Former West Virginia Law Enforcement Officer Charged with Federal Civil Rights Offense

A federal grand jury in West Virginia returned an indictment Tuesday charging a former West Virginia police officer with a civil rights offense against an arrestee.

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Servicemembers can obtain these services at military treatment facilities—referred to as direct care—or receive care purchased from civilian providers—referred to as purchased care. DOD officials told us that the specialized level of care necessary to treat eating disorders is available to TRICARE beneficiaries through purchased care, rather than direct care. The Defense Health Agency (DHA), which oversees the TRICARE program, uses two contractors to develop regional provider networks. According to the two TRICARE contractors’ data for purchased care, as of spring 2020, there were 166 eating disorder facilities located in 32 states throughout the country and the District of Columbia. The facilities vary by geographic location, population served, and level of treatment provided: Geography: About half of the 166 facilities (79) are located in the following five states: California (24), Florida (18), Illinois (15), Texas (13), and Virginia (nine).  Population: Of the 166 eating disorder facilities, over three-quarters provide treatment to both adult (132 facilities) and child and adolescent (132 facilities) populations. Level of Treatment: Most facilities provide inpatient hospitalization programs, which are for serious cases requiring medical stabilization (81 facilities); partial hospitalization, which are day programs providing treatment 5 to 7 days a week (133 facilities); or intensive outpatient programs, which are treatment programs providing therapy 2 to 6 days a week (107 facilities). About one-fifth of the facilities (35) provide residential treatment services, which are living accommodations providing intensive therapy and 24-hour supervision. TRICARE contractors have met with some challenges entering into contracts with eating disorder treatment facilities in certain areas of the country, according to DHA officials and both contractors. However, both contractors told GAO they consider it their responsibility to ensure beneficiaries receive the care they need regardless of the location of the facility. No access-to-care complaints related to eating disorder treatment were reported by TRICARE beneficiaries, according to the most recent DHA data for years 2018 through 2019. Eating disorders are complex conditions affecting millions of Americans and involve dangerous eating behaviors, such as the restriction of food intake. They can have a severe impact on heart, stomach, and brain functionality, and they significantly raise the risk of mortality. Many with eating disorders also experience co-occurring conditions such as depression. Research has yielded a range of estimates of the number of servicemembers with an eating disorder, due to differences in research methods. For example, a 2018 DOD study concluded that servicemembers likely experienced eating disorders at rates that are comparable to rates in the general population, while other survey-based research suggested the number of servicemembers with eating disorders may be higher than those with a medical diagnoses of such disorders. The potential effects that eating disorders can have on the health and combat readiness of servicemembers and their dependents underscores the importance of screening and treating this population. GAO was asked to provide information on eating disorders among servicemembers and their dependents. To describe how DOD screens for eating disorders among servicemembers, GAO reviewed DOD policies related to health screening and interviewed behavioral health specialists from the military branches. To understand approaches and challenges with implementing screening in a military environment, any planned or ongoing DOD-sponsored research related to this topic, and available eating disorder treatment, GAO interviewed representatives from the Eating Disorder Coalition, Uniformed Services University of Health Sciences, and the University of Kansas. To describe how DOD provides eating disorder treatment to servicemembers and their dependents, GAO interviewed DHA officials and TRICARE contractors and reviewed the TRICARE policy manual to identify the types of eating disorder diagnoses and treatments that are covered through direct and purchased care. GAO received data from the two TRICARE contractors related to the availability of eating disorder treatment services as of spring 2020. For more information, contact Sharon Silas at (202) 512-7114 or Silass@gao.gov.
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  • K-12 Education: Observations on States’ School Improvement Efforts
    In U.S GAO News
    Many states use flexibilities in the Elementary and Secondary Education Act (ESEA), as amended, in identifying low-performing schools and student subgroups (e.g., students from major racial and ethnic groups and low-income students) that need support and improvement. For example, states must identify all public high schools failing to graduate at least one-third of their students. According to GAO's state plan analysis, four states used ESEA's flexibilities to set higher graduation rates (i.e., 70-86 percent) for purposes of state accountability. Similarly, while ESEA requires states to identify schools in which students in certain subgroups are consistently underperforming, 12 states assess the performance of additional student subgroups. Although states are generally required to set aside a portion of their federal education funding for school improvement activities (see figure), states have some discretion in how they allocate these funds to school districts. According to GAO's survey, 27 states use a formula to allocate funds. GAO also found that in at least 34 states, all school districts that applied for federal funds received them in school year 2018-2019, but states had discretion regarding which schools within those districts to fund and at what level. Funding for School Improvement through the Elementary and Secondary Education Act (ESEA) Title I, Part A Note: For more details, see figure 2 in GAO-21-199. A majority of the 50 states and the District of Columbia responding to our survey reported having at least moderate capacity to support school districts' school improvement activities. Education provides various types of technical assistance to build local and state capacity such as webinars, in-person training, guidance, and peer networks. About one-half of states responding to GAO's survey sought at least one type of technical assistance from Education's program office and various initiatives, and almost all of those found it helpful. For example, Education's Regional Educational Laboratories (REL) help states use data and evidence, access high-quality research to inform decisions, identify opportunities to conduct original research, and track progress over time using high-quality data and methods. Several states most commonly reported finding the following assistance by RELs to be helpful: in-person training (26), webinars (28), and reviews of existing research studies to help select interventions (24). The Elementary and Secondary Education Act (ESEA) requires states to have statewide accountability systems to help provide all children significant opportunity to receive a fair, equitable, and high-quality education, and to close educational achievement gaps high-quality education. These systems must meet certain federal requirements, but states have some discretion in how they design them. For example, ESEA requires states to identify low-performing schools and student subgroups for support and improvement. Senate Report 115-289 accompanying the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Bill, 2019, includes a provision for GAO to review states' school improvement activities. This report addresses (1) how states identify and allocate funds for schools identified for support and improvement; and (2) the extent to which states have capacity to support districts' school improvement activities and how helpful states find Education's technical assistance. GAO analyzed the most current approved state accountability plans from all 50 states and the District of Columbia as of September 2020. The information in these plans predates the COVID-19 pandemic and represents a baseline from which to compare school improvement activities going forward. GAO also surveyed and received responses from all 50 states and the District of Columbia. GAO also conducted follow-up interviews with officials in three states selected based on variation in reported capacity and geographic diversity. For more information, contact Jacqueline M. Nowicki at (617) 788-0580 or nowickij@gao.gov.
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