Biosurveillance
Developing a Collaboration Strategy Is Essential to Fostering Interagency Data and Resource Sharing Gao ID: GAO-10-171 December 18, 2009Recently, there has been an increased focus on developing the ability to provide early detection of and situational awareness during a disease outbreak. The Implementing Recommendations of the 9/11 Commission Act sought to enhance this capability, in part, by creating the National Biosurveillance Integration Center (NBIC) within the Department of Homeland Security. NBIC is to help provide early detection and situational awareness by integrating information and supporting an interagency biosurveillance community. The act directed the Government Accountability Office (GAO) to report on the state of biosurveillance and resource use in federal, state, local, and tribal governments. This report is one in a series responding to that mandate. This report focuses on the actions taken by NBIC to (1) acquire resources to accomplish its mission and (2) effectively collaborate with its federal partners. To conduct this work, GAO reviewed documents, such as NBIC's Concept of Operations, and interviewed officials at NBIC and 11 federal partners.
To carry out its early detection and situational awareness mission, NBIC has made efforts to acquire data from the integration center's community of federal partners, obtain analytical expertise from other agencies, establish governance bodies to develop and oversee the community of federal partners, and provide information technologies to support data collection, analysis, and communication. However, NBIC does not receive the kind of data it has identified as most critical for supporting its early detection mission--particularly, data generated at the earliest stages of an event. In addition, NBIC has faced challenges leveraging the expertise of its federal partners. For example, NBIC officials have emphasized the importance of agencies temporarily assigning personnel to supplement the expertise at NBIC. However, only 2 of 11 partner agencies have assigned personnel to support the integration center. NBIC has developed governance bodies that provide oversight for the integration center and the interagency community. Although the integration center has also developed an information technology system, it is primarily used to help identify and collect publicly available Internet data because NBIC lacks data from federal partners that best support the early detection goal of biosurveillance. NBIC is not fully equipped to carry out its mission because it lacks key resources--data and personnel--from its partner agencies, which may be at least partially attributed to collaboration challenges it has faced. Integrating biosurveillance data is an inherently interagency enterprise, as reflected by both law and NBIC's strategy for meeting its mission. NBIC is to help coordinate and support a community of federal partners for early detection and enhanced situational awareness. Consequently, for NBIC to obtain the resources it needs to meet its mission, it must effectively employ collaborative practices. However, in interviews with partner agencies, GAO encountered widespread confusion, uncertainty, and skepticism around the value of participation in the interagency community, as well as the mission and purpose of NBIC within that community. Further, interviews with agency officials demonstrated a lack of clarity about roles, responsibilities, joint strategies, policies, and procedures for operating across agency boundaries. We have previously reported on key practices that can help enhance and sustain collaboration among federal agencies. For collaborating agencies to overcome barriers to working together, they need to, among other things, (1) develop a clear and compelling rationale for working together by articulating a common federal outcome or purpose; (2) establish joint strategies, policies, and procedures to help align activities, core processes, and resources; (3) identify resources needed to initiate or sustain their collaborative effort; (4) work together to define and agree on their respective roles and responsibilities; and (5) develop accountability mechanisms to guide implementation and monitoring of their efforts to collaborate. Development of a strategy for collaboration and the use of these key collaboration practices could enhance NBIC's ability to foster interagency data and resource sharing.
RecommendationsOur 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.
Director: Team: Phone:GAO-10-171, Biosurveillance: Developing a Collaboration Strategy Is Essential to Fostering Interagency Data and Resource Sharing
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Report to Congressional Committees:
United States Government Accountability Office:
GAO:
December 2009:
Biosurveillance:
Developing a Collaboration Strategy Is Essential to Fostering
Interagency Data and Resource Sharing:
GAO-10-171:
GAO Highlights:
Highlights of GAO-10-171, a report to Congressional Committees.
Why GAO Did This Study:
Recently, there has been an increased focus on developing the ability
to provide early detection of and situational awareness during a
disease outbreak. The Implementing Recommendations of the 9/11
Commission Act sought to enhance this capability, in part, by creating
the National Biosurveillance Integration Center (NBIC) within the
Department of Homeland Security. NBIC is to help provide early
detection and situational awareness by integrating information and
supporting an interagency biosurveillance community. The act directed
GAO to report on the state of biosurveillance and resource use in
federal, state, local, and tribal governments. This report is one in a
series responding to that mandate. This report focuses on the actions
taken by NBIC to (1) acquire resources to accomplish its mission and
(2) effectively collaborate with its federal partners. To conduct this
work, GAO reviewed documents, such as NBIC‘s Concept of Operations, and
interviewed officials at NBIC and 11 federal partners.
What GAO Found:
To carry out its early detection and situational awareness mission,
NBIC has made efforts to acquire data from the integration center‘s
community of federal partners, obtain analytical expertise from other
agencies, establish governance bodies to develop and oversee the
community of federal partners, and provide information technologies to
support data collection, analysis, and communication. However, NBIC
does not receive the kind of data it has identified as most critical
for supporting its early detection mission”particularly, data generated
at the earliest stages of an event. In addition, NBIC has faced
challenges leveraging the expertise of its federal partners. For
example, NBIC officials have emphasized the importance of agencies
temporarily assigning personnel to supplement the expertise at NBIC.
However, only 2 of 11 partner agencies have assigned personnel to
support the integration center. NBIC has developed governance bodies
that provide oversight for the integration center and the interagency
community. Although the integration center has also developed an
information technology system, it is primarily used to help identify
and collect publicly available Internet data because NBIC lacks data
from federal partners that best support the early detection goal of
biosurveillance.
NBIC is not fully equipped to carry out its mission because it lacks
key resources”data and personnel”from its partner agencies, which may
be at least partially attributed to collaboration challenges it has
faced. Integrating biosurveillance data is an inherently interagency
enterprise, as reflected by both law and NBIC‘s strategy for meeting
its mission. NBIC is to help coordinate and support a community of
federal partners for early detection and enhanced situational
awareness. Consequently, for NBIC to obtain the resources it needs to
meet its mission, it must effectively employ collaborative practices.
However, in interviews with partner agencies, GAO encountered
widespread confusion, uncertainty, and skepticism around the value of
participation in the interagency community, as well as the mission and
purpose of NBIC within that community. Further, interviews with agency
officials demonstrated a lack of clarity about roles, responsibilities,
joint strategies, policies, and procedures for operating across agency
boundaries. We have previously reported on key practices that can help
enhance and sustain collaboration among federal agencies. For
collaborating agencies to overcome barriers to working together, they
need to, among other things, (1) develop a clear and compelling
rationale for working together by articulating a common federal outcome
or purpose; (2) establish joint strategies, policies, and procedures to
help align activities, core processes, and resources; (3) identify
resources needed to initiate or sustain their collaborative effort; (4)
work together to define and agree on their respective roles and
responsibilities; and (5) develop accountability mechanisms to guide
implementation and monitoring of their efforts to collaborate.
Development of a strategy for collaboration and the use of these key
collaboration practices could enhance NBIC‘s ability to foster
interagency data and resource sharing.
What GAO Recommends:
To enhance collaboration, GAO recommends that NBIC work with its
interagency advisory body to develop a strategy for addressing barriers
to collaboration”such as the lack of clear mission, roles, and
procedures”and to develop accountability mechanisms to monitor these
efforts. We provided this draft to DHS and 11 federal partners. DHS
concurred with our recommendations.
View [hyperlink, http://www.gao.gov/products/GAO-10-171] or key
components. For more information, contact William O. Jenkins at (202)
512-8777or jenkinswo@gao.gov.
[End of section]
Contents:
Letter:
Background:
NBIC Has Undertaken Efforts to Coordinate the NBIS and Acquire
Resources, but Lacks Key Mission-Critical Elements:
Use of Key Collaboration Practices Could Help NBIC Strengthen
Collaboration and Promote Fuller Participation:
Conclusions:
Recommendations for Executive Action:
Agency Comments and Our Evaluation:
Appendix I: Comments from the Department of Homeland Security:
Appendix II: GAO Contact and Staff Acknowledgments:
Tables:
Table 1: 9/11 Commission Act Requirements for NBIC and NBIC Member
Agencies:
Table 2: Three Data Categories Collected by Federal Agencies:
Abbreviations:
BCON: Biosurveillance Common Operating Network:
BIWAC: Biosurveillance Indications and Warnings Analytic Community:
DHS: Department of Homeland Security:
HHS: Department of Health and Human Services:
HSPD-9: Homeland Presidential Security Directive-9:
HSPD-10: Homeland Presidential Security Directive-10:
HSPD-21: Homeland Presidential Security Directive-21:
IAA: interagency agreements:
ISA: interagency security agreements:
IT: information technology:
MOU: memomorandum of understanding:
NBIC: National Biosurveillance Integration Center:
NBIS: National Biosurveillance Integration System:
NIOC: NBIS Interagency Oversight Council:
NIWG: NBIS Interagency Working Group:
NOC: National Operations Center:
USDA: United States Department of Agriculture:
[End of section]
United States Government Accountability Office:
Washington, DC 20548:
December 18, 2009:
The Honorable Joe Lieberman:
Chairman:
The Honorable Susan M. Collins:
Ranking Member:
Committee on Homeland Security and Governmental Affairs:
United States Senate:
The Honorable Bennie Thompson:
Chairman:
The Honorable Peter King:
Ranking Member:
Committee on Homeland Security:
House of Representatives:
In recent years, there has been an increasing awareness of the
potential for biological agents to be used as weapons of mass
destruction and of the threat of catastrophic effects arising from
emerging strains of infectious disease. For example, the October 2001
anthrax attacks highlighted longstanding weaknesses in the current
public health infrastructure and prompted efforts to improve the
nation's preparedness for and response to public health emergencies,
including bioterrorism. In addition, the 2001 accidental outbreak of
foot-and-mouth disease in the United Kingdom caused approximately $5
billion dollars in losses to the food and agriculture sector, as well
as comparable losses within the industry.[Footnote 1] These events and
others like them have underscored the importance of developing and
maintaining a national biosurveillance capability--that is, the ability
to detect biological events of national significance with the aim of
providing earlier warning and better information to guide public health
or other types of emergency response.
Effective preparation for, detection of, and response to a major
biological event requires effective pre-and postdisaster coordination
and cooperation among different federal agencies, levels of government,
nongovernmental organizations, and the private sector. In the case of
biological threats, detection of biological agents is a first step in
an effective response to a natural, accidental, or intentional outbreak
of a biological event of national concern. The U.S. government has a
long history of monitoring human, animal, and plant health--in some
cases for more than a century--to help limit malady, loss of life, and
economic impact. Although the United States has numerous surveillance
programs and systems at various levels of government and in the private
sector to monitor disease, these programs and systems were developed
separately for a variety of mission objectives, and as such are
relatively uncoordinated.
Since at least the 1990s, there has been an ongoing and evolving effort
by the federal government to address the need for a strategic approach
to improving disease surveillance and response. Among numerous federal
efforts to establish a coordinated national biosurveillance capability,
a provision in the Implementing Recommendations of the 9/11 Commission
Act of 2007 (9/11 Commission Act),[Footnote 2] sought to enhance the
capability of the federal government to rapidly identify, characterize,
localize, and track biological events of national concern. The 9/11
Commission Act established, within the Department of Homeland Security
(DHS), the National Biosurveillance Integration Center (NBIC), which
was specifically tasked with fulfilling the biosurveillance objectives
established in the act by integrating and analyzing information from
surveillance systems across the federal government and disseminating
alerts, if any biological events are detected. The federal partners
that maintain these surveillance systems and those that may have
information helpful for decisionmaking during an event are collectively
known as the National Biosurveillance Integration System (NBIS). A
central responsibility for NBIC is to further develop and oversee the
NBIS with the goal of earlier detection of and enhanced information
about potentially catastrophic biological events.
In the same title, the 9/11 Commission Act directed us to examine the
state of federal, state, local, and tribal government biosurveillance
efforts and the federal government's use of resources to implement and
execute biosurveillance systems.[Footnote 3] This report responds in
part to that mandate by examining actions that NBIC has taken to
integrate and analyze data for the purposes of early detection and
warning of biological events of national concern. Specifically, this
report addresses (1) what actions NBIC has taken to coordinate the NBIS
and acquire essential resources; and (2) how effectively NBIC has
employed collaborative practices with NBIS partners to help ensure that
it acquires and develops essential resources.[Footnote 4]
In summer 2008, we testified on the status of NBIC's efforts to
implement its 9/11 Commission Act responsibilities, particularly by
entering into information-sharing and interagency personnel-assignment
agreements with NBIS partners.[Footnote 5] At that time, we noted that
DHS faced difficulties completing some key tasks, such as defining what
capabilities the center will provide once fully operational,
formalizing agreements to obtain interagency coordination, and
completing work related to information technology (IT) systems. In
addition to this NBIC-specific report, we have ongoing work on
biosurveillance activities throughout the federal government from which
we expect to issue a report in early 2010, and a review of state,
local, and tribal activities, which we expect to report on later in the
year.
To determine the extent of NBIC's efforts to acquire the necessary data
and resources, we reviewed documents including relevant laws and
directives, operating documents, program guidance, program evaluation
reports, and other documentation and interviewed officials at NBIC with
knowledge of NBIC's management and analytical activities. We visited
NBIC facilities, specifically NBIC's analysis center at DHS's Nebraska
Avenue Complex, DHS's National Operations Center, and the 2009 H1N1
Incident Management Cell at the Office of Health Affairs in Washington,
D.C., where we observed key meetings, processes, and technologies. To
identify the elements that are necessary for NBIC to achieve its
mission, we analyzed the relevant provisions of the 9/11 Commission
Act, the NBIS Concept of Operations, and interviews with NBIC
officials.[Footnote 6] Once we identified these elements, we vetted
them with NBIC officials who agreed they were accurate. To determine
the extent to which NBIC and NBIS partners have collaborated to help
ensure that NBIC acquires and develops essential resources, we reviewed
existing federal interagency agreements and other documentation, such
as the NBIS Concept of Operations, NBIC's draft strategic plan, and
post meeting reports from meetings of NBIS governance bodies. We also
spoke with agency officials from the 11 NBIS partners--agencies NBIC
has identified as having relevant data or resources to contribute to
the biosurveillance objectives established in the 9/11 Commission Act.
[Footnote 7] We conducted semistructured interviews, based on our
previous work describing practices to enhance and sustain collaboration
in the federal government.[Footnote 8] We conducted these interviews
with 14 components of the 11 federal agencies that NBIC identified as
NBIS partners. We identified the components to interview by contacting
the 11 partner agencies to determine which had regular interaction with
NBIC's processes and products. We explored officials' experiences
working with NBIC and within the NBIS at all of the identified
components. We asked these officials about their understanding of
NBIC's mission and purpose; the perceived value to their respective
agencies of participation in the NBIS; the extent of and reasons for
their agency's level of participation; and the extent to which joint
strategies, policies, and procedures have been established and are
commonly understood and accepted between NBIC and individual agencies,
as well as across the NBIS. We then analyzed the results of these
interviews to identify recurrent themes. We provided these officials
the opportunity to comment on a standard set of collaborative practices
and provide examples from their experiences, and we analyzed the
content of their responses to develop our findings. However, due to the
semistructured nature of our interviews, different groups of officials
focused on different aspects of their experiences with NBIC; therefore,
not every theme identified in our analysis was explicitly discussed by
every group of officials.
This report is limited to the efforts NBIC has taken or planned to
carry out related to its 9/11 Commission Act responsibilities. On the
whole, federal biosurveillance efforts rely on state, local, and tribal
biosurveillance efforts, and there are many federal efforts designed to
collect and analyze biosurveillance data. However, this report focuses
on NBIC's integration efforts and not the effectiveness of the various
federal systems the data of which NBIC would integrate.
We conducted this performance audit from February 2008 through November
2009, in accordance with generally accepted government auditing
standards. Those standards require that we plan and perform the audit
to obtain sufficient, appropriate evidence to provide a reasonable
basis for our findings and conclusions based on our audit objectives.
We believe that the evidence obtained provides a reasonable basis for
our findings and conclusions based on our audit objectives.
Background:
NBIC Is Responsible for Facilitating Collaboration across Multiple
Agencies to Enhance Biosurveillance Effectiveness by Integrating Data
and Expert Analysis:
Biosurveillance is the process of gathering, analyzing, and
interpreting data in order to achieve early detection and warning and
overall situational awareness of biological events with the potential
to have catastrophic human and economic consequences.[Footnote 9] In
August 2007, the 9/11 Commission Act established NBIC to contribute to
the nation's biosurveillance capability by enhancing the ability of the
federal government to rapidly identify, characterize, localize, and
track biological events of national concern through integration and
analysis of data relating to human health, animal, plant, food, and
environmental monitoring systems (both national and international).
[Footnote 10] Once a potential event is detected, NBIC is to
disseminate alerts to enable response to a biological event of national
concern. To achieve these objectives, NBIC is to coordinate with
federal and other stakeholders that have information that can be used
to enhance the safety and security of the United States against
potential biological events of national significance. This community of
federal stakeholders is known as the NBIS.
The NBIS community predated the enactment of the 9/11 Commission Act.
Beginning in 2004, DHS managed the NBIS and developed an IT system to
manage other agencies' biosurveillance information, an effort that was
moved among several DHS Directorates, including DHS's Science and
Technology Directorate and the Preparedness Directorate. In 2007, DHS
created the Office of Health Affairs, headed by the DHS Chief Medical
Officer, to lead DHS's biodefense activities and provide timely
incident-specific management guidance for the medical consequences of
disasters. At that time, DHS placed NBIS in the Office of Health
Affairs.[Footnote 11] Shortly after that, the 9/11 Commission Act
created NBIC and gave it responsibility for managing the NBIS, which
has remained in the Office of Health Affairs. Since fiscal year 2008,
NBIC has operated with an annual budget of $8 million dollars.
Biosurveillance activities at NBIC are carried out by its Operations
Division, which is headed by the Deputy Director and Chief Scientist
and supported by 10 contract employees that serve as the analytic core
for NBIC's daily operations. These staff members have various
backgrounds related to biodefense, including public health, veterinary,
environmental, and intelligence training.
NBIC Draws Its Early Detection and Situational Awareness Missions from
Multiple Presidential Directives, in Addition to the 9/11 Commission
Act:
As shown in table 1, the 9/11 Commission Act outlines certain
requirements for NBIC and NBIS member agencies, and most of these
relate to how NBIC is to coordinate NBIS member agency data and
information management resources. Generally, there are four elements
that are critical for NBIC to achieve its early detection and
situational awareness missions established in the 9/11 Commission Act:
(1) acquire data from NBIS partners that can be analyzed for
indications of new or ongoing biological events, (2) leverage
scientific and event-specific expertise from across the NBIS, (3)
obtain strategic and operational guidance from NBIS partners, and (4)
develop and maintain information technologies to support data
collection, analysis, and communication.
Table 1: 9/11 Commission Act Requirements for NBIC and NBIC Member
Agencies:
Requirements for NBIC:
* Consolidate data from all relevant surveillance systems maintained by
member agencies across human, animal, and plant domains;
* Seek private sources of surveillance when such sources would enhance
coverage of gaps;
* Use an IT system with the best available statistical and other
analytical tools to identify and characterize biological events of
national concern in as close to real time as practical;
* Provide the infrastructure for integration including IT systems and
space, and support for personnel from member agencies with sufficient
expertise to analyze and interpret data;
* Work with member agencies to create IT systems that use the minimum
amount of patient data necessary and consider patient confidentiality
and privacy in all stages of development;
* Alert member agencies as well as public health agencies of state,
local, and tribal governments (in coordination with or through member
agencies) of incidents that could develop into a biological event of
national concern.
Requirements for NBIC member agencies:
* Use best efforts to integrate biosurveillance information into the
NBIC, with the goal of promoting information sharing between federal,
state, local, and tribal governments to detect biological events of
national concern;
* Provide timely information to assist the NBIC in maintaining
biological situational awareness for accurate detection and response
purposes;
* Enable the NBIC to receive and use biosurveillance information from
member agencies to carry out its requirements;
* Connect the biosurveillance data systems of that member agency to the
NBIC data system under mutually agreed protocols;
* Participate in the formation of strategy and policy for the operation
of the NBIC and its information sharing;
* Provide personnel to the NBIC under an interagency personnel
agreement and consider the qualifications of such personnel necessary
to provide human, animal, and environmental data analysis and
interpretation support to the NBIC; and retain responsibility for the
surveillance and intelligence systems of that department or agency, if
applicable.
Source: Pub. L. No. 110-53, § 1101, 121 Stat. 266, 375-79 (2007)
(codified at 6 U.S.C. § 316).
[End of table]
Although the act does not specify any member agency that must
participate in the NBIS, it defines a member agency as any agency that
signifies agreement to participate by signing a memorandum of
understanding (MOU) and establishes for them specific requirements--
generally related to sharing information and human assets. For example,
as shown in table 1, the act provides that each member agency shall use
its best efforts to integrate biosurveillance information into the
NBIC, with the goal of promoting information sharing between federal,
state, local, and tribal governments to detect biological events of
national concern. NBIC has identified 11 NBIS partners at the federal
level--the Departments of Health and Human Services (HHS), Agriculture
(USDA), Commerce, Defense, Interior, Justice, State, Transportation,
and Veterans Affairs, as well as the Environmental Protection Agency
and the United States Postal Service. In some departments, more than
one component has been identified for participation. Some of these
departments, such as HHS and USDA, have major mission responsibilities
for collecting health data that may indicate an outbreak of a disease
or other biological event. Other departments may collect data or have
subject matter expertise that may be used during the course of a
biological event. For example, the National Oceanic and Atmospheric
Agency within the Department of Commerce collects meteorological data
that may be used by NBIC to help inform the progression of an outbreak
based on weather patterns.
Around the same time as the enactment of the 9/11 Commission Act, the
President issued Homeland Security Presidential Directive-21 (HSPD-
21), as a high-level biodefense strategy. HSPD-21 is built on the
principles of earlier directives--HSPD-9 and HSPD-10--which
collectively describe the role of the federal government in building a
national capability to detect a biological event. For example, HSPD-21
lays out goals for addressing each of four biodefense elements for
human health,[Footnote 12] one of which is surveillance. In this
respect, HSPD-21 calls for the United States to develop a nationwide,
robust, and integrated biosurveillance capability to provide early
warning and ongoing characterization of disease outbreaks in near real-
time. Consistent with this goal, HSPD-21 directs the Secretary of
Health and Human Services to establish a national epidemiologic
surveillance system for human health, in part, to integrate federal,
state, and local data into a national biosurveillance common operating
picture. Although HSPD-21 does not specify a role for DHS in
biosurveillance, the earlier directives did, and creation and
maintenance of an electronic biosurveillance common operating picture
has been an NBIS goal since its inception.
Biosurveillance Involves Data Gathering and Analysis at Multiple Levels
of Government for the Purposes of Earlier Warning and Enhanced
Situational Awareness:
The data needed to detect an infectious disease outbreak or
bioterrorism may come from a variety of sources, and aggregating and
integrating data across multiple sources is intended to help recognize
the nature of a disease event or understand its scope. Combining and
comparing data streams from different sectors to detect or interpret
indications of a potential health emergency is called biosurveillance
integration. Both HSPD-21 and the 9/11 Commission Act seek enhanced
integration of disparate systems and programs that collect data with
the aim of providing early warning and ongoing characterization of
biological events. HSPD-21 and the 9/11 Commission Act each also seek
to enhance the situational awareness for the detection of and response
to biological events. Much of the information gathered for these
biosurveillance purposes is generated at the state government level.
For example, state health departments collect and analyze data on
notifiable diseases submitted by health care providers and
others.[Footnote 13] In addition, state-run laboratories conduct
testing of samples for clinical diagnosis and participate in special
clinical or epidemiologic studies. Finally, state public health
departments verify cases of notifiable diseases, monitor disease
incidence, and identify possible outbreaks within their states. At the
federal level, agencies and departments generally collect and analyze
surveillance data gathered from the states and from international
sources, although some federal agencies and departments also support
their own national surveillance systems and laboratory networks.
When an issue crosses federal agency lines, as biosurveillance
integration does, the agencies involved must collaborate to deliver
results more efficiently and effectively. Due to NBIC's role as an
integrator of information across the biosurveillance community, it is
important for NBIC to ensure that it effectively collaborates with the
NBIS to obtain the cooperation of this interagency community. One
reason that it is important that NBIC effectively collaborate with
federal partners is that agencies are not required by law to support
NBIC or participate in the NBIS community. We have previously reported
that for collaborating agencies to enhance and sustain collaboration,
they need to, among other things, (1) have a clear and compelling
rationale for working together; (2) establish joint strategies,
policies, and procedures for aligning core processes and resources; (3)
identify resources needed to initiate or sustain their collaborative
effort; (4) work together to define and agree on their respective roles
and responsibilities; and (5) develop accountability mechanisms to help
implement and monitor their efforts to achieve collaborative results.
[Footnote 14]
NBIC Has Undertaken Efforts to Coordinate the NBIS and Acquire
Resources, but Lacks Key Mission-Critical Elements:
NBIC has made some efforts to put mission-critical elements in place,
such as requesting data from other federal partners, initiating
relationship-building activities among NBIC analysts and subject matter
experts at other agencies, and establishing governance bodies to
oversee and guide the NBIS. However, NBIC currently relies on publicly
available data because it receives limited data from NBIS partners and
generally lacks assignments of personnel from other agencies to
leverage analytical expertise from across the NBIS partners.
NBIC Generally Has Not Acquired Data from Other Agencies to Support the
Early Detection Mission and Instead Relies on Nonfederal, Open-Source
Data:
NBIC's ability to acquire and consolidate data from NBIS partners as
well as from nonfederal sources is central to achieving its mission.
Current and initial drafts of the NBIS Concept of Operations reinforce
this notion,[Footnote 15] noting that the identification of relevant
and timely data sources, which act in combination to provide actionable
information for decisionmaking, is essential to accomplishing early
detection. NBIC has taken some action to acquire these types of data
from NBIS partners, for instance, by requesting that NBIS partners
identify the types of data they collect or generate that might aid in
NBIC's early detection mission. However, as of October 2009, NBIC was
generally not receiving the types of data best suited to early
detection of biological events of national concern. NBIC officials
acknowledge that they lack key data, and NBIC and other NBIS member
officials described numerous challenges to sharing such information,
including but not limited to scant availability of such data throughout
the federal government and concerns about trust and control over
sensitive information before it is vetted and verified.
Based on our discussions with NBIS agency officials and review of NBIC
documents, we have defined and verified with NBIC officials three
categories of electronic data that are critical for NBIC to achieve its
mission and might be available from federal agencies or other sources.
As described in table 2, these data categories are (1) raw structured
data, (2) raw unstructured data, and (3) final products which are
typically briefings produced by other agencies in the course of
monitoring routine and emerging disease. As of October 2009, NBIC was
receiving some final products from NBIS partners, but was not receiving
any raw data--particularly data that are generated at the earliest
stages of a biological event.
Table 2: Three Data Categories Collected by Federal Agencies:
Data Category: Raw structured;
Description: Data that have been collected in an electronic format that
can be automatically processed by a computer but have not been analyzed
to reach conclusions about their meaning, such as whether the data are
signs of a potentially catastrophic infectious disease outbreak. These
data may frequently be expressed in quantitative terms;
Example: Codes that represent chief complaints reported by patients and
entered into a hospital emergency room medical database or test results
from health laboratories.
Data Category: Raw unstructured;
Description: Data that requires manual review or manipulation and are
not structured for automatic processing by a computer system. Data is
often qualitative rather than quantitative;
Example: Media reports of disease outbreaks, gathered from free and
subscription Internet sites.
Data Category: Final products;
Description: A final written product that contains an analysis and
interpretation of data to provide contextual meaning. Products have
been reviewed and approved by the leadership of the agency that created
them before they are shared;
Example: A written report that is issued after raw or unstructured data
have been analyzed and interpreted to identify a disease cluster.
Source: GAO analysis and verification with NBIC officials responsible
for acquiring and using data.
[End of table]
According to officials, receipt of all three types of electronic data
is important to help NBIC achieve its mission of detecting and warning
of a biological event because detection of events that are novel, from
multiple sources, or widespread requires analysis of multiple
independent data streams. However, the officials told us that they do
not receive from NBIS partners the raw structured or unstructured data
that best support the early detection goal of biosurveillance. In
particular, NBIC identified data that are generated at the earliest
stages of a biological event--which can include raw data collected by
federal agencies as part of their biosurveillance responsibilities--as
being among the highest value for enabling the earlier detection of
biological events of national concern. For instance, structured data,
such as medical codes corresponding to diagnoses that are entered into
databases, as well as some sources of unstructured data, such as
written observations noted on medical forms, are generated at the
earliest stages of a biological event and have been identified by NBIC
as a high priority for early detection. These data can be collected or
generated by federal agencies with responsibilities for biosurveillance
and which are participating in NBIS. For example, HHS has developed a
surveillance system that collects data on symptoms of patients entering
emergency departments, that when analyzed with statistical tools, may
be able to indicate the presence of an outbreak in less time than it
takes to perform diagnostic lab tests.
NBIC seeks to finalize three types of agreements with NBIS partners to
articulate and establish protocols and legal authority for resource
sharing: (1) MOUs, (2) interagency agreements (IAA), and (3)
interagency security agreements (ISA).[Footnote 16] To date, 7 of the
11 agencies have signed MOUs,[Footnote 17] but only 1 has a finalized
ISA in place for data sharing, according to NBIC officials. As of
October 2009, the federal agency that signed an ISA agreed to provide a
single data source related to food safety. NBIC officials told us that
although the agreement and the technology allowing the electronic data
exchange are in place, the agency has not yet begun transferring the
data to NBIC, and they did not know when to expect the transfer to
begin. NBIC's inability to finalize agreements can be attributed in
part to challenges it faces in ensuring effective collaboration, which
will be discussed later in this report.
Five NBIS partners provide NBIC with written final products, such as
briefings produced on a routine basis that provide information on
outbreaks of diseases or special alerts of potentially dangerous
biological events issued as needed. However, NBIC officials noted that
there are limitations on the value of final reports for supporting
early detection. These finished products represent the agency's final
analysis and interpretation of the raw data that it collects and have
been reviewed and approved by the agency leadership for general
dissemination to interested parties. According to NBIC officials, these
products are generally useful for providing context but not for early
detection of a biological event because they are not generated in a
timely enough fashion to be valuable for detecting new biological
events and focus on biological events that have already been detected.
In the absence of proprietary information from NBIS partners, NBIC
relies on mostly nonfederal sources of data, such as media reports of
illness, to attempt to identify biological events. The bulk of data--
according to NBIC officials more than 98 percent--NBIC currently uses
to pursue its mission is unstructured and comes from nonfederal, open
sources, including an international information gathering service
called Global Argus, a federally-funded program in partnership with
Georgetown University. The service searches and filters over 13,000
overseas media sources, in more than 34 languages. The practice of
monitoring and translating local news articles has the potential to
provide information about undiagnosed and other suspicious disease
activity before it is reported through more official channels. NBIC
officials stated that continuous monitoring of global news media
sources and publicly available Web sites would be important to round
out potential gaps in coverage, even if other data are available from
federal agencies.
NBIC Has Had Limited Success Obtaining Expertise from NBIS Partners
through Interagency Personnel Assignments:
NBIC officials told us that regardless of the quantity and quality of
data types shared by collaborating agencies, effective biosurveillance
depends on human analysts to interpret events and place them in
context. For example, determining whether an outbreak of a new emerging
infectious disease has occurred and further assessing whether this
event is one of national concern are analytic judgments that require
not only data but also the expertise of an experienced, knowledgeable
analyst. According to these officials, analyst-to-analyst communication
in a trusted environment is absolutely essential for rapid vetting,
verification, and contextualization of events.
The 9/11 Commission Act calls for member agencies to provide personnel
to NBIC under an interagency personnel agreement and consider the
qualifications of such personnel necessary to provide human, animal,
and environmental data analysis and interpretation support.[Footnote
18] However, for the most part, NBIC has not consistently received this
kind of support from NBIS partners. Personnel detailed (that is,
personnel employed by a federal agency and temporarily assigned to NBIC
for a specified period of time) from other federal agencies enable
analysis and interpretation of data by serving as subject matter
experts for specific issues that are part of their home agencies'
missions and as conduits of information from their respective home
agencies. NBIC has signed MOUs with seven agencies, but only two have
provided a personnel detail to the NBIC headquarters in Washington,
D.C., and as of October 2009, only one of those personnel details was
active, because one of those agencies did not replace personnel after
the initial detail ended. NBIC officials told us that daily interaction
with officials who had been on detail at NBIC not only enhanced their
ability to interpret the information immediately on hand but also
contributed to ongoing contextual learning for NBIC's analytical corps.
Although most of the NBIS partners have not detailed their subject
matter experts to NBIC, the integration center officials have used
other means to obtain expertise and information from other agency
analysts. NBIC officials told us that they have co-located the NBIC
analysts at other collaborating agencies where they spend up to 2 weeks
working with analysts from these other agencies both to learn more
about their operations and to help forge ongoing relationships. NBIC
officials stated they have also established a daily process to engage
the NBIS in sharing information and analytic insights with each other.
During this process--which NBIC calls the daily production process--
NBIC analysts compile information on reports of outbreaks that may be
of concern, and then this information is disseminated to the NBIS
community for discussion at a daily teleconference. The participants in
the teleconference determine whether the events merit further
monitoring or evaluation and share any relevant information they may
have about the event. NBIC analysts then use the information gathered,
as refined by the daily teleconference, to finalize NBIC daily reports
and update its electronic Biosurveillance Common Operating Picture,
which is a manually updated electronic picture of current worldwide
biological events being tracked.
For example, NBIC analysts might identify local news reports that
suggest food contamination in a region. During the daily conference
call, one or more of the agencies with responsibility for monitoring
food safety or foodborne illness might contribute more information,
such as a history of similar issues in the same geographical region,
that gives more context to the reports. Then, collectively, the
responsible agencies might decide that the event, first uncovered in
open source media, warrants further investigation and monitoring. NBIC
analysts would then post all known information to its electronic
Biosurveillance Common Operating Picture for all interested parties to
follow. Meanwhile, the agencies with missions of jurisdiction would
conduct their investigations and report any new findings during the
following day's teleconference. NBIC officials told us that this
process requires a wide range of expertise from across the agencies.
These officials said that they may also communicate directly with an
agency prior to the daily teleconference if NBIC plans to discuss an
item relevant to the agency's mission at the meeting.
Another means NBIC uses to obtain expertise and information from other
agency analysts is through participation in the Biosurveillance
Indications and Warnings Analytic Community (BIWAC). The BIWAC is a
self-governing interagency body composed of federal officials who are
actively responsible for pursuing a biosurveillance mission. The
agencies represented include: the Department of Defense, HHS's Centers
for Disease Control and Prevention, USDA, DHS, and the intelligence
community. The mission of the BIWAC is to provide a secure, interagency
forum for the collaborative exchange of critical information regarding
biological events that may threaten U.S. national interests. On behalf
of the BIWAC, the Department of Defense's National Center for Medical
Intelligence hosts an encrypted information sharing portal called
Wildfire. According to NBIC's Chief Scientist and Deputy Director, in
addition to engaging in the information exchange through Wildfire, she
is an active supporter and participant in BIWAC meetings and
teleconferences.
According to NBIC officials, although these efforts to obtain the
analytical insights of subject matter experts from collaborating
agencies may be valuable, they do not provide a substitute for
personnel details to the integration center itself. For example, with
the daily teleconference, NBIC may have limited access to NBIS agency
subject matter experts because analysts from only a few of the various
agencies may be available for immediate communication on any given day,
and not all agencies regularly participate in the daily teleconference.
In addition, apart from the daily teleconference, NBIC officials said
that agencies may limit NBIC's ability to communicate with their
subject matter experts, particularly in the early stages of responding
to a biological event when the agency is prioritizing its response
needs. Finally, NBIC analysts may also communicate through federal
agencies' operations centers during the course of an ongoing biological
event, but NBIC officials noted that this channel of communication is
not always an effective means to get meaningful input from agencies'
subject matter experts. The lack of sustained personnel detailed to
NBIC from other NBIS partner agencies can be attributed, in part, to
challenges it faces with ensuring effective interagency collaboration,
which will be discussed later in this report.
NBIC Established Governance Structures to Develop and Oversee the NBIS:
In order to support the ability for NBIS partners to engage in
overseeing and guiding the NBIS, NBIC has established and administers
two governance bodies. NBIC sponsors meetings of the two groups on a
regular basis. The NBIS Interagency Oversight Council (NIOC) is
composed of representatives at the assistant secretary level from each
NBIS agency. The NIOC is to act as the senior oversight body to provide
guidance and direction for the operation, implementation, and
maintenance of the NBIS, as well as to resolve interagency or
intradepartmental issues that cannot be resolved at lower levels. The
NBIS Interagency Working Group (NIWG) is a senior, director-level
working body created to share information on NBIC activities, such as
the status of developing draft documents and standard operating
procedures including procedures undertaken during ongoing biological
events of national concern. The NIWG can also establish sub-working
groups to conduct specific work as necessary to provide support to the
NBIC and the NIOC. For example, NIWG established a sub-working group to
propose procedures for resolving conflict during the daily production
cycle.
NBIC Uses an IT System to Manage Publicly Available Data and to
Communicate Alerts, but Generally Lacks the Ability to Apply Analytical
Tools to Data:
One of the elements that is critical for NBIC to carry out its mission
is development and maintenance of information technologies to support
data collection, analysis, and communication of alerts. The 9/11
Commission Act also specifically mentions the need for statistical
tools to analyze data to identify and characterize trends of biological
events of national concern.[Footnote 19] NBIC has taken steps to
develop an IT system that can manage data from NBIS partners and can
help identify open source reports of potential biological events, but
NBIC largely lacks data from federal agencies. Given this condition,
rather than a system designed to electronically process structured data
received directly from NBIS partners, NBIC has configured its IT
system--the Biosurveillance Common Operating Network (BCON)--primarily
to identify and assemble unstructured data from public sources on the
Internet that it will later vet with other NBIS analysts in the daily
production process.[Footnote 20] Therefore, NBIC relies on the NBIS
community and member agency subject matter experts for analysis and
interpretation of publicly available data rather than providing the
NBIS community with an analysis of integrated, raw, structured data
from the NBIS partners. According to NBIC officials, they anticipate
using BCON to manage any agency data streams that they may eventually
acquire.
BCON is a system of systems that is built on multiple commercial-off-
the-shelf software packages. Currently, the central feature of BCON is
its use of a set of keywords within a language algorithm to search the
Internet for media articles that may contain biosurveillance-relevant
information and compile them for NBIC analysts to review. As part of
this function, BCON also flags events for immediate analyst attention.
Additionally, the information from BCON is the basis for the NBIC
Biosurveillance Common Operating Picture, which is a manually updated
Google Maps application of current worldwide biological events being
tracked. NBIS agency officials can view the Biosurveillance Common
Operating Picture on the Homeland Security Information Network.
[Footnote 21] According to NBIC officials, in the future NBIS agency
officials will also have the ability to create and update event
information.
Although NBIC generally lacks direct-feed, raw, structured data from
NBIS partners to apply statistical and analytical tools, according to
our observations and review of documents supporting the development of
the system, BCON is designed to locate and log information associated
with the events contained in the open source media that it searches.
This information includes the geographic coordinates and the date and
time of occurrence for each event. This data is archived and, according
to NBIC officials, can be used to conduct cross-domain analysis for
trends, historical context, associated events, anomaly detection, and
hypothesis generation. Among the applications planned for inclusion in
BCON is a tool that is designed to perform historical analysis of this
archived data to help monitor and refine the effectiveness of the
algorithm. According to NBIC officials, the goal of this analysis is to
help ensure that NBIC analysts will be able to identify events that
merit attention by refining the algorithm to limit results that are
less relevant for monitoring for biological events of national concern.
However, these officials told us that this aspect of BCON has been put
on hold due to budget constraints.
To advance information sharing among federal agencies, NBIC is also
pursuing $90 million dollars in supplemental funding for a broader
information sharing initiative. This initiative is intended to enable
greater information sharing capabilities among federal, state, and
local agencies and to have the necessary data security to house
classified data. According to NBIC officials, this initiative is being
led by the National Security Council.
To communicate alerts to member agencies and the larger NBIS community
regarding any incident that could develop into a biological event of
national concern, NBIC has developed an IT system to provide alerts and
warnings, based on an existing system that had been developed for
another DHS component. However, according to NBIC officials, the system
has not yet been fully implemented because they recently acquired it,
and NBIC is still testing protocols for using it. According to our
observations of the system and review of operational protocols, the
system provides NBIC with the capability to tailor alerts and warnings
to specific recipients via distribution lists. These officials said
that in spring 2008 the protocols were approved by the NIWG and briefed
to the NIOC. NBIC officials said they are currently testing the
protocols but have not yet needed to employ the system during a
biological event.
Use of Key Collaboration Practices Could Help NBIC Strengthen
Collaboration and Promote Fuller Participation:
Our analysis and interviews with NBIS partners suggest that NBIC could
strengthen its use of collaborative practices. Because participation in
the NBIS is voluntary, effective use of collaborative practices is
essential to NBIC's ability to successfully develop and oversee the
NBIS in a way that enhances federal biosurveillance capabilities.
However, we found (1) widespread uncertainty and skepticism around the
value of participating in the NBIS and the purpose of NBIC; (2)
incomplete joint strategies, policies, and procedures for operating
across agency boundaries; (3) an inability or unwillingness of NBIS
members to respond to plans for leveraging resources; (4) confusion and
dissatisfaction around the definitions of mission, roles, and
responsibilities of NBIC and its NBIS partners; and (5) a lack of
mechanisms to monitor and account for collaborative results.
Clearly Defining the Mission and Purpose, the Value of Participation,
and Joint Strategies and Procedures Could Promote More Effective
Interagency Cooperation:
Biosurveillance integration is an inherently interagency enterprise,
requiring expertise and resources from various federal agencies, such
as information on human and zoonotic diseases monitored by HHS and
USDA.[Footnote 22] Indeed, NBIC officials acknowledged that NBIC cannot
provide national-level capability for cross-domain biosurveillance
relying solely on DHS resources. As a result, it is crucial for NBIC to
ensure stakeholder buy-in and participation in clearly defining the
value of NBIS participation and NBIC's mission or purpose, as well as
establishing the strategies and procedures for how the partners will
work together. Our prior work states that effective collaboration
requires agencies to have a clear and compelling rationale for working
together, which can be achieved by defining and articulating a common
federal outcome or purpose.[Footnote 23] The rationale can be imposed
externally through legislation or other directives or can come from the
agencies' own perceptions of the value of working together. In either
case, agency staff can accomplish this by working across agency lines
to define and articulate the common purpose they are seeking to achieve
that is consistent with their respective agency goals and mission.
Because there is no legal requirement for agencies to participate in
NBIS, agencies must have a clear and compelling rationale to work
together as a community of federal partners by joining the NBIS and
providing data and personnel to the integration center. In the case of
an agency like NBIC, for which collaboration is essential, clearly
defining and communicating its purpose and mission can help to ensure
that partners share a vision of the desired outcomes.[Footnote 24] In
addition, our work has shown that to enhance and sustain collaboration,
it is important to establish joint strategies, policies, and procedures
for operating across agency boundaries. Establishing joint strategies
and compatible policies and procedures helps align collaborating
agencies' activities, processes, and resources to, among other things,
bring together diverse organizational cultures to enable a cohesive
working relationship across agency boundaries and create the mutual
trust required to sustain the collaborative effort.
However, we found in interviews with agency officials from 14
components of the 11 NBIS partners,[Footnote 25] widespread uncertainty
and skepticism around the value of and rationale for participation in
the NBIS and incomplete strategies, policies, and procedures for
operating across agency boundaries that lack key stakeholder buy-in.
Twelve of the 14 NBIS-partner components expressed uncertainty about
the value of participating in the NBIS community or confusion about the
purpose of NBIC. For example, officials from one component stated that
they were uncertain whether sharing resources with the integration
center, something that is required of members of the NBIS community,
would further their agency's missions. Officials from another component
expressed concerns about the rationale for participating in the NBIS
and supporting the integration center, stating they were unsure whether
NBIC contributed anything to the federal biosurveillance community that
other agencies were not already accomplishing in the course of carrying
out their biosurveillance-relevant missions. Officials from five of
these components noted that their uncertainty about the value of
participation in the NBIS was a factor in not assigning personnel to
NBIC. Further, officials from 7 of the 14 components we interviewed
indicated that their experience with a recent tabletop exercise and
real life events had contributed to their concerns about the value of
participating in NBIS and the purpose of NBIC. For example, officials
from one component said that the tabletop exercise showcased agencies'
reluctance to share information and underscored that there was no role
for NBIC; while officials from another component said that during 2009
H1N1 activities, NBIC was not able to demonstrate that it had unique
value to add. Officials from seven of the components indicated that
they lacked a concrete understanding of the purpose for which NBIC was
requesting their agencies' data, which was, in part, the reason they
had not been able to identify appropriate data sources or to work out
data sharing agreements with NBIC.
NBIC officials told us that they regularly reminded NBIS partners of
NBIC's mission as the coordinator of the NBIS and the value of sharing
data and personnel to achieve the goal of earlier detection and
enhanced situational awareness. However, officials from 8 of the 14
components told us that during negotiations with NBIC, they had raised
concerns about the purpose of the data or the value of detailing
personnel to NBIC, and NBIC had not followed up in a timely and
consistent manner to resolve those concerns. NBIC officials also stated
that they have taken actions to demonstrate the value of participating
in NBIS and of sharing resources with the integration center. For
example, NBIC co-located the integration center's analysts with
analysts at other agencies, such as the Centers for Disease Control and
Prevention, for brief periods of time to enhance mutual understanding
between NBIC and NBIS partner agencies. Further, NBIC officials have
attempted to demonstrate the value of participating in NBIS and
supporting the integration center by encouraging agencies to
participate in NBIC's daily production process. NBIC officials said
that through daily engagement in the production process and during
recent real life events like food borne illness outbreaks they have
been able to demonstrate the value of NBIC. However, agency officials
told us that their experiences with NBIC during real life events and
the tabletop exercise created questions about the value of
participating in the NBIS and NBIC's purpose.
NBIC officials have drafted but not completed a strategic plan for NBIC
that includes a mission statement, which could help clarify NBIC's
purpose. The plan is also to provide strategic and operational guidance
to NBIC officials for achieving that mission. According to NBIC
officials, however, they have not shared the draft strategic plan with
NBIS officials or solicited their input, and it is not currently their
plan to do so because it is an internal document. Officials have not
set a deadline for completing the NBIC strategic plan because they are
still in the process of vetting the initial draft internally.
In addition to uncertainty about the value of participating in the NBIS
and the purpose of NBIC, we also found that NBIC has not completed and
achieved buy-in for joint strategies, policies, and procedures for
operating across agency boundaries. NBIC has drafted a Concept of
Operations, which is intended to communicate joint strategies,
policies, and procedures for operating across the NBIS. According to
NBIC officials, they have solicited and considered comments from NBIS
partners as they developed the draft, which is currently on its third
version. However, NBIC has not yet achieved agreement around
strategies, policies, and procedures that would support effective
collaboration across the NBIS. For example, one key partner agency--one
for which biosurveillance is a mission critical function and is thus
essential to a strong and effective NBIS--shared with us a memo they
had written to NBIC expressing their lack of concurrence with the
current Concept of Operations. The memo cited several concerns that
related largely to lack of clarity in the document about the desired
common federal outcome and the role of the different partners in
achieving it. NBIC officials told us they plan to finalize the Concept
of Operations by the end of 2009.
Clearly defining its mission, as well as articulating the value of
participation in the NBIS, could help NBIC overcome challenges
convincing agencies to work collectively as part of the NBIS. In
addition, establishing and clarifying joint strategies, policies, and
procedures with buy-in across the NBIS, could help address barriers to
collaboration.
NBIC Has Not Clearly Identified How to Leverage Resources or
Effectively Defined Roles and Responsibilities with NBIS Partners:
Two of the collaborative practices we recommend speak to how agencies
will share human and other assets to achieve the desired outcomes--
identifying and addressing needs by leveraging resources and agreeing
on roles and responsibilities.[Footnote 26] According to NBIC
officials, the concept of a national center for integrating
biosurveillance data from multiple agencies depends on the willingness
of the collaborating agencies to detail their experts to the center for
a period of time to interpret the data for signs of an outbreak or
biological attack; consequently, effectively identifying what resources
are available and how to leverage them is important.
In our work on practices to enhance and sustain collaboration, we call
for agencies to assess relative strengths and weaknesses to identify
opportunities to leverage each other's resources, thus obtaining
additional benefits that would not be available were the agencies
working separately. However, agency officials we met with stated that
NBIC did not recognize the different levels of resources and capacities
that each agency brought to this effort. Seven of the 14 groups of
agency officials we interviewed noted that the NBIC made personnel
requests that were not compatible with the resources agencies had
available. For example, one of the comments officials made to us
regarding NBIC's request for personnel details was that they did not
have available or could not spare personnel that matched NBIC's request
for senior-level officials with sufficient analytical knowledge and
authority to make immediate decisions about sharing information across
the NBIS. Officials from one of the components without a direct
biosurveillance mission told us that they only have one such person on
staff and needed to keep that person in house to be able to carry out
their mission-critical activities. Officials at two agencies described
methods they had devised for human-resource sharing arrangements that
did not involve locating senior staff at NBIC for several months.
However, NBIC officials told us that this is no substitute for the
value of a member agency personnel detail that is physically located at
NBIC. NBIC officials noted that the Secretary of Homeland Security had
sent a memo to other NBIS agency leadership requesting help in securing
personnel details on May 23, 2008. In addition, they stated that the
issue is regularly addressed in NIWG and NIOC meetings. The officials
also provided several examples of outreach to NBIS officials at all 11
agencies, such as through discussions with NBIS partner agency
representatives at NIWG meetings.
Similarly, 5 of 14 groups of officials we interviewed reported that
they had experienced confusion about how NBIC planned to use personnel
details if they were provided. For example, one such agency expressing
this confusion said that NBIC's guidance on what it is looking for in a
personnel detail had changed frequently. NBIC officials told us that
initially they requested individuals with strong scientific backgrounds
to assist with data analysis and interpretation (analyst model).
However, they later determined that they could use senior-level agency
officials who were knowledgeable about their home organization to act
as liaisons by identifying specific subject matter experts to consult
with NBIC, as needed (liaison model). According to these NBIC
officials, they have communicated to the NBIS partners that if they
detail personnel to NBIC, they can follow either the analyst model or
the liaison model. Nevertheless, during our interviews a lack of
clarity about personnel detail roles and responsibilities was among the
reasons cited for not finalizing MOUs or interagency agreements for
personnel details.
Of the two NBIS partners that placed personnel at NBIC, officials from
one agency told us that although they still were not entirely clear on
NBIC's needs, they were committed to the NBIS concept. Therefore, they
committed to send two half-time detailees each fitting one of the two
types of detailees NBIC had alternately requested. These personnel
details were ongoing as of October 2009. According to agency officials,
they committed to a shorter detail than NBIC requested because they
intend to use the current detail placement to help clarify for
themselves what NBIC's needs are and the extent to which the detail
arrangement might be valuable to their agency. However, officials at
the only other agency that had detailed personnel to NBIC told us that
they had not renewed the detail agreement when it ended, in part
because of budgetary challenges, but also because of a general
perception at their agency that the detail had not been particularly
valuable for the individual or for their agency. According to NBIC
officials, the personnel details from this agency assisted NBIC
immeasurably in both the analysis work and in thinking through how to
grow and shape the personnel detail program.
We also discuss in our work on practices for enhancing and sustaining
collaboration the importance of defining and agreeing on roles and
responsibilities, to allow each agency to clarify who will do what,
organize their joint and individual efforts, and facilitate decision
making.[Footnote 27] Our analysis of NIOC and NIWG post meeting
reports, NBIS tabletop exercise results, and interviews with NBIS
agency officials reveals some ambiguity about NBIC's mission, roles,
and responsibilities, particularly during a crisis. Officials from 8 of
14 components we interviewed expressed uncertainty about NBIC's role
during a response relative to the biosurveillance capability provided
by other agencies in the course of their routine, mission-critical
duties. In large part, these officials said that if they had
information to share that might involve a biological emergency, they
would be more likely to interact with DHS's National Operations Center
(NOC), at which NBIC has representation, than directly with NBIC.
[Footnote 28] The after action report, as well as comments from these
officials, show that such questions about NBIC's response role
manifested during a recent tabletop exercise. In our interviews,
officials from seven components expressed concerns about NBIC's role in
the exercise or real life events, ranging from lack of clarity about
what role NBIC played or should play to statements that the exercise
showed clearly that NBIC has no proper role in event response.
According to the memo that the moderator prepared after the tabletop
exercise, although the NOC did not participate, some participants
thought NBIC would have been bypassed in favor of the NOC. They said
the NOC would perform the essential biosurveillance integration roles
of coordinating and disseminating information across agencies, states,
and the private sector. In addition, the memo notes that exercise
participants were not in agreement about the proper role for NBIC in
ongoing collection and dissemination of data specific to an identified
event. Among the recommendations in the after-action memo was for NBIC
to work internally with the appropriate DHS parties, including the NOC,
to write protocols defining the NBIC role inside DHS. According to NBIC
officials, they have followed up on this recommendation, by among other
things, exploring it through the NIWG. Additionally, NBIC, the NOC, and
other stakeholders have initiated discussions about how to develop
appropriate protocols.
A related issue that came to light during the tabletop exercise and was
a theme in interviews with NBIS officials is the extent to which NBIS
partners trust NBIC to use their information and resources
appropriately. According to the exercise after-action memo,
participants repeatedly raised concerns about trusting NBIC with data,
and participants also expressed concern that NBIC would reach the wrong
conclusions or disseminate erroneous data or reports. Similarly, in our
semistructured interviews, officials from 5 of 14 components said they
were cautious about sharing data or information with NBIC because they
lack confidence that NBIC will either interpret it in the appropriate
context or reach back to the agency to clarify before sharing the data
across the whole interagency community. These comments generally noted
concerns that NBIC's lack of contextual sophistication could lead to
confusion, a greater volume of unnecessary communication in the
biosurveillance environment, or even panic. NBIC officials acknowledged
that subject matter expertise from the agencies with frontline
responsibility for disease surveillance is essential for drawing
appropriate conclusions about emerging situations. However, they also
noted that analysts at NBIC have experience with public health and have
been building their expertise as the program matures. Clearly
identifying how NBIS resources, including personnel details, will be
leveraged and establishing institutional roles and responsibilities,
could strengthen NBIC's efforts to obtain buy-in for agencies to fully
participate in the NBIS, including by committing to personnel detail
arrangements.
Creating a Mechanism to Monitor Performance and Accountability Could
Help NBIC Enhance and Sustain Collaboration:
We have previously reported that federal agencies can use their
strategic and annual performance plans as tools to drive collaboration
with other agencies and partners.[Footnote 29] Such plans can also
reinforce accountability for collaboration by establishing performance
measures and aligning agency goals and strategies with those of the
collaborative efforts. Using established performance measures to
evaluate and report on the effectiveness of collaboration could
identify ways to improve it. NBIC's draft strategic plan outlines
milestones, goals, objectives, and key tasks needed for NBIC to meet
its mission. These tasks include, among other things, defining an
information-sharing strategy among its stakeholders, deploying IT to
support its mission, and establishing standard operating procedures.
However, despite acknowledging that interagency cooperation and
collaboration remain a concern to resolve, the strategic plan does not
address how NBIC will improve collaboration among current and potential
NBIS member agencies or how it will measure collaborative results.
NBIC's draft strategic plan includes one proposed performance metric
related to collaboration with NBIS partners--to assess current
collaboration activities for relevance and contribution to NBIS mission
requirements. However, the plan lacks a discussion of strategic
objectives to achieve collaboration and, correspondingly, lacks
associated measures and targets to monitor efforts to achieve
collaborative results. Strategic objectives for collaboration and
associated targets and measures could provide NBIC with a critical tool
to help ensure that it appropriately focuses its efforts on enhancing
collaboration with NBIS members and that the desired results are
achieved.
Leveraging NBIS Governing Bodies to Develop a Strategy for
Collaboration Could Help NBIC More Effectively Meet Its Mission:
NBIC has the means to engage NBIS partners through the organizations
that help organize and manage the NBIS community--the NIOC and the
NIWG--but our analysis shows the integration center has not yet fully
leveraged these groups to develop effective collaboration strategies.
The purpose of the NIOC and NIWG governance bodies is to provide
strategy and policy advice on the operation of the NBIS. Information on
the status of NBIC's efforts to achieve its mission has been provided
to the NIOC, an oversight council serving the NBIS community, but
substantive discussion of strategies for overcoming barriers to
collaboration that impact NBIC's execution of its mission did not occur
during meetings with the NIOC. For example, post meeting reports from
the NIOC--the higher level strategic governance body for the community
of NBIS partners--show that the NBIC director routinely gave a status
update of the MOUs and interagency agreements for each agency, during
which agencies report the status from their perspective. However, in
these segments of the NIOC meetings, the post meeting reports reflect
little, if any, discussion of the reasons NBIS agency officials cited
in our interviews for not finalizing the agreements. Neither do the
reports show any focused effort to discuss barriers to participation or
solutions to working across agency boundaries.
The NIWG--operational level working group--post meeting reports between
March 2008 and May 2009 reflect only one discussion during which the
need to finalize agreements was addressed. Although the NIWG has formed
a sub-working group specifically to address collaboration, our review
of the post meeting reports shows that neither the full NIWG nor the
sub-working group has been effectively engaged in a focused effort to
identify, discuss, and address challenges to working across agency
boundaries. According to NBIC officials, they place contentious issues
before the NBIS governance structure in a way that may not be clearly
captured in post meeting reports. NBIC officials noted that the post
meeting reports do not clearly reflect the numerous times they have
made proposals for solutions to problems and have been met with silence
from the attendees. However, they acknowledge that they have approached
the NBIS governance bodies seeking buy-in for their proposals for
tactical and operational approaches rather than an open-ended
discussion seeking strategic solutions to the broader barriers to
information and resource sharing. Leveraging these bodies to get
meaningful input from NBIS-partner leadership could help NBIC ensure
that it is able to identify commonly accepted solutions to working
across agency boundaries.
Conclusions:
Enhancing the federal government's ability to detect and warn of
biological events of national concern and to provide better situational
awareness for response to those events depends on multiple actors
inside and outside the federal government to work together effectively.
The 9/11 Commission Act charged NBIC with early detection and
situational awareness, but both the act and the operational guidance
NBIC has developed acknowledges that this is to be done, in large part,
through the NBIS--a multi-agency collaborative community. Despite the
critical role of this collaborative community in achieving the act's
charge, the act does not require any specific agency to participate in
the NBIS or to support the integration center. Therefore, it is
imperative that NBIC employ collaborative practices to enhance and
sustain collaboration across the NBIS so that this community of federal
partners are fully and effectively engaged in pursuit of the
overarching missions of early detection and enhanced situational
awareness.
Although NBIC has made some efforts to strengthen relationships with
and solicit participation from NBIS partners, working with the NBIS to
develop a strategy for collaboration that includes key collaboration
practices identified in our previous work could help the integration
center promote more effective collaboration. During the course of our
review, officials from the NBIS community recounted a number of
constraints on their participation, including concerns about the
clarity of NBIC's mission and the ends to which shared information and
resources would be used. We have previously reported that having a
mission statement helps to clarify an agency's focus and purpose.
Moreover, our prior work on enhancing and sustaining collaboration in
the federal government advises that practices such as articulating
common outcomes, identifying appropriate resources to be shared,
clarifying roles and responsibilities, and developing mechanisms to
monitor performance and accountability could help NBIC address barriers
to collaboration. However, NBIC has not formulated goals and objectives
for overcoming barriers to collaboration and has no supporting
performance and accountability mechanisms--such as performance
measures--to help ensure that they are pursuing those goals
effectively. In addition, although NBIC has created the NIOC and NIWG
to provide strategic and operational advice on how the NBIS should
function, NBIC had not effectively engaged them in a focused effort to
identify shared solutions for overcoming barriers to collaboration and
creating buy-in for joint strategies, policies, procedures, roles, and
responsibilities. A strategy for helping ensure that NBIC applies key
collaborative practices effectively and consistently, that draws on the
existing intellectual resources of its strategic partners in the NIOC,
and that includes mechanisms to monitor performance and accountability
for collaborative results, may help NBIC and NBIS partners to identify
and overcome challenges to sharing data and personnel for the purposes
of earlier detection and enhanced situational awareness of potentially
catastrophic biological events.
Recommendations for Executive Action:
In order to help NBIC ensure that it effectively applies practices to
enhance and sustain collaboration, including the provision of data,
personnel, and other resources, we are making the following two
recommendations to the Director of NBIC:
* In conjunction with the NIOC, finalize a strategy for more
effectively collaborating with current and potential NBIS members, by
(1) clearly defining NBIC's mission and purpose, along with the value
of NBIS membership for each agency; (2) addressing challenges to
sharing data and personnel, including clearly and properly defining
roles and responsibilities in accordance with the unique skills and
assets of each agency; (3) developing and achieving buy-in for joint
strategies, procedures, and policies for working across agency
boundaries.
* Establish and use performance measures to monitor and evaluate the
effectiveness of collaboration with current and potential NBIS
partners.
Agency Comments and Our Evaluation:
We provided a draft of this report for review and comment to the
following agencies: DHS, HHS, USDA, and the Departments of Commerce,
Defense, Interior, Justice, State, Transportation, and Veterans
Affairs, as well as the Environmental Protection Agency and the United
States Postal Service. DHS provided written comments on December 10,
2009, which are summarized below and presented in their entirety in
appendix I of this report. HHS, USDA, and the Departments of Commerce,
Defense, Interior, Justice, Transportation, and Veterans Affairs, as
well as the Environmental Protection Agency and the United States
Postal Service did not provide written comments. We incorporated
technical comments from DHS, USDA, and the United States Postal Service
where appropriate.
DHS generally concurred with our findings and recommendations and
stated that NBIC will work with the NIOC and all NBIS partners to
develop a collaboration strategy to clarify both the mission space and
roles and responsibilities of all NBIS partners. DHS has taken initial
steps to implement our recommendations. For example, DHS noted that at
the December 9, 2009, quarterly NIOC meeting, the Assistant Secretary
of Health Affairs and Chief Medical Officer for DHS, Dr. Alex Garza,
referenced this report's findings and challenged NIOC members to work
to resolve and address confusion regarding NBIS and NBIC. We are
encouraged by DHS's efforts to engage the NIOC to identify and overcome
barriers to collaboration; continuing to work with the NIOC to develop
and finalize a strategy for collaboration could help NBIC overcome
challenges to sharing data and personnel. In addition, monitoring the
effectiveness of collaboration through the use of performance metrics
could help NBIC ensure they are progressing towards their goal of
obtaining the resources necessary to accomplish its mission of early
detection and situational awareness of biological events of national
concern.
While DHS stated that we clearly identify the challenges faced by NBIC
in carrying out its mission, the department also commented that the
lack of a legal requirement for other federal agencies to participate
in the NBIS prevents DHS from compelling the cooperation that is needed
to ensure success of the NBIC mission. As we noted in our report, the
lack of a legal requirement is what makes the effective use of
collaboration best practices crucial for NBIC to be successful.
We are sending copies of this report to the Secretary of Homeland
Security, Secretary of Health Human and Services, Secretary of
Agriculture, Secretary of Commerce, Secretary of Defense, Secretary of
Interior, Attorney General, Secretary of State, Secretary of
Transportation, and the Secretary of Veterans Affairs, as well as the
Administrator of the Environmental Protection Agency, the Postmaster
General, the Director of NBIC, and interested congressional committees.
The report is also available at no charge on GAO's Web site at
[hyperlink, http://www.gao.gov].
If you or your staff have any questions about this report please
contact me at (202) 512-8777 or JenkinsWO@gao.gov. Contact points for
our Offices of Congressional Relations and Public Affairs may be found
on the last page of this report. GAO staff who made major contributions
to this report are listed in appendix II.
Signed by:
William O. Jenkins, Jr.
Director, Homeland Security and Justice Issues:
[End of section]
Appendix I: Comments from the Department of Homeland Security:
US. Department of Homeland Security:
Washington, DC 20528:
December 10, 2009:
Mr. William 0. Jenkins:
Director, Homeland Security and Justice Issues:
U.S. Government Accountability Office:
441 G St., N.W.
Washington, D.C. 20548:
Dear Mr. Jenkins:
Thank you for the opportunity to review and provide comments on the
Government Accountability Office's (GAO) draft report titled,
Biosurveillance: Developing a Collaboration Strategy Is Essential to
Fostering Interagency Data and Resource Sharing (GAO-10-171).
The Department of Homeland Security (DHS) has reviewed the referenced
draft GAO report and generally concurs with its findings regarding the
National Biosurveillance Integration System (NBIS) and the National
Biosurveillance Integration Center (NBIC). DHS would, however, like to
offer two additional comments to more properly place the
recommendations in context.
First, the GAO report clearly identifies the challenges faced by NBIC
in carrying out its mission ” challenges exacerbated by the lack of
data and personnel resources from federal partner agencies. DHS
respectfully points out that there is no legal requirement for other
federal agencies to cooperate with NBIC, and therefore, DHS cannot
compel the cooperation that is needed to ensure success of the NBIC
mission. Nonetheless, DHS has and will continue to make every effort to
engage appropriate interagency members and bolster confidence in the
NBIC mission, which is to provide homeland security-relevant
biosurveillance information to senior leaders and partner agencies
regarding natural disease outbreaks, accidental or intentional uses of
biological agents, and emergent biohazards through the acquisition,
integration, analysis and dissemination of information from existing
human disease, food, agriculture, water, meteorological, and
environmental surveillance systems and relevant threat and intelligence
information.
Second, DHS acknowledges the shared responsibility among NBIC and the
NBIS partners related to GAO's findings that there is "widespread
confusion, uncertainty, and skepticism around the value of
participation in the interagency community, as well as the mission and
purpose of NBIC." NBIC established the NBIS Interagency Oversight
Council (NIOC) as an Assistant-Secretary-level governance function to
provide guidance and assist in the resolution of interagency issues
that are not resolved at the staff level. All NBIS partners are
represented at the NIOC and other working groups. Since the signing of
the NIOC charter in August 2008, the NIOC has met quarterly to review
NBIC actions, progress, and future plans. In August 2009, Dr. Alex
Garza was appointed as the Assistant Secretary of Health Affairs and
Chief Medical Officer for DHS. At the December 9, 2009, NIOC meeting,
Dr. Garza referenced GAO's findings and challenged NIOC principals to
work to resolve and address confusion regarding NBIS and NBIC. The NBIC
will work with the NIOC and all NBIS partners to develop a strategy to
eliminate the impediments to collaboration to clarify both the mission
space and roles and responsibilities of all NBIS participants. Through
the focused, joint efforts of the NIOC principals, NBIS partners and
the NBIC staff, we will improve our Nation's biosurveillance
capabilities to better secure and protect the homeland from intentional
and naturally occurring biological threats and events.
DHS is dedicated to ensuring the Nation is prepared against all threats
and will ensure NBIC is best able to accomplish its important mission.
Thank you for the opportunity to review and provide comments to the
draft report and we look forward to working with you on future homeland
security issues.
Sincerely,
Signed by:
Jerald E. Levine:
Director:
Departmental DHS GAO/OIG Liaison:
[End of section]
Appendix II: GAO Contact and Staff Acknowledgments:
GAO Contact:
William O. Jenkins, Jr., (202) 512-8777 or jenkinswo@gao.gov:
Acknowledgments:
In addition to the contact named above, Anne Laffoon, Assistant
Director; Michelle Cooper; Clare Dowdle; Kathryn Godfrey; and Andrea
Yohe made significant contributions to the work. Keira Dembowski,
Susanna Kuebler, Alberto Leff, and Juan Tapiavidela also provided
support. Amanda Miller assisted with design, methodology, and analysis.
Tracey King provided legal support. Linda Miller provided
communications expertise.
[End of section]
Footnotes:
[1] GAO, Homeland Security: Much Is Being Done to Protect Agriculture
from a Terrorist Attack, but Important Challenges Remain, [hyperlink,
http://www.gao.gov/products/GAO-05-214] (Washington, D.C.: Mar. 8,
2005).
[2] Pub. L. No. 110-53 § 1101, 121 Stat. 266, 375-79 (2007) (codified
at 6 U.S.C. § 316).
[3] § 1102, 121 Stat. at 379.
[4] The 9/11 Commission Act defines an NBIS "Member Agency" as a
federal department or agency that has signified its willingness to
participate in the NBIS by signing a memorandum of understanding with
NBIC. 6 U.S.C. § 316(j)(4). We use the term "NBIS partner" throughout
this report to describe those federal departments and agencies and
their related components that NBIC has identified as having potential
to share relevant information and data with the NBIS community
irrespective of whether the agency in question has entered into any
interagency agreement. At least one such federal department, for
example, told us that it does not plan to sign a memorandum of
understanding to become a "Member Agency," but participates with the
NBIS community to some degree.
[5] GAO, Biosurveillance: Preliminary Observations on Department of
Homeland Security's Biosurveillance Initiatives, [hyperlink,
http://www.gao.gov/products/GAO-08-960T] (Washington, D.C.: July 16,
2008).
[6] NBIC issued the first version of the Concept of Operations in
December 2007. Subsequently, NBIC created version 2.0 of the Concept of
Operations, which has not yet been finalized. We reviewed both of these
documents in the course of our work.
[7] NBIC has identified the following NBIS partners at the federal
level--The Departments of Health and Human Services (HHS), Agriculture
(USDA), Commerce, Defense, Interior, Justice, State, Transportation,
and Veterans Affairs, as well as the Environmental Protection Agency
and the United States Postal Service.
[8] GAO, Results-Oriented Government: Practices That Can Help Enhance
and Sustain Collaboration among Federal Agencies, [hyperlink,
http://www.gao.gov/products/GAO-06-15] (Washington, D.C.: Oct. 21,
2005).
[9] Situational awareness, in the biosurveillance context, includes
cognizance of the existence and meaning of a biological threat, as well
as the ability to make projections regarding its probable status in the
near future--for example, the likelihood of an emerging infectious
disease becoming an epidemic.
[10] 6 U.S.C. § 316.
[11] In July 2007 the DHS Office of Inspector General reported that the
program lacked sustained program leadership and was not a priority,
because ownership of the program shifted among department organizations
numerous times, with corresponding fluctuations in the program
approach, priority, and accomplishments. According to the DHS Inspector
General, despite the changes in program focus, the program benefited
from increased senior-level support and priority under the Office of
the Chief Medical Officer. DHS OIG Report, Better Management Needed for
the National Bio-Surveillance Integration System Program, OIG-07-61
(July 26, 2007).
[12] HSPD-10, also called Biodefense for the 21st Century, describes
four "pillars" of biodefense: (1) threat awareness, (2) prevention and
protection, (3) surveillance and detection, and (4) response and
recovery.
[13] Most states use a national list of notifiable diseases maintained
and revised by the Council of State and Territorial Epidemiologists in
collaboration with HHS's Centers for Disease Control and Prevention.
This national list is reviewed annually and revised periodically.
However, each state adapts this list such that the diseases considered
notifiable and the requirements for reporting them vary by state.
[14] [hyperlink, http://www.gao.gov/products/GAO-06-15].
[15] NBIC issued the first version of the NBIS Concept of Operations--
version 1.0--in December 2007. Subsequently, NBIC issued version 1.1 of
the Concept of Operations in October 2008 and created version 2.0 of
the Concept of Operations to incorporate NBIS member comments regarding
the earlier versions. NBIC shared the latest version with NBIS member
agencies for review in August 2009 and it is currently undergoing
interagency review.
[16] The MOU is a general agreement to participate in NBIC. The IAA is
a more specific agreement that outlines how personnel will be shared.
The ISA, which ultimately must be finalized for data to be shared,
addresses security and privacy issues related to the handling of the
data.
[17] The number of MOUs signed does not directly reflect the level of
agency participation in the NBIS. In the absence of an MOU outlining
agencies' agreement to participate in the NBIS, NBIC and other NBIS
officials told us that federal agencies may still take part in NBIS
activities. For example, three of the federal agencies that have not
signed an MOU participate in key NBIS processes and meetings while some
agencies have not provided data or personnel to NBIC even though they
have signed an MOU.
[18] 6 U.S.C. § 316(e)(1)(F).
[19] 6 U.S.C. § 316(c)(3).
[20] The early version of the information management system was called
NBIS 2.0, but it is currently known as the Biosurveillance Common
Operating Network. For the purposes of this report, we use the current
NBIC nomenclature, where NBIS refers to a community of stakeholders and
the Biosurveillance Common Operating Network is the technology
management system.
[21] The Homeland Security Information Network is a comprehensive,
nationally secure and trusted Web-based platform able to facilitate
Sensitive but Unclassified information sharing and collaboration among
federal, state, local, tribal, private sector, and international
partners.
[22] Zoonotic diseases are those that can be transmitted from animals
to humans.
[23] [hyperlink, http://www.gao.gov/products/GAO-06-15].
[24] In addition to our call for agencies to clearly define common
outcomes to support collaborative efforts, we have also recommended
clearly defined mission statements to keep agency objectives in focus.
In prior work on strategic planning and management, we have reported
that statements that clearly define the mission of an organization are
important because they bring the agency into focus, explain why the
agency exists, and tells what it does. GAO, Agencies' Strategic Plans
under GPRA: Key Questions to Facilitate Congressional Review, GAO/GGD-
10.1.16 (Washington, D.C.: May 1997).
[25] At HHS, we interviewed a group of officials from the Office of the
Assistant Secretary for Preparedness and Response, groups of officials
at the Centers for Disease Control and Prevention, and a group of
officials from the Food and Drug Administration. At USDA, we
interviewed officials from the Animal and Plant Health Inspection
Service and the Food Safety Inspection Service. At the Department of
Defense, we interviewed a group of officials responsible for medical
force readiness and a group of officials at the National Medical
Intelligence Center. Although DHS is a member of the NBIS, we excluded
DHS from our analysis of these 14 components from 11 federal agencies
because it houses the program.
[26] [hyperlink, http://www.gao.gov/products/GAO-06-15].
[27] [hyperlink, http://www.gao.gov/products/GAO-06-15].
[28] DHS's NOC is to provide real-time situational awareness and
monitoring, coordinate incidents and response activities, and, in
conjunction with the Office of Intelligence and Analysis, issue
advisories and bulletins concerning threats to homeland security, as
well as specific protective measures. The NOC operates 24 hours a day,
7 days a week, 365 days a year. Information on domestic incident
management is shared with Emergency Operations Centers at all levels
through the Homeland Security Information Network.
[29] [hyperlink, http://www.gao.gov/products/GAO-06-15].
[End of section]
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