Correspondence issued by the General Accounting Office with an abstract that begins "Despite a recent decline in the population that smokes, smoking is considered the leading cause of preventable death in this country. According to the Centers for Disease Control and Prevention (CDC), over 2 million deaths in the 5-year period from 1995 through 1999 were attributable to cigarette smoking. CDC, part of the Department of Health and Human Services (HHS), is a primary source of information on the health consequences of smoking tobacco. CDC reported its most recent estimates of selected health consequences of cigarette smoking in an April 2002 issue of its publication Morbidity and Mortality Weekly Report. CDC reported that, on average, over 440,000 deaths, 5.6 million years of potential life lost, $82 billion in mortality-related productivity losses, and $76 billion in medical expenditures were attributable to cigarette smoking each year from 1995 through 1999. CDC and others tasked with making such estimates face challenges. They build estimates on a set of assumptions and make choices about the data sources and methods used, each of which may have limitations that must be weighed against its advantages. Policymakers at both the state and federal levels have relied on …

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 hearing today deals with the important congressional obligation to exercise oversight over the use of taxpayer funds, recognizing that waste, fraud, abuse, and mismanagement are not victimless activities. When resources are diverted for inappropriate, illegal, inefficient, or ineffective purposes, both taxpayers and legitimate program beneficiaries are cheated. Beyond preventing obvious abuse, government also has an obligation to modernize its practices and processes and fundamentally reexamine and reprioritize its activities to meet the demands and needs of today's changing world."

A letter report issued by the General Accounting Office with an abstract that begins "In December 2001, Congress passed the No Child Left Behind Act (NCLBA). The act required that all teachers of core subjects be highly qualified by the end of the 2005-06 school year and provided funding to help states and districts meet the requirement. In general, the act requires that teachers have a bachelor's degree, meet full state certification, and demonstrate subject area knowledge for every core subject they teach. This report focuses on the (1) number of teachers who met the highly qualified criteria during the 2002-03 school year, (2) conditions that hinder states' and districts' ability to meet the requirement, and (3) activities on which states and districts were planning to spend their Title II funds. GAO surveyed 50 states and the District of Columbia and a nationally representative sample of districts about their plans to implement the requirement. GAO also visited and interviewed officials in 8 states and 16 districts to discuss their efforts to implement the law."

Testimony issued by the General Accounting Office with an abstract that begins "The Department of Energy (DOE) oversees the treatment and disposal of 94 million gallons of highly radioactive nuclear waste from the nation's nuclear weapons program, currently at DOE sites in Washington, Idaho, and South Carolina. In 2002, DOE began an initiative to reduce the estimated $105-billion cost and 70-year time frame of this cleanup. GAO was asked to testify on the status of this initiative, the legal and technical challenges DOE faces in implementation, and any further opportunities to reduce costs or improve program management. GAO's testimony is based on a report (GAO-03-593) released at the hearing."

Testimony issued by the General Accounting Office with an abstract that begins "Since 1998, the Congress and Administration have focused considerable attention on improving the quality of care in the nation's nursing homes, which provide care for about 1.7 million elderly and disabled residents in about 17,000 homes. GAO has earlier reported on serious weaknesses in processes for conducting routine state inspections (surveys) of nursing homes and complaint investigations, ensuring that homes with identified deficiencies correct the problems without recurrence, and providing consistent federal oversight of state survey activities to ensure that nursing homes comply with federal quality standards. GAO was asked to update its work on these issues and to testify on its findings, as reported in Nursing Home Quality: Prevalence of Serious Problems, While Declining, Reinforces Importance of Enhanced Oversight, GAO-03-561 (July 15, 2003). In commenting on this report, the Centers for Medicare & Medicaid Services (CMS) generally concurred with the recommendations to address survey and oversight weaknesses. In this testimony, GAO addresses (1) the prevalence of serious nursing home quality problems nationwide, (2) factors contributing to continuing weaknesses in states' survey, complaint, and enforcement activities, and (3) the status of key federal efforts to oversee state survey …