A letter report issued by the General Accounting Office with an abstract that begins "Testifying before Congress in 2002, military beneficiary groups described problems accessing care from TRICARE's civilian medical providers. Providers also testified on their dissatisfaction with the TRICARE program, specifying low reimbursement rates and administrative burdens. The Bob Stump National Defense Authorization Act of 2003 required GAO to review the oversight of the TRICARE network of civilian providers. Specifically, GAO describes how the Department of Defense (DOD) oversees the adequacy of the civilian provider network, evaluates DOD's oversight of the civilian provider network, and describes the factors that have been reported to contribute to network inadequacy. GAO analyzed TRICARE Prime--the managed care component of TRICARE. To describe and evaluate DOD's oversight, GAO reviewed and analyzed information from reports on network adequacy and interviewed DOD and contractor officials in 5 of 11 TRICARE regions."

A letter report issued by the General Accounting Office with an abstract that begins "Two types of nonprofit organizations, cooperating associations and friends groups, provide substantial support to the national parks. GAO was asked to report on (1) the number of park units supported by nonprofits and the amount of their contributions, (2) the revenue-generating activities of nonprofits and how they compete with park concessioners, (3) factors that contribute to competition between nonprofits and for-profit concessioners, and (4) how park managers are held accountable for meeting goals for nonprofit financial support."

Testimony issued by the General Accounting Office with an abstract that begins "No government should waste its taxpayers' money, whether we are operating during a period of budget surpluses or deficits. Further, it is important for everyone to recognize that fraud, waste, abuse, and mismanagement are not victimless activities. Resources are not unlimited, and when they are diverted for inappropriate, illegal, inefficient, or ineffective purposes, both taxpayers and legitimate program beneficiaries are cheated. Both the Administration and the Congress have an obligation to safeguard benefits for those that deserve them and avoid abuse of taxpayer funds by preventing such diversions. Beyond preventing obvious abuse, government also has an obligation to modernize its priorities, practices, and processes so that it can meet the demands and needs of today's changing world. More broadly, the federal government must reexamine the entire range of policies and programs--entitlements, discretionary, and tax incentives--in the context of the 21st century."

A letter report issued by the General Accounting Office with an abstract that begins "To better monitor children and families served by state child welfare agencies, Congress authorized matching funds for the development of statewide automated child welfare information systems (SACWIS) and required that the Department of Health and Human Services (HHS) compile information on the children served by state agencies. This report reviews (1) states' experiences in developing child welfare information systems and HHS's role in assisting in their development, (2) factors that affect the reliability of data that states collect and report on children served by their child welfare agencies and HHS's role in ensuring the reliability of those data, and (3) practices that child welfare agencies use to overcome challenges associated with SACWIS development and data reliability."

A letter report issued by the General Accounting Office with an abstract that begins "The Department of Veterans Affairs (VA) provides graduate medical education (GME) to as many as one-third of U.S. resident physicians, but oversight responsibilities spread across VA's organizational components and multiple affiliated hospitals and medical schools could allow supervision problems to go undetected or uncorrected. GAO was asked to examine VA's procedures for (1) monitoring VA medical centers' adherence to VA's requirements for resident supervision, (2) using evaluations of supervision by GME accrediting bodies and residents, and (3) using information about resident supervision drawn from VA's programs for monitoring the quality and outcomes of patient care."

Testimony issued by the General Accounting Office with an abstract that begins "SARS is a highly contagious respiratory disease that infected more than 8,000 individuals in 29 countries principally throughout Asia, Europe, and North America and led to more than 800 deaths as of July 11, 2003. Due to the speed and volume of international travel and trade, emerging infectious diseases such as SARS are difficult to contain within geographic borders, placing numerous countries and regions at risk with a single outbreak. While SARS did not infect large numbers of individuals in the United States, the possibility that it may reemerge raises concerns about the ability of public health officials and health care workers to prevent the spread of the disease in the United States. GAO was asked to assist the Subcommittee in identifying ways in which the United States can prepare for the possibility of another SARS outbreak. Specifically, GAO was asked to determine 1) infectious disease control measures practiced within health care and community settings that helped contain the spread of SARS and 2) the initiatives and challenges in preparing for a possible SARS resurgence."

A letter report issued by the General Accounting Office with an abstract that begins "As a separately organized agency within the Department of Energy (DOE), the National Nuclear Security Administration (NNSA) administers the Stockpile Life Extension Program, whose purpose is to extend, through refurbishment, the operational lives of the weapons in the nuclear stockpile. NNSA encountered significant management problems with its first refurbishment. NNSA has begun three additional life extensions. This study was undertaken to determine the extent to which budgetary, cost accounting, and other management issues that contributed to problems with the first refurbishment have been adequately addressed."

A letter report issued by the General Accounting Office with an abstract that begins "Social Security is an important social insurance program affecting virtually every American family. It is the foundation of the nation's retirement income system and also provides millions of Americans with disability insurance and survivors' benefits. Over the long term, as the baby boom generation retires, Social Security's financing shortfall presents a major solvency and sustainability challenge. The Chairman of the Senate Special Committee on Aging and the Chairman of the Senate Committee on Finance asked GAO to use its analytic framework to evaluate an illustrative "Trust Fund Exhaustion" scenario under which benefits are reduced proportionately for all beneficiaries by the shortfall in revenues occurring upon exhaustion of the combined Old-Age and Survivors Insurance and Disability Insurance Trust Funds. The analytic framework consists of three basic criteria: (1) the extent to which the proposal achieves sustainable solvency and how it would affect the U.S. economy and the federal budget; (2) the balance struck between the twin goals of income adequacy and individual equity; and (3) how readily changes could be implemented, administered, and explained to the public. The Trust Fund Exhaustion scenario is intended as an analytic …

A letter report issued by the General Accounting Office with an abstract that begins "The Social Security Administration (SSA) has had difficulty in conducting timely reviews of beneficiaries' cases to ensure they are still eligible for disability benefits. SSA has been taking steps to improve the cost-effectiveness of its review process. SSA has linked the review process to eligibility for a new benefit that provides return-to-work services. This report looks at SSA's ability to stay current with future reviews, identifies potential improvements to the review process, and assesses the review process--return-to-work link."

Testimony issued by the General Accounting Office with an abstract that begins "GAO, the Department of the Interior, and others have reported on the National Park Service's efforts to develop an effective maintenance management process that would, among other things, enable the agency to accurately and reliably estimate the amount of deferred maintenance on its assets. Over the years, the agency's estimates of the amount of its deferred maintenance have varied widely--sometimes by billions of dollars. Currently, the agency estimates that its deferred maintenance backlog is over $5 billion. In April 2002, GAO reported on the status of efforts to develop better deferred maintenance data. (National Park Service: Status of Efforts to Develop Better Deferred Maintenance Data)(Apr. 12, 2002, GAO-02-568R) This testimony presents the results of GAO's April report and updates the progress the Park Service is making in implementing its new asset management process."

A letter report issued by the General Accounting Office with an abstract that begins "With annual obligations for goods and services totaling $1.7 billion, the Immigration and Naturalization Service (INS) is one of the largest of 23 entities coming into the Department of Homeland Security (DHS). INS's procurement organization will continue to acquire goods and services under DHS. GAO was asked to review INS's contracting processes to assess whether INS has an adequate infrastructure to manage its acquisitions and to determine whether INS is following sound contracting policies and procedures in awarding and managing individual contracts."

Testimony issued by the General Accounting Office with an abstract that begins "The circumstances of armed conflicts in Bosnia, Kosovo, and Afghanistan differed in many respects, but in all three cases the United States and the international community became involved in the wars and post-conflict assistance because of important national and international interests. Over the past 10 years, GAO has done extensive work assessing post-conflict assistance in Bosnia and Kosovo and, more recently, has evaluated such assistance to Afghanistan. GAO was asked to provide observations on assistance efforts in these countries that may be applicable to ongoing assistance in Iraq. Specifically, GAO assessed (1) the nature and extent of post-conflict assistance in Bosnia, Kosovo, and Afghanistan; (2) essential components for carrying out assistance effectively; (3) challenges to implementation; and (4) mechanisms used for accountability and oversight."

Testimony issued by the General Accounting Office with an abstract that begins "The Department of Defense (DOD) faces many risks in its use of globally networked computer systems to perform operational missions--such as identifying and tracking enemy targets--and daily management functions--such as paying soldiers and managing supplies. Weaknesses in these systems, if present, could give hackers and other unauthorized users the opportunity to modify, steal, inappropriately disclose, and destroy sensitive military data. GAO was asked, among other things, to discuss DOD's efforts to protect its information systems and networks from cyber attack, focusing on its reported progress in implementing statutory information security requirements."

A letter report issued by the General Accounting Office with an abstract that begins "With the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), the Congress made sweeping changes to federal policy for needy families. PRWORA ended the Aid to Families with Dependent Children (AFDC) program and created the Temporary Assistance for Needy Families (TANF) block grant to states. The Department of Health and Human Services (HHS) oversees the TANF block grant program, which provides grants to states totaling up to $16.5 billion each year and requires states to maintain a historical level of state spending on welfare reform programs. Under TANF, states have greater flexibility and face greater uncertainty than they did under AFDC. States have greater flexibility to design, finance, and implement programs for low-income families, including determining who is to be served and what services to provide. TANF also emphasizes the transitional nature of assistance and the importance of employment for welfare recipients. Because the amount of the TANF block grant is fixed, as caseloads decline--as they did in all states through the late 1990s--states have had additional resources that they have used to expand their programs, achieve some budgetary savings, and …

A letter report issued by the General Accounting Office with an abstract that begins "The way in which the federal government views the defense of the United States has dramatically changed since September 11, 2001. Consequently, the Department of Defense (DOD) has adjusted its strategic and operational focus to encompass not only traditional military concerns posed by hostile states overseas but also the asymmetric threats directed at our homeland by both terrorists and hostile states. GAO was asked to review DOD's domestic missions, including (1) how DOD's military and nonmilitary missions differ; (2) how DOD's military and nonmilitary missions have changed since September 11, 2001; (3) how the 1878 Posse Comitatus Act affects DOD's nonmilitary missions; and (4) the extent to which DOD's organizations, plans, and forces are adequate for domestic military missions and the consequent sustainability of the current mission approach."

Testimony issued by the General Accounting Office with an abstract that begins "Recent news articles in over 30 states and prominent mental health advocacy organizations have described the difficulty many parents have in accessing mental health services for their children. As these reports documented, some parents choose to place their children in the child welfare or juvenile justice systems in order to obtain the mental health services that their children need. Senators Susan Collins and Joseph Lieberman of the Senate Committee on Governmental Affairs asked GAO to testify on: (1) the number and characteristics of children voluntarily placed in the child welfare and juvenile justice systems to receive mental health services, (2) the factors that influence such placements, and (3) promising state and local practices that may reduce the need for child welfare and juvenile justice placements. This testimony is based on our April 2003 report on the results of a study addressing these same objectives. For that report, we surveyed state child welfare directors in all states and the District of Columbia and juvenile justice officials in 33 counties in the 17 states with the largest populations of children under age 18. We surveyed juvenile justice officials at the …

Testimony issued by the General Accounting Office with an abstract that begins "The five Great Lakes, which comprise the largest system of freshwater in the world, are threatened on many environmental fronts. To address the extent of progress made in restoring the Great Lakes Basin, which includes the lakes and surrounding area, GAO (1) identified the federal and state environmental programs operating in the basin and the funding devoted to them, (2) evaluated the restoration strategies used and how they are coordinated, and (3) assessed overall environmental progress made in the basin restoration effort."

Testimony issued by the General Accounting Office with an abstract that begins "GAO has been providing ongoing assistance to the Capitol Preservation Commission and the Senate and House Appropriations Committees in their monitoring and oversight of the Capitol Visitor Center construction project. Given the current decisions facing the Congress, this testimony covers (1) management of the project, (2) the estimated cost for the project, (3) the status of the project's schedule, and (4) actions that Congress and the AOC should consider taking to address funding gaps and other current project issues and risks."

A letter report issued by the General Accounting Office with an abstract that begins "The decisions that retiring workers make about how and when to draw down their pension plan assets determine in part whether they will have pension income that lasts throughout retirement. Individuals will need pension and other retirement income to sustain them over a longer period of time than in the past. Moreover, the continuing trend towards pension plans with individual accounts has increased participants' responsibility for managing their pension assets during retirement. As such, our objectives were to determine: (1) what benefit payout options and accompanying information pension plans make available to participants at retirement, (2) what benefit payouts plan participants receive at retirement, and (3) the actions available to help retiring participants preserve their pension and retirement savings plan assets."

A chapter report issued by the General Accounting Office with an abstract that begins "The widespread drought conditions of 2002 focused attention on a critical national challenge: ensuring a sufficient freshwater supply to sustain quality of life and economic growth. States have primary responsibility for managing the allocation and use of water resources, but multiple federal agencies also play a role. For example, Interior's Bureau of Reclamation operates numerous water storage facilities, and the U.S. Geological Survey collects important surface and ground-water information. GAO was asked to determine the current conditions and future trends for U.S. water availability and use, the likelihood of shortages and their potential consequences, and states' views on how federal activities could better support state water management efforts to meet future demands. For this review, GAO conducted a web-based survey of water managers in the 50 states and received responses from 47 states; California, Michigan, and New Mexico did not participate."

Testimony issued by the General Accounting Office with an abstract that begins "DOE is the largest civilian-contracting agency in the federal government, and relies primarily on contractors to operate its sites and carry out its diverse missions. For fiscal year 2003, DOE will spend about 90 percent of its total annual budget, or $19.8 billion, on contracts, including $9.4 billion to operate 16 of its research laboratories (called federally funded research and development centers). Since 1990, GAO has identified DOE's contract management as high-risk for fraud, waste, abuse, and mismanagement. In 1994, DOE began reforming its contracting practices to, among other things, improve contractor performance and accountability. As part of that effort, DOE has at times used competition in awarding contracts to manage and operate its research laboratories. In September 2002, GAO reported on the status of contract reform efforts in DOE. (Contract Reform: DOE Has Made Progress, but Actions Needed to Ensure Initiatives Have Improved Results) (Sep. 2002, GAO-02-798) This testimony discusses some of the findings in that report. GAO was asked to testify on DOE's rationale for deciding whether to compete a laboratory research contract, the extent to which DOE has competed these contracts, and the role of …

A letter report issued by the General Accounting Office with an abstract that begins "The Professional Boxing Safety Act of 1996 established minimum health and safety standards for professional boxing and provided for limited federal oversight by the Department of Justice and the Federal Trade Commission. In 2000, the Muhammad Ali Boxing Reform Act amended the act to better protect boxers' economic well-being and enhance the integrity of the sport. However, reports of problems continue, including permanent and sometimes fatal injuries, economic exploitation, and corruption. GAO was asked to (1) identify fundamental elements considered important to protect professional boxers and enhance the integrity of the sport; (2) assess the extent to which provisions of the Professional Boxing Safety Act of 1996, as amended (the act), cover these elements and determine whether selected state and tribal boxing commissions have documentation indicating compliance with the act's provisions; (3) determine whether selected states and tribes have provisions that cover additional elements; and (4) identify federal actions taken under the act."

Testimony issued by the General Accounting Office with an abstract that begins "It is important to ensure that longterm spending on transportation programs meets the goals of increasing mobility and improving transportation safety. In this testimony, GAO discusses what recently completed work on four transportation programs suggests about challenges and strategies for improving the oversight and use of taxpayer funds. These four programs are (1) the federal-aid highway program, administered by the Federal Highway Administration (FHWA); (2) highway safety programs, administered by the National Highway Traffic Safety Administration (NHTSA); (3) the New Starts program, administered by the Federal Transit Administration (FTA); and (4) the Essential Air Service (EAS) program, administered out of the Office of the Secretary of Transportation. Differences in the structure of these programs have contributed to the challenges they illustrate. The federal-aid highway program uses formulas to apportion funds to the states, the highway safety programs use formulas and grants, the New Starts program uses competitive grants, and the EAS program provides subsidies. For each program, GAO describes in general how the program illustrates a particular challenge in managing or overseeing long-term spending and in particular what challenges and strategies for addressing the challenges GAO and others …

Testimony issued by the General Accounting Office with an abstract that begins "The Comptroller General formed the Employee Advisory Council (EAC) about 4 years ago to be fully representative of the GAO population and advise him on issues pertaining to both management and employees. The members of the EAC represent a variety of employee groups and almost all employees outside of the senior executive service (more than 3,000 of GAO's 3,200 employees or 94 percent). The EAC operates as an umbrella organization that incorporates representatives of GAO's long-standing employee organizations including groups representing the disabled, Hispanics, Asian-Americans, African-Americans, gays and lesbians, veterans, and women, as well as employees in various pay bands, attorneys, and administrative and professional staff. As established in our charter, the Employee Advisory Council serves as an advisory body to the Comptroller General and other senior executives by: seeking and conveying the views and concerns of the individual employee groups it represents while being sensitive to the mutual interests of all employees, regardless of their grade, band, or classification group; proposing solutions to concerns raised by employees, as appropriate; providing input by assessing and commenting on GAO policies, procedures, plans, and practices; and, communicating issues and concerns …