	Summary of Findings

The roles of certain key federal officials initially involved in the advisory  board’s review of the dose reconstructions may not have been sufficiently  independent and actions were taken to replace these officials. Nonetheless, continued diligence by HHS is required to prevent such  problems from recurring as new candidates are considered for these roles. Initially, the project officer assigned responsibility for reviewing the  monthly progress reports and monitoring the technical performance of the  contractor was also a manager of the NIOSH dose reconstruction program  being reviewed. In addition, the designated federal officer for the advisory  board, who is responsible for scheduling and attending board meetings,  was the director of the dose reconstruction program being reviewed. The progress of the contracted review of NIOSH’s site profiles and dose  reconstructions has been hindered by the complexity of the work. Specifically, in the first 2 years, the contractor spent almost 90 percent of  the $3 million that had been allocated to the contract for a 5-year  undertaking. Various adjustments have been made in the review approach  in light of the identified complexities, which were not initially understood. However, further improvements could be made in the oversight and  planning of the review process. With regard to reviewing special exposure cohort petitions, the advisory  board has asked for and received the contractor’s assistance, expanded its  charge, and acknowledged the need for the board to review the petitions  in a timely manner. The board has reviewed eight petitions as of October  2005, and the contractor assisted with six of these by reviewing the site  profiles associated with the facilities. The contractor will play an  expanded role by reviewing some of the other submitted petitions and  NIOSH’s evaluation of those petitions and recommending to the advisory  board whether the petitioning group should be added to the special  exposure cohort. The contractor will also develop procedures for the  advisory board to use when reviewing petitions. While NIOSH is generally  required by law to complete its review of a petition within 180 days of  determining that the petition has met certain initial qualification  requirements, the advisory board has no specified deadline for its review  of petitions. Appendix I: Briefing Slides

	Introduction

		• For the last several decades, the Department of Energy and its

predecessor agencies and contractors have employed thousands of  individuals in secret and dangerous work in the atomic weapons industry. The Energy Employees Occupational Illness Compensation Program Act  (EEOICPA) of 2000 compensates individuals who have developed cancer  or other specified diseases related to on-the-job exposure to radiation and  other hazards at these work sites. Under Subtitle B, determining a claimant’s eligibility for compensation  involves developing estimates of the likely radiation levels a worker was  exposed to based on information such as exposure records. These estimates are referred to as “dose reconstructions” and are developed by  the National Institute for Occupational Safety and Health (NIOSH) under  the Department of Health and Human Services (HHS). NIOSH also compiles information in “site profiles” about the radiation  protection practices and hazardous materials used at various plants and  facilities, which assist NIOSH in completing the dose reconstructions. Their claims are paid  without completing exposure estimates. The law also allows the Secretary, HHS, to designate additional groups of  employees as members of the special exposure cohort. For quality control and to raise public confidence in the fairness of the

claims process, EEOICPA created a citizen’s advisory board of scientists,  physicians, and employee representatives—the President’s Advisory Board  on Radiation and Worker Health (advisory board). Members of board  serve part-time, and the board has limited staff support. The advisory board is tasked with reviewing the scientific validity and  quality of NIOSH’s dose reconstructions and advising the Secretary of  HHS. The board has the flexibility to determine the scope and  methodology for this review. Key Questions

We focused our work on three questions: Are the roles of key federal officials involved in the review of NIOSH’s  dose reconstructions sufficiently independent to assure the objectivity  of the review? Have the agency’s management controls and the advisory board’s  oversight been sufficient to ensure that the contract to review site  profiles and dose reconstructions is adequately carried out? Multiple Entities and Officials Involved in the Review of NIOSH’s Dose Reconstructions

(HHS) (CDC)
National Institute for Occupational Safety and Health  (PGO)
Designated federal officer (since 12/04)
Project officer (since 12/04)
Office of Compensation Analysis and Support  (OCAS)

			Designated federal officer (prior to 12/04)

Project officer (prior to 12/04) (SC&A)

		Roles of HHS and CDC

			HHS The Secretary of HHS has overall responsibility for the advisory board, as

delegated by the President, and is tasked by executive order with providing  administrative services, funds, facilities, staff, and other necessary support  services to assist the advisory board in carrying out its responsibilities. The Advisory Board Is Using the Contractor’s Work in Reviewing Special Exposure Cohort Petitions

			The advisory board is using the contractor’s work in reviewing special

exposure cohort petitions. Nonetheless, the advisory board has discussed the fact that special  exposure cohort petition reviews have required more time and effort to  reach a recommended decision than originally estimated and that the  advisory board needs to manage its workload in order to reach timely  decisions.
Why GAO Did This Study

For the last several decades, the Department of Energy and its predecessor agencies and contractors have employed thousands of individuals in secret and dangerous work in the atomic weapons industry. In 2000, Congress enacted the Energy Employees Occupational Illness Compensation Program Act to compensate those individuals who have developed cancer or other specified diseases related to on-the-job exposure to radiation and other hazards at these work sites. Under Subtitle B, determining the eligibility of claimants for compensation is a complex process, involving several federal agencies and a reconstruction of the historical evidence available. The Department of Labor must consider a claimant's case based on records of his or her employment and work activities, which are provided by the Department of Energy. Labor considers the compensability of certain claims by relying on estimates of the likely radiation levels to which particular workers were exposed. These "dose reconstructions" are developed by the National Institute for Occupational Safety and Health (NIOSH) under the Department of Health and Human Services (HHS). NIOSH also compiles information in "site profiles" about the radiation protection practices and hazardous materials used at various plants and facilities, which helps complete the dose reconstructions. Because certain facilities are known to have exposed employees to radiation while keeping few records of individuals' exposure, their employees have been designated under the law as members of a "special exposure cohort," and their claims may be paid without individual dose reconstructions. The law also allows the Secretary of HHS to add additional groups of employees to the special exposure cohort. For quality control and to raise public confidence in the fairness of the claims process, the compensation act also created a citizen's advisory board of scientists, physicians, and employee representatives--the President's Advisory Board on Radiation and Worker Health. Members of the board serve part-time and the board has limited staff support. The advisory board is tasked to review the scientific validity and quality of NIOSH's dose reconstructions and advise the Secretary of HHS. The board has the flexibility to determine the scope and methodology for this review. We assessed how well the advisory board's review and the contracted work with SC&A are proceeding. We focused on three questions: (1) Are the roles of key federal officials involved in the review of NIOSH's dose reconstructions sufficiently independent to assure the objectivity of the review? (2) Have the agency's management controls and the advisory board's oversight been sufficient to ensure that the contract to review site profiles and dose reconstructions is adequately carried out? and (3) Is the advisory board using the contractor's expertise in reviewing special exposure cohort petitions?

What GAO Found

The roles of certain key federal officials initially involved in the advisory board's review of the dose reconstructions may not have been sufficiently independent and actions were taken to replace these officials. Nonetheless, continued diligence by HHS is required to prevent such problems from recurring as new candidates are considered for these roles. Initially, the project officer assigned responsibility for reviewing the monthly progress reports and monitoring the technical performance of the contractor was also a manager of the NIOSH dose reconstruction program being reviewed. In addition, the designated federal officer for the advisory board, who is responsible for scheduling and attending board meetings, was the director of the dose reconstruction program being reviewed. The progress of the contracted review of NIOSH's site profiles and dose reconstructions has been hindered by the complexity of the work. Specifically, in the first 2 years, the contractor spent almost 90 percent of the $3 million that had been allocated to the contract for a 5-year undertaking. Various adjustments have been made in the review approach in light of the identified complexities, which were not initially understood. However, further improvements could be made in the oversight and planning of the review process. With regard to reviewing special exposure cohort petitions, the advisory board has asked for and received the contractor's assistance, expanded its charge, and acknowledged the need for the board to review the petitions in a timely manner. The board has reviewed eight petitions as of October 2005, and the contractor assisted with six of these by reviewing the site profiles associated with the facilities. The contractor will play an expanded role by reviewing some of the other submitted petitions and NIOSH's evaluation of those petitions and recommending to the advisory board whether the petitioning group should be added to the special exposure cohort. The contractor will also develop procedures for the advisory board to use when reviewing petitions. While NIOSH is generally required by law to complete its review of a petition within 180 days of determining that the petition has met certain initial qualification requirements, the advisory board has no specified deadline for its review of petitions. However, the board has discussed the fact that special exposure cohort petition reviews have required more time and effort than originally estimated and that the advisory board needs to manage its workload in order to reach timely decisions.