Detailed Information on the
Injury Prevention and Control Assessment

Explicitly tie budget requests to the accomplishment of annual and long-term goals, and present resource needs in a complete and transparent manner.

Demonstrate adequate progress in achieving all the programs long-term performance goals.

Independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results.

Measure: Reduce the amount of time to submit funding packages for non-research funding opportunities to CDC's Procurement and Grants Office.

Explanation:This efficiency measure will track NCIPC's efforts to meet one of CDC's Procurement and Grants Office's (PGO) key performance indicators (KPI's). The funding package cycle time is defined as the time from the conclusion of the review panel until the funding package is sent to PGO. During this time frame, NCIPC is required to summarize the reviews (primary and secondary) of each application for a particular funding opportunity and develop a funding package document to submit to PGO. PGO's target is for this time frame is 7 days. In 2006, NCIPC took an average of 52 days to submit the funding package to PGO. NCIPC will use its NEXT system to track its performance for this KPI. In February, 2006, PGO established four agency-wide KPIs and targets that outline the amount of time required to award a new grant or cooperative agreement.

Measure: Reduce by 10% homicide rates among youth aged 15-24 in NVDRS states with FY 2003 baseline data.

Explanation:Source is The National Violent Death Reporting System

Measure: Reduce youth homicide rate by 0.1 per 100,000 annually.

Explanation:The data source is the National Violent Death Reporting System (NVDRS) which started data collection in FY 2003.

Measure: Impact self-reported victimization of youth as measured by reductions in 2 of 3 of the following: unwanted sexual intercourse, dating violence, and physical fighting.

Explanation:Data Source is the Youth Risk Behavior Survey

Measure: Reduce victimization of youth enrolled in grades 9-12 as measured by a reduction in the lifetime prevalence of unwanted sexual intercourse, the 12-month incidence of dating violence, and the 12-month incidence of physical fighting.

Explanation:Data Source: The Youth Risk Behavior Survey. The YRBS is conducted biennially, in the odd year. Thus, FY 2007 data will not be available until December, 2008.

Measure: Among the states receiving funding from CDC, reduce deaths from residential fire to 1.02 per 100,000 population.

Explanation:Data Source: National Vital Statistics System (OMB Control No. 0920-0213) *NCIPC is entering a new funding cycle for this cooperative agreement and anticipates expanding the coverage under this cooperative agreement. This means that we may see a temporary increase in the actual results as resources are targeted to areas with higher incidence of residential fire deaths.

Measure: Among states receiving funding from CDC, reduce deaths from residential fires by 0.01 per 100,000.

Explanation:In 2004, fire departments responded to more than 410,000 home fires in the United States which claimed the lives of an estimated 3,190 people (not including fire fighters) and injured another 14,175. Almost half of home fire deaths occurred in homes without working smoke detectors. Residential fires accounted for approximately 80% of all fire-related injuries and deaths in 2004. Persons at greatest risk of sustaining fire-related injuries are children ages 5 years and younger and adults ages 65 and older, African Americans, Native Americans, and Alaska Natives, rural dwellers, and persons living in substandard housing or older manufactured homes. The data source for this measure is the National Vital Statistics Survey (OMB Control No. 0920-0213).

Measure: Achieve an age-adjusted fall fatality rate among persons age 65+ years of no more than 69.6 per 100,000.

Explanation:In 2001, the age-adjusted annual fall fatality rate among persons aged 65+ years was 38.1 per 100,000 population. Because mortality from cardiovascular and other chronic diseases is decreasing, average life expectancy is increasing, and the elderly are becoming more active, NCIPC anticipates that fall fatality rates in this population will continue to rise over the next decade, based on review of national data since 1981. In addition, the number in the targeted population for this measure will increase greatly as baby boomers age. CDC estimates that the percent increase of fall fatality rates for this population without CDC activity will be 80.8 per 100,000 in 2018.

Measure: Decrease the estimated percent increase of age-adjusted fall fatality rates among persons age 65+ years.

Explanation:The target population for this measure is adults over age 65. This population will experience a large increase as baby boomers age. In 2006, the first baby boomers will turn 60. The projected rate of fatalities due to falls in 2018 is estimated to be 73.8 per 100,000 population. In this measure, NCIPC, through its interventions in falls prevention, will lower the projected rate of fatalities to 69.6 per 100,000 population, a decrease of 10% in the estimated percent increase of fall fatality rates. The data source for this measure is the National Vital Statistics Survey (OMB Control No. 0920-0213).

Is the program purpose clear?

Explanation: The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Prevention and Control (CDC), was established in 1992 to promote and support research into the causes, treatment, prevention, and rehabilitation of injuries; to promote cooperation among specialists in the many fields involved in injury research and prevention; and to promote coordination among the numerous organizations and agencies involved in injury research and prevention. NCIPC is authorized under the Public Health Service Act and the Keeping Children and Families Safe Act. The mission of the program is clear.

Evidence: The mission of NCIPC is to prevent premature death and disability and to reduce the human suffering and medical costs caused by injuries. Evidence also includes appropriations history, authorizing legislation in the Public Health Service Act, and program documentation in the Catalog of Federal Domestic Assistance.

Does the program address a specific and existing problem, interest, or need?

Explanation: Unintentional and violence-related injuries are leading causes of death and disability among Americans. Many injured people are left with long-term disabilities. NCIPC works to prevent premature death and disability and to reduce the human suffering and medical costs caused by injuries and violence.

Evidence: Injuries are the number one killer of children and young adults in the United States and the leading cause of years of potential life lost before age 65. For Americans aged 44 years and under, unintentional injuries are the leading cause of death. In 2002, more than 161,000 people died from unintentional and violence-related injuries and nearly 30 million people sustained injuries serious enough to require treatment in an emergency department. The total lifetime costs associated with both fatal and nonfatal injuries are estimated to exceed $117 billion in medical expenses each year. The program makes data on injury rates available on its website (http://www.cdc.gov/ncipc) and through the Morbidity and Mortality Weekly Report.

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: NCIPC is the only federal agency responsible for addressing injuries, with a comprehensive mission that includes all phases of injury research and programs. While there are State and non-profit activities related to injury control and prevention, the program does not duplicate their efforts; the program assumes a leadership role in guiding injury prevention activities on a national level. Several nonprofit organizations conduct programs to promote safety in the home and community, particularly the National SAFE KIDS Campaign, the National Fire Protection Association, and the National Safety Council. NCIPC has collaborated with these organizations and other federal and nonprofit partners to build more effective interventions at the community level.

Evidence: NCIPC collaborates with other federal agencies, state and local partners, and private partners to document the incidence and impact of injuries, understand the causes, identify effective interventions, and promote their widespread adoption. NCIPC collects surveillance data through its National Violent Death Reporting System (NVDRS) and provides customized reports of injury-related data through an interactive database system called WISQARS (Web-based Injury Statistics Query and Reporting System). NCIPC works closely with other Federal agencies to ensure that its work is complementary, but not duplicative. Examples include research about smoke alarm technology; analysis of residential fires, including their causes and risk factors; prevention of older adult falls; and promotion of effective childhood injury prevention strategies. The U.S. Fire Administration (USFA) has authority in fire suppression and responsibility for primary data collection on causes and consequences of fires. NCIPC works with USFA to support improved fire and burn surveillance. Other federal agencies also address older adult falls, including the Centers for Medicare and Medicaid Services (quality of case and cost/benefit issues), the National Institute of Aging (biology of aging, older adult fall prevention trials), and the Administration on Aging (programs). NCIPC collaborates with these agencies to support science and public health practice promoting home and community safety.

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: There is no evidence of major design flaws that limit the program's efficiency or effectiveness. The program follows proven public health methods based on monitoring, research, and prevention, intervening across the lifespan. Public health methods are utilized in monitoring injuries, conducting research into causes of injuries, and designing interventions to prevent injuries. By having the public health response for these conditions coordinated across the lifespan, efficiencies are more readily achieved.

Evidence: NCIPC funds its partners through cooperative agreements to ensure information is shared and disseminated through a collaborative process, ensuring the effectiveness of the program. In FY 2005, about 69 percent of extramural injury prevention funding supported state and local data collection, programs and program evaluation. Thirty states were funded to build core injury programs, including traumatic brain injury surveillance. Four states received funding to develop the capacity of state health agencies to implement targeted injury prevention interventions. The program includes an evaluation component to ensure that interventions are effective. NCIPC follows CDC's Policy on Peer Review of Research. The purpose of this review is to assess portfolios in specific topic areas in terms of their focus, relevance, quality, and outcomes. All phases of research - foundational research, developmental research, efficacy and effectiveness studies, and dissemination research - are evaluated.

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: NCIPC accomplishes its mission through grants, cooperative agreements, and contracts with state, local, and territorial health departments, other federal agencies, and private organizations. Cooperative agreements give the program greater control to ensure that program objectives are being achieved to meet the program's purpose. With these cooperative agreements, State and local health departments collect data on traumatic brain injuries, violent deaths, domestic violence, and emergency department visits; develop and implement programs to prevent violent behavior; conduct programs to prevent unintentional injuries such as distributing smoke alarms and educating families about fire safety; and evaluate public health programs. The program can demonstrate that the appropriate beneficiaries are being targeted with resources. The program provides leadership and coordination of injury prevention activities.

Evidence: To achieve its mission, over 85 percent of the program's resources for injury prevention and control are distributed extramurally to state, local, and territorial health departments, other federal agencies, and private organizations. Evaluation of the program's Youth Violence Portfolio demonstrates that program activities have been effectively targeted. The evaluation found that this research has produced findings that have added to scientific base of the field. This research has supplemented and paralleled research funded by other institutions and sources about the influence of prior aggressive behavior evolving into more serious violence; peer and family factors; parental monitoring and supervision; and neighborhood characteristics. The final report of the Youth Violence Research Portfolio found that interventions with school-age children have been found to have positive effects on problem-solving skills and other competencies, as well as on aggression and fighting.

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The program has two new long-term outcome goals that reflect the purpose of the program. These long-term outcome goals aim to measure performance in some of the program's most critical areas.

Evidence: The long-term measures include the reduction of youth homicide rates; reductions in measures related to victimization of youth (i.e., unwanted sexual intercourse, dating violence, and physical fighting); reduction in residential fire deaths; and a reduction in the age-adjusted fall fatality rate among persons aged 65 and older.

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: The program has challenging but realistic quantifiable targets and timeframes for the long-term outcome measures.

Evidence: The targets include a ten percent reduction in homicide rates among youth aged 15-24 by 2018, a 13 percent reduction in rates of deaths from residential fires. These targets are ambitious, and will require aggressive actions by the program if they are to be achieved.

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The program has established a limited number of annual performance measures that are intended to ensure accountability for the program as it works towards the achievement of the long-term outcome goals.

Evidence: The measures include annual performance improvements toward reaching several of the long-term outcome goals, with annual quantitative benchmarks. Included in these annual measures are reductions in youth homicide rates; reductions in unwanted sexual intercourse, dating violence, and physical fighting; reduction in residential fire deaths; and a reduction in the age-adjusted fall fatalilty rate among persons aged 65 and older.

Does the program have baselines and ambitious targets for its annual measures?

Explanation: The program has established base-lines and ambitious targets for each of its annual measures. These annual performance measures are linked to the programs long-term measures and also support the program's long-term goals.

Evidence: The targets include annual reductions in youth homicide rates, reductions in dating violence among youths, reductions in the death rate from residential fires, and reductions in the age-adjusted mortality rate from falls for those age 65 and above.

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: The program accomplishes its mission through grants, cooperative agreements, and contracts. Since 2002, NCIPC has included text in each program announcement relating the objectives of the announcement to the NCIPC Research Agenda and the Department of Health and Human Services Healthy People 2010 Injury and Violence Prevention priority areas. NCIPC includes as one of the eligibility criteria which deems applications responsive to NCIPC announcements, the "overall match between the proposed research and programmatic objectives of the Center and program priorities described under the heading "Research Objectives"." If an application does not demonstrate this match, the application is considered non-responsive. By including this text and using it as a basis for selection of applicant/proposals in its RFAs, NCIPC ensures that all partners are working toward its long-term goals of reducing the burden of injuries, disability, or death from intentional and unintentional injuries for people at all life stages. Grantees report performance in annual reports.

Evidence: Evidence includes all program funding announcements, which are listed on the website at http://www.cdc.gov/ncipc/. The program also collects annual performance reports on a grantee basis that describe in detail the grantee's performance. The grantee reports include detail on how grantee activities support and contribute to the program's achievement of their performance goals. These reports also include timelines for the achievement of any goals that are not met on a grantee basis.

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: The program is taking actions to ensure that all of the programs activities will be evaluated over the next few years, and will receive regular evaluations in the future. Currently, completed evaluations reflect the assessment of a sufficiently broad range of key program areas, including rape and domestic violence prevention, fall and domestic fire prevention for older adults, and youth violence prevention. The program should continue to be aggressive in its evaluation activities to ensure that 100 percent of program areas are evaluated within the coming years. The program should also ensure that evaluations are unbiased and independent, to the extent possible.

Evidence: The program has a research portfolio review that rotates among the program's three divisions, and each division is scheduled to conduct a portfolio review once every three years. These evaluations are conducted under the auspices of the Science and Program Review Subcommittee (SPRS) of the HHS Secretary's Advisory Committee for Injury Prevention and Control by external subject matter experts. Completed reviews are rigorous and were conducted by independent contractors or academic organizations.

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: While the program has made progress in integrating performance and budget, the relationship between performance and budget levels is not clearly defined. The program does not quantify or estimate how changes in funding levels could impact performance levels.

Evidence: Evidence includes the GPRA plans and reports and annual Congressional Justification and budget documents provided to OMB.

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: The agency is taking a comprehensive effort to integrate budget and performance agency-wide. Also, through a strategic planning process that began in 1999, NCIPC continues to refine its priorities and align its programs to CDC's goals. The program developed its Strategic Plan developed in 1999 and organized objectives and measures around four goals: Communications, Programs, Research, and Surveillance. The program used the Strategic Plan to attune its funding announcements to research needs or gaps identified in the Plan. The Plan also called for the development of a national research agenda for injury prevention which NICPC published in June 2002. As with the Strategic Plan, NCIPC has used the Injury Research Agenda to attune funding announcements to research needs identified in the Research Agenda. In the fall of 2005, the program began a process to further identify priority areas. Also in the fall of 2005, the program hired RAND to assist in the development of a logic model for the National Center. The logic model shows how the program's activities impact the nation's health. As part of its planning process, NCIPC's divisions are working to describe how their activities relate to this logic model.

Evidence: Evidence includes the annual budget submissions to OMB and Congress, and documentation from the program on the strategic plan and performance goals. Evidence also includes the logic model developed by RAND.

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: The program collects performance information from internal programs and external program partners, including grantees and contractors. This performance information is used to guide programs and research, improve performance. NCIPC tracks grantee performance through annual and close-out reports, financial status reports, and site visits. This information is used to make program improvements and changes. Requirements for progress and performance evaluation and reporting are clearly listed in the Program Announcements and Notice of Award. Measurable outcomes of the programs are required to be in alignment with NCIPC's Injury Research Agenda and Healthy People 2010 goals.

Evidence: Contractors are required to provide regular and final reports and are evaluated at least annually. An example of how the program uses information collected from grantees to manage program is NCIPC's Rape Prevention and Education (RPE) Grant Program. NCIPC assumed full responsibility for the RPE program in FY 2002 following the 2000 reauthorization of the Violence Against Women Act (VAWA). At this time, the RPE program was redirected from the Preventive Health and Health Services block grant to a categorical grant program administered by the NCIPC. In order to establish a performance management and monitoring system for this "new" program, the RPE program was changed from a grant funding mechanism to a cooperative agreement funding mechanism. Since 2002, NCIPC has been engaged in a variety of activities with grantees aimed at defining goals, objectives, and performance indicators to better evaluate and manage implementation and impact of the program.

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: Program managers are held responsible for cost, schedule and performance results. The program directly links organizational and leadership performance objectives to performance rating for all management officials. The performance plans of all employees are aligned with the plans of management officials and work collectively to achieve the specific HHS Strategic Goals and Objectives. The program also establishes performance standards and accountability for program partners. Program partners are held accountable through program deliverables and financial controls. The program has terminated awards early for poor performance. Extramural grantees are required to produce a final progress report and financial status report. The program makes clear in grantee guidance that failure to do so may affect future funding.

Evidence: Evidence includes Employee Performance Merit Systems workplans, employee workplans that include criteria for accountability for the Center Director and other program senior management. The program uses the NEXT (NCIPC Extramural Tracking) system to track and monitor program announcements for grants and cooperative agreements from inception to grantee award. This system has been used since October 2002 and provides information about the status of each program announcement. It also provides electronic reminders of important milestones, holding Federal manager accountable for schedule deadlines.

Are funds (Federal and partners') obligated in a timely manner, spent for the intended purpose and accurately reported?

Explanation: Funds are obligated in a timely manner and spent for the intended purposes. CDC's Financial Management Office (FMO) ensures that appropriated funds are properly obligated in a timely manner and that mechanisms are in place to ensure that funds are spent for the purpose for which they are intended. The creation of CDC goals action plans lay out measurable objectives and specific activities that will result in progress toward achieving public health impact. Aligned to these efforts will be the execution spending plans. The spending plans provide CDC with a detailed sketch of CDC estimated resources needed for the fiscal year by quarter. Each plan is then used to control the incurrence of obligations and is subject to strict fund control procedures. Reviews indicate that the agency successfully prevents erroneous payments.

Evidence: Evidence includes standard operating procedures of the budget execution branch at CDC, which explains efforts to ensure that spending plans are executes properly and support agency goals. Spending plans developed at the program level also serve as evidence. The spending plans are used to certify and monitor the status of funds at the program and agency level. Status of funds reports display the funds allotted to the program, and list obligations, commitments, and unobligated balances. CDC uses this information to monitor obligation rates and potential variances. Risk assessments were completed to determine whether they were susceptible to improper payments exceeding $10 million and a 2.5 percent error rate and required to estimate improper payments under the Improper Payments Information Act of 2002 (IPIA) and the related OMB Guidance.

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: The program has an efficiency measure that aims to reduce the amount of time it takes to process funding packages to grantees by over 85 percent. CDC continues to examine agency operations to identify areas where efficiencies may be realized. In addition to competitive sourcing studies to meet the requirements of the President's Management Agenda, CDC has reviewed and reorganized its organizational and reporting structure. Further efforts to increase efficiencies include two restructuring initiatives, covering administrative and business service functions. Goals of restructuring these functions include alignment with and support of CDC's new organizational structure, as well as targeting greater efficiencies through process improvements and standardization across the agency. CDC has completed de-layering the agency to no more than four management layers.

Evidence: CDC has completed several competitive sourcing studies over the past three years, covering such services as Animal Care, Facilities Planning and Management, Library Services, Statistical Support, and Writer/Editor functions. CDC has won 13 of the 14 studies completed. Savings realized from competitive sourcing are reinvested in mission-direct public health activities. With the elimination of over 200 "sections", a 33% decrease in the official number of organizational units since 2001 has been achieved. Additionally, CDC's supervisory ratio has more than doubled from 1:5.5 in 2002 to over 1:12.6 in January 2006.

Does the program collaborate and coordinate effectively with related programs?

Explanation: The program collaborates with other federal and non-federal partners to ensure a coordinated response to the complex issues under their mission. NCIPC collaborates and coordinates with a large number of related public and private sector programs in the United States and internationally. Many of these partnerships are formalized through Memoranda of Understanding, while others are based on more formal collaborative relationships.

Evidence: The program has a long history of successful collaborations with other Federal agencies and organizations beyond the Federal government. The program funds the National Youth Violence Prevention Resource Center. The resource center is a collaborative effort between NCIPC and other federal agencies, including HHS' Office of the Surgeon General, Office of Public Health and Science, Substance Abuse and Mental Health Services Administration (SAMHSA), Health Resources and Services Administration (HRSA), Administration for Children and Families (ACF), National Institute of Mental Health (NIMH), Department of Education, Department of Justice, Department of Labor, Department of Agriculture, and the Department of Housing and Urban Development. The program works with the United States Fire Administration (USFA) to evaluate fire prevention and safety programs supported by the Assistance to Firefighters Grant Program. The program, along with the Consumer Product Safety Commission, funds the National Electronic Injury Surveillance System (NEISS) to collect data on injury cases treated in the emergency departments of NEISS participating hospitals.

Does the program use strong financial management practices?

Explanation: In April 2005, CDC implemented a new Unified Financial Management System (UFMS). UFMS is an integrated, Department-wide financial system that consistently produces relevant, reliable, and timely financial information to support decision-making and cost-effective business operations at all levels throughout the Department. UFMS replaced the legacy mainframe-based financial system, which was over 15 years old. UFMS provides the program with more real-time financial data, improved financial reports that allow managers to make timely decisions, and streamlined financial processes. UFMS will help the Department continue to achieve unqualified audit opinions. The HHS FY 2005 Performance and Accountability Report noted a material weakness related to the transition to UFMS, but full implementation will eliminate this material weakness.

Evidence: Evidence includes the HHS Performance and Accountability Report. The report stated that system implementations frequently create data conversion and other issues that can lead to difficulties in processing transactions appropriately and preparing accurate reports, and constitute a risk over the next several years. In the interim, substantial "work-arounds," cumbersome reconciliation and consolidation processes, and significant adjustments to reconcile subsidiary records to reported balances have been necessary under the existing systems. Specifically, the report stated UFMS could not produce financial statements, and therefore, CDC continued to use cumbersome processes to crosswalk the unadjusted trial balance to the financial statements increasing the risk of errors. UFMS implementation actively addresses the financial systems issue. CDC anticipates producing system-generated financial statements by the end of first quarter FY 2008 and reducing the manual processes and excessive efforts identified in the FY 2005 report. To date, CDC has implemented reviews, reconciliations, fluctuation analysis, and checks to ensure the accuracy and completeness of the financial statements. CDC has also streamlined the statement preparation outside the central financial system by using automated tools to expedite consolidating financial data.

Has the program taken meaningful steps to address its management deficiencies?

Explanation: The program has no major management deficiencies. However, the program continues to take steps to improve any management deficiencies that may remain.

Evidence: Steps have been taken to address management deficiencies is in the internal controls system. OMB Circular 123 requires that investments be evaluated for vulnerability and susceptibility to fraud, waste, and abuse. The program has identified seven business areas that have the potential to fall victim to fraud, waste, and abuse. The program has conducted susceptibility and vulnerability analysis of these areas are in the process of conducting a process audit to confirm that policies are in place to avert any potential for fraud, waste, and abuse and to document that the policies are being followed.

Are grants awarded based on a clear competitive process that includes a qualified assessment of merit?

Explanation: The program uses a competitive process to make all awards. NCIPC uses two different approaches to award grants, depending on the type of project; 1) objective review panels for non-research cooperative agreements; and 2) external peer review of research grants, cooperative agreements, and contracts. 100 percent of the program's grants are awarded through a peer reviewed process. The program makes efforts to encourage new grantees to participate.

Evidence: For its non-research cooperative agreements, the program follows the guidance for objective reviews as outlined in the HHS Awarding Agency Grants Administration Manual (AAGAM) Chapter 2.04.104C Objective Review of Grant Applications. The objective review panels evaluate applications using specific criteria listed in the program announcement. The program convenes objective review panels of qualified experts in the field to evaluate applications received in response to the program announcement. Examples of specific criteria include background and need, description of the project including the targeted population, relevance to the Injury Research Agenda, expected outcomes, communication and dissemination, and efficacy/effectiveness studies. For its research program announcements, the program uses an approach consistent with CDC's Peer Review Policy in addition to the HHS AAGAM. This CDC policy is a modification of the NIH model. Outreach activities to new grantees include 1) announcing new funding opportunities using the NCIPC ListServ which has 2,500 registered members; 2) email announcements to all Association of Schools of Public Health (ASPH) Deans regarding dissertation grants to overcome past poor response; 3) a one page paper announcement and a summary slide that NCIPC staff incorporate into their scientific presentations at professional conferences and meetings (see attached pdf of FY 2006 brochure); and 4) exhibit material at the annual American Public Health Association (APHA) meeting.

Does the program have oversight practices that provide sufficient knowledge of grantee activities?

Explanation: The program oversees grantees and holds them accountable for cost, schedule, and performance. Each cooperative agreement and contract defines deliverables, quality controls, and indicators of performance. Awardees' roles and responsibilities are clearly defined in these agreements. Both interim and final progress reports must include information on performance and progress on project objectives and an overview on financial status of the award. Financial reports are reviewed to ensure the timely, appropriate, and effective use of available funding. These reports also include verification that funds are used for their designated purpose. Grantee performance is also tracked through site visits, which examine programmatic and financial activities. NCIPC holds regular grantee meetings, monitoring workshops, and conference calls to review activities, discuss priorities, share updated scientific and program information, and best practices.

Evidence: Evidence includes grantee progress reports, that include comprehensive and detailed information on grantee performance, staffing, and financial tracking. The program also conducts site visits of grantees, and files reports detailing grantee performance and recommendations for improvements. Should problems be identified, the program will work with grantees to develop a corrective action plan to ensure improvements.

Does the program collect grantee performance data on an annual basis and make it available to the public in a transparent and meaningful manner?

Explanation: The program collects grantee performance data. Performance information is presented at aggregate and individual State levels. Performance information is made public on the web through the GPRA performance reports found in CDC's Budget Performance submission to Congress. In addition, research data from NCIPC's grantees is available in CDC's Morbidity and Mortality Weekly Report. NCIPC provides an Injury ListServ which offers information on CDC's injury programs. NCIPC publishes an Injury Fact Book every other year. NCIPC also published state profiles every other year.

Evidence: Evidence includes the program's GPRA performance plans, which can be found online at (http://www.cdc.gov/od/perfplan/2004/2004perf.pdf.). The program also makes a significant amount of performance information available on the website at http://www.cdc.gov/ncipc/. Examples include Injury Fact Sheets, funding announcements, state by state data on injury and violence programs, and links to injury news and charts.

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: Performance information indicates that the program is making progress towards the achievement of three of their four long term outcome-goals. These include the reduction of homicides among youth aged 15 through 24, the reduction in the victimization of youth (including dating violence and physical fighting), and the reduction of death rates from residential fires. Data on progress made toward the fourth long-term outcome measure (reductions in age-adjusted fall fatality rates among persons age 65 or older) will not become available until December of 2006.

Evidence: Performance information on long-term measures indicate success in making progress on these long-term outcome goals. This improvement has been reported by CDC in the annual Congressional Justification and other agency publications.

Does the program (including program partners) achieve its annual performance goals?

Explanation: The program has demonstrated progress in achieving annual performance goals. The program has surpassed performance goals in recent years in reducing the fatality rate from residential fires. The program has also made noteworthy progress in reducing youth homicide rates and reducing youth victimization (including dating violence and physical fighting), even though annual performance targets for these two areas do not begin until fiscal year 2008. Data for annual performance in measuring reductions in the death rate caused by falls for those over the age of 65 will not be available until later this year.

Evidence: Performance information on achievement of annual goals related to long-term measures indicate success in making progress on these long-term outcome goals. This improvement has been reported by CDC in the annual Congressional Justification and other agency publications.

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: The adoption of a new efficiency measure and a wide range of efficiency enhancement at the agency in the past year demonstrate improved efficiencies. Examples of efficiency enhancements include: more than doubling CDC's supervisory ratio from 1:5.5 in 2002 to 1:12.6 in January 2006; completing several competitive sourcing studies from 2003 through 2005, with CDC winning 13 of 14 studies; consolidation of 13 IT infrastructure functions, services, staff and fiscal resources into the new Information Technology Services Office (ITSO), which reduced operating costs by 30% and staff by 29% and decreased costs from a baseline of $8,454 per user in 2003 to $6,157 per user for 2005; and, consolidation of multiple business services (budget execution, travel, graphics, and training).

Evidence: Evidence of these improved efficiencies can be found in the annual CDC Congressional Justification, in competitive sourcing studies, the Business Services Consolidation Plan, and the Business Consolidation Update.

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: N/A

Evidence: There are no other federal programs that share the role of the program and the program's activities cannot be compared directly with other federal, state or private entities.

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: The program receives evaluations that are sufficient in scope and quality, and these evaluations in general conclude that the program is effective and achieving results. Some of the evaluations do reveal weaknesses in program activities. As noted above, the program should work to ensure that future evaluations are independent and unbiased, to the extent possible.

Evidence: An independent contracted evaluation of rape prevention and education activities concluded that the goal of the program is clear, and that the program succeeds in targeting funding effectively and fostering positive relationships with grantees. Weaknesses were identified in providing information on best practices and standardization of data collection and surveillance. A Georgia State University evaluation of activities to address the prevention of fires and falls among older adults indicated that the program is effective in providing older Americans with the information and tools necessary to reduce the prevalence in domestic fires and falls among seniors.