The HSC Monitors Agencies’ Progress on Most Action Items

The HSC monitors the status of action items in the Plan tasked to federal  agencies by convening regular interagency meetings and requesting  summaries of progress from agencies. For action items that involve multiple federal agencies, the six agencies  monitor the action items assigned to them by designating one or two  agencies to report one consolidated summary of progress for each action  item to the HSC, according to agency officials. We found that the Plan does not describe the specific circumstances, such  as the type or severity of an outbreak or pandemic, under which the  response-related action items would be undertaken. Federal agencies may have operational plans or other existing guidance  that would specify the information needed to determine whether to  undertake the response-related action items during a pandemic. Status of Some Selected Action Items Considered Complete Was Difficult to Determine

The HSC reported in October 2008 that about 75 percent of the 324 action  items in the Plan were designated as complete based on its criteria of  whether the measures of performance were achieved. Our review found,  however, that for more than half of the action items considered complete,  the measures of performance did not fully address all the activities  contained in their descriptions. All of the 49 action items designated as complete that we reviewed have  both a description of activities to be carried out, and a measure of  performance, which generally is used as an indicator to measure progress  of completion by responsible parties in carrying out what is specified in its  respective description. While the HSC’s  progress summaries sometimes corrected for this by referring to activities  in the action item’s description omitted from the measures of  performance, future progress reports would benefit from using measures  of performance that are more consistent with the action items’  descriptions. Finally, although the administration has prepared an additional planning  document tailored specifically to the 2009 H1N1 pandemic, the Strategy  and Plan will still be needed for future events. Because most of the action  items were to be completed by May 2009, the Plan should be updated, as  we earlier recommended, to include all the elements identified in our 2007  report and to take into account the lessons learned from the 2009 H1N1  pandemic. Recommendations for Executive Action

To improve how progress is monitored and completion is assessed under  the Plan and in future updates of the Plan, the HSC should instruct the  NSS to work with responsible federal agencies to    develop a monitoring and reporting process for action items that are  intended for nonfederal entities, such as state and local governments;  identify the types of information needed to decide whether to carry out  the response-related action items; and    develop measures of performance that are more consistent with the  descriptions of the action items. Appendix I: Objectives, Scope, and Methodology

The objectives of this study were to (1) determine how the Homeland  Security Council (HSC) and the responsible federal agencies are  monitoring the progress and completion of the Implementation Plan for  the National Strategy for Pandemic Influenza (Plan) action items, and (2)  assess the extent to which selected action items have been completed,  whether activity has continued on the selected action items reported as  complete, and the nature of that work. We did not assess the response  efforts for the 2009 H1N1 pandemic in this report, but we continue to  monitor the outbreak and the federal government’s response. In addition, we interv a senior HSC official from the previous administration and the Director of aff  Medical Preparedness Policy for the White House National Security St (NSS) in the current administration responsible for overseeing the  implementation of the Plan. Data are from the Implementation Plan for the Nation al Strategy for Pandemic Influenza.
Why GAO Did This Study

The current H1N1 pandemic highlights the threat posed to our nation by an influenza pandemic. The previous administration's Homeland Security Council (HSC) issued the Implementation Plan for the National Strategy for Pandemic Influenza (Plan) in May 2006 to help address a pandemic. The Government Accountability Office (GAO) was asked to (1) determine how the HSC and responsible federal agencies monitor the progress and completion of the Plan's action items; and (2) assess the extent to which selected action items have been completed. To do this, GAO interviewed officials from the HSC and the six federal agencies responsible for implementing most of the Plan, and analyzed a random sample of 60 action items. While this report does not assess the response efforts for the H1N1 pandemic, GAO continues to monitor the outbreak and the federal response.

What GAO Found

To oversee agencies' progress in implementing the Plan's action items, the HSC, which is supported by the White House National Security Staff in this administration, convenes regular interagency meetings, asks agencies for summaries of progress; and leads the interagency process that monitors the progress of the Plan. Officials from the six agencies stated that they monitor action items tasked to more than one agency by selecting one or two agencies to report a consolidated summary of progress, approved by each responsible agency, to the HSC. However, neither the HSC nor the agencies monitor or report on the 17 action items intended for nonfederal entities, including, for example, action items asking state, local, and tribal entities to ensure their preparedness plans address mass immunization, even though the information may have been available from other sources, such as the interagency review of state pandemic plans led by the Department of Health and Human Services. In addition, the Plan does not describe the types of information needed to carry out the Plan's response-related action items, although agencies may have operational plans or other existing guidance that would provide this information. The HSC reported in October 2008 that the majority of the 324 action items were designated as complete. However, GAO's review of 60 action items found that it was difficult to determine the actual status of some of the 49 designated as complete. All of the action items reviewed have both a description of activities to be carried out and a measure of performance, which the HSC stated that it used to assess completion. However, for more than half of the action items considered complete, the measures of performance do not fully address all of the activities contained in their descriptions. While the HSC's progress summaries sometimes corrected for this by either referring to activities in the action item's description or some other information not reflected in either the measure of performance or description, future progress reports would benefit from using measures of performance that are more consistent with the action items' descriptions. The Plan is predicated on a type of pandemic different in severity and origin than the current H1N1 pandemic, but it is serving as the foundation for the response to the outbreak, supplemented by an additional plan tailored specifically to the characteristics of the H1N1 pandemic. Nevertheless, the National Strategy for Pandemic Influenza and Plan will still be needed for future events as most of the action items in the Plan were to be completed by May 2009. As recommended in earlier GAO work, but not yet implemented, the Plan should be updated to take into account certain missing elements and lessons learned from the H1N1 pandemic; the update should also address the monitoring and assessment improvements GAO identified in this report.