A letter report issued by the Government Accountability Office with an abstract that begins "VA has policies to ensure that physicians have appropriate qualifications and clinical abilities through the processes of credentialing, privileging, and continuous monitoring of performance. Results of a VA investigatory report in 2008 cited deficiencies in the Marion, Illinois, VA medical center's (VAMC) credentialing and privileging processes and oversight of its surgical program. This report examines VA's policies and guidance to help ensure that information about physician qualifications and performance is accurate and complete, VAMCs' compliance with selected VA credentialing and privileging policies, and their implementation of VA policies to continuously monitor performance. The Government Accountability Office (GAO) reviewed VA's policies, interviewed VA officials, and reviewed a judgmental sample of 30 credentialing and privileging files at each of six VAMCs that GAO visited. GAO selected the files to ensure inclusion of highly paid specialties, newly hired physicians, and other physician characteristics. GAO selected the judgmental sample of six VAMCs based on geographic balance and other factors."

Correspondence issued by the Government Accountability Office with an abstract that begins "This report is in response to section 1899L of the American Recovery and Reinvestment Act of 2009. The statute required the Comptroller General to examine issues related to participation in and administrative costs associated with the Health Coverage Tax Credit program administered by the Internal Revenue Service (IRS) in the Department of the Treasury, and to provide the results to Congress by March 1, 2010."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Defense Manpower Data Center (DMDC) conducts a series of Web-based surveys called Status of Forces surveys, which help enable decision makers within the Department of Defense (DOD) to (1) evaluate existing programs and policies, (2) establish baselines before implementing new programs and policies, and (3) monitor the progress of programs and policies and their effects on the total force. In recent years, we have discussed the results of these surveys in several of our reports. While we have generally found the survey results to be sufficiently reliable for the purposes of our reporting, several of our reports have discussed low response rates and the potential for bias in the survey results. Nonresponse analysis is an established practice in survey research that helps determine whether nonresponse bias (i.e., survey results that do not accurately reflect the population) might occur due to under- or overrepresentation of some respondents' views on survey questions. When nonresponse analysis is performed, survey researchers can use the results to select and adjust the statistical weighting techniques they use that help ensure that survey results accurately reflect the survey population. Because we have noted, in …

A letter report issued by the Government Accountability Office with an abstract that begins "The Logistics Modernization Program (LMP) is an Army business system that is intended to replace the aging Army systems that manage inventory and depot repair operations. From 1999 through 2009, the Army expended more than $1 billion for LMP. LMP was originally scheduled to be completed by 2005, but after the first deployment in July 2003, the Army delayed fielding because of significant problems. The Army later decided to field the system in two additional deployments: the second in May 2009 and the third in October 2010. GAO was asked to evaluate the extent to which the Army will achieve the intended functionality (e.g., supply chain management and materiel maintenance) from LMP for the commands, depots, and arsenals participating in the third deployment. To do this, GAO reviewed Army plans and policies related to LMP and met with Army officials at three Army commands and several third deployment sites."

Correspondence issued by the Government Accountability Office with an abstract that begins "The United States faces challenges to ensuring food safety. First, imported food makes up a substantial and growing portion of the U.S. food supply, with 60 percent of fresh fruits and vegetables and 80 percent of seafood coming from across our borders. In recent years, there has been an increase in reported outbreaks of foodborne illness associated with both domestic and imported produce. Second, we are increasingly eating foods that are consumed raw and that have often been associated with foodborne illness outbreaks, including leafy greens such as spinach. Finally, shifting demographics means that more of the U.S. population is, and increasingly will be, susceptible to foodborne illnesses. The risk of severe and life-threatening conditions caused by foodborne illnesses is higher for older adults, young children, pregnant women, and immune-compromised individuals. In January 2007 GAO designated federal oversight of food safety as a high-risk area needing urgent attention and transformation because of the federal government's fragmented oversight of food safety. The Food and Drug Administration (FDA) is responsible for ensuring the safety of roughly 80 percent of the U.S. food supply--virtually all domestic and imported foods except for …

A letter report issued by the Government Accountability Office with an abstract that begins "The North Atlantic Treaty Organization (NATO) established the Partnership for Peace (PfP) to increase cooperation with former Warsaw Pact members and provide many of these countries with a path to NATO membership. As NATO confronts new security challenges, including the war in Afghanistan, its relationships with partner countries have grown in scope and importance. Additionally, NATO is developing a new Strategic Concept to clarify its mission and activities, including its relationship with PfP countries and other partners. The Department of Defense (DOD)-funded Warsaw Initiative Fund (WIF) supports the goals of the PfP program. GAO was asked to review (1) how the PfP program has evolved since GAO last reported on it in 2001; (2) options NATO is considering for the future of the PfP and other partnership programs; and (3) support to PfP countries through the U.S. WIF program. GAO analyzed NATO, DOD, and State Department (State) documents; and WIF funding data. GAO also interviewed DOD, State, NATO, and selected country officials."

A letter report issued by the Government Accountability Office with an abstract that begins "To assist the growing number of taxpayers facing foreclosure or mortgage restructuring, the Mortgage Forgiveness Debt Relief Act of 2007, and its 3-year extension as part of the Emergency Economic Stabilization Act of 2008, allows taxpayers to generally exclude from taxable income forgiven mortgage debt used to buy, build, or substantially improve a principal residence. Joint Committee on Taxation (JCT) estimates originally suggested that the exclusion of forgiven mortgage debt from taxable income may result in about $968 million in federal revenue losses from fiscal year (FY) 2008 through FY 2013 and more recent estimates suggest that the revenue losses could be closer to $1.9 billion. The Department of Treasury estimates suggest that the exclusion may result in federal revenue losses of about $1.4 billion from FY 2008 through FY 2013. Some taxpayers with forgiven mortgage debts may be bankrupt or insolvent; however, others are not and therefore may have the ability to pay taxes on forgiven mortgage debts. The briefing slides summarize our assessment of the Internal Revenue Service's (IRS) administration of this tax provision. In response to your request, our objectives were to identify …

A letter report issued by the Government Accountability Office with an abstract that begins "Pakistan's Federally Administered Tribal Areas (FATA) has been a recognized safe haven for al Qaeda leadership and a base for the Taliban to launch cross-border attacks into Afghanistan. The United States, in an effort to assist Pakistan in addressing this threat, pledged $750 million between 2007 and 2011 to support development activities in the FATA region. This report focuses on (1) the extent U.S. development objectives align with U.S. national security goals and Pakistan's objectives, (2) U.S. efforts to track the pledge, (3) U.S. efforts to measure program performance in the FATA, and (4) efforts to monitor assistance in the FATA. GAO reviewed U.S. and Pakistani documents and interviewed U.S. and Pakistani officials in Washington, D.C., and Pakistan. GAO has prepared this report under the Comptroller General's authority to conduct evaluations on his own initiative."

A letter report issued by the Government Accountability Office with an abstract that begins "As Congress considers reauthorization of the laws which provide funding for the Child Care and Development Fund (CCDF), there is interest in understanding what accounts for recent trends in child care subsidy receipt among eligible families and what research says about subsidies' effects on parents' ability to obtain and maintain employment. The U.S. Department of Health and Human Services (HHS) administers CCDF, but states have flexibility in its implementation. As requested, GAO examined: (1) trends in federal estimates of the number and proportion of eligible children and families who receive child care subsidies, (2) factors that may affect trends in estimates of the number of children served, and (3) what is known about the extent to which access to subsidies supports low-income parents' employment. To address these issues, GAO reviewed recent federal estimates of the number and proportion of eligible children and families served; conducted a survey of state child care administrators in 50 states and the District of Columbia; interviewed HHS officials, state officials in four selected states, and researchers and experts in child care subsidies; and reviewed research on the relationship between subsidy receipt …

A letter report issued by the Government Accountability Office with an abstract that begins "This report responds to two ongoing GAO mandates under the American Recovery and Reinvestment Act of 2009 (Recovery Act). It is the fifth in a series of reports since passage of the Recovery Act on the uses of and accountability for Recovery Act funds in 16 selected states, certain localities in those jurisdictions, and the District of Columbia (District). These jurisdictions are estimated to receive about two-thirds of the intergovernmental assistance available through the Recovery Act. It is also the second report in which GAO is required to comment on the jobs created or retained as reported by recipients of Recovery Act funds. GAO collected and analyzed documents and interviewed state and local officials and other Recovery Act award recipients. GAO also analyzed federal agency guidance and spoke with officials at federal agencies overseeing Recovery Act programs."

A letter report issued by the Government Accountability Office with an abstract that begins "A catastrophic public health event could threaten our national security and cause hundreds of thousands of casualties. Recognizing the need for efficient sharing of real-time information to help prevent devastating consequences of public health emergencies, Congress included in the Pandemic and All-Hazards Preparedness Act in December 2006 a mandate for the Secretary of the Department of Health and Human Services (HHS), in collaboration with state, local, and tribal public health officials, to develop and deliver to Congress a strategic plan for the establishment and evaluation of an electronic nationwide public health situational awareness capability. Pursuant to requirements of the act, GAO reviewed HHS's plans for and status of efforts to implement these capabilities, described collaborative efforts to establish a network, and determined grants authorized by the act and awarded to public health entities. GAO assessed relevant strategic planning documents and interviewed HHS officials and public health stakeholders."

A letter report issued by the Government Accountability Office with an abstract that begins "Millions of Americans use propane and oil heat for such purposes as heating and cooking. Congress authorized creation of the Propane Education and Research Council (PERC) in 1996 and the National Oilheat Research Alliance (NORA) in 2000 to provide research and development, safety and training, and consumer education for propane and oil heat, as the highest priority activities. Congressional deliberations on the groups' creation emphasized providing funding for research and development. PERC and NORA fund operations by assessing fees on propane and oil heat sales. GAO examined (1) how PERC and NORA spent assessments collected; (2) the extent to which their reported activities help strategic goals; (3) the extent to which key statutory requirements were met; and (4) the extent of federal oversight. GAO analyzed the Propane and Oilheat Acts and PERC and NORA documents and interviewed representatives of PERC, NORA, and the Departments of Energy (DOE) and Commerce."

A letter report issued by the Government Accountability Office with an abstract that begins "Public demand and federal funding for transit have grown in recent years, yet most of this funding is not tied to performance. As Congress prepares for reauthorization of the federal surface transportation programs, GAO was asked to report on (1) the extent to which federal transit programs use performance information in making decisions about funding distribution and in evaluating the programs' effectiveness; (2) mechanisms for making these programs more performance based, and strategies for supporting their successful implementation; and (3) how selected U.S. and foreign transit agencies have used performance measurement in their planning and decisions, and their views on the federal role in transit. To do so, GAO analyzed legislation, federal documents, and literature; interviewed federal officials and transit experts; and conducted semistructured interviews with selected transit agencies using criteria that, for U.S. agencies, covered a variety of regions and population sizes and, for foreign agencies, multiple transit modes and English language capability."

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Funding Accountability and Transparency Act of 2006 (FFATA) is intended to increase the transparency of and accountability for the over $1 trillion that federal agencies award each year in contracts, loans, grants, and other awards. Among other things, the act required the Office of Management and Budget (OMB) to establish, no later than January 1, 2008, a publicly accessible Web site containing data on federal awards. The act also authorized OMB to issue guidance to federal agencies on reporting award data and instructs agencies to comply with that guidance. OMB launched the site (www.USAspending.gov) in December 2007. GAO's objectives were to determine the extent to which (1) OMB is complying with FFATA requirements to make federal award data available, (2) federal agencies are reporting required award data, and (3) inconsistencies exist between data on the Web site and records at federal agencies. To do this, GAO reviewed FFATA requirements and OMB guidance, interviewed OMB and agency officials, and examined a sample of awards reported to OMB."

A letter report issued by the Government Accountability Office with an abstract that begins "The President's Emergency Plan for AIDS Relief (PEPFAR), reauthorized at $48 billion for fiscal years 2009 through 2013, supports HIV/AIDS prevention, treatment, and care services overseas. The reauthorizing legislation, as well as other key documents and PEPFAR guidance, endorses the alignment of PEPFAR activities with partner country HIV/AIDS strategies and the promotion of partner country ownership of U.S.-supported HIV/AIDS programs. This report, responding to a legislative directive, (1) examines alignment of PEPFAR programs with partner countries' HIV/AIDS strategies and (2) describes several challenges related to alignment or promotion of country ownership. GAO analyzed PEPFAR planning documents and national strategies for four countries--Cambodia, Malawi, Uganda, and Vietnam--selected to represent factors such as diversity of funding levels and geographic location. GAO also reviewed documents and reports by the U.S. government, research institutions, and international organizations and interviewed PEPFAR officials and other stakeholders in headquarters and the four countries."

A letter report issued by the Government Accountability Office with an abstract that begins "Perchlorate is both a man-made and naturally occurring chemical. It is used in rocket fuel, explosives, fireworks, and other products. Naturally occurring perchlorate is produced through atmospheric processes and then settles on surface water or land. Perchlorate can disrupt the uptake of iodide in the thyroid, potentially interfering with thyroid function and negatively affecting fetal and infant brain development and growth. As of June 2010, there is no federal regulatory standard for perchlorate in drinking water, and the Environmental Protection Agency (EPA), which has the authority to regulate contaminants in public drinking water systems, had not determined whether to establish one. The Department of Defense (DOD), the National Aeronautics and Space Administration (NASA), and the Department of Energy (DOE) are the primary federal users of perchlorate. GAO was asked to examine (1) what is known about the extent to which perchlorate occurs in the nation's water and food supply and its likely sources; (2) what actions DOD, NASA, and DOE have taken to respond to or lessen perchlorate releases; and (3) what actions states, such as California and Massachusetts, have taken to regulate perchlorate. To address …

A letter report issued by the Government Accountability Office with an abstract that begins "The Supervisory Capital Assessment Program (SCAP) was established under the Capital Assistance Program (CAP)--a component of the Troubled Asset Relief Program (TARP)--to assess whether the 19 largest U.S. bank holding companies (BHC) had enough capital to withstand a severe economic downturn. Led by the Board of Governors of the Federal Reserve System (Federal Reserve), federal bank regulators conducted a stress test to determine if these banks needed to raise additional capital, either privately or through CAP. This report (1) describes the SCAP process and participants' views of the process, (2) assesses SCAP's goals and results and BHCs' performance, and (3) identifies how regulators and the BHCs are applying lessons learned from SCAP. To do this work, GAO reviewed SCAP documents, analyzed financial data, and interviewed regulatory, industry, and BHC officials."

A letter report issued by the Government Accountability Office with an abstract that begins "According to the Department of Homeland Security (DHS), there are thousands of facilities in the United States that if destroyed by a disaster could cause casualties, economic losses, or disruptions to national security. The Homeland Security Act of 2002 gave DHS responsibility for leading and coordinating the nation's effort to protect critical infrastructure and key resources (CIKR). Homeland Security Presidential Directive 7 (HSPD-7) defined responsibilities for DHS and certain federal agencies--known as sector-specific agencies (SSAs)--that represent 18 industry sectors, such as energy. In accordance with the Homeland Security Act and HSPD-7, DHS issued the National Infrastructure Protection Plan (NIPP) in June 2006 to provide the approach for integrating the nation's CIKR. GAO was asked to study DHS's January 2009 revisions to the NIPP in light of a debate over whether DHS has emphasized protection--to deter threats, mitigate vulnerabilities, or minimize the consequences of disasters---rather than resilience---to resist, absorb, or successfully adapt, respond to, or recover from disasters. This report discusses (1) how the 2009 NIPP changed compared to the 2006 NIPP and (2) how DHS and SSAs addressed resiliency as part of their planning efforts. GAO …

A letter report issued by the Government Accountability Office with an abstract that begins "Since GAO's first audit of the fiscal year 1997 consolidated financial statements of the U.S. government (CFS), material weaknesses in internal control and other limitations on the scope of GAO's work have prevented GAO from expressing an opinion on the consolidated financial statements, other than the Statement of Social Insurance (accrual-based consolidated financial statements). The Department of the Treasury (Treasury), in coordination with the Office of Management and Budget (OMB), is responsible for preparing the CFS. As part of the fiscal year 2009 CFS audit, GAO identified material weaknesses and other control deficiencies in Treasury's processes used to prepare the CFS that warrant management's attention and corrective action. The purpose of this report is to (1) provide details on new control deficiencies GAO identified during its audit of the fiscal year 2009 CFS that related to the preparation of the CFS, (2) recommend improvements, and (3) provide the status of corrective actions taken to address GAO's previous 44 recommendations in this area."

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2007, attention has been focused on nursing home ownership by private investment (PI) firms. Nursing home providers are required to disclose parties with an ownership or control interest in order to participate in Medicare or Medicaid. CMS, the HHS agency responsible for managing these two programs, maintains ownership and chain data in its Provider Enrollment, Chain, and Ownership System (PECOS). GAO examined (1) the extent of PI nursing home ownership and firms' involvement in homes' operations, (2) whether PECOS reflects PI ownership, and (3) how HHS and states use ownership data for oversight. GAO identified PI ownership using a proprietary database and analyzed data from six PI firms about their interest and involvement in nursing homes. GAO examined PECOS data for selected PI-owned nursing home chains and discussed ownership data with officials from HHS, CMS, and six states that also collect data."

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter formally transmits the summary of a briefing we gave in June 2010 in response to a mandate in the Department of Homeland Security Appropriations Act, 2010, and subsequent agency comments. This mandate required the Department of Homeland Security (DHS) to complete an expenditure plan that satisfied 11 specified conditions, and for the plan to be submitted to and approved by the House and Senate Appropriations Committees before the agency could obligate $75 million of the $800 million appropriated for U.S. Customs and Border Protection (CBP) border security fencing, infrastructure and technology. Also, the Act required us to review this expenditure plan. In addition, Conference, Senate, and House committee reports accompanying the act directed that the plan address 7 items (referred to as "committee reports' directions" in this letter). In response to these requirements, the Department of Homeland Security submitted a plan to Congress on May 20, 2010, titled "Border Security Fencing, Infrastructure and Technology (BSFIT) Fiscal Year 2010 Expenditure Plan." As required by the act, we reviewed the plan and on June 17 and 18, 2010, briefed the offices of the Senate and House Appropriations Subcommittees, …

A letter report issued by the Government Accountability Office with an abstract that begins "In connection with the Omnibus Appropriations Act, 2009, GAO was required to study the What Works Clearinghouse (WWC), a federal source of evidence about effective education practices. Operating through a 5-year contract awarded by the U.S. Department of Education's Institute of Education Sciences (IES), the WWC reviews education research and disseminates its findings. GAO examined: (1) the extent to which the WWC review process meets accepted standards for research evaluation and how the WWC has responded to recommendations and criticism, (2) how WWC output and costs have changed over time and how its performance is measured, and (3) how WWC products are disseminated and how useful educators find them to be. To conduct its work, GAO reviewed WWC-related documents, analyzed cost and performance data, surveyed all states and a nationally representative sample of school districts, and interviewed IES officials, WWC contractors, researchers, and others."

A letter report issued by the Government Accountability Office with an abstract that begins "The Army Working Capital Fund (AWCF) collected over $16 billion for goods and services provided to customers in fiscal year 2009. Cash generated from sales is used by AWCF to cover its expenses such as paying employees. In light of the Army's changing role in the Middle East, GAO was asked to determine whether (1) AWCF's monthly cash balances fell within the Department of Defense's (DOD) cash requirements for fiscal years 2000 through 2009, (2) the cash transfers resulted in AWCF's monthly cash balances falling below the minimum amount required by DOD, and (3) the AWCF's projected monthly cash balances are expected to fall below DOD's minimum cash requirement for fiscal years 2010 and 2011 and actions the Army can take to manage those balances. To address these objectives, GAO (1) reviewed relevant DOD guidance, (2) obtained and analyzed AWCF budget and accounting reports containing cash information, and (3) interviewed DOD and Army officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Originally established in 2002 to fight terrorism, the Combined Joint Task Force-Horn of Africa (CJTF-HOA), based at Camp Lemonnier, Djibouti, is the military's main operational presence in Africa. The U.S. Africa Command (AFRICOM), created in 2007 to focus on stability in Africa, has been assessing existing activities--as well as CJTF-HOA--against its mission of sustained security engagement in Africa. This report discusses: (1) AFRICOM's decisions on CJTF-HOA's future and whether CJTF-HOA's activities align with the command's mission, and (2) benefits of the task force and challenges it faces. For its review, GAO analyzed AFRICOM and CJTF-HOA guidance, conducted interviews at the command's and task force's headquarters, and obtained perspectives from U.S. embassies in the region."