Centers for Disease Control and Prevention: Human Capital	 
Planning Has Improved, but Strategic View of Contractor Workforce
Is Needed (28-MAY-08, GAO-08-582).				 
                                                                 
The Centers for Disease Control and Prevention (CDC)--an agency  
in the Department of Health and Human Services (HHS)--has	 
experienced an expanding workload due to emerging health threats,
such as bioterrorism. Strategic planning helps agencies like CDC 
sustain a workforce with the necessary education, skills, and	 
competencies--human capital--to fulfill their missions. In	 
September 2007, CDC released its Strategic Human Capital	 
Management Plan (CDC Plan). GAO was asked to review CDC's human  
capital planning. GAO determined (1) whether the CDC Plan was	 
designed to address the human capital challenges CDC faces; (2)  
the extent to which the CDC Plan is strategically aligned with	 
agency goals, plans, and budget; and (3) the extent to which CDC 
incorporated GAO's principles for strategic human capital	 
planning. To do so, GAO interviewed officials and analyzed data  
and documents.							 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-08-582 					        
    ACCNO:   A82200						        
  TITLE:     Centers for Disease Control and Prevention: Human Capital
Planning Has Improved, but Strategic View of Contractor Workforce
Is Needed							 
     DATE:   05/28/2008 
  SUBJECT:   Agency missions					 
	     Contract administration				 
	     Contract oversight 				 
	     Contractor personnel				 
	     Contractors					 
	     Demography 					 
	     Diversity management				 
	     Employee retention 				 
	     Hiring policies					 
	     Human capital					 
	     Human capital management				 
	     Human capital planning				 
	     Knowledge, skills and abilities			 
	     Performance measures				 
	     Personnel recruiting				 
	     Skilled labor					 
	     Staff utilization					 
	     Strategic planning 				 
	     GAO High Risk Series				 

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GAO-08-582

   

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Report to Congressional Requesters: 

United States Government Accountability Office: 
GAO: 

May 2008: 

Centers for Disease Control and Prevention: 

Human Capital Planning Has Improved, but Strategic View of Contractor 
Workforce Is Needed: 

GAO-08-582: 

GAO Highlights: 

Highlights of GAO-08-582, a report to congressional requesters. 

Why GAO Did This Study: 

The Centers for Disease Control and Prevention (CDC)ï¿½an agency in the 
Department of Health and Human Services (HHS)ï¿½has experienced an 
expanding workload due to emerging health threats, such as 
bioterrorism. Strategic planning helps agencies like CDC sustain a 
workforce with the necessary education, skills, and competenciesï¿½human 
capitalï¿½to fulfill their missions. In September 2007, CDC released its 
Strategic Human Capital Management Plan (CDC Plan). GAO was asked to 
review CDCï¿½s human capital planning. GAO determined (1) whether the CDC 
Plan was designed to address the human capital challenges CDC faces; 
(2) the extent to which the CDC Plan is strategically aligned with 
agency goals, plans, and budget; and (3) the extent to which CDC 
incorporated GAOï¿½s principles for strategic human capital planning. To 
do so, GAO interviewed officials and analyzed data and documents. 

What GAO Found: 

GAO identified six key challenges CDC faces in its efforts to sustain a 
skilled workforce to fulfill its mission and goals, and the CDC Plan 
includes strategies that could help the agency address five of them. 
These challenges are (1) changing workforce demographics, highlighted 
by the potential loss of essential personnel due to retirement; (2) the 
limited supply of skilled public health professionals; (3) CDCï¿½s 
acknowledged need to increase the diversity of its workforce; (4) 
changing workforce needs resulting from the agencyï¿½s expanding scope of 
work and responsibilities; (5) logistical difficulties involved in 
acquiring and retaining a skilled workforce; and (6) difficulties 
presented by managing a workforce with a large and growing number of 
contractors. While the CDC Plan includes strategies designed to address 
the first five challenges, it does not address the challenge involving 
contractors, which represent more than one-third of its workforce. 
Thus, the CDC Plan may not be as useful as it could be to provide a 
strategic view of its contractor workforce and to assist the agency 
with managing all of its human capital. 

The CDC Plan only partially meets the criteria for strategic alignment: 
the strategies in it are linked with the agencyï¿½s mission and goals, 
but they are not integrated with the documents that serve as the 
strategic plan, performance plan, or budget. According to CDC 
officials, the agency will update the CDC Plan annually and will 
integrate it with these documents as it is updated. 

CDC incorporated aspects of all of GAOï¿½s principles of strategic human 
capital planning into the CDC Plan and has outlined intended actions 
that could further incorporate the principles in subsequent updates. 
CDC partially incorporated the first principleï¿½to involve managers, 
other employees, and stakeholders in developing, communicating, and 
implementing the human capital planï¿½by formally involving management 
and stakeholders in plan development. CDC intends to involve other 
employees in implementation and future updates. CDC partially 
incorporated the second principleï¿½to determine the skills and 
competencies needed to achieve agency mission and goals, including 
identifying skill and competency gapsï¿½by conducting a preliminary 
workforce analysis. The agency had not completed its analyses of skill 
and competency gaps for the occupations it deemed most critical when 
the plan was developed, but has now completed an analysis for one 
critical occupation and is conducting others. The plan partially 
follows the third principleï¿½to develop strategies to acquire, retain, 
and develop a skilled workforce and to address gaps. CDC developed 
strategies for its plan and intends to target gaps once they are 
identified. CDC has incorporated the fourth principleï¿½to build 
capabilities to support the strategiesï¿½through such activities as 
ongoing efforts to streamline hiring. The fifth principle is to monitor 
and evaluate the contribution that strategies have made toward 
achieving mission and goals. The agency indicated in the CDC Plan that 
it intends to monitor and evaluate its strategies as part of its 
implementation activities. Further incorporation of GAOï¿½s principles 
into plan updates could help the agency strengthen its human capital 
efforts. 

What GAO Recommends: 

GAO recommends that CDC address the challenge of managing a workforce 
with a large and growing number of contractors in CDC Plan updates. In 
its comments on a draft, HHS indicated that GAO implied that CDC should 
treat contractors as if they were federal employees and it lacked 
adequate oversight of them. GAO believes HHS misinterpreted the 
recommendation, which is to ensure that CDCï¿½s human capital planning 
encompasses strategies for the use of its federal employee and 
contractor resources. 

To view the full product, including the scope and methodology, click on 
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-582]. For more 
information, contact Cynthia A. Bascetta, 202-512-7114, 
[email protected]. 

[End of section] 

Contents: 

Letter: 

Results in Brief: 

Background: 

The CDC Plan Includes Strategies to Address Key Human Capital 
Challenges, Except for Managing a Workforce with a Large and Growing 
Number of Contractors: 

Strategies in the CDC Plan Are Linked with CDC's Mission and Goals but 
Are Not Integrated with Its Strategic Plan, Performance Plan, or 
Budget: 

CDC Incorporated Aspects of Our Principles for Strategic Human Capital 
Planning into the CDC Plan and Has Outlined Further Actions: 

Conclusions: 

Recommendation for Executive Action: 

Agency Comments and Our Evaluation: 

Appendix I: Scope and Methodology: 

Appendix II: CDC Coordinating Centers and Coordinating Offices and 
Their Missions: 

Appendix III: CDC Workforce and Breakdown by Each Organizational Unit 
as of August 2007: 

Appendix IV: CDC's Objectives and Strategies from Its Strategic Human 
Capital Management Plan: 

Appendix V: Summary of CDC's Health Protection Goals: 

Appendix VI: Comments from the Centers for Disease Control and 
Prevention: 

Appendix VII: GAO Contact and Staff Acknowledgments: 

Tables: 

Table 1: GAO's Five Principles for Strategic Human Capital Planning and 
Some Associated Key Points: 

Table 2: Human Capital Challenges at CDC and Examples of Related 
Strategies: 

Figures: 

Figure 1: CDC Organizational Structure: 

Figure 2: A Comparison of OPM's HCAAF and CDC's Human Capital 
Management Framework: 


Abbreviations: 

AHRC: Atlanta Human Resources Center: 

CDC: Centers for Disease Control and Prevention: 

HCAAF: Human Capital Assessment and Accountability Framework: 

HHS: Department of Health and Human Services: 

OPM: Office of Personnel Management: 

OWCD: Office of Workforce and Career Development: 

SARS: severe acute respiratory syndrome: 

[End of section] 

United States Government Accountability Office:
Washington, DC 20548: 

May 28, 2008: 

The Honorable Daniel K. Akaka: 
Chairman: 
The Honorable George V. Voinovich: 
Ranking Member: 
Subcommittee on Oversight of Government Management, the Federal 
Workforce, and the District of Columbia: 
Committee on Homeland Security and Governmental Affairs: 
United States Senate: 

The Honorable Charles E. Grassley: 
Ranking Member: 
Committee on Finance: 
United States Senate: 

With an annual budget of about $8.6 billion, the Centers for Disease 
Control and Prevention (CDC) has a mission to promote health and 
quality of life by preventing and controlling disease, injury, and 
disability. The agency's scope of work and responsibilities--as one of 
the major operational divisions of the Department of Health and Human 
Services (HHS)--have expanded over the years in concert with new and 
emerging infectious diseases such as avian influenza, and health 
threats, including bioterrorism. CDC's ability to fulfill its mission 
and address its expanded scope of work and responsibilities depends on 
whether it can sustain its human capital--a workforce with the 
necessary education, knowledge, skills, and competencies. However, 
concerns have begun to surface about CDC's management of its workforce. 
For example, the Office of Personnel Management's (OPM) 2006 Federal 
Human Capital Survey noted a CDC-wide decrease in staff satisfaction 
with the agency between 2004 and 2006.[Footnote 1] Reports issued by 
CDC's Ombudsman Office in 2007 delineated staff concerns about 
personnel problems and the workplace environment.[Footnote 2] 
Additionally, media reports have highlighted several issues related to 
CDC's workforce, such as stories in 2005 and 2006 on the loss of senior 
leadership and key scientists and a 2007 journal article discussing 
problems with morale at the agency.[Footnote 3] 

CDC's workforce consists of employees in about 168 occupations, 
including physicians, statisticians, epidemiologists,[Footnote 4] and 
laboratory experts. This workforce consists of full-and part-time 
federal staff--Civil Service or U.S. Public Health Service Commissioned 
Corps[Footnote 5]--and contractors. In fiscal year 2007, CDC's 
workforce included 9,000 federal staff and an estimated 5,000 
contracted staff. Of the federal staff, about two-thirds worked in 
CDC's headquarters in Atlanta, Georgia. In addition, about 2,500 
employees worked at other locations in the United States, and about 200 
federal staff worked in 50 foreign countries. The estimated 5,000 
contractors worked in various locations and occupations throughout the 
agency. 

Managing a complex federal agency such as CDC requires strategic human 
capital planning--the systematic assessment of current and future human 
capital needs and the development of long-term strategies to address 
any identified gaps--in order to optimize workforce performance to 
achieve the agency's mission and goals. In past work, we noted that 
effective strategic human capital planning requires strategic 
alignment. Strategic alignment exists when an agency's human capital 
strategies[Footnote 6] are linked with its mission and goals and 
integrated with its strategic plan, performance plan, and budget. It is 
important because it allows agencies to assess and understand the 
extent to which their workforce contributes to achieving their 
overarching mission and goals. We also noted in our prior work that 
strategic human capital planning should incorporate five principles, 
which are (1) involving top management, managers, other employees, and 
stakeholders in developing, communicating, and implementing the human 
capital plan; (2) determining the skills and competencies needed to 
achieve an agency's mission and goals, including identifying gaps in 
these skills and competencies; (3) developing strategies to acquire, 
retain, and develop a skilled workforce and to address gaps in skills 
and competencies; (4) building capabilities needed to support the 
strategies; and (5) monitoring and evaluating the contribution that 
strategies have made toward achieving the agency's mission and goals. 
[Footnote 7] 

We have previously identified strategic human capital management as a 
governmentwide high-risk area.[Footnote 8] We found that a lack of 
attention to strategic human capital planning is a pervasive problem in 
the federal government and creates a risk to its ability to effectively 
serve the American people and to address the challenges of the 21st 
century. In a January 2004 report on CDC's management, we noted that 
while CDC was facing several human capital challenges, including the 
loss through retirement of a key portion of its workforce that 
possessed both managerial and technical expertise, CDC had suspended 
development of its human capital plan.[Footnote 9] At that time, we 
recommended that CDC ensure that its human capital planning efforts 
receive appropriate leadership attention, including resuming human 
capital planning and linking these efforts to the agency's strategic 
plan. CDC resumed its strategic human capital planning, and in 
September 2007 released its Strategic Human Capital Management Plan 
(CDC Plan).[Footnote 10] 

Given your interest in strategic human capital planning in federal 
agencies that heavily rely on a scientific, technical, and engineering- 
based workforce,[Footnote 11] you asked us to review human capital 
planning at CDC. We determined (1) whether the CDC Plan was designed to 
address the human capital challenges CDC faces in sustaining a skilled 
workforce; (2) the extent to which the strategies in the CDC Plan are 
linked with the agency's mission and goals and integrated with its 
strategic plan, performance plan, and budget, that is, the extent to 
which the plan is strategically aligned; and (3) the extent to which 
CDC incorporated our five principles for strategic human capital 
planning into its plan. 

To determine whether the CDC Plan was designed to address the human 
capital challenges CDC faces in sustaining a skilled workforce, we 
analyzed information collected from interviews we conducted with 
officials from CDC, HHS, OPM, and CDC's external partners, which 
include policy research and professional associations that work with 
the agency. We corroborated testimonial evidence from our interviews 
with analysis of relevant documents, such as reports on the public 
health workforce, and workforce statistics and retirement eligibility 
data computed by CDC. On the basis of our review and analysis of these 
workforce data and our interviews with CDC officials, we determined 
that the data were sufficiently reliable for the purposes of this 
report. We used this information to identify the challenges faced by 
CDC and then analyzed the CDC Plan to determine whether it was designed 
to address the challenges. To determine the extent to which the CDC 
Plan meets criteria for strategic alignment, we interviewed CDC and HHS 
officials and analyzed the CDC Plan and OPM's Human Capital Assessment 
and Accountability Framework (HCAAF), which provides guidance on human 
capital planning and management.[Footnote 12] We also analyzed other 
relevant CDC and HHS documents. To determine the extent to which CDC 
incorporated our five principles for strategic human capital planning, 
we examined the CDC Plan and interviewed officials from CDC and HHS's 
Atlanta Human Resources Center (AHRC), a stakeholder in CDC's human 
capital planning. We also analyzed related documents about CDC's 
workforce and training efforts and past and planned strategies to 
acquire, retain, and develop CDC's workforce; new systems, programs, 
and processes that support human capital planning; and efforts to 
monitor and evaluate the agency's human capital efforts. We conducted 
our work from March 2007 to May 2008 in accordance with generally 
accepted government auditing standards. (See app. I for more detailed 
information on our scope and methodology.) 

Results in Brief: 

The CDC Plan includes strategies that could help the agency address 
five of the six key challenges we identified that it faces in 
sustaining a skilled workforce. The first challenge is the agency's 
changing workforce demographics, highlighted by the potential loss of 
essential personnel due to retirement. For example, 34 percent of 
medical officers, who are essential to many of CDC's scientific 
activities, are eligible to retire within the next 5 years. It may be 
difficult for CDC to replace these retiring medical officers because of 
a second challenge CDC faces--a limited supply of skilled public health 
professionals. A third challenge is CDC's acknowledged need to increase 
the diversity of its workforce. CDC officials acknowledged that the 
agency's workforce was not as diverse as it could be and told us the 
agency needed to improve its recruitment of Hispanics and persons with 
disabilities. CDC's fourth challenge is its changing workforce needs 
resulting from its expanding scope of work and responsibilities. For 
example, the globalization of public health threats has increased the 
need for employees who can prepare for and respond to infectious 
disease outbreaks at home and in other countries. The logistical 
difficulties involved in acquiring and retaining a skilled workforce-- 
including problems with the hiring process--constitute the fifth 
challenge. CDC's sixth challenge is the difficulties presented by 
managing a workforce with a large and growing number of contractors. 
Contractors have been the faster growing segment of CDC's workforce, 
increasing 139 percent from fiscal year 2000 through fiscal year 2006, 
and now represent more than one-third of the agency's workforce. The 
CDC Plan was designed to address five of the challenges, but not the 
challenge of managing a workforce with a large and growing number of 
contractors. Without addressing our sixth challenge, the CDC Plan will 
not give the agency a strategic view of its governmental and contractor 
workforce and thus, may not be as useful as it could be in assisting 
the agency with strategic human capital planning for its entire 
workforce. 

The CDC Plan has partially met criteria for strategic alignment, 
because while the strategies in the CDC Plan are linked with the 
agency's mission and goals, they are not integrated with the documents 
that serve as the agency's strategic plan, performance plan, or budget. 
CDC relied on HCAAF as guidance for developing the framework that 
served as the foundation for the CDC Plan. Both HCAAF's and CDC's 
frameworks include strategic alignment as an integral element, but 
CDC's plan only partially follows HCAAF and its framework for strategic 
alignment. CDC officials told us they intend to update the CDC Plan 
annually and to integrate the plan with the documents that serve as the 
agency's strategic plan, performance plan, and budget during the next 
CDC Plan update. 

CDC incorporated aspects of all five of our principles for strategic 
human capital planning into the CDC Plan and has outlined additional 
actions it intends to take that could further incorporate the 
principles in subsequent updates. CDC partially incorporated the first 
principle--to involve top management, managers, other employees, and 
stakeholders in developing, communicating, and implementing the human 
capital plan--by including top management and AHRC as stakeholders in 
reviewing and commenting on the CDC Plan while it was being developed. 
CDC intends to further incorporate this principle by involving 
nonsupervisory employees in the future implementation of the plan. For 
the second principle--to determine the skills and competencies needed 
to achieve an agency's mission and goals, including identifying gaps in 
these skills and competencies--CDC conducted a preliminary workforce 
analysis that garnered useful information, but had not completed an 
analysis of gaps in skills and competencies for the occupations most 
critical to achieving its mission at the time the CDC Plan was 
developed. CDC has completed a gap analysis for one mission-critical 
occupation and is conducting analyses for others. For the third 
principle--to develop strategies to acquire, retain, and develop a 
skilled workforce and to address gaps--CDC has developed such 
strategies, but because it had not completed the identification of 
skill and competency gaps, the strategies may be of limited 
effectiveness in addressing any gaps. However, the agency recognized 
this shortcoming and developed a strategy to take further steps once 
the gap analyses were completed. CDC has taken steps to incorporate the 
fourth principle--to build the capabilities needed to support its 
strategies. For example, CDC officials told us they have hired an 
individual to oversee the development and implementation of their 
recruitment strategy, as described in the CDC Plan. The fifth principle 
involves monitoring and evaluating the contribution that strategies 
have made toward achieving the agency's mission and goals. While CDC 
previously collected limited information with which to monitor and 
assess its human capital efforts, the agency indicated in the CDC Plan 
that it intends to monitor and evaluate its strategies as part of its 
implementation activities. 

To improve CDC's human capital planning efforts, we recommend that the 
Director of CDC incorporate strategies that address the challenge of 
managing a workforce with a large and growing number of contractors 
into future updates of the CDC Plan. 

In its written comments on a draft of this report, HHS noted concerns 
that our recommendation implied that CDC should treat contractors as if 
they were federal employees and that the agency does not ensure 
adequate oversight of them. (See app. VI.) We believe that HHS 
misinterpreted what we wrote regarding the challenge of managing a 
workforce with a large and growing number of contractors and the intent 
of the recommendation. The report discusses contractors in relation to 
understanding the specific ways that they are used throughout CDC to 
complement federal staff. The recommendation focuses on the need for 
CDC to incorporate strategies to help it better manage its blended 
workforce of federal workers and contractors to meet its mission and 
goals. 

Background: 

CDC currently serves as the national focal point for developing and 
applying disease prevention and control, environmental health, and 
health promotion and education activities designed to improve the 
health of Americans. CDC is also responsible for leading national 
efforts to detect, respond to, and prevent illnesses and injuries that 
result from natural causes or the release of biological, chemical, or 
radiological agents. To achieve its mission and goals, CDC relies on an 
array of partners, including public health associations and state and 
local public health agencies. CDC collaborates with these partners on 
initiatives such as monitoring the public's health, investigating 
disease outbreaks, and implementing prevention strategies. CDC also 
uses its staff located in foreign countries to aid in international 
efforts, such as guarding against global diseases. 

CDC Organizational Structure: 

In April 2005, CDC completed a reorganization known as the Futures 
Initiative, which was designed to realign its resources to better meet 
the challenges of 21st century health threats. Before the 
reorganization, CDC consisted of an Office of the Director,[Footnote 
13] 10 national centers, and the National Institute for Occupational 
Safety and Health. The reorganization created 4 coordinating centers 
and 2 coordinating offices that report to the Office of the Director. 
(See fig. 1.) The 4 coordinating centers facilitate and integrate the 
work of the 11 discipline-specific national centers and 1 national 
office. (See app. II for a description of the work of the 4 
coordinating centers and 2 coordinating offices.) The national centers 
are primarily responsible for operating CDC's public health programs 
and generally include, among other things, a director's office, 
programmatic divisions, and branches. 

Figure 1: CDC Organizational Structure: 

[See PDF for image] 

This figure is an organizational chart depicting the following 
structure: 

Office of the Director: [top tier connections]
* Office of Chief Science Officer; 
* Office of Chief of Public Health Practice; 
* Office of Chief Operating Officer; 
* CDC Washington Office; 
* Office of Strategy and Innovation; 
* Office of Workforce and Career Development; 
* Office of Enterprise Communication; 
* Office of Chief of Staff; 
* Office of Dispute Resolution & Equal Employment Opportunity; 

Office of the Director: [second tier connections] 
* Coordinating Office for Global Health; 
* Coordinating Office for Terrorism Preparedness & Emergency Response; 
* Coordinating Center for Environmental Health and Injury Prevention; 
- National Center for Environmental Health/Agency for Toxic Substances 
& Disease Registry; 
- National Center for Injury Prevention and Control; 
* Coordinating Center for Health Information and Service; 
- National Center for Health Marketing; 
- National Center for Health Statistics; 
- National Center for Public Health Informatics; 
* Coordinating Center for Health Promotion; 
- National Center on Birth Defects and Developmental Disabilities; 
- National Center for Chronic Disease Prevention and Health Promotion; 
- National Office of Public Health Genomics; 
* Coordinating Center for Infectious Diseases; 
- National Center for Immunization & Respiratory Diseases; 
- National Center for Zoonotic, Vector-Borne, & Enteric Diseases; 
- National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention; 
- National Center for Preparedness, Detection, & Control of Infectious 
Diseases; 
* National Institute for Occupational Safety and Health. 

Source: GAO analysis of CDC data. 

[End of figure] 

CDC Goals and Goal Action Plans: 

As part of the Futures Initiative, CDC also created new agency goals-- 
its Health Protection Goals, which are (1) Healthy People in Every 
Stage of Life, (2) Healthy People in Healthy Places, (3) People 
Prepared for Emerging Health Threats, and (4) Healthy People in a 
Healthy World. CDC uses the Health Protection Goals to develop Goal 
Action Plans, which aid in the agency's strategic planning of the 
direction of its work. Goal Action Plans are associated with specific 
objectives, strategies, and actions, as well as performance goals, 
which are measured quarterly by the Organizational Excellence 
Assessment process.[Footnote 14] Coordinating centers and coordinating 
offices are charged with implementing these goals and the related Goal 
Action Plan in its areas of expertise, while also providing intra-
agency support and resources for cross-cutting issues and specific 
health threats. For example, the Coordinating Center for Infectious 
Diseases leads the Goal Action Plan associated with addressing emerging 
infections under the third Health Protection Goal--People Prepared for 
Emerging Health Threats. At the same time, this coordinating center 
supports the Coordinating Center for Environmental Health and Injury 
Prevention in its lead role for the Goal Action Plan on adolescent 
health, which links to the first Health Protection Goal--Healthy People 
in Every Stage of Life. 

CDC Human Capital Entities: 

Although each coordinating center and coordinating office conducts some 
of its own human capital activities, such as recruiting staff and 
conducting succession planning, two entities are responsible for CDC's 
human capital activities agencywide--HHS's AHRC and CDC's Office of 
Workforce and Career Development (OWCD). AHRC is responsible for CDC's 
administrative personnel activities, and OWCD is responsible for human- 
capital-related planning for the agency. Before 2004, CDC's Human 
Resources Management Office was responsible for the administrative and 
the planning activities at CDC. The office, which was one of 40 human 
resource offices in HHS, reported directly to CDC management. In 2004, 
CDC's Human Resources Management Office was consolidated into AHRC. At 
that time, CDC began reimbursing HHS for the services provided by AHRC. 
AHRC reports directly to HHS management and manages all of CDC's 
administrative services relating to personnel, including processing pay 
and benefits, posting vacancy announcements, conducting initial 
screenings of candidates, and hiring new employees. OWCD is part of 
CDC's Office of the Director. OWCD assists coordinating centers and 
coordinating offices with human-capital-related efforts, such as 
workforce analysis or succession planning. In addition to human- 
capital-related planning, specific activities of this office include 
developing and implementing a human resources leadership and career 
management program for all occupations within CDC and the CDC Plan. 
Additionally, OWCD manages the agency's fellowship programs and is 
responsible for CDC University, which provides training and development 
opportunities to CDC staff. 

Federal Strategic Human Capital Management: 

OPM is responsible for providing guidance to agencies on federal human 
capital policies and procedures and for an initiative associated with 
strategic human capital management within the President's Management 
Agenda.[Footnote 15] As part of this responsibility, OPM developed 
HCAAF in conjunction with GAO and the Office of Management and Budget. 
[Footnote 16] HCAAF is intended to assist federal agencies with their 
human capital planning process, including developing strategies that 
support each agency's mission and goals. HCAAF outlines an ongoing 
process of human capital planning for five elements: (1) strategic 
alignment, (2) leadership and knowledge management, (3) results- 
oriented performance culture, (4) talent management, and (5) 
accountability. The first element involves planning and goal-setting 
activities that are essential to promoting strategic alignment, which 
includes linking strategies with an agency's mission and goals and 
integrating these strategies into an agency's strategic plan, 
performance plan, and budget. The next three HCAAF elements are used in 
implementing an agency's strategies. Specifically, leadership and 
knowledge management ensures continuity in leadership and maintaining 
organizational knowledge; results-oriented performance culture promotes 
a diverse, high-performing workforce; and talent management addresses 
gaps in needed skills. The fifth element--accountability-- focuses on 
the importance of evaluating the results of strategies to assess their 
effectiveness and to determine whether adjustments are needed. 

GAO's Five Principles for Strategic Human Capital Planning: 

In our past work on human capital issues, we identified five principles 
for strategic human capital planning that agencies should incorporate 
as they develop plans and strategies for how they will meet their 
current and future human capital needs. Associated with each principle 
are some key points for agency officials to consider when applying 
these principles to their planning efforts. (See table 1.) 

Table 1: GAO's Five Principles for Strategic Human Capital Planning and 
Some Associated Key Points: 

Principle: Involve top management, managers, other employees, and 
stakeholders in developing, communicating, and implementing the human 
capital plan; 
Key points: 
* Ensure that top management sets the overall direction and goals of 
the agency's human capital planning; 
* Involve nonsupervisory employees and other stakeholders in developing 
and implementing future strategies; 
* Establish a communication strategy to create shared expectations, 
promote transparency, and report progress, with involvement of agency 
managers, employees, and employee unions. 

Principle: Determine the critical skills and competencies that will be 
needed to achieve the agency's current and future mission and goals, 
including identifying gaps in these skills and competencies; 
Key points: 
* Ensure that the skills and competencies identified as needed are 
clearly linked to the agency's mission and that long-term goals are 
developed jointly with stakeholders; 
* Consider utilizing various data sources for making fact-based 
determinations of the critical skills and competencies needed, 
including using attrition and projected retirement rates and 
demographic trends; 
* Consider opportunities for reshaping the workforce by, for example, 
reengineering current work processes and sharing work among offices 
within an agency, when estimating the number of employees needed with 
specific skills and competencies. 

Principle: Develop strategies to acquire, retain, and develop a skilled 
workforce and to address gaps in skills and competencies; 
Key points: 
* Develop strategies that (1) are tailored to the agency's needs; (2) 
address how a skilled workforce is acquired, retained, and developed; 
and (3) can be implemented with available resources; 
* Consider how these strategies can be implemented to address gaps in 
skills and competencies; 
* Identify and utilize appropriate human capital authorities, or 
flexibilities,[A] such as recruitment and retention bonuses, to build 
and maintain a skilled workforce. 

Principle: Build the capability needed to address administrative, 
educational, and other requirements important to supporting strategies; 
Key points: 
* Consider practices that are important to the effective use of human 
capital authorities, or flexibilities, such as (1) streamlining and 
improving administrative processes for using flexibilities; (2) 
building transparency and accountability into how flexibilities are 
used to ensure their fair and effective use; and (3) educating managers 
and employees on the availability and use of flexibilities. 

Principle: Monitor and evaluate the agency's progress toward its human 
capital goals and the contribution that strategies have made toward 
achieving agency mission and goals; 
Key points: 
* Identify areas of success and areas for improvement in human capital 
planning by measuring the progress toward an agency's human capital 
goals, such as those for acquiring skilled staff, and the contribution 
that strategies have made toward achieving an agency's mission and 
goals. 

Source: GAO, Human Capital: Key Principles for Effective Strategic 
Workforce Planning, GAO-04-39. 

[A] Human capital flexibilities represent policies and practices that 
an agency has the authority to implement in managing its workforce. 

[End of table] 

The CDC Plan Includes Strategies to Address Key Human Capital 
Challenges, Except for Managing a Workforce with a Large and Growing 
Number of Contractors: 

The CDC Plan includes strategies that could help the agency address 
five of the six key human capital challenges we identified that it 
faces in its efforts to sustain a skilled workforce. These six key 
challenges are (1) changing workforce demographics, highlighted by the 
potential loss of essential personnel due to retirement; (2) the 
limited supply of skilled public health professionals; (3) CDC's 
acknowledged need to increase the diversity of its workforce; (4) 
changing workforce needs resulting from the agency's expanding scope of 
work and responsibilities; (5) logistical difficulties involved in 
acquiring and retaining a skilled workforce; and (6) difficulties 
presented by managing a workforce with a large and growing number of 
contractors. While the CDC Plan includes strategies designed to address 
the first five challenges, it does not include strategies that address 
the challenge of managing a workforce with a large and growing number 
of contractors. 

CDC Faces Six Key Challenges in Sustaining a Skilled Workforce: 

The first challenge, changing workforce demographics, is highlighted by 
the potential loss of essential personnel due to retirement. As of the 
end of fiscal year 2007, about 27 percent of CDC's overall workforce 
was eligible for retirement within the next 5 years. For CDC's three 
most-populated occupations--general health scientist, public health 
analyst, and medical officer--the percentages of employees eligible for 
retirement in the next 5 years were 20 percent, 22 percent, and 34 
percent, respectively. Collectively, these three occupations account 
for 34 percent of CDC's workforce eligible to retire within the next 5 
years. The potential loss of so many essential personnel creates a 
challenge for CDC because it could result in a shortfall of staff with 
the experience and skills needed to fulfill CDC's mission and goals. 
For example, one of the most-populated occupations is medical officer, 
which is a difficult position to fill due to a shortage of physicians 
with specific training in public health. 

The limited supply of skilled public health professionals is the second 
challenge we identified. According to reports issued by CDC, the 
Institute of Medicine, and the American Public Health Association, 
federal, state, and local agencies are experiencing workforce 
shortages, some of which are severe, in many of the public health 
professions vital to CDC. For example, epidemiologists play an 
important role in responding to emerging infectious diseases. However, 
states have reported needing more epidemiologists than are currently 
available in the workforce.[Footnote 17] In addition to shortages of 
public health physicians and epidemiologists noted in these reports, 
other shortages occur in the positions of public health informatics 
specialists,[Footnote 18] laboratory scientists, and environmental 
health specialists. 

The third challenge that CDC faces is its acknowledged need to increase 
the diversity of its workforce. Results from OPM's Federal Human 
Capital Surveys showed a decrease from 2004 to 2006 in the percentage 
of staff who agreed that CDC management worked well with employees of 
different backgrounds and was committed to creating a diverse 
workforce.[Footnote 19] CDC officials acknowledged that the agency's 
workforce was not as diverse as it could be and told us the agency 
needs to improve its recruitment of Hispanics and persons with 
disabilities. However, in its plan, CDC noted that establishing a 
diverse workforce is a challenge for several reasons. For example, 
technical skills and education levels vary across racial, ethnic, and 
socioeconomic groups, which in turn can have an impact on the pool of 
qualified job applicants from which to hire. 

CDC's fourth challenge is the changing workforce needs resulting from 
the agency's expanding scope of work and responsibilities. For example, 
the globalization of health threats has increased CDC's responsibility 
to prepare for and respond to infectious disease outbreaks. In 2003 the 
rapid spread of severe acute respiratory syndrome (SARS) in Asia showed 
that disease outbreaks pose an immediate threat beyond the borders of 
the country where they originate. For this reason, CDC needs a 
workforce that is capable of working with global partners, such as 
other countries' ministries of health, to expand surveillance systems 
used to detect and respond quickly to outbreaks. In addition, 
throughout the SARS outbreak, CDC was the foremost participant in the 
multinational response effort, with CDC officials constituting about 
two-thirds of the public health experts deployed to affected areas. 
CDC's significant role in the SARS response highlights the agency's 
expanding need for a workforce that is capable of rapidly responding to 
international public health emergencies. 

A fifth challenge that CDC faces is logistical difficulties involved in 
acquiring and retaining a skilled workforce, including problems with 
the hiring process and difficulties associated with retaining employees 
for international positions. For example, from fiscal year 2003 to 
fiscal year 2007, CDC did not meet its 2007 goal of hiring new 
employees in an average of 58 days or fewer; instead, during this time, 
it has averaged between 73 and 92 days to hire each new employee. 
[Footnote 20] HHS and CDC officials told us that logistical 
difficulties were exacerbated when hiring responsibilities were 
centralized from CDC to HHS and the human resources staff was reduced 
from 178 to 105 people. Logistical difficulties have also hindered 
CDC's efforts to sustain international positions. For example, HHS 
officials told us the process to approve and hire staff for overseas 
positions can take 9 months to 1 year. Officials added that part of 
this process--the amount of time it takes to get an individual 
approved, including obtaining clearance through the Department of 
State--can be particularly problematic because an individual may lose 
interest and accept another employment offer. In addition, retaining 
staff can be difficult because international programs have few 
opportunities for promotion. 

The sixth challenge we identified is the difficulties presented by 
managing a workforce with a large and growing number of contractors. 
From fiscal year 2000 through fiscal year 2006, the estimated number of 
contractors working at CDC increased 139 percent, while CDC's federal 
staff increased by 3.5 percent. CDC officials told us that using 
contractors is beneficial, particularly because they can be brought on 
board quickly to fill an immediate need for specific skills. For 
example, as of August 2007 over 75 percent of employees in the National 
Center for Public Health Informatics were contractors because the area 
is a relatively new field and the skills needed are constantly 
changing. (See app. III for more information on CDC's workforce and the 
number of contractors within each organizational unit.) While there are 
benefits to using contractors, there are also concerns. For example, 
CDC officials told us that because contractors are not CDC employees, 
the agency does not control certain aspects of their employment, such 
as diversity or training, and does not technically supervise their 
work. For instance, if a CDC manager determines that the work provided 
by a contractor is unsatisfactory, the manager has to communicate his 
or her concerns to the contractor's firm instead of directly addressing 
the contractor. Moreover, CDC does not fund training to assist 
contractors in improving their work. CDC officials also told us that 
data collection on how contractors are used within the agency is 
primarily decentralized and not systematically monitored at an 
agencywide level. CDC has begun collecting more data on contractors 
across the agency because of increased security needs. Understanding 
how contractors are used across the agency is important to ensure their 
appropriate use and oversight. For example, federal regulations call 
for enhanced oversight of contracts for services that could potentially 
influence the authority, accountability, and responsibilities of 
government officials.[Footnote 21] Issues may arise when contractors 
have been involved in activities relating to policy development, 
reorganization and planning, technical advice or assistance, developing 
or providing information regarding regulations, or preparing budgets. 
[Footnote 22] Because CDC lacks information on how its contractors are 
used across the agency, it may not be able to ensure adequate oversight 
of contractors. 

The CDC Plan Includes Strategies to Address Five Human Capital 
Challenges, but Not the Challenge of Managing a Workforce with a Large 
and Growing Number of Contractors: 

CDC developed strategies to address the human capital challenges 
described by the agency in the CDC Plan,[Footnote 23] which correspond 
to five of the six challenges we identified. (See table 2. For a full 
list of strategies in the CDC Plan, see app. IV.) CDC officials told us 
they used the human capital challenges identified in the plan to 
develop related strategies that directly addressed specific areas of 
concern. On the basis of our analysis of the CDC Plan and additional 
documentation, we found that the CDC Plan contains strategies that 
could help address the first five challenges we identified. According 
to CDC officials, the CDC Plan does not include strategies to address 
the challenge of managing a workforce with a large and growing number 
of contractors--our sixth challenge--because CDC wanted to follow HHS 
guidance, under which contractors are not considered part of the HHS 
workforce, and to maintain consistency with the department in the 
treatment of contractors. 

Table 2: Human Capital Challenges at CDC and Examples of Related 
Strategies: 

Challenges we identified: 
1. Changing workforce demographics; 
Descriptions of challenges CDC included in the CDC Plan[A]: 
1. Demographic trends--The federal workforce is aging rapidly, and 
today over 30 percent of employees are eligible to retire. Increased 
retirement eligibility within the workforce can result in a loss of 
institutional knowledge and technical expertise and can adversely 
affect leadership continuity; 
2. Workforce mobility--Employees have grown increasingly mobile, and it 
is now typical for employees to move among federal agencies or between 
the public and the private sectors. This mobility generates additional 
retention challenges; 
3. Generational differences--Younger workers today have different 
values and expectations and may seek a different work environment than 
their predecessors. Federal agencies must be flexible enough to adapt 
to these generational differences; 
Examples of strategies in the CDC Plan intended to address human 
capital challenges[B]: 
1. Develop, implement, and evaluate plans to expand use of the Federal 
Career Intern Program--This strategy is intended to improve the 
usability of the Federal Career Intern Program as an effective tool for 
strategic recruitment and selection at CDC. CDC plans to review current 
HHS and AHRC policies and guidelines related to the Federal Career 
Intern Program, develop a communication plan about the program and 
distribute its policies and guidelines, approve and monitor relevant 
recruitment activities and events, report quarterly on the activities 
conducted for the program, assess the recruitment and selection 
process, and review intern attrition and retention rates; 
2. Develop, implement, and evaluate agencywide workforce planning 
methodology--With this strategy CDC intends to develop procedures, 
templates, and systems that can be used by the coordinating centers and 
offices in developing their workforce plans. In addition, CDC plans to 
develop an evaluative process for assessing adoption of agencywide 
workforce planning procedures and the comprehensiveness of template 
information submitted for updates to the CDC Plan. 

Challenges we identified: 
2. Limited supply of skilled public health professionals; 
Descriptions of challenges CDC included in the CDC Plan[A]: 
4. Workforce shortages--There is a shortage of skilled, qualified 
individuals available in a number of public health occupations, 
including laboratory science and epidemiology; 
5. Labor market--Competition for scarce professional, medical, and 
scientific workers is a growing challenge that has resulted in a 
limited labor market; 
Examples of strategies in the CDC Plan intended to address human 
capital challenges[B]: 
1. Develop, implement, and evaluate plans to expand Career Paths to 
Public Health--The purpose of this strategy is to develop a systematic 
approach for Career Paths to Public Health activities targeting 
students at all levels. As part of accomplishing this strategy, CDC 
plans to initiate assessments of career path activities at CDC, develop 
and implement an overarching framework for Career Paths to Public 
Health, complete a gap analysis and assessment of these activities, 
establish a working group to guide specific career path activities, and 
evaluate the usefulness of the systematic approach of Career Paths to 
Public Health.
2. Develop, implement, and evaluate a Fellowship Management System--
This strategy intends to develop an integrated electronic system that 
will allow applicants to apply to fellowships online and for fellows 
and alumni to keep their information current. This system will be used 
during the recruitment, application, and selection process. As part of 
this strategy, CDC plans to develop a fellowship application system, 
develop an alumni directory system, develop a directory system for 
fellowships, and assess the percentage of fellowships using the online 
application system. 

Challenges we identified: 
3. CDC's acknowledged need to increase the diversity of its workforce; 
Descriptions of challenges CDC included in the CDC Plan[A]: 
6. Workforce diversity--Agencies working to achieve a diverse workforce 
must overcome challenges such as language barriers. In addition, 
educational levels vary across racial, ethnic, and socioeconomic 
groups, which can affect the pool of qualified applicants from which to 
hire; 
Examples of strategies in the CDC Plan intended to address human 
capital challenges[B]: 
1. Develop, implement, and evaluate a Diversity Education and Training 
Curriculum--When completed, this strategy will educate leaders and 
employees on diversity-related issues and help CDC address them. The 
steps to complete this strategy include developing a comprehensive 
diversity education and training curriculum and workforce and career 
exploration courses, developing and implementing a pilot program for 
Optimizing Diversity for a Global Workforce, developing an evaluative 
process for assessing employee satisfaction with this pilot, developing 
a series of miniworkshops to address specific diversity-related issues, 
and evaluating diversity education and training; 
2. Develop, implement, and evaluate an outreach plan, materials, and 
activities--This strategy was created to improve outreach and 
recruitment by developing an outreach plan with materials and 
activities that are based on several areas, including age, generation, 
English proficiency, gender, and ethnicity. CDC plans to define terms 
and scope of outreach efforts, identify audience segments and target 
audiences, develop outreach goals and objectives, develop a draft 
outreach plan and activities, identify current activities, assess the 
need for new materials and activities, evaluate outcomes including 
attainment of goals and objectives, and implement a tracking system. 

Challenges we identified: 
4. Changing workforce needs resulting from the agency's expanding scope 
of work and responsibilities; 
Descriptions of challenges CDC included in the CDC Plan[A]: 
7. Globalization of the workforce--Demand for CDC employees who can 
work in an overseas environment has increased; 
8. Emergency response--In addition to carrying out day-to-day 
operations, the CDC workforce must also be prepared to quickly and 
effectively provide surge capacity for emergency response and emerging 
public health threats; 
9. Expanding mission--CDC's workforce must be prepared to respond not 
only to today's public health challenges; 
Examples of strategies in the CDC Plan intended to address human 
capital challenges[B]: 
1. Develop, implement, and evaluate a collaborative strategic 
recruitment function--CDC intends to develop resources and practices to 
ensure access to quality candidates to meet agency recruitment 
objectives. CDC plans to disseminate a succession planning guide; 
review inventory type, source, availability, and currency of materials 
presently used for agency recruitment activities; investigate options 
for developing measures of return on investment for resources committed 
to strategic recruitment; develop and implement templates for planning 
strategic recruitment activities; develop and deploy a recruiting 
database; and assess efficacy of strategic recruitment planning 
elements; 
2. Develop, implement, and evaluate a global workforce plan--This 
strategy will be used to develop a CDC-wide global health strategic 
workforce plan. In order to accomplish this strategy, CDC will review 
existing global health competencies, assess the presence of these 
competencies in CDC's global health workforce, develop a training 
curriculum and offer courses to strengthen these competencies, develop 
career paths for its global public health workforce, develop and 
implement a global assignment management system, and review this system 
and make recommendations for improvement. 

Challenges we identified: 
5. Logistical difficulties involved in acquiring and retaining a 
skilled workforce; 
Descriptions of challenges CDC included in the CDC Plan[A]: 
10. Federal hiring system--Civil Service laws governing the federal 
hiring process can often be an impediment to effective employee hiring, 
compensation, and retention; 
11. Downsized human resources--Recent reductions in staff of federal 
human resources organizations have had a negative impact on the 
timeliness, scope, and quality of products and services provided; 
Examples of strategies in the CDC Plan intended to address human 
capital challenges[B]: 
1. Develop, implement, and evaluate plans to reduce time-to-hire--This 
strategy will help the agency find ways to reduce the time-to-hire at 
CDC. As part of this strategy, CDC plans to implement standardized 
position descriptions, measure increased utilization of them in the 
recruiting process, re-engineer part of the hiring process, measure 
impact of new guidelines on average days to hire, assess data results 
from this measurement, and modify and update other recruitment 
processes; 
2. Develop, implement, and evaluate plans to expand use of career 
ladders[C]--The purpose of this strategy is to monitor the 
effectiveness of career ladders in CDC organizations and assess their 
impact on position management, recruitment, employee turnover, 
retention, and overall employee satisfaction. CDC plans to review 
historical data on the career ladder use at CDC, develop guidelines on 
developing career ladder positions, develop a communication plan for 
career ladder guidelines, implement guidelines, and assess possible 
program and process changes. 

Challenges we identified: 
6. Difficulties presented by managing a workforce with a large and 
growing number of contractors; 
Descriptions of challenges CDC included in the CDC Plan[A]: (None); 
Examples of strategies in the CDC Plan intended to address human 
capital challenges[B]: (None). 

Source: GAO analysis and the CDC Strategic Human Capital Management 
Plan. 

[A] The challenges and their descriptions include information from the 
CDC Strategic Human Capital Plan. 

[B] Agency officials told us that strategies in the CDC Plan may 
address more than one challenge. 

[C] A career ladder is a formally recognized succession of positions 
that represent the anticipated career progression for most permanent 
employees assigned to a specific occupation. Career ladders are 
established for large groups of similar positions that have established 
career progression and known promotion potential. 

[End of table] 

However, without considering the challenge of managing a workforce with 
a large and growing number of contractors and without developing 
related strategies, the CDC Plan excludes any efforts to address more 
than one-third of the total workforce. As a result, it may not be as 
useful as it could be in assisting the agency with improvements in 
human capital management. For example, CDC cannot fully assess the 
human capital available across the agency and how it is assisting the 
agency in meeting its expanding scope of work and responsibilities 
without understanding how contractors are used across the agency and 
what gaps in skills and competencies they are filling. Because CDC does 
not monitor the use of contractors agencywide, the agency's ability to 
determine the appropriate balance of government-performed and 
contractor-performed services is hindered. CDC's lack of information to 
oversee contractors agencywide is also a problem because, as our 
reviews of other agencies have shown, adequate oversight of contractors 
is critical to ensure that they are producing outcomes to achieve the 
agencies' respective missions and goals and the agencies are not 
risking having mission-related decisions influenced by contractor 
judgment.[Footnote 24] 

Strategies in the CDC Plan Are Linked with CDC's Mission and Goals but 
Are Not Integrated with Its Strategic Plan, Performance Plan, or 
Budget: 

The CDC Plan partially meets criteria for strategic alignment. CDC 
relied on HCAAF guidance, which includes strategic alignment as an 
element, to develop its framework for the CDC Plan. The CDC Plan 
partially meets the criteria for strategic alignment by explicitly 
linking the plan's strategies to the agency's mission and goals. 
However, the CDC Plan does not integrate these strategies with the 
agency's Goal Action Plans--the documents that serve as CDC's strategic 
plan--or with its performance plan or budget. CDC officials told us 
they intended to update the CDC Plan annually and to integrate the plan 
with these documents as the plan is updated. 

CDC Plan Was Based on HCAAF Framework, but Only Partially Meets Its 
Criteria for Strategic Alignment: 

CDC officials relied on HCAAF as guidance when developing the framework 
for the CDC Plan. According to CDC, HCAAF was the best model framework 
to follow because of its simplicity, transparency, and alignment with 
the President's Management Agenda. The CDC Human Capital Management 
framework, which serves as the foundation for the CDC Plan, uses the 
HCAAF model. Specifically, CDC's framework includes the same elements-
-strategic alignment, leadership and knowledge management, performance 
management for results, talent management, and accountability. (See 
fig. 2.) The HCAAF criteria for strategic alignment are consistent with 
the definition we have used in our past work. 

Figure 2: A Comparison of OPM's HCAAF and CDC's Human Capital 
Management Framework: 

[See PDF for image] 

This figure is an illustration of a comparison of OPM's HCAAF and CDC's 
Human Capital Management Framework, as follows: 

The HCAF model: 

Planning and Goal setting: [Provides Direction] 
* Strategic Alignment (leads directly to the Results-oriented 
Performance Culture. 

Implementation: [Delivers Human Capital Outcomes] 
* Leadership and Knowledge Management; 
* Results-oriented Performance Culture; 
* Talent Management. 

Evaluating Results: [Provides Performance Information] 
* Accountability. 

The key structure of the HCAAF model is adopted in the CDC Human 
Capital Management framework. 

The CDC Human Capital Management framework: 

Top level: Strategic Alignment: 
Second level: Workforce Analysis and Planning[A]; 
Third level (all are interconnected and connected to level two): 
Leadership and Knowledge Management; 
Performance Management for Results; 
Talent Management; 
Four level: Accountability (expected of all on level three). 

Source: GAO analysis of CDC information. 

[A] CDC defines workforce analysis and planning as the process for 
ensuring that the right number of people with the right skills, 
experiences, and competencies are in the right place at the right time 
to accomplish CDC's mission. 

[End of figure] 

In examining the CDC Plan, we determined that the plan partially meets 
the criteria for strategic alignment. In developing its plan, CDC 
linked the strategies in the plan to its mission and goals as well as 
to those of HHS. The plan states that its purpose is to ensure that 
CDC's human capital efforts are aligned to most effectively support the 
agency's accomplishment of its mission and goals. Further, the plan 
integrates CDC's Health Protection Goals and the Organizational 
Excellence Assessment, which CDC uses to measure its progress toward 
meeting the Health Protection Goals. Specifically, CDC linked the 
strategies in its plan to the Organizational Excellence Assessment. To 
ensure linkage with HHS's mission and goals, the CDC Plan refers to 
HHS's strategic plan for fiscal years 2007 through 2012, which 
delineates how the department will achieve its mission "to enhance the 
health and well-being of Americans by providing for effective health 
and human services and by fostering sound, sustained advances in the 
sciences underlying medicine, public health, and social services" and 
outlines HHS's four strategic goals.[Footnote 25] CDC also linked the 
CDC Plan to HHS's strategic plan. For example, the CDC Plan describes 
how CDC has adopted a program described in HHS's strategic plan--the 
Performance Management Appraisal Program--to connect employee 
expectations to the agency's mission and to link employee performance 
ratings with measurable outcomes.[Footnote 26] 

The CDC Plan only partially meets the criteria for strategic alignment 
as defined by GAO and OPM because the strategies in the CDC Plan are 
not integrated with the documents that serve as the agency's strategic 
plan, its performance plan, or its budget. CDC officials told us that 
while the agency did not have a strategic plan, the agency's Goal 
Action Plans served in this capacity. Goal Action Plans are organized 
according to the four Health Protection Goals and are designed to link, 
leverage, and coordinate CDC's activities across the agency to increase 
effectiveness and impact. (See app. V for a summary of CDC's Health 
Protection Goals.) While the strategies in the CDC Plan are not 
currently integrated with the Goal Action Plans, officials told us they 
intended to integrate the strategies with the Goal Action Plans and 
have taken initial steps to do this in their January 2008 revision of 
the CDC Plan. Additionally, the strategies have not been integrated 
with the agency's performance plan or budget, which limits the plan's 
usefulness in supporting day-to-day activities aimed at long-term human 
capital goals. However, officials told us they also intended to 
integrate the strategies in the CDC Plan with the agency performance 
plan and the budget as the plan is updated. 

CDC Incorporated Aspects of Our Principles for Strategic Human Capital 
Planning into the CDC Plan and Has Outlined Further Actions: 

CDC incorporated aspects of our five principles for strategic human 
capital planning into the CDC Plan and has outlined further actions it 
intends to take. (See table 1 for the principles.) The agency 
incorporated part of the first principle by having top management and a 
stakeholder comment on a draft of the plan, and it intends to involve 
nonsupervisory employees in future implementation. For the second 
principle, CDC conducted a preliminary workforce analysis, but it has 
not completed the analysis of gaps in skills and competencies. However, 
CDC intends to conduct additional analyses and plans to use them in 
subsequent plan updates. CDC incorporated an aspect of the third 
principle by developing strategies to acquire, retain, and develop a 
skilled workforce, but it is unclear to what degree these strategies 
will address the agency's gaps in skills and competencies because they 
were developed before the gap analyses were completed. CDC has also 
taken steps to incorporate the fourth principle, which stresses 
building the capabilities needed to support the strategies. With regard 
to the fifth principle, while CDC previously collected limited 
information with which to monitor and assess its human capital efforts, 
the CDC Plan outlines steps to monitor and evaluate its strategies. 

CDC Involved Top Management and a Stakeholder in Developing Its Plan 
and Intends to Include Nonsupervisory Employees in Future 
Implementation and Updates: 

In development of the CDC Plan, the agency incorporated aspects of our 
first principle, which is to involve top management, managers, other 
employees, and stakeholders in developing, communicating, and 
implementing the human capital plan, but it did not formally involve 
nonsupervisory employees. CDC involved top management, managers, and 
AHRC as a stakeholder in the development of the CDC Plan through the 
agency's leadership groups, specifically the Executive Leadership 
Board, the Management Council, and the Center Leadership Council. 
[Footnote 27] AHRC participated as part of the Management Council. 
[Footnote 28] A CDC official involved in creating the plan briefed 
members of the board and councils on the outline of the plan while it 
was being developed, and members subsequently reviewed and provided 
recommendations on drafts of the plan. Additionally, OWCD officials 
worked with selected members of the board and the Management Council in 
developing some of the strategies. CDC officials told us they did not 
formally involve nonsupervisory employees in the development of the 
plan. For example, managers in the diversity office informally shared 
the CDC Plan with nonsupervisory employees during its development. In 
our prior work on the principles, we found that involving such 
employees on strategic workforce planning teams can identify new ways 
to streamline processes and improve human capital strategies. 
Nonsupervisory employee involvement in the development of the human 
capital plan can also garner support for proposed changes and help an 
agency develop clear and transparent procedures to implement 
strategies. 

CDC officials told us that they intended to communicate the CDC Plan 
within the agency and to involve nonsupervisory employees in 
implementing and updating it. The CDC Plan has been approved by the 
Director of CDC and after final clearance will be communicated via 
CDC's intranet site and an intranet article, or through an e-mail 
message to all agency employees. CDC officials said that, in addition 
to top management, other agency managers, and stakeholders, they 
intended to involve nonsupervisory employees in implementing the plan 
and updating it in the future. For example, OWCD has conducted several 
focus groups with employees regarding the results of the 2006 Federal 
Human Capital Survey, and CDC officials indicated that the findings 
from these focus groups would be considered in updating strategies in 
future updates of the CDC Plan. 

CDC Conducted a Preliminary Workforce Analysis and Is Completing 
Efforts to Identify Gaps in Skills and Competencies: 

CDC has begun to incorporate the second principle--determining the 
skills and competencies needed to achieve the mission and goals, 
including identifying gaps in these skills and competencies--by 
conducting a preliminary workforce analysis and is working to complete 
analyses to identify gaps in skills and competencies. In this 
preliminary analysis, CDC determined useful information regarding its 
workforce, including the number of individuals in each occupation, the 
size and diversity of its workforce, agencywide retirement eligibility, 
and the number of mission-critical occupations[Footnote 29] in each 
coordinating center and coordinating office. However, CDC has not 
completed competency gap analyses for its employees to determine 
whether employees have the skills needed to perform effectively, and to 
identify any gaps between their current skill levels and skills needed 
in the future. In 2006, CDC conducted a competency gap analysis for one 
of its mission-critical occupations, and it has begun competency gap 
analyses for its other mission-critical occupations. 

In addition, CDC plans to conduct additional workforce analyses, which 
it anticipates completing in fiscal year 2008, as part of the workforce 
planning process outlined in the CDC Plan. Prior to the CDC Plan, each 
coordinating center and coordinating office conducted its own workforce 
planning activities, resulting in wide variability across the agency. 
CDC has implemented standardized procedures for its workforce planning 
process, by developing a consistent methodology and approach for 
workforce analyses to be used throughout the agency. As part of the 
agencywide methodology, the coordinating centers and coordinating 
offices have been asked to provide information about how federal 
employees and contractors are used to meet their needs. Additionally, 
OWCD has developed a standardized template for the coordinating centers 
and coordinating offices to use to collect data on employees' skills 
and competencies. As of January 2008, OWCD was in the process of using 
the template to collect information, which could then be aggregated to 
an agencywide level and used in the annual update of the CDC Plan. 

The CDC Plan Has Strategies to Acquire, Retain, and Develop Skilled 
Staff, but It Is Unclear How Well They Will Address Current Gaps in 
Skills and Competencies: 

The CDC Plan includes strategies to improve its current efforts to 
acquire, retain, and develop its skilled staff, and their 
implementation could address some past weaknesses in CDC's efforts. The 
CDC Plan thus incorporates an aspect of our third principle, which is 
to develop strategies to acquire, retain, and develop a skilled 
workforce and to address skill and competency gaps. However, the plan's 
strategies may have limitations in how well they address skill and 
competency gaps, because they were developed before the agency finished 
its gap analyses. 

Developing new strategies to acquire and retain staff is important 
because CDC's efforts conducted prior to the publication of the CDC 
Plan had several weaknesses with regard to recruitment and retention. 
For example, because recruitment efforts were decentralized throughout 
the agency, CDC and AHRC officials conducted recruitment efforts on an 
ad hoc basis, and coordinating centers and offices offered recruitment 
and relocation incentives[Footnote 30] as part of their recruitment 
efforts with little coordination. Regarding retention, we found that 
CDC had programs and incentives designed to promote retention, but 
lacked information on their effectiveness. For example, CDC offers 
retention incentives[Footnote 31] to key individuals to induce them to 
remain with the agency. However, CDC does not collect and analyze data 
on how successful these programs and incentives have been in retaining 
skilled employees. 

As part of CDC's efforts to improve recruiting and retention efforts, 
one of the strategies in the CDC Plan calls for developing, 
implementing, and evaluating a collaborative strategic recruitment 
effort, for the purpose of establishing initiatives, resources, 
operational strategies, and practices to ensure agency access to 
quality candidates and to aid in meeting CDC's recruitment objectives. 
In January 2008, CDC established a strategic recruitment team comprised 
of representatives from various entities, including each coordinating 
center and coordinating office, AHRC, and OWCD. As part of its work, 
this team intends to develop a database for targeted recruitment, which 
is scheduled for completion in February 2009. This strategy could help 
address weaknesses in CDC's current ad hoc approach. Another strategy 
involves expanding the use of "career ladders"[Footnote 32] within the 
agency, including identifying target positions to be used on a career 
ladder and assessing the career ladder program for potential areas of 
improvement. CDC anticipates completing this strategy by the end of 
2008. 

Our review of CDC's current efforts to develop skilled staff found that 
the agency based its current employee development efforts on a training 
needs assessment and had additional strategies that could improve 
employee development in the CDC Plan. According to CDC officials, CDC 
University, the unit responsible for training at CDC, worked with 
partners throughout the agency to develop and implement agencywide 
strategies for training and to identify the skills needed by CDC's 
workforce in the future. CDC University also conducted annual 
competency-based needs assessments that allow employees and supervisors 
to review the competencies for each occupation and determine whether 
sufficient training exists or additional training is needed.[Footnote 
33] Several strategies in the CDC Plan could build on these current 
efforts. For example, CDC plans to implement a transition from its 
current training system to HHS's Learning Management System. According 
to CDC, this transition will improve the career development of its 
employees, in part by allowing CDC to target its learning plans to 
specific groups of employees and to track competency gaps by employee, 
CDC entity, occupational group, and specific competency. CDC has begun 
this transition and expects it to be completed by September 2008. 

Although CDC has developed strategies that may improve some of its 
current efforts, it is unclear how well these strategies will address 
current gaps in skills and competencies. In our prior work on the 
principles, we found that it is important for agencies to consider how 
their strategies can be aligned to eliminate gaps and improve the 
contribution of critical skills and competencies. However, developing 
strategies to eliminate gaps assumes that an agency has identified the 
gaps in skills and competencies before its strategies are developed, 
and while CDC has begun gap analyses, these analyses were not completed 
when the CDC Plan was developed. As a result, the strategies in the 
plan could not be tailored to address specific gaps in skills and 
competencies. However, CDC recognized this need, is completing the gap 
analyses, and has outlined, as part of one strategy, the development of 
additional steps to close identified gaps in skills and competencies. 
It is also working to improve its ability to identify training needs to 
address skill and competency gaps. 

CDC Has Been Building Capabilities to Support Its Strategies: 

Consistent with the fourth principle, CDC has taken steps to build the 
capabilities needed to support its strategies. Developing and 
effectively utilizing agencies' resources, human capital flexibilities, 
[Footnote 34] and personnel are essential to the successful 
implementation of strategies. CDC is making efforts to establish these 
capabilities. For example, OWCD has hired a strategic recruiter to 
oversee the development and implementation of its recruitment function 
strategy, as described in the CDC Plan. 

CDC officials are also planning to streamline the agency's 
administrative processes, with a focus on hiring. In response to AHRC's 
current efforts to achieve its goal of hiring new employees within an 
average of 58 workdays, CDC and AHRC have developed a system to track 
the hiring process and have created a committee to evaluate the current 
hiring process. The system has generated reports that would allow 
managers to see how long the hiring process takes. In addition, CDC 
officials are implementing some of the recommendations made by the 
hiring committee. One problem the committee identified was the use of 
individualized position descriptions for vacancies. Historically, 
managers requested individualized descriptions for most positions. New 
position descriptions needed to be formally reviewed, adding time and 
complexity to the hiring process. As of February 2008, AHRC and CDC 
have standardized position descriptions for 20 occupations, which could 
help the agency reduce the time it spends filling positions. 

In addition, CDC is working to create transparency and accountability 
and to improve the utilization of its human capital flexibilities. For 
example, a responsible individual has been identified for each of the 
strategies described in the plan. According to CDC officials, the 
agency intends to incorporate this responsibility into these 
individuals' performance reviews. Also, agency supervisors and managers 
are to receive training on their roles and responsibilities in employee 
development, which includes using human capital flexibilities. Detailed 
information on these flexibilities is available via the Web to all 
employees. However, CDC officials told us they were limited in how they 
implemented some of these flexibilities because policies and practices 
of this type are developed at the department level by the HHS Office of 
Human Resources. As these policies are delegated to the agency, CDC 
management may in turn develop implementing policies and practices for 
the agency that support the department's policies. 

CDC Has Incorporated Efforts to Monitor and Evaluate the Contribution 
of Its Strategies: 

Prior to the CDC Plan, CDC had limited information with which to assess 
its human capital efforts. However, consistent with the fifth 
principle, the agency has incorporated efforts to monitor and evaluate 
its human capital strategies into its plan. In our prior work on the 
principles, we found that high-performing agencies understood the 
fundamental importance of measuring both the outcomes of their human 
capital strategies and how these outcomes have helped them accomplish 
their mission and goals.[Footnote 35] CDC officials told us that prior 
to completing the CDC Plan they relied on multiple mechanisms to 
evaluate the effectiveness of the agency's strategies to acquire, 
retain, and develop staff. However, these strategies were not always 
effective. For example, while retention was measured in part by 
evaluating exit survey data, only 20 percent of departing employees 
completed the exit survey. 

The CDC Plan includes strategies to address the issues of limited data 
for monitoring and evaluation. For example, one strategy related to 
retention evaluates the factors affecting turnover and is designed to 
develop plans for improvement. This strategy outlines specific 
milestones and time frames for addressing this issue, such as 
conducting a literature review of factors affecting employee turnover, 
which was completed in November 2007. In addition, CDC officials 
planned to develop strategies in January 2008 to increase the exit 
survey response rate. Improving the response rate could make the data 
collected more valuable. The CDC Plan also has a milestone to develop 
recommendations for improving the collection and analysis of employee 
data associated with turnover by September 2009. Further, the plan 
includes a strategy to develop an outreach plan with materials and 
activities targeted to specific groups of potential employees. As part 
of this strategy, CDC has a milestone to evaluate outcomes of these 
outreach materials, including attainment of goals and objectives and 
return on investment for its efforts by September 2008. CDC officials 
told us the CDC Plan principally focuses on using data from existing 
measures to develop strategies for improvement. They noted that while 
some monitoring and evaluation approaches might be refined, the 
emphasis in the plan is on how to use the data currently being 
collected more effectively. 

Conclusions: 

CDC identified challenges it faced in achieving its human capital needs 
in the CDC Plan and considered the challenges in developing its human 
capital strategies. However, the strategies in the CDC Plan do not 
address the sixth challenge we identified--the difficulties presented 
by managing a workforce with an increasing number of contractors, which 
make up more than one-third of the agency's workers. Without addressing 
this challenge as part of its strategies, the CDC Plan may not be as 
useful as it could be in providing the agency with a strategic view of 
its governmental and contractor workforce. Thus, the plan will be less 
helpful to guide the agency in improving the management of its entire 
human capital so it can effectively and efficiently meet its expanding 
scope of work and responsibilities and thereby achieve its mission and 
goals. 

The strategies in the CDC Plan are linked with the agency's mission and 
goals; however, they are not integrated into a strategic plan, 
performance plan, or budget. CDC officials told us they intended to 
integrate the strategies in the CDC Plan with the documents that serve 
as the agency's strategic plan, the performance plan, and the budget as 
the plan is updated. Completing this effort is important because 
without it the CDC Plan may not be as effective as it could be in 
helping the agency meet its human capital needs or in assessing and 
understanding the extent to which CDC's workforce contributes to 
achieving its mission and goals. Additionally, the plan may be limited 
in its usefulness in supporting day-to-day activities aimed at long- 
term human capital goals. 

The CDC Plan represents progress in the agency's human capital planning 
efforts because the CDC Plan includes strategies, due dates, and the 
individuals responsible for implementing them. However, because the 
plan is new and has not been fully implemented, it is too soon to 
determine the degree to which it will improve CDC's human capital 
management. As the agency moves forward with the CDC Plan, it is 
important that the planned strategies are fully implemented and the 
agency continues to incorporate HCAAF and our principles for strategic 
human capital planning into subsequent plan updates, in order to 
strengthen its human capital efforts. 

Recommendation for Executive Action: 

To improve CDC's ability to use its human capital planning efforts to 
meet its current and future needs for a skilled workforce, we recommend 
that the Director of CDC incorporate strategies that address the 
challenge of managing a workforce with a large and growing number of 
contractors into future updates of the CDC Plan. 

Agency Comments and Our Evaluation: 

HHS provided written comments on a draft of this report, which are 
included in appendix VI, and a technical comment, which we partially 
incorporated. In its comments, HHS concurred with our conclusion that 
the strategic alignment component of the September 2007 edition of the 
CDC Plan could be improved by better connecting the plan with the 
agency's Goal Action Plans. HHS stated that it addressed the issue of 
aligning the plan with the Goal Action Plans in its January 2008 
revision of the CDC Plan, but the documentation it provided to us did 
not show how strategies from the CDC Plan would be integrated with the 
Goal Action Plans. Further, strategic alignment includes integrating 
the CDC Plan with the agency's performance plan and budget, a step that 
CDC has yet to complete. 

HHS also stated that our recommendation--to incorporate strategies in 
the CDC Plan that address the challenge of managing a workforce with a 
large and growing number of contractors--was somewhat unexpected. HHS 
noted that CDC officials reviewed human capital plans of other agencies 
and several GAO and OPM human capital reports and did not address the 
use of contractors in detail when developing the CDC Plan in order to 
be consistent with these sources. Further, it stated that the agency 
does not control contractors' hiring, diversity, compensation, 
training, and other key human capital factors and noted that our draft 
report did not recognize the legal, regulatory, and policy prohibitions 
in treating contractors as if they were federal employees. 

We believe that HHS misinterpreted our findings and recommendation 
related to the challenge of managing a workforce with a large and 
growing number of contractors. At CDC, contractors represent more than 
one-third of the agency's workforce and thus are clearly a critical 
part of the agency's human capital. Our December 2003 report on key 
principles for effective strategic human capital planning noted that it 
involves developing long-term strategies for acquiring, developing, and 
retaining an organization's total workforce, which includes full-and 
part-time federal staff and contractors. In our current report, we 
clearly state that CDC does not control certain aspects of contractor 
employment such as diversity or training and technically does not 
supervise the work of contractors. 

Nevertheless, as we have explained in this report, strategic human 
capital planning includes identifying the skills and competencies 
needed and developing strategies to address those needs. CDC could not 
provide us with specific information on how contractors were being used 
agencywide to complement federal staff. Without this information, the 
CDC Plan cannot present the nature of the current balance of government-
performed and contractor-performed work at the agency, a complete 
picture of the skills and competencies needed agencywide, or strategies 
to address those needs. It is unclear to us how the entire workforce of 
both federal and contractor staff could be managed strategically 
without such information. Such information would facilitate making 
informed decisions, such as whether CDC needs to increase training for 
federal staff or contract for those skills. Similarly, without 
information on how contractors are used throughout the agency, it 
remains unclear to us how top-level management can be assured that 
contractors are being used appropriately and that sufficient oversight 
is provided for contractor staff engaged in activities that could 
potentially influence the authority, accountability, and 
responsibilities of government officials. Consequently, we concluded 
that CDC should incorporate strategies related to the use of 
contractors into the CDC Plan. 

HHS also commented that our report indicated that CDC does not have a 
comprehensive repository of human capital information on its 
contracting staff and thus does not ensure adequate contractor 
oversight. HHS said that it disagreed with our assessment. However, we 
did not make such an assessment. We did not suggest or recommend that 
CDC develop a comprehensive repository of human capital information on 
contractor staff. In addition, we did not review whether such a 
repository would be needed for effective contractor oversight, because 
such work was outside the scope of this engagement. Our concern is that 
CDC does not have a strategic human capital plan that encompasses 
strategies for the use of its contractors as complements to its federal 
employees so that the agency can most effectively manage these blended 
resources to achieve its mission and goals. 

As agreed with your offices, unless you publicly announce the contents 
of this report earlier, we plan no further distribution until 30 days 
from its date. At that time we will send copies to the Secretary of 
HHS, the Director of CDC, and other interested parties. We will also 
make copies available to others on request. In addition, the report 
will be available at no charge on GAO's Web site at [hyperlink, 
http://www.gao.gov]. 

If you or your staffs have any questions about this report, please 
contact me at (202) 512-7114 or [email protected]. Contact points for 
our Offices of Congressional Relations and Public Affairs may be found 
on the last page of this report. GAO staff who made major contributions 
to this report are listed in appendix VII. 

Signed by: 

Cynthia A. Bascetta: 
Director, Health Care: 

[End of section] 

Appendix I: Scope and Methodology: 

To determine whether the Centers for Disease Control and Prevention 
(CDC) 2007 Strategic Human Capital Management Plan (CDC Plan) was 
designed to address the challenges CDC faces in sustaining a skilled 
workforce, we analyzed interviews we conducted with multiple entities 
from CDC, the Department of Health and Human Services (HHS), the Office 
of Personnel Management (OPM), and three policy research and 
professional associations. Specifically, the interviews included 
officials from CDC's four coordinating centers and two coordinating 
offices, Office of Workforce and Career Development (OWCD), Executive 
Leadership Board, Management Council, Center Leadership Council, 
Division Directors Council, and Office of Diversity. We also 
interviewed officials from the U.S. Public Health Service Commissioned 
Corps who work at CDC and officials from HHS's Office of Global Health 
Affairs and Atlanta Human Resources Center (AHRC). Further, we 
interviewed policy research and professional association officials who 
work with CDC, including officials from the National Academy of Public 
Administration, the Association of State and Territorial Health 
Officials, and the National Association of County and City Health 
Officials. We corroborated testimonial evidence from our interviews 
with analysis of relevant documents, workforce statistics, and 
retirement eligibility data computed by CDC. We assessed the 
reliability of CDC's data by confirming that the data included the 
elements we requested and were consistent with CDC-provided 
documentation and information collected from interviews, including 
interviews with officials responsible for maintaining these databases. 
As a result, we determined that the data generated from CDC's system 
were sufficiently reliable for the purposes of this report. In 
addition, we reviewed reports on the public health workforce written by 
the Institute of Medicine, the American Public Health Association, and 
CDC, as well as our prior work on the use and management of contractors 
in the federal government. Some interviewees noted the difficulties of 
managing CDC's responsibilities given its funding; however, we did not 
assess the adequacy of CDC's budget.[Footnote 36] Based on our analysis 
of these interviews, reports, and data, we identified the challenges 
that CDC faces in sustaining a skilled workforce. In order to determine 
whether the CDC Plan was designed to address the challenges we 
identified, we reviewed CDC's plan. We also interviewed OWCD officials 
about how they used the challenges CDC identified in the plan to 
develop related strategies. We then compared the CDC challenges to the 
challenges we identified and determined how the strategies in the CDC 
Plan corresponded to the challenges we identified. 

To determine the extent to which the CDC Plan is strategically aligned, 
we interviewed CDC officials from OWCD and the Office of Strategy and 
Innovation. We also reviewed and analyzed the CDC Plan, OPM's Human 
Capital Assessment and Accountability Framework (HCAAF), and our prior 
work on human capital planning to understand the guidance used to 
develop the plan. Additionally, to determine how the strategies in the 
plan were linked to the agency's mission and goals, we analyzed the CDC 
Plan, the CDC Health Protection Goals,[Footnote 37] and HHS's 2007-2012 
Strategic Plan. To determine how the plan was integrated into other 
agency documents, we reviewed CDC's budget documents for fiscal years 
2006 through 2008, annual performance plans and reports for fiscal 
years 2005 and 2006, and CDC Goal Action Plans and related documents, 
which serve as the agency's strategic plan.[Footnote 38] We also 
interviewed officials from HHS's Office of the Assistant Secretary for 
Administration and Management about the criteria and guidance that 
office provides to CDC on human capital planning efforts. 

To determine the extent to which the CDC Plan incorporated the five 
principles for effective strategic human capital planning, we reviewed 
our previous work on the five principles and examined the CDC Plan. 

* Specifically, for the first principle--involving top management, 
managers, other employees, and stakeholders in developing, 
communicating, and implementing the plan--we interviewed officials from 
CDC's Executive Leadership Board, Management Council, Center Leadership 
Council, and the Division Directors Council to determine management and 
employee involvement in the development of the plan. We interviewed 
officials from AHRC, a stakeholder in CDC's human capital planning, to 
determine its involvement in the development of the plan. We also 
interviewed officials with OWCD, the entity responsible for the plan, 
to determine how management, stakeholders, and employees would be 
involved in communicating and implementing the plan. 

* For the second principle--determining the skills and competencies 
needed to achieve the agency's mission and goals--we analyzed documents 
on CDC's (1) workforce analysis, (2) training needs assessments, and 
(3) competency gap assessments. We also interviewed officials in OWCD 
and discussed plans for additional workforce analyses. 

* For the third principle--developing strategies to acquire, retain, 
and develop a skilled workforce and to address gaps in skills and 
competencies--we examined the CDC Plan and how the strategies in the 
plan related to CDC's workforce analysis. We also interviewed CDC 
officials and reviewed pertinent documents. To determine how the 
strategies in the plan compared to CDC's efforts prior to the plan, we 
interviewed officials and analyzed prior human capital documents. We 
interviewed officials from HHS's AHRC and CDC's four coordinating 
centers and two coordinating offices, the National Institute for 
Occupational Safety and Health, CDC University, and OWCD to discuss 
human capital efforts prior to the CDC Plan and how they related to the 
efforts in the CDC Plan. We also analyzed documents from these 
entities, including AHRC's July 2006 Workforce Plan, CDC's Talent 
Management Plan, CDC's 2006 Strategic Human Capital Plan, and human 
capital documents from the coordinating centers and coordinating 
offices. 

* For the fourth principle--building capabilities needed to support the 
strategies--we examined CDC's new programs and processes that support 
human capital planning. Additionally, we interviewed officials from 
both OWCD and AHRC. 

* For the fifth principle--monitoring and evaluating the contribution 
that strategies have made toward achieving the agency's mission and 
goals--we reviewed the CDC Plan and related documents and interviewed 
OWCD officials in order to determine CDC's current monitoring efforts 
and how CDC planned to monitor and evaluate the agency's progress 
toward its human capital goals. 

We conducted our work from March 2007 to May 2008 in accordance with 
generally accepted government auditing standards. 

[End of section] 

Appendix II: CDC Coordinating Centers and Coordinating Offices and 
Their Missions: 

Coordinating centers: Coordinating Center for Environmental Health and 
Injury Prevention; 
Mission: To plan, direct, and coordinate national and global public 
health research, programs, and laboratory sciences that improve health 
and eliminate illness, disability, and/or death caused by injuries or 
environmental exposures. 

Coordinating centers: Coordinating Center for Health Information and 
Service; 
Mission: To assure that CDC provides high-quality information and 
programs in the most effective ways to help people, families, and 
communities protect their health and safety. 

Coordinating centers: Coordinating Center for Health Promotion; 
Mission: To plan, direct, and coordinate a national program for the 
prevention of prematurity, mortality, morbidity, and disability due to 
chronic diseases, genomics, disabilities, birth defects, reproductive 
outcomes, and adverse consequences of hereditary conditions. 

Coordinating centers: Coordinating Center for Infectious Diseases; 
Mission: To protect health and enhance the potential for full, 
satisfying, and productive living across the lifespan of all people in 
all communities related to infectious diseases. 

Coordinating offices: Coordinating Office for Global Health; 
Mission: To provide leadership, coordination, and support for CDC's 
global health activities in collaboration with CDC's global health 
partners. The office's mission is to increase life expectancy and years 
of quality life, especially among those at highest risk for premature 
death, particularly vulnerable children and women, and increase global 
preparedness to prevent and control naturally occurring and man-made 
threats to health. 

Coordinating offices: Coordinating Office for Terrorism Preparedness 
and Emergency Response; 
Mission: To protect health and enhance the potential for full, 
satisfying, and productive living across the lifespan of all people in 
all communities related to community preparedness and response. 

Source: CDC. 

[End of table] 

[End of section] 

Appendix III: CDC Workforce and Breakdown by Each Organizational Unit 
as of August 2007: 

Entity within CDC: Office of the Director; 
Civil Service: 203; 
U.S. Public Health Service Commissioned Corps[A]: 10; 
Contractors: 4; 
Percentage of contractors in each entity: 2. 

Entity within CDC: Office of Strategy and Innovation; 
Civil Service: 20; 
U.S. Public Health Service Commissioned Corps[A]: 5; 
Contractors: 12; 
Percentage of contractors in each entity: 32. 

Entity within CDC: Office of Workforce and Career Development; 
Civil Service: 248; 
U.S. Public Health Service Commissioned Corps[A]: 119; 
Contractors: 67; 
Percentage of contractors in each entity: 15. 

Entity within CDC: Office of Enterprise Communications; 
Civil Service: 14; 
U.S. Public Health Service Commissioned Corps[A]: 0; 
Contractors: 15; 
Percentage of contractors in each entity: 52. 

Entity within CDC: Office of the Chief of Staff; 
Civil Service: 14; 
U.S. Public Health Service Commissioned Corps[A]: 0; 
Contractors: 2; 
Percentage of contractors in each entity: 13. 

Entity within CDC: Office of Dispute Resolution and Equal Employment 
Opportunity; 
Civil Service: 15; 
U.S. Public Health Service Commissioned Corps[A]: 0; 
Contractors: 0; 
Percentage of contractors in each entity: 0. 

Entity within CDC: Office of the Chief Science Officer; 
Civil Service: 38; 
U.S. Public Health Service Commissioned Corps[A]: 0; 
Contractors: 76; 
Percentage of contractors in each entity: 67. 

Entity within CDC: Office of Chief of Public Health Practice; 
Civil Service: 92; 
U.S. Public Health Service Commissioned Corps[A]: 7; 
Contractors: 16; 
Percentage of contractors in each entity: 14. 

Entity within CDC: Office of the Chief Operating Officer; 
Civil Service: 1,199; 
U.S. Public Health Service Commissioned Corps[A]: 25; 
Contractors: 1,928; 
Percentage of contractors in each entity: 61. 

Entity within CDC: CDC Washington Office; 
Civil Service: 18; 
U.S. Public Health Service Commissioned Corps[A]: 1; 
Contractors: 1; 
Percentage of contractors in each entity: 5. 

Entity within CDC: Coordinating Office for Global Health; 
Civil Service: 96; 
U.S. Public Health Service Commissioned Corps[A]: 13; 
Contractors: 43; 
Percentage of contractors in each entity: 28. 

Entity within CDC: Coordinating Office for Terrorism Preparedness and 
Emergency Response; 
Civil Service: 211; 
U.S. Public Health Service Commissioned Corps[A]: 27; 
Contractors: 308; 
Percentage of contractors in each entity: 56. 

Entity within CDC: Coordinating Center for Environmental Health and 
Injury Prevention; 
Civil Service: 17; 
U.S. Public Health Service Commissioned Corps[A]: 2; 
Contractors: 0; 
Percentage of contractors in each entity: 0. 

Entity within CDC: National Center for Environmental Health/Agency for 
Toxic Substances and Disease Registry; 
Civil Service: 635; 
U.S. Public Health Service Commissioned Corps[A]: 96; 
Contractors: 222; 
Percentage of contractors in each entity: 23. 

Entity within CDC: National Center for Injury Prevention and Control; 
Civil Service: 156; 
U.S. Public Health Service Commissioned Corps[A]: 9; 
Contractors: 33; 
Percentage of contractors in each entity: 17. 

Entity within CDC: Coordinating Center for Health Information and 
Service; 
Civil Service: 13; 
U.S. Public Health Service Commissioned Corps[A]: 4; 
Contractors: 9; 
Percentage of contractors in each entity: 35. 

Entity within CDC: National Center for Health Marketing; 
Civil Service: 246; 
U.S. Public Health Service Commissioned Corps[A]: 8; 
Contractors: 181; 
Percentage of contractors in each entity: 42. 

Entity within CDC: National Center for Health Statistics; 
Civil Service: 463; 
U.S. Public Health Service Commissioned Corps[A]: 15; 
Contractors: 70; 
Percentage of contractors in each entity: 13. 

Entity within CDC: National Center for Public Health Informatics; 
Civil Service: 147; 
U.S. Public Health Service Commissioned Corps[A]: 9; 
Contractors: 490[B]; 
Percentage of contractors in each entity: 76[C]. 

Entity within CDC: Coordinating Center for Health Promotion; 
Civil Service: 20; 
U.S. Public Health Service Commissioned Corps[A]: 1; 
Contractors: 2; 
Percentage of contractors in each entity: 9. 

Entity within CDC: National Center on Birth Defects and Developmental 
Disabilities; 
Civil Service: 162; 
U.S. Public Health Service Commissioned Corps[A]: 6; 
Contractors: 87; 
Percentage of contractors in each entity: 34. 

Entity within CDC: National Center for Chronic Disease Prevention and 
Health Promotion; 
Civil Service: 793; 
U.S. Public Health Service Commissioned Corps[A]: 81; 
Contractors: 301; 
Percentage of contractors in each entity: 26. 

Entity within CDC: National Office of Public Health Genomics; 
Civil Service: 14; 
U.S. Public Health Service Commissioned Corps[A]: 1; 
Contractors: 0; 
Percentage of contractors in each entity: 0. 

Entity within CDC: Coordinating Center for Infectious Diseases; 
Civil Service: 197; 
U.S. Public Health Service Commissioned Corps[A]: 5; 
Contractors: 276; 
Percentage of contractors in each entity: 58. 

Entity within CDC: National Center for Immunization and Respiratory 
Diseases; 
Civil Service: 399; 
U.S. Public Health Service Commissioned Corps[A]: 41; 
Contractors: 73; 
Percentage of contractors in each entity: 14. 

Entity within CDC: National Center for Zoonotic, Vector-Borne, and 
Enteric Diseases; 
Civil Service: 271; 
U.S. Public Health Service Commissioned Corps[A]: 8; 
Contractors: 159; 
Percentage of contractors in each entity: 36. 

Entity within CDC: National Center for HIV/AIDS, Viral Hepatitis, STD, 
and TB Prevention; 
Civil Service: 986; 
U.S. Public Health Service Commissioned Corps[A]: 129; 
Contractors: 164; 
Percentage of contractors in each entity: 13. 

Entity within CDC: National Center for Preparedness, Detection, and 
Control of Infectious Diseases; 
Civil Service: 680; 
U.S. Public Health Service Commissioned Corps[A]: 180; 
Contractors: 147; 
Percentage of contractors in each entity: 15. 

Entity within CDC: National Institute for Occupational Safety and 
Health; 
Civil Service: 1,149; 
U.S. Public Health Service Commissioned Corps[A]: 91; 
Contractors: 334; 
Percentage of contractors in each entity: 21. 

Source: GAO analysis of CDC data. 

[A] The U.S. Public Health Service Commissioned Corps is a part of HHS 
and fills essential public health leadership and service roles in 
federal government agencies and programs. Officers are hired under a 
different pay system and have different training requirements than 
employees under the Civil Service system. 

[B] The National Center for Public Health Informatics also includes 20 
contractors who work part-time. 

[C] Contractors who work part-time are not included in this 
calculation. 

[End of table] 

[End of section] 

Appendix IV: CDC's Objectives and Strategies from Its Strategic Human 
Capital Management Plan: 

Objectives: A. Ensure Effective Human Capital Planning; 
Strategies: 
1. Develop, Implement, and Evaluate Agencywide Workforce Planning 
Methodology.
2. Develop, Implement, and Evaluate Global Workforce Plan.
3. Develop, Implement, and Evaluate Predictive Models to Support Human 
Capital Planning.
4. Develop, Implement, and Evaluate Workforce Planning and Succession 
Planning Training for Managers. 

Objectives: B. Improve Recruitment, Retention, and Outreach; 
Strategies: 
5. Develop, Implement, and Evaluate a Collaborative Strategic 
Recruitment Function.
6. Develop, Implement, and Evaluate an Outreach Plan, Materials, and 
Activities.
7. Develop, Implement, and Evaluate Plans to Expand Career Paths to 
Public Health.
8. Develop, Implement, and Evaluate a Diversity Education and Training 
Curriculum.
9. Develop, Implement, and Evaluate Plans to Expand Use of the Federal 
Career Intern Program.
10. Develop, Implement, and Evaluate Plans to Expand use of Career 
Ladders.
11. Develop, Implement, and Evaluate a Fellowship Management System.
12. Evaluate Factors Affecting Employee Turnover and Develop Strategies 
for Improvement. 

Objectives: C. Improve Career Development of Employees; 
Strategies: 
13. Transition to the Department of Health and Human Services (HHS) New 
Learning Management System.
14. Develop, Implement, and Evaluate Plans to Improve "Mandatory" 
Training Compliance.
15. Develop, Implement, and Evaluate Plans to Improve the Individual 
Development Plan and Individual Learning Account Utilization.
16. Develop, Implement, and Evaluate Plans to Complete Mission-Critical 
Occupation Competency Gap Analysis and Closure. 

Objectives: D. Improve Leadership Development; 
Strategies: 
17. Implement and Evaluate Initiative for Leadership Enhancement and 
Development (ILEAD) Framework.
18. Develop, Implement, and Evaluate a Blended Learning Supervisor 
Survival Skills Course.
19. Expand and Evaluate Executive Coaching. 

Objectives: E. Improve Human Resources Processes; 
Strategies: 
20. Develop, Implement, and Evaluate Plans to Reduce Time-to-Hire. 

Source: CDC, Strategic Human Capital Management Plan, September 2007. 

[End of table] 

[End of section] 

Appendix V: Summary of CDC's Health Protection Goals: 

Health Protection Goal: Healthy People in Every Stage of Life--All 
people, and especially those at greater risk of health disparities, 
will achieve their optimal lifespan with the best possible quality of 
health in every stage of life. 

Specific Goal: 
1. Start Strong--increase the number of infants and toddlers that have 
a strong start for healthy and safe lives (Infants and Toddlers, ages 0-
3 years); 
Objectives: 
(a) Promote healthy pregnancy and birth outcomes; 
(b) Promote social and physical environments that support the health, 
safety, and development of infants and toddlers; 
(c) Promote optimal development among infants and toddlers; 
(d) Increase early identification, tracking, and follow up of infants 
and toddlers with special health care and developmental needs; 
(e) Prevent infectious diseases and their consequences among infants 
and toddlers; 
(f) Prevent injury and violence and their consequences among infants 
and toddlers; 
(g) Promote access to and receipt of quality, comprehensive pediatric 
health services, including dental services, by infants and toddlers. 

Specific Goal: 
2. Grow Safe and Strong--increase the number of children who grow up 
healthy, safe, and ready to learn (Children, ages 4-11 years); 
Objectives: 
(a) Promote social and physical environments that are accessible; that 
support health, safety, and development; and that promote healthy 
behaviors for children; 
(b) Promote social, emotional, and mental well-being for children; 
(c) Prevent infectious diseases and their consequences for children; 
(d) Prevent injury and violence and their consequences for children; 
(e) Promote the early identification, tracking, prevention, and follow-
up treatment of chronic disease and health conditions in children; 
(f) Promote the early identification, tracking, and follow up of 
children with, or at risk for, developmental delays, disorders, or 
disabilities; 
(g) Promote access to and receipt of quality, comprehensive pediatric 
health services, including dental and mental health services, by 
children; 
h) Improve behaviors that promote children's health and well-being in 
future life stages. 

Specific Goal: 
3. Achieve Health Independence--increase the number of adolescents who 
are prepared to be healthy, safe, independent, and productive members 
of society (Adolescents, ages 12-19 years); 
Objectives: 
(a) Promote social and physical environments that are accessible; that 
support health, safety, and development; and that promote healthy 
behaviors among adolescents; 
(b) Promote access to and receipt of recommended quality, effective, 
evidence-based preventive and health care services, including dental 
and mental health care, among adolescents; 
(c) Promote social, emotional, and mental well-being for adolescents; 
(d) Prevent injury, violence, and suicide and their consequences among 
adolescents; 
(e) Prevent Human Immunodeficiency Virus, sexually transmitted 
diseases, and unintended pregnancies and their consequences among 
adolescents; 
(f) Promote healthy activity and nutrition behaviors and prevent 
overweight and its consequences among adolescents; (g) Prevent 
substance use and its consequences, including tobacco, alcohol, and 
other substance use, among adolescents. 

Specific Goal: 
4. Live a Healthy, Productive, and Satisfying Life--increase the number 
of adults who are healthy and able to participate fully in life 
activities and enter their later years with optimum health (Adults, 
ages 20-49 years); 
Objectives: 
(a) Promote social and physical environments that are accessible; that 
support health, safety, and quality of life; and that promote healthy 
behaviors among adults; 
(b) Promote access to and receipt of recommended quality, effective, 
evidence-based preventive and health care services, including dental 
and mental health care, among adults; 
(c) Promote, social, emotional, and mental well-being for adults; 
(d) Promote reproductive and sexual health among adults; 
(e) Prevent chronic diseases and their consequences among adults; 
(f) Prevent infectious diseases and their consequences among adults; 
(g) Prevent injury, violence, suicide, and their consequences among 
adults; 
(h) Improve behaviors among adults that promote health and well-being. 

Specific Goal: 
5. Live Better Longer--increase the number of older adults who live 
longer, high-quality, productive, and independent lives (Older Adults 
and Seniors, ages 50 and over); 
Objectives: 
(a) Promote social and physical environments that are accessible; that 
support health, safety, and quality of life; and that promote healthy 
behaviors among older adults; 
(b) Promote access to and receipt of recommended quality, effective, 
evidence-based preventive and health care services, including dental 
and mental health care, among older adults; 
(c) Promote independence, optimal physical, emotional, mental, sexual 
health, and social functioning among older adults; 
(d) Prevent chronic diseases and their consequences among older adults; 
(e) Prevent infectious diseases and their consequences among older 
adults; 
(f) Prevent injury, violence, and suicide and their consequences among 
older adults; 
(g) Improve behaviors among older adults that promote health and well-
being. 

Health Protection Goal: Healthy People in Healthy Places--The places 
where people live, work, learn, and play will protect and promote their 
health and safety, especially those at greater risk of health 
disparities. 

Specific Goal: 
1. Healthy Communities--increase the number of communities that protect 
and promote health and safety and prevent illness and injury; 
Objectives: 
(a) Promote safe and high-quality air, water, food, and waste disposal, 
and safety from toxic, infectious, and other hazards, in communities; 
(b) Support the design and development of built environments that 
promote physical and mental health by encouraging healthy behaviors, 
quality of life, and social connectedness; 
(c) Support a robust, sustainable capacity to provide access to and 
ensure receipt of essential public health, health promotion, health 
education, and medical services; 
(d) Understand and reduce the negative health consequences of climate 
change; 
(e) Prevent injuries and violence and their consequences in 
communities; 
(f) Improve the social determinants of health among communities with 
excess burden and risk. 

Specific Goal: 
2. Healthy Homes--protect and promote health through safe and healthy 
home environments; 
Objectives: 
(a) Promote homes that are healthy, safe, and accessible; 
(b) Promote adoption of behaviors that keep people healthy and safe in 
their homes; 
(c) Promote the availability of healthy, safe, and accessible homes. 

Specific Goal: 
3. Healthy Schools--increase the number of schools that protect and 
promote the health, safety, and development of all students, and 
protect and promote the health and safety of all staff (e.g., healthy 
food vending, physical activity programs); 
Objectives: 
(a) Improve the health and safety of students and school staff by 
implementing comprehensive and coordinated instruction, programs, 
policies, and services that involve families and the community; 
(b) Promote safe, healthy, and accessible physical environments in 
schools; 
(c) Promote supportive social, psychological, and emotional 
environments in schools. 

Specific Goal: 
4. Healthy Workplaces--promote and protect the health and safety of 
people who work by preventing workplace-related fatalities, illnesses, 
injuries, and personal health risks; 
Objectives: 
(a) Prevent work-related deaths, injuries, and illnesses; 
(b) Improve adoption of comprehensive workplace programs, policies, and 
practices that protect employees from work-related risks and promote 
safe and healthful lifestyles for workers and their families. 

Specific Goal: 
5. Healthy Health Care Settings--increase the number of health care 
settings that provide safe, effective, and satisfying patient care; 
Objectives: 
(a) Promote delivery of quality prevention and screening services in 
health care settings; 
(b) Promote compliance with evidence-based guidelines for preventing, 
identifying, and managing disease in health care settings; 
(c) Prevent adverse events in patients and health care workers in 
health care settings; 
(d) Promote health, safety, and accessibility in health care settings; 
(e) Promote patient-centered clinical care and prevention services in 
health care settings. 

Specific Goal: 
6. Healthy Institutions--increase the number of institutions that 
provide safe, healthy, and equitable environments for their residents, 
clients, or inmates; 
Objectives: 
(a) Promote institutional settings that are designed, constructed, and 
modified to be hazard free and promote health; 
(b) Promote delivery of health promotion programs in institutions; 
(c) Prevent infectious diseases and their consequences among people in 
institutional settings; 
(d) Prevent chronic diseases and their consequences among people in 
institutions; 
(e) Prevent injuries and violence, and their consequences, among people 
in institutions; 
(f) Promote continuity of patient care across institutional public 
health, medical systems, and community health systems. 

Specific Goal: 
7. Healthy Travel and Recreation--increase the numbers of environments 
that enhance health and prevent illness and injury during travel and 
recreation; 
Objectives: 
(a) Reduce injury risk associated with travel, transportation, and 
recreation; 
(b) Reduce exposure to infectious and environmental hazards associated 
with travel, transportation, and recreation; 
(c) Promote healthy, safe, and accessible environments for travel, 
transportation, and recreation. 

Health Protection Goal: People Prepared for Emerging Health Threats-- 
People in all communities will be protected from infectious, 
occupational, environmental, and terrorist threats. 

Specific Goal: 
1. Preparedness goals will be developed to address scenarios that 
include natural and intentional threats, such as influenza, anthrax, 
plague, emerging infections, toxic chemical exposure, and radiation 
exposure; 
(a) Prevention; 
* Increase the use and development of interventions known to prevent 
human illness from chemical, biological, radiological agents, and 
naturally occurring health threats; 
(b) Detection and Reporting; 
* Decrease the time needed to classify health events as terrorism or 
naturally occurring in partnership with other agencies; 
* Decrease the time needed to detect and report chemical, biological, 
radiological agents in tissue, food, or environmental samples that 
cause threats to the public's health; 
* Improve the timeliness and accuracy of communications regarding 
threats to the public's health; 
(c) Investigation; 
* Decrease the time to identify causes, risk factors, and appropriate 
interventions for those affected by threats to the public's health; 
(d) Control; 
* Decrease the time needed to provide countermeasures and health 
guidance to those affected by threats to the public's health; 
(e) Recovery; 
* Decrease the time needed to restore health services and environmental 
safety to pre-event levels; 
* Improve the long-term follow up provided to those affected by threats 
to the public's health; 
(f) Improvement; 
* Decrease the time needed to implement recommendations from after-
action reports following threats to the public's health; 
Objectives: 
(a) Integrate and enhance the existing surveillance systems at the 
local, state, national, and international levels to detect, monitor, 
report, and evaluate public health threats; 
(b) Support and strengthen human and technological epidemiologic 
resources to prevent, investigate, mitigate, and control current, 
emerging, and new public health threats and to conduct research and 
development that lead to interventions for such threats; 
(c) Enhance and sustain nationwide and international laboratory 
capacity to gather, ship, screen, and test samples for public health 
threats and to conduct research and development that lead to 
interventions for such threats; 
(d) Assure an integrated, sustainable, nationwide response and recovery 
capacity to limit morbidity and mortality from public health threats; 
(e) Expand and strengthen integrated, sustained, national foundational 
and surge capacities capable of reaching all individuals with effective 
assistance to address public health threats. 

Health Protection Goal: Healthy People in a Healthy World--People 
around the world will live safer, healthier, and longer lives through 
health promotion, health protection, and health diplomacy. 

Specific Goal: 
1. Health Promotion--global health will improve by sharing knowledge, 
tools, and other resources with people and partners around the world; 
Objectives: 
(a) Prevent and control infectious diseases and their consequences 
globally; 
(b) Prevent infant and child morbidity and mortality globally; 
(c) Prevent non-communicable diseases and their consequences globally; 
(d) Prevent injuries and their consequences globally; 
(e) Promote safe, healthy, and accessible physical environments 
globally. 

Specific Goal: 
2. Healthy Global Health Protection--Americans at home and abroad will 
be protected from health threats through a transnational prevention, 
detection, and response; 
Objectives: 
(a) Prepare for, prevent, detect, respond to, and contain health 
threats globally. 

Specific Goal: 
3. Health Diplomacy--CDC and the United States Government will be a 
trusted and effective resource for health development and health 
protection around the globe; 
Objectives: 
(a) Supportive achievement of international and national goals for the 
acceleration of control, and the eradication and elimination of 
diseases; 
(b) Develop sustainable public health capacity among partner 
organizations and governments globally; 
(c) Prevent maternal morbidity and mortality globally; 
(d) Improve response to natural and manmade disasters, including 
complex humanitarian emergencies globally. 

Source: CDC. 

[End of table] 

[End of section] 

Appendix VI: Comments from the Centers for Disease Control and 
Prevention: 

Department Of Health & Human Services: 
Office of the Assistant Secretary for Legislation: 
Washington, DC 20201: 

May 1, 2008: 

Cynthia A. Bascetta: 
Director, Health Care: 
U.S. Government Accountability Office: 
441 G Street NW: 
Washington, DC 20548: 

Dear Ms. Bascetta: 

Enclosed are the Department's comments on the U.S. Government 
Accountability Office's (GAO) draft report entitled: "Centers for 
Disease Control and Prevention: Human Capital Planning Has Improved, 
but Attention to Contractor Workforce Needed" (GAO 08-582). 

The Department appreciates the opportunity to comment on this report 
before its publication. 

Sincerely, 

Signed by: 

Jennifer P. Luong, for: 
Vincent J. Ventimiglia, Jr. 
Assistant Secretary for Legislation: 

Attachment: 

General Comments Of The Department Of Health And Human Services (HHS) 
On The U.S. Government Accountability Office's (GAO) Draft Report 
Entitled: Centers For Disease Control And Prevention: Human Capital 
Planning Has Improved, But Attention To Contractor Workforce Needed 
(GAO 08-582). 

We concur with the Government Accountability Office's (GAO's) 
observation that the strategic alignment component of the September 
2007 edition of CDC's Strategic Human Capital Management Plan (SHCMP) 
could be improved by better connecting the Plan with our agency's goal 
action plans. We addressed this concern in the "Performance Management 
for Results" section of a revised version of the SHCMP (January 2008), 
which CDC provided to the GAO review team on March 3, 2008. 

* A critical element in implementing effective performance management 
is "cascading" an organization's business objectives down to the 
workforce and subsequently assessing level of accomplishment. This 
requires cascading the agency's mission down through the four major 
Health Protection Goals into Goal Action Plans (GAPs) associated with 
16 specific performance goals. Progress towards goal accomplishment is 
evaluated quarterly by the Organizational Excellence Assessment (OEA) 
process. To further promote accountability, objectives/goals from the 
Strategic Human Capital Management Plan (SHCMP), OEA, and GAPs are 
cascaded into the performance plans of responsible individuals. 

* While the GAPs include a discussion of objectives, strategies, and 
actions, they do not currently address human capital and other critical 
resource requirements. Clearly, it is imperative, for GAP-related 
workforce requirements to be addressed in the agency's SHCMP. Thus, to 
address this issue, the agency-wide workforce planning process will 
capture the critical human capital components required to support each 
GAP. It is anticipated that the Coordinating Center/Office Workforce 
Planning Template (see appendix D of the SHCMP) data submitted will to 
some extent address workforce capacity (size and competency) needs 
associated with each GAP. However, due to the cross-cutting nature of 
GAPs, it is unlikely that individual CC/CO workforce plans will suffice 
to fully capture human capital requirements of the respective Plans. 
Thus, OWCD's SWDD staff will review all GAPs to supplement and 
integrate the CC/CO information as needed. SWDD will meet with Goal 
Team Leaders, WCDOs, and others as required to compile the information. 
It is anticipated that workforce planning templates may subsequently be 
revised based upon the "lessons learned" of utilizing this approach. It 
is important to note that the "external" human capital requirements of 
GAPs will not he addressed in detail because the focus of the SHCMP is 
on the agency's workforce. CDC's "cascading" approach to performance 
management for results is depicted in the figure below: 

[See PDF for image] 

Mission: Promoting Health and Quality of Life by Preventing and 
Controlling Disease, Injury, and Disability: 

Healthy People in Every Stage of Life: 
* Specific Goals (6); 
* Measure/Monitor Progress: 
- Objectives; 
- Strategies; 
- Actions. 

Healthy People in Healthy Places: 
* Specific Goals (7); 
* Measure/Monitor Progress: 
- Objectives; 
- Strategies; 
- Actions. 

People Prepared for Emerging Health Threats: 
* Specific Goals (1); 
* Measure/Monitor Progress: 
- Objectives; 
- Strategies; 
- Actions. 

Healthy People in a Healthy World: 
* Specific Goals (3); 
* Measure/Monitor Progress: 
- Objectives; 
- Strategies; 
- Actions. 

[End of figure] 

We are pleased that the report confirms CDC not only incorporated all 
five of GAO's principles of human capital planning into our SHCMP but 
also outlined actions we intend to take to further incorporate the 
principles into future updates. The recommendation to "incorporate 
strategies that address the challenge of managing a workforce with a 
large and growing number of contractors into future updates of the CDC 
Plan" was somewhat unexpected. In developing the SHCMP, we reviewed the 
human capital management plans of several other agencies-plans that the 
Office of Personnel Management (OPM) identified as being "best 
practice." Additionally. we reviewed several GAO and OPM human capital 
reports. Consistent with these sources, we did not address the use of 
contractors in detail. The SHCMP describes the rationale for this 
approach in a "blended workforce" discussion summarized below: 

* Efforts to downsize the federal workforce without reducing its 
functions have resulted in a greater reliance on the private sector (i. 
e., contractors) to address staffing and competency gaps. Effectively 
managing an ever-increasing "blended workforce" (i.e., FT Es and non-
FTEs working side-by-side) is an ongoing challenge for most agencies 
and CDC is no exception. While contractors undeniably represent a 
critical component of CDC's overall workforce, they will be excluded 
from further discussion in the SHCMP because the agency does not 
control their hiring diversity, compensation, training and other key 
human capital factors. 

Additionally, the GAO finding regarding CDC's lack of managing its 
contractor workforce as part of its overall human capital strategy does 
not recognize the legal, regulatory, and policy prohibitions in 
treating contractors as if they were federal employees. 

The Acquisition Advisory Panel, created by the Services Acquisition 
Reform Act of 2003, issued a report in January 2007 [hyperlink, 
http://acquisition.gov/comp/aap/finalaapreport.html] recognizing the 
significant increase in federal service contractors and the increasing 
role they play in what has been termed a "blended workforce." However, 
the report also acknowledges the federal prohibition on personal 
services contracting except where specifically authorized by statute. 
Moreover, federal procurement policy also prohibits contractors from 
conducting inherently governmental functions. As a result of these and 
other related barriers, federal agencies cannot treat and manage 
contractors and their staff as its workforce. Rather, agencies are 
required to acquire contractor services on a task and performance-
oriented basis. In doing so, agencies specify the outcomes needed and 
the contractor is required to provide the necessary staff with 
sufficient knowledge, experience and competency to deliver the 
specified outcomes. Competencies, credentials, training, and education 
are the role of the contracting company to supply and not the federal 
agency. 

Nevertheless, CDC has addressed the contractor workforce as part of its 
overall human capital strategy in ways including: 

* Providing CDC Corporate University training to contractor staff on a 
space available basis for CDC unique curricula; 

* Authorizing contractors to serve on public health readiness and 
emergency deployment teams; 

* Permitting contractors to use CDC employee services such as the 
occupational health clinic and fitness facilities. 

Finally, the draft report indicates that because CDC does not have a 
comprehensive repository of human capital information on its service 
contracting staff, it therefore is not ensuring adequate contractor 
oversight. CDC disagrees with this assessment. CDC has a very mature 
contract oversight practice that includes legal and regulatory 
oversight provided by contract officers and specialists in the 
Procurements and Grants Office (PGO) who are highly trained acquisition 
professionals. Additionally, project officers (also known as 
contracting officer's technical representatives) are program 
professionals who provide contractor oversight from a technical and 
outcome management perspective. 

Together these federal employees ensure the terms, conditions, 
products, and services commissioned by CDC through the contract are 
delivered on time, on budget, and within scope with quality and 
functionality. 

Working within the aforementioned legal and regulatory constraints. CDC 
has put in place the following procedures to better assess the 
contractor component of our workforce: 

* Using templates for updating the SHCMP that require CDC Coordinating 
Centers/Offices to address the use of contractors for filling "gaps" 
identified during the workforce planning process. 

* Addressing the challenge of managing a blended workforce as part of 
the Workforce Planning training we provide to CDC managers. We also are 
developing an on-line version of this training. 

Additionally, we are planning to: 

* Enhance CDC Neighborhood, an on-line directory of individuals who 
have clearance to work at the agency. The updated directory will 
capture data reflecting contractors' "occupational series." 

* Explore options for developing a position-based personnel system that 
would enable CDC to more effectively manage the entire workforce, 
including contractors. Capital HR, the personnel system used by HHS, is 
person-based and limited to data regarding federal employees. 

[End of section] 

Appendix VII: GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Cynthia A. Bascetta, (202) 512-7114 or [email protected]: 

Acknowledgments: 

In addition to the contact named above, Sheila K. Avruch, Assistant 
Director; Danielle Bernstein; George Bogart; La Sherri Bush; Gay Hee 
Lee; and Roseanne Price made key contributions to this report. 

[End of section] 

Footnotes: 

[1] OPM, 2006 Federal Human Capital Survey, Department of Health and 
Human Services--Centers for Disease Control and Prevention Trend Report 
(Washington, D.C.: 2006). This survey was first conducted in 2002 and 
has been conducted every 2 years thereafter. The survey measures 
federal employees' perceptions about how effectively agencies manage 
their workforces and to what extent conditions that sustain employee 
commitment to a federal agency are present. 

[2] CDC, Report from the Ombudsman Office (Atlanta, Ga.: April 2007), 
and CDC, Report from the Ombudsman Office (Atlanta, Ga.: July 2007). 

[3] R. Stein, "Internal Dissension Grows as CDC Faces Big Threats to 
Public Health," Washington Post, Mar. 6, 2005; A. Young, "Exodus, 
Morale Shake CDC," The Atlanta Journal-Constitution, Sept. 10, 2006; 
and A. Young, "U.S. Congress Eyes CDC's Lingering Morale Problems," The 
Lancet, vol. 370 (2007): 207-08. 

[4] Epidemiologists are responsible for determining the causes of 
disease, disability, and other health outcomes; tracking their 
incidence and spread; and developing ways to prevent, contain, and 
control them. 

[5] The U.S. Public Health Service Commissioned Corps is a part of HHS 
and fills essential public health leadership and service roles in 
federal government agencies and programs. Officers are hired under a 
different pay system than employees under the Civil Service system. 
According to officials, they also have different training requirements, 
which include training to be deployed for an emergency. 

[6] Human capital strategies are the programs, policies, and processes 
that agencies use to build and manage their workforce. 

[7] GAO, Human Capital: Key Principles for Effective Strategic 
Workforce Planning, [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-
04-39] (Washington, D.C.: Dec. 11, 2003). 

[8] GAO, Major Management Challenges and Program Risks: A 
Governmentwide Perspective, [hyperlink, http://www.gao.gov/cgi-
bin/getrpt?GAO-03-95] (Washington, D.C.: January 2003); GAO, High-Risk 
Series: An Update, [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-03-
119] (Washington, D.C.: January 2003); GAO, High-Risk Series: An 
Update, [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-05-207] 
(Washington, D.C.: January 2005); and GAO, High-Risk Series: An Update, 
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-07-310] (Washington, 
D.C.: January 2007). 

[9] GAO, Centers for Disease Control and Prevention: Agency Leadership 
Taking Steps to Improve Management and Planning, but Challenges Remain, 
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-04-219] (Washington, 
D.C.: Jan. 30, 2004). 

[10] CDC, Strategic Human Capital Management Plan (Atlanta, Ga.: 
September 2007). 

[11] GAO, Human Capital: Retirements and Anticipated New Reactor 
Applications Will Challenge NRC's Workforce, [hyperlink, 
http://www.gao.gov/cgi-bin/getrpt?GAO-07-105] (Washington, D.C.: Jan. 
17, 2007); and GAO, NASA: Progress Made on Strategic Human Capital 
Management, but Future Program Challenges Remain, [hyperlink, 
http://www.gao.gov/cgi-bin/getrpt?GAO-07-1004] (Washington, D.C.: Aug. 
8, 2007). 

[12] OPM, HCAAF Practitioners' Guide (Washington, D.C.: September 
2005). 

[13] In addition to overseeing the overall management of CDC, the 
Director of CDC serves as the Administrator of the Agency for Toxic 
Substances and Disease Registry. Established within the Public Health 
Service of HHS, the Agency for Toxic Substances and Disease Registry's 
administrative and management functions were consolidated with those of 
the National Center for Environmental Health in 2003. 

[14] CDC developed the Organizational Excellence Assessment in fiscal 
year 2007 for use as a management and communication tool, in part to 
improve the execution of the agency's strategies to accomplish the 
Health Protection Goals and Goal Action Plans; to communicate 
priorities, plans, and accountability throughout the agency; and to 
identify areas for improvement. 

[15] In August 2001 the President launched the President's Management 
Agenda--an effort to "address the most apparent deficiencies for which 
the opportunity to improve performance is the greatest." This agenda 
outlines five initiatives, including strategic human capital 
management, in areas identified as having management weaknesses and 
needing attention by federal agencies. The other four initiatives are 
competitive sourcing, improved financial performance, expanded 
electronic government, and budget and performance integration. 

[16] The Office of Management and Budget works with OPM to establish 
policies and oversee many of the internal functions and structures of 
federal agencies, including strategic human capital management. The 
Office of Management and Budget's primary mission is to assist the 
President in overseeing the preparation of the federal budget and to 
supervise its administration in the executive branch agencies. 

[17] American Public Health Association, Issue Brief, The Public Health 
Workforce Shortage: Left Unchecked, Will We Be Protected? (Washington, 
D.C.: September 2006). 

[18] Public health informatics merges the disciplines of computer 
science and public health practice, research, and learning. Those who 
work in public health informatics endeavor to develop and deploy 
information technology solutions that provide accurate, timely, and 
secure information to guide public health action. 

[19] OPM, 2006 Federal Human Capital Survey, Department of Health and 
Human Services--Centers for Disease Control and Prevention Trend Report 
(Washington, D.C.: 2006). 

[20] AHRC officials measure the time to hire from the date a request 
for a position is received at AHRC until the date an offer is made. 
This includes the time it takes to draft the vacancy announcement, but 
it does not include the days during which the vacancy is announced or 
advertised, which typically ranges from 5 to 15 days. 

[21] 48 C.F.R. ï¿½ 37.114 (2007). 

[22] GAO, Department of Homeland Security: Risk Assessment and Enhanced 
Oversight Needed to Manage Reliance on Contractors, [hyperlink, 
http://www.gao.gov/cgi-bin/getrpt?GAO-08-142T] (Washington, D.C.: Oct. 
17, 2007). 

[23] The CDC Plan included 20 strategies that were designed to 
strengthen its human capital efforts. Developed for the 2008 through 
2010 time frame, these 20 strategies can be grouped into five broader 
objectives, which are ensuring effective human capital planning; 
improving recruitment, retention, and outreach; improving career 
development of employees; improving leadership development; and 
improving human resource processes. 

[24] GAO, Federal-Aid Highways: Increased Reliance on Contractors Can 
Pose Oversight Challenges for Federal and State Officials, [hyperlink, 
http://www.gao.gov/cgi-bin/getrpt?GAO-08-198] (Washington, D.C.: Jan. 
8, 2008); GAO, Foreign Assistance: Strategic Workforce Planning Can 
Help USAID Address Current and Future Challenges, [hyperlink, 
http://www.gao.gov/cgi-bin/getrpt?GAO-03-946] (Washington, D.C.: Aug. 
22, 2003); and [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-
142T]. 

[25] HHS's four strategic goals are to (1) improve the safety, quality, 
affordability, and accessibility of health care; (2) prevent and 
control disease, injury, illness, and disability across the lifespan, 
and protect the public from infectious, occupational, environmental, 
and terrorist threats; (3) promote the economic and social well-being 
of individuals, families, and communities; and (4) advance scientific 
and biomedical research and development related to health and human 
services. 

[26] HHS's Performance Management Appraisal Program is a tool designed 
to assist HHS employees to achieve organizational and individual 
performance goals. 

[27] Members of CDC management serve on leadership groups that 
collectively determine the direction of the agency. The primary group 
is the Executive Leadership Board, which makes key decisions about 
CDC's direction, policy, and investments covering science, programs, 
and operations. Other councils advise the Executive Leadership Board, 
including (1) the Management Council, which governs CDC's management 
practices and makes recommendations to the Executive Leadership Board 
about fiscal management and agency operations; and (2) the Center 
Leadership Council, which oversees the quality, impact, and integrity 
of CDC's scientific and public health programs and informs the 
Executive Leadership Board of important and impending scientific, 
program, or policy issues. 

[28] An official from AHRC, a stakeholder in CDC human capital 
activities, is a member of the Management Council. 

[29] CDC identified four mission-critical occupations: (1) 
microbiology, (2) general health science, (3) medical officer, and (4) 
public health advisor/analyst. 

[30] According to HHS, a recruitment incentive is an incentive paid to 
a newly appointed employee and a relocation incentive is an incentive 
paid to a current federal employee who must relocate to accept a 
position in a different geographic area. Both incentives can only be 
used if it has been determined that the position is critical to the 
mission of the organization and is likely to be difficult to fill in 
the absence of such an incentive. 

[31] A retention incentive is payment of a percentage of a current 
employee's annual basic pay to retain his or her services. 

[32] A career ladder is a formally recognized succession of positions 
that represent the anticipated career progression for large groups of 
permanent employees assigned to a specific occupation. Career ladders 
are established for large groups of similar positions that have 
established career progression and known promotion potential. 

[33] For these needs assessments, the CDC University uses an online 
tool it developed called the Competency Assessment Profile System, 
which allows employees and their supervisors to assess competency 
relevance for an individual occupation. If a need exists in a 
particular competency, the employee and supervisor can identify 
training courses or other developmental activities that address the 
need. 

[34] Human capital flexibilities represent policies and practices that 
an agency has the authority to implement in managing its workforce. 
Examples of human capital flexibilities include relocation and 
retention incentives. GAO, Human Capital: Effective Use of 
Flexibilities Can Assist Agencies in Managing Their Workforces, 
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-03-2] (Washington, 
D.C.: Dec. 6, 2002); also see OPM, Human Resources Flexibilities and 
Authorities in the Federal Government (Washington, D.C.: Apr. 1, 2002). 

[35] [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-04-39], 20. 

[36] For work related to CDC's budget see GAO, Centers for Disease 
Control and Prevention: Changes in Obligations and Activities Before 
and After Fiscal Year 2005 Budget Reorganization, [hyperlink, 
http://www.gao.gov/cgi-bin/getrpt?GAO-08-328R] (Washington, D.C.: Feb. 
25, 2008). 

[37] Health Protection Goals are the agency goals that were completed 
in the 2005 reorganization known as the Futures Initiative: (1) Healthy 
People in Every Stage of Life, (2) Healthy People in Healthy Places, 
(3) People Prepared for Emerging Health Threats, and (4) Healthy People 
in a Healthy World. 

[38] Goal Action Plans are developed using the agency's Health 
Protection Goals, and these plans aid in the agency's planning of the 
direction of its work. 

[End of section] 

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