A letter report issued by the Government Accountability Office with an abstract that begins "Military medical personnel, who are essential to maintaining one of the largest and most complex health systems in the nation, are in great demand due to the need to treat injured or ill servicemembers, and advances in technology that require specialized personnel. To determine how well the Department of Defense (DOD) and the services are developing their medical and dental personnel requirements, GAO evaluated (1) the extent to which the services have incorporated cross-service collaboration in their medical personnel requirement processes, and (2) the service-specific processes for determining their requirements for military and civilian medical personnel. To conduct this review, GAO evaluated manpower policies, analyzed the services' requirements data and determination processes, and interviewed officials from the Office of the Secretary of Defense (OSD) and each of the services."

A letter report issued by the Government Accountability Office with an abstract that begins "Numerous occurrences in the United States--both scheduled events and emergencies--require the Department of Defense (DOD) to coordinate, integrate, and synchronize its homeland defense and civil support missions with a broad range of U.S. federal agencies. In response to congressional inquiry, GAO examined the extent to which DOD has (1) identified clearly defined roles and responsibilities for DOD entities to facilitate interagency coordination for homeland defense and civil support missions, (2) articulated to its federal partners the DOD entities' approach toward interagency coordination, and (3) adopted key practices for managing homeland defense and civil support liaisons. GAO reviewed numerous DOD policy and guidance documents and interviewed officials from DOD and its partner agencies, including the departments of Homeland Security, Justice, Health and Human Services, and Agriculture; and the Office of the Director of National Intelligence."

Correspondence issued by the Government Accountability Office with an abstract that begins "On July 21, 2010, we testified to Congress on the Department of Homeland Security's (DHS) progress and challenges in key areas of port security. Members of the committee requested that we provide additional comments to a number of post hearing questions. The responses are based on work associated with previously issued GAO products and also include selected updates--conducted in September 2010--to the information provided in these products."

A letter report issued by the Government Accountability Office with an abstract that begins "The nation's 4-year not-for-profit colleges and universities collectively held more than $400 billion in endowments in 2008. Some institutions' large endowments coupled with the high and growing cost of college have led to questions about institutions' use of endowments. This mandated report describes (1) the size and change in value of endowments over the last 20 years, (2) the extent and manner to which endowment funds are restricted for financial aid and other purposes, and (3) institutions' distribution of endowment assets. GAO obtained and analyzed data on college and university endowments from the Department of Education and other sources. Because industry-wide data were not available on endowment restrictions and distributions, GAO selected 10 colleges and universities for case studies. The case-study institutions were selected to include a mix of public, private, large, small, and minority-serving institutions. Information from these schools cannot be generalized to all U.S. colleges and universities."

A letter report issued by the Government Accountability Office with an abstract that begins "Rail transit offers society a number of benefits, including reduced congestion and pollution and increased mobility. However, rail systems and cars are costly: Transit agencies can pay more than $3 million per car, often using federal funds. As requested, this report describes (1) characteristics of the U.S. market for transit rail cars, (2) the federal government's role in funding and setting standards for transit rail cars, and (3) challenges transit agencies face when procuring rail cars. GAO analyzed U.S. and worldwide rail car market data for commuter, heavy, and light rail systems and interviewed Department of Transportation (DOT) officials and domestic and international industry stakeholders, including the American Public Transportation Association (APTA)."

Correspondence issued by the Government Accountability Office with an abstract that begins "Substance use disorders (SUD), such as alcohol abuse and drug addiction, are serious health conditions that affect many Americans, including a substantial number of veterans. According to the Department of Veterans Affairs (VA), about 420,000 of the over 5 million veterans receiving health care from VA had SUD diagnoses in fiscal year 2009. Both older veterans and veterans of the current military operations in Iraq and Afghanistan are at risk for SUDs, as veterans may use drugs or alcohol to help cope with the effects of stressful events experienced during deployment or with difficulties they encounter in readjusting from wartime military service to civilian life. The identification and treatment of veterans with SUDs is important, as SUDs can have harmful effects on veterans' physical, psychological, and social well-being if left untreated. VA provides SUD services in a range of settings, including inpatient SUD programs that provide acute in-hospital care, which may include detoxification services; residential rehabilitation treatment programs, which provide intensive treatment and rehabilitation services with supported housing; intensive outpatient programs, which provide at least 3 hours of treatment services 3 days per week; and standard outpatient programs, …

A letter report issued by the Government Accountability Office with an abstract that begins "The Term Asset-Backed Securities Loan Facility (TALF) was created by the Board of Governors of the Federal Reserve System (Federal Reserve) to help meet consumer and small business credit needs by supporting issuance of asset-backed securities (ABS) and commercial mortgage-backed securities (CMBS). This report assesses (1) the risks TALF-eligible assets pose to the Troubled Asset Relief Program (TARP), (2) Department of the Treasury's (Treasury) role in decision making for TALF, and (3) the condition of securitization markets before and after TALF. GAO reviewed program documents, analyzed data from prospectuses and other sources, and interviewed relevant agency officials and TALF participants."

A letter report issued by the Government Accountability Office with an abstract that begins "Federal and tribal lands on the U.S. borders with Canada and Mexico are vulnerable to illegal cross-border activity. The Department of Homeland Security (DHS)--through its U.S. Customs and Border Protection's Office of Border Patrol (Border Patrol)--is responsible for securing these lands, while the Departments of the Interior (DOI) and Agriculture (USDA) manage natural resources and protect the public. GAO was asked to examine the extent that (1) border security threats have changed on federal lands; (2) federal agencies operating on these lands have shared threat information and communications; and (3) federal agencies have coordinated budgets, resources, and strategies. GAO reviewed interagency agreements and threat assessments; analyzed enforcement data from 2007 through 2009; and interviewed officials at headquarters and two Border Patrol sectors selected due to high volume of illegal cross-border activity (Tucson) and limited ability to detect this activity (Spokane). GAO's observations cannot be generalized to all sectors but provide insights. This is a public version of a sensitive report that GAO issued in October 2010. Information that DHS deemed sensitive has been redacted."

A letter report issued by the Government Accountability Office with an abstract that begins "The Departments of Defense (DOD) and State and the U.S. Agency for International Development (USAID) have relied extensively on contracts, grants, and cooperative agreements for a wide range of services in Afghanistan and Iraq. However, as GAO previously reported, the agencies have faced challenges in obtaining sufficient information to manage these contracts and assistance instruments. As part of our third review under the National Defense Authorization Act for Fiscal Year (FY) 2008, as amended, GAO assessed the implementation of the Synchronized Predeployment and Operational Tracker (SPOT) and data reported by the three agencies for Afghanistan and Iraq for FY 2009 and the first half of FY 2010 on the (1) number of contractor and assistance personnel, including those providing security; (2) number of personnel killed or wounded; and (3) number and value of contracts and assistance instruments and extent of competition for new awards. GAO compared agency data to other available sources to assess reliability."

A letter report issued by the Government Accountability Office with an abstract that begins "The Honest Leadership and Open Government Act of 2007 amended the Lobbying Disclosure Act of 1995 (LDA). This is GAO's third report in response to the LDA's requirement for GAO to annually (1) determine the extent to which lobbyists can demonstrate compliance with the LDA by providing support for information on their registrations and reports, (2) identify challenges and potential improvements to compliance for registered lobbyists, and (3) describe the efforts the U.S. Attorney's Office for the District of Columbia (the Office) has made to improve its enforcement of the LDA. GAO reviewed a random sample of 134 lobbying disclosure reports filed from the fourth quarter of calendar year 2008 through the third quarter of calendar year 2009. GAO also selected two random samples of federal political campaign contributions reports from year-end 2008 through midyear 2009. GAO sampled 100 reports listing contributions and 100 reports listing no contributions. This methodology allowed GAO to generalize to the population of 53,756 disclosure reports, 10,928 contributions reports, and 22,572 reports with no contributions. GAO also met with officials from the Office regarding efforts to focus resources on lobbyists who …

A letter report issued by the Government Accountability Office with an abstract that begins "In July 2008, the Department of State (State) began issuing passport cards as a lower-cost alternative to passports for U.S. citizens to meet Western Hemisphere Travel Initiative requirements. In October 2008, State began issuing the second generation border crossing card (BCC) based on the architecture of the passport card. GAO was asked to examine the effectiveness of the physical and electronic security features of the passport card and second generation BCC. This report addresses: (1) How effectively State's development process--including testing and evaluation--for the passport card and second generation BCC mitigates the risk of fraudulent use? (2) How are U.S. Customs and Border Protection (CBP) officers using the cards' security features to prevent fraudulent use at land ports of entry? To conduct this work, GAO evaluated the security features of passport cards and second generation BCCs against international standards and guidance and results from testing and evaluation and observed the inspection of these cards at five land ports of entry (POE)."

A letter report issued by the Government Accountability Office with an abstract that begins "Telemedicine offers a way to improve health care access for patients in rural areas. The Federal Communications Commission's (FCC) Rural Health Care Program, established in 1997, provides discounts on rural health care providers' telecommunications and information services (primary program) and funds broadband infrastructure and services (pilot program). GAO was asked to review (1) how FCC has managed the primary program to meet the needs of rural health care providers, and how well the program has addressed those needs; (2) how FCC's design and implementation of the pilot program affected participants; and (3) FCC's performance goals and measures for both the primary program and the pilot program, and how these goals compare with the key characteristics of successful performance goals and measures. GAO reviewed program documents and data, interviewed program staff and relevant stakeholders, and surveyed all 61 pilot program participants with recent participation in the program."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Food, Conservation, and Energy Act of 2008 authorized appropriations of $10 million annually for the Housing Assistance Council (HAC) from fiscal years 2009 through 2011. Established in 1971, HAC is a nonprofit rural housing organization that aims to improve housing conditions for low-income rural residents, especially in high-need areas such as Indian country and Appalachia and among groups such as farmworkers. As part of its mission, HAC also offers technical assistance in developing affordable rural housing and capacity building to a variety of groups involved in rural housing. HAC signs agreements each year with the Department of Housing and Urban Development (HUD) detailing how it will use its appropriations. The 2008 act required GAO to report on HAC's use of appropriated funds over the last 7 years, from 2003 to 2009--a period when HAC received more than $20 million in appropriations. To respond to this mandate, our work had four objectives: to (1) describe HAC programs and activities, (2) identify the sources of HAC's funding and its use of the funds it receives, (3) discuss the results of HAC's programs and activities, and (4) determine what is …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) is the federal government's largest purchaser of contractor-provided services and relies on contractors to support its varied missions. DOD's contractors provide a range of services, such as consulting and administrative support, information technology services, and weapon system and base operations support. However, DOD contract management has been on our high-risk list since 1992, and our recent work continues to identify weaknesses in DOD's management and oversight of services contracts. In particular, we have reported on the need for reliable data on how service acquisition dollars are spent to make informed contract management decisions and achieve positive acquisition outcomes. Congress has enacted legislation in recent years to increase the availability of information on services acquisitions to improve DOD's ability to manage these purchases. As part of those efforts, the National Defense Authorization Act for Fiscal Year 2008 amended 10 U.S.C. 2330a to require DOD to submit an annual inventory of the activities performed pursuant to contracts for services for or on behalf of DOD during the preceding fiscal year. These inventories are to contain a number of different elements for the service contracts listed, …

A letter report issued by the Government Accountability Office with an abstract that begins "This is GAO's eighth annual assessment of selected Department of Defense (DOD) weapon programs. The report examines how well DOD is planning and executing its weapon acquisition programs, an area that has been on GAO's high-risk list since 1990. This year's report is in response to the mandate in the joint explanatory statement to the DOD Appropriations Act, 2009. The report includes (1) observations on DOD's efforts to manage its portfolio of major defense acquisition programs; (2) an assessment of the knowledge attained by key junctures in the acquisition process for a subset of 42 weapon programs from the 2009 portfolio; (3) data on other factors that can affect program execution; and (4) examples of how DOD is implementing recent acquisition reforms. To conduct the assessment, GAO analyzed data on the composition of DOD's portfolio of major defense acquisition programs. GAO did not analyze the cost and schedule performance of the portfolio because DOD did not issue timely or complete Selected Acquisition Reports for the second consecutive presidential transition. GAO expects to resume its portfolio analysis in next year's assessment. GAO also collected data from program …

Correspondence issued by the Government Accountability Office with an abstract that begins "Nonprofit organizations, such as the Association of Community Organizations for Reform Now (ACORN), play an important role in providing a wide range of public services. To provide these services, these organizations rely on funding through federal grants and contracts, among other sources. Just as it is important for federal agencies to be held accountable for the efficient and effective use of taxpayer dollars, it is also important for these nonprofit organizations to be held accountable for their use of federal funds. ACORN was established in 1970 as a grassroots organization to advocate for low-income families. By 2009, ACORN reportedly had 500,000 members and had expanded into a national network of organizations involved in the development of affordable housing, foreclosure counseling, voter registration, and political mobilization, among other things. ACORN organizations relied on membership dues and on federal and private foundation funding to support various activities. Voter registration fraud allegations in a number of states and widely distributed videotapes depicting what appeared to be inappropriate behavior by employees of several local ACORN chapters spurred calls to identify federal funding provided to ACORN and ACORN-related organizations and for legislation to …

A letter report issued by the Government Accountability Office with an abstract that begins "Postsecondary education plays an important role in producing a skilled workforce able to compete in the global economy. Some stakeholders have suggested that collecting information on graduates' employment outcomes--whether they are employed in their field of study, for example--will provide better information to help assess the impact of a postsecondary education. The Higher Education Opportunity Act directed GAO to study the information that states have on the employment outcomes of postsecondary graduates. This report describes (1) the extent and purposes for which states collect employment-related information and the challenges they faced in doing so, (2) potential approaches to expanding states' collection efforts across states and nationwide, and (3) how selected states and schools collaborate with employers to align education and workforce needs. To address these objectives, GAO reviewed relevant research and interviewed officials from the U.S. Departments of Education (Education) and Labor, as well as postsecondary institutions, state agencies, and employers in seven states and two countries selected based on their data collection capabilities."

A letter report issued by the Government Accountability Office with an abstract that begins "A growing number of older Americans are choosing continuing care retirement communities (CCRC) to help ensure that their finances in retirement will cover the cost of housing and care they may require. However, recent economic conditions have placed financial stress on some CCRCs. GAO was asked to (1) describe how CCRCs operate and the risks they face, (2) describe how state laws address these risks, (3) describe risks that CCRC residents face, and (4) describe how state laws address these risks. To review these areas, GAO analyzed state statutory provisions pertaining to CCRCs with respect to financial oversight and consumer protection, met with selected state regulators, and interviewed CCRC providers, resident's associations, and consumer groups. While GAO is not recommending specific action at this time, the potential risks to CCRC residents--as well as the potential for this industry to grow--highlight the importance of states being vigilant in their efforts to help ensure adequate consumer protections for residents. GAO provided a draft copy of this report to the Department of Health and Human Services and the National Association of Insurance Commissioners for review, but neither commented on …

Correspondence issued by the Government Accountability Office with an abstract that begins "Terrorist attacks on mass transit and commuter rail facilities in Moscow, Madrid, London, and Mumbai, and the significant loss of life and disruption they caused, have highlighted the vulnerability of transportation facilities to terrorism and the need for greater focus on securing these facilities, including intermodal transportation terminals. Such intermodal transportation terminals--locations where multiple modes or types of passengers or cargo transportation connect an merge--are potentially high value targets for terrorists because the large number of passengers or volume of cargo can lead to significant loss of human life and economic disruption. For example, New York City's Pennsylvania ("Penn") Station, the nation's busiest rail station, functions as an intermodal hub for Amtrak, two ma commuter rail lines (New Jersey Transit and the Long Island Rail Road), as well as six city subway routes. According to Amtrak, an average of 500,000 passengers the station daily. The Department of Homeland Security (DHS) has primary responsibility for homeland security, including transportation security, under the Homeland Security Act. Within DHS, the Transportation Security Administration (TSA) has primary responsibility for securing the aviation and surface transportation sectors. The Department of Transportation (DOT) supports …

A letter report issued by the Government Accountability Office with an abstract that begins "The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed the Department of Health and Human Services (HHS) to enter into a 4-year contract with an entity to perform five duties related to health care quality measurement and authorized $40 million from the Medicare Trust Funds for the contract. In January 2009, HHS awarded a contract to the National Quality Forum (NQF), under which HHS will reimburse NQF for its costs and pay additional fixed fees. Established in 1999, NQF is a nonprofit member organization that fosters agreement on national standards for measuring and public reporting of health care performance data. This is the first of two reports MIPPA requires GAO to submit on NQF's contract with HHS. In this report, which covers the first contract year--January 14, 2009, to January 13, 2010--GAO describes (1) the status of NQF's work on the five duties under MIPPA; (2) the costs and fixed fees NQF has reported; and (3) what NQF and HHS do in order to help ensure that NQF's reported costs are proper. GAO reviewed relevant MIPPA provisions and reviewed HHS and NQF documents, …

A letter report issued by the Government Accountability Office with an abstract that begins "Congress has enacted laws to safeguard against former federal employees, including former trade officials, from using their access to influence government officials. These former officials' post-employment activities are restricted by a federal conflict of interest law, known as the "Revolving Door" law. Two other laws--the Foreign Agents Registration Act (FARA) and the Lobbying Disclosure Act (LDA)--are disclosure statutes that do not prohibit any activities per se, but require individuals conducting certain representation activities to publicly disclose them. FARA and LDA are not specific to former federal officials; they apply to all individuals. GAO was asked to provide a summary of the Revolving Door law, FARA, and LDA. GAO reviewed these laws, as well as guidance from the Office of Government Ethics (OGE). GAO interviewed ethics officials at three agencies whose missions focus on trade--the United States Trade Representative (USTR), the International Trade Administration (ITA), and the International Trade Commission (USITC)--and collected data on the number of senior officials who separated from these agencies from 2004 through 2009. In addition, GAO interviewed Department of Justice (Justice) officials concerning enforcement of these laws. GAO makes no recommendations in …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) leads detection and monitoring of aerial and maritime transit of illegal drugs into the United States in support of law enforcement agencies. Additionally, DOD's counternarcotics activities include sharing information with U.S. and foreign agencies, as well as helping foreign countries build their counternarcotics capacity. In support of these activities, Congress provided just over $6.1 billion to DOD's Counternarcotics Central Transfer Account from fiscal year 2005 through 2010. In November 2005, GAO recommended that DOD, in conjunction with other agencies performing counternarcotics activities, develop and coordinate counternarcotics performance measures. GAO has found that measuring performance allows organizations to track the progress they are making toward their goals and provides managers a basis for making key decisions to improve programs and results. In May 2007, the Office of National Drug Control Policy (ONDCP) released a circular that required agencies, including DOD, to submit a report on their performance-related information for counternarcotics activities, including how the agency's performance measures are used in the management of the program. The National Defense Authorization Act for Fiscal Year 2010 (Pub. L. No. 111-84, 1016) mandated that GAO report on …

A letter report issued by the Government Accountability Office with an abstract that begins "Virtually all Department of Defense (DOD) weapon systems and equipment rely on power sources, such as batteries. In response to a mandate in the National Defense Authorization Act for Fiscal Year 2010, GAO determined (1) DOD's approximate investment in power sources, (2) the extent to which DOD coordinates its power source investments, and (3) the extent to which DOD's policies facilitate the use of standard power sources. To address these objectives, GAO obtained and analyzed DOD investment data, met with DOD officials and industry representatives, and attended DOD conferences aimed at facilitating power source coordination."

A letter report issued by the Government Accountability Office with an abstract that begins "The H-2B visa program assists U.S. employers anticipating a shortage of domestic nonagricultural workers by permitting them to hire nonimmigrant foreign workers temporarily. The program is overseen by several agencies, including the Department of Labor (Labor), the Department of Homeland Security's United States Citizenship and Immigration Services (USCIS), and the Department of State. Employers often hire labor recruiters or other intermediaries to assist with the process of obtaining labor certifications and finding foreign workers. GAO was asked to determine if there were examples of recruiters and employers engaging in illegal or fraudulent activity within the H-2B visa program. GAO reviewed recent closed civil and criminal court cases involving H-2B workers, obtained data from Labor and USCIS on H-2B visas issued in fiscal years 2008 and 2009 and in first 6 months of fiscal year 2010, and interviewed advocacy groups that represent H-2B workers in litigation. In addition, GAO made undercover calls and site visits to recruiters, posing as H-2B employers and foreign H-2B workers and asked a series of questions related to legal requirements of the program. GAO also visited several H-2B housing and work site …