1. Knowing What ¢ount$: Connecting Performance to the Budget
Alex Camacho, PhD, CHES, CADC, CPP
George Zangaro, PhD, RN
U.S. Department of Health and Human Services
Health Resources and Services Administration
Bureau of Health Professions
Division of Workforce and Performance Management

2. Since taking office, the President has emphasized the need to use evidence and rigorous evaluation in budget, management, and policy decisions to make government work effectively. This need has only grown in the current fiscal environment. Where evidence is suggestive, we should consider it. Where evidence is weak, we should build the knowledge to support better decisions in the future.
--OMB Memo 12-14 2

3. Role of Data in The Federal Budget
The Government Performance and Results Act (GPRA) of 1993 requires that all federal agencies identify, track, and report data that demonstrates the outcomes associated with each program.
Federal agencies are required to report performance data to Congress and the public in their annual Congressional Budget Justification. 3

4. Recent Changes in Performance Monitoring and Reporting
In 2011, President Obama signed into law the GPRA Modernization Act of 2010.
New law strengthened the requirements for performance management and reporting.
Outlined specific terms and courses of actions for programs that do not meet performance targets. 4

5. GPRA Modernization Act
Original GPRA Purpose
GPRA Modernization Act
To provide for the establishment of strategic planning and performance measurement in the federal government, and for other purposes.
To require quarterly performance assessments of government programs for purposes of assessing agency performance and improvement, and to establish agency performance improvement officers and the Performance Improvement Council. 5

6. the phtc program & Performance data
Knowing What ¢ount$: Connecting Performance to the Budget
the phtc program & Performance data 6

7. The Public Health Training Center Program
Legislative Purposes
To establish or strengthen field placements for students in health agencies or organizations;
To involve faculty members and students in collaborative projects to enhance public health services to medically underserved communities;
To designate a geographic area or medically underserved population to be served by the center; and
To assess the health personnel needs of the designated area and assist in the planning and development of training programs to meet such needs.
FY 2012 Appropriation: $24,189,000 7

8. Performance Data for the PHTC Program
BHPr recently assessed the availability and quality of performance data to support the appropriation request for the PHTC program.
Focused on FY 2002 through FY 2011.
Aimed to determine whether data are available to determine the success of the program in meeting its legislative goals and objectives. 8

9. State of the Data for the PHTC Program
Challenges with Internal Validity
Significant changes in measures over time has affected the ability to trend outcomes.
Limited data
Data were not collected to support all 4 goals of the program 9

10. State of the Data for the PHTC Program (cont.)
Duplication
Counts of trainees are duplicative—making it difficult to assess the breadth and depth of the program’s reach
Varying reporting patterns
Different interpretation of measures is affecting what is reported 10

11. State of the Data for the PHTC Program (cont.)
Example of Varying Reporting Patterns:
From the PCB-2A Table aimed to capture trainings by public health discipline.
All grantees reported training “public health” workers rather than identifying the discipline. 11

12. State of the Data for the PHTC Program (cont.)
Example of Limited Data
Data reported by PHTCs included number of trainees and courses.
Data on collaborations, needs assessment, or field placements is limited and not uniform. 12

13. Knowing What ¢ount$: Connecting Performance to the Budget
Moving forward 13

14. Improving the Availability of Performance Data
New performance reporting will be implemented September 1, 2012
Will capture program performance more effectively
New evaluation contract will help track and monitor outcomes for PHTCs
Will be instrumental in complying with Section 5103 of the Patient Protection and Affordable Care Act 14

15. Questions? 15

16. Contact Information
Alex Camacho, PhD Social Scientist, DWPM George Zangaro, PhD, RN Director, DWPM 16