A strategic plan for 2012-2013 to provide quality health care to people affected with diabetes, to provide access to effective treatment guidelines, to reduce the burden of diabetes in the state, to improve coverage for people with diabetes, and to reduce the costs associated with the care of complications.

Handbook providing general references and applicable state rules and regulation pertaining to oversize/overweight vehicles and loads.

Correspondence issued by the Government Accountability Office with an abstract that begins "Illicit drug use endangers public health and safety and depletes financial resources. According to the Office of National Drug Control Policy (ONDCP), each day in this country, an estimated 8,000 Americans illegally consume a drug for the first time and the risks posed by their drug use--like that of the estimated 20 million individuals that already use illicit drugs--will radiate to their families and the communities in which they live. Efforts to combat drug abuse and its consequences also represent a considerable financial investment. ONDCP, which is responsible for overseeing and coordinating the implementation of the national drug policy, reported that, for fiscal year 2010, about $22 billion was allocated for drug control programs and other related drug control activities across 49 federal agencies, departments, components, or programs. ONDCP was established by the Anti-Drug Abuse Act of 1988 to enhance national drug control planning and assist Congress in overseeing that effort. In this role, ONDCP provides advice and governmentwide oversight of drug programs and coordinates the development of the National Drug Control Strategy (Strategy). By statute, the Director of ONDCP is to annually (1) develop a National Drug …

Guidance issued by the Government Accountability Office with an abstract that begins "This publication supersedes GAO-05-739SP, Performance Measurement and Evaluation: Definitions and Relationships, June 2005. Both the executive branch and congressional committees need evaluative information to help them make decisions about the programs they oversee--information that tells them whether, and why, a program is working well or not. In enacting the Government Performance and Results Act of 1993 (GPRA), Congress expressed frustration that executive and congressional decisionmaking was often hampered by the lack of good information on the results of federal program efforts. To promote improved federal management and greater efficiency and effectiveness, GPRA instituted a governmentwide requirement that agencies set goals and report annually on performance. Many analytic approaches have been employed over the years by the agencies and others to assess the operations and results of federal programs, policies, activities, and organizations. Most federal agencies now use performance measures to track progress towards goals, but few seem to regularly conduct indepth program evaluations to assess their programs' impact or learn how to improve results. Individual evaluation studies are designed to answer specific questions about how well a program is working, and GPRA explicitly encourages a complementary role for …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses patient safety incidents at Department of Veterans Affairs (VA) medical centers and potential strategies to address the underlying causes of those incidents. VA operates one of the largest integrated health care delivery systems in the United States, providing care to over 5.5 million veterans annually. Organized into 21 Veterans Integrated Service Networks (VISN), VA's health care system includes 153 VA medical centers (VAMC) nationwide that offer a variety of outpatient, residential, and inpatient services. In providing health care services to veterans, clinicians at VAMCs use reusable medical equipment (RME), which is designed to be reused for multiple patients and includes such equipment as endoscopes and some surgical and dental instruments. Because RME is used when providing care to multiple veterans, this equipment must be reprocessed--that is, cleaned and disinfected or sterilized--between uses. VA has established requirements for VAMCs to follow when reprocessing RME, which are designed, in part, to help ensure the safety of the veterans who receive care at VAMCs. This testimony, based on our May 2011 report, which is being released today, examines issues related to veterans' safety, including (1) selected reprocessing requirements …

This document contains the summaries of papers presented in poster format at the March 2010 Atmospheric System Research Science Team Meeting held in Bethesda, Maryland. More than 260 posters were presented during the Science Team Meeting. Posters were sorted into the following subject areas: aerosol-cloud-radiation interactions, aerosol properties, atmospheric state and surface, cloud properties, field campaigns, infrastructure and outreach, instruments, modeling, and radiation. To put these posters in context, the status of ASR at the time of the meeting is provided here.

Testimony issued by the Government Accountability Office with an abstract that begins "As Congress considers the role and design of appropriate budget enforcement mechanisms in changing the government's fiscal path, this testimony outlines some elements that could facilitate debate and contribute to efforts to place the government on a more sustainable long-term fiscal path. Budgeting is the process by which we as a nation resolve the large number of often conflicting objectives that citizens seek to achieve through government action. The budget determines the fiscal policy stance of the government--that is, the relationship between spending and revenues. And it is through the budget process that Congress and the President reach agreement about the areas in which the federal government will be involved and in what way. Because these decisions are so important, we expect a great deal from our budget and budget process. We want the budget to be clear and understandable. We want the process to be simple--or at least not too complex. But at the same time we want a process that presents Congress and the American people with a framework to understand the significant choices and the information necessary to make the best-informed decisions about federal tax …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses the efforts by the Departments of Defense (DOD) and Veterans Affairs (VA) to integrate their disability evaluation systems. Wounded warriors unable to continue their military service must navigate DOD's and VA's disability evaluation systems to be assessed for eligibility for disability compensation from the two agencies. GAO and others have found problems with these systems, including long delays, duplication in DOD and VA processes, confusion among servicemembers, and distrust of systems regarded as adversarial by servicemembers and veterans. To address these problems, DOD and VA have designed an integrated disability evaluation system (IDES), with the goal of expediting the delivery of VA benefits to servicemembers. After pilot testing the IDES at an increasing number of military treatment facilities (MTF)--from 3 to 27 sites--DOD and VA are in the process of deploying it worldwide. As of March 2011, the IDES has been deployed at 73 MTFs--representing about 66 percent of all military disability evaluation cases--and worldwide deployment is scheduled for completion in September 2011. This testimony summarizes and updates our December 2010 report on the IDES and addresses the following points: (1) the results of DOD …

Testimony issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) included $4 billion for the Environmental Protection Agency's (EPA) Clean Water State Revolving Fund (SRF) and $2 billion for the agency's Drinking Water SRF. This testimony is based on GAO's ongoing review of clean and drinking water projects. It provides preliminary observations on (1) the status and use of Recovery Act SRF program funds nationwide and in nine selected states, (2) jobs funded by the Recovery Act SRF programs and federal and state efforts to oversee the programs, and (3) challenges, if any, that states have faced in implementing Recovery Act requirements. For this ongoing work, GAO is, among other things, obtaining and analyzing EPA nationwide data on the status of Recovery Act clean and drinking water funds and projects, as well as information from a nonprobability sample of nine states that it had not reviewed in previous bimonthly reports. These states represent all but one of EPA's 10 regions. GAO is also interviewing EPA and state officials about their experiences with the Recovery Act clean and drinking water funds"

Testimony issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) provided more than $48 billion to the Department of Transportation (DOT) to be distributed through existing programs and through two new competitive grant programs--high speed intercity passenger rail and the Transportation Investment Generating Economic Recovery (TIGER) program. As requested, this testimony addresses the (1) status and use of Recovery Act transportation funds, (2) outcomes and long-term benefits of Recovery Act transportation investments, and (3) lessons learned from DOT's and states' experiences implementing the Recovery Act. GAO reviewed prior and ongoing work, federal legislation, and guidance. GAO also analyzed Recovery Act data and interviewed federal, state, and local officials."

Testimony issued by the Government Accountability Office with an abstract that begins "Since GAO reported on the commercial space launch industry in 2006 and 2009, the industry has evolved and moved further toward space tourism. Commercial space tourism promises to make human space travel available to the public for the first time. In addition, the National Aeronautics and Space Administration (NASA) plans to use private companies to transport cargo, and eventually personnel, to the International Space Station after NASA retires the space shuttle later in 2011. The Federal Aviation Administration (FAA) oversees the safety of commercial space launches, licensing and monitoring the safety of such launches and of commercial spaceports (sites for launching spacecraft), and promotes the industry. This testimony addresses (1) recent industry trends, (2) FAA's related budget request for fiscal year 2012, and (3) challenges that FAA and industry faces. This statement is based on GAO's October 2006 report and December 2009 testimony on commercial space launches, updated with information GAO gathered from FAA and industry experts in April and May 2011 on industry trends and recent FAA and NASA actions. In past work, GAO recommended that FAA take several actions to improve its oversight of commercial space …

Correspondence issued by the Government Accountability Office with an abstract that begins "In May 2010, the Federal Motor Carrier Safety Administration (FMCSA) alerted your offices that it might have violated statutory restrictions when obligating funds to states for its Commercial Vehicle Information Systems and Networks (CVISN) program. CVISN awards grants to state offices to support improved information technology exchanges between government agencies and the motor carrier industry to enhance motor carrier safety and other efforts. In 2005, the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU) provided $25 million annually in contract authority and established funding restrictions for CVISN awards. FMCSA temporarily shut down the CVISN program in May 2010 to determine whether it violated funding restrictions and to prevent exacerbating any problems; it has not determined when it will restart the program. In response to congressional request, this report addresses (1) whether FMCSA complied with statutory requirements when awarding CVISN grants to states and (2) actions that the agency is taking to manage the award of CVISN grants effectively."

Document issued by the Office of the Attorney General of Texas in Austin, Texas, providing an interpretation of Texas law. It provides the opinion of the Texas Attorney General, Greg Abbott, regarding a legal question submitted for clarification; Authority of commissioners court with regard to working hours, overtime and compensatory time, and timekeeping by county employees (RQ-0930-GA)

Document issued by the Office of the Attorney General of Texas in Austin, Texas, providing an interpretation of Texas law. It provides the opinion of the Texas Attorney General, Greg Abbott, regarding a legal question submitted for clarification; Whether section 271.121, Local Government Code, prohibits a governmental entity from requiring a contractor or other vendor to sign a project labor agreement as a condition of submitting a bid (RQ-0931-GA)

Document issued by the Office of the Attorney General of Texas in Austin, Texas, providing an interpretation of Texas law. It provides the opinion of the Texas Attorney General, Greg Abbott, regarding a legal question submitted for clarification; Whether a sheriff or a fire department is responsible for determining where to land a helicopter during the investigation of a traffic accident (RQ-0932-GA)

Document issued by the Office of the Attorney General of Texas in Austin, Texas, providing an interpretation of Texas law. It provides the opinion of the Texas Attorney General, Greg Abbott, regarding a legal question submitted for clarification; Information must be provided by the Texas Youth Commission to an independant school district pursuant to article 15.27, Code of Criminal Procedure (RQ-0933-GA)

Correspondence issued by the Government Accountability Office with an abstract that begins "With the passage of the Post-9/11 Veterans Educational Assistance Act of 2008 (Post- 9/11 GI Bill), Congress created a comprehensive education benefit program for veterans, service members, and their dependents pursuing postsecondary education. Since implementation, the Department of Veterans Affairs (VA) has provided just over $5.7 billion for the Post-9/11 GI Bill to fund education expenses for about 381,000 veterans, service members, and their dependents through fiscal year 2010, and estimates it will provide almost $8 billion in fiscal year 2011--an amount that would represent about 71 percent of all expected costs for education benefits. From the passage of the law to August 1, 2009, the start of the first semester in which funds were available, VA had about 13 months to implement the program. The Post-9/11 GI Bill program is substantially different from previously authorized VA education benefits or GI Bill programs that characteristically provide monthly payments to eligible claimants. The Post-9/11 GI Bill, by contrast, includes a more complex payment system that channels funds to both students and schools. GAO and VA have reported on various challenges VA faced when implementing the new program, including claims …

Testimony issued by the Government Accountability Office with an abstract that begins "The federal government is the world's largest and most complex entity, with about $3.5 trillion in outlays in fiscal year 2010 that fund a broad array of programs and operations. GAO's long-term simulations of the federal budget show--absent policy change--growing deficits accumulating to an unsustainable increase in debt. While the spending side is driven by rising health care costs and demographics, other areas should also be scrutinized. In addition, there are significant performance and management challenges that the federal government needs to confront. GAO was asked to testify on the Government Performance and Results Act (GPRA) Modernization Act of 2010 (GPRAMA), as the administration begins implementing the act. This statement is based on GAO's past and ongoing work on GPRA implementation, as well as recently issued reports (1) identifying opportunities to reduce potential duplication in government programs, save tax dollars, and enhance revenue; and (2) updating GAO's list of government operations at high risk due to their greater vulnerabilities to fraud, waste, abuse, and mismanagement, or the need for transformation. As required by GPRAMA, GAO will periodically evaluate implementation of the act and report to Congress on its …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses credentialing issues associated with the security of U.S. transportation systems and facilities. Securing these systems requires balancing security to address potential threats while facilitating the flow of people and goods that are critical to the U.S. economy and international commerce. As we have previously reported, these systems and facilities are vulnerable and difficult to secure given their size, easy accessibility, large number of potential targets, and proximity to urban areas. The Maritime Transportation Security Act of 2002 (MTSA) required regulations preventing individuals from having unescorted access to secure areas of MTSA-regulated facilities and vessels unless they possess a biometric transportation security card and are authorized to be in such an area. MTSA further required that biometric transportation security cards be issued to eligible individuals unless determined that an applicant poses a security risk warranting denial of the card. The Transportation Worker Identification Credential (TWIC) program is designed to implement these biometric maritime security card requirements. The TWIC program, once implemented, aims to meet the following stated mission needs: (1) Positively identify authorized individuals who require unescorted access to secure areas of the nation's transportation system. …

Coal-fired power plants are a significant part of the nation's power generating capacity, currently accounting for more than 55% of the country's total electricity production. Extending the reliable lifetimes of fossil fired boiler components and reducing the maintenance costs are essential for economic operation of power plants. Corrosion and erosion are leading causes of superheater and reheater boiler tube failures leading to unscheduled costly outages. Several types of coatings and weld overlays have been used to extend the service life of boiler tubes; however, the protection afforded by such materials was limited approximately one to eight years. Power companies are more recently focused in achieving greater plant efficiency by increasing steam temperature and pressure into the advanced-ultrasupercritical (A-USC) condition with steam temperatures approaching 760°C (1400°F) and operating pressures in excess of 35MPa (5075 psig). Unfortunately, laboratory and field testing suggests that the resultant fireside environment when operating under A-USC conditions can potentially cause significant corrosion to conventional and advanced boiler materials1-2. In order to improve reliability and availability of fossil fired A-USC boilers, it is essential to develop advanced nanostructured coatings that provide excellent corrosion and erosion resistance without adversely affecting the other properties such as toughness and thermal fatigue …

Advanced Research Projects Agency-Energy project sheet summarizing general information about a new program to develop a cost-effective thermal storage system utilizing a supercritical fluid to replace molten salt systems (project title "Thermal Energy Storage With Supercritical Fluids") including critical needs, innovation and advantages, impact, and contact information. This sheet is the first open solicitation, announcing funding opportunities for involvement in the project.

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses the findings from our recent work on federal employment and training programs and our prior work on the Workforce Investment Act of 1998 (WIA). GAO has recently identified 47 federally-funded employment and training programs for fiscal year 2009, defining them as programs that are specifically designed to enhance the job skills of individuals in order to increase their employability, identify job opportunities, and/or help job seekers obtain employment. These programs, which are administered by nine separate federal agencies--including the Departments of Labor, Education, and Health and Human Services (HHS)--spent about $18 billion dollars in fiscal year 2009 to provide services such as job search assistance and job counseling to program participants. Seven programs accounted for about three-fourths of this spending, and two--Wagner- Peyser funded Employment Service (ES) and WIA Adult--together reported serving over 18 million individuals, or about 77 percent of the total number of participants served across all programs. Forty-four of the 47 programs we identified, including those with broader missions such as multipurpose block grants, overlap with at least one other program in that they provide at least one similar service to a …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses strategies that health centers-- facilities that provide primary care and other services to individuals in communities they serve regardless of ability to pay--employ that may help reduce hospital emergency department use. Hospital emergency departments are a major component of the nation's health care safety net as they are open 24 hours a day, 7 days a week, and generally are required to medically screen all people regardless of ability to pay. From 1997 through 2007, U.S. emergency department per capita use increased 11 percent. In 2007, there were approximately 117 million visits to emergency departments; of these visits, approximately 8 percent were classified as nonurgent. The use of emergency departments, including use for nonurgent conditions, may increase as more people obtain health insurance coverage as the provisions of the Patient Protection and Affordable Care Act (PPACA) are implemented. Some nonurgent visits are for conditions that likely could be treated in other, more cost-effective settings, such as health centers. In 2008, the average amount paid for a nonemergency visit to the emergency department was seven times more than that for a health center visit, according to …

Testimony issued by the Government Accountability Office with an abstract that begins "The use of information technology (IT) is crucial to helping the Department of Veterans Affairs (VA) effectively serve the nation's veterans, and the department has expended billions of dollars annually over the last several years to manage and secure its information systems and assets. VA has, however, experienced challenges in managing its IT. GAO has previously highlighted VA's weaknesses in managing and securing its information systems and assets. GAO was asked to testify on its past work on VA's weaknesses in managing its IT resources, specifically in the areas of systems development, information security, and collaboration with the Department of Defense (DOD) on efforts to meet common health system needs."