Court Orders Toledo Pharmacy and Two Pharmacists to Stop Dispensing Dangerous Doses and Combinations of Opioids and Other Controlled Substances

A federal court in Ohio ordered a Toledo pharmacy and two of its pharmacists to pay a $375,000 civil penalty and imposed restrictions related to the dispensing of opioids and other controlled substances.

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    In Crime News
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    Both the executive branch and congressional committees need evaluative information to help them make decisions about the programs they oversee—information that tells them whether, and why, a program is working well or not. The Government Performance and Results Act of 1993 (GPRA) and GPRA Modernization Act of 2010 (GPRAMA) established a framework for performance management and accountability within the federal government. Building on that foundation, Congress has since passed, among other laws, the Foundations for Evidence-Based Policymaking Act of 2018 (Evidence Act) to strengthen the evidence-building efforts of executive branch agencies. This product updates our previous glossary (GAO-11-646SP) to highlight different types of evaluations for answering questions about program performance, as well as relevant issues to ensure study quality. This glossary can help agency officials better understand fundamental concepts related to evaluation and enhance their evidence-building capacity. For more information, contact Lawrance Evans, Jr. at 202-512-2700 or EvansL@gao.gov.
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    In U.S GAO News
    During fiscal years 2018 and 2019, the Department of Housing and Urban Development (HUD) obligated about $421 million through two grant programs to state and local governments to help identify and control lead paint hazards in housing for low-income households. HUD also issued guidelines for evaluating and controlling lead paint hazards, generally encouraging abatement (such as replacing building components containing lead) as the preferred long-term solution. HUD has supported research on lead paint hazard control and provided education and outreach to public housing agencies, property owners, and the public through publications and training events. HUD monitors lead paint-related risks in its Project-Based Rental Assistance Program, one of HUD's three largest rental assistance programs, through management reviews and periodic physical inspections, but has not conducted a comprehensive risk assessment to identify properties posing the greatest risk to children under the age of 6. HUD's management reviews include assessing property owners' compliance with lead paint regulations—such as by reviewing lead disclosure forms, records of lead inspections, and plans to address lead paint hazards. Inspectors from HUD's Real Estate Assessment Center also assess the physical condition of properties, including identifying damaged paint that could indicate lead paint risks. According to HUD officials, they have not conducted risk assessments in project-based rental assistance housing because they believe the program has relatively few older and potentially riskier properties. However, GAO's analysis of HUD data found that 21 percent of project-based rental assistance properties have at least one building constructed before 1978 (when lead paint was banned in homes) and house over 138,000 children under the age of 6. If HUD used available program data to inform periodic risk assessments, HUD could identify which of the properties pose the greatest risk of exposure to lead paint hazards for children under the age of 6. Unless HUD develops a strategy for managing the risks associated with lead paint and lead paint hazards in project-based rental assistance housing, it may miss the opportunity to prevent children under the age of 6 from being inadvertently exposed to lead paint in those properties. Project-Based Rental Assistance Properties with at Least One Building Built before 1978 and That House Children under Age 6, as of December 31, 2019 Note: Children under the age of 6 are at the greatest risk of lead exposure because they have frequent hand-to-mouth contact, often crawl on the floor, and ingest nonfood items. Lead paint exposure in children under the age of 6 can cause brain damage, slowed development, and learning and behavioral problems. Exposure to lead paint hazards can cause serious harm to children under 6 years old. HUD is required by law to reduce the risk of lead paint hazards in HUD-assisted rental housing—including project-based rental assistance (subsidies to make privately owned multifamily properties affordable to low-income households). The 2019 Consolidated Appropriations Act Joint Explanatory Statement includes a provision for GAO to review, among other things, HUD's oversight of lead paint and related hazards in affordable rental housing. This report (1) describes how HUD programs and guidance address lead paint hazards in HUD-assisted and other low-income rental housing, and (2) examines HUD's oversight procedures for assessing risk for lead paint hazards in project-based rental assistance housing. GAO reviewed HUD and Environmental Protection Agency (EPA) lead paint regulations and documents on lead programs and methods for addressing lead paint hazards. GAO reviewed HUD oversight policies and procedures and analyzed HUD data on building and tenant age. GAO interviewed staff at HUD, EPA, and organizations that advocate for safe affordable housing. GAO recommends that HUD (1) conduct periodic risk assessments for the Project-Based Rental Assistance Program and (2) develop and implement plans to proactively manage identified lead paint risks. HUD agreed to conduct periodic risk assessments and develop and implement a plan to proactively manage risks. For more information, contact John H. Pendleton at (202) 512-8678 or pendletonj@gao.gov.
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    In Crime News
    The daughter of the leader of the Mexican drug trafficking organization known as the Cartel de Jalisco Nueva Generacion (CJNG), a  dual U.S.-Mexican citizen, was sentenced today to 30 months in prison for willfully engaging in financial dealings with Mexican companies that had been identified as specially designated narcotics traffickers by the Office of Foreign Assets Control of the U.S. Department of the Treasury (OFAC). 
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    In U.S GAO News
    The Department of Energy (DOE) and its national labs have taken several steps to address potential barriers to technology transfer—the process of providing DOE technologies, knowledge, or expertise to other entities. GAO characterized these barriers as (1) gaps in funding, (2) legal and administrative barriers, and (3) lack of alignment between DOE research and industry needs. For example, the “valley of death” is a gap between the end of public funding and start of private-sector funding. DOE partly addresses this gap with its Technology Commercialization Fund, which provides grants of $100,000 to $1.5 million to DOE researchers to advance promising technologies with private-sector partners. Further, DOE's Energy I-Corps program trains researchers to commercialize new technologies and to identify industry needs and potential customers. However, DOE has not assessed how many and which types of researchers would benefit from such training. Without doing so, DOE will not have the information needed to ensure its training resources target the researchers who would benefit most. Illustration of Funding Gap for Commercializing New Technologies DOE plans and tracks the performance of its technology transfer activities by setting strategic goals and objectives and annually collecting department-wide technology transfer measures, such as the number of patented inventions and licenses. However, the department does not have objective and measurable performance goals to assess progress toward the broader strategic goals and objectives it developed. For example, without a performance goal for the number of DOE researchers involved in technology transfer activities and a measure of such involvement, DOE cannot assess the extent to which it has met its objective to encourage national laboratory personnel to pursue technology transfer activities. Internal control standards for government agencies call for management to define objectives in measurable terms, either qualitative or quantitative, so that performance toward those objectives can be assessed. Moreover, DOE has not aligned the 79 existing measures that it collects with its goals and objectives, nor has it prioritized them. Some lab stakeholders said that collecting and reporting these measures is burdensome. Prior GAO work has found that having a large number of performance measures may risk creating a confusing excess of data that will obscure rather than clarify performance issues. Researchers at DOE and its 17 national labs regularly make contributions to new energy technologies, such as more efficient batteries for electric vehicles. Technology transfer officials at the labs help these researchers license intellectual property and partner with private-sector companies to bring these technologies to market. However, several recent reports have highlighted barriers and inconsistencies in technology transfer at DOE, including a 2015 commission report that found barriers related to the costs of collaboration and low maturity level of many DOE technologies. This report examines (1) steps DOE has taken to address barriers to technology transfer and (2) the extent to which DOE plans and tracks the performance of its technology transfer and commercialization activities. GAO analyzed DOE documents on technology transfer and spoke with officials at DOE and seven national labs, as well as with representatives of universities and private-sector companies. GAO selected labs across a range of DOE activities and based on their technology transfer activities. GAO recommends that DOE assess researchers' needs for commercialization training and develop objective, quantifiable, and measurable performance goals and a limited number of related performance measures for its technology transfer efforts. DOE concurred with the recommendations. For more information, contact Candice Wright at (202) 512-6888 or WrightC@gao.gov.
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  • Disaster Resilience: FEMA Should Take Additional Steps to Streamline Hazard Mitigation Grants and Assess Program Effects
    In U.S GAO News
    From fiscal years 2010 through 2018, the Federal Emergency Management Agency (FEMA) obligated over $11 billion through four grant programs that fund state and local hazard mitigation efforts. FEMA awarded about 88 percent of this amount through the two grant programs that fund hazard mitigation post-disaster. State and local officials from selected jurisdictions reported challenges with FEMA's hazard mitigation grant programs. Specifically, officials GAO interviewed from 10 of the 12 jurisdictions said grant application processes were complex and lengthy. To address this, FEMA officials augmented guidance and began monitoring application review time frames for one program and said they intend to assess two other programs to identify opportunities to streamline. However, they did not have a documented plan for doing so. By developing and implementing a plan to identify ways to streamline applications and reviews for all four programs, FEMA could reduce barriers to investments in hazard mitigation. Officials from eight of the 12 jurisdictions also cited challenges with applicants' technical capacity to successfully apply for grants. To address this, FEMA developed training and guidance, but GAO found that these resources are listed on different parts of its website and can be difficult for state and local officials to locate. Creating a centralized inventory of resources could improve applicant capacity to successfully develop mitigation projects and apply for grants. Examples of Hazard Mitigation Projects FEMA has assessed some effects of grant-funded hazard mitigation projects, but could expand efforts and better share results. FEMA uses benefit-cost analysis, which estimates the benefits over the life of a project, and post-disaster loss avoidance studies, which estimate project benefits from actual hazard events, to assess project effects. However, the loss avoidance studies have been limited to hurricanes, floods, and tornados, and have not assessed wildfires, winter storms, or other disasters. FEMA officials stated that they would like to expand these studies but do not have specific plans to do so. In addition, FEMA requires some states to assess the effectiveness of their mitigation projects, but does not share these studies. Developing a plan to conduct loss avoidance studies for other hazards and sharing the state studies could help FEMA and stakeholders make better informed mitigation investment decisions. The rising number of natural disasters and increasing reliance on federal assistance are key sources of federal fiscal exposure. FEMA has four grant programs to increase disaster resilience through hazard mitigation projects. The Additional Supplemental Appropriations for Disaster Relief Act, 2019, included a provision for GAO to review the federal response to disasters in 2018. This report addresses 1) FEMA's use of grants to support hazard mitigation; 2) challenges reported by selected jurisdictions applying for grants; and 3) how FEMA has assessed the effects of its hazard mitigation projects and shared the results. GAO analyzed FEMA's grant data for fiscal years 2010 through 2018 to capture the most complete recent data, conducted nongeneralizable site visits with 12 state and local jurisdictions selected to capture a range of grant funding levels and hazards, reviewed FEMA grant documents, and interviewed FEMA mitigation officials. GAO is making six recommendations, including that FEMA develop a plan to assess and streamline its hazard mitigation grant programs, create a centralized inventory of related resources, develop a plan to conduct more loss avoidance studies, and share state studies on hazard mitigation effectiveness. The Department of Homeland Security concurred with our recommendations. For more information, contact Chris Currie at (404) 679-1875 or CurrieC@gao.gov.
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