Public Health Service

Evaluation Set-Aside Has Not Realized Its Potential to Inform the Congress Gao ID: PEMD-93-13 April 8, 1993

The Department of Health and Human Services can earmark as much as one percent of the annual Public Health Service appropriations to evaluate federal health programs. As a result, over the past five fiscal years, more than $500 million could have been made available for evaluating public health service programs through the set-aside authority. This report describes the use of the evaluation set-aside authorized under the Public Health Service Act and examines how effective the evaluation set-aside has been in providing Congress with information 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.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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