Bøger af U S Government Accountability Office

" In January 2010, the President announced the goal of doubling U.S. exports over 5 years. The President's plan in the National Export Initiative included prioritizing exports by small businesses and called for improved coordination among agencies involved in federal export promotion activities. Recently, Congress has also directed SBA to expand its export counseling and financing activities. This report (1) describes SBA's role within federal export promotion efforts, (2) assesses the extent to which SBA collaborates with other agencies in its export promotion activities, and (3) assesses the extent to which SBA is meeting requirements under the Small Business Jobs Act of 2010 to expand export promotion training and staffing. GAO analyzed agencies' documents and interviewed agency officials, including those in six selected field office locations serving areas with high export potential and where staff from at least two agencies were colocated. "

"The North Atlantic Treaty Organization (NATO) established the Partnership for Peace (PfP) to increase cooperation with former Warsaw Pact members and provide many of these countries with a path to NATO membership. As NATO confronts new security challenges, including the war in Afghanistan, its relationships with partner countries have grown in scope and importance. Additionally, NATO is developing a new Strategic Concept to clarify its mission and activities, including its relationship with PfP countries and other partners. The Department of Defense (DOD)-funded Warsaw Initiative Fund (WIF) supports the goals of the PfP program. GAO was asked to review (1) how the PfP program has evolved since GAO last reported on it in 2001; (2) options NATO is considering for the future of the PfP and other partnership programs; and (3) support to PfP countries through the U.S. WIF program. GAO analyzed NATO, DOD, and State Department (State) documents; and WIF funding data. GAO also interviewed DOD, State, NATO, and selected country officials. "

"The Institute of Medicine (IOM) estimated in 1999 that preventable medical errors cause as many as 98,000 deaths a year among hospital patients in the United States. Congress passed the Patient Safety and Quality Improvement Act of 2005 (the Patient Safety Act) to encourage health care providers to voluntarily report information on medical errors and other events-patient safety data-for analysis and to facilitate the development of improvements in patient safety using these data. The Patient Safety Act directed GAO to report on the law's effectiveness. This report describes progress by the Department of Health and Human Services, Agency for Healthcare Research and Quality (AHRQ) to implement the Patient Safety Act by (1) creating a list of Patient Safety Organizations (PSO) so that these entities are authorized under the Patient Safety Act to collect patient safety data from health care providers to develop improvements in patient safety, and (2) implementing the network of patient safety databases (NPSD) to collect and aggregate patient safety data. These actions are important to complete before the law's effectiveness can be evaluated. To do its work, GAO interviewed AHRQ officials and their contractors. GAO also conducted structured interviews with officials from a randomly..."

" DOD uses armored military vehicles for combat and operational support, but it also uses armored commercial vehicles to transport military and civilian personnel in areas that pose a threat to their safety. These vehicles differ in many ways, including mission and appearance. The House Armed Services Committee report accompanying the National Defense Authorization Act for Fiscal Year 2017 contained a provision for GAO to assess multiple aspects of DOD's procurement practices for ACPVs. This report assesses (1) DOD's guidance and procedures for acquiring ACPVs and how they compare with those at the Department of State; and (2) the extent to which selected DOD components adhere to guidance and procedures for ensuring the safety and quality of ACPVs. To conduct this work, GAO analyzed policies, procedures, and regulations that govern aspects of acquiring, armoring, inspecting, and managing ACPVs; interviewed DOD and State Department officials; and compared armoring standards DOD components-Army, Navy, Marine Corps, and Defense Intelligence Agency-use for ACPVs against minimally acceptable protection standards. GAO reviewed contract actions for selected DOD components between 2011 and 2015. "

" USDA and USAID spent about $9.2 billion to provide international emergency food aid during fiscal years 2007-2012. USDA developed WBSCM with USAID's input to manage domestic and international food aid procurements. USDA spent about $187 million to develop and implement the system. GAO was asked to examine the international emergency food aid procurement process. This report examines (1) the extent to which agencies agree to use WBSCM to manage the process, (2) how the agencies' use of WBSCM and other systems affects USDA's ability to have accurate information, and (3) the extent to which the agencies are collaborating on how to use WBSCM. GAO reviewed the procurement process and observed WBSCM in use. We analyzed inventory spreadsheets used to compile USDA's financial reports. We compared agencies' efforts to collaborate against key elements for effective interagency collaboration. "

"Information technology (IT) is critical to the Department of Housing and Urban Development's (HUD) ability to carry out its home ownership and community development mission. Provisions of the Consolidated Appropriations Act, 2010, require HUD to develop and submit to Congress an expenditure plan for its efforts to modernize the department's IT environment prior to using 75 percent of the funds made available for IT modernization. The plan is to satisfy certain statutory conditions and is to be reviewed by GAO. Accordingly, GAO's objectives were to (1) determine whether HUD's revised plan satisfies statutory conditions and (2) provide observations about the plan and management of HUD's IT modernization program. To accomplish this, GAO assessed the plan against the statutory conditions, analyzed department documentation and relevant plans on key internal management controls, and reviewed HUD's efforts to address open GAO recommendations. GAO also interviewed cognizant department officials. "

The Department of Defense (DOD) operates nearly 70,000 lodging roomssimilar to hotel roomsand spent nearly $1 billion in 2009 to operate them. In 2002, Congress provided authority to privatize lodging facilities. Army privatized lodging at 10 installations in August 2009 and plans to privatize its remaining domestic facilities in the future. The National Defense Authorization Act for Fiscal Year 2008 requires GAO to review lodging privatization and an Army report. This report addresses (1) the factors the military services considered in their decisions to privatize, (2) challenges in the Armys privatization efforts, (3) the effect of the economic downturn on the Armys privatization program, and (4) the extent to which an Army report required by the act, issued in March 2010, addresses the elements in the law. GAO reviewed documentation and interviewed officials from the Office of the Secretary of Defense, the military services, the developer for the Armys privatization project, and four Army installations where lodging was privatized.

" DRAA provided approximately $50 billion in supplemental appropriations, before sequestration, to 19 federal agencies for expenses related to Hurricane Sandy and other purposes. DRAA deemed all programs and activities receiving appropriations under the act as susceptible to significant improper payments, making such appropriations subject to improper payment estimation requirements established in law and through OMB guidance. GAO was asked to review agencies' efforts to estimate improper payments for expenses related to Hurricane Sandy. For DRAA funds, this report (1) describes how selected agencies estimated and reported improper payments and (2) determines the extent to which selected agencies developed policies and procedures for estimating improper payments. GAO reviewed the Departments of Homeland Security, Housing and Urban Development, and Transportation; the U.S. Army Corps of Engineers; and the Small Business Administration, which collectively received most of the DRAA funds. GAO reviewed sampling plans, evaluated agencies' policies and procedures, and conducted interviews with officials at these agencies and OMB. "

Federal real property, leases with purchase options are infrequently used but may provide benefits

" HHS provides funding to the 50 states and 12 municipalities, territories, and freely associated states, primarily through ASPR's HPP and CDC's PHEP cooperative agreements, to help them build their capability to respond to emergencies such as hurricanes, pandemics, or terrorist events. The 62 awardees are to use this funding to help achieve the HPP goals of strengthening hospital preparedness and medical surge capacity and the PHEP goal of strengthening public health preparedness, and they must meet certain application, financial, and reporting requirements. GAO was asked about the effects of federal support on state and local response capabilities. GAO (1) assessed awardee progress in meeting HPP goals and how ASPR measures that progress, (2) assessed awardee progress in meeting the PHEP goal and how CDC measures that progress, and (3) identified the mechanisms HHS uses to ensure that awardees are meeting application, financial, and reporting requirements. GAO reviewed HPP and PHEP guidance, performance measures, and other documents; interviewed HHS officials; and analyzed HPP and PHEP data for fiscal years 2007 through 2011. "

" The Centers for Disease Control and Prevention has declared that the United States is in the midst of an epidemic of prescription drug overdose deaths, with deaths associated with prescription pain relievers of particular concern. To address this issue, federal agencies are raising awareness by educating prescribers and the general public. In response to your request, GAO (1) described recent national trends in prescription pain reliever abuse and misuse, (2) described how federal agencies are educating prescribers, (3) assessed the extent to which federal agencies follow key practices for developing public education efforts, and (4) identified educational efforts that use similar strategies and assessed how agencies coordinate those efforts. GAO interviewed officials and reviewed documents and websites from seven agencies involved in federal drug control efforts and analyzed the most recent data from several data sources related to prescription pain reliever abuse and misuse. GAO also assessed the development of public education efforts and federal coordination efforts against key practices from prior GAO work. "

The 2010 Patient Protection and Affordable Care Act (PPACA) expands health insurance to millions of individuals, including many parents. New insurance options for parents raise a question about whether providing health insurance to parents benefits their children. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) asked GAO to assess (1) the extent a parent's health insurance status is associated with a child's health insurance status, use of services, and parental satisfaction with their child's care; and (2) how selected states' parent coverage under Medicaid and CHIP may change given upcoming expansions. To examine the association between a parent's and a child's health insurance status, GAO analyzed data from 3 years of the Medical Expenditure Panel Survey (2005-2007), a nationally representative survey. GAO categorized parent and child health insurance status as private, public, or uninsured, and analyzed nine parent/child insurance combinations. GAO also analyzed relevant, peer-reviewed literature. To examine how states may change their Medicaid- and CHIP-funded parent coverage, GAO reviewed CHIPRA and PPACA, and interviewed officials from the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) and eight states with authority to cover parents in their...

" IHS provides care to American Indians and Alaska Natives through a system of health care facilities. PPACA provides states the option to expand their Medicaid programs and creates new health care coverage options, including for American Indians and Alaska Natives, beginning in 2014. PPACA also requires GAO to study IHS's coordination with public programs. In this report, GAO (1) estimated the number of American Indians and Alaska Natives potentially eligible for the expanded and new coverage options and (2) reviewed efforts by IHS, CMS, states, tribal organizations, and facilities to promote enrollment of American Indians and Alaska Natives in current programs and expanded and new coverage options, and any challenges associated with their enrollment. To address the objectives, GAO (1) analyzed U.S. Census Bureau data and (2) interviewed IHS and CMS officials and state, facility, and tribal officials from three IHS areas with high levels of uninsured. "

" The United States and DOD depend on space assets to support national security, civil, and commercial activities. Having sufficient quantities of qualified personnel to acquire space assets-on which DOD expects to spend $8 billion in fiscal year 2013-is critical to DOD's ability to carry out its mission. Approximately 1,800 federal civilians at the Air Force SMC manage the acquisition of space systems. During fiscal year 2012, the Air Force implemented a pilot program that moved $187.1 million for SMC's acquisition civilian personnel from its O&M to its RDT&E appropriation. GAO was mandated to review the Air Force pilot program. This report addresses (1) the extent to which the Air Force evaluated the impact of the pilot, and (2) the processes in place to manage realignment of the funds. GAO obtained and reviewed documentation of the pilot implementation; compared the implementation with established practices GAO has identified for implementing and evaluating pilot programs; and interviewed officials at the Air Force and DOD. GAO also reviewed applicable regulations and guidance about realigning funds and interviewed knowledgeable officials. "

Pakistan: reporting on visa delays that disrupt U.S. assistance could be improved: report to the Chairman, Subcommittee on Near Eastern and South and Central Asian Affairs, Committee on Foreign Relations, U.S. Senate.

"The National Transportation Safety Board (NTSB), whose reauthorization is the subject of today's hearing, plays a vital role in advancing transportation safety by investigating accidents, determining their causes, issuing safety recommendations, and conducting safety studies. To support the agency's mission, NTSB's Training Center provides training to NTSB investigators and others. NTSB's 2006 reauthorization legislation mandates an annual review by GAO, and from 2006 through 2008, GAO made 21 recommendations to NTSB that address its management, information technology (IT), accident investigation criteria, safety studies, and Training Center use. This testimony addresses NTSB's progress in implementing GAO's recommendations that it (1) follow leading management practices, (2) conduct aspects of its accident investigations and safety studies more efficiently, and (3) increase the use of its Training Center. The testimony also discusses (4) changes NTSB seeks in its 2010 reauthorization proposal. This testimony is based on GAO's assessment from July 2009 to January 2010 of plans and procedures NTSB developed to address these recommendations. NTSB provided technical comments that GAO incorporated..."

The Department of Defense (DOD) has developed certifications and training for acquisition and intelligence personnel, but it does not have certifications for certain personnel who provide intelligence support to acquisition programs. These personnel help integrate threat information on foreign capabilities and intelligence mission data-technical intelligence such as radar signatures and geospatial mapping data-into acquisition programs. DOD uses certifications to determine that an employee has necessary education, training, and experience. The lack of certifications for personnel providing intelligence support to acquisition programs has led to the services developing varying levels of training: the Air Force certifies and requires training specific to providing intelligence support, the Army offers training that is not required, and the Navy has no formal training. Without certifications for personnel providing intelligence support to acquisition programs, DOD does not have assurance that these personnel are prepared to carry out their duties. DOD has multiple efforts underway to improve processes and procedures for integrating intelligence into its acquisitions but does not require prioritization of intelligence mission data, which would identify those data most needed for a weapon system to perform its mission. A task force DOD created in 2015 to better integrate intelligence into acquisition programs identified the need for prioritization and proposed processes and procedures for doing so. Without department-wide requirements to prioritize intelligence mission data, new processes and procedures such as those developed by the task force may not be fully implemented and weapon systems could be deployed without the intelligence mission data they need to perform their missions. DOD is developing two tools for integrating intelligence into major defense acquisition programs. One tool to share threat information lacks a communication plan to obtain feedback from users to better ensure its effectiveness. Without user feedback, DOD may not receive useful information to develop the tool. The other tool is for acquisition programs to communicate their intelligence needs to the intelligence community, though the services did not identify a need for the tool and there is no mechanism to fund its implementation and operation. Without assessing the need for such a tool or plans or funding for implementation and operation, DOD may be using funds unnecessarily to develop an unneeded tool.

" Tax expenditures-exclusions, credits, deductions, deferrals, and preferential tax rates-are one tool the government uses to promote community development. Multiple tax expenditures contribute to community development. GAO (1) identified community development tax expenditures and potential overlap and interactions among them; (2) assessed the data and performance measures available and used to assess their performance; and (3) determined what previous studies have found about selected tax expenditures' performance. GAO identified community development activities using criteria based on various federal sources and compared them with authorized uses of tax expenditures. GAO reviewed agency documents and interviewed officials from the Internal Revenue Service (IRS) and five other agencies. GAO also reviewed empirical studies for selected tax expenditures, including the New Markets Tax Credit and Empowerment Zone program which expired in 2011. "

" NRC issues RAIs to obtain information in licensing requests to ensure that officials can make a fully informed, technically correct, and legally defensible regulatory decision. RAIs are necessary when the information was not included in an applicant's initial submission, is not contained in any other docketed correspondence, or cannot reasonably be inferred from the information available to agency staff. NRC's use of RAIs has come under scrutiny in the past. For example, NRC's Inspector General, in a 2015 report, cited concerns about RAIs, including the amount of time it took to complete the RAI process and the resources required to do so. GAO was asked to review how NRC uses RAIs. This report examines (1) NRC's guidance for developing and issuing RAIs and how it differs across offices; (2) how many RAIs NRC has issued over the past 5 years and the kinds of activities that elicit RAIs; and (3) strengths and weaknesses of NRC's processes to develop RAIs identified by NRC and licensees and the actions NRC is taking to address concerns. GAO examined agency guidance documents and selected licensing actions containing RAIs. GAO interviewed NRC officials and selected licensees. GAO randomly selected licensing actions and licensees from a sample of recent licensing actions that included cases from each of NRC's"

"Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care to American Indians and Alaska Natives. When care at an IHSfunded facility is unavailable, IHS's contract health services (CHS) program pays for care from external providers if the patient meets certain requirements and funding is available. The Patient Protection and Affordable Care Act requires GAO to study the adequacy of federal funding for IHS's CHS program. To examine program funding needs, IHS collects data on unfunded services-services for which funding was not available-from the federal and tribal CHS programs. GAO examined (1) the extent to which IHS ensures the data it collects on unfunded services are accurate to determine a reliable estimate of CHS program need, (2) the extent to which federal and tribal CHS programs report having funds available to pay for contract health services, and (3) the experiences of external providers in obtaining payment from the CHS program. GAO surveyed 66 federal and 177 tribal CHS programs and spoke to IHS officials and 23 providers. "

" Some transit agencies have found that they can save money by contracting out some or all of their services with private providers, while others have found it more beneficial to use their own staff to provide services. The Moving Ahead for Progress in the 21st Century Act mandated that GAO review issues related to transit contracting. In this report, GAO identified: (1) the extent that public transit agencies contract operations and reasons why agencies decide to do so, (2) methods used to select and oversee contracted services, and (3) potential benefits, challenges, and disadvantages of contracting out public transit operations and other services. GAO conducted a web-based survey of 637 transit agencies that submit reports to the Department of Transportation (DOT) and obtained 463 responses for a 73 percent response rate. The survey and results can be found at GAO-13-824SP. In addition, GAO interviewed federal officials, representatives from industry organizations, and national union officials. GAO also interviewed officials from 10 transit agencies, chosen based on a variety of characteristics, including geographic diversity, population served, use of contracting, and modes operated. At each transit location, GAO interviewed private transit providers, citizens' advisory groups, and local unions. The results of the survey and interviews are not generalizeable to all transit agencies. GAO also reviewed relevant studies and literature on transit contracting"

"The drawdown of U.S. forces in Iraq and the transition from a U.S. military to a civilian-led presence after December 2011 continue amid an uncertain security and political environment. This report is one in a series of reviews regarding the planning and execution of the drawdown. Specifically, this report assesses the extent to which DOD has planned for, begun to execute, and mitigated risk associated with (1) transferring and removing personnel and equipment from remaining bases in Iraq; (2) curtailing unneeded contract services, transitioning expiring contracts, and providing adequate contract oversight; and (3) facilitating and supporting the transition to a civilian-led presence in Iraq. GAO examined relevant DOD planning documents, attended drawdown-related conferences, interviewed State officials and DOD officials throughout the chain of command in the United States, Kuwait, and Iraq, and visited several locations in Kuwait and Iraq to observe drawdown operations. "

Since the terrorist attacks of September 11, 2001, the nation's ports and waterways have been viewed as potential targets of attack. The Department of Homeland Security (DHS) has called for using risk-informed approaches to prioritize its investments, and for developing plans and allocating resources that balance security and the flow of commerce. The U.S. Coast Guard?a DHS component and the lead federal agency responsible for maritime security?has used its Maritime Security Risk Analysis Model (MSRAM) as its primary approach for assessing and managing security risks. GAO was asked to examine (1) the extent to which the Coast Guard's risk assessment approach aligns with DHS risk assessment criteria, (2) the extent to which the Coast Guard has used MSRAM to inform maritime security risk decisions, and (3) how the Coast Guard has measured the impact of its maritime security programs on risk in U.S. ports and waterways. GAO analyzed MSRAM's risk assessment methodology and interviewed Coast Guard officials about risk assessment and MSRAM's use across the agency.

" A complete count of the nation's population is an enormous challenge requiring the U.S. Census Bureau (Bureau) to balance requirements for accuracy with the need to control escalating costs. The 2010 Census was the costliest U.S. Census in history at about $13 billion, and was about 56 percent more costly than the $8 billion cost of the 2000 Census (in 2010 dollars). The fundamental challenge facing the Bureau going forward is cost effectively counting a population that is growing steadily larger, more diverse and becoming increasingly difficult to enumerate. As requested, this report assesses (1) the key factors affecting cost growth from the 2000 Census to the 2010 Census; (2) the Bureau's plans for controlling costs for the 2020 Census and what additional steps, if any, could be taken; and (3) the extent to which the Bureau's plans for developing life cycle cost estimates for 2020 are consistent with best practices. The report is based on GAO's analysis of Bureau data and documents as well as interviews with Bureau officials. "

"Enrollment in for-profit colleges has grown from about 365,000 students to almost 1.8 million in the last several years. These colleges offer degrees and certifications in programs ranging from business administration to cosmetology. In 2009, students at for-profit colleges received more than $4 billion in Pell Grants and more than $20 billion in federal loans provided by the Department of Education (Education). GAO was asked to 1) conduct undercover testing to determine if for-profit colleges' representatives engaged in fraudulent, deceptive, or otherwise questionable marketing practices, and 2) compare the tuitions of the for-profit colleges tested with those of other colleges in the same geographic region. To conduct this investigation, GAO investigators posing as prospective students applied for admissions at 15 for-profit colleges in 6 states and Washington, D.C.. The colleges were selected based on several factors, including those that the Department of Education reported received 89 percent or more of their revenue from federal student aid. GAO also entered information on four fictitious prospective students into education search Web sites to determine what type of follow-up contact resulted from an inquiry. GAO compared tuition for the 15 for-profit colleges tested with tuition for the same programs..."

International food assistance, USAID has controls for implementation and support costs but should strengthen financial oversight: report to the Chairman, Committee on Agriculture, House of Representatives. " In recent years, USAID has awarded about $1.4 billion annually for international food assistance projects under Title II of the Food for Peace Act (Title II). This funding has traditionally been used to provide U.S.-purchased commodities to food-insecure...

The U.S. Coast Guard, a component of the Department of HomelandSecurity (DHS), conducts 11 statutory missions that range from marine safety to defense readiness. In an effort to enhance performance the Coast Guard continues to implement its Deepwater programthe acquisition program to replace or upgrade its vessels and aircraftwhile also carrying out a reorganization program to update its command structure, among other things. This testimony discusses the Coast Guards (1) budget request for fiscal year 2011 and key performance indicators for fiscal year 2009; and (2) key management challenges confronting the Coast Guard. This testimony is based on GAO products issued in 2009 and 2010 (including GAO-09-682, GAO-09-810T, and GAO-10-268R); other GAO products issued over the past 11 yearswith selected updates in February 2010; and preliminary observations from ongoing GAO work on the Deployable Operations Group. GAO analyzed budget and performance documents, such as DHSs fiscal year 2011 budget justification, and interviewed Coast Guard officials.

" In fiscal year 2011, civilian agencies reported $161 billion in contract obligations, $126 billion (almost 80 percent) of which were for services such as professional management and information technology support. Concerned about agencies' reliance on contractors, Congress included a requirement in the Consolidated Appropriations Act of 2010 for civilian agencies to compile and review an annual inventory of service contracts to examine certain issues, such as contractors performing inherently governmental functions or functions closely associated with inherently governmental functions, which would require enhanced management oversight. It also required OMB to develop guidance to assist agencies in meeting the act's requirements and for GAO to report on agency efforts. GAO assessed agency efforts to (1) compile their fiscal year 2011 inventories and (2) review and report on their fiscal year 2010 inventories. To meet these objectives, GAO analyzed agencies' fiscal year 2011 service contract inventories and fiscal year 2010 service contract inventory review reports and compared them to legislative requirements, OMB guidance, and federal procurement data. "

" The Foreign Assistance Act of 1961, as amended, prohibits assistance to a unit of a foreign government's security forces if the Secretary of State has credible information that such unit has committed a gross violation of human rights. DOD's annual appropriation contains a similar provision that applies to DOD-funded training programs. State administers a vetting process to address these laws, commonly referred to as the Leahy laws. GAO was asked to review implementation of these laws. This report examines the extent to which (1) State and DOD provide guidance to their personnel to address the Leahy laws, (2) State monitors whether U.S. embassies have developed procedures to address the requirements of the Leahy laws, and (3) State provides training to personnel who conduct human rights vetting. This is a public version of a sensitive but unclassified GAO report. Information State deemed sensitive has been redacted. GAO reviewed agency guidance and training materials and interviewed officials in Washington, D.C., and at eight U.S. embassies selected in part based on whether they were in countries that State identified as countries of human rights concern. "

VA and IHS: further action needed to collaborate on providing health care to Native American veterans: report to congressional requesters.