Joint Statement on Hong Kong

Office of the Spokesperson

The text of the following statement was released by the Governments of the United States of America, Australia, Canada, New Zealand, and the United Kingdom.

Begin Text:

We, the Foreign Ministers of Australia, Canada, New Zealand, and the United Kingdom, and the United States Secretary of State, reiterate our serious concern regarding China’s imposition of new rules to disqualify elected legislators in Hong Kong. Following the imposition of the National Security Law and postponement of September’s Legislative Council elections, this decision further undermines Hong Kong’s high degree of autonomy and rights and freedoms.

China’s action is a clear breach of its international obligations under the legally binding, UN-registered Sino-British Joint Declaration. It breaches both China’s commitment that Hong Kong will enjoy a ‘high degree of autonomy’, and the right to freedom of speech.

The disqualification rules appear part of a concerted campaign to silence all critical voices following the postponement of September’s Legislative Council elections, the imposition of charges against a number of elected legislators, and actions to undermine the freedom of Hong Kong’s vibrant media.

We call on China to stop undermining the rights of the people of Hong Kong to elect their representatives in keeping with the Joint Declaration and Basic Law. For the sake of Hong Kong’s stability and prosperity, it is essential that China and the Hong Kong authorities respect the channels for the people of Hong Kong to express their legitimate concerns and opinions.

As a leading member of the international community, we expect China to live up to its international commitments and its duty to the people of Hong Kong. We urge the Chinese central authorities to re-consider their actions against Hong Kong’s elected legislature and immediately reinstate the Legislative Council members.

End text.

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    Like other U.S. territories and states, Puerto Rico implements major functions of its Medicaid program by procuring services from contractors, such as the delivery of managed care services to Medicaid beneficiaries. In 2018, procurement costs represented $2.4 billion of Puerto Rico's $2.5 billion in total Medicaid expenditures. A 2019 federal indictment alleging Puerto Rico officials unlawfully steered Medicaid contracts to certain individuals has raised concerns about Puerto Rico's Medicaid procurement process, including whether this process helps ensure appropriate competition. The Centers for Medicare & Medicaid Services (CMS), within the Department of Health and Human Services, is responsible for overseeing the Medicaid program. CMS requires states and territories to use the same process for Medicaid procurements as they do for their non-federal procurements. However, CMS has not taken steps to ensure Puerto Rico has met this requirement. Instead, CMS has relied on Puerto Rico to oversee the territory's procurement process and to attest to its compliance. CMS approved Puerto Rico's attestation of compliance in 2004 and has not required subsequent updates. CMS officials told GAO that states and territories are in the best position to ensure compliance with their respective procurement laws. GAO and others have found that competition is a cornerstone of procurement. Using competition can reduce costs, improve contractor performance, curb fraud, and promote accountability. GAO reviewed selected Puerto Rico Medicaid procurements against federal procurement standards designed to promote competition and reduce risks of fraud. States and territories are generally not required to meet such standards. However, GAO and others have found that such standards can indicate whether a state's or territory's procurement process includes necessary steps to achieve fair competition. GAO found that seven of the eight selected Puerto Rico procurements did not include important steps to promote competition and mitigate the risk for fraud, waste, and abuse, underscoring the need for federal oversight. Competitive procurements. The requests for proposals for two of the three competitive procurements GAO reviewed did not include certain information on factors used to evaluate proposals and make awards. In contrast, Puerto Rico's managed care procurement—the largest procurement reviewed—included this information. Noncompetitive procurements. None of the five noncompetitive procurements GAO reviewed documented circumstances to justify not using competitive procurements, such as a lack of competition or an emergency. Puerto Rico officials explained that territorial law allows noncompetitive procurement for professional services regardless of circumstances. Because CMS does not oversee Puerto Rico's procurement process, the agency lacks assurance that Puerto Rico's Medicaid program is appropriately managing the risk of fraud, waste, and abuse. Procurements that did not include important steps to promote competition could have unnecessarily increased Medicaid costs, reducing funding for Medicaid services to beneficiaries. States' and U.S. territories' Medicaid procurement processes can directly affect their ability to prevent fraud, waste, and abuse in the program. A 2019 federal indictment alleging fraudulent Medicaid procurements in Puerto Rico has raised questions about the program's oversight. The Consolidated Appropriations Act, 2020 includes a provision for GAO to review oversight of Puerto Rico's Medicaid procurement process and its use of competition. This report examines CMS oversight of Puerto Rico's procurement process from its initial steps through the award, and how it helps ensure competition. GAO reviewed federal regulations, guidance, and Puerto Rico's December 2020 procurement reform plan; interviewed Puerto Rico and federal officials; and reviewed eight awards that represented about 97 percent of the costs of Puerto Rico's procurements in effect as of April 2020. These procurements were selected based on variation in cost, use of competition, and other factors. GAO assessed whether CMS addressed risks in Puerto Rico's procurement process by reviewing selected procurements against certain federal standards that apply to other non-federal entities and aim to mitigate the risk of fraud, waste, and abuse. GAO also assessed CMS's policies and procedures against federal internal control standards. GAO recommends that CMS implement risk-based oversight of the Medicaid procurement process in Puerto Rico. The Department of Health and Human Services concurred with this recommendation. For more information, contact Carolyn L. Yocom at (202) 512-7114 or YocomC@gao.gov.
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  • Department of Defense: Eating Disorders in the Military
    In U.S GAO News
    The Department of Defense (DOD) screens for eating disorders for all applicants entering into the military but does not specifically screen servicemembers for eating disorders after entrance. However, after joining the military, servicemembers receive annual health screenings, and medical personnel may be able to diagnose eating disorders during in-person physical exams. Service branch behavioral health specialists told GAO that DOD medical personnel are trained to notice signs of eating disorders, such as changes in vital signs and emaciated appearance. DOD is examining ways to improve its screening of eating disorders in the military and recently expanded the available research funding for eating disorders in its Peer-Reviewed Medical Research Program (PRMRP). DOD provides health care services to approximately 9.5 million eligible beneficiaries, including services to treat those diagnosed with eating disorders, through TRICARE, DOD’s regionally structured health care system. Servicemembers can obtain these services at military treatment facilities—referred to as direct care—or receive care purchased from civilian providers—referred to as purchased care. DOD officials told us that the specialized level of care necessary to treat eating disorders is available to TRICARE beneficiaries through purchased care, rather than direct care. The Defense Health Agency (DHA), which oversees the TRICARE program, uses two contractors to develop regional provider networks. According to the two TRICARE contractors’ data for purchased care, as of spring 2020, there were 166 eating disorder facilities located in 32 states throughout the country and the District of Columbia. The facilities vary by geographic location, population served, and level of treatment provided: Geography: About half of the 166 facilities (79) are located in the following five states: California (24), Florida (18), Illinois (15), Texas (13), and Virginia (nine).  Population: Of the 166 eating disorder facilities, over three-quarters provide treatment to both adult (132 facilities) and child and adolescent (132 facilities) populations. Level of Treatment: Most facilities provide inpatient hospitalization programs, which are for serious cases requiring medical stabilization (81 facilities); partial hospitalization, which are day programs providing treatment 5 to 7 days a week (133 facilities); or intensive outpatient programs, which are treatment programs providing therapy 2 to 6 days a week (107 facilities). About one-fifth of the facilities (35) provide residential treatment services, which are living accommodations providing intensive therapy and 24-hour supervision. TRICARE contractors have met with some challenges entering into contracts with eating disorder treatment facilities in certain areas of the country, according to DHA officials and both contractors. However, both contractors told GAO they consider it their responsibility to ensure beneficiaries receive the care they need regardless of the location of the facility. No access-to-care complaints related to eating disorder treatment were reported by TRICARE beneficiaries, according to the most recent DHA data for years 2018 through 2019. Eating disorders are complex conditions affecting millions of Americans and involve dangerous eating behaviors, such as the restriction of food intake. They can have a severe impact on heart, stomach, and brain functionality, and they significantly raise the risk of mortality. Many with eating disorders also experience co-occurring conditions such as depression. Research has yielded a range of estimates of the number of servicemembers with an eating disorder, due to differences in research methods. For example, a 2018 DOD study concluded that servicemembers likely experienced eating disorders at rates that are comparable to rates in the general population, while other survey-based research suggested the number of servicemembers with eating disorders may be higher than those with a medical diagnoses of such disorders. The potential effects that eating disorders can have on the health and combat readiness of servicemembers and their dependents underscores the importance of screening and treating this population. GAO was asked to provide information on eating disorders among servicemembers and their dependents. To describe how DOD screens for eating disorders among servicemembers, GAO reviewed DOD policies related to health screening and interviewed behavioral health specialists from the military branches. To understand approaches and challenges with implementing screening in a military environment, any planned or ongoing DOD-sponsored research related to this topic, and available eating disorder treatment, GAO interviewed representatives from the Eating Disorder Coalition, Uniformed Services University of Health Sciences, and the University of Kansas. To describe how DOD provides eating disorder treatment to servicemembers and their dependents, GAO interviewed DHA officials and TRICARE contractors and reviewed the TRICARE policy manual to identify the types of eating disorder diagnoses and treatments that are covered through direct and purchased care. GAO received data from the two TRICARE contractors related to the availability of eating disorder treatment services as of spring 2020. For more information, contact Sharon Silas at (202) 512-7114 or Silass@gao.gov.
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    In Crime News
    A criminal complaint was unsealed today in federal court in the Eastern District of New York charging Baimadajie Angwang, 33, a New York City Police Department officer and United States Army reservist, with acting as an illegal agent of the People’s Republic of China (PRC) as well as committing wire fraud, making false statements and obstructing an official proceeding. Angwang was arrested earlier today in Williston Park, New York, and his initial appearance is scheduled for this afternoon before United States Magistrate Judge Peggy Kuo at the United States Courthouse in Brooklyn, New York.
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  • Owner and Operator of India-Based Call Centers Sentenced to Prison for Scamming U.S. Victims out of Millions of Dollars
    In Crime News
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  • Lake Ontario-St. Lawrence River Plan: Improved Communication and Adaptive Management Strategy Could Help Address Stakeholder Concerns
    In U.S GAO News
    The International Joint Commission's (IJC) process for developing and selecting the Lake Ontario-St. Lawrence River Plan 2014 (Plan 2014) was generally consistent with relevant essential elements of risk-informed decision-making. During the 18-year process, IJC took steps to define objectives and performance measures to be used in its decision-making, identify various options, assess uncertainties like climate change, and engage with stakeholders, among other steps. These steps are all essential elements of risk-informed decision making. Plan 2014 Affects Various Users of Lake Ontario and the St. Lawrence River, Including (from Left to Right) Commercial Navigation, Coastal Development, and Recreational Boating, Including Marinas IJC uses two mechanisms—a communications committee and a strategic communication plan—and a variety of methods—such as its website, social media, and public meetings—to communicate with stakeholders about its implementation of Plan 2014. Nevertheless, 12 of the 14 stakeholders GAO interviewed expressed concerns about IJC's communication. GAO found that IJC's strategic communication plan and related documents partially align with best practices. For example, the communication plan and related documents do not comprehensively identify target audiences or include mechanisms to monitor and evaluate the effectivness of their communication efforts. Updating its strategic communication plan to align with best practices and principles for risk communication could help IJC ensure improved stakeholder communication. Of the 14 stakeholders interviewed, nine expressed concerns about the rules and criteria in Plan 2014 and 10 expressed concerns about its implementation. For example, seven stakeholders told us that they do not believe that the Plan allows IJC to act proactively in anticipation of future water conditions. IJC has taken initial steps to develop an adaptive management process that may help address stakeholder concerns and approved a long-term adaptive management strategy in March 2020. However, the document does not fully incorporate the key elements and essential characteristics of an adaptive management process that could help IJC transparently and effectively assess Plan 2014 and adjust future actions to achieve the plan's objectives. For example, the Plan does not fully incorporate a communication strategy for engaging stakeholders throughout the process or information on how IJC will determine if adjustments to the Plan's rules and criteria are warranted. Water releases from Lake Ontario into the St. Lawrence River are determined by a set of regulatory rules and criteria called Plan 2014—issued pursuant to IJC's Supplementary Order of Approval and the Boundary Waters Treaty of 1909. The IJC—a binational commission—developed and issued the Plan and Order with the concurrence of the United States and Canada. The rules affect a variety of users of the waterway, including ecosystems, hydropower, and municipal and industrial water use. After flooding from the lake and river in 2017, GAO was asked to examine the process IJC used to develop and evaluate Plan 2014 and how IJC has addressed stakeholder concerns. This report examines (1) the extent to which IJC's process to develop and select Plan 2014 was consistent with essential elements of risk-informed decision-making, (2) actions IJC has taken to communicate with stakeholders about its implementation of Plan 2014 and stakeholder concerns regarding IJC's communication, and (3) stakeholder concerns about Plan 2014 and the extent to which IJC has developed a process to assess and adjust Plan 2014. GAO reviewed Plan 2014 and other IJC documents, interviewed IJC and federal officials and a nongeneralizable sample of 14 stakeholders, selected for a variety of user interests and stakeholder types. GAO is making three recommendations, including that the U.S. Section of the IJC work with its Canadian counterpart to ensure that the communication plan aligns with best practices and the adaptive management strategy fully incorporates key elements. IJC agreed with our recommendations. For more information, contact J. Alfredo Gómez at (202) 512-3841 or gomezj@gao.gov.
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  • Justice Department Settles with New Jersey-Based Staffing Company to Resolve Immigration-Related Discrimination Claims
    In Crime News
    The Justice Department announced today that it reached a settlement with Collabera, Inc., a Basking Ridge, New Jersey-based information technology (IT) staffing agency.  The settlement resolves the department’s claims that Collabera violated the Immigration and Nationality Act (INA) when it discriminated against work-authorized non-U.S. citizens.
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  • Forced Labor Imports: DHS Increased Resources and Enforcement Efforts, but Needs to Improve Workforce Planning and Monitoring
    In U.S GAO News
    Since 2016, U.S. Customs and Border Protection (CBP), within the Department of Homeland Security (DHS), has increased its resources to enforce a prohibition on importing goods made with forced labor, but has not determined its workforce needs. CBP formed the Forced Labor Division in 2018 to lead its efforts, and increased expenditures for the division from roughly $1 million in fiscal year 2018 to $1.4 million in fiscal year 2019. However, CBP has not assessed and documented the staffing levels or skills needed for the Forced Labor Division. For example, the division suspended some ongoing investigations due to a staff shortage and has plans to expand and train its workforce; however, the division has not assessed the number, type, locations, or specialized skills of positions it needs to achieve programmatic results. Without assessing its workforce needs, the division lacks reasonable assurance that it has the right number of people, with the right skills, in the right places. CBP has increased forced labor investigations and civil enforcement actions, but managers lack complete and consistent data summarizing cases. CBP detained shipments under 13 Withhold Release Orders (WRO) from 2016 through 2019, as shown in the figure below. However, the Forced Labor Division uses incomplete and inconsistent summary data to monitor its investigations. For example, data were missing on the sources of evidence collected for almost all active cases. Incomplete and inconsistent summary data on the characteristics and status of cases may hinder managers' effective monitoring of case progress and enforcement efforts. Figure: U.S. Customs and Border Protection (CBP) Forced Labor Withhold Release Orders, 2016 through 2019 With regard to criminal violations, DHS's U.S. Immigration and Customs Enforcement (ICE) has increased its resources to investigate allegations of forced labor, including those related to U.S. imports. ICE coordinates criminal investigations of forced labor, conducted in the U.S. and abroad. ICE reported spending about $40 million on forced labor investigations in fiscal year 2019, an increase of over 50 percent since 2016. Forced labor investigations often involve a range of criminal violations, including violations that are not related to the importation of goods. As such, reported expenditures include costs for cases on related issues, such as human trafficking. Forced labor is a global problem in which individuals are exploited to perform labor or services. The International Labour Organization estimates that forced labor generates profits of $150 billion a year globally. CBP is responsible for enforcing Section 307 of the Tariff Act of 1930, which prohibits the importation of goods made with forced labor. CBP has authority to detain shipments when information indicates that forced labor produced the goods. ICE is responsible for investigating potential crimes related to forced labor, and importers may be subject to prosecution. GAO was asked to review the status of DHS resources for implementing the Section 307 prohibition on forced labor imports, following an amendment of the law in 2016. This report examines (1) the extent to which CBP assessed agency needs for the enforcement of the prohibition on forced labor imports, (2) the outcome of CBP enforcement activities and monitoring of such efforts, and (3) ICE resources for investigations on forced labor. GAO reviewed CBP and ICE documents and data, and interviewed agency officials. This is a public version of a sensitive report GAO issued in July 2020. Information that CBP deemed sensitive has been omitted. GAO is making three recommendations, including that CBP assess the workforce needs of the Forced Labor Division, and improve its forced labor summary case data. CBP concurred with all three recommendations. For more information, contact Kimberly Gianopoulos at (202) 512-8612 or gianopoulosk@gao.gov.
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    In Crime News
    A rheumatology professor and researcher with strong ties to China pleaded guilty to making false statements to federal authorities as part of an immunology research fraud scheme. Song Guo Zheng, 58, of Hilliard, appeared in federal court today, at which time his guilty plea was accepted by Chief U.S. District Judge Algenon L. Marbley.
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