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Computer-Based Patient Records: Short-Term Progress Made, but Much Work Remains to Achieve a Two-Way Data Exchange Between VA and DOD Health Systems (open access)

Computer-Based Patient Records: Short-Term Progress Made, but Much Work Remains to Achieve a Two-Way Data Exchange Between VA and DOD Health Systems

Testimony issued by the General Accounting Office with an abstract that begins "For the past 5 years, the Departments of Veterans Affairs and Defense have been working to exchange health care data and create electronic records for veterans and active duty personnel. Such exchange is seen as a means of reducing the billions of dollars that the departments spend annually on health care services and making such data more readily accessible to those treating our country's approximately 13 million veterans, military personnel, and dependents. This is especially critical when military personnel are engaged in conflicts all over the world, and their health records can reside at multiple locations. GAO has reported on these efforts several times, most recently in September 2002. At the request of the Subcommittee, GAO is updating its observations on the departments' efforts, focusing on (1) the reported status of the ongoing, one-way exchange of data, the Federal Health Information Exchange, and (2) progress toward achieving the longer term two-way exchange under the HealthePeople (Federal) initiative."
Date: November 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Ambulance Services: Medicare Payments Can Be Better Targeted to Trips in Less Densely Populated Rural Areas (open access)

Ambulance Services: Medicare Payments Can Be Better Targeted to Trips in Less Densely Populated Rural Areas

A letter report issued by the General Accounting Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS) recently implemented a Medicare ambulance fee schedule in which providers are paid a base payment per trip plus a mileage payment. An adjustment is made to the mileage rate for rural trips to account for higher costs. CMS has stated that this rural adjustment may not sufficiently target providers serving sparsely populated rural areas. The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) directed GAO to examine rural ambulance costs. GAO identified factors that affect ambulance costs per trip, examined how these factors varied across geographic areas, and analyzed whether Medicare payments account for geographic cost differences. GAO used survey data on ambulance providers and Medicare claims data."
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
DOD Business Systems Modernization: Important Progress Made to Develop Business Enterprise Architecture, but Much Work Remains (open access)

DOD Business Systems Modernization: Important Progress Made to Develop Business Enterprise Architecture, but Much Work Remains

A letter report issued by the General Accounting Office with an abstract that begins "The National Defense Authorization Act for Fiscal Year 2003 directed the Department of Defense (DOD) to develop an enterprise architecture and a transition plan that meets certain requirements. The act also directed DOD to have a process for controlling its system investments. As required by the act, GAO assessed DOD's actions to comply with the act's requirements and recently issued a report to congressional defense committees. This report provides further details of GAO's assessment results regarding (1) the extent to which DOD's actions complied with the requirements of the act and (2) DOD's plans for further development and implementation of its architecture."
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Homeland Security: Risks Facing Key Border and Transportation Security Program Need to Be Addressed (open access)

Homeland Security: Risks Facing Key Border and Transportation Security Program Need to Be Addressed

A letter report issued by the General Accounting Office with an abstract that begins "The Department of Homeland Security (DHS) plans to establish a program to strengthen management of the pre-entry, entry, status, and exit of foreign nationals who travel to the United States. The goals of the program, known as the United States Visitor and Immigrant Status Indicator Technology (US-VISIT), are to facilitate legitimate trade and travel, enhance national security, and adhere to U.S. privacy laws and policies. By congressional mandate, DHS is to develop and submit for approval an expenditure plan for US-VISIT that satisfies certain conditions, including being reviewed by GAO. GAO was asked to determine, among other things, whether the plan satisfies these conditions and to provide observations about the plan and DHS's management of the program."
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Military Personnel: Preliminary Observations Related to Income, Benefits, and Employer Support for Reservist During Mobilizations (open access)

Military Personnel: Preliminary Observations Related to Income, Benefits, and Employer Support for Reservist During Mobilizations

A statement of record issued by the General Accounting Office with an abstract that begins "Since the end of the Cold War, there has been a shift in the way reserve forces have been used. Previously, reservists were viewed primarily as an expansion force that would supplement active forces during a major war. Today, reservists not only supplement but also replace active forces in military operations worldwide. Citing the increased use of the reserves to support military operations, House Report 107-436 accompanying the Fiscal Year 2003 National Defense Authorization Act directed GAO to review compensation and benefits for reservists. In response, GAO is reviewing (1) income protection for reservists called to active duty, (2) family support programs, and (3) health care access. For this statement, GAO was asked to discuss its preliminary observations. GAO also was asked to discuss the results of its recently completed review concerning employer support for reservists."
Date: March 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Regulatory Takings: Implementation of Executive Order on Government Actions Affecting Private Property Use (open access)

Regulatory Takings: Implementation of Executive Order on Government Actions Affecting Private Property Use

A letter report issued by the General Accounting Office with an abstract that begins "Each year federal agencies issue numerous proposed or final rules or take other regulatory actions that may potentially affect the use of private property. Some of these actions may result in the property owner being owed just compensation under the Fifth Amendment. In 1988 the President issued Executive Order 12630 on property rights to ensure that government actions affecting the use of private property are undertaken on a well-reasoned basis with due regard for the potential financial impacts imposed on the government. GAO was asked to provide information on the compliance of the Department of Justice and four agencies--the Department of Agriculture, the Army Corps of Engineers, the Environmental Protection Agency, and the Department of the Interior--with the executive order. Specifically, GAO examined the extent to which (1) Justice has updated its guidelines for the order to reflect changes in case law and issued supplemental guidelines for the four agencies, (2) the four agencies have complied with the specific provisions of the executive order, and (3) just compensation awards have been assessed against the four agencies in recent years. We provided the agencies with a draft …
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Bioterrorism: A Threat to Agriculture and the Food Supply (open access)

Bioterrorism: A Threat to Agriculture and the Food Supply

A statement of record issued by the General Accounting Office with an abstract that begins "When the President created the Department of Homeland Security, he included U.S. agriculture and food industries in the list of critical infrastructures needing protection. The Secretaries of Agriculture and of Health and Human Services have publicly declared that the U.S. food supply is susceptible to deliberate contamination. GAO was asked to provide an overview of the potential vulnerabilities of the food supply and agriculture sector to deliberate contamination and to summarize four recent GAO reports that identified problems with federal oversight that could leave the nation's agriculture and food supply vulnerable to deliberate contamination."
Date: November 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem (open access)

Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem

A letter report issued by the General Accounting Office with an abstract that begins "Amid heightened awareness that many patients with cancer and other chronic diseases suffer from undertreated pain, the Food and Drug Administration (FDA) approved Purdue Pharma's controlled-release pain reliever OxyContin in 1995. Sales grew rapidly, and by 2001 OxyContin had become the most prescribed brandname narcotic medication for treating moderate-to-severe pain. In early 2000, reports began to surface about abuse and diversion for illicit use of OxyContin, which contains the opioid oxycodone. GAO was asked to examine concerns about these issues. Specifically, GAO reviewed (1) how OxyContin was marketed and promoted, (2) what factors contributed to the abuse and diversion of OxyContin, and (3) what actions have been taken to address OxyContin abuse and diversion."
Date: December 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Unemployment Insurance: Survey of State Administrators and Contacts with Companies Promoting Tax Avoidance Practices (open access)

Unemployment Insurance: Survey of State Administrators and Contacts with Companies Promoting Tax Avoidance Practices

Testimony issued by the General Accounting Office with an abstract that begins "GAO appeared before Subcommittees on Oversight and Human Resources, House Committee on Ways and Means to discuss the results of our investigation of the extent to which states have found that companies manipulate state unemployment tax rates through a variety of methods in order to lower their unemployment taxes, a practice known as "SUTA dumping," and of the extent to which some consulting firms promote SUTA dumping methods. We conducted our investigation from March 2003 through June 2003 in accordance with quality standards for investigations as set forth by the President's Council on Integrity and Efficiency. To obtain an overview of the extent of the problem, we conducted a survey of unemployment insurance administrators, in the 50 states, the District of Columbia, U.S. Virgin Islands and Puerto Rico. Additionally, one of our agents, posing as a business owner who was looking for ways to reduce state unemployment insurance taxes, placed telephone calls to four consulting firms we identified through the Internet to determine whether they promote SUTA dumping techniques. We also interviewed officials of the Office of Workforce Security, Department of Labor to determine how the federal-state unemployment …
Date: June 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Rural Housing Service: Opportunities to Improve Management (open access)

Rural Housing Service: Opportunities to Improve Management

Testimony issued by the General Accounting Office with an abstract that begins "Federal housing assistance in rural America dates back to the 1930s, when most rural residents worked on farms. Without electricity, telephone service, or good roads connecting residents to population centers, residents were comparatively isolated and their access to credit was generally poor. These conditions led Congress to authorize separate housing assistance for rural residents, to be administered by USDA. Over time, the quality of the housing stock has improved and credit has become more readily available in rural areas. Also, advances in transportation, computer technology, and telecommunications have diminished many of the distinctions between rural and urban areas. These changes call into question whether rural housing programs still need to be maintained separately from urban housing programs, and whether RHS is adapting to change and managing its resources as efficiently as possible."
Date: June 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Water Quality: EPA Should Improve Guidance and Support to Help States Develop Standards That Better Target Cleanup Efforts (open access)

Water Quality: EPA Should Improve Guidance and Support to Help States Develop Standards That Better Target Cleanup Efforts

Testimony issued by the General Accounting Office with an abstract that begins "Water quality standards comprise designated uses and water quality criteria. These standards are critical in making accurate, scientifically based determinations about which of the nation's waters are most in need of cleanup. GAO examined the extent to which (1) states are changing designated uses when necessary, (2) EPA is assisting states toward that end, (3) EPA is updating the "criteria documents" states use to develop the pollutant limits needed to measure whether designated uses are being attained, and (4) EPA is assisting states in establishing criteria that can be compared with reasonably obtainable monitoring data."
Date: June 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Electronic Procurement: Business Strategy Needed for GSA's Advantage System (open access)

Electronic Procurement: Business Strategy Needed for GSA's Advantage System

A letter report issued by the General Accounting Office with an abstract that begins "The Congress has been seeking to increase federal agency purchases of equipment and services on line. The General Services Administration's (GSA) Advantage Internet-based ordering system is meant for conducting market research and ordering all types of products and services on line. About $84 million has already been invested in this endeavor. GAO was asked to assess how effectively GSA has managed this investment."
Date: February 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
The Worker Adjustment and Retraining Notification Act: Revising the Act and Educational Materials Could Clarify Employer Responsibilities and Employee Rights (open access)

The Worker Adjustment and Retraining Notification Act: Revising the Act and Educational Materials Could Clarify Employer Responsibilities and Employee Rights

A letter report issued by the General Accounting Office with an abstract that begins "In 2001, 1.75 million workers lost jobs through extended mass layoffs. The Worker Adjustment and Retraining Notification (WARN) Act requires advance notice of plant closures and mass layoffs. The report discusses (1) the extent to which plant closures and mass layoffs were subject to WARN's requirements, (2) the extent to which employers with mass layoffs and plant closures provided notice, and (3) what issues employers and employees face when assessing the applicability of WARN to their circumstances."
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Internal Revenue Service: Challenges Remain in Combating Abusive Tax Schemes (open access)

Internal Revenue Service: Challenges Remain in Combating Abusive Tax Schemes

A letter report issued by the General Accounting Office with an abstract that begins "Abusive tax avoidance schemes could threaten our tax system's integrity and fairness if honest taxpayers believe that significant numbers of individuals are not paying their fair share of taxes. Abusive schemes encompass such distortions of the tax system as falsely describing the law (saying, for example, that the income tax is unconstitutional), misrepresenting facts (for instance, promoting the deduction of personal expenses as business expenses), or using trusts or offshore bank accounts to hide income. As agreed, this report focuses on three objectives. They are to (1) describe the nature and scope of abusive tax avoidance schemes as determined by the Internal Revenue Service (IRS), (2) describe IRS's strategy to combat these schemes and the performance goals and measures IRS uses to track its major effort related to them, and (3) describe how IRS determined the amount and source of staff resources to be devoted to these schemes in the IRS operating division most directly affected."
Date: November 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Federal Real Property: Vacant and Underutilized Properties at GSA, VA, and USPS (open access)

Federal Real Property: Vacant and Underutilized Properties at GSA, VA, and USPS

A letter report issued by the General Accounting Office with an abstract that begins "The federal government has many vacant and underutilized properties that are no longer needed. Retaining unneeded real properties presents federal agencies with significant potential risks for (1) lost dollars because such properties are costly to maintain; and (2) lost opportunities because the properties could be put to more cost-beneficial uses, exchanged for other needed property, or sold to generate revenue for the government. The General Services Administration (GSA), the Department of Veterans Affairs (VA), and the U.S. Postal Service (USPS) hold a significant number of real property assets. GAO was asked to provide information on how these agencies identify vacant and underutilized real properties and the numbers, types, and locations of these properties."
Date: August 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Military Munitions: DOD Needs to Develop a Comprehensive Approach for Cleaning Up Contaminated Sites (open access)

Military Munitions: DOD Needs to Develop a Comprehensive Approach for Cleaning Up Contaminated Sites

A letter report issued by the General Accounting Office with an abstract that begins "Over 15 million acres in the United States are suspected of being, or known to be, contaminated with military munitions. These sites include ranges on closing military installations, closed ranges on active installations, and formerly used defense sites. Under the Defense Environmental Restoration Program, established in 1986, the Department of Defense (DOD) must identify, assess, and clean up military munitions contamination at these sites. DOD estimates these activities will cost from $8 billion to $35 billion. Because of the magnitude of DOD's cleanup effort, both in terms of cost and affected acreage, as well as the significant public safety, health, and environmental risks that military munitions may pose, The Ranking Minority Member of the House Committee on Energy and Commerce asked us to evaluate (1) DOD's progress in implementing its program to identify, assess, and clean up military munitions sites and (2) DOD's plans to clean up remaining sites in the future."
Date: December 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Defense Health Care: Quality Assurance Process Needed to Improve Force Health Protection and Surveillance (open access)

Defense Health Care: Quality Assurance Process Needed to Improve Force Health Protection and Surveillance

A letter report issued by the General Accounting Office with an abstract that begins "Following the 1990-91 Persian Gulf War, many servicemembers experienced health problems that they attributed to their military service in the Persian Gulf. However, a lack of servicemember health and deployment data hampered subsequent investigations into the nature and causes of these illnesses. Public Law 105-85, enacted in November 1997, required the Department of Defense (DOD) to establish a system to assess the medical condition of service members before and after deployments. GAO was asked to determine whether (1) the military services met DOD's force health protection and surveillance requirements for servicemembers deploying in support of Operation Enduring Freedom (OEF) in Central Asia and Operation Joint Guardian (OJG) in Kosovo and (2) DOD has corrected problems related to the accuracy and completeness of databases reflecting which servicemembers were deployed to certain locations."
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
State Department: Targets for Hiring, Filling Vacancies Overseas Being Met, but Gaps Remain in Hard-to-Learn Languages (open access)

State Department: Targets for Hiring, Filling Vacancies Overseas Being Met, but Gaps Remain in Hard-to-Learn Languages

A letter report issued by the General Accounting Office with an abstract that begins "During the 1990s, the State Department lost more people than it hired. The resultant shortfalls in the number and skills of Foreign Service officers have endangered U.S. diplomatic readiness. Furthermore, recent studies, including several by GAO, have questioned whether State's recruitment system identifies people with the appropriate skills and whether State is assigning officers with specialized skills, such as the ability to speak a difficult language, to positions where they can be utilized. GAO was asked to review State's processes for determining the number and skills of junior officers the department needs and to determine whether it is hiring and assigning officers with the general skills to carry out foreign policy overseas. GAO was also asked to examine the challenges State still needs to address, especially regarding officers' foreign language skills."
Date: November 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Medicare: Modest Eligibility Expansion for Critical Access Hospital Program Should Be Considered (open access)

Medicare: Modest Eligibility Expansion for Critical Access Hospital Program Should Be Considered

A letter report issued by the General Accounting Office with an abstract that begins "Critical Access Hospitals (CAHs) are small rural hospitals that receive payment for their reasonable costs of providing inpatient and outpatient services to Medicare beneficiaries, rather than being paid fixed amounts under Medicare's prospective payment systems. Between fiscal years 1997 and 2002, 681 hospitals have become CAHs. In the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000, GAO was directed to examine requirements for CAH eligibility, including the ban on inpatient psychiatric or rehabilitation distinct part units (DPUs) and limit on patient census, and to make recommendations on related program changes."
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Military Recruiting: DOD Needs to Establish Objectives and Measures to Better Evaluate Advertising's Effectiveness (open access)

Military Recruiting: DOD Needs to Establish Objectives and Measures to Better Evaluate Advertising's Effectiveness

A letter report issued by the General Accounting Office with an abstract that begins "The Department of Defense (DOD) must convince more than 200,000 people each year to join the military. To assist in recruiting, the military services advertise on television, on radio, and in print and participate in other promotional activities. In the late 1990s, some of the services missed their overall recruiting goals. In response, DOD added recruiting resources by increasing its advertising, number of recruiters, and financial incentives. By fiscal year 2003, DOD's total recruiting budget was approaching $4 billion annually. At the request of Congress, GAO determined the changes in DOD's advertising programs and funding trends since the late 1990s and assessed the adequacy of measures used by DOD to evaluate the effectiveness of its advertising. GAO recommends that DOD set clear, measurable advertising"
Date: September 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Defense Infrastructure: Changes in Funding Priorities and Strategic Planning Needed to Improve the Condition of Military Facilities (open access)

Defense Infrastructure: Changes in Funding Priorities and Strategic Planning Needed to Improve the Condition of Military Facilities

A letter report issued by the General Accounting Office with an abstract that begins "GAO prepared this report in response to its basic legislative responsibilities. Its objectives are threefold: (1) to examine the historical funding trends and their impact on the condition of the active forces' facilities, (2) to evaluate the consistency of the services' information on facility conditions, and (3) to assess the Department of Defense's (DOD) long-term strategic plan and objectives to improve facility conditions."
Date: February 19, 2003
Creator: United States. General Accounting Office.
Object Type: Report
System: The UNT Digital Library
Sourcing and Acquisition: Challenges Facing the Department of Defense (open access)

Sourcing and Acquisition: Challenges Facing the Department of Defense

Testimony issued by the General Accounting Office with an abstract that begins "The Department of Defense (DOD) is on the brink of operations in Iraq while seeking to respond to changes in security threats and still meeting the challenges transforming the military. DOD spends an average of $150 billion annually on acquisitions that support these and other missions. Moreover, this investment is expected to grow considerably in the future as DOD works to keep legacy systems while investing in future capabilities such as unmanned aircraft, satellite networks, and information and communications systems. Such demands clearly require DOD to be as efficient and effective as possible in obtaining the systems, services, and equipment it needs to carry out its mission. But GAO's reviews continue to show that DOD is not carrying out acquisitions cost-effectively and that the acquisitions themselves are not always achieving DOD's objectives. Pervasive problems persist regarding high-risk acquisition strategies and unrealistic cost, schedule, and performance estimates. This testimony focuses on two aspects fundamental to successful acquisitions in DOD: (1) the implementation of sound policies for making sourcing decisions, and (2) the adoption of best practices."
Date: March 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
U.S. Postal Service: Issues Associated with Anthrax Testing at the Wallingford Facility (open access)

U.S. Postal Service: Issues Associated with Anthrax Testing at the Wallingford Facility

Testimony issued by the General Accounting Office with an abstract that begins "The anthrax attacks of 2001 resulted in 23 cases of the disease, 5 deaths, and the contamination of numerous U.S. Postal Service facilities, including the Southern Connecticut Processing and Distribution Center in Wallingford, Connecticut (the Wallingford facility). But none of the workers at the Wallingford facility contracted the disease from the anthrax contamination. As a result, GAO was asked to examine the adequacy of methods used to determine whether the Wallingford facility and other postal facilities were contaminated. In this testimony, GAO presents its preliminary findings concerning the test results for the Wallingford facility: (1) the collection of samples to detect anthrax, (2) the meaning of the test results, and (3) the communication of the test results to workers."
Date: May 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library
Military Personnel: Preliminary Observations Related to Income, Benefits, and Employer Support for Reservists During Mobilizations (open access)

Military Personnel: Preliminary Observations Related to Income, Benefits, and Employer Support for Reservists During Mobilizations

Testimony issued by the General Accounting Office with an abstract that begins "Since the end of the Cold War, there has been a shift in the way reserve forces have been used. Previously, reservists were viewed primarily as an expansion force that would supplement active forces during a major war. Today, reservists not only supplement but also replace active forces in military operations worldwide. Citing the increased use of the reserves to support military operations, House Report 107-436 accompanying the Fiscal Year 2003 National Defense Authorization Act directed GAO to review compensation and benefits for reservists. In response, GAO is reviewing (1) income protection for reservists called to active duty, (2) family support programs, and (3) health care access. For this testimony, GAO was asked to discuss its preliminary observations. GAO also was asked to discuss the results of its recently completed review concerning employer support for reservists."
Date: March 19, 2003
Creator: United States. General Accounting Office.
Object Type: Text
System: The UNT Digital Library