Justification of Budget Estimates FY 2007

Program Support

Authorizing Legislation: Federal funds pursuant to Title IX and Section 927(c) of the Public Health Service Act.

A. Statement of the Budget

A total of $2,700,000 is provided at the Request for Program Support, the same level as the FY 2006 Appropriation level. These funds are directly related to AHRQ's work on the President's Management Agenda.

B. Program Description

This activity supports the overall direction and management of the AHRQ. This includes the formulation of policies and program objectives; and administrative management and services activities.

C. Performance Analysis

AHRQ has instituted a systematic approach to addressing and implementing the President's Management Agenda. The five government-wide agenda reforms—Strategic Management of Human Capital, Competitive Sourcing, Improve Financial Performance, Budget and Performance Integration, and Expanding Electronic Government—are teamed with other program reforms with which the Department has been charged. In a realignment announced in May 2003, the AHRQ Director created a new organizational entity—an Office of Performance, Accountability, Resources, and Technology—to better manage the Agency's progress against these reforms as well as other management initiatives that cross-cut Agency components.

Program Support

Over the past year, AHRQ has taken advantage of automation to streamline processes and increase efficiency where feasible. Examples include:

• Automating the annual OGE 450 (Confidential Financial Disclosure Report) filing process. Instead of sending each employee a paper copy of the required memo and OGE-450, employees are notified via E-mail of the reporting requirements as well as link to the on-line form and accompanying instructions. This reduces staff time needed to create the documents, collate, and disseminate to staff.
• AHRQ staff is systematically being trained on the "sign in" and "sign out" feature of the Integrated Time and Attendance System (ITAS). This will allow employees greater control over their time and attendance reporting and will allow us to reduce the number of timekeepers from 14 to 3.
• Ninety percent of Agency vacancies are filled through the automated QuickHire staffing mechanism. This has reduced the amount of paperwork generated for each announcement and also created a standardized approach to recruiting positions.
• AHRQ has begun deploying the Enterprise Human Resource Program (EHRP) to select Offices and Centers in AHRQ. This allows designated staff to independently generate documents (e.g., award nomination forms, SF-52 [Request for Personnel Action]) without having to contact either the Rockville HR Center or program staff in the Office of Performance, Accountability, Resources, and Technology (OPART) for HR-related information (e.g., position title, series, grade, salary, etc.). In FY 2005, AHRQ will begin the process of using the automated SF-52 process in select Offices/Center. This will minimize the number of people involved in the routing/clearance of an SF-52.

In FY 2003, AHRQ conducted 11 streamlined competitive sourcing studies in the functional areas of accounting, visual information, program/management analysis, information technology, and program assistance. The performance decision for each of these studies was in favor of the agency. In FY 2004, AHRQ conducted a streamlined (with Most Efficient Organization, or MEO) competitive sourcing study in the functional area of secretarial/program assistance. This study encompassed 20 FTEs; the performance decision made was for the Agency, which utilized an MEO, The MEO is in the process of being staffed and implemented.

As part of the President's Management Agenda and the Department's 20 Management Objectives, AHRQ submitted a succession plan in the Spring of 2005 that addressed issues such as infusion of new talent and developing and validating competencies for mission-critical occupational series. Additionally, AHRQ revised its list of mission-critical occupations (a total of six) and has developed competencies/skill levels for three occupational series and completed a gap analysis and action plan to address deficiencies for one of the series. Efforts continue to develop competencies and skill levels for the other three occupational series.

AHRQ is also working to implement the HHS Performance Management Program. The Agency is scheduled to migrate to this new system by March 31, 2006, and will serve as the Department's Beta site with the Office of Personnel Management to identify best practices and possible deficiencies. AHRQ has laid out a timeline for the implementation, including management and employee briefings, on-line training, and technical assistance in the development of plans.

AHRQ's major activities regarding the integration and implementation of the President's Management Agenda (PMA) through e-Government technologies within the Agency include:

• Government Paperwork Elimination Act (GPEA).
• Security.
• Full participation in HHS PMA activities that intersect with the mission of the Agency, Patient Safety, and Consolidated Health Informatics initiatives that cross Government Agency boundaries.

In line with these program initiatives, AHRQ's Information Technology (IT) services team explicitly defined its mission and vision: buttressed by three strategic goals:

• Ongoing development of IT systems that link AHRQ's IT initiatives directly to the mission and performance goals of the Agency by developing an electronic planning system that allows selection and tracking of business investments (Grants, Contracts and Intramural research) that link directly to the Agency mission and Government Performance Results Act (GPRA) goals and budget performance. This ensures that all IT initiatives (applications development to include intramural and extramural) are evaluated and prioritized based upon the strategic goals of the Agency. In addition, this ensures that all IT initiatives are not undertaken without the consent and approval of AHRQ Senior Management. This process has been 95 percent effective.

The IT services team defined its mission and vision, buttressed by three strategic goals:

• Ensure AHRQ's IT initiatives are aligned with departmental and agency enterprise architectures. Utilizing HHS-defined Federal Health Architecture (FHA) and HHS Enterprise Architectures, AHRQ ensures that all internal and contracted application initiatives are consistent with the technologies and standards adopted by HHS. This uniformity improves application integration (leveraging of existing systems) as well as reducing cost and development time. Due to its recent adoption, this effort is estimated to be 100 percent effective for new initiatives and less than 10 percent effective for existing and in-process applications and systems.
• Provide quality customer service to AHRQ-developed applications and operations support to AHRQ's centers, offices, and outside stakeholders. This objective entails providing uniform tools, methods, processes, and standards to ensure all projects and programs are effectively managed utilizing industry best practices. These practices include those of Project Management Institute (PMI) (Project Management Book of Knowledge [PMBOK] and Earned Value Management [EVM]), Rational Unified Process (RUP) (Software Development Life Cycle [SDLC]), Capital Planning and Investment Control (CPIC), and Enterprise Architecture (EA). These practices have appreciably improved AHRQ's ability to satisfy project objectives to include cost and schedule. Due to its recent adoption, this effort is estimated to be 100 percent effective for new initiatives and less than 10 percent effective for existing and in-process applications and systems.
• Ensure the protection of all AHRQ data, commensurate with legislation and OMB directives. AHRQ has modified the systems development life-cycle to ensure that security is addressed throughout each project phase. Additionally, AHRQ is in the process of Certifying and Accrediting all Tier 2 systems to ensure compliance with OMB and NIST directives and guidance.

Financial accountability is a cornerstone of the "Improved Financial Performance" initiative of the President's Management Agenda. Federal managers continue to experience growing pressures from their executive leaders, Congress, the public, and their customers to achieve more under the programs they manage. To that end, this initiative asks agencies to evaluate their financial management capabilities to ascertain if sufficient internal controls are in place to safeguard against the misuse of federal funds, and to ensure that these controls provide the accountability required to make certain that funds are spent as intended. The essential goal of this initiative is for managers to have access to and use financial information to make informed program and management decisions on a "day to day" basis.

The Federal managers Financial Integrity Act of 1982 (FMFIA) and the Office of Management and Budget (OMB) Circular A-123 Internal Control Systems establish the requirements for internal control in federal agencies. Circular A-123 was revised in 2004 to include a detailed process that agency management must follow to document, assess, test, and report on the effectiveness of internal controls over financial reporting. This process includes establishing an effective control environment by identifying the risks that need to be mitigated to prevent improper payments. AHRQ will use its Improper Payment Risk Assessment as one of the sources to identify the business processes that will be assessed under A-123 and determine the adequacy of Agency internal controls.

AHRQ continued to support the Department's efforts to develop and implement the unified financial management system by participating in the Steering Committee and the Planning and Development Committee meetings.

General program direction and budget and performance integration is accomplished through the collaboration of the Office of the Director and the offices and centers that have programmatic responsibility for portions of the Agency's research portfolio. The Agency links budget and performance management through its focus on the Annual Performance Plan.

As a result of the increased emphasis on strategic planning, the Agency has shifted from a focus on output and process measurement to a focus on outcome measures. These outcome measures are being developed to cascade down from our strategic goal areas of safety/quality, effectiveness, efficiency, and organizational excellence. Portfolios of work (combinations of activities that make up the bulk of our investments) support the achievement of our highest-level outcomes.

In FY 2006, AHRQ will conclude the Phase I development of a software application that maps each performance measure to strategic goals and the portfolio structure. This application will provide a strategy map of all program measures and how they are structured to support the strategic goals and the portfolio missions. In FY 2007, Phase II efforts will continue to build upon the initial software pilot by mapping outputs and activities associated with achieving the long-term goals.

Recognizing the importance of PART in performance and budget integration, in FY 2005 AHRQ began work to conduct internal assessments on its remaining portfolios of work. These assessments are scheduled to be completed in FY 2006.

Finally, AHRQ completed OMB PART comprehensive program assessments on five key programs within the Agency:

• The Medical Expenditure Panel Survey (MEPS).
• The Healthcare Cost and Utilization Project (HCUP).
• The Consumer Assessment of Healthcare Plans Survey (CAHPS®).
• The grant component of the Agency's Translation of Research into Practice (TRIP) activity.
• The Patient Safety program.

The Pharmaceutical Outcomes Portfolio was the latest program to undergo an official OMB PART review. These reviews provide the basis for the Agency to move forward in more closely linking high quality outcomes with associated costs of programs. Over the next few years, the Agency will focus on fully integrating financial management of these programs with their performance.

D. Rationale for the FY 2007 Request

The FY 2007 Request for Program Support is maintained at the FY 2006 Appropriation level. These funds will provide for mandatory increases, including funds for the Unified Financial Management system (UFMS).

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Current as of February 2006

Internet Citation:

Program Support. From: Justification for Budget Estimates for Appropriations Committees, Fiscal Year 2007, February 2006. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/cj2007/prog07.htm

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