A letter report issued by the Government Accountability Office with an abstract that begins "Available measures and awardee data provide some evidence that Hospital Preparedness Program (HPP) awardees have generally made progress in carrying out activities to achieve medical preparedness goals; however, the Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) lacked a comprehensive performance management system to fully assess awardee progress. According to prior GAO work and the GPRA Modernization Act of 2010 (GPRAMA), successful performance measurement systems should include a select set of performance measures tied to realistically achievable targets with clearly defined milestones. GAO's analysis of ASPR data showed general progress. For example, the percentage of all 62 awardees' participating hospitals with medical evacuation and shelter-in-place plans increased from 79.9 percent to 88.3 percent from fiscal year 2007 to fiscal year 2011. However, while ASPR collected data on a range of activities, it did not have consistent performance measures and targets in place across this entire period. Beginning with fiscal year 2012, ASPR developed new provisional performance measures for the eight new capabilities that awardees are to use for HPP planning for the next 5 years and set …

A letter report issued by the Government Accountability Office with an abstract that begins "The federal government increasingly relies on information technology (IT) systems to provide essential services affecting the health, economy, and defense of the nation. To assist in providing these important services, the federal government relies extensively on contractors to provide IT services and systems. In addition to contractors that provide systems and services to the federal government, other organizations possess or use federal information or have access to federal information systems. These other organizations with privileged access to federal data and systems can include grantees, state and local governments, and research and educational institutions. The Office of Management and Budget (OMB) cited contractor security as a governmentwide challenge in a 2001 information security report to Congress. Recognizing the need for agencies to have effective information security programs, Congress passed the Federal Information Security Management Act of 2002 (FISMA), which provides the overall framework for ensuring the effectiveness of information security controls that support federal operations and assets. FISMA requirements apply to all federal contractors and organizations or sources that possess or use federal information or that operate, use, or have access to federal information systems on behalf …

A letter report issued by the Government Accountability Office with an abstract that begins "The Workforce Investment Act of 1998 (WIA) required that many federal workforce employment and training programs for low-income individuals, the unemployed, and other job seekers provide their services through a streamlined delivery system. WIA also promoted greater employer engagement in this delivery system by, among other things, calling for it to help meet employers' workforce needs with services provided through one-stop centers. In 2005, we found that about half of employers were aware of their local one-stop centers. However, questions remained about how employers use them. In this report, GAO addressed (1) the extent to which employers, both large and small, hire their employees through one-stops; (2) the extent to which these employers view one-stop services as useful; and (3) factors that may affect one-stop service to employers. To answer these questions we surveyed employers who had used the one-stop system, visited eight one-stops, and talked to one-stop and Labor officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Average health insurance premiums for plans participating in the Federal Employees Health Benefits Program (FEHBP) have risen each year since 1997. These growing premiums result in higher costs to the federal government and plan enrollees. The Office of Personnel Management (OPM) oversees FEHBP, negotiating benefits and premiums and administering reserve accounts that may be used to cover plans' unanticipated spending increases. GAO was asked to evaluate the nature and extent of premium increases. To do this, GAO examined (1) FEHBP premium trends compared with those of other purchasers, (2) factors contributing to average premium growth across all FEHBP plans, and (3) factors contributing to differing trends among selected FEHBP plans. GAO reviewed data provided by OPM relating to FEHBP premiums and factors contributing to premium growth. For comparison purposes, GAO also examined premium data from the California Public Employees' Retirement System (CalPERS) and surveys of other public and private employers. GAO also interviewed officials from OPM and eight FEHBP plans with premium growth that was higher than average, and six FEHBP plans with premium growth that was lower than average to discuss premium growth trends and …

A letter report issued by the Government Accountability Office with an abstract that begins "Concerns about difficulties civilian employees of the U.S. government may have in obtaining workers' compensation benefits for medical conditions they developed as a result of their exposure to Agent Orange in Vietnam led to GAO being asked to determine (1) what is known about the number of civilians who served in Vietnam, both those employed directly by the U.S. government and those employed by companies that contracted with the government; (2) what is known about the number, processing, and disposition of claims filed by these civilians; and (3) what options are available if Congress chooses to improve access to benefits for civilians exposed to Agent Orange in Vietnam who developed illnesses as a result of their exposure, and what are their cost implications?"

A letter report issued by the Government Accountability Office with an abstract that begins "In recent years GAO and others have reported on problems in the financial management environment at the Department of Homeland Security's (DHS) Science and Technology Directorate (S&T). S&T was established by the Homeland Security Act of 2002 to, among other things, coordinate the federal government's civilian efforts to identify and develop countermeasures to emerging terrorist threats to our nation. As DHS's primary research and development arm, the directorate is tasked with providing federal, state, local, and tribal officials with state-of-the-art technology and other resources, such as protocols and training procedures for use in responding to, and recovery from, chemical, biological, radiological, nuclear, and explosive attacks. S&T is led by an Under Secretary and has a Chief Financial Officer (CFO) who is responsible for all budgeting and accounting for financial resources. S&T receives funds for research, development, acquisition, and operations. It also receives funds for management and administration that support the operations of the directorate in both headquarters and the field, such as the expenditures for personnel compensation and benefits, travel, and rent. The Department of Homeland Security Appropriations Act, 2007 (Appropriations Act) provided about $973 million …

A letter report issued by the Government Accountability Office with an abstract that begins "There has been long-standing congressional interest in whether the Department of Defense (DOD) could use the Department of Veterans Affairs (VA) Consolidated Mail Outpatient Pharmacy (CMOP) system as a cost-effective alternative to beneficiaries picking up outpatient refill prescriptions at DOD military treatment facilities (MTF). To evaluate this possibility, DOD and VA conducted a pilot program in fiscal year 2003 in which a VA CMOP provided outpatient pharmaceutical refill services to DOD beneficiaries served through three MTFs. GAO was asked to estimate cost savings that could be achieved if DOD used VA's CMOP instead of MTF pharmacies for outpatient refill prescriptions, and what other benefits were achieved at the three pilot sites. To estimate potential cost savings and determine what other benefits were achieved, GAO reviewed pilot and pharmacy program documentation and interviewed DOD and VA officials responsible for purchasing and dispensing drugs. GAO also compared drug and administrative costs of dispensing outpatient refills through the fiscal year 2003 pilot program with the costs of dispensing the refills at the three DOD MTFs that participated in the pilot."

A letter report issued by the Government Accountability Office with an abstract that begins "The Trade Adjustment Assistance (TAA) Reform Act of 2002 consolidated two programs serving trade-affected workers and made changes to expand benefits and decrease the time it takes for workers to get services. GAO was asked to provide information on (1) how key reform provisions have affected program services, (2) what have been the challenges in implementing new provisions, (3) whether demand for TAA training has changed and how states are meeting this demand, and (4) what is known about what the TAA program is achieving."

A letter report issued by the Government Accountability Office with an abstract that begins "The Army Working Capital Fund (AWCF) collected over $16 billion for goods and services provided to customers in fiscal year 2009. Cash generated from sales is used by AWCF to cover its expenses such as paying employees. In light of the Army's changing role in the Middle East, GAO was asked to determine whether (1) AWCF's monthly cash balances fell within the Department of Defense's (DOD) cash requirements for fiscal years 2000 through 2009, (2) the cash transfers resulted in AWCF's monthly cash balances falling below the minimum amount required by DOD, and (3) the AWCF's projected monthly cash balances are expected to fall below DOD's minimum cash requirement for fiscal years 2010 and 2011 and actions the Army can take to manage those balances. To address these objectives, GAO (1) reviewed relevant DOD guidance, (2) obtained and analyzed AWCF budget and accounting reports containing cash information, and (3) interviewed DOD and Army officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Under the Medicare Part D program, prescription drug coverage is provided through plans sponsored by private companies. Beneficiaries, their appointed representatives, or physicians can ask sponsors to cover prescriptions restricted under their plan--a process known as a coverage determination--and can appeal denials to the sponsor and the independent review entity (IRE). GAO was asked to review (1) the processes for sponsors' coverage determination decisions and the approval rates, (2) the processes for appealing coverage denials and the approval rates at the sponsor and IRE levels, and (3) the Centers for Medicare & Medicaid Services' (CMS) efforts to inform the public about sponsors' performance and oversee sponsors' processes. GAO visited seven sponsors that account for over half of Part D enrollment. GAO also interviewed and obtained data from CMS and IRE officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The Emergency Economic Stabilization Act directed GAO to study the role of leverage in the current financial crisis and federal oversight of leverage. GAO's objectives were to review (1) how leveraging and deleveraging by financial institutions may have contributed to the crisis, (2) regulations adopted by federal financial regulators to limit leverage and how regulators oversee compliance with the regulations, and (3) any limitations the current crisis has revealed in regulatory approaches used to restrict leverage and regulatory proposals to address them. To meet these objectives, GAO built on its existing body of work, reviewed relevant laws and regulations and academic and other studies, and interviewed regulators and market participants."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2008, the Department of Treasury (Treasury) plans to spend approximately $3 billion on information technology (IT) investments--the third largest planned IT expenditure among civilian agencies. To more effectively manage such investments, in 2005 the Office of Management and Budget required agencies to use earned value management (EVM). EVM is a project management approach that, if implemented appropriately, provides objective reports of project status, produces early warning signs of impending schedule delays and cost overruns, and provides unbiased estimates of a program's total costs. GAO was asked to assess whether the department and its key component agencies (1) have the policies in place to effectively implement EVM and (2) are adequately using EVM techniques to manage critical system investments. GAO compared agency policies to best practices identified in the Cost Assessment Guide and reviewed the implementation of key EVM practices for several investments."

A letter report issued by the Government Accountability Office with an abstract that begins "About two-thirds of drugs that are prescribed for children have not been studied and labeled for pediatric use, which places children at risk of being exposed to ineffective treatment or incorrect dosing. The Best Pharmaceuticals for Children Act (BPCA), enacted in 2002, encourages the manufacturers, or sponsors, of drugs that still have marketing exclusivity--that is, are on-patent--to conduct pediatric drug studies, as requested by the Food and Drug Administration (FDA). If they do so, FDA may extend for 6 months the period during which no equivalent generic drugs can be marketed. This is referred to as pediatric exclusivity. BPCA required that GAO assess the effect of BPCA on pediatric drug studies and labeling. As discussed with the committees of jurisdiction, GAO (1) assessed the extent to which pediatric drug studies were being conducted under BPCA for on-patent drugs, including when drug sponsors declined to conduct the studies; (2) evaluated the impact of BPCA on labeling drugs for pediatric use and the process by which the labeling was changed; and (3) illustrated the range of diseases treated by the drugs studied under BPCA. GAO examined data about …

A letter report issued by the Government Accountability Office with an abstract that begins "CBP revised its training program for newly hired CBP officers in accordance with its own training development standards. Consistent with these standards, CBP convened a team of subject-matter experts to identify and rank the tasks that new CBP officers are expected to perform. As a result, the new curriculum was designed to produce a professional law enforcement officer capable of protecting the homeland from terrorist, criminal, biological and agricultural threats. In addition, the curriculum stated that the CBP officer is to draw conclusions and take appropriate action to identify behavioral indicators displayed by criminals, effectively interview travelers to identify potential threats, identify fraudulent documents, and use technology in support of the inspection process."

A letter report issued by the Government Accountability Office with an abstract that begins "DODIG has taken multiple steps, in collaboration with the service IGs in some instances, to improve DOD’s ability to process military whistleblower reprisal cases in a timely manner. Timeliness is important to ensure the reliability of evidence and appropriate resolution of reprisal allegations. However, DODIG has generally not met statutory requirements to report on investigations within 180 days, or to provide alternative notification. DODIG has undertaken efforts to improve timeliness by, for example, eliminating a time-consuming phase of its investigative process. However, DOD’s efforts are hampered by unreliable and incomplete data. For instance, GAO found that DODIG has not consistently or accurately recorded key dates to track how long investigations take to complete. Without key timeliness data, DODIG may have difficulty in identifying process areas requiring improvement and evaluating the impact of reforms. Further, the absence of this information limits congressional decision makers’ ability to provide oversight of DOD’s whistleblower reprisal investigative program."

A letter report issued by the Government Accountability Office with an abstract that begins "Since the 1940s, the development of nuclear weapons technologies has generated transuranic wastes--materials contaminated by certain man-made radioactive elements. These wastes can remain dangerous for thousands of years. Until 1970, the Department of Energy's (DOE) predecessors buried these wastes in shallow pits and trenches. Today, state officials and communities near DOE's major disposal sites have expressed concerns that such wastes might contaminate important ground and surface water resources. GAO was asked to (1) determine the legal requirements and policies affecting DOE's efforts to address transuranic wastes buried before 1970, (2) determine what DOE is doing to address sites where these transuranic wastes are buried, and (3) assess the reliability of DOE's estimated costs to address these sites. We met with federal and state officials at five DOE sites containing buried transuranic wastes, reviewed environmental laws and guidance, and obtained buried waste cleanup cost estimates from each site. In commenting on this report, DOE generally agreed with our findings, and provided some clarifying comments."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) provides health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through a managed care option that requires enrollment and the use of civilian provider networks, which are developed and managed by contractors. Beneficiaries who do not enroll may receive care through TRICARE Standard, a fee-for-service option, using nonnetwork civilian providers or through TRICARE Extra, a preferred provider organization option, using network civilian providers. Nonenrolled beneficiaries in some locations have reported difficulties finding civilian providers who will accept them as patients. The National Defense Authorization Act (NDAA) for fiscal year 2004 directed GAO to provide information on access to care for nonenrolled TRICARE beneficiaries. This report describes (1) how DOD and its contractors evaluate nonenrolled beneficiaries' access to care and the results of these evaluations; (2) impediments to civilian provider acceptance of nonenrolled beneficiaries, and how they are being addressed; and (3) how DOD has implemented the NDAA fiscal year 2004 requirements to take actions to ensure nonenrolled beneficiaries' access to care. To address these objectives, GAO examined DOD's survey results and DOD and contractor documents and interviewed DOD …

A letter report issued by the Government Accountability Office with an abstract that begins "Competitive sourcing is aimed at promoting competition between federal employees and the private sector as a way to improve government operations. Key work activities--those that are either inherently governmental or core to the agency's mission--are generally exempt from competitions. In fiscal year 2004, Congress began placing spending limitations on the Forest Service's competitive sourcing program because of concerns about how the program was managed. Also, like other agencies, the Forest Service must report annually to Congress on the savings achieved from any competitions it conducted. GAO was asked to determine the extent to which the Forest Service has (1) plans and guidance to help implement its competitive sourcing program effectively and (2) sufficient cost data to ensure that it complied with its spending limitations and accurately reported its savings to Congress for fiscal years 2004 through 2006. To answer these objectives, GAO examined the agency's strategic plan, guidance, and available cost data for competitive sourcing and interviewed key agency officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Aeronautics and Space Administration (NASA) has long relied on the Delta II medium class launch vehicle to launch science missions. Delta II, however, is no longer in production, and no other vehicle in the relative cost and performance range is currently certified for NASA use. Thus, NASA faces a potential gap in the availability of medium class launch vehicles that could cause design challenges, delays, or funding issues. GAO was asked to assess (1) NASA's and the Delta II contractor's, steps to ensure resources (budget, workforce, and facilities) are available to support safe Delta II operations through the last planned NASA flight in 2011; (2) NASA's plans and contingencies for ensuring a smooth transition from current small and medium class launch vehicles to other launch vehicles for future science missions; (3) the risks associated with NASA's planned approach to fill the medium launch capability gap; and (4) technical and programmatic implications to science missions if NASA commits to new launch vehicles before they are certified and proven. GAO identified and assessed transition plans and mitigation activities and interviewed responsible NASA and government officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Each year, the Department of Homeland Security's (DHS) U.S. Citizenship and Immigration Services (USCIS) processes millions of applications for immigration benefits using a paper-based process. In 2005, USCIS embarked on a major, multiyear program to transform its process to a system that is to incorporate electronic application filing, adjudication, and case management. In 2007, GAO reported that USCIS was in the early stages of the Transformation Program and that USCIS's plans partially or fully met key practices. In 2008, USCIS contracted with a solutions architect to help develop the new system. As requested, GAO evaluated the extent to which USCIS has followed DHS acquisition policy in developing and managing the Transformation Program. GAO reviewed DHS acquisition management policies and guidance; analyzed transformation program planning and implementation documents such as operational requirements; compared schedule and cost information with GAO best practice guidance; and interviewed USCIS officials.."

A letter report issued by the Government Accountability Office with an abstract that begins "The Transportation Security Administration (TSA), in the Department of Homeland Security (DHS), is committed to sharing information with public transit agencies. The Implementing Recommendations of the 9/11 Commission Act directed GAO to report on public transit information sharing. This report describes (1) the primary mechanisms used to share security information with public transit agencies; and evaluates (2) public transit agencies' satisfaction with federal efforts to share security-related information (e.g., security threats) and opportunities to improve these efforts; and (3) the extent to which DHS has identified goals and measures for sharing information. GAO surveyed 96 of the 694 U.S. public transit agencies based on 2008 ridership and received 80 responses. The 96 public transit agencies surveyed represent about 91 percent of total 2008 ridership. GAO also reviewed documents, such as DHS's Information Sharing Strategy, and interviewed agency officials."

A letter report issued by the Government Accountability Office with an abstract that begins "As the responsible DOD agency for leading, advocating, and coordinating all DOD efforts to defeat improvised explosive devices (IED) the Joint IED Defeat Organization (JIEDDO) was directed to develop DOD’s counter-IED strategic plan in February 2006 under DOD Directive 2000.19E. As previously recommended by GAO, JIEDDO has made several attempts to develop such a plan, but its strategic-planning actions have not followed leading strategic-management practices or have since been discontinued. For example, JIEDDO’s 2007 strategic plan did not contain a means of measuring its performance outcomes—a leading strategic-management practice. In addition, JIEDDO’s 2009–2010 strategic plan contained performance measures, but JIEDDO discontinued using these measures because it later determined that the measures were not relevant to the organization’s goals. Although DOD tasked JIEDDO to develop its counter-IED strategic plan, DOD has not translated DOD’s counter-IED general mission objective of eliminating IEDs as a weapon of strategic influence into actionable goals and objectives. JIEDDO issued a new counter-IED strategic plan in January 2012; however, the new plan does not apply to all other counter-IED efforts departmentwide, only to those managed by JIEDDO. Consequently, JIEDDO’s new strategic plan alone …

A letter report issued by the Government Accountability Office with an abstract that begins "GAO has prepared this report to assist Congress in identifying and addressing debt management challenges. Since 1995, the statutory debt limit has been increased 12 times to its current level of $14.294 trillion. The Department of the Treasury (Treasury) recently notified Congress that the current debt limit could be reached as early as April 5, 2011, and the Congressional Budget Office (CBO) projects that under current law debt subject to the limit will exceed $25 trillion in 2021. This report (1) describes the actions that Treasury traditionally takes to manage debt near the limit, (2) analyzes the effects that approaching the debt limit has had on the market for Treasury securities, and (3) describes alternative mechanisms that would permit consideration of the link between policy decisions and the effect on debt when or before decisions are made. GAO analyzed Treasury and market data; interviewed Treasury officials, budget and legislative experts, and market participants; and reviewed practices in selected countries."

A letter report issued by the Government Accountability Office with an abstract that begins "The Army could not readily identify the population of Army military payroll accounts given its existing procedures and systems. The Army and DFAS-IN did not have an effective, repeatable process for identifying the population of active duty payroll records. For example, it took 3 months and repeated attempts before DFAS-IN could provide a population of service members who received active duty Army military pay in fiscal year 2010. Further, because the Army does not have an integrated military personnel and payroll system, it was necessary to compare the payroll file to active Army personnel records. However, the Defense Manpower Data Center (DMDC), DOD’s central repository for information on DOD-affiliated personnel, did not have an effective process for comparing military pay account files with military personnel files to identify a valid population of military payroll transactions. It took DMDC over 2 months and labor-intensive research to compare and reconcile the total number of fiscal year 2010 active duty payroll accounts to its database of personnel files. DOD’s Financial Improvement and Audit Readiness (FIAR) Guidance states that identifying the population of transactions is a key task essential to …