Biosurveillance: Developing a Collaboration Strategy Is Essential to Fostering Interagency Data and Resource Sharing
Published: 2009-12-18T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: Recently, there has been an increased focus on developing the ability to provide early detection of and situational awareness during a disease outbreak. The Implementing Recommendations of the 9/11 Commission Act sought to enhance this capability, in part, by creating the National Biosurveillance Integration Center (NBIC) within the Department of Homeland Security. NBIC is to help provide early detection and situational awareness by integrating information and supporting an interagency biosurveillance community. The act directed the Government Accountability Office (GAO) to report on the state of biosurveillance and resource use in federal, state, local, and tribal governments. This report is one in a series responding to that mandate. This report focuses on the actions taken by NBIC to (1) acquire resources to accomplish its mission and (2) effectively collaborate with its federal partners. To conduct this work, GAO reviewed documents, such as NBIC's Concept of Operations, and interviewed officials at NBIC and 11 federal partners.
section_title: What GAO Found
paragraphs: To carry out its early detection and situational awareness mission, NBIC has made efforts to acquire data from the integration center's community of federal partners, obtain analytical expertise from other agencies, establish governance bodies to develop and oversee the community of federal partners, and provide information technologies to support data collection, analysis, and communication. However, NBIC does not receive the kind of data it has identified as most critical for supporting its early detection mission--particularly, data generated at the earliest stages of an event. In addition, NBIC has faced challenges leveraging the expertise of its federal partners. For example, NBIC officials have emphasized the importance of agencies temporarily assigning personnel to supplement the expertise at NBIC. However, only 2 of 11 partner agencies have assigned personnel to support the integration center. NBIC has developed governance bodies that provide oversight for the integration center and the interagency community. Although the integration center has also developed an information technology system, it is primarily used to help identify and collect publicly available Internet data because NBIC lacks data from federal partners that best support the early detection goal of biosurveillance. NBIC is not fully equipped to carry out its mission because it lacks key resources--data and personnel--from its partner agencies, which may be at least partially attributed to collaboration challenges it has faced. Integrating biosurveillance data is an inherently interagency enterprise, as reflected by both law and NBIC's strategy for meeting its mission. NBIC is to help coordinate and support a community of federal partners for early detection and enhanced situational awareness. Consequently, for NBIC to obtain the resources it needs to meet its mission, it must effectively employ collaborative practices. However, in interviews with partner agencies, GAO encountered widespread confusion, uncertainty, and skepticism around the value of participation in the interagency community, as well as the mission and purpose of NBIC within that community. Further, interviews with agency officials demonstrated a lack of clarity about roles, responsibilities, joint strategies, policies, and procedures for operating across agency boundaries. We have previously reported on key practices that can help enhance and sustain collaboration among federal agencies. For collaborating agencies to overcome barriers to working together, they need to, among other things, (1) develop a clear and compelling rationale for working together by articulating a common federal outcome or purpose; (2) establish joint strategies, policies, and procedures to help align activities, core processes, and resources; (3) identify resources needed to initiate or sustain their collaborative effort; (4) work together to define and agree on their respective roles and responsibilities; and (5) develop accountability mechanisms to guide implementation and monitoring of their efforts to collaborate. Development of a strategy for collaboration and the use of these key collaboration practices could enhance NBIC's ability to foster interagency data and resource sharing.

section_title: Letter
paragraphs: In recent years, there has been an increasing awareness of the potential  for biological agents to be used as weapons of mass destruction and of the  threat of catastrophic effects arising from emerging strains of infectious  disease. For example, the October 2001 anthrax attacks highlighted  longstanding weaknesses in the current public health infrastructure and  prompted efforts to improve the nation’s preparedness for and response to  public health emergencies, including bioterrorism. In addition, the 2001  accidental outbreak of foot-and-mouth disease in the United Kingdom  caused approximately $5 billion dollars in losses to the food and  agriculture sector, as well as comparable losses within the industry. These  events and others like them have underscored the importance of  developing and maintaining a national biosurveillance capability—that is,  the ability to detect biological events of national significance with the aim  of providing earlier warning and better information to guide public health  or other types of emergency response.
Effective preparation for, detection of, and response to a major biological  event requires effective pre- and postdisaster coordination and  cooperation among different federal agencies, levels of government,  nongovernmental organizations, and the private sector. In the case of  biological threats, detection of biological agents is a first step in an  effective response to a natural, accidental, or intentional outbreak of a  biological event of national concern. The U.S. government has a long  history of monitoring human, animal, and plant health—in some cases for  more than a century—to help limit malady, loss of life, and economic  impact. Although the United States has numerous surveillance programs  and systems at various levels of government and in the private sector to  monitor disease, these programs and systems were developed separately  for a variety of mission objectives, and as such are relatively  uncoordinated.
Since at least the 1990s, there has been an ongoing and evolving effort by  the federal government to address the need for a strategic approach to  improving disease surveillance and response. Among numerous federal  efforts to establish a coordinated national biosurveillance capability, a  provision in the Implementing Recommendations of the 9/11 Commission  Act of 2007 (9/11 Commission Act), sought to enhance the capability of  the federal government to rapidly identify, characterize, localize, and track  biological events of national concern. The 9/11 Commission Act  established, within the Department of Homeland Security (DHS), the  National Biosurveillance Integration Center (NBIC), which was  specifically tasked with fulfilling the biosurveillance objectives established  in the act by integrating and analyzing information from surveillance  systems across the federal government and disseminating alerts, if any  biological events are detected. The federal partners that maintain these  surveillance systems and those that may have information helpful for  decisionmaking during an event are collectively known as the National  Biosurveillance Integration System (NBIS). A central responsibility for  NBIC is to further develop and oversee the NBIS with the goal of earlier  detection of and enhanced information about potentially catastrophic  biological events.
In the same title, the 9/11 Commission Act directed us to examine the state  of federal, state, local, and tribal government biosurveillance efforts and  the federal government’s use of resources to implement and execute  biosurveillance systems. This report responds in part to that mandate by  examining actions that NBIC has taken to integrate and analyze data for  the purposes of early detection and warning of biological events of  national concern. Specifically, this report addresses (1) what actions NBIC  has taken to coordinate the NBIS and acquire essential resources; and (2)  how effectively NBIC has employed collaborative practices with NBIS  partners to help ensure that it acquires and develops essential resources.
In summer 2008, we testified on the status of NBIC’s efforts to implement  its 9/11 Commission Act responsibilities, particularly by entering into  information-sharing and interagency personnel-assignment agreements  with NBIS partners. At that time, we noted that DHS faced difficulties  completing some key tasks, such as defining what capabilities the center  will provide once fully operational, formalizing agreements to obtain  interagency coordination, and completing work related to information  technology (IT) systems. In addition to this NBIC-specific report, we have  ongoing work on biosurveillance activities throughout the federal  government from which we expect to issue a report in early 2010, and a  review of state, local, and tribal activities, which we expect to report on  later in the year.
To determine the extent of NBIC’s efforts to acquire the necessary data  and resources, we reviewed documents including relevant laws and  directives, operating documents, program guidance, program evaluation  reports, and other documentation and interviewed officials at NBIC with  knowledge of NBIC’s management and analytical activities. We visited  NBIC facilities, specifically NBIC’s analysis center at DHS’s Nebraska  Avenue Complex, DHS’s National Operations Center, and the 2009 H1N1  Incident Management Cell at the Office of Health Affairs in Washington,  D.C., where we observed key meetings, processes, and technologies. To  identify the elements that are necessary for NBIC to achieve its mission,  we analyzed the relevant provisions of the 9/11 Commission Act, the NBIS  Concept of Operations, and interviews with NBIC officials. Once we  identified these elements, we vetted them with NBIC officials who agreed  they were accurate. To determine the extent to which NBIC and NBIS  partners have collaborated to help ensure that NBIC acquires and  develops essential resources, we reviewed existing federal interagency  agreements and other documentation, such as the NBIS Concept of  Operations, NBIC’s draft strategic plan, and post meeting reports from  meetings of NBIS governance bodies. We also spoke with agency officials  from the 11 NBIS partners—agencies NBIC has identified as having  relevant data or resources to contribute to the biosurveillance objectives  established in the 9/11 Commission Act. We conducted semistructured  interviews, based on our previous work describing practices to enhance  and sustain collaboration in the federal government. We conducted these  interviews with 14 components of the 11 federal agencies that NBIC  identified as NBIS partners. We identified the components to interview by  contacting the 11 partner agencies to determine which had regular  interaction with NBIC’s processes and products. We explored officials’  experiences working with NBIC and within the NBIS at all of the identified  components. We asked these officials about their understanding of NBIC’s  mission and purpose; the perceived value to their respective agencies of  participation in the NBIS; the extent of and reasons for their agency’s level  of participation; and the extent to which joint strategies, policies, and  procedures have been established and are commonly understood and  accepted between NBIC and individual agencies, as well as across the  NBIS. We then analyzed the results of these interviews to identify  recurrent themes. We provided these officials the opportunity to comment  on a standard set of collaborative practices and provide examples from  their experiences, and we analyzed the content of their responses to  develop our findings. However, due to the semistructured nature of our  interviews, different groups of officials focused on different aspects of  their experiences with NBIC; therefore, not every theme identified in our  analysis was explicitly discussed by every group of officials.
This report is limited to the efforts NBIC has taken or planned to carry out  related to its 9/11 Commission Act responsibilities. On the whole, federal  biosurveillance efforts rely on state, local, and tribal biosurveillance  efforts, and there are many federal efforts designed to collect and analyze  biosurveillance data. However, this report focuses on NBIC’s integration  efforts and not the effectiveness of the various federal systems the data of  which NBIC would integrate.
subsections: section_title: Background
paragraphs: We conducted this performance audit from February 2008 through  November 2009, in accordance with generally accepted government  auditing standards. Those standards require that we plan and perform the  audit to obtain sufficient, appropriate evidence to provide a reasonable  basis for our findings and conclusions based on our audit objectives. We  believe that the evidence obtained provides a reasonable basis for our  findings and conclusions based on our audit objectives.
subsections: section_title: NBIC Is Responsible for Facilitating Collaboration across Multiple Agencies to Enhance Biosurveillance Effectiveness by Integrating Data and Expert Analysis
paragraphs: Biosurveillance is the process of gathering, analyzing, and interpreting  data in order to achieve early detection and warning and overall  situational awareness of biological events with the potential to have  catastrophic human and economic consequences. In August 2007, the 9/11  Commission Act established NBIC to contribute to the nation’s  biosurveillance capability by enhancing the ability of the federal  government to rapidly identify, characterize, localize, and track biological  events of national concern through integration and analysis of data  relating to human health, animal, plant, food, and environmental  monitoring systems (both national and international). Once a potential  event is detected, NBIC is to disseminate alerts to enable response to a  biological event of national concern. To achieve these objectives, NBIC is  to coordinate with federal and other stakeholders that have information  that can be used to enhance the safety and security of the United States  against potential biological events of national significance. This  community of federal stakeholders is known as the NBIS.
The NBIS community predated the enactment of the 9/11 Commission Act.  Beginning in 2004, DHS managed the NBIS and developed an IT system to  manage other agencies’ biosurveillance information, an effort that was  moved among several DHS Directorates, including DHS’s Science and  Technology Directorate and the Preparedness Directorate. In 2007, DHS  created the Office of Health Affairs, headed by the DHS Chief Medical  Officer, to lead DHS’s biodefense activities and provide timely incident- specific management guidance for the medical consequences of disasters.  At that time, DHS placed NBIS in the Office of Health Affairs. Shortly  after that, the 9/11 Commission Act created NBIC and gave it responsibility  for managing the NBIS, which has remained in the Office of Health Affairs.  Since fiscal year 2008, NBIC has operated with an annual budget of $8  million dollars. Biosurveillance activities at NBIC are carried out by its  Operations Division, which is headed by the Deputy Director and Chief  Scientist and supported by 10 contract employees that serve as the  analytic core for NBIC’s daily operations. These staff members have  various backgrounds related to biodefense, including public health,  veterinary, environmental, and intelligence training.
section_title: NBIC Draws Its Early Detection and Situational Awareness Missions from Multiple Presidential Directives, in Addition to the 9/11 Commission Act
paragraphs: As shown in table 1, the 9/11 Commission Act outlines certain  requirements for NBIC and NBIS member agencies, and most of these  relate to how NBIC is to coordinate NBIS member agency data and  information management resources. Generally, there are four elements  that are critical for NBIC to achieve its early detection and situational  awareness missions established in the 9/11 Commission Act: (1) acquire  data from NBIS partners that can be analyzed for indications of new or  ongoing biological events, (2) leverage scientific and event-specific  expertise from across the NBIS, (3) obtain strategic and operational  guidance from NBIS partners, and (4) develop and maintain information  technologies to support data collection, analysis, and communication.
Although the act does not specify any member agency that must  participate in the NBIS, it defines a member agency as any agency that  signifies agreement to participate by signing a memorandum of  understanding (MOU) and establishes for them specific requirements— generally related to sharing information and human assets. For example,  as shown in table 1, the act provides that each member agency shall use its  best efforts to integrate biosurveillance information into the NBIC, with  the goal of promoting information sharing between federal, state, local,  and tribal governments to detect biological events of national concern.  NBIC has identified 11 NBIS partners at the federal level—the  Departments of Health and Human Services (HHS), Agriculture (USDA),  Commerce, Defense, Interior, Justice, State, Transportation, and Veterans  Affairs, as well as the Environmental Protection Agency and the United  States Postal Service. In some departments, more than one component has  been identified for participation. Some of these departments, such as HHS  and USDA, have major mission responsibilities for collecting health data  that may indicate an outbreak of a disease or other biological event. Other  departments may collect data or have subject matter expertise that may be  used during the course of a biological event. For example, the National  Oceanic and Atmospheric Agency within the Department of Commerce  collects meteorological data that may be used by NBIC to help inform the  progression of an outbreak based on weather patterns.
Around the same time as the enactment of the 9/11 Commission Act, the  President issued Homeland Security Presidential Directive-21 (HSPD-21),  as a high-level biodefense strategy. HSPD-21 is built on the principles of  earlier directives—HSPD-9 and HSPD-10—which collectively describe the  role of the federal government in building a national capability to detect a  biological event. For example, HSPD-21 lays out goals for addressing each  of four biodefense elements for human health, one of which is  surveillance. In this respect, HSPD-21 calls for the United States to  develop a nationwide, robust, and integrated biosurveillance capability to  provide early warning and ongoing characterization of disease outbreaks  in near real-time. Consistent with this goal, HSPD-21 directs the Secretary  of Health and Human Services to establish a national epidemiologic  surveillance system for human health, in part, to integrate federal, state,  and local data into a national biosurveillance common operating picture.  Although HSPD-21 does not specify a role for DHS in biosurveillance, the  earlier directives did, and creation and maintenance of an electronic  biosurveillance common operating picture has been an NBIS goal since its  inception.
section_title: Biosurveillance Involves Data Gathering and Analysis at Multiple Levels of Government for the Purposes of Earlier Warning and Enhanced Situational Awareness
paragraphs: The data needed to detect an infectious disease outbreak or bioterrorism  may come from a variety of sources, and aggregating and integrating data  across multiple sources is intended to help recognize the nature of a  disease event or understand its scope. Combining and comparing data  streams from different sectors to detect or interpret indications of a  potential health emergency is called biosurveillance integration. Both  HSPD-21 and the 9/11 Commission Act seek enhanced integration of  disparate systems and programs that collect data with the aim of providing  early warning and ongoing characterization of biological events. HSPD-21  and the 9/11 Commission Act each also seek to enhance the situational  awareness for the detection of and response to biological events. Much of  the information gathered for these biosurveillance purposes is generated  at the state government level. For example, state health departments  collect and analyze data on notifiable diseases submitted by health care  providers and others. In addition, state-run laboratories conduct testing  of samples for clinical diagnosis and participate in special clinical or  epidemiologic studies. Finally, state public health departments verify cases  of notifiable diseases, monitor disease incidence, and identify possible  outbreaks within their states. At the federal level, agencies and  departments generally collect and analyze surveillance data gathered from  the states and from international sources, although some federal agencies  and departments also support their own national surveillance systems and  laboratory networks.
When an issue crosses federal agency lines, as biosurveillance integration  does, the agencies involved must collaborate to deliver results more  efficiently and effectively. Due to NBIC’s role as an integrator of  information across the biosurveillance community, it is important for  NBIC to ensure that it effectively collaborates with the NBIS to obtain the  cooperation of this interagency community. One reason that it is important  that NBIC effectively collaborate with federal partners is that agencies are  not required by law to support NBIC or participate in the NBIS  community. We have previously reported that for collaborating agencies to  enhance and sustain collaboration, they need to, among other things, (1)  have a clear and compelling rationale for working together; (2) establish  joint strategies, policies, and procedures for aligning core processes and  resources; (3) identify resources needed to initiate or sustain their  collaborative effort; (4) work together to define and agree on their  respective roles and responsibilities; and (5) develop accountability  mechanisms to help implement and monitor their efforts to achieve  collaborative results.
section_title: NBIC Has Undertaken Efforts to Coordinate the NBIS and Acquire Resources, but Lacks Key Mission-Critical Elements
paragraphs: NBIC has made some efforts to put mission-critical elements in place, such  as requesting data from other federal partners, initiating relationship- building activities among NBIC analysts and subject matter experts at  other agencies, and establishing governance bodies to oversee and guide  the NBIS. However, NBIC currently relies on publicly available data  because it receives limited data from NBIS partners and generally lacks  assignments of personnel from other agencies to leverage analytical  expertise from across the NBIS partners.
subsections: section_title: NBIC Generally Has Not Acquired Data from Other Agencies to Support the Early Detection Mission and Instead Relies on Nonfederal, Open-Source Data
paragraphs: NBIC’s ability to acquire and consolidate data from NBIS partners as well  as from nonfederal sources is central to achieving its mission. Current and  initial drafts of the NBIS Concept of Operations reinforce this notion,  noting that the identification of relevant and timely data sources, which  act in combination to provide actionable information for decisionmaking,  is essential to accomplishing early detection. NBIC has taken some action  to acquire these types of data from NBIS partners, for instance, by  requesting that NBIS partners identify the types of data they collect or  generate that might aid in NBIC’s early detection mission. However, as of  October 2009, NBIC was generally not receiving the types of data best  suited to early detection of biological events of national concern. NBIC  officials acknowledge that they lack key data, and NBIC and other NBIS  member officials described numerous challenges to sharing such  information, including but not limited to scant availability of such data  throughout the federal government and concerns about trust and control  over sensitive information before it is vetted and verified.
Based on our discussions with NBIS agency officials and review of NBIC  documents, we have defined and verified with NBIC officials three  categories of electronic data that are critical for NBIC to achieve its  mission and might be available from federal agencies or other sources. As  described in table 2, these data categories are (1) raw structured data, (2)  raw unstructured data, and (3) final products which are typically briefings  produced by other agencies in the course of monitoring routine and  emerging disease. As of October 2009, NBIC was receiving some final  products from NBIS partners, but was not receiving any raw data— particularly data that are generated at the earliest stages of a biological  event.
According to officials, receipt of all three types of electronic data is  important to help NBIC achieve its mission of detecting and warning of a  biological event because detection of events that are novel, from multiple  sources, or widespread requires analysis of multiple independent data  streams. However, the officials told us that they do not receive from NBIS  partners the raw structured or unstructured data that best support the  early detection goal of biosurveillance. In particular, NBIC identified data  that are generated at the earliest stages of a biological event—which can  include raw data collected by federal agencies as part of their  biosurveillance responsibilities—as being among the highest value for  enabling the earlier detection of biological events of national concern. For  instance, structured data, such as medical codes corresponding to  diagnoses that are entered into databases, as well as some sources of  unstructured data, such as written observations noted on medical forms,  are generated at the earliest stages of a biological event and have been  identified by NBIC as a high priority for early detection. These data can be  collected or generated by federal agencies with responsibilities for  biosurveillance and which are participating in NBIS. For example, HHS  has developed a surveillance system that collects data on symptoms of  patients entering emergency departments, that when analyzed with  statistical tools, may be able to indicate the presence of an outbreak in less  time than it takes to perform diagnostic lab tests.
NBIC seeks to finalize three types of agreements with NBIS partners to  articulate and establish protocols and legal authority for resource sharing:  (1) MOUs, (2) interagency agreements (IAA), and (3) interagency security  agreements (ISA). To date, 7 of the 11 agencies have signed MOUs, but  only 1 has a finalized ISA in place for data sharing, according to NBIC  officials. As of October 2009, the federal agency that signed an ISA agreed  to provide a single data source related to food safety. NBIC officials told  us that although the agreement and the technology allowing the electronic  data exchange are in place, the agency has not yet begun transferring the  data to NBIC, and they did not know when to expect the transfer to begin.  NBIC’s inability to finalize agreements can be attributed in part to  challenges it faces in ensuring effective collaboration, which will be  discussed later in this report.
Five NBIS partners provide NBIC with written final products, such as  briefings produced on a routine basis that provide information on  outbreaks of diseases or special alerts of potentially dangerous biological  events issued as needed. However, NBIC officials noted that there are  limitations on the value of final reports for supporting early detection.  These finished products represent the agency’s final analysis and  interpretation of the raw data that it collects and have been reviewed and  approved by the agency leadership for general dissemination to interested  parties. According to NBIC officials, these products are generally useful  for providing context but not for early detection of a biological event  because they are not generated in a timely enough fashion to be valuable  for detecting new biological events and focus on biological events that  have already been detected.
In the absence of proprietary information from NBIS partners, NBIC relies  on mostly nonfederal sources of data, such as media reports of illness, to  attempt to identify biological events. The bulk of data—according to NBIC  officials more than 98 percent—NBIC currently uses to pursue its mission  is unstructured and comes from nonfederal, open sources, including an  international information gathering service called Global Argus, a  federally-funded program in partnership with Georgetown University. The  service searches and filters over 13,000 overseas media sources, in more  than 34 languages. The practice of monitoring and translating local news  articles has the potential to provide information about undiagnosed and  other suspicious disease activity before it is reported through more official  channels. NBIC officials stated that continuous monitoring of global news  media sources and publicly available Web sites would be important to  round out potential gaps in coverage, even if other data are available from  federal agencies.
section_title: NBIC Has Had Limited Success Obtaining Expertise from NBIS Partners through Interagency Personnel Assignments
paragraphs: NBIC officials told us that regardless of the quantity and quality of data  types shared by collaborating agencies, effective biosurveillance depends  on human analysts to interpret events and place them in context. For  example, determining whether an outbreak of a new emerging infectious  disease has occurred and further assessing whether this event is one of  national concern are analytic judgments that require not only data but also  the expertise of an experienced, knowledgeable analyst. According to  these officials, analyst-to-analyst communication in a trusted environment  is absolutely essential for rapid vetting, verification, and contextualization  of events.
The 9/11 Commission Act calls for member agencies to provide personnel  to NBIC under an interagency personnel agreement and consider the  qualifications of such personnel necessary to provide human, animal, and  environmental data analysis and interpretation support. However, for the  most part, NBIC has not consistently received this kind of support from  NBIS partners. Personnel detailed (that is, personnel employed by a  federal agency and temporarily assigned to NBIC for a specified period of  time) from other federal agencies enable analysis and interpretation of  data by serving as subject matter experts for specific issues that are part  of their home agencies’ missions and as conduits of information from their  respective home agencies. NBIC has signed MOUs with seven agencies,  but only two have provided a personnel detail to the NBIC headquarters in  Washington, D.C., and as of October 2009, only one of those personnel  details was active, because one of those agencies did not replace  personnel after the initial detail ended. NBIC officials told us that daily  interaction with officials who had been on detail at NBIC not only  enhanced their ability to interpret the information immediately on hand  but also contributed to ongoing contextual learning for NBIC’s analytical  corps.
Although most of the NBIS partners have not detailed their subject matter  experts to NBIC, the integration center officials have used other means to  obtain expertise and information from other agency analysts. NBIC  officials told us that they have co-located the NBIC analysts at other  collaborating agencies where they spend up to 2 weeks working with  analysts from these other agencies both to learn more about their  operations and to help forge ongoing relationships. NBIC officials stated  they have also established a daily process to engage the NBIS in sharing  information and analytic insights with each other. During this process— which NBIC calls the daily production process—NBIC analysts compile  information on reports of outbreaks that may be of concern, and then this  information is disseminated to the NBIS community for discussion at a  daily teleconference. The participants in the teleconference determine  whether the events merit further monitoring or evaluation and share any  relevant information they may have about the event. NBIC analysts then  use the information gathered, as refined by the daily teleconference, to  finalize NBIC daily reports and update its electronic Biosurveillance  Common Operating Picture, which is a manually updated electronic  picture of current worldwide biological events being tracked.
For example, NBIC analysts might identify local news reports that suggest  food contamination in a region. During the daily conference call, one or  more of the agencies with responsibility for monitoring food safety or  foodborne illness might contribute more information, such as a history of  similar issues in the same geographical region, that gives more context to  the reports. Then, collectively, the responsible agencies might decide that  the event, first uncovered in open source media, warrants further  investigation and monitoring. NBIC analysts would then post all known  information to its electronic Biosurveillance Common Operating Picture  for all interested parties to follow. Meanwhile, the agencies with missions  of jurisdiction would conduct their investigations and report any new  findings during the following day’s teleconference. NBIC officials told us  that this process requires a wide range of expertise from across the  agencies. These officials said that they may also communicate directly  with an agency prior to the daily teleconference if NBIC plans to discuss  an item relevant to the agency’s mission at the meeting.
Another means NBIC uses to obtain expertise and information from other  agency analysts is through participation in the Biosurveillance Indications  and Warnings Analytic Community (BIWAC). The BIWAC is a self- governing interagency body composed of federal officials who are actively  responsible for pursuing a biosurveillance mission. The agencies  represented include: the Department of Defense, HHS’s Centers for  Disease Control and Prevention, USDA, DHS, and the intelligence  community. The mission of the BIWAC is to provide a secure, interagency  forum for the collaborative exchange of critical information regarding  biological events that may threaten U.S. national interests. On behalf of the  BIWAC, the Department of Defense’s National Center for Medical  Intelligence hosts an encrypted information sharing portal called Wildfire.  According to NBIC’s Chief Scientist and Deputy Director, in addition to  engaging in the information exchange through Wildfire, she is an active  supporter and participant in BIWAC meetings and teleconferences.
According to NBIC officials, although these efforts to obtain the analytical  insights of subject matter experts from collaborating agencies may be  valuable, they do not provide a substitute for personnel details to the  integration center itself. For example, with the daily teleconference, NBIC  may have limited access to NBIS agency subject matter experts because  analysts from only a few of the various agencies may be available for  immediate communication on any given day, and not all agencies regularly  participate in the daily teleconference. In addition, apart from the daily  teleconference, NBIC officials said that agencies may limit NBIC’s ability  to communicate with their subject matter experts, particularly in the early  stages of responding to a biological event when the agency is prioritizing  its response needs. Finally, NBIC analysts may also communicate through  federal agencies’ operations centers during the course of an ongoing  biological event, but NBIC officials noted that this channel of  communication is not always an effective means to get meaningful input  from agencies’ subject matter experts. The lack of sustained personnel  detailed to NBIC from other NBIS partner agencies can be attributed, in  part, to challenges it faces with ensuring effective interagency  collaboration, which will be discussed later in this report.
section_title: NBIC Established Governance Structures to Develop and Oversee the NBIS
paragraphs: In order to support the ability for NBIS partners to engage in overseeing  and guiding the NBIS, NBIC has established and administers two  governance bodies. NBIC sponsors meetings of the two groups on a  regular basis. The NBIS Interagency Oversight Council (NIOC) is  composed of representatives at the assistant secretary level from each  NBIS agency. The NIOC is to act as the senior oversight body to provide  guidance and direction for the operation, implementation, and  maintenance of the NBIS, as well as to resolve interagency or  intradepartmental issues that cannot be resolved at lower levels. The NBIS  Interagency Working Group (NIWG) is a senior, director-level working  body created to share information on NBIC activities, such as the status of  developing draft documents and standard operating procedures including  procedures undertaken during ongoing biological events of national  concern. The NIWG can also establish sub-working groups to conduct  specific work as necessary to provide support to the NBIC and the NIOC.  For example, NIWG established a sub-working group to propose  procedures for resolving conflict during the daily production cycle.
section_title: NBIC Uses an IT System to Manage Publicly Available Data and to Communicate Alerts, but Generally Lacks the Ability to Apply Analytical Tools to Data
paragraphs: One of the elements that is critical for NBIC to carry out its mission is  development and maintenance of information technologies to support data  collection, analysis, and communication of alerts. The 9/11 Commission  Act also specifically mentions the need for statistical tools to analyze data  to identify and characterize trends of biological events of national  concern. NBIC has taken steps to develop an IT system that can manage  data from NBIS partners and can help identify open source reports of  potential biological events, but NBIC largely lacks data from federal  agencies. Given this condition, rather than a system designed to  electronically process structured data received directly from NBIS  partners, NBIC has configured its IT system—the Biosurveillance  Common Operating Network (BCON)—primarily to identify and assemble  unstructured data from public sources on the Internet that it will later vet  with other NBIS analysts in the daily production process. Therefore,  NBIC relies on the NBIS community and member agency subject matter  experts for analysis and interpretation of publicly available data rather  than providing the NBIS community with an analysis of integrated, raw,  structured data from the NBIS partners. According to NBIC officials, they  anticipate using BCON to manage any agency data streams that they may  eventually acquire.
BCON is a system of systems that is built on multiple commercial-off-the- shelf software packages. Currently, the central feature of BCON is its use  of a set of keywords within a language algorithm to search the Internet for  media articles that may contain biosurveillance-relevant information and  compile them for NBIC analysts to review. As part of this function, BCON  also flags events for immediate analyst attention. Additionally, the  information from BCON is the basis for the NBIC Biosurveillance Common  Operating Picture, which is a manually updated Google Maps application  of current worldwide biological events being tracked. NBIS agency  officials can view the Biosurveillance Common Operating Picture on the  Homeland Security Information Network. According to NBIC officials, in  the future NBIS agency officials will also have the ability to create and  update event information.
Although NBIC generally lacks direct-feed, raw, structured data from NBIS  partners to apply statistical and analytical tools, according to our  observations and review of documents supporting the development of the  system, BCON is designed to locate and log information associated with  the events contained in the open source media that it searches. This  information includes the geographic coordinates and the date and time of  occurrence for each event. This data is archived and, according to NBIC  officials, can be used to conduct cross-domain analysis for trends,  historical context, associated events, anomaly detection, and hypothesis  generation. Among the applications planned for inclusion in BCON is a  tool that is designed to perform historical analysis of this archived data to  help monitor and refine the effectiveness of the algorithm. According to  NBIC officials, the goal of this analysis is to help ensure that NBIC analysts  will be able to identify events that merit attention by refining the algorithm  to limit results that are less relevant for monitoring for biological events of  national concern. However, these officials told us that this aspect of BCON  has been put on hold due to budget constraints.
To advance information sharing among federal agencies, NBIC is also  pursuing $90 million dollars in supplemental funding for a broader  information sharing initiative. This initiative is intended to enable greater  information sharing capabilities among federal, state, and local agencies  and to have the necessary data security to house classified data. According  to NBIC officials, this initiative is being led by the National Security  Council.
To communicate alerts to member agencies and the larger NBIS  community regarding any incident that could develop into a biological  event of national concern, NBIC has developed an IT system to provide  alerts and warnings, based on an existing system that had been developed  for another DHS component. However, according to NBIC officials, the  system has not yet been fully implemented because they recently acquired  it, and NBIC is still testing protocols for using it. According to our  observations of the system and review of operational protocols, the  system provides NBIC with the capability to tailor alerts and warnings to  specific recipients via distribution lists. These officials said that in spring  2008 the protocols were approved by the NIWG and briefed to the NIOC.  NBIC officials said they are currently testing the protocols but have not yet  needed to employ the system during a biological event.
section_title: Use of Key Collaboration Practices Could Help NBIC Strengthen Collaboration and Promote Fuller Participation
paragraphs: Our analysis and interviews with NBIS partners suggest that NBIC could  strengthen its use of collaborative practices. Because participation in the  NBIS is voluntary, effective use of collaborative practices is essential to  NBIC’s ability to successfully develop and oversee the NBIS in a way that  enhances federal biosurveillance capabilities. However, we found (1)  widespread uncertainty and skepticism around the value of participating  in the NBIS and the purpose of NBIC; (2) incomplete joint strategies,  policies, and procedures for operating across agency boundaries; (3) an  inability or unwillingness of NBIS members to respond to plans for  leveraging resources; (4) confusion and dissatisfaction around the  definitions of mission, roles, and responsibilities of NBIC and its NBIS  partners; and (5) a lack of mechanisms to monitor and account for  collaborative results.
subsections: section_title: Clearly Defining the Mission and Purpose, the Value of Participation, and Joint Strategies and Procedures Could Promote More Effective Interagency Cooperation
paragraphs: Biosurveillance integration is an inherently interagency enterprise,  requiring expertise and resources from various federal agencies, such as  information on human and zoonotic diseases monitored by HHS and  USDA. Indeed, NBIC officials acknowledged that NBIC cannot provide  national-level capability for cross-domain biosurveillance relying solely on  DHS resources. As a result, it is crucial for NBIC to ensure stakeholder  buy-in and participation in clearly defining the value of NBIS participation  and NBIC’s mission or purpose, as well as establishing the strategies and  procedures for how the partners will work together. Our prior work states  that effective collaboration requires agencies to have a clear and  compelling rationale for working together, which can be achieved by  defining and articulating a common federal outcome or purpose. The  rationale can be imposed externally through legislation or other directives  or can come from the agencies’ own perceptions of the value of working  together. In either case, agency staff can accomplish this by working  across agency lines to define and articulate the common purpose they are  seeking to achieve that is consistent with their respective agency goals and  mission. Because there is no legal requirement for agencies to participate  in NBIS, agencies must have a clear and compelling rationale to work  together as a community of federal partners by joining the NBIS and  providing data and personnel to the integration center. In the case of an  agency like NBIC, for which collaboration is essential, clearly defining and  communicating its purpose and mission can help to ensure that partners  share a vision of the desired outcomes. In addition, our work has shown  that to enhance and sustain collaboration, it is important to establish joint  strategies, policies, and procedures for operating across agency  boundaries. Establishing joint strategies and compatible policies and  procedures helps align collaborating agencies’ activities, processes, and  resources to, among other things, bring together diverse organizational  cultures to enable a cohesive working relationship across agency  boundaries and create the mutual trust required to sustain the  collaborative effort.
However, we found in interviews with agency officials from 14  components of the 11 NBIS partners, widespread uncertainty and  skepticism around the value of and rationale for participation in the NBIS  and incomplete strategies, policies, and procedures for operating across  agency boundaries that lack key stakeholder buy-in. Twelve of the 14  NBIS-partner components expressed uncertainty about the value of  participating in the NBIS community or confusion about the purpose of  NBIC. For example, officials from one component stated that they were  uncertain whether sharing resources with the integration center,  something that is required of members of the NBIS community, would  further their agency’s missions. Officials from another component  expressed concerns about the rationale for participating in the NBIS and  supporting the integration center, stating they were unsure whether NBIC  contributed anything to the federal biosurveillance community that other  agencies were not already accomplishing in the course of carrying out  their biosurveillance-relevant missions. Officials from five of these  components noted that their uncertainty about the value of participation  in the NBIS was a factor in not assigning personnel to NBIC. Further,  officials from 7 of the 14 components we interviewed indicated that their  experience with a recent tabletop exercise and real life events had  contributed to their concerns about the value of participating in NBIS and  the purpose of NBIC. For example, officials from one component said that  the tabletop exercise showcased agencies’ reluctance to share information  and underscored that there was no role for NBIC; while officials from  another component said that during 2009 H1N1 activities, NBIC was not  able to demonstrate that it had unique value to add. Officials from seven of  the components indicated that they lacked a concrete understanding of  the purpose for which NBIC was requesting their agencies’ data, which  was, in part, the reason they had not been able to identify appropriate data  sources or to work out data sharing agreements with NBIC.
NBIC officials told us that they regularly reminded NBIS partners of  NBIC’s mission as the coordinator of the NBIS and the value of sharing  data and personnel to achieve the goal of earlier detection and enhanced  situational awareness. However, officials from 8 of the 14 components told  us that during negotiations with NBIC, they had raised concerns about the  purpose of the data or the value of detailing personnel to NBIC, and NBIC  had not followed up in a timely and consistent manner to resolve those  concerns. NBIC officials also stated that they have taken actions to  demonstrate the value of participating in NBIS and of sharing resources  with the integration center. For example, NBIC co-located the integration  center’s analysts with analysts at other agencies, such as the Centers for  Disease Control and Prevention, for brief periods of time to enhance  mutual understanding between NBIC and NBIS partner agencies. Further,  NBIC officials have attempted to demonstrate the value of participating in  NBIS and supporting the integration center by encouraging agencies to  participate in NBIC’s daily production process. NBIC officials said that  through daily engagement in the production process and during recent real  life events like food borne illness outbreaks they have been able to  demonstrate the value of NBIC. However, agency officials told us that  their experiences with NBIC during real life events and the tabletop  exercise created questions about the value of participating in the NBIS and  NBIC’s purpose.
NBIC officials have drafted but not completed a strategic plan for NBIC  that includes a mission statement, which could help clarify NBIC’s  purpose. The plan is also to provide strategic and operational guidance to  NBIC officials for achieving that mission. According to NBIC officials,  however, they have not shared the draft strategic plan with NBIS officials  or solicited their input, and it is not currently their plan to do so because it  is an internal document. Officials have not set a deadline for completing  the NBIC strategic plan because they are still in the process of vetting the  initial draft internally.
In addition to uncertainty about the value of participating in the NBIS and  the purpose of NBIC, we also found that NBIC has not completed and  achieved buy-in for joint strategies, policies, and procedures for operating  across agency boundaries. NBIC has drafted a Concept of Operations,  which is intended to communicate joint strategies, policies, and  procedures for operating across the NBIS. According to NBIC officials,  they have solicited and considered comments from NBIS partners as they  developed the draft, which is currently on its third version. However,  NBIC has not yet achieved agreement around strategies, policies, and  procedures that would support effective collaboration across the NBIS.  For example, one key partner agency—one for which biosurveillance is a  mission critical function and is thus essential to a strong and effective  NBIS—shared with us a memo they had written to NBIC expressing their  lack of concurrence with the current Concept of Operations. The memo  cited several concerns that related largely to lack of clarity in the  document about the desired common federal outcome and the role of the  different partners in achieving it. NBIC officials told us they plan to  finalize the Concept of Operations by the end of 2009.
Clearly defining its mission, as well as articulating the value of  participation in the NBIS, could help NBIC overcome challenges  convincing agencies to work collectively as part of the NBIS. In addition,  establishing and clarifying joint strategies, policies, and procedures with  buy-in across the NBIS, could help address barriers to collaboration.
section_title: NBIC Has Not Clearly Identified How to Leverage Resources or Effectively Defined Roles and Responsibilities with NBIS Partners
paragraphs: Two of the collaborative practices we recommend speak to how agencies  will share human and other assets to achieve the desired outcomes— identifying and addressing needs by leveraging resources and agreeing on  roles and responsibilities. According to NBIC officials, the concept of a  national center for integrating biosurveillance data from multiple agencies  depends on the willingness of the collaborating agencies to detail their  experts to the center for a period of time to interpret the data for signs of  an outbreak or biological attack; consequently, effectively identifying what  resources are available and how to leverage them is important.
In our work on practices to enhance and sustain collaboration, we call for  agencies to assess relative strengths and weaknesses to identify  opportunities to leverage each other’s resources, thus obtaining additional  benefits that would not be available were the agencies working separately.  However, agency officials we met with stated that NBIC did not recognize  the different levels of resources and capacities that each agency brought  to this effort. Seven of the 14 groups of agency officials we interviewed  noted that the NBIC made personnel requests that were not compatible  with the resources agencies had available. For example, one of the  comments officials made to us regarding NBIC’s request for personnel  details was that they did not have available or could not spare personnel  that matched NBIC’s request for senior-level officials with sufficient  analytical knowledge and authority to make immediate decisions about  sharing information across the NBIS. Officials from one of the components  without a direct biosurveillance mission told us that they only have one  such person on staff and needed to keep that person in house to be able to  carry out their mission-critical activities. Officials at two agencies  described methods they had devised for human-resource sharing  arrangements that did not involve locating senior staff at NBIC for several  months. However, NBIC officials told us that this is no substitute for the  value of a member agency personnel detail that is physically located at  NBIC. NBIC officials noted that the Secretary of Homeland Security had  sent a memo to other NBIS agency leadership requesting help in securing  personnel details on May 23, 2008. In addition, they stated that the issue is  regularly addressed in NIWG and NIOC meetings. The officials also  provided several examples of outreach to NBIS officials at all 11 agencies,  such as through discussions with NBIS partner agency representatives at  NIWG meetings.
Similarly, 5 of 14 groups of officials we interviewed reported that they had  experienced confusion about how NBIC planned to use personnel details  if they were provided. For example, one such agency expressing this  confusion said that NBIC’s guidance on what it is looking for in a  personnel detail had changed frequently. NBIC officials told us that  initially they requested individuals with strong scientific backgrounds to  assist with data analysis and interpretation (analyst model). However, they  later determined that they could use senior-level agency officials who  were knowledgeable about their home organization to act as liaisons by  identifying specific subject matter experts to consult with NBIC, as needed  (liaison model). According to these NBIC officials, they have  communicated to the NBIS partners that if they detail personnel to NBIC,  they can follow either the analyst model or the liaison model.  Nevertheless, during our interviews a lack of clarity about personnel detail  roles and responsibilities was among the reasons cited for not finalizing  MOUs or interagency agreements for personnel details.
Of the two NBIS partners that placed personnel at NBIC, officials from one  agency told us that although they still were not entirely clear on NBIC’s  needs, they were committed to the NBIS concept. Therefore, they  committed to send two half-time detailees each fitting one of the two types  of detailees NBIC had alternately requested. These personnel details were  ongoing as of October 2009. According to agency officials, they committed  to a shorter detail than NBIC requested because they intend to use the  current detail placement to help clarify for themselves what NBIC’s needs  are and the extent to which the detail arrangement might be valuable to  their agency. However, officials at the only other agency that had detailed  personnel to NBIC told us that they had not renewed the detail agreement  when it ended, in part because of budgetary challenges, but also because  of a general perception at their agency that the detail had not been  particularly valuable for the individual or for their agency. According to  NBIC officials, the personnel details from this agency assisted NBIC  immeasurably in both the analysis work and in thinking through how to  grow and shape the personnel detail program.
We also discuss in our work on practices for enhancing and sustaining  collaboration the importance of defining and agreeing on roles and  responsibilities, to allow each agency to clarify who will do what, organize  their joint and individual efforts, and facilitate decision making. Our  analysis of NIOC and NIWG post meeting reports, NBIS tabletop exercise  results, and interviews with NBIS agency officials reveals some ambiguity  about NBIC’s mission, roles, and responsibilities, particularly during a  crisis. Officials from 8 of 14 components we interviewed expressed  uncertainty about NBIC’s role during a response relative to the  biosurveillance capability provided by other agencies in the course of their  routine, mission-critical duties. In large part, these officials said that if they  had information to share that might involve a biological emergency, they  would be more likely to interact with DHS’s National Operations Center  (NOC), at which NBIC has representation, than directly with NBIC. The  after action report, as well as comments from these officials, show that  such questions about NBIC’s response role manifested during a recent  tabletop exercise. In our interviews, officials from seven components  expressed concerns about NBIC’s role in the exercise or real life events,  ranging from lack of clarity about what role NBIC played or should play to  statements that the exercise showed clearly that NBIC has no proper role  in event response. According to the memo that the moderator prepared  after the tabletop exercise, although the NOC did not participate, some  participants thought NBIC would have been bypassed in favor of the NOC.
They said the NOC would perform the essential biosurveillance integration  roles of coordinating and disseminating information across agencies,  states, and the private sector. In addition, the memo notes that exercise  participants were not in agreement about the proper role for NBIC in  ongoing collection and dissemination of data specific to an identified  event. Among the recommendations in the after-action memo was for  NBIC to work internally with the appropriate DHS parties, including the  NOC, to write protocols defining the NBIC role inside DHS. According to  NBIC officials, they have followed up on this recommendation, by among  other things, exploring it through the NIWG. Additionally, NBIC, the NOC,  and other stakeholders have initiated discussions about how to develop  appropriate protocols.
A related issue that came to light during the tabletop exercise and was a  theme in interviews with NBIS officials is the extent to which NBIS  partners trust NBIC to use their information and resources appropriately.  According to the exercise after-action memo, participants repeatedly  raised concerns about trusting NBIC with data, and participants also  expressed concern that NBIC would reach the wrong conclusions or  disseminate erroneous data or reports. Similarly, in our semistructured  interviews, officials from 5 of 14 components said they were cautious  about sharing data or information with NBIC because they lack confidence  that NBIC will either interpret it in the appropriate context or reach back  to the agency to clarify before sharing the data across the whole  interagency community. These comments generally noted concerns that  NBIC’s lack of contextual sophistication could lead to confusion, a greater  volume of unnecessary communication in the biosurveillance  environment, or even panic. NBIC officials acknowledged that subject  matter expertise from the agencies with frontline responsibility for disease  surveillance is essential for drawing appropriate conclusions about  emerging situations. However, they also noted that analysts at NBIC have  experience with public health and have been building their expertise as  the program matures. Clearly identifying how NBIS resources, including  personnel details, will be leveraged and establishing institutional roles and  responsibilities, could strengthen NBIC’s efforts to obtain buy-in for  agencies to fully participate in the NBIS, including by committing to  personnel detail arrangements.
section_title: Creating a Mechanism to Monitor Performance and Accountability Could Help NBIC Enhance and Sustain Collaboration
paragraphs: We have previously reported that federal agencies can use their strategic  and annual performance plans as tools to drive collaboration with other  agencies and partners. Such plans can also reinforce accountability for  collaboration by establishing performance measures and aligning agency  goals and strategies with those of the collaborative efforts. Using  established performance measures to evaluate and report on the  effectiveness of collaboration could identify ways to improve it. NBIC’s  draft strategic plan outlines milestones, goals, objectives, and key tasks  needed for NBIC to meet its mission. These tasks include, among other  things, defining an information-sharing strategy among its stakeholders,  deploying IT to support its mission, and establishing standard operating  procedures. However, despite acknowledging that interagency  cooperation and collaboration remain a concern to resolve, the strategic  plan does not address how NBIC will improve collaboration among  current and potential NBIS member agencies or how it will measure  collaborative results. NBIC’s draft strategic plan includes one proposed  performance metric related to collaboration with NBIS partners—to  assess current collaboration activities for relevance and contribution to  NBIS mission requirements. However, the plan lacks a discussion of  strategic objectives to achieve collaboration and, correspondingly, lacks  associated measures and targets to monitor efforts to achieve  collaborative results. Strategic objectives for collaboration and associated  targets and measures could provide NBIC with a critical tool to help  ensure that it appropriately focuses its efforts on enhancing collaboration  with NBIS members and that the desired results are achieved.
section_title: Leveraging NBIS Governing Bodies to Develop a Strategy for Collaboration Could Help NBIC More Effectively Meet Its Mission
paragraphs: NBIC has the means to engage NBIS partners through the organizations  that help organize and manage the NBIS community—the NIOC and the  NIWG—but our analysis shows the integration center has not yet fully  leveraged these groups to develop effective collaboration strategies. The  purpose of the NIOC and NIWG governance bodies is to provide strategy  and policy advice on the operation of the NBIS. Information on the status  of NBIC’s efforts to achieve its mission has been provided to the NIOC, an  oversight council serving the NBIS community, but substantive discussion  of strategies for overcoming barriers to collaboration that impact NBIC’s  execution of its mission did not occur during meetings with the NIOC. For  example, post meeting reports from the NIOC—the higher level strategic  governance body for the community of NBIS partners—show that the  NBIC director routinely gave a status update of the MOUs and interagency  agreements for each agency, during which agencies report the status from  their perspective. However, in these segments of the NIOC meetings, the  post meeting reports reflect little, if any, discussion of the reasons NBIS  agency officials cited in our interviews for not finalizing the agreements.  Neither do the reports show any focused effort to discuss barriers to  participation or solutions to working across agency boundaries.
The NIWG—operational level working group—post meeting reports  between March 2008 and May 2009 reflect only one discussion during  which the need to finalize agreements was addressed. Although the NIWG  has formed a sub-working group specifically to address collaboration, our  review of the post meeting reports shows that neither the full NIWG nor  the sub-working group has been effectively engaged in a focused effort to  identify, discuss, and address challenges to working across agency  boundaries. According to NBIC officials, they place contentious issues  before the NBIS governance structure in a way that may not be clearly  captured in post meeting reports. NBIC officials noted that the post  meeting reports do not clearly reflect the numerous times they have made  proposals for solutions to problems and have been met with silence from  the attendees. However, they acknowledge that they have approached the  NBIS governance bodies seeking buy-in for their proposals for tactical and  operational approaches rather than an open-ended discussion seeking  strategic solutions to the broader barriers to information and resource  sharing. Leveraging these bodies to get meaningful input from NBIS- partner leadership could help NBIC ensure that it is able to identify  commonly accepted solutions to working across agency boundaries.
section_title: Conclusions
paragraphs: Enhancing the federal government’s ability to detect and warn of  biological events of national concern and to provide better situational  awareness for response to those events depends on multiple actors inside  and outside the federal government to work together effectively. The 9/11  Commission Act charged NBIC with early detection and situational  awareness, but both the act and the operational guidance NBIC has  developed acknowledges that this is to be done, in large part, through the  NBIS—a multi-agency collaborative community. Despite the critical role of  this collaborative community in achieving the act’s charge, the act does  not require any specific agency to participate in the NBIS or to support the  integration center. Therefore, it is imperative that NBIC employ  collaborative practices to enhance and sustain collaboration across the  NBIS so that this community of federal partners are fully and effectively  engaged in pursuit of the overarching missions of early detection and  enhanced situational awareness.
Although NBIC has made some efforts to strengthen relationships with  and solicit participation from NBIS partners, working with the NBIS to  develop a strategy for collaboration that includes key collaboration  practices identified in our previous work could help the integration center  promote more effective collaboration. During the course of our review,  officials from the NBIS community recounted a number of constraints on  their participation, including concerns about the clarity of NBIC’s mission  and the ends to which shared information and resources would be used.  We have previously reported that having a mission statement helps to  clarify an agency’s focus and purpose. Moreover, our prior work on  enhancing and sustaining collaboration in the federal government advises  that practices such as articulating common outcomes, identifying  appropriate resources to be shared, clarifying roles and responsibilities,  and developing mechanisms to monitor performance and accountability  could help NBIC address barriers to collaboration. However, NBIC has not  formulated goals and objectives for overcoming barriers to collaboration  and has no supporting performance and accountability mechanisms—such  as performance measures—to help ensure that they are pursuing those  goals effectively. In addition, although NBIC has created the NIOC and  NIWG to provide strategic and operational advice on how the NBIS should  function, NBIC had not effectively engaged them in a focused effort to  identify shared solutions for overcoming barriers to collaboration and  creating buy-in for joint strategies, policies, procedures, roles, and  responsibilities. A strategy for helping ensure that NBIC applies key  collaborative practices effectively and consistently, that draws on the  existing intellectual resources of its strategic partners in the NIOC, and  that includes mechanisms to monitor performance and accountability for  collaborative results, may help NBIC and NBIS partners to identify and  overcome challenges to sharing data and personnel for the purposes of  earlier detection and enhanced situational awareness of potentially  catastrophic biological events.
section_title: Recommendations for Executive Action
paragraphs: In order to help NBIC ensure that it effectively applies practices to  enhance and sustain collaboration, including the provision of data,  personnel, and other resources, we are making the following two  recommendations to the Director of NBIC:  In conjunction with the NIOC, finalize a strategy for more effectively  collaborating with current and potential NBIS members, by (1) clearly  defining NBIC’s mission and purpose, along with the value of NBIS  membership for each agency; (2) addressing challenges to sharing data  and personnel, including clearly and properly defining roles and  responsibilities in accordance with the unique skills and assets of each  agency; (3) developing and achieving buy-in for joint strategies,  procedures, and policies for working across agency boundaries.
Establish and use performance measures to monitor and evaluate the  effectiveness of collaboration with current and potential NBIS partners.
section_title: Agency Comments and Our Evaluation
paragraphs: We provided a draft of this report for review and comment to the following  agencies: DHS, HHS, USDA, and the Departments of Commerce, Defense,  Interior, Justice, State, Transportation, and Veterans Affairs, as well as the  Environmental Protection Agency and the United States Postal Service.  DHS provided written comments on December 10, 2009, which are  summarized below and presented in their entirety in appendix I of this  report. HHS, USDA, and the Departments of Commerce, Defense, Interior,  Justice, Transportation, and Veterans Affairs, as well as the Environmental  Protection Agency and the United States Postal Service did not provide  written comments. We incorporated technical comments from DHS,  USDA, and the United States Postal Service where appropriate.
DHS generally concurred with our findings and recommendations and  stated that NBIC will work with the NIOC and all NBIS partners to develop  a collaboration strategy to clarify both the mission space and roles and  responsibilities of all NBIS partners. DHS has taken initial steps to  implement our recommendations. For example, DHS noted that at the  December 9, 2009, quarterly NIOC meeting, the Assistant Secretary of  Health Affairs and Chief Medical Officer for DHS, Dr. Alex Garza,  referenced this report’s findings and challenged NIOC members to work to  resolve and address confusion regarding NBIS and NBIC. We are  encouraged by DHS’s efforts to engage the NIOC to identify and overcome  barriers to collaboration; continuing to work with the NIOC to develop  and finalize a strategy for collaboration could help NBIC overcome  challenges to sharing data and personnel. In addition, monitoring the  effectiveness of collaboration through the use of performance metrics  could help NBIC ensure they are progressing towards their goal of  obtaining the resources necessary to accomplish its mission of early  detection and situational awareness of biological events of national  concern.
While DHS stated that we clearly identify the challenges faced by NBIC in  carrying out its mission, the department also commented that the lack of a  legal requirement for other federal agencies to participate in the NBIS  prevents DHS from compelling the cooperation that is needed to ensure  success of the NBIC mission.  As we noted in our report, the lack of a legal  requirement is what makes the effective use of collaboration best  practices crucial for NBIC to be successful.
We are sending copies of this report to the Secretary of Homeland  Security, Secretary of Health Human and Services, Secretary of  Agriculture, Secretary of Commerce, Secretary of Defense, Secretary of  Interior, Attorney General, Secretary of State, Secretary of Transportation,  and the Secretary of Veterans Affairs, as well as the Administrator of the  Environmental Protection Agency, the Postmaster General, the Director of  NBIC, and interested congressional committees. The report is also  available at no charge on GAO’s Web site at http://www.gao.gov.
If you or your staff have any questions about this report please contact me  at (202) 512-8777 or JenkinsWO@gao.gov. Contact points for our Offices of  Congressional Relations and Public Affairs may be found on the last page  of this report. GAO staff who made major contributions to this report are  listed in appendix II.
William O. Jenkins, Jr Director, Homeland Security  and Justice Issues  .
section_title: Appendix I: Comments from the Department of Homeland Security
section_title: Appendix II: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact
section_title: Acknowledgments
paragraphs: In addition to the contact named above, Anne Laffoon, Assistant Director;  Michelle Cooper; Clare Dowdle; Kathryn Godfrey; and Andrea Yohe made  significant contributions to the work. Keira Dembowski, Susanna Kuebler,  Alberto Leff, and Juan Tapiavidela also provided support. Amanda Miller  assisted with design, methodology, and analysis. Tracey King provided  legal support. Linda Miller provided communications expertise.