A letter report issued by the Government Accountability Office with an abstract that begins "Deaths of individuals with developmental disabilities due to poor quality of care have been highlighted in the media. Prior GAO work has raised concerns about inadequate safeguards for such individuals receiving care through state Medicaid home and community-based services (HCBS) waivers. CMS approves and oversees these waivers. Safeguards include the review of, and follow-up action to, critical incidents--events that harm or have the potential to harm waiver beneficiaries. GAO was asked to examine the extent to which states (1) include, as a critical incident, deaths among individuals with developmental disabilities in waiver programs; (2) have basic components in place to review such deaths; and (3) have adopted additional components to review deaths. GAO interviewed state developmental disabilities agency officials and external stakeholders in 14 states, e-mailed a survey to 35 states and D.C., interviewed experts, and reviewed documents."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy's National Nuclear Security Administration (NNSA) is responsible for manufacturing pits, a key component in a nuclear warhead. The department lost its ability to manufacture pits in 1989 with the closing of the Rocky Flats Plant. In 1996, the Los Alamos National Laboratory (LANL) was directed to reestablish a pit manufacturing capability, starting with a limited number of pits for the W88 warhead. In recent years, NNSA has considered ways to increase its pit manufacturing capacity, including building a new, large-scale pit manufacturing facility. It has also proposed producing pits for the Reliable Replacement Warhead (RRW). GAO was asked to determine the (1) extent to which NNSA achieved its major goals for reestablishing its pit manufacturing capability, (2) factors that currently constrain its ability to increase its pit manufacturing capacity, and (3) status of its plans for future pit manufacturing. For this review, GAO met with NNSA and LANL officials, reviewed agency documents, and visited the nuclear facility used to manufacture pits."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2002, Medicare implemented a national fee schedule designed to standardize payments for ambulance services. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) required GAO to study ambulance service costs. GAO examined providers' costs of ground ambulance transports in 2004 and factors that contributed to cost differences; average Medicare ambulance payments expected under the national fee schedule in 2010 and how those payments will relate to providers' costs per transport; and changes that occurred in Medicare beneficiaries' use of ambulance transports from 2001 to 2004. GAO estimated costs of ambulance transports based on a nationally representative survey of 215 ambulance providers that did not share costs with nonambulance services. Providers that shared costs with other institutions or services and could not report their costs for ambulance services separately, such as fire departments, were excluded because their reported costs appeared unreliable. GAO used its survey, Medicare claims, and other data for its analyses."

Testimony issued by the Government Accountability Office with an abstract that begins "Few issues generate more attention and anxiety among American consumers than the price of gasoline. The most current upsurge in prices is no exception. According to data from the Energy Information Administration (EIA), the average retail price of regular unleaded gasoline in the United States has increased almost every week this year since January 29th and reached an all-time high of $3.21 the week of May 21st. Over this time period, the price has increase $1.05 per gallon and added about $23 billion to consumers' total gasoline bill, or about $167 for each passenger car in the United States. Given the importance of gasoline for the nation's economy, it is essential to understand the market for gasoline and the factors that influence gasoline prices. In this context, this testimony addresses the following questions: (1) what key factors affect the prices of gasoline and (2) what effects have mergers had on market concentration and wholesale gasoline prices?"

Testimony issued by the Government Accountability Office with an abstract that begins "According to one report, at the end of 2006, about 92 million U.S. adults used the Internet on a typical day. As public use of the Internet grew from the mid-1990s onward, Internet access became a potential target for state and local taxation. In 1998, Congress imposed a moratorium temporarily preventing state and local governments from imposing new taxes on Internet access. Existing state and local taxes were grandfathered. In amending the moratorium in 2004, Congress required GAO to study its impact on state and local government revenues. The objectives of the resulting 2006 report were to determine the scope of the moratorium and its impact, if any, on state and local revenues. This testimony is based on that report (GAO-06-273)."

A letter report issued by the Government Accountability Office with an abstract that begins "There are a number of ways that the U.S. government provides assistance to Iraqi or Afghan civilians who are killed, injured, or suffer property damage as a result of U.S. and coalition forces' actions. For instance, the U.S. Agency for International Development funds projects to assist Iraqi and Afghan civilians and communities directly impacted by actions of U.S. or coalition forces. Also, the Department of State administers a program that makes payments, in accordance with local custom, to Iraqi civilians who are harmed in incidents involving U.S. protective security details. In addition, the Department of Defense (DOD) administers a program that provides compensation under the Foreign Claims Act to inhabitants of foreign countries for death, injury, or property damage caused by noncombat activities of U.S. military personnel overseas. Further, DOD provides monetary assistance in the form of solatia and condolence payments to Iraqi and Afghan nationals who are killed, injured, or incur property damage as a result of U.S. or coalition forces' actions during combat. From fiscal years 2003 to 2006, DOD has reported about $1.9 million in solatia payments and more than $29 million in …

Testimony issued by the Government Accountability Office with an abstract that begins "Every year the Internal Revenue Service (IRS) does not collect tens of billions of dollars in delinquent taxes. In 2004, Congress authorized IRS to use private collection agencies (PCA) to help collect some of these debts. To ensure that taxpayers are treated properly and that the program achieves the desired results, IRS contracted with a consulting company to perform a survey of right party contacts--those individuals who confirmed their identity and tax debt to PCAs over the telephone. The consulting company reported overall taxpayer satisfaction ratings from 94 to 96 percent for contacts made from November 2006 through February 2007. At the request of the Chairman, House Committee on Ways and Means, GAO attempted to obtain, for the period September 2006 through February 2007, the number of tax debt cases IRS referred to PCAs, right party contacts who were offered the taxpayer survey, and right party contacts who took the survey. GAO was also asked to report any other key observations related to the PCA program and taxpayer survey. To perform this work, GAO collected information and interviewed officials from IRS, the consulting group that administered the survey, …

Correspondence issued by the Government Accountability Office with an abstract that begins "To avoid flooding in New Orleans after a rain storm, the city's Sewerage and Water Board pumps rainwater from the city into three drainage canals which then flow unrestricted into Lake Pontchartrain. While critical to prevent flooding from rainfall, these canals are vulnerable to storm surge from Lake Pontchartrain during a hurricane, and consequently are lined with floodwalls along both sides to protect storm surge from overtopping the canals and flooding the city. However, during Hurricane Katrina, several breaches occurred in the canal floodwalls allowing significant amounts of water to enter New Orleans from Lake Pontchartrain. In its efforts to restore pre-Katrina levels of hurricane protection to New Orleans by the June 1st start of the 2006 hurricane season, in late 2005, the U.S. Army Corps of Engineers (Corps) considered strengthening the drainage canal floodwalls but decided to postpone this effort due to cost and time constraints. Instead, the Corps decided to install three interim closure structures (gates) at the points where the canals meet the lake. These gates would be closed during major storm events to prevent storm surge from entering the canals and potentially breaching the …

A letter report issued by the Government Accountability Office with an abstract that begins "State vocational rehabilitation (VR) agencies, under the Department of Education (Education), play a crucial role in helping individuals with disabilities prepare for and obtain employment, including individuals receiving disability benefits from the Social Security Administration (SSA). In a prior report (GAO-05-865), GAO found that state VR agencies varied in the rates of employment achieved for SSA beneficiaries. To help understand this variation, this report analyzed SSA and Education data and surveyed state agencies to determine the extent to which (1) agencies varied in earnings outcomes over time; (2) differences in state economic conditions, client demographic traits, and agency strategies could account for agency performance; and (3) Education's data could be used to identify factors that account for differences in individual earnings outcomes."

Testimony issued by the Government Accountability Office with an abstract that begins "For federal fiscal year 2004, state and local child protective services staff determined that an estimated 872,000 children have been victims of abuse or neglect. Title IV-B subparts 1 and 2 authorize a wide array of child welfare services with some restrictions on states' use of funds. This testimony discusses: (1) how states used Title IV-B dollars to serve families under subparts 1 and 2; (2) the extent that federal oversight ensured state compliance with spending requirements under subpart 1; and (3) what the research said about the effectiveness of service states have provided to families using Title IV-B funds. This testimony was primarily based on a 2003 report (GAO-03-956)."

Testimony issued by the Government Accountability Office with an abstract that begins "We are grateful to the Congress for providing us with the support and resources that have helped us in our quest to be a world-class professional services organization. We are proud of the work we accomplish as we continue to provide our congressional clients with professional, objective, fact-based, non-partisan, non-ideological, fair, balanced, and reliable information in a timely manner regarding how well government programs and policies are working and, when needed, recommendations to make government work better. We believe that investing in GAO produces a sound return and results in substantial benefits to the Congress and the American people. In the years ahead, our support to the Congress will likely prove even more critical because of the pressures created by our nation's current and projected budget deficit and long-term fiscal imbalance. These fiscal pressures will require the Congress to make tough choices regarding what the government should do, how it will do its work, who will help carry out its work in the future, and how government will be financed in the future. We summarized the larger challenges facing the federal government in our recently issued 21st Century …

A letter report issued by the General Accounting Office with an abstract that begins "Because of concerns that not enough students who start college are completing a bachelor's degree, we examined (1) the extent to which students who enroll in a 4-year college complete a bachelor's degree and identify the factors that affect completion; (2) what states and 4-year colleges and universities are doing to foster bachelor's degree completion; and (3) what the Department of Education (Education) is doing to foster degree completion."

A chapter report issued by the General Accounting Office with an abstract that begins "Coordination of federal programs to combat terrorism overseas became even more critical as a result of the terrorist attacks against the United States on September 11, 2001. In response to these attacks, the federal government has taken unprecedented political, diplomatic, legal, law enforcement, financial, military, and intelligence actions to combat terrorism abroad. Among these actions is the publication of a series of new national strategies to combat terrorism. Congress asked that we develop baseline information identifying and describing federal programs and activities to combat terrorism overseas. This report describes the interagency framework and policies for planning and coordinating federal efforts to counter international terrorism. It identifies the relationships between and among the new national strategies to combat terrorism. It also describes the federal programs and activities governmentwide to detect and prevent terrorism, disrupt and destroy terrorist organizations, and respond to terrorist incidents overseas. Finally, it provides detailed matrices of selected departments' programs and activities to combat terrorism overseas. We briefed Congress previously on the preliminary results of our work and issued an interim report on Combating Terrorism: Department of State Programs to Combat Terrorism Abroad. This …

A letter report issued by the General Accounting Office with an abstract that begins "The federal government has a long-term commitment to helping states construct, improve, and repair roads and bridges to meet the nation's mobility needs. The Federal Highway Administration (FHWA) expects to provide states about $20 billion for highway construction projects in fiscal year 2003. State departments of transportation are primarily responsible for initiating and completing projects. Many federal and state agencies with environmental responsibilities (called resource agencies) help ensure that environmental issues are considered. The environmental review of a federally funded highway project can take from several days to several years. GAO is reporting on the (1) activities involved in the environmental reviews of federally funded highway projects and (2) stakeholders' views on the aspects of environmental review, if any, that unduly add time to gaining environmental approval. GAO obtained stakeholder views from 16 transportation improvement and 12 environmental officials from a variety of federal, state, and private organizations with responsibilities for or interests in constructing federally funded highways. The Department of Transportation had no comments on a draft of this report. Other agencies provided either technical comments or did not respond to our request for comments."

A letter report issued by the General Accounting Office with an abstract that begins "Women and children refugees, who comprise 80 percent of the estimated 12 million refugees worldwide, are among the world's most vulnerable populations. They are subject to gender-based violence, including physical harm, rape, and unequal access to humanitarian assistance. GAO was asked to (1) assess efforts by the U.N. High Commissioner for Refugees (UNHCR) to protect refugees, especially with regard to women and girls; (2) determine what steps U.N. and international organizations have taken to prevent sexual exploitation of refugee women by humanitarian workers; and (3) describe U.S. government efforts to support adequate protection for vulnerable populations."

Correspondence issued by the General Accounting Office with an abstract that begins "GAO appeared before the Subcommittee on Readiness and Management Support, House Committee on Armed Services on March 19, 2003, to discuss various sourcing and acquisition issues. This letter responds to a request for our views on the following questions for the record."

A letter report issued by the General Accounting Office with an abstract that begins "The Department of Defense's Missile Defense Agency (MDA) is developing a ballistic missile defense system designed to counter a wide spectrum of ballistic missile threats. A future element of this system is the Space Tracking and Surveillance System (STSS). STSS will eventually be composed of a constellation of satellites that will work together to detect and track missiles throughout all phases of their flight. GAO was asked to analyze MDA's approach to demonstrate capabilities for STSS."

Correspondence issued by the General Accounting Office with an abstract that begins "Value engineering (VE) is a recognized technique for reducing costs while maintaining or improving productivity and quality. The Department of Defense's (DOD) VE program consists of both government- and contractor-developed cost-reduction projects designed to reduce a system's life-cycle costs. In response to Congress' request, we agreed to provide information on (1) the role the VE program has played in supporting cost reduction in DOD weapons system programs and (2) the alternative measures program managers take to reduce costs and/or incentivize contractors."

A letter report issued by the General Accounting Office with an abstract that begins "Genetically modified foods pose the same risks to human health as do other foods. These risks include allergens, toxins, and compounds known as antinutrients which inhibit the absorption of nutrients. Before marketing a genetically modified food, company scientists seek to determine whether these foods pose any heightened risks. The Food and Drug Administration (FDA) published guidelines in 1992 to ensure that companies worked with the agency to assess the safety of genetically modified foods. GAO found that FDA's evaluation process could be enhanced by randomly verifying the test data provided and by increasing the transparency of the evaluation process, including communicating more clearly the scientific rationale for FDA's final decision on an assessment of genetically modified food. Scientists expect that genetic modifications will increasingly enhance the nutritional value of genetically modified foods. Although current tests have been adequate for evaluating the few genetically modified foods that have, so far, undergone relatively simple compositional changes, new technologies are being developed to evaluate the increasingly complex compositional changes expected. Monitoring the long-term health risks of genetically modified foods is generally neither necessary nor feasible. No scientific evidence exists, …

Testimony issued by the General Accounting Office with an abstract that begins "Preventive health care services can extend lives and promote the well being of the nation's seniors. Medicare now covers 10 preventive services--three types of immunizations and seven types of screenings--and legislation has been introduced to cover additional services. However, not all beneficiaries avail themselves of Medicare's preventive services. Some may simply choose not to use them, but others may be unaware that these services are covered by Medicare. Although the use of Medicare preventive service is growing, it varies from service to service and by state, ethnic group, income, and level of education. To ensure that preventive services are delivered to those who need them, the Centers for Medicare and Medicaid Services (CMS) sponsors activities to increase their use. CMS now funds interventions to increase the use of three services--breast cancer screening and immunizations against the flu and pneumonia--in each state. CMS also pays for interventions to increase use of services by minorities and low-income beneficiaries with low usage rates. CMS is evaluating the effectiveness of current efforts and expects to have the evaluation results later in 2002."

Correspondence issued by the General Accounting Office with an abstract that begins "This report discusses the variation in Medicare home health use across states. Using home health claims for the first 6 months of 2001 from the Centers for Medicare and Medicaid, GAO compiled statistics on home health users, home health visits, home health episodes, and the percentage of home health users with multiple episodes for each state. A home health episode, the basis for Medicare payment under the prospective payment system, is up to a 60-day period of care during which any number of visits may be provided."

Correspondence issued by the General Accounting Office with an abstract that begins "This report examines whether the National Aeronautics and Space Administration (NASA) had significant problems with overpayments to its contractors. GAO did not find that NASA had a significant or systemic problem with overpayments or underpayments during fiscal year 2001. The controls that NASA put in place to prevent and detect payment errors appeared to be properly designed."

Testimony issued by the General Accounting Office with an abstract that begins "The Department of Energy (DOE) has been investigating Yucca Mountain, Nevada, as a possible repository for highly radioactive nuclear waste. In February, the Secretary of Energy endorsed the Yucca Mountain site, and the President recommended that Congress approve the site. If the site is approved, DOE must apply to the Nuclear Regulatory Commission (NRC) for authorization to build a repository. If the site is not approved for a license application, or if NRC denies a construction license, the administration and Congress will have to consider other options. GAO concludes that DOE is unprepared to submit an acceptable license application to NRC within the statutory deadlines if the site is approved. On the basis of a reassessment done by DOE's managing contractor in September 2001, GAO believes that DOE would not have enough time to obtain a license from NRC and build and open the repository by 2010. DOE lacks a reliable estimate of when, and at what cost, a license application can be submitted or a repository can be opened."

A letter report issued by the General Accounting Office with an abstract that begins "United Nations sanctions were first imposed in August 1990 following Iraq's invasion of Kuwait. In 1991, the Security Council established sanctions to stop Iraq from acquiring or developing biological, chemical, and nuclear weapons. To achieve this, the Security Council prohibited all nations from buying Iraqi oil or selling the country any commodities except for food and medicine. It further established a weapons inspection regime to ensure that Iraq destroyed its weapons of mass destruction and stopped its weapons programs. Concerned about the humanitarian need of the Iraqi people, in 1995 the Security Council established a controls program for Iraq's oil sales that allows for the purchase of food, medicine, and essential civilian goods (the oil for food program). With international support for the sanctions eroding, in 2001 the Security Council passed a new sanctions resolution to address humanitarian concerns while keeping Iraq from rebuilding its weapons systems. Although the U.N. controlled $51 billion of Iraq's oil revenues from 1997 to 2001, Iraq earned an additional $6.6 billion in illegal revenue from oil smuggling and surcharges during the same time. Further, although the sanctions prohibit Iraq from …