The Results Act

Pursuant to a congressional request, GAO reviewed the latest available version of the Department of Health and Human Services' (HHS) April 1997 draft strategic plan, focusing on: (1) the plan's response to the Results Act's six requirements and the strengths and weaknesses of the plan's elements; (2) whether the plan covers the agency's key statutory authorities; (3) whether any agency programs, activities, or functions are crosscutting, that is, similar to or related to goals, activities, or functions of other agencies, and the extent to which the strategic plan reflects interagency coordination; (4) if the draft plan addresses major management problems; and (5) the agency's capacity to provide reliable information about performance.

GAO noted that: (1) HHS' draft strategic plan is more a summary of current programs than a document projecting actions the Department might take in the next several years to achieve its six goals; (2) although a description of current programs is helpful, a strategic plan should allow the Congress and the American people to understand the direction in which HHS' programs will move; (3) the plan in its draft form does not provide a useful basis for consultation with the Congress and others interested in the Department's future; (4) greater attention in the plan to the six critical elements in the Results Act would allow for more informed evaluation of the appropriateness of HHS' goals and objectives and the strategies for achieving them; (5) HHS officials recognize that the plan is incomplete but felt that it was important to make available at least the framework for the plan in time to get comments from their many stakeholders; (6) officials said they have been working on the missing elements and expect to have them in place by September 30; (7) specifically, while the plan's mission statement successfully captures the broad array of the Department's activities, many required elements of HHS' draft strategic plan are incomplete or missing; (8) the draft plan identifies six overarching Department-wide goals, such as to improve the quality of health care, public health, and human services and to promote self-sufficiency and parental responsibility; (9) it also recognizes that many different departmental agencies, such as the Health Care Financing Administration (HCFA), the National Institutes of Health (NIH), and Administration for Children and Families, are responsible for achieving the goals; (10) HHS has not, however, consistently identified strategies for achieving the goals or included measurable objectives indicating, for example, how to measure an increase in self-sufficiency; (11) similarly, the draft plan does not sufficiently acknowledge the many other federal partners, like the Department of Education, that share responsibility with HHS for many of the same kinds of programs, such as education and training; (12) also missing are discussions of the considerable management challenges HHS faces in carrying out both its program responsibilities and the type of strategic planning and performance measurement the Results Act requires; and (13) in particular, the draft plan does not give enough weight to the role that state and local governments play in carrying out many of HHS' programs and the fact that these partners may lack the capacity to provide reliable and comparable information on achieving HHS' goals.