Public Health Service:

Evaluation Set-Aside Has Not Realized Its Potential to Inform the Congress

PEMD-93-13, Apr 8, 1993

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Pursuant to a congressional request, GAO reviewed the Public Health Service's (PHS) evaluation set-aside to assess whether it effectively provides information to Congress on federal health programs.

GAO found that: (1) PHS has not allocated the maximum appropriations for program evaluation because of competition with program needs for funding and staff, delayed decisions about obligated amounts for earmarks and taps, restrictive policies, and spending constraints on consulting services; (2) PHS could not calculate the total amount of funds for evaluations because evaluation offices did not always track evaluation projects funded by program funds rather than the set-aside; (3) individual PHS agencies are responsible for generating new evaluation ideas, monitoring evaluation projects, and disseminating evaluation results; (4) 27 percent of projects funded in part by the evaluation set-aside did not generate information on the implementation or effectiveness of federal health programs; (5) some PHS agencies have used evaluation set-aside funds for administrative expenses; (6) PHS guidelines permit set-aside funding for projects that do not evaluate PHS programs; and (7) PHS does not group evaluation results by program area and often does not communicate evaluations to Congress unless specifically requested to do so, which makes congressional oversight difficult.

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 efficacy of the set-aside in informing Congress about the effectiveness of federal health programs, the Secretary of Health and Human Services should take steps to ensure that funds set aside for evaluation are in fact used to support evaluations of PHS programs.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: The Office of the Assistant Secretary for Health (OASH) issued new guidance to the PHS agencies to clarify appropriate uses of the set-aside funds.

    Recommendation: To improve the efficacy of the set-aside in informing Congress about the effectiveness of federal health programs, the Secretary of Health and Human Services should ensure that evaluation results are synthesized by program area (regardless of how the evaluation was funded) and communicated to Congress.

    Agency Affected: Department of Health and Human Services

    Status: Closed - Implemented

    Comments: The mandated annual report for the committees that summarizes the evaluations completed and ongoing for FY 1994 was published in March 1996 and is available on the Internet. Reports summarizing evaluations conducted in FY 1995 and FY 1996 are in process for publication by ASPE in fall 1996 and spring 1997, respectively.

    Matter for Congressional Consideration

    Matter: The Senate Committee on Labor and Human Resources should consider whether to provide more guidance on the permissible uses of the evaluation set-aside funds, such as for the direct evaluation of the implementation and effectiveness of PHS programs.

    Status: Closed - Implemented

    Comments: Language to clarify the intended use of the funds and require an annual report summarizing evaluation findings was incorporated in reauthorizing legislation (P.L. 103-183).