The design, construction, operation, and retrofit of buildings is evolving in response to ever-increasing knowledge about the impact of indoor environments on people and the impact of buildings on the environment. Research has shown that the quality of indoor environments can affect the health, safety, and productivity of the people who occupy them. Buildings are also resource intensive, accounting for 40 percent of primary energy use in the United States, 12 percent of water consumption, and 60 percent of all non-industrial waste. The processes for producing electricity at power plants and delivering it for use in buildings account for 40 percent of U.S. greenhouse gas emissions. The U.S. federal government manages approximately 429,000 buildings of many types with a total square footage of 3.34 billion worldwide, of which about 80 percent is owned space. More than 30 individual departments and agencies are responsible for managing these buildings. The characteristics of each agency's portfolio of facilities are determined by its mission and its programs. In 2010, GSA's Office of Federal High-Performance Green Buildings asked the National Academies to appoint an ad hoc committee of experts to conduct a public workshop and prepare a report that identified strategies and approaches for achieving a range of objectives associated with high-performance green federal buildings. Achieving High-Performance Federal Facilities identifies examples of important initiatives taking place and available resources. The report explores how these examples could be used to help make sustainability the preferred choice at all levels of decision making. Achieving High-Performance Federal Facilities can serve as a valuable guide federal agencies with differing missions, types of facilities, and operating procedures.

The deteriorating condition of federal facilities poses economic, safety, operational, and environmental risks to the federal government, to the achievement of the missions of federal agencies, and to the achievement of public policy goals. Primary factors underlying this deterioration are the age of federal facilities-about half are at least 50 years old-and decades of inadequate investment for their maintenance and repair. These issues are not new and there are no quick fixes. However, the current operating environment provides both the impetus and the opportunity to place investments in federal facilities' maintenance and repair on a new, more sustainable course for the 21st Century. Despite the magnitude of investments, funding for the maintenance and repair of federal facilities has been inadequate for many years, and myriad projects have been deferred. Predicting Outcomes of Investments in Maintenance and Repair of Federal Facilities identifies processes and practices for transforming the current portfolio of federal facilities into one that is more economically, physically, and environmentally sustainable. This report addresses ways to predict or quantify the outcomes that can be expected from a given level of maintenance and repair investments in federal facilities or facilities' systems, and what strategies, measures, and data should be in place to determine the actual outcomes of facilities maintenance and repair investments.

Facilities now owned by the Federal Government are valued at over $300 billion. It also spends over $25 billion per year for acquisition, renovation, and upkeep. Despite the size of these sums, there is a growing litany of problems with federal facilities that continues to put a drain on the federal budget and compromise the effectiveness of federal services. To examine ways to address these problems, the sponsoring agencies of the Federal Facilities Council (FFC) asked the National Research Council (NRC) to develop guidelines for making improved decisions about investment in and renewal, maintenance, and replacement of federal facilities. This report provides the result of that assessment. It presents a review of both public and private practices used to support such decision making and identifies appropriate objectives, practices, and performance measures. The report presents a series of recommendations designed to assist federal agencies and departments improve management of and investment decision making for their facilities.

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.