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."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Armed Forces Retirement Home (AFRH), an independent executive branch entity, operates two continuing care retirement communities (CCRC). It provides care in three settings--independent living, assisted living, and a nursing home--and also operates a health and dental clinic for residents. The responsibilities of a CCRC generally include (1) appropriately transitioning residents from independent living to other settings as their care needs increase, (2) ensuring the availability of appropriate health services as residents progress to higher-level settings, and (3) ensuring residents' access to community-based or on-site health care. The law establishing AFRH sets forth the framework for its oversight and management. The NDAA for Fiscal Year 2006 required GAO to assess the regulatory oversight and monitoring of health care and nursing home care services provided by AFRH. As discussed with the committees of jurisdiction, we focused our review on (1) the standards that could be used to monitor health care provided by AFRH and (2) the adequacy of DOD oversight of AFRH health care. To address these issues, we (1) identified existing standards applicable to health services in the three settings at AFRH and similar facilities; (2) discussed accreditation …

A letter report issued by the Government Accountability Office with an abstract that begins "Passenger prescreening--a process that includes matching passengers' identifying information against records extracted from the U.S. government terrorist watch list--is one of several security measures in place to help ensure the safety of commercial flights traveling to or from the United States. DHS has several efforts underway to strengthen international aviation passenger prescreening. This report focuses on certain elements of the passenger prescreening process as well as some of the actions that DHS is taking or has planned to strengthen prescreening procedures. This report is a limited version of the original November 2006 report as various agencies that we reviewed deemed some of the information in the original report to be security sensitive. GAO's work included interviewing officials and assessing relevant documentation from federal agencies, U.S. and foreign air carriers, industry groups, and several foreign countries."

A letter report issued by the Government Accountability Office with an abstract that begins "The Transportation Security Administration's (TSA) efforts to evaluate the security of foreign airports and air carriers that service the United States are of great importance, particularly considering that flights bound for the United States from foreign countries continue to be targets of coordinated terrorist activity, as demonstrated by the alleged August 2006 liquid explosives terrorist plot. For this review, GAO evaluated the results of foreign airport and air carrier evaluations; actions taken and assistance provided by TSA when security deficiencies were identified; TSA's oversight of its foreign airport and air carrier evaluation programs; and TSA's efforts to address challenges in conducting foreign airport and air carrier evaluations. To conduct this work, GAO reviewed foreign airport and air carrier evaluation results and interviewed TSA officials, foreign aviation security officials, and air carrier representatives."

Testimony issued by the Government Accountability Office with an abstract that begins "The Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 requires individuals to receive credit counseling before filing for bankruptcy and to take a debtor education course before having debts discharged. Concerns were raised that the new requirements could expose consumers to abusive practices by credit counseling agencies or become barriers to filing for bankruptcy. This testimony is based on GAO's report issued last month, and addresses (1) the process of approving counseling and education providers, (2) the content and results of the counseling and education sessions, (3) the fees charged, and (4) the availability of and challenges to accessing services. To address these issues, GAO reviewed Trustee Program data and application case files, and interviewed a wide range of individuals and groups involved in the bankruptcy process."

A letter report issued by the Government Accountability Office with an abstract that begins "In 1995, GAO first designated the Department of Defense's (DOD) business systems modernization program as "high-risk," and continues to do so today. In 2004, Congress passed legislation reflecting prior GAO recommendations for DOD to adopt a corporate approach to information technology (IT) business system investment management. To support GAO's legislative mandate to review DOD's efforts, GAO assessed whether the department's corporate investment management approach comports with relevant federal guidance. In doing so, GAO applied its IT Investment Management framework and associated methodology, focusing on the framework's stages related to the investment management provisions of the Clinger-Cohen Act of 1996."

Testimony issued by the Government Accountability Office with an abstract that begins "Despite substantial federal and state investment, states have had difficulty ensuring the safety, well-being, and permanency of children in foster care. Ensuring these outcomes becomes even more difficult in the event of disasters such as Hurricanes Katrina and Rita, when children and families may become displaced across state lines. This testimony discusses (1) the issues that states reported as most important to resolve now and in the future to improve outcomes for children under their supervision (2) initiatives states reported taking to address these issues and how recent law provides support for additional state efforts and (3) federal action taken to assist states' efforts in developing child welfare disaster plans. This testimony is primarily based on our October 2006 report on state child welfare challenges (GAO-07-75) and our July 2006 report on state child welfare disaster planning (GAO-06-944). The Department of Health and Human Services (HHS) and the Congress took action that addressed our July report recommendations. However, HHS disagreed with our October report recommendation to improve awareness of and access to federal social services by modifying the Catalog of Federal Domestic Assistance or other means. We continue …

A letter report issued by the Government Accountability Office with an abstract that begins "Urban storm water runoff is a major contributor to the nation's degraded waters. Under the Clean Water Act, the Environmental Protection Agency (EPA) established a program requiring communities to obtain permits and implement activities to control storm water pollution. EPA's Phase I regulations (1990) applied to communities with populations of 100,000 or more, and its Phase II regulations (1999) covered smaller urban communities. Communities must report progress in meeting permit requirements. Some have raised concerns that storm water requirements impose an undue burden. To evaluate storm water program costs, EPA developed estimates for both phases. GAO was asked to (1) determine the progress in implementing the storm water program, (2) evaluate the extent to which the program burdens communities, (3) examine the accuracy of EPA's cost estimates, and (4) examine the data available for assessing program burden. GAO collected data for all states and a sample of 130 communities, among other steps."

Testimony issued by the Government Accountability Office with an abstract that begins "Weather-related events in the United States have caused tens of billions of dollars in damages annually over the past decade. A major portion of these losses is borne by private insurers and by two federal insurance programs-- the Federal Emergency Management Agency's National Flood Insurance Program (NFIP), which insures properties against flooding, and the Department of Agriculture's Federal Crop Insurance Corporation (FCIC), which insures crops against drought or other weather disasters. In this testimony, GAO (1) describes how climate change may affect future weather-related losses, (2) provides information on past insured weather-related losses, and (3) determines what major private insurers and federal insurers are doing to prepare for potential increases in such losses. This testimony is based on a report entitled Climate Change: Financial Risks to Federal and Private Insurers in Coming Decades are Potentially Significant (GAO-07-285) released on April 19, 2007."

A letter report issued by the Government Accountability Office with an abstract that begins "Three U.S. national strategies, developed in the wake of the 9/11 attacks, directed U.S. law enforcement agencies (LEA) to focus on the prevention of terrorist attacks. The strategies called for LEAs to intensify their efforts to help foreign nations identify, disrupt, and prosecute terrorists. GAO was asked to assess (1) the guidance for LEAs to assist foreign nations to identify, disrupt, and prosecute terrorists and (2) the extent to which LEAs have implemented this guidance."

Correspondence issued by the Government Accountability Office with an abstract that begins "Supplementing our December 2006 report entitled Compacts of Free Association: Micronesia and the Marshall Islands Face Challenges in Planning for Sustainability, Measuring Progress, and Ensuring Accountability, this report provides information on the uses of economic assistance provided under the amended U.S. compacts with the Federated States of Micronesia (FSM) and the Republic of the Marshall Islands (RMI) from 2004 through 2006."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Transportation's (DOT) Federal Motor Carrier Safety Administration (FMCSA) is responsible for protecting consumers involved in interstate household goods moves by issuing regulations and conducting oversight and enforcement actions. The Safe, Accountable, Flexible, Efficient Transportation Equity Act--A Legacy for Users (SAFETEA-LU), enacted in 2005, included provisions to enhance consumer protections for household goods moves and mandated that GAO study (1) the protections federal laws and regulations provide to consumers of interstate household goods moves and the effectiveness of federal enforcement efforts, (2) the protections states provide to consumers of intrastate household goods moves and how they have affected consumers and movers, and (3) the potential effects on both consumers and interstate movers if movers were subject to state consumer protection laws. To address these issues, GAO analyzed federal and state legislation, federal complaint and enforcement data, and interviewed federal and state officials."

Testimony issued by the Government Accountability Office with an abstract that begins "The U.S. Dept. of Agriculture's (USDA) Risk Management Agency (RMA) administers the federal crop insurance program in partnership with private insurers. In 2006, the program cost $3.5 billion, including millions in losses from fraud, waste, and abuse, according to USDA. The Agricultural Risk Protection Act of 2000 granted RMA authority to renegotiate the terms of RMA's standard reinsurance agreement with companies once over 5 years. This testimony is based on GAO's 2005 report, Crop Insurance: Actions Needed to Reduce Program's Vulnerability to Fraud, Waste, and Abuse, as well as new analyses this Committee requested on underwriting gains and administrative and operating expenses USDA paid companies. GAO discusses (1) USDA's processes to address fraud, waste, and abuse; (2) extent the program's design makes it vulnerable to abuse; and (3) reasonableness of underwriting gains and other expenses. USDA agreed with most of GAO's 2005 recommendations to improve program integrity. RMA agreed that GAO's new analyses were technically accurate."

Correspondence issued by the Government Accountability Office with an abstract that begins "In August 2006, we reported to Congress on the results of our review, which Congress requested, of factors affecting Hispanic representation in the federal workforce and efforts being taken by the Equal Employment Opportunity Commission (EEOC), Office of Personnel Management (OPM), and other agencies related to Hispanic representation. We reported that EEOC and OPM require agencies to analyze their workforces to help ensure equal employment opportunity and that EEOC requires agencies to analyze subsets of their workforce to determine whether barriers to such opportunities may exist. As indicated in that report, and as discussed with Congress, this report contains additional data on Hispanic representation in various subsets of the federal workforce with some comparisons to Hispanic representation in the Civilian Labor Force (CLF). The data in this report provide a foundation for further analyses by agency officials and policymakers as they consider a broad spectrum of issues related to Hispanic representation in the federal workforce. These data include analyses by agency, selected occupation, occupational category, grade, and among new hires. For purposes of these analyses, the federal workforce governmentwide includes civilian employees of all cabinet-level departments, independent agencies, …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) is experiencing a growing demand for intelligence, surveillance, and reconnaissance (ISR) assets to provide vital information in support of military operations. Over the next 7 years, DOD plans to invest over $28 billion in existing and new airborne ISR acquisition systems. This represents a marked increase over prior ISR investments. Given the significant investments, GAO was asked to (1) evaluate various ISR platforms for potential synergies and assess their cost and schedule status and the impact of any increases or delays on legacy systems and (2) assess the effectiveness of ISR investment decisions. To assess cost and schedule status, we reviewed programmatic and budget documentation. To evaluate investment decisions, we collected information on system capability, mission, and concept of operation and analyzed the data for similarities."

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) is relying more and more on contractors to provide billions of dollars in services. Congress has pushed DOD to employ sound business practices when using the private sector for services. This testimony discusses DOD's (1) increasing reliance on contractors; (2) efforts to follow sound business practices when acquiring services; and (3) actions to improve its management and oversight of services. This testimony is based on GAO's work spanning several years as well as recent reports issued by the Inspectors General."

A letter report issued by the Government Accountability Office with an abstract that begins "The Advanced SEAL Delivery System (ASDS) is a hybrid combatant submersible providing clandestine delivery and extraction of Navy SEALs and equipment in high-threat environments. The first ASDS has had significant performance issues and has cost, to date, over $885 million. In May 2006, Congress requested that GAO review ASDS. This report examines (1) how the Navy managed ASDS risks through its contracts and (2) the status of major technical issues and program restructuring."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) spent about 40 percent of the total defense budget to operate and maintain the nation's military forces in fiscal year 2005. Operation and maintenance (O&M) funding is considered one of the major components of funding for readiness. O&M appropriations fund the training, supply, and equipment maintenance of military units as well as the infrastructure of military bases. Over the past several years, DOD has increasingly used contractors, rather than uniformed or DOD civilian personnel, to provide O&M services in areas such as logistics, base operations support, information technology services, and administrative support. The House Appropriations Committee directed GAO to examine growing O&M costs and support services contracting. This GAO report (1) identifies the trends in O&M costs and services contracts and the reasons for the trends, (2) discusses whether increased services contracting has exacerbated the growth of O&M costs, and (3) provides perspectives on the benefits and concerns associated with increased contracting for support services. GAO analyzed DOD's O&M appropriations, budgets, and services contract costs over a 10-year period and developed case studies of outsourced O&M-related work at three installations. GAO …

A letter report issued by the Government Accountability Office with an abstract that begins "In the early 1980s, volatile organic compounds (VOCs) were discovered in some of the water systems serving housing areas on Marine Corps Base Camp Lejeune. Exposure to certain VOCs may cause adverse health effects, including cancer. In 1999, the Department of Health and Human Services' (HHS) Agency for Toxic Substances and Disease Registry (ATSDR) began a study to examine whether individuals who were exposed in utero to the contaminated drinking water are more likely to have developed certain childhood cancers or birth defects. ATSDR has projected a December 2007 completion date for the study. The National Defense Authorization Act of Fiscal Year 2005 required GAO to report on past drinking water contamination and related health effects at Camp Lejeune. In this report GAO describes (1) efforts to identify and address the past contamination, (2) activities resulting from concerns about possible adverse health effects and government actions related to the past contamination, and (3) the design of the current ATSDR study, including the study's population, time frame, selected health effects, and the reasonableness of the projected completion date. GAO reviewed documents, interviewed officials and former residents, and …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) relies on a network of DOD and non-DOD infrastructure assets in the United States and abroad so critical that its unavailability could hinder DOD's ability to project, support, and sustain its forces and operations worldwide. DOD established the Defense Critical Infrastructure Program (DCIP) to identify and assure the availability of mission-critical infrastructure. GAO was asked to evaluate the extent to which DOD has (1) developed a comprehensive management plan to implement DCIP and (2) identified, prioritized, and assessed its critical infrastructure. GAO analyzed relevant DCIP documents and guidance and met with officials from more than 30 DOD organizations that have DCIP responsibilities, and with Department of Homeland Security (DHS) officials involved in protecting critical infrastructure."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) built the Cheyenne Mountain Operations Center located near Colorado Springs, Colorado, in the early 1960s to withstand a multimegaton-yield-weapon strike and to provide protection against chemical and biological warfare. The mission of the Cheyenne Mountain Directorate is to monitor, process, and interpret air, missile, and space events that could threaten North America or have operational effects on U.S. forces or capabilities. This mission is conducted at five major centers--the Command Center, Air Warning, Missile Correlation, Operations Intelligence Watch, and Space Control--all currently located within Cheyenne Mountain. Elements of United States Strategic Command (USSTRATCOM) and Air Force Space Command are also located in Cheyenne Mountain. The Air Force's modernization of the attack warning systems within Cheyenne Mountain will cost more than $700 million from fiscal years 2000 through 2006. DOD officials have stated that they no longer need to continue operating in this hardened facility considering that the threat of an intercontinental ballistic missile strike in today's environment is low. In July 2006, the former Commander of NORAD and USNORTHCOM announced plans to move certain functions from Cheyenne Mountain and create an integrated command …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) transports second destination freight from over 600 locations to thousands of destinations throughout the continental United States each year at a cost of approximately $900 million. In 2001, DOD conducted a prototype program to better understand whether commercial best practices--specifically the use of a third-party logistics provider--could be applied to its freight transportation system and reduce costs. The prototype, which included a 1-year base agreement with two 1-year option periods, was conducted at selected Defense Logistics Agency (DLA) and military service shipping locations in the southeastern United States. At the conclusion of the first year, DLA exercised an option to extend the prototype at its shipping locations, whereas the military service shipping locations returned to DOD's previous freight shipping system due to dissatisfaction with the prototype's performance. On the basis of the prototype, DOD concluded that a third-party logistics provider could successfully integrate with DOD transportation processes if the program was designed and implemented correctly to capitalize on the benefits of using a third-party logistics provider while also addressing the performance problems that were experienced with the prototype. In 2004, the Under Secretary …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has been working to improve its personal property program since the mid-1990s to fix long-standing problems, such as excessive loss or damage to servicemembers' property and poor quality of service from moving companies. DOD plans to replace its current program with Families First, a program that promises to offer servicemembers an improved claims process and quality of service. GAO was mandated to (1) assess the steps DOD has taken to achieve the goals and benefits of the Families First program; (2) evaluate the growth in costs of the program, including the costs for a new information management system, since GAO's last assessment in 2003; and (3) assess the extent to which DOD faces management challenges--such as staffing--in implementing Families First. To address these objectives, GAO analyzed DOD's program, funding and staffing data, and interviewed personal property officials and stakeholders."

A letter report issued by the Government Accountability Office with an abstract that begins "Since 1990, Department of Energy (DOE) contract management (which includes project management) has been designated as a high-risk area for fraud, waste, abuse, and mismanagement. For years, GAO has reported on DOE's inadequate management and oversight of its contracts and projects. GAO has made dozens of recommendations on steps that DOE could take to improve project management. Furthermore, in 1999 The National Academies' National Research Council developed a series of recommendations to address weaknesses in DOE's project management. This GAO report discusses (1) DOE's main efforts since 1999 to address project management weaknesses, (2) the extent to which DOE's project performance has improved, and (3) the extent to which DOE's project management guidelines have been consistently followed."