Correspondence issued by the Government Accountability Office with an abstract that begins "To carry out complex national security initiatives--such as combating illicit financing of terrorist activities, undertaking development projects in conflict zones, and countering piracy off the Horn of Africa--U.S. government agencies must coordinate with a large number of organizations in their planning efforts. Our prior work on the federal government's national security initiatives has determined that U.S. agencies face a number of challenges to effectively collaborating with one another, potentially resulting in gaps and overlaps in policy implementation. In particular, we have found that agencies face challenges to developing overarching strategies to achieve common goals, creating effective mechanisms for operating across agencies, and sharing sensitive information. For example, our work has shown that the Department of State (State) and the U.S. Agency for International Development (USAID) have different planning time frames than the Department of Defense (DOD), which poses a challenge for the three organizations. This report summarizes and formally transmits the enclosed briefing in response to Section 1055 of the Ike Skelton National Defense Authorization Act for Fiscal Year 2011, which required us to examine the need for and implications of a common alignment of world regions in …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses the findings from our recent work on federal employment and training programs and our prior work on the Workforce Investment Act of 1998 (WIA). GAO has recently identified 47 federally-funded employment and training programs for fiscal year 2009, defining them as programs that are specifically designed to enhance the job skills of individuals in order to increase their employability, identify job opportunities, and/or help job seekers obtain employment. These programs, which are administered by nine separate federal agencies--including the Departments of Labor, Education, and Health and Human Services (HHS)--spent about $18 billion dollars in fiscal year 2009 to provide services such as job search assistance and job counseling to program participants. Seven programs accounted for about three-fourths of this spending, and two--Wagner- Peyser funded Employment Service (ES) and WIA Adult--together reported serving over 18 million individuals, or about 77 percent of the total number of participants served across all programs. Forty-four of the 47 programs we identified, including those with broader missions such as multipurpose block grants, overlap with at least one other program in that they provide at least one similar service to a …

Correspondence issued by the Government Accountability Office with an abstract that begins "Hospital emergency departments are a major component of the nation's health care safety net as they are open 24 hours a day, 7 days a week, and generally are required to medically screen all people regardless of ability to pay. From 1997 through 2007, U.S. emergency department per capita use increased 11 percent. In 2007, there were approximately 117 million visits to emergency departments; of these visits, approximately 8 percent were classified as nonurgent. The use of emergency departments, including use for nonurgent conditions, may increase as more people obtain health insurance coverage as the provisions of the Patient Protection and Affordable Care Act (PPACA) are implemented. Some nonurgent visits are for conditions that likely could be treated in other, more cost-effective settings, such as health centers--facilities that provide primary care and other services to individuals in communities they serve regardless of ability to pay. Care provided in an emergency department may be substantially more costly than care provided in a health center. The average amount paid for a nonemergency visit to the emergency department was seven times more than that for a health center visit, according to …

Correspondence issued by the Government Accountability Office with an abstract that begins "This document is in response to the mandate contained in the National Aeronautics and Space Administration (NASA) Authorization Act of 2010, Pub. L. No. 111-267, Section 503(c)(2), for GAO to provide an evaluation of the accuracy and level of confidence in the findings contained in NASA's assessment of the essential modules, operational systems and components, structural elements, and permanent scientific equipment required to ensure complete, effective, and safe functioning and full scientific utilization of the International Space Station through 2020. We provided to Congress a draft copy of this briefing in meetings with them on April 6 and 7, 2011. We also provided a draft to NASA for comment. NASA agreed with our findings and provided technical comments that we incorporated as appropriate."

Correspondence issued by the Government Accountability Office with an abstract that begins "This report responds to questions that Congress raised about Air Force engine maintenance and repair work currently performed at Kelly Aviation Center (KAC) and the potential transfer of that work to another location. In 1999, Oklahoma City Air Logistics Center (OC-ALC) awarded a contract to KAC to perform work, including depot-level maintenance, repair, and overhaul on TF39 engines, which are typically used for C-5 Galaxy aircraft; T56 engines, which are typically used for C-130 aircraft; and fuel accessories on these engines. The Air Force estimates the total expenditure under the contract for this work to be $3.7 billion from February 16, 1999, through December 1, 2010. The contract is not to exceed 15 years (the contract had an initial 7-year ordering period that could be extended to 15 years or reduced to 5 years based on performance), and will expire not later than February 15, 2014. The Air Force will need to determine how to conduct the engine maintenance work after the term of the contract ends. Congress requested that we review the potential transfer of the engine maintenance and repair workload from KAC. Our objectives were to …

Testimony issued by the Government Accountability Office with an abstract that begins "The use of information technology (IT) is crucial to helping the Department of Veterans Affairs (VA) effectively serve the nation's veterans, and the department has expended billions of dollars annually over the last several years to manage and secure its information systems and assets. VA has, however, experienced challenges in managing its IT. GAO has previously highlighted VA's weaknesses in managing and securing its information systems and assets. GAO was asked to testify on its past work on VA's weaknesses in managing its IT resources, specifically in the areas of systems development, information security, and collaboration with the Department of Defense (DOD) on efforts to meet common health system needs."

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses strategies that health centers-- facilities that provide primary care and other services to individuals in communities they serve regardless of ability to pay--employ that may help reduce hospital emergency department use. Hospital emergency departments are a major component of the nation's health care safety net as they are open 24 hours a day, 7 days a week, and generally are required to medically screen all people regardless of ability to pay. From 1997 through 2007, U.S. emergency department per capita use increased 11 percent. In 2007, there were approximately 117 million visits to emergency departments; of these visits, approximately 8 percent were classified as nonurgent. The use of emergency departments, including use for nonurgent conditions, may increase as more people obtain health insurance coverage as the provisions of the Patient Protection and Affordable Care Act (PPACA) are implemented. Some nonurgent visits are for conditions that likely could be treated in other, more cost-effective settings, such as health centers. In 2008, the average amount paid for a nonemergency visit to the emergency department was seven times more than that for a health center visit, according to …

Testimony issued by the Government Accountability Office with an abstract that begins "The National Flood Insurance Program (NFIP) has been on GAO's high-risk list since 2006, when the program had to borrow from the U.S. Treasury to cover losses from the 2005 hurricanes. The outstanding debt is $17.8 billion as of March 2011. This sizeable debt, plus operational and management challenges that GAO has identified at the Federal Emergency Management Agency (FEMA), which administers NFIP, have combined to keep the program on the high-risk list. NFIP's need to borrow to cover claims in years of catastrophic flooding has raised concerns about the program's long-term financial solvency. This testimony 1) discusses ways to place NFIP on a sounder financial footing in light of public policy goals for federal involvement in natural catastrophe insurance and 2) highlights operational and management challenges at FEMA that affect the program. In preparing this statement, GAO relied on its past work on NFIP and on its ongoing review of FEMA's management of NFIP, which focuses on its planning, policies, processes, and systems. The management review includes areas such as strategic and human capital planning, acquisition management, and intra-agency collaboration."

Testimony issued by the Government Accountability Office with an abstract that begins "Despite decades of significant investment, most of the Department of Defense's (DOD) large space acquisition programs have collectively experienced billions of dollars in cost increases, stretched schedules, and increased technical risks. Significant schedule delays of as much as 9 years have resulted in potential capability gaps in missile warning, military communications, and weather monitoring. These problems persist, with other space acquisition programs still facing challenges in meeting their targets and aligning the delivery of assets with appropriate ground and user systems. To address cost increases, DOD reduced the number of satellites it would buy, reduced satellite capabilities, or terminated major space system acquisitions. Broad actions have also been taken to prevent their occurrence in new programs, including better management of the acquisition process and oversight of its contractors and resolution of technical and other obstacles to DOD's ability to deliver capability. This testimony will focus on the (1) status of space system acquisitions, (2) results of GAO's space-related reviews over the past year and the challenges they signify, (3) efforts DOD has taken to address causes of problems and increase credibility and success in its space system acquisitions …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses the U.S. Government Accountability Office's (GAO) budget request for fiscal year 2012. In fiscal year 2010, GAO provided assistance to every standing congressional committee and 70 percent of their subcommittees. Our work yielded significant results across the government, including financial benefits of $49.9 billion--a return on investment of $87 for every dollar invested in GAO. In addition, we documented over 1,300 other benefits resulting from our work that helped improve services to the public, promote improved management throughout government and change laws, such as the Improper Payments Elimination and Recovery Act of 2010."