Testimony issued by the Government Accountability Office with an abstract that begins "The U.S. federal government has played an ever-increasing role in providing benefits to individuals injured as a result of exposure to harmful substances. Over the years, it has established several key compensation programs, including the Black Lung Program, the Vaccine Injury Compensation Program (VICP), the Radiation Exposure Compensation Program (RECP), and the Energy Employees Occupational Illness Compensation Program (EEOICP), which GAO has reviewed in prior work. Most recently, the Congress introduced legislation to expand the benefits provided by the September 11th Victim Compensation Fund of 2001. As these changes are considered, observations about other federal compensation programs may be useful. In that context, GAO's testimony today will focus on four federal compensation programs, including (1) the structure of the programs; (2) the cost of the programs through fiscal year 2004, including initial cost estimates and the actual costs of benefits paid, and administrative costs; and (3) the number of claims filed and factors that affect the length of time it takes to finalize claims and compensate eligible claimants. To address these issues, GAO relied on its 2005 report on four federal compensation programs. As part of that work, …

Testimony issued by the Government Accountability Office with an abstract that begins "DOD's investment in weapon systems represents one of the largest discretionary items in the budget. The department expects to invest about $900 billion (fiscal year 2008 dollars) over the next 5 years on development and procurement with more than $335 billion invested specifically in major defense acquisition programs. Every dollar spent inefficiently in acquiring weapon systems is less money available for other budget priorities--such as the global war on terror and growing entitlement programs. This testimony focuses on (1) the overall performance of DOD's weapon system investment portfolio; (2) our assessment of 72 weapon programs against best practices standards for successful product developments; and (3) potential solutions and recent DOD actions to improve weapon program outcomes. It is based on GAO-08-467SP, which included our analysis of broad trends in the performance of the programs in DOD's weapon acquisition portfolio and our assessment of 72 defense programs, and recommendations made in past GAO reports. DOD was provided a draft of GAO-08-467SP and had no comments on the overall report, but did provide technical comments on individual assessments. The comments, along with the agency comments received on the individual assessments, …

Correspondence issued by the Government Accountability Office with an abstract that begins "Meeting the nation's mobility needs requires constructing, improving, and repairing roads and bridges. However, these actions can have serious environmental impacts, such as harming water quality and wildlife and their habitats. The federal government's policy is to carry out federally funded highway projects in an environmentally responsible manner, as directed by the National Environmental Policy Act of 1969 (NEPA) and other environmental and natural resource protection laws. The environmental review of projects, as required by the act, involves identifying and assessing environmental impacts; evaluating alternatives; seeking input, and in some cases approvals, from federal and state agencies responsible for natural resources, environmental protection, and historic preservation (referred to hereafter as resource agencies); and obtaining approval from the Federal Highway Administration (FHWA). These reviews provide important environmental protections, yet it is generally agreed that it often takes too long to complete the most complex highway projects and the environmental review is the most time-consuming aspect. In 2005, the Safe, Accountable, Flexible, and Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU) made a number of changes to the planning and environmental review processes required of state and local transportation …

Testimony issued by the Government Accountability Office with an abstract that begins "According to the Centers for Disease Control and Prevention (CDC), health-care-associated infections (HAI)--infections that patients acquire while receiving treatment for other conditions--are estimated to be 1 of the top 10 causes of death in the nation. This statement summarizes a report issued in March and released today, Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections (GAO-08-283). In this report, GAO examined (1) CDC's guidelines for hospitals to reduce or prevent HAIs and what HHS does to promote their implementation, (2) Centers for Medicare & Medicaid Services' (CMS) and hospital accrediting organizations' required standards for hospitals to reduce or prevent HAIs, and (3) HHS programs that collect data related to HAIs and integration of the data across HHS. To conduct the work, GAO reviewed documents and interviewed HHS agency and accrediting organization officials."

Testimony issued by the Government Accountability Office with an abstract that begins "The International Space Station (ISS), the most complex scientific space project ever attempted, remains incomplete. NASA expects the station's final construction cost will be $31 billion and expects sustainment costs through the station's planned retirement in fiscal year 2016 to total $11 billion. The space shuttle, the only vehicle capable of transporting large segments of the station into orbit, is critical to its completion. NASA plans to complete ISS assembly and retire the shuttle in 2010 in order to pursue a new generation of space flight vehicles, which will not begin to be available until 2015. To provide crew rotation and logistical support during this 5-year gap, NASA plans to rely on spacecraft developed by the commercial sector and other countries. In light of these circumstances, GAO examined the risks and challenges NASA faces in (1) completing assembly of the ISS by 2010 and (2) providing logistics and maintenance to the ISS after 2010. GAO's work to accomplish this included reviewing budget, planning, and other documents from NASA; reviewing NASA officials' testimonies; and interviewing NASA and foreign space program officials."

Testimony issued by the Government Accountability Office with an abstract that begins "Certified registered nurse anesthetists (CRNA), registered nurses who have completed a master's degree program in nurse anesthesia, provide the majority of anesthesia care in the Department of Veterans Affairs (VA) medical facilities. There are approximately 500 VA-employed CRNAs (VA CRNA) who provide care to veterans in VA medical facilities. While the demand for CRNAs has increased, many employed by VA are nearing retirement eligibility age. Concerns have been raised about the challenges VA may face in making VA CRNA salaries competitive in order to maintain its VA CRNA workforce, particularly in local markets that can be highly competitive. This testimony is based on GAO work reported in VA Health Care: Many Medical Facilities Have Challenges in Recruiting and Retaining Nurse Anesthetists, (GAO-08-56, Dec. 13, 2007). This testimony (1) identifies workforce challenges that VA medical facilities experience related to VA CRNAs, and (2) identifies a key mechanism that VA medical facilities have to help make VA CRNA salaries competitive and the extent to which VA facilities use this mechanism. For the December 2007 report, GAO analyzed surveys sent to VA chief anesthesiologists, VA human resources officers, and VA CRNAs. …

Correspondence issued by the Government Accountability Office with an abstract that begins "Improving collaboration and health resource sharing between the Department of Veterans Affairs (VA) and the Department of Defense (DOD) has been the focus of numerous efforts by Congress and the executive branch for more than two decades. In 1982, Congress passed the Veterans' Administration and Department of Defense Health Resources Sharing and Emergency Operations Act (Sharing Act), which authorized VA and DOD health care facilities to partner and enter into sharing agreements to buy, sell, and barter medical and support services. Since then, Congress has passed additional legislation to continue to promote VA and DOD health resource sharing. However, in previous work we have pointed out continuing barriers to such efforts, including incompatible computer systems that affect the exchange of patient health information, inconsistent reimbursement and budgeting policies, and burdensome processes for approving agreements between the departments. On May 28, 2001, the President established the 15-member President's Task Force to Improve Health Care Delivery for Our Nation's Veterans. The task force's mission was to identify ways to improve coordination and sharing between VA and DOD in order to improve health care for servicemembers and veterans. The task force …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) is simultaneously implementing a number of force realignments that contribute to personnel growth at military installations throughout the United States. DOD plans to execute over 800 actions from the 2005 Base Realignment and Closure (BRAC) round, which entail relocating over 123,000 personnel. Concurrent with its BRAC 2005 actions, DOD is also implementing or planning to implement other extensive worldwide transformation initiatives, which include relocating about 50,000 soldiers primarily from Europe and Korea to the United States; transforming the Army's force structure from an organization based on divisions to more rapidly deployable, brigade-based units (known as Army modularity); and increasing its active duty end strength by 92,000, all of which will affect DOD's facilities infrastructure. These force realignments will result in dramatic growth at some DOD installations across the United States. Based on data provided by the services, the DOD Office of Economic Adjustment (OEA) had identified, as of January 2008, 20 locations where expected growth as a result of force realignments in fiscal years 2006 through 2012 will adversely affect surrounding communities. The National Defense Authorization Act for Fiscal Year 2008 mandated that …

Correspondence issued by the Government Accountability Office with an abstract that begins "On November 16, 2007, we issued our report on the U.S. Securities and Exchange Commission's (SEC) fiscal years 2007 and 2006 financial statements and on SEC's internal control as of September 30, 2007. We also reported on the results of our tests of SEC's compliance with selected provisions of laws and regulations during fiscal year 2007. The purpose of this report is to present areas of SEC's internal controls identified during our fiscal year 2007 audit that could be improved. This report contains 14 recommendations to SEC to improve these internal controls and procedures. These recommendations are in addition to those we already provided to SEC as a result of our prior audits of SEC's financial statements."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Millennium Challenge Corporation (MCC), now in its fourth year of operations, provides aid to developing countries that have demonstrated a commitment to ruling justly, encouraging economic freedom, and investing in people. MCC provides monetary assistance to eligible countries through multiyear compact agreements to fund specific programs targeted at reducing poverty and stimulating economic growth. MCC has received appropriations for fiscal years 2004 to 2008 totaling more than $7.5 billion, and has set aside about $6.4 billion of this amount for compact assistance. The President has requested an additional $2.225 billion for MCC for 2009, of which MCC plans to use $1.88 billion for compact assistance with countries currently eligible for compacts. MCC compact development is a four-phase process: (1) an eligible country submits a compact proposal; (2) MCC conducts a due diligence review of the proposed projects; (3) MCC and the country negotiate and sign the compact; (4) MCC and the country complete preparations, including developing disbursement plans, for the compact to enter into force. After the compact enters into force, compact implementation begins, and funds are obligated and disbursed. As of March 2008, MCC had selected …

Correspondence issued by the Government Accountability Office with an abstract that begins "With health care spending increasing in the United States, you enacted legislation effective in 2004 establishing tax advantaged health savings accounts (HSA) to be coupled with high-deductible health insurance plans. HSA-eligible high-deductible health plans typically have lower premiums than traditional health plans and HSAs allow account holders to accumulate tax-free savings to pay for medical expenses. The novel structure of HSA-eligible plans coupled with HSAs has raised questions about who selects them and how they use the accounts. Proponents contend that the low premiums of HSA-eligible plans and the tax-free savings potential of HSAs appeal to many consumers, while the high deductibles encourage them to be more astute health care consumers. However, some critics are concerned that HSA-eligible plans may attract enrollees who seek lower premiums but lack the resources to contribute to an HSA, and wealthy enrollees who may seek to use the HSA primarily to accumulate tax-advantaged savings rather than pay for medical expenses. In a 2006 report, GAO described individuals' early experiences with HSA-eligible plans and HSAs and certain characteristics of HSA account holders. You asked us to update certain information from that report with …

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter formally responds to section 371 of the National Defense Authorization Act for Fiscal Year 2008. The act requires GAO to provide an analysis of the Department of Defense's (DOD) budget submission for corrosion control and prevention and a DOD report that was to be submitted with defense budget materials to the congressional defense committees within 60 days after submission of the budget for a fiscal year. On April 3, 2008, we provided the briefing to staff of Congressional committees to satisfy the mandate and 60-day reporting requirement."

Correspondence issued by the Government Accountability Office with an abstract that begins "Temporomandibular joint and muscle disorders (TMJD) include a heterogeneous group of disorders with overlapping--but not identical--signs and symptoms. Symptoms of TMJDs vary, but typically include pain in the jaw joint and surrounding muscles. Other symptoms may include limited or no movement of the jaw joint, clicking or grating in the jaw joint when opening or closing the mouth, headaches, and shoulder or back pain. Most people with TMJDs have relatively mild forms of these disorders with symptoms that diminish without treatment. However, a small number of individuals develop significant, long-term problems, including persistent and debilitating pain and loss of jaw function. Although some TMJDs are due to a specific known cause, such as jaw injury or arthritis, the causes of many TMJDs are unknown. While the level of understanding about these conditions has evolved with scientific advancements, diagnosis and treatment are difficult because the exact causes and patterns of symptoms remain unclear. The National Institutes of Health (NIH), an agency within the Department of Health and Human Services (HHS), funds research on the causes of, treatments for, and other aspects of TMJDs. The NIH is organized into 27 …

Correspondence issued by the Government Accountability Office with an abstract that begins "Global mobility is a key component of U.S. national security. Since the end of the Cold War, senior decision makers have relied upon Department of Defense (DOD) mobility studies to provide insights they need to build and maintain the right mix of mobility capabilities. The most recent study, the Mobility Capabilities Study, identified the mobility support needed for the full range of strategic operations in the context of the September 11, 2001 attacks, the global war on terror, and DOD's evolving global defense posture, all in support of the National Military Strategy. According to DOD officials, the department plans to issue the next mobility study--the Mobility Capabilities Requirements Study--in the spring of 2009. The 2005 mobility study also assessed requirements for two overlapping war fights, DOD support to homeland defense, civil support, lesser contingency operations, sustainment of forward-deployed forces, and national strategic missions. In accomplishing these missions, DOD depends on its airlift force. The National Defense Authorization Act for Fiscal Year 2008 mandated a requirements-based study on alternatives for the proper size and mix of the airlift force to meet the needs of the National Military Strategy to …

Correspondence issued by the Government Accountability Office with an abstract that begins "Military physicians and other health care professionals are needed to support operational forces during war or other military conflicts and to maintain the well-being of the forces during nonoperational periods. These professionals also provide health care services to military retirees and dependents. The Department of Defense (DOD) acquires its health care professionals primarily through two programs--the Armed Forces Health Professions Scholarship Program and the Financial Assistance Program--with which it recruits and trains military health care providers who fill medical specialty positions. These programs offer participants reimbursement for tuition, books, fees, other education expenses, and a stipend, which is a fixed amount of money given to the participants on a monthly basis, in return for an active duty service obligation. Recruiting and retaining highly qualified health care professionals, however, is becoming more challenging for each of the military services. The added stresses of repeated deployments and the general perceptions of war, along with the potential for health care providers to earn significantly more money outside of DOD, have caused some professionals to choose to separate themselves from military service, even after DOD has paid for all or part of …

Correspondence issued by the Government Accountability Office with an abstract that begins "The United Nations (UN) headquarters in New York City neither conforms to current building codes nor meets UN technology or security requirements. As the UN's host country and largest contributor, the United States has a substantial interest in the success of the Capital Master Plan (CMP), a project to renovate the complex. In this update, GAO reviewed the following key areas: renovation approach, schedule, cost, funding, risk management, project progress, procurement, and oversight. To perform this work, GAO reviewed UN documents and met with officials from the CMP office and other UN departments. To assess oversight and monitoring, GAO reviewed UN documents and oversight reports and interviewed UN officials from the Office of Internal Oversight Services (OIOS) and officials from the U.S. Department of State (State)."

Testimony issued by the Government Accountability Office with an abstract that begins "The fiscal year 2009 budget request for the Internal Revenue Service (IRS) is a road map for how IRS plans to allocate resources and achieve ambitious goals for improving enforcement, improving taxpayer service, increasing research, and continuing to invest in modernized information systems. One complicating factor in implementing IRS's plans in the immediate future is the recent passage of the Economic Stimulus Act of 2008, which creates additional, unanticipated workload for IRS. GAO was asked to (1) assess how the President's budget request for IRS allocates resources and justifies proposed initiatives; (2) determine the status of IRS's efforts to develop and implement its Business Systems Modernization (BSM) program; and (3) determine the total costs of administering the economic stimulus legislation. To meet these objectives, GAO drew upon and updated recently issued reports."

Other written product issued by the Government Accountability Office with an abstract that begins "From the terrorist attacks of September 11, 2001, to Hurricane Katrina, homeland security risks vary widely. The nation can neither achieve total security nor afford to protect everything against all risks. Managing these risks is especially difficult in today's environment of globalization, increasing security interdependence, and growing fiscal challenges for the federal government. It is increasingly important that organizations effectively target homeland security funding--totaling nearly $65 billion in 2008 federal spending alone--to address the nation's most critical priorities. GAO convened a forum of experts on October 25, 2007, to advance a national dialogue on applying risk management to homeland security. Broadly defined, risk management is a process that helps policymakers assess risk, strategically allocate finite resources, and take actions under conditions of uncertainty. Participants included federal, state, and local officials and risk management experts from the private sector and academia. The forum addressed effective practices, challenges federal agencies face in applying risk management to homeland security, and actions that can strengthen homeland security risk management. Comments expressed during the proceedings do not necessarily represent the views of any one participant, the organizations they represent, or GAO. …

Testimony issued by the Government Accountability Office with an abstract that begins "The budget authority GAO is requesting for fiscal year 2009--$545.5 million--represents a prudent request of 7.5 percent to support the Congress as it confronts a growing array of difficult challenges. GAO will continue to reward the confidence you place in us by providing a strong return on this investment. In fiscal year 2007 for example, in addition to delivering hundreds of reports and briefings to aid congressional oversight and decisionmaking, our work yielded: financial benefits, such as increased collection of delinquent taxes and civil fines, totaling $45.9 billion--a return of $94 for every dollar invested in GAO; over 1,300 other improvements in government operations spanning the full spectrum of national issues, ranging from helping Congress create a center to better locate children after disasters to strengthening computer security over sensitive government records and assets to encouraging more transparency over nursing home fire safety to strengthening screening procedures for VA health care practitioners; and expert testimony at 276 congressional hearings to help Congress address a variety of issues of broad national concern, such as the conflict in Iraq and efforts to ensure drug and food safety."

Testimony issued by the Government Accountability Office with an abstract that begins "Following the September 11 terrorist attacks, state and local governments formed fusion centers, collaborative efforts to detect, prevent, investigate, and respond to criminal or terrorist activity. Recognizing that the centers are a critical mechanism for sharing information, the federal government--including the Department of Homeland Security (DHS), Department of Justice (DOJ), and the Program Manager for the Information Sharing Environment (PM-ISE), which has primary responsibility for governmentwide information sharing--is taking steps to partner with fusion centers. This testimony focuses on (1) the characteristics of fusion centers as of September 2007 and (2) federal efforts to help alleviate challenges centers identified. This testimony is based on GAO's October 2007 report on 58 fusion centers and related federal efforts to support them as well as updated information GAO obtained in March 2008 by reviewing plans describing selected federal efforts and attending the second annual national fusion center conference."

Testimony issued by the Government Accountability Office with an abstract that begins "Following the September 11 terrorist attacks, state and local governments formed fusion centers, collaborative efforts to detect, prevent, investigate, and respond to criminal or terrorist activity. Recognizing that the centers are a critical mechanism for sharing information, the federal government--including the Department of Homeland Security (DHS), Department of Justice (DOJ), and the Program Manager for the Information Sharing Environment (PM-ISE), which has primary responsibility for governmentwide information sharing--is taking steps to partner with fusion centers. This testimony focuses on (1) the characteristics of fusion centers as of September 2007 and (2) federal efforts to help alleviate challenges centers identified. This testimony is based on GAO's October 2007 report on 58 fusion centers and related federal efforts to support them as well as updated information GAO obtained in March 2008 by reviewing plans describing selected federal efforts and attending the second annual national fusion center conference."

Testimony issued by the Government Accountability Office with an abstract that begins "The Strategic Petroleum Reserve (SPR) was created in 1975 to help protect the U.S. economy from oil supply disruptions and currently holds about 700 million barrels of crude oil. The Energy Policy Act of 2005 directed the Department of Energy (DOE) to increase the SPR storage capacity from 727 million barrels to 1 billion barrels, which it plans to accomplish by 2018. Since 1999, oil for the SPR has generally been obtained through the royalty-in-kind program, whereby the government receives oil instead of cash for payment of royalties on leases of federal property. The Department of Interior's Minerals Management Service (MMS) collects the royalty oil and transfers it to DOE, which then trades it for oil suitable for the SPR. As DOE begins to expand the SPR, past experiences can help inform future efforts to fill the reserve in the most cost-effective manner. In that context, GAO's testimony today will focus on: (1) factors GAO recommends DOE consider when filling the SPR, and (2) the cost-effectiveness of using oil received through the royalty-in-kind program to fill the SPR. To address these issues, GAO relied on its 2006 report …

Testimony issued by the Government Accountability Office with an abstract that begins "Nationwide, federal funding to states supported more than 200,000 youth in facilities seeking help for behavioral or emotional challenges in 2004. Recent federal reviews and investigations highlighted maltreatment in some facilities, resulting in hospitalizations and deaths. This testimony discusses (1) what is known about incidents that adversely affect youth well-being in residential facilities, (2) the extent that state oversight ensures youth well-being in these facilities, and (3) the factors that affect the ability of federal agencies to hold states accountable for youth well-being in residential facilities. This testimony is based on GAO's ongoing work, which included national surveys to state agencies of child welfare, health and mental health, and juvenile justice for the year 2006. GAO achieved an 85 percent response rate for each of the three surveys. The work also included site visits to four states (California, Florida, Maryland, and Utah) and discussions with the Departments of Education (Education), Justice (DOJ), and Health and Human Services (HHS). Interim work related to this testimony was completed between November 2006 and March 2008, in accordance with generally accepted government auditing standards."

Testimony issued by the Government Accountability Office with an abstract that begins "In 2007, the U.S. Census Bureau (Bureau) estimated the 2010 Census would cost $11.5 billion, including $3 billion on automation and technology. At a March hearing, the Department of Commerce (Commerce) stated that the Field Data Collection Automation (FDCA) program was likely to incur significant cost overruns and announced a redesign effort. At that time, GAO designated the 2010 Decennial Census as high risk, citing long-standing concerns in managing information technology (IT) investments and uncertain costs and operations. This testimony is based on past work and work nearing completion, including GAO's observation of the address canvassing dress rehearsal. For IT acquisitions, GAO analyzed system documentation, including deliverables, cost estimates, other acquisitions-related documents, and interviewed Bureau officials and contractors. This testimony describes the implications of redesign for (1) dress rehearsal and decennial operations, (2) IT acquisitions management, and (3) Decennial Census costs."