Program Support

Budget Estimates for Appropriations Committees, Fiscal Year 2010

FY 2009 Authorization: Title III and IX and Section 937(c) of the Public Health Service Act.
Allocation Method: Contracts, and Other.

A. Program Description and Accomplishments

This budget activity supports the overall direction and management of the AHRQ.

Strategic Management of Human Capital

AHRQ participated in the Federal Human Capital Survey (FHCS) and is assessing the impact of the results at the Office/Center levels and communicating this information to staff. Additionally, Agency staff involved in the Making AHRQ Great Initiative (MAG) has been called upon to foster solutions and ensure issues on a large scale are resolved (e.g., themes which cut across AHRQ). An action plan is currently being developed which will address issues and concerns that were revealed through the survey.

Recently, AHRQ conducted forums to assess the current Performance Management Appraisal Program system (PMAP) and provided responses to the Department suggesting changes to the existing policy. In an effort to ensure full and open conversations, forums and questionnaires were utilized to obtain feedback from managers and employees. Notable suggestions included weighting of the performance elements and implementation of a five tiered appraisal system. AHRQ recently engaged in testing of the new automated performance management application and conducted a pilot test with a small group of staff in the Agency. AHRQ continues to support workforce development programs and initiatives through competency assessment, development and implementation for mission critical activities. The Agency identified a need for, and implemented mandatory Project Management training for all AHRQ staff and participated in the Department-wide effort to identify and establish core competencies across OPDIVs/STAFFDIVs. Finally, AHRQ continues to strive towards meeting the OPM 45-day timeline for hiring and notifying applicants to SES and non-SES vacancies. We are working in collaboration with the Rockville Human Resources Center to ensure timelines are met and we consistently inform selecting officials of this requirement through the issuance of action due dates upon release of certificates identifying eligible applicants.

Improve Financial Performance

AHRQ is working to demonstrate to the Office of Finance at HHS effective use of financial information to drive results in key areas of operations and to develop and implement a plan to
continuously expand the scope to additional areas of operations. AHRQ has completed the review and updating of all internal controls in light of the transition to an integrated, department wide financial management solution—the Unified Financial Management System (UFMS). In addition, AHRQ continued to participate in the Department's A-123 internal control efforts and implemented all corrective actions for deficiencies reported as a result of the FMFIA/A-123 internal control processes identified in FY 2008. In FY 2009, AHRQ is also working to update all internal controls based on the transition to the HHS Consolidated Acquisition Solution (HCAS). HCAS is the standardized acquisition system that will be used across multiple OPDIVs, including AHRQ. Finally, AHRQ continues to maintain a low-risk status for improper payments.

Electronic Government

AHRQ's current activities include:

• Ongoing development of policies and procedures that link AHRQ's IT initiatives directly to the mission and performance goals of the Agency. Our governance structure ensures that all IT initiatives are not undertaken without the consent and approval of AHRQ Senior Management and prioritized based upon the strategic goals and research priorities of the agency.
• Ensuring AHRQ's IT initiatives are aligned with departmental and agency enterprise architectures. Utilizing HHS defined FHA and HHS Enterprise Architectures, AHRQ ensures
  that all internal and contracted application initiatives are consistent with the technologies and standards and adopted by HHS as well as OMB directives. This uniformity improves
  application integration (leveraging of existing systems) as well as reducing cost and development time.
• Providing quality customer service and operations support to AHRQ's centers, offices and outside stakeholders. This objective entails providing uniform tools, methods, processes,
  practices and standards to ensure all projects and programs are effectively managed utilizing industry best practices. These practices include PMI (PMBOK, EVM), RUP (SDLC), CPIC, and EA. These practices have appreciably improved AHRQ's ability to satisfy project objectives to include cost and schedule.
• Ensuring the protection of AHRQ data; commensurate with current and future legislation and OMB directives. AHRQ's security program goals focus on executing the defined goals developed in our strategic and tactical plans which are targeted at three key areas: People, Process and Technology. These goals include but are not limited to: implementation of LOB Information and Security and Privacy Awareness training, System Development Life Cycle and FIPS 140-2 compliant encryption solutions. AHRQ continues to ensure 98 percent or higher of AHRQ's employees will complete the LOB Information Security and Privacy Awareness training. AHRQ will continue to follow the modified systems development lifecycle to ensure that security is addressed throughout each project phase. The Agency will deploy encryption solutions for mobile devices, removable media, and data and will ensure FDCC settings are applied to all desktops, laptops, and ensure servers are deployed with departmental approved standard security settings.

Performance Improvement

General program direction 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. AHRQ created a framework to provide a more thoughtful and strategic alignment of its activities. This framework represents the Agency's collaborative efforts on strategic opportunities for growth and synergy. As the result of increased emphasis on strategic planning, the Agency continues the shift from a focus on output and process measurement to a focus on outcome measures where feasible. These outcome measures 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.

Performance data will be tracked electronically using the Agency's electronic performance tracking system and published as soon as it becomes available. Also, work will continue with
program staff to establish and display a close alignment of projects and how they support AHRQ's performance measures and the Department's strategic goal areas.

In FY 2008 and FY 2009, AHRQ continued the implementation of strong budget and performance integration practices through the use of structured Project Management processes. AHRQ has begun a campaign to design and implement a quality improvement process for managing major programs that support the Agency's strategic goals and Departmental strategic goals and specific objectives.

AHRQ has successfully completed comprehensive program assessments on six 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 Patient Safety portfolio; the Pharmaceutical Outcomes portfolio; and most recently the Health Information and Technology portfolio. 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.

B. Funding History

Funding for the Program Support budget activity during the last five years has been as follows:

C. Budget Request

The FY 2010 President's Budget Request for Program Support totals $2,700,000, the same level of support as the prior year. In FY 2010, AHRQ will:

• Fully implement the Departmental Learning Management System (LMS) for training and development needs (Strategic Management of Human Capital); and
• Complete updating of all internal controls following AHRQ's conversion to HCAS (Improve Financial Management).

D. Outputs and Outcomes Tables

Program: Program Support

Long-Term Objective: Improve performance in all areas of Program Support.