Veterinarian Workforce: Actions Are Needed to Ensure Sufficient Capacity for Protecting Public and Animal Health
Published: 2009-02-04T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: Veterinarians are essential for controlling zoonotic diseases--which spread between animals and humans--such as avian influenza. Most federal veterinarians work in the Departments of Agriculture (USDA), Defense (DOD), and Health and Human Services (HHS). However, there is a growing national shortage of veterinarians. GAO determined the extent to which (1) the federal government has assessed the sufficiency of its veterinarian workforce for routine activities, (2) the federal government has identified the veterinarian workforce needed during a catastrophic event, and (3) federal and state agencies encountered veterinarian workforce challenges during four recent zoonotic outbreaks. GAO surveyed 24 federal entities about their veterinarian workforce; analyzed agency workforce, pandemic, and other plans; and interviewed federal and state officials that responded to four recent zoonotic outbreaks.
section_title: What GAO Found
paragraphs: The federal government lacks a comprehensive understanding of the sufficiency of its veterinarian workforce. More specifically, four of five component agencies GAO reviewed have assessed the sufficiency of their veterinarian workforce to perform routine activities and have identified current or future concerns. This includes USDA's Animal and Plant Health Inspection Services (APHIS), Food Safety and Inspection Service (FSIS), and Agricultural Research Service (ARS); and DOD's Army. Current and future shortages, as well as noncompetitive salaries, were among the concerns identified by these agencies. HHS's Food and Drug Administration (FDA) does not perform such assessments and did not identify any concerns. In addition, at the department level, USDA and HHS have not assessed their veterinarian workforces across their component agencies, but DOD has a process for doing so. Moreover, there is no governmentwide effort to search for shared solutions, even though 16 of the 24 federal entities that employ veterinarians raised concerns about the sufficiency of this workforce. Further exacerbating these concerns is the number of veterinarians eligible to retire in the near future. GAO's analysis revealed that 27 percent of the veterinarians at APHIS, FSIS, ARS, Army, and FDA will be eligible to retire within 3 years. Efforts to identify the veterinarian workforce needed for a catastrophic event are insufficient. Specifically, agencies' plans lack important elements necessary for continuing essential veterinarian functions during a pandemic, such as identifying which functions must be performed on-site and how they will be carried out if absenteeism reaches 40 percent--the rate predicted at the height of the pandemic and used for planning purposes. In addition, one federal effort to prepare for the intentional introduction of a foreign animal disease is based on the unrealistic assumption that all affected animals will be slaughtered, as the United States has done for smaller outbreaks, making the resulting veterinarian workforce estimates irrelevant. A second effort lacks crucial data, including data on how the disease would spread in wildlife. If wildlife became infected, as they have in the past, response would be greatly complicated and could require more veterinarians and different expertise. Officials from federal and state agencies involved in four recent zoonotic disease outbreaks commonly cited insufficient veterinarian capacity as a workforce challenge. However, 10 of the 17 agencies that GAO interviewed have not assessed their own veterinarian workforce's response to individual outbreaks and are thus missing opportunities to improve future responses. Moreover, none of the entities GAO reviewed has looked across outbreaks to identify common workforce challenges and possible solutions.

section_title: Letter
paragraphs: Veterinarians play a vital role in the defense against animal diseases— Veterinarians play a vital role in the defense against animal diseases— whether naturally or intentionally introduced—and these diseases can  whether naturally or intentionally introduced—and these diseases can  cause serious harm to human health and the economy. For example,  cause serious harm to human health and the economy. For example,  veterinarians were at the forefront of the response to the 2001 United  veterinarians were at the forefront of the response to the 2001 United  Kingdom outbreak of foot-and-mouth disease, which resulted in the  Kingdom outbreak of foot-and-mouth disease, which resulted in the  slaughter of more than 4 million animals to control the outbreak, losses of  slaughter of more than 4 million animals to control the outbreak, losses of  over $5 billion to the food and agriculture sectors, and comparable losses  over $5 billion to the food and agriculture sectors, and comparable losses  to the tourism industry. Veterinarians are also essential for controlling  to the tourism industry. Veterinarians are also essential for controlling  zoonotic diseases, which are diseases that spread between animals and  zoonotic diseases, which are diseases that spread between animals and  humans. Zoonotic diseases are of particular concern because, in recent  humans. Zoonotic diseases are of particular concern because, in recent  years, about 75 percent of the newly emerging infectious diseases affecting  years, about 75 percent of the newly emerging infectious diseases affecting  humans have originated in animals. For example, over the past few years,  humans have originated in animals. For example, over the past few years,  a highly pathogenic strain of avian influenza has killed millions of wild and  a highly pathogenic strain of avian influenza has killed millions of wild and  domestic birds worldwide and infected over 400 people, more than half of  domestic birds worldwide and infected over 400 people, more than half of  whom have died. Health experts are concerned that this virus could cause  whom have died. Health experts are concerned that this virus could cause  a pandemic if it develops the ability to spread efficiently from human to  a pandemic if it develops the ability to spread efficiently from human to  human. Veterinarians also help prevent foodborne illness, which humans  human. Veterinarians also help prevent foodborne illness, which humans  can acquire, for example, from meat contaminated with viruses or  can acquire, for example, from meat contaminated with viruses or  bacteria. Each year, about 76 million Americans contract foodborne  bacteria. Each year, about 76 million Americans contract foodborne  illnesses, and about 5,000 die.  illnesses, and about 5,000 die.
However, there is a growing shortage of veterinarians nationwide,  However, there is a growing shortage of veterinarians nationwide,  particularly of veterinarians who care for animals raised for food, serve in  particularly of veterinarians who care for animals raised for food, serve in  rural communities, and have training in public health, according to several  rural communities, and have training in public health, according to several  professional associations. This shortage has, according to the American  professional associations. This shortage has, according to the American  Veterinary Medical Association, placed the nation’s food supply at risk and  Veterinary Medical Association, placed the nation’s food supply at risk and  could hinder efforts to protect humans from zoonotic diseases. The  could hinder efforts to protect humans from zoonotic diseases. The  veterinarian shortage is expected to worsen, partly as a result of space  veterinarian shortage is expected to worsen, partly as a result of space  constraints at the country’s 28 veterinary colleges, which can graduate  constraints at the country’s 28 veterinary colleges, which can graduate  only about 2,500 students a year combined, according to the American  only about 2,500 students a year combined, according to the American  Association of Veterinary Medical Colleges. The demand for veterinarians  Association of Veterinary Medical Colleges. The demand for veterinarians  is expected to increase, however. For example, the Bureau of Labor  Statistics predicts that demand will increase by 35 percent from 2006 to  2016—from 62,000 full-time jobs to 84,000. Subsequently, the Congress  enacted two pieces of legislation that address these concerns. In 2003, it  enacted the National Veterinary Medical Services Act directing the  Secretary of Agriculture to carry out a program to help repay school loans  for veterinarians who agree to work in areas of need. In August 2008, the  Congress passed the Higher Education Opportunity Act, which has  provisions intended to increase the number of veterinarians in the  workforce.
The federal government employs more than 3,000 veterinarians. Although  this number represents a small portion of the federal workforce, these  veterinarians play a crucial role in helping to protect people and the  economy from animal diseases. More than 2,900 federal veterinarians  work for component agencies within the Departments of Agriculture  (USDA), Defense (DOD), and Health and Human Services (HHS). The  1,771 veterinarians at USDA have numerous functions, including the  following:    Animal and Plant Health Inspection Service (APHIS) veterinarians help  protect and maintain the health of American livestock and poultry during  production, and monitor wildlife populations for critical endemic and  foreign animal diseases;   Food Safety and Inspection Service (FSIS) veterinarians inspect animals at  slaughter plants to help ensure the safety of meat and poultry products,  and they also oversee the humane treatment of livestock during slaughter;  and   Agricultural Research Service (ARS) veterinarians research critical  endemic and foreign animal diseases.
DOD employs 841 veterinarians, the majority of whom work for the Army  as active duty veterinarians or as part of the Army’s veterinary reserve  corps. These veterinarians are responsible for caring for service and  research animals, ensuring food safety at military installations, and  conducting intelligence work related to bioterrorism, among other things.
HHS employs 316 veterinarians, whose functions include the following:    Food and Drug Administration (FDA) veterinarians are responsible for  ensuring that animal drugs are safe and effective, that animal feed is safe, and that food from medically treated animals is safe to eat. They also help  ensure the safety of food, drugs, and cosmetics, among other things;   Centers for Disease Control and Prevention (CDC) veterinarians help  promote human health by conducting research and investigating human  disease outbreaks of animal origin. They also oversee the welfare of  animals used in such research, as required by federal regulation.
Veterinarians work in other departments, such as the Department of the  Interior (Interior), whose 24 veterinarians play a role in researching,  diagnosing, and responding to wildlife diseases. The Department of  Homeland Security (DHS) also employs veterinarians to, among other  things, help develop national policy for defending the nation’s agriculture  and food supply against terrorist attacks and other emergencies. See  appendix I for a list of veterinarian roles and responsibilities within the  federal government.
As this list of responsibilities indicates, the federal veterinarian workforce  plays a critical role in ensuring the safety of the U.S. food supply.  However, we testified in 2008 that the staffing levels at FSIS—where  veterinarians play an important role in helping to ensure the safety of our  food supply and the humane treatment of animals during slaughter—have  declined since 1995 despite an increasing budget, and some districts have  experienced high vacancy rates among inspectors. This could impair  enforcement of the Humane Methods of Slaughter Act of 1978 and of food  safety regulations generally. In addition, we have designated the federal  oversight of food safety as a high-risk area of government operations  because the current system is fragmented, causing inconsistent oversight,  ineffective coordination, and inefficient use of resources.
As with all professions in the federal government, departments and their  component agencies are responsible for hiring and maintaining a  veterinarian workforce sufficient to meet their missions. High-performing  public organizations have found that maintaining a quality workforce  requires them to systematically assess current and future workforce needs  and formulate a long-term strategy to attract, retain, develop, and motivate  employees. The Office of Personnel Management (OPM) provides  guidance and leadership intended to help build a high-quality and diverse  federal workforce. Our prior work has identified the need for OPM to use  its leadership position to help departments and agencies recruit and retain  a capable and committed workforce.
In this context, you asked us to determine the extent to which (1) the  federal government has assessed the sufficiency of its veterinarian  workforce for routine program activities, (2) the federal government has  identified the veterinarian workforce needed during a catastrophic event,  and (3) federal and state agencies encountered veterinarian workforce  challenges during four recent zoonotic outbreaks.
To address the first objective, we identified and surveyed departments,  component agencies, and other federal entities employing veterinarians to  determine, among other things, the number, salaries, and roles and  responsibilities of veterinarians, as well as the sufficiency of this  workforce. We then selected component agencies within three  departments for further analysis to determine the extent to which they  assessed the sufficiency of their veterinarian workforce. We selected  USDA, DOD, and HHS because these departments employ about 96  percent of federal veterinarians. Within these departments, we focused our  veterinarian workforce assessment review on APHIS, FSIS, Army, and  FDA, because these component agencies employ the most veterinarians.  We also selected ARS for further review because it is USDA’s chief  scientific research agency and conducts research to solve agricultural  problems of high national priority. We interviewed officials involved in  workforce planning, as well as those that carry out program activities such  as veterinarians working in slaughter plants. To address the second  objective, we analyzed agency plans for continuing essential functions  during a pandemic, and compared them with DHS national planning  guidance, which identifies essential elements that federal departments and  agencies should consider. We also reviewed veterinarian workforce  outcomes from DHS’s nationwide effort to assess the nation’s  preparedness for multiple, intentional introductions of foot-and-mouth  disease. We selected a pandemic and intentional foot-and-mouth disease  outbreak because these are two potential catastrophic events the White  House Homeland Security Council has deemed critical for planning  purposes. To address the third objective, we conducted semistructured  interviews with selected officials from 17 federal and state agencies  involved in responding to the following four recent zoonotic outbreaks:    bovine tuberculosis in Michigan: a bacterial disease that spreads from deer    exotic Newcastle disease in California: a highly infectious virus that  spread rapidly throughout poultry;   monkeypox in Wisconsin: a virus not seen in the United States until 2003,  when there was an outbreak in exotic pets and humans; and   West Nile virus in Colorado: a disease that spread rapidly across the  United States, infecting numerous species.
We focused our review on these outbreaks because they were most  frequently recommended by federal officials as examples of zoonotic  diseases, are still occurring or occurred since 2001, and affected various  types of animals, among other things. Additional details about our scope  and methodology are presented in appendix II.
We conducted this performance audit from September 2007 to February  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: Background
paragraphs: High-performing public organizations have found that maintaining a  quality workforce requires them to systematically assess current and  future workforce needs and formulate a long-term strategy to attract,  retain, develop, and motivate employees. While simple in theory, strategic  planning can be difficult to carry out. Managers must, for example, acquire  accurate information on the workforce, set goals for employee  performance, and develop ways to measure that performance. According  to our previous work, strategic workforce planning should involve certain  key principles. Among these principles is the need to involve top  management, employees, and other stakeholders in developing,  communicating, and implementing a strategic workforce plan. Other  principles include determining the critical skills that will be needed,  developing strategies to address any gaps in these skills, building the  capability needed to address educational and other requirements  important to support workforce planning strategies, and monitoring and  evaluating progress toward workforce goals. However, federal agencies  have for years lacked a strategic approach to workforce management.  Consequently, since 2001, we have identified human capital management  as a high-risk area needing urgent attention and transformation.
OPM provides information and guidance on a wide range of strategies that  departments and agencies can use to help strategically plan for and  maintain a workforce sufficient to accomplish their missions. This  includes standard retention and recruitment payments, such as  recruitment incentives and student loan repayments. OPM can also  authorize departments to use additional strategies to address workforce  shortage situations should standard strategies prove insufficient. For  example, OPM can approve higher salaries for individual positions in an  occupation if the agency has difficulty staffing a position requiring an  extremely high level of expertise that is critical to the agency’s successful  accomplishment of an important mission.
In addition to maintaining a workforce sufficient for routine functions,  departments and agencies are directed by the President to ensure they can  carry out essential functions during a “catastrophic event.” Such a  catastrophic event is any natural or man-made incident, including  terrorism, that results in extraordinary levels of mass casualties, damage,  or disruption severely affecting the population, infrastructure,  environment, economy, national morale, and/or government functions. To  do so, agencies must develop continuity of operation plans for  emergencies that disrupt normal operations. Continuity planning includes  identifying and establishing procedures to ensure vital resources are  safeguarded, available, and accessible to support continuity operations.  Vital resources are personnel, equipment, systems, infrastructures,  supplies, and other assets required to perform an agency’s essential  functions. DHS’s Federal Emergency Management Agency (FEMA)  provides direction to the federal executive branch for developing  continuity plans and programs, including pandemic plans.
For one type of catastrophic event, a pandemic that severely reduces the  workforce, DHS has developed guidance that identifies specific elements  agencies should consider as they plan to maintain essential services and  functions. FEMA concluded that planning for a pandemic requires a state  of preparedness that goes beyond normal continuity of operations  planning. On March 1, 2006, FEMA first issued guidance to assist  departments and agencies in identifying special considerations for  protecting the health and safety of employees and maintaining essential  functions and services during a pandemic. The Implementation Plan for  the National Strategy for Pandemic Influenza recommends that  organizations plan for a 40 percent absenteeism rate at the height of a  pandemic. In addition, it called for department and agency pandemic plans  to be completed by March 31, 2006.
Departments and agencies must also plan for other events that could place  extraordinary demands on their workforce, such as a catastrophic  outbreak of a foreign animal disease. In December 2003, the President  issued a Homeland Security Presidential Directive (HSPD-8) to establish  national policy to strengthen the preparedness of the United States to  prevent and respond to terrorist attacks, major disasters, and other  emergencies. As part of its efforts to meet HSPD-8, a White House  Homeland Security Council working group developed National Planning  Scenarios for 15 major events, including a biological attack with a foreign  animal disease, foot-and-mouth disease. According to the scenario,  terrorists introduce the disease in several locations and states  simultaneously. The transportation of livestock spreads the contagious  virus to surrounding states and, within 10 days of the attack, more than  half of the states may be affected. Ultimately, almost half the nation’s beef,  dairy, and swine would be affected. These scenarios serve as the basis for  assessing the nation’s preparedness for such an event by defining tasks  that may be required and the capabilities needed governmentwide to  perform these tasks. Although not a prescription for the resources needed  to achieve these capabilities, they are intended to help identify such  resource needs and guide planning efforts. No single jurisdiction or agency  will be expected to perform every task, so the response to a catastrophic  event will require coordination among all levels of government. State and  local agencies are typically the first to respond, but federal agencies  become involved if state resources are overwhelmed. In certain  catastrophic events, it becomes the responsibility of DHS to coordinate  the federal response.
section_title: The Federal Government Lacks a Comprehensive Understanding of the Sufficiency of Its Veterinarian Workforce
paragraphs: Four of the five key agencies that employ veterinarians—APHIS, FSIS,  ARS, and Army—regularly assess the sufficiency of their veterinarian  workforces for routine program activities, and all four identified existing  or potential shortages. FDA does not perform such assessments. At the  department level, USDA and HHS have not assessed their veterinarian  workforces across their component agencies, whereas DOD has delegated  this task to the Army. Finally, there is no governmentwide assessment of  the veterinarian workforce. Specifically, OPM has not conducted a  governmentwide effort to address current and future veterinarian  shortages identified by component agencies, and efforts by the Congress  to address the national shortage have thus far had minimal impact.
subsections: section_title: Four of Five Agencies Have Identified Existing and Potential Veterinarian Shortages
paragraphs: APHIS, FSIS, ARS, and Army conduct regular workforce assessments.  While APHIS reported it does not currently have a shortage, it identified a  potential future shortage. FSIS, ARS, and Army have identified both  existing and potential future shortages. FDA does not conduct such  assessments, but officials there told us the veterinarian workforce is  adequate to meet its responsibilities. Our work has shown that agencies  should be held accountable for the ongoing monitoring and refinement of  human capital approaches to recruit and hire a capable and committed  federal workforce.
APHIS reported that none of its six units that employ veterinarians has  identified a current shortage, but officials told us they are concerned  about the future size and skills of the veterinarian workforce. First, the  agency reported that 30 percent of its veterinarians will be eligible to retire  by the end of fiscal year 2011, potentially creating a serious shortage. This  is consistent with our previous work where we reported that one-third of  federal career employees on board at the end of fiscal year 2007 are  eligible to retire between spring 2008 and 2012. In addition, APHIS is  concerned that it will be unable to maintain an adequate workforce of  veterinary pathologists. This is consistent with a report by the United  States Animal Health Association, which found a shortage of over 40  percent nationwide. An APHIS laboratory director told us that veterinary  pathologists are integral to work conducted in APHIS diagnostic  laboratories, including work on diseases that threaten animal and human  health. For example, APHIS veterinary pathologists work on bovine  spongiform encephalopathy, a fatal degenerative disease—commonly  known as mad cow disease—that has been linked to at least 165 human  deaths worldwide. APHIS also identified a need to maintain a veterinarian  workforce with sufficient expertise to help protect livestock and the  nation’s food supply from foreign animal diseases. We reported in 2005  that many U.S. veterinarians lack the training needed to identify such  diseases, whether naturally or intentionally introduced. Finally, after the  terrorist attacks of 2001, USDA’s responsibilities were broadened to  enhance the ability of the United States to manage domestic incidents. As  such, in addition to being the lead for coordinating any response efforts to  incidents involving an animal disease, APHIS will now also play a  supporting role in incidents not directly related to animal diseases. For  example, APHIS veterinarians may be called upon to assist in ensuring the  safety and security of the commercial food supply or for caring for  livestock stranded in hurricanes and floods. These increased  responsibilities raise concerns about the ability of veterinarians to respond  to multiple, simultaneous events, according to agency officials.
APHIS has supported training opportunities to help overcome some of  these projected skill gaps. The agency has also set a goal of recruiting at  all veterinary colleges and working with universities to help them include  relevant training in their course offerings. In addition, APHIS uses bonuses  to attract and maintain its veterinarian workforce. During the first 9  months of fiscal year 2008, it provided one retention and one relocation  bonus to veterinarians, totaling $41,654.
Over the past decade, FSIS has not had a sufficient number of  veterinarians and remains unable to overcome this shortage, according to  FSIS officials. The agency’s goal was to have 1,134 veterinarians on staff in  fiscal year 2008, but it fell short of that by 166 veterinarians, or 15 percent.  Moreover, since fiscal year 2003, the FSIS veterinarian workforce has  decreased by nearly 10 percent—from 1,073 to 968. The majority of these  veterinarians work in slaughter plants. Federal law prohibits slaughtering  livestock or poultry at a plant that prepares the livestock or poultry for  human consumption for use in interstate commerce unless the animals  have been examined by USDA inspectors and requires the humane  slaughtering and handling of livestock at such plants. In implementing  federal law, each slaughter plant is covered by one or more FSIS  veterinarians to, among other things, ensure the safety and quality of meat  and poultry products and the humane treatment of livestock during  slaughter. Agency data from the past 5 years reveal that vacancy rates for  veterinarian positions in slaughter plants vary by location and year, from  no vacancy to as many as 35 percent of the positions vacant.
FSIS headquarters officials and veterinarians working in slaughter plants  differed on the impact of this shortage. Headquarters officials told us that,  despite the shortage, the agency has been able to meet its food safety and  other responsibilities by redistributing the workforce. For example, in  some cases, FSIS has assigned one veterinarian to several slaughter plants  or assigned only one to plants that previously had two. In contrast, several  veterinarians working in slaughter plants told us that, because of  inadequate staffing, they are not always able to meet their responsibilities  and perform high-quality work. For example, veterinarians told us they  cannot always verify crucial sanitation and security checks of the plant or  promptly log data on animal diseases and welfare.
In early 2008, veterinarians also told us they did not always have time to  ensure the humane treatment of livestock. Inhumane treatment triggered  an investigation that led to the largest beef recall in U.S. history. More  specifically, in February 2008, the Humane Society of the United States  released videos to the public that documented abuse of cattle awaiting  slaughter at a plant in Chino, California. These alleged abuses, which took  place in the fall of 2007, included electrically shocking nonambulatory  “downer” cattle, spraying them with high-pressure water hoses, and  ramming them with a forklift in an apparent attempt to force them to rise  for slaughter. These acts are not only cruel, they pose a risk to the safety  of the food supply, because downer animals are known to be at greater  risk for bovine spongiform encephalopathy. FSIS regulations require that  downer cattle be separated to await disposition by an inspector, even if  they become nonambulatory after an inspector has approved the animal  for slaughter during the preslaughter inspection. On February 1, 2008, the  plant voluntarily ceased operations pending investigation by FSIS into the  alleged abuses. On February 17, 2008, the plant announced that it was  voluntarily recalling approximately 143 million pounds of raw and frozen  beef products because of its failure to notify FSIS of the downer cows and  the remote possibility that the beef being recalled could cause adverse  health effects if consumed. The release of the videos by the Humane  Society led congressional committees and USDA to question how such  events could have occurred at a plant in which FSIS inspectors were  assigned. At the request of the Secretary of Agriculture, USDA’s Office of  Inspector General (OIG) is leading a criminal investigation that is ongoing  at the time of this report. In addition, OIG conducted an audit of FSIS’s  controls over preslaughter activities and reported in November 2008 that  controls to demonstrate the sufficiency and competency of FSIS’  personnel resources could be strengthened to minimize the chance that  such events could recur, among other things.
Veterinarians and other FSIS officials we interviewed told us that, at the  time of the incident, only one veterinarian was assigned to the plant that  was the source of the recall, whereas two had been assigned in past years.  Two veterinarians were needed, according to these officials, because the  plant processed “cull” dairy cows, which are no longer used for milk  production. These cows are generally older and in poorer condition than  other livestock and thus require more frequent veterinary inspection. In  the wake of this incident, FSIS required veterinarians to spend more time  verifying the humane treatment of animals. However, veterinarians told us  that this exacerbated the difficulty of completing their other work. In 2004,  we made recommendations aimed at ensuring that FSIS can make well- informed estimates about the inspection resources—including  veterinarians—needed to enforce the Humane Methods of Slaughter Act of  1978. Specifically, we recommended that FSIS periodically assess  whether the level of resources dedicated to humane handling and  slaughter activities is sufficient, but the agency has yet to demonstrate that  they have done so.
FSIS officials told us that there are several reasons for the agency’s  ongoing shortage of veterinarians. For example, most veterinarians do not  want to work in the unpleasant environment of a slaughterhouse.  Furthermore, veterinarians are trained to heal animals, but FSIS  veterinarians are hired to oversee the slaughter of animals. The job can  also be physically and emotionally grueling, and many of the plants are in  remote and sometimes undesirable locations. In addition, as a result of  staff shortages, there is little opportunity to take time off for training that  could lead to promotion. Finally, FSIS veterinarians told us that their  salaries do not sufficiently compensate for the working conditions and are  low relative to those of other veterinarians. According to OPM’s Central  Personnel Data File, the mean annual salary for FSIS veterinarians in 2007  was $77,678; in contrast, the mean salary for private-practice veterinarians  was $115,447 in 2007, according to the most recent data from the American  Veterinary Medical Association. In commenting on a draft of this report,  FSIS officials added that there is a lack of public health and food-safety  emphasis in veterinary schools.
FSIS has taken several steps to address the shortage. For example, it  awarded 35 recruitment bonuses totaling more than $583,000 in the first 9  months of fiscal year 2008. FSIS also has internship programs that have,  according to agency officials, increased awareness and generated interest  in veterinarian work at the agency. For example, over the past 5 years,  FSIS has established agreements with 16 veterinary schools to provide  volunteer training opportunities to veterinary students with an interest in  food safety and public health. In fiscal year 2008, there were 26  participants in the program, compared with only 1 when the program  began in 2003. Two participants have thus far returned to FSIS for full-time  employment after graduation. FSIS also has a paid veterinary student  program that is designed to provide experience directly related to the  student’s educational program and career goals. Since 2002, when FSIS  began tracking this program, 77 students have participated, and 6 have  become full-time employees. In addition, FSIS has sought special hiring  authorities from OPM. For example, in July 2008, the agency was  delegated authority to hire a limited number of retirees at full salary  instead of at the reduced salary required for those with annuity income.  Officials told us they hope this will encourage retired veterinarians to join  FSIS, but, as of the date of this report, no retirees have been hired through  this program. FSIS intends to track the effectiveness of this special hiring  authority. Moreover, FSIS has proposed implementing a demonstration  project that would allow the agency to test a pay system that offers more  competitive salaries to veterinarians, among others. OPM requires that  agencies undertaking such a project provide OPM with an analysis of the  impact of the project results in relation to its objectives. OPM officials told  us the project may be implemented in July 2009. Finally, OPM has in the  past granted FSIS the ability to make immediate job offers to veterinarians  without following prescribed competitive procedures, which can slow the  hiring process. This “direct-hire authority” expired in 2007 and was not  renewed at that time because, according to FSIS officials, USDA did not  provide the expiration notification to FSIS. We were recently informed  that USDA received approval from OPM on November 25, 2008, for direct  hire for FSIS veterinarians lasting through December 31, 2009. However,  FSIS officials raised concerns about the length of time of the authority,  among other things, stating that it takes 5 to 6 months to renew this  authority.
ARS employed 57 veterinarians in fiscal year 2008, 12 percent short of its  goal of 65. It has reported similar shortages throughout the last 5 years.  Although veterinarians represent a small share of the ARS workforce  (about 1 percent of more than 4,300 scientists and research technicians),  the agency considers them critical to its mission. According to ARS  officials, a sufficient veterinarian workforce is important to the quality and  breadth of research ARS is able to conduct. For example, ARS would not  have been able to conduct its research on the detection of avian influenza  and development of vaccines against it, or on the transmission of bovine  tuberculosis, without its veterinarians’ skills and experience.
ARS officials told us it is difficult to attract and retain veterinarians  because the agency requires its research veterinarians and senior program  leaders who are veterinarians to have a Ph.D. in animal sciences or a  related field, as well as a veterinary degree, and there is a limited pool of  candidates for these positions. A recent report by the National Academy of  Sciences identified a declining interest in veterinary research among  veterinary students as a cause of a shortage of Ph.D. veterinarians. In  addition, ARS officials told us the agency cannot compete with many of  the salaries offered in the private sector. In 2007, the mean salary for ARS  veterinarians was $102,081, according to OPM’s Central Personnel Data  File. This is about $28,000 less than the mean salary reported by the  American Veterinary Medical Association for veterinarians with a Ph.D.  working at universities and colleges and about $96,000 less than those  working in industry with similar qualifications, such as at pharmaceutical  companies.
To address its shortage of Ph.D. veterinarians, ARS provided six  recruitment or retention bonuses to its veterinarians totaling $48,313 in the  first 9 months of fiscal year 2008. The agency also created a tuition  program in 2003, but participation has been limited. Only four individuals  have been hired through the tuition program, and only two remained with  the agency, according to officials. Under this program, ARS hires  veterinarians without a Ph.D. and pays tuition and other educational costs  while they earn this degree. Officials told us that the lack of success is  most likely due to low salaries at ARS. In addition, the agency is reluctant  to use this program because it diverts funding from the hiring of  employees already qualified and ready to work.
subsections: section_title: Army
paragraphs: The Army reported that it filled its 446 authorized active-duty veterinarian  positions, but that its veterinary reserve corps is not at full strength.  Specifically, the Army only filled 173 of its 197 reserve positions in fiscal  year 2008, a 12 percent shortage. According to the Army’s analysis, the  reserve corps has been at less than full strength since fiscal year 2005.  These veterinarians commit to part-time training and to being deployed to  full-time active duty when needed. The shortage means there is not a  sufficient pool of veterinarians that can be called into active duty as the  need arises. This is a concern, according to the official responsible for  assessing Army veterinarian workforce needs, because the Army’s need  for veterinarian services is increasing due to growing concerns over  bioterrorism, intentional contamination of the food supply, emerging  zoonotic diseases, and due to operational requirements, such as  agricultural reconstruction in Afghanistan and Iraq, among other things.  This official told us that recruitment into the reserves has been a problem  because of the length, frequency, and uncertainty of deployments, which,  in some cases has also resulted in veterinarians losing their jobs or  suffering financial hardships. However, he told us that recent changes to  the reserve corps program—such as decreasing the length of deployment  from 1 year to 180 days, and making additional incentives available to  veterinarians in the reserves—have helped strengthen the capacity of the  veterinary reserve corps.
Officials also told us they are concerned about a growing need for certain  special veterinary skills. For example, there is an increasing demand for  Army veterinary pathologists, who are essential for interpreting test  results from animals used in drug and vaccine research. The official  responsible for assessing Army veterinarian workforce needs told us the  Army has yet to formally assess this need. Other Army veterinarians  conduct medical intelligence work for DOD’s Defense Intelligence Agency,  where officials told us they are concerned about the difficulty of recruiting  veterinarians with appropriate skills to meet a growing need to, among  other things, collect and analyze data on animal diseases that could be  used in a terrorist attack. Veterinarians are important to such work  because, according to these officials, the majority of diseases considered  to be potential bioterrorism agents are animal diseases that could also  affect humans. They told us that while the agency is working to expand its  workforce capabilities to address bioterrorism, there is a concern that the  growing demand for veterinarian capabilities may outpace the growth of  the Army’s workforce.
The primary reason for the Army’s success in maintaining its active-duty  veterinarian workforce is a scholarship program, according to the official  responsible for assessing Army veterinarian workforce needs. This  program targets veterinary students and pays their tuition and fees to  veterinary school in exchange for a commitment to (1) serve as a  veterinarian in the Army for 3 years and (2) serve an additional 5 years  either in active duty or in the Army reserve program. In fiscal year 2008,  the Army reported it had 106 qualified applicants for 47 scholarships.  According to the official, the program is successful because it targets  students before they accumulate school-related debt. Veterinary students  graduate with more than $106,000 in debt, on average, according to the  American Veterinary Medical Association. In addition, the funding for this  program is directed specifically by congressional committees, separate  from funds the Army uses to hire veterinarians.
FDA officials reported that the agency has not assessed the sufficiency of  its veterinarian workforce, but they told us that the workforce is sufficient  to meet its responsibilities. However, a 2007 report by an FDA Advisory  Committee found that FDA cannot fulfill its mission because of an  insufficient scientific workforce. More specifically, the report states that  FDA’s scientific workforce has remained static while its workload has  increased, and that FDA’s Center for Veterinary Medicine (CVM) is in a  state of crisis. This center employs nearly two-thirds of FDA’s 152  veterinarians and is responsible for ensuring the safety of veterinary drugs  and regulating animal feed, among other things. An author of the report  told us that veterinarians enter FDA employment lacking necessary skills  and experience to examine the wide variety of veterinary products that  require FDA approval and that FDA needs to better train its veterinarians  to review the many diverse products under its jurisdiction. FDA officials  told us the agency is currently undertaking significant reforms to address  fundamental concerns in the report. For example, FDA reported it hired  more than 1,000 scientists in order to build a more robust workforce, and  it created the position of Chief Scientist to improve coordination of  science planning and execution across the agency. However, FDA did not  tell us how these reforms address the identified veterinarian skill gaps.
Although FDA officials said the veterinarian workforce is sufficient, CVM  officials recently told us that as a result of new obligations, the center  hired 26 veterinarians in 2008 to fill vacancies. This represents a 17  percent increase in FDA’s overall veterinarian workforce in 2008, and it  plans to hire more. The additional staff will enhance FDA’s ability to  review generic animal drug submissions, among other things, according to  these officials. In addition, in commenting on a draft of this report, OPM  informed us that it is currently reviewing a request for direct-hire authority  from FDA to fill veterinary positions. According to OPM, this request is  based on a severe shortage of candidates and it is projected that this  authority may be granted through December 31, 2010. CVM also plans to  develop an internship program for entry-level veterinarians and other  scientists in order to develop a qualified talent pool from which to draw  permanent employees. Further, these officials said that, as a result of  recent participation in interagency efforts to protect the nation’s food  supply, CVM has begun to analyze the gap between its current resources  and its needs.
section_title: Departments Have Done Little to Assess the Sufficiency of Their Veterinarian Workforces across Their Component Agencies
paragraphs: Even though their component agencies identified concerns about their  veterinarian workforces, officials from both USDA and HHS told us that  they have not undertaken a departmentwide assessment of these  workforces to gain a broader perspective on trends and shared issues. In  contrast, DOD has a process for such an assessment. Our prior work has  found that top-level management needs to be involved in order for  strategic workforce planning to be effective.
Although USDA regularly collects veterinarian workforce data from its  component agencies that employ veterinarians, it does not use this  information to assess the sufficiency of the veterinarian workforce  departmentwide. Department officials told us that workforce assessment  is the responsibility of the agencies. Because USDA delegates this  responsibility, it appears to be unaware of the scope of the workforce  problems facing its agencies. For example, in its fiscal year 2007 human  capital management report, USDA reported that its agencies had met or  surpassed certain veterinarian workforce goals but made no mention of  the shortages that FSIS and ARS identified in their workforce reports.  USDA officials agreed that the report did not capture this critical  information and that future reports should address the shortages.
One result of this lack of department-level involvement is that USDA  agencies compete against one another for veterinarians instead of  following a departmentwide strategy to balance the needs of the agencies.  According to FSIS officials, APHIS is attracting veterinarians away from  FSIS because the work at APHIS is more appealing, there are more  opportunities for advancement, and the salaries are higher. Indeed, our  analysis shows that veterinarians are more concentrated in lower grade  levels at FSIS than at APHIS (see fig. 1). Moreover, according to OPM’s  Central Personnel Data File, the mean annual salary for veterinarians at  FSIS in 2007 was about $78,000, the lowest among the three key USDA  agencies (see fig. 2). According to an APHIS human resources official, the  agency hired 75 veterinarians from FSIS between fiscal years 2003 and  2007, 17 percent of total new APHIS veterinarians hired.
HHS neither assesses veterinarian workforce needs departmentwide nor  has it instructed any of its component agencies that employ  veterinarians—FDA, CDC, and the National Institutes of Health (NIH)—to  assess their own workforces. HHS is thus not fully aware of the status of  the veterinarian workforce at these component agencies and cannot  strategically plan for future veterinarian needs. If it were able to provide  such planning, it might be able to help FDA address workforce concerns  raised in the 2007 FDA Science and Mission at Risk report. However,  senior HHS strategic workforce planning officials we spoke with were  unaware of the report.
HHS officials told us that departmental leadership in workforce planning  is important. In fact, they said the department is in the preliminary stages  of developing a strategic departmentwide approach to workforce planning  for certain professions. This effort will initially focus on workforce  assessments for specific occupations, such as nurses and medical doctors.
HHS officials told us they will not initially include veterinarians in this  effort, because veterinarians are not deemed mission critical for the  department, even though they are critical to the missions of FDA, CDC,  and NIH. However, HHS officials said that this effort does not preclude  agencies from assessing their own veterinarian workforce needs and  sharing that information with the department. HHS officials also told us  that because the department is expected to provide veterinary medical  care and support during public health and medical disasters that warrant a  coordinated federal response, it is critical that appropriate veterinary  resources are identified and maintained. Furthermore, these officials told  us that efforts are under way at the component agency level to address the  national veterinary shortage. Specifically, CDC, in collaboration with  Emory University, has developed a residency program designed to provide  comprehensive training in laboratory animal medicine to better prepare  veterinarians for working in laboratory research facilities at CDC and  across the nation. In addition, in 2006 and 2008 CDC sponsored a  “Veterinary Student Day” to promote public health careers for  veterinarians.
Unlike USDA and HHS, DOD has a process for assessing veterinarian  workforce needs departmentwide. It has given this responsibility to the  Army, which employs 89 percent of DOD veterinarians, with the remaining  veterinarians working as public health officials for the Air Force. The  Army assesses not only the number and type of veterinarians it will need  but also what will be needed for the other services. For example, Army  veterinarians are routinely assigned to care for working dogs and other  animals at Army, Navy, Air Force, and Marine bases. Army veterinarians  also conduct medical intelligence activities at the Defense Intelligence  Agency. As the executive agency charged with assessing veterinarian  workforce requirements for DOD, the Army takes all of these needs into  consideration, then forwards the assessment results to DOD, which  integrates them with overall workforce planning.
section_title: There Is No Governmentwide Assessment of the Veterinarian Workforce
paragraphs: No effort is being made to assess the sufficiency of the veterinarian  workforce governmentwide. This is problematic because the majority (67  percent) of the 24 component agencies and other federal entities that  employ veterinarians told us they have concerns about their veterinarian  capabilities. OPM has not conducted a governmentwide effort to address  current and future veterinarian shortages identified by component  agencies, as it has done for other professions, and efforts by the Congress  to address the national shortage have thus far had minimal impact.
Sixteen of the 24 component agencies and other entities employing  veterinarians reported concerns about their veterinarian workforce (see  table 1). For example, several agencies reported that they lack veterinarian  expertise required to fully meet agency responsibilities, such as addressing  wildlife disease outbreaks.
These current challenges are likely to worsen because a large number of  federal veterinarians are eligible to retire in the near future. These  retirements would exacerbate the veterinarian shortage and possibly  increase interagency competition. Our analysis found that 697  veterinarians at FSIS, APHIS, ARS, Army, and FDA—27 percent of the  combined veterinarian workforce of these agencies—are eligible to retire  over the next 3 years. As the shortage grows, agencies across the federal  government may experience a situation similar to the competition  between FSIS and APHIS, and agencies with higher salaries for  veterinarians are likely to gain an advantage. As figure 3 illustrates, mean  veterinarian base salaries vary widely across agencies, from just under  $70,000 at Interior’s National Park Service to just about $122,000 at DHS’s  Office of Health Affairs. Salaries for individual veterinarians range from  $35,000 for those in the residency program at the National Zoo to $205,000  for the highest paid veterinarian at NIH.
Some agencies, such as those within HHS and the Department of Veterans  Affairs, can augment base salaries for veterinarians using special statutory  authorities. Agencies can use these authorities to hire veterinarians when  standard hiring practices, including the use of recruitment incentives, are  impracticable, less effective, or have been exhausted. In addition, DOD  can provide all of its veterinarians with a $100 per month stipend, as well  as up to an additional $5,000 per year of special pay if they have met the  education and training standards of an American Veterinary Medical  Association-recognized specialty college. There is no similar authority for  USDA veterinarians.
OPM’s mission is to ensure the federal government has an effective civilian  workforce, but it has not conducted a governmentwide effort to address  current and potential veterinarian shortages, as it has done for other  professions. For certain professions, OPM has initiated governmentwide  direct-hire authority, which allows expediting hiring during a time of  critical need or a severe shortage of candidates. For example, in 2003,  OPM authorized departments to immediately hire doctors, nurses, and  other types of medical professionals without following prescribed  competitive procedures. OPM officials told us their agency issued this  authority based in part on department and agency concerns. OPM can also  hold interagency forums to discuss workforce concerns but has not done  so for veterinarians. According to OPM officials, interagency forums are  open to all senior human capital representatives from all departments,  including USDA and HHS. The forums provide an opportunity to discuss  concerns, exchange ideas, and explore solutions to governmentwide  staffing issues. OPM officials told us that no department has requested a  discussion about veterinarian workforce concerns. Further, officials told  us that the agency will facilitate a governmentwide solution, such as an  interagency forum, if the departments demonstrate that a shortage exists.  Our prior work has identified the need for OPM to use its leadership  position to provide assistance to departments and agencies efforts to  recruit and retain a capable and committed workforce.
OPM officials told us the agency has taken some steps that could improve  veterinarian recruitment and retention. During the course of our review,  OPM created a Personnel Action Team to determine whether a  governmentwide direct-hire authority should be granted for all  veterinarians. OPM did not provide further details other than to state that  a decision is expected in early 2009. In addition, OPM recently changed the  federal classification of veterinarians. OPM raised the entry grade level for  newly hired veterinarians from GS-9 to GS-11 and expanded the  description of the federal veterinarian occupation to include areas of  specialization, such as toxicology and pathology. OPM officials believe this  will help attract more veterinarians into federal service. Agency officials  also told us that they meet periodically with departments to ensure  occupation classifications meet department needs. This was the first  change of the veterinarian classification in over 20 years and was initiated  at USDA’s request.
The Congress has taken steps that address the broader, national  veterinarian shortage, but its efforts thus far have had minimal impact. The  National Veterinary Medical Services Act enacted in 2003, directs the  Secretary of Agriculture to carry out a program to help veterinarians repay  their school loans when they agree to work in areas of need. Although  USDA is responsible for implementing the act, it has been delayed in doing  so. USDA’s Undersecretary for Research, Education, and Economics  testified before the Congress that this was because the Cooperative State  Research, Education, and Extension Service (CSREES)—the USDA  agency in charge of implementation—does not have experience with  complex loan repayment programs. The Congress provided initial funding  for the act in fiscal year 2006. In August 2008, CSREES began holding  public hearings to solicit stakeholder input. Officials from USDA and  veterinary associations told us that the $1.8 million allocated thus far for  the program is insufficient and would have minimal impact on the  shortage. With veterinary student debt averaging $106,000 upon  graduation, $1.8 million would cover about 17 students with loans.  Moreover, the program targets veterinarians who already have their degree  and may not have the skill set the federal government is seeking. To be  effective, officials from professional veterinary associations told us, the  program would have to provide guarantees and target students early in  veterinary school. The Congress also enacted the Higher Education  Opportunity Act in August 2008, which has provisions intended to increase  the number of veterinarians in the workforce through a competitive grant  program that can increase capacity at veterinary colleges. According to the  American Veterinary Medical Association, however, these grants will be  capped at $500,000 per school, which will not be enough to increase  capacity to meet veterinarian demands.
section_title: Efforts to Identify the Veterinarian Workforce Needed during a Pandemic and Large-Scale Animal Disease Outbreak Are Insufficient
paragraphs: Four of the five key agencies we reviewed—APHIS, FSIS, ARS, and FDA— have plans intended to detail how essential functions and services,  including those that veterinarians perform, would continue during a  pandemic that has the potential to severely reduce the workforce.  However, each lacks elements that FEMA considers important for  effective planning. The Army is still in the process of getting its plan  approved and, therefore, we have not evaluated it. In addition, DHS’s  efforts to identify the veterinarian workforce needed to address a  catastrophic nationwide outbreak of foot-and-mouth disease are based on  an unrealistic assumption and limited information.
subsections: section_title: Agency Planning to Ensure Continuity of Essential Veterinary Functions during a Pandemic Is Incomplete
paragraphs: FEMA’s pandemic guidance assists agencies in identifying special  considerations for maintaining essential functions and services during a  pandemic outbreak that may cause absenteeism to reach 40 percent. For  example, the guidance directs agencies to identify in their pandemic plans  how operations will be sustained until normal business activity can be  reconstituted, which may be longer than the 30 days usually planned for  other types of emergencies. Agency plans are also to identify the essential  functions that must be continued on-site and those that can be conducted  from a remote location. They also should take into consideration the need  for logistical support, services, and infrastructure that help an agency  achieve and maintain essential functions and services. To account for the  expected high rate of absenteeism at the peak of a pandemic, FEMA  guidance also directs agencies to identify at least three people who can  carry out each responsibility and identify how the agency will continue to  operate if leadership and essential staff are unavailable. Finally, agencies  are directed to test their pandemic plans, including the impacts of reduced  staffing on facilities and essential functions and services.
APHIS has developed pandemic plans for its headquarters, regional  offices, and three laboratories that employ veterinarians, but these plans  are missing elements in FEMA’s guidance and are not well-organized. For  example, they do not explain how animal care, disease investigation, and  other essential functions and services would continue if leadership and  essential staff are unavailable. Moreover, pieces of these pandemic plans  are spread throughout a large number of documents and are not well  linked. For example, APHIS officials provided us with an undated  pandemic plan that they told us was an appendix to the headquarters  continuity of operations plan. But this continuity of operations plan made  no reference to such an appendix, and officials were never able to provide  us with a document that made reference to such an appendix. USDA  recently hired a new emergency preparedness director to revise APHIS’s  pandemic plans, among other things. The director told us that APHIS  recognizes the importance of easily locating the plans and quickly  implementing them in the event of a pandemic, and he acknowledged that  the current documents are not an effective plan. APHIS is now combining  its plans into one comprehensive document that will cover APHIS  headquarters, regional offices, and laboratories. In addition, the director  told us the new plan, to be completed by early 2009, will better adhere to  FEMA guidance.
FSIS has developed a pandemic plan that addresses many of the elements  in FEMA’s guidance, but it lacks some crucial details. Importantly, the plan  takes into account the work that veterinarians do at private slaughter  plants. However, it does not address the logistics of how FSIS will work  with industry to ensure veterinarians and other employees are available in  the event of a pandemic so that food production can continue. FSIS  officials told us that they have discussed this logistic with industry and  expect, based on these discussions, that some plants would not be able to  operate during a pandemic, as a result of FSIS or plant personnel  absenteeism. The agency would maintain close communication with  industry during a pandemic in order to determine how best to allocate  available veterinarians and other FSIS inspection personnel so that  slaughter plants could continue to operate. Veterinarians would be  allocated to plants based on considerations such as the location of the  outbreak and the type of slaughter plant affected. For instance, poultry  plants may receive priority consideration because birds can only be  slaughtered at a very specific weight. That is, the equipment for processing  birds is designed for birds of a very specific size, and industry would not  be able to process them if they were permitted to grow too large.  However, such logisitcs are absent from FSIS’s plan, effectively  postponing any decisions until the middle of a crisis. Similarly, the plan  does not mention how FSIS would work with APHIS, even though the  agencies have formally agreed to jointly plan for critical activities related  to surveillance of animal diseases. In addition, the plan does not consider  the impact of local quarantines on access to plants.
ARS has developed pandemic plans for all of its 12 laboratories where  veterinarians work. We reviewed plans for the two laboratories that  employ the most veterinarians: the Southeast Poultry Research Laboratory  and the National Animal Disease Center (NADC). These plans are  important because they spell out the site-specific details needed to ensure  that essential functions at each laboratory can continue. However, the  plans lack crucial details, such as how the laboratories will continue  operations if absenteeism reaches 40 percent. Specifically, neither of the  plans take into account how the laboratories would continue to conduct  essential functions and services if leadership and essential staff are  unavailable. Agency officials told us they would temporarily suspend  projects to account for increased absenteeism, but there is no mention of  this in the plans; nor is there mention of how the agency will select  projects for suspension or what would trigger suspension. Ensuring a  sufficient veterinarian workforce at these laboratories during a pandemic  is important because veterinarians carry out critical research and must be  available to ensure the proper care of research animals. In addition, NADC  is part of a USDA research complex that is transitioning to joint ARS and  APHIS support services, including veterinary care for research animals.  However, ARS and APHIS have yet to jointly plan for continuity of  operations for any type of emergency.
FDA has also developed a pandemic plan, but it is high-level plan that does  not address several of FEMA’s elements, leaving it unclear if consideration  has been given to how veterinarians would carry out any essential  functions and services during a pandemic. For example, it does not  identify which essential functions—whether they be the responsibility of  the veterinarian or others—must be performed on-site and which can be  performed remotely. Nor does it explain how veterinarians, or others, will  continue operations if absenteeism reaches 40 percent by, for example,  delegating authority to three individuals capable of carrying out each of  the agency’s essential functions. The plan omits other important details,  such as contact information for individuals who could assume authority  should essential staff and leadership become unavailable. FDA officials  told us they will take these gaps into consideration when they update their  plan in 2009.
The Army is still in the process of getting its pandemic plan approved and,  therefore, we have not evaluated it. According to Army officials, the  agency has developed a pandemic plan that has been validated by the U.S.  Army Northern Command, but it has not yet been formally referred for  approval to the Army’s senior leadership, and it does not contain details of  how essential functions would continue. According to DOD officials,  subordinate divisions within the Army intend to develop detailed plans,  but the division responsible for veterinary services (Veterinary Command)  has yet to do so. However, DOD officials told us that the Army has been  instrumental in helping the United States plan for an outbreak of highly  pathogenic avian influenza in birds. Controlling the outbreak in birds  reduces the opportunity for the virus to mutate into a strain that could  cause a pandemic in humans.
FEMA guidance also directs agencies to test how well their pandemic  plans might maintain essential functions and services given reduced  staffing levels. FSIS and FDA are the only agencies we reviewed that have  done so. In March 2007, FSIS conducted a “tabletop” pandemic exercise  where key personnel discuss simulated scenarios in an informal setting in  order to test their plans, policies, and procedures. In a summary report,  FSIS officials noted that, among other things, additional exercises were  needed to improve coordination with industry. FSIS subsequently  conducted a similar tabletop exercise with industry in November 2008, but  the summary report on lessons learned has yet to be published. FDA  conducted an operational exercise in October 2008—a drill to test how  well it could continue operations under a staffing shortage. As part of this  exercise, FDA tested its ability to reassign tasks, but it is not clear if tasks  performed by veterinarians were among those reassigned. FDA officials  told us that they plan to issue a report with lessons learned from the  exercise in early 2009 and will incorporate that information into FDA’s  pandemic plan. ARS and APHIS have not tested their plans to see how well  their agencies might maintain essential functions and services in the event  of reduced staffing levels, but officials told us they intend to do so.
section_title: An Infeasible Assumption and Limited Information Hinder Veterinarian Workforce Planning Efforts for a Catastrophic Outbreak of Foot-and- Mouth Disease
paragraphs: DHS has two efforts under way that involve identifying the veterinarian  workforce needed to quickly perform rapid diagnoses and other essential  activities during a large-scale outbreak of foot-and-mouth disease, but  both efforts have shortcomings. The first is a long-term national effort that  DHS is coordinating to assess the nation’s preparedness for multiple,  intentional introductions of foot-and-mouth disease. This effort includes  identifying the veterinarian workforce and other capabilities that would be  needed to best respond to such an outbreak. For example, it has identified  the need for 750 veterinarians nationwide to conduct animal health  epidemiological investigations and surveillance. It has also identified the  need for teams of six livestock and six companion animal veterinarians in  each affected state and local jurisdiction to implement disease  containment measures, provide animal welfare, and euthanize and dispose  of animals.
However, this effort is based on a national planning scenario that USDA  and DHS officials’ say includes an infeasible assumption. The scenario,  developed by a White House Homeland Security Council working group in  2006, involves the mass slaughter of all potentially exposed animals. This  “stamping out” method is the same one the United States has used in the  past for eradicating smaller outbreaks of foreign animal diseases, but  under this scenario, it would result in the slaughter of almost half the  nation’s beef, dairy, and swine. DHS and USDA officials, as well as state  officials who have conducted large-scale foot-and-mouth disease  exercises, consider this stamping out method infeasible because, among  other things, it would lead to serious logistical and environmental  concerns, would not be tolerated by the public, and could wipe out a  viable livestock industry. As a result, DHS and USDA officials told us, any  workforce estimates produced from this effort are not relevant. However,  these officials told us it has helped them better understand the enormity of  the workforce response and the coordination that would be required for  such a catastrophic event.
DHS and USDA officials told us that to arrive at more relevant workforce  estimates, the United States would have to consider alternatives to  stamping out for outbreaks as large as the one depicted in the national  planning scenario. For example, some countries protect against and  control foot-and-mouth disease using vaccines. There are numerous  reasons the United States has not used this approach, including limitations  to vaccine technology. However USDA, DHS, and state officials recognize  that newer, more promising vaccines may play an important role in  controlling a catastrophic outbreak. DHS officials also told us that they are  looking into revising the Homeland Security Council’s planning scenario to  make it a more useful planning tool.
For its second effort to identify the veterinarian workforce needed during  a foot-and-mouth disease outbreak, DHS has contracted with the  Department of Energy’s Lawrence Livermore National Laboratory to  create a decision support system that models various foot-and-mouth  disease outbreak scenarios. This effort includes estimating the number  and type of workforce needed for responding to outbreaks, both with and  without vaccination. However, according to the project leader, modeling  efforts could be improved if certain information were available. For  example, in order to model workforce needs for a response that includes  the use of vaccines without subsequent stamping out, known as “vaccinate  to live,” it is important to know what segments of the livestock industry  might use such a strategy, and under what circumstances, and how  animals and animal products would be identified and their movement  tracked. Because the concept of vaccinate to live is new in the United  States, USDA has yet to detail in contingency response plans how it would  employ this concept, according to agency officials. In the absence of such  plans, the project leader, a veterinarian who took part in the response to  the 2001 United Kingdom foot-and-mouth disease outbreak, told us that  she is left to base her modeling assumptions on personal knowledge and  experience, as well as conversations with agency subject matter experts.
Moreover, data limitations make it difficult for any computer modeling  effort to accurately predict the spread of the disease. Specifically,  modelers must estimate the number and location of animals, as well as  their interaction with other segments of industry, because the United  States does not have a mandatory, national system that identifies the  location and tracks the movement of livestock. Instead, modelers  currently use outdated county-level data from USDA’s National  Agricultural Statistical Survey census, reducing the accuracy of  predictions about the spread of foot-and-mouth disease. Also, without  knowing the exact location of livestock, it is difficult to understand the  interaction between livestock and wildlife. Limited data and information  on the number and movement of wildlife and the susceptibility of wildlife  populations to the virus further complicates matters, according to agency  officials. This is an important gap, since foot-and-mouth disease has been  known to spread from livestock to wildlife in past outbreaks. In fact, the  last time the United States had an outbreak was in California in the 1920s,  when the virus spread from pigs to cattle and black-tailed deer. It took 2  years and the slaughter of 22,000 deer to eradicate the disease from a local  deer population in one national park. In areas where livestock graze  extensively, there is potential for interaction with susceptible species,  such as deer and feral pigs. According to the project leader, as well as  USDA and DHS officials, control and eradication strategies would be  greatly complicated if wildlife became infected and could require more  veterinarians and different expertise. Given the important role wildlife can  play in disease outbreak, officials agree it is important to better  understand the interaction between livestock and wildlife. In fact, new  technologies, such as global positioning systems, have been developed  that can, for example, help determine the number and movement of  animals, making it possible to gather this type of data, according to a  USDA Wildlife Services official. A DHS official told us that, as a first step,  it would be important for those agencies with responsibility for overseeing  the health of humans, wildlife, and livestock to discuss how wildlife data  can be gathered to most accurately model the spread of disease in wildlife.
section_title: Federal and State Agencies Are Missing Important Opportunities to Ensure Efficient Use of Veterinarians During Disease Outbreaks
paragraphs: During four recent zoonotic disease outbreaks, the veterinarian workforce  challenge cited most often by federal and state officials was having too  few veterinarians to control the outbreak while also adequately carrying  out other routine activities. Specifically, officials from 3 of 4 federal  agencies—APHIS, CDC, and Interior’s U.S. Geological Survey (USGS)— and 9 of 13 state agencies cited this challenge. See table 2 for the 17  agencies that were identified as playing an important role, those that cited  insufficient veterinarian capacity as a challenge, and other details about  these outbreaks.
Two primary reasons emerged for this insufficient capacity. First,  according to federal and state officials, veterinarian capacity was  insufficient because most of the agencies involved in the four outbreaks  had difficulty recruiting and retaining veterinarians in general. For  example, officials at many of the public health agencies and diagnostic  laboratories we spoke with said that it has been challenging to hire or  retain veterinarians with the specialized qualifications they need—public  health and pathology skills, respectively. According to 2008 survey results  from the American Association of Veterinary Laboratory Diagnosticians, it  takes most diagnostic laboratories more than 6 months to fill vacancies for  veterinary pathologists. In addition, numerous state agency officials told  us that the salaries they offer are not competitive with those of the federal  or private sectors. Moreover, officials told us that it has been particularly  challenging recruiting veterinarians to work in remote areas or in areas  with a high cost of living.
Second, in 2002 and 2003 many veterinarians went to California to address  a particularly demanding outbreak of exotic Newcastle disease, limiting  the number of veterinarians available to respond to other outbreaks. The  exotic Newcastle disease outbreak quickly exhausted California’s supply  of veterinarians, both at state agencies and APHIS, because so many  backyard birds—which are kept as a hobby or for personal consumption— were affected. Responders had to spend valuable time going door-to-door  trying to locate potentially infected birds in densely populated urban  areas. APHIS called in over 1,000 federal, state, and private-sector  veterinarians from outside California to help with the response. But, even  with a task force of over 6,000, it took almost a year to control the  outbreak. Moreover, because so many veterinarians converged on  California, the number available to work on the other three outbreaks— located in Michigan, Wisconsin, and Colorado—was insufficient,  according to federal and state agency officials. In part because of the  strain on veterinarian resources during the four outbreaks, officials from  16 federal and state agencies expressed concern that they will not have  sufficient veterinarian capacity for multiple outbreaks in the future. FDA  assisted in one of the four outbreaks and was the only agency not to  express concerns about veterinarian capacity. Some federal officials said  that the United States has never been tested with two major outbreaks  occurring at once, such as simultaneous outbreaks of foot-and-mouth  disease and highly pathogenic avian influenza—two highly infectious  foreign animal diseases. They said that should this happen, the effects on  animal and public health could be devastating.
Federal and state agency officials reported several consequences of this  insufficient veterinarian capacity. Examples are as follows:    Michigan state agency officials told us they had trouble testing enough  cattle during the bovine tuberculosis outbreak. Over a 6-1/2 year period,  veterinarians struggled to test more than a million cows—an average of  more than 3,500 a week—but the state has yet to eradicate the disease.
Some Michigan officials told us that APHIS and the Michigan Department  of Agriculture did not have enough veterinarians to both respond to bovine  tuberculosis and address other animal diseases, such as E. coli. In fact,  during all four outbreaks, veterinarians at some point had to delay  important work on other diseases, in part because there were not enough  veterinarians.
During the 2003 West Nile virus outbreak in Colorado, a lack of sufficient  veterinarians to track and control the disease, among other things, may  have allowed the virus to infect more people and animals than it otherwise  would have.
The volume of work required to control and eventually eradicate exotic  Newcastle disease in California physically and emotionally exhausted  veterinarians to the extent that, once the outbreak was over, they needed  significant time off to recover, further delaying work on routine activities.
The demanding nature of the exotic Newcastle disease and bovine  tuberculosis outbreaks may have caused some veterinarians to seek  employment elsewhere.
Despite reports of insufficient veterinarian capacity during these four  outbreaks, the agencies have not taken full advantage of two important  opportunities to learn from past experience. First, 10 of the 17 agencies  have not assessed how well their own veterinarian workforces responded  to individual outbreaks. Our prior work has shown that agencies can  improve response by conducting postoutbreak assessments. One  outcome of such an assessment might be a better understanding of how to  most efficiently use veterinarians. For example, APHIS—one of the  agencies that has performed postoutbreak assessments—found that it had  difficulty locating veterinarians with the specialized expertise needed for  addressing the exotic Newcastle disease outbreak. As a result, APHIS is  developing a national list identifying veterinarians and their credentials to  call upon in the future. In addition, federal and state agencies working on  bovine tuberculosis in Michigan meet periodically to assess what  strategies are working and what they need to change in order to better  control the disease. APHIS also conducts periodic reviews of its efforts  and the state’s efforts to address bovine tuberculosis.
Moreover, none of the 17 agencies have come together to share their  experiences across the outbreaks in order to identify workforce  challenges that they may have had in common, including veterinarian  workforce challenges. Consequently, the agencies are missing the  opportunity to identify and address challenges they are likely to face in the  future. The majority of the federal and state agency officials we spoke with  agreed that it would be useful for agencies not only to conduct  assessments of their own workforce response but also to periodically meet  to identify common workforce challenges across multiple outbreaks and  discuss strategies for overcoming these challenges. However, some  agencies told us that their veterinarian workforce is already facing heavy  workload demands that make it difficult for them to meet their existing  responsibilities, and thus they have not had time to conduct postoutbreak  assessments.
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Veterinarians are a small but vital part of the federal workforce, playing  important roles in protecting people from zoonotic and foodborne  diseases, ensuring the health and humane treatment of food animals, and  helping to keep America’s food system safe. The nation is facing a growing  shortage of veterinarians, and component agencies and other federal  entities have already identified insufficiencies in their veterinarian  workforces. At FSIS, for example, the veterinarian workforce is finding it  difficult to adequately carry out its responsibilities for ensuring food safety  and the humane treatment of animals. In 2004, we recommended that FSIS  periodically assess whether it has enough inspection resources, including  veterinarians, dedicated to humane handling and slaughter activities, but  the agency has yet to demonstrate that they have done so. Nor has the  federal government conducted the broader assessments and planning  activities necessary to address veterinarian workforce problems at FSIS  and beyond. Unless USDA and HHS conduct departmentwide assessments  of their veterinarian workforces, they will not fully understand the size  and nature of the challenges they face in recruiting and retaining  veterinarians with the appropriate skills. This will leave their component  agencies without a high-level solution to problems they have so far been  unable to solve on their own. Moreover, without a governmentwide effort  to identify shortcomings in veterinarian capabilities, the federal  government may be missing opportunities to find common solutions for  attracting veterinarians into federal service.
In addition, unless component agencies complete and test their pandemic  plans in keeping with FEMA guidance, they will not be fully prepared to  carry out essential veterinarian functions in the face of high rates of  absenteeism. Until USDA details how responders would control a foot- and-mouth disease outbreak using vaccines, the nation will not have a  complete understanding of the veterinarian workforce needed to control  such an outbreak. Similarly, until more information is gathered on the  spread of foot-and-mouth disease in wildlife, agencies will not be able to  more accurately model the number and type of veterinarians that would be  needed if the disease were to spread beyond livestock. Failure to  understand the workforce needed during a catastrophic event—whether a  pandemic or an attack on the food supply—could unnecessarily increase  the scope and severity of the crisis. Finally, unless component agencies  involved in responding to outbreaks of zoonotic disease regularly review  their own performance and collectively assess opportunities for  improvement, they cannot be assured they are using veterinarians as  efficiently as possible. They are, therefore, more likely to face an  insufficient veterinarian workforce capacity during future outbreaks,  which may cause an unnecessary increase in the severity of the outbreaks  and worsen the threat to public health.
section_title: Recommendations for Executive Action
paragraphs: We are making nine recommendations to improve the ability of the federal  veterinarian workforce to carry out routine activities, prepare for a  catastrophic event, and respond to zoonotic disease outbreaks.
To help ensure the federal veterinarian workforce is sufficient to meet the  critical responsibilities it carries out on a routine basis, we recommend  that  1.  the Secretary of Agriculture direct FSIS to periodically assess whether  its level of inspection resources dedicated to food safety and humane  slaughter activities is sufficient, and  2.  the Secretary of Agriculture conduct a departmentwide assessment of  USDA’s veterinarian workforce—based, for example, on workforce  assessments by its component agencies—to identify current and future  workforce needs (including training and employee development) and  departmentwide solutions to problems shared by its agencies. When  the Secretary completes the assessment, the results should be  forwarded to the Director of the Office of Personnel Management.  3.  We also recommend that the Secretary of Health and Human Services  direct the department’s component agencies that employ veterinarians  to conduct regular workforce assessments and that the Secretary then  conduct a departmentwide assessment of HHS’s veterinarian  workforce to identify current and future workforce needs (including  training and employee development) and solutions to problems shared  by its agencies. When the Secretary completes the assessment, the  results should be forwarded to the Director of the Office of Personnel  Management.  4.  Finally, we recommend that the Director of the Office of Personnel  Management determine, based on USDA’s and HHS’s departmentwide  veterinarian workforce evaluations, whether a governmentwide effort  is needed to address shortcomings in the sufficiency of the current and  future veterinarian workforce.
To help the veterinarian workforce continue essential functions during a  pandemic, we recommend that  5.  the Secretaries of Agriculture, Defense, and Health and Human  Services ensure that their component agencies that employ  veterinarians complete pandemic plans that contain the necessary  elements put forth in DHS’s continuity of operations pandemic  guidance, including periodically testing, training, and exercising plans.
To improve estimates of the veterinarian workforce needed to respond to  a large-scale foot-and-mouth disease outbreak, we recommend that  6.  the Secretary of Agriculture detail in a contingency response plan how  a response using vaccines would be implemented, and  7.  the Secretary of Homeland Security coordinate an interagency effort to  identify the data necessary to model the spread of disease in wildlife  and how best to gather these data.
To improve the ability of the federal veterinarian workforce to respond to  zoonotic outbreaks in the future while also effectively carrying out routine  activities, we recommend that the Secretaries of those departments most  likely to be involved in response efforts—such as USDA, HHS, and  Interior—ensure that their agencies:  8.  conduct postoutbreak assessments of workforce management; and  9. in coordination with relevant federal, state, and local agencies,  periodically review the postoutbreak assessments to identify common  workforce challenges and strategies for addressing them.
section_title: Agency Comments and Our Evaluation
paragraphs: We provided a draft of this report to USDA, DOD, HHS, OPM, DHS, and  Interior for their review and comment. USDA, DOD, OPM, DHS, and  Interior generally agreed with the recommendations. HHS generally  concurred with the report but not with one finding we reported regarding  FDA’s veterinarian workforce. Also, all departments provided technical  comments, which we incorporated as appropriate.
USDA agreed that it should periodically assess whether its level of  inspection resources dedicated to food safety and humane slaughter  activities is sufficient and believes that FSIS is already doing this  assessment as a part of its budget formulation process. However, we made  this recommendation in 2004, and are repeating it now, because FSIS has  yet to demonstrate that they have done this assessment. USDA also  reported that because APHIS and FSIS employ the majority of  veterinarians within the department, these component agencies will work  together, with departmental consultation, as needed, to develop solutions  to shared problems. We continue to believe that a departmentwide  assessment is necessary. In addition, the department commented that it  will track veterinarian workforce trends and devise strategies to train,  recruit, and retain veterinarians in order to mitigate attrition and maintain  progress toward the department’s mission to protect the public health.  Furthermore, USDA reported that APHIS and FSIS are already taking steps  to revise their pandemic plans to overcome many of the gaps we identified  to help ensure the USDA veterinarian workforce can carry out essential  functions during a pandemic. USDA’s written comments and our  evaluation appear in appendix III.
DOD stated that efforts are under way to finalize the Army’s pandemic  influenza plan and that the implementation date will be determined based  on current mission priorities. DOD’s written comments and our evaluation  appear in appendix IV.
HHS reported that veterinarians are essential to protecting the health of  the American people. In addition, the department commented that  veterinarians are a valuable resource at CDC and conducting workforce  assessments, as recommended in our report, will ensure that HHS  maintains a sufficient capacity for outbreak response. HHS further  reported that all operating staff division heads are required to have  workforce plans in place for their organizations by September 2009. Once  the plans are completed, the HHS Office of Human Resources will look  across the plans to identify opportunities for collaboration with regard to  strategic recruitment, development, and retention. The department also  plans to strengthen its oversight of the operating divisions to ensure that  they are implementing their workforce plans, focusing on those  occupations critical to the success of their missions. While veterinarians  are not currently identified as a department-level Mission Critical  Occupation, largely because they represent less than 1 percent of the HHS  workforce, the department plans to review its Mission Critical  Occupations in the coming year using criteria that are more risk-based.  However, HHS did not agree with a statement in our report that references  a 2007 FDA Advisory Committee report claiming that CVM is in a state of  crisis. The department stated that, given the broad nature of the 2007  Advisory Committee report, it is not applicable to veterinarians. However,  we reported information pertaining directly to veterinarians—information  we obtained from an interview with an author of the Advisory Committee  report. Furthermore, HHS stated that CVM has made great strides in the  past few years assessing its workforce needs and that the 2007 report is  outdated. Our report identifies many of the efforts CVM has recently  undertaken, such as hiring additional veterinarians and beginning an effort  to analyze the gap between current resources and needs. It also notes that,  according to FDA officials, the agency is undertaking significant reforms  to address fundamental concerns in the 2007 report. However, as our  report also states, FDA did not tell us how these efforts address the  identified veterinarian skill gap specifically. HHS’s written comments and  our evaluation appear in appendix V.
OPM informed us that it has established a team to research and analyze  data to determine the feasibility of issuing a governmentwide direct-hire  authority for veterinarians under its statutory and regulatory authority.  OPM did not provide further details except to say that a decision is  expected early in 2009. Until this study is completed, OPM relies on  individual agencies to make such requests when they have encountered a  severe shortage of candidates or a critical hiring need for veterinarians. In  addition, OPM informed us that on November 25, 2008, it approved USDA’s  request for direct-hire authority. OPM also commented that, in 2003, the  agency approved direct-hire authority for temporary and term positions,  including veterinarians, to help protect the health or safety of the U.S. food  supply during a pandemic or other declared emergency situation. OPM’s  written comments and our evaluation appear in appendix VI.
DHS recommended that the federal government enhance efforts to identify  the veterinarian workforce needed during catastrophic events. They stated  that this could be achieved through an OPM pursuit of a multidepartment  assessment of veterinary manpower requirements. They further  recommended that agencies develop plans that identify how veterinarians  will continue essential functions during additional catastrophic events,  taking into consideration the potential for absenteeism that exceeds the  level of 40 percent estimated for a pandemic. In addition, DHS stated that,  once a governmentwide veterinarian workforce need is determined,  effective recruitment and retention programs should be developed that are  consistent across all agencies. However, DHS disagreed with our finding  that the estimate produced from one of its efforts to identify the workforce  needed during a catastrophic outbreak of foot-and-mouth disease is not  relevant. We continue to believe, as does DHS, that this effort is based on  an infeasible assumption. Therefore, we do not agree that this estimate is  relevant to any response that could reasonably be implemented during  such an outbreak. DHS’s written comments and our evaluation appear in  appendix VII.
Interior commended GAO for conducting a well-researched examination  of the federal veterinarian workforce. The department emphasized the  importance of including wildlife disease expertise in a strategy for  protecting human and animal health. The department also identified the  importance of detecting and preventing non-native invasive infectious  diseases from entering U.S. borders via imported wildlife as important to  protecting human and animal health. Interior’s written comments and our  evaluation appear in appendix VIII.
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If you or your staff have any questions about this report, please contact me  at (202) 512-3841 or shamesl@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 contributions to this report are listed  in appendix IX.
section_title: Appendix I: Location and Responsibilities of Veterinarians in the Federal Government
subsections: section_title: Number of veterinarians by component agency or other entity
paragraphs: 1,771  Animal and Plant  Health Inspection  Service  667 Protect American livestock and poultry health through diagnosis,  control and eradication of animal diseases, and partnering with  state officials to manage and eradicate disease outbreaks. Some  are employed overseas.
Secretary for  Preparedness and  Response  personnel for events requiring emergency and disaster-related  veterinary medical care services to impacted animal populations  (including household pets and service animals) in or outside of  shelter locations until local infrastructures are reestablished.
Number of veterinarians by  component agency   or other entity37 Conduct research to improve the health of veterans and oversee  the health and welfare of animals used in research.  16 Investigate, diagnose, develop control methods, and develop  databases for wildlife diseases; provide training to wildlife  biologists and resource managers in wildlife disease identification  and control; conduct clinical veterinary research on wildlife  diseases; and oversee the health and welfare of experimental and  wild animals used in research, including research on wildlife  diseases.
Growth, Agriculture  and Trade; for Global  Health; and for Africa  pathogenic avian influenza outbreaks and recovery; identify  opportunities to share and leverage resources for avian influenza  response efforts with international and domestic health agencies  and universities.
Number of veterinarians by  component agency   or other entity9 Conduct audits of seafood plants and products as part of the  Seafood Inspection Program; provide guidelines and oversight of  the Marine Mammal Health and Stranding Response Program,  Aquatic Animal Health Program, disease surveillance, health  monitoring, outbreak investigations, and  contaminants/pathogen/toxin/health research.
5  Office of the Chief  5 Provide and coordinate animal care at agency research facilities;  one veterinarian is an astronaut.  1 Oversees the laboratories’ Food and Agricultural Security  program, which includes the work on modeling animal disease to  determine workforce resources that will be needed for response to  outbreaks.  1 Provide veterinary expertise in the investigation of an intentional  disease outbreak.
The Army veterinarian workforce consists of 446 active duty; 173 reserve corps; and 134 other.
The number of veterinarians listed for the Department of Health and Human Services does not  include those United States Public Health Service Commissioned Corps veterinarians working at the  FSIS and the Environmental Protection Agency because they are counted as employees of those  agencies.
section_title: Appendix II: Scope and Methodology
paragraphs: To determine the extent to which the federal government has assessed the  sufficiency of its veterinarian workforce for routine activities, we  interviewed officials and collected documents from the American  Veterinary Medical Association, the National Association of Federal  Veterinarians (NAFV), and the Association of American Veterinary Medical  Colleges to identify general concerns about the federal veterinarian  workforce. NAFV also provided a review it had conducted in 1996 that  identified federal departments and agencies that employ veterinarians. We  expanded this list of departments and component agencies based on  referrals and experience from our past reports, resulting in a list of 24  component agencies and other federal entities. We then surveyed these 24  entities to obtain information on the federal veterinarian workforce— including the number of veterinarians employed, their grade level, salaries,  roles and responsibilities, number of vacancies, and sufficiency of the  workforce. We conducted this self-administered electronic survey in  October 2007 and then requested an update of this survey information in  July 2008. We achieved a 100 percent response rate both times. However,  one entity was unable to provide some of the specific salary information  we requested, and we noted this in our report.
Because this was not a sample survey, but rather a survey of the universe  of respondents, it has no sampling errors. However, the practical  difficulties of conducting any survey may introduce errors, commonly  referred to as nonsampling errors. For example, respondents may have  difficulty interpreting a particular question, the sources of information  available to respondents may introduce errors or variability, and analysts  may introduce errors when entering data into a database or analyzing  these data. We took steps in developing the questionnaire, collecting the  data, and analyzing them to minimize such nonsampling error. For  example, we pretested the survey to ensure that the questions were  relevant, clearly stated, and easy to understand.
To obtain salary information for Department of Agriculture (USDA)  agencies over the past 5 years, we used data from the Office of Personnel  Management’s (OPM) Central Personnel Data File. We did not  independently verify these data for the years we reviewed; however, in a  1998 report, we found that governmentwide data from this file for the key  variables in this study (agency, birth date, service computation date,  occupation, and retirement plan) were 99 percent accurate or better.
Therefore, we feel these data were sufficiently reliable for the purposes of  this review.
On the basis of information we received in our survey of these component  agencies and other entities, we then analyzed the workforce assessment  efforts of USDA, the Department of Defense (DOD), and the Department  of Health and Human Services (HHS). We selected these departments  because they employ the majority of federal veterinarians (96 percent)  identified in our survey. Within these three departments, we further  focused our review on five component agencies—the Animal and Plant  Health Inspection Service (APHIS), FSIS, Army, and the Food and Drug  Administration (FDA)—to determine the extent to which they assessed  the sufficiency of their veterinarian workforce. We also selected the  Agricultural Research Service (ARS) for further review because it is  USDA’s chief scientific research agency and conducts research to solve  agricultural problems of high national priority. We conducted our  assessment by reviewing department and agency documents, such as  workforce plans, human capital management reports, workforce models,  and gap assessments. We then compared workforce assessment efforts of  the three departments and five component agencies with GAO workforce  planning guidance. We also conducted semistructured interviews with  workforce planning and veterinarian program officials. In addition, we  interviewed an author of the report FDA Science and Mission at Risk  regarding the report’s findings and their relation to FDA veterinarian skill  gaps. Further, we visited one poultry and two beef slaughter plants of  varying sizes to observe conditions and interview veterinarians and other  FSIS officials. We also interviewed FSIS officials working at the slaughter  plant that was the subject of the nation’s largest beef recall. We selected  these plants on the basis of proximity to the sites of the four recent  zoonotic disease outbreaks we reviewed, and recommendations from FSIS  officials. Moreover, other veterinarians contacted us to relay concerns  about the sufficiency of the FSIS veterinarian workforce. We interviewed  officials from the OPM to determine the agency’s role in workforce  planning for federal veterinarians and to identify recruitment and retention  authorities available to agencies and departments. Finally, we interviewed  experts from the Council of State and Territorial Epidemiologists, the  National Association of State Public Health Veterinarians, the American  College of Veterinary Pathologists, the American Association of Wildlife  Veterinarians, the American Association of Veterinary Laboratory  Diagnosticians, and the National Academy of Sciences to identify  workforce needs for veterinary specialties including public health, wildlife  veterinarians, veterinary laboratory diagnostics, and veterinary pathology.
To determine the extent to which the federal government has identified  the veterinarian workforce needed during a catastrophic event, we  analyzed workforce planning efforts for two potential large-scale national  incidents that the White House Homeland Security Council deemed critical  for planning purposes: a pandemic and a foot-and-mouth disease outbreak.  For the first, we compared pandemic plans from APHIS, FSIS, ARS, Army,  and FDA to guidance the Department of Homeland Security’s (DHS)  Federal Emergency Management Agency provided to departments and  agencies for identifying special considerations for maintaining essential  functions and services under such conditions. These agencies were  selected for the reasons described above. We interviewed agency officials  to discuss identified gaps and determine the extent to which the plans  were being updated and tested. Furthermore, we interviewed HHS officials  to understand their review of state pandemic plans, which are under  development to ensure continuity of the food supply system and the ability  to respond to agriculture emergencies. For the second, we reviewed  veterinarian workforce outcomes from DHS’s nationwide effort to assess  the nation’s preparedness for multiple, intentional introductions of foot- and-mouth disease. In addition to interviewing the DHS official  responsible for coordinating the animal health emergency capability, we  also interviewed state officials who have conducted large-scale exercises  simulating a response to foot-and-mouth disease, as well as USDA officials  with responsibility for such an event, to determine the feasibility of the  response depicted in the scenario. Because vaccine use was suggested as  an alternative strategy to the slaughter of animals infected with foot-and- mouth disease, we also interviewed USDA’s Chief Veterinary Officer, and  DHS and USDA officials at Plum Island Animal Disease Center to  determine the status of foot-and-mouth disease vaccine development and  the feasibility, as well as practicality, of their use. Finally, at the  recommendation of DHS, we interviewed the Department of Energy  official responsible for overseeing the development of a decision support  system that models various foot-and-mouth disease outbreak scenarios in  order to estimate the number and type of workforce needed for  responding to outbreaks. The Department of Energy is performing this  work under contract for DHS. We also interviewed USDA, DHS, and  Department of the Interior (Interior) officials to determine the extent to  which agencies are including the possible spread of foot-and-mouth  disease in wildlife in their planning efforts.
To determine the extent to which federal and state agencies encountered  veterinarian workforce challenges during four recent zoonotic outbreaks,  we conducted semistructured interviews with 17 federal and state  agencies involved in these outbreaks. We relied on federal and state  officials to identify those agencies that played an important role in  outbreak response. Based on this information, we then interviewed  officials from USDA, HHS, Interior, state public health departments, state  agriculture and wildlife agencies, state diagnostic laboratories, and one  county public health agency. We also interviewed other individuals  involved in the outbreaks, including researchers from Northwestern  University, the University of California at Davis, and Western University of  Health Sciences. We selected the four outbreaks in our review—bovine  tuberculosis in Michigan, exotic Newcastle disease in California,  monkeypox in Wisconsin, and West Nile virus in Colorado—because these  outbreaks were most frequently recommended by federal officials as  examples of recent zoonotic diseases; are ongoing or have occurred since  2001; and have affected various types of animals, including livestock,  wildlife, pets, and exotic animals. In addition, we chose these four  outbreaks for review because of the unique nature of the outbreaks in  these states. Specifically, we selected Michigan as the state for the bovine  tuberculosis review because the ongoing outbreak is the longest outbreak  of this disease in the United States in recent history. We chose California  because it experienced the greatest number of animal infections for the  exotic Newcastle disease outbreak. We selected Wisconsin because it  experienced the most human monkeypox infections. We selected  Colorado for West Nile virus because the number of human infections in  Colorado in 2003 was the highest for a single state. In addition to the  interviews, we also analyzed federal, state, and county documents, such as  after action reports, in order to (1) understand the extent to which  agencies formally assessed the management of their veterinarian  workforces during these outbreaks and (2) identify any workforce-related  challenges and steps agencies took to address these challenges.
section_title: Appendix III: Comments from the Department of Agriculture
paragraphs: The following are GAO’s comments on the Department of Agriculture’s  letter dated January 16, 2009.
subsections: section_title: GAO Comments
paragraphs: 1.  USDA commented that FSIS already regularly assesses the level of  inspection resources it needs, as we recommended in 2004. However,  as our report states, FSIS has yet to demonstrate that they have done  so. We regularly follow up to request evidence that agencies have  implemented our recommendations, and FSIS has not provided such  evidence.  2.  USDA reported the majority of its veterinarian workforce is located  within two agencies, APHIS and FSIS, and each has the staff and  expertise to conduct veterinarian workforce analyses for their  respective agencies. Therefore, these two agencies will work together,  with departmental consultation, as needed, to develop solutions to  problems shared by both agencies. We continue to believe that a  departmental assessment, not a consultation, is necessary, particularly  in light of the competition between the two agencies. As we reported,  APHIS is attracting veterinarians away from FSIS because the work at  APHIS is more appealing, there are more opportunities for  advancement, and the salaries are higher. Furthermore, ARS continues  to experience difficulties recruiting and retaining highly qualified  veterinarians to carry out critical research of national importance, yet  there is no mention of ARS in USDA’s comments.  3.  USDA commented that it has contingency plans and a decision tree for  use of foot-and-mouth disease vaccine from the North American Foot- and-Mouth Disease Vaccine Bank. We acknowledge that USDA has  these plans. In fact, we reviewed a draft plan titled, Response to the  Detection of Foot-and-Mouth Disease in the United States, dated  October 2007, that USDA officials told us was their new response plan  that considered alternative response strategies, including “vaccinate to  live.” However, this plan does not detail how a policy of this nature  would be implemented. USDA further commented that policy  decisions as to who may administer the vaccine will be made based on  the circumstances of the outbreak. While we recognize that each  outbreak is unique, this should not preclude USDA from identifying a  plausible scenario or scenarios and detailing how a vaccinate to live  strategy would be carried out in order to enhance preparation,  response, and recovery in a time of crises.  4.  We modified our report to reflect that USDA would like to change their  statement from FSIS has “never” had a sufficient number of  veterinarians to “over the past decade.” USDA also asserts that our  report says that FSIS has been able to reallocate veterinary resources  sufficient to meet its statutory mandates for food safety and humane  handling of livestock. However, our report only presents this as the  view of FSIS headquarters officials. We raise this point to illustrate  that FSIS headquarters officials and veterinarians working in slaughter  plants differ on the impact of this shortage.  5.  We modified our report to reflect more clearly the relationship  between the events at a Chino, California, plant and the February 2008  beef recall.  6.  USDA commented that that our report emphasizes the incident at a  plant in Chino, California. We raise the point because some  veterinarians told us they did not have time to ensure the humane  treatment of livestock, and this example illustrates inhumane  treatment occurred despite the presence of FSIS inspectors. USDA  further commented that we attribute this incident to having only one  veterinarian. We do not state this in our report. We use this and other  statements about resources to illustrate the need for FSIS to  periodically assess whether the level of resources dedicated to humane  handling and slaughter activities is sufficient. They have yet to do so.  In addition, USDA commented that the USDA Inspector General did  not find systematic problems associated with oversight of humane  handling at slaughter facilities that process cull cows. However, the  Inspector General did conclude that there is inherent vulnerability at  the other plants in the scope of its audit, and that inhumane handling  could occur and not be detected by FSIS inspectors due to lack of  continuous surveillance.  7.  USDA commented that GAO has closed the 2004 recommendation that  FSIS periodically assess whether the level of resources dedicated to  humane handling and slaughter activities is sufficient. We recognize  that FSIS has taken actions in response to a number of  recommendations made in the 2004 report and have documented  implementation of these recommendations. However, with regard to  periodic assessment, we closed this recommendation because enough  time had passed that we considered it unlikely to be implemented. As  our report states, FSIS has yet to demonstrate that it has been  implemented. Based on our current work, we continue to believe that  periodic assessment is needed, and we make a recommendation to that  effect.  8.  We modified our report to include the recent approval of USDA’s  direct-hire authority and noted that USDA has raised some concerns.  9.  We modified our report to include the concern about veterinary  schools and enhanced the chart to include the concern for salary.
section_title: Appendix IV: Comments from the Department of Defense
section_title: Appendix V: Comments from the Department of Health and Human Services
paragraphs: The following are GAO’s comments on the Department of Health and  Human Services’ letter dated January 14, 2009.
subsections: section_title: GAO Comments
paragraphs: 1.  HHS commented that a premise of our report is that the control of  zoonotic diseases is solely dependent on the capacity of the  veterinarian workforce. Our report does not state this. The scope of  this report, as described in the introduction, was to review the  sufficiency of the federal veterinarian workforce.  2.  Our report does not identify the Centers for Disease Control and  Prevention (CDC) as having too few veterinarians to control the 2003  West Nile virus outbreak while also adequately carrying out other  routine activities. However, CDC officials we interviewed who were  involved with the 2003 monkeypox outbreak in Wisconsin told us there  were too few veterinarians during this outbreak.  3.  We modified our report to reflect the new information about the  difficulty the National Institutes of Health has recruiting veterinarians.  4.  Our report states conclusions from the FDA Advisory Committee  report: that FDA “cannot fulfill its mission” because its scientific  workforce has remained static while its workload has increased, and  that FDA’s Center for Veterinary Medicine (CVM) is “in a state of  crisis.” We discussed with an author of the Advisory Committee report  how that report’s findings specifically related to veterinarians.  Consequently, our report also states that an author of the FDA  Advisory Committee report told us that veterinarians enter FDA  employment lacking necessary skills and experience to examine the  wide variety of veterinary products that require FDA approval and that  FDA needs to better train its veterinarians to review the many diverse  products under its jurisdiction. HHS further stated that CVM has made  great strides in the past few years in assessing its workforce needs and  that the conclusions of the Advisory Committee report are out of date.  Our report identifies several of the efforts CVM has recently  undertaken, such as hiring additional veterinarians and beginning  efforts to analyze the gap between current resources and needs. It also  notes that, according to FDA officials, the agency is undertaking  significant reforms to address fundamental concerns in the 2007  report. However, as our report states, FDA did not tell us how these  efforts address the identified veterinarian skill gap specifically.  5.  We modified our report to add a statement that the increase observed  in CVM’s veterinarian workforce was primarily in response to new  obligations.
section_title: Appendix VI: Comments from the Office of Personnel Management
paragraphs: The following are GAO’s comments on the Office of Personnel  Management’s letter dated January 15, 2009.
subsections: section_title: GAO Comments
paragraphs: 1.  We modified our report to reflect OPM’s establishment of a team to  determine the feasibility of issuing a governmentwide direct-hire  authority for veterinarians.  2.  We modified our report to include OPM’s recent approval of USDA’s  direct-hire authority request.
section_title: Appendix VII: Comments from the Department of Homeland Security
paragraphs: The following are GAO’s comments on the Department of Homeland  Security’s letter dated January 14, 2009.
subsections: section_title: GAO Comments
paragraphs: 1.  DHS stated that current policy requires slaughter of all potentially  exposed animals and, therefore, the projected manpower requirement  is relevant. We agree that this estimate is relevant to this method. As  our report notes, the United States has used this “stamping out”  method in the past for eradicating smaller outbreaks of foreign animal  diseases. However, DHS and USDA officials told us, and DHS  reiterates in its comments, that stamping out is infeasible for a large- scale outbreak of foot-and-mouth disease. Therefore, we do not agree  that this estimate is relevant to a catastrophic outbreak, which was the  scope of this section of our report. Indeed, as we note, DHS and USDA  officials we interviewed during the course of our review told us that  the estimate was not relevant.  2.  We modified our report to clarify the Office of Health Affairs’ concerns  about the sufficiency of its veterinarian workforce.
section_title: Appendix VIII: Comments from the Department of the Interior
section_title: Appendix IX: GAO Contact and Staff Acknowledgments
subsections: section_title: Staff Acknowledgments
paragraphs: In addition to the individual named above, Charles Adams, Assistant  Director; Mary Denigan-Macauley; Jennifer Gregory; Terry Richardson;  Benjamin Shouse; and Michelle K. Treistman made key contributions to  this report.
Other important contributors included Kevin Bray; Candace Carpenter;  Nancy Crothers; William Doherty; Joyce Evans; Brian Friedman; Katheryn  Hubbell; Judith Kordahl; Jena Sinkfield; and Gloria Sutton.