Correspondence issued by the General Accounting Office with an abstract that begins "Costs for nursing home care have almost doubled since 1990, from $53 billion to $92 billion in 2000. Much of that spending has been financed with public monies. Under the Medicare and Medicaid programs, the federal government financed 39 percent of the nation's nursing home spending in 2000, up from 28 percent in 1990. As federal outlays have grown, Congress has focused attention on the quality of care delivered and the level of staffing in nursing homes. Nursing home expenditures per resident day varied considerably across Ohio, Mississippi, and Washington--the 3 states covered in GAO's survey. Although the total level of spending varied, the average share devoted to resident-care activities, such as nursing care and medical supplies, was relatively stable. The share of spending devoted to buildings and equipment, by comparison, was more variable. Homes in Ohio and Washington that provided more nursing hours per resident day, especially nurses' aide hours, were less likely than homes providing fewer nursing hours to have repeated serious or potentially life-threatening quality problems. However, GAO found no clear relationship between a nursing home's spending per resident day and the number of serious …

Correspondence issued by the General Accounting Office with an abstract that begins "Government, commercial, and foreign entities rely almost exclusively on information generated by the United States space surveillance network to reduce the risk of space collisions when launching and operating their respective space missions. The network is maintained and operated by the Air Force Space Command; surveillance data is processed and an unclassified portion is sent to the National Aeronautics and Space Administration (NASA) and made available to users. Currently, the Air Force Space Command is proposing a pilot study to replace the current NASA arrangement with one using a Federally Funded Research and Development Center (FFRDC). The study would test the FFRDC's ability to support commercial and foreign entities with space surveillance information and to ensure there is a sufficient market for the data. If the study is approved by the Air Force and Department of Defense, and if authorizing legislation is enacted that includes providing space surveillance support to foreign and commercial entities as part of DOD's mission, the study will begin in about 1 year."

Correspondence issued by the General Accounting Office with an abstract that begins "Congress has provided funding for numerous highway demonstration projects in legislation authorizing surface transportation programs as well as annual appropriations acts for the Department of Transportation (DOT). In some cases, the projects are identified in the legislation itself. In others, they are identified in committee reports accompanying the legislation. These projects are all designated for specific locations within states and for specific purposes, and funds made available for them generally remain available until expended. As of March 31, 2002, there were 30 highway demonstration projects with unobligated balances no longer needed by the states totaling $5.6 million. These unobligated funds were provided in authorization or appropriations acts enacted from 1978 through 1994. Eight of the 30 projects have very small unobligated balances of less than $1.50 each."

Correspondence issued by the General Accounting Office with an abstract that begins "The Department of Energy's (DOE) complex of research and nuclear facilities is not inspected or licensed by an independent external regulator, such as the Nuclear Regulatory Commission (NRC). Instead, DOE and its predecessors have, since 1946, been granted legislative authority to self-regulate nuclear and worker safety in the department's facilities. DOE officials told GAO that (1) the department's current position on external regulation is "neutral" because the Secretary has insufficient information on which to make a decision; (2) another study is needed to develop data on the costs and benefits of making the transition to, and operating under, external regulation, and (3) a realistic implementation plan cannot be developed for the six to nine months DOE estimates the study will take. On the other hand, NRC and the Occupational Safety and Health Administration (OSHA) report that they are prepared to begin regulating the department's 10 science laboratories. The cost of upgrading DOE facilities to regulator standards may not be significant for a variety of reasons. First, NRC concluded from its simulations that few changes to DOE facilities are needed to meet it's licensing requirements. Second, NRC stated that …

Other written product issued by the General Accounting Office with an abstract that begins "This report updates GAO's strategic plan for serving Congress from fiscal year 2002-2007. Although the overall framework of the old plan is still valid, greater emphasis is being placed in a number of areas to reflect the altered agenda of policymakers. Recognizing that Congress and the federal government will focus considerable effort and resources on homeland security, GAO is proposing to increasing its emphasis on overseeing the efficiency and effectiveness of effort across the public and private sectors to protect against and respond to various forms of terrorism. In light of the changing public expectations and needs as well as fiscal pressures, GAO has redefined one of its strategic goals to focus on transforming the federal government's role to meet the challenges of the 21st century--what it does and how it does business. Because of the far reaching demographic and fiscal trends that will affect the United States, GAO excepts to add greater long-range focus to its work to support Congress in addressing program priorities and budget decisions."

Correspondence issued by the General Accounting Office with an abstract that begins "The Centennial of Flight Commission was created in November to commemorate the 100th anniversary of the Wright brothers' flight at Kitty Hawk, North Carolina, in 1903. The Commission is to provide recommendations and advice to the President, Congress, and federal agencies on the most effective ways to encourage and promote national and international participation and sponsorships in commemoration of the centennial of powered flight. All 156 of the Commission's recorded obligations and expenditures during fiscal year 2001 were supported by documentation that was approved by management. The Commission recorded no donations, user fees, or in-kind donations for fiscal year 2001. The Commission's financial records for fiscal year 2001 contained some minor errors that went unnoticed due to a lack of complete records being maintained by the Commission, as well as the Federal Aviation Administration and the National Aeronautics and Space Administration which provide administrative support to the Commission."

Correspondence issued by the General Accounting Office with an abstract that begins "Although pilots and other crew members are currently prohibited from carrying weapons on-board aircraft, the Aviation and Transportation Security Act raises the possibility of arming pilots in the future. In responses to a congressional request, GAO provided information on reasons for and against allowing pilots to carry firearms in the cockpit; questions to be addressed if pilots were armed; and possible alternatives to arming pilots, such as providing them with less than lethal weapons. Proponents' and opponents' views on firearms in the cockpit fall into four categories: the potential effectiveness, risk, and cost-effectiveness of pilots carrying weapons, and policy issues that would arise if pilots were allowed to carry weapons. GAO concluded that without additional research, the potential benefits, risks, and costs of using weapons on aircraft cannot be fully determined."

Correspondence issued by the General Accounting Office with an abstract that begins "GAO reviewed the roles and responsibilities of the General Services Administration's (GSA) Federal Supply Service (FSS) and Federal Technology Service (FTS). Specifically, (1) the possible impact of the current FSS/FTS overlap on the prices paid for and quality of the services provided customer agencies by FSS and FTS, (2) whether the use of streamlined practices and procedures could result in savings and increases in service effectiveness, and (3) whether the statement of work that governs the study of the FSS and FTS that GSA has under contract will likely result in the kind of information needed to assess whether the current organization needs to be restructured."

Correspondence issued by the General Accounting Office with an abstract that begins "Congress limited the Executive Office of the President's use of systems modernization funds until the White House gave Congress a report that included an enterprise architecture, a description of information technology (IT) capital planning and investment control processes, a capital investment plan, and an IT human capital plan. The White House submitted its report to Congress in March 2002. GAO reviewed the report and found progress in the following four areas: (1) developing an officewide blueprint for modernizing its enterprise architecture; (2) defining officewide IT capital planning and investment control processes for implementing the enterprise architecture consistent with best practices; (3) correcting existing system problems and introducing infrastructure upgrades consistent with its defined technical rules and definitions; and (4) facilitating ongoing and planned efforts to complete the enterprise architecture, expand the capital planning and investment process, and manage the implementation of its fiscal year 2002 and 2003 capital investment plans. The White House has also begun using effective IT human capital management practices. Theses efforts should be considered a work in progress rather than a completed task. Therefore, the success of the White House's modernization effort depends on …

Correspondence issued by the General Accounting Office with an abstract that begins "Title I of the Global AIDS and Tuberculosis Relief Act provided for the creation of a trust fund to be administered by the World Bank to combat the HIV/AIDS epidemic. The act mandates that the Comptroller General of the United States submit a report to Congress evaluating the effectiveness of the fund within 2 years of enactment of the statute. In January 2002, the Global Fund to Fight AIDS, Tuberculosis, and Malaria was formally established, but as of May 2002, funds had not been disbursed to any project. GAO reviewed the status of the Global Fund and found that as of May 2002, the Global Fund had received more than $2 billion in pledges, with $700 million available for disbursement in 2002. The United States has pledged a total of $300 million to the Fund through fiscal year 2002, and the administration has requested an additional $200 million in its fiscal year 2003 budget request. At its first board meeting in January 2002, the Fund called for proposals for its first round of grants and had received 322 proposals for projects in 101 countries by the March deadline. …

Correspondence issued by the General Accounting Office with an abstract that begins "This report responds to a congressional request that GAO review allegations that the National Cancer Institute's Special Virus Cancer Program (SVCP) created the AIDS virus. GAO found no evidence to support the allegations that SVCP created the AIDS virus."

Correspondence issued by the General Accounting Office with an abstract that begins "To meet long-standing concerns about the Department of Defense's (DOD) organization and management of national security space activities, Congress chartered the Commission to Assess United States National Security Space Management and Organization to study the organization and management of space activities that support U.S. national security interests and make recommendations for improvements. DOD has decided to take actions related to 10 of the commission's 13 recommendations. These include recommendations for organizational changes aimed at consolidating some activities, changing chains of command, opening lines of communications, and modifying policies to achieve greater responsibility and accountability. Many changes have been implemented within the last few months, and thus related processes and procedures have not been completed. As a result, it is too early to determine whether these changes will enable DOD to promote and protect U.S. interests in space more effectively. Moreover, DOD has not yet completed plans for achieving some long-range goals, such as developing a cadre of space professionals and integrating military and intelligence space activities. The Secretary of Defense chose not to implement three of the commission's recommendations and is instead (1) opting to establish a focal …

Testimony issued by the General Accounting Office with an abstract that begins "The Federal Financial Management Improvement Act (FFMIA) of 1996 ensures that agency financial management systems routinely provide reliable and timely financial information on the investment of resources, reduced costs and programs oversight. Although many agencies are receiving unqualified opinions on their financial statements, auditor determinations of FFMIA compliance are lagging. To achieve the financial management improvements envisioned by the Chief Financial Officers Act, FFMIA, and more recently, the President's Management Agenda, agencies need to modernize their financial systems to generate reliable, useful, and timely financial information throughout the year and at year-end."

Testimony issued by the General Accounting Office with an abstract that begins "The Medicaid program served 33.4 million low-income families as well as elderly, blind, and disabled persons at a cost of $119 billion to the federal government and $88 billion to the states in fiscal year 2000. States are responsible for safeguarding Medicaid funds by making proper payments to providers, recovering misspent funds, and accurately reporting costs for federal reimbursement. At the federal level, the Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing state financial activities and ensuring the propriety of expenditures reported for federal reimbursement. Audits of state Medicaid finances have identified millions of dollars of questionable or unallowable costs. In addition, annual financial statement audits have identified many internal control weaknesses in CMS oversight of state Medicaid operations. CMS has only recently begun to assess areas at greatest risk for improper payments. As a result, controls that focus on the highest risk areas and resources had not yet been deployed for areas of greatest risk. Since 1998, auditors have noted that CMS failed to institute an oversight process that effectively reduced the risk of inappropriate medical claims and payments. CMS attributed most of the …

Testimony issued by the General Accounting Office with an abstract that begins "During World War I, the U.S. Army operated a large research facility to develop and test chemical weapons and explosives in the area that became the Spring Valley neighborhood in Washington, D.C. Buried ordnance, discovered there in 1993, led to the designation by the Department of Defense (DOD) of 61 acres as a formerly used defense site. Through fiscal year 2001, DOD had spent over $50 million to identify and remove hazards at the site. The government entities involved have identified and removed a large number of hazards, but the number remaining is unknown. The health risks influencing cleanup activities at Spring Valley are the possibility of injury or death from exploding or leaking ordnance and containers of chemical warfare agents and potential long-term health problems from exposure to arsenic-contaminated soil. As of April 2002, the U.S. Army estimated that the remaining cleanup activities would cost $7.1 million and take 5 years, but these estimates are unreliable. This testimony summarized a June report (See GAO-02-556)."

Testimony issued by the General Accounting Office with an abstract that begins "The Department of Labor's Unemployment Insurance (UI) program is a federal-state partnership designed to partially replace lost earnings of individuals who become unemployed through no fault of their own and to stabilize the economy in times of economic downturn. The health of each state's UI program depends, in part, on their ability to control benefit payments by accurately determining eligibility for UI benefits in a timely manner. Labor's Office of Inspector General (OIG) and others have identified numerous aspects of the UI program that may be vulnerable to overpayments and fraud. Of the $30 billion in UI benefits paid in calendar year 2001, Labor estimates that this includes $2.4 billion in overpayments, including $560 million attributable to fraud or abuse. Labor's analysis also suggests that the states could have detected or recovered $1.3 billion of the total overpayments given their current policies and procedures. The management and operational practices at both the state and federal level contribute to overpayments in the UI program. At the state level, many states place a higher priority on quickly processing and paying UI claims than on taking the necessary steps to adequately …

Testimony issued by the General Accounting Office with an abstract that begins "The Environmental Protection Agency's (EPA) hazardous waste ombudsman was established as a result of the 1984 amendments to the Resource Conservation and Recovery Act. Recognizing that the ombudsman provides a valuable service to the public, EPA retained the ombudsman function as a matter of policy after its legislative authorization expired in 1988. Over time, EPA expanded the national ombudsman's jurisdiction to include Superfund and other hazardous waste programs, and, by March 1996, EPA had designated ombudsmen in each of its ten regional offices. In November 2001, the agency announced that the national ombudsman would be relocated from the Office of Solid Waste and Emergency Response to the Office of the Inspector General (OIG) and would address concerns across the spectrum of EPA programs, not just hazardous waste programs. Although there are no federal requirements or standards specific to the operation of ombudsman offices, several professional organizations have published standards of practice relevant to ombudsmen who deal with public inquiries. If EPA intends to have an ombudsman function consistent with the way the position is typically defined in the ombudsman community, placing the national ombudsman within the OIG does …

Testimony issued by the General Accounting Office with an abstract that begins "Since the terrorist attacks on September 11, 2001, and the subsequent anthrax incidents, there has been concern about the ability of the federal government to prepare for and coordinate an effective public health response given the broad distribution of responsibility for that task at the federal level. More then 20 federal departments and agencies carry some responsibility for bioterrorism preparedness and response. The President's proposed Homeland Security Act of 2002 would bring many of these federal entities with homeland security responsibilities--including public health preparedness and response--into one department to mobilize and focus assets and resources at all levels of government. The proposed reorganization has the potential to assist in the coordination of public health preparedness and response programs at the federal, state, and local levels. There are concerns, however, about the proposed transfer of control of public health assistance programs that have both basic public health and homeland security functions from Health and Human Services to the new department. Transferring control over these programs, including priority setting, to the new department has the potential to disrupt some programs critical to basic public health responsibilities. The President's proposal is …

Testimony issued by the General Accounting Office with an abstract that begins "Medicare has paid higher than market rates for various medical equipment and supplies and often considerably higher than provider acquisition costs for Medicare-covered outpatient drugs. Congress has enacted a series of legislative changes affecting payment methods and payment adjustment authority for medical equipment and supplies and outpatient drugs since the late 1980s. However, progress in setting appropriate rates has been mixed, owing, in part, to various constraints faced by the agency responsible for administering Medicare--the Centers for Medicare and Medicaid Services (CMS). Because of the program's size, scope, and role as a public payer, Medicare has limited options to set and adjust payments for medical equipment, supplies and outpatient drugs. Medicare's method of paying for medical equipment and supplies is through fee schedules that remain tied to suppliers' historical charges to Medicare rather than market prices. Medicare's payment approaches lack flexibility to keep pace with market changes, and, as a result, Medicare often pays higher prices than other public payers. Previous efforts to lower Medicare's overly generous payments suggest several lessons. First, payment changes are most effectively implemented when the process used to set or adjust a rate …

Testimony issued by the General Accounting Office with an abstract that begins "The federal government has spent billions of dollars attempting to reduce the consumption of petroleum in the transportation sector for over 25 years. Throughout the period, the government has tried tax incentives, mandates to use vehicles that run on alternative fuels, and laws designed to enhance fuel efficiency. More recently, the federal government conducted a $1.2 billion partnership between industry and government, the Partnership for a New Generation of Vehicle, to develop a highly fuel-efficient car. The administration has proposed a new initiative, known as FreedomCAR, focused on developing hydrogen fuel cells that will provide the technology necessary to create cars and trucks that do not require petroleum and have no polluting emissions--without sacrificing safety or convenience. FreedomCAR will operate as a cooperative research effort between the Department of Energy and General Motors, Daimler-Chrysler, and the Ford Motor Company. The FreedomCAR initiative should make sure that it (1) performs research that private industry would not do on its own, (2) specifies a clear and measurable goal, (3) devises a strategy to directly address that goal, and (4) considers whether consumers will buy the products resulting from the research …

Testimony issued by the General Accounting Office with an abstract that begins "Identity theft involves "stealing" another person's personal identifying information, such as their Social Security number, date of birth, or mother's maiden name, and using that information to fraudulently establish credit, run up debt, or take over existing financial accounts. Another pervasive category is the use of fraudulent identity documents by aliens to enter the United States illegally to obtain employment and other benefits. The prevalence of identity theft appears to be growing. Moreover, identity theft is not typically a stand-alone crime; rather identity theft is usually a component of one or more white-collar or financial crimes. According to Immigration and Naturalization Service (INS) officials, the use of fraudulent documents by aliens is extensive, with INS inspectors intercepting tens of thousands of fraudulent documents at ports of entry in each of the last few years. These documents were presented by aliens attempting to enter the United States to seek employment or obtain naturalization or permanent residency status. Federal investigations have shown that some aliens use fraudulent documents in connection with more serious illegal activities, such as narcotics trafficking and terrorism. Efforts to combat identity fraud in its many forms …

Testimony issued by the General Accounting Office with an abstract that begins "This testimony describes China's development of rule of law practices related to the commitments China made to the World Trade Organization (WTO), which it joined in November 2001. When China joined the WTO, it agreed that its legal measures would be consistent with its WTO obligations. GAO found 60 commitments that specifically obligate China to enact, repeal, or modify trade-related laws or regulations. In addition, China has made a substantial number of other WTO commitments related to the rule of law in transparency, judicial review, uniform enforcement of laws, and nondiscriminatory treatment. Chinese government officials described how their efforts for reform go beyond China's WTO commitments and include broad reforms of laws and regulations at the national and provincial levels, as well as reforms of judicial and administrative procedures. However, Chinese officials acknowledged the challenges they face in completing the necessary reforms and identified the need for outside training assistance. According to GAO's survey, U.S. businesses in China consider rule of law-related WTO commitments to be important, especially the consistent application of laws, regulations, and practices in China, and enforcement of intellectual property rights. However, a majority of …

Testimony issued by the General Accounting Office with an abstract that begins "The District of Columbia Superior Court has made progress in planning the transition of its Family Division to a Family Court, but some challenges remain. The Superior Court's transition plan addresses most, but not all, of the required elements outlined in the District of Columbia Family Court Act of 2001. Significantly, the completion of the transition hinges on timely completion of a complex series of interdependent plans intended to obtain and renovate physical space to house the court and its functions. All required space may not be available, as currently planned, to support the additional judges the Family Court needs to perform its work in accordance with the act, making it uncertain as to when the court can fully complete its transition. Although not required as part of its transition plan efforts, the Superior Court has begun to coordinate its activities with social services agencies in the District. However, the court and agencies face challenges in achieving coordinated services in the longer term. Finally, the development and application of the District of Columbia Courts' Integrated Justice Information System will be critical for the Family Court to be able …

Testimony issued by the General Accounting Office with an abstract that begins "The Immigration and Naturalization Service (INS) developed strategies in the 1990s to control illegal immigration across U.S. borders and to address enforcement priorities within the country. In 1994, INS's Border Patrol issued a strategy to deter illegal entry through "prevention through deterrence;" that is, to raise the risk of being apprehended for illegal aliens to where they would consider it futile to try to enter. The plan called for targeting resources in a phased approach, starting in areas with the greatest illegal activity. In 1999, INS issued its Interior Enforcement Strategy to focus resources on areas that would have the greatest impact on reducing the size and annual growth of the illegal resident population. The strategy established the following five areas: (1) identify and remove criminal aliens and minimize recidivism; (2) deter, dismantle, and diminish smuggling or trafficking of aliens; (3) respond to community reports and complaints about illegal immigration; (4) minimize immigration benefit fraud and other document abuse; and (5) block and remove employers' access to undocumented workers. For these to be effective, INS needs better data to determine staff needs, reliable information technology, clear and consistent …