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VA Health Care: Implementation of Prescribing Guideline for Atypical Antipsychotic Drugs Generally Sound
A letter report issued by the General Accounting Office with an abstract that begins "The Department of Veterans Affairs (VA) provides health care services to veterans who have been diagnosed with psychosis--primarily schizophrenia, a disorder that can substantially limit their ability to care for themselves, secure employment, and maintain relationships. These veterans also have a high risk of premature death, including suicide. Effective treatment, especially antipsychotic drug therapy, has reduced the severity of their illnesses and increased their ability to function in society. VA's guideline for prescribing atypical antipsychotic drugs is sound and consistent with published clinical practice guidelines used by public and private health care systems. VA's prescribing guideline, recommends that physicians use their best clinical judgment, based on clinical circumstances and patients' needs, when choosing among the atypical drugs. Most Veterans Integrated Service Networks and facilities use VA's prescribing guideline; however, five VISNs have additional policies and procedures for prescribing atypical antipsychotic drugs. Although these procedures help manage pharmaceutical cost, they also have the potential to result in more weight given to cost than clinical judgment which is not consistent with the prescribing guideline."
Date:
April 29, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Skilled Nursing Facilities: Medicare Payments Exceed Costs for Most but Not All Facilities
A letter report issued by the General Accounting Office with an abstract that begins "This report addresses (1) the relationship between Medicare skilled nursing facility (SNF) payments and the costs of treating Medicare patients in freestanding SNFs, as well as the effect of Medicare SNF payments on the financial condition of these facilities, and (2) the relationship between Medicare SNF payments and the costs of treating patients in hospital-based SNFs, as well as the factors that may account for cost differences between hospital-based and freestanding SNFs."
Date:
December 31, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Highway Trust Fund: Overview of Highway Trust Fund Financing
A statement of record issued by the General Accounting Office with an abstract that begins "The Transportation Equity Act for the 21st Century changes the budgetary treatment of programs financed by the Highway Trust Fund. In particular, the act guaranteed annual funding levels for most highway and transit programs and linked highway user tax receipts, such as those from motor fuel and truck tire taxes, to the annual funding levels for highway programs. Revenue aligned budget authority adjustments are made to the annual guaranteed funding level provided in the act as highway account receipt levels change. For the first time, the adjustment for fiscal year 2003 is negative--decreasing the guaranteed level of highway funding by $4.369 billion. GAO found that the amounts distributed to the Highway Trust Fund for the first nine months of fiscal year 2001, as adjusted based on the Internal Revenue Service's certifications, were reasonable and adequately supported based on available information."
Date:
February 11, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Federally Chartered Corporation: Review of the Financial Statement Audit Report for the Agricultural Hall of Fame for 2001 and 2000
Correspondence issued by the General Accounting Office with an abstract that begins "GAO reviewed the audit report covering the financial statements of the Agricultural Hall of Fame for fiscal years 2000 and 2001. GAO found no reportable instances of noncompliance. The audit reports included the auditors' opinions that the financial statements of the corporation were presented fairly in accordance with generally accepted accounting principles."
Date:
July 26, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Applying Agreed-Upon Procedures: Highway Trust Fund Excise Taxes
Correspondence issued by the General Accounting Office with an abstract that begins "GAO helped the Department of Transportation to determine whether the net excise tax revenue distributed to the Highway Trust Fund for fiscal year 2001 was supported by the underlying records. In performing the agreed-upon procedures, GAO did its work in accordance with U.S. generally accepted government auditing standards, which incorporate financial audit and attestation standards established by the American Institute of Certified Public Accountants."
Date:
February 11, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
National Park Service: Status of Efforts to Develop Better Deferred Maintenance Data
Correspondence issued by the General Accounting Office with an abstract that begins "Beginning in the 1980s, the National Park Service spent $11 million to develop and implement a maintenance management system. The system was eventually terminated because it failed to provide park managers with all the information they needed to manage their deferred maintenance workload. In 1998, the Park Service started a new asset management process to provide a systematic method for documenting deferred maintenance needs and tracking progress in reducing the amount of deferred maintenance. GAO found that the Park Service has made progress in developing a new asset management process. When finally implemented, the process should provide the agency with a (1) reliable inventory of its assets; (2) process for reporting on the condition of each asset; and (3) systemwide methodology for estimating deferred maintenance costs for each asset. Although the new process is promising, its success cannot be determined until staff in each of the park units are trained and the new asset management process is fully and properly implemented."
Date:
April 12, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Federally Chartered Corporation: Review of the Financial Statement Audit Report for the Aviation Hall of Fame for 2000 and 1999
Correspondence issued by the General Accounting Office with an abstract that begins "GAO reviewed the audit report covering the financial statements of the Aviation Hall of Fame for fiscal years 1999 and 2000. The audit reports included the auditors' opinions that the financial statements of the corporation were presented fairly in accordance with generally accepted accounting principles."
Date:
July 26, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
U.S. Postal Service: Accounting for Postretirement Benefits
Correspondence issued by the General Accounting Office with an abstract that begins "A 1992 GAO report found that the U.S. Postal Service's (USPS) use of the pay-as-you-go basis of accounting for the postretirement health benefit costs of employers participating in multiemployer plans was in accordance with existing private sector generally accepted accounting principles. GAO recently concluded that that report did not adequately consider the potential accounting ramifications of USPS's unique statutory obligations, which are not applicable to other multiemployer plans--both pension and other postretirement benefit plans. Given this, combined with the economic and competitive environment USPS now faces, ongoing efforts to transform USPS to address its financial and operational challenges, and both the Congress's and the public's call for more information and transparency in financial reporting, GAO concludes that now is an opportune time for USPS to reassess how best to account for and disclose this significant financial obligation."
Date:
September 12, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Bureau of Prisons Contract Payments
Correspondence issued by the General Accounting Office with an abstract that begins "GAO reviewed the Bureau of Prisons to determine whether it had made overpayments to contractors. During fiscal year 2001, the Bureau of Prisons had 24 open construction contracts that totaled about $1.9 billion. In addition to general disbursement controls, GAO found internal controls specific to construction contracts in which both the project representative and the contracting officer must approve each monthly progress payment invoice. GAO sampled 27 payments on five construction contracts to determine if construction contract payment controls were properly designed, in place, and operating to prevent or detect overpayments. GAO found that the internal controls were in place and operating and construction contract payment amounts were correct, or, if errors occurred, they were detected and corrected promptly as a normal part of the payment system. A few minor clerical errors were subsequently detected and corrected by the Bureau of Prisons through its own routine control procedures before GAO made its review. GAO concludes that the risk of undetected construction contractor overpayments at the Bureau of Prisons appears to be small."
Date:
March 20, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Charitable Choice: Overview of Research Findings on Implementation
A briefing report issued by the General Accounting Office with an abstract that begins "Charitable choice provisions require states and localities to allow religious organizations to compete for federal funding on the same basis as other social service providers, without impairing the religious character of such organizations. Congress has been considering legislation to expand charitable choice provisions to other government programs. At least 19 states have contracted with faith-based organizations (FBOs) to provide some welfare services. Moreover, states are using various approaches to implement charitable choice legislation. For example, some states have created state faith-based liaisons to promote greater awareness of charitable choice provisions or removed barriers to contracting with FBOs. Several factors have limited the establishment of collaborations between FBOs and states, including some FBOs' lack of awareness and understanding of charitable choice provisions, their reluctance to partner with government, and the limited financial and administrative capacity of some FBOs. Once collaborations have occurred, some small FBOs have had problems (1) covering ongoing costs while awaiting government reimbursement or (2) managing the performance-based contracts because of limited technological and management systems. GAO found no information with which to assess the effectiveness of FBOs as providers of social services. Although …
Date:
January 18, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Federally Chartered Corporation: Review of the Financial Statement Audit Report for the National Conference on Citizenship for Fiscal Years 2001 and 2000
Correspondence issued by the General Accounting Office with an abstract that begins "GAO reviewed the audit report covering the financial statements of the National Conference on Citizenship, for fiscal years 2001 and 2002. GAO found no reportable instances of noncompliance. The audit report included the auditors' opinions that the financial statements of the corporation were presented fairly in accordance with generally accepted accounting principles."
Date:
September 20, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Department of Defense's Compliance with Statutory Requirements for Funding Military Operations Where Funds Were Not Provided in Advance
Correspondence issued by the General Accounting Office with an abstract that begins "Section 127a, title 10 of the United States Code provides the Department of Defense (DOD) with two options for funding nontraining deployments and operations when Congress has not provided funds in advance. These options involve waiving reimbursements for support services and transferring amounts from other DOD accounts. Section 127a prescribes specific procedures to be followed by DOD when these funding options are used; requires DOD to notify Congress of and report on certain new contingency operations; and states that the Comptroller General of the United States shall from time to time, and when requested by a Committee of Congress, conduct a review to determine whether DOD is complying with the statutory requirements and limitations. GAO found that DOD has complied with the requirements contained in section 127a. Since the current notification and reporting requirements of section 127a were enacted in 1996, DOD has provided congressional notification for four operations, involving Bosnia, Kosovo, hurricane relief in Central America, and East Timor. DOD has rarely used the funding options provided in section 127a. It used the section 127a funding option allowing waiver of reimbursement for units providing support once, for …
Date:
July 19, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Options to Enhance the Long-term Viability of the Essential Air Service Program
Correspondence issued by the General Accounting Office with an abstract that begins "Over two decades ago, Congress deregulated the airline industry, phasing out the federal government's control over domestic fares and routes served and allowing market forces to determine the price, quantity, and quality of service. Concerned that air service to some small communities would suffer in a deregulated environment, Congress established the Essential Air Service (EAS) program as part of the Airline Deregulation Act of 1978. The act guaranteed that communities served by air carriers before deregulation would continue to receive a certain level of scheduled air service. As of July 1, 2002, the EAS program provided subsidies to air carriers to serve 114 communities--79 in the continental United States and another 35 in Alaska, Hawaii and Puerto Rico. From 1995 to July 2002, the net member of EAS-subsidized communities increased by four in the continental United States. Several factors--including increasing carrier costs, limited passenger revenue, and increasing numbers of eligible communities requiring subsidized service--are likely to affect potential future subsidy requirements of the EAS program. GAO identified and evaluated major categories of options to enhance the long-term viability of the EAS program, each of which has associated potential …
Date:
August 30, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
District of Columbia: Planned Funding and Schedule for D.C. Public Schools' Modernization Program Are Unrealistic
Correspondence issued by the General Accounting Office with an abstract that begins "In April 2002, GAO testified on the major challenges facing the District of Columbia Public School system faces in modernizing and renovating the District's schools (see GAO-02-628T). The school system, with the assistance of the U.S. Army Corps of Engineers, has made considerable progress in making emergency repairs during the past few years. However, the school system now faces the more complex task of modernizing--either through renovation or through new construction--virtually every public school in the District of Columbia. As a result, the school system must adopt a modernization program that will cost significantly more and take longer to accomplish than originally projected. In addition, the school system faces the challenge of ensuring that sufficient funds are budgeted for asbestos management activities."
Date:
July 25, 2002
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
Multifamily Rural Housing: Prepayment Potential and Long-Term Rehabilitation Needs for Section 515 Properties
A letter report issued by the General Accounting Office with an abstract that begins "Nearly 450,000 elderly and other households depend on federal assistance to live in multifamily rural rental properties that were constructed with subsidized federal loans. Because the properties were built in areas when and where privately financed housing units, affordable by lower income households, were not considered economically feasible, the U.S. Department of Agriculture's Rural Housing Service (RHS) has made direct loans available to developers of affordable multifamily housing under its section 515 program. RHS has funded many more new properties than the portfolio has lost through prepayment. The number of new properties added to the portfolio exceeded the number that left the program after prepayment in every year except 2001. If the statutory requirement restricting prepayment for loans made before December 1989, were changed to allow prepayment without restrictions after 20 years from the date of the loan, prepayment could be an option for the owners of 3,900 of all section 515 properties over the next eight years. RHS field staff routinely inspect properties, complete and retain detailed descriptions of noted deficiencies, and transmit the summaries of the deficiencies identified to a central database. Only current …
Date:
May 10, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Nonproliferation R&D: NNSA's Program Develops Successful Technologies, but Project Management Can Be Strengthened
A letter report issued by the General Accounting Office with an abstract that begins "The mission of the National Nuclear Security Administration's (NNSA) Nonproliferation and Verification Research and Development (R&D) Program is to conduct needs-driven research, development, testing, and evaluation of new technologies that are intended to strengthen the United States' ability to prevent and respond to nuclear, chemical, and biological attacks. In fiscal years 1998 through 2002, the Nonproliferation and Verification R&D program received an average of $218 million per year--a total of $1.2 billion. Nearly 75 percent of that total was distributed for R&D at three NNSA national laboratories. Two of the three research areas of the Nonproliferation and Verification R&D Program lack a formal process to identify users' needs, and the tools used to monitor project progress are inadequate. In terms of users, NNSA's role is to develop technologies for, and transfer them to, users in the federal government, the intelligence community, law enforcement, and others. The program requires that projects' life-cycle plans and quarterly reports contain detailed information on project time frames, milestones, users of technologies, and deliverables. Officials from federal, state, and local agencies that use the technology developed by NNSA's R&D program have found …
Date:
August 23, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
The White House: Allegations of Damage During the 2001 Presidential Transition
A letter report issued by the General Accounting Office with an abstract that begins "Damage, theft, vandalism, and pranks occurred in the White House complex during the 2001 presidential transition. Several Executive Office of the President (EOP) staff claim that they observed (1) messy offices containing excessive trash or personal items, (2) numerous prank signs containing derogatory and offensive statements about the president, (3) government property that was damaged, and (4) missing items. Further, EOP staff believed that what they observed during the transition was done intentionally. Some former Clinton administration staff acknowledged that they observed some damaged items and prank signs. However, the former Clinton administration staff said that (1) the amount of trash found during the transition was what could be expected; (2) they did not take the missing items; (3) some furniture was unintentionally broken before the transition, and little money was spent on repairs and upkeep during the administration; and (4) many of the reported observations were not of vandalism. This report makes several recommendations regarding the prevention and documentation of vandalism during future presidential transitions."
Date:
June 7, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Skilled Nursing Facilities: Providers Have Responded to Medicare Payment System By Changing Practices
A letter report issued by the General Accounting Office with an abstract that begins "In 1998, the Health Care Financing Administration implemented a prospective payment system (PPS) for skilled nursing facility (SNF) services provided to Medicare beneficiaries. PPS is intended to control the growth in Medicare spending for skilled nursing and rehabilitative services that SNFs provide. Two years after the implementation of PPS, the mix of patients across the categories of payment groups has shifted, as determined by the patients' initial minimum data set assessments. Although the overall share of patients classified into rehabilitation payment group categories based on their initial assessments remained about the same, more patients were classified into the high and medium rehabilitation payment group categories, and fewer were initially classified into the most intensive (highest paying) and least intensive (lowest paying) rehabilitation payment group categories. Two years after PPS was implemented the majority of patients in rehabilitation payment groups received less therapy than was provided in 1999. This was true even for patients within the same rehabilitation payment group categories. Across all rehabilitation payment group categories, fewer patients received the highest amounts of therapy associated with each payment group."
Date:
August 23, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Purchase Cards: Control Weaknesses Leave the Air Force Vulnerable to Fraud, Waste, and Abuse
A letter report issued by the General Accounting Office with an abstract that begins "In July 2001 and March 2002, GAO testified on significant breakdowns in internal controls over purchase card transactions at two Navy sites that resulted in fraud, waste, and abuse. As a result, the Congress asked GAO to audit purchase card controls at DOD. This report focuses on Air Force purchase card controls and addresses whether the overall management control environment and key internal controls were effective in preventing potentially fraudulent, improper, and abusive purchase card transactions."
Date:
December 20, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Military Personnel: Active Duty Benefits Reflect Changing Demographics, but Opportunities Exist to Improve
A letter report issued by the General Accounting Office with an abstract that begins "The Department of Defense (DOD) uses employee benefits--that is, indirect compensation above and beyond a service member's basic pay--as a tool to recruit and retain personnel. DOD has instituted a number of benefits that reflect demographic changes in the active duty force since the draft ended and the military became an all-volunteer force in 1973. Many of these benefits address one of the most significant demographic changes--an increase in service members with family obligations. A second major demographic change in the active military has been a growing proportion of female service members. DOD has responded positively to most demographic changes by incorporating a number of family-friendly benefits; however, opportunities exist to improve current benefits in this area. In comparing the types of benefits offered by the military with those offered in the private sector, GAO did not identify significant gaps in the benefits available to military personnel. GAO did not make direct comparisons between individual military and private-sector benefits but did determine that all the core benefits offered by most private-sector firms--retirement pay, health care, life insurance, and paid time off--are offered by the military."
Date:
September 18, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Defense Acquisitions: Steps to Improve the Crusader Program's Investment Decisions
A letter report issued by the General Accounting Office with an abstract that begins "The Army wants an artillery system with greater firepower, range, and mobility than its current self-propelled howitzer. In 1994, the Army began to develop the Crusader, an advanced artillery system consisting of a self-propelled 155-millimeter howitzer and a resupply vehicle. The Department of Defense (DOD) will decide next year whether the Crusader program should enter its system development and demonstration stage, which will require the commitment of major resources. GAO found that the Crusader program has made considerable progress in developing key technologies and reducing its size and weight. However, more progress and knowledge is needed to minimize the risk of cost overruns, schedule delays, and performance shortfalls. The Crusader program will likely enter product development with most of its critical technologies less mature than best practices recommend. Most of the Crusader's critical technologies have been demonstrated in a relevant environment but not in the more demanding operational environment. Although the Army is reducing the Crusader's weight so that two vehicles can be deployed on a C-17 aircraft, the deployability advantage gained does not appear significant. The reduction in the Crusader system's weight would only decrease …
Date:
February 25, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Surface and Maritime Transportation: Developing Strategies for Enhancing Mobility: A National Challenge
A letter report issued by the General Accounting Office with an abstract that begins "The U.S. surface and maritime transportation systems include roads, mass transit systems, railroads, and ports and waterways. One of the major goals of these systems is to provide and enhance mobility, that is, the free flow of passengers and goods. Mobility provides people with access to goods, services, recreation, and jobs; provides businesses with access to materials, markets and people; and promotes the movement of personnel and material to meet national defense needs. During the past decade, total public sector spending increased for public roads and transit, remained constant for waterways, and decreased for rail. Passenger and freight travel are expected to increase over the next 10 years, according to Department of Transportation projections. Passenger vehicle travel on public roads is expected to grow by 24.7 percent from 2000 to 2010. Passenger travel on transit systems is expected to increase by 17.2 percent over the same period. Amtrak has estimated that intercity passenger rail ridership will increase by 25.9 percent from 2001 to 2010. The key factors behind increases in passenger travel, and the modes travelers choose, are expected to be population growth, the aging of …
Date:
August 30, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Drug Control: DEA Could Improve Its Heroin Signature and Domestic Monitor Programs' Geographic Source Data
A letter report issued by the General Accounting Office with an abstract that begins "The Drug Enforcement Administration (DEA) runs two programs--the Heroin Signature Program and the Domestic Monitor Program--that provide information on trends in heroin trafficking. The only programs of their kind in this country, these two program conduct chemical analyses to pinpoint the geographic origin of heroin being sold on the streets. The Domestic Monitor Program determines (1) the source of heroin that has been bought undercover in 23 U.S. cities and (2) the purity and price of heroin at the retail level. The Heroin Signature Program provides law enforcement with information on the origins of heroin at the wholesale and retail level in some U.S. cities. Data from the two programs are included in intelligence and investigative reports provided to DEA and other federal law enforcement agencies, which use this information to adjust their drug enforcement efforts. The quantity of heroin seized by the Customs Service at ports-of-entry but not sent to DEA for testing may make a difference in the results reported by DEA. All seizures at ports-of-entry forwarded to DEA are tested for geographic source, according to DEA officials. However, Customs is not required to …
Date:
March 29, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Military Personnel: Management and Oversight of Selective Reenlistment Bonus Program Needs Improvement
A letter report issued by the General Accounting Office with an abstract that begins "Because of the recent growth in DOD's Selective Reenlistment Bonus Program, the House Appropriations Committee asked GAO to determine (1) the extent to which the services have followed their criteria for managing their programs and (2) whether DOD has provided adequate guidance for and oversight of the program."
Date:
November 25, 2002
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library