Federal Autism Activities:

Better Data and More Coordination Needed to Help Avoid the Potential for Unnecessary Duplication

GAO-14-16: Published: Nov 20, 2013. Publicly Released: Nov 20, 2013.

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Marcia G. Crosse
(202) 512-7114
crossem@gao.gov

 

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What GAO Found

Eighty-four percent of the autism research projects funded by federal agencies had the potential to be duplicative. Of the 1,206 autism research projects funded by federal agencies from fiscal years 2008 through 2012, 1,018 projects were potentially duplicative because the projects were categorized to the same objectives in the Interagency Autism Coordinating Committee's (IACC) strategic plan. Funding similar research on the same topic is sometimes appropriate--for example, for purposes of replicating or corroborating results--but in some instances, funding similar research may lead to unnecessary duplication. The potentially duplicative research projects included those funded by the Department of Defense (DOD), Department of Education (Education), National Science Foundation (NSF), and agencies within the Department of Health and Human Services (HHS)--Administration for Children and Families, Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services, Health Resources and Services Administration, National Institutes of Health (NIH), and the Substance Abuse and Mental Health Services Administration. Each agency funded at least 1 autism research project in the same strategic plan objective as another agency. For example, 5 agencies awarded approximately $15.2 million for 20 autism research projects related to 1 objective to test methods to improve dissemination, implementation, and sustainability of evidence-based interventions, services, and supports in diverse community settings.

The IACC's and federal agencies' efforts to coordinate and monitor federal autism activities were limited. The IACC--composed of federal and nonfederal members--met regularly and issued several reports, such as a strategic plan and portfolio analysis--a report that provides information on autism research projects, organized by the strategic plan objectives. The IACC has also released a companion database to its portfolio analysis. However, IACC members provided mixed views on the usefulness of the IACC's meetings, strategic plan, and portfolio analysis in aiding coordination and monitoring. While three agencies--CDC, DOD, and NIH--regularly used the committee's strategic plan and portfolio analysis, others did not. Shortcomings in the data the IACC used for its portfolio analysis limited its ability to coordinate HHS autism activities and monitor federal autism activities--as required by the Combating Autism Act of 2006 (CAA). For example, GAO found that the data used by the IACC was outdated, not tracked over time, inconsistent, and incomplete. These weaknesses limited the IACC's ability to monitor its progress on its coordination and monitoring efforts--which, in prior work, GAO established as a best practice for inter-agency collaboration, as well as a federal internal control standard. In addition, these weaknesses limited agencies' ability to use these data to identify coordination opportunities and avoid the potential for unnecessary duplication. Such information is important because of the involvement of multiple agencies. Lastly, apart from their participation on the IACC, there were limited instances of agencies coordinating, and agencies did not have robust or routine procedures for monitoring federal autism activities. Per federal internal control standards, agencies should establish a means of communicating with other agencies; this is important to maximize the efficiency of the federal autism investment and minimize the potential for unnecessary duplication.

Why GAO Did This Study

Autism—a developmental disorder involving communication and social impairment—is an important public health concern. From fiscal years 2008 through 2012, 12 federal agencies awarded at least $1.4 billion to support autism research and other autism-related activities. The CAA directed the IACC to coordinate HHS autism activities and monitor all federal autism activities. It also required the IACC to develop and annually update a strategic plan for autism research. This plan is organized into 7 research areas that contain specific objectives.

GAO was asked to examine federal autism efforts. In this report, GAO (1) analyzes the extent to which federal agencies fund potentially duplicative autism research, and (2) assesses the extent to which IACC and agencies coordinate and monitor federal autism activities. GAO analyzed agencies’ data and documents, and interviewed federal agency officials and select nonfederal IACC members.

What GAO Recommends

GAO is recommending that (1) HHS improve the usefulness of IACC data to enhance coordination and monitoring of federal autism activities, and (2) DOD, Education, HHS, and NSF improve their coordination of autism research. HHS disagreed with the first recommendation stating that it was already making adequate efforts. The agencies supported the need for improved coordination but, except for DOD, disputed that any duplication occurs. GAO continues to believe the recommendations are warranted as discussed in the report.

For more information, contact Marcia Crosse at (202) 512-7114 or crossem@gao.gov.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To improve the usefulness of IACC data and enhance its efforts to coordinate HHS autism activities and monitor all federally funded autism activities, the Secretary of Health and Human Services should direct the IACC and NIH, in support of the IACC, to provide consistent guidance to federal agencies when collecting data for the portfolio analysis and web tool so that information can be more easily and accurately compared over multiple years.

    Agency Affected: Department of Health and Human Services

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To improve the usefulness of IACC data and enhance its efforts to coordinate HHS autism activities and monitor all federally funded autism activities, the Secretary of Health and Human Services should direct the IACC and NIH, in support of the IACC, to create a document or database that provides information on non-research autism-related activities funded by the federal government and make this document or database publicly available.

    Agency Affected: Department of Health and Human Services

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To improve the usefulness of IACC data and enhance its efforts to coordinate HHS autism activities and monitor all federally funded autism activities, the Secretary of Health and Human Services should direct the IACC and NIH, in support of the IACC, to identify projects through its monitoring of federal autism activities--including Office of Autism Research Coordination's annual collection of data for the portfolio analysis and the IACC's annual process to update the strategic plan--that may result in unnecessary duplication and thus may be candidates for consolidation or elimination, and identify potential coordination opportunities among agencies.

    Agency Affected: Department of Health and Human Services

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To promote better coordination among federal agencies that fund autism research and avoid the potential for unnecessary duplication before research projects are funded, the Secretary of Health and Human Services, the Secretary of Defense, the Secretary of Education, and the Director of NSF should each determine methods for identifying and monitoring the autism research conducted by other agencies, including by taking full advantage of monitoring data the IACC develops and makes available.

    Agency Affected: Department of Health and Human Services

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To promote better coordination among federal agencies that fund autism research and avoid the potential for unnecessary duplication before research projects are funded, the Secretary of Health and Human Services, the Secretary of Defense, the Secretary of Education, and the Director of NSF should each determine methods for identifying and monitoring the autism research conducted by other agencies, including by taking full advantage of monitoring data the IACC develops and makes available.

    Agency Affected: National Science Foundation

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To promote better coordination among federal agencies that fund autism research and avoid the potential for unnecessary duplication before research projects are funded, the Secretary of Health and Human Services, the Secretary of Defense, the Secretary of Education, and the Director of NSF should each determine methods for identifying and monitoring the autism research conducted by other agencies, including by taking full advantage of monitoring data the IACC develops and makes available.

    Agency Affected: Department of Education

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: To promote better coordination among federal agencies that fund autism research and avoid the potential for unnecessary duplication before research projects are funded, the Secretary of Health and Human Services, the Secretary of Defense, the Secretary of Education, and the Director of NSF should each determine methods for identifying and monitoring the autism research conducted by other agencies, including by taking full advantage of monitoring data the IACC develops and makes available.

    Agency Affected: Department of Defense

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

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