A letter report issued by the Government Accountability Office with an abstract that begins "Of the 9,215 veterans who entered the Department of Veterans Affairs' (VA) Independent Living (IL) track within the Vocational Rehabilitation and Employment (VR&E) program in fiscal years 2008 to 2011, most were male Vietnam era veterans in their 50s or 60s. Almost 60 percent served in the U.S. Army, and fewer than 1 percent served in the National Guard or Reserve. The most prevalent disabilities among these veterans were post-traumatic stress disorder and tinnitus. GAO's review of 182 IL cases from fiscal year 2008 found that VR&E provided a range of IL benefits to veterans. Among these cases, the most common benefits were counseling services and computers. Less common benefits included gym memberships, camping equipment, and a boat. GAO estimated that VR&E spent nearly $14 million on benefits for veterans entering the IL track in fiscal year 2008--an average of almost $6,000 per IL veteran."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) has struggled to provide timely reviews for veterans who appeal decisions on their disability compensation claims. A veteran appeals to the VA regional office that made the initial decision, and if still dissatisfied, to the Board of Veterans Appeals (Board). An appeal to the Board adds more than 2 years, on average, to the wait for a decision on the appeal. To resolve more appeals at the regional level and avoid waits at the Board, VA, in 2001, established the Decision Review Officer (DRO) review as an alternative to the traditional regional office appeal review. A DRO is given authority to grant additional benefits after reviewing an appeal based on a difference of opinion with the original decision. In contrast, under the traditional review, new evidence is generally required for a grant of additional benefits. GAO examined (1) the extent to which veterans choose a DRO review, (2) outcomes for DRO reviews, and (3) VA's challenges in managing DROs. GAO analyzed Board data, surveyed managers in all 57 regional offices, visited 4 offices, and interviewed veterans."

A letter report issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) has provided about $6 billion in grants for three Department of Housing and Urban Development (HUD) programs that fund housing or community development. As of March 31, 2010, HUD's Capital Fund awarded nearly $3 billion in grants to 3,134 public housing agencies, the Community Development Block Grant-Recovery (CDBG-R) awarded about $1 billion to 1,167 recipients, and the Tax Credit Assistance Program (TCAP) awarded $2.25 billion to 52 state housing finance agencies. The act requires recipients to report specific information on fund use. Recipients began reporting in October 2009. This information is publicly available on Recovery.gov, the official Recovery Act Web site. As requested, for these three HUD programs, the report (1) examines what information recipients are required to report as a part of their descriptions of funded projects, and (2) assesses the extent to which descriptions of a representative sample of 219 grants in Recovery.gov are transparent in providing a basic understanding of grant activities and expected outcomes. GAO reviewed requirements for reporting in the act and Office of Management and Budget (OMB) and HUD guidance."

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2009, the Department of Veterans Affairs (VA) provided more than 59 million prosthetic items to more than 2 million veterans. After VA physicians and other clinicians prescribe prosthetic items, VA's Prosthetic and Sensory Aids Service (PSAS) is responsible for processing prescriptions and providing prosthetic items to veterans. PSAS is also responsible for managing VA's spending for prosthetic items--more than $1.6 billion in fiscal year 2009. In fiscal year 2008, this spending exceeded VA's budget estimates. Each year, VA makes an initial funding allocation for prosthetic items, and may reallocate by increasing or decreasing the funding available for prosthetic items during the fiscal year. GAO was asked to examine (1) how, for fiscal years 2005 through 2009, VA's spending for prosthetic items compared to budget estimates, and the extent to which VA reallocated funding for prosthetic items; (2) how PSAS monitors its performance in processing and providing prosthetic items to veterans; and (3) the efforts VA has undertaken to improve PSAS's performance. GAO reviewed VA's spending and funding allocation data for fiscal years 2005 through 2009. GAO also reviewed documents and interviewed VA officials …

A letter report issued by the Government Accountability Office with an abstract that begins "Ice formation on aircraft can disrupt the smooth flow of air over the wings and prevent the aircraft from taking off or decrease the pilot's ability to maintain control of the aircraft. Takeoff and landing operations can also be risky in winter weather. Despite persistent efforts by the Federal Aviation Administration (FAA) and others to mitigate icing risks, icing remains a serious concern. GAO reviewed (1) the extent to which commercial airplanes have experienced accidents and incidents related to icing, (2) FAA's inspection and enforcement activities related to icing, (3) the efforts of FAA and others to improve safety in winter weather, and (4) the challenges that continue to affect aviation safety in winter weather. GAO analyzed data obtained from FAA, the National Transportation Safety Board (NTSB), the National Aeronautics and Space Administration (NASA), and others. Further, GAO obtained information from FAA and NTSB officials and representatives of key aviation industry stakeholders."

A letter report issued by the Government Accountability Office with an abstract that begins "A hallmark of efforts to implement the $862 billion American Recovery and Reinvestment Act of 2009 (Recovery Act) is to be transparent and accountable about what the money is being spent on and what is being achieved. To help achieve these goals, recipients are to report every 3 months on their award activities and expected outcomes, among other things. This information is available on Recovery.gov, the government's official Recovery Act Web site. As requested, this report covers 11 federal programs focused on broadband, energy, transportation, federal buildings, and civil works activities, representing $67 billion in Recovery Act funding. Primarily, the report (1) describes how the Office of Management and Budget (OMB) and federal agencies implemented the act to report funds' uses and (2) assesses the extent to which descriptions of awards meet GAO's transparency criteria. It also describes reported uses of funds for the 11 programs. GAO reviewed requirements for reporting in the act and OMB's guidance. Based on these requirements, GAO developed a transparency assessment and applied it to a probability sample of descriptions from 14,089 recipient reports. In addition, GAO reviewed 52 projects in …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) provides health care and mental health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through TRICARE Prime, an option that includes the use of civilian provider networks and requires enrollment. TRICARE beneficiaries who do not enroll in this option may obtain care from nonnetwork providers through TRICARE Standard, or from network providers through TRICARE Extra. In addition, qualified National Guard and Reserve servicemembers may purchase TRICARE Reserve Select, a plan whose care options are similar to those of TRICARE Standard and TRICARE Extra. We refer to servicemembers who use TRICARE Standard, TRICARE Extra, or TRICARE Reserve Select as nonenrolled beneficiaries. The National Defense Authorization Act for Fiscal Year 2008 directed GAO to analyze the adequacy of DOD's surveys of TRICARE beneficiaries and providers and report what the surveys' results indicate about access to care for nonenrolled beneficiaries. To do so, GAO evaluated the surveys' methodology by interviewing DOD officials and reviewing relevant documentation, including the Office of Management and Budget's (OMB) survey standards. GAO also assessed the surveys' results by interviewing DOD officials, obtaining relevant documentation, and analyzing …

Testimony issued by the Government Accountability Office with an abstract that begins "Ice formation on aircraft can disrupt the smooth flow of air over the wings and prevent the aircraft from taking off or decrease the pilot's ability to maintain control of the aircraft. Taxi and landing operations can also be risky in winter weather. Despite a variety of technologies designed to prevent ice from forming on planes, as well as persistent efforts by the Federal Aviation Administration (FAA) and other stakeholders to mitigate icing risks, icing remains a serious concern. As part of an ongoing review, this statement provides preliminary information on (1) the extent to which large commercial airplanes have experienced accidents and incidents related to icing and contaminated runways, (2) the efforts of FAA and aviation stakeholders to improve safety in icing and winter weather operating conditions, and (3) the challenges that continue to affect aviation safety in icing and winter weather operating conditions. GAO analyzed data obtained from FAA, the National Transportation Safety Board (NTSB), the National Aeronautics and Space Administration (NASA), and others. GAO conducted data reliability testing and determined that the data used in this report were sufficiently reliable for our purposes. Further, GAO …

A letter report issued by the Government Accountability Office with an abstract that begins "Congress, policy analysts, and groups representing physicians have raised questions about beneficiary access to Medicare physician services. At the same time, high levels of spending for health care in some parts of the country, and rapid increases in spending for physician services, have been identified as factors that threaten the long-term fiscal sustainability of the Medicare program. GAO was asked to assess beneficiary access to physician services and to identify indicators of potential overutilization of physician services. In this report, GAO (1) examines whether, from 2000 through 2008, beneficiaries had problems accessing physician services; (2) identifies areas of the country in which Medicare beneficiaries are potentially overserved by physicians; and (3) describes characteristics that distinguish the potentially overserved areas from other areas in the nation. GAO analyzed the most recent data available from several sources, including an annual Centers for Medicare & Medicaid Services (CMS) survey of fee-for-service (FFS) Medicare beneficiaries, Medicare physician claims for services provided in April of each year from 2000 through 2008, the Health Resources and Services Administration's Area Resource File, and the U.S. Census Bureau."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2008, GAO reported that 1,088 oil industry mergers occurred between 2000 and 2007. Given the potential for price effects, GAO recommended that the Federal Trade Commission (FTC), the agency with the authority to maintain petroleum industry competition, undertake more regular retrospective reviews of past petroleum industry mergers, and FTC said it would consider this recommendation. GAO was asked to conduct such a review of its own to determine how mergers and market concentration--a measure of the number and market shares of firms in a market--affected wholesale gasoline prices since 2000. GAO examined the effects of mergers and market concentration using an economic model that ruled out the effects of many other factors. GAO consulted with a number of experts and used both public and private data in developing the model. GAO tested the model under a variety of assumptions to address some of its limitations. GAO also interviewed petroleum market participants."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Wildlife Refuge System, which is administered by the Fish and Wildlife Service in the Department of the Interior, comprises 585 refuges on more than 96 million acres of land and water that preserve habitat for waterfowl and other migratory birds, threatened and endangered species, and other wildlife. Refuges also provide wildlife-related activities such as hunting and fishing to nearly 40 million visitors every year. GAO was asked to (1) describe changing factors that the refuge system experienced from fiscal years 2002 through 2007, including funding and staffing changes, and (2) examine how habitat management and visitor services changed during this period. We surveyed all refuges; visited 19 refuges in 4 regions; and interviewed refuge, regional, and national officials. In commenting on a draft of this report, the Department of the Interior made technical comments that we have incorporated as appropriate. GAO is not making recommendations in this report."

A letter report issued by the Government Accountability Office with an abstract that begins "The Veterans Health Administration (VHA) has been using miscellaneous obligations for over 60 years to record estimates of obligations to be incurred at a later time. The large percentage of procurements recorded as miscellaneous obligations in fiscal year 2007 raised questions about whether proper controls were in place over the authorization and use of billions of dollars. GAO was asked to review (1) how VHA used miscellaneous obligations during fiscal year 2007, and (2) whether Department of Veterans Affairs (VA) policies and procedures were designed to provide adequate controls over their authorization and use. GAO obtained and analyzed available VHA data on miscellaneous obligations, reviewed VA policies and procedures, and reviewed a nongeneralizable sample of 42 miscellaneous obligations at three case study locations."

Testimony issued by the Government Accountability Office with an abstract that begins "The Veterans Health Administration (VHA) has been using miscellaneous obligations for over 60 years to record estimates of obligations to be incurred at a later time. The large percentage of procurements recorded as miscellaneous obligations in fiscal year 2007 raised questions about whether proper controls were in place over the authorization and use of billions of dollars. GAO's testimony provides preliminary findings related to (1) how VHA used miscellaneous obligations during fiscal year 2007, and (2) whether the Department of Veterans' Affairs (VA) policies and procedures were designed to provide adequate controls over their authorization and use. GAO recently provided its related draft report to the Secretary of Veterans Affairs for review and comment and plans to issue its final report as a follow-up to this testimony. GAO obtained and analyzed available VHA data on miscellaneous obligations, reviewed VA policies and procedures, and reviewed a nongeneralizable sample of 42 miscellaneous obligations at three case study locations. GAO's related draft report includes four recommendations to strengthen internal controls governing the authorization and use of miscellaneous obligations, in compliance with applicable federal appropriations law and internal control standards."

Testimony issued by the Government Accountability Office with an abstract that begins "GAO has issued reports on the U.S. Postal Service's (USPS) strategy for realigning its mail processing network and improving delivery performance information. These reports recommended that the Postmaster General (1) strengthen planning and the overall integration of its realignment efforts, and enhance accountability by establishing measurable targets and evaluating results, (2) improve delivery service standards and performance measures, and (3) improve communication with stakeholders by revising its Area Mail Processing (AMP) Communication Plan to improve public notice, engagement, and transparency. The 2006 postal reform act required USPS to develop a network plan by June 2008 that described its vision and strategy for realigning its network; the anticipated costs, cost savings, and other benefits of its realignment initiatives; performance measures for its delivery service standards, and its communication procedures for consolidating AMP operations. This testimony discusses USPS's actions toward addressing GAO recommendations to (1) strengthen network realignment planning and accountability, (2) improve delivery performance information, and (3) improve communication with stakeholders. This testimony is based on prior GAO work, a review of USPS's 2008 Network Plan and revised AMP Communication Plan, and updated information from USPS officials. USPS did …

A letter report issued by the Government Accountability Office with an abstract that begins "Traumatic brain injury (TBI) has emerged as a leading injury among servicemembers serving in the Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) combat theaters. The widespread use of improvised explosive devices, such as roadside bombs, in these combat theaters increases the likelihood that servicemembers will be exposed to incidents that can cause a TBI. TBIs can vary from mild to severe, and in general, mild TBI can be difficult to identify. Because mild TBI can have lasting effects if not identified and treated, concerns have been raised about how the Department of Veterans Affairs (VA) identifies and treats OEF/OIF veterans with a mild TBI. In this report GAO describes VA's (1) efforts to screen OEF/OIF veterans for mild TBI, (2) steps taken so that those OEF/OIF veterans at risk for mild TBI are evaluated and treated, and (3) challenges in screening and evaluating OEF/OIF veterans for mild TBI. GAO reviewed VA's policies, interviewed VA officials and TBI experts, and reviewed nine VA medical facilities' efforts to implement TBI screening and evaluation processes."

A letter report issued by the Government Accountability Office with an abstract that begins "To better assist veterans with service-connected disabilities seeking employment, in 2005, the Departments of Labor (Labor) and Veterans Affairs (VA) signed an agreement to coordinate employment services for disabled veterans. Around the same time, VA rolled out a redesigned employment program for these veterans, known as the Five-Track program, which also established an employment coordinator position and job resource labs. To help Congress understand the status of these initiatives, GAO was asked to provide information on (1) the progress in implementing the 2005 agreement and challenges to implementation, (2) the status of implementation of VA's Five-Track program and challenges posed by recently returning veterans, and (3) the role of employment coordinators and job resource labs in serving veterans. To obtain this information, GAO interviewed Labor and VA officials and national veterans' service organizations, and conducted site visits in five states."

Testimony issued by the Government Accountability Office with an abstract that begins "GAO reported in 2005 on major changes in the mailing industry that have reinforced the need for the U.S. Postal Service (USPS) to reduce costs and increase efficiency. To address these changes and become more efficient, USPS is implementing initiatives aimed at realigning its mail processing network. In a follow-up review, GAO recently reported that USPS has made progress in implementing these initiatives, yet challenges such as maintaining delivery standards and addressing stakeholder and community resistance remain. In July 2006, GAO also reported on USPS's progress in improving delivery performance information. This testimony describes (1) the changes that have affected USPS's processing network, (2) GAO's concerns related to USPS's strategy for realigning its mail processing network and implementing its area mail processing consolidations, and (3) GAO's concerns related to USPS's progress in improving delivery performance information. This testimony is based on prior GAO reports."

A letter report issued by the Government Accountability Office with an abstract that begins "Since the 1970s, the roles of women as both students and athletes have changed in higher education, with female enrollment surpassing male enrollment, and female athletic participation showing gains as well. These changes have generated public interest in whether women participate in athletics at comparable levels to men and whether men's opportunities have decreased as a result of the increased opportunities for women. Under the Comptroller General's authority, GAO assessed the extent to which the numbers of men's and women's intercollegiate sports teams and participants at 4-year colleges have changed from the 1991-1992 through 2004-2005 school years."

A letter report issued by the Government Accountability Office with an abstract that begins "Major changes in the mailing industry have reinforced the need for the U.S. Postal Service (USPS) to reduce costs and increase efficiency. In its 2002 Transformation Plan, USPS proposed doing so by realigning its mail processing network. The objectives of this requested report are to (1) describe the status of the initiatives USPS has developed for realignment; (2) evaluate how the planning, impacts, and results of these initiatives align with realignment goals; and (3) evaluate USPS's communication practices with stakeholders in making realignment decisions."

A letter report issued by the Government Accountability Office with an abstract that begins "Congress is concerned about the health care spending burden facing the Federal Employees Health Benefits Program (FEHBP), the largest private health insurance program in the country. Health care spending per person varies geographically, and the underlying causes for the spending variation have not been fully explored. Understanding market forces and other factors that may influence health care spending may contribute to efforts to moderate health care spending. Health care spending varies across the country due to differences in its components, the utilization and price of health care services. A wide body of research describes extensive geographic variation in utilization. However, less is known about private sector geographic variation in prices. This report examined prices and spending in FEHBP Preferred Provider Organizations (PPOs) to determine (1) the extent to which hospital and physician prices varied geographically, (2) which factors were associated with geographic variation in hospital and physician prices, and (3) the extent to which hospital and physician price variation contributed to geographic variation in spending. We analyzed claims data from several large national PPOs participating in FEHBP. We used 2001 data, the most current data available …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) operates one of the nation's largest health care systems. In 1999, GAO reported on VA's aged, obsolete capital assets, noting that better management of these assets could significantly reduce VA's operating costs. GAO further noted that VA could reinvest the savings to enhance veterans' health care services. In response, VA initiated its Capital Asset Realignment for Enhanced Services (CARES) process. Through CARES, VA identified what health care services it should provide and in which locations through 2022. The CARES process included assessing alternative ways to align inpatient services by closing or adding services at existing VA medical facilities or establishing new facilities. In May 2004, VA published its CARES decisions, but did not provide a national comprehensive summary of all its decisions about the alignment of inpatient services. GAO was asked to provide additional information about the inpatient service assessments and decisions made by VA. To provide a national, comprehensive summary, GAO summarized the locations where VA (1) identified a need to evaluate alternative ways to align inpatient health care service to improve quality, efficiency, or access and (2) made …

A letter report issued by the General Accounting Office with an abstract that begins "As part of the No Child Left Behind Act (NCLBA) of 2001, the Congress authorized a 3-year, $17 million per year school-based mentoring grant program. For fiscal year 2004, Congress has increased funding to about $50 million to fund additional mentoring efforts. Congress requested that GAO provide information on the student mentoring program. To do this, GAO answered the following questions: (1) What are the basic elements, policies, and procedures of successful mentoring programs? (2) What are the key characteristics of NCLBA-funded mentoring efforts, including the extent to which they have the basic elements, policies, and procedures of successful mentoring programs? (3) How does the Department of Education monitor program implementation? (4) What are Education's and grantees' plans to assess program outcomes?"

A letter report issued by the General Accounting Office with an abstract that begins "For the past 50 years, the federal government has had a metropolitan area program designed to provide a nationally consistent set of standards for collecting, tabulating, and publishing federal statistics for geographic areas in the United States and Puerto Rico. Before each decennial census, the Office of Management and Budget (OMB) reviews the standards to ensure their continued usefulness and relevance and, if warranted, revises them. While designed only for statistical purposes, various federal programs use the statistical areas to determine eligibility and to allocate federal funds. OMB advises agencies to carefully review program goals to ensure that appropriate geographic entities are used in making these decisions. GAO was asked to examine the process used for developing the OMB standards issued in 2000 and their effects on certain federal programs. Specifically, GAO agreed to report on (1) the process used to develop the 2000 standards, (2) how the 2000 standards differed from the 1990 standards, (3) how the application of the standards affected the geographic distribution of counties into statistical areas, and (4) the effect of standards on the eligibility and funding allocations for four federal …

A letter report issued by the General Accounting Office with an abstract that begins "Congress established the Empowerment Zone and Enterprise Community (EZ/EC) program in 1993 and the Renewal Community (RC) program in 2000 to provide assistance to the nation's distressed communities. To date, Congress has authorized three rounds of EZs, two rounds of ECs, and one round of RCs. The Community Renewal Tax Relief Act of 2000 mandated that GAO audit and report in 2004, 2007, and 2010 on the EZ/EC and RC programs and their effect on poverty, unemployment, and economic growth. This report describes (1) the features of the EZ/EC and RC programs, (2) the extent to which the programs have been implemented, and (3) the methods used and results found in evaluations of their effectiveness."