A letter report issued by the Government Accountability Office with an abstract that begins "Since 2003, the Department of Homeland Security's (DHS) Visa Security Program (VSP) has participated in the visa process by reviewing applications at some embassies and consulates, with the intention of preventing individuals who pose a threat from entering the United States. The attempted bombing of an airline on December 25, 2009, renewed concerns about the security of the visa process and the effectiveness of the VSP. For this report GAO assessed (1) the ability of DHS's Immigration and Customs Enforcement (ICE) to measure the program's objectives and performance, (2) challenges to VSP operations, and (3) ICE efforts to expand the VSP program. To evaluate the VSP, we reviewed VSP data, guidance, and the ICE's 5-year expansion plan. We also interviewed ICE officials, and observed VSP operations at 6 posts overseas."

Correspondence issued by the Government Accountability Office with an abstract that begins "Over the past few years, the United States has increased its emphasis on training and equipping foreign police as a means of supporting a wide range of U.S. foreign-policy goals, including countering terrorists overseas and stopping the flow of narcotics to the United States. Funding for these activities has increased significantly since we last reported on these issues in 1992. In response to congressional request, this report provides estimates of the funding the U.S. government provided for activities to train and equip foreign police, hereafter referred to as "police assistance," during fiscal year 2009. We defined "police" as all law-enforcement units or personnel with arrest, investigative, or interdiction authorities."

A letter report issued by the Government Accountability Office with an abstract that begins "Federally funded employment and training programs play an important role in helping job seekers obtain employment. The Departments of Labor, Education, and Health and Human Services (HHS) largely administer these programs. GAO's objectives were to determine: (1) whether the number of federal employment and training programs and funding for them have changed since our 2003 report, (2) what kinds of outcome measures the programs use and what is known about program effectiveness, (3) the extent to which the programs provide similar services to similar populations, (4) the extent to which duplication may exist among selected large programs, and (5) what options exist for increasing efficiencies among these programs. To address these objectives, GAO searched federal program lists, surveyed federal agency officials, reviewed relevant reports and studies, and interviewed officials in selected states."

A publication issued by the Government Accountability Office with an abstract that begins "In fiscal year 2010, the Department of Veterans Affairs (VA) provided health care to about 5.2 million veterans. Recent legislation has increased many Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) veterans' priority for accessing VA's health care, and concerns have been raised about the extent to which VA is providing mental health care to eligible veterans of all eras. There also are concerns that barriers may hinder some veterans from accessing needed mental health care. GAO was asked to provide information on veterans who receive mental health care from VA. In this report, GAO provides information on (1) how many veterans received mental health care from VA from fiscal years 2006 through 2010, (2) key barriers that may hinder veterans from accessing mental health care from VA, and (3) VA efforts to increase veterans' access to VA mental health care. GAO obtained data from VA's Northeast Program Evaluation Center (NEPEC) on the number of veterans who received mental health care from VA. The number of veterans represents a unique count of veterans; veterans were counted only once, even if they received care multiple times during a …

A letter report issued by the Government Accountability Office with an abstract that begins "What GAO Found"

A publication issued by the Government Accountability Office with an abstract that begins "This testimony discusses our recent work on the Coast Guard's Deepwater acquisition, which represents the majority of the Coast Guard's efforts to recapitalize its fleet of vessels and aircraft. This statement is based on our July 28, 2011, report, Coast Guard: Action Needed as Approved Deepwater Program Remains Unachievable. This report discusses areas in which the Coast Guard has strengthened its acquisition management capabilities but also emphasizes actions the Coast Guard needs to take to address the cost growth, schedule delays, and capability shortfalls that have made the approved Deepwater Program unachievable. Today's climate of rapidly building fiscal pressures underscores the importance of assessing priorities--from a Coast Guard-wide perspective--so that more realistic budgets can be submitted to Congress. Such a step would help alleviate what has become a pattern of churn in revising program baselines when unrealistic planned funding does not materialize, which contributes to schedule delays and can lead to other issues such as unhealthy competition for funding. We also recognize several steps that the Coast Guard has taken to improve the management of the Deepwater Program. For example, the Coast Guard has updated its Major …

Correspondence issued by the Government Accountability Office with an abstract that begins "In 2009, Medicare--a federal health insurance program that serves about 46.3 million beneficiaries--spent approximately $8.1 billion on durable medical equipment (DME), prosthetics, orthotics, and related supplies for 10.6 million beneficiaries. DME includes items such as wheelchairs, hospital beds, and walkers. Medicare beneficiaries typically obtain DME items from suppliers, who submit claims for payment for these items to Medicare on behalf of beneficiaries. The Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), has responsibility for administering the Medicare program. Both we and HHS's Office of Inspector General (OIG) have reported that Medicare and its beneficiaries--through their out-of-pocket costs--have sometimes paid higher than market rates for various medical equipment and supplies. To achieve Medicare savings for DME and to address DME fraud concerns, Congress, through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), required CMS to phase in a competitive bidding program (CBP) for DME suppliers in selected competitive bidding areas (CBA). In CBP, suppliers submit bid prices in the amounts they are willing to accept as payment to provide DME items to Medicare beneficiaries. CMS then …

Correspondence issued by the Government Accountability Office with an abstract that begins "Section 8102 of the Department of Defense (DOD) and Full-Year Continuing Appropriations Act for fiscal year 2011 directed us to evaluate the effect on national security resulting from the section's requirements. These requirements, as well as those previously included in Section 8116 of the DOD Appropriations Act for fiscal year 2010, prohibit DOD's use of funds appropriated by the respective acts for any contract over $1 million unless the contractor agrees not to use or enforce mandatory arbitration agreements to resolve specified employee claims, such as those under Title VII of the Civil Rights Act of 1964. These statutes also provide that the Secretary of Defense can waive the application of these restrictions on mandatory arbitration to avoid harm to U.S. national security interests."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Nuclear Security Administration (NNSA)--a semiautonomous agency within the Department of Energy (DOE)-- proposed in March 2010 a new acquisition strategy that includes consolidating the management and operating (M&O) contracts for two of its eight sites--the Y-12 National Security Complex (Y-12) in Tennessee and the Pantex Plant in Texas--and consolidating all construction projects for all of its sites under a single, enterprise-wide contract. NNSA anticipates that this strategy will reduce costs, enhance mission performance, and improve construction management. NNSA's sites are overseen by colocated federal site offices. GAO was asked to assess NNSA's preliminary proposals for (1) a consolidated M&O contract for Y-12 and Pantex and (2) an enterprise-wide construction contract. GAO reviewed analyses supporting NNSA's acquisition strategy; examined agency directives and guidance; and interviewed DOE, NNSA, and contractor officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Agency for International Development (USAID) and the Department of Defense (DOD) award direct assistance to Afghanistan, using bilateral agreements and multilateral trust funds that provide funds through the Afghan national budget. GAO assessed (1) the extent to which the United States, through USAID and DOD, has increased direct assistance, (2) USAID and DOD steps to ensure accountability for bilateral direct assistance, and (3) USAID and DOD steps to ensure accountability for direct assistance via multilateral trust funds for Afghanistan. GAO reviewed USAID, DOD, and multilateral documents and met with U.S. officials and staffs of multilateral trust funds in Washington, D.C., and Afghanistan."

A letter report 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 $382 billion to develop and procure 2,457 aircraft. This report, prepared in response to a congressional mandate in the National Defense Authorization Act for Fiscal Year 2010, discusses (1) program cost and schedule changes and their implications on affordability; (2) progress made during 2010; (3) design and manufacturing maturity; and (4) test plans and progress. GAO's work included analyses of a wide range of program documents and interviews with defense and contractor officials."

A publication issued by the Government Accountability Office with an abstract that begins "The Justice Department has reported that Indians are at least twice as likely to be raped or sexually assaulted as all other races in the United States. Indians living in remote areas may be days away from health care facilities providing medical forensic exams, which collect evidence related to an assault for use in criminal prosecution. The principal health care provider for Indians, which operates or funds tribes to operate 45 hospitals, is the Department of Health and Human Services' Indian Health Service (IHS). In response to a Tribal Law and Order Act of 2010 mandate, GAO examined (1) the ability of IHS and tribally operated hospitals to collect and preserve medical forensic evidence involving cases of sexual assault and domestic violence, as needed for criminal prosecution; (2) what challenges, if any, these hospitals face in collecting and preserving such evidence; and (3) what factors besides medical forensic evidence contribute to a decision to prosecute such cases. GAO surveyed all 45 IHS and tribally operated hospitals and interviewed IHS and law enforcement officials and prosecutors.."

A letter report issued by the Government Accountability Office with an abstract that begins "Television stations that broadcast at lower power levels were not required to meet the 2009 digital transition deadline for full-power stations. These low-power television stations transmit over a smaller area, and most are less regulated than full-power stations. Low-power television stations use valuable radio frequency spectrum, and the Federal Communications Commission (FCC) noted the stations' digital transition could aid its efforts to clear spectrum for wireless broadband. GAO examined (1) low-power television stations' location and status in transitioning to digital, (2) FCC's steps to transition low-power television stations to digital and whether these stations are facing challenges transitioning to digital, and (3) why low-power television stations were established and the extent to which FCC collects information to determine if low-power television service is meeting FCC's statutory and policy goals. GAO analyzed FCC data and documents, reviewed stakeholder comments, and interviewed agency officials, stakeholders, and low-power television licensees."

A letter report issued by the Government Accountability Office with an abstract that begins "The federal government invests billions in information technology (IT) each year to help agencies accomplish their missions. Federal law, particularly the Clinger-Cohen Act of 1996, has defined the role of Chief Information Officer (CIO) as the focal point for IT management within agencies. Given the longstanding challenges the government faces in managing IT and the continued importance of the CIO, GAO was asked to (1) determine the current roles and responsibilities of CIOs, (2) determine what potential modifications to the Clinger-Cohen Act and related laws could be made to enhance CIOs' authority and effectiveness, and (3) identify key lessons learned by CIOs in managing IT. To do this, GAO administered a questionnaire to 30 CIOs, compared responses to legislative requirements and the results of a 2004 GAO study, interviewed current CIOs, convened a panel of former agency CIOs, and spoke with the Office of Management and Budget's (OMB) Federal CIO."

A letter report issued by the Government Accountability Office with an abstract that begins "For the past 2 years, the Department of Defense (DOD) has been implementing the Weapon Systems Acquisition Reform Act (Reform Act) requirements for systems engineering and developmental testing. These activities are important to DOD's ability to control acquisition costs, which increased by $135 billion over the past 2 years for 98 major defense acquisition programs. GAO was asked to determine (1) DOD's progress in implementing the Reform Act's requirements and (2) whether there are challenges at the military service level that could affect their systems engineering and developmental testing activities. To do this, GAO analyzed implementation status documents, discussed developmental testing office concerns with current and former DOD officials, and analyzed military service workforce growth plans and test range funding data.."

A letter report issued by the Government Accountability Office with an abstract that begins "TRICARE Reserve Select (TRS) provides certain members of the Selected Reserve--reservists considered essential to wartime missions--with the ability to purchase health care coverage under the Department of Defense's (DOD) TRICARE program after their active duty coverage expires. TRS is similar to TRICARE Standard, a fee-forservice option, and TRICARE Extra, a preferred provider option. The National Defense Authorization Act for Fiscal Year 2008 directed GAO to review TRS education and access to care for TRS beneficiaries. This report examines (1) how DOD ensures that members of the Selected Reserve are informed about TRS and (2) how DOD monitors and evaluates access to civilian providers for TRS beneficiaries. GAO reviewed and analyzed documents and evaluated an analysis of claims conducted by DOD. GAO also interviewed officials with the TRICARE Management Activity (TMA), the DOD entity responsible for managing TRICARE; the regional TRICARE contractors; the Office of Reserve Affairs; and the seven reserve components."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of the Treasury (Treasury), in coordination with the Office of Management and Budget (OMB), is primarily responsible for preparing the financial report of the U.S. government, which contains the consolidated financial statements of the U.S. government (CFS). Since GAO's first audit of the fiscal year 1997 CFS, certain material weaknesses in internal control and other limitations on the scope of GAO's work have prevented GAO from expressing an opinion on the CFS, exclusive of the Statement of Social Insurance (SOSI). Also, GAO was unable to express an opinion on the 2010 SOSI because of significant uncertainties primarily related to the achievement of projected reductions in Medicare cost growth reflected in the 2010 SOSI. As part of the fiscal year 2010 CFS audit, GAO identified material weaknesses and other control deficiencies in the processes used to prepare the CFS. The purpose of this report is to (1) provide details on new financial statement preparation control deficiencies GAO identified during its audit of the fiscal year 2010 CFS, (2) recommend improvements, and (3) provide the status of corrective actions taken to address GAO's recommendations in this …

A letter report issued by the Government Accountability Office with an abstract that begins "The McGovern-Dole International Food for Education and Child Nutrition Program (MGD Program) provides donations of U.S. agricultural products and financial and technical assistance for school feeding programs in the developing world. According to the U.S. Department of Agriculture (USDA), with about $200 million in funding in fiscal year 2010, the MGD Program served about 5 million beneficiaries in 28 countries. In 2006 and 2007, USDA's Office of the Inspector General (OIG) audited the department's food aid programs and identified significant weaknesses. This report examines (1) USDA's oversight of the MGD Program and (2) the extent to which USDA has addressed the program's internal control weaknesses. GAO conducted field work in Cambodia, Guatemala, and Kenya; reviewed USDA and implementing partners' documents and studies on school feeding; and interviewed officials from U.S. agencies and various organizations.."

Testimony issued by the Government Accountability Office with an abstract that begins "The Office of Personnel Management (OPM) is the central human resources agency for the federal government and, as such, is tasked with ensuring the government has an effective civilian workforce. As part of its mission, OPM defines recruiting and hiring processes and procedures; provides federal employees with various benefits, such as health benefits; and administers the retirement program for federal employees. The use of information technology (IT) is crucial in helping OPM to carry out its responsibilities, and in fiscal year 2011 the agency invested $79 million in IT systems and services. For over 2 decades, OPM has been attempting to modernize its federal employee retirement process by automating paper-based processes and replacing antiquated information systems. However, these efforts have been unsuccessful, and OPM canceled its most recent retirement modernization effort in February 2011. GAO was asked to provide a statement summarizing its work on challenges OPM has faced in managing its efforts to modernize federal employee retirement processing. To do this, GAO relied on previously published work as well as a limited review of more recent documentation on OPM's retirement modernization activities."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. has devoted an increasing proportion of its economy and federal budget to the provision of health care services, but high levels of spending do not guarantee good care. Policymakers, health practitioners, and others have implemented numerous health care interventions that make discrete changes in the organization of health care services in order to enhance the value of health care--that is, improve the quality of care while reducing costs. Examples include programs to reduce bloodstream infections and to coordinate patient care following hospital discharges. This report (1) examines the availability of evidence on the effect of selected interventions on quality of care and costs; (2) identifies key dimensions for assessing the strength of such evidence; and (3) examines factors that can facilitate the implementation and replication of health care interventions. GAO identified a broad and diverse set of health care interventions using published and unpublished sources. For 127 of those interventions, GAO analyzed responses to a questionnaire that it sent to persons knowledgeable about available information on the effect of that particular intervention on quality of care and costs. GAO's questionnaire also asked respondents to …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Justice (DOJ) reports from the latest available data that from 1992 to 2001 American Indians experienced violent crimes at more than twice the national rate. The Department of the Interior (DOI) and DOJ provide support to federally recognized tribes to address tribal justice issues. Upon request, GAO analyzed (1) the challenges facing tribes in adjudicating Indian country crimes and what federal efforts exist to help address these challenges and (2) the extent to which DOI and DOJ have collaborated with each other to support tribal justice systems. To do so, GAO interviewed tribal justice officials at 12 tribes in four states and reviewed laws, including the Tribal Law and Order Act of 2010, to identify federal efforts to assist tribes. GAO selected these tribes based on court structure, among other factors. Although the results cannot be generalized, they provided useful perspectives about the challenges various tribes face in adjudicating crime in Indian country. GAO also compared DOI and DOJ's efforts against practices that can help enhance and sustain collaboration among federal agencies and standards for internal control in the federal government."

A letter report issued by the Government Accountability Office with an abstract that begins "In 1935 the Indian Arts and Crafts Act was enacted, establishing the Indian Arts and Crafts Board as an entity within the Department of the Interior. A priority of the Board is to implement and enforce the act's provisions to prevent misrepresentation of unauthentic goods as genuine Indian arts and crafts. As the market for Indian arts and crafts grew and the problem of misrepresentation persisted, the act was amended to, among other things, enhance the penalty provisions and strengthen enforcement. GAO was asked to examine (1) what information exists regarding the size of the market and the extent to which items are misrepresented and (2) actions that have been taken to curtail the misrepresentation of Indian arts and crafts and what challenges, if any, exist. In addition, this report provides information on some options available to protect Indian traditional knowledge and cultural expressions. GAO analyzed documents and interviewed international, federal, state, and local officials about the arts and crafts market and enforcement of the act. GAO is making no recommendations in this report. In commenting on a draft of this report, the Departments of Commerce …

A letter report issued by the Government Accountability Office with an abstract that begins "Very little is known about sexual abuse among children that are regularly cared for by more than 1.3 million child care providers every week in the United States. In this context, GAO was asked to (1) provide an overview of federal and state laws related to the employment of sex offenders at child care facilities and (2) examine cases where individuals who were convicted of serious sexual offenses were subsequently employed or present at child care facilities. To provide an overview of selected laws, GAO searched for prohibitions against offenders being present at child care facilities, requirements for conducting criminal-history checks, and penalties for violating these requirements. The cases GAO examined focus only on individuals who were convicted of serious sexual offenses and cannot be generalized to all child care facilities. To identify the cases, GAO reviewed open-source information from 2000 to 2010. GAO also compared the years 2007 to 2009 in employment databases from 20 states and the District of Columbia to data in the National Sex Offender Registry. GAO ultimately selected 10 cases from eight states and the District of Columbia for review. For …

A letter report issued by the Government Accountability Office with an abstract that begins "To support ongoing operations, the Army gives priority to providing personnel to its operating forces over its support organizations, including Training and Doctrine Command (TRADOC).TRADOC performs various functions, such as developing warfighting doctrine and providing training. To help manage its workforce, TRADOC has taken certain actions, such as relying more on contractors and reassigning other staff to be instructors. In a February 2010 memorandum, the TRADOC Commander stated that because of various factors TRADOC's ability to successfully perform its core competencies and functions was increasingly at risk. House Armed Services Committee report 111-491 directed GAO to evaluate the availability of Army trainers. GAO assessed the extent to which TRADOC has (1) identified the number and type of personnel needed to carry out its training mission and (2) evaluated the impact of its workforce management actions on the quality of training. GAO interviewed key Army and TRADOC officials and reviewed relevant doctrine, guidance, curricula, personnel requirements data, and training survey results."