The three stamps issued thus far in the nation’s semipostal program have all been authorized through separate congressional acts pertaining solely to those stamps. The Stamp Out Breast Cancer Act required that the Service issue a Breast Cancer Research stamp, the nation’s first semipostal. Two additional semipostals—the Heroes of 2001 and Stop Family Violence stamps—were mandated by Congress in the 9/11 Heroes Stamp Act of 2001 and the Stamp Out Domestic Violence Act of 2001. Figure 2 shows the three semipostals. Following the authorization of these semipostals by Congress, a number of stakeholders became involved with the semipostals, including the Service, designated federal agencies, and advocacy groups. For example, after Congress mandated the semipostals, the Service issued the stamps and then transferred semipostal proceeds to the designated federal agencies, which then directed the funds toward the identified causes. Additionally, advocacy groups involved with the charitable causes have assisted in promoting the semipostals. Table 1 identifies the various stakeholders and summarizes their primary roles related to the semipostals. Authorized for 2 years in 1998, the Breast Cancer Research stamp has subsequently been reauthorized three times, and there are proposals in Congress to further extend the sales period through December 31, 2007. The Breast Cancer Research stamp raises money for breast cancer research programs at NIH and DOD, with the former receiving 70 percent of the funds raised and the latter receiving the remaining 30 percent. The Heroes of 2001 stamp was offered for sale from June 7, 2002, to December 31, 2004, and funds raised were transferred to FEMA to provide assistance to the families of emergency relief personnel who were killed or permanently disabled in the line of duty in connection with the terrorist attacks against the United States on September 11, 2001. The Service started selling the Stop Family Violence stamp on October 8, 2003, and it is scheduled to expire on December 31, 2006. Proceeds from the Stop Family Violence stamp are being transferred to HHS for domestic violence programs. For a period of just over 1 year, between October 8, 2003, and December 31, 2004, all three semipostals were on sale simultaneously. Figure 3 shows the authorized sales periods for each of the semipostals. Separately from the provisions that authorized the three semipostals, the Semipostal Authorization Act gave the Service the authority to issue semipostals that it considers to be appropriate and in the national public interest; however, the Service has not yet exercised this authority. Further, the Service has indicated that it does not plan to issue any semipostals under its own authority until sales of the Breast Cancer Research stamp and other congressionally authorized semipostals have concluded. However, legislative proposals to establish new semipostals continue to be made. In the 109th Congress, for example, a bill has been introduced to establish a new semipostal to benefit the Peace Corps. In February 2005, the House Committee on Government Reform, the oversight committee for the Service, adopted a rule that stated that the Committee will not give consideration to legislative proposals specifying the subject matter of new semipostals. That rule also stated that the Service should determine the subject matter of new semipostals. In September 2005, a bill was introduced to establish a semipostal to provide disaster relief for residents of Louisiana, Mississippi, and Alabama who were affected by Hurricane Katrina. The proceeds are to be transferred to the American Red Cross Disaster Relief Fund for Hurricane Katrina, which is not a government entity. This contrasts with the existing semipostals that transfer their proceeds to designated federal agencies. In our previous work, we reported that the Breast Cancer Research stamp has been an effective fund-raiser and that funds raised through sales of the stamp had contributed to key insights and approaches for the treatment of breast cancer. Most of the key stakeholders we spoke with and, according to our survey, members of the public viewed the stamp as an appropriate way of raising funds for a nonpostal purpose. We expressed some concerns, however, about the Service’s identification and recovery of costs associated with carrying out the act. We recommended that the Service reexamine and, as necessary, revise its Breast Cancer Research stamp cost- recovery regulations. We also suggested that Congress consider establishing annual reporting requirements for NIH and DOD. Semipostals have raised over $56 million to date, and sales were likely impacted by several factors. In addition to variations in the amounts raised by each of the semipostals, sales patterns were also different, and on the basis of our discussions with Service officials, advocacy groups, and other stakeholders, we identified four key factors that affected sales, including (1) fund-raising cause, (2) support of advocacy groups, (3) stamp design, and (4) Service promotional activities. The funds raised by the semipostals vary from $44 million for the Breast Cancer Research stamp to over $10.5 million for the Heroes of 2001 stamp and nearly $2 million for the Stop Family Violence stamp, totaling over $56 million. The length of time that each semipostal has been sold affected the amounts raised: the Breast Cancer Research stamp has been available for 7 years, the Heroes of 2001 stamp was available for just over 2½ years, and the Stop Family Violence stamp has been available for under 2 years. Semipostal sales patterns reveal marked differences. Breast Cancer Research stamp sales have fluctuated since the semipostal’s issuance in 1998 but have remained at a comparably high level over time (see fig. 4). The Heroes of 2001 and Stop Family Violence stamps each had initial sales surges—although at much different levels—with subsequent declines. Sales of the Breast Cancer Research stamp have averaged over 22 million semipostals per quarter since it was issued in 1998, with total sales of 606.8 million semipostals by May 31, 2005. Sales of the Heroes of 2001 stamp averaged over 13 million semipostals per quarter throughout its sales period and totaled 132.9 million, although over 50 percent of total sales occurred in the first two-quarters after issuance in 2002. Finally, as of May 31, 2005, sales of the Stop Family Violence stamp have averaged over 4 million semipostals per quarter and total 25.3 million since issuance. Public awareness about the fund-raising causes represented by the semipostals likely affected sales levels. The two semipostals addressing causes with high levels of public awareness—finding a cure for breast cancer and supporting the families of September 11 emergency personnel—had higher sales than the Stop Family Violence stamp, which raises funds for domestic violence programs, a cause that, while well known, has a lower profile. An official with the Komen Foundation pointed out that in the case of the Breast Cancer Research stamp, the fact that about one in eight women are affected by breast cancer keeps the subject in the public spotlight. Likewise, the national significance of the events surrounding the September 11 terrorist attacks ensured a high level of public awareness regarding the cause represented by the Heroes of 2001 stamp. In contrast, Service officials pointed to the lack of general coverage about domestic violence, which may have limited sales of the Stop Family Violence stamp. The appeal of the particular fund-raising cause was also a factor affecting semipostal sales. While the Breast Cancer Research and Heroes of 2001 stamps were associated with causes that generate a strong and supportive response, the Stop Family Violence stamp deals with a cause that may evoke a more complex response. Officials with the Association of Fundraising Professionals noted that certain causes generate a greater response than others, regardless of fund-raising methods. According to an official with the BBB Wise Giving Alliance, for example, four popular fund- raising causes currently are cancer, children’s issues, relief efforts, and animals, although the popularity of fund-raising causes fluctuates over time. Such an impact can be particularly acute for campaigns that use affinity fund-raising, whereby donors demonstrate their support for a specific cause with a public sign of their commitment. Fund-raising experts we spoke with at the Association of Fundraising Professionals stated that semipostals are examples of this kind of effort, and officials with the American Red Cross noted that other well-known examples of such marketing include the Lance Armstrong Foundation’s LiveStrong yellow bracelets and pink breast cancer awareness ribbons. Such branding can be problematic, however, for causes that, for a variety of reasons, may be more difficult to embrace. For example, officials with the National Coalition Against Domestic Violence and the Service mentioned that consumers may be reluctant to use the Stop Family Violence stamp given that the fund-raising cause is particularly sensitive. Service officials noted that some consumers pay close attention to the ways in which stamps can send intended or unintended messages about the sender or receiver of letters. The difference in appeal between fund-raising causes can also be seen in the degree to which they readily attract support or promotion by businesses or organizations. In the case of the semipostals, American Express and NASCAR approached the Service about partnership promotions for the Breast Cancer Research and Heroes of 2001 stamps, respectively. The partnerships resulted in promotion for the semipostals, done largely at the expense of the Service’s partners, who were able to affiliate themselves with these popular causes. American Express advertised the Breast Cancer Research stamp in print and inserts, while NASCAR placed an image of the Heroes of 2001 stamp prominently on a stock car at very little cost to the Service (see fig. 5). The Service did not receive any comparable offers in support of the Stop Family Violence stamp. While awareness and appeal may affect the size of the response, the length of the response may be related to another characteristic: whether the fund- raising cause is for an episodic event, such as a disaster, or for an ongoing concern, such as finding a cure for a disease. The Heroes of 2001 stamp sales reflected the dramatic emotional spike typically associated with episodic events, with fund-raising efforts building quickly and then declining as events begin to retreat from the public spotlight or become affected by subsequent developments, according to officials with the American Red Cross and the BBB Wise Giving Alliance. These organizations pointed to the fund-raising efforts generated by the December 2004 tsunami as an example of another episodic event, noting that the tsunami fund-raising surge lasted about 30 days. Officials with the Association of Fundraising Professionals told us that such fund-raising spikes are common for one-time events. More specifically, many September 11 fund-raising efforts experienced the same initial surge and the subsequent decline that the Heroes of 2001 stamp experienced, according to representatives with the New York City Police Foundation, the September 11th Families Association, and the National Association of Fallen Firefighters. By contrast, ongoing causes, such as finding a cure for breast cancer, are more likely to have staying power over time, according to fund-raising experts. Sales of the semipostals were likely affected by the capacity of advocacy groups working to promote them. Several of the breast cancer advocacy groups supporting the Breast Cancer Research stamp have large networks of members and have promoted the semipostal at events involving thousands of participants. For example, the Komen Foundation, an active supporter of the semipostal, has more than 80,000 individuals in an online advocacy group involved in lobbying to extend sale of the semipostal. The foundation also conducts “Race for the Cure” events around the world, with more than 1 million walkers or runners participating each year since 2000; and a partnership effort between the Komen Foundation and Yoplait (and its parent company General Mills) has contributed over $14 million to the breast cancer cause over 7 years. In contrast, family violence prevention groups tend to be smaller, according to officials with the Association of Fundraising Professionals. The National Resource Center on Domestic Violence noted that it has a mailing list of about 5,000 to which it has sent information about the Stop Family Violence stamp; and another group, the National Domestic Violence Hotline, provided information about the semipostal to over 100 local domestic violence programs. Further, an official with the National Coalition Against Domestic Violence described a cell phone donation program that earned about $2 million over 6 or 7 years. Finally, Service officials noted that there were no organized groups to coordinate with when the Heroes of 2001 stamp was developed. Beyond the capacity of advocacy groups, the specific efforts undertaken in support of the semipostals by such groups over time likely affected sales. Several breast cancer advocacy groups have actively supported the Breast Cancer Research stamp since its issuance, while comparatively less was done by advocacy groups to support the Heroes of 2001 or Stop Family Violence stamps, which may account for their declining sales trends. Service officials link semipostal sales to the support of advocacy groups. Several breast cancer advocacy groups that we spoke with mentioned carrying on activities to promote the Breast Cancer Research stamp. (Table 2 provides examples of these activities.) Likewise, Service officials stated that grassroots support given to the Breast Cancer Research stamp helps to explain its long-term success, pointing to the organized support of the semipostal by breast cancer advocacy groups and individuals, which has included use by doctors’ offices, sponsored walks and runs, and activities surrounding Breast Cancer Awareness Month. None of the advocacy groups affiliated with emergency personnel affected by the terrorist attacks of September 11 that we spoke with regarding the Heroes of 2001 stamp had engaged in promotional activities for the semipostal. The advocacy groups we spoke with were aware that the funds raised through sales of the semipostal were to be directed to September 11 emergency responders in some capacity, but they were unaware of the specifics of how the proceeds would be used. Like the Stop Family Violence stamp, sales of the Heroes of 2001 stamp did not have the boosts in sales seen periodically with the Breast Cancer Research stamp, although its initial sales were higher. The semipostal’s limited staying power may have reflected the lack of advocacy group activity on behalf of the semipostal. Several domestic and family violence advocacy groups mentioned that while they had intended to support the Stop Family Violence stamp with promotional activities, they have done less than originally planned. Confusion about how Stop Family Violence stamp proceeds would be used led some domestic and family violence advocacy groups to limit their promotional activities on behalf of the semipostal. As a result, although some local advocacy groups carried out promotional activities with local post offices, such as semipostal unveiling ceremonies, the national domestic or family violence groups that we spoke with typically limited their promotional activities to articles in newsletters or features on group Web sites. Some domestic and family violence advocacy groups acknowledged that they could have done more to promote the Stop Family Violence stamp and that the semipostal’s sales were likely adversely affected by this lack of promotion. The designs of both the Breast Cancer Research and Heroes of 2001 stamps were lauded by stakeholders; however, there was concern that the design of the Stop Family Violence stamp may have negatively affected sales of that semipostal. Both the Breast Cancer Research and Heroes of 2001 stamps had designs that were praised by stakeholders as having inspiring images that conveyed some information about where proceeds would be directed. Consumers could assume that funds would go to breast cancer research or September 11 emergency personnel in some capacity, according to officials with the American Red Cross. However, officials with the Association of Fundraising Professionals noted that the exact use of the funds was not clearly spelled out on either semipostal. Further, in-store messaging also provided limited information. (See fig. 6 for an example of an in-store counter card featuring the semipostals.) In contrast, although the design of the Stop Family Violence stamp won an international award, and the story behind the design was described as inspiring by some advocacy groups, advocates with such organizations as the Family Violence Prevention Fund and the National Network to End Domestic Violence questioned how likely postal customers would be to buy the stamp to use on their mail, given the image of a crying child. In addition, the semipostal’s design and information provided by the Service on in-store materials are less clear regarding how semipostal proceeds are to be used,referring to both domestic and family violence, which are viewed by some as separate causes. Both the Breast Cancer Research and Heroes of 2001 stamps had extensive Service advertising campaigns. The Service spent nearly $900,000 to advertise the Breast Cancer Research stamp and more than $1.1 million for the Heroes of 2001 stamp. This advertising included a billboard in Times Square for the Breast Cancer Research stamp and a national print advertising campaign for the Heroes of 2001 stamp. The Service also received the Gold “Reggie” award from the Promotion Marketing Association for the Service’s efforts in promoting the Breast Cancer Research stamp. As the result of an overall reduction in the Service’s budget, advertising for all stamps, including semipostals, has been limited to in-store messaging since 2003. As a consequence, Service officials determined that all funds spent to advertise semipostals would be deducted from the totals raised through their sales. This policy change had a marked impact on promotional activities for the Stop Family Violence stamp, which was issued in October 2003. While advertising costs associated with the Breast Cancer Research and Heroes of 2001 stamps had been paid by the Service, all advertising costs for the Stop Family Violence stamp were to be deducted from the stamp’s proceeds. In light of these limitations, the Service met with HHS before the Stop Family Violence stamp was issued. At this meeting the Service proposed spending $1.5 million or more on an advertising campaign that would be funded by the future semipostal proceeds. Because of uncertainty about how much money would be raised through sales of the Stop Family Violence stamp, HHS decided that the proposed advertising campaign not be pursued. In lieu of such a campaign, the Service and HHS looked to the advocacy groups to promote the semipostal. The Service and HHS officials met with advocacy group representatives and provided them with examples of the types of promotional activities that breast cancer advocacy groups had done to help publicize the Breast Cancer Research stamp and a poster for use in promotional activities. Through March 31, 2005, the Service spent about $77,000 to advertise the Stop Family Violence stamp, and this amount was recovered from semipostal proceeds. Table 3 provides examples of Service promotional efforts and partnerships in support of the semipostals. Service officials said that differences in sales among the three semipostals were not the result of the level of actions on the part of the Service. They said a semipostal’s success is dependent on the support provided by external groups or individuals. Service officials point out that for each semipostal, the Service issued a field and press kit and met with officials from the agencies receiving semipostal proceeds. In addition, the Service initiated kickoff events for each of the semipostals at the White House, with involvement from either the President or First Lady (see fig. 7). Finally, Service officials noted that local post offices are available to sponsor local events at the discretion of the postmaster. For example, the Service’s South Georgia District employees established the “Circle of Hope” campaign to promote and raise funds for the Breast Cancer Research stamp. In 2004, the campaign raised an estimated $21,000 in proceeds through stamp sales. Likewise, the Cardiss Collins Postal Facility in Chicago held a rededication ceremony for the Stop Family Violence stamp on August 2, 2005, in collaboration with the Illinois Secretary of State and officials from the Chicago Abused Women Coalition and the Chicago Police Department. The federal agencies receiving semipostal proceeds currently award or plan to award these funds using grants, and although each agency has collected and maintained information on semipostal proceeds, none has reported specifically on their use of proceeds thus far. NIH and DOD use Breast Cancer Research stamp proceeds to award research grants under existing programs. HHS has not distributed any proceeds from the Stop Family Violence stamp, but officials reported that they have established new grants within an existing program to award grants for domestic violence programs. While the other semipostals address ongoing causes, the Heroes of 2001 stamp raised funds for an episodic event without an established mechanism for distributing such funds. As a result, FEMA is establishing a new program and accompanying regulations for distributing Heroes of 2001 stamp proceeds to families of emergency relief personnel who were killed or permanently disabled in the line of duty in connection with the September 11 terrorist attacks. The laws authorizing these three specific semipostals do not include reporting requirements such as those of the Semipostal Authorization Act. Of the four agencies, FEMA and HHS have plans to report specifically as to the use of semipostal proceeds. Both NIH and DOD reported that they began receiving Breast Cancer Research stamp proceeds from the Service in November 1998, and breast cancer research grants have been awarded using established programs at both agencies since June 2000 and June 1999, respectively. NIH initially directed these proceeds to the National Cancer Institute (NCI) to award high-risk research grants through the “Insight Awards to Stamp Out Breast Cancer” initiative. This initiative was specifically designed for the Breast Cancer Research stamp proceeds, but exists within NCI’s grants program. One example of these grants includes funding research related to the development of a potential antitumor drug. In 2003, NIH approved new Breast Cancer Research stamp grants through the “Exceptional Opportunities in Breast Cancer Research” initiative, also administered by NCI, which uses semipostal proceeds to fund more traditional research. According to NIH officials, this change was made when it was determined that there were highly meritorious research applications outside the funding ability of NCI, and they noted that many outstanding grant applications would remain unfunded without the use of semipostal proceeds. Exceptional Opportunities awards have covered breast cancer research areas that include prevention, diagnosis, biology, and treatment. DOD uses Breast Cancer Research stamp proceeds to fund innovative approaches to breast cancer research through “Idea Award” grants under its existing Breast Cancer Research Program, which is administered by the U.S. Army Medical Research and Materiel Command. The scope of the grants has not changed since DOD began awarding them in 1999. Table 4 contains additional information about these initiatives and the size and number of grants awarded with Breast Cancer Research stamp proceeds. Since NIH and DOD both apply Breast Cancer Research stamp proceeds to established grant programs the agencies used existing procedures and regulations for awarding grants funded with the proceeds. For example, both agencies use existing review procedures to evaluate grant applications with input from advocacy groups. NIH and DOD officials stated that advocacy groups play an important role, and both agencies involve advocacy groups in their grants processes. Grants funded by NIH and DOD using Breast Cancer Research stamp proceeds have produced significant findings in breast cancer research. The first NIH Exceptional Opportunities Awards funded with Breast Cancer Research stamp proceeds were distributed in fiscal year 2003 and are awarded for a maximum of 4 years; therefore, it is still too early to report results from these awards. Both NIH and DOD use existing programs and processes such as monitoring grantees and requiring annual grantee reporting, which has made measuring grant performance and tracking grant outcomes relatively straightforward. Officials at each agency were pleased to gain new sources of funding and pleased that there have been some significant findings in the field of breast cancer research resulting from these awards. Table 5 provides select examples of research findings from NIH Insight Awards and DOD Idea Awards funded with Breast Cancer Research stamp proceeds. HHS began receiving Stop Family Violence stamp proceeds from the Service in May 2004, and, as of July 2005, HHS has not yet awarded any grants using semipostal proceeds. HHS is using an established grant program, the Family Violence and Prevention Services Program, to make the proceeds available at the end of fiscal year 2005 for grants aimed at enhancing services to children exposed to domestic violence. As of June 30, 2005, the Service had transferred about $1.8 million to HHS, and the agency has directed these proceeds to ACF, which is responsible for distributing the funds. In June 2005, ACF released an announcement for the grants, and ACF officials stated that they expect the first grants to be awarded during the end of fiscal year 2005. The purpose of the grants is to provide enhanced services and support to children who have been exposed to domestic violence in order to mitigate the impact of such exposure and increase the opportunities for these children to lead healthy lives as adults. Grant applicants are required to collaborate with a state’s domestic violence coalition and the state agency responsible for administering family violence programs. According to agency officials, it has always been ACF’s intention to use Stop Family Violence proceeds for enhanced services to children. Table 6 provides additional information about the ACF grants, to be awared including the size and number of awards. According to ACF officials, the agency used an established program to develop its grants to award Stop Family Violence stamp proceeds. The officials stated that ACF is using existing competitive review procedures to evaluate grant applications. These review procedures are described in the grant announcement, which was developed through ACF’s existing grant application process and made available on ACF’s Web site. ACF also plans to use its existing project grant reporting system to monitor grantee performance (see table 6). ACF consulted with domestic violence advocacy groups, state agencies, and state domestic violence coalitions on the current distribution of children’s services offered by domestic violence organizations and solicited their input on a fair and equitable method for grant participation. Although ACF involved advocacy groups in developing the way that semipostal funds could be used initially, many groups that we spoke with in the spring of 2005 expressed concern about how the Stop Family Violence stamp proceeds would be spent. Some national domestic violence groups reported that they were unaware of ACF’s intentions for semipostal proceeds because no semipostal grants have been announced and no funds had been spent. FEMA started receiving Heroes of 2001 stamp proceeds from the Service in November 2002, and FEMA has not yet distributed any of the semipostal proceeds. To determine the total amount of funds available, FEMA officials stated that the agency made a decision to wait until the Service had transferred all semipostal proceeds—in May 2005—before finalizing its grants program. Following the final transfer, FEMA had received over $10.5 million in semipostal proceeds. FEMA is establishing a program to make grants available to eligible emergency relief personnel who are permanently disabled or to the families of emergency relief personnel who were killed as a result of the terrorist attacks of September 11. According to FEMA officials, while distributing funds to disaster victims is within the scope of FEMA’s mission, distributing the semipostal proceeds is not within the scope of its disaster authority. As a result, FEMA has had to establish a new program with new regulations for semipostal proceeds, which includes establishing the mechanism through which the funds would be distributed. After undergoing regulatory review at the Office of Management and Budget (OMB), FEMA’s interim rule for their assistance program under the 9/11 Heroes Stamp Act of 2001 was made publicly available on July 26, 2005. The interim rule states that FEMA intends to distribute all Heroes of 2001 stamp proceeds equally among all eligible claimants. Table 7 provides additional information about the FEMA grants. When designing its program and regulations, FEMA officials stated that the agency considered the findings resulting from the Department of Justice September 11th Victim Compensation Fund of 2001, which provided over $7 billion in compensation to victims of the terrorist attacks. One of the observations detailed in the Final Report of the Special Master for the September 11th Victim Compensation Fund of 2001 is that there are serious problems posed by a statutory approach mandating individualized awards for each eligible claimant and that a better approach might be to provide the same amount for all eligible claimants. Prior to publicizing its interim rule, FEMA had informal discussions with stakeholder groups, and FEMA officials also stated that the program regulation would be available for public comment. New York City police, firefighter, and representatives of victims’ foundations whom we spoke with expressed some concern regarding FEMA’s use of the proceeds, because they were unaware if FEMA planned to allocate the Heroes of 2001 stamp proceeds through assistance programs or grants to individual families. These groups also noted that since the September 11 terrorist attacks, there has been an evolving set of needs that have little funding support, including long-term programs such as counseling and health care for emergency relief personnel involved in the September 11 recovery and clean-up efforts. None of the designated federal agencies receiving semipostal proceeds is required to issue a report to Congress detailing how these funds are used or any accomplishments resulting from semipostal-funded grants. The agencies would face such a reporting requirement if the three existing semipostals had been authorized under the Semipostal Authorization Act. Specifically, the act contains an accountability mechanism consisting of annual reports to include (1) the total amount of funding received by the agency, (2) an accounting of how proceeds were allocated or otherwise used, and (3) a description of any significant advances or accomplishments during the year that were funded—in whole or in part—with funds received. However, the laws that created the three semipostals did not specify any reporting requirements, and the agencies themselves have decided to take varying actions in this regard. NIH and DOD do not report specifically on the use of semipostal proceeds, though the agencies do collect information that, if necessary, could be assembled for such a report. To help manage their respective grant programs, NIH and DOD require award recipients to provide periodic reports on research progress and any breakthroughs achieved. Research findings from grants funded by Breast Cancer Research stamp proceeds can be found in some NIH publications, but the agency does not report specifically on its use of these funds. DOD provides limited information on its Idea Awards through annual reports on its Congressionally Directed Medical Research Programs. This reporting is limited to the number of Idea Awards and does not provide information on which awards are funded with Breast Cancer Research stamp proceeds. ACF plans to monitor grantee performance and to report on its use of semipostal proceeds through HHS’ grants system and will make an additional report available to Congress. Although FEMA initially indicated to us that the agency was not required to report on its use of semipostal proceeds, FEMA recently provided information to Congress—in part as a result of our work—on the total proceeds received from the sales of the Heroes of 2001 stamp. FEMA officials have indicated that once proceeds have been distributed, a report will be provided to Congress on the status of the 9/11 Heroes Stamp Act of 2001. According to FEMA officials, the report will summarize the agency’s Heroes of 2001 stamp program including information on its development, the process undertaken, and who is receiving the semipostal proceeds. Various fund-raising organizations that we spoke with indicated that program reporting is a useful accountability tool and may lead to greater fund-raising success. For example, the BBB Wise Giving Alliance, a charity watchdog group, recommends reporting requirements, in the form of annual reports, for charitable organizations to ensure that representations to the public are accurate, complete, and respectful. These reports should be made available to all, on request, and should include the organization’s mission, a summary of the past year’s accomplishments, and financial information. Further, officials with the American Red Cross stated that disclosure provides transparency, allowing consumers to determine if the cause is the best use of their money, and Association of Fundraising Professional officials noted that such reporting can even secure additional support by encouraging more people to contribute to the effort. While many of the agency officials, fund-raising groups, and charitable organizations that we contacted believe that the semipostals have been good fund-raisers, nearly all of them also believe that there were lessons learned. For the past several years, there have been multiple proposals introduced in Congress to establish new semipostals. For example in the 108th Congress, proposals had been introduced for semipostals promoting childhood literacy, the Peace Corps, and prevention of childhood drinking. Each of these proposals expired in committee, and—so far—the Peace Corps semipostal proposal has been reintroduced in the 109th Congress. Any lessons learned from the existing semipostals may be especially relevant for any future semipostals, whether congressionally mandated or issued under the Service’s authority. The lessons we identified from these three semipostals related primarily to five areas: use of funds raised, and agency reporting. The existing semipostals have been issued for a minimum 2-year sales period, and one—the Breast Cancer Research stamp—has been extended 3 times. The experience with the three existing semipostals indicates that the particular nature of the charitable causes may be important in how much money is raised, how long consumers continue to purchase the semipostal, and other results achieved. Among these differences are the following: One-time charitable causes, such as response to a major disaster, may provide a substantial immediate response but may also have limited staying power as ongoing fund-raisers. The Heroes of 2001 stamp was issued in 2002, while various national organizations were still raising funds for victims of the families of emergency relief personnel killed or disabled in the line of duty. Sales were highest for the initial two- quarters, followed by a dramatic drop. By contrast, the Breast Cancer Research stamp, which raises funds for an ongoing health issue, has had sales that have remained at a high level over its entire sales period. Considering a cause’s appeal in drawing affinity support is important in setting fund-raising expectations. Some charitable causes are simply less popular than others, and recognition of these differences can aid in forming assumptions about how much money will be raised through semipostal sales. For some consumers, applying a postage stamp serves as a symbol of loyalty to a particular charitable cause; therefore, it can be anticipated that the magnitude of a particular cause’s base of support will be reflected in semipostal sales. Association of Fundraising Professionals officials noted that certain causes generate a greater response than others, regardless of fund-raising methods. That is, breast cancer is a pervasive and ongoing concern; the September 11 terrorist attacks were a popular concern, but also an event likely to fade in intensity over time; and family violence, while an ongoing concern, is likely to engender less appeal. According to Association of Fundraising Professionals officials, the amounts raised by each semipostal are consistent with the popularity of the type of fund-raising cause represented on the stamps. In some cases, a growth in cause awareness may be a success that transcends the amount of money raised. In addition to raising funds, the semipostal program provides an avenue for increased exposure for particular charitable causes. While the amount of funds raised may not be as high for some causes, there are additional benefits of having a semipostal representing a particular cause visible and for sale in post offices throughout the country. Organizations and individuals whom we spoke with agreed that for all of the semipostals, heightened awareness of the cause was one benefit of having a semipostal. One Breast Cancer Research stamp supporter commented that the contribution that the semipostal has made to breast cancer awareness is priceless and more precious than the funds raised. Likewise an official from the National Fallen Firefighters Foundation stated that the Heroes of 2001 stamp has helped raise public awareness about the fire service. Support of advocacy groups is an important marketing device for semipostals. American Red Cross and BBB Wise Giving Alliance officials told us that advocacy groups are the most useful tool for getting the word out about charitable causes and fund-raising efforts, and Service officials agreed. Broad supportive networks of private organizations that are willing and capable of assisting in local and national marketing help sustain semipostal awareness and sales. Where it is not possible to do aggressive private-sector style marketing, as is the case with semipostals, advocacy groups can fill this gap. In the case of the Breast Cancer Research stamp, for example, the Service no longer has a budget to advertise stamps, which includes semipostals, but there are numerous advocacy groups that publicize the Breast Cancer Research stamp on their Web sites, at events they sponsor, and through letters to members and legislators. To sustain support from advocacy groups, the Service must cultivate this support, and the agency receiving the semipostal proceeds must sustain this support. Organizations involved with charitable causes told us that due to their multitude of priorities, if their input and support are not solicited and they are not kept informed about issues related to the relevant semipostal, including fund usage and program outcomes, group support for the semipostal will wane. For example, several advocacy groups associated with the domestic violence cause told us that immediately following launch of the Stop Family Violence stamp there was uncertainty as to how HHS was going to use the proceeds because the public announcement at the stamp’s kickoff event differed from the groups’ expectations. These advocacy groups told us that as a result of this confusion, they did not aggressively promote the semipostal. Semipostal design is one of the variables that can affect whether consumers are willing to signal their support for a cause. We received comments from numerous stakeholders, for example, that the design of the Stop Family Violence stamp, while certainly drawing attention, may not create a positive response—or affinity—because of its tone. A semipostal’s design can evoke emotion, and the emotional reaction to the image may be important in a consumer’s decision to purchase a semipostal and use it on a letter to make a statement. For example, the Heroes of 2001 stamp provided an image that was not only recognizable but inspiring. By contrast, the image on the Stop Family Violence stamp may create a more complex reaction, and result in a consumer’s decision not to buy the semipostal. The extent of promotion and advertising of a semipostal can also greatly affect sales. Fund-raising organizations that we spoke with agreed that in most cases, there is a connection between the amount invested in a fund- raising effort and the amounts raised. Although a direct correlation has not been determined, it should be noted that as a result of a Service budget reduction, which eliminated stamp advertising, the Stop Family Violence stamp did not benefit from a million-dollar promotional campaign as the two other semipostals did, and sales have remained lower in comparison for the stamp. Support may be further enhanced if the semipostal or the available marketing information clearly indicates how the proceeds will be used. Transparency is critical to fund-raising efforts, and semipostals are no exception. According to the BBB Wise Giving Alliance, one of the standards for charity accountability is to clearly disclose how the charity benefits from the sale of product or services. American Red Cross officials also emphasized that providing this information to consumers is critical to fund- raising efforts like semipostals. We found widespread confusion among advocacy groups about specifically how the Stop Family Violence stamp proceeds would be used. Officials added that the disclosure of where funding is to be directed is particularly important, given that consumers are increasingly savvy, and people have become increasingly skeptical about the distribution of charitable funds. The time lag between when funds are first raised and when they are distributed can be considerable, depending on the type of program that the agency implements for distributing semipostal proceeds. Semipostal sales generate revenues immediately upon going on sale at post offices, and semipostal revenues are distributed by the Service to designated agencies biannually, after the Service’s reasonable costs are deducted. However, it can then take an additional 2 years, or longer, for the funds to be used. For example, the Breast Cancer Research stamp, which was authorized in August 1997, was first sold in July of 1998, and the initial grants resulting from the proceeds were awarded by DOD in June of 1999 and by NIH in June of 2000 (nearly 1 and 2 years after issuance); the Heroes of 2001 stamp was first sold in June of 2002, and the proceeds raised have not yet been awarded by FEMA (3 years after the stamp was issued); and the Stop Family Violence stamp was first available in October of 2003, and no funds have yet been awarded by ACF (nearly 2 years after issuance). When semipostals are used as a fund-raising vehicle, the time lag is a consideration. Agencies awarding semipostal proceeds may need to consider this time lag in deciding how to apply the funds, particularly for episodic events that may involve a fund-raising surge and short-term or evolving needs. For example, program and funding priorities may change from the time that a semipostal is launched to the time proceeds are actually distributed. This time lag can result in consumer skepticism of or disagreement with the original program selection, resulting from changing or new funding priorities. For example, FEMA’s plan for distributing the Heroes of 2001 stamp proceeds has taken about 3 years to finalize, and while it is clear that the initial intent of the semipostal was to “provide financial assistance to the families of emergency relief personnel killed or permanently disabled in the terrorist attacks of September 11,” other organizations working with these families suggested that currently, the most prevalent needs of this group are programs and services directed at addressing the long-term effects of the terrorist attacks. The amounts raised by semipostals vary, and it is difficult to determine how much money will be raised by semipostal sales. For example, FEMA and ACF, which receive proceeds from the Heroes of 2001 and Stop Family Violence stamps respectively, reported to us that they delayed spending in these programs due to the uncertainty of how much money would be raised. ACF officials told us they initially expected the Stop Family Violence stamp to raise considerably more than it has. Once ACF officials realized that the amounts raised may not be sufficient to cover the planned programs, officials revisited their plans for the proceeds. Further, FEMA waited until all semipostal proceeds were received from the Service before pursuing its grant program. Due to the uncertainties surrounding how much money will be raised by semipostals, establishing a program that will be funded solely by semipostal proceeds may present challenges. In addition, attaching funds to already established mechanisms, such as existing grant guidelines or programs, may ease administration and allow for additional flexibility. For example, both the Breast Cancer Research and Stop Family Violence stamp proceeds are being used to distribute new grants within existing programs, which has allowed the agencies to make grants available using semipostal proceeds without developing and establishing the rules and regulations for new programs. Program reporting is an important standard for ensuring accountability. In general, we found that organizations we spoke with were unclear as to how semipostal proceeds were being used or would be used, and we found that none knew of any outcomes resulting from these funds. The Semipostal Authorization Act, which does not specifically apply to these three existing semipostals, requires that the agencies receiving funds under the act report to the congressional committees with jurisdiction over the Service about the semipostal funds received and used. Fund-raising organizations we spoke with, including the American Red Cross and the BBB Wise Giving Alliance, also recommend such reporting, pointing to the need to inform consumers about how proceeds have been used. Additionally, annual reporting may make information about program goals, plans, or funding mechanisms available to Congress, advocacy groups, and others earlier, thereby addressing some of the uncertainty that may arise between the initial issuance of the semipostal and the actual distribution of funds. Currently, none of the agencies administering the three semipostals are providing this degree of disclosure for semipostal programs. Agency reporting for these semipostals is either subsumed in reports about the larger programs to which the proceeds are applied or has not yet been produced. However, these agencies do collect and track this information and could report it with little difficulty. We found widespread agreement among most parties involved that the Breast Cancer Research, Heroes of 2001, and Stop Family Violence stamps were a success. Success can be measured in terms of funds raised, but also in less tangible ways, such as increased public awareness of an important issue. If the definition of semipostals success is narrowed specifically to the funds raised, however, the differences among these three make it all the more important to pay attention to the lessons learned, which can help in setting expectations for further semipostal sales. Given that new semipostals have been proposed in Congress and the Service is authorized to issue additional semipostals, the potential is always there for new semipostals, and therefore the lessons learned may be helpful in any future considerations. One of these lessons—the need for accountability—involves actions that can still be taken on these semipostals, rather than just applied to future semipostals. Through the Semipostal Act and its related regulations, Congress and the Service have taken measures to develop criteria for the selection of semipostal issues, identification of recipient agencies, and reporting of program operations, but these criteria have thus far been largely bypassed due to the provisions that have authorized these three semipostals. These three semipostals lie outside the Semipostal Authorization Act, and may benefit from applying the reporting requirement. Additionally, if any future semipostals are authorized by Congress separately from this act, this type of requirement could be included as part of the legislation in order to ensure greater accountability and greater support for the semipostals. To enhance accountability for semipostal proceeds, we recommend that the Secretary of Defense, Secretary of Homeland Security, and Secretary of Health and Human Services annually issue reports to the congressional committees with jurisdiction over the Service, as is currently required for agencies that are to receive semipostal proceeds under the Semipostal Authorization Act. Reports should include information on the amount of funding received, accounting for how the funds were allocated or otherwise used, and any significant advances or accomplishments that were funded, in whole or in part, out of the funds received through the semipostal program. We requested comments on a draft of this report from the Service, ACF, DOD, FEMA, HHS, and NIH. The Service and DOD provided written comments, which are summarized below and reprinted in appendix VI and VII, respectively. ACF, FEMA, HHS, and NIH did not provide comments on this report. The Service stated in its comments on the draft report that it generally agreed with the four key factors that we cited as affecting stamp sales. The Service agreed that the fund-raising cause and support of advocacy groups were key factors in the stamps’ success. However, the Service suggested that stamp design and its promotion of the stamps seem to be of less importance to a semipostal stamp’s success as a fund-raiser. The Service said that its experience indicates that a semipostal’s design plays little role in its effectiveness as a fund-raiser. We based our conclusion, that stamp design affects the extent to which consumers support the semipostal, on our discussions with advocacy groups and fund-raising experts who expressed concern that the design of the Stop Family Violence stamp—an image of a crying child—may have negatively affected the sales of that semipostal. Therefore, we continue to believe that the design was a factor in the stamp’s sales. Regarding promotional activities for specific semipostals, the Service correctly noted that its current policy requires that promotional costs be deducted from the funds raised, which can lead to the federal agencies receiving less semipostal proceeds. We acknowledge that HHS chose not to have the Service develop an extensive advertising campaign after the Service changed its policy on semipostal promotional costs, and our finding is not meant as a criticism of the Service. Nevertheless, the striking differences in results leads us to conclude that the Service’s promotional efforts can make a difference: the Service spent about $1 million to promote the Breast Cancer Research stamp, which raised $44 million in 7 years; it spent about $1 million to promote the Heroes of 2001 stamp, which raised over $10.5 million in 2.5 years; and it spent about $77,000 to promote the Stop Family Violence stamp, which has raised nearly $2 million in 1.6 years. Our conclusion was reinforced by the fund-raising experts that we spoke with who agreed that in most cases there is a connection between the amount invested in a fund-raising effort and the amounts raised. DOD concurred with our recommendation to improve reporting of how semipostal proceeds are used. DOD explained that the Army will include in its annual report to Congress on “Congressionally Directed Medical Research Programs” a section on DOD’s use of Breast Cancer Research stamp proceeds. It noted that this report will highlight significant advances or accomplishments that were funded, in whole or in part, through these proceeds. We are sending copies of this report to Senators Dianne Feinstein and Kay Bailey Hutchison and Representative Joe Baca because of their interest in the Breast Cancer Research stamp; Senators Hillary Rodham Clinton and Charles E. Schumer because of their interest in the Heroes of 2001 stamp; the Postmaster General; the Chairman of the Postal Rate Commission; and other interested parties. We will make copies available to others upon request. This report will also be available on our Web site at no charge at http://www.gao.gov. If you have any question about this report, please contact me at (202) 512-2834 or at siggerudk@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. Key contributors to this report included Gerald P. Barnes, Assistant Director; Kathleen Gilhooly; Molly Laster; Heather MacLeod; Joshua Margraf; Stan Stenersen; and Gregory Wilmoth. To determine the amount of money raised by the semipostals, we analyzed semipostal sales data provided to us by the U.S. Postal Service (Service). For each semipostal, these data included the amount of quarterly stamp sales and the amount of proceeds transferred to the designated federal agencies. The data also included administrative costs deducted by the Service from the total sales amounts, which we have reported in appendix II. To determine the reliability of the data we received, we obtained and reviewed specific information on the Service’s data collection methods, including data storage and system controls. We determined that the data were sufficiently reliable for the purpose of this report. To identify potential factors affecting the patterns of fund-raising sales for each of the semipostals, we asked stakeholders for their opinions regarding such factors and identified common trends. As part of this effort, we spoke with Service officials; the American Philatelic Society; professional fund- raising organizations; and national advocacy groups affiliated with breast cancer, emergency relief personnel affected by the terrorist attacks of September 11, and domestic violence. We also spoke with Dr. Ernie Bodai, who is credited with conceiving the idea for the Breast Cancer Research stamp, and Ms. Betsy Mullen, who along with Dr. Bodai lobbied Congress for the stamp. Additionally, we gathered information about Service and advocacy group efforts to promote each of the semipostals. Table 8 identifies the stakeholders whom we spoke with. To determine how the designated federal agencies have used semipostal proceeds and reported results, we interviewed key officials from each agency receiving funds. These agencies included the National Cancer Institute (NCI) within the National Institutes of Health (NIH), the Army Medical Research and Materiel Command within the Department of Defense (DOD), the Federal Emergency Management Agency within the Department of Homeland Security, and the Administration for Children and Families within the Department of Health and Human Services. We also obtained and reviewed available agency documentation about grant programs funded with semipostal proceeds, including grant program development, purpose and goals, award and program guidelines, the number and amounts of awards, reporting requirements, performance measures, and grant outcomes. We did not assess each agency’s semipostal grant program as this was not included in the scope of our work, nor did we evaluate grant performance measures that might be included in agency reporting. Finally, to describe the monetary and other resources expended by the Service in operating and administering the semipostal program, we obtained and analyzed the Service’s data on costs of administering semipostals as well as what costs the Service has recovered. We also interviewed officials in the Service’s Offices of Stamp Services and Finance to determine what progress the Service has made in revising its regulations. We spoke with officials from the Service’s Legal Counsel to determine whether the Service has established baseline costs for the semipostal program as per our prior recommendation. The Service has incurred over $16.5 million on operating and administering the Breast Cancer Research, Heroes of 2001, and Stop Family Violence stamps. Of this amount, the Service has recovered about $1.8 million from semipostal proceeds, with the remainder recovered through the First-Class postage rate. The Service’s costs related to the Breast Cancer Research stamp have by far eclipsed costs of the other two semipostals, reflecting the amount of time that the stamp has been offered for sale and other factors. In our previous work, we expressed concern over the Service’s cost recovery regulations. Since our 2003 report, the Service has taken several steps to revise its cost recovery regulations, and has established baseline costs to identify and recover the Service’s reasonable costs related to the semipostals. According to Service policy, cost items recoverable from the funds raised by semipostals include, but are not limited to, packaging costs in excess of those for comparable stamps, printing costs for flyers or special receipts, costs of changes to equipment, costs of developing and executing marketing and promotional plans in excess of those for comparable stamps, and other costs that would not normally have been incurred for comparable stamps. Specifically, the Service has identified 13 cost categories that it uses to track semipostal costs. These categories include the following: stamp production and printing; withdrawing stamps from sale; destroying unsold stamps; printing flyers and special receipts; developing and executing marketing and promotional plans; and other costs (legal, market research, and consulting). Costs reported by the Service totaled $16.5 million through March 31, 2005 (see table 9). Costs for the Breast Cancer Research stamp accounted for more than $11 million of this amount. The Service determined that about $1.8 million of the total costs related to the three stamps represented costs that were attributable specifically to the semipostals and would not normally have been incurred for comparable stamps, and therefore needed to be recovered. The recovered amounts ranged from over $1 million for the Breast Cancer Research stamp, to just over $200,000 for the Stop Family Violence stamp. The Service reported that the majority of costs incurred by the semipostals were covered by the First-Class postage rate, and not recovered from the proceeds. Table 9 describes the semipostal costs incurred and recovered by the Service. The specific costs recovered from surcharge revenues varied by semipostal not only in amount, but to a degree, in the type of expenditure as well (see tables 10 to 12, which show costs for each semipostal). For example, when the Breast Cancer Research and Heroes of 2001 stamps were issued, the Service had a budget to advertise stamps. Both semipostals incurred advertising costs of about $1 million, and because advertising costs would be incurred for comparable stamps, the Service did not recover those costs. When the Stop Family Violence stamp was issued, the Service reduced its overall budget and eliminated, among other things, all stamp advertising, including that for semipostals. Subsequently, the Service established a policy that all costs incurred for advertising semipostals would be deducted from the applicable semipostal’s surcharge revenue. Therefore, the advertising costs incurred ($77,000) for this semipostal were recovered from the surcharge revenue. While policies changed for some cost categories, they remained consistent for others such as design and production and printing. In our September 2003 report on the Breast Cancer Research stamp, we recommended that the Service reexamine and, as necessary revise its cost- recovery regulations to ensure that the Service establishes baseline costs for comparable stamps and uses these baselines to identify and recover costs from the Breast Cancer Research stamp’s surcharge revenue. The Service has taken several steps to revise its regulations including the following: 1. The final rule in 39 C.F.R. §551.8, in effect since February 5, 2004, clarifies Service cost offset policies and procedures for the semipostal program. Specific changes include expanding the types of “comparable stamps” that could be used in conducting cost comparisons to allow other types of stamps (such as definitive or special issue stamps) to serve as a baseline for cost comparisons; allowing for the use of different comparable stamps for specific cost clarifying that costs that do not need to be tracked include not only costs that are too burdensome to track, but also those costs that are too burdensome to estimate; and clarifying that several types of costs could be recovered when they materially exceed the costs of comparable stamps. 2. The Service also amended the regulation 39 C.F.R. §551.8(e) effective February 9, 2005, to delete the word “may” from the cost items recoverable from the surcharge revenue, making the recovery of the costs listed mandatory rather than optional. Additionally, we have recommended that the Service establish and publish baseline costs to provide assurance that the Service is recovering all reasonable costs of the Breast Cancer Research stamp from the surcharge revenue. In response, on June 25, 2004, the Service provided a copy of its baseline analysis to both Congress and GAO in a report entitled United States Postal Service: Response to the General Accounting Office Recommendations on the Breast Cancer Research Stamp. In this analysis, the Office of Stamp Services and Office of Accounting identified comparable stamps and created a profile of the typical costs characteristics, thereby establishing a baseline for Breast Cancer Research stamp cost recovery. Additionally, Service officials reported that they would use the baseline for the other semipostals. Congress has selected the subject matter for the three semipostals issued to date. In each case, the Service has then applied the same design process used for regular commemorative stamps. According to Service officials, most subjects that appear on commemorative stamps are the result of suggestions sent in by the public, which number about 50,000 annually. In the case of commemorative stamps, the Postmaster General determines what stamps will be produced with the assistance of the Citizens’ Stamp Advisory Committee (CSAC), which works on behalf of the Postmaster General to evaluate the merits of all stamp proposals and selects artwork that best represents the subject matter. Since the three existing semipostals were mandated by Congress, the Service and CSAC were not involved in selecting the subject matter. However, the rest of the stamp design process was the same, with CSAC determining what design would be used, and the Postmaster General giving final approval. Figure 8 shows the three semipostals. The Breast Cancer Research stamp was designed by Ethel Kessler of Bethesda, MD, and features the phrases "Fund the Fight" and "Find a Cure." Whitney Sherman of Baltimore provided the illustration of Diana, mythical goddess of the hunt, who is reaching behind her head to pull an arrow from her quiver to fend off an enemy—in this case, breast cancer. This image reflects the same position that a woman assumes for a breast self examination and mammography. The various colors represent the diversity of Americans affected by breast cancer. The Heroes of 2001 stamp was designed by Derry Noyes of Washington, D.C., and features a detail of a photograph by Thomas E. Franklin. The photograph shows three firefighters, each of whom participated in the September 11 rescue efforts, raising the U.S. flag in the ruins of the World Trade Center at Ground Zero in New York. The flag had been discovered in a boat near the area and was raised on a pole found in the rubble. The space between the foreground and background of the picture, which was about 100 yards, helps convey the enormity of the debris and the task at hand. According to the photographer, the raising of the flag symbolizes the strength of the firefighters and of the American people battling the unimaginable. All three firefighters and the photographer attended the stamp’s unveiling ceremony, which marked the 6-month anniversary of the September 11 terrorist attacks. Stop Family Violence Stamp When art director Carl T. Herrman selected Monique Blais, a six-year-old from Santa Barbara, CA, to model for a photograph that was to be the original design of the Stop Family Violence stamp, his intention was to photograph Blais erasing a domestic violence image from a chalkboard— symbolizing eradication of the issue. During a break in the photo session, however, and without prompting, Blais began drawing her own picture of what she thought best represented domestic violence. Photographed by Philip Channing, Blais’s drawing became the basis for the final Stop Family Violence stamp design, which was later selected by a jury at the 34th Asiago International Prize for Philatelic Art, in Asiago, Italy as the most beautiful social awareness-themed stamp issued during 2003. The young artist attended the stamp’s unveiling ceremony at the White House in 2003. As of April 2005, NIH had awarded 106 breast cancer research grants totaling about $16.1 million using proceeds from the Breast Cancer Research stamp. Individual awards ranged from $47,250 to $616,010 and averaged about $151,652. Funds received from sales of the Breast Cancer Research stamp were initially used to fund breast cancer research under NCI’s “Insight Awards to Stamp Out Breast Cancer” initiative, according to NIH officials. In 2003, NCI’s Executive Committee decided to direct the funds to a newly approved Breast Cancer Research stamp initiative entitled “Exceptional Opportunities in Breast Cancer Research.” Grants awarded under each program are listed below. The Insight Awards were designed to fund high-risk exploration by scientists who are employed outside the federal government and who conduct breast cancer research at their institutions. NCI distributed 86 Insight Awards at a total of about $9.5 million. Most of the awards were for 2-year periods. Individual awards ranged from $47,250 to $142,500 and averaged $111,242, discounting a one-time supplement of $4,300. Table 13 provides information about each Insight Award funded with Breast Cancer Research stamp proceeds, including the fiscal year of the award, sponsoring institution, principal investigator, research area, and the amount of the award. The Exceptional Opportunities were designed to advance breast cancer research by funding high-quality, peer-reviewed, breast cancer grant applications that are outside the current funding ability of NCI. When NIH began awarding these grants, the number of annual awards decreased from about 29 per year to 10, while the average amount tripled. In all, NCI dispersed Breast Cancer Research stamp proceeds to 20 Exceptional Opportunities awards, each funded for a maximum of 4 years. The awards totaled about $6.6 million and covered research areas that included prevention, diagnosis, biology, and treatment. Individual awards ranged from $81,000 to $616,010 and averaged $330,763. Table 14 provides information about each Exceptional Opportunities Award, including the fiscal year of the award, sponsoring institution, principal investigator, research area, and the amount of the award. As of April 2005, DOD had awarded 27 breast cancer research grants totaling about $11 million using proceeds from the Breast Cancer Research stamp. Individual awards ranged from $5,000 to $767,171 and averaged $400,405. DOD applies Breast Cancer Research stamp proceeds to its Breast Cancer Research Program in order to fund Idea Awards, which are grants that focus on innovative approaches to breast cancer research and cover research areas such as genetics, biology, imaging, epidemiology, immunology, and therapy. According to DOD officials, about $500,000 of the transferred funds had been used for overhead costs. Table 15 provides information about each Idea Award funded with Breast Cancer Research stamp proceeds, including the fiscal year of the award, sponsoring institution, principal investigator, research area, and the amount of the award.

Summary: Congress has directed the U.S. Postal Service to issue three fund-raising stamps, also called semipostals, since 1998. These stamps are sold at a higher price than First-Class stamps, with the difference going to federal agencies for specific causes. The proceeds from the three stamps address breast cancer research, assistance to families of emergency personnel killed or permanently disabled in the terrorist attacks of September 11, and domestic violence. The law authorizing the Breast Cancer Research stamp directed GAO to report on the fund-raising results. To provide additional information to the Congress, GAO expanded the study to include all three semipostals. GAO's study addressed (1) the amounts raised and the factors affecting sales, (2) how the designated agencies used the proceeds and reported the results, and (3) lessons learned for the Postal Service, agencies receiving the proceeds, and others. Over $56 million has been raised through semipostal sales as of June 2005, and sales were likely affected by several key factors. Individually, proceeds totaled $44 million for the Breast Cancer Research stamp, over $10.5 million for the Heroes of 2001 stamp, and nearly $2 million for the Stop Family Violence stamp. Sales patterns and levels differed greatly, with four key factors affecting sales patterns: (1) fund-raising cause, (2) support of advocacy groups, (3) stamp design, and (4) promotion by the Postal Service. The designated federal agencies currently award or plan to award grants with the proceeds; none of the agencies has reported specifically on results. Breast Cancer Research stamp proceeds have been used to award research grants by the National Institutes of Health and the Department of Defense. No grants have yet been awarded with the proceeds from the two other semipostals. The Federal Emergency Management Agency plans to distribute Heroes of 2001 stamp proceeds through grants to families of emergency personnel killed or permanently disabled from the September 11 attacks, while the Department of Health and Human Services plans to use Stop Family Violence stamp proceeds for grants to organizations for projects aimed at enhancing services to children exposed to domestic violence. Key lessons that have emerged from the three semipostals: (1) the nature of the charitable cause can greatly affect sales patterns and other results. A disaster, for example, is more likely to have a brief but intense response, while an ongoing health issue will have a longer one; (2) early and continued involvement of advocacy groups helps sustain semipostal support; (3) stamp design, promotion, and clear understanding about how proceeds will be used can greatly affect consumers' response; (4) semipostals generate proceeds immediately, but the logistics of using the moneys raised takes much longer, and (5) reporting can enhance accountability. Congress included a reporting requirement in the Semipostal Authorization Act of 2000, but these three semipostals are not subject to that requirement.