Improper payments—payments that should not have been made or that were made in incorrect amounts—continue to be an area of fiscal concern in the federal government. Improper payments have been estimated to total almost $1.7 trillion government-wide from fiscal years 2003 through 2019. From fiscal year 2003 through 2016, a government-wide estimate and rate had been included in government-wide financial reports based on the programs and activities that reported estimates. However, financial reports for fiscal years 2017 and 2018 did not include a government-wide improper payment estimate or rate. Agency-reported improper payment estimates are posted on the Office of Management and Budget's Paymentaccuracy.gov website. IPERA requires IGs to annually determine and report on whether executive branch agencies complied with six IPERA criteria, such as conducting risk assessments and publishing and meeting improper payment reduction targets. This report summarizes (1) federal agencies' reported improper payment estimates for fiscal years 2018 and 2019, and reasons for substantial changes between years, and (2) CFO Act agencies compliance with IPERA criteria for fiscal year 2018, as determined by their IGs, and overall compliance trends for fiscal years 2016 through 2018. GAO summarized (1) improper payment estimates from agency financial reports and Paymentaccuracy.gov and (2) information on CFO Act agencies' IPERA compliance reported in IGs' fiscal year 2018 IPERA compliance reports and prior GAO reports. Agency-reported improper payment estimates for fiscal year 2019 totaled about $175 billion, based on improper payment estimates reported by federal programs, an increase from the fiscal year 2018 total of $151 billion. Of the $175 billion, about $121 billion (approximately 69 percent) was concentrated in three program areas: (1) Medicaid, (2) Medicare, and (3) Earned Income Tax Credit. About $74.6 billion (approximately 42.7 percent) of the government-wide estimate was reported as monetary loss, an amount that should not have been paid and in theory should or could be recovered. However, the federal government's ability to understand the full scope of its improper payments is hindered by incomplete, unreliable, or understated agency estimates; risk assessments that may not accurately assess the risk of improper payment; and agencies not complying with reporting and other requirements in the Improper Payments Elimination and Recovery Act of 2010 (IPERA). Eight years after the implementation of IPERA, half of the 24 Chief Financial Officers Act of 1990 (CFO Act) agencies—whose estimates account for over 99 percent of the federal government's reported estimated improper payments—complied with IPERA overall for fiscal year 2018, as reported by their inspectors general (IG). Based on the IGs' fiscal year 2018 compliance reports, agencies were most frequently reported as noncompliant with the requirement to publish and meet annual targets for improper payment reduction. Out of the 14 agencies for which this requirement was applicable, eight agencies were noncompliant. The second most-frequently reported area of noncompliance related to the requirement for agencies' reported improper payment rates to be below 10 percent for programs that published estimates. Out of the 15 agencies for which this requirement was applicable, five agencies were noncompliant. Chief Financial Officers Act of 1990 Agencies' Fiscal Year 2018 Compliance with IPERA Criteria, as Reported by Their IGs The IGs reported that 21 programs were noncompliant with IPERA for each of the past 3 fiscal years (2016–2018). These programs represented about $78 billion, or approximately 52 percent of the $151 billion government-wide reported improper payment estimates for fiscal year 2018.


Improper payments—payments that should not have been made or were made in an incorrect amount—are a significant problem in the federal government. Agencies are required to perform risk assessments to identify programs that are susceptible to significant improper payments. House Report 115-697 included a provision for GAO to review DOE's system for tracking improper payments. This report examines the extent to which (1) the amounts reported in DOE's AFRs for fiscal years 2015 through 2019 were accurate and complete, and (2) its fiscal year 2018 risk assessment provided a reasonable basis for its risk determination. GAO reviewed DOE's improper payment reporting for fiscal years 2015 through 2019 and its fiscal year 2018 risk assessment, and reviewed documents and interviewed officials from 10 of 48 reporting sites selected to provide a range of sites and about half of fiscal year 2018 reported improper payments. The improper payments amounts that the Department of Energy (DOE) reported in its annual agency financial reports (AFR) for fiscal years 2015 through 2019 may not be accurate or complete. Agencies with programs that are susceptible to significant improper payments—including those with more than $100 million of improper payments in a year—are required to report statistically valid estimates of their improper payments. DOE determined these requirements did not apply, but optionally reported information on actual improper payments it made and identified in the prior year. For example, in its fiscal year 2019 AFR, DOE reported fiscal year 2018 improper payments—such as those made to contractors for unallowable costs—totaling about $36 million, less than 0.1 percent of its outlays. However, DOE did not disclose that these amounts do not include improper payments identified through reviews, audits, and investigations completed several years after it issues its AFR (see figure). For example, as of September 2019, DOE had not audited $23.8 billion of its $38.5 billion in fiscal year 2018 outlays. Such audits may increase the improper payments in a year by millions of dollars. For example, based on a 2017 audit, DOE identified $34 million in fiscal year 2010 improper payments. DOE does not always track information on the year improper payments were made that would allow it to determine whether improper payments identified later would increase the total to more than $100 million. By tracking and disclosing such information, DOE could better inform Congress, the public, and others about whether it exceeded the $100 million threshold and should be subject to additional reporting requirements. DOE determined that its risk of significant improper payments was low in its fiscal year 2018 risk assessment. However, GAO found that the risk assessment may not provide a reasonable basis for DOE's determination. DOE did not provide sufficient documentation to support that it considered the known lag in identifying improper payments as an inherent risk, nor did it provide sufficient documentation to support its rationale for the scale it used to score risk factors or for weighting risk ratings of payment reporting sites. For example, a payment site processing $3 million of outlays had the same weight in the overall assessment as a payment site processing $5.7 billion of outlays. As a result, DOE cannot demonstrate that its low-risk determination is reasonable and that its risk assessment process produces reliable results.


In 1996, Congress enacted the Military Housing Privatization Initiative in response to DOD concerns about inadequate and poor quality housing for servicemembers. Today, private partners are responsible for the ownership, construction, renovation, maintenance, and repair of about 99 percent of housing units on military bases in the continental United States. DOD's policy requires that the department ensure eligible personnel and their families have access to affordable, quality housing facilities. The Office of the Secretary of Defense is responsible for providing guidance and general procedures related to military housing privatization. The military departments are responsible for executing and managing privatized housing projects. Drawing from ongoing work, GAO discusses (1) DOD's oversight of privatized military housing for servicemembers and their families, (2) efforts of the military departments to communicate their roles and responsibilities to servicemembers and their families, and (3) DOD and private partner development and implementation of initiatives to improve privatized housing. GAO reviewed relevant policies, guidance, and legal documents; visited 10 installations; conducted 15 focus groups; analyzed maintenance work order data; and interviewed relevant DOD and private partner officials. GAO will continue its ongoing work and make recommendations as appropriate in the final report. Each military department conducts a range of oversight activities—some more extensive than others—for its privatized housing projects, but these efforts have been limited in key areas. Specifically, based on GAO's ongoing work: The Department of Defense (DOD) conducts oversight of the physical condition of housing, but some efforts have been limited in scope. Military departments have guidance for conducting oversight of the condition of privatized housing. This oversight generally consists of reviewing a sample of work order requests, visually inspecting housing during change of occupancy, and conducting other point in time assessments. However, GAO found that these efforts are limited in scope. For example, interior walk-throughs may have been limited to just a few homes at each installation. DOD uses performance metrics to assess private partners, but metrics may not provide meaningful information on the condition of housing. The Office of the Secretary of Defense (OSD) has recently issued guidance to ensure consistency in the framework used to measure project performance. However, the specific indicators used to determine if the metrics are being met may not fully reflect private partner performance. For example, a common measure is how quickly the private partner responded to a work order, not whether the issue was actually addressed. DOD and private partners collect maintenance data on homes, but these data are not captured reliably or consistently. DOD is expanding its use of work order data to monitor and track the condition of privatized housing. However, based on GAO's analysis of data provided by all 14 private partners, these data cannot reliably be used for ongoing monitoring of privatized housing because of data anomalies and inconsistent business practices in how these data are collected. DOD provides reports to Congress on the status of privatized housing, but some data in these reports are unreliable and may be misleading. DOD provides periodic reports to Congress on the status of privatized housing, but reported results on resident satisfaction are unreliable due to variances in the data military departments provide to OSD and in how OSD has calculated and reported these data. Military housing offices located at each installation are available to provide resources to servicemembers experiencing challenges with their privatized housing, but GAO's ongoing work showed these offices have not always effectively communicated this role to residents. For example, residents in GAO's focus groups noted confusion over the roles and responsibilities of these offices, and military housing officials have found that residents could not readily differentiate between military and private housing officials. DOD, working with the private partners, has made progress in developing and implementing a series of initiatives. However, both DOD and private partner officials have noted several challenges that could affect implementation, including limitations to DOD's legal authority to unilaterally make changes to the terms of the projects and limited resources to implement increased oversight.


In 2000, Congress authorized the WOSB program, allowing contracting officers to set aside procurements to women-owned small businesses in industries in which they are substantially underrepresented. To be eligible to participate in the WOSB program, firms have the option to self-certify or be certified by a third-party certifier. However, the 2015 NDAA changed the WOSB program by (1) authorizing SBA to implement sole-source authority, (2) eliminating the option for firms to self-certify as being eligible for the program, and (3) allowing SBA to implement a new certification process. This testimony is based on a report GAO issued in March 2019 ( GAO-19-168 ). For that report, GAO examined (1) the extent to which SBA has addressed the 2015 NDAA changes, (2) SBA's efforts to address previously identified deficiencies, and (3) use of the WOSB program. GAO reviewed relevant laws, regulations, and program documents; analyzed federal contracting data from April 2011 through June 2018; and interviewed SBA officials, officials from contracting agencies selected to obtain a range of experience with the WOSB program, and the three (out of four) private third-party certifiers that agreed to meet with GAO. The Small Business Administration (SBA) has implemented one of the three changes to the Women-Owned Small Business (WOSB) program authorized in the National Defense Authorization Act of 2015 (2015 NDAA). In September 2015 SBA published a final rule to implement sole-source authority (to award contracts without competition), effective October 2015. As of early May 2019, SBA had not eliminated the option for program participants to self-certify that they are eligible to participate, as required by the 2015 NDAA. SBA officials stated that the agency intended to address the third change made by the 2015 NDAA (meaning implement a new certification process for the WOSB program). SBA has not addressed WOSB program oversight deficiencies and recommendations in GAO's 2014 report ( GAO-15-54 ). For example, GAO recommended that SBA establish procedures to assess the performance of four third-party certifiers—private entities approved by SBA to certify the eligibility of WOSB firms. While SBA generally agreed with GAO's recommendations and conducted a compliance review of the certifiers in 2016, it has no plans to regularly monitor their performance. By not improving its oversight, SBA is limiting its ability to ensure third-party certifiers are following program requirements. Further, the implementation of sole-source authority in light of these continued oversight deficiencies can increase program risk. GAO maintains that its recommendations aimed at improving oversight should be addressed. In addition, GAO's March 2019 ( GAO-19-168 ) report found that about 3.5 percent of contracts using a WOSB set-aside were awarded for ineligible goods or services from April 2011 through June 2018. At that time, SBA was not reviewing contracting data that could identify which agencies may need targeted training. GAO recommended that SBA review such data to help address identified issues. In early May 2019, SBA said it had initiated such efforts. While federal contract obligations to all women-owned small businesses and WOSB program set-asides have increased since fiscal year 2012, WOSB program set-asides remain a small percentage (see figure). Note: Obligations to women-owned small businesses represent contract obligations to women-owned small businesses under WOSB-program-eligible North American Industry Classification System codes. FPDS-NG obligation amounts have been adjusted for inflation.


In 2003, GAO designated Implementing and Transforming DHS as a high-risk area to the federal government. DHS has made considerable progress in transforming its original component agencies into a single cabinet-level department, and as a result, in 2013, GAO narrowed the scope of the high-risk area to focus on Strengthening DHS Management Functions . In addition, DHS leadership is responsible for implementing numerous recommendations that GAO has made to the department and its component agencies. Current vacancies in top leadership positions could pose a challenge to addressing high-risk areas and priority recommendations that span DHS's diverse missions, which include preventing terrorism and enhancing security, managing our borders, administering immigration laws, securing cyberspace, and responding to disasters. This testimony discusses the need for DHS leadership commitment to strengthen its management functions and address GAO's priority recommendations. This testimony is based on GAO's 2019 high-risk update and other reports issued from March 2006 through April 2019. With the support and commitment of top leadership, the Department of Homeland Security (DHS) has made important progress in strengthening its management functions; however, considerable work remains. As of March 2019, DHS had fully addressed 17 of the 30 outcomes related to its management functions (see table). DHS needs to continue to show sustained leadership commitment in implementing its Integrated Strategy for High-Risk Management to achieve the remaining outcomes. Leadership commitment is also pivotal in addressing other GAO high-risk areas where DHS has a role, such as ensuring the cybersecurity of the nation, the National Flood Insurance Program, and limiting the federal government's fiscal exposure by better managing climate change risks. Currently, DHS has acting officials serving in eight positions requiring Senate confirmation, including positions with responsibilities for implementing high-risk outcomes, such as the Secretary, Deputy Secretary, and Under Secretary for Management. a “Mostly addressed”: Progress is significant and a small amount of work remains. b “Partially addressed”: Progress is measurable, but significant work remains. c “Initiated”: Activities have been initiated to address the outcome, but it is too early to report progress. In April 2019, GAO sent a letter to the Acting Secretary of Homeland Security detailing 26 open recommendations that GAO believes warrant the highest priority personal attention from the department and its components. These 26 recommendations fall into six major areas—emergency preparedness and response, border security, transportation security, infrastructure and management, cybersecurity, and chemical and nuclear security. For example, GAO has recommended that DHS take steps to strengthen human capital management, such as better managing and assessing its cybersecurity workforce gaps and areas of critical need. Fourteen of the 26 recommendations have been issued to acting officials serving in vacant positions, including 12 to the Secretary of Homeland Security, and two to the Federal Emergency Management Agency which is currently operating under acting leadership.


In 2003, the United States approved amended compacts of free association with the FSM and RMI, providing a total of $3.6 billion in economic assistance in fiscal years 2004 through 2023 and access to several U.S. programs and services. Compact grant funding, overseen by the Department of the Interior (Interior), generally decreases annually. However, the amount of the annual decrease in grants is added to the annual U.S. contributions to the compact trust funds, managed by joint U.S.-FSM and U.S.-RMI trust fund committees and chaired by Interior. Trust fund earnings are intended to provide a source of income after compact grants end in 2023. This testimony summarizes GAO's May 2018 report on compact grants and trust funds ( GAO-18-415 ). In that report, GAO examined (1) the use and role of U.S. funds and programs in the FSM and RMI budgets, (2) projected compact trust fund disbursements, and (3) trust fund committee actions needed to address the 2023 transition to trust fund income. For this testimony, GAO also reviewed key variables for its trust fund model as of June 2019 to determine whether these variables had substantially changed. In addition, GAO reviewed the status of Interior's response to GAO's May 2018 recommendations. The Federated States of Micronesia (FSM) and the Republic of the Marshall Islands (RMI) rely on U.S. grants and programs, including several that are scheduled to end in 2023. In fiscal year 2016, U.S. compact sector grants and supplemental education grants, both scheduled to end in 2023, supported a third of the FSM's expenditures and a quarter of the RMI's. Agreements providing U.S. aviation, disaster relief, postal, weather, and other programs and services are scheduled to end in 2024, but some U.S. agencies may provide programs and services similar to those in the agreements under other authorities. GAO's 2018 report noted that the FSM and RMI compact trust funds face risks and may not provide disbursements in some future years. GAO projected a 41 percent likelihood that the FSM compact trust fund would be unable to provide any disbursement in 1 or more years in fiscal years 2024 through 2033, with the likelihood increasing to 92 percent in 2054 through 2063. GAO projected a 15 percent likelihood that the RMI compact trust fund would be unable to provide any disbursement in 1 or more years in fiscal years 2024 through 2033, with the likelihood increasing to 56 percent in 2054 through 2063. Potential strategies such as reduced trust fund disbursements would reduce or eliminate the risk of years with no disbursement. However, some of these strategies would require changing the trust fund agreements, and all of the strategies would require the countries to exchange a near-term reduction in resources for more-predictable and more-sustainable disbursements in the longer term. Interior has not yet implemented the actions GAO recommended to prepare for the 2023 transition to trust fund income. The trust fund committees have not developed distribution policies, required by the agreements, which could assist the countries in planning for the transition to trust fund income. The committees have not developed the required fiscal procedures for oversight of disbursements or addressed differences between the timing of their annual determinations of the disbursement amounts and the FSM's and RMI's annual budget cycles.


In 2003, the United States approved amended compacts of free association with the FSM and RMI, providing a total of $3.6 billion in economic assistance in fiscal years 2004 through 2023 and access to several U.S. programs and services. Compact grant funding, overseen by the Department of the Interior (Interior), generally decreases annually. However, the amount of the annual decrease in grants is added to the annual U.S. contributions to the compact trust funds, managed by joint U.S.–FSM and U.S.–RMI trust fund committees and chaired by Interior. Trust fund earnings are intended to provide a source of income after compact grants end in 2023. This testimony summarizes GAO's May 2018 report on compact grants and trust funds (GAO-18-415). In that report, GAO examined (1) the use and role of U.S. funds and programs in the FSM and RMI budgets, (2) projected compact trust fund disbursements, and (3) trust fund committee actions needed to address the 2023 transition to trust fund income. For this testimony, GAO also reviewed key variables for its trust fund model as of June 2019 to determine whether these variables had substantially changed. In addition, GAO reviewed the status of Interior's response to GAO's May 2018 recommendations. The Federated States of Micronesia (FSM) and the Republic of the Marshall Islands (RMI) rely on U.S. grants and programs, including several that are scheduled to end in 2023. In fiscal year 2016, U.S. compact sector grants and supplemental education grants, both scheduled to end in 2023, supported a third of the FSM's expenditures and a quarter of the RMI's. Agreements providing U.S. aviation, disaster relief, postal, weather, and other programs and services are scheduled to end in 2024, but some U.S. agencies may provide programs and services similar to those in the agreements under other authorities. GAO's 2018 report noted that the FSM and RMI compact trust funds face risks and may not provide disbursements in some future years. GAO projected a 41 percent likelihood that the FSM compact trust fund would be unable to provide any disbursement in 1 or more years in fiscal years 2024 through 2033, with the likelihood increasing to 92 percent in 2054 through 2063. GAO projected a 15 percent likelihood that the RMI compact trust fund would be unable to provide any disbursement in 1 or more years in fiscal years 2024 through 2033, with the likelihood increasing to 56 percent in 2054 through 2063. Potential strategies such as reduced trust fund disbursements would reduce or eliminate the risk of years with no disbursement. However, some of these strategies would require changing the trust fund agreements, and all of the strategies would require the countries to exchange a near-term reduction in resources for more-predictable and more-sustainable disbursements in the longer term. Interior has not yet implemented the actions GAO recommended to prepare for the 2023 transition to trust fund income. The trust fund committees have not developed distribution policies, required by the agreements, which could assist the countries in planning for the transition to trust fund income. The committees have not developed the required fiscal procedures for oversight of disbursements or addressed differences between the timing of their annual determinations of the disbursement amounts and the FSM's and RMI's annual budget cycles.


In 2006, the U.S. Army Corps of Engineers began its Centers of Standardization program to develop design standards for facility types that the Army constructs on a regular basis. The Centers support broader Army efforts under the AFSP to standardize facility types with objectives such as improving design quality, reducing design and construction costs and time, and reducing change orders. Senate Report 115-262 accompanying the John S. McCain National Defense Authorization Act for Fiscal Year 2019 included a provision for GAO to evaluate the Centers' effectiveness. This report assesses, among other things, the extent to which (1) the Centers have identified activities that support their objectives, and (2) the Army tracks the Centers' progress toward their objectives. GAO reviewed and analyzed applicable regulations and program and project documentation; compared Center activities to program objectives; and interviewed cognizant agency officials to gain an understanding of the Centers' operations and potential financial liabilities. The nine Centers of Standardization (Centers) within the U.S. Army Corps of Engineers undertake a number of activities designed to support each of their program objectives. Their charter includes three objectives: (1) developing and refining Centers' policies and processes; (2) assuring consistent application of the Centers' standards; and (3) monitoring execution to meet the overarching objectives and priorities of the Army Facilities Standardization Program (AFSP) and standardization process. We found that the Centers' various activitiessuch as conducting value engineering and life-cycle cost studies to identify possible cost savings and analyze long-term costs of new facilitiesare consistent with key principles and concepts in Office of Management and Budget guidance for a disciplined capital planning process. Additionally, the post-occupancy evaluations led by the Centers are designed to evaluate whether the Army functional requirements have been met, Army standard design has been implemented, and there are any areas where the design could be improved. These evaluations support all three of the Centers' objectives by evaluating whether a design needs improvement, a facility was constructed in accordance with the approved project design, and customer needs were met. The Army has limited performance measures to track the Centers' progress in achieving program objectives. Semi-annual meetings of the Army's Centers of Standardization Management Board (Board) enable the Army to track the Centers' progress toward their goal of developing and updating Center policies and processes (first objective of the Centers). However, GAO found that the Army lacks performance measures to assess the Centers' progress in ensuring the consistent application of Army standard designs (second objective of the Centers) and in monitoring how well the Centers meet the objectives and priorities of the AFSP and standardization process (third objective of the Centers). Specifically, the Board does not maintain, consolidate, or analyze information about how frequently the Centers participate in construction projects, or how this activity affects the program and supports AFSP objectives, such as reducing project costs, times, and change orders. Taking steps to develop and implement appropriate performance measures would enhance the Army's efforts to ensure that the Centers are meeting their program objectives.


In 2007, Congress passed legislation that established a schedule of periodic increases that would have raised all minimum wages in American Samoa to the current federal level ($7.25 per hour) by 2016. However, subsequent legislation has postponed or reduced scheduled minimum wage increases. The most recent minimum wage increase in American Samoa occurred on September 30, 2018, but all minimum wages in American Samoa are not scheduled to converge with the current federal level until 2036. Pub. L. No. 111-5, enacted in February 2009, included a provision for GAO to report periodically on the economic impact of minimum wage increases in American Samoa. This report examines (1) economic trends including changes in employment and earnings since the minimum wage increases in American Samoa began in 2007, (2) the status of the tuna canning industry, and (3) stakeholder views on the minimum wage increases. GAO analyzed federal and American Samoa data for 2016 through 2018, and interviewed employers and workers in American Samoa selected on the basis of employment levels, among other criteria. Commenting on a draft of this report, the American Samoa government suggested creating a committee to set minimum wages in the territory and a moratorium on minimum wage increases until the committee is formed. The Department of the Interior suggested GAO conduct further study, including on the use of a committee to set minimum wages. The suggested further study was beyond the scope of this report. American Samoa's economy largely contracted during the past decade. Adjusted for inflation, gross domestic product declined by 18.2 percent from 2007 to 2017, and increased by 2.2 percent in 2018 (see fig.). While American Samoa employment varied by year from 2007 to 2018, workers' inflation-adjusted earnings generally declined. American Samoa's economy continues to depend on the territorial government and tuna canning industry as key sectors. Changes in government spending and the tuna canning industry, including cannery closures, have impacted American Samoa's economy. To reduce the territory's dependence on the government and the tuna canning industry, the American Samoa government continues its efforts to diversify the economy. American Samoa's tuna canning industry faces multiple challenges, including increased competition and minimum wage increases, which led to cannery closures from 2007 to 2018. The companies that experienced the closures explained that minimum wage increases were a factor in the closures, but not a main factor. With the closures, employment of cannery workers decreased but inflation-adjusted earnings of cannery workers who maintained their jobs increased. StarKist Co. now operates the single remaining cannery in American Samoa, StarKist Samoa, but faces financial challenges. In addition to increased competition and labor market challenges, the industry faces other challenges, such as lower wages relative to those in American Samoa for cannery workers in other countries. However, American Samoa offers the tuna canning industry advantages relative to the U.S. mainland and other countries, including lower wages compared to those in the U.S. mainland as well as duty-free access to the U.S. canned tuna market, according to StarKist Samoa officials. The American Samoa government and the American Samoa Chamber of Commerce (the Chamber) view the minimum wage increases as conflicting with sustainable economic development, but employers and workers GAO interviewed noted benefits and challenges presented by minimum wage increases. The government supports setting a minimum wage that the economy can support, while the Chamber supports delaying minimum wage increases for the cannery. Employers and workers GAO interviewed noted a potential positive impact on the livelihood of workers but a potential negative impact on the remaining cannery, among other things.


In 2009, CHIPRA increased and equalized federal excise tax rates for cigarettes, roll-your-own tobacco, and small cigars but did not equalize tax rates for pipe tobacco and large cigars—products that can be cigarette substitutes. GAO reported in 2012 and 2014 on the estimated federal revenue losses due to the market shifts from roll-your-own to pipe tobacco and from small to large cigars. This report updates GAO's prior products by examining (1) the market shifts among smoking tobacco products since CHIPRA, (2) the estimated effects on federal revenue if the market shifts had not occurred, and (3) what is known about the revenue effects if Congress were to eliminate current tax disparities between smoking tobacco products. GAO analyzed data from the Department of the Treasury and U.S. Customs and Border Protection to identify sales trends for domestic and imported smoking tobacco products, to estimate the effect on tax collection if market substitutions had not occurred, and to model the effects of equalizing tax rates for smoking tobacco products. Large federal excise tax disparities among similar tobacco products after enactment of the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 led to immediate market shifts (see figure). Specifically, CHIPRA created tax disparities between roll-your-own and pipe tobacco and between small and large cigars, creating opportunities for tax avoidance and leading manufacturers and consumers to shift to the lower-taxed products. Following the market shifts after CHIPRA, the lower-taxed products have sustained their dominant position in their respective markets. Market shifts to avoid increased tobacco taxes following CHIPRA have continued to reduce federal revenue. GAO estimates that federal revenue losses due to market shifts from roll-your-own to pipe tobacco and from small to large cigars range from a total of about $2.5 to $3.9 billion from April 2009 through September 2018, depending on assumptions about how consumers would respond to a tax increase. Federal revenue would likely increase if Congress were to equalize the tax rate for pipe tobacco with the rates currently in effect for roll-your-own tobacco and cigarettes. GAO estimates that federal revenue would increase by a total of approximately $1.3 billion from fiscal year 2019 through fiscal year 2023 if the pipe tobacco tax rate were equalized with the higher rate for roll-your-own tobacco and cigarettes. While equalizing federal excise taxes on small and large cigars should raise revenue based on past experience, the specific revenue effect is unknown because data for conducting this analysis are not available. These data are not collected by the Department of the Treasury because such data are not needed to administer and collect large cigar taxes under the current tax structure.


A 2014 study conducted by the National Center for Education Statistics within the U.S. Department of Education (ED) found that 53% of public elementary and secondary schools need to spend money on repairs, renovations, and modernizations to put their onsite buildings in good overall condition. The study estimated that the nationwide spending necessary to reach this standard would be approximately $197 billion, or about $4.5 million per school that needs improvements. This report provides a description of and background for selected provisions in the Rebuild America's Schools Act of 2019 ( H.R. 865 / S. 266 ), which would provide federal funding for public school construction. H.R. 865 was ordered to be reported by the House Committee on Education and Labor on February 26, 2019. As no action has been taken on the identical companion bill S. 266 since it was introduced in the Senate, this report addresses H.R. 865 . While the construction, renovation, repair, and maintenance of public school facilities are typically the responsibility of state and local governments, the federal government has provided some funding for construction and renovation for specific purposes. H.R. 865 proposes to authorize $70 billion in grants and facilitate $30 billion in school infrastructure tax credit bonds to be used toward the construction and repair of public elementary and secondary school facilities. Funds would be allocated to states proportionally based on their prior-year share of grant allocations under Title I-A of the Elementary and Secondary Education Act (ESEA), a grant program designed to provide educational and related services to low-achieving and other students attending schools with relatively high concentrations of students from low-income families. States are directed to award grant funds provided through the bill to local educational agencies (LEAs) with the highest numbers or percentages of students who are "counted" in the formulas used to allocate ESEA Title I-A grantsâand among LEAs meeting this criterion, to those prioritizing improvement of facilities of public schools that serve the highest percentages of students who qualify for free or reduced price lunches. Additional consideration in the awarding of grants to LEAs may be given to those with school facilities that pose a severe health or safety threat. Funds would also be authorized under H.R. 865 for Impact Aid construction for FY2020 through FY2023 at levels substantially higher than current authorization of appropriations levels. H.R. 865 would place certain restrictions on how funds from grants or bonds may be used. For instance, it specifies for each fiscal year a certain percentage of covered funds that must be used for construction or renovation that is consistent with "green" standards. Additionally, LEAs that receive covered funds from grants or bonds authorized by the bill would be required to ensure that any iron, steel, and manufactured products used in projects are produced in the United States. However, the Secretary of Education would have authority to waive this requirement under certain circumstances. The bill would also require the Institute of Education Sciences to carry out and submit to the appropriate congressional committees a comprehensive study of the physical condition of all public schools in the United States at least once every five years. The Congressional Budget Office estimates that enactment of H.R. 865 would result in an increase of approximately $8.4 billion in direct spending, a decrease of approximately $1.2 billion in revenues, and an increase of approximately $55.6 billion in outlays subject to appropriation in the period from FY2019 to FY2029.


Aerial refueling—the transfer of fuel from airborne tankers to combat and airlift forces—is critical to the U.S. military's ability to effectively operate globally. The Air Force initiated the KC-46 program in 2011 to replace about a third of its aging KC-135 aerial refueling fleet. Boeing was awarded a fixed-price incentive contract to develop the first four aircraft, which are being used for testing. Boeing was also required to deliver the first 18 fully capable aircraft by August 2017. The program plans to eventually field 179 aircraft. This report assesses the program's progress toward meeting cost, schedule, and performance goals. The report also assesses how the program's contracting and sustainment planning approach could inform other acquisition programs. GAO analyzed cost, schedule, performance, test, manufacturing, contracting, and sustainment planning documents; and interviewed officials from the KC-46 program office, other defense offices, such as the Defense Contract Management Agency, the Federal Aviation Administration, and Boeing. Costs for the KC-46 program remain lower than expected, as shown below. The Air Force accepted the first KC-46 in January 2019, but Boeing remains nearly 3 years behind schedule. As shown below, Boeing now plans to deliver the first 18 aircraft with all three aerial refueling subsystems by June 2020. Program officials expect the KC-46 to meet key performance goals over the next few years as it accumulates 50,000 fleet hours. However, the Air Force is accepting aircraft that do not fully meet contract specifications and have critical deficiencies, including ones that affect (1) the operators' ability to guide the fuel delivery boom into position, and (2) the boom itself. The deficiencies could affect operations and cause damage to stealth aircraft being refueled, making them visible to radar. Program officials estimate it will take 3 to 4 years to develop fixes for the deficiencies and a few more years to retrofit up to 106 aircraft. The Air Force and Boeing will incur costs to fix the deficiencies, with the Air Force's portion estimated to be more than $300 million. The Air Force is withholding 20 percent payment on each aircraft until Boeing fixes the deficiencies and non-compliances. Meanwhile, the Air Force has limited some refueling operations. GAO identified a number of insights that could benefit other programs, including the use of a fixed-price-type development contract and a correction of deficiencies clause in the contract that protected the government from some cost increases. The Department of Defense agreed to provide lessons learned about the KC-46 program for future acquisition programs based on a recommendation GAO made in March 2012, but does not plan to do so until development is complete in 2021. GAO believes other programs could benefit from insights identified in this report if they were disseminated sooner.


In 2014, NASA awarded two firm-fixed-price contracts to Boeing and SpaceX, worth a combined total of up to $6.8 billion, to develop crew transportation systems and conduct initial missions to the ISS. In July 2018, GAO found that both contractors continued to delay their certification dates and that further delays were likely. NASA must certify the contractors' crew transportation systems before the contractors can begin operational missions to the ISS. The contractors were originally required to provide NASA all the evidence it needed to certify that their systems met its requirements in 2017. The House Committee on Appropriations included a provision in its 2017 report for GAO to continue to review NASA's human space exploration programs. This is the latest in a series of reports addressing the mandate. This report examines the extent to which the Commercial Crew Program and its contractors have made progress towards certification. To do this work, GAO analyzed contracts, schedules, and other documentation and spoke with officials from the Commercial Crew Program, Boeing, and SpaceX. Both of the Commercial Crew Program's contractors, Boeing and SpaceX, have made progress on their crew transportation systems. However, neither is ready to begin carrying astronauts into space as both continue to experience delays to certification. Certification is a process that the National Aeronautics and Space Administration (NASA) will use to ensure that each contractor's spacecraft, launch vehicle, and ground support systems meet its requirements for human spaceflight before any operational missions to the International Space Station (ISS) can occur. Factors contributing to schedule uncertainty include: Fluctuating schedules. As the contractors continue to build and test hardware—including SpaceX's March 2019 uncrewed test flight— their schedules for certification change frequently. As of May 2019, both contractors had delayed certification nine times, equating to more than 2 years from their original contracts (see figure). This includes several delays since GAO last reported in July 2018. Program Workload. NASA's ability to process certification data packages for its two contractors continues to create uncertainty about the timing of certification. The program has made progress conducting these reviews but much work remains. In addition, the program allowed both contractors to delay submitting evidence that they have met some requirements. This deferral has increased the amount of work remaining for the program prior to certification. In February 2019, NASA acknowledged that delays to certification could continue, and announced plans to extend U.S. access to the ISS through September 2020 by purchasing seats on the Russian Soyuz vehicle. However, this arrangement does not fully address GAO's July 2018 recommendation to develop a contingency plan for ensuring access to the ISS until a Commercial Crew Program contractor is certified. NASA concurred with the recommendation but has not yet implemented it. Continued NASA attention on this issue is needed given the uncertainty associated with the final certification dates.


In 2014, a series of congressional testimonies highlighted problems with veterans' access to care after significant appointment wait times at VA medical centers reportedly resulted in harm to veterans. In response, VHA implemented several initiatives, including same-day services at its medical centers and outpatient clinics. GAO was asked to review the same-day services initiative and VHA's related oversight activities. This report (1) describes how VHA designed and how selected medical centers implemented the same-day services initiative; and (2) examines VHA's efforts to assess the impact of the same-day services initiative on veterans' access to care. GAO reviewed VHA documents, including policies, guidance, and requirements related to same-day services and interviewed VHA officials regarding implementation and oversight. GAO visited six VA medical centers selected for the complexity of services offered, range of wait times, and geographic variation, among other factors. GAO interviewed officials from (1) the six VA medical centers and affiliated outpatient clinics, (2) VHA's networks with oversight responsibility, and (3) two veterans service organizations. The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) introduced its same-day services initiative in primary and mental health care in April 2016, and used a five-pronged approach for its design: it defined same-day services, developed guidance, updated its mental health policies, offered training, and assessed VA medical center readiness to implement the initiative. Officials from all six VA medical centers GAO visited said they already were providing same-day services prior to the initiative and generally relied on previous approaches to implement VHA's same-day-services initiative. However, these officials told GAO that some of VHA's guidance and updated policies were difficult to implement due to long-standing challenges of staffing and space constraints, among others. For example, one medical center official stated that the medical center did not have the appropriate providers readily available to complete the initial mental health assessments of new patients in a timely manner—a new requirement under VHA's updated policies. VHA officials stated that the objectives of the same-day services initiative are to improve veterans' access to care and customer service. However, VHA has not documented these objectives in a directive or developed and documented performance goals that, with associated performance measures, would monitor progress. Although VHA does monitor patient experience scores and the number of same-day appointments, these measures are not tied to specific performance goals. For example, VHA has not specified targets for the number of same-day appointments medical centers should provide. Furthermore, monitoring the number of same-day appointments does not capture all of the ways VA medical centers provide same-day services, such as renewing prescriptions. VHA officials acknowledged the intitiative was quickly developed in response to the 2014 access crisis, and developing new policies or processes, which could include documenting objectives and developing performance goals, was not the priority. Without performance goals and related measures, VHA will continue to be limited in its ability to determine, how, if at all, the same-day services initiative has improved veterans' access to care.


In 2014, the Secretary of Defense directed two reviews of DOD's nuclear enterprise. These reviews made recommendations to address problems with leadership, organization, investment, morale, policy, and procedures, as well as other shortcomings that adversely affected the nuclear deterrence mission. In 2015, DOD conducted a review focused on NC3 systems, which resulted in additional recommendations to improve NC3. The National Defense Authorization Act for Fiscal Year 2017 includes a provision for GAO to review DOD's processes for addressing these recommendations. This report addresses the extent to which DOD has made progress in (1) the implementation and tracking of the recommendations from the 2014 and 2015 nuclear enterprise reviews and (2) addressing sustainment and maintenance-related challenges and planning for the continued sustainment and maintenance of existing defense nuclear enterprise systems. GAO reviewed documents and interviewed DOD officials. This is a public version of a classified report that GAO issued in October 2019. Information that DOD deemed classified has been omitted. The Department of Defense (DOD) continues to make progress in implementing recommendations to improve the nuclear enterprise. These recommendations stemmed from DOD's 2014 internal and independent nuclear enterprise reviews, a U.S. Strategic Command 2014 memorandum, and an internal DOD 2015 report on nuclear command, control, and communications (NC3). Since GAO last reported—in November 2018—an additional five of the 247 sub-recommendations from the 2014 reviews have been closed; 91 remain open. In that time, DOD has also closed two more of the 13 recommendations from the 2015 review; six remain open. However, the key tracking tools DOD uses to provide visibility on the status of the recommendations do not provide current and complete information. For example, for those items that are behind schedule, many of the expected completion dates have not been updated to reflect when the items are now expected to be completed. The current DOD guidance for tracking the recommendations' status does not include a specific requirement to keep the information current in the tracking tools. Until DOD addresses these issues, it will not have a complete and accurate picture of when tasks are expected to be finished, whether progress is being made, whether efforts have stalled, or if there are other challenges. Ensuring that there is current and complete information regarding enduring recommendations would also help inform DOD's effort to monitor the health of the defense nuclear enterprise. DOD and the military services are experiencing challenges related to sustainment and maintenance of nuclear weapon systems and have ongoing and planned initiatives intended to mitigate these challenges. All of the systems we reviewed have been operational since before 1998, making these systems at least 22 years old (see figure). The age of the systems has resulted in maintenance and supply issues. For example, the Ohio -class submarine has experienced the failure of parts that were not originally intended to be replaced. DOD and the services have ongoing and planned efforts to mitigate these challenges, such as improving maintenance processes and sources of supply.


In 2015, Congress granted DOD permanent authority to use agreements known as other transactions to acquire prototype projects that, among other things, demonstrate whether technologies and products can be adapted for DOD's use. This contracting approach can help DOD attract companies that do not typically do business with DOD—such as commercial science and technology firms. This is because other transactions are not subject to certain federal contract laws and requirements. GAO was asked to review DOD's use of other transactions for prototype projects. For the purposes of this report, GAO refers to these instruments as prototype other transactions. This report examines, among other issues, (1) DOD's use of prototype other transactions for fiscal years 2016 through 2018 and (2) the extent to which agreements officers followed established review processes before awarding selected transactions. GAO analyzed Federal Procurement Data System-Next Generation data and examined relevant documents from a non-generalizable sample of 11 prototype other transactions. These transactions represented various dollar values from the four DOD components that had the highest obligations through prototype other transactions in fiscal year 2018. GAO also examined DOD and component policies and interviewed DOD officials. The Department of Defense (DOD) significantly increased its use of agreements known as other transactions for prototype projects from fiscal years 2016 through 2018 (see figure). DOD data shows that companies that typically did not do business with DOD participated to a significant extent on 88 percent of the transactions awarded during this time. The Army awarded the most transactions; some of which were on the behalf of other DOD components that wanted to leverage transactions the Army previously awarded to meet their own components' needs. In nine of the 11 prototype other transactions GAO reviewed, DOD contracting officials, known as agreements officers, followed their components' established review policies before awarding the transactions. Agreements officers did not obtain higher level reviews on the two remaining transactions. In both cases, agency officials reviewed the transactions after GAO brought these situations to their attention and found no issues with the awarded transactions. A Defense Advanced Research Projects Agency agreements officer did not have a higher level review of a $7.8 million transaction before it was awarded, as required. An Army Contracting Command-New Jersey Center Director served as the agreements officer on a $10 million transaction. The Director, who would typically review transactions of this value, had his Branch Chief review this transaction prior to award. The Defense Advanced Research Projects Agency also plans to complete an internal file review of awarded transactions to check compliance with its review policy in fiscal year 2020 and take corrective actions, if necessary. The Army Contracting Command-New Jersey plans to clarify who should review transactions in such situations.


In 2016, TSA began using behavior detection in a more limited way to identify potentially high-risk passengers who exhibit certain behaviors it asserts are indicative of stress, fear, or deception, and refer them for additional screening or, when warranted, to law enforcement. TSA's policies and procedures prohibit unlawful profiling, i.e., screeners are prohibited from selecting passengers for additional screening based on race, ethnicity, or other factors. Allegations of racial profiling have raised questions about TSA's use of behavior detection. GAO was asked to review TSA's measures to prevent behavior detection activities from resulting in unlawful profiling. This report examines, among other things, (1) TSA's oversight of behavior detection activities and (2) the number of complaints alleging violations of civil rights and civil liberties related to passenger screening and actions taken by TSA to address them. GAO reviewed TSA policies and procedures; analyzed passenger complaint data received by TSA from October 2015 through February 2018 and actions taken to address them; and interviewed TSA officials. Complaint data we analyzed alleged conduct that occurred at the screening checkpoint and was not specific to behavior detection activities. Transportation Security Administration (TSA) policy requires managers to ensure behavior detection is conducted without regard to race or ethnicity, among other factors. TSA uses seven oversight checklists to assess whether behavior detection activities are conducted in accordance with TSA policy, such as monitoring whether screeners trained in behavior detection observe and engage passengers correctly. However, these checklists do not instruct supervisors to monitor for indications of profiling. TSA officials stated that the training screeners receive, adherence to operating procedures, and general supervisory oversight are sufficient to alert supervisors to situations when unlawful profiling may occur. However, developing a specific mechanism to monitor behavior detection activities for compliance with policies prohibiting unlawful profiling would provide TSA with greater assurance that screeners are adhering to such policies. From October 2015 through February 2018, TSA received about 3,700 complaints alleging civil rights and civil liberties violations related to passenger screening. These complaints are not specific to behavior detection activities. The TSA Contact Center (TCC), the office that initially receives these complaints, reported that about half of the complaints did not have complete information from passengers necessary for further review, such as the airport and date of the incident. According to TCC officials, they attempt to obtain the additional information from passengers, but often the complaint does not include the correct contact information or the passenger does not respond to the TCC's request for additional information. The TCC complaint data show that the remaining 51 percent (about 1,900) of complaints were referred to the TSA Multicultural Branch, the office responsible for reviewing complaints alleging civil rights and civil liberties violations. The Multicultural Branch reported reviewing 2,059 complaints, including approximately 1,900 complaints from TCC, as well as complaints referred from other TSA offices. For about half of the complaints (1,066) the Multicultural Branch reviewed, it found indications of potential discrimination and unprofessional conduct that involved race or other factors and recommended a range of refresher training across airports or for screeners at individual airports identified in the complaints. TSA's Multicultural Branch Reviewed 2,059 Complaints Alleging Violations of Civil Rights and Civil Liberties from October 2015 through February 2018


In 2016, about 323,000 individuals age 12 or older were reported victims of sexual assault, according to the Bureau of Justice Statistics. Studies have shown that exams performed by sexual assault forensic examiners—medical providers trained in collecting and preserving forensic evidence—may result in better physical and mental health care for victims, better evidence collection, and higher prosecution rates. Yet, concerns have been raised about the availability of such examiners. The Department of Justice administers grant programs that can be used by states and other eligible entities to train and fund examiners. This statement summarizes GAO's findings from its March 2016 report ( GAO-16-334 ) describing (1) what was known in 2016 about the availability of sexual assault forensic examiners nationally and in selected states and (2) the challenges selected states faced in maintaining a supply of sexual assault forensic examiners. For that report, GAO reviewed literature on the availability of examiners and challenges training and retaining them. GAO also interviewed knowledgeable officials, including recipients of federal sexual assault examiner related grants and officials from sexual assault coalitions in six states (Colorado, Florida, Massachusetts, Nebraska, Oregon, and Wisconsin) selected to achieve variation in factors such as population and geographic location. GAO's March 2016 report examining the availability of sexual assault forensic examiners found that only limited nationwide data existed on the availability of sexual assault forensic examiners—both the number of practicing examiners and health care facilities that had examiner programs. At the state level, GAO found that, in three of the six states it selected to review, grant administrators or officials from sexual assault coalitions were able to provide estimates of the number of practicing examiners and, in all six states, they were able to provide information on the estimated number of examiner program locations in their state. However, officials in all six selected states told GAO that the number of examiners available in their state did not meet the need for exams, especially in rural areas. For example, officials in Wisconsin explained that nearly half of all counties in the state did not have any sexual assault examiner programs available and officials in Nebraska told GAO that most counties in the state did not have examiner programs available. As a consequence, officials said victims may need to travel long distances to be examined by a trained examiner. In health care facilities where examiners were available, they were typically available in hospitals on an on-call basis, though the number available varied by facility and may not provide enough capacity to offer examiner coverage 24 hours, 7 days a week. GAO's March 2016 report also found there were multiple challenges to maintaining a supply of examiners, according to its review of the literature and interviews with officials in the six selected states. These challenges include: Limited availability of training . Officials in five of the six selected states reported that the limited availability of classroom, clinical, and continuing education training opportunities is a challenge to maintaining a supply of trained examiners. For example, officials told us that there is a need for qualified instructors to run training sessions. Weak stakeholder support for examiners. Officials in five of the six selected states reported that obtaining support from stakeholders, such as hospitals, was a challenge. For example, hospitals may be reluctant to cover the costs of training examiners or pay for examiners to be on call. Low examiner retention rates. The above-mentioned and other challenges, including the emotional and physical demands on examiners, contribute to low examiner retention rates. Officials in one of the selected states estimated that while the state trained 540 examiners over a two-year period, only 42 of those examiners were still practicing in the state at the end of those 2 years. Officials described a variety of strategies they have employed that can help address these challenges, such as implementing web-based training courses, clinical practice labs, mentorship programs, and multidisciplinary teams that respond to cases of sexual assault.


In 2017 and 2018, deadly wildfires struck the state of California, tragically resulting in 159 deaths and over 32,000 structures destroyed. FEMA, as the lead federal agency for responding to and recovering from disasters, has obligated about $2 billion in housing, debris removal, and other assistance following these disasters. According to recent environmental assessments, fire seasons are increasing in length, putting more people and infrastructure at risk. GAO was asked to assess a range of response and recovery issues related to the 2017 disasters. Specifically, this report addresses (1) the assistance FEMA provided to jurisdictions in response to major disaster declarations stemming from wildfires from 2015 through 2018, (2) selected jurisdictions' perspectives on FEMA wildfire response and recovery efforts, and (3) the extent to which FEMA has identified and addressed key lessons learned. GAO obtained data on FEMA wildfire disaster assistance and statistics on fire damages and fatalities; reviewed key documentation, such as incident action plans and after action reports; and interviewed officials from FEMA headquarters and regional offices, states, and a nonprobability sample of affected local jurisdictions (e.g., counties). For wildfire-related major disaster declarations from 2015 through 2018, the Federal Emergency Management Agency (FEMA)—consistent with its authorities and responsibilities—helped state and local officials obtain and coordinate federal resources to provide for the needs of wildfire survivors and execute recovery efforts. This support totalled over $2.4 billion and included providing staff to assist at Emergency Operations Centers and establishing Disaster Recovery Centers to coordinate disaster assistance services for survivors. In addition, FEMA provided Public Assistance grant funds to local jurisdictions to help address community infrastructure needs, such as debris removal. FEMA also assigned federal agencies to perform various missions to help with response and recovery—for example, the U.S. Army Corps of Engineers was assigned with contracting for debris removal services in some instances. Officials from jurisdictions that GAO spoke with described practices that aided in wildfire response and recovery, but also reported experiencing challenges. Specifically, officials in affected areas noted that collaboration between FEMA and California's Office of Emergency Services allowed for timely information sharing, and FEMA's assistance at Disaster Recovery Centers greatly assisted survivors in obtaining necessary services. Among the challenges cited were onerous documentation requirements for FEMA's Public Assistance grant program and locating temporary housing for survivors whose homes were completely destroyed. In addition, the unique challenge of removing wildfire debris led to confusion over soil excavation standards and led to overexcavation on some homeowners' lots, lengthening the rebuilding process. FEMA has developed an after-action report identifying lessons learned from the October and December 2017 wildfires, but could benefit from a more comprehensive assessment of its operations to determine if additional actions are needed to ensure that policies and procedures are best suited to prepare for future wildfires. The combination of recent devastating wildfires and projections for increased wildfire activity suggest a potential change in FEMA's operating environment. According to Standards for Internal Control in the Federal Government , such changes should be analyzed and addressed to help ensure that agencies maintain their effectiveness.


In 2017 and 2018, the Attorney General directed federal prosecutors to prioritize prosecutions of immigration-related offenses, including improper entry into the United States, illegal reentry after a prior removal from the country, and alien smuggling, among other offenses. Most individuals prosecuted for such offenses are arrested by DHS's U.S. Border Patrol and referred to DOJ's USAOs for prosecution in federal court. GAO was asked to review the actions DOJ, DHS, and the federal judiciary took in response to the 2017 and 2018 memoranda. GAO reviewed (1) how DOJ prioritized prosecutions of immigration-related offenses in response to the Attorney General's memoranda, (2) what DHS and DOJ data from fiscal years 2014 through 2018 indicate about such prosecutions, and (3) resources that DOJ, DHS, and the federal judiciary used to support increased immigration-related prosecutions. GAO visited three of the five southwest border USAO districts and interviewed DOJ, DHS, and federal judiciary officials by phone from the other two districts. GAO also analyzed U.S. Border Patrol data on its arrests and prosecution referrals from fiscal years 2014 through 2018; analyzed Executive Office for U.S. Attorneys data on its prosecutions from fiscal years 2014 through 2018; and reviewed relevant laws and DOJ, DHS, and federal judiciary policies, operational guidance, and budget data. This is a public version of a sensitive report that GAO issued in August 2019. Information that DOJ, DHS, or the federal judiciary deemed sensitive has been removed. Department of Justice (DOJ) U.S. Attorney's Offices (USAO) in all five districts along the southwest border—Arizona, California Southern, New Mexico, Texas Southern, and Texas Western—have adopted prosecution priorities aligned with the Attorney General's prioritization of criminal immigration enforcement. In particular, all five USAOs prioritized misdemeanor improper entry cases in response to the Attorney General's 2017 and 2018 memoranda. Some USAOs, such as Arizona, were able to quickly increase such prosecutions using existing practices. In other districts, such as California Southern, USAOs had to establish new practices in coordination with other stakeholders in the federal criminal prosecution process—including the Department of Homeland Security (DHS), other DOJ components such as the U.S. Marshals Service (USMS), and the federal judiciary—before they could begin accepting a significant number of improper entry cases. Note: The lead charge is typically the most serious charged offense at the time the case is filed. The number of improper entry cases more than doubled from fiscal year 2017 (about 27,000) to fiscal year 2018 (about 62,000). In fiscal year 2018, about 84 percent of all improper entry cases filed were completed in districts with one-day improper entry court proceedings. In these proceedings, the initial hearing, presentation of evidence, plea, and sentencing took place in one day or less. DOJ, DHS, and the federal judiciary realigned resources to support the prosecution priorities outlined in the 2017 and 2018 memoranda, including personnel and physical space. In addition, agencies temporarily surged personnel to the southwest border. For example, USMS reassigned personnel from other enforcement areas to judicial security duties to support increased immigration-related prosecutions.


In 2017 two major hurricanes – Irma and Maria – caused extensive damage throughout Puerto Rico. Hurricane Maria, a Category 4 hurricane, was the most intense hurricane to make landfall in Puerto Rico since 1928, destroying roads, buildings, and cutting power and communication lines, among other things. Puerto Rico estimates that $132 billion will be needed to repair and reconstruct infrastructure and services. FEMA—a component of the Department of Homeland Security (DHS)—is the lead federal agency responsible for assisting Puerto Rico as it recovers. FEMA administers the Public Assistance program in partnership with Puerto Rico to provide funds to rebuild damaged infrastructure and restore critically-needed services. GAO was asked to review the federal government's recovery efforts related to the 2017 hurricanes. This report, among other objectives, describes (1) FEMA's Public Assistance spending in Puerto Rico and oversight efforts of federal recovery funds, and (2) initial challenges with the recovery process. GAO reviewed Public Assistance program documents; analyzed grant funding data; and interviewed officials from Puerto Rico and DHS about the Public Assistance program and recovery efforts, as well as officials from ten municipalities selected on the basis of population and Public Assistance spending. GAO is not making recommendations at this time, but will continue monitoring the recovery as part of its ongoing work. The Federal Emergency Management Agency (FEMA) obligated almost $4 billion in Public Assistance grant funding to Puerto Rico as of September 30, 2018 in response to the 2017 hurricanes. FEMA obligated about $3.63 billion for emergency work—emergency measures such as debris removal and generators—and about $151 million for permanent work to repair and replace public infrastructure such as roads (see figure). Puerto Rico established a central recovery office to oversee federal recovery funds and is developing an internal controls plan to help ensure better management and accountability of the funds. In the interim, FEMA instituted a manual reimbursement process—requiring FEMA to review each reimbursement request before providing Public Assistance funds—to mitigate risk and help ensure financial accountability. FEMA officials stated that they will remove this manual process once the agency approves Puerto Rico's internal controls plan. Officials from FEMA and Puerto Rico's central recovery office and municipalities that GAO interviewed reported initial challenges with the recovery process, including with Public Assistance alternative procedures. Unlike in the standard Public Assistance program where FEMA will fund the actual cost of a project, the Public Assistance alternative procedures allow awards for permanent work projects to be made on the basis of fixed cost estimates to provide financial incentives for the timely and cost-effective completion of work. Challenges identified included concerns about lack of experience and knowledge of the alternative procedures being applied in Puerto Rico; concerns about missing, incomplete, or conflicting guidance on the alternative procedures; and concerns that municipalities have not been fully reimbursed for work already completed in the immediate aftermath of the hurricanes, causing financial hardships in some municipalities. FEMA officials stated that the agency is taking actions to address reported recovery challenges, such as leveraging existing expertise to train personnel and developing supplemental guidance on alternative procedures and reducing delays in reimbursements. GAO will continue to monitor these issues and plans to report additional findings and recommendations as appropriate later this year.


In 2017, Hurricanes Irma and Maria damaged much of the electricity grids' transmission and distribution systems in USVI and Puerto Rico. The hurricanes left most of USVI's 106,405 people and all of Puerto Rico's 3.3 million without power and resulted in the longest blackout in U.S. history. Under the National Response Framework, electric utilities are responsible for repairing infrastructure and restoring service. They often use mutual assistance—voluntary partnerships with other electric utilities—to bring in additional resources to help restore electricity. Federal agencies provide financial assistance; help coordinate the federal response; and in severe emergencies, provide logistical support, such as assisting in damage assessments and location and transportation of repair crews and equipment. GAO was asked to review the federal response to the 2017 hurricanes. This report provides information on federal support for restoring the electricity grids in Puerto Rico and USVI and factors affecting this support. GAO has ongoing work examining federal support to improve grid resilience in Puerto Rico. GAO reviewed agency documents and funding data through July 20, 2018, the most recent data available; interviewed officials from FEMA, DOE, and USACE; and conducted site visits to Puerto Rico and USVI. Federal agencies supported efforts to restore electricity in the U.S. Virgin Islands (USVI) and Puerto Rico through the types of support they traditionally provide following disasters and, in Puerto Rico, in some unprecedented ways. USVI. Federal agencies provided traditional federal support to the electric utility's restoration efforts. For example, the Federal Emergency Management Agency (FEMA) provided financial assistance through its Public Assistance Program, and the Department of Energy (DOE) provided subject matter expertise to assist the local utility. In addition, the U.S. Army Corps of Engineers (USACE) provided generators for hospitals and other critical facilities. FEMA obligated about $795 million for these efforts as of July 20, 2018. According to the local utility, it took about 5 months for power to be restored to all customers with structures deemed safe for power restoration. Puerto Rico. In addition to the traditional types of support, FEMA and USACE undertook unprecedented roles of helping to coordinate and directly assist with grid restoration in Puerto Rico. FEMA requested that USACE lead federal grid repair efforts because of the scale of the damage and because the Puerto Rico Electric Power Authority (PREPA) did not have the capacity to respond, according to FEMA officials. FEMA obligated about $3.2 billion for electricity restoration efforts as of July 20, 2018, and PREPA estimated that it took roughly 11 months for power to be restored to all customers with structures deemed safe for power restoration. Various factors affected federal support for electricity grid restoration, according to officials GAO interviewed and documents reviewed. For example, getting the crews and materials needed to islands was more difficult and time-consuming than on the mainland. In Puerto Rico, PREPA was insolvent, which presented challenges for restoring the grid. For example, PREPA canceled its vegetation management program; this contributed to the destruction of the grid when the hurricane arrived, according to FEMA officials. In addition, FEMA did not anticipate or plan for the extensive federal role in grid restoration in Puerto Rico, and USACE did not have a contract in place to immediately initiate grid repair efforts, according to USACE officials. FEMA and USACE identified potential actions to address these challenges, such as reviewing advance contracts.


Afghanistan has been a significant U.S. foreign policy concern since 2001, when the United States, in response to the terrorist attacks of September 11, 2001, led a military campaign against Al Qaeda and the Taliban government that harbored and supported it. In the intervening 18 years, the United States has suffered approximately 2,400 military fatalities in Afghanistan, with the cost of military operations reaching nearly $750 billion. Congress has appropriated approximately $133 billion for reconstruction. In that time, an elected Afghan government has replaced the Taliban, and most measures of human development have improved, although Afghanistan's future prospects remain mixed in light of the country's ongoing violent conflict and political contention. Topics covered in this report include: Security dynamics . U.S. and Afghan forces, along with international partners, combat a Taliban insurgency that is, by many measures, in a stronger military position now than at any point since 2001. Many observers assess that a full-scale U.S. withdrawal would lead to the collapse of the Afghan government and perhaps even the reestablishment of Taliban control over most of the country. Taliban insurgents operate alongside, and in periodic competition with, an array of other armed groups, including regional affiliates of Al Qaeda (a longtime Taliban ally) and the Islamic State (a Taliban foe and increasing focus of U.S. policy). U.S. military engagement . The size and goals of U.S. military operations in Afghanistan have evolved over the course of the 18-year war, the longest in American history. Various factors, including changes in the security situation and competing U.S. priorities, have necessitated adjustments. While some press reports indicate that the Trump Administration may be considering at least a partial withdrawal, U.S. officials maintain that no decision has been made to reduce U.S. force levels. Regional context . Afghanistan has long been an arena for, and victim of, regional and great power competition. Pakistan's long-standing, if generally covert, support for the Taliban makes it the neighbor whose influence is considered the most important. Other actors include Russia and Iran (both former Taliban foes now providing some measure of support to the group); India (Pakistan's main rival); and China. Reconciliation efforts. U.S. officials have long contended that there is no military solution to the war in Afghanistan. Direct U.S.-Taliban negotiations, ongoing since mid-2018, on the issues of counterterrorism and the presence of U.S. troops could offer greater progress than past efforts. However, U.S. negotiators caution that the Taliban's continued refusal to negotiate with the Afghan government could preclude the stated U.S. goal of a comprehensive settlement. Afghan governance and politics. Afghanistan's democratic system has achieved some success since its post-2001 establishment, but corruption, an evident failure to provide sufficient security and services, and infighting between political elites has undermined it. The unsettled state of Afghan politics complicates ongoing efforts to negotiate a settlement: the presidential election has been postponed twice and is now scheduled for September 2019. U.S. and foreign assistance. Military operations have been complemented by large amounts of development assistance; since 2001, Afghanistan has been the largest single recipient of U.S. aid. Most of that assistance has been for the Afghan military (a trend particularly pronounced in recent years), but aid has also supported efforts to build Afghan government capacity, develop the Afghan economy, and promote human rights.


In 2017, State initiated a series of reform efforts in response to an executive order by the President and guidance issued by the Office of Management and Budget aimed at reorganizing and streamlining the government. GAO's prior work has shown that successful agency reform efforts follow key implementation practices, such as establishing a dedicated team to manage the implementation of reforms, and ensuring transparency by setting public goals and milestones to monitor progress. This report examines (1) the status of the reform efforts that State reported to Congress in February 2018 and (2) the extent to which State addressed key practices critical to the successful implementation of agency reform efforts. GAO reviewed State's reform plans, proposals, and related documents; met with officials involved in State's reform efforts; and assessed implementation of the reform efforts against relevant key practices identified in GAO's prior work. The Department of State (State) is implementing most of the 17 reform projects it reported to Congress in February 2018, but a few are stalled or discontinued. State completed one project streamlining policy formulation, and continues working to implement 13 projects on topics including human resources, information technology, and data analytics. Progress on two projects related to overseas presence has stalled, and State has discontinued a project to consolidate real property management. State has not addressed certain key practices related to leadership focus and attention in implementing its reform efforts. Multiple transitions in State's leadership and changing priorities contributed to uncertainty about leadership support for reform projects.Top leadership is expected to drive any needed transformation by clarifying priorities and communicating direction to employees and stakeholders. In March 2018, the President replaced the Secretary of State, a transition that created uncertainty within the agency regarding the future of ongoing reform projects. While some officials stated that the new Secretary had expressed support for data analytics and cyber security reform efforts, other officials said they were unclear as to whether their projects remained a priority. According to senior officials, the current Secretary has focused on critical needs, such as ending the hiring freeze and increasing recruitment, and on launching new initiatives. In April 2018, State disbanded the dedicated teams overseeing its reform efforts and shifted responsibility to bureaus and offices. In some cases, officials assigned to lead reform projects reported receiving little or no direction from department leadership. GAO's prior work has highlighted the benefits of having a dedicated team to manage agency transformations. In addition, State officials indicated that the challenges posed by these transitions were compounded by a lack of Senate-confirmed leadership in key positions. Specifically, during the first 2 years of State's reform efforts, bureaus and offices responsible for implementing 12 of State's 13 continuing reform projects reported directly to one or more officials serving in an acting capacity. For example, State did not have a Senate-confirmed Under Secretary for Management from January 2017 to May 2019, which, according to senior officials, hindered State's reform efforts. According to State officials, taken together these leadership transitions led to several projects being scaled back, slowed down, or both. Although uncertainties exist about leadership priorities regarding the reform efforts, the bureaus and offices responsible for implementing reform projects have taken steps to manage and monitor them, consistent with key practices. Each of the continuing projects has implementation plans that include milestones and deliverables, and some report their progress publicly. For example, State reports on the progress of some projects in its annual performance plans and reports. The lack of a dedicated team to manage the reform process, however, could slow State's overall efforts.


In 2017, an estimated 11.1 million Americans misused a prescription pain reliever, which included opioids. This misuse contributes to opioid abuse and death, which has quintupled from 1999 to 2017; about 17,000 people died from prescription opioid overdoses in 2017. Government agencies and stakeholders have attempted to address the potential for misuse and abuse by facilitating safe disposal of unused prescription opioids and other drugs. The SUPPORT for Patients and Communities Act enacted in 2018 included a provision for GAO to review patient disposal of unused opioids, among other things. This report examines (1) federally recommended and other available methods patients may use to dispose of unused prescription opioids, and (2) what is known about patients' use of these methods. To do this work, GAO examined peer-reviewed, academic literature on outcomes for prescription opioid disposal; reviewed federal agency documentation; interviewed federal agency officials, independent researchers, and stakeholder group representatives—such as those from the American Medical Association; and analyzed DEA data as of April 2019 on permanent drug collection sites. GAO also interviewed representatives of three companies that manufacture commercial in-home disposal products and reviewed publicly available documents about these products. The Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), and Environmental Protection Agency (EPA) recommend that patients dispose of unused presciption opioids by bringing them to DEA-registered collection sites or a DEA take-back event, or using mail-back programs. As of April 2019, 70 percent of the U.S. population lived less than 5 miles from permanent collection sites, which are often located at pharmacies. If collection sites, take-back events, or mail-back programs are not feasible, FDA recommends quickly and permanently removing the most dangerous prescription opioids, such as hydrocodone and fentanyl, from the home by flushing them down the toilet. For all other prescription opioids, the agencies recommend disposal in the trash after mixing them with unpalatable substances, such as cat litter. Commercial products to facilitate in-home disposal also exist, and FDA is aware that patients may opt to use these products for disposal in the trash. Available studies suggest that many patients are unaware of federally recommended disposal methods or choose not to dispose of unused prescription opioids. For example, five studies found that between one-quarter and three-quarters of patients stored unused opioids for future use or had misplaced their unused opioids. Further, federal data indicate that 85 percent of intentional misuse occurs with the patient's knowledge—for example, when a patient sells or gives away unused prescription opioids. To educate and motivate patients to dispose of unused opioids, FDA launched a public awareness campaign called “Remove the Risk” in April 2019. Also, FDA and other stakeholders have created educational materials for patients and providers on safe opioid disposal.


In 2017, hurricanes in Texas, Florida, and Puerto Rico caused $1 billion in estimated damage. FHWA's Emergency Relief Program provides funding for states to repair or reconstruct federal-aid highways damaged or destroyed by natural disasters, including funding for emergency and permanent repairs. As of September 2019, FHWA has allocated $634 million in federal funds to the two states and Puerto Rico. By statute, emergency repairs are undertaken during or immediately following a disaster to quickly restore essential traffic and minimize further damage. These repairs receive 100 percent federal reimbursement if accomplished within 180 days and may proceed under expedited contracting and environmental procedures. GAO was asked to evaluate the federal response to the 2017 disasters. This report assesses how FHWA applied program guidance to classify selected emergency relief projects, among other objectives. GAO visited 33 out of approximately 2,500 projects in Texas, Florida, and Puerto Rico; analyzed 25 emergency repair project files; and interviewed FHWA, state, and local government officials. GAO found that the Federal Highway Administration (FHWA) did not document the bases for decisions to classify projects as emergency repairs in 22 of the 25 project files reviewed. Without such documentation, it is not possible to definitively determine the justification for these decisions; GAO identified at least three projects that may have been inappropriately classified. For example, FHWA classified a $10.7 million ferry project in Lynchburg, Texas as an emergency repair to restore essential traffic. Several highways, however, were available immediately following the disaster that service the same locations and result in faster travel times than the ferry. FHWA guidance does not require officials to document decisions to classify projects as emergency repairs or clearly define what constitutes restoration of essential traffic. Designating projects as emergency repairs can increase the federal fiscal exposure in disasters. Had FHWA classified the ferry project as a permanent repair—instead of an emergency repair—the state would have been responsible for paying approximately $2.1 million in matching funds. GAO also identified two temporary bridge projects in Puerto Rico classified as emergency repairs even though (1) work did not start within180 days of a disaster, as generally required; (2) the bridges are not to be completed until late 2019 and early 2020; and (3) both are to be replaced by permanent bridges within a couple of years. Out of approximately 1,200 eligible projects in Puerto Rico, FHWA officials reported undertaking 34, including the two bridges GAO identified, after 180 days. Officials also stated they did not document the basis for continuing to classify these projects as emergency repairs. FHWA officials in Puerto Rico stated they were not required to complete repairs within the 180 day limit established in law because Congress exempted Puerto Rico from federal matching share requirements. Further, emergency repair projects are allowed to expedite contracting and environmental procedures. After GAO raised this issue with FHWA, the agency stated that emergency repair projects are only permitted to use these expedited procedures within the first 180 days. While officials stated they plan to update guidance to include this policy, there is no specific timeline for doing so.


In 2017, nearly 1,400 health centers provided care to more than 27 million people, regardless of their ability to pay. Health centers were established to increase the availability of primary and preventive health services for low-income people living in medically underserved areas. Health centers rely on revenue from a variety of public and private sources, including revenue from CHCF grants. HRSA began awarding grants funded by the CHCF in fiscal year 2011. GAO was asked to review the sources and amounts of health center revenue. This report describes (1) trends in health centers' revenue and (2) the purposes for which CHCF grants have been awarded. GAO analyzed HRSA data collected from health centers and compiled in its Uniform Data System to identify the sources and amounts of revenue health centers received from 2010 through 2017, the most recent data at the time of GAO's analysis. GAO also reviewed HRSA grant documentation for grants funded by the CHCF for fiscal years 2011-2017—the most recent data at the time of GAO's analysis—including information on the award amount and purpose of the grant, and reviewed published studies that described the purposes for which CHCF grants have been made. Additionally, GAO interviewed HRSA officials, authors of the published studies, and an association representing health centers. GAO provided a draft of this report to HHS. HHS provided technical comments, which GAO incorporated as appropriate. Health centers' revenue more than doubled from calendar years 2010 through 2017, from $12.7 billion to $26.3 billion. Health centers' revenue comes from a variety of sources, including reimbursements from Medicaid, Medicare, private insurance, and federal and state grants. While total health center revenue increased from 2010 through 2017, the share of revenue from each source changed in different ways. In particular, revenue from federal and state grants decreased from 38.0 percent of total revenue in 2010 to about 30.2 percent of total revenue in 2017 while reimbursements from Medicaid, Medicare, and private insurance increased. Over the same time period, the number of health centers increased from 1,124 centers in 2010 to 1,373 centers in 2017. In addition, the number of patients served over the same time period increased by 7.7 million patients, from 19.5 million to 27.2 million. GAO's analysis of Health Resources and Services Administration (HRSA) data shows that from fiscal years 2011 through 2017, health centers received approximately $15.8 billion in federal grants funded by the Community Health Center Fund (CHCF), which was established by the Patient Protection and Affordable Care Act in 2010. Of this total amount, 79.7 percent—or $12.6 billion—was awarded for the purpose of maintaining operations at existing health centers (see figure). According to HRSA officials, these CHCF grants are used to fill the gap between what it costs to operate a health center and the amount of revenue a health center receives. As such, officials explained, the awards are a primary means through which health centers provide health care services that may be uncompensated, including services for uninsured patients or services not typically reimbursed by other payers, such as adult dental care. The remaining $3.2 billion in CHCF grants were made to increase the amount of services provided at existing health centers; increase the number of health centers and sites; and other special initiatives, such as implementing health information technology.


In 2017, the Navy had four mishaps at sea including two collisions that resulted in the loss of 17 sailors' lives and hundreds of millions of dollars in damage to Navy ships. In the wake of those mishaps, the Navy identified deficiencies in SWO ship-driving training and related experience as contributing factors and has undertaken a number of efforts to improve these areas. Senate Report 115-262, accompanying a bill for the Fiscal Year 2019 National Defense Authorization Act, contained a provision that GAO assess SWO training. This report (1) describes the changes the Navy has made to SWO ship-driving training since the 2017 collisions and (2) assesses the extent to which the Navy has taken actions to evaluate the effectiveness of changes made to SWO ship-driving training. GAO reviewed and analyzed changes made to Navy training and assessment practices and related investments; interviewed cognizant officials; and conducted discussions with SWOs aboard 12 ships. Since 2017, the Navy has made numerous changes and plans additional changes to enhance Surface Warfare Officer (SWO) ship-driving training. The Navy plans for these changes to result in a threefold increase in the number of initial ship-driving training hours for SWOs by 2021, compared with the number of training hours prior to the 2017 collisions (see fig.). The Navy added classroom and simulator time to existing training courses to improve ship-driving skills and is developing two additional simulator-based ship-driving courses planned for 2021. These plans hinge on the completion of two new simulator-based training facilities, scheduled for completion in June 2021 and in January 2023. The Navy has relied on added skill checks conducted throughout a SWO's career to ensure that each SWO has basic ship-driving skills, but has not put key processes and assessments in place to evaluate comprehensively the effectiveness of its changes to ship-driving training. Senior Navy officials stated that it could take 16 years or more to know if the planned changes to SWO training were effective in increasing Commanding Officer ship-driving proficiency across the fleet and stated that they intend to closely monitor the implementation of changes to the training. However, GAO found that in planning an approach for evaluating the changes, the Navy has not: (1) identified a method to solicit fleet-wide feedback on the quality of the increased ship-driving training received by SWOs; (2) planned to routinely conduct ship-driving competency “spot checks” that were instituted after the 2017 collisions despite Navy inspectors having found concerns with more than 80 percent of SWOs' ship-driving skills; (3) provided standard criteria to ship Commanding Officers for qualifying SWOs to drive ships, contributing to significant variance in ship-driving experience and competency levels across the fleet; nor (4) developed a specific plan to analyze and use information from logbooks in which SWOs are to document ship-driving and related experience. Without addressing these challenges, the Navy cannot assess in the near term if the significant investments made to expand and enhance SWO ship-driving training are effective; further adjustments are necessary; and Navy ships are being operated safely at sea.