Correspondence issued by the General Accounting Office with an abstract that begins "Specialty hospitals represent a small but growing segment of the health care industry. These hospitals specialize in providing care for certain conditions, such as cardiac care, or performing certain procedures, such as orthopedic surgery. Specialty hospitals are not an entirely new phenomenon, as children's and other types of specialty hospitals have existed for decades. Consequently, it is challenging to distinguish between the old and new types of specialty hospitals. One aspect that sets apart the newer genre of specialty hospitals is that many are owned, in part, by the physicians who work in them. Advocates contend that, because of their focused mission, specialty hospitals can provide high-quality specialty services more efficiently than general hospitals. Because specialty hospitals can tailor their facilities and resources to best fit the needs of certain types of patients, individuals treated in such hospitals may enjoy relatively greater convenience and comfort. Specialty hospitals may also offer physicians financial and work environment advantages. Advocates have stated that the focused mission and dedicated resources of specialty hospitals allow physicians to treat more patients than they could in general hospitals. Physicians may gain financially from this increased …

Correspondence issued by the General Accounting Office with an abstract that begins "In October 2002, we reported the results of our audit of selected internal control activities at three military treatment facilities: Eisenhower Army Medical Center, Augusta, Georgia; Naval Medical Center-Portsmouth, Portsmouth, Virginia; and Wilford Hall Air Force Medical Center, San Antonio, Texas. As part of our work for that report, we requested data files of all patients who had been admitted, treated as outpatients, or received pharmaceutical benefits during fiscal year 2001. Despite considerable effort by the three facilities, only Wilford Hall Air Force Medical Center was able to provide a file of beneficiaries who received pharmaceuticals during the year. We compared this file to data in the Social Security Administration's (SSA) Death Master File as a technique to identify instances of potential fraud or abuse. For Wilford Hall, we identified 41 cases in which a prescription was ordered for an individual after the date of his or her death as recorded in the SSA Death Master File. Congress requested that we determine whether individuals fraudulently obtained pharmaceuticals or other health benefits by assuming the identity of a dead person, and, if so, to identify the specific breakdowns in …

Correspondence issued by the General Accounting Office with an abstract that begins "In response to a Congressional request, we issued a report in March 2003 on the Department of Defense's (DOD) strategic planning efforts for civilian personnel at DOD and selected defense components, including the four military services and two defense agencies. In that report we made recommendations to the Secretary of Defense to strengthen civilian human capital planning, including integration with military personnel and sourcing initiatives. DOD's response to our March 2003 report and recommendations were received too late to be included in that report. To provide our perspective on DOD's comments, we briefly summarize our March 2003 report's objectives, results, and recommendations and DOD's comments, along with our evaluation of the comments. DOD's civilian employees play key roles in such areas as defense policy, intelligence, finance, acquisitions, and weapon systems maintenance. Although downsized 38 percent between fiscal years 1989 and 2002, this workforce has taken on greater roles as a result of DOD's restructuring and transformation. Responding to congressional concerns about the quality and quantity of, and the strategic planning for, the civilian workforce, we determined the following for DOD, the military services, and selected defense agencies (the …

A letter report issued by the General Accounting Office with an abstract that begins "Although Social Security's benefit and contribution provisions are neutral with respect to race, ethnicity, and gender, concerns about the experiences of minority groups under Social Security focus on whether they benefit less than whites, particularly because of the shorter life expectancy of blacks. These concerns are related to the concept of equity, or how benefits compare with taxes. To gain a thorough understanding of the experiences of minority populations under Social Security, GAO was asked to examine (1) what socioeconomic and demographic factors influence Social Security taxes paid and benefits received and (2) how different equity measures compare across racial groups. Because of the current system's projected actuarial deficit, to conduct this study, GAO made its calculations using three policy scenarios, each of which achieves 75-year solvency: a payroll tax increase and a progressive and proportional benefit cut. Further, GAO used three measures of equity: lifetime benefit-to-tax ratios, net lifetime benefits, and real internal rates of return. GAO also examined four birth cohorts: 1931-40, 1941-45, 1946-55, and 1956-64."

A letter report issued by the General Accounting Office with an abstract that begins "In January 2001, the congressionally chartered Commission to Assess United States National Security Space Management and Organization--known as the Space Commission--reported that the Department of Defense (DOD) lacked the senior-level focus and accountability to provide guidance and oversight for national security space operations. Congress mandated that GAO provide an assessment of DOD's actions to implement the Space Commission's recommendations. Thus, GAO (1) updated its June 2002 assessment of DOD's actions to address the Space Commission's recommendations, (2) ascertained progress in addressing other long- term management concerns, and (3) assessed the extent to which DOD has developed a results-oriented management framework for space activities."

A letter report issued by the General Accounting Office with an abstract that begins "Over half of the $80.4 billion in financial aid provided to college students in the 2000-01 school year came from the federal government in the form of grants and loans provided under Title IV of the Higher Education Act (HEA). To help finance their education, students and families may have received other funds from states, private groups or lenders, and/or the schools themselves. We initiated this study to, among other things, determine how often federal financial aid recipients received aid that was greater than their federally defined need and what cost or other implications might result from changing HEA to limit such aid."

A letter report issued by the General Accounting Office with an abstract that begins "The Veterans Entrepreneurship and Small Business Development Act of 1999 (Act) created the National Veterans Business Development Corporation (The Veterans Corporation) to address perceived gaps in providing small business and entrepreneurship assistance to veterans. The Act requires GAO to review The Veterans Corporation. GAO described The Veterans Corporation's (1) efforts to provide small business assistance to veterans, including service-disabled veterans; (2) use of and controls over federal funds in providing these services; and (3) efforts to become financially self- sufficient."

A letter report issued by the General Accounting Office with an abstract that begins "Constructing, improving, and repairing roads is fundamental to meeting the nation's mobility needs. The Federal Highway Administration (FHWA) supplies most of the money (about $20 billion in fiscal year 2003), and state departments of transportation are primarily responsible for completing projects. Many federal and state agencies (called resource agencies) help ensure that environmental and other concerns are considered. These and other organizations have recognized that the time it takes to complete complex federally funded highway projects is too long--in some cases nearly 20 years. GAO was asked to report the views of knowledgeable officials on the most promising approaches for reducing completion time for federally funded highway projects. GAO obtained the views of 33 officials from federal, state, and private organizations with interests in federally funded roads."

A letter report issued by the General Accounting Office with an abstract that begins "The 1998 terrorist attacks on two U.S. embassies in Africa highlighted security deficiencies in diplomatic facilities, leading the Department of State to embark on an estimated $16 billion embassy construction program. The program's key objective is to provide safe, secure, and cost-effective buildings for employees overseas. Given that the size and cost of new facilities are directly related to agencies' anticipated staffing needs, it is imperative that future requirements be projected as accurately as possible. GAO was asked to (1) assess whether State and other federal agencies have adopted a disciplined process for determining future staffing requirements and (2) review cost-sharing proposals for agencies with overseas staff."

A letter report issued by the General Accounting Office with an abstract that begins "Much of the response to a bioterrorist attack would occur at the local level. Many local areas and their supporting state agencies, however, may not be adequately prepared to respond to such an attack. In the Public Health Improvement Act that was passed in 2000, Congress directed GAO to examine state and local preparedness for a bioterrorist attack. In this report GAO provides information on state and local preparedness and state and local concerns regarding the federal role in funding and improving preparedness. To gather this information, GAO visited seven cities and their respective state governments, reviewed documents, and interviewed officials. Cities are not identified because of the sensitive nature of this issue."

Correspondence issued by the General Accounting Office with an abstract that begins "Our June 2000 report Securities Arbitration: Actions Needed to Address Problem of Unpaid Awards revealed that, although investors had won a majority of awards against brokers, a high proportion of those awards had not been paid. Nearly all of the unpaid awards involved cases decided in the National Association of Securities Dealer's (NASD) arbitration program and most involved brokers that had left the securities industry. A year later we reported on limited data suggesting that the rate of unpaid awards had declined. However, we noted that given the short time period that the data covered, regulators needed to continue monitoring the payment of the awards to determine whether additional steps need to be taken. Arbitration attorneys and claimants have also expressed concern about the timeliness of NASD's updating of arbitrator disclosure information, which can be used by the parties in arbitration to judge the competence and objectivity of arbitrators, and with NASD's ability to remove arbitrators from cases if conflicts arise. In addition, arbitration attorneys also expressed concern about the use of motions to dismiss and motions for summary judgment to terminate NASD-administered arbitration cases. This report responds …

A statement of record issued by the General Accounting Office with an abstract that begins "Floods have been, and continue to be, the most destructive natural hazard in terms of economic loss to the nation. The National Flood Insurance Program is a key component of the federal government's efforts to minimize the damage and financial impact of floods. The program identifies flood-prone areas of the country, makes flood insurance available in the nearly 20,000 communities that participate in the program, and encourages flood-plain management efforts. Since its inception in 1969, the National Flood Insurance has provided $12 billion in insurance claims to owners of flood-damaged properties, and its building standards are estimated to save $1 billion annually. The program has been managed by the Federal Emergency Management Agency, but along with other activities of the agency, it was recently placed into the Department of Homeland Security. GAO has issued a number of reports on the flood insurance program and was asked to discuss the current challenges to the widespread success of the program."

Correspondence issued by the General Accounting Office with an abstract that begins "The U.S. Marshal Service was created by the first Congress in the Judiciary Act of 1789. U.S. Marshals were placed in each federal judicial district and were given broad authority to support the federal courts and to carry out all lawful orders issued by judges, Congress, and the President. Early duties of U.S. Marshals included taking the census, distributing presidential proclamations, protecting the borders, and making arrests. Beginning in the late nineteenth century, some responsibilities of U.S. Marshals were transferred to newly created federal agencies, including the U.S. Census Bureau, Immigration and Naturalization Service, and Federal Bureau of Investigation. Today, the primary responsibilities of U.S. Marshals include protecting federal judges and witnesses, transporting federal prisoners, apprehending federal fugitives, and managing assets seized from criminal enterprises. We obtained information on the (1) U.S. Marshals' appointment process and, for comparison, the processes used by the Bureau of Alcohol, Tobacco, and Firearms (ATF); Drug Enforcement Administration (DEA); and Internal Revenue Service-Criminal Investigation (IRS-CI) to select senior field supervisors; (2) experience, education and diversity of U.S. Marshalls and senior field supervisors at the ATF, DEA, and IRS-CI; (3) authority of the Director …

A letter report issued by the General Accounting Office with an abstract that begins "The 109th Airlift Wing, New York Air National Guard, conducts supply missions for scientific research in the polar regions. Most unit members do not spend more than 30 consecutive days in the polar regions. Therefore, they are not eligible for hardship duty pay, which requires more than 30 consecutive days of duty in a designated hardship location. Congress considered legislation in 2002 to make an exception to the 30-day hardship duty pay threshold for polar duty. This legislation was not approved. In addition, the 109th Airlift Wing proposed designating polar duty as a hazardous duty. The Conference Report accompanying the National Defense Authorization Act for Fiscal Year 2003 directed GAO and DOD to conduct separate reviews of special and incentive pays for polar duty. GAO assessed DOD's rationale for hardship duty pay and the implications of making an exception to hardship duty pay. In addition, GAO assessed the 109th Airlift Wing's justification for hazardous duty pay for polar duty."

A letter report issued by the General Accounting Office with an abstract that begins "Since the mid-1990s, GAO has highlighted the need for the Department of State and other agencies to establish a systematic process for determining their overseas staffing levels. To support this long-standing need and in support of the President's Management Agenda, GAO developed a framework for assessing overseas workforce size and identified options for rightsizing. Because the framework was largely based on work at the U.S. embassy in Paris, GAO was asked to determine whether the rightsizing framework is applicable at U.S. embassies in developing countries. To accomplish this objective, we visited three U.S. embassies in West Africa--a medium-sized post in Dakar, Senegal; and two small embassies in Banjul, The Gambia; and Nouakchott, Mauritania--and applied the framework and its corresponding questions there."

Correspondence issued by the General Accounting Office with an abstract that begins "The electromagnetic radio frequency spectrum is critical to the development and operation of a variety of military systems such as radios, radars, and satellites. Due to the changing nature of warfighting, more and more military systems depend on the spectrum to guide precision weapons and obtain information superiority. In recent years, demand for the spectrum increased with advances in commercial technology. This demand has led to competition between government and nongovernment users, making spectrum management vital to prevent harmful interference and to promote spectrum efficiency. With these goals in mind, the Department of Defense (DOD) has long-standing policies and procedures that require system developers and acquirers to consider and deal with spectrum supportability knowledge early in the development and acquisition of systems. Early assessment of spectrum needs provides DOD the opportunity to identify, and therefore, better manage program and operational risks. DOD policy requires developers of spectrum dependent systems to obtain certification before assumption of contractual obligations for the full-scale development, production or procurement of those systems. Senate Report 107-151 and House Report 106-945 required us to assess DOD's spectrum management process. We focused our assessment on (1) …

Correspondence issued by the General Accounting Office with an abstract that begins "Weaknesses in the Department of Housing and Urban Development's (HUD) financial management systems have been a long-standing challenge for the department and have contributed to our designating two of its major programs areas as high-risk and the financial management information systems in particular as a major management challenge. While some progress has been made, both GAO and the HUD Office of the Inspector General (IG) have reported extensively on weaknesses related to HUD's financial management systems. In audits of HUD's consolidated financial statements, the IG has consistently identified several material internal control weaknesses resulting from inadequate financial management systems. In recent audit reports, the HUD OIG also noted that the completion of the development of adequate financial management systems is the most critical need faced by HUD in improving its financial management control environment. Responsive financial management systems are particularly critical to HUD's ability to meet its mission, deliver key services, and establish sufficient management control over its operations. In light of these issues, Congress asked that we (1) summarize HUD's past efforts to implement an integrated financial management system, (2) identify the challenges HUD faces with its …

Guidance issued by the General Accounting Office with an abstract that begins "This publication is superseded by GAO-10-846G, Organizational Transformation: A Framework for Assessing and Improving Enterprise Architecture Management (Version 2.0), August 2010. Effective use of enterprise architectures is a recognized hallmark of successful public and private organizations. For over a decade, GAO has promoted the use of architectures, recognizing them as a crucial means to a challenging goal: agency operational structures that are optimally defined, in both business and technological environments. The alternative, as GAO's work has shown, is perpetuation of the kinds of operational environments that saddle most agencies today, in which lack of integration among business operations and supporting information technology (IT) resources leads to inefficiencies and duplication. Why are enterprise architectures so important? Metaphorically, an enterprise architecture is to an organization's operations and systems as a set of blue prints is to a building. That is, building blueprints provide those who own, construct, and maintain the building with a clear and understandable picture of the building's uses, features, functions, and supporting systems, including relevant building standards. Further, the building blueprints capture the relationships among building components and govern the construction process. Enterprise architectures provide to people …

Guidance issued by the General Accounting Office with an abstract that begins "In July 2001, the U.S. General Accounting Office (GAO) and the President's Council on Integrity and Efficiency (PCIE) issued the GAO/PCIE Financial Audit Manual (FAM). The FAM provides guidance for financial audits conducted by the Inspector General community, GAO, and their contractors. The FAM is a key part in enhancing accountability over taxpayer-provided resources. GAO and the PCIE are committed to keeping the FAM current and intend to prepare updates as needed. With this goal in mind, a GAO/PCIE task force prepared this update to volume II of the FAM, which provides tools to assist the auditor in complying with audit standards ."

A letter report issued by the General Accounting Office with an abstract that begins "Because of concern about school district spending on administration, Congress directed GAO in two separate mandates in the No Child Left Behind Act of 2001 to (1) examine how school districts defined and spent Title I funds on administrative activities and (2) review Title I expenditures in at least six school districts. In response to these mandates, we are reporting on (1) how five studies define Title I administrative expenditures and what they found about the percentage of funds spent on these activities and (2) what proportion of Title I funds was spent on administrative activities compared with instructional and other activities in six school districts."

A letter report issued by the General Accounting Office with an abstract that begins "On October 15, 1990, the Radiation Exposure Compensation Act (RECA) was enacted providing for payments to individuals who contracted certain cancers and other serious diseases presumably as a result of their exposure to radiation released during aboveground nuclear weapons tests or as a result of their employment associated with the uranium mining industry during the Cold War era. The RECA Amendments of 2000 required that GAO report to the Congress on the Department of Justice's administration of RECA not later than 18 months after the enactment of the amendments and every 18 months thereafter. GAO originally reported on the status of the program in September 2001. The objectives of this report are to update information on claims processing, payments from the Trust Fund, and administrative expenses."

A letter report issued by the General Accounting Office with an abstract that begins "Due to the Department of Housing and Urban Development's (HUD) increasing use of purchase cards and the inherent risk associated with their use, Congress asked GAO to audit the purchase card program concentrating on assessing internal controls and determining whether purchases being made are a valid use of government funds."

A letter report issued by the General Accounting Office with an abstract that begins "The attacks on September 11, 2001, show that threats to U.S. security can now come from any number of terrorist groups, at any number of locations, and in wholly unexpected ways. As a result, the Department of Defense (DOD) is shifting to a new defense strategy focused on dealing with uncertainty by acting quickly across a wide range of combat conditions. One key ingredient of the new strategy is the availability of aircraft to carry out their missions. Key measures of availability include the percentage of time an aircraft can perform at least one or all of its assigned missions, termed the "mission capable" (MC) and "full mission capable" (FMC) rates, respectively. GAO examined whether key DOD aircraft have been able to meet MC and FMC goals in recent years, and DOD's process for setting aircraft availability goals."

A letter report issued by the General Accounting Office with an abstract that begins "The Metropolitan Area Acquisition (MAA) program, managed by the General Services Administration (GSA), provides local telecommunications services to government agencies in selected metropolitan areas. Of the 25 cities in which MAA contracts were awarded as of January 2003, 15 were awarded to two or more providers. Such multiple-award contracts are a means of promoting competition. To ensure equity in the award of task orders under these contracts, the Federal Acquisition Regulation (FAR) requires that the government provide contractors a fair opportunity to be considered. GAO was asked to review, among other things, whether GSA's implementation of the fair consideration process is consistent and the effect of any inconsistency, as well as the adequacy of GSA's documentation to support the decisions reached."