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entitled 'Energy Employees Compensation: Adjustments Made to Contracted
Review Process, But Additional Oversight and Planning Would Aid the
Advisory Board in Meeting Its Statutory Responsibilities' which was
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Report to the Chairman, Committee on the Judiciary, House of
Representatives:
United States Government Accountability Office:
GAO:
February 2006:
Energy Employees Compensation:
Adjustments Made to Contracted Review Process, But Additional Oversight
and Planning Would Aid the Advisory Board in Meeting Its Statutory
Responsibilities:
GAO-06-177:
Contents:
Letter:
Summary of Findings:
Conclusions:
Recommendations for Executive Action:
Agency and Other Comments and Our Evaluation:
Appendix I: Briefing Slides:
Appendix II: Comments from the Department of Health & Human Services:
Appendix III: Comments from S. Cohen & Associates:
Appendix IV: GAO Contact and Staff Acknowledgments:
Related GAO Products:
Abbreviations:
CDC: Centers for Disease Control and Prevention:
EEOICPA: Energy Employees Occupational Illness Compensation Program
Act:
FACA: Federal Advisory Committee Act:
HHS: Department of Health and Human Services:
NIOSH: National Institute for Occupational Safety and Health:
OCAS: Office of Compensation Analysis and Support:
ORAU: Oak Ridge Associated Universities:
PGO: Procurement and Grants Office:
SC&A: Sanford Cohen & Associates:
United States Government Accountability Office:
Washington, DC 20548:
February 10, 2006:
The Honorable F. James Sensenbrenner, Jr.:
Chairman:
Committee on the Judiciary:
House of Representatives:
Dear Mr. Chairman:
For the last several decades, the Department of Energy and its
predecessor agencies and contractors have employed thousands of
individuals in secret and dangerous work in the atomic weapons
industry. In 2000, Congress enacted the Energy Employees Occupational
Illness Compensation Program Act to compensate those individuals who
have developed cancer or other specified diseases related to on-the-job
exposure to radiation and other hazards at these work sites. Under
Subtitle B, determining the eligibility of claimants for compensation
is a complex process, involving several federal agencies and a
reconstruction of the historical evidence available. The Department of
Labor must consider a claimant's case based on records of his or her
employment and work activities, which are provided by the Department of
Energy. Labor considers the compensability of certain claims by relying
on estimates of the likely radiation levels to which particular workers
were exposed. These "dose reconstructions" are developed by the
National Institute for Occupational Safety and Health (NIOSH) under the
Department of Health and Human Services (HHS). NIOSH also compiles
information in "site profiles" about the radiation protection practices
and hazardous materials used at various plants and facilities, which
helps complete the dose reconstructions. Because certain facilities are
known to have exposed employees to radiation while keeping few records
of individuals' exposure, their employees have been designated under
the law as members of a "special exposure cohort," and their claims may
be paid without individual dose reconstructions. The law also allows
the Secretary of HHS to add additional groups of employees to the
special exposure cohort.
For quality control and to raise public confidence in the fairness of
the claims process, the compensation act also created a citizen's
advisory board of scientists, physicians, and employee representatives-
-the President's Advisory Board on Radiation and Worker Health. Members
of the board serve part-time and the board has limited staff support.
The advisory board is tasked to review the scientific validity and
quality of NIOSH's dose reconstructions and advise the Secretary of
HHS. The board has the flexibility to determine the scope and
methodology for this review. In addition, the advisory board is tasked
with reviewing NIOSH's evaluation of petitions for special exposure
cohort status and recommending whether such status should be granted.
To facilitate the advisory board's review, HHS awarded a 5-year $3
million contract to Sanford Cohen & Associates (SC&A) in October 2003
to perform a variety of tasks, such as examining selected site profiles
and a sample of dose reconstructions. The contract awarded was an
indefinite-delivery, indefinite-quantity type of contract, which
establishes the basic terms of the contract but then allows the
advisory board to develop specific task orders requiring the contractor
to complete certain tasks within specified time frames and budgets.
SC&A is to be reimbursed for its costs and receive an additional fixed
fee. However, this effort has been marked by delays and higher than
originally anticipated costs and some concerns over the roles of the
federal officials assigned by the Secretary of HHS to oversee this
work. Because citizen advisory bodies do not have direct authority to
spend federal monies, the government is responsible for awarding and
managing support contracts. Insofar as the charge of the advisory board
has been not merely to advise but to review the scientific validity and
quality of NIOSH's work, there could potentially be a conflict of roles
for agency officials responsible for the program under review if they
also oversee the contract work or assist the advisory board. In
addition, there are congressional concerns about whether the advisory
board is using the contractor's expertise as the board evaluates
special exposure cohort petitions.
There is another contractor--Oak Ridge Associated Universities (ORAU)-
-that also plays an important role in the Energy Employees Occupational
Illness Compensation Program. In September 2002, NIOSH awarded a 5-year
contract to ORAU to support NIOSH in performing its responsibilities
related to the program, such as developing site profiles and performing
dose reconstructions. About $70 million was originally allocated to
this contract, but this figure had increased to over $200 million by
2004.
We assessed how well the advisory board's review and the contracted
work with SC&A are proceeding. We focused on three questions: (1) Are
the roles of key federal officials involved in the review of NIOSH's
dose reconstructions sufficiently independent to assure the objectivity
of the review? (2) Have the agency's management controls and the
advisory board's oversight been sufficient to ensure that the contract
to review site profiles and dose reconstructions is adequately carried
out? and (3) Is the advisory board using the contractor's expertise in
reviewing special exposure cohort petitions?
To perform our review, we analyzed pertinent contract-related
materials, including the contract; monthly progress reports submitted
by the contractor; minutes of advisory board meetings; special exposure
cohort regulations; and correspondence between the contractor, agency,
and advisory board. In addition, we interviewed agency officials,
contractor officials, and advisory board members, and also attended
meetings of the advisory board. The scope of our work did not include
examining NIOSH's contract with ORAU. We conducted our review from
March 2005 to November 2005 in accordance with generally accepted
government auditing standards. On December 13, 2005, we briefed your
office on the results of our work (see app. I). This report conveys the
information provided at that briefing, as updated to reflect changes we
made in response to comments received on a draft of this report.
Summary of Findings:
The roles of certain key federal officials initially involved in the
advisory board's review of the dose reconstructions may not have been
sufficiently independent and actions were taken to replace these
officials. Nonetheless, continued diligence by HHS is required to
prevent such problems from recurring as new candidates are considered
for these roles. Initially, the project officer assigned responsibility
for reviewing the monthly progress reports and monitoring the technical
performance of the contractor was also a manager of the NIOSH dose
reconstruction program being reviewed. In addition, the designated
federal officer for the advisory board, who is responsible for
scheduling and attending board meetings, was the director of the dose
reconstruction program being reviewed. In response to concerns about
the appearance of conflicting roles, the director of NIOSH replaced
both of these officials in December 2004 with a senior NIOSH official
not involved in the NIOSH program under review. The contractor and
members of the board told us that implementation of the contract
improved after these replacements were made. With regard to structural
independence, we found it appropriate that the contracting officers,
who are responsible for managing the contract on behalf of the advisory
board, have been federal officials with the Centers for Disease Control
and Prevention (CDC), NIOSH's parent agency. The contracting officers
do not have responsibilities for the NIOSH program under review and are
not accountable to its managers. Members of the advisory board helped
facilitate the independence of the contractor's work by playing the
leading role in developing and approving the initial statement of work
for the contractor and the independent cost estimate for the contract.
The progress of the contracted review of NIOSH's site profiles and dose
reconstructions has been hindered by the complexity of the work.
Specifically, in the first 2 years, the contractor spent almost 90
percent of the $3 million that had been allocated to the contract for a
5-year undertaking. Various adjustments have been made in the review
approach in light of the identified complexities, which were not
initially understood. However, further improvements could be made in
the oversight and planning of the review process. First, the
contractor's expenditure levels were not adequately monitored by the
agency in the initial months and the contractor's monthly progress
reports did not provide sufficient details on the level of work
completed compared to funds expended. The monthly report for each
individual task order was subsequently revised to provide more details
but developing more integrated data across the various tasks could
further improve the board's ability to track the progress of the
overall review. Second, while the advisory board has made mid-course
adjustments to the contractor's task orders and review procedures, the
board has not comprehensively reexamined its long-term plan for the
overall project. The board revised the task orders for the contractor
several times, in part to reflect adjustments made as the board gained
a deeper understanding of the needs of the project. Nonetheless, the
board has not reexamined its original plan for the total number of site
profile and dose reconstruction reviews needed, and the time frames and
funding levels for completing them. Third, there is still a gap with
regard to management controls for the resolution of the findings and
recommendations that emerge from SC&A's review. The advisory board
developed a six-step resolution process to help resolve technical
issues between the contractor and NIOSH, and this process uses matrices
to track the findings and recommendations of the contractor and
advisory board. However, NIOSH currently lacks a system for documenting
that changes it agrees to make as part of this resolution process are
implemented.
With regard to reviewing special exposure cohort petitions, the
advisory board has asked for and received the contractor's assistance,
expanded its charge, and acknowledged the need for the board to review
the petitions in a timely manner. The board has reviewed eight
petitions as of October 2005, and the contractor assisted with six of
these by reviewing the site profiles associated with the facilities.
The contractor will play an expanded role by reviewing some of the
other submitted petitions and NIOSH's evaluation of those petitions and
recommending to the advisory board whether the petitioning group should
be added to the special exposure cohort. The contractor will also
develop procedures for the advisory board to use when reviewing
petitions. While NIOSH is generally required by law to complete its
review of a petition within 180 days of determining that the petition
has met certain initial qualification requirements, the advisory board
has no specified deadline for its review of petitions. However, the
board has discussed the fact that special exposure cohort petition
reviews have required more time and effort than originally estimated
and that the advisory board needs to manage its workload in order to
reach timely decisions.
Conclusions:
Credibility is essential to the work of the advisory board and the
contractor, and actions were taken in response to initial concerns
about the independence of federal officials in certain key roles.
Nonetheless, it is important for HHS to continue to be diligent in
avoiding actual or perceived conflicts of roles as new candidates are
considered for these roles over the life of the advisory board.
The advisory board's review of site profiles and dose reconstructions
has presented a steep learning curve for the various parties involved.
These experiences have prompted the board to make various adjustments
to the contractor's work that are intended to better meet the needs of
the review, such as the establishment of a formal six-step resolution
process that increases transparency. Nonetheless, further improvements
could be made to the oversight and planning of the contracted review.
Even though the advisory board has made numerous midcourse adjustments
to the work of the contractor, the board has not comprehensively
reexamined its long-term plan for the project to determine whether the
plan needs to be modified in light of the knowledge gained over the
past few years. In addition, while the contractor's monthly reports
were modified to provide more detailed expenditure data, the lack of
integrated and comprehensive data across the various tasks makes it
more difficult for the advisory board to track the progress of the
overall review or make adjustments to funding or deliverables across
tasks. Finally, without a system to track the actions taken by NIOSH in
response to the findings and recommendations of the advisory board and
contractor, there is no assurance that any needed improvements are
being made.
Recommendations for Executive Action:
We are making three recommendations to the Secretary of HHS.
To assist the advisory board meet its statutory responsibilities, we
recommend that the Secretary of HHS:
(1) direct the contracting and project officers to develop and share
with the advisory board more integrated and comprehensive data on
contractor spending levels compared to work completed and:
(2) consider the need for providing HHS staff to collect and analyze
pertinent information that would help the advisory board
comprehensively reexamine its long-term plan for assessing the NIOSH
site profiles and dose reconstructions.
To ensure that the findings and recommendations of the advisory board
and the contractor are promptly resolved, we recommend that the
Secretary of HHS direct the Director of NIOSH to establish a system to
track the actions taken by the agency in response to these findings and
recommendations and update the advisory board periodically on the
status of such actions.
Agency and Other Comments and Our Evaluation:
We provided a draft of this report to HHS, the contractor, and all the
members of the advisory board for comment. We received comments from
HHS, the contractor, and four individual members of the advisory board.
The comments from the four members of the board represent the views of
these individuals and not an official position of the advisory board.
HHS agreed with GAO's recommendations to provide more integrated and
comprehensive data to the advisory board and said that it will consider
the need to provide staff to help the advisory board reexamine its
overall plan for assessing NIOSH site profiles and dose
reconstructions. With regard to the third recommendation, HHS stated
that a system is already in place to track actions taken by the agency
in response to advisory board recommendations in letters from the board
to the Secretary of HHS. HHS added that matrices used in conjunction
with the six-step resolution process outline the contractor's concerns,
NIOSH's response, and the actions to be taken. However, we believe that
these matrices do not provide sufficient closure with regard to
tracking the actions NIOSH has actually implemented in response to
advisory board and contractor findings and recommendations. For
example, in some of the matrices, the advisory board has made numerous
recommendations that NIOSH perform certain actions to resolve various
issues, but there is no system in place to provide assurance that these
actions have in fact been taken. Thus, we continue to see a need for
this recommendation.
Some individual advisory board members who provided comments expressed
concerns about our recommendations, although differing in their
reasons. One individual board member expressed concern about the
recommendations to provide more integrated and comprehensive data to
the advisory board or to provide staff to help in reexamining the
overall review plan, suggesting that these changes might not be very
helpful. We still believe that these recommendations are necessary to
ensure that the advisory board has more complete information to better
oversee the review as well as a long-term plan for completing the
review; hence we did not revise the recommendation. Another individual
board member suggested that a system be established to track the
advisory board's recommendations rather than the contractor's
recommendations since it is these that should be of greater concern.
While GAO believes it is important to track the resolution of the
board's recommendations, it also important to track the resolution of
the contractor's recommendations, and we therefore revised the wording
of our recommendation to reflect this position.
HHS, the contractor, and individual advisory board members took issue
with statements in the report about the contractor being over budget
and behind schedule. While they agreed with GAO's assessment that the
review process got off to a slow start, they thought that the report
did not provide sufficient information about the various factors that
complicated or led to an expansion of work for the contractor, the
revisions to the contractor's task orders, and the performance of the
contractor with respect to the revised task orders. For example,
commenters pointed out that in some instances, the contractor had to
review a site profile more than once after NIOSH had revised the site
profile to include additional information. Commenters added that the
contractor's work also had to shift to accommodate changing priorities.
For instance, NIOSH's increased reliance on using the site profiles to
complete dose reconstructions prompted a shift in contractor priorities
to devote more time and resources to site profile reviews than
originally anticipated. The commenters added that since the task orders
were revised, the contractor has been meeting the time frames and
budgets specified in the task orders. We therefore revised the report
to incorporate additional information on factors that complicated or
led to an expansion in the work of the contractor, the revisions that
were made to the task orders, and the contractor's progress in meeting
the terms of the revised task orders.
HHS, the contractor, and some of the individual members of the advisory
board maintained that the advisory board has taken actions to reexamine
and adjust its strategy for reviewing site profiles and dose
reconstruction cases. For instance, HHS stated that during the advisory
board's meetings in 2005, the board regularly discussed the future of
contract activities and altered the review schedule and scope of work
several times. For example, the contractor was asked to perform site
profile reviews for sites not originally anticipated in order to
facilitate the advisory board's review of related special exposure
cohort petitions. Other commenters pointed out the board's development
of a six-step resolution process for use by NIOSH and the contractor to
resolve differences on technical issues. We revised the report to more
fully reflect actions taken by the advisory board to reexamine and
adjust its strategy for the review. We also changed the report title to
reflect changes made in the report in this regard. However, we continue
to see a need for the advisory board to build on its actions by
comprehensively reexamining whether its original long-term plan for the
overall project is still appropriate.
Several individual advisory board members commented that they remain
concerned about the independence of the board and its contractor.
Although acknowledging that replacement of the original officials
appointed as the designated federal officer and project officer has
helped reduce possible challenges to independence, the members pointed
out that NIOSH officials remain involved in managing the contract and
could still potentially influence the work of the contractor. These
individual board members also emphasized that the board has no
independent budgetary authority and that it relies on NIOSH to obtain
funding. Our review suggests that the contractor has been able to
demonstrate its independence during the review. For instance, our
report notes that the contractor's reports have criticized numerous
aspects of NIOSH site profiles and dose reconstructions. Further,
contractor officials told us that they believe relations with NIOSH are
thoroughly professional and board members told us that they are
satisfied with the information provided by the contractor. We
acknowledge that the potential for impairment of the contractor's
efforts remains. In fact, our draft report concluded that there is a
need for continued diligence in avoiding actual or perceived conflicts
of roles as new candidates are considered for certain positions over
the life of the advisory board. We have further highlighted this point
in the final report.
HHS's comments are provided in appendix II, and the contractor's
comments are provided in appendix III. HHS, the contractor, and
individual board members also provided technical comments, which we
have incorporated as appropriate.
As arranged with your office, unless you publicly announce its contents
earlier, we plan no further distribution of this report until 30 days
from the issue date. At that time, we will send copies of this report
to the Secretary of Health and Human Services, interested congressional
committees, and other interested parties. We are also sending copies to
the Chair and members of the advisory board. We will make copies
available to others upon request. In addition, the report will be
available at no charge on GAO's Web site at http://www.gao.gov.
If you have any questions about this report, please contact me at (202)
512-7215. Contact points for our Offices of Congressional Relations and
Public Affairs may be found on the last page of this report. GAO staff
that made major contributions to this report are listed in appendix
III.
Sincerely yours,
Signed by:
Robert E. Robertson:
Director, Education, Workforce, and Income Security Issues:
[End of section]
Appendix I: Briefing Slides:
Energy Employees Compensation: Adjustments Made to Contracted Review
Process, But Additional Oversight and Planning Would Aid the Advisory
Board in Meeting Its Statutory Responsibilities:
Briefing for Staff of Congressman F. James Sensenbrenner, Jr.:
Chairman, House Committee on the Judiciary:
December 13, 2005:
Introduction:
For the last several decades, the Department of Energy and its
predecessor agencies and contractors have employed thousands of
individuals in secret and dangerous work in the atomic weapons
industry.
The Energy Employees Occupational Illness Compensation Program Act
(EEOICPA) of 2000 compensates individuals who have developed cancer or
other specified diseases related to on-the-job exposure to radiation
and other hazards at these work sites.
Under Subtitle B, determining a claimant's eligibility for compensation
involves developing estimates of the likely radiation levels a worker
was exposed to based on information such as exposure records. These
estimates are referred to as "dose reconstructions" and are developed
by the National Institute for Occupational Safety and Health (NIOSH)
under the Department of Health and Human Services (HHS).
NIOSH also compiles information in "site profiles" about the radiation
protection practices and hazardous materials used at various plants and
facilities, which assist NIOSH in completing the dose reconstructions.
Employees at certain facilities were designated under the law as
members of a "special exposure cohort" because it was believed that
exposure records were insufficient and the reasonable likelihood was
that the workers' radiation exposure caused their cancers. Their claims
are paid without completing exposure estimates.
The law also allows the Secretary, HHS, to designate additional groups
of employees as members of the special exposure cohort.
For quality control and to raise public confidence in the fairness of
the claims process, EEOICPA created a citizen's advisory board of
scientists, physicians, and employee representatives-the President's
Advisory Board on Radiation and Worker Health (advisory board). Members
of board serve part-time, and the board has limited staff support.
The advisory board is tasked with reviewing the scientific validity and
quality of NIOSH's dose reconstructions and advising the Secretary of
HHS. The board has the flexibility to determine the scope and
methodology for this review. In addition, the advisory board is tasked
with reviewing NIOSH's evaluation of petitions for special exposure
cohort status and recommending whether such status should be granted.
To facilitate the advisory board's review, HHS awarded a 5-year, $3-
million contract to Sanford Cohen & Associates (SC&A) in October 2003
to examine a sample of dose reconstructions and particular site
profiles and to perform a variety of other tasks.
NIOSH awarded a 5-year contract to Oak Ridge Associated Universities to
assist NIOSH in developing site profiles and in performing dose
reconstructions. Originally, about $70 million was allocated to the
contract, but this figure had increased to over $200 million by 2004.
Key Questions:
We focused our work on three questions:
* Are the roles of key federal officials involved in the review of
NIOSH's dose reconstructions sufficiently independent to assure the
objectivity of the review?
* Have the agency's management controls and the advisory board's
oversight been sufficient to ensure that the contract to review site
profiles and dose reconstructions is adequately carried out?
* Is the advisory board using the contractor's expertise in reviewing
special exposure cohort petitions?
Scope and Methodology:
We reviewed pertinent contract-related materials and correspondence
among key officials and interviewed these officials to document their
roles. We used the broad principles specified in various criteria,
including those specified in the Federal Acquisition Regulation and
Government Auditing Standards, to assess the independence of key
officials' roles.
We analyzed the contract provisions, including the specific task orders
and monthly progress reports as well as the actions taken by officials
to manage the contract. We assessed whether the management controls
were adequate, considering criteria such as the Federal Acquisition
Regulation.
We analyzed the special exposure cohort regulations and advisory board
meeting minutes as well as interviewed key officials and attended
advisory board meetings, to determine the process the advisory board
has used and plans to use to evaluate petitions.
The scope of our work did not include examining the contract NIOSH
awarded to Oak Ridge Associated Universities.
We conducted this review from March 2005 through November 2005 in
accordance with generally accepted government auditing standards.
Summary of Findings:
The roles of certain key federal officials initially involved in the
review of dose reconstructions may not have been sufficiently
independent and these officials were replaced. However, continued
diligence by HHS is required to prevent such problems from recurring as
new candidates are considered for these roles.
The progress of the contracted review of site profiles and dose
reconstructions has been hindered, largely by the complexity of the
work. Some adjustments have been made, but further improvements could
be made to the oversight and planning of the review.
The advisory board is using the contractor's work in reviewing special
exposure cohort petitions and has acknowledged the need to review the
petitions in a timely manner.
Background:
Multiple Entities and Officials Involved in the Review of NIOSH's Dose
Reconstructions:
[See PDF for image]
[End of figure]
Roles of HHS and CDC:
HHS:
The Secretary of HHS has overall responsibility for the advisory board,
as delegated by the President, and is tasked by executive order with
providing administrative services, funds, facilities, staff, and other
necessary support services to assist the advisory board in carrying out
its responsibilities.
CDC:
NIOSH's parent agency awarded the contract on behalf of the advisory
board.
A CDC Procurement and Grants Office (PGO) official serves as the
contracting officer.
* The contracting officer is responsible for administering and
providing management of the contract on the advisory board's behalf.
This includes reviewing the monthly progress reports and paying the
contractor for its approved costs.
Role of NIOSH:
NIOSH:
The Office of Compensation Analysis and Support (OCAS) is responsible
for preparing the site profiles and completing the dose
reconstructions.
NIOSH officials serve as the project officer for the contract and the
designated federal officer for the advisory board.
* The project officer is responsible for reviewing the monthly progress
reports and monitoring the technical performance of the contractor.
* The designated federal officer schedules and attends meetings of the
advisory board.
Roles of Advisory Board and Contractor:
Advisory Board:
* Required to (1) review the scientific validity and quality of NIOSH's
dose reconstructions and (2) review NIOSH's evaluation of special
exposure cohort petitions and recommend whether such status should be
granted.
* Operates under Federal Advisory Committee Act (FACA) requirements
such as conducting its meetings in public.
Contractor - SC&A:
Under contract, assists the advisory board in meeting its statutory
responsibilities by reviewing a sample of dose reconstructions and
their associated site profiles and providing assistance with special
exposure cohort petitions.
Provides monthly progress reviews to the contracting officer, project
officer, and advisory board.
Contract Initiated in October 2003 for 5 years and $3 Million Maximum:
Task Orders for contractor now include:
Dose Reconstructions:
* Task 1: Review selected NIOSH-developed site profiles.
* Task 2: Develop automated system to track NIOSH dose reconstruction
cases.
* Task 3: Review NIOSH dose reconstruction procedures.
* Task 4: Review a sample of NIOSH dose reconstruction cases.
Special Exposure Cohort Petitions:
* Review NIOSH's special exposure cohort petition procedures and
individual petitions.
Other:
* Provide administrative (logistical) support to advisory board
(monthly progress reports, attendance at advisory board meetings, etc.)
Finding 1:
Two Federal Officials Were Replaced to Protect Independence of Review:
Two officials were replaced by the Director of NIOSH because of
concerns about the appearance of conflicting roles:
* project officer:
* designated federal officer:
Initially, certain officials performing key roles did not appear to be
sufficiently independent of the review and actions were taken to
replace these officials. Advisory board members and the contractor have
said that the implementation of the contract has improved as a result.
Nonetheless, continued diligence is required to prevent such problems
from recurring as new candidates may be considered for these roles.
The contracting officer is a CDC employee whose organization is
independent of the NIOSH program under review.
Two Federal Officials Were Replaced:
Replacement of Project Officer:
In 2003-2004, the project officer also served as a NIOSH program
manager of the program under review.
In December, 2004, a senior NIOSH official, who does not have
responsibilities for the program under review, took over this role.
Replacement of Designated Federal Officer:
In 2002-2004, the designated federal officer also served as the NIOSH
director of the program under review.
In December 2004, a senior NIOSH official, who does not have
responsibilities for the program, took over this role.
Other Officials Are Independent of the Program under Review:
The contracting officers have been CDC officials in the Procurement and
Grants Office. They do not have responsibilities for the NIOSH program
under review and are not accountable to its managers.
Members of the advisory board played the leading role in developing and
approving the initial statement of work for the contractor and the
independent government cost estimate for the contract, actions which
helped facilitate the independence of the contractor's work.
Finding 2:
Adjustments Were Made to SC&A's Review But Further Improvements in
Oversight and Planning Could be Made:
The project officer did not adequately monitor contract spending
relative to overall project performance in the initial months. More
detailed expenditure data were subsequently provided to facilitate
monitoring but developing more comprehensive data would be useful.
While the advisory board has made various adjustments to the
contractor's task orders and work processes after the contractor
encountered initial difficulties, the board has not comprehensively
reexamined its long-term plan for the project.
Additionally, NIOSH lacks a process for documenting actions it has
taken in response to the contractor's findings that are reported to the
advisory board and the advisory board's recommendations to HHS.
Finding 2: Contract Monitoring:
CDC Did Not Adequately Monitor Contract Spending Compared to Work
Completed:
The contractor's expenditure levels were not adequately monitored in
the initial months.
Although the contractor's reports indicated that costs were higher than
anticipated, the project officer was caught by surprise in October 2004
when the contractor announced a need for work stoppage because
expenditures on a specific task order had approached budget ceilings.
The contracting officer noted that during this period the contractor's
reports did not reflect the actual percent of work completed, making it
very difficult to identify the actual cost of performance.
* Work was suspended on the site profile review task and a smaller task
for several days in November until additional funds were authorized.
Separate monthly progress reports are submitted for each task order.
However, there is no single comprehensive report on overall contract
performance, which could facilitate tracking the progress of the
overall review or making strategic adjustments where needed.
Finding 2: Initial Task Orders:
Initial Task Order Budgets and Schedules Proved Unrealistic:
Initial task orders called for the contractor to complete:
* 12 to 16 site profile reviews by February 2005 for $426,000;
* 60 dose reconstruction reviews by August 2004 for $467,000.
These tasks cost more or took longer to complete than originally
estimated.
At the end of January 2005, the contractor had completed 2 site profile
reviews and partially completed 2 others while spending $481,000.
The contractor completed the first 60 dose reconstruction reviews by
September 2005 while spending about $1.0 million. (According to SC&A,
the cost increase consisted of costs related to overall contract
management, not to increased dose reconstruction review costs.)
Overall, in the first 2 years, the contractor spent almost 90 percent
of the $3 million allocated for a 5-year undertaking.
Several Factors Hindered Contractor from Meeting Original Task Order
Goals and Budgets:
Complexity of work was much greater than originally anticipated.
* Both the contractor and NIOSH officials involved in the review
reported that reviews of site profiles and dose reconstructions have
proven considerably more complex than originally anticipated; thus the
original cost estimates for the project based on very limited
information and experience were not realistic.
Contractor encountered initial delays in obtaining information.
* The contractor's progress was initially hindered by substantial
delays it encountered in obtaining necessary security clearances and
access from NIOSH to various technical documents. These early
implementation issues have generally been resolved, according to the
contractor.
Finding 2: Task Order Revisions:
The Advisory Board Has Significantly Revised Major Task Orders during
First 2 Fiscal Years:
Site profile review task modified 5 times:
* Completion date extended from Feb. 2005 to Oct. 2005;
* Number of site reviews reduced from 12-16 to 9;
* Funding increased from $426,000 to $1.6 million.
Dose reconstruction review task modified 4 times:
* Completion date extended from Aug. 2004 to Dec. 2005;
* Number of reviews (60) remained constant;
* Funding increased from $467,000 to $1 million.
Contractor has met these revised task order requirements.
Task Order Revisions In Part Reflect Board's Changing Needs for
Contractor Support As Operations Matured:
Board shifted more contractor resources to site profile reviews in
response to NIOSH's increased reliance on site profiles.
* Site profiles were originally seen as one of numerous resources to be
used in developing dose reconstructions. However, as site profiles
became the primary resource used by NIOSH, the advisory board wanted
assurance that these site profiles were credible.
NIOSH revisions to site profiles required the contractor to complete
multiple reviews in some instances.
* For example, the contractor completed four reviews of the
Mallinckrodt site profile as a result of NIOSH's changes. NIOSH views
the site profiles as "living documents" that can be added to as new
information is identified or changes need to be made. In addition, as
NIOSH worked to complete many of the site profiles within an 18-month
time frame, many "loose ends" remained in the site profiles, according
to the contractor.
Board developed a six-step process for use by NIOSH and contractor to
resolve their differences of views on technical issues. This process
expanded the time and resources needed for reviews.
Unanticipated site profile reviews (e.g., Iowa Army Ammunition Plant)
were needed to facilitate the advisory board's review of special
exposure cohort petitions.
Finding 2: Next Steps for Board:
While the Advisory Board Has Authorized Contractor Work for Fiscal Year
2006...
Congress provided $4.5 million in fiscal year 2006 for use by, or in
support of, the advisory board.
The advisory board has authorized a new set of contractor reviews for
fiscal year 2006.
* An additional 6 site profile reviews, 60 dose reconstruction case
reviews, and 6 special exposure cohort petition reviews.
.. the Advisory Board Has Not Comprehensively Reassessed Its Long-Term
Plan for the Project:
Contract with SC&A included estimates of total work to be performed:
* 22 site profile reviews: 5 per year in each of the first 3 years, 4
in the fourth year, and 3 in the fifth year;
* 600 dose reconstruction reviews: 150 in each of the first 3 years,
100 cases the fourth year, and 50 the fifth year.
In August 2005, the designated federal officer pointed out that at the
current rate of progress, the original plan to review a total of 600
dose reconstructions would require about 10 years to complete.
But the advisory board has not comprehensively reexamined its original
long-term plan for the project to determine if it needs to be modified.
* Total number of site profile reviews needed?
* Total number of dose reconstruction case reviews needed?
* Time frames for completion and funding levels required?
Finding 2: Tracking Process NIOSH Lacks Processes to Track Actions
Taken in Response to Contractor's Findings and Board's Recommendations:
The contractor's reports have criticized various aspects of NIOSH's
site profiles and dose reconstructions, such as NIOSH's failure to
consider information provided by site experts in its site profiles and
certain assumptions NIOSH used to calculate dose reconstructions.
As part of the six-step resolution process, the contractor and NIOSH
develop matrices that specify NIOSH's response and any planned actions
for each of the contractor's findings and recommendations. In some
matrices, space is provided for the board to recommend that NIOSH take
certain actions to resolve issues.
However, there is no system in place to track NIOSH's implementation of
these actions or advisory board recommendations. Procedures for prompt
resolution and implementation of audit findings and other reviews
should be part of all federal agencies' internal controls.
Finding 3:
The Advisory Board Is Using the Contractor's Work in Reviewing Special
Exposure Cohort Petitions:
The advisory board is using the contractor's work in reviewing special
exposure cohort petitions.
A recent task order expands the contractor's role for this facet of the
board's work.
A potentially large increase in the board's petition review workload
did not occur because many petitions did not meet initial qualification
requirements.
The advisory board has acknowledged the need to review the petitions in
a timely manner.
Finding 3: Use of Contractor:
The Advisory Board Is Using the Contractor's Work in Reviewing
Petitions:
Advisory Board's Efforts as of October 31, 2005:
The advisory board has reviewed eight petitions representing five
sites.
* For six of these petitions, the contractor reviewed the site profiles
(though not the actual petitions associated with the named facilities).
* For the other two petitions, the advisory board did not request the
contractor's assistance.
Finding 3: Task Order:
Recent Task Order Expands the Contractor's Role in Reviewing Petitions:
Specifics of the Task Order include:
The contractor will review some of the submitted petitions and NIOSH's
evaluations of these petitions to recommend to the advisory board
whether the petitioning group should be added to the special exposure
cohort.
The contractor will also develop the procedures for the advisory board
to use when reviewing petitions.
Finding 3: Future Workload:
A Potentially Large Increase in the Board's Petition Review Workload
Did Not Occur:
Many petitions did not meet the initial qualification requirements and
thus did not need to be reviewed by the board.
* As of October 2005, NIOSH had determined that 18 of the submitted
petitions did not meet the qualification requirements.
The advisory board may have to review five to eight more petitions
filed as of October 2005:
* One petition is ready for the advisory board to review.
* NIOSH is completing its evaluation of four more petitions that will
be sent to the board for review.
* NIOSH is assessing three other petitions to determine if they meet
the qualification requirements.
Finding 3: Timeliness of Petition Reviews:
The Advisory Board Has Acknowledged the Need for Timely Review of
Petitions:
The number of new petitions that may be submitted and that may qualify
for evaluation is unknown.
While NIOSH is generally required by law to complete its review of a
petition within 180 days of the petition's being qualified, there is no
specified time frame for the advisory board's review of petitions.
Nonetheless, the advisory board has discussed the fact that special
exposure cohort petition reviews have required more time and effort to
reach a recommended decision than originally estimated and that the
advisory board needs to manage its workload in order to reach timely
decisions.
Conclusions:
Independence of Roles:
After concerns were raised about the independence of certain federal
officials performing key roles, actions were taken to replace these
officials.
Credibility is essential to the work of the advisory board and the
contractor. Thus, it is important to continue to be diligent in
avoiding actual or perceived conflicts of roles as new candidates are
considered for certain positions over the life of the advisory board.
Management and Oversight of the Review of Site Profiles and Dose
Reconstructions:
The advisory board's review has presented a steep learning curve for
the various parties involved. Despite some adjustments, further
improvements could be made:
* reassessing the long-term plan for the project;
* integrating data on contractor expenditures;
* tracking resolution of board and contractor findings and
recommendations.
Reassessing the long-term plan for the project:
The advisory board has made numerous midcourse adjustments to the work
of the contractor as operations have matured.
It would thus be appropriate for the advisory board to comprehensively
reexamine its long-term plan for the overall project to determine
whether this plan needs to be modified.
Integrated data on contractor expenditures:
Contractor's monthly reports were modified to provide more detailed
data for individual tasks on expenditures compared to work completed.
However, the lack of integrated and comprehensive data across the
various tasks makes it more difficult for the advisory board to track
the progress of the overall review or make strategic adjustments to
funding or deliverables across tasks.
Tracking resolution of findings and recommendations:
The advisory board developed a six-step resolution process that uses
matrices to track the findings and recommendations of the contractor
and board. However, without a system for documenting the actions NIOSH
has taken in response, there is no assurance that any needed
improvements are being made.
Recommendations:
To assist the advisory board meet its statutory responsibilities, we
recommend that the Secretary of HHS:
* direct the contracting and project officers to develop and share with
the advisory board more integrated and comprehensive data on
contractor's spending levels compared to work completed and:
* consider the need for providing HHS staff to collect and analyze
pertinent information that would help the advisory board
comprehensively reexamine its long-term plan for assessing the NIOSH
site profiles and dose reconstructions.
To ensure that the findings and recommendations of the advisory board
and the contractor are promptly resolved, we recommend that the
Secretary of HHS:
* direct the Director of NIOSH to establish a system to track the
actions taken by the agency in response to these findings and
recommendations and update the advisory board periodically on the
status of such actions.
[End of section]
Appendix II: Comments from the Department of Health & Human Services:
DEPARTMENT OF HEALTH & HUMAN SERVICES:
Office of Inspector General:
Washington DC 20201:
JAN 13 2006:
Mr. Robert E. Robertson:
Director, Education, Workforce, and Income Security Issues:
U.S. Government Accountability Office:
Washington, DC 20548:
Dear Mr. Robertson:
Enclosed are the Department's comments on the U.S. Government
Accountability Office's (GAO's) draft report entitled, "ENERGY
EMPLOYEES COMPENSATION: More Strategic Oversight Is Needed to Assist
Advisory Hoard in Meeting Its Statutory Responsibilities" (GAO-06-177).
These comments represent the tentative position of the Department and
are subject to reevaluation when the final version of this report is
received.
The Department appreciates the opportunity to comment on this draft
report before its publication.
Sincerely,
Signed by:
Daniel R. Levinson:
Inspector General:
Enclosure:
The Office of Inspector General (OIG) is transmitting the Department's
response to this draft report in our capacity as the Department's
designated focal point and coordinator for U.S. Government
Accountability Office reports. OIG has not conducted an independent
assessment of these comments and therefore expresses no opinion on
them.
COMMENTS OF THE. DEPARTMENT OF HEALTH AND HUMAN SERVICES ON THE U.S.
GOVERNMENT ACCOUNTABILITY OFFICE'S DRAFT REPORT ENTITLED. "ENERGY
EMPLOYEES COMPENSATION: MORE STRATEGIC OVERSIGHT IS NEEDED TO ASSIST
ADVISORY BOARD IN MEETING ITS STATUTORY RESPONSIBILITIES" (GAO-06-177):
General Comments:
The Department of Health and Human Services (HHS) appreciates the
opportunity to comment on the Government Accountability Office's (GAO)
draft report.
To address the recommendations for executive action as noted in the
draft, HHS will develop and share with the Advisory Board on Radiation
and Worker Health (the Board) more integrated and comprehensive data on
contractor spending levels compared to work completed. HHS also will
consider the need to provide HHS staff to collect and analyze pertinent
information that would help the Board reexamine its overall strategy
for assessing the Centers for Disease Control and Prevention's (CDC),
National Institute for Occupational Safety and Health (NIOSH) site
profiles and dose reconstructions.
Regarding the recommendation to have the Secretary of THIS direct CDC's
NIOSH Director to establish a system to track the actions taken by the
agency in response to findings and recommendations of the contractor,
an established system is in place to track recommendations of the
Board. Letters from the Board to the Secretary of HHS are entered into
a database system and responses and/or follow-up actions are noted in
the system. NIOSH will continue to track Board recommendation letters
to the Secretary of HHS using this system, and NIOSH also will continue
to post letters from the Board to the Secretary of HHS on the NIOSH
website.
As noted in the draft, a six-step process is in place to address
technical issues raised by the contractor. NIOSH currently utilizes a
matrix to outline the concerns of the contractor, the NIOSH response,
and the action to be taken. The matrix allows user-friendly tracking of
the status of each contractor recommendation, and NIOSH plans to
continue using the system, information from which is shared with the
advisory-board upon request.
[End of section]
Appendix III: Comments from S. Cohen & Associates:
S. Cohen & Associates:
January 3, 2006:
Mr. Andrew Sherrill:
Government Accountability Office:
441 G Street NW:
Room 5835:
Washington, DC 20548:
Re: Draft GAO Report, GAO-06-177:
Dear Mr. Sherrill:
In accordance with your e-mail request dated December 21, 2005,1 have
reviewed the Drag GAO Report, GAO-06-177, and respectfully offer below
my comments. A more detailed discussion of my comments and
recommendations is contained in the attachment to this letter.
1 am primarily concerned about the repeated statements made in the
draft report that SC&A is behind schedule and over budget in its work
for the Advisory Board. Although this may have been the case in the
early months of our work (the first Task Order was issued in February
2004), it is not correct for the work performed subsequent to the
"shutdown" (in November 2004), after which the work was reorganized,
and the project officer and designated Federal officer were replaced,
because of concerns about the appearance of conflict of interest. The
early work was behind schedule and over budget because the government's
"original cost estimates for the project were based on very limited
information and experience and were not realistic." The words in
quotation marks in the previous sentence, which are attributed to NIOSH
officials, come directly from the briefing slide on page 25 of your
draft report entitled, "The Project Has Had a Steep Learning Curve." On
that same page, you state that "reviews of site profiles and dose
reconstructions have been considerably mom complex than originally
anticipated," and that "addressing differences of views between the
contractor and NIOSH on numerous technical issues has required adding a
resolution process that has added substantial time to the project."
As amply discussed in the attachment, the reviews and audits were more
complex than originally envisioned, additional work was needed above
and beyond that envisioned in the original scope of work, and new and
time-consuming processes were added in order for the results of our
work to he useful to NTOSH and the Board.
Notwithstanding this recognition within the draft report that there are
valid reasons why our costs might have been in excess of the original
budget, the draft report continues to harp on SC&A's cost overruns and
schedule slippage (see the briefing slides on pages 26 and 27, entitled
"Consequently the Project is Over Budget and Behind Schedule" and "Site
Profile Reviews Have Fallen Behind While Expenditures Have More Than
Tripled," respectively). Why does GAO need to put a spotlight on costs
that initially exceeded an unrealistic budget, completely overlooking
the reorganization of the project after the shutdown in November 2004
with new scopes of work, budgets, and schedules (all of which have been
met). To make matters worse, the draft report incorrectly states that
the budget slippage and cost overruns are current ("Currently, the
contractor's work is behind schedule and over budget..." page 3 of the
Draft Report).
It is interesting to note that the issue of potential NIOSH conflict of
interest is treated in the draft report quite differently than the
issue of contractor performance. The draft report stales that initial
problems relating to potential NIOSH conflict of interest have been
resolved, and so it does not dwell on the early problems in this
respect. However, the draft report does not approach the issue of cost
overruns in the same manner, even though these were also resolved after
the shutdown in November 2004. Instead, the draft report makes it seem
like contractor performance is a current problem.
Please forgive me for the potentially zealous tone of my foregoing
objections to the treatment of SC&A's performance under the NIOSH
contract. You must recognize, however, that the excellence of our past
performance is our most valuable asset, and the inaccuracies and
misleading statements contained in the current draft of the report
could be very damaging to our reputation. It is not difficult to
correct these statements,. possibly by adding significantly more
context to the history of the contract performance. Although this might
result in a more tedious document, it would also be mom accurate in
describing what actually happened.
Thank you for providing me with the opportunity to comment on the Draft
GAO Report.
Most respectfully yours,
[Unintelligible signature]
Project Manager and Senior Vice President:
SC&A, Inc.
Attachment:
[End of section]
Appendix IV: GAO Contact and Staff Acknowledgments:
GAO Contact:
Robert E. Robertson, (202) 512-7215 or robertsonr@gao.gov:
Staff Acknowledgements:
Andy Sherrill, Assistant Director; Margaret Armen, Richard Burkard,
Susan Bernstein, Sandra Chefitz, Mary Nugent, and Robert Sampson made
significant contributions to this report.
[End of section]
Related GAO Products:
Energy Employees Compensation: Many Claims Have Been Processed, but
Action Is Needed to Expedite Processing of Claims Requiring Radiation
Exposure Estimates. GAO-04-958. Washington, D.C.: Sept. 10, 2004.
Energy Employees Compensation: Even with Needed Improvements in Case
Processing, Program Structure May Result in Inconsistent Benefit
Outcomes. GAO-04-516. Washington, D.C.: May 28, 2004.
[End of section]
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