Sustained and Coordinated Efforts Could Facilitate Data Sharing While Protecting Privacy
GAO-13-106: Published: Feb 8, 2013. Publicly Released: Feb 21, 2013.
What GAO Found
Four selected states or localities used systematic and automated data sharing to improve eligibility verification or case management processes. Such data sharing improved eligibility verification processes in Michigan and Utah. Specifically, program officials said that data sharing improved program integrity because more accurate payments were made, and staff noted program efficiencies through more automated and consolidated systems. In terms of case management, officials from New York City and Allegheny County, Pennsylvania said that data sharing helped caseworkers obtain client information more quickly and make more informed decisions. For instance, child welfare workers used client data from other agencies to quickly obtain background information on other household members when child maltreatment was reported or to locate potential caregivers when needed. Officials cited various factors contributing to the success of their initiatives, with strong leadership as the most commonly cited.
The stakeholders GAO surveyed identified a number of challenges to increased data sharing related to the interpretation of federal privacy requirements. These included confusion or misperceptions around what agencies are allowed to share, as well as a tendency to be risk averse and overly cautious in their interpretation of federal privacy requirements. For example, stakeholders said an agency's legal counsel may advise against sharing data as a precautionary measure rather than because of an explicit prohibition. Stakeholders also reported that potential inconsistencies in federal privacy requirements that apply to data sharing across multiple programs are a challenge. In particular, they, along with some officials at the sites GAO visited, noted that child welfare workers have difficulty meeting a federal obligation to monitor and support foster care children's educational stability and performance because of the federal law limiting access to education records without parental consent. An amendment enacted on January 14, 2013, includes provisions to address this issue.
To address identified challenges, stakeholders suggested that federal agencies could clarify federal privacy requirements and consider harmonizing requirements. Nearly all stakeholders GAO surveyed said that coordinated, multi-agency guidance that clarifies what data sharing is permissible would be extremely useful. They also suggested that developing model data sharing agreements and informed consent language that comply with federal privacy requirements, or providing existing examples, would be useful. Stakeholders also said it would be highly useful to reexamine requirements to ensure more consistent privacy rules for data sharing across human services programs and agencies. Federal agencies have some related efforts under way. For example, the Department of Health and Human Services (HHS) is preparing a "toolkit"--currently under internal review--that is expected to describe privacy rules among several programs as well as typical data sharing activities, although specific plans for its completion, dissemination, and follow-up have not been established. Also, the Office of Management and Budget (OMB) issued a 2010 memorandum to federal agencies that encouraged sharing data while protecting privacy, and has efforts under way to promote data sharing generally. However, officials said OMB has no plans to undertake specific actions related to privacy requirements, such as identifying model data sharing agreements or other tools, citing resource constraints, although they acknowledged the usefulness of such tools.
Why GAO Did This Study
State and local human services agencies administer funds from various federal programs to help those in need --many of whom are served by multiple programs. Data sharing across programs can improve administrative efficiencies and client service; however, some agencies are concerned about how to share more data while maintaining client privacy. GAO was asked to review issues related to data sharing. This report examines (1) how selected states or localities have shared data across programs to improve the administration of human services, (2) challenges state and local human services agencies face in balancing privacy protections with greater data sharing, and (3) actions that the federal government could take to help address these challenges. GAO reviewed relevant federal laws, regulations, and policies, interviewed federal officials, conducted site visits with state or local human services agencies in four selected states, and surveyed 40 stakeholders from the public, private, and non-profit sectors to identify challenges and possible federal actions.
What GAO Recommends
GAO recommends that HHS ensure timely completion of its current work to clarify privacy requirements across programs, and OMB consider additional ways to disseminate useful data sharing practices and tools that address privacy requirements. HHS agreed with our recommendation. OMB stated in its technical comments that it already had ongoing efforts to promote data sharing. GAO continues to believe that OMB should do more in this area to specifically address privacy issues within existing resources.
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Recommendations for Executive Action
Status: Closed - Implemented
Comments: In August 2014, HHS published its Confidentiality Toolkit on its Interoperability Initiative website. In a preface, HHS noted that the toolkit aims to support state and local efforts by bringing greater clarity to the rules governing confidentiality in certain human services programs, by providing examples of how confidentiality requirements can be addressed and met in a manner fully consistent with governing laws and underlying policies; by including sample Memoranda of Understanding and data sharing agreements; and by providing guidance that HHS hopes can be helpful in efforts to move forward to states and localities. HHS acknowledged that the toolkit does not address all programs and potential issues, and welcomed suggestions for additional guidance and actions that can further support state and local efforts.
Recommendation: To ensure that state and local human services agencies have additional information to help facilitate useful data sharing, the Secretary of HHS should ensure timely completion of the department's planned activities to clarify what data sharing is permissible under federal privacy requirements and consider other ways to bolster the efficacy of its efforts. For example, HHS could develop a strategy for the effective dissemination of its Confidentiality Toolkit and consider ways to solicit and incorporate feedback on the information's usefulness from a range of users.
Agency Affected: Department of Health and Human Services
Comments: In its technical comments to the draft report, OMB noted that it had already taken some steps to encourage data sharing while protecting privacy. In the final report, we clarified some information and the recommendation to OMB to emphasize that such encouragement would be more effective if accompanied by the dissemination of concrete tools, such as model data sharing agreements, that ultimately could be leveraged by state and local agencies. OMB has not provided an update on any actions it has taken or plans to take related to the revised recommendation.
Recommendation: To follow through on its efforts to improve the delivery of federal assistance programs and to help federal agencies promote useful data sharing activities that comply with federal privacy requirements, the Director of OMB should take a more active leadership role in considering additional opportunities to identify and disseminate useful data sharing practices and tools that address privacy requirements among human services programs. For example, OMB could leverage the Collaborative Forum's existing network of federal, state, and local agencies and other stakeholder organizations to collect and disseminate useful information, such as model data sharing agreements that comply with federal privacy requirements.
Agency Affected: Executive Office of the President: Office of Management and Budget