Federal Budget: Opportunities for Oversight and Improved Use of Taxpayer Funds

Published by the Government Accountability Office on 2003-07-16.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                             United States General Accounting Office

GAO                          Testimony
                             Before the Committee on Government
                             U.S. House of Representatives
For Release on Delivery
Expected at 10:00 a.m. EDT
Wednesday, July 16, 2003     FEDERAL BUDGET
                             Opportunities for
                             Oversight and Improved
                             Use of Taxpayer Funds
                             Statement of Paul L. Posner
                             Managing Director for Federal Budget and
                             Intergovernmental Relations Issues, Strategic Issues

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Mr. Chairman, Mr. Waxman, members of the Committee

It is a pleasure to be here today to assist you in what Comptroller General Walker has
described as one of your important obligations—to exercise prudence and due care in
connection with taxpayer funds. No government should waste its taxpayers’ money,
whether we are operating during a period of budget surpluses or deficits. Further, it is
important for everyone to recognize that fraud, waste, abuse, and mismanagement are not
victimless activities. Resources are not unlimited, and when they are diverted for
inappropriate, illegal, inefficient, or ineffective purposes, both taxpayers and legitimate
program beneficiaries are cheated. Both the Administration and the Congress have an
obligation to safeguard benefits for those that deserve them and avoid abuse of taxpayer
funds by preventing such diversions. Beyond preventing obvious abuse, government also
has an obligation to modernize its priorities, practices, and processes so that it can meet
the demands and needs of today’s changing world. More broadly, the federal
government must reexamine the entire range of policies and programs—entitlements,
discretionary, and tax incentives—in the context of the 21st century.

Periodic reexamination and revaluation of government activities has never been more
important than it is today. Our nation faces long-term fiscal challenges. Increased
pressure also comes from world events: both from the recognition that we cannot
consider ourselves “safe” between two oceans--which has increased demands for
spending on homeland security-- and from the U.S. role in an increasingly interdependent
world. And government faces increased demands from the American public for modern
organizations and workforces that are responsive, agile, accountable and responsible.

Efforts to assure prudent use of taxpayer funds, efforts to guard against fraud, waste,
abuse and mismanagement, and efforts to improve economy, efficiency and effectiveness
must be broad, encompassing those programs subject to annual appropriations,
mandatory programs, and tax preferences/tax incentives.

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Direct, or mandatory, spending programs are by definition assumed in the baseline and
not automatically subject to annual congressional review as are appropriated
discretionary programs. Nonetheless, a periodic reassessment of these programs, as well
as tax incentives, is critical to achieving fiscal discipline in the budget as a whole.
Moreover, such a review can help ascertain whether these programs are protected from
the risk of fraud, waste and abuse and are designed to be as cost effective and efficient as

As you know, the Budget Resolution directs GAO to prepare a report identifying
“instances in which the committees of jurisdiction may make legislative changes to
improve the economy, efficiency, and effectiveness of programs within their
jurisdiction.” This report will be based on examples drawn from GAO’s recent work
highlighting programs and operations where improvements could be made to address
performance issues that may have budgetary consequences. My testimony draws in part
on some of the items that will be included in that report.

As Mr. Walker did before the House Budget Committee last month, today I want to talk
about program reviews, oversight, and stewardship of taxpayer funds in three tiers:

    •   First, it is important to deal with areas vulnerable to fraud, waste, abuse and
        mismanagement. Payments to ineligibles drain resources that could otherwise go
        to the intended beneficiaries of a program. Everyone should be concerned about
        the diversion of resources and subsequent undermining of program integrity.

    •   Second, and more broadly, policymakers and managers need to look at ways to
        improve the economy, efficiency and effectiveness of federal programs and
        specific tax expenditures. Even where we agree on the goals of programs,
        numerous opportunities exist to streamline, target and consolidate to improve
        their delivery. This means looking at program consolidation, at overlap and at
        fragmentation. For example, it means tackling excess federal real property—
        whether at home or abroad. It means improved targeting in both spending

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        programs and tax incentives-- in some cases, spreading limited funds over a wide
        population or beneficiary group may not be the best approach.

    •   Finally, a fundamental reassessment of government programs, policies, and
        activities can help weed out programs that are outdated, ineffective,
        unsustainable, or simply a lower priority than they used to be. In most federal
        mission areas—from low-income housing to food safety to higher education
        assistance—national goals are achieved through the use of a variety of tools and,
        increasingly, through the participation of many organizations, such as state and
        local governments and international organizations, that are beyond the direct
        control of the federal government. Government cannot accept as “givens” all of
        its existing major programs, policies, and operations. A fundamental review of
        what the federal government does, how it does it, and in some cases, who does the
        government’s business will be required, particularly given the demographic tidal
        wave that is starting to show on our fiscal horizon.

Addressing Vulnerabilities to Fraud, Waste, Abuse and Mismanagement

Programs and functions central to national goals and objectives have been hampered by
daunting financial and program management problems, exposing these activities to fraud,
waste and abuse. These weaknesses have real consequences with large stakes that are
important and visible to many Americans. Some of the problems involve the waste of
scarce federal resources. Other problems compromise the ability of the federal
government to deliver critically needed services, such as ensuring airline safety and
efficiently collecting taxes. Still others may undermine government’s ability to safeguard
critical assets from theft and misuse.

In recent years, GAO’s work across the many government programs and operations has
highlighted threats to the integrity of programs which prompt potential for fraud, waste
and abuse. As the next sections illustrate, much of our work for the Congress in fact is

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dedicated to helping redesign programs and improve management to address these long
standing problems, in areas ranging from uncollected taxes, both corporate and
individual, to major entitlement programs.

In 1990, GAO began a program to report on government operations we identified as
“high-risk.” This label has helped draw attention to chronic, systemic performance and
management shortfalls threatening taxpayer dollars and the integrity of government
operations. Over the years GAO has made many recommendations to improve these
high-risk operations. We discovered that the label often inspired corrective action—
indeed 13 areas have come off the list since its inception. For each of these areas, we
focus on (1) why the area is high-risk; (2) the actions that have been taken and that are
under way to address the problem since our last update report and the issues that are yet
to be resolved; and (3) what remains to be done to address the risk.

In January of this year we provided an update for the 108th Congress, giving the status of
high-risk areas included in our last report [January 2001] and identifying new high-risk
areas warranting attention by the Congress and the administration.1 GAO’s 2003 high-
risk list is shown in Attachment I. Lasting solutions to high-risk problems offer the
potential to save billions of dollars, dramatically improve service to the American public,
strengthen public confidence and trust in the performance and accountability of our
national government, and ensure the ability of government to deliver on its promises.

In addition to perseverance by the administration in implementing needed solutions, we
have noted that continued congressional interest and oversight, such as that exemplified
by this hearing today are of crucial importance. The administration has looked to our
recommendations in shaping government-wide initiatives such as the President’s
Management Agenda, which has at its base many of the areas we have previously
designated as high-risk.

 U.S. General Accounting Office, High-Risk Series: An Update, GAO-03-119 (Washington, D.C.:
January 2003).

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Clearly progress has been made in addressing most of the areas on our current high-risk
list, both through executive actions and congressional initiatives. However, many of
these problems and risks are chronic and long standing in nature and their ultimate
solution will require persistent and dedicated efforts on many fronts by many actors.
Some will require changes in laws to simplify or change rules for eligibility, provide
improved incentives or to give federal agencies additional tools to track and correct
improper payments. Continued progress in improving agencies’ financial systems,
information technology resources and human capital will be vital in attacking and
mitigating risks to federal program integrity. Some areas may indeed require additional
investments in people and technology to provide effective information, oversight and
enforcement to protect programs from abuse.

Ultimately, a transformation will be needed in the cultures and operations of many
agencies to permit them to manage risks and foster the kind of sustained improvements in
program operations called for. Continued persistence and perseverance in addressing the
high-risk areas will ultimately yield significant benefits for the taxpayers over time.
Finding lasting solutions offers the potential to achieve savings, improved service and
strengthened public trust in government.

I will now address some specific areas and examples from both our high-risk work and
other program reviews that illustrate both the problems facing us and the opportunities
for congressional and executive actions to better safeguard taxpayer funds.2

Improper Payments

Improper payments include inadvertent errors, such as duplicate payments and
miscalculations; payments for unsupported or inadequate supported claims; payments for
services not rendered; payments to ineligible beneficiaries; and payments resulting from
outright fraud and abuse by program participants and/or federal employees. Recently,
agencies' financial statements also have begun to identify and measure the wide range of

    Attached to this testimony is a list of selected GAO reports related to the specific examples cited.

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improper payments involved in many activities throughout government. Agency
financial statements for both fiscal years 2002 and 2001 identified improper payment
estimates of approximately $20 billion. OMB recently testified that the amount of
improper payments was closer to $35 billion annually for major benefit programs. This
range may be indicative of the fact that it is hard to get a handle on the precise total.
Furthermore, as significant as these amounts are, they do not represent a true picture of
the magnitude of the problem governmentwide because they do not consider other
significant but smaller programs and other types of agency activities that could result in
improper payments. In reviewing fiscal year 2002, financial statements of the 24 CFO
Act agencies, we found references to improper payments in 17 agencies and 27
programs—and a variety of program activities. Unfortunately, not all of the agencies
provided information on their estimate of the amount of such payments.

Many of these problems can most effectively be addressed by individual programs and
the agencies that manage them. However, crosscutting approaches can also be essential to
making progress. For example, enhanced sharing of data across programs and purposes
can help to verify program eligibility and provide improved controls over payments.
Access to IRS taxpayer information is available to many programs but not all. Such
access could have helped the Department of Education prevent some of the $100 million
in excess payments under the Pell Grant awards in 2000 stemming from underreporting
of income by recipients. Computer matching enabled the SSI program and Food Stamp
and TANF programs in certain states to identify over 110,000 beneficiaries who are
fugitive felons ineligible for assistance, enabling estimated cost savings of over $96
million for SSI alone. However, most states administering TANF and food stamps, as
well as HUD, were not conducting these kinds of matches.

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Collection of Unpaid Taxes

Ensuring that taxpayers meet their tax obligations under an increasingly complex tax
code has long presented the Internal Revenue Service (IRS) with daunting challenges.
Although the majority of taxpayers voluntarily and timely pay the taxes they owe,
regrettably high levels of noncompliance by some taxpayers persist. Some
noncompliance is intentional and may be due to outright fraud and the use of abusive tax
shelters or schemes. Some noncompliance stems from unintentional errors and
taxpayers’ misunderstanding of their obligations. Regardless of the cause, we have
designated the collection of unpaid taxes—including detecting noncompliance and
collecting taxes due but not paid—as a high-risk area because of the potential revenue
losses and the threat to voluntary compliance.

Collecting taxes due includes both compliance programs, like audits, that identify those
who owe more than they self-report and collection programs that seek payment of taxes
assessed but not timely paid. However, IRS compliance and collections programs have
seen larger workloads, less staffing, and fewer cases closed per employee. For the last
several years, Congress and others have been concerned that the declines in IRS's
enforcement programs are eroding taxpayers' confidence in the fairness of our tax system
putting at risk their willingness to voluntarily comply with the tax laws.

The number of tax returns increases every year. Between 1993 and 2002, the number of
individual returns filed went from 114.7 million to approximately 130 million—a 13
percent increase over those 10 years. IRS projects the number of total individual returns
filed will be 132.3 million in 2003 and continue to increase at an annual rate of 1.5
percent until 2009. Such a rate of increase would lead to 145.3 million total individual
returns filed in 2009. Returns from businesses and other entities have also increased

While the number of tax returns has increased, key compliance program rates have
declined. In testimonies and reports, GAO has highlighted large and pervasive declines

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in IRS’s compliance programs. These programs, not all of which have seen declines,
include computerized checks for nonfiling and underreported income as well as audits of
both individual taxpayers and business entities. Between 1996 and 2001, key programs
generally experienced growing workloads, decreased staffing, and decreases in the
number of cases closed per employee. Figure 1 shows the decline in audit rates for
different types of taxpayers.

Figure 1: Change in Percent of Returns Audited, 1996 - 2001


IRS collections programs are also increasingly stressed. As we reported in May 2002,
between fiscal years 1996 and 2001 trends in the collection of delinquent taxes showed
almost universal declines in collection program performance, in terms of coverage of
workload, cases closed, direct staff time used, productivity, and dollar of unpaid taxes

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collected.3 Although the number of delinquent cases assigned to collectors went down
during this period, the number of collections cases closed declined more rapidly, creating
an increasing gap. During that 6-year period, the gap between the new collection
workload and collection cases closed grew at an average annual rate of about 31 percent.

                                       Uncollected Taxes

By the end of fiscal year 2002, IRS had deferred collection action on about one out of
three collection cases and had an inventory of $112 billion of known unpaid taxes with
some collection potential.

A key to reversing these trends and ensuring compliance with the tax laws is continuing
to modernize IRS’s management and systems. Such change is required across IRS. IRS
needs to acquire and analyze data on noncompliance by continuing to implement the
National Research Program as planned. IRS needs to reengineer it compliance and
collection programs. Reengineering depends, in turn, on successfully modernizing
business information systems by implementing recommended management controls.
IRS needs to implement its planned centralized cost accounting system in order to
strengthen controls over unpaid tax assessments. Because of their magnitude, these
efforts are a major management challenge. IRS has tried to increase enforcement
staffing. However, the hiring of additional staff has been delayed by factors such as
unbudgeted cost increases.

Recoup Delinquent Taxes from Those Benefiting from Federal Programs

Many taxpayers, both individuals and businesses, who owe the federal government
billions of dollars in delinquent taxes, are receiving billions of dollars in federal payments
annually. In addition to SSA benefit payments, these delinquent taxpayers may be paid

 U.S. General Accounting Office, Tax Administration: Impact of Compliance and Collection Program
Declines on Taxpayers, GAO-02-674 (Washington, D.C.: May 22, 2002).

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federal civilian retirement payments and federal civilian salaries, payments on federal
contracts, and Small Business Administration loans.

IRS and federal payment records indicate that nearly one million taxpayers who were
receiving some type of federal payments owed about $26 billion in delinquent taxes as of
February 2002. To help the IRS collect these delinquent tax debts, provisions in the
Taxpayer Relief Act of 1997 gave IRS authority to continuously levy4 up to 15 percent of
certain federal payments made to delinquent taxpayers.5 Payments subject to IRS’
continuous levy program include Social Security, federal salary and retirement payments,
and federal vendor payments. According to IRS, the program resulted in collecting over
$60 million in fiscal year 2002 by directly levying federal payments. However, not all
agencies have been included in the continuous levy program.6 When we reviewed three
of these we found, that as of June 30, 2000, about 70,400 individuals and businesses that
received about $1.9 billion in federal payments collectively from three agencies owed
over $1 billion in federal taxes. IRS has either tested or commenced with levies of
vendors or employees for the Department of Defense and the U.S. Postal Service. IRS
has not begun to levy payments made to Centers for Medicare and Medicaid Services’
vendors. In another report we found that IRS blocks many eligible delinquent accounts
from being included in the Federal Payment Levy Program, missing an opportunity to
gather information on which debtors are receiving federal payments.7 IRS officials
imposed these blocks because of concerns that the potential volume of levies—about 1.4
million taxpayer accounts—would disrupt ongoing collection activities. However we
estimate that about 112,000 would actually qualify for levy. These taxpayers were
collectively receiving about $6.7 billion in federal payments and owed about $1.5 billion
in delinquent taxes. In January 2003, IRS unblocked and began matching delinquent

  Levy is the legal process by which IRS orders a third party to turn over property in its possession that
belongs to the delinquent taxpayer named in a notice of levy. A continuous levy remains in effect from the
date such levy is first made until the tax debt is fully paid or IRS releases the levy.
  Specifically, the 1997 legislation allows continuous levy of “specified payments,” including non-means
tested federal payments, as well as certain previously exempt payments.
  U.S. General Accounting Office, Tax Administration: Millions of Dollars Could be Collected if IRS
Levied More Federal Payments, GAO-01-711 (Washington, D.C.: July 20, 2001).
  U.S. General Accounting Office, Tax Administration: Federal Payment Levy Program Measures,
Performance, and Equity Can Be Improved, GAO-03-356 (Washington, D.C.: March 6, 2003).

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taxpayer accounts identified as receiving a federal salary or annuity payment. IRS
officials will not unblock the remaining delinquent accounts until sometime in 2005.

In addition, OMB circular A-129, revised, directs agencies to determine whether
applicants for federal credit programs are delinquent on any federal debt—including tax
debt—and to suspend processing of credit applications until the applicant pays the debt or
enters into a payment plan. Unfortunately, these polices have not been effective in
preventing the disbursement of federal dollars to individuals and businesses with
delinquent taxes. In order to fully realize this benefit, the Congress could enact
legislation codifying the provisions of OMB Circular A-129, as revised, that relate to this
matter. A key aspect of this legislation would be to ensure that IRS's efforts to modernize
its business systems are successful in enabling it to generate timely and accurate
information on the taxpayer's status to assist other agencies in making determinations
about eligibility for federal benefits and payments.

The Medicare Program

The sheer size and complexity of the Medicare program makes it highly vulnerable to
fraud, waste and abuse. In fiscal year 2002, Medicare paid about $257 billion for a wide
variety of inpatient and outpatient health care services for over 40 million elderly and
disabled Americans. To help administer claims the Centers for Medicare & Medicaid
Services (CMS) contracts with 38 health insurance companies to process about 900
million claims submitted each year by over 1 million hospitals, physicians, and other
health care providers. Although CMS has made strides, much remains to be done.
Today I will note a few specific areas in which we have recommended actions:

     •   Reducing improper payments: Since 1996, annual audits by the Department of
         Health and Human Services’ Office of the Inspector General have found that
         Medicare contractors have improperly paid claims worth billions of dollars—
         $13.3 billion in fiscal year 2002 alone. CMS has been working to better hold

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         individual contractors accountable for claims payment performance and help them
         target remedial actions to address problematic billing practices.

     •   Monitoring managed care plans: In 2001 auditors found that 59 of 80 health
         plans had misreported key financial data or had accounting records too unreliable
         to support their data, but CMS did not have a plan in place to resolve these issues.

     •   Improving financial management processes: Despite a “clean” opinion on its
         financial statements, CMS financial systems and processes do not routinely
         generate information that is timely or reliable and do not ensure confidentiality of
         sensitive information.

     •   Collecting debt: At the end of fiscal year 1999, over $7 billion of debt had
         accumulated on contractors’ books as accounts receivable that were neither
         collected nor written off. While Medicare contractors have referred eligible
         delinquent debt to the Treasury for collection, CMS continues to face challenges
         in ensuring that contractors consistently make these referrals and is working to
         address this.

     •   Enhancing program oversight: Program safeguard activities, such as the
         Medicare Integrity Program, have historically produced savings—in the past CMS
         has estimated a return of over $10 for every dollar spent in this area. While
         funding for the Medicare Integrity Program has increased, in 2002 it remained
         below comparable levels in the previous decade, adjusted for inflation. Moreover,
         freeing the Medicare program to directly choose contractors used to administer
         program payments on a competitive basis would enable the program to benefit
         from the advantages conferred by competition.

     •   Reducing excessive payments for services and products: These hurt not only the
         taxpayers but also the program’s beneficiaries who are generally liable for co-

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       payments equal to 20 percent of Medicare’s approved fee. Excessive payments
       have been found for both medical products and outpatient drugs.

           o Medical products—Medicare’s payment approaches lack the flexibility to
              keep pace with market changes. Payments for medical equipment and
              supplies are through fee schedules that remain tied to suppliers’ historical
              charges to the program. Evidence from two competitive bidding projects
              suggests that competition might provide a tool that facilitates setting more
              appropriate payment rates that result in program savings.

           o Outpatient drugs—Medicare pays list prices set by drug manufacturers,
              not prices providers actually pay. In September 2001, we reported that in
              2000 Medicare paid over $1 billion more than other purchasers for
              outpatient drugs that the program covers. CMS has not acted upon our
              recommendations in this area.8

                      Medicare Excessive Payments: Outpatient Drugs
               •   In some cases, Medicare’s payments were so high that the
                   beneficiaries’ co-payments alone exceeded the purchase price
                   available to the provider.

               •   In 2001,
                       o Medicare paid $3.34 per unit for Ipratropium bromide
                         although it is widely available for $0.77 per unit;
                       o Medicare paid $588 for leuprolide acetate although it
                         was widely available at a cost of $510.

The Medicaid Program

Medicaid, which pays for both acute health care and long-term care services for over 44
million low-income Americans, has been subject to waste and exploitation. In fiscal year

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2001, federal and state Medicaid expenditures totaled $228 billion. The federal share
was about 57 percent, representing 7 percent of all federal outlays. Medicaid is the third
largest social program in the federal budget (after Social Security and Medicare) and the
second largest budget item for most states (after education).

CMS, in the Department of Health and Human Services (HHS) is responsible for
administering the program at the federal level, while the states administer their respective
program’s day-to-day operations. The challenges inherent in overseeing a program of
Medicaid’s size, growth, and diversity, combined with the open-ended nature of the
program’s federal funding, puts the program at high risk. Inadequate fiscal oversight has
led to increased and unnecessary federal spending. GAO has made recommendations in a
number of areas, such as:

     •   Curb state financing schemes: Such schemes inappropriately increase the federal
         share of Medicaid expenditures. For example, some states have created the
         illusion that they made large Medicaid payments to providers while in reality they
         only made temporary electronic funds transfers that the providers were required to
         return to them. In some cases, states have used federal payments for purposes
         other than Medicaid. Although Congress and CMS have repeatedly acted to
         curtail abusive financing schemes, states have developed new variations. Each
         has the same result: some of the state’s share of program expenditures is shifted
         to the federal government. Curbing abusive state practices is of increasing
         importance today since states are under budgetary pressures. Experience shows
         that some states are likely to look for other creative means to supplant state
         financing, making a compelling case for the Congress and CMS to sustain
         vigilance over federal Medicaid payments.

         Curbing states’ exploitative practices can yield substantial savings. CMS’ 2001
         regulation to close one significant loophole that was being increasingly used by

 Medicare: Payments for Covered Outpatient Drugs Exceed Providers’ Cost, GAO-01-1118
(Washington, D.C.: Sept. 21, 2001).

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         states to generate excessive federal Medicaid payments, referred to as the upper
         payment limit, is estimated to save the federal government $55 billion over 10
         years, and a related 2002 CMS regulation is estimated to yield an additional $9
         billion over 5 years. To reduce these and other exploitative schemes and to better
         ensure that federal funds were used to reimburse providers only for Medicaid-
         covered services actually provided to eligible beneficiaries, we recommended in
         1994 that the Congress enact legislation to prohibit making Medicaid payments to
         a government-owned facility in excess of the facility’s costs. To date, no action
         has been taken.

         The figure below shows one state’s arrangement to increase federal Medicaid
         payments inappropriately.

     •   Improve federal and state agency controls over payments: CMS does not have a
         sound method for states to identify areas at high risk for improper Medicaid
         payments. Also, in our June 2001 review, we noted that no state requested the full
         amount of federal funds available for antifraud efforts due to a reluctance to put
         up state matching funds.

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HUD Single-Family Mortgage Insurance and Rental Assistance Programs

HUD manages about $550 billion in insurance and $19 billion per year in rental
assistance. The department relies on a complex network of thousands of third parties to
manage their risk. We have made recommendations in a number of areas:

     •   Reducing rental subsidy overpayments: HUD estimates that rental subsidy
         overpayments in fiscal year 2000 were $2 billion—over 10 percent of total
         program expenditures. A significant portion of this overpayment is attributable
         to tenants’ underreporting of income. We have recommended steps to improve
         data sharing between HUD and the Department of Health and Human Services to
         help identify unreported income before rental subsidies are provided.9 HUD
         needs to ensure that its rental housing assistance programs operate effectively and
         efficiently, specifically that assistance payments are accurate, recipients are
         eligible, assisted housing meets quality standards, and contractors perform as

     •   Reduce risk of losses in the single-family housing program: HUD also needs to
         reduce the risk of losses in its single-family housing program due to fraud, loan
         defaults, and poor management of foreclosed properties. Ineligible buyers
         sometimes fraudulently obtain loans, or loans are made on properties actually
         worth less than the loan amount, increasing the risk of default and losses. In
         addition, foreclosed properties are not always secured and maintained in a timely
         fashion and their condition can deteriorate, resulting in lower sales prices and
         limiting FHA’s ability to recover its costs. HUD’s IG has reported that fraud in
         the origination of mortgages of single-family properties continues to be the most
         pervasive problem uncovered by its investigations. We have reported on
         weaknesses in HUD’s oversight of mortgage lenders and have made
         recommendations aimed at strengthening HUD’s processes for approving and

 U.S. General Accounting Office, Benefit and Loan Programs: Improved Data Sharing Could Enhance
Program Integrity, GAO/HEHS-00-19 (Washington, D.C., Sept. 13, 2000).

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         monitoring lenders and holding them accountable for poor performance.10 We
         have also recommended that HUD adopt a foreclosure process more like that
         used by other entities to better ensure that properties do not deteriorate and that it
         recoups more of its losses when the houses are sold.11 HUD needs to improve
         the management and oversight of its single-family housing programs to reduce its
         risk of financial losses.

                                         Fraud in FHA Program

     •    A joint investigation between HUD’s Inspector General and the Federal Bureau of
          Investigation uncovered a 20-person property-flipping scheme in Chicago, Illinois,
          that resulted in 21 indictments and convictions and 12 jail sentences.

     •    The use of fraudulent documentation to qualify borrowers for FHA-insured
          mortgages had led to criminal indictments and convictions in several other

     •   Improve acquisition management and monitoring of contractor performance:
         Contractors are responsible for managing and disposing of HUD’s inventory of
         single-family and multifamily properties–properties that had a combined value of
         about $3 billion as of September 30, 2001. Our review of HUD’s files and
         disbursements indicates that its oversight processes have not identified instances
         in which contractors were not performing as expected. Weaknesses in HUD’s
         acquisition management limit its ability to readily prevent, identify, and address
         contractor performance problems. Without a systematic approach to oversight
         and adequate on-site monitoring, the department’s ability to identify and correct
         contractor performance problems and hold contractors accountable is reduced.

   U.S. General Accounting Office, Single-Family Housing: Stronger Oversight of FHA Lenders Could
Reduce HUD’s Insurance Risk, GAO/RCED-00-112 (Washington, D.C.: April 28, 2000).
   U.S. General Accounting Office, Single-Family Housing: Opportunities to Improve Federal Foreclosure
and Property Sales Processes, GAO-02-305 (Washington, D.C.: April 17, 2002).

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         The resulting vulnerability limits HUD’s ability to assure that it is receiving the
         services for which it pays.

Improving Economy, Efficiency, Effectiveness

Important as safeguarding funds from fraud, waste, abuse and mismanagement is, I
believe that for long-lasting improvements in government performance the federal
government needs to move to the next step: to widespread opportunities to improve the
economy, efficiency and effectiveness of existing federal goals and program
commitments. The basic goals of many federal programs—both mandatory and
discretionary—enjoy widespread support. That support only makes it more important for
us to pay attention to the substantial opportunities to improve their cost effectiveness and
the delivery of services and activities. No activity should be exempt from some key
questions about its design and management.

                              Key Questions for Program Oversight

     •   Is the program targeted appropriately?

     •   Does the program duplicate or even work at cross purposes with related programs
         and tools?

     •   Is the program financially sustainable and are there opportunities for instituting
         appropriate cost sharing and recovery from nonfederal parties including private
         entities that benefit from federal activities?

     •   Can the program be made more efficient through reengineering or streamlining
         processes or restructuring organizational roles and responsibilities?

     •   Are there clear goals, measures and data with which to track progress, benefits
         and costs?

GAO’s work illustrates numerous examples where programs can and should be changed
to improve their impact and efficiency. Today I want to touch on some of these areas and

18                                                                        GAO-03-1029T
highlight some significant opportunities for program changes that promise to improve
their cost effectiveness. I recognize that many of these will prompt debate—but that
debate is both necessary and healthy.


Our work has shown that scarce federal funds could have a greater impact on program
goals by improving their targeting to places or people most in need of assistance. Poorly
targeted funding can result in providing assistance to recipients who have the resources
and interest to undertake the subsidized activity on their own without federal financing.
Moreover, lax eligibility rules and controls can permit scarce funds to be diverted to
clients with marginal needs for program funds.

     •   Grant programs: Many federal grant programs with formula distributions to state
         and local governments are not well targeted to places with high needs but low
         fiscal capacity. As a result, recipients in wealthier areas may enjoy higher levels
         of federal funds than harder pressed areas. Better targeting of grants offers a
         strategy to reduce federal outlays by concentrating reductions in wealthier
         communities with comparatively fewer needs and greater capacity to finance
         services from their own resources. For such mandatory programs as Medicaid,
         Foster Care and Adoption Assistance, reimbursement formulas can be changed to
         better reflect relative need, geographic differences in the cost of services and state

     •   Flood insurance losses: Repetitive flood losses are one of the major factors
         contributing to the financial difficulties facing the National Flood Insurance
         Program. Approximately 45,000 buildings currently insured under the National
         Flood Insurance Program have been flooded on more than one occasion and have
         received flood insurance claims payments of $1,000 or more for each loss. These
         repetitive losses account for about 38 percent of all program claims historically
         (currently about $200 million annually) even though repetitive-loss structures
         make up a very small portion of the total number of insured properties—at any

19                                                                        GAO-03-1029T
         one time, from 1 to 2 percent. The cost of these multiple-loss properties over the
         years to the program has been $3.8 billion. One option that would increase
         savings would be for FEMA to consider eliminating flood insurance for certain
         repeatedly flooded properties.

     •   Medicare Incentive Payment Program: The Medicare Incentive Payment
         program was established in 1987 to provide a bonus payment for physicians to
         provide primary care in underserved areas. However, specialists receive most of
         the program dollars, even though primary care physicians have been identified as
         being in short supply. Shortages of specialists, if any, have not been determined.
         Moreover, since 1987 the Congress generally increased reimbursement rates for
         primary care services and reduced the geographic variation in physician
         reimbursement rates. HHS has acknowledged that structural changes to this
         program are necessary to better target incentive payments to rural areas with the
         highest degree of shortage. For example, if the program’s intent is to improve
         access to primary care services in underserved rural areas, the bonus payments
         should be targeted and limited to physicians providing primary care services to
         underserved populations in rural areas with the greatest need.

     •   Federal Employees’ Compensation Act: The formula for determining workers’
         compensation benefits for disabled federal employees replaced more than 100
         percent of their estimated take-home pay for 30 percent of those included in our
         analyses, and over 90 percent for another 40 percent of beneficiaries. The high
         replacement rates for this tax-free benefit stem from the use of gross pay in the
         formula rather than the use of a base that subtracts federal and state taxes, as some
         state programs do. Such benefit levels may potentially discourage employees
         from returning to work. Savings could be achieved if the formula were revised to
         subtract taxes from gross pay.

20                                                                        GAO-03-1029T

GAO’s work over the years has shown that numerous program areas are characterized by
significant program overlap and duplication. In program area after program area, we
have found that unfocused and uncoordinated programs cutting across federal agency
boundaries waste scarce resources, confuse and frustrate taxpayers and beneficiaries and
limit program effectiveness.

     •   Food safety: The federal system to ensure the safety and quality of the nation’s
         food is inefficient and outdated. The Food Safety and Inspection Service within
         USDA is responsible for the safety of meat, poultry and eggs and some egg
         products, while the Food and Drug Administration (FDA) under HHS is
         responsible for the safety of most other foods. USDA, FDA and ten other federal
         agencies administer over 35 different laws for food safety. The current system
         suffers from overlapping and duplicative inspections, poor coordination and
         inefficient allocation of resources. The Congress may wish to consider
         consolidating federal food safety agencies under a single risk-based food safety
         inspection agency with a uniform set of food safety laws.

     •   Grants for homeland security: GAO identified at least 16 different grant
         programs that can be used by the nation’s first responders to address homeland
         security needs. These grants are currently provided through two different
         directorates within the Department of Homeland Security, the Department of
         Justice, and the Department of Health and Human Services and serve state
         governments, cities and localities, counties, and others. Multiple fragmented
         grant programs create a confusing and administratively burdensome process for
         state and local officials and complicate their efforts to better coordinate
         preparedness and response to potential terrorist attacks across the wide range of
         specialized agencies and programs. In addressing the fragmentation prompted by
         the current homeland security grant system, Congress should consider
         consolidating separate categorical grants into a broader purpose grant with

21                                                                        GAO-03-1029T
         national performance goals defining results and perhaps standards expected for
         the state and local partnership.

     •   Rural housing assistance: USDA and HUD both provide assistance for rural
         housing, targeting some of the same kinds of households in the same markets. The
         programs of both agencies could be merged, using the same network of lenders. A
         consolidation of these programs building off the best practices of both programs
         would improve the efficiency with which the federal government delivers rural
         housing programs.

     •   Department of Veterans Affairs (VA) food & laundry services: VA provides
         inpatient food services and laundry processing for thousands of inpatients a day in
         hospitals, nursing homes, and domiciliaries. As of November 2000, VA had
         consolidated 28 of its food production locations into 10, begun using less
         expensive Veterans Canteen Service workers in 9 locations and contracted out in
         2 locations. For laundry services, VA had consolidated 116 of its laundries into 67
         locations and used competitive sourcing to contract with the private sector in
         other locations. VA has the potential to further reduce its inpatient food service
         and laundry costs. For example, VA could consolidate food production locations
         within a 90-minute driving distance of each other and laundry locations within a
         4-hour driving distance of each other.

     •   USDA: Common Administrative Functions, County Offices:

            o Common administrative functions-- In the mid 1990s, USDA began a
                reorganization and modernization effort targeted at achieving greater
                economy and efficiency and better customer service by the Farm Service
                Agency, the Natural Resources & Conservation Service, and the agencies
                in the Rural Development mission. However, despite the agencies’
                collocation of county offices, little has changed in how the three agencies
                serve their customers. USDA has made substantial progress in deploying

22                                                                       GAO-03-1029T
                personal computers and a telecommunications network to link its service
                centers. USDA could do more to combine agencies’ support functions,
                such as legal and legislative affairs and public information into a single

            o County office consolidation-- USDA’s field office structure dates back to
                the 1930s. In 1933 the U.S. had more than 6 million farmers; today the
                number of farms in the U.S. is less than 2 million, and a small fraction of
                these produce more than 70 percent of the nation’s agricultural output. As
                the client base for USDA programs changes and technology offers
                opportunities for program delivery efficiencies, USDA needs to consider
                alternative program delivery approaches. Although the USDA has closed
                over 1000 county offices, an agency report in September 2001 said,
                “Further actions are necessary to ensure that the USDA farm service
                structure is appropriately sized, configured and located…”

Cost Recovery

The allocation of costs that once made sense when programs were created needs to be
periodically reexamined to keep up with the evolution of markets. In some cases, private
markets and program beneficiaries can play greater roles in financing and delivery of
program services.

     •   User charges and fees: Greater opportunities exist to charge users of federal
         programs across a number of areas to better reflect the full costs of services
         provided to particular users or beneficiaries. For example, the fees paid by utilities
         to pay for the costs of storage for high-level radioactive wastes have not changed
         since 1983, making the fund insufficient to cover increased costs due to inflation.
         Registration fees charged to aircraft owners by the Federal Aviation

23                                                                        GAO-03-1029T
         Administration have not changed since 1968, resulting in over $6 million in lost
         revenue for the agency. Federal food inspection agencies do not recover the costs
         of inspections for meat, poultry, domestic foods and processing facilities;
         Agriculture Department inspection agencies recovered only $403 million of the
         $1.3 billion they spent in 2002 for these purposes.

     •   Child support enforcement: The Child Support Enforcement Program is to
         strengthen state and local efforts to obtain child support for both families eligible
         for Temporary Assistance for Needy Families (TANF) and non-TANF families.
         From fiscal year 1984 through 1998, non-TANF caseloads and costs rose about
         500 percent and 1200 percent, respectively. While states have the authority to
         fully recover the costs of their services, states have charged only minimal
         application and service fees for non-TANF clients, doing little to recover the
         federal government’s 66 percent share of program costs. In fiscal year 1998, for
         example, state fee practices returned about $49 million of the estimated $2.1
         billion spent to provide non-TANF services. To defray some of the costs of child
         support programs, Congress could require that mandatory application fees should
         be dropped and replaced with a minimum percentage service fee on successful
         collections for non-TANF families.

     •   Fannie Mae and Freddie Mac: These enterprises are privately-owned
         corporations chartered to enhance the availability of mortgage credit across the
         nation. HUD is charged with mission oversight responsibilities for the
         enterprises. Other federal organizations responsible for regulating government-
         sponsored enterprises are financed by assessments on the regulated entities.
         However, HUD’s mission oversight expenditures are funded with taxpayer dollars
         through HUD’s appropriations. Requiring Fannie Mae and Freddie Mac to
         reimburse HUD for mission oversight expenditures would not only result in
         budgetary savings but could also enable HUD to strengthen its oversight activities
         by for example dedicating new resources to verify housing goal data.

24                                                                        GAO-03-1029T
     •   Water subsidies: Federal water programs to promote efficient use of finite water
         resources for the nation’s agricultural and rural water systems have been used to
         provide higher subsidies than Congress may have intended. Some farmers have
         reorganized large farming operations into multiple, smaller landholdings to be
         eligible to receive additional federally subsidized irrigation water. However, due
         to the vague definition of the term “farm,” the flow of federally subsidized water
         to land holdings above the law’s 960-acre limit has not been stopped, and the
         federal government is not collecting revenues to which it is entitled under the law.
         In addition, Interior Department studies have shown that some farmers received
         the water subsidy for using irrigated water and USDA subsidies for crop
         production. Congress could consider collecting the full costs of subsidized
         federal water for large farms and/or restructuring the subsidies for crops produced
         with federally subsidized water.

Governmentwide economy and efficiency: the case of federal real property

Beyond program management, there are governmentwide areas where major savings
could come from improving economy, efficiency and effectiveness. Today I would like
to highlight one GAO thinks is so important that we added it to the high-risk list—the
management of federal real property.

Excess and underused property and deteriorating facilities present a real challenge—but
also an opportunity to reap great rewards in terms of improved structure and savings for
the federal government’s operations. The U.S. government’s fiscal year 2002 financial
statements show an acquisition cost of more than $335 billion for the federal
government’s real property. This includes military bases, office buildings, embassies,
prisons, courthouses, border stations, labs, and park facilities. Available governmentwide
data suggest that the federal government owns roughly one-fourth of the total acreage of
the nation—about 636 million acres.

25                                                                       GAO-03-1029T
Underutilized or excess property is costly to maintain. DoD alone estimates that it
spends about $3 to $4 billion per year maintaining unneeded facilities. Excess DoE
facilities cost more than $70 million per year, primarily for security and maintenance.
There are opportunity costs –these buildings and land could be put to more cost-
beneficial uses, exchanged for needed property, or sold to generate revenue for the
government. Table 1 below highlights excess and underutilized property challenges
faced by some of the major real property-holding agencies.

26                                                                     GAO-03-1029T
Table 1: Excess Property Challenges at Some of the Major Real Property-Holding

Agency                       Excess and underutilized property challenge

DOD      Even with four rounds of base realignment and closures that reduced its holdings by
         21 percent, DOD recognized that it still had some excess and obsolete facilities.
         Accordingly, Congress gave DOD the authority for another round of base
         realignment and closure in the fiscal year 2002 defense authorization act, scheduled
         for fiscal year 2005.

VA       VA recognizes that it has excess capacity and has an effort underway known as the
         Capital Asset Realignment for Enhanced Services (CARES) that is intended to
         address this issue. VA recently completed its initial CARES study involving
         consolidation of services among medical facilities in its Great Lakes Network
         (including Chicago) as well as expansion of services in other locations. VA
         identified 31 buildings that are no longer needed to meet veterans' health care needs
         in this network, including 30 that are currently vacant.

GSA      GSA recognizes that it has many buildings that are not financially self-sustaining
         and/or for which there is not a substantial, long-term federal purpose. GSA is
         developing a strategy to address this problem. The L. Mendel Rivers Federal
         Building in Charleston, S.C. is a prime example of a highly visible, vacant federal
         building held by GSA.

DOE      After shifting away from weapons production, DOE had 1,200 excess facilities
         totaling 16 million square feet, and the performance of its disposal program had not
         been fully satisfactory, according to DOE’s Inspector General. Facility disposal
         activities have not been prioritized to balance mission requirements, reduce risks,
         and minimize life-cycle costs. In some cases, disposal plans were in conflict with
         new facility requirements.

USPS     The issue of excess and underutilized property will need to be part of USPS’s efforts
         to operate more efficiently. Facility consolidations and closures are likely to be
         needed to align USPS’s portfolio more closely with its changing business model.

State    Although State has taken steps to improve its disposal efforts and substantially
         reduce its inventory of unneeded properties, it reported that 92 properties were
         potentially available for sale as of September 30, 2001, with an estimated value of
         more than $180 million. State has begun the disposal process for some of these
         properties. State will also need to dispose of additional facilities over the next
         several years as it replaces more than 180 vulnerable embassies and consulates for
         security reasons. Security also has become a primary factor in considering the
         retention and sale of excess property.

27                                                                   GAO-03-1029T
If the federal government is to more effectively respond to the challenges associated with
strategically managing its multi-billion dollar real property portfolio, a major departure
from the traditional way of doing business is needed. Better managing these assets in the
current environment calls for a significant paradigm shift to find solutions. Solutions
should not only correct the long-standing problems we have identified but also be
responsive to and supportive of agencies’ changing missions, security concerns, and
technological needs in the 21st century. Solving the problems in this area will undeniably
require a reconsideration of funding priorities at a time when budget constraints will be

Because of the breadth and complexity of the issues involved, the long-standing nature of
the problems, and the intense debate about potential solutions that will likely ensue,
current structures and processes may not be adequate to address the problems. Thus, as
discussed in our high-risk report, there is a need for a comprehensive and integrated
transformation strategy for federal real property. This strategy could address challenges
associated with having adequate capacity (people and resources) to resolve the problems.
The development of a transformation strategy would demonstrate a strong commitment
and top leadership support to address the risk. An independent commission or
governmentwide task force may be needed to develop the strategy. We believe that
OMB is uniquely positioned to be the catalyst for identifying and bringing together the
stakeholders that would develop the transformation strategy, drawing on resources and
expertise from the General Services Administration, the Federal Real Property Council,
and other real property-holding agencies. For example, OMB could assess agency real
property activities as part of the executive branch management scorecard effort.
Congress will need to play a key role in implementing the transformation strategy’s
roadmap for realigning and rationalizing the government’s real property assets so that the
portfolio is more directly tied to agencies’ missions. Without measurable progress and a
comprehensive strategy to guide improvements, real property will most likely remain on
the high-risk list.

28                                                                      GAO-03-1029T
Reassessing What Government Does

I have talked about the need to protect taxpayer dollars from fraud, waste, abuse and
mismanagement and about the need to take actions improving the economy, efficiency
and effectiveness of government programs, policies, and activities. However, to meet the
challenges of today and the future, we must move beyond this to a more fundamental
reassessment of what government does and how it does it.

In part this requires looking at current federal programs—both spending and tax
incentives—in terms of their goals and results. Why does the program/activity exist? Is
the activity achieving its intended objective? If not, can it be fixed? If so, how? If not,
what other approaches might succeed in achieving the goal/objective? More
fundamentally, even if a program/activity is achieving its stated mission—or can be
“fixed” so that it does so—where does it fit in competition for federal resources? Is its
priority today higher or lower than before given the nation’s evolving challenges and
fiscal constraints?

It also requires asking whether an existing program, policy, or activity “fits” the world we
face today and in the future. It is important not to fall into the trap of accepting all
existing activities as “givens” and subjecting new proposals to greater scrutiny than
existing ones undergo. Think about how much the world has changed in the past few
decades and how much it will change in future years.

One example of a disconnect between program design and today’s world is the area of
federal disability programs—a disconnect great enough to warrant designation as a “high-
risk” area this year. Already growing, disability programs are poised to surge as baby-
boomers age, yet the programs remain mired in outdated economic, workforce, and
medical concepts and are not well positioned to provide meaningful and timely support to
disabled Americans. Disability criteria have not been updated to reflect the current state
of science, medicine, technology and labor market conditions. Using outdated
information, agencies—primarily SSA and VA--risk overcompensating some individuals

29                                                                        GAO-03-1029T
while under-compensating or denying compensation entirely to others. Although federal
disability programs present serious management challenges and can be vulnerable to
fraud or abuse, the overarching and longer-term challenge is to design a disability system
for the modern world.

We should be striving to maintain a government that is effective and relevant to a
changing society—a government that is as free as possible of outmoded commitments
and operations that can inappropriately encumber the future. The difference between
“wants,” “needs,” and overall “affordability” and long-term “sustainability” is an
important consideration when setting overall priorities and allocating limited resources.

Finally, any reassessment of federal missions and strategies should include the entire set
of tools the federal government can use to address national objectives. These tools
include discretionary and mandatory spending, loans and loan guarantees, tax provisions,
and regulations. Spending is most visible and it is all too easy when we look to define
federal support for an activity to look at the spending side of the budget. Federal support,
however, may come in the form of direct loans or loan guarantees. It may come in the
design of regulations. It may come in the form of exclusions or credits in the tax code.
We contrast discretionary spending—which is controlled annually through the
appropriations process—with mandatory or direct spending. Entitlements and
mandatories are not uncontrollable, but because they continue unless changed, they may
seem less controllable and may be subject to less frequent attention. While mandatory
spending programs may too often be taken as “givens,” think about the lack of public
attention given tax preferences. These may be even less visible. Yet none of these tools
should be ignored if we are to get a true picture of federal activity in an area. So, for
example, if we are evaluating federal support for health care we need to look not only at
spending, but also at tax preferences. If we are evaluating federal support for higher
education, we need to look not only at spending but also at tax preferences such as the
Lifetime Learning and HOPE tax credits. The same thing is true for health care. The
figure below shows federal activity in health care and Medicare budget functions in FY

30                                                                       GAO-03-1029T
2003: $48 billion in discretionary budget authority, $419 billion in mandatory outlays,
$177 million in loan guarantees, and $129 billion in tax expenditures.

                   Relative Reliance on Policy Tools in the
                   Health Care Budget Functions (FY2003)



          Tax Expenditures               Discretionary budget authority                   Mandatory outlays

       Note: Loan guarantees account for about $177 million or 0.03% of the approximately $597 billion in total federal
       health care resources.
       Source: GAO analysis of data from the Office of Management and Budget.

Approaches and Mechanisms to Facilitate Reexamination of Programs and

As the examples in this statement illustrate, a broad array of opportunities exist for
improving the programs and operations of the federal government. Oversight and
reassessment of programs and priorities is called for to address many of the long standing
performance challenges in government programs and reposition the federal government
for the 21st Century. The oversight challenge takes place on many levels:
 •   The management and effectiveness of individual programs;
 •   Progress on cross-cutting governmentwide management challenges;
 •   Looking across agency and program boundaries at the full range of federal activities
     and tools used to advance any given goal—and perhaps choosing among them.
This oversight agenda will be helped by the reforms instituted over the past decade. The
Congress and several administrations have put in place a structure which is increasing the

31                                                                                                                        GAO-03-1029T
focus on and accountability for government performance. Federal agencies have been
working to carry out the Government Performance and Results Act (GPRA), which
requires the development of periodic strategic and annual performance plans and reports.
GPRA requires linkages of performance plans to budgets, recognizing that one of the
ways in which the full acceptance and potential of performance management can be
promoted is if this information becomes relevant for the allocation of resources. The
current administration has made linking resources to results one of the top five priorities
in the President’s Management Agenda. In this regard, OMB’s Program Assessment
Rating Tool (PART) represents an effort to use performance information more explicitly
in the federal budget formulation process by summarizing performance and evaluation
information. As you know, we are looking at the first year’s experience with PART for
one of your subcommittees and its counterpart in the Senate. Credible outcome-based
performance information is absolutely critical to foster the kind of national debate that is
needed about government in the 21st Century.

While PART focuses on the performance of individual programs, many of the key
performance issues affecting the public cut across individual programs and governmental
tools, as illustrated by the examples discussed in my statement. The importance of seeing
the overall picture cannot be overestimated. A single outcome, such as improving access
to higher education or health care, are in fact provided through numerous spending, loan,
loan guarantee and now tax incentive programs. Moreover, as the examples above
illustrate, the failure to develop a consistent and coordinated program profile can frustrate
and limit the outcomes we can achieve.

Congress and the administration need a vehicle to compare the performance results across
similar programs addressing common outcomes. We have previously reported that the
Government Performance and Results Act (Results Act) could provide a tool to
reexamine roles and structure at the governmentwide level. The Results Act requires the
President to include in his annual budget submission a federal government performance
plan. The Congress intended that this plan provide a ‘‘single cohesive picture of the
annual performance goals for the fiscal year.’’ The governmentwide performance plan
could be a unique tool to help the Congress and the executive branch address critical

32                                                                      GAO-03-1029T
federal performance and management issues. It also could provide a framework for any
restructuring efforts. Unfortunately, this provision has not been fully implemented.

Beyond an annual performance plan, a strategic plan for the federal government might be
an even more useful tool to provide broad goals and facilitate integration of programs,
functions, and activities, by providing a longer planning horizon. In the strategic planning
process, it is critical to achieve mission clarity in the context of the environment in which
we operate. With the profound changes in the world, a reexamination of the roles and
missions of the federal government is certainly needed. From a clearly defined mission,
goals can be defined and organizations aligned to carrying out the mission and goals.
Integration and synergy can be achieved between components of the government and
with external partners to provide more focused efforts on goal achievement. If fully
developed, a governmentwide strategic plan can potentially provide a cohesive
perspective on the long-term goals for a wide array of federal activities.

In addition, a strategic plan can provide a much needed framework for considering any
organizational changes and restructuring of federal agencies and programs. Essentially,
organizations and resources (e.g., human, financial, and technological) are the ways and
means of achieving the goals articulated by the strategic plan. Organizational structures
should ideally be aligned to be consistent with the goals and objectives of the strategic
plan. Clear linkages should exist between the missions and functions of an organization
and the goals and objectives it is trying to achieve. The development of a strategic plan
can also facilitate the building of consensus by key stakeholders, including most notably
the Congress, for any restructuring proposals.

As the Comptroller General testified last fall, fifty years of past efforts to link resources
with results has shown that any successful effort must involve the Congress as a partner.
In fact, the administration acknowledged that performance and accountability are shared
responsibilities that must involve the Congress. It will only be through the continued
attention of the Congress, the administration and federal agencies that progress can be
sustained and more importantly, accelerated. The Congress has, in effect, served as the
institutional champion for many previous performance management initiatives, such as

33                                                                        GAO-03-1029T
GPRA and the CFO Act, by providing a consistent focus for oversight and reinforcement
of important policies.

More generally, effective congressional oversight can help improve federal performance
by examining the program structures agencies use to deliver products and services to
ensure the best, most cost-effective mix of strategies is in place to meet agency and
national goals. This means looking beyond the current structure of PART to the policy,
management, and policy implications of crosscutting programs.

We have suggested in the past that the Congress might consider the need for mechanisms
that allow it to more systematically focus its oversight on problems with the most serious
and systemic weaknesses and risks. At present, the Congress has no direct mechanism to
provide a congressional perspective on governmentwide performance issues. The
Congress has no established mechanism to articulate performance goals for the broad
missions of government, to assess alternative strategies that offer the most promise for
achieving these goals, or to define an oversight agenda targeted on the most pressing
cross-cutting performance and management issues. Congress might consider whether a
more structured oversight mechanism is needed to permit a coordinated congressional
perspective on governmentwide performance matters.

One possible approach would involve developing a congressional performance resolution
identifying the key oversight and performance goals that the Congress wishes to set for
its own committees and for the government as a whole. Such a resolution could be linked
to the current congressional budget resolution. Initially, this might involve collecting the
“views and estimates” of authorization and appropriations committees on priority
performance issues for programs under their jurisdiction and working with such cross-
cutting committees as such as this one. There are, of course, other possible approaches to
the objective of enhancing congressional oversight. The issue I am raising is that
Congress should assess whether its current structures and processes are adequate to take
full advantage of the benefits arising from the reform agenda under way in the executive
branch. Ultimately, what is important is not the specific approach or process, but rather

34                                                                      GAO-03-1029T
achieving the result of helping the Congress better promote improvements in government
operations through broad and comprehensive oversight and deliberation.

Reexamination of the role and activities of government for the 21st Century requires more
than performance information on individual programs or governmentwide management
issues. As the Comptroller General has said on many occasions, any discussion about the
role of the federal government, about the design and performance of federal activities,
and about the near-term federal fiscal outlook takes place in the context of two
dominating facts: a demographic tidal wave is on the horizon, and it combined with
rising health care costs threatens to overwhelm the nation’s fiscal future. The numbers
do not add up. The fiscal gap is too great for any realistic expectation that the country
can grow its way out of the problem.

Metrics and mechanisms need to be developed to facilitate consideration of the long-term
implications of existing and proposed policies or programs. These range from explicit
liabilities such as environmental cleanup requirements and federal pensions to the more
implicit obligations presented by life-cycle costs of capital acquisition or disaster
assistance. We have suggested that more systematic reporting on the nature and extent of
these exposures would be beneficial.12

Concluding Remarks

Tackling areas at risk for fraud, waste, abuse and mismanagement will require
determination, persistence and sustained attention by both agency managers and
Congressional committees. Large and complex federal agencies must effectively use a
mixture of critical resources and improved processes to improve their economy,
efficiency, and effectiveness; Congressional oversight will be key.

  U.S. General Accounting Office, Fiscal Exposures: Improving the Budgetary Focus on Long-Term Costs
and Uncertainties, GAO-03-213 (Washington, D.C.: January 24, 2003).

35                                                                            GAO-03-1029T
In view of the broad trends and long-term fiscal challenges facing the nation, there is a
need to fundamentally review, reassess, and reprioritize the proper role of the federal
government, how the government should do business in the future, and—in some
instances—who should do the government’s business in the 21st century. It is also
increasingly important that federal programs use properly designed and aligned tools to
manage effectively across boundaries, work with individual citizens, other levels of
government, and other sectors. Evaluating the role of government and the programs it
delivers is key in considering how best to address the nation’s most pressing priorities.
Periodic reviews of programs in the budget, on the mandatory and discretionary sides of
the budget as well as tax preferences, can prompt a healthy reassessment of our priorities
and of the changes in program design, resources and management needed to get the
results we collectively decide we want from government.

Needless to say, we at GAO are pleased to help Congress in this very important work.

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                                      Attachment I:
                               GAO’s 2003 High-Risk List

                         2003 High-Risk Areas                                Designated
                                                                             High Risk
Addressing Challenges In Broad-based Transformations
• Strategic Human Capital Management*                                           2001
• U.S. Postal Service Transformation Efforts and Long-Term Outlook*             2001
• Protecting Information Systems Supporting the Federal Government              1997
    and the Nation’s Critical Infrastructures
• Implementing and Transforming the New Department of Homeland                  2003
• Modernizing Federal Disability Programs*                                      2003
• Federal Real Property*                                                        2003
Ensuring Major Technology Investments Improve Services
• FAA Air Traffic Control Modernization                                         1995
• IRS Business Systems Modernization                                            1995
• DOD Systems Modernization                                                     1995
Providing Basic Financial Accountability
• DOD Financial Management                                                      1995
• Forest Service Financial Management                                           1999
• FAA Financial Management                                                      1999
• IRS Financial Management                                                      1995
Reducing Inordinate Program Management Risks
• Medicare Program*                                                             1990
• Medicaid Program*                                                             2003
• Earned Income Credit Noncompliance                                            1995
• Collection of Unpaid Taxes                                                    1990
• DOD Support Infrastructure Management                                         1997
• DOD Inventory Management                                                      1990
• HUD Single-Family Mortgage Insurance and Rental Assistance                    1994
• Student Financial Aid Programs                                                1990
Managing Large Procurement Operations More Efficiently
• DOD Weapon Systems Acquisition                                                1990
• DOD Contract Management                                                       1992
• Department of Energy Contract Management                                      1990
• NASA Contract Management                                                      1990

*Additional authorizing legislation is likely to be required as one element of addressing
this high-risk area.
Source: GAO

37                                                                     GAO-03-1029T
                                   Attachment II:

          Selected Reports Regarding Specific Examples Cited in Testimony

Erroneous payments, Misuse of benefits, Child and Adult Care Food Program
(CACFP), National School Lunch Program:

Food Assistance: WIC Faces Challenges in Providing Nutrition Services. GAO-02-142.
Washington, D.C.: December 7, 2001.

Food Stamp Program: Better Use of Electronic Data Could Result in Disqualifying More
Recipients Who Traffic Benefits. GAO/RCED-00-61. Washington, D.C.: March 7, 2000.

Food Assistance: Efforts to Control Fraud and Abuse in the Child and Adult Care Food
Program Should Be Strengthened. GAO/RCED-00-12. Washington, D.C.: November 29,

Food Stamp Program: Storeowners Seldom Pay Financial Penalties Owed for Program
Violations. GAO/RCED-99-91. Washington, D.C.: May 11, 1999.

HUD Single-Family Mortgage Insurance and Rental Assistance Programs:

U.S. General Accounting Office, Financial Management: Strategies to Address Improper
Payments at HUD, Education and Other Federal Agencies, GAO-03-167T (Washington,
D.C.: Oct 3, 2002).

U.S. General Accounting Office, Strategies to Manage Improper Payments: Learning
from Public and Private Sector Organizations, GAO-02-69G (Washington, D.C.:
October 2001).

U.S. General Accounting Office, Major Management Challenges and Program Risks,
Department of Housing and Urban Development, GAO-01-248 (Washington, D.C.:
January 2001).

U.S. General Accounting Office, HUD Management: HUD’s High-Risk Program Areas
and Management Challenges, GAO-02-869T (Washington, D.C.: July 24, 2002).

U.S. General Accounting Office, Financial Management: Coordinated Approach Needed
to Address the Government’s Improper Payments Problems, GAO-02-749 (Washington,
D.C.: Aug 9, 2002).

38                                                               GAO-03-1029T
Grant Programs:

Formula Grants: Effects of Adjusted Population Counts on Federal Funding to States.
GAO/HEHS-99-69. Washington, D.C.: February 26, 1999.

Medicaid Formula: Effects of Proposed Formula on Federal Shares of State Spending.
GAO/HEHS-99-29R. Washington, D.C.: February 19, 1999.

Welfare Reform: Early Fiscal Effect of the TANF Block Grant. GAO/AIMD-98-137.
Washington, D.C.: August 22, 1998.

Public Housing Subsidies: Revisions to HUD’s Performance Funding System Could
Improve Adequacy of Funding. GAO/RCED-98-174. Washington, D.C.: June 19, 1998.

School Finance: State Efforts to Equalize Funding Between Wealthy and Poor School
Districts. GAO/HEHS-98-92. Washington, D.C.: June 16, 1998.

School Finance: State and Federal Efforts to Target Poor Students. GAO/HEHS-98-36.
Washington, D.C.: January 28, 1998.

School Finance: State Efforts to Reduce Funding Gaps Between Poor and Wealthy
Districts. GAO/HEHS-97-31. Washington, D.C.: February 5, 1997.

Federal Grants: Design Improvements Could Help Federal Resources Go Further.
GAO/AIMD-97-7. Washington, D.C.: December 18, 1996.

Public Health: A Health Status Indicator for Targeting Federal Aid to States.
GAO/HEHS-97-13. Washington, D.C.: November 13, 1996.

School Finance: Options for Improving Measures of Effort and Equity in Title I.
GAO/HEHS-96-142. Washington, D.C.: August 30, 1996.

Highway Funding: Alternatives for Distributing Federal Funds. GAO/RCED-96-6.
Washington, D.C.: November 28, 1995.

Ryan White Care Act of 1990: Opportunities to Enhance Funding Equity. GAO/HEHS-
96-26. Washington, D.C.: November 13, 1995.

39                                                                   GAO-03-1029T
Department of Labor: Senior Community Service Employment Program Delivery Could
Be Improved Through Legislative and Administrative Action. GAO/HEHS-96-4.
Washington, D.C.: November 2, 1995.

Flood Insurance Losses:

Flood Insurance: Information on Financial Aspects of the National Flood Insurance
Program. GAO/T-RCED-00-23. Washington, D.C.: October 27, 1999.

Flood Insurance: Information on Financial Aspects of the National Flood Insurance
Program. GAO/T-RCED-99-280. Washington, D.C.: August 25, 1999.

Flood Insurance: Financial Resources May Not Be Sufficient to Meet Future Expected
Losses. GAO/RCED-94-80. Washington, D.C.: March 21, 1994.

Medicare Incentive Payment Programs:

Physician Shortage Areas: Medicare Incentive Payments Not an Effective Approach to
Improve Access. GAO/HEHS-99-36. Washington, D.C.: February 26, 1999.

Health Care Shortage Areas: Designations Not a Useful Tool for Directing Resources to
the Underserved. GAO/HEHS-95-200. Washington, D.C.: September 8, 1995.

Social Security Pension Offset Provision:

Social Security Administration: Revision to the Government Pension Offset Exemption
Should Be Considered. GAO-02-950. Washington, D.C.: August 15, 2002.

Social Security: Congress Should Consider Revising the Government Pension Offset
“Loophole”. GAO-03-498T. Washington, D.C.: February 27, 2002.

40                                                                 GAO-03-1029T
Food Safety:

Food Safety: CDC Is Working to Address Limitations in Several of Its Foodborne
Surveillance Systems. GAO-01-973. Washington, D.C.: September 7, 2001.

Food Safety: Federal Oversight of Shellfish Safety Needs Improvement. GAO-01-702.
Washington, D.C.: July 9, 2001.

Food Safety: Overview of Federal and State Expenditures. GAO-01-177. Washington,
D.C.: February 20, 2001.

Food Safety: Federal Oversight of Seafood Does Not Sufficiently Protect Consumers.
GAO-01-204. Washington, D.C.: January 31, 2001.

Food Safety: Actions Needed by USDA and FDA to Ensure That Companies Promptly
Carry Out Recalls. GAO/RCED-00-195. Washington, D.C.: August 17, 2000.

Food Safety: Improvements Needed in Overseeing the Safety of Dietary Supplements and
“Functional Foods”. GAO/RCED-00-156. Washington, D.C.: July 11, 2000.

Meat and Poultry: Improved Oversight and Training Will Strengthen New Food Safety
System. GAO/RCED-00-16. Washington, D.C.: December 8, 1999.

Food Safety: Agencies Should Further Test Plans for Responding to Deliberate
Contamination. GAO/RCED-00-3. Washington, D.C.: October 27, 1999.

Food Safety: U.S. Needs a Single Agency to Administer a Unified, Risk-Based Inspection
System. GAO/T-RCED-99-256. Washington, D.C.: August 4, 1999.

Food Safety: Opportunities to Redirect Federal Resources and Funds Can Enhance
Effectiveness. GAO/RCED-98-224. Washington, D.C.: August 6, 1998.

Food Safety: Federal Efforts to Ensure the Safety of Imported Foods Are Inconsistent
and Unreliable. GAO/RCED-98-103. Washington, D.C.: April 30, 1998.

Food Safety: Changes Needed to Minimize Unsafe Chemicals in Food. GAO/RCED-94-
192. Washington, D.C.: September 26, 1994.

Food Safety and Quality: Uniform Risk-based Inspection System Needed to Ensure Safe
Food Supply. GAO/RCED-92-152. Washington, D.C.: June 26, 1992.

41                                                                  GAO-03-1029T
Grants for Homeland Security:

Federal Assistance: Grant System Continues to Be Highly Fragmented. GAO-03-718T.
Washington, D.C.: April 29, 2003.

Multiple Employment and Training Programs: Funding and Performance Measures for
Major Programs. GAO-03-589. Washington, D.C.: April 18, 2003.

Managing for Results: Continuing Challenges to Effective GPRA Implementation.
GAO/T-GGD-00-178. Washington, D.C.: July 20, 2000.

Workforce Investment Act: States and Localities Increasingly Coordinate Services for
TANF Clients, but Better Information Needed on Effective Approaches. GAO-02-696.
Washington, D.C.: July 3, 2002.

Fundamental Changes are Needed in Federal Assistance to State and Local
Governments. GAO/GGD-75-75. Washington, D.C.: August 19, 1975.

Rural Housing Assistance:

Rural Housing Programs: Opportunities Exist for Cost Savings and Management
Improvement. GAO/RCED-96-11. Washington, D.C.: November 16, 1995.

Public Power:

Congressional Oversight: Opportunities to Address Risks, Reduce Costs, and Improve
Performance. GAO/T-AIMD-00-96. Washington, D.C.: February 17, 2000.

Federal Power: The Role of the Power Marketing Administrations in a Restructured
Electricity Industry. GAO/T-RCED/AIMD-99-229. Washington, D.C.: June 24, 1999.

Federal Power: PMA Rate Impacts, by Service Area. GAO/RCED-99-55. Washington,
D.C.: January 28, 1999.

Federal Power: Regional Effects of Changes in PMAs’ Rates. GAO/RCED-99-15.
Washington, D.C.: November 16, 1998.

Power Marketing Administrations: Repayment of Power Costs Needs Closer Monitoring.
GAO/AIMD-98-164. Washington, D.C.: June 30, 1998.

42                                                                  GAO-03-1029T
Federal Power: Options for Selected Power Marketing Administrations’ Role in a
Changing Electricity Industry. GAO/RCED-98-43. Washington, D.C.: March 6, 1998.

Federal Electricity Activities: The Federal Government’s Net Cost and Potential for
Future Losses. GAO/AIMD-97-110 and 110A. Washington, D.C.: September 19, 1997.

Federal Power: Issues Related to the Divestiture of Federal Hydropower Resources.
GAO/RCED-97-48. Washington, D.C.: March 31, 1997.

Power Marketing Administrations: Cost Recovery, Financing, and Comparison to
Nonfederal Utilities. GAO/AIMD-96-145. Washington, D.C.: September 19, 1996.

Federal Power: Outages Reduce the Reliability of Hydroelectric Power Plants in the
Southeast. GAO/T-RCED-96-180. Washington, D.C.: July 25, 1996.

Federal Power: Recovery of Federal Investment in Hydropower Facilities in the Pick-
Sloan Program. GAO/T-RCED-96-142. Washington, D.C.: May 2, 1996.

Federal Electric Power: Operating and Financial Status of DOE’s Power Marketing
Administrations. GAO/RCED/AIMD-96-9FS. Washington, D.C.: October 13, 1995.

Child Support Enforcement:

Child Support Enforcement: Clear Guidance Would Help Ensure Proper Access to
Information and Use of Wage Withholding by Private Firms. GAO-02-349, March 26,

Child Support Enforcement: Effects of Declining Welfare Caseloads Are Beginning to
Emerge. GAO/HEHS-99-105. Washington, D.C.: June 30, 1999.

Welfare Reform: Child Support an Uncertain Income Supplement for Families Leaving
Welfare. GAO/HEHS-98-168. Washington, D.C.: August 3, 1998.

Child Support Enforcement: Early Results on Comparability of Privatized and Public
Offices. GAO/HEHS-97-4. Washington, D.C.: December 16, 1996.

Child Support Enforcement: Reorienting Management Toward Achieving Better Program
Results. GAO/HEHS/GGD-97-14. Washington, D.C.: October 25, 1996.

43                                                                 GAO-03-1029T
Child Support Enforcement: States’ Experience with Private Agencies’ Collection of
Support Payments. GAO/HEHS-97-11. Washington, D.C.: October 23, 1996.

Child Support Enforcement: States and Localities Move to Privatized Services.
GAO/HEHS-96-43FS. Washington, D.C.: November 20, 1995.

Child Support Enforcement: Opportunity to Reduce Federal and State Costs. GAO/T-
HEHS-95-181. Washington, D.C.: June 13, 1995.


44                                                                  GAO-03-1029T
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