Detailed Information on the
EPA Indoor Air Quality Assessment

Improve transparency by making State radon grantee performance data available to the public via a website or other easily accessible means.

Use efficiency measures to demonstrate improved efficiencies or cost effectiveness in achieving program goals.

The program shall review the existing mechanisms for tracking programmatic performance data. Based upon the findings of the review, the program shall develop and implement a database tool that will efficiently track and consolidate program outputs and outcomes by September 30, 2008.

Link budget requests more explicitly to accomplishment of performance goals, specifically by stipulating how adjustments to resource levels would impact performance.

Measure: Estimated future premature lung cancer deaths prevented annually through lowered radon exposure

Explanation:To estimate the reduced number of lung cancer deaths resulting from lowered radon exposure, EPA applies risk reduction estimates from its 2003 radon risk assessment to the number of existing homes mitigated for elevated radon levels and the number of new homes built with radon resistant new construction

Measure: Number of additional homes (new and existing) with radon reducing features

Explanation:Includes radon resistant new construction (RRNC), which is reported by industry on an annual basis, as well as radon mitigations which are estimated from annual radon fan sales. Mitigations and RRNC have been clearly linked to reduced risk of radon-related lung cancer.

Measure: Total cost (public and private) per future premature lung cancer death prevented through lowered radon exposure

Explanation:To estimate the reduced number of lung cancer deaths resulting from lowered radon exposure, EPA applies risk reduction estimates from its 2003 radon risk assessment to the number of existing homes mitigated for elevated radon levels and the number of new homes built with radon resistant new construction. Cost estimate includes both public and private sector costs, using EPA's 2003 estimate as a baseline.

Measure: Number of people taking all essential actions to reduce exposure to indoor environmental asthma triggers

Explanation:Data from EPA survey conducted every three years. Essential actions address mold, dust mites, secondhand smoke, cockroaches, pets, nitrogen dioxide, and chemical irritants.

Measure: Additional health care professionals trained annually by EPA and its partners on the environmental management of asthma triggers

Explanation:This information is collected by the program and its partners. Participants are considered to be unique, but repeats are possible. EPA believes the targets are ambitious because reaching a unique group of at least 2,000 professionals each year requires changing the practices and behaviors of more and more difficult to reach providers each year.

Measure: Percentage of public that is aware of the EPA asthma program's media campaign.

Explanation:EPA's partner, the Ad Council, tracks public awareness of the asthma program's media campaign. The measure is an indicator of the number of people in the general public who are hearing EPA's message on asthma triggers.

Measure: Annual cost to EPA per person with asthma taking all essential actions to reduce exposure to indoor environmental asthma triggers

Explanation:Asthma trigger data from EPA survey conducted every three years. Essential actions address mold, dust mites, secondhand smoke, cockroaches, pets, nitrogen dioxide, and chemical irritants. Cost includes EPA full cost of implementing the asthma program.

Measure: Total number of schools implementing an effective Indoor Air Quality plan

Explanation:On a 3-year basis, EPA conducts a survey to determine the number of schools implementing an IAQ plan. Effectiveness is defined as a plan that is consistent with EPA's Tool for Schools guidance and scores a 70 or higher on EPA's IAQ management index.

Measure: Estimated annual number of schools establishing Indoor Air Quality programs based on EPA's Tools for Schools guidance

Explanation:Number of schools is calculated from regional and partner reports, information and commitments made at the annual indoor air quality (IAQ) Tools for Schools Symposium, and information from the IAQ Tools for Schools Awards Program.

Measure: Average cost to EPA per student per year in a school that is implementing an effective indoor air quality plan.

Explanation:Number of students is derived from the number of school multiplied by the nationwide average of 525 students, faculty and staff. Effectiveness is defined as a plan that is consistent with EPA's Tool for Schools guidance and scores a 70 or higher on EPA's indoor air quality (IAQ) management index. Cost includes EPA full cost of implementing IAQ programs.

Is the program purpose clear?

Explanation: The purpose of EPA's Indoor Environments Program is to reduce the human health risks posed by contaminants in indoor environments by gaining a better understanding of those risks and using the knowledge to promote appropriate risk reduction actions. The Program implements two primary statutory authorities: the Radon Gas and Indoor Air Quality Research Act (1), and the Indoor Radon Abatement Act (2). The program has evolved to its current focus on reducing public health risks in two priority areas: radon, and environmental contaminants associated with respiratory and related illnesses (3).

Evidence: ?? 1. Radon Gas and Indoor Air Quality Research Act, Superfund Amendments and Reauthorization Act of 1986; ?? 2. Indoor Radon Abatement Act, Title III Toxic Substances Control Act of 1988; ?? 3. Report to Congress on Indoor Air Quality. Vol. II. Assessment and Control of Indoor Air Pollution. (EPA/400/1-89/001C), 1989.

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

Explanation: According to EPA's Science Advisory Board, indoor air pollution is one of the top four environmental public health risks facing the nation (1). Americans spend approximately 90 percent of their time indoors (2), where the concentrations of some contaminants are often 2 to 5 times higher than outdoor concentrations, and the primary route of exposure for these contaminants is through the indoor air (3). EPA estimates that the economic costs to the nation of poor indoor air are on the order of tens of billions of dollars per year (2). Radon, one of the program's priorities, is the second leading cause of lung cancer and responsible for an estimated 21,000 deaths per year (4). Nearly one in 15 homes may have radon concentrations above the EPA recommended action level (5). Another program priority is to minimize exposure to environmental contaminants associated with respiratory and related illnesses. Indoor exposures to allergens from dust mites, pests, molds, and pets as well as to environmental tobacco smoke (ETS), can play a significant role in triggering asthma episodes. ETS and dust mites are also causally linked to the development of asthma (4). ETS is also known to cause cancer and cardiovascular disease and poses significant respiratory and related health risks to young children, including bronchitis, pneumonia, and ear infections (5). An estimated 20 million people in the United States have asthma (6), and the number of children with asthma has more than doubled since 1980 (7). In addition, nearly 60 million people (staff and students) spend their days in our elementary and secondary schools. One in five of our nation's public schools report unsatisfactory indoor air quality, and one in four public schools report that ventilation--which is critical for reducing indoor pollution--is unsatisfactory (8). These problems cause or contribute to respiratory infections, allergic diseases, adverse reactions to chemicals, reduced performance, and increased absenteeism (9).

Evidence:  1. Reducing Risk: Setting Priorities and Strategies for Environmental Protection, Report of the Science Advisory Board Relative Risk Reduction Strategies Committee to EPA, September 1990;  2. Report to Congress on Indoor Air Quality. Vol. II. Assessment and Control of Indoor Air Pollution. EPA 400/1-89/001C. U.S. Environmental Protection Agency, Office of Air and Radiation. 1989;  3. The total exposure assessment methodology (TEAM) study: Summary and Analysis. Volume 1. EPA 600/6-87/002a. U.S. Environmental Protection Agency, Office of Air and Radiation. 1987;  4. U.S. Environmental Protection Agency. EPA Assessment of Risks from Radon in Homes. June 2003;  5. EPA's National Residential Radon Survey, 1992;  6. Clearing the Air: Asthma and Indoor Air Exposures Institute of Medicine, National Academy of Sciences. U.S. Committee on the Assessment of Asthma and Indoor Air. ISBN 0-309-06496-1. January 2000.);  7. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders, U.S. Environmental Protection Agency, 1993. www.epa.gov/iaq/pubs/etsfs.html;  8. Condition of America's Public School Facilities: 1999, National Center for Education Statistics, Office of Educational Research and Improvement, U.S. Department of Education, NCES2000-032, June 2000;  9. Indoor Air Quality and Student Performance: 2003. U.S. Environmental Protection Agency, 402-K-03-006. (References over 60 peer reviewed journal articles.).

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

Explanation: EPA's IAQ program is focused on conducting broad public education and outreach programs to reduce the public health risks from indoor air quality (IAQ) problems. Other federal agencies play an important role in IAQ research (NIOSH, HHS, DOE, NAS, CPSC, NASA), workplace safety (OSHA), IAQ in public housing (HUD) and federal buildings (GSA). EPA, however, has a unique role in analyzing relevant research and communicating IAQ risks and risk reducing actions to the public (3). EPA partners and coordinates with state and local officials, private organizations, and industry to maximize the effectiveness of these communication efforts (4). EPA also provides funding to the states to conduct radon programs and does not excessively overlap with these efforts. When working with private industry, EPA provides guidance for remediation of IAQ problems and relies on industry partners to provide these services. Non-governmental public health groups, such as the American Lung Association, also work to raise public awareness of IAQ issues. When working with these groups, EPA limits its role to activities where its influence, expertise, and credibility are uniquely valuable.

Evidence: ?? 1. Indoor Radon Abatement Act, Title III Toxic Substances Control Act of 1988; ?? 2. Remarks of Administrator Carol Browner and Secretary Donna Shalala, meeting of The President's Task Force on Environmental Health Risks and Safety Risks to Children, July 10, 2000; ?? 3. For example, EPA was directed by a Presidential Task Force to play a greater role in federal asthma efforts, especially as they related to indoor triggers. Asthma and the Environment: A Strategy to Protect Children. President's Task Force on Environmental Health Risks and Safety Risks to Children. 1999; ?? 4. EPA co-chairs (along with the Consumer Product Safety Commission (CPSC), the Department of Energy (DOE), the National Institute for Occupational Safety and Health (NIOSH), and the Occupational Safety and Health Administration (OSHA)), the Federal Interagency Committee on Indoor Air Quality (CIAQ), which is designed to coordinate the activities of the Federal Government on issues relating to Indoor Air Quality. ?? 5. EPA Summary of the 2000 Budget. EPA 205-S-99-001, pg. 47.

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

Explanation: EPA's Indoor Environments Program is non-regulatory and is designed to promote voluntary actions by the general public to improve indoor air quality. The Program uses social marketing through training, education, and outreach to change behavior. There is no evidence that this voluntary approach is ineffective. There are, however, areas where increased authority could improve the program's ability to achieve greater progress toward its outcome goals. The program is limited to its authority to provide training, outreach and education on indoor air quality, and to perform limited demonstration projects. Additional authority to implement indoor air quality programs directly or to provide funding to partners for this purpose could improve the program's effectiveness by providing EPA a more direct role in assisting its customers to improve indoor air quality, particularly in low-income households. Expanded authority to support State programs that address other indoor contaminants besides radon could also improve the program's ability to achieve increased outcome results.

Evidence: ?? EPA's FY 2005 Congressional Justification and Annual Performance Report; ?? GAO Report. Indoor Air Quality: Federal and State Actions to Address the Indoor Air Quality Problems in Selected Buildings, (B-279615), 1998; ?? GAO Report, Indoor Radon: Limited Federal Response to Reduce Contamination in Housing, 1988 (GAO/RCED-88-103); ?? GAO Report, Air Pollution: Actions to Promote Radon Testing; 1992 (GAO/RCED-93-20).

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

Explanation: The Program develops tools and mechanisms to reach target audiences in each of its priority areas. The radon program emphasizes reducing radon risks in homes located in identified high radon areas. The program then maximizes the reach of its resources by focusing on key targets of opportunity, such as real estate transactions and new home construction. Radon grants and outreach efforts are focused most heavily on the highest risk radon areas of the country. The State Indoor Radon Grants, for example, are allocated by a formula which takes relative risk into account. The Asthma program has concluded, based on numerous studies and their 2003 Asthma Survey that children and low-income populations are especially at risk from indoor asthma triggers, such as environmental tobacco smoke or mold. To target these populations, most of the program's outreach materials and National Public Service Campaigns are targeted to reach urban and lower literacy populations, and are also produced in Spanish, increasing the accessibility of the information. Further, the program provides targeted training to health care professionals in order to increase their reach to patients with asthma. In addition to the home environment, the program targets the school environment where children spend much of their time each day. The Program's IAQ Tools for Schools (TfS) guidance is designed to promote indoor air quality improvement strategies in schools to reduce respiratory and related illnesses.

Evidence: ?? State Indoor Radon Grants are allocated by a formula which takes relative risk into account. As a result, from 1990 through 2003, 700,000 homes were built radon resistant in the designated highest radon risk areas (classified as Zone 1 by EPA), about 60% of the total 1.2 million radon resistant homes built in the United States; ?? According to EPA's survey, more than 30% of children with allergic asthma now benefit from caretaker actions to reduce exposure to indoor asthma allergic triggers, indicating the Program's resources are being effectively targeted; ?? The program's schools survey, conducted in 2002 found that approximately 22% of the nation's schools (or 25,000 schools), accounting for 10 million students, now use an IAQ management plan consistent with the IAQ TfS guidance.

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 Indoor Environments Program has long-term performance measures for each of its key program elements: radon, asthma & Tools for School (TfS). The radon measure is meaningful because it represents the program's fundamental health outcome: prevention of lung-cancer deaths through reduction in exposure to indoor radon. The number of lives saved is extrapolated from radon mitigation data using methodology based on a 1999 report from the National Academy of Science Committee on the Biological Effects of Ionizing Radiation (BEIR)(1). On average, for every 5,292 new homes built with radon-resistant new construction in the highest risk areas (classified as Zone 1 areas by EPA), one future life is saved annually. Historically, about 60% of the new homes built with RRNC in the U.S. are built in these Zone 1 areas. On average, for every 1,542 existing homes mitigated for elevated radon levels, one future life is saved annually. The asthma triggers measure is meaningful because a greater number of people taking essential actions to reduce exposure to asthma triggers is likely to lead to positive health outcomes such as reduced ER visits, reduced hospitalizations, reduced sick days, improved productivity, and other benefits. Published estimates in the scientific literature suggest that asthma-related ER visits are reduced by 13%-61% as a result of individuals with asthma taking measures to reduce exposures to triggers. The schools program measure is meaningful because schools implementing an effective (defined as a score of 70 or higher on EPA's index) Indoor Air Quality (IAQ) plan provide a large number of health benefits for students and staff, including reduced absenteeism and asthma attacks, and improved learning. The measure focuses on schools implementing those practices shown to be most effective in improving indoor air quality and reducing adverse health impacts.

Evidence: ?? 1. National Academy of Science, Committee on the Biological Effects of Ionizing Radiation (BEIR). Health Effects of Exposure to Radon. National Academy Press 1999. ?? 2005 PART measures (Agency has committed to including these measures in forthcoming GPRA documents, including the FY 2006 Performance and Accountability Report). ?? U.S. EPA Survey of Indoor Air Quality Practices in Schools, ICR No. 1885.02, 2003

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

Explanation: The baseline for the long term-radon goal is 1996. As a result of homes that had installed radon reducing features through 1996, EPA estimates that approximately 285 future cancer deaths were being prevented annually, out of an estimated 21,000 people who die each year from radon-related lung cancer (1). The 2012 radon goal is based on increasing the annual number of homes mitigated and built with radon resistant new construction. The 2012 goal calls for more than doubling (from current levels) of the number of active mitigations and the annual number of new homes built with radon resistant new construction. As a result, these goals are ambitious, but should be achievable with through work with new and existing partners. EPA's long-term goal for asthma requires an increase from an estimated baseline of 3 million asthmatics taking action to reduce exposure to environmental triggers in 2003, as measured by EPA's survey, to 6.5 million in 2012. This is ambitious because it will require EPA to reach new asthmatics and harder to reach asthmatics (e.g. low income) to achieve the target. Meeting EPA's long-term goal for the schools program will require that more urban and rural schools adopt effective indoor air quality management plans. The 2012 goal is ambitious, as these schools face more significant resource and facility challenges than many early adopters of the program. EPA's effort will increase the number of schools implementing indoor air quality management plans from 25,000 in 2002 (baseline) to over 40,000 in 2012. This would represent over one-third of all public and private elementary and secondary schools in the U.S.

Evidence: ?? According to the National Academy's Health Effects of Exposure to Radon report (BEIR IV), "Depending on which model is used, indoor radon contributes to 15,400 or 21,800 of the estimated 157,400 lung cancer deaths each year in the United States, the committee said. The majority of radon-related deaths are among smokers; perhaps 1,200 or 2,900 are among non-smokers." ?? 2005 PART measures (Agency has committed to including these measures in forthcoming GPRA documents, including the FY 2006 Performance and Accountability Report) ?? National Survey on Environmental Management of Asthma and Children's Exposure to ETS [NSEMA/CEE], ICR No. 1996.01

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: EPA has annual performance measures for each of its key program elements. For the radon program, EPA tracks and sets goals for annual increase in the number of homes with radon reducing features. This measures the program's progress toward the long term outcome goal by measuring both the number of active mitigation systems in existing homes, and the number of new homes built with radon resistant new construction (RRNC). Mitigations and RRNC have been clearly linked to reduced risk of radon-related lung cancer. For the asthma indoor triggers program, EPA will annually track the number of health care professionals directly educated by EPA and its partners, and the success of the national media campaign, as measured by the Ad Council in terms of public awareness. These annual measures clearly relate to long term health outcomes because health care professionals care for hundreds of thousands of patients with asthma, and public awareness is an indicator of the number of people in the general public who are hearing EPA's message on asthma triggers. Research has shown that education and awareness leads to more people with asthma taking essential actions to reduce their environmental triggers. For the schools program, EPA estimates the number of new schools that establish Indoor Air Quality (IAQ) Tools for Schools programs each year. This estimate is based on partner reports, reports from regional recruiters, and the volume of guidance kits requested. This measure clearly relates annual progress to the long-term goals of schools implementing effective IAQ plans.

Evidence: ?? 2005 PART measures (Agency has committed to including these measures in forthcoming GPRA documents, including the FY 2006 Performance and Accountability Report)

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

Explanation: The program has baselines and ambitious targets for each of its annual measures. For the radon program, EPA estimates that in 1997 an additional 107,000 additional homes had radon reducing features. The annual targets for radon are ambitious, as they involve annual increases that require EPA to implement a strategy to work with its partners, and identify new partners to implement programs which will increase rates of actions. The targets for the indoor asthma triggers program's healthcare measure are ambitious because reaching a unique group of at least 2,000 professionals each year requires changing the practices and behaviors of more and more difficult to reach providers each year. Maintaining a high level of ad awareness (above 20%) is ambitious as it requires consistently developing effective and innovative media messages. EPA's 2003-2004 ad awareness rate of 27% compares to a national average of 15% awareness for Ad Council public service campaigns (4). For the schools program, EPA used 2002 survey data to establish a baseline of 22% of schools (or 25,000 of 118,000 primary and secondary schools) that were implementing effective indoor air quality management plans (5). The annual goals for the schools program decrease over time to 1000 additional schools establishing IAQ Tools for Schools programs each year, but remain ambitious. As the program becomes more highly targeted toward urban and rural schools -- which face greater resource and infrastructure challenges -- recruitment will be more difficult.

Evidence: ?? 1. Builder Practices Report: Radon Reducing Features in New Construction 2003, Annual Builder and Consumer Practices Surveys, National Association of Home Builders Research Center, Inc., November 2004. ?? 2. National Radon Results: 1985 to 2003. EPA, www.epa.gov/radon/images/natl_radon_results_update.pdf ?? 3. National Survey on Environmental Management of Asthma and Children's Exposure to ETS [NSEMA/CEE], ICR No. 1996.01 ?? 4. Personal Communication with the Ad Council; March 2005 ?? 5. U.S. EPA Indoor Air Quality Practices in Schools Survey Contractor Report; July, 2003. (ICR Number 1885.02) ?? 2005 PART measures (Agency has committed to including these measures in forthcoming GPRA documents, including the FY 2006 Performance and Accountability Report)

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: EPA's contracts and statements of work include clear descriptions of outcomes and goals, as well as terms and conditions that require annual, quarterly, or monthly reporting of progress against those goals. Contractors are held accountable for costs, schedule, and performance results through the written terms of the contract, work assignments, and technical direction. The Program tracks contractor progress through required monthly status and cost reports for each project. At the end of each work assignment and contract year, an annual performance evaluation is completed. The performance evaluation addresses quality and quantity of the products, services, and outcomes in addition to cost control, and timeliness of performance. EPA discontinues funding to contractors who have not produced results toward Program goals or other performance criteria. EPA's partnerships, including cooperative agreements, grants, and interagency agreements, also complement and align with the Program's annual and long-term performance goals. Partner program managers ensure their organizations measure and report at least annually on their performance as it relates to accomplishing the Program's goals. As a means to ensure that the goals of non-profit partners are compatible with EPA's goals, the Program's 2003 Indoor Air Quality Request for Applications (RFA) cooperative agreement competition (1) and its 2004 Radon RFA (2) ranked proposals on the basis of whether goals and objectives clearly stated how the project activities would achieve and report outcome results. For example, the 2004 Radon RFA evaluations examined whether the projects would generate behavioral changes to increase radon testing, mitigation, and radon-resistant new construction. Proposals were also ranked on applicants' stated ability to generate and track the number of outcomes achieved by their work. In addition, the Program is fully incorporating EPA's new requirements for Assistance Agreements, which require that assistance agreements be linked to the Agency's Strategic Plan, appropriately address outputs and outcomes, and contribute to the Agency's programmatic goals and objectives (3).

Evidence: ?? 1. Indoor Air Quality: Communication, Education, and Outreach Programs Request for Applications; 2002 ?? 2. Radon: Communication, Education, Outreach, and Risk Reduction Projects - Request for Applications; 2004 ?? 3. EPA Order 5700.7, Environmental Results Under EPA Assistance Agreements; Jan. 1, 2005. ?? Sample partner reports

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: EPA has commissioned independent studies that have improved understanding of risks addressed by the program, and several evaluations from the Government Accounting Office (GAO) have provided important input to the Program, but reviews generally have not been conducted to evaluate effectiveness and fill gaps in performance information.

Evidence: ?? GAO Report. Indoor Air Quality: Federal and State Actions to Address the Indoor Air Quality Problems in Selected Buildings, (B-279615), 1998. ?? GAO Report. Indoor Pollution, Status of Federal Research Activities, 1999. ?? GAO Report. Air Pollution: Changes Needed in EPA's Program That Assesses Radon Measurement Firms; 1990 (GAO/RCED-90-209). ?? GAO Report. Air Pollution: Actions to Promote Radon Testing; 1992 (GAO/RCED-93-20).

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: Budget requests are not explicitly tied to accomplishment of performance goals. Budget and performance information presented in program and agency requests do not make clear the impact of funding decisions on expected performance. There is evidence that performance data is considered during the planning and budgeting process, so the program should be able to make adjustments that will improve budget and performance presentation.

Evidence: ?? EPA's FY 2006 Congressional Justification and Annual Performance Report ?? Indoor Environments Program Strategic Budget Guidance; 2004

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

Explanation: The Indoor Environments Program has taken several meaningful steps to fill strategic planning gaps, for example on environmental tobacco smoke, asthma and schools, as they have been identified. EPA has also sponsored and used the results of important health effects and health outcomes studies (1,2), as well as public action surveys (3,4), as the basis for establishing health outcome goals and estimating bottom-line health outcomes of the program.

Evidence: ?? The Program recently revised its strategy on the environmental tobacco smoke (ETS) component of its asthma program from a broad-based outreach strategy to a targeted campaign aimed at low-income and asthmatic children. This strategy adjustment reflected findings (3) that showed children with asthma had the same ETS exposure as children without asthma. In response, the Program worked with the Ad Council to create a radio announcement on ETS as an asthma trigger as part of the program's newest asthma media campaign. ?? Before 2002, the program did not have measured baselines for its asthma and school components. Based on expert judgment in the field, the program assumed that the initial baselines for asthma triggers and schools were close to zero for actions in these areas. However, the Program identified a need for more accurate baseline data to measure future progress towards its respiratory and related illness performance goals. In 2002-2003, the Program conducted two national surveys (3,4) to determine what actions are being taken on both asthma and schools, data from which was then used to establish the new baselines for both programs. This has also enabled the program to move from reporting long-term results as outputs or action outcomes to health based outcomes whenever possible (e.g. radon deaths and asthma ER visits avoided). ?? References: 1. NICAS reference; ?? 2. BEIR VI reference; ?? 3. National Survey on Environmental Management of Asthma and Children's Exposure to ETS [NSEMA/CEE], ICR No. 1996.0, 2004; ?? 4. U.S. EPA Survey of Indoor Air Quality Practices in Schools, ICR No. 1885.02, 2003.

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: Periodic national surveys are conducted in each of the major program areas to measure progress. For the radon program, EPA collects data annually on the number of new homes built with radon resistant construction and the number of homes mitigated and uses this information to track progress. EPA is using this information in its effort to identify and implement new opportunities to increase testing and mitigation of homes, and new construction with radon resistant features. EPA conducts broad national surveys on the environmental management of asthma and on indoor air quality management practices in schools every three years. The Program also collects monthly, quarterly or annual status reports from funded non-profit organizations to provide performance-oriented information on their programs such as the number of people trained, target audiences reached, and estimates of actions taken as a result of their efforts. The program holds quarterly meetings with its partners to gather input on how their program efforts are proceeding and to provide synergy of efforts and check program direction.

Evidence: Specific examples of how information has been used to improve program performance include: ?? The 2003 National Survey on Environmental Management of Asthma and Children's Exposure to environmental tobacco smoke (ETS) identified specific opportunities for EPA to refine its message. For example, the survey showed low awareness of cockroach allergen as an asthma trigger, and that few respondents were taking recommended actions to address that trigger. In response, the Program worked with the Ad Council to create a radio piece on cockroach allergen as part of its asthma media campaign. In addition, the survey demonstrated greater overall progress towards reducing exposure to ETS than predicted, but less success in reaching vulnerable subpopulations (children with asthma and low-income populations). In response, the Program adjusted its ETS strategy to better target these vulnerable populations. ?? The Indoor Air Quality (IAQ) Tools for Schools program receives regular feedback from it customers and partners. For example, the Program holds an "IAQ Tools for Schools Symposium" every year, and hosts nearly 600 members of the school community, including school superintendents, principals, facility managers, school nurses, teachers, custodians, parents, and others. As a result of this dialogue, the Program has made several significant changes to improve performance. The Program has expanded its outreach to a broader group of stakeholders which includes district-level administrators and business officials to prompt action district-wide. In addition, the Program identified the need to work with architects and school designers to address inherent design problems resulting in poor indoor air quality and has developed well-received, web-based guidance for the design of new schools, and the repair, renovation and maintenance of existing facilities.

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: EPA managers and staff with fiduciary responsibilities have performance standards which specifically hold them accountable for cost, schedule and performance results (1,2). For grantees, the Program's 2003 Indoor Air Quality Request for Applications (RFA) cooperative agreement competition (3) and its 2004 Radon RFA (4) shows evidence that potential partners are evaluated upon cost, schedule, and performance results. RFAs also tie subsequent funding levels to preliminary results. The State Radon Indoor Grant (SIRG) Program guidance shows that the program provides accountability standards for state grantees to be followed by grantee program managers (5). Further, EPA conducts Grantee Compliance Award reviews on ten percent of assistance agreements each year. EPA provides a report to the recipient documenting findings with recommendations for corrective actions. EPA then works with the grantee's managers to ensure the required corrective actions by the recipient are completed to the Agency's satisfaction. In addition to these reviews, the program continues to implement Agency requirements for post award-monitoring activities regularly for each agreement throughout its period of performance. Contractual statements of work and individual work assignments include cost schedules, specified deliverables and due dates, and clearly articulated outcomes (6). Contractors are held accountable for costs, schedule, and performance results through the written terms of the contracts, work assignments, and technical directives. The Program tracks contractor progress through required monthly status/cost reports for each project. EPA conducts an annual performance evaluation which addresses the quality of products and services, cost controls, timeliness of performance, and business relations. The Program also conducts on-site visits of contractor facilities to ensure that the facility is maintained and managed according to the terms and clauses written in the contract. The program also examines partners' performance as a precursor to annual funding decisions. The program, in some cases, has not renewed grants for poorly performing grantees. In addition, the program evaluates contractors' performance annually using technical and financial status reports. If the contractor's performance is not acceptable, project officers recommend to the contracting officer that option periods not be exercised.

Evidence: ?? 1. Indoor Environments Managers and Staff with Fiduciary Responsibilities Sample Performance Standards ?? 2. Indoor Environments Program Sample Performance Standards ?? 3. Indoor Air Quality: Communication, Education, and Outreach Programs Request for Assistance, 2002 ?? 4. Radon: Communication, Education, Outreach, and Risk Reduction Projects - Request for Applications; 2004, hardcopy provided, taken off website after closing date ?? 5. State and Tribal Indoor Radon Grants Program Guidance and Handbook; pp. 36-40; 2005. ?? 6. Sample Contract Work Assignments

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

Explanation: The Indoor Environments Program routinely obligates 98% to 100% of its financial resources each fiscal year. For example, in FY 2004, the end of year status of funds report reflected that the Division had committed and obligated 99% of its financial resources (1). That percentage was also confirmed in the Agency's end of fiscal year report, provided mid-October. Prior to the beginning of each fiscal year, the Program develops an operating plan that reflects how it plans to spend its budget allocation as requested in the President's Budget (2), and allocates resources by GPRA goal, objective, sub-objective, program element, and budget object class. The program then adjusts the operating plan to reflect appropriated levels of funding (3). EPA's budget and annual Operating Plan are aligned with the Agency's Strategic Plan and approved by OMB and Congressional Appropriations Committees. EPA tracks its obligations and expenditures in the Agency's Integrated Financial Management System (IFMS) against the Operating Plan allocations. EPA notifies Congress for approval of any funding transfers between program objectives in excess of Congressionally established limits. Partners with the State Indoor Radon Grant Program meet their financial responsibilities by filing required fiscal reports that addresses negotiated workplan activities and fiscal obligations. In addition, at a minimum, each grantee files an end of year progress report and a required Financial Status Report to the appropriate Finance Office. The financial status is checked routinely at the Regional Level through the Agency's Integrated Financial Management System (IFMS) to ensure that actual spending is aligned with program plans (4). In fact, the Agency recently identified delays in some State deliverables and corresponding unexpended balances in those State accounts and in response, redirected its FY2005 SIRG allocation to other States and Tribes who were on schedule with program deliverables and results.

Evidence: ?? 1. FY 2004 13th Month Status of Funds Report ?? 2. EPA's 2005 Annual Operating Plan and Congressional Justification ?? 3. IED's budget tracking spreadsheet ?? 4. The Agency's Integrated Financial Management System (IFMS) provides complete data on regional obligation and State expenditure of funds specific to individual grants awarded to State grantees.

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 established outcome-oriented efficiency measures for each of its main program elements. Baselines and targets have been established for each. These measures are used to determine whether positive health outcomes are being achieved more efficiently over time. Other procedures to achieve efficiencies include the selection of contractors and grantees through a competitive process based on both cost and performance criteria to maximize efficiency (see evidence for process details). The program also invests in information technology improvements, including online training and web-based support tools, to increase its efficiency in reaching its target audience (see evidence for specific examples). The Office of Radiation and Indoor Air is also participating in an Agency pilot of the Integrated Grants Management System (IGMS), which provides electronic submission of assistance agreement decision/funding packages through an automated system that will expedite the processing time for award actions.

Evidence: ?? ?? 2005 PART measures (Agency has committed to including this measure in forthcoming GPRA documents, including the FY 2006 Performance and Accountability Report) ?? The following text provides details of specific processes mentioned above: ?? The Program conducted its first multi-priority cooperative agreement Request for Applications (RFA) competition in 2002-03, through which most current cooperative agreement partners were selected (1). A second radon-specific competition was held in 2004 through early 2005 (2). EPA plans to hold a third indoor environments cooperative agreement competition later in 2005. One of the ranking factors deals directly with the cost per result gained. Organizations that demonstrated the highest results towards the program goals with the least cost were ranked high and selected to receive an award. This process has resulted in high quality, cost effective projects, which might not otherwise have been funded. ?? Contractors are selected through full and open competition. The contracts undergo a cost analysis that is considered in the negotiation process prior to award. Each potential contractor must also undergo an outside audit conducted by the Defense Contracting Audit Agency (DCAA) to determine the reasonableness of costs, particularly indirect costs submitted by the contractor. Any findings by the DCAA must be resolved prior to the award of a contract. The Program then relies on work assignments placed against these negotiated competitive contracts to carry out specific tasks. ?? The program offers a number of interactive online training programs, including recently established quarterly web conference trainings for its indoor triggers of asthma and schools programs. These efforts are designed to reduce travel and conference costs, and allow the program to reach a larger audience. The program also offers technical support tools over the web. For example, EPA offers web-based guidance for the design of new schools, and the repair, renovation and maintenance of existing facilities, including technical software to help schools choose ventilation systems that are cost effective and appropriate for their school. Finally, all program guidance is available on the internet.

Does the program collaborate and coordinate effectively with related programs?

Explanation: There is evidence that the Indoor Environments Program collaborates and coordinates effectively, through formal and informal mechanisms, with partners in other federal agencies, state agencies, foreign governments, private programs, and the academic research community. For example: EPA established and co-chairs the Interagency Committee for Indoor Air Quality (CIAQ), as directed by Congress (1). Other co-chairs include the Consumer Product Safety Commission, the Department of Energy, the National Institute for Occupational Safety and Health, and the Occupational Safety and Health Administration. The Committee meets quarterly to ensure that federal indoor air quality policies and programs are well coordinated, not duplicative, and lead to meaningful actions in management and resource allocation. For example, the Office of the Federal Environmental Executive (OFEE) and the Office of the Surgeon General are both members of the CIAQ. In 2003 and 2004, CIAQ coordination led to OFEE promoting radon action by Federal agencies, including a recommendation OFEE that Federal programs involving controlled or financed residential property test those properties for radon and fix high levels. In 2005, CIAQ coordination led to the Surgeon General issuing a National Radon Health Advisory urging all Americans to test their homes for radon and fix high levels. EPA and the Surgeon General are now collaborating to merge EPA's IAQ Tools for Schools program into the Surgeon General's schools visits during his Year of the Healthy Child initiative. EPA and the CPSC (two CIAQ Co-chairs) are currently collaborating on updating key indoor environments documents to the public. EPA sponsors the annual National Radon Meeting bringing together state, federal, non-profit, and private sector radon stakeholders (2) to share the latest research on radon and develop cooperative strategies to reduce radon risk. The 2004 meeting resulted in new State-wide and private sector initiatives to conduct more aggressive public education and outreach programs. EPA co-Chairs with HHS the Asthma Workgroup of the President's Task Force on Environmental Health and Safety Risks to Children (3). This group is responsible for developing and refining the federal childhood asthma strategy, bringing together researchers and practitioners within the federal government. In response to the Task Force's 2000 report, EPA was granted new funding to implement the strategy's goals of reducing childhood exposure to asthma triggers and eliminating the disproportionate impact of asthma on minorities and those living in poverty. EPA regularly coordinates with HHS and CDC to share information and collaborate on projects which has resulted in a more efficient use of resources. For example, EPA has worked with CDC to include a module of questions on IAQ and environmental conditions in CDC's 2006 School Health Policies and Programs Survey (SHPPS). SHPPS, conducted every six years, surveys schools about their broader health related policies and programs. Previously, air quality and other environmental conditions were not included in this effort, and CDC asked for EPA's assistance to incorporate these issues. As a result of this collaboration, EPA will not need to conduct its own survey in 2006 or 2012, thus saving hundreds of thousands of dollars. In addition, since SHPPS also surveys school districts and states, EPA will have access to information on policies at these levels, something it would not be able to do on its own.

Evidence: ?? 1. Title IV, Section 403(c) of the Superfund Amendments and Re-authorization Act (SARA) of 1986. ?? 2. Proceedings of the 14th National Radon Meeting, EPA 828391-01 ?? 3. Executive Order 13045, April 1997.

Does the program use strong financial management practices?

Explanation: The Indoor Environments Program establishes an annual operating plan for each fiscal year that ties in with our strategic goals and measures and is linked to the comprehensive EPA Operating Plan approved by OMB and Congress. In addition to routine, regular tracking and monthly review of expenditures (1), the Program conducts a thorough mid-year review to assess progress against the operating plan, reconcile deviations, and establish mid-course correction if needed (2). At the end of the fiscal year, the Program's financial performance is rolled into the Agency-wide financial statements. The Indoor Environments Program follows EPA's financial management guidance for committing, obligating, reprogramming, and reconciling appropriated funds. Managers and staff with fiduciary responsibility are required to take all required training and have the fiduciary responsibility written in their performance standards (3). The program ensures that all staff responsible for approving purchases, committing funds, and invoice review are properly trained and certified. EPA received an unqualified audit opinion on its FY 2004 and FY 2003 financial statements and had no material weaknesses associated with the audit (4).

Evidence:  1. FY 2004 Allocation and Year End Status of Funds Report  2. FY 2005 Indoor Environments Mid-Year Review and Resource Status  3. Example performance standards for IED senior managers.  4. www.epa.gov/OIG/reports/financial.htm. ""Audit of EPA's Fiscal Year 2004 and 2003 Financial Statements, Audit Report 2005-1-00021"" November 15, 2004.

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

Explanation: Through the annual Federal Management and Financial Integrity Act (FMFIA) process, the program is required to review its program implementation practices for any material weaknesses. No material weaknesses have been identified for the Indoor Environments Program under the FMFIA. In addition to FMFIA, the program annually reviews practices and processes to identify program areas, management practices, and or policies that would benefit from an IG audit or evaluation (no indoor environments programs have been identified to date). The program also performs two formal program briefings annually to the office director that include discussion of management practices and policies. As a result of this process, the program has identified and corrected a number of lesser management issues over the past several years to successfully implement Agency policies and guidance on various program management issues.

Evidence: Examples of actions taken based on review of current management policies and practices: ?? During interviews with OAR's project officers, management identified the need for a single point of contact for grants advice within organization/program areas, so the program established an internal Grants Coordinator position. This individual has oversight responsibility for all aspects of our assistance administration, including quality control, oversight of the evaluative site visit process and ensuring grants close-outs occur in a timely manner. ?? The program has adopted recommendations from the Office of Inspector General (OIG) and the Government Accountability Office (GAO). For example, an on-site grant review identified irregularities with one of ORIA's recipients in both their organization structure and accounting practices. The Agency suspended work under the cooperative agreement until the recipient could provide a corrective action plan for approval. The IG later confirmed these irregularities, and as a result of this action, ORIA developed a "lessons learned" document from the OIG and OGD findings and used it as an instructional tool at subsequent quarterly IED Project Officers Meetings. The "lessons learned" document highlights how these issues should be appropriately addressed and managed in both current and future assistance agreements.

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

Explanation: Funding is dependent on EPA's evaluation of recipients' alignment with the State and Tribal Indoor Radon Grant (SIRG) program priority areas and is weighted toward the States and Tribes with the highest radon risks (1). EPA negotiates program proposals with States and Tribes which provide detailed outlines of work plans, schedules, and costs as well as program objectives and goals. EPA tracks progress against these work plans and program goals through active relationships with State and Tribal programs and a system of informal and formal mechanisms. In addition to frequent phone and e-mail exchange, EPA project officers hold frequent face-to-face meetings with State programs individually and collectively. Advanced Monitoring is conducted on a minimum of 10 percent of active SIRG grantees. Active grantees include only those whose projects are open but not expired. All on-site evaluations include transaction testing for unallowable costs, checking files as necessary, viewing match documentation, and other activities not routinely evaluated. EPA also formally tracks progress through quarterly and annual reports that provide measurable results and indications of success. In addition, baseline monitoring by the programs is conducted on an ongoing basis throughout the lifetime of each award, assessing whether terms and conditions have been satisfied, progress reports are received and acceptable, needed Quality Assurance requirements have been met, and that work progresses. EPA also reviews State and Tribal expenditures through the Agency's Integrated Financial Management System (IFMS) to ensure that actual spending is aligned with program plans. In fact, the Agency recently identified delays in some State deliverables and corresponding unexpended balances in those State accounts and in response, redirected its FY2005 SIRG allocation to other States and Tribes who were on schedule with program deliverables and results (2).

Evidence: ?? 1. State and Tribal Indoor Radon Grants - Draft Program Guidance; August, 2004. ?? 2. FY 2005 Revised State Indoor Radon Grant Allocation to Regions; Dec. 2004.

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: Overall national radon results are available on EPA's website (1), but because the program only provides aggregated information to the public, it receives a No for this question. The program collects a range of grantee activity and performance information from States and Tribes participating in the State and Tribal Indoor Radon Grants (SIRG) program. Information on State and Tribal SIRG related activities are available on EPA's website and from The Conference of Radiation Control Program Directors' (CRPCD) website (2,3). EPA requires quarterly and annual performance reports from the States and Tribes on program expenditures and progress against program goals (4), and these reports are available from each Regional Office for review by the public.

Evidence: ?? 1. National Radon Results: 1985 to 2003. EPA, www.epa.gov/radon/images/natl_radon_results_update.pdf ?? 2. EPA State and Regional Contact Information website, www.epa.gov/iaq/whereyoulive.html ?? 3. Conference of Radiation Control Program Directors website, www.crcpd.org/Radon.asp ?? 4. State radon program work plans, quarterly and annual reports submitted to EPA regional offices

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

Explanation: The program has made significant progress to date, and appears to be on track to exceed its 2008 strategic plan targets and achieve its 2012 long-term goal for each of its program components. ?? Progress toward radon goal: Through 1996, an estimated 880,000 homes had radon-reducing features. These accomplishments led to an estimated 285 future premature cancer deaths prevented annually. Through 2003, an estimated 1.7 million homes had radon-reducing features (515,000 active mitigations and 1.2 million homes with radon resistant new construction), preventing an estimated 470 future premature cancer deaths annually. In 2004, the number of active mitigations increased to over 575,000. EPA will receive 2004 radon resistant new construction data from the National Home Builders Association Research Center in late 2005. However, the mitigation component contributes over 70% of the future cancer cases prevented by the program, so the mitigation data alone shows progress toward this goal continues (1,2). ?? Progress toward Asthma goal: This is a new measure and data to compare against the baseline will be available in 2006. However, when EPA began the indoor environmental triggers of asthma program in 2000, experts in the field believed that there was little action being taken by people with asthma to reduce exposure to their triggers of asthma (3,4). Results of the EPA 2003 National Survey on Environmental Management of Asthma and Children's Exposure to Environmental Tobacco Smoke (5) indicate that approximately 3 million people with asthma have taken the essential actions recommended by EPA to reduce exposure to indoor triggers. This includes approximately 1.7 million caregivers of children with asthma and 200,000 low-income adults with asthma. These numbers indicate strong progress since 2000, and EPA is confident that its national public service campaigns and its targeted work with the health care industry and people with asthma have had a significant impact. In addition, in 2003 and 2004, program partners achieved their outcome targets, training over 4,500 health care professionals, who collectively care for hundreds of thousands of patients who have asthma. EPA also had a high level of success (over 20% public awareness) with its national media campaign during this period. These successes indicate continued progress towards EPA's long term goal. ?? Progress toward Schools goal: This is also a new measure, and data to compare against the baseline will be available in 2006. However, data from EPA's annual measure indicate that EPA met its targets for 2003 and 2004, and has made continued progress towards the long term goal since the 2002 survey, and the 2002 baseline that will be used for this measure represents significant progress since the program began in the mid 1990's, when the program estimates that fewer than 11% of schools were implementing an effective plan.

Evidence: ?? 1. "Builder Practices Report: Radon Reducing Features in New Construction 2002, Annual Builder and Consumer Practices Surveys," NAHB Research Center, Inc., December 29, 2003. Similar report titles exist for prior years. ?? 2. National Radon Results: 1985 to 2003. EPA, www.epa.gov/radon/images/natl_radon_results_update.pdf ?? 3. For example, the 1998 CDC National Health Indicators Survey indicated that only 8% of people with asthma had been educated on their triggers. ?? 4. In 1999, EPA was recommended by the President's Task Force on Children's Environmental Health Risk to play a greater role in federal asthma efforts, especially as they related to indoor triggers. ?? 5. National Survey on Environmental Management of Asthma and Children's Exposure to ETS [NSEMA/CEE], ICR No. 1996.01 ?? 6. U.S. EPA Indoor Air Quality Practices in Schools Survey Contractor Report; July, 2003. (ICR Number 1885.02) ?? 7. Example regional/ partner reports for IAQ TfS

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

Explanation: The program regularly achieves its annual performance goals. For the Radon program, EPA surpassed its 2003 goal for radon mitigations (sum of active radon mitigations and the number of new homes built with radon resistant construction). For 2004, EPA set a goal of 162,000 additional homes with radon reducing features. EPA has 2004 data for the number of active mitigations, and met its target for mitigations. Data for the new home construction component will be available in late 2005. For the Indoor Environmental Triggers of Asthma program component, EPA met its goals in 2003 and 2004 for high ad awareness (over 20%), and to educate 2,000 health care professionals each year. For the Schools program, EPA met its annual goals in 2003 and 2004 for schools implementing IAQ Tools for Schools (4).

Evidence: ?? 1. "Builder Practices Report: Radon Reducing Features in New Construction 2002, Annual Builder and Consumer Practices Surveys," by the NAHB Research Center, Inc., December 29, 2003. Similar report titles exist for prior years. ?? 2. National Radon Results: 1985 to 2003. EPA, www.epa.gov/radon/images/natl_radon_results_update.pdf ?? 3. National Survey on Environmental Management of Asthma and Children's Exposure to ETS [NSEMA/CEE], ICR No. 1996.01 ?? 4. Each year, EPA reviews partner/grantee reports, consults with the Indoor Environments Partners Network, tracks Headquarters outreach activities, and reviews EPA Regional annual results reports to track progress. Sample Cooperative Agreement Recipients' progress reports and sample EPA Regional annual progress reports are provided.

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

Explanation: Though data on the program's efficiency measures will not be available until FY 2006, the program has developed several analyses to assess various aspects of the program's efficiency and cost-effectiveness. Examples of such data and analyses are presented below and suggest that the program is efficient and cost-effective. ?? EPA has completed a full cost benefit analysis of the radon program, considering both program and private costs (1). This analysis demonstrates improved cost effectiveness over time in terms of the cost per life saved. Estimated cost per future life saved was approximately $515,000 in 2002, and $495,000 in 2003. (EPA has received data only on mitigations for 2004, but estimates that the cost per future life saved will be approximately $475,000.) ?? For the indoor environmental triggers of asthma program, the EPA program cost per person with asthma per year taking all essential actions to reduce exposure to indoor environmental asthma triggers is declining over time. EPA estimates that the cost per person per year was $25.10 in 2004, will be less than $17.00 in 2005, and will be approximately $12.70 in 2006. ?? The EPA program cost per person in schools with effective air quality management plans per year is declining over time (cost per person is based on as average of 525 per school, as calculated by the National Center for Education Studies). For example, the cost per person per year was $6.00 in 2003, and less that $3.50 in 2004 (accounting for results and costs after 2003.) In addition, the IAQ Tools for Schools (TfS) program has evidence that schools typically see long-term cost savings from the implementation of indoor air quality management plans, as implementing an IAQ plan will help identify problems early, avoiding future costly repairs (2).

Evidence: ?? 1. Update to Indoor Radon Cost-Benefit Analyses; 2003 ?? 2. Indoor Air Quality Tools for Schools Program: Benefits of Improving Air Quality in School Environment, p 3,4 ?? 3. Ad Council Reports of Asthma Public Service Advertising Campaign

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

Explanation: EPA has not extensively compared its program to other public or private efforts with similar goals. Nevertheless, some indirect performance comparisons can be made: ?? EPA has estimated a benefits to cost ratio for the radon program of 7.6. to 1. This compares favorably to other federal environmental, health, and safety programs (1,2,3). ?? While no other domestic national radon program exists, evidence suggests the EPA compares favorably with its international counterparts. In the United Kingdom, one of the other leading national radon programs in the world, an estimated 450,000 of 25 million homes have been tested (4), approximately 2% of the nation's homes, compared to 20% of 100 million U.S. homes (5). Few international programs collect mitigation or radon resistant new construction data, making further direct comparisons extremely difficult and costly. ?? The Ad Council works with many agencies and organizations to develop public education campaigns used to promote beneficial behaviors changes such as blood donation, forest fire prevention, child car seat use, flu shots, etc. Although the campaigns address a diverse array of issues, they are all based on social marketing principles. The asthma media campaign developed through the Ad Council has an awareness rating of 27% compared to an Ad Council average of 15%. Of the Ad Council's 40 active media campaigns, the asthma campaign consistently ranks in the top ten for total broadcast time for both the English and Spanish versions.

Evidence: ?? 1. U.S. EPA National Radon Program. Briefing to Charlie Johnson, EPA Chief Financial Officer, November 2004. ?? 2. Draft 2003 Report to Congress on the Costs and Benefits of Federal Regulations. Office of Management and Budget, Federal Register, Vol. 68, No. 22. ?? 3. Van Houtven, G. and M.L. Cropper. When is a Life Too Costly to Save? The Evidence from U.S. Environmental Regulations. Journal of Environmental Economics and Management. Vol. 30, 1996, 348-368. ?? 4. Radon Questions in Parliament. Environmental Radon Newsletter, Issue 39. U.K. National Radiological Protection Board, Summer 2004. ?? 5. National Radon Results: 1985 to 2003. EPA, www.epa.gov/radon/images/natl_radon_results_update.pdf

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

Explanation: Though none of the evaluations assessed in section 2.6 are of sufficient scope to provide strong evidence that the program is achieving results, some of these evaluations have assessed program effectiveness. A National Academy of Science (NAS) panel confirmed in 2000 that a triggers-based approach was appropriate for asthma management, and helped focus the program on highest risk triggers. Several GAO reports throughout the history of EPA's radon program have supported EPA's overall strategic approach, and made recommendations for improving program performance.

Evidence: See section 2.6 evidence