A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) revised its New Access Point (NAP) competitive award process in fiscal year 2011 to increase the emphasis on the need for services in the applicant’s proposed service area, and on the three special populations—migrant and seasonal farmworkers, homeless people, and residents of public housing—designated by the Public Health Service Act. The act requires that certain proportions of Health Center Program funding go to health centers serving the special populations. To increase the emphasis on need, HRSA increased the weight given to need in the application review process. To target health centers serving special populations, HRSA gave extra points in the application process to applicants proposing to serve them. When this was insufficient to meet the required proportions, HRSA moved some applicants ahead of others in the award rank order list, a method it had used in the past. The effect of HRSA’s actions on the award outcome was magnified in fiscal year 2011 because (1) HRSA received less program funding than it had anticipated, and (2) it needed to increase the share …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) relies on three main methods to oversee grantees’ compliance with the 19 key program requirements."

A letter report issued by the Government Accountability Office with an abstract that begins "Multiple Title IV programs and tax expenditures provided substantial aid to populations across income levels. In 2009, 12.8 million students received Title IV aid, and approximately 18-million tax filers claimed a higher education tax benefit for current expenses. Recent increases in both programs from 2008 to 2009 may be because of enrollment increases and legislative actions, among other factors. Title IV grants tend to benefit students and families with incomes below the national median (about $52,000 from 2006–2010), while loans and work-study serve these students and those with family incomes above the median. Most tax benefits from the tuition and fees deduction and the parental exemption for dependent students went to households with incomes above $60,000, whereas the majority of benefits from the other higher education tax expenditures in GAO’s review—such as the American opportunity credit—went to households with lower incomes."

Testimony issued by the Government Accountability Office with an abstract that begins "GAO’s past work has found that the Department of Homeland Security (DHS) and the Transportation Security Administration (TSA) have faced challenges in developing and meeting program requirements when acquiring screening technologies. GAO’s past work has demonstrated that program performance cannot be accurately assessed without valid baseline requirements established at the program start. In June 2010, GAO reported that more than half of the 15 DHS programs GAO reviewed awarded contracts to initiate acquisition activities without component or department approval of documents essential to planning acquisitions, setting operational requirements, or establishing acquisition program baselines. At the program level, in January 2012, GAO reported that TSA did not fully follow DHS acquisition policies when acquiring advanced imaging technology (AIT)—commonly referred to as a full body scanner that identifies objects or anomalies on the outside of the body—which resulted in DHS approving full AIT deployment without full knowledge of TSA’s revised specifications. In July 2011, GAO reported that in 2010 TSA revised its explosive detection systems (EDS) requirements to better address current threats and planned to implement these requirements in a phased approach; however, GAO reported that some number of the …

A letter report issued by the Government Accountability Office with an abstract that begins "Homelessness programs are fragmented across multiple agencies and some show evidence of overlap. In fiscal year 2010, eight federal agencies obligated roughly $2.8 billion to administer 26 homelessness programs. Three agencies—the Departments of Health and Human Services (HHS), Housing and Urban Development (HUD), and Veterans Affairs (VA)—are responsible for the majority of programs and dollars, 22 of 26 programs, and 89 percent of total funds. GAO found that these agencies and the Department of Labor (Labor) have multiple programs that offer similar services to similar beneficiaries. Fragmentation of services and overlap in some programs is partly due to their legislative creation and partly due to programs evolving to offer services that meet the variety of needs of persons experiencing homelessness. Fragmentation and overlap can lead to inefficient use of resources. For example, both HHS and VA have programs that provide similar services, but each agency separately manages its programs under different administrative units. In addition, some local service providers told us that managing multiple applications and reporting requirements was burdensome, difficult, and costly. Moreover, according to providers, persons experiencing homelessness have difficulties navigating services that are …

Correspondence issued by the Government Accountability Office with an abstract that begins "Information on the overall effectiveness (or impact) of the CDBG and HOME programs is limited. According to HUD officials, the agency has faced challenges in evaluating the impact of CDBG and HOME because, among other things, such an evaluation would have to compare neighborhoods that received program assistance with those that did not. Our previous work has also identified the difficulties of evaluating the impact of block grant programs that do not represent a uniform package of activities or desired outcomes across the country, as well as the common problem of attributing differences in communities’ outcomes to the effect of a program in the absence of controls for other explanations. As a result, few comprehensive studies on the impact of the CDBG and HOME programs exist, but studies that focused on specific activities have generally found that each of the programs has made positive contributions. We identified two studies that attempted to examine the overall impact of the CDBG program on communities, but both studies encountered evaluation challenges due to the program’s design. For example, a 1995 study that HUD considers the most comprehensive evaluation of CDBG suggests …

Correspondence issued by the Government Accountability Office with an abstract that begins "State has an extensive process designed to make the country reports on human rights as comprehensive, objective, and uniform as possible. This process includes annually issuing detailed instructions, consulting and assessing information from multiple sources, and collaboratively and iteratively drafting and reviewing the reports. State issues instructions for preparing the country reports each year, outlining a consistent structure and describing, for example, the topics that should be included in each subsection. The instructions also, among other things, indicate that the country reports should build on the previous year’s reports and specify guidelines for new and updated content. In addition, the instructions state that staff preparing the country reports are to use and assess multiple sources, including host governments, local and international human NGOs, labor unions, and host country media as well as classified information. State officials told us that they also obtain information from business leaders and industry groups, although there is no legal requirement to do so. In general, according to State officials, Foreign Service officers—often on their first or second tour of duty—prepare first drafts of the country reports with the assistance of other embassy personnel, …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Justice (DOJ) administered 13 grant programs from fiscal years 2005 through 2010 that recipients could use to support indigent defense, 4 of which required recipients to use all or part of the funding for this purpose. DOJ also provides training to indigent defense providers, among other things."

A letter report issued by the Government Accountability Office with an abstract that begins "HUD’s fiscal year 2011 expenditure plan, which seeks to obligate about $114 million for seven modernization projects, along with enterprisewide services and program management, satisfies both sets of statutory conditions contained in the 2011 appropriations act. Specifically, for the first set of statutory conditions, the plan identified the functional and performance capabilities, mission benefits, lifecycle costs, and key milestones for each of the projects. For example, the plan described specific and measurable mission benefits associated with HUD’s Place-Based Performance Management System project, such as reducing the time to compile performance information from 50 hours to 20 hours. In addition, the plan described costs associated with the lifecycle of each project, providing details on funds needed for major work activities."

Testimony issued by the Government Accountability Office with an abstract that begins "As discussed in our report, OMB and key federal agencies have made progress on selected action items identified in the IT Reform Plan, but there are several areas where more remains to be done. Of the 10 key action items we reviewed, 3 were completed and the other 7 were partially completed by December 2011. The action items that are behind schedule share a common reason for the delays: the complexity of the initiatives. In all seven of the cases, OMB and the federal agencies are still working on the initiatives. However, OMB and federal agencies have established time frames for completing only two of these initiatives."

A letter report issued by the Government Accountability Office with an abstract that begins "During the 5-year period from fiscal year 2007 through 2011, the Department of Housing and Urban Development’s (HUD) Office of Inspector General (OIG) had budget and staffing resources that were consistent with other OIGs, and a monetary return for each budget dollar which exceeded the average return for Cabinet-level OIGs. During the 5-year period, the HUD OIG had total budgetary resources ranging from $121 million to $144 million, consistently ranking it fifth among all Cabinet-level OIGs. However, while the total budgetary resources for all Cabinet-level OIGs increased by about 45 percent over the 5-year period, the HUD OIG’s total budgetary resources increased by 19 percent. In terms of staffing, the HUD OIG’s full-time-equivalent staff (FTE) consistently ranked in the top four or five of the Cabinet-level OIGs. Also, the HUD OIG’s FTEs increased by about 13 percent during the 5-year period, as compared to about a 17 percent average increase for all Cabinet-level OIGs. During the same 5-year period, the HUD OIG reported an estimated average dollar return of about $13.62 for each HUD OIG total budgetary dollar received, while the 16 OIGs in the Cabinet-level …

Correspondence issued by the Government Accountability Office with an abstract that begins "During our audit of CFPB’s fiscal year 2011 financial statements, we identified seven internal control issues that could adversely affect CFPB’s ability to meet its internal control objectives. We do not consider these issues to represent material weaknesses or significant deficiencies in relation to CFPB’s financial statements. Nonetheless, we believe they warrant management’s attention and action. These issues concern necessary controls to ensure"

Correspondence issued by the Government Accountability Office with an abstract that begins "During our audit of FHFA’s fiscal years 2011 and 2010 financial statements, we identified one internal control issue and a continuing issue related to information systems controls that could adversely affect FHFA’s ability to meet its internal control objectives. We do not consider these issues to represent material weaknesses or significant deficiencies in relation to FHFA’s financial statements. Nonetheless, we believe they warrant management’s attention and action."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy’s (DOE) Isotope Development and Production for Research and Applications program (Isotope Program) provides over 300 different isotopes for commercial and research applications. The Isotope Program is responsible for 243 stable isotopes that are no longer produced in the United States but are sold from the program’s existing inventory and for 55 radioactive isotopes, called radioisotopes, that the program is able to produce at DOE facilities. An additional 10 isotopes sold by the Isotope Program are provided by the National Nuclear Security Administration (NNSA), a separate agency within DOE, as by-products of its nuclear weapons program."

Correspondence issued by the Government Accountability Office with an abstract that begins "The act requires that OMB develop federal government priority goals (crosscutting goals) and a federal government performance plan, which is to be updated annually and released concurrently with the President’s budget. Specifically, it requires OMB, starting with the 2015 budget and in coordination with agencies and in consultation with the Congress, to develop—every 4 years—long-term, outcome-oriented goals for a limited number of crosscutting policy areas and goals for management improvement areas, including: financial management; human capital management; information technology management; procurement and acquisition management; and real property management. The goals are to be updated or revised every 4 years. In addition, OMB is required to develop interim priority goals, starting with the 2013 budget. OMB is also required to provide information on how these federal government priority goals will be achieved in a federal government performance plan."

A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare and Medicaid Services (CMS), within the Department of Health and Human Services (HHS), implemented the durable medical equipment (DME) competitive bidding program’s (CBP) bidding process for the round 1 rebid. Nearly the same number of suppliers submitted a similar number of bids for both the CBP round 1 rebid and round 1. Many suppliers continued to have difficulty complying with financial documentation requirements; however, the number of bids disqualified in the round 1 rebid was significantly less than for round 1. After being notified of their bid results, some suppliers were found to have bids that were disqualified incorrectly and were subsequently offered round 1 rebid contracts. About one-third of the bidding suppliers were awarded CBP contracts."

Testimony issued by the Government Accountability Office with an abstract that begins "Our work on the outcomes of the CBP round 1 rebid found that the number of bidding suppliers and the number of contracts awarded in the CBP round 1 rebid were very similar to the CBP round 1 and about a third of the 1,011 suppliers that bid in the rebid were awarded at least one CBP contract. CMS made improvements to the bidding process for the CBP round 1 rebid—such as providing additional information about disqualification reasons—and significantly fewer bids were disqualified than in round 1. However, many suppliers still had difficulty meeting bid requirements. Of the bids that were disqualified during the initial bid review, 73 percent were disqualified because suppliers failed to provide the required financial documentation or did not meet CMS’s minimum financial standard threshold for suppliers. The number of bids disqualified for missing financial documentation in the CBP round 1 rebid would have been higher if many suppliers had not benefited from a MIPPA provision that required that CMS provide suppliers the opportunity to be notified of and to submit missing required financial documentation—a process not available during CBP round 1. As a …

Correspondence issued by the Government Accountability Office with an abstract that begins "Overall, orthopedic IMD admission rates were substantially higher in 2009 compared with 2003, while admission rate patterns among cardiac IMDs were mixed. Admission rates rose for each of the orthopedic IMDs in our study, with knee replacement rates growing 6.7 percent per year. The picture for inpatient cardiac IMD procedures was more mixed; admission rates for dual-chamber pacemakers decreased steadily while rates for AICDs and drug-eluting stents increased through 2006 and generally declined thereafter, in part reflecting a shift of surgeries to the outpatient setting. While the proportion of both orthopedic and cardiac IMD beneficiaries in poor or very poor health grew throughout our period of study, this trend was far more evident for cardiac IMD beneficiaries after 2007."

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, this report provides information on the incidence of treatment exclusions for MH/SU for the 2011 or 2010 plan year and the 2008 plan year for employers that responded to our survey. In total, for the 2011 or 2010 plan year, of the 96 employers that responded to our question about whether their most popular plan excluded coverage for any specific treatments related to MH/SU, 39 employers reported excluding a treatment. In comparison, for the 2008 plan year, of the 81 employers that responded to our question about whether their most popular excluded coverage for any specific treatments related to MH/SU, 27 employers reported excluding a treatment."

Testimony issued by the Government Accountability Office with an abstract that begins "Case processing times under the Integrated Disability Evaluation System (IDES) process have increased over time, and measures of servicemember satisfaction have shortcomings. Each year, average processing time for IDES cases has climbed, reaching 394 and 420 days for active and reserve component members in fiscal year 2011—well over established goals of 295 and 305 days, respectively. Also in fiscal year 2011, just 19 percent of active duty servicemembers and 18 percent of guard or reserve members completed the IDES process and received benefits within established goals, down from 32 and 37 percent one year prior. Of the four phases comprising IDES, the medical evaluation board phase increasingly fell short of timeliness goals and, within that phase, the time required for the military’s determination of fitness was especially troubling. During site visits to IDES locations, we consistently heard concerns about timeframes and resources for this phase of the process. With respect to servicemember satisfaction with the IDES process, GAO found shortcomings in how these data are collected and reported, such as unduly limiting who is eligible to receive a survey and computing average satisfaction scores in a manner that …

A letter report issued by the Government Accountability Office with an abstract that begins "From fiscal years 2006 to 2010, the National Science and Technology Council (NSTC) reported more than a doubling of National Nanotechnology Initiative (NNI) member agencies’ funding for nanotechnology environmental, health, and safety (EHS) research––from approximately $38 million to $90 million. Reported EHS research funding also rose as a percentage of total nanotechnology funding over the same period, ending at about 5 percent in 2010. However, GAO identified several reporting problems that raise concerns about the quality of EHS funding data reported. For example, for 18 percent of the 2010 projects GAO reviewed that were reported as EHS research, it was not clear that the projects were primarily directed at EHS risks. In addition, NNI member agencies did not always report funding using comparable data. The absence of detailed guidance on how agencies should report funding for their nanotechnology research has contributed to these problems, as GAO also reported in 2008 and made a related recommendation."

A letter report issued by the Government Accountability Office with an abstract that begins "Under section 319 of the Clean Water Act, state-selected projects to reduce nonpoint source pollution have helped restore more than 350 impaired water bodies since 2000, but other projects have encountered significant challenges. According to GAO survey results, 28 percent of projects did not achieve all objectives originally identified in the project proposal (e.g., implementing the desired number of pollution reduction practices), while many that did so still faced considerable challenges. About half such challenges were beyond staff control (e.g., bad weather or staff turnover), but the other half were challenges that generally could have been identified and mitigated before projects were proposed and selected for funding, such as gaining access to desired properties. In one state, for example, $285,000 in section 319 funds was to subsidize the cost to homeowners of repairing damaged septic systems. Once the grant was awarded, however, one homeowner signed up to participate."

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, we found the following:"

Correspondence issued by the Government Accountability Office with an abstract that begins "Fleet Mix Phase One, which was not cost constrained, indicated that the planned program of record does not fully meet long-term strategic goals and found that, to meet these goals, the Coast Guard requires a fleet that could cost as much as $65 billion to acquire, which is about $40 billion more than the $24.2 billion program of record. Coast Guard officials stated that the analysis supports the continued pursuit of the program of record. However, DHS Program Analysis & Evaluation (PA&E) and OMB officials told us that the analysis has limited utility without cost constraints and trade-offs."