more than an 85 percent increase over the last eight years (OMB, 2004, 2008a).

As Figure 1-4 shows, the vast majority of the department’s budget is designated for mandatory spending under entitlement and other service, training, and research programs. Only about 10 percent of the budget each year is discretionary (the largest share of which supports NIH).

Structure is a central contributor to the overall performance of any organization. It affects the movement of information up and down the chain of command, the level of cooperation between divisions, the development and implementation of policy, and workforce morale (Appendix G).

Over the years, organizational management literature has suggested many approaches to structuring large private-sector entities, and current analysis tends toward the view that “there is no single best way to organize” (Bradach, 1996). In the federal government context, numerous reorganization efforts have been attempted, but many have not achieved substantial or long-lasting change (Radin, 2000).

FIGURE 1-4 HHS mandatory and discretionary budget allocations, 2007.

SOURCE: HHS (2008).