A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2007, the Department of Veterans Affairs (VA) spent about $4.1 billion on long-term care for veterans. VA provides--through VA or other providers--institutional care in nursing homes and noninstitutional care in veterans' homes or the community. In response to a statute, VA published in 2007 a long-term care strategic plan through fiscal year 2013. VA includes long-term care spending estimates in its annual budget justifications for Congress. These estimates are based on workload projections--the amount of care to be provided--and cost assumptions. VA has discretion in allocating appropriated funds among its medical services, such as long-term care. GAO examined (1) VA's reporting of planned workload in its 2007 long-term care strategic plan and (2) VA's long-term care spending estimates, including its cost assumptions and workload projections, in VA's fiscal year 2009 budget justification. GAO analyzed budget and planning documents and interviewed VA officials."

A letter report issued by the Government Accountability Office with an abstract that begins "A timing difference between cash in- and outflows poses challenges for the Department of the Treasury. Increased volatility of monthly cash flows may lead to unexpected short-term debt issuance and hence increased borrowing. While Social Security payments made at the start of the month will diminish gradually in coming years, start-of month payments to Medicare plan sponsors for Medicare Advantage and Part D benefits are projected to grow. As requested, this report (1) describes how Treasury, the Centers for Medicare & Medicaid Services (CMS), and plan sponsors operate under the current payment schedule; (2) identifies timing options; and (3) describes potential implications for Treasury, CMS, and Medicare. GAO analyzed Treasury cash flows, and interviewed Treasury, CMS officials, and plan sponsor representatives."

A letter report issued by the Government Accountability Office with an abstract that begins "From fiscal years 2000 through 2008, the number of persons employed by federal agencies who perform various law enforcement functions and receive either special pay or enhanced retirement benefits, in the form of a faster-accruing pension, has increased by 55 percent. In addition, as of September 2008, approximately 51,000 personnel were employed in law enforcement-related occupations that could seek enhanced retirement benefits in the future. GAO was asked to conduct a review of the retirement benefits provided to law enforcement personnel. This report addresses (1) the processes used to grant enhanced retirement benefits to federal law enforcement personnel, (2) the rationales and potential costs for extending benefits to additional occupations, and (3) the extent to which federal agencies used human capital tools to retain law enforcement and other related personnel. GAO reviewed relevant laws, regulations, and other documentation, such as agency reports describing the processes used to grant enhanced benefits, and interviewed officials from the Office of Personnel Management (OPM), Department of Homeland Security (DHS), Department of Justice (DOJ), and the Internal Revenue Service (IRS) because these entities employed approximately 84 percent of all law enforcement …

A letter report issued by the Government Accountability Office with an abstract that begins "Biosafety laboratories are primarily regulated by either the Department of Health and Human Services (HHS) or the U.S. Department of Agriculture (USDA), depending on whether the substances they handle pose a threat to the health of humans or plants, animals, and related products, respectively. Currently, all operational biosafety level 4 (BSL-4) labs are overseen by HHS's Centers for Disease Control and Prevention (CDC). BSL-4 labs handle the world's most dangerous agents and toxins that cause incurable and deadly diseases. In September 2008, GAO reported that two of the five operational BSL-4 labs had less than a third of the key perimeter security controls GAO assessed and recommended that CDC implement specific perimeter controls for all BSL-4 labs. GAO was asked to (1) provide an update on what action, if any, CDC took to address the 2008 recommendation; (2) determine whether perimeter security controls at the two deficient BSL-4 labs had improved since the 2008 report; and (3) provide other observations about the BSL-4 labs it assessed. To meet these objectives, GAO reviewed CDC's statement to Congress as well as other agency and HHS documentation on actions …

A letter report issued by the Government Accountability Office with an abstract that begins "Americans increasingly rely on wireless phones, with 35 percent of households now primarily or solely using them. Under federal law, the Federal Communications Commission (FCC) is responsible for fostering a competitive wireless marketplace while ensuring that consumers are protected from harm. States also have authority to oversee some aspects of service. As requested, this report discusses consumers' satisfaction and problems with wireless phone service and FCC's and state utility commissions' efforts to oversee this service. To conduct this work, Government Accountability Office (GAO) surveyed 1,143 adult wireless phone users from a nationally representative, randomly selected sample; surveyed all state utility commissions; and interviewed and analyzed documents obtained from FCC and stakeholders representing consumers, state agencies and officials, and the industry."

A letter report issued by the Government Accountability Office with an abstract that begins "The Senate report accompanying the U.S. Department of Agriculture's (USDA) fiscal year 2008 appropriations expressed concern that USDA's Greenbook charges--the transfer of funds authority USDA used to charge the appropriations accounts of its agencies and staff offices for programs to centrally provide certain services--had grown excessively. USDA's Office of the Chief Financial Officer (OCFO) oversees Greenbook charges. The report directed GAO to review these charges and USDA to report on them. This report identifies the agencies and offices assessed Greenbook charges, the amounts of the charges, and the programs supported by Greenbook charges for fiscal years 1999 through 2009. It also (1) assesses how USDA selected programs and monitored Greenbook charges and (2) describes the benefits of the programs, as reported by USDA. GAO reviewed and assessed USDA budget and program documents and discussed processes with officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Under the No Child Left Behind Act (NCLBA), districts and schools must demonstrate adequate yearly progress (AYP) for all students. Because schools may spend more time improving students' academic skills to meet NCLBA's requirements, some are concerned that arts education might be cut back. To determine how, if at all, student access to arts education has changed since NCLBA, the Congress asked: (1) has the amount of instruction time for arts education changed and, if so, have certain groups been more affected than others, (2) to what extent have state education agencies' requirements and funding for arts education changed since NCLBA, (3) what are school officials in selected districts doing to provide arts education since NCLBA and what challenges do they face in doing so, and (4) what is known about the effect of arts education in improving student outcomes? GAO analyzed data from the U.S. Department of Education (Education), surveyed 50 state arts officials, interviewed officials in 8 school districts and 19 schools, and reviewed existing research."

A letter report issued by the Government Accountability Office with an abstract that begins "The federal government has increasingly focused on linking affordable housing to transit-oriented developments--compact, walkable, mixed-use neighborhoods located near transit--through the Department of Housing and Urban Development's (HUD) housing programs and the Department of Transportation's (DOT) Federal Transit Administration's (FTA) transit programs. GAO was asked to review (1) what is known about how transit-oriented developments affect the availability of affordable housing; (2) how local, state, and federal agencies have worked to ensure that affordable housing is available in transit-oriented developments; and (3) the extent to which HUD and FTA have worked together to ensure that transportation and affordable housing objectives are integrated in transit-oriented developments. To address these issues, GAO reviewed relevant literature, conducted site visits, and interviewed agency officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Department of Defense (DOD) weapon programs often experience significant cost and schedule problems because they are allowed to start with too many technical unknowns and not enough knowledge about the development and production risks they entail. GAO was asked to review the department's Analysis of Alternatives (AOA) process--a key first step in the acquisition process intended to assess the operational effectiveness, costs, and risks of alternative weapon system solutions for addressing a validated warfighting need. This report (1) examines whether AOAs have been effective in identifying the most promising options and providing a sound rationale for weapon program initiation, (2) determines what factors have affected the scope and quality of AOAs, and (3) assesses whether recent DOD policy changes will enhance the effectiveness of AOAs. To meet these objectives, GAO efforts included collecting information on AOAs from 32 major defense acquisition programs, reviewing guidance and other documents, and interviewing subject matter experts."

A letter report issued by the Government Accountability Office with an abstract that begins "The Medicare Improvements for Patients and Providers Act of 2008 directed the Secretary of Health and Human Services to develop a program to give physicians confidential feedback on the Medicare resources used to provide care to Medicare beneficiaries. GAO was asked to evaluate the per capita methodology for profiling physicians--a method which measures a patient's resource use over a fixed period of time and attributes that resource use to physicians--in order to assist the Centers for Medicare & Medicaid Services (CMS) with the development of a physician feedback approach. In response, this report examines (1) the extent to which physicians in selected specialties show stable practice patterns and how beneficiary utilization of services varies by physician resource use level; (2) factors to consider in developing feedback reports on physicians' performance, including per capita resource use; and (3) the extent to which feedback reports may influence physician behavior. GAO focused on four medical specialties and four metropolitan areas chosen for their geographic diversity and range in average Medicare spending per beneficiary. To identify considerations for developing a physician feedback system, GAO reviewed the literature and interviewed officials …

A letter report issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) is estimated to cost about $787 billion over the next several years, of which about $280 billion will be administered through states and localities. The Recovery Act requires GAO to do bimonthly reviews of the use of funds by selected states and localities. In this first report, GAO describes selected states' and localities' (1) uses of and planning of Recovery Act funds, (2) accountability approaches, and (3) plans to evaluate the impact of funds received. GAO's work is focused on 16 states and the District of Columbia--representing about 65 percent of the U.S. population and two-thirds of the intergovernmental federal assistance available through the Recovery Act. GAO collected documents from and interviewed state and local officials, including Governors, "Recovery Czars," State Auditors, Controllers, and Treasurers. GAO also reviewed guidance from the Office of Management and Budget (OMB) and other federal agencies."

A letter report issued by the Government Accountability Office with an abstract that begins "The federal government expects to spend about $71 billion for information technology (IT) projects for fiscal year 2009. Given the amount of money at stake, it is critical that these projects be planned and managed effectively to ensure that the public's resources are being invested wisely. This includes ensuring that they receive appropriate selection and oversight reviews. Selection involves identifying and analyzing projects' risks and returns and selecting those that will best support the agency's mission needs; oversight includes reviewing the progress of projects against expectations and taking corrective action when these expectations are not being met. GAO was asked to determine whether (1) federal departments and agencies have guidance on the role of their department-level investment review boards in selecting and overseeing IT projects and (2) these boards are performing reviews of poorly planned and poorly performing projects. In preparing this report, GAO reviewed the guidance of 24 major agencies and requested evidence of department-level board reviews for a sample of 41 projects that were identified as being poorly planned or poorly performing."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Merchant Marine Academy (Academy), a component of the Department of Transportation's Maritime Administration (MARAD), is one of five U.S. service academies. The Academy is affiliated with 14 non-appropriated fund instrumentalities (NAFI) and two foundations. GAO was asked to determine whether there (1) were any potentially improper or questionable sources and uses of funds by the Academy, including transactions with its affiliated organizations; (2) was an effective control environment with key controls in place over the Academy's sources and uses of funds; and (3) were any actions taken, under way, or planned to improve controls and accountability. GAO analyzed selected transactions from fiscal years 2006, 2007, and 2008 to identify improper or questionable sources and uses of funds and reviewed documents and interviewed cognizant officials to assess the Academy's internal controls, and identify corrective actions to improve controls."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Department of Agriculture (USDA) administers the federal crop insurance program with private insurance companies, which, in turn, work with insurance agencies that sell crop insurance. In 2008, according to USDA, the program cost $6.5 billion, including about $2.0 billion in allowances to insurance companies to cover their administrative and operating (A&O) expenses, such as salaries and sales commissions to agencies. GAO was asked to examine (1) the reasons for recent substantial increases in A&O allowances, and the purposes for which insurance companies use these allowances, and (2) insurance agencies' expenses for selling federal crop insurance policies, and questionable practices, if any, that agencies use to compete for business among farmers. GAO analyzed USDA and private insurers' data, among other things."

A letter report issued by the Government Accountability Office with an abstract that begins "Foot-and-mouth disease (FMD) is the most highly infectious animal disease known: nearly 100 percent of exposed animals become infected with it. Although the United States has not had an outbreak of FMD since 1929, a single outbreak of FMD virus as a result of an accidental or intentional release from a laboratory on the U.S. mainland could have significant consequences for U.S. agriculture. The traditional approach to the disease, once infection is confirmed, is to depopulate infected and potentially infected livestock herds to eradicate the disease. The value of U.S. livestock sales was $140 billion in 2007; about 10 percent of this figure, or approximately $13 billion, was accounted for by export markets. The Plum Island Animal Disease Center (PIADC), on a federally owned island off the northern tip of Long Island, New York, is the only facility in the United States that studies the live FMD virus. The U.S. Department of Agriculture (USDA) was responsible for the PIADC from its opening in the 1950s until June 2003, when USDA transferred responsibility for it to the U.S. Department of Homeland Security (DHS), as required by the …

A letter report issued by the Government Accountability Office with an abstract that begins "Of the estimated 1.1 million Americans living with HIV, not all are aware of their HIV-positive status. Timely testing of HIV-positive individuals is important to improve health outcomes and to slow the disease's transmission. It is also important that individuals have access to HIV care after being diagnosed, but not all diagnosed individuals are receiving such care. The Centers for Disease Control and Prevention (CDC) provides grants to state and local health departments for HIV prevention and collects data on HIV. In 2006, CDC recommended routine HIV testing for all individuals ages 13-64. The Health Resources and Services Administration (HRSA) provides grants to states and localities for HIV care and services. GAO was asked to examine issues related to identifying individuals with HIV and connecting them to care. This report examines: 1) CDC and HRSA's coordination on HIV activities and steps they have taken to encourage routine HIV testing; 2) implementation of routine HIV testing by select state and local health departments; 3) available information on CDC funding for HIV testing; and 4) available data on the number of HIV-positive individuals not receiving care for HIV. …

A letter report issued by the Government Accountability Office with an abstract that begins "After the Small Business Administration (SBA) was widely criticized for its performance following the 2005 Gulf Coast hurricanes, the agency took steps to reform the Disaster Loan Program and Congress enacted the Small Business Disaster Response and Loan Improvements Act of 2008 (Act). GAO was asked to determine (1) the extent to which SBA addressed the Act's requirements, and (2) how SBA's response to major disasters in 2008 aligned with key components of its June 2007 Disaster Recovery Plan (DRP). GAO reviewed the Act, as well as SBA information on requirements addressed and steps taken, including the DRP, various reports to Congress, and policy memoranda. GAO also conducted site visits to areas affected by major 2008 disasters, reviewed SBA's customer satisfaction survey, and obtained the opinions of relevant stakeholders."

A letter report issued by the Government Accountability Office with an abstract that begins "In passing the Food for Peace Act in 2008, Congress authorized up to $22 million annually for fiscal years 2009 to 2012 to the U.S. Agency for International Development (USAID) to improve, monitor, and evaluate the effectiveness and efficiency of nonemergency food aid programs. Congress also required USAID to report on its oversight of these programs and the Comptroller General to review and report to Congress on USAID's report. Through analysis of agency documents; interviews with agency officials, experts, and partners; and visits to Bangladesh and Haiti, this mandated report reviews (1) USAID's plans and actions to improve its monitoring and evaluation of nonemergency food aid programs and (2) the extent to which USAID has integrated its monitoring and evaluation of nonemergency food aid with program management."

A letter report issued by the Government Accountability Office with an abstract that begins "Having the right number of civilian personnel with the right skills is critical to achieving the Department of Defense's (DOD) mission. With more than 50 percent of its civilian workforce (about 700,000 civilians) eligible to retire in the next few years, DOD may be faced with deciding how to fill numerous mission-critical positions--some involving senior leadership. The National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2006 requires DOD to develop a strategic human capital plan, update it annually through 2010, and address eight requirements. GAO previously found that DOD's 2007 plan did not meet most requirements. The 2007 NDAA added nine requirements to the annual update to shape DOD's senior leader workforce. GAO was asked to assess the extent to which DOD's 2008 update addressed (1) the 2006 human capital planning requirements, (2) the 2007 senior leader requirements, and (3) key factors that may affect civilian workforce planning. GAO analyzed the update, compared it with the requirements, and reviewed factors identified in the update and prior GAO work."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2005, Congress created a traumatic injury insurance benefit program, known as TSGLI, to help servicemembers with traumatic brain injury and other serious injuries with the financial burdens that they and their families face. The Department of Veterans Affairs (VA) administers the program, in collaboration with the Department of Defense (DOD), while the branches of service are responsible for deciding servicemembers' claims. GAO examined (1) the TSGLI approval rate for traumatic brain injury claimants, and whether DOD and VA have assurance that claims are processed accurately, consistently, and in a timely manner and (2) any challenges servicemembers with traumatic brain injury may have faced in accessing TSGLI benefits, and the extent to which DOD and VA have taken steps to address such challenges. GAO analyzed program data and interviewed DOD and VA officials, servicemembers, and medical professionals."

A letter report issued by the Government Accountability Office with an abstract that begins "Federal and other decision makers have had a renewed interest in how high speed rail might fit into the national transportation system and address increasing mobility constraints on highways and at airports due to congestion. GAO was asked to review (1) the factors affecting the economic viability--meaning whether total social benefits offset or justify total social costs--of high speed rail projects, including difficulties in determining the economic viability of proposed projects; (2) the challenges in developing and financing high speed rail systems; and (3) the federal role in the potential development of U.S. high speed rail systems. GAO reviewed federal legislation; interviewed federal, state, local, and private sector officials, as well as U.S. project sponsors; and reviewed high speed rail development in France, Japan, and Spain."

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2008, the Department of Defense (DOD) obligated $200 billion on services contracts, including $42 billion for professional and management services. The Government Accountability Office (GAO) previously identified weaknesses in DOD's management and oversight of services contracts, contributing to DOD contract management being on GAO's high-risk list. For selected professional and management support contracts, GAO was asked to examine (1) the extent to which DOD considered the risks of contractors closely supporting inherently governmental functions at key decision points, (2) how DOD implemented performance-based practices, (3) the extent to which DOD designated trained surveillance personnel, and (4) whether a new review process may improve DOD's management of such contracts. GAO reviewed federal regulations, agency policies and guidance, and analyzed seven acquisitions approved from 2004 to 2007 and 64 related task orders for services."

A letter report issued by the Government Accountability Office with an abstract that begins "The current H1N1 pandemic highlights the threat posed to our nation by an influenza pandemic. The previous administration's Homeland Security Council (HSC) issued the Implementation Plan for the National Strategy for Pandemic Influenza (Plan) in May 2006 to help address a pandemic. The Government Accountability Office (GAO) was asked to (1) determine how the HSC and responsible federal agencies monitor the progress and completion of the Plan's action items; and (2) assess the extent to which selected action items have been completed. To do this, GAO interviewed officials from the HSC and the six federal agencies responsible for implementing most of the Plan, and analyzed a random sample of 60 action items. While this report does not assess the response efforts for the H1N1 pandemic, GAO continues to monitor the outbreak and the federal response."

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."