Testimony issued by the General Accounting Office with an abstract that begins "As the baby boomers age, spending on long-term care for the elderly could quadruple by 2050. The growing demand for long-term care will put pressure on federal and state budgets because long-term care relies heavily on public financing, particularly Medicaid. Nursing home care traditionally has accounted for most Medicaid long-term care expenditures, but the high costs of such care and the preference of many individuals to stay in their own homes has led states to expand their Medicaid programs to provide coverage for home- and community-based long-term care. GAO found that a Medicaid-eligible elderly individual with the same disabling conditions, care needs, and availability of informal family support could find significant differences in the type and intensity of home and community-based services that would be offered for his or her care. These differences were due in part to the very nature of long-term care needs--which can involve physical or cognitive disabling conditions--and the lack of a consensus as to what services are needed to compensate for these disabilities and what balance should exist between publicly available and family-provided services. The differences in care plans were also due to …

Testimony issued by the General Accounting Office with an abstract that begins "In March of this year, GAO testified before the House Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, about the Department of Veterans Affairs' (VA) information technology (IT) program, and the strides that the Secretary had made in improving departmental leadership and management of this critical area--including the hiring of a chief information officer. At the Subcommittee's request, GAO evaluated VA's new IT organizational structure, and provided an update on VA's progress in addressing other specific areas of IT concern and our related recommendations pertaining to enterprise architecture, information security, the Veterans Benefits Administration's replacement compensation and pension payment system and maintenance of the Benefits Delivery Network, and the government computer-based patient record initiative."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the letters the Social Security Administration (SSA) sends to the public, focusing on: (1) awarding Social Security benefits; (2) adjusting Social Security benefits; (3) awarding Supplemental Security Income (SSI) Program, benefits; and (4) adjusting SSI benefits."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the National Railroad Passenger Corporation's (Amtrak) intercity passenger rail, focusing on: (1) Amtrak's progress toward achieving operating self-sufficiency; (2) its capital investment needs and how these capital needs compare with expected federal funding; and (3) the future of Amtrak and intercity passenger rail."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the management challenges facing the Department of Housing and Urban Development (HUD), focusing on: (1) HUD's progress in addressing the major management challenges identified in the past and GAO's plans for updating the risk status of HUD's programs; (2) issues HUD faces in ensuring that the reforms it has implemented are sustainable and will result in its becoming a high-performing federal agency, including GAO's plans for monitoring HUD's activities; and (3) the importance of congressional oversight in ensuring that federal agencies like HUD, successfully manage for results in the 21st century."

Testimony issued by the General Accounting Office with an abstract that begins "The Interstate Highway System has become central to transportation in the United States. It extends over 46,000 miles in length and includes 210,000 lane miles. The System carries over 24 percent of all vehicle miles traveling in the nation, while making up just 2.5 percent of total lane miles. Funding for the Interstate Highway System has been a major part of total highway funding since 1954 when interstate highway construction began. From 1954 through 2001, federal funding for interstates total over $370 billion (2001 dollars)--46 percent of all apportionments administered by the Federal Highway Administration (FHWA) during this period. Congestion on interstate highways has increased over the last decade; the physical condition of interstate highways has generally improved, and the level of safety has remained steady. Some of the factors states expect to negatively affect the conditions of their interstate highways in the future include increases in passenger and freight traffic, aging infrastructure, and financial constraints. FHWA's estimates of future annual interstate highway investment requirements vary depending on the goal transportation officials have for performance of the interstate system. In 2000, GAO evaluated the model that FHWA uses …

Testimony issued by the General Accounting Office with an abstract that begins "Increasingly, the issues of distance education and federal student aid intersect. About one in every 13 postsecondary students enrolls in at least one distance education course, and the Department of Education estimates that the number of students involved in distance education has tripled in just 4 years. As the largest provider of financial aid to postsecondary students, the federal government has a considerable interest in distance education. Overall, 1.5 million out of 19 million postsecondary students took at least one distance education course in the 1999-2000 school year. The distance education students differ from other postsecondary students in a number of respects. Compared to other students, they tend to be older and are more likely to be employed full-time while attending school part-time. They also have higher incomes and are more likely to be married. Many students enrolled in distance education courses participate in federal student aid programs. As distance education continues to grow, several major aspects of federal laws, rules, and regulations may need to be reexamined. Certain rules may need to be modified if a small, but growing, number of schools are to remain eligible for …

Testimony issued by the General Accounting Office with an abstract that begins "Federal agencies, and other public and private groups, rely extensively on computer systems and electronic data. The security of these systems and data is essential to avoiding disruptions in critical operations and preventing data tampering, fraud, and inappropriate disclosure of sensitive information. However, federal computer systems contain weaknesses that continue to put critical operations and assets at risk. In particular, deficiencies exist in entitywide security programs that are critical to agencies' success in ensuring that risks are understood and effective controls are implemented. Many efforts have been undertaken to implement the nationally critical infrastructure protection strategy outlined in Presidential Decision Directive (PDD) 63. However, progress in key areas has been limited. Although outreach efforts by many federal entities to establish cooperative relationships with and among private and other nonfederal entities have raised awareness and prompted information sharing, efforts to perform substantive analyses of sector-wide and cross-sector interdependencies and related vulnerabilities have been limited. A major impediment to implementing the strategy outlined in PDD 63 is the lack of a national plan that clearly spells out the roles and responsibilities of federal and nonfederal entities and defines interim objectives."

A letter report issued by the General Accounting Office with an abstract that begins "Drug effectiveness and adverse events can vary between children and adults and among racial and ethnic groups. The Food and Drug Administration (FDA) is authorized under the pediatric exclusivity provision to grant drug sponsors 6 months of additional exclusive marketing rights for conducting clinical drug studies in children. The Best Pharmaceuticals for Children Act of 2002 (BPCA) expanded this provision to require FDA to take into account the adequacy of minority representation in pediatric exclusivity studies. BPCA also directed GAO to evaluate the representation of minorities in such studies. GAO examined the extent to which minority children are represented, whether drugs that treat diseases disproportionately affecting minority groups are studied under the provision, and FDA's monitoring of the representation of minority children in the studies. GAO reviewed related FDA documents, FDA requests for pediatric studies and final study results, and interviewed FDA officials and other experts."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO provided information on the Financial Management Service's (FMS) computer controls in fiscal year (FY) 1999, focusing on: (1) the significant weaknesses GAO identified in its limited official use report and the recommendations that GAO had made; and (2) a follow-up on previously reported weaknesses."

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) maintains partnerships, or affiliations, with university medical schools to obtain medical services for veterans and provide training for medical residents. In 2002, the Medical University of South Carolina (MUSC)--which is affiliated with VA's medical facility in Charleston--proposed that VA and MUSC enter into a joint venture for a new VA facility as part of MUSC's plan to expand its medical campus. Under the proposal, MUSC and VA would jointly construct and operate a new medical center in Charleston. In 2004, the Capital Asset Realignment for Enhanced Services (CARES) Commission, an independent body charged with assessing VA's capital asset requirements, issued its recommendations on the realignment and modernization of VA's capital assets. Although the Commission did not recommend a replacement facility for Charleston, it did recommend, among other things, that VA promptly evaluate MUSC's proposal. This testimony discusses GAO's preliminary findings on the (1) current condition of the Charleston facility, (2) extent to which VA and MUSC collaborated on the joint venture proposal, and (3) issues for VA to consider when exploring the opportunity to participate in the joint venture. VA concurred with …

Testimony issued by the Government Accountability Office with an abstract that begins "The government's senior executives need to lead the way in transforming their agencies' cultures. Credible performance management systems--those that align individual, team, and unit performance with organizational results--can help manage and direct this process. In past work, GAO found that the performance management systems for senior executives fell short in this regard. In November 2003, recognizing that reforms were needed, Congress authorized a new performance-based pay system that ended the practice of giving annual pay adjustments to senior executives. Instead, agencies are to consider such factors as individual results and contributions to agency performance. If the Office of Personnel Management (OPM) certifies an agency's new performance system and the Office of Management and Budget (OMB) concurs, the agency has the flexibility to raise the pay of its highest performing senior executives above certain pay caps. This testimony addresses (1) the performance management system's regulatory structure, (2) OPM's certification process and agencies' views of it, and (3) OPM's role in monitoring the system, and the number of agencies that have been certified to date. This statement is based on GAO's issued work, which included interviews with senior OPM officials, …

Other written product issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO reviewed the Social Security Administration's (SSA) new rule on supplemental security income for childhood disabilities. GAO noted that: (1) the rule would revise and finalize the interim rule published on February 11, 1997, which implemented the childhood disabilities provisions of Public Law 104-193; and (2) SSA complied with applicable requirements in promulgating the rule."

A letter report issued by the General Accounting Office with an abstract that begins "As the baby boomers age, spending on long-term care for the elderly could quadruple by 2050. The growing demand for long-term care will put pressure on federal and state budgets because long-term care relies heavily on public financing, particularly Medicaid. Nursing home care traditionally has accounted for most Medicaid long-term care expenditures, but the high costs of such care and the preference of many individuals to stay in their own homes has led states to expand their Medicaid programs to provide coverage for home- and community-based long-term care. GAO found that a Medicaid-eligible elderly individual with the same disabling conditions, care needs, and availability of informal family support could find significant differences in the type and intensity of home and community-based services that would be offered for his or her care. These differences were due in part to the very nature of long-term care needs--which can involve physical or cognitive disabling conditions--and the lack of a consensus as to what services are needed to compensate for these disabilities and what balance should exist between publicly available and family-provided services. The differences in care plans were also …

A letter report issued by the General Accounting Office with an abstract that begins "Day laborers generally are individuals who work and get paid on a daily or short-term basis. To find work, they often congregate on street corners and wait for employers to drive by and offer them work. Day laborers may also be employed by temporary staffing agencies that assign them work on a daily basis with client employers. Day laborers have an informal relationship with the labor market, often working for different employers each day, being paid in cash, and lacking key benefits, such as health or unemployment insurance. However, day laborers may be eligible for wage and safety protections provided by the Fair Labor Standards Act (FLSA) and the Occupational Safety and Health (OSH) Act. The U.S. Department of Labor administers both acts. Its Wage and Hour Division (WHD) is responsible for ensuring that all covered workers receive at least the federal minimum hourly wage and overtime pay. The Occupational Safety and Health Administration (OSHA) is required to ensure that employers provide safe and healthy workplaces to help their workers avoid injury or death. Coverage under both laws does not depend on a worker's immigration status. …

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) has encountered numerous challenges in managing its information technology (IT) and securing its information systems. In October 2005, the department initiated a realignment of its IT program to provide greater authority and accountability over its resources. The May 2006 security incident highlighted the need for additional actions to secure personal information maintained in the department's systems. In this testimony, GAO discusses its recent reporting on VA's realignment effort as well as actions to improve security over its information systems. To prepare this testimony, GAO reviewed its past work on the realignment and on information security, and it updated and supplemented its analysis with interviews of VA officials."

A letter report issued by the General Accounting Office with an abstract that begins "The United Nations responded to the failure of some past peacekeeping operations by developing a strategy to help peacekeeping operations move a country from conflict to sustainable peace. It has attempted to apply this strategy to the large and costly peacekeeping operations in Sierra Leone, East Timor, and the Democratic Republic of the Congo since 2001. As a contributor of over 25 percent of the cost of U.N. operations, the United States has a stake in the successful application of this strategy. The strategy also has implications for the conduct of international peace operations in other post-conflict countries. GAO was asked to (1) identify the elements of the U.N. transition strategy; (2) assess the extent to which the United Nations has applied the strategy to operations; and (3) assess the challenges to implementing the strategy in these three countries."

A letter report issued by the General Accounting Office with an abstract that begins "This report examines the acquisition of the Composite Health Care System (CHCS) II. It is one in a series of reports reviewing the Department of Defense's use of best practices in acquiring information technology systems. CHCS II is expected to cost about $1 billion to deliver full capability to almost 1,100 health facilities worldwide by 2008. GAO's objectives were to determine (1) what progress has been made against project commitments, (2) whether the system has been economically justified, and (3) whether effective technical and management controls are in place."

Testimony issued by the Government Accountability Office with an abstract that begins "The International Atomic Energy Agency's (IAEA) safeguards system has been a cornerstone of U.S. efforts to prevent nuclear weapons proliferation since the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) was adopted in 1970. Safeguards allow IAEA to verify countries' compliance with the NPT. Since the discovery in 1991 of a clandestine nuclear weapons program in Iraq, IAEA has strengthened its safeguards system. In addition to IAEA's strengthened safeguards program, there are other U.S. and international efforts that have helped stem the spread of nuclear materials and technology that could be used for nuclear weapons programs. This testimony is based on GAO's report on IAEA safeguards issued in October 2005 (Nuclear Nonproliferation: IAEA Has Strengthened Its Safeguards and Nuclear Security Programs, but Weaknesses Need to Be Addressed, GAO-06-93 [Washington, D.C.: Oct. 7, 2005]). This testimony is also based on previous GAO work related to the Nuclear Suppliers Group--a group of more than 40 countries that have pledged to limit trade in nuclear materials, equipment, and technology to only countries that are engaged in peaceful nuclear activities--and U.S. assistance to Russia and other countries of the former Soviet Union …

Testimony issued by the Government Accountability Office with an abstract that begins "The federal government's long-standing policy has been to use its buying power to maximize procurement opportunities for various types of small businesses. GAO initiated work and completed a report in March 2007 under the Comptroller General's authority describing the extent to which small businesses participated in contracting opportunities related to Hurricane Katrina. This testimony discusses (1) results from the March 2007 GAO report, including the amounts that small and local businesses received directly from federal agencies from contracts related to Hurricane Katrina and the lack of required information in official procurement data systems on subcontracting plans, (2) information from two previous GAO reports regarding the small business advocacy responsibilities of Small Business Administration (SBA) and federal agencies that award contracts, and (3) GAO work on SBA's efforts to advocate for small disadvantaged businesses, and similar efforts by entities within selected agencies. In conducting the studies discussed in this testimony, GAO analyzed agency contract data, reviewed federal acquisition regulations, and interviewed agency procurement officials; we also sent a questionnaire to agency officials regarding Office of Small and Disadvantaged Business Utilization (OSDBU) reporting relationships; reviewed organizational charts and other pertinent …

Testimony issued by the Government Accountability Office with an abstract that begins "An influenza pandemic is a real and significant potential threat facing the United States and the world. Pandemics are unlike other emergencies because they are not a singular event nor discretely bounded in space and time. This testimony addresses (1) federal leadership roles and responsibilities for preparing for and responding to a pandemic, (2) our assessment of the Strategy and Plan, and (3) opportunities to increase clarity of federal leadership roles and responsibilities and improve pandemic planning. GAO used its characteristics of an effective national strategy to assess the Strategy and Plan. The issues discussed in the testimony are based primarily on the GAO report, Influenza Pandemic: Further Efforts Are Needed to Ensure Clearer Federal Leadership Roles and an Effective National Strategy (GAO-07-781). In this report, GAO recommended that (1) The Secretaries of Homeland Security and Health and Human Services develop rigorous testing, training, and exercises for pandemic influenza to ensure that federal leadership roles and responsibilities are clearly defined, understood and work effectively and (2) HSC set a time frame to update the Plan, involve key stakeholders, and more fully address the characteristics of an effective national …

Testimony issued by the Government Accountability Office with an abstract that begins "Health savings accounts (HSA) and the high-deductible health insurance plans that are eligible to be coupled with them are a new type of consumer-directed health plan attracting interest among employers and consumers. HSA-eligible plans constitute a small but growing share of the private insurance market, and the novel structure of the plans has raised questions about how they could affect enrollees' health care purchasing decisions and costs. This statement is based on GAO's August 2006 report entitled "Consumer-Directed Health Plans: Early Enrollee Experiences with Health Savings Accounts and Eligible Health Plans" (GAO-06-798). In this report, GAO reviewed (1) the financial features of HSA-eligible plans in comparison with those of traditional plans, such as preferred provider organizations (PPO); (2) the characteristics of HSA-eligible plan enrollees in comparison with those of traditional plan enrollees or others; (3) HSA funding and use; and (4) enrollees' experiences with HSA-eligible plans."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO assessed the equality of the Social Security Administration's (SSA) letters to the public, focusing on the: (1) problems that make SSA's letters difficult to understand; and (2) status of SSA's actions to fix the problems."

A letter report issued by the General Accounting Office with an abstract that begins "Money laundering is a serious crime, with hundreds of billions of dollars laundered annually. Congress passed the Money Laundering and Financial Crimes Strategy Act of 1998 to better coordinate the efforts of law enforcement agencies and financial regulators in combating money laundering. This act required the issuance of an annual National Money Laundering Strategy for 5 years, ending with the issuance of the 2003 strategy. To help with deliberations on reauthorization, GAO determined (1) agency perspectives on the benefit of the strategy and factors that affected its development and implementation, (2) whether the strategy has served as a useful mechanism for guiding the coordination of federal law enforcement agencies' efforts, (3) the role of the strategy in influencing the activities of federal financial regulators, and (4) whether the strategy has reflected key critical components."