A letter report issued by the Government Accountability Office with an abstract that begins "Department of Defense (DOD) installations have about 2,600 electric, water, wastewater, and natural gas utility systems valued at about $50 billion. In 1997, DOD decided that privatization was the preferred method for improving utility systems, and Congress approved legislative authority for privatizing DOD's utility systems with Public Law No. 105-85. DOD estimates that some utility privatization contracts will cost over $100 million. In a May 2005 report, GAO identified several management weaknesses in DOD's implementation of the program. The Fiscal Year 2006 National Defense Authorization Act required GAO to evaluate and report on changes to the utility privatization program since May 2005. Accordingly, this report updates the status of the program and discusses the effect of DOD's changes on the concerns noted last year. To conduct this review, GAO summarized program status and costs, assessed DOD's changes to program guidance and in other areas, and reviewed the services' implementation of the changes."

A letter report issued by the Government Accountability Office with an abstract that begins "Health-care-associated infections (HAI) are infections that patients acquire while receiving treatment for other conditions. Normally treated with antimicrobial drugs, HAIs are a growing concern as exposure to multidrug-resistant organisms (MDRO) becomes more common. Infections caused by MDROs, such as methicillin-resistant Staphylococcus aureus (MRSA), lead to longer hospital stays, higher treatment costs, and higher mortality. In response to demands for more public information on HAIs, some states began to establish HAI public reporting systems. The federal Centers for Disease Control and Prevention (CDC) developed a system--the National Healthcare Safety Network (NHSN)--to collect HAI data from hospitals and some states have chosen to use it for their programs. In addition, some hospitals have adopted initiatives to reduce MRSA by routinely testing some or all patients and isolating those who test positive for MRSA from contact with other patients. GAO was asked to examine (1) the design and implementation of state HAI public reporting systems, (2) the initiatives hospitals have undertaken to reduce MRSA infections, and (3) the experience of certain early-adopting hospitals in overcoming challenges to implement such initiatives. GAO interviewed state officials, reviewed documents, and surveyed or …

A letter report issued by the Government Accountability Office with an abstract that begins "In 2005, GAO added the Department of Defense's (DOD) approach to business transformation to its high-risk list because (1) DOD's improvement efforts were fragmented, (2) DOD lacked an integrated and enterprisewide business transformation plan, and (3) DOD had not designated a senior official at the right level with the right authority to be responsible for overall business transformation efforts. This report assesses (1) the progress DOD has made in setting up a management framework for overall business transformation efforts and (2) the challenges DOD faces in maintaining and ensuring the success of those efforts. GAO conducted this work under the Comptroller General's authority to conduct evaluations under his own initiative. In conducting its work, GAO compared DOD's actions to key practices of successful transformations."

A letter report issued by the Government Accountability Office with an abstract that begins "Extraordinary recent flood events raise serious questions about the solvency of the National Flood Insurance Program (NFIP), which is administered by the Federal Emergency Management Agency (FEMA). The NFIP is largely implemented by private insurance companies that sell and service policies and adjust claims under the Write Your Own (WYO) Program. This report, prepared under the authority of the Comptroller General, examines (1) how much FEMA paid the WYO companies in recent years for operating costs and how FEMA determined payment amounts; (2) how FEMA's approach to determining operating costs assures that payments are reasonable estimates of companies' expenses; and (3) how FEMA assures that financial and management controls are in place for the WYO program and operate as intended. To do these assessments, GAO interviewed FEMA and insurance officials, and analyzed statutes, regulations, payment data, methodologies, and audits of WYO companies."

A letter report issued by the Government Accountability Office with an abstract that begins "Estimates of the size of shale oil and gas resources in the United States by the Energy Information Administration (EIA), U.S. Geological Survey (USGS), and the Potential Gas Committee--three organizations that estimate the size of these resources--have increased over the last 5 years, which could mean an increase in the nation's energy portfolio. For example, in 2012, EIA estimated that the amount of technically recoverable shale gas in the United States was 482 trillion cubic feet--an increase of 280 percent from EIA's 2008 estimate. However, according to EIA and USGS officials, estimates of the size of shale oil and gas resources in the United States are highly dependent on the data, methodologies, model structures, and assumptions used to develop them. In addition, less is known about the amount of technically recoverable shale oil than shale gas, in part because large-scale production of shale oil has been under way for only the past few years. Estimates are based on data available at a given point in time and will change as additional information becomes available. In addition, domestic shale oil and gas production has experienced substantial growth; …

A letter report issued by the Government Accountability Office with an abstract that begins "To help defray the cost of prescription drugs for beneficiaries with limited means, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) included the low-income subsidy (LIS) in the Part D prescription drug insurance program. To qualify for the LIS, beneficiaries must be enrolled in a Part D plan and their assets and income must be less than the thresholds established by the law. Part D is administered by the Centers for Medicare & Medicaid Services (CMS), and the Social Security Administration (SSA) administers the eligibility determination for the LIS. The MMA directed GAO to compare the utilization of and access to Part D prescription drugs among beneficiaries who received the LIS with those who were denied it because of the amount of their assets. This report focuses on beneficiaries' access to prescription drugs by examining (1) the importance of assets and income in LIS denials in 2006 and 2007, and (2) state and manufacturer programs providing access to prescription drugs for Medicare beneficiaries. To do this, GAO analyzed data from SSA, reviewed information on state and drug manufacturer pharmaceutical programs, and interviewed officials …

A letter report issued by the Government Accountability Office with an abstract that begins "The Navy faces technical, design, and construction challenges to completing Gerald R. Ford (CVN 78) that have led to significant cost increases and reduced the likelihood that a fully functional ship will be delivered on time. The Navy has achieved mixed progress to date developing CVN 78's critical technologies, such as a system intended to more effectively launch aircraft from the ship. In an effort to meet required installation dates aboard CVN 78, the Navy has elected to produce some of these systems prior to demonstrating their maturity--a strategy that GAO's previous work has shown introduces risk of late and costly design changes and rework, and leaves little margin to incorporate additional weight growth in the ship. In addition, progress in constructing CVN 78 has been overshadowed by inefficient out-of-sequence work, driven largely by material shortfalls, engineering challenges, and delays developing and installing critical technology systems. These events are occurring in a constrained budget environment, even as lead ship costs have increased by over 22 percent since construction authorization in fiscal year 2008--to $12.8 billion. Additional increases could follow due to uncertainties facing critical technology systems …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has relied on special operations forces to conduct military operations in Afghanistan and Iraq and to perform other tasks such as training foreign military forces. To meet the demand for these forces, DOD established a Marine Corps service component under the U.S. Special Operations Command (USSOCOM) to integrate Marine Corps forces. Under the authority of the Comptroller General, GAO assessed the extent to which (1) the Marine Corps special operations command has identified its force structure requirements, (2) the Marine Corps has developed a strategic human capital approach to manage personnel in its special operations command, and (3) USSOCOM has determined whether Marine Corps training programs are preparing its forces for assigned missions. GAO performed its work with the Marine Corps and USSOCOM and analyzed DOD plans for this new command."

A letter report issued by the Government Accountability Office with an abstract that begins "The No Child Left Behind Act of 2001 (NCLBA) focused national attention on improving schools so that all students reach academic proficiency by 2014. In the 2006- 2007 school year, about 4,500 of the 54,000 Title I schools failed to make adequate yearly progress (AYP) for 4 or more years. Schools that miss AYP for 4 years are identified for corrective action, and after 6 years, they must be restructured. GAO examined (1) the characteristics of Title I schools in corrective action and restructuring; (2) the actions that schools in corrective action and restructuring implemented; (3) the assistance those schools received from districts and states; and (4) how Education supports states in their efforts to assist these schools. GAO administered two Web-based surveys to a nationwide sample of schools in corrective action and restructuring status and conducted site visits to five states."

A letter report issued by the Government Accountability Office with an abstract that begins "The General Services Administration (GSA) issues different types of delegations, whereby agencies may request authority to perform certain real property activities, such as leasing space and maintaining property. Effective management of the program is critical to ensuring that federal dollars are well spent and adequate workspace is provided. GAO was asked to determine (1) what real property authority GSA has delegated to its tenant agencies, (2) what policies GSA used to manage delegated authority, and (3) reasons the tenant agencies requested delegated authority. GAO reviewed the law, federal regulations, and GSA policies relating to six types of delegated authority and interviewed GSA officials and officials from six select tenant agencies. GAO analyzed GSA data on delegations issued from fiscal years 1996 to 2006."

A letter report issued by the Government Accountability Office with an abstract that begins "Federal contractors and state Medicaid agencies are responsible for the day-to-day operations of the Medicare, Medicaid, and TRICARE programs. Because these entities may contract with vendors to perform services involving the use of personal health data, outsourcing and privacy protections are of interest. GAO surveyed all federal Medicare and TRICARE contractors and all state Medicaid agencies (a combined total of 378 entities) to examine whether they (1) outsource services--domestically or offshore--and (2) must notify federal agencies when privacy breaches occur. Survey response rates ranged from 69 percent for Medicare Advantage contractors to 80 percent for Medicaid agencies. GAO interviewed officials at the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS), which oversees Medicare and Medicaid, and the Department of Defense's TRICARE Management Activity (TMA), which oversees TRICARE."

A letter report issued by the Government Accountability Office with an abstract that begins "Between January 2004 and December 2005, more than 30,000 mass layoffs involving 50 or more workers occurred in the United States, causing more than 3.4 million workers to lose their jobs. National emergency grants expand services to laid-off workers when other state and federal programs are insufficient to meet their needs. GAO assessed (1) whether Labor has shortened grant award times since GAO's 2004 report and was meeting own timeliness goal, (2) the uniformity of the program data that Labor now collects, and (3) Labor's oversight of national emergency grant projects. To address these objectives, GAO analyzed information for program year 2004 and the first 2 quarters of 2005 and compared it with data collected for program years 2000- 2002."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO estimates, on the basis of recent U.S. Census Bureau data, that most American Indians and Alaska Natives will be potentially eligible for either expanded or new coverage options created by the Patient Protection and Affordable Care Act (PPACA). These options include expanded eligibility for Medicaid--the federal-state program for certain low-income individuals--and eligibility for the Health Insurance Exchanges (Exchanges), which are marketplaces where health insurance plans can be compared and purchased. While it is still unclear which states will opt to expand Medicaid, their decisions may affect a large proportion of American Indians and Alaska Natives, as GAO estimates that potential new enrollment could include about a quarter of this population. For example, in the Oklahoma City area--one of the Indian Health Service's (IHS) 12 federally designated service areas--tens of thousands of American Indians and Alaska Natives could be affected by the state of Oklahoma's decision not to expand its Medicaid program. For the Exchanges, GAO found that more than one-third of American Indians and Alaska Natives are potentially eligible for premium tax credits in the Exchanges--which help offset the cost of premiums for low-income individuals--and …

A letter report issued by the Government Accountability Office with an abstract that begins "Since the terrorist attacks of September 11, 2001, the war on terrorism has dominated the global security environment. Ongoing overseas operations and heavy reliance on reservists have raised concerns about how the Department of Defense (DOD) will continue to meet its requirements using an all-volunteer force. The Army, in particular, has faced continuing demand for large numbers of forces, especially for forces with support skills. GAO was mandated to examine the extent of DOD's reliance on personnel with high-demand skills and its efforts to reduce or eliminate reliance on these personnel. Accordingly, GAO assessed (1) the combat support and combat service support skills that are in high demand and the extent to which DOD officials have visibility over personnel who are available for future deployment and (2) the extent to which DOD has conducted a comprehensive, data-driven analysis of alternatives for providing needed skills."

A letter report issued by the Government Accountability Office with an abstract that begins "The September 11, 2001, terrorist attacks and World Trade Center (WTC) collapse blanketed Lower Manhattan in dust from building debris. In response, the Environmental Protection Agency (EPA) conducted an indoor clean and test program from 2002 to 2003. In 2003, EPA's Inspector General (IG) recommended improvements to the program and identified lessons learned for EPA's preparedness for future disasters. In 2004, EPA formed an expert panel to, among other goals, guide EPA in developing a second voluntary program; EPA announced this program in 2006. As requested, GAO's report primarily addresses EPA's second program, including the (1) extent to which EPA incorporated IG and expert panel member recommendations and input; (2) factors, if any, limiting the expert panel's ability to meet its goals; (3) completeness of information EPA provided to the public; (4) way EPA estimated resources for the program; and (5) extent to which EPA has acted upon lessons learned regarding indoor contamination from disasters."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on whether agencies were adhering to the Office of Management and Budget's (OMB) memorandum requiring federal agencies to post privacy policies on their Internet Websites, focusing on: (1) whether agencies have clearly labelled and easily accessed privacy policies posted on their principal Web sites; (2) whether agencies' privacy policies posted on their principal Web sites inform visitors about what information an agency collects, why the agency collects it, and how the agency will use the information; (3) how selected agencies have interpreted the requirement to post privacy policies at major entry points; and (4) whether selected agencies have posted privacy policies on Web pages where the agency collects substantial personal information or when applicable, notices that refer to the Privacy Act of 1974."

A letter report issued by the General Accounting Office with an abstract that begins "In calendar year 2001, the Social Security Administration (SSA) paid cash benefits of $60 billion to more than six million working-age adults with disabilities and eligible family members under its Social Security Disability Insurance (DI) program, and $20 billion to more than 3.5 million working-age adults with disabilities under the Supplemental Security Income (SSI) program. Some beneficiaries, known as concurrent beneficiaries, receive cash and medical benefits from both programs. Concurrent beneficiaries comprised about 14 percent of SSA's disability population; 58 percent have mental impairments, and about 53 percent are female. Eleven percent of concurrent beneficiaries worked and earned a median income of approximately $250 per month. There is little coordination between SSI and DI program rules for individuals who work and receive benefits from both programs concurrently. Because most field office staff specialize in one program, they may not be sufficiently knowledgeable of the procedures for the other program to ensure that concurrent beneficiaries who work are paid the appropriate benefit amount under both programs. Applying both SSI and DI program rules to concurrent beneficiaries may make it difficult for them to make informed decisions about …

A letter report issued by the General Accounting Office with an abstract that begins "Despite a drop in injury and fatality rates since the formation of the Department of Labor's Mine Safety and Health Administration (MSHA), mining is still a dangerous industry. Focusing on underground coal mines, GAO assessed how well MSHA oversees its process for reviewing and approving critical types of mine plans and the extent to which MSHA's inspections and accident investigations processes help ensure the safety and health of underground coal miners."

A letter report issued by the General Accounting Office with an abstract that begins "The Workforce Investment Act (WIA) of 1998 made sweeping changes to federal employment and training programs. The act sought to unify previously fragmented programs and create a more comprehensive workforce investment system by bringing together most federally funded employment and training services into a single service delivery system known as the one-stop center system. The administration has twice proposed reducing the program's budget, citing the large amounts of unexpended funds that states carried over from the prior year. State and local workforce officials, however, have requested more funding in light of current economic conditions. GAO found that the Department of Labor lacks accurate information on states' WIA spending because of reporting inconsistencies--all states do not report expenditures or commitments in the same way. To determine how states manage their spending, Labor has established its own spending benchmarks, using them to access whether states are on track with their spending, to target technical assistance, and to formulate budget requests. Several factors affect when expenditures occur or are reported. State officials said that cumbersome processes to get spending approval, lengthy contract procurement procedures, and untimely billing by key …

A letter report issued by the General Accounting Office with an abstract that begins "In the mid-1990s, John F. Kennedy Center for the Performing Arts (Kennedy Center) officials recognized a need for additional parking and better site access. As a precursor to a planned project to construct an 8-acre plaza and two additional buildings at the site, the Kennedy Center is currently in the process of constructing a garage expansion and site improvement project. GAO did this study because of congressional concerns over project delays and costs as well as challenges that the Kennedy Center faces as it pursues this major construction effort. GAO's objectives were to (1) compare the garage expansion and site improvement project's current costs, time frames, and scope with the estimates provided to congressional stakeholders in 1997 and 1998 and (2) identify what challenges the Kennedy Center faces in managing large construction projects."

A letter report issued by the Government Accountability Office with an abstract that begins "As with conventional oil and gas development, requirements from eight federal environmental and public health laws apply to unconventional oil and gas development. For example, the Clean Water Act (CWA) regulates discharges of pollutants into surface waters. Among other things, CWA requires oil and gas well site operators to obtain permits for discharges of produced water—which includes fluids used for hydraulic fracturing, as well as water that occurs naturally in oil- or gas-bearing formations—to surface waters. In addition, the Resource Conservation and Recovery Act (RCRA) governs the management and disposal of hazardous wastes, among other things. However, key exemptions or limitations in regulatory coverage affect the applicability of six of these environmental and public health laws. For example, CWA also generally regulates stormwater discharges by requiring that facilities associated with industrial and construction activities get permits, but the law and its regulations largely exempt oil and gas well sites. In addition, oil and gas exploration and production wastes are exempt from RCRA hazardous waste requirements based on a regulatory determination made by the Environmental Protection Agency (EPA) in 1988. EPA generally retains its authorities under federal …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) asked Congress for $73.2 billion in fiscal year 2007 for research, development, testing, and evaluation (RDT&E). DOD organized this request using program element (PE) codes, which are designed to convey key information about the budget request. DOD also provides documents called budget exhibits detailing the activities for which funds are being requested. The National Defense Authorization Act for Fiscal Year 2006 mandated that GAO examine the program elements and budget exhibits. GAO assessed (1) whether the RDT&E program element code structure and the associated budget exhibits provide accurate, consistent, complete, and clear information, and (2) what factors contribute to any problems found. In conducting this review GAO analyzed all of the fiscal year 2007 program element codes and 47 budget exhibits. GAO also interviewed key DOD officials."

A letter report issued by the General Accounting Office with an abstract that begins "Congress expressed concerns about the Chemical Demilitarization Program cost and schedule, and its management structure. In 2001, the program underwent a major reorganization. Following a decade long trend of missed schedule milestones, in September 2001, the Department of Defense (DOD) revised the schedule, which extended planned milestones and increased program cost estimates beyond the 1998 estimate of $15 billion to $24 billion. GAO was asked to (1) examine the effect that recent organization changes have had on program performance and (2) assess the progress DOD and the Army have made in meeting the revised 2001 cost and schedule and Chemical Weapons Convention (CWC) deadlines."