Georgia Correctional Officer Pleads Guilty to Civil Rights Offense for Assaulting Inmate

A Georgia correctional officer pleaded guilty today to violating the civil rights of an inmate.

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  • Aircraft Noise: Information on a Potential Mandated Transition to Quieter Airplanes
    In U.S GAO News
    Based on Federal Aviation Administration (FAA) data and GAO estimates, most U.S. large commercial jet airplanes are certificated at the minimum required stage 3 noise standards, but nearly all of them are able to meet more stringent noise standards. Sixty-three percent of large commercial airplanes in the United States are certificated as meeting the stage 3 standards; however, 87 percent of them were manufactured with technologies that are able to meet more recent and stringent stage 4 or 5 standards as currently configured, according to FAA's 2017 analysis. By analyzing updated data from airlines and aviation manufacturers, GAO estimated that this proportion is even higher: 96 percent of large commercial airplanes are able to meet stage 4 or 5 standards (see figure). According to FAA officials and aviation stakeholders, the primary reason many large commercial airplanes certificated as stage 3 produce lower than stage 3 noise levels is because engine and airframe technology has outpaced the implementation of noise standards. More recently, some airlines have accelerated retirement of certain airplanes, some of which are certificated as stage 3, due to the decrease in travel amid the COVID-19 pandemic. For the generally smaller regional commercial jets (i.e., generally with less than 90 seats), 86 percent are able to meet stage 4 or stage 5 standards, according to manufacturers' data. With regard to general aviation (which are used for personal or corporate flights), 73 percent of the jet airplanes in that fleet are able to meet the more stringent stage 4 or 5 standards, according to manufacturers' data. GAO Estimate of The Number of Large Airplanes in the U.S. Commercial Fleet That Are Able to Meet Stage 3 or Stage 4 and 5 Noise Standards, January 2020 According to stakeholders GAO interviewed, a phase-out of jet airplanes that are certificated as meeting stage 3 standards would provide limited noise reduction and limited other benefits, and could be costly and present other challenges. A phase-out could require recertificating the vast majority of stage 3 airplanes to comply with stage 4 or 5 standards. This process could be costly for operators and manufacturers but would provide little reduction in noise. Further, airplanes currently unable to meet more stringent standards would require modifications or face retirement. For older airplanes that could not be recertificated to meet stage 4 or 5 standards, some operators could incur costs for replacement airplanes sooner than originally planned. Although stakeholders indicated that a phase-out would not substantially reduce noise, they identified other limited benefits newer airplanes generate, such as reduced greenhouse gas emissions and fuel consumption. Although advances in technology have led to quieter aircraft capable of meeting increasingly stringent noise standards, airport noise remains a concern. FAA regulates aircraft noise by ensuring compliance with relevant noise standards. In 1990, federal law required large jet airplanes to comply with stage 3 noise standards by 1999, leading to a phase-out of the noisiest airplanes (stage 1 and 2 airplanes). Later, federal law required smaller airplanes to comply with stage 3 standards by 2016. The FAA Reauthorization Act of 2018 included a provision for GAO to review a potential phase-out of stage 3 airplanes—the loudest aircraft currently operating in the United States. This report describes (1) the proportion of stage 3 airplanes in the U.S. fleet, and what proportion of these stage 3 airplanes are able to meet more stringent noise standards and (2) selected stakeholders' views on the potential benefits, costs, and challenges of phasing out stage 3 airplanes. GAO reviewed FAA's analysis of December 2017 fleet data, analyzed January 2020 fleet data from select airlines and airframe and engine manufacturers, and interviewed FAA officials. GAO also interviewed a non-generalizable sample of 35 stakeholders, including airlines; airframe and engine manufacturers; airports; and industry associations, selected based on fleet and noise data, stakeholder recommendations, or prior GAO knowledge. For more information, contact Heather Krause at (202) 512-2834 or krauseh@gao.gov.
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  • Medicaid Information Technology: Effective CMS Oversight and States’ Sharing of Claims Processing and Information Retrieval Systems Can Reduce Costs
    In U.S GAO News
    The Centers for Medicare and Medicaid Services (CMS) has reimbursed billions of dollars to states for the development, operation, and maintenance of claims processing and information retrieval systems—the Medicaid Management Information Systems (MMIS) and Eligibility and Enrollment (E&E) systems. Specifically, from fiscal year 2008 through fiscal year 2018, states spent a total of $44.1 billion on their MMIS and E&E systems. CMS reimbursed the states $34.3 billion of that total amount (see figure). Money Spent by States and Reimbursed by CMS from 2008–2018 for Medicaid Management Information Systems (MMIS) and Eligibility and Enrollment (E&E) Systems For fiscal years 2016 through 2018, CMS approved 93 percent and disapproved 0.4 percent of MMIS funding requests, while for E&E it approved 81 percent and disapproved 1 percent of the requests. The remaining 6.6 percent of MMIS requests and 18 percent of E&E requests were either withdrawn by states or were pending. GAO estimates that CMS had some level of supporting evidence of its review for about 74 percent of MMIS requests and about 99 percent of E&E requests. However, GAO estimates that about 100 percent of E&E requests and 68 percent of MMIS requests lacked pertinent information that would be essential for indicating that a complete review had been performed. Among CMS requirements for system implementation funding is that states submit an alternatives analysis, feasibility study, and cost benefit analysis. However, GAO found that about 45 percent of such requests it sampled for fiscal years 2016 through 2018 did not include these required documents. The above weaknesses were due, in part, to a lack of formal, documented procedures for reviewing state funding requests. CMS also lacked a risk-based process for overseeing systems after federal funds were provided. CMS provided helpful comments and recommendations to states in selected cases, but in other instances it did not. In two states that had contractors struggling to deliver successful projects, state officials said they had not received recommendations or technical assistance from CMS. The states eventually terminated the projects after spending a combined $38.5 million in federal funds. According to CMS officials, they rely largely on states to oversee systems projects. This perspective is consistent with a 2018 Office of Management and Budget (OMB) decision that federal information technology (IT) grants totaling about $9 billion annually would no longer be tracked on OMB's public web site on IT investment performance. Accordingly, the CMS and Health and Human Services chief information officers (CIO) are not involved in overseeing MMIS or E&E projects. Similarly, 21 of 47 states responding to GAO's survey reported that their state CIO had little or no involvement in overseeing their MMISs. Such non-involvement of officials with duties that should be heavily focused on successful acquisition and operation of IT projects could be hindering states' ability to effectively implement systems. To improve oversight, CMS has begun a new outcome-based initiative that focuses the agency's review of state funding requests on the successful achievement of business outcomes. However, as of February 2020, CMS had not yet established a timeline for including MMIS and E&E systems in the new outcome-based process. CMS had various initiatives aimed at reducing duplication of Medicaid systems (see table). Description and Status of Centers for Medicare and Medicaid Services Initiatives Aimed at Reducing Duplication by Sharing, Leveraging, and Reusing Medicaid Information Technology Initiative Description Implementation status Number of surveyed states reporting use of the initiative Reuse Repository Used by states to collect and share reusable artifacts. Made available in August 2017. As of January 2020, CMS was no longer supporting this initiative. 25 of the 50 reporting states Poplin Project Was to provide free, open-source application program interfaces for states to use in developing their modular Medicaid systems. Initiative never fully implemented. As of January 2020, CMS was no longer supporting this initiative. Three of the 50 reporting states Open Source Provider Screening Module Open-source module for states to use at no charge. Made available in August 2018. As of January 2020, CMS was no longer supporting this initiative. One of the 50 states reported attempting to use the module. Medicaid Enterprise Cohort Meetings A forum where states can discuss sharing, leveraging, and/or reuse of Medicaid technologies. As of January 2020, Cohort meetings were being held on a monthly basis. 47 of the 50 states reported participating in the meetings. Source: GAO analysis of agency data. | GAO-20-179 However, as of January 2020, the agency was no longer supporting most of these initiatives because they failed to produce the desired results. CMS regulations and GAO's prior work have highlighted the importance of reducing duplication by sharing and reusing Medicaid IT. To illustrate the potential for reducing duplication, 53 percent of state Medicaid officials responding to our survey reported using the same contractor to develop their MMIS. Nevertheless, selected states are taking the initiative to share systems or modules. Further support by CMS could result in additional sharing initiatives and potential cost savings. The Medicaid program is the largest source of health care funding for America's most at-risk populations and is funded jointly by states and the federal government. GAO was asked to assess CMS's oversight of federal expenditures for MMIS and E&E systems used for Medicaid. This report examines (1) the amount of federal funds that CMS has provided to state Medicaid programs to support MMIS and E&E systems, (2) the extent to which CMS reviews and approves states' funding requests for the systems and oversees the use of these funds, and (3) CMS's and states' efforts to reduce potential duplication of Medicaid IT systems. GAO assessed information related to MMIS and E&E systems, such as state expenditure data, federal regulations, and CMS guidance to the states for submitting funding requests, states' system funding requests, and IT project management documents. GAO also evaluated a generalizable sample of approved state funding requests from fiscal years 2016 through 2018 to analyze, among other things, CMS's review and approval process and conducted interviews with agency and state Medicaid officials. GAO also reviewed relevant regulations and guidance on promoting, sharing, and reusing MMIS and E&E technologies; and surveyed 50 states and six territories (hereafter referred to as states) regarding the MMIS and E&E systems, and assessed the complete or partial responses received from 50 states. GAO is making nine recommendations to improve CMS's processes for approving and overseeing the federal funds for MMIS and E&E systems and for bolstering efforts to reduce potential duplication. Among these recommendations are that CMS should develop formal, documented procedures that include specific steps to be taken in the advanced planning document review process and instructions on how CMS will document the reviews; develop, in consultation with the HHS and CMS CIOs, a documented, comprehensive, and risk-based process for how CMS will select IT projects for technical assistance and provide recommendations to assist states that is aimed at improving the performance of the systems; encourage state Medicaid program officials to consider involving state CIOs in overseeing Medicaid IT projects; establish a timeline for implementing the outcome-based certification process for MMIS and E&E systems; and identify, prior to approving funding for systems, similar projects that other states are pursuing so that opportunities to share, leverage, or reuse systems or system modules are considered. In written comments on a draft of this report, the department concurred with eight of the nine recommendations, and described steps it had taken and/or planned to take to address them. The department did not state whether it concurred with GAO's recommendation to encourage state officials to consider involving state CIOs in Medicaid IT projects. HHS stated that it was unable to discern evidence as to whether a certain structure contributed to a specific outcome. GAO believes, consistent with federal law, that CIOs are critically important to the success of IT projects. For more information, contact Vijay D’Souza at (202) 512-6240 or dsouzav@gao.gov.
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  • Briefing With Assistant Secretary for African Affairs Tibor P. Nagy and U.S. Ambassador to Ethiopia Michael A. Raynor on the Situation in Ethiopia’s Tigray Region
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  • F-35 Joint Strike Fighter: DOD Needs to Update Modernization Schedule and Improve Data on Software Development
    In U.S GAO News
    What GAO Found The Department of Defense (DOD) delayed the completion of key testing until problems with the F-35 aircraft simulator are resolved, which GAO also reported last year, and will again delay its full-rate production decision. In August 2020, the program office determined the aircraft simulator—to be used to replicate complex test scenarios that could not be accomplished in real-world environment testing—did not fully represent F-35 capabilities and could not be used for further testing until fixed. Since then, program officials have been developing a new plan to ensure the simulator works as intended. Until they finalize the plan and fix the simulator, the next production milestone date—which would formally authorize DOD's transition from development to full production—remains undetermined (see figure). F-35 Operational Test Schedule and Key Events through 2021, as of November 2020 DOD is now in its third year of its modernization effort, known as Block 4, to upgrade the hardware and software of the aircraft. While DOD added another year to the schedule, GAO found the remaining development time frame is not achievable. The program routinely underestimated the amount of work needed to develop Block 4 capabilities, which has resulted in delays, and has not reflected historical performance into its remaining work schedule. Unless the F-35 program accounts for historical performance in the schedule estimates, the Block 4 schedule will continue to exceed estimated time frames and stakeholders will lack reliable information on when capabilities will be delivered. GAO found the F-35 program office collects data on many Block 4 software development metrics, a key practice from GAO's Agile Assessment Guide, but has not met two other key practices for monitoring software development progress. Specifically, the F-35 program office has not implemented tools to enable automated data collection on software development performance, a key practice. The program's primary reliance on the contractor's monthly reports, often based on older data, has hindered program officials' timely decision-making. The program office has also not set software quality performance targets, inconsistent with another key practice. Without these targets, the program office is less able to assess whether the contractor has met acceptable quality performance levels. Why GAO Did This Study The F-35 Lightning II Joint Strike Fighter program remains DOD's most expensive weapon system program. DOD is 3 years into a development effort that is loosely based on Agile software development processes to modernize the F-35 aircraft's capabilities. With this approach, DOD intends to incrementally develop, test, and deliver small groups of new capabilities every 6 months. Congress included provisions in two statutes for GAO to review the F-35 program. This report addresses the F-35 operational testing status, DOD's Block 4 modernization development schedule, and how the F-35 program office implements key practices for evaluating Agile software development progress. To assess cost and schedule concerns identified in prior years, GAO selected three key practices that focus on evaluating Agile software development progress. GAO reviewed DOD and contractor documentation and interviewed DOD officials and contractor representatives.
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  • Two Individuals Charged with Bribery Related to Iraq Contracts
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    Two individuals have been charged with bribery offenses in connection with Department of Defense contracts as part of the Fraud Section’s ongoing efforts to combat corruption and fraud in contracting on U.S. military installations overseas.
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  • South Carolina Man Sentenced for Making a Bomb Threat to a Clinic and Lying to the FBI
    In Crime News
    Rodney Allen, 43, of Beaufort, South Carolina, was sentenced today in federal court in Jacksonville, Florida, to 24 months in prison. Allen previously pleaded guilty to one count of intimidating and interfering with the employees of an abortion clinic by making a bomb threat and one count of making false statements to a Special Agent with the FBI.
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  • Assistant Secretary for East Asian and Pacific Affairs David R. Stilwell on the Secretary’s Travel to Japan, Mongolia, and the Republic of Korea
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    In Crime News
    The Justice Department announced today that a federal court in Orlando, Florida, permanently enjoined Advanced Tax Services Inc. and Genson Financial Group LLC from preparing federal tax returns for others and ordered the businesses to disgorge $710,191.55, jointly and severally, representing the ill-gotten gains that they received for the preparation of tax returns. The court also entered permanent injunctions and disgorgement judgments against defendants Lenorris Lamoute and Dosuld Pierre, whom the court found prepared tax returns for compensation at Advanced Tax Services. The order was entered on default because the defendants failed to defend against the government’s allegations.
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  • Judiciary Calls for Passage of Security Legislation
    In U.S Courts
    The Judiciary implores Congress to pass the Daniel Anderl Judicial Security and Privacy Act of 2020 during the current lame duck session. The bipartisan bill if passed, would improve security at judges’ homes and at federal courthouses across the country.
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  • F-35 Sustainment: DOD Needs to Address Key Uncertainties as It Re-Designs the Aircraft’s Logistics System
    In U.S GAO News
    The Autonomic Logistics Information System (ALIS) is integral to supporting F-35 aircraft operations and maintenance. However, F-35 personnel at 5 locations GAO visited for its March 2020 report cited several challenges. For example, users at all 5 locations we visited stated that electronic records of F-35 parts in ALIS are frequently incorrect, corrupt, or missing, resulting in the system signaling that an aircraft should be grounded in cases where personnel know that parts have been correctly installed and are safe for flight. At times, F-35 squadron leaders have decided to fly an aircraft when ALIS has signaled not to, thus assuming operational risk to meet mission requirements. GAO found that DOD had not (1) developed a performance-measurement process for ALIS to define how the system should perform or (2) determined how ALIS issues were affecting overall F-35 fleet readiness, which remains below warfighter requirements. DOD recognizes that ALIS needs improvement and plans to leverage ongoing re-design efforts to eventually replace ALIS with a new logistics system. However, as DOD embarks on this effort, it faces key technical and programmatic uncertainties (see figure). Uncertainties about the Future F-35 Logistics Information System These uncertainties are complicated and will require significant planning and coordination with the F-35 program office, military services, international partners, and the prime contractor. For example, GAO reported in March 2020 that DOD had not determined the roles of DOD and the prime contractor in future system development and management. DOD had also not made decisions about the extent to which the new system will be hosted in the cloud as opposed to onsite servers at the squadron level. More broadly, DOD has experienced significant challenges sustaining a growing F-35 fleet. GAO has made over 20 recommendations to address problems associated with ALIS, spare parts shortages, limited repair capabilities, and inadequate planning. DOD has an opportunity to re-imagine the F-35's logistics system and improve operations, but it must approach this planning deliberately and thoroughly. Continued attention to these challenges will help ensure that DOD can effectively sustain the F-35 and meet warfighter requirements. The F-35 Lightning II is DOD's most ambitious and costly weapon system in history, with total acquisition and sustainment costs for the three U.S. military services who fly the aircraft estimated at over $1.6 trillion. Central to F-35 sustainment is ALIS—a complex system that supports operations, mission planning, supply-chain management, maintenance, and other processes. A fully functional ALIS is critical to the more than 3,300 F-35 aircraft that the U.S. military services and foreign nations plan to purchase. Earlier this year, DOD stated that it intends to replace ALIS with a new logistics system. This statement highlights (1) current user challenges with ALIS and (2) key technical and programmatic uncertainties facing DOD as it re-designs the F-35's logistics system. This statement is largely based on GAO's March 2020 report on ALIS ( GAO-20-316 ), as well as previous F-35 sustainment work. GAO previously recommended that DOD develop a performance-measurement process for ALIS, track how ALIS is affecting F-35 fleet readiness, and develop a strategy for re-designing the F-35's logistics system. GAO also suggested that Congress consider requiring DOD to develop a performance-measurement process for its logistics system. DOD concurred with GAO's recommendations and is taking actions to address them. For more information, contact Diana C. Maurer at (202) 512-9627 or maurerd@gao.gov.
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  • COVID-19: HHS Should Clarify Agency Roles for Emergency Return of U.S. Citizens during a Pandemic
    In U.S GAO News
    What GAO Found At the beginning of the COVID-19 pandemic, the U.S. returned, or repatriated, about 1,100 U.S. citizens from abroad and quarantined them domestically to prevent the spread of COVID-19. The Department of Health and Human Services (HHS) experienced coordination and safety issues that put repatriates, HHS personnel, and nearby communities at risk. This occurred because HHS component agencies—the Administration for Children and Families, the Office of the Assistant Secretary for Preparedness and Response, and the Centers for Disease Control and Prevention—did not follow plans or guidance delineating their roles and responsibilities for repatriating individuals during a pandemic—an event these agencies had never experienced. While they had general repatriation plans, there was disagreement as to whether the effort was in fact a repatriation. This led to fundamental problems for HHS agencies and their federal partners, including at the March Air Reserve Base quarantine facility in California where the first repatriated individuals were quarantined prior to widespread transmission of COVID-19 in the U.S. These problems included the following: Lack of clarity as to which agency was in charge when the first repatriation flight from Wuhan, China, arrived at the quarantine facility, which caused confusion among the HHS component agencies. Coordination issues among HHS component agencies resulted in component agencies operating independently of each other, and led to frustration and complications. HHS's delay in issuing its federal quarantine order, during which time a repatriate tried to leave the quarantine facility. HHS personnel's inconsistent use of personal protective equipment (PPE), and HHS officials' disagreement on which agency was responsible for managing infection prevention and control. An HHS official also directed personnel to remove their PPE as it created “bad optics,” according to an HHS report that examined the repatriation effort. The National Response Framework, a guide to how the U.S. responds to disasters and emergencies, instructs agencies to understand their respective roles and responsibilities, know what plans apply, and develop appropriate guidance for emergency responses. Until HHS revises or develops new plans that clarify agency roles and responsibilities during a repatriation in response to a pandemic, it will be unable to prevent the coordination and health and safety issues it experienced during the COVID-19 repatriation response in future pandemic emergencies. HHS also did not include repatriation in its pandemic planning exercises. As a result, agencies lacked experience deploying together to test repatriation plans during a pandemic, which contributed to serious coordination issues. GAO has previously reported that exercises play an important role in preparing for an incident by providing opportunities to test response plans and assess the clarity of roles and responsibilities. Until HHS conducts such exercises, it will be unable to test its repatriation plans during a pandemic and identify areas for improvement. Why GAO Did This Study HHS provides temporary assistance to U.S. citizens repatriated by the Department of State (State) from a foreign country because of destitution, illness, threat of war, or similar crises through the U.S. Repatriation Program. In January and February 2020, HHS assisted State in repatriating individuals from Wuhan, China, and the Diamond Princess cruise ship in Yokohama, Japan, to the U.S. HHS quarantined repatriates at five Department of Defense (DOD) installations to ensure they did not infect others with COVID-19. GAO was asked to examine HHS's COVID-19 repatriation efforts to ensure the health and safety of those involved in the response. This report examines HHS's coordination and management of its COVID-19 repatriation response. GAO reviewed relevant documentation from HHS, State, and DOD related to repatriation planning, including documentation on pandemic planning exercises. GAO also interviewed officials from HHS, State, and DOD.
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  • Heavy Lift Helicopter Program: Navy Should Address Cost and Schedule Risks
    In U.S GAO News
    Fifteen years into development, the CH-53K program has made progress in testing the aircraft. Program documentation indicates that there is a moderate risk of not demonstrating the required levels of reliability or payload carrying weight by the end of operational testing. The technical issues identified during testing caused program milestones to slip. For example, the full-rate production decision was delayed by nearly 7 years—from December 2015 to November 2022. CH-53K total program costs also increased by nearly $15.3 billion since the program began due to technical issues and a quantity increase fielded helicopters from 156 to 200. The program faces several challenges going forward. First, the schedule for completing the development of the CH-53K does not meet all of the leading practices, which makes the schedule unreliable. Specifically, GAO found that the master schedule is not fully credible or well-constructed. For example, the schedule indicates there is more flexibility in the schedule than it truly has, which can affect the ability to change allocated resources appropriately to meet schedule milestones. Second, the program faces potential further cost increases due to concurrency—or overlap between testing and procurement—which has increased due to delays in the completion of testing. In previous reviews of weapon systems, GAO found that while some concurrency is understandable, it can also result in cost increases and schedule delays, and deny timely, critical information to policy makers. Concurrency, coupled with plans for increased numbers of helicopters to be produced, beyond the six per year currently being built, could result in costly retrofits to helicopters built before the completion of operational testing. This testing will provide decision makers needed information on the resolution of the technical issues facing the program (see figure). CH-53K Helicopter Testing and Procurement, Fiscal Years 2017-2030 The Marine Corps is replacing its aging CH-53E helicopters with the CH-53K heavy-lift helicopter. Designed as an evolution of the CH-53E, the CH-53K is intended to transport armored vehicles, equipment, and personnel from ships to deep inland locations. The CH-53K program office is overseen by the Department of the Navy. As we have previously reported, the program has experienced delayed milestones and cost increases from almost its inception in 2005, in part, due to technical issues. GAO was asked to review the CH-53K program. This report examines the program's (1) progress toward completing testing and demonstrating system experience, (2) schedule and cost performance to date, and (3) potential future challenges. GAO analyzed cost, schedule, performance, test, manufacturing, and planning documents; and interviewed officials from the CH-53K program office, other defense offices—such as the Defense Contract Management Agency—the testing community, and the prime contractor, Sikorsky. GAO recommends that the Navy take steps to ensure the CH-53K schedule is credible and well-constructed, and that the Navy should not exceed the current annual procurement of six helicopters per year until the completion of initial operational test and evaluation. The Department of Defense did not concur with these recommendations. GAO continues to believe that the recommendations are valid, as discussed in this report. For more information, contact Jon Ludwigson at (202) 512-4841 or ludwigsonj@gao.gov.
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  • Marketing Company Agrees to Pay $150 Million for Facilitating Elder Fraud Schemes
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  • Department of Justice Releases Report on its Efforts to Disrupt, Dismantle, and Destroy MS-13
    In Crime News
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    GAO found that the Patient-Centered Outcomes Research Institute (PCORI)—a federally funded, nonprofit corporation—and the Department of Health and Human Services (HHS) have continued to perform comparative clinical effectiveness research (CER) activities required by law since our prior report issued in 2015. CER evaluates and compares health outcomes, risks, and benefits of medical treatments, services, or items. The requirements direct PCORI and HHS to, among other things, fund CER and disseminate and facilitate the implementation of CER findings. GAO's analysis of PCORI and HHS documents show that they allocated a total of about $3.6 billion for CER activities and program support during fiscal years 2010 through 2019 from the Patient Centered Outcomes Research Trust Fund (Trust Fund). Specifically, PCORI allocated about $2 billion for research awards and another $542 million for other awards, to be paid over multiple years. HHS allocated about $598 million for activities such as the dissemination and implementation of CER findings. PCORI and HHS also allocated about $470 million for program support. PCORI and HHS Allocations for Comparative Clinical Effectiveness Research (CER) Activities, Fiscal Years 2010 through 2019 aTotals may not add up due to rounding. bPCORI and HHS allocated $457 million and $13 million for program support, respectively. PCORI assessed the effectiveness of its activities using performance measures and targets. Since fiscal year 2017, when early CER projects were completed, PCORI officials reported that the institute met its performance targets, such as an increased number of research citations of its CER findings in news and online sources. HHS described accomplishments or assessed the effectiveness of its dissemination and implementation activities. PCORI and HHS officials told GAO they are planning comprehensive evaluations of their CER dissemination and implementation activities as part of their strategic plans for the next 10 years. The 2010 Patient Protection and Affordable Care Act (PPACA) authorized establishment of PCORI to conduct CER and improve its quality and relevance. PPACA also established new requirements for HHS to, among other things, disseminate findings from federally funded CER and coordinate federal programs to build data capacity for this research. To fund CER activities, PPACA established the Trust Fund, which provided a total of about $3.6 billion to PCORI and HHS for CER activities during fiscal years 2010 through 2019. The Further Consolidated Appropriations Act, 2020, added new CER requirements and extended funding at similar levels through fiscal year 2029. PPACA and the Appropriations Act 2020 included provisions that GAO review PCORI and HHS's CER activities. This report describes (1) the CER activities PCORI and HHS carried out to meet legislative requirements, (2) how PCORI and HHS allocated funding to those CER activities, and (3) PCORI and HHS efforts to evaluate the effectiveness of their CER dissemination and implementation activities, such as changes in medical practice. GAO reviewed legislative requirements and PCORI and HHS documentation and data for fiscal years 2010-2019. GAO also interviewed PCORI and HHS officials and obtained information from nine selected stakeholder groups that were familiar with PCORI's or HHS's CER activities. These groups included payer, provider, and patient organizations. GAO incorporated technical comments from PCORI and HHS as appropriate. For more information, contact John Dicken at (202) 512-7114 or dickenj@gao.gov.
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    What GAO Found GAO identified 70 efforts to develop hypersonic weapons and related technologies that are estimated to cost almost $15 billion from fiscal years 2015 through 2024 (see figure). These efforts are widespread across the Department of Defense (DOD) in collaboration with the Department of Energy (DOE) and, in the case of hypersonic technology development, the National Aeronautics and Space Administration (NASA). DOD accounts for nearly all of this amount. Hypersonic Weapon-related and Technology Development Total Reported Funding by Type of Effort from Fiscal Years 2015 through 2024, in Billions of Then-Year Dollars The majority of this funding is for product development and potential fielding of prototype offensive hypersonic weapons. Additionally, it includes substantial investments in developing technologies for next generation hypersonic weapons and a smaller proportion aimed at countering hypersonic threats. Hypersonic weapon systems are technically complex, and DOD has taken several steps to mitigate some of the challenges to developing them. For example, DOD has attempted to address challenges posed by immature technologies and aggressive schedules by pursuing multiple potential technological solutions so that it has options. Other challenges DOD is addressing relate to industrial base and human capital workforce investments needed to support large-scale production and the availability of wind tunnels and open-air flight test ranges needed to test hypersonic weapons. DOE and NASA have agreements with DOD on supporting roles, but DOD itself has not documented the roles, responsibilities, and authorities of the multitude of its organizations, including the military services, that are working on hypersonic weapon development. Such governing documentation would provide for a level of continuity when leadership and organizational priorities inevitably change, especially as hypersonic weapon development efforts are expected to continue over at least the next decade. Without clear leadership roles, responsibilities, and authorities, DOD is at risk of impeding its progress toward delivering hypersonic weapon capabilities and opening up the potential for conflict and wasted resources as decisions over larger investments are made in the future. Why GAO Did This Study Hypersonic missiles, which are an important part of building hypersonic weapon systems, move at least five times the speed of sound, have unpredictable flight paths, and are expected to be capable of evading today's defensive systems. DOD has begun multiple efforts to develop offensive hypersonic weapons as well as technologies to improve its ability to track and defend against them. NASA and DOE are also conducting research into hypersonic technologies. The investments for these efforts are significant. This report identifies: (1) U.S. government efforts to develop hypersonic systems that are underway and their costs, (2) challenges these efforts face and what is being done to address them, and (3) the extent to which the U.S. government is effectively coordinating these efforts. This is a public version of a sensitive report that GAO issued in January 2021. Information that DOD deemed to be sensitive has been omitted. GAO collected and reviewed information from DOD, DOE, and NASA to identify hypersonic weapons development efforts from fiscal years 2015 through 2024. GAO also analyzed agency documentation and interviewed agency officials.
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    In U.S GAO News
    Most state Adult Protective Services (APS) agencies have been providing data on reports of abuse to the Department of Health and Human Services (HHS), including data on financial exploitation, although some faced challenges collecting and submitting these data. Since states began providing data to HHS's National Adult Maltreatment Reporting System (NAMRS) in 2017, they have been voluntarily submitting more detailed data on financial exploitation and perpetrators each year (see figure). However, some APS officials GAO interviewed in selected states said collecting data is difficult, in part, because victims are reluctant to implicate others, especially family members or other caregivers. APS officials also said submitting data to NAMRS was challenging initially because their data systems often did not align with NAMRS, and caseworkers may not have entered data in the system correctly. HHS has provided technical assistance and grant funding to help states address some of these challenges and help provide a better picture of the prevalence of the various types of financial exploitation and its perpetrators nationwide. Number of States That Provide Data on Financial Exploitation and Perpetrators to NAMRS Studies estimate some of the costs of financial exploitation to be in the billions, but comprehensive data on total costs do not exist and NAMRS does not currently collect cost data from APS agencies. The Consumer Financial Protection Bureau found actual losses and attempts at elder financial exploitation reported by financial institutions nationwide were $1.7 billion in 2017. Also, studies published from 2016 to 2020 from three states—New York, Pennsylvania, and Virginia—estimated the costs of financial exploitation could be more than $1 billion in each state alone. HHS does not currently ask states to submit cost data from APS casefiles to NAMRS, though officials said they have begun to reevaluate NAMRS with state APS agencies and other interested parties, including researchers, and may consider asking states to submit cost data moving forward. Adding cost data to NAMRS could make a valuable contribution to the national picture of the cost of financial exploitation. Recognizing the importance of these data, some APS officials GAO interviewed said their states have developed new data fields or other tools to help caseworkers collect and track cost data more systematically. HHS officials said they plan to share this information with other states to make them aware of practices that could help them collect cost data, but they have not established a timeframe for doing so. Elder financial exploitation—the fraudulent or illegal use of an older adult's funds or property—has far-reaching effects on victims and society. Understanding the scope of the problem has thus far been hindered by a lack of nationwide data. In 2013, HHS worked with states to create NAMRS, a voluntary system for collecting APS data on elder abuse, including financial exploitation. GAO was asked to study the extent to which NAMRS provides information on elder financial exploitation. This report examines (1) the status of HHS's efforts to compile nationwide data through NAMRS on the extent of financial exploitation and the challenges involved, and (2) what is known about the costs of financial exploitation to victims and others. GAO analyzed NAMRS data from fiscal year 2016 through 2019 (the most recent available); reviewed relevant federal laws; and interviewed officials from HHS, other federal agencies, elder abuse prevention organizations, and researchers. GAO also reviewed APS documents and spoke with officials in eight states, selected based on their efforts to study, collect, and report cost data; and reviewed studies on financial exploitation. GAO recommends that HHS (1) work with state APS agencies to collect and submit cost data to NAMRS, and (2) develop a timeframe to share states' tools to help collect cost data. HHS did not agree with the first recommendation, but GAO maintains that it is warranted, as discussed in the report. HHS agreed with the second recommendation. For more information, contact Kathryn A. Larin at (202) 512-7215 or larink@gao.gov.
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    In U.S GAO News
    What GAO Found The Department of the Interior's (Interior) Bureau of Safety and Environmental Enforcement (BSEE) does not have a robust oversight process for ensuring the integrity of approximately 8,600 miles of active offshore oil and gas pipelines located on the seafloor of the Gulf of Mexico. Specifically, BSEE does not generally conduct or require any subsea inspections of active pipelines. Instead, the bureau relies on monthly surface observations and pressure sensors to detect leaks. However, officials told us that these methods and technologies are not always reliable for detecting ruptures. In response to a pair of significant oil leaks in 2016 and 2017, BSEE partnered with industry to improve subsea leak detection, but the technologies identified remain relatively new and cannot be retrofitted to a majority of pipelines. According to BSEE, the bureau's regulations are outdated and do not address how pipelines should be inspected, the complexities of deep water pipeline operations, and changes in technological standards. BSEE has long recognized the need to improve its pipeline regulations, and in 2007 issued a proposed rule that cited the need to enhance safety and protect the environment, but this effort stalled. The 2007 proposed rule addressed offshore pipeline integrity, including new requirements regarding pipeline inspection and subsea leak detection technologies. Since 2013, BSEE has noted plans to update its pipeline regulations but has made limited progress in the interim. Without taking actions to develop, finalize, and implement updated regulations to address identified oversight gaps, BSEE will continue to be limited in its ability to ensure the integrity of active pipelines. BSEE does not have a robust process to address the environmental and safety risks posed by leaving decommissioned pipelines in place on the seafloor due to the cumulative effects of oversight gaps before, during, and after the decommissioning process. First, BSEE does not thoroughly account for such risks during the review of decommissioning applications. This has contributed to BSEE and its predecessors authorizing industry to leave over 97 percent (about 18,000 miles) of all decommissioned pipeline mileage on the Gulf of Mexico seafloor since the 1960s. Generally, pipelines must be removed from the seafloor. BSEE, however, may allow pipelines to be decommissioned-in-place if certain criteria are met. Such a high rate of approval indicates that this is not an exception, however, but rather that decommissioning-in-place has been the norm for decades. Second, BSEE does not ensure that operators meet decommissioning standards, such as cleaning pipelines, because they do not observe any pipeline decommissioning activities, inspect pipelines after their decommissioning, or verify most of the pipeline decommissioning evidence submitted. Third, BSEE does not monitor the condition and location of pipelines following their decommissioning-in-place, which reduces its ability to mitigate any long-term risks, such as pipeline exposure or movement. Additionally, if pipelines decommissioned-in-place are later found to pose risks, there is no funding source for removal. As discussed above, BSEE has made limited progress in updating what it acknowledges are outdated pipeline regulations. Without taking actions to develop, finalize, and implement updated pipeline regulations, BSEE will continue to be limited in its ability to ensure that its pipeline decommissioning process addresses environmental and safety risks. Why GAO Did This Study The offshore oil and gas industry has installed approximately 40,000 miles of oil and gas pipelines in federal offshore waters since the 1940s. BSEE is responsible for enforcing standards and regulations for oil and gas operations—including the oversight of active pipelines and their decommissioning—to enhance environmental protection and safety. As pipelines age, they are more susceptible to damage from corrosion, mudslides, and seafloor erosion, which can result in leakage of oil and gas into the ocean. Additionally, hurricanes can move pipelines extensive distances, which may damage subsea habitat, impede access to sediment resources, and create navigational and trawling hazards. GAO was asked to review BSEE's management of offshore oil and gas pipelines. This report examines BSEE's processes for (1) ensuring active pipeline integrity and (2) addressing safety and environmental risks posed by decommissioning. GAO reviewed regulations, procedures, and other documents and data related to BSEE's pipeline management processes. GAO also interviewed BSEE officials and those from other agencies with offshore responsibilities.
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    In U.S GAO News
    What GAO Found The Navy has a process for proposing and implementing homeport changes that considers a range of factors. The first key step in this process involves the Navy developing and updating an annual plan, known as the Strategic Laydown and Dispersal Plan, that guides the Navy's positioning of operating forces worldwide. Based on the plan, fleet commanders then identify requirements for any changes to homeports and submit requests to schedule a homeport change. Throughout the process, Navy leadership and a working group of stakeholders from across the Navy provide input and analysis. Among other things , the working group develops and assesses proposed changes among the possible aircraft carrier homeports based on their expertise and evaluates various homeport installation factors, such as maintenance dry docks (see figure) or ship power and maintenance facilities. The Navy also considers local factors including crew support and quality of life, such as schools and morale, and possible impacts to the natural and physical environment. The Navy has strengthened its process by implementing prior GAO recommendations, and has other planned actions underway to further improve and update its guidance. Recent Navy Aircraft Carrier Homeport Locations and Dry Dock at Puget Sound Naval Shipyard The Navy made 15 aircraft carrier homeport changes in fiscal years 2011 through 2020 among the five available homeports. The driving factor for all 15 changes was maintenance. For example, 10 of the 15 changes involved ships moving to or returning from shipyards in Bremerton or Norfolk for planned dry-dock maintenance or midlife refueling. In 2015 and 2019, the Navy decided to homeport aircraft carriers in Bremerton and San Diego because Everett lacked nuclear maintenance facilities, which were available at the Navy's other aircraft carrier homeport locations. Previously, carriers homeported in Everett received regularly scheduled maintenance at the shipyard in Bremerton but did not conduct an official homeport change. The Navy reported that during these maintenance periods that lasted 6 months or more, the crew commuted 3 to 4 hours daily, which negatively affected maintenance and crew morale. As a result, the Navy decided not to return an aircraft carrier to Everett. According to Navy officials, factors in addition to maintenance needs also informed the changes, including a long-held plan to homeport three aircraft carriers in San Diego. Why GAO Did This Study The Navy relies on 11 aircraft carriers homeported on the East and West Coasts and in Japan to support U.S. defense strategic objectives and operations. These nuclear-powered ships require complex infrastructure, technology, and maintenance, some of which may not be available near their homeport. Changing an aircraft carrier's homeport means moving the ship's approximately 3,200 sailors, a fluctuation of 5,000 or more people depending on the number of family members involved. In House Report 116-120, accompanying a bill for the National Defense Authorization Act for Fiscal Year 2020, the House Armed Services Committee noted that the Navy reversed previous plans to homeport an aircraft carrier at Naval Station Everett, Washington. The House Report also included a provision for GAO to review the Navy's process to assign aircraft carriers' homeports. This report examines, for Navy aircraft carriers, (1) the extent to which the Navy has a process for making homeport changes, and considers local installation and other factors in the homeporting process, and (2) homeport changes from fiscal years 2011 through 2020 and the reasons for them. GAO analyzed Navy instructions and related policies, laws, and regulations; homeport plans and maintenance schedules; and fiscal years 2011–2020 documentation of homeport changes. GAO also interviewed Navy officials, including from relevant commands and homeports. For more information, contact Diana Maurer at (202) 512-9627 or MaurerD@gao.gov.
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