Memorandum of Meeting with Naval Hospital Cherry Point, Craven Regional Medical Center, and Carteret General Hospital staff regarding the assessment of the community hospitals' ability to handle Naval Hospital Cherry Point's in-patient care.

Testimony issued by the Government Accountability Office with an abstract that begins "The Chairman, Committee on Veterans' Affairs, U.S. Senate, asked GAO to testify on the current state of VA's disability claims process and factors that may impede VA's ability to improve performance. For years, the claims process has been the subject of concern and attention within VA and by the Congress and veterans service organizations. Many of their concerns have focused on long waits for decisions, large claims backlogs, and the accuracy of decisions. Our work and recent media reports of significant discrepancies in average disability payments from state to state have also highlighted concerns over the consistency of decision-making within VA. In January 2003, GAO designated federal disability programs, including VA's compensation and pension programs, as a high-risk area because of continuing challenges to improving the timeliness and consistency of its disability decisions, and the need to modernize programs."

Testimony issued by the Government Accountability Office with an abstract that begins "Since the National Aeronautics and Space Administration (NASA) created the strategy for the Commercial Orbital Transportation Services (COTS) project in 2005, the space landscape has changed significantly--the Space Shuttle program is retiring and the Ares I will not be available--increasing the importance of the timely development of COTS vehicles. The lack of alternatives for supplying the International Space Station and launching science missions have all contributed to an increased need for the COTS vehicles. The two COTS project partners, Orbital and SpaceX, have made progress in the development of their respective vehicles; however, both providers are behind schedule. As a result, the project recently received an additional $300 million to augment development efforts with risk reduction milestones. This testimony focuses on: (1) COTS development activities, including the recent funding increase; (2) the extent to which any COTS demonstration delays have affected commercial resupply services (CRS) missions and NASA's plans for meeting the space station's cargo resupply needs; and (3) lessons learned from NASA's acquisition approach for COTS. To prepare this statement, GAO used its prior relevant work and conducted additional audit work, such as analyzing each partner's agreement …

Correspondence issued by the Government Accountability Office with an abstract that begins "Today, GAO issued a correspondence identifying the internal controls that the National Aeronautics and Space Administration (NASA) has in place for reimbursable Space Act agreements and assessing to what extent the agency is adhering to those controls. Specifically, our review focused on NASA's internal controls related to (1) fair reimbursement from agreement partners; (2) interference between agreement partners' work and NASA's use of its facilities; and (3) alignment of agreement partners' work with NASA's mission. In that correspondence, we reported that NASA was generally adhering to its controls for entering into reimbursable Space Act agreements. In our review, however, we also found several instances in which agreements were not completely and accurately recorded in the Space Act Agreement Maker (SAAM) database. In addition, we identified one instance where NASA awarded a reimbursable agreement when similar services may have been available in the private sector. This action appears contrary to the National Space Policy and may have also been contrary to the Commercial Space Competitiveness Act. Federal government standards for internal controls state that control activities should help ensure that all transactions are completely and accurately recorded. NASA's SAAM …

Correspondence issued by the Government Accountability Office with an abstract that begins "Over the last few years, the National Aeronautics and Space Administration (NASA) has increasingly relied on its authority under the Space Act of 1958 to enter into agreements, commonly referred to as Space Act agreements (SAA), to stimulate private sector development of systems capable of transporting cargo and crew to the International Space Station and to assist partner firms in developing their technologies. Reimbursable Space Act agreements involve the use of NASA's facilities, personnel, or equipment primarily for the benefit of the agreement partner. NASA undertakes reimbursable work when it has unique goods, services, or facilities which can be made available to another party in a manner that does not interfere with NASA mission requirements and is consistent with the agency's mission. According to NASA guidance, the agency generally collects full reimbursement for costs associated with a reimbursable agreement. These types of agreements are known as fully reimbursable SAAs. However, NASA can accept less than full reimbursement in certain instances, such as when the reimbursement is fair and reasonable when compared to the benefits NASA receives from the work. When NASA waives costs under a reimbursable SAA, NASA …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the Bureau of Reclamation's sources and uses of funds at federal water projects, focusing on: (1) the Bureau's legal authorities and policies and procedures for obtaining, using, and accounting for funds, the types and amounts of funding obtained, and how funds were spent; (2) controls that were established to ensure that funds are properly obtained, used, and accounted for; (3) operations and maintenance (O&M) activities, expenses, and policies and procedures; and (4) other issues, such as the repayment of O&M and construction costs at the Central Valley Project (CVP)."

Correspondence issued by the Government Accountability Office with an abstract that begins "Our recent reviews of U.S counternarcotics programs in Mexico and Afghanistan highlighted the need to improve the programs' performance measures to track progress. The Department of State (State) received over $1 billion in its fiscal year 2010 appropriation for international counternarcotics assistance programs. The vast majority of this funding--about 90 percent in fiscal year 2010--supports counternarcotics programs in five countries--Mexico, Afghanistan, Colombia, Peru, and Bolivia. State's Bureau of International Narcotics and Law Enforcement Affairs (INL) is primarily responsible for implementing U.S. assistance programs involving eradication of illicit crops, interdiction of drug trafficking, and drug demand reduction, which represented about 85 percent of State's counternarcotics appropriation in fiscal year 2010. INL implements a large share of its funding through contractors, primarily for aviation support for eradication and interdiction efforts. Congress asked us to review State's performance measures for its counternarcotics programs. On March 10, 2011, we briefed congressional staff on our preliminary findings in which we described State's performance management system, including State's standard indicators for measuring the performance of counternarcotics assistance in recipient countries and requirements for posts to develop project-specific performance measures. Following the briefing, in subsequent …

Correspondence issued by the General Accounting Office with an abstract that begins "GAO testified before Congress at the hearing A System Rued: Inspecting Food. This report responds to Congress's request that GAO provide answers to follow-up questions from the hearing."

Correspondence issued by the General Accounting Office with an abstract that begins "On June 25, 2002, WorldCom, Inc., announced its intention to restate its financial statements for 2001 and the first quarter of 2002, reducing previously reported earnings by nearly $4 billion. WorldCom's announcement sparked a series of investigations by the Securities and Exchange Commission (SEC), the Department of Justice, and WorldCom's Board of Directors, among others, and eventually resulted in criminal charges against six of its corporate officials. WorldCom filed for bankruptcy protection in July 2002, and, over the next several months, announced restatements for additional periods. On July 31, 2003--over a year after WorldCom first announced its intention to restate its earnings--the General Services Administration (GSA) formally proposed the company for debarment, making the company ineligible for future government contracts. When WorldCom consented to a 3-year administrative agreement allowing GSA to continue monitoring the company's conduct, GSA terminated the debarment proceedings on January 7, 2004. House Report 108-243, which accompanied the Transportation, Treasury, and Independent Agencies Appropriations Act, 2004, required us to review the actions GSA took between WorldCom's June 2002 announcement and GSA's July 2003 decision to propose the company for debarment. We agreed to (1) identify …

Correspondence issued by the Government Accountability Office with an abstract that begins "To restore stability and liquidity to the financial system, Congress established the $700 billion Troubled Asset Relief Program (TARP) and directed the Department of the Treasury (Treasury) to use the authorities granted under TARP to, among other things, preserve homeownership and protect home values. In February 2009, Treasury announced that up to $50 billion in TARP funds had been allocated to help struggling homeowners avoid potential foreclosure. However, the number of borrowers facing potential foreclosure has remained at historically high levels. In fact, in the first 2 years of the TARP-funded Home Affordable Modification Program (HAMP), more borrowers were denied or canceled from trial loan modifications than were given permanent modifications. In three prior reports, we looked at the implementation of HAMP and made several recommendations that were intended to address the challenges that Treasury faced in implementing the program. To better understand the experience of borrowers seeking HAMP modifications, we conducted a Web-based survey of housing counselors through the National Foreclosure Mitigation Counseling Program (NFMC) to obtain the counselors' perspectives of borrowers' experiences with HAMP. NFMC is administered by NeighborWorks America and funds approximately 130 grantees and …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the Small Business Administration's (SBA) 7(a) General Business Loan Program, focusing on: (1) the general characteristics of the 7(a) program, including how the program operates; (2) certain issues, such as the lack of coordinated lender oversight, that have been identified in recent studies and reports on the program; and (3) how SBA has responded to these issues."

Other written product issued by the Government Accountability Office with an abstract that begins "This supplementary report to GAO-10-605SP provides individual state appendixes for 16 states and the District of Columbia for GAO's work on the sixth of its bimonthly reviews of the American Recovery and Reinvestment Act (Recovery Act)."

Testimony issued by the Government Accountability Office with an abstract that begins "Since the unprecedented flight delays in 2000, a year in which one in four flights were delayed, our aviation system has been adversely affected by many unanticipated events--such as the September 11th terrorist attacks, and Severe Acute Respiratory Syndrome (SARS)--that significantly reduced the demand for air travel. However, demand for air travel is rebounding. For example, the number of passengers traveling by air increased from 642 million in 2003 to 688 million in 2004. Flight delays have been among the most vexing problems in the national transportation system and are defined by the Department of Transportation as instances when aircraft arrive at the gate 15 minutes or more after scheduled arrival time. In 2004, one in five flights were delayed primarily at New York La Guardia and Chicago O'Hare. Delays at these airports have consequences for the rest of the system. GAO's testimony addresses the following questions that pertain to flight delays and enhancing capacity: (1) What initiatives are ongoing by the federal government, airlines, and airports to address flight delays and enhance capacity? (2) What are some of the challenges in reducing flight delays and enhancing capacity? …

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the Department of Energy's (DOE) efforts to implement GAO's recommendations to improve the deployment of innovative cleanup technologies, focusing on whether DOE: (1) established coordination between technology developers and users; (2) modified completed technologies to meet site-specific needs; (3) provided technical assistance to sites; and (4) improved the quality of deployment data."

Testimony issued by the Government Accountability Office with an abstract that begins "Vaccine shortages and distribution problems during the 2004-2005 influenza season raised concerns about the nation's ability to respond to a worldwide influenza epidemic--or influenza pandemic--which many experts believe to be inevitable. Some experts believe that the next pandemic could be spawned by the recurring avian influenza in Asia. If avian influenza strains directly infect humans and acquire the ability to be readily transmitted between people, a pandemic could occur. Modeling studies suggest that its effect in the United States could be severe, with one estimate from the Centers for Disease Control and Prevention (CDC) ranging from 89,000 to 207,000 deaths and from 38 million to 89 million illnesses. GAO was asked to discuss surveillance systems in place to identify and monitor an influenza pandemic and concerns about preparedness for and response to an influenza pandemic. This testimony is based on GAO's 2004 report on disease surveillance; reports and testimony on influenza outbreaks, influenza vaccine supply, and pandemic planning that GAO has issued since October 2000; and work GAO has done in May 2005 to update key information."

Testimony issued by the Government Accountability Office with an abstract that begins "Before 1969, IRS required hospitals to provide charity care to qualify for tax-exempt status. Since then, however, IRS has not specifically required such care, as long as the hospital provides benefits to the community in other ways. Seeking a better understanding of the benefits provided by nonprofit hospitals, Congress requested that GAO examine whether nonprofit hospitals provide levels of uncompensated care and other community benefits that are different from other hospitals. This statement focuses on, by ownership group, hospitals' (1) provision of uncompensated care, which consists of charity care and bad debt, and (2) reporting of other community benefits. The hospital ownership groups were (nonfederal) government, nonprofit, and for-profit. To compare the three hospital ownership groups, GAO obtained 2003 data from five geographically diverse states with substantial representation of the three ownership groups in each state. GAO analyzed cost data from two perspectives--each hospital group's percentage of (1) total uncompensated care costs in a state and (2) patient operating expenses devoted to uncompensated care."

Testimony issued by the Government Accountability Office with an abstract that begins "U.S. Customs and Border Protection (CBP) has in place two programs to help address the threat posed by terrorists smuggling weapons of mass destruction (WMD) into the United States: the Customs-Trade Partnership Against Terrorism (C-TPAT) and the Container Security Initiative (CSI). In July 2003, GAO reported that these programs had management challenges that limited their effectiveness. Given plans to expand both programs, in two recently issued reports GAO examined selected aspects of both programs' operations. This statement is a summary of those publicly available reports."

Testimony issued by the Government Accountability Office with an abstract that begins "Recent studies have shown that use of herbal dietary supplements--chamomile, echinacea, garlic, ginkgo biloba, and ginseng--by the elderly within the United States has increased substantially. Sellers, such as retail stores, Web sites, and distributors, often claim these supplements help improve memory, circulation, and other bodily functions. GAO was asked to determine (1) whether sellers of herbal dietary supplements are using deceptive or questionable marketing practices and (2) whether selected herbal dietary supplements are contaminated with harmful substances. To conduct this investigation, GAO investigated a nonrepresentative selection of 22 storefront and mail-order retailers of herbal dietary supplements. Posing as elderly consumers, GAO investigators asked sales staff (by phone and in person) at each retailer a series of questions regarding herbal dietary supplements. GAO also reviewed written marketing language used on approximately 30 retail Web sites. Claims were evaluated against recognized scientific research published by the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). GAO also had an accredited lab test 40 unique popular single-ingredient herbal dietary supplements for the presence of lead, arsenic, mercury, cadmium, organichlorine pesticides, and organophosphorous pesticides."

Testimony issued by the Government Accountability Office with an abstract that begins "The digital television (DTV) transition offers the promise of enhanced television. At the end of the transition, radiofrequency spectrum currently used for analog broadcast television will be used for other wireless services and for critical public safety services. To spur the digital transition while preventing any loss of television service to households, some industry participants and experts have suggested that the government subsidize DTV equipment to enable households to view digital broadcast signals. This testimony provides information on (1) some challenges to administering a subsidy program for DTV equipment, (2) some administrative options for implementing a DTV subsidy, (3) examples of government programs that make use of rebates or vouchers to provide subsidies, and (4) other efforts necessary for the completion of the DTV transition. We discussed administrative challenges to and options for a DTV subsidy with federal and state government officials, electronics manufacturers and retailers, and experts in product promotion. As in our previous work, we take no position on whether a subsidy should be implemented or not, or whether, if a subsidy program is established, it should be implemented in any particular way. While policies other …

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed efforts to reform the Medicare program, focusing on: (1) a conceptual framework for considering the various possible combinations of reform options; and (2) lessons about implementing reforms learned from recent Medicare experience."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed export controls for high performance computers, focusing on how the executive branch: (1) assesses the national security risks associated with the export of high performance computers going to countries of concern; (2) determines when the exports of computers at existing performance levels can no longer be controlled; and (3) has addressed arrangements for post-shipment verifications of high performance computer exports."

Testimony issued by the Government Accountability Office with an abstract that begins "The Nuclear Regulatory Commission (NRC) has the regulatory responsibility to, among other things, ensure that the nation's 103 commercial nuclear power plants are operated in a safe and secure manner. While the nuclear power industry's overall safety record has been good, safety issues periodically arise that threaten the credibility of NRC's regulation and oversight of the industry. Recent events make the importance of NRC's regulatory and oversight responsibilities readily apparent. The terrorist attacks on September 11, 2001, focused attention on the security of facilities such as commercial nuclear power plants, while safety concerns were heightened by shutdown of the Davis-Besse nuclear power plant in Ohio in 2002, and the discovery of missing or unaccounted for spent nuclear fuel at three nuclear power plants. GAO has issued a total of 15 recent reports and testimonies on a wide range of NRC activities. This testimony (1) summarizes GAO's findings and associated recommendations for improving NRC mission-related activities and (2) presents several cross-cutting challenges NRC faces in being an effective and credible regulator of the nuclear power industry."

A statement of record issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the labeling requirements for fresh produce, focusing on: (1) the potential costs associated with the compliance and enforcement of a mandatory country-of-origin labeling requirement at the retail level for fresh produce; (2) the potential trade issues associated with such a requirement; (3) the potential impact of such a requirement on the ability of the federal government and the public to respond to outbreaks of illness caused by contaminated fresh produce; and (4) consumers' views of country-of-origin labeling."

Correspondence issued by the Government Accountability Office with an abstract that begins "The financing of the federal government depends importantly on the effectiveness of the Internal Revenue Service's (IRS) ability to administer the tax laws, including achieving its goals of providing taxpayer services to make voluntary compliance easier and enforcing tax laws to ensure everyone meets their obligations to pay taxes. The President requested $12.6 billion to fund IRS's fiscal year (FY) 2011 operations, including $5.8 billion for enforcement, $4.1 billion for operations support, and $2.3 billion for taxpayer services. Another $387 million is for IRS's Business Systems Modernization (BSM) program, IRS's ongoing effort to improve the agency's tax processing systems. In addition to its annual appropriation, IRS projects that it will also collect and have available to use about $339 million in offsetting collections, including user fees and reimbursable programs. IRS's Strategic Plan 2009-2013 guides budget and program decisions and emphasizes IRS's goals. It recognizes the increasing complexity of tax laws, changing business models, expanding use of electronic data and related security risks, accelerating growth in international tax activities, and growing human capital challenges. With all of these competing priorities for spending in IRS programs, limited resources make it …