael T. Blair, Jr., David P. Bixler, Chester 

M. Joy, Jacqueline M. Nowicki, and Sarah E. Veale provided key 

assistance. 

Appendix III: GAO Contact and Staff 

Acknowledgments 

GAO Contact 

Acknowledgments 

(450336) 
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