How Engineers at NASA JPL Persevered to Develop a Ventilator


As coronavirus hit, JPL engineers teamed up to make a ventilator prototype that could be mass produced to fill a massive need. It’s not rocket science; it’s something more.


On April 30, the Food and Drug Administration approved VITAL for a ventilator Emergency Use Authorization. Developed in just 37 days by NASA’s Jet Propulsion Laboratory in response to the coronavirus pandemic, VITAL (short for Ventilator Intervention Technology Accessible Locally) wouldn’t replace current hospital ventilators, which can treat a broader range of medical issues.

Designed specifically for COVID-19 patients, the prototype is composed of far fewer parts than traditional ventilators and is intended to last three to four months. Its license is being offered free to manufacturers through the Office of Technology Transfer and Corporate Partnerships at Caltech, which manages JPL for NASA.

More than 100 manufacturers from around the world applied for a free license to build VITAL, and licensees will be announced later this month.

This is the story of how a team of engineers, fueled by a desire to help during the crisis, brought VITAL into being.

On March 11, Mechanical Systems Engineer David Van Buren found himself waiting in line for a cup of coffee at NASA’s Jet Propulsion Laboratory in Southern California. It was a typical bustling Wednesday before mandatory teleworking kicked in, but Van Buren wasn’t focused on his typical workload.

Instead, the mechanical systems engineer was crunching coronavirus numbers. In February, he’d given a lecture on pandemics in relation to COVID-19 for his physics course at Cal State Los Angeles, and he saw clear signs of a developing pandemic.

“It didn’t take much extrapolating to see the potential of what could happen here,” Van Buren said. “And at the same time, I was thinking about our work; we have these missions and efforts to explore other planets, but I started questioning if what we were doing at JPL was what we should be doing,” Van Buren said.

That same morning, JPL Chief Engineer Rob Manning’s thoughts were preoccupied by the virus, and he needed coffee, too.

“I had just seen some projections, and I was worried,” Manning said.

In a chance encounter, the two chatted about upcoming work and a bit about their coronavirus concerns.

“I went back to my desk after talking with Rob, and the question was still nagging me,” Van Buren said. “We have incredible engineering talent and capabilities here. How can we help reduce the ventilator shortage that could be coming?”

This, well before most people even knew the meaning of “ventilator,” let alone the fatal implications of a shortage.

Van Buren sent an email, outlining a plan to develop and proof a low-cost respirator design that could be made quickly and in volume. Manning was hooked.

“We needed to do something, and this was it,” Manning said.

Thirty-seven days later, a team of more than 50 – some working on-site at JPL, but most from home – had designed, built and tested VITAL, a breathing aid that would help critically ill COVID-19 patients and bolster scarce stocks of traditional hospital ventilators.

The timeline is a feat nearly unheard of in medical device development, completed by a research and development center that makes robots for space, not breathing aids for humans. In JPL terms, the team would say they crammed an entire planetary flight mission – from formulation to launch to landing – in a little more than a month. Most team members worked 14-hour days, seven days a week, and mandatory telework restrictions established on March 17 put unique strains on an already daunting task. Van Buren said the obstacles discouraged no one.

“The difference is the purpose,” Van Buren said. “Landing something on Mars is incredibly exciting, but saving lives is a different beast.”

The Medical Link

So how did the team turn the initial idea into action?

Enter Leon Alkalai, manager of the JPL Office of Strategic Partnerships, who for the past six years has led a medical engineering forum at JPL aimed at identifying the Lab’s unique space technologies that could be applied to solving challenging problems in healthcare and medicine.

“The broad vision has been there,” Alkalai said. “David’s idea brought the urgency and the opportunity for JPL to make a significant contribution in a unique way, and I wanted to help in any way I could.”

The ventilator had to meet specific high-pressure oxygen flow rates to aid COVID-19 patients battling Acute Respiratory Distress Syndrome; it had to be made of far fewer parts than a typical hospital ventilator to keep costs down; those parts had to be widely available in the U.S. supply chain so the ventilators could be built in mass quantities; and those parts couldn’t be the same used by traditional ventilators so manufacturing VITAL wouldn’t block production of other ventilators.

Van Buren canvassed JPL for experts, and the team – now about a dozen or so strong – held its kickoff meeting Monday, March 16 in Left Field, a whiteboard-lined space typically used for brainstorming early mission concepts. The team had turned the room into a ventilator learning station. And thanks to one world-renowned pulmonologist, the learning curve was about to get steep.

No Time to Breathe

As the Medical Director of the School of Respiratory Therapy for East Los Angeles and Santa Monica Colleges, Dr. Michael Gurevitch had access to a supply of ventilators, circuits, valves and filters he could bring to the Lab to give a crash course on what was needed to make a COVID-19-fighting device.

“Since coronavirus restrictions had shut down the colleges, the school leadership granted us access to grab just about anything we needed from their labs that would help aid JPL’s project,” Gurevitch said.

After the meeting, VITAL’s design team, led by Mechatronic Engineer Mike R. Johnson, turned Gurevitch’s lecture into requirements as they developed a working concept, design and prototype.

“They were amazing. They not only grasped the medical concepts and physiology,” Gurevitch said, “but they understood how those requirements would interface with the mechanics of the device.”

Called to the Lab in a Pandemic

While a majority of the team worked from home, a limited staff stayed on Lab as mission-essential to work on prototype assembly and testing.

Mechatronic engineer Michelle Easter worked as prototype logistics and hardware test lead for VITAL. “We were considering the FDA approval process on top of making sure each part we choose is available for mass production, and not just available, but available right now,” Easter said. “This had to be technically excellent, and the parts had to be readily available. We’re not used to that at JPL. If I’m working on a flight instrument and I want a part, I’ll just give a company a 20-month lead time to custom build it. That’s not an option here.”

Despite the early growing pains, the team found their groove, designing, building and testing two different prototype models – one powered by a blower and another by a pneumatic system. Both contain about one-seventh the parts of a traditional ventilator, and both can deliver the high-pressure oxygen flows needed for COVID-19 patients while keeping the lungs slightly inflated even as they exhale – key for patients to stave off infections like pneumonia.

“It’s been amazing to be a part of such a grassroots project, and watching it just explode in an organic way from those first meetings into these working prototypes,” Easter said. “I joke that I’ve met all my new favorite coworkers from this project. Because everyone on this team has a big heart, and they’re on this project because they want to make a difference. That pureness of intention is incredible. Everybody is all in for the good, and it just feels great.”

Jargon Jumble, Telework Tango

Systems Engineer Stacey Boland is no stranger to JPL’s penchant for acronyms and jargon, but as operations lead on VITAL, she was tasked with essentially writing a user manual for the device as it was being built.

“The medical professionals definitely have their own language,” Boland said. “Different specialties within the healthcare profession even seem to have their own dialects – so there’s been a fair amount of iteration and editing involved.”

Boland’s other job is working on the MAIA instrument (Multi-Angle Imager for Aerosols) – NASA’s first time partnering with epidemiologists and health organizations to use satellite data to study human health. “In a given day, I’m talking to doctors, engineers, managers, visual strategists and sometimes also regulators,” Boland said.

It uniquely qualified her for a position on VITAL. And while there were a lot of different points of view to try to reconcile, a sense of purpose prevailed. “We all talk. We all listen. We’re all learning together. There’s something beautiful and enabling in having a singular focus – there’s a real unmet need and we’re responding to it. There truly is a sense that we’re all in this together.”

Ready to Help

With the prototypes built, Leon Alkalai connected the team with Dr. Matthew Levin at the Icahn School of Medicine at Mount Sinai in New York. On April 22, barely a month after the project began, the ventilator passed critical tests in the center’s high-fidelity human simulation lab, performing under a wide variety of simulated patient conditions.

On April 30, after reviewing the 505-page submission, the FDA approved VITAL for a ventilator Emergency Use Authorization. The selection process for which companies would be granted a free license was underway.

The team’s accomplishments have captured the world’s attention as well. On April 23, NASA Administrator Jim Bridenstine held a media briefing where JPL Associate Director of Strategic Integration Dave Gallagher discussed the development of VITAL. Two days later, Gallagher was in the White House, showing off the ventilator to President Donald Trump.

“Congratulate the engineer, OK? Say hello to Dave,” Trump said to Gallagher, referring to Van Buren.

For Van Buren, the congratulations go all around for the team, and beyond.

“The medical workers, the people knitting face masks, providing PPE for groups on the front lines … the amount of compassion people are displaying while we are all trying to cope with this epidemic is really heartwarming.”

What VITAL will mean to the world is yet unknown. Currently, ventilator usage remains below critical levels in the United States, but that doesn’t mean VITAL won’t be needed if coronavirus cases spike again in the future.

“It looks like we’re near the peak in the U.S., but it could get worse as easily as it gets better,” Van Buren said. “We won’t know it’s over until it’s obvious we have beat it. No matter what happens, what we’ve shown through this project is a pathway to get important, time-sensitive work done. There will be another pandemic, and we’re putting in place principles on how to attack them here.”

It has the potential to save lives, but all who helped build it hope coronavirus numbers never swell to a place where hospital ventilator capacities are exhausted.

News Media Contact

Andrew Good
Jet Propulsion Laboratory, Pasadena, Calif.
818-393-2433
andrew.c.good@jpl.nasa.gov

Written by Taylor Hill

2020-093

Hits: 1

News Network

  • Department of Justice Announces Charges of North Korean and Malaysia Nationals for Bank Fraud, Money Laundering and North Korea Sanctions Violations
    In Crime News
    The Department of Justice announced a criminal complaint charging Ri Jong Chol, Ri Yu Gyong, North Korean nationals, and Gan Chee Lim, a Malaysia national. The three were charged with conspiracy to violate North Korean Sanctions Regulations and bank fraud, and conspiracy to launder funds. The defendants allegedly established and utilized front companies that transmitted U.S. dollar wires through the United States to purchase commodities on behalf of North Korean customers.
    [Read More…]
  • Monaco National Day
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Seychelles Travel Advisory
    In Travel
  • On Intra Afghan Negotiations and the Road to Peace
    In Crime News
    Morgan Ortagus, [Read More…]
  • Secretary Michael R. Pompeo With Bret Baier of Fox News Special Report
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Fugitive Charged with Leading Multimillion Dollar Fraud Scheme, Falsifying Evidence, and Tax Crimes
    In Crime News
    An American citizen was charged in two indictments unsealed this week for his alleged participation in an investment fraud scheme in which he allegedly misappropriated $6.1 million in investor-funds, manufactured evidence to mislead an investigation by the Securities and Exchange Commission (SEC) and concealed the proceeds of his fraudulent scheme from the IRS.
    [Read More…]
  • Armenia Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Special Presidential Envoy for Arms Control Billingslea to Address the Conference on Disarmament 
    In Crime Control and Security News
    Office of the [Read More…]
  • Justice Department Charges 500+ Domestic Violence-Related Firearm Cases in Fiscal Year 2020
    In Crime News
    Today, the Department of Justice announced it has charged more than 500 domestic violence cases involving firearms during Fiscal Year (FY) 2020. A department priority since 2019 when Attorney General William P. Barr created the Department of Justice’s first ever-Domestic Violence Working Group, these charges are the result of the critical law enforcement partnership between United States Attorneys’ Offices and the Bureau of Alcohol, Tobacco, Firearms and Explosives, led by Acting Director Regina Lombardo, who has made domestic violence firearms-related investigations a priority.
    [Read More…]
  • Jersey/Swiss Financial Services Firm Admits to Conspiring with U.S. Taxpayers to Hide Assets and Income in Offshore Accounts
    In Crime News
    Strachans SA in Liquidation pleaded guilty yesterday to conspiring with U.S. taxpayers and others to hide income and assets in offshore entities and bank accounts from the IRS, and was sentenced in accordance with the guilty plea, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division, U.S. Attorney Nicola T. Hanna, and Chief James Lee of the Internal Revenue Service, Criminal Investigation (IRS-CI).
    [Read More…]
  • Military Child Care: Off-Base Financial Assistance and Wait Lists for On-Base Care
    In U.S GAO News
    The Department of Defense (DOD) has reviewed the financial assistance it provides for off-base child care services and taken steps to standardize this assistance across the military services. Specifically, in August 2018, representatives of each service agreed to work toward a goal of standardizing the only element of the fee assistance calculation that varies among the services—the maximum provider rate. DOD officials said that they assess progress toward this goal each year, but have not set a definite deadline for full standardization. With respect to assistance for off-base child care at high-cost duty stations, DOD's 2020 report on its child care programs states that the Air Force, Marines, and Navy review high-cost locations annually, and the services may approve increased provider rate caps for specific high-cost locations. In addition, it states that the services may grant waivers allowing increased fee assistance for individual families experiencing hardship. DOD has also assessed factors that contribute to wait lists for on-base child care. According to DOD’s report, DOD found that wait lists are the result of a myriad of factors, including staff shortages and facility conditions that vary across service locations. Officials said DOD has worked for several years to analyze and address wait lists. In 2017, DOD launched a web portal that consolidates child care data across the services and in August 2019, DOD officials began monthly monitoring of wait list data from this portal. These data allowed DOD to identify four geographic regions and six additional locations that account for the majority of wait lists, and focus their efforts on addressing the issues affecting these regions and locations, according to the report. DOD officials said that any requests for additional resources to help address wait lists must be handled through the individual services’ budgeting processes. DOD offers child care in a variety of on- and off-base settings for children of military families. In fiscal year 2020 these child care programs received nearly $1.2 billion in federal funds; in addition, parents pay a portion of the costs. The National Defense Authorization Act for Fiscal Year 2020 required DOD to report on elements of its financial assistance to off-base child care providers and wait lists for on-base child care, and included a provision for GAO to review DOD's report. This report describes DOD's assessment of (1) financial assistance provided to off-base child care providers, and (2) its efforts to reduce wait lists for child care at military bases. GAO reviewed DOD's report on this assessment, interviewed DOD officials, and reviewed relevant federal law. For more information, contact Kathryn A. Larin at (202) 512-7215 or larink@gao.gov.
    [Read More…]
  • Former Venezuelan Official Charged in Connection with International Bribery and Money Laundering Scheme
    In Crime News
    Charges were unsealed today against a former official at Citgo Petroleum Corporation, a Houston-based subsidiary of Venezuela’s state-owned and state-controlled energy company Petróleos de Venezuela S.A. (PDVSA).
    [Read More…]
  • U.S.-Greenland Technical Engagement on Mining Sector Education and Training
    In Crime Control and Security News
    Office of the [Read More…]
  • Nevada Woman Charged with COVID-Relief Fraud
    In Crime News
    A Nevada woman was charged in a criminal complaint unsealed Wednesday with fraudulently seeking over $1 million in Paycheck Protection Program (PPP) loans, announced Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division and U.S. Attorney Nicholas A. Trutanich of the U.S. Attorney’s Office for the District of Nevada.
    [Read More…]
  • Congress Urged to Adopt Judicial Security Measures
    In U.S Courts
    Citing the recent fatal attack at the home of a federal judge in New Jersey and increasing threats against federal judges, the Judiciary has asked Congress to enact a package of safety measures that would improve security at judges’ homes and at federal courthouses.
    [Read More…]
  • Liberia Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • State Department Terrorist Designation of Saraya al-Mukhtar
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Department of Justice Invests More than $87 Million in Grants to Address School Violence
    In Crime News
    The Department of [Read More…]
  • Seven MS-13 Gang Members Indicted in Violent Crime and Drug Distribution Conspiracy
    In Crime News
    A federal grand jury in Nashville, Tennessee, returned a 16-count superseding indictment Wednesday, charging seven MS-13 gang members with conspiracy to distribute cocaine and marijuana and serious firearm-related offenses, announced Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division and U.S. Attorney Don Cochran for the Middle District of Tennessee.
    [Read More…]
  • At the Virtual Launch of the Inaugural U.S.-UAE Strategic Dialogue
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Justice Department Applauds the Passage and Enactment of the Servicemembers and Veterans Initiative Act of 2020
    In Crime News
    On Jan. 5, 2021, President Donald J. Trump signed H.R. 8354, the Servicemembers and Veterans Initiative Act of 2020, a bill to permanently establish the Servicemembers and Veterans Initiative, or “SVI”, within the Civil Rights Division of the Department of Justice.
    [Read More…]
  • Hungary Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Attack on Kurdistan Democratic Party Baghdad Office
    In Crime Control and Security News
    Morgan Ortagus, [Read More…]
  • Arrests Made in Conspiracy to Illegally Manufacture Firearms
    In Crime News
    On Oct. 20, 2020, a former United States Marine Lance Corporal, recently stationed at Camp Lejeune in Jacksonville, North Carolina, and two co-defendants were arrested in Boise, Idaho on the federal charge of conspiracy to unlawfully manufacture, possess, and distribute various weapons, ammunition, and suppressors.  Liam Montgomery Collins, 21, and Paul James Kryscuk, 35, recently of Boise, were charged via an indictment, while Jordan Duncan, 25, a North Carolina native also currently residing in Boise, was charged via a complaint, both obtained in the Eastern District of North Carolina.
    [Read More…]
  • Air Pollution: Opportunities to Better Sustain and Modernize the National Air Quality Monitoring System
    In U.S GAO News
    The ambient air quality monitoring system is a national asset that provides standardized information for implementing the Clean Air Act and protecting public health. The Environmental Protection Agency (EPA) and state and local agencies cooperatively manage the system, with each playing different roles in design, operation, oversight, and funding. For example, EPA establishes minimum requirements for the system, and state and local agencies operate the monitors and report data to EPA. Officials from EPA and selected state and local agencies identified challenges related to sustaining the monitoring system. For example, they said that infrastructure is aging while annual EPA funding for state and local air quality management grants, which cover monitoring, has decreased by about 20 percent since 2004 after adjusting for inflation (see fig.). GAO found inconsistencies in how EPA regions have addressed these challenges. GAO's prior work has identified key characteristics of asset management, such as identifying needed resources and using quality data to manage infrastructure risks, which can help organizations optimize limited resources. By developing an asset management framework that includes such characteristics, EPA could better target limited resources toward the highest priorities for consistently sustaining the system. Annual Inflation-Adjusted EPA Funding for State and Local Air Quality Management Grants Air quality managers, researchers, and the public need additional information so they can better understand and address the health risks from air pollution, according to GAO's review of literature and interviews GAO conducted. These needs include additional information on (1) air toxics to understand health risks in key locations such as near industrial facilities; and (2) how to use low-cost sensors to provide real-time, local-scale air quality information. EPA and state and local agencies face persistent challenges meeting such air quality information needs, including challenges in understanding the performance of low-cost sensors. GAO illustrated this challenge by collecting air quality data from low-cost sensors and finding variability in their performance. EPA has strategies aimed at better meeting the additional air quality information needs of managers, researchers, and the public, but the strategies are outdated and incomplete. For example, they do not clearly define roles for meeting additional information needs. GAO's prior work on asset management suggests that a more strategic approach could help EPA modernize the system to better meet the additional information needs. By developing a modernization plan that aligns with leading practices for strategic planning and risk management, such as establishing modernization goals and roles, EPA could better ensure that the system meets the additional information needs of air quality managers, researchers, and the public and is positioned to protect public health. The national ambient air quality monitoring system shows that the United States has made progress in reducing air pollution but that risks to public health and the environment continue in certain locations. The system consists of sites that measure air pollution levels around fixed locations across the country using specific methods. Since the system began in the 1970s, air quality concerns have changed—such as increased concern about the health effects of air toxics. GAO was asked to evaluate the national air quality monitoring system. This report examines the role of the system and how it is managed, challenges in managing the system and actions to address them, and needs for additional air quality information and actions to address challenges in meeting those needs. GAO reviewed literature, laws, and agency documents; conducted a demonstration of low-cost sensors; and interviewed EPA officials, selected state and local officials, representatives from air quality associations, and stakeholders. GAO is making two recommendations for EPA to (1) establish an asset management framework for the monitoring system that includes key characteristics and (2) develop an air quality monitoring modernization plan that aligns with leading practices. In written comments on the report, EPA generally agreed with the recommendations. For more information, contact J. Alfredo Gómez at (202) 512-3841 or gomezj@gao.gov.
    [Read More…]
  • Federal Employees’ Compensation Act: Comparisons of Benefits in Retirement and Actions Needed to Help Injured Workers Choose Best Option
    In U.S GAO News
    Factors such as the timing of an injury in a career affect how Federal Employees' Compensation Act (FECA) total disability benefits compare to income security from typical federal retirement. The FECA program compensates federal employees for lost wages from work-related injuries, among other benefits. FECA recipients can receive this compensation for as long as their disability continues. At retirement age, they can remain on FECA or, instead, choose to receive their benefits from the Federal Employees Retirement System (FERS). Thus, FECA benefits represent a significant portion of retirement income for some injured federal employees. Through simulations, GAO found that factors such as the length of retirees' careers absent injury affected how similar their hypothetical FECA benefits packages were to their FERS packages in 2018. FERS benefits increase substantially the longer a federal employee works. As a result, median current and reduced FECA packages were greater than the FERS median for retirees with shorter careers absent injury. However, median FECA packages were similar to or less than FERS for retirees with longer careers (see figure). Median FECA Benefits as a Percentage of FERS Benefits by Career Length Absent an Injury For FECA recipients who choose to compare their FECA and FERS benefit options at retirement, estimates for most components of those benefits packages are available. However, the Department of Labor (DOL) does not routinely remind recipients to compare benefits, so they may be unaware of their options or how to consider them. In addition, DOL and the Social Security Administration (SSA) use a manual and highly complex process to calculate one key component of a FECA recipient's compensation in retirement related to Social Security benefits. As a result, estimates of FECA benefits in retirement that include this component are not readily available prior to retirement. These challenges hinder recipients' ability to accurately compare their options and may result in some recipients not choosing their best option at retirement. The President's budgets for fiscal years 2019-2021 have proposed several FECA reforms, including reducing disability compensation at retirement age. In a series of reports published in 2012, GAO analyzed the effects of similar proposed revisions to FECA compensation. GAO was asked to update its FECA and FERS benefit comparisons. This report examines (1) how FERS and total disability FECA benefits at retirement age compare under current and previously proposed reduced FECA compensation rates, and (2) the extent to which FECA recipients have access to information to compare their FECA and FERS benefits options. GAO compared the FERS benefits selected retirees received in 2018 with the hypothetical total disability FECA benefits they would have received from simulated injuries. GAO reviewed agency documents and interviewed officials from DOL, SSA, and other federal agencies. GAO is recommending that DOL remind FECA recipients as they approach retirement to obtain FERS benefit estimates for comparisons with FECA, and that DOL and SSA take steps to modernize and improve their process for calculating and providing information on certain FECA benefits in retirement that would enable recipients to make complete comparisons of retirement options. DOL and SSA concurred with all three recommendations. For more information, contact Cindy Brown Barnes at (202) 512-7215 or brownbarnesc@gao.gov.
    [Read More…]
  • Arkansas Project Manager Sentenced in Connection with COVID-Relief Fraud
    In Crime News
    A project manager employed by a major retailer was sentenced to 24 months in prison followed by five years of supervised release for fraudulently seeking more than $8 million in forgivable loans guaranteed by the Small Business Administration (SBA) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act announced Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division and U.S. Attorney R. Trent Shores of the Northern District of Oklahoma.
    [Read More…]
  • Saint Vincent and the Grenadines’ Independence Day
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Taiwan Travel Advisory
    In Travel
    Exercise normal [Read More…]
  • Deputy Secretary Biegun’s Call with Minister Kyaw Tin of Burma
    In Crime Control and Security News
    Office of the [Read More…]
  • Former Construction Executive Sentenced to 38 Months in Prison
    In Crime News
    A former senior New York construction official was sentenced to 38 months in prison today for tax evasion, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division.
    [Read More…]
  • Secretary Michael R. Pompeo With Ben Shapiro of The Ben Shapiro Show
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Judiciary Report Underscores Commitment to Civics Education
    In U.S Courts
    Federal courts are approaching the 2020-2021 academic year with an endorsement of volunteer civics education efforts by judges and a willingness to support teachers in bringing the human face of the Judiciary into their civics and government classes, whether students are at home or in school.
    [Read More…]
  • Indian Health Service: Actions Needed to Improve Oversight of Federal Facilities’ Decision-Making About the Use of Funds
    In U.S GAO News
    The Indian Health Service's (IHS) oversight of federally operated health care facilities' decision-making process about the use of funds has been limited and inconsistent. Funds include those from appropriations, as well as payments from federal programs, such as Medicaid and from private insurance, for care provided by IHS to American Indians and Alaska Natives (AI/AN). While some oversight functions are performed at IHS headquarters, the agency has delegated primary responsibility for the oversight of health care facilities' decision-making about the use of funds to its area offices. Area office officials said the oversight they provide has generally included (1) reviewing facilities' scope of services, and (2) reviewing facilities' proposed expenditures. However, GAO's review found that this oversight was limited and inconsistent across IHS area offices, in part, due to a lack of consistent agency-wide processes. While IHS officials from all nine area offices GAO interviewed said they reviewed facilities' scope of services and coordinated with tribes when doing so, none reported systematically reviewing the extent to which their facilities' services were meeting local health needs, such as by incorporating the results of community health assessments. Such assessments can involve the collection and assessment of data, as well as the input of local community members and leaders to identify and prioritize community needs. These assessments can be used by facilities to assess their resources and identify priorities for facility investment. While IHS has identified such assessments as a priority, the agency does not require federally operated facilities to conduct such assessments or require the area offices to use them as they review facilities' scope of services. To ensure that facilities are effectively managing their resources, IHS has a process to guide its review of facilities' proposed construction projects that cost at least $25,000. However, IHS does not have a similar process to guide its oversight of other key proposed expenditures, such as those involving the purchase of major medical equipment, the hiring of providers, or the expansion of services. Specifically, GAO found limitations and inconsistencies with respect to requiring a documented justification for proposed expenditures; documenting the review and approval of decisions; and conducting an impact assessment on patient access, cost, and quality of care. The limitations and inconsistencies that GAO found in IHS's oversight are driven by the lack of consistent oversight processes across the area offices. Without establishing a systematic oversight process to compare federally operated facilities' current services to population needs, and to guide the review of facilities' proposed expenditures, IHS cannot ensure that its facilities are identifying and investing in projects to meet the greatest community needs, and therefore that federal resources are being maximized to best serve the AI/AN population. IHS, an agency of the Department of Health and Human Services, provides care to AI/AN populations through a system of federally operated and tribally operated health care facilities. AI/AN have experienced long standing problems accessing needed health care services. GAO has previously reported that IHS has not been able to pay for all eligible health care services; however, the resources available to federally operated facilities have recently grown. This report assesses IHS oversight of federal health care facilities' decision-making about the use of funds. GAO reviewed IHS policies and documents; and interviewed IHS officials from headquarters, nine area offices, and three federally operated facilities (two hospitals and one health clinic). GAO recommends that IHS develop processes to guide area offices in (1) systematically assessing how federally operated facilities will effectively meet the needs of their patient populations, and (2) reviewing federal facilities' spending proposals. HHS concurred with these recommendations. For more information, contact Jessica Farb at (202) 512-7114 or farbj@gao.gov.
    [Read More…]
  • The Importance of Diversity and Inclusion in Diplomacy: A Conversation with Security Engineering Officer Rahim Theriot
    In Crime Control and Security News
    Bureau of Diplomatic [Read More…]
  • The Nation’s Fiscal Health: Effective Use of Fiscal Rules and Targets
    In U.S GAO News
    In fiscal year 2019, debt held by the public reached 79 percent of gross domestic product (GDP). The government's fiscal response to COVID-19 combined with the severe economic contraction from the pandemic will substantially increase federal debt. The Congressional Budget Office (CBO) projected that debt held by the public will reach 98 percent of GDP by the end of fiscal year 2020. The nation's fiscal challenges will require attention once the economy has substantially recovered and public health goals have been attained. GAO has previously reported that a long-term plan is needed to put the government on a sustainable fiscal path. Other countries have used well-designed fiscal rules and targets—which constrain fiscal policy by controlling factors like expenditures or revenue—to contain excessive deficits. For example, Germany's constitution places limits on its deficits. The U.S. federal government has previously enacted fiscal rules, such as those in the Budget Control Act of 2011. However, current fiscal rules have not effectively addressed the misalignment between spending and revenues over time. GAO identified key considerations to help Congress if it were to adopt new fiscal rules and targets, as part of a long-term plan for fiscal sustainability (see table). Key Considerations for Designing, Implementing, and Enforcing Fiscal Rules and Targets Setting clear goals and objectives can anchor a country's fiscal policy. Fiscal rules and targets can help ensure that spending and revenue decisions align with agreed-upon goals and objectives. The weight given to tradeoffs among simplicity, flexibility, and enforceability depends on the goals a country is trying to achieve with a fiscal rule. In addition, there are tradeoffs between the types and combinations of rules, and the time frames over which the rules apply. The degree to which fiscal rules and targets are binding, such as being supported through a country's constitution or nonbinding political agreements, can impact their permanence, as well as the extent to which ongoing political commitment is needed to uphold them. Integrating fiscal rules and targets into budget discussions can contribute to their ongoing use and provide for a built-in enforcement mechanism. The budget process can include reviews of fiscal rules and targets. Fiscal rules and targets with limited, well-defined exemptions, clear escape clauses for events such as national emergencies, and adjustments for the economic cycle can help a country address future crises. Institutions supporting fiscal rules and targets need clear roles and responsibilities for supporting their implementation and measuring their effectiveness. Independently analyzed data and assessments can help institutions monitor compliance with fiscal rules and targets. Having clear, transparent fiscal rules and targets that a government communicates to the public and that the public understands can contribute to a culture of fiscal transparency and promote fiscal sustainability for the country. Source: GAO analysis of literature review and interviews. | GAO-20-561 Our nation faces serious challenges at a time when the federal government is highly leveraged in debt by historical norms. The imbalance between revenue and spending built into current law and policy have placed the nation on an unsustainable long-term fiscal path. Fiscal rules and targets can be used to help frame and control the overall results of spending and revenue decisions that affect the debt. GAO was asked to review fiscal rules and targets. This report (1) assesses the extent to which the federal government has taken action to contribute to long-term fiscal sustainability through fiscal rules and targets, and (2) identifies key considerations for designing, implementing, and enforcing fiscal rules and targets in the U.S. GAO compared current and former U.S. fiscal rules to literature on the effective use of rules and targets; reviewed CBO reports and relevant laws; and interviewed experts. GAO conducted case studies of national fiscal rules in Australia, Germany, and the Netherlands. Congress should consider establishing a long-term fiscal plan that includes fiscal rules and targets, such as a debt-to-GDP target, and weigh GAO's key considerations to ensure proper design, implementation, and enforcement of these rules and targets. The Department of the Treasury and other entities provided technical comments, which GAO incorporated as appropriate. For more information, contact Jeff Arkin, at (202) 512-6806 or arkinj@gao.gov.
    [Read More…]
  • U.S. Special Envoy to Monitor and Combat Anti-Semitism Elan S. Carr On Recent Progress In the Fight Against Anti-Semitism
    In Crime Control and Security News
    Elan S. Carr, Special [Read More…]
  • The Free World’s Leadership Will Defeat COVID-19
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Former Supervisory Corrections Officer Sentenced for Repeatedly Tasing Restrained Detainee
    In Crime News
    Former supervisory corrections officer Mark Bryant, 42, was sentenced today to 5 years in prison for repeatedly tasing a restrained pretrial detainee inside the Cheatham County Jail in Tennessee. In January 2020, a jury in the Middle District of Tennessee convicted Bryant of two counts of violating Title 18, U.S. Code, Section 242, for using excessive force while acting under color of law. 
    [Read More…]
  • 2019 END Wildlife Trafficking Report
    In Climate - Environment - Conservation
    Bureau of Oceans and [Read More…]
  • Finland National Day
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Office for Victims of Crime Awards Nearly $4 Million to Support Sexual Assault Nurse Examiner Programs
    In Crime News
    The Office of Justice [Read More…]
  • Kevin M. Epstein Appointed as U.S. Trustee for the Southern and Western Districts of Texas
    In Crime News
    Attorney General William P. Barr has appointed Kevin M. Epstein as the U.S. Trustee for the Southern and Western Districts of Texas (Region 7) effective Jan. 1, 2021, the Executive Office for U.S. Trustees (EOUST) announced today.
    [Read More…]
  • Secretary Pompeo’s Meeting with Slovenian Foreign Minister Logar
    In Crime Control and Security News
    Office of the [Read More…]
  • Owner of Montana Construction Company Pleads Guilty to Employment Tax Fraud
    In Crime News
    A Great Falls, Montana, businessman pleaded guilty today to employment tax fraud, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division and U.S. Attorney Kurt G. Alme for the District of Montana.
    [Read More…]
  • Democratic Republic of the Congo Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • History, Ambition, and Technology: The Chinese Communist Party’s Challenges to U.S. Export Control Policy
    In Crime Control and Security News
    Dr. Christopher Ashley [Read More…]
  • The Ortega Regime’s New Authoritarian Law Undermines Democracy
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • PRC Military Pressure Against Taiwan Threatens Regional Peace and Stability
    In Crime Control and Security News
    Ned Price, Department [Read More…]
  • Deputy Secretary Biegun’s Calls with Armenian Foreign Minister Mnatsakanyan and Azerbaijani Foreign Minister Bayramov
    In Crime Control and Security News
    Office of the [Read More…]
  • Vanuatu Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Justice Department Seeks Forfeiture of Two Commercial Properties Purchased with Funds Misappropriated from PrivatBank in Ukraine
    In Crime News
    The United States filed two civil forfeiture complaints today in the U.S. District Court for the Southern District of Florida alleging that commercial real estate in Louisville, Kentucky, and Dallas, Texas, both acquired using funds misappropriated from PrivatBank in Ukraine, are subject to forfeiture based on violations of federal money laundering statutes.
    [Read More…]
  • Montenegro Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Jamaica Travel Advisory
    In Travel
    Reconsider travel [Read More…]
  • NFL Player Charged for Role in $24 Million COVID-Relief Fraud Scheme
    In Crime News
    An NFL player has been charged for his alleged participation in a scheme to file fraudulent loan applications seeking more than $24 million in forgivable Paycheck Protection Program (PPP) loans guaranteed by the Small Business Administration (SBA) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
    [Read More…]
  • Bangladeshi National Sentenced for Conspiracy to Bring Aliens to the United States
    In Crime News
    A Bangladeshi national formerly residing in Monterrey, Mexico, was sentenced to 46 months in prison followed by three years of supervised release for his role in a scheme to smuggle aliens from Mexico into the United States.
    [Read More…]
  • On the First Anniversary of the Death of Abu Bakr al-Baghdadi 
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Attorney General Barr Chairs Meeting of the Federal Interagency Council on Crime Prevention and Improving Reentry
    In Crime News
    Attorney General William [Read More…]
  • U.S Department of Agriculture-Office of Inspector General and Justice Department Conduct Animal Welfare Criminal Investigations Training
    In Crime News
    On Sept. 14 to 18, criminal investigators and attorneys from the U.S. Department of Agriculture’s Office of Inspector General (USDA-OIG) and the U.S. Justice Department’s Environment and Natural Resources Division (ENRD) collaborated to put on a week-long training for USDA-OIG criminal investigators, as well as other federal law enforcement agencies on animal welfare criminal investigations and prosecutions.
    [Read More…]
  • Medicaid Long-Term Services and Supports: Access and Quality Problems in Managed Care Demand Improved Oversight
    In U.S GAO News
    At the state and federal levels, GAO found weaknesses in the oversight of Medicaid managed long-term services and supports (MLTSS), which assist individuals with basic needs like bathing or eating. Through various monitoring approaches, six selected states identified significant problems in their MLTSS programs with managed care organization (MCO) performance of care management, which includes assessing beneficiary needs, authorizing services, and monitoring service provision to ensure quality and access to care. State efforts may not be identifying all care management problems due to limitations in the information they use to monitor MCOs, allowing some performance problems to continue over multiple years. Performance Problems in Managed Care Organization (MCO) Care Management, Identified by Selected States GAO found that the Centers for Medicare & Medicaid Services' (CMS) oversight of state implementation of its 2016 requirements, and of access and quality in MLTSS more broadly, was limited. This hinders the agency's ability to hold states and MCOs accountable for quality and access problems beneficiaries may face. Oversight did not detect quality and access problems. GAO identified cases where CMS learned about problems not through its regular oversight, but instead from beneficiary complaints, media reports, or GAO. CMS officials said that states had not reported these problems to the agency. Lack of national oversight strategy and assessment of problems in MLTSS. Weaknesses in oversight reflect a broader area of concern—namely, that CMS lacks a strategy for oversight. CMS also has not assessed the nature and extent of access and quality problems across states. Without a strategy and more robust information, CMS risks being unable to identify and help address problems facing beneficiaries. As of July 2020, CMS had convened a new workgroup focused on MLTSS oversight, though the goals and time frames for its work were unclear. An increasing number of states are using managed care to deliver long-term services and supports in their Medicaid programs, thus delegating decisions around the amounts and types of care beneficiaries receive to MCOs. Federal guidance requires that MLTSS programs include monitoring procedures to ensure the appropriateness of those decisions for this complex population, which includes adults and children who may have physical, cognitive, and mental disabilities. GAO was asked to review care management in MLTSS programs. Among other things, this report examines state monitoring of care management, and CMS oversight of state implementation of 2016 requirements related to MLTSS quality and access. GAO examined documentation of monitoring procedures and problems identified in six states selected for variation in program age and location. GAO reviewed federal regulations and oversight documents, interviewed state and federal Medicaid officials, and assessed CMS's policies and procedures against federal internal control standards. GAO is making two recommendations to CMS to (1) develop a national strategy for overseeing MLTSS, and (2) assess the nature and prevalence of MLTSS quality and access problems across states. CMS did not concur with the recommendations. GAO maintains the recommendations are warranted, as discussed in this report. For more information, contact at (202) 512-7114 or yocomc@gao.gov.
    [Read More…]