Jurisdictions Have Expended over Four- Fifths of Fiscal Year 2002 Funds and over Half of Fiscal Year 2003 Funds

Jurisdictions had expended a substantial amount of fiscal year 2002 and  2003 program funds as of August 30, 2004. They had expended over four- fifths of the fiscal year 2002 funds awarded through the HHS P accounts  for the program’s third budget period and over half of the fourth budget  period funds awarded through the HHS P accounts. Few Bioterrorism Funds Remained Unobligated, According to Jurisdiction Reports

At the end of the Bioterrorism program’s third budget period, jurisdictions  reported that less than one-sixth of fiscal year 2001 and 2002 funds  awarded for that period remained unobligated. Seven  jurisdictions reported that all their funds from that period had been  obligated, and 44 jurisdictions reported that less than one-quarter of their  third budget period funds remained unobligated. Jurisdiction Estimates Indicated That One-Fifth of Fourth Budget Period Funds Remained Unobligated

According to jurisdiction estimates as of August 1, 2004, approximately   20 percent of all Bioterrorism funds awarded for the program’s fourth  budget period (August 31, 2003, to August 30, 2004) would remain  unobligated as of August 30, 2004. Jurisdictions Identified Administrative Processes and Other Challenges to Obligation and Expenditure, and Some Jurisdictions Described Solutions

Many jurisdictions faced challenges, partly related to state and local  administrative processes, that slowed the pace of their obligation and  expenditure of bioterrorism funds. Reported challenges included  workforce issues, contracting and procurement processes to ensure the  prudent use of public funds, and problems stemming from lengthy  information technology upgrades. Jurisdictions Reported Challenges to Obligation and Expenditure

State and municipal officials told us that the obligation and expenditure of  funds were delayed during the Bioterrorism program’s third and fourth  budget periods for a variety of reasons, including issues related to the  workforce, contracting and procurement, and information technology  upgrades. However, jurisdictions  expended and obligated a substantial amount of program funds as of  August 30, 2004. Agency Comments

We provided a draft of this report to HHS for comment, and the agency  informed us it had no comments on the draft report. Major contributors to this report are  listed in appendix V.

Appendix I: Scope and Methodology

For the Department of Health and Human Services (HHS) Centers for  Disease Control and Prevention’s (CDC) Public Health Preparedness and  Response for Bioterrorism program cooperative agreement, we provide  information on the extent to which jurisdictions had expended fiscal year  2002 funds awarded for the third budget period as of August 30, 2003, and  August 30, 2004, and had expended fiscal year 2003 funds awarded for the  fourth budget period as of August 30, 2004. To describe factors that jurisdictions say contributed to delays in  obligating and expending funds and actions some jurisdictions took to  address those factors, we contacted selected jurisdictions via e-mail in two  phases. Bioterrorism: Public Health Response to Anthrax Incidents of 2001.
Why GAO Did This Study

In 1999, the Department of Health and Human Services' (HHS) Centers for Disease Control and Prevention (CDC) began funding jurisdictions' efforts to prepare for bioterrorism attacks through the Public Health Preparedness and Response for Bioterrorism program. After the events of September 11, 2001, and the 2001 anthrax incidents, program funds increased almost twentyfold. Citing jurisdictions' unexpended program funds, HHS reallocated some fiscal year 2004 funds to support other local and national bioterrorism initiatives. Jurisdictions and associations representing jurisdictions disputed HHS's assertion that large amounts of funds remain unused, noting that HHS did not acknowledge obligated funds that had not yet been expended. GAO was asked to provide information on (1) the extent to which jurisdictions had expended the fiscal year 2002 funds awarded for the program's third budget period as of August 30, 2003, and August 31, 2004, and the fiscal year 2003 funds awarded for the program's fourth budget period, as of August 30, 2004; (2) the extent to which fiscal year 2001, 2002, and 2003 funds awarded for the third and fourth budget periods remained unobligated as of August 30, 2004; and (3) factors jurisdictions identified as contributing to delays in expending and obligating funds and actions some jurisdictions took to address them.

What GAO Found

Jurisdictions have expended a substantial amount of Bioterrorism program funds. As of August 30, 2004, jurisdictions had expended over four-fifths of the fiscal year 2002 funds awarded during the third budget period through the HHS P accounts--the public assistance accounts that track over 90 percent of all funds awarded. As of that date, they had expended slightly over half of P account funds awarded for the program's fourth budget period. Jurisdictions continued, as authorized, to expend funds beyond the budget period for which they were awarded. For example, some expenditures, such as contract payments, extend beyond one budget period. A t the end of the program's third budget period, jurisdictions reported that less than one-sixth of all bioterrorism funds awarded for that period--including both fiscal year 2001 and 2002 funds--remained unobligated, and some jurisdictions reported that none of their funds remained unobligated. As of August 1, 2004, jurisdictions estimated that less than one-quarter of all funds awarded for the fourth budget period would remain unobligated as of August 30, 2004, and five jurisdictions estimated that they would have no funds remaining unobligated. Many jurisdictions reported facing challenges, partly related to administrative processes, that delayed their obligation and expenditure of bioterrorism funds. These included workforce issues such as hiring freezes; contracting and procurement processes to ensure responsible use of public funds; and lengthy information technology upgrades. Some jurisdictions have simplified these processes to expedite the obligation and expenditure of funds. We provided a draft of this report to HHS for comment, and the agency informed us it had no comments on the draft report.