Testimony issued by the Government Accountability Office with an abstract that begins "VA clinicians use expendable medical supplies--disposable items that are generally used one time--and reusable medical equipment (RME), which is designed to be reused for multiple patients. VA has policies that VA medical centers (VAMC) must follow when purchasing such supplies and equipment and tracking--that is, accounting for--these items at VAMCs. GAO was asked to evaluate VA's purchasing and tracking of expendable medical supplies and RME and their potential impact on veterans' safety. This testimony is based on GAO's ongoing work and provides preliminary observations on (1) the extent of compliance with VA's requirements for purchasing and tracking of expendable medical supplies and RME and (2) steps VA plans to take to improve its oversight of VAMCs' purchasing and tracking of expendable medical supplies and RME. GAO reviewed VA policies and selected three requirements that GAO determined to be relevant to patient safety. At each of the five VAMCs GAO visited, GAO reviewed documents used to identify issues related to the three requirements and interviewed officials to gather further information on these issues. The VAMCs GAO visited represent different surgical complexity groups, sizes of veteran populations served, and geographic …

Testimony issued by the Government Accountability Office with an abstract that begins "Under the Defense Environmental Restoration Program (DERP), the Department of Defense (DOD) is responsible for cleaning up about 5,400 sites on military bases that have been closed under the Base Realignment and Closure (BRAC) process, as well as 21,500 sites on active bases and over 4,700 formerly used defense sites (FUDS), properties that DOD owned or controlled and transferred to other parties prior to October 1986. The cleanup of contaminants, such as hazardous chemicals or unexploded ordnance, at BRAC bases has been an impediment to the timely transfer of these properties to parties who can put them to new uses. The goals of DERP include (1) reducing risk to human health and the environment (2) preparing BRAC properties to be environmentally suitable for transfer (3) having final remedies in place and completing response actions and (4) fulfilling other established milestones to demonstrate progress toward meeting program performance goals. This testimony is based on prior work and discusses information on (1) how DOD allocates cleanup funding at all sites with defense waste and (2) BRAC cleanup status. It also summarizes other key issues that GAO has identified in the …

Testimony issued by the Government Accountability Office with an abstract that begins "The overall goal of the U.S. National Drug Control Strategy, prepared by the White House Office of National Drug Control Policy (ONDCP), is to reduce illicit drug use in the United States. GAO has issued more than 20 products since 2000 examining U.S.-funded international programs aimed at reducing the supply of drugs. These programs have been implemented primarily in drug source countries, such as Colombia and Afghanistan as well drug transit countries, such as Mexico, Guatemala, and Venezuela. They have included interdiction of maritime drug shipments on the high seas, support for foreign military and civilian institutions engaged in drug eradication, detection, and interdiction; and rule of law assistance aimed at helping foreign legal institutions investigate and prosecute drug trafficking, money laundering, and other drug-related crimes."

Testimony issued by the Government Accountability Office with an abstract that begins "The F-35 Lightning II, also known as the Joint Strike Fighter (JSF), is the Department of Defense's (DOD) most costly and ambitious aircraft acquisition, seeking to simultaneously develop and field three aircraft variants for the Air Force, Navy, Marine Corps, and eight international partners. The JSF is critical for recapitalizing tactical air forces and will require a long-term commitment to very large annual funding outlays. The current estimated investment is $323 billion to develop and procure 2,457 aircraft. This statement draws substantively from GAO's March 19, 2010 report (GAO-10-382). That report discusses JSF costs and schedules, warfighter requirements, manufacturing performance, procurement rates, and development testing plans. This statement also provides an updated analysis of relative costs and benefits from a second (or alternate) engine program. In previous years, we recommended, among other things, that DOD rethink plans to cut test resources, improve reliability of cost estimates, and reduce the number of aircraft procured before testing demonstrates their performance capabilities. In our March 2010 report, we recommended that DOD (1) make a new, comprehensive assessment of the program's costs and schedule and (2) reassess warfighter requirements. DOD concurred with …

Other written product issued by the Government Accountability Office with an abstract that begins "The Rehabilitation Act of 1973 (Rehabilitation Act) requires agencies to take proactive steps to provide equal opportunity to qualified individuals with disabilities, but their rate of employment with the federal government remains low. GAO was asked to identify barriers to the employment of people with disabilities in the federal workforce and leading practices that could be used to overcome these barriers. On July 20, 2010, GAO convened a forum to identify leading practices that federal agencies could implement within the current legislative context. In preparation for the forum, GAO surveyed a wide range of knowledgeable individuals to identify barriers and leading practices. Forum participants were selected from among respondents (or their representatives) to reflect varying expertise and views concerning the employment of individuals with disabilities. The survey results formed the basis for the initial forum agenda, and were refined by participants to focus on actions they deemed most important. Comments in this report do not necessarily represent the views of any individual participant or the organizations that these participants represent or with which they are affiliated, including GAO."

Testimony issued by the Government Accountability Office with an abstract that begins "To reduce spending on durable medical equipment (DME) and related items, under federal law the Centers for Medicare & Medicaid Services (CMS) is phasing in, with several rounds of bidding, a competitive bidding program (CBP) for certain DME and other items. Because of numerous concerns, the Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) terminated the CBP round 1 supplier contracts and required CMS to repeat the CBP round 1, the rebid that began in 2009. In November 2009, GAO issued the report Medicare: CMS Working to Address Problems from Round 1 of the Durable Medical Equipment Competitive Bidding Program (GAO-10-27) that documented problems in CMS's implementation of CBP round 1. This statement discusses some of the problems GAO identified and how CMS has or plans to address them in the ongoing CBP rebid bidding process, particularly (1) the bid submission information provided to suppliers, (2) the electronic bid submission system, and (3) the bid disqualification notification process. For the 2009 report, GAO reviewed data provided by CMS and relevant laws and regulations, and interviewed CMS officials. For this statement, GAO also obtained select information on …

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has numerous intelligence, surveillance, and reconnaissance (ISR) systems--including manned and unmanned airborne, space-borne, maritime, and terrestrial systems--that play critical roles in support of current military operations. The demand for these capabilities has increased dramatically. Today's testimony addresses (1) the challenges the military services and defense agencies face processing, exploiting, and disseminating the information collected by ISR systems and (2) the extent to which the military services and defense agencies have developed the capabilities required to share ISR information. This testimony is based on GAO's January 2010 report on DOD's ISR data processing capabilities. GAO reviewed and analyzed documentation, guidance, and strategies of the military services and defense agencies in regard to processing, exploiting, and disseminating ISR data as well as information-sharing capabilities. GAO also visited numerous commands, military units, and locations in Iraq and the United States."

Testimony issued by the Government Accountability Office with an abstract that begins "Among the lessons learned from the aftermath of Hurricane Katrina was that effective disaster response requires planning followed by the execution of training and exercises to validate those plans. The Federal Emergency Management Agency (FEMA) is responsible for disaster response planning. This testimony focuses on (1) criteria for effective disaster response planning established in FEMA's National Response Framework, (2) additional guidance for disaster planning, (3) the status of disaster planning efforts, and (4) special circumstances in planning for oil spills. This testimony is based on prior GAO work on emergency planning and response, including GAO's April 2009 report on the FEMA efforts to lead the development of a national preparedness system. GAO reviewed the policies and plans that form the basis of the preparedness system. GAO did not assess any criteria used or the operational planning for the Deepwater Horizon response."

Testimony issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act)--initially estimated to cost $787 billion in spending and tax provisions--aims to promote economic recovery, make investments, and minimize or avoid reductions in state and local government services. The Recovery Act provided the Department of Energy (DOE) more than $43.2 billion, including $36.7 billion for projects and activities and $6.5 billion in borrowing authority, in areas such as energy efficiency and renewable energy, nuclear waste clean-up, and electric grid modernization. This testimony discusses (1) the extent to which DOE has obligated and spent its Recovery Act funds, and (2) the factors that have affected DOE's ability to select and start Recovery Act projects. In addition, GAO includes information on ongoing work related to DOE Recovery Act programs. This testimony is based on prior work and updated with data from DOE."

Testimony issued by the Government Accountability Office with an abstract that begins "Federal entities--agencies, corporations, and others--are growing users of credit and debit cards, as both "merchants" (receiving payments) and purchasers. Federal entities, like other merchants that accept cards, incur fees--called merchant discount fees--to process card transactions. For Visa and MasterCard transactions, a large portion of these fees-- referred to as interchange fees--goes to the card-issuing banks. This statement addresses (1) the amounts of revenue that federal entities have collected using credit and debit cards and the costs of such acceptance, (2) these entities' efforts to reduce their interchange fee costs, including negotiations, and (3) the extent to which card network rules affect these entities and other card accepters' ability to reduce interchange fee costs. The information for this statement was drawn from Credit and Debit Cards: Federal Entities Are Taking Actions to Limit Their Interchange Fees, but Additional Revenue Collection Cost Savings May Exist (GAO-08-558) and Credit Cards: Rising Interchange Fees Have Increased Costs for Merchants, but Options for Reducing Fees Pose Challenges (GAO-10-45). GAO analyzed data on accepting and using cards from the Department of the Treasury (Treasury), Amtrak, the Postal Service, and General Services Administration (GSA); and …

Testimony issued by the Government Accountability Office with an abstract that begins "Recent events including last month's attack on Internal Revenue Service offices in Texas, and the January 2010 shooting in the lobby of the Nevada, federal courthouse demonstrate the continued vulnerability of federal facilities and the safety of the federal employees who occupy them. These events also highlight the continued challenges involved in protecting federal real property and reiterate the importance of protecting the over 1 million government employees, as well as members of the public, who work in and visit the nearly 9,000 federal facilities. This testimony is based on past GAO reports and testimonies and discusses challenges Federal Protective Service (FPS) faces in protecting federal facilities and tenant agencies' perspective of FPS's services. To perform this work, GAO visited a number of federal facilities, surveyed tenant agencies, analyzed documents, and interviewed officials from several federal agencies."

Testimony issued by the Government Accountability Office with an abstract that begins "Recent terrorist events such as the attempted bomb attacks in New York's Times Square and aboard an airliner on Christmas Day 2009 are reminders that national security challenges have expanded beyond the traditional threats of the Cold War Era to include unconventional threats from nonstate actors. Today's threats are diffuse and ambiguous, making it difficult--if not impossible--for any single federal agency to address them alone. Effective collaboration among multiple agencies and across federal, state, and local governments is critical. This testimony highlights opportunities to strengthen interagency collaboration by focusing on four key areas: (1) developing overarching strategies, (2) creating collaborative organizations, (3) developing a well-trained workforce, and (4) improving information sharing. It is based on GAO's body of work on interagency collaboration."

Testimony issued by the Government Accountability Office with an abstract that begins "In March 2008, GAO designated the 2010 Census a high-risk area in part because of information technology (IT) shortcomings and uncertainty over the ultimate cost of the census, now estimated at around $15 billion. The U.S. Census Bureau (Bureau) has since made improvements to various IT systems and taken other steps to mitigate the risks of a successful census. However, last year, GAO noted that a number of challenges and uncertainties remained, and much work remained to be completed under very tight time frames. As requested, this testimony provides an update on the Bureau's readiness for an effective headcount, covering (1) the status of key IT systems; (2) steps the Bureau has taken to revise its cost estimates; and (3) the extent to which critical enumeration activities, particularly those aimed at hard-to-count populations, are on track. The testimony is based on previously issued and ongoing GAO work."

Correspondence issued by the Government Accountability Office with an abstract that begins "During the course of a recent engagement reviewing noncompetitive contracting, we found that departments and agencies in the Department of Defense (DOD) are not submitting complete information, as required, to the Office of the Assistant Secretary of Defense for Public Affairs (OASD[PA]), which then posts the information on its Web site as a public announcement. President Obama has emphasized transparency and openness in how the government spends taxpayer dollars. We are bringing this issue to the attention of the Defense Department's Defense Procurement and Acquisition Policy due to its responsibility for acquisition and procurement policy matters in DOD. The Federal Acquisition Regulation (FAR) requires contracting officers to make information on a contract action over a certain dollar amount publicly available on the same day the contract is awarded. The Defense Federal Acquisition Regulation Supplement (DFARS) further specifies that for contract actions over $5.5 million, departments and agencies are to submit certain information to the OASD(PA) by the close of business the day before the date of the proposed award, including, "as a minimum" (1) contract data, for example, contract number, face value of the action and total cumulative …

Correspondence issued by the Government Accountability Office with an abstract that begins "According to the Centers for Disease Control and Prevention (CDC), pathogens such as Salmonella, E. coli, and Listeria cause an estimated 14 million cases of foodborne illnesses each year, resulting in about 60,000 hospitalizations and 1,800 deaths. Foodborne illness symptoms can range from mild gastroenteritis to life-threatening renal syndromes. The populations most susceptible to the more serious symptoms include very young children, individuals 60 years and older, pregnant women, and people who have a weakened immune system. In 2007, about 20 to 25 percent of the U.S. population was in this high-risk category. Moreover, consumers' vulnerability to foodborne illness is increasing as a result of changes in demographics, among other things. For example, older Americans will make up an estimated 20 percent of the U.S. population by 2015. The pathogens that account for much of the most severe foodborne illness can be greatly reduced by subjecting food to ionizing radiation, also known as food irradiation. Many experts believe that irradiation can be effectively incorporated into an establishment's food safety program to further ensure the safety of the food against pathogens. Irradiation can also be used as a phytosanitary …

Correspondence issued by the Government Accountability Office with an abstract that begins "Counties containing federal lands have historically received a percentage of the receipts generated by the sale or use of natural resources on the federal lands. A steep decline in federal timber sales during the 1990s, however, resulted in a significant decrease in federal payments to counties that previously depended on timber receipts. The Secure Rural Schools and Community Self-Determination Act of 2000, reauthorized in 2008, was enacted, in part, to address this decline by stabilizing payments to counties that depended on revenues from timber sales on Forest Service and certain Bureau of Land Management (BLM) lands. Under the aceach county may continue to receive a portion of the revenues generated from the sale or use of resources from these lands or may choose instead to receive annual payments based in part on historical revenue payments to the county. Among other things, the act provides for the Forest Service and BLM to implement certain land management projects, known as Title II projects, using a portion of these funds. The act mandates that a certain percentage of Title II projects involving the sale of merchantable timber be carried out under …

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter formally transmits the briefing in response to the National Defense Authorization Act for Fiscal Year 2010 (Pub. L. No. 111-84), which required GAO to submit a report on rare earth materials in the defense supply chain to the Committees on Armed Services of the Senate and House of Representatives by April 1, 2010."

Correspondence issued by the Government Accountability Office with an abstract that begins "Hospitals and other health care providers use purchasing intermediaries--group purchasing organizations (GPO)--as a way to control the cost of various medical products. Through GPO-negotiated contracts, hospitals and other health care providers can purchase everything from commodities, such as cotton balls and bandages, to high-technology medical devices, such as pacemakers and stents. By pooling the purchases of these products for their customers, GPOs are in a position to negotiate lower prices from manufacturers, distributors, and other suppliers, which may in turn benefit health care providers and, ultimately, consumers and payers of health care such as insurers and employers. Members of Congress and others have recently raised questions about the extent to which GPOs negotiate lower prices for health care providers. GPO and other trade associations have funded studies on the impact of GPOs. However, these studies have limitations. Congress asked us to review research on the impact of GPOs on pricing for hospitals and other health care providers. This report summarizes the peer-reviewed and nonpeer-reviewed literature on the impact of GPOs on pricing for hospitals and other health care providers that GAO identified in GAO's literature review."

Correspondence issued by the Government Accountability Office with an abstract that begins "Each year, billions of dollars in arms and "dual-use" items--items that have both commercial and military applications--are exported to U.S. allies and strategic partners. To further national security, foreign policy, and economic interests, the U.S. government controls the export of these items. Over the past 10 years, we have reported on numerous weaknesses in the export control system, including poor coordination among the multiple agencies involved, which have led to jurisdictional disputes and enforcement challenges, and the lack of systematic assessment of the overall effectiveness of the export control system. As a result, since 2007 the arms and dual-use export control systems have been included as part of our high-risk area on ensuring the effective protection of technologies critical to U.S. national security interests. We have also called for a strategic reexamination of existing programs within the U.S. export control system to identify needed changes and ensure the advancement of U.S. interests. In August 2009, the President announced that he had directed a comprehensive review of the U.S. export control system and, in April 2010, proposed a framework under which the current system would be streamlined to include …

Correspondence issued by the Government Accountability Office with an abstract that begins "In February 2009, Congress created two new programs as part of the American Recovery and Reinvestment Act of 2009 (Recovery Act): (1) the Tax Credit Assistance Program (TCAP) administered by the Department of Housing and Urban Development (HUD) and (2) the Grants to States for Low-Income Housing Projects in Lieu of Low-inome Housing Credits Program under Section 1602 of the Recovery Act (Section 1602 Program) administered by the Department of the Treasury (Treasury). Congress created these new programs to address the lack of private investment capital in Low-Income Housing Tax Credit (LIHTC) projects after the credit market was disrupted in 2008. Both programs were intended to provide gap financing for stalled, "shovel-ready" projects and to offset a drop in tax credit demand and pricing. Under these programs, state Housing Finance Agencies (HFA) administer federal funds in the form of grants and loans from HUD and Treasury to fill financing gaps in planned tax credit projects."

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter formally transmits the briefing in response to the Conference Report accompanying the Fiscal Year 2010 Consolidated Appropriations Act (H.R. Rep. No. 111-366, at 673-74 (2009) (Conf. Rep)), which directed us to evaluate BOP's strategic approach to budgeting for its inmate re-entry programs, including activities related to the Second Chance Act (SCA). To conduct this work, we analyzed the Federal Bureau of Prison's (BOP) programs, activities, and management initiatives that play a key role in implementing SCA requirements, such as the Inmate Skills Development Initiative (ISDI). Through ISDI, BOP intends to measure skills inmates acquired through effective reentry programs with the goal of reducing rates of recidivism. We also evaluated BOP's processes and initiatives that play a key role in implementing SCA, such as ISDI, to determine the extent to which BOP followed leading practices for planning, implementing, and identifying resources needed for projects."

Correspondence issued by the Government Accountability Office with an abstract that begins "In connection with fulfilling our requirement to audit the financial statements of the U.S. government, we audited and reported on the Schedules of Federal Debt Managed by the Bureau of the Public Debt (BPD) for the fiscal years ended September 30, 2009 and 2008. As part of these audits, we performed a review of the general and application information security controls over key financial systems maintained and operated by the Federal Reserve Banks (FRB) on behalf of the Department of the Treasury's (Treasury) BPD relevant to the Schedule of Federal Debt. As we reported in connection with our audit of the Schedules of Federal Debt for the fiscal years ended September 30, 2009 and 2008, we concluded that BPD maintained, in all material respects, effective internal control relevant to the Schedule of Federal Debt related to financial reporting and compliance with applicable laws and regulations as of September 30, 2009, that provided reasonable assurance that misstatements, losses, or noncompliance material in relation to the Schedule of Federal Debt would be prevented or detected on a timely basis. However, we found deficiencies involving information security controls that we do …

Correspondence issued by the Government Accountability Office with an abstract that begins "Medicare funds health care services for more than 46 million beneficiaries. The Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--contracts with private organizations known as Quality Improvement Organizations (QIO) to, among other core functions, improve the quality of care for Medicare beneficiaries. CMS contracts with one QIO for each of the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. One of the QIOs' many responsibilities is to review quality of care concerns, raised by Medicare beneficiaries or others, to determine whether Medicare-financed medical services meet professionally recognized standards of health care. Quality of care reviews may address a range of issues, such as inappropriate treatment or hospital staff not administering medications on time; may involve a variety of health care services and settings; and may include a range of Medicare providers or practitioners. CMS enters into 3-year contracts with QIOs for a range of activities and reviews, including quality of care reviews. For each QIO contract, CMS establishes a budget reflecting the estimated costs of these activities and reviews. For the most recent contracts, which cover August 1, 2008, through …

Correspondence issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) mandates GAO to review states' and localities' use of funds made available under the act. Since April 2009, GAO has published bimonthly reports on our findings related to federal, state, and local implementation of the Recovery Act. Currently, we are examining the efforts of selected states and local educational agencies (LEA) to ensure appropriate uses of Recovery Act funds. In North Carolina, we have been reviewing efforts undertaken by the North Carolina Department of Public Instruction (DPI) and selected LEAs to administer and oversee the use of Recovery Act funds under the State Fiscal Stabilization Fund (SFSF) education stabilization funds; Title I of the Elementary and Secondary Education Act of 1965 (ESEA Title I), as amended; and Part B of the Individuals with Disabilities Education Act (IDEA); as amended. As part of this effort, we met with various DPI staff and, from February 1 through 3, 2010, we visited Avery County Schools (ACS) to review and test the adequacy of controls and procedures in place pertaining to Recovery Act funds for these three federal programs. During our visit, …