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management through elimination of one of OTA's three Division management groups and the operations manager as well as two general assignment senior associates generated significant personnel savings. The outline of the new organization is displayed in Schedules A and A-a and in the sections below. A planning and strategic process was also begun to fulfill further needs. Reorganized Divisions should consist of Programs which form sensible, coherent intellectual and scientific units, ones which foster increased intercommunication and efficient cooperative use of personnel resources. Continued savings should be possible through coalescing Programs and the elimination of a few Program management teams. This process is underway and should result in a leaner and more efficient organization with as little loss of productivity to downsizing as possible.

Relation of Work to Legislative Activity

OTA's role is neither to promote nor to discourage the development or the application of any particular technology or legislation, but rather to help Congress determine whether or when some form of Federal government participation may make sense. OTA identifies and clarifies options; exposes misleading, unsupportable, or incorrect information; and works to raise the level of understanding in the debate about expensive and controversial technical issues.

In each section on accomplishments in OTA's divisions, we identify some activities during fiscal year 1993 that illustrate the link between OTA's work and specific congressional activity. Please see the following pages for this information.

■ Industry, Commerce, and International Security Division 35

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OTA works closely with members of TAB and the Appropriations Committees to maintain the authority of TAB to set the agenda of the agency and the best use of OTA's limited resources for the whole Congress. Mandates are strongly discouraged as a mechanism to obtain OTA's help, and potential mandates are often avoided when we are able to work with the interested parties prior to passage of legislation into law.

Because of the support of OTA's Board and the Appropriations Committees, no mandates occurred in the 103d Congress. OTA also successfully convinced a committee to repeal an earlier mandate. Two small mandated studies were passed at the end of the 102d Congress, P.L. 102-571 mandating a study of the regulatory and health assessment of dietary supplements and P.L. 102-585 mandating a study of registries of health data on Persian Gulf veterans. Both studies will be

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Continuing Mandated Functions

OTA continues to monitor veterans studies: P.L. 96-151 requires OTA to monitor and evaluate certain studies by the Department of Veterans Affairs; P.L. 98-160 requires OTA to monitor certain Federal research activities with regard to veterans exposed to atomic radiation; P.L. 99-272 requires OTA to monitor certain Federal research activities related to women veterans.

OTA continues to appoint the members of the Prospective Payment Assessment Commission (ProPAC) and the Physician Payment Review Commission (PPRC). ProPAC is an independent advisory committee mandated under the Social Security Amendments of 1983 (P.L. 98-21, Section 601, 42 U.S.C. 1395ww) that reform the Medicare program payment method. The law requires the OTA Director to select the Commission members. The first Commissioners were appointed in 1983.

PPRC is also an independent advisory committee and was mandated by the Consolidated Omnibus Budget Reconciliation Act of 1985 (P.L. 99-272, 42 U.S.C. 1395w-1). PPRC's purpose is to advise Congress and the Executive Branch on possible ways of reforming physician payment under the Medicare program. The law requires the OTA Director to select the Commission members. Initial appointments to the 13-member Commission were made in 1986, for terms ranging from one to three years.

P.L. 99-960 and P.L. 102-507 also require the Director of OTA to appoint the members of the Advisory Panel on Alzheimer's Disease, which advises the Secretary of Health and Human Services on priorities and emerging issues related to Alzheimer's disease and related dementia. The first panel was appointed by the OTA director in 1987, and the panel was reauthorized in 1992. The panel's authorization terminates in 1995.

Interagency Coordination

In carrying out OTA's mission as a shared resource of the committees of the Congress, our staff cooperate and interact extensively with congressional members and staff and with the staffs of other Federal agencies, the private sector, and institutions around the world. This extensive networking serves to avoid duplication and to increase Congress's analytical resource base as it enables OTA to utilize the most up-to-date information available. In particular, OTA and the three other congressional support agencies have adopted processes that ensure fuller utilization of each other's expertise-in administrative as well as substantive areas. Senior staff from OTA, CRS, CBO, and GAO meet regularly to discuss topics on which each agency works, such as trade, education, health care, energy, agriculture, environment, transportation, and defense, in order to eliminate duplication and ensure that resources are devoted to each facet of an issue. A few recent examples of OTA networking that resulted in notable benefits to the Federal, State, and local government include:

■ OTA continues to work closely with CRS, GAO, the Health Resources and Services Administration (HRSA), and the HHS Assistant Secretary for Planning and Evaluation (ASPE) on longterm care and case management issues. In July 1993, GAO held a congressional forum on long-term care; OTA staff assisted in planning the forum and moderated the forum for GAO. OTA and CRS have shared data and findings on State case management regulations and procedures for case management; this sharing of data benefits both agencies and is particularly helpful

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■ OTA participated in a CRS-sponsored congressional briefing on drug pricing in April, 1993. In addition, in August 1993, GAO staff asked OTA to review a draft of a GAO study of the impact of price controls on R&D, a subject that was briefly discussed in OTA's report. OTA's staff met with GAO staff and as a result of that review, the GAO report is currently undergoing extensive revision.

OTA conducted extensive coordination with GẠO, CRS, CBO, Physician Payment Review Commission, and Prospective Payment Review Commission, regarding Assessing the Assumptions Behind Health Reform Projections. GAO, CRS, CBO, PPRC all have work under way in this area, and OTA is consulting with them to ensure that there is not unnecessary overlap. Further, CBO has ongoing responsibilities in this area, and OTA is continuing to solicit information from CBO on the ways in which they model health reform proposals. ■OTA and GAO have coordinated their studies on Health Professions Training, with GAO concentrating on evaluation of the effectiveness of past efforts to improve specialty mix and lessen the impact on underserved areas, and OTA concentrating on potential techniques and programs to improve the situation in the future.

■ In November 1992, soon after the start of OTA's assessment, The Continuing Challenge of Tuberculosis, OTA staff met with GAO staff who were also beginning work on TB in response to congressional requests. The purpose of the meeting was coordination avoiding duplication of effort and sharing of resources. The meeting indicated that the work of the two agencies complement each other well. While OTA has focused on synthesizing current scientific understanding of TB and its control and giving a broad overview of Federal involvement, GAO was asked to evaluate in some detail Federally-funded TB control programs administered by State and local governments in several hard-hit communities. Staff from the two agencies have talked with each periodically about their respective projects. The GAO research is on-going at this date.

■ On the basis of a list of questions from OTA about case management for long-term care and discussions with OTA staff, the Health Resources and Services Administration (HRSA) contracted for an analysis of policy-relevant findings from its congressionally-mandated "Health Care Services in the Home Demonstration Program." The results of the contract analysis are to be presented in November 1993. Also based on a list of questions from OTA about case management for long-term care, HRSA conducted a workshop on case management for special populations, the results of which were published in February 1993.

■ HHS's Assistant Secretary for Planning and Evaluation (ASPE) is currently working on criteria for determining eligibility for long-term care for persons with cognitive impairment. OTA has provided information developed in 1989 to assist the Subcommittee on Health of the House Committee on Ways and Means in its work on the "Frail Elderly Bill," legislation intended to provide home and community-based services for people with dementia. OTA continues to participate on the advisory panel for ASPE's case management study.

The HHS Office of Inspector General requested, and used, previously unpublished data from OTA's study of home infusion therapy, in an HHS IG report published September. 1993. OTA staff provided information, consulted with IG staff, and reviewed the IG report.

■ Health Care Financing Administration (HCFA) staff used the OTA Home Drug Infusion Therapy report to help them make decisions about uniform Medicare coverage policy decisions under the new regional carrier system being put in place by HCFA, according to the medical director of

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■Many of the options included in OTA's report on Adolescent Health were incorporated into the President's Health Security Plan (the health care reform plan).

■ OTA coordinated the Science & Technology, Renewable Resources, and International Development study with GAO's new project on the role of private volunteer organizations (PVO's) in development that addresses: 1) when are PVOS appropriate in development, 2) how do their overhead rates affect funding use, and 3) AID effectiveness in determining when to use grants, contracts, cooperative agreements and how well do they administer/manage them.

■ OTA coordinated the Science & Technology, Renewable Resources, and International Development study with GAO's new project on World Bank's portfolio management, including review of World Bank actions to improve accountability, loan policy, level of U.S. financial risk because of World Bank loans.

■GAO is reviewing OTA's body of work (5 reports) on African agriculture and environment as they develop a new GAO project on the role of U.S. industry and organizations in foreign aid. OTA coordinated the Science & Technology, Renewable Resources, and International Development study with ongoing CRS work on reviews of the Foreign Assistance Act and sustainable development discussions.

■ CRS staff participated in several OTA meetings during the course of the study, Harmful Nonindigenous Species in the United States, including the hearings at which the study was released.

The OTA report, Energy Efficiency in the Federal Government: Government by Good Example?, has been used extensively by several Executive agencies. The General Services Administration (GSA), with whom OTA worked closely in the course of this assessment, adopted an agency wide practice promoting equipment retrofits outlined in the report. OTA work has also been credited with improving communication between Federal facility personnel and private sector suppliers of energy efficient goods and services. For example, one large energy management company distributed copies of OTA's report to all its field representatives to improve their understanding of Federal energy management needs and opportunities.

■The OTA report, Building Energy Efficiency, is being used by several Federal agencies: by the Energy Information Administration, Department of Energy in planning their data collection and analysis on building energy use; by the National Renewable Energy Laboratory (NREL) for project planning and analysis; as a basic reference by the General Services Administration (GSA); and by the GSA's New York Field Office as a guide in putting together a training course for building operators. The report is also being used by State energy offices in Colorado and Arizona.

■ Since the delivery of OTA's report, Fueling Development: Energy Technologies for Developing Countries, the World Bank has reported changing the structure of some of it energy projects in developing countries to reflect the "energy services" approach outlined in the OTA assessment. OTA staff have been invited to brief the senior World Bank staff on the project. In addition, the World Energy Conference has adopted the interim report, Energy in Developing Countries, as the basic document for discussion in their subcommittee on developing countries and it continues to have considerable impact on the thinking of the subcommittee.

■ OTA's 1989 background paper, Biological Effects of Electromagnetic Fields, continues to be

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confer with counterparts in other research agencies including EPA, DOE, and Electric Power Research Institute (EPRI) on issues related to electromagnetic fields (EMF) and electric power systems and equipment. A number of outside experts have credited the OTA report and the publicity surrounding it as an important factor in encouraging both EPA and DoE to develop broader EMF research agendas.

■ The World Bank continues to rely heavily on OTA's reports Fueling Development and Energy in Developing Countries in formulating its projects on energy efficiency and environmental issues. The Environment Department also recommends the reports as guides for environmental agencies in developing countries.

■ OTA staff participate periodically in meetings with CBO, CRS, GAO on defense conversion issues.

■ Many Federal agencies were engaged in the course of the study, Dismantling the Bomb and Managing the Nuclear Materials. The Department of Energy was prominent, with meetings and briefings on specific programs and issues held both at headquarters, as well as in trips to field facilities. A cooperative symposium was held with DoE that brought Russian scientists to OTA to discuss issues of mutual concern relative to treatment and management of high-level waste. Military agencies were also consulted, including the Defense Nuclear Agency, the Office of the Assistant to the Secretary of Defense for Atomic Energy, the Defense Intelligence Agency, the U.S. Army Corps of Engineers, and the nuclear decision-making components of each service. Other Federal agencies consulted included the Nuclear Regulatory Commission, the Department of State, and the Environmental Protection Agency.

■ OTA received extensive cooperation from the Executive Branch in conducting the Literacy Study, especially from the Office of Vocational and Adult Education of the Department of Education. After the study was released, staff briefed the Assistant Secretary and senior staff in the Adult Education Division of the Department of Education.

■Throughout the study, Access to Over-the-Road Buses for Persons with Disabilities, OTA coordinated its efforts with the Office of the Secretary of the Department of Transportation (DOT) and the federal Architectural and Transportation Barriers Compliance Board. As directed under the Americans With Disabilities Act (ADA), the OTA report has been used as the basis of DoT's regulatory analysis for the implementation of regulations informing over-the-road bus operators of their compliance obligations under the ADA.

■ OTA coordinated with GAO staff on data analysis in support of the GAO study, The Availability of Intercity Bus Service Continues to Decline, and the OTA study, Access to Over-the-Road Buses for Persons with Disabilities.

■ OTA staff assisted FAA in organizing the Civil Tiltrotor Development Advisory Committee. This Committee was mandated by Public Law 102-581.

■ OTA staff participated in or worked with four separate Federal Advisory Committees to the Federal Aviation Administration: FAA Research, Engineering, and Development Advisory Committee; Aviation Rulemaking Advisory Committee; Aviation Capacity Advisory Committee; and the FAA-sponsored Task Force for Global Navigation Satellite System Implementation.

■ OTA participated in a joint NASA/American Institute of Aeronautics and Astronautics (AIAA) workshop on interactive effects of environmental technologies programs on other aviation

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