Release of the U.S. Strategy to Prevent Conflict and Promote Stability

Michael R. Pompeo, Secretary of State

America’s prosperity and security depend on peaceful, self-reliant, U.S. economic and security partners.  By breaking the costly cycle of conflict and instability, the United States advances its own security.  Today, the Department of State released the U.S Strategy to Prevent Conflict and Promote Stability.  This Strategy sets forth a framework for U.S. government efforts to prevent conflict, stabilize conflict-affected areas, and address global fragility, in line with the Global Fragility Act of 2019.  The Strategy will reinforce the National Security Strategy, which commits the United States to strengthening the resilience of communities and states “where state weakness or failure would magnify threats to the American homeland.”

The Strategy emphasizes bilateral, multilateral, public-private, and civil society partnerships.  It elevates prevention and facilitates an integrated U.S. response.  It was developed through extensive consultations with stakeholders and partners, including civil society experts, non‑governmental organizations, government partners, and multilateral agencies.  The United States is committed to sustaining a consultative, collaborative approach throughout Strategy implementation, monitoring, and evaluation.

Read the Strategy here.

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    As of October 2020, the Departments of Defense (DOD) and Veterans Affairs (VA) had jointly developed 22 clinical practice guidelines (VA/DOD CPG) that address specific health conditions, including those related to chronic diseases, mental health issues, pain management, and rehabilitation. Such guidelines are important as military and veteran populations may have different health care needs than civilians due to involvement in combat or occupational exposures (e.g., fumes from burn pits) that may amplify physical and psychological stresses. GAO found that DOD and VA considered the health care needs of these populations throughout the guideline development process and that the guidelines include information about these health care needs in different sections. In some cases, the guidelines include treatment recommendations that specifically address the health care needs of the military and veteran populations. In other instances, they may include information about the prevalence of a specific condition for these populations, among other information. Each of the military services (Army, Air Force, and Navy) has its own process for distributing VA/DOD CPGs to providers at their military treatment facilities (MTF). However, DOD's Defense Health Agency (DHA) is in the process of assuming administrative operations—to include distributing guidelines—for all of the military services' MTFs through an incremental transition process that is to be completed by the end of September 2021. While DHA officials acknowledged that they need to develop a uniform distribution process for the guidelines once they complete the transition, MTF providers can currently access the guidelines through VA's designated website and DOD's electronic health record systems. Congress directed DOD to implement VA/DOD CPGs, using means such as providing education and training, and to monitor MTFs' implementation of them. However, GAO found that DHA and the military services are not systematically monitoring MTFs' implementation of these guidelines. While the Army tracks VA/DOD CPG education and training at its MTFs, officials with DHA, the Navy, and the Air Force explained that they have not been monitoring MTF implementation of these guidelines. DHA officials acknowledged that they need to develop a monitoring process as they assume administrative and oversight responsibilities for the military services' MTFs, but have not yet developed a plan to do so. Without a systematic process to monitor MTF implementation of these guidelines, DHA does not know the extent to which MTF providers may be using VA/DOD CPGs to reduce the variability and improve the quality of health care services provided—factors that may contribute to better health outcomes across the military health system. Through DOD's TRICARE program, eligible beneficiaries may receive care from providers at MTFs or from civilian providers. The National Defense Authorization Act for Fiscal Year 2017 required DOD to establish a program to develop, implement, update, and monitor clinical practice guidelines, which are evidence-based treatment recommendations to improve the consistency and quality of care delivered by MTF providers. The Act also included a provision for GAO to assess issues related to the military health system, including the process of ensuring that providers adhere to clinical practice guidelines, and to report annually for 4 years. This is GAO's fourth report based on the Act. This report describes (1) how the process for developing the guidelines considers the health care needs of the military and veteran populations, (2) how they are distributed by the military services to their providers and how providers access them, and (3) the extent to which DHA and the military services monitor MTF implementation of them, among other things. GAO reviewed relevant policies and guidance; analyzed each of the 22 CPGs; and interviewed officials with DOD, the military services, and VA. GAO recommends that DHA work with the military services to develop and implement a systematic process to monitor MTFs' implementation of VA/DOD CPGs. DOD concurred with this recommendation. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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  • Higher Education: Children’s Savings Account Programs Can Help Families Build Savings and Envision College
    In U.S GAO News
    Eighty-two Children's Savings Account (CSA) programs operated and had collectively enrolled about 700,000 children in 2019, according to survey data from the nonprofit organization Prosperity Now. These programs—operated by states, cities, and other organizations—use a variety of strategies to enroll families, especially those with lower incomes, and help them save and prepare for college. For example, CSA programs enroll families by partnering with trusted organizations (e.g., schools) or through automatic enrollment, according to the Consumer Financial Protection Bureau (CFPB) and CSA experts. In addition, these programs help families build savings once children are enrolled by, for example, providing initial deposits or financial education. While experts GAO interviewed said savings may be modest given lower-income families' and programs' limited resources, CSA programs also aim to help lower-income families prepare for college, such as by increasing financial knowledge. There is evidence that CSA program strategies have positive short-term effects on families, including those with lower incomes. These effects include increased CSA program enrollment and participation, amounts saved, and educational expectations, based on research GAO reviewed (see figure). For example, strategies such as automatically enrolling families and providing financial contributions (e.g., initial deposits) may help CSA programs reach more families and encourage saving. Several studies of a CSA program that used both these strategies found increases in the number of children enrolled and the amount saved by enrolled families. One study found that families who were enrolled for 7 years saved over four times more of their own money, on average, than families who were not enrolled—$261 compared to $59. When including financial contributions from the CSA program, enrolled families had about six times more total savings ($1,851) compared to other families ($323). Enrollment and participation in CSA programs may also increase families' educational expectations for their children. For example, a study found that parents with children enrolled in one CSA program were nearly twice as likely to expect their children to attend college. However, information on college enrollment and other long-term effects on families participating in CSA programs is limited because most of the children have not yet reached college age. Effects of CSA Program Strategies in Three Commonly Assessed Areas Rising college costs have outpaced federal grant aid and placed more of the financial burden on students and their families. CSA programs help families, especially lower-income families, save for college—and other postsecondary education—by providing financial contributions and possibly other supports. A Senate Appropriations Committee report included provisions for GAO to examine various aspects of college savings account programs and their effectiveness. This report examines (1) the number of CSA programs and how they use strategies to help families, especially lower-income families, save and prepare for college; and (2) what is known about the effects of these strategies on families, including lower-income families. GAO reviewed 2016–2019 annual CSA program survey data collected by the nonprofit Prosperity Now. GAO also analyzed CFPB documents and the findings of 33 peer-reviewed studies from 2010 through 2019—and one working paper from 2017—that met GAO's criteria for inclusion, for example, used data from the United States. In addition, GAO interviewed officials from CFPB, the Department of Education, and four organizations that have expertise on these programs. For more information, contact Melissa Emrey-Arras at (617) 788-0534 or emreyarrasm@gao.gov.
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  • Amateur Athletes: The U.S. Center for SafeSport’s Response and Resolution Process for Reporting Abuse
    In U.S GAO News
    The U.S. Center for SafeSport (the Center), an independent nonprofit organization, was established in response to concerns about the consistency of investigations conducted and resolutions reached by amateur sports organizations of allegations of misconduct and abuse. According to Center staff, their response to allegations of misconduct are guided by the SafeSport Code, which establishes acceptable standards of conduct for all individuals who participate in U.S. Olympic and Paralympic events and training, Standard Operating Procedures (SOPs), and other tools. The SafeSport Code defines the scope of the Center's jurisdiction, establishes the standard of proof for its decisions, identifies types of prohibited conduct, describes possible temporary measures and sanctions, and outlines the resolution process and requirements to report to law enforcement. SOPs outline intake and investigation staff roles and responsibilities and provide a step-by-step guide of processes, and a case management system is used by intake and investigation staff to document their work. The Center seeks to ensure its intake and investigation process is fair by taking steps to ensure anonymity and privacy; providing opportunities for claimants (the persons alleged to have experienced misconduct) and respondents (the individuals accused of misconduct) to participate in investigations; and providing parties with the right to consult with an advisor and to seek arbitration of sanctions or other measures imposed by the Center. The Center refers to allegations of misconduct as cases when it establishes that it has enough information to proceed with intake and investigation. From February 2018 through June 2020, the Center created and resolved 3,909 cases. Most of the Center’s cases were resolved through administrative closure or jurisdictional closure. Administrative closure may occur as a result of insufficient evidence, claimants who elect not to participate in the resolution process, or other factors. Jurisdictional closure occurs when the Center does not have jurisdiction or the Center chooses not to exercise its discretionary jurisdiction, as defined in the SafeSport Code. As of June 30, 2020, approximately 1,300 individuals were listed in the Center’s Centralized Disciplinary Database; this number includes individuals placed on temporary restriction(s) or temporary suspension, as well as individuals suspended or rendered permanently ineligible to participate. On February 14, 2018, the Protecting Young Victims from Sexual Abuse and Safe Sport Authorization Act of 2017 was enacted, which codified the Center’s jurisdiction over the U.S. Olympic and Paralympic Committee and its affiliated organizations with regard to safeguarding amateur athletes against abuse in sports. It also required the Center to develop resources and policies to prevent abuse of amateur athletes. The Center investigates and resolves allegations of sexual misconduct by coaches, trainers, managers, peers, and others that may be in violation of the Center’s policies and procedures. In addition, the Center may, at its discretion, investigate and resolve allegations of other policy violations, including non-sexual child abuse and emotional and physical misconduct. The Center plays a key role in ensuring the safety of amateur athletes, many of whom are minors, who participate in Olympic, Paralympic, and Pan-American events and training. GAO was asked to describe the process the Center uses in responding to, investigating, and resolving allegations of misconduct. This report describes (1) how the Center responds to allegations of misconduct in amateur athletics and seeks to ensure its process for investigating and resolving allegations is fair, and (2) what is known about incidents reported to the Center from February 2018 through June 2020. GAO reviewed documents relevant to Center intake and investigation policies and practices and interviewed the Center's leadership, including individuals responsible for the intake and investigation of allegations of misconduct. In addition, GAO requested summary data for the period February 2018 through June 2020—the most recent data available—including information about allegations of misconduct and abuse, and the investigation and resolution of cases. For more information, contact Kathy A. Larin at (202) 512-7215 or larink@gao.gov.
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  • Chemical Security: Overlapping Programs Could Better Collaborate to Share Information and Identify Potential Security Gaps
    In U.S GAO News
    Eight federal programs addressing chemical safety or security from four departments or agencies that GAO reviewed contain requirements or guidance that generally align with at least half of the Department of Homeland Security's (DHS) 18 Chemical Facility Anti-Terrorism Standards (CFATS) program standards. At least 550 of 3,300 (16 percent) facilities subject to the CFATS program are also subject to other federal programs. Analyses of CFATS and these eight programs indicate that some overlap, duplication, and fragmentation exists, depending on the program or programs to which a facility is subject. For example, six federal programs' requirements or guidance indicate some duplication with CFATS. CFATS program officials acknowledge similarities among these programs' requirements or guidance, some of which are duplicative, and said that the CFATS program allows facilities to meet CFATS program standards by providing information they prepared for other programs. more than 1,600 public water systems or wastewater treatment facilities are excluded under the CFATS statute, leading to fragmentation. While such facilities are subject to other programs, those programs collectively do not contain requirements or guidance that align with four CFATS standards. According to DHS, public water systems and wastewater treatment facilities are frequently subject to safety regulations that may have some security value, but in most cases, these facilities are not required to implement security measures commensurate to their level of security risk, which may lead to potential security gaps. The departments and agencies responsible for all nine of these chemical safety and security programs—four of which are managed by DHS, three by the Environmental Protection Agency (EPA), and one each managed by the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) and the Department of Transportation (DOT)—have previously worked together to enhance information collection and sharing in response to Executive Order 13650, issued in 2013. This Executive Order directed these programs to take actions related to improving federal agency coordination and information sharing. However, these programs have not identified which facilities are subject to multiple programs, such that facilities may be unnecessarily developing duplicative information to comply with multiple programs. Although CFATS allows facilities to use information they prepared for other programs, CFATS program guidance does not specify what information facilities can reuse. Finally, DHS and EPA leaders acknowledged that there are differences between CFATS requirements and the security requirements for public water systems and wastewater treatment facilities, but they have not assessed the extent to which potential security gaps may exist. By leveraging collaboration established through the existing Executive Order working group, the CFATS program and chemical safety and security partners would be better positioned to minimize unnecessary duplication between CFATS and other programs and better ensure the security of facilities currently subject to fragmented requirements. Facilities with hazardous chemicals could be targeted by terrorists to inflict mass casualties or damage. Federal regulations applicable to chemical safety and security have evolved over time as authorizing statutes and regulations established programs for different purposes, such as safety versus security, and with different enforcement authorities. GAO has reported that such programs may be able to achieve greater efficiency where overlap exists by reducing duplication and better managing fragmentation. GAO was asked to review issues related to the effects that overlap, duplication, and fragmentation among the multiple federal programs may have on the security of the chemical sector. This report addresses the extent to which (1) such issues may exist between CFATS and other federal programs, and (2) the CFATS program collaborates with other federal programs. GAO analyzed the most recent available data on facilities subject to nine programs from DHS, EPA, ATF, and DOT; reviewed and analyzed statutes, regulations, and program guidance; and interviewed agency officials. GAO is making seven recommendations, including that DHS, EPA, ATF, and DOT identify facilities subject to multiple programs; DHS clarify guidance; and DHS and EPA assess security gaps. Agencies generally agreed with six; EPA did not agree with the recommendation on gaps. GAO continues to believe it is valid, as discussed in the report. For more information, contact Nathan Anderson at (206) 287-4804 or AndersonN@gao.gov.
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  • Automated Technologies: DOT Should Take Steps to Ensure Its Workforce Has Skills Needed to Oversee Safety
    In U.S GAO News
    Stakeholders GAO interviewed said that federal oversight of automated technologies—such as those that control a function or task of a plane, train, or vehicle without human intervention—requires regulatory expertise as well as engineering, data analysis, and cybersecurity skills. Stakeholders also stated that as automated systems become more common across transportation modes, overseeing them will require understanding vehicle operating systems, software code, and the vast amounts of data produced by these systems to ensure their safety. Skills Needed to Oversee the Safety of Automated Technologies, according to Stakeholders The U.S. Department of Transportation's (DOT) Departmental Office of Human Resources Management has identified most skills DOT needs to oversee automated technologies, but it has not fully assessed whether its workforce has these skills. Through its workforce planning efforts, DOT identified many of the skills cited by stakeholders as important for overseeing automated technologies—regulatory expertise, engineering, and data analysis. In 2016 and 2020, DOT surveyed staff in related positions and identified gaps in some of these skills, including regulatory expertise. However, DOT did not survey staff or assess skill gaps in data analysis or cybersecurity positions important to automated technology oversight. As a result, DOT lacks critical information needed to identify skill gaps and ensure key relevant staff are equipped to oversee the safety of these technologies now and in the future. DOT developed strategies to address some but not all gaps in skills needed to oversee automated technologies. For example, DOT implemented some recruiting strategies and established hiring goals as a means of closing gaps identified in the 2016 survey and plans to continue these efforts in light of the 2020 survey. However, DOT has not tracked the progress of strategies implemented to close skill gaps since the 2016 survey, nor has it implemented training strategies. Accordingly, some skill gaps related to overseeing the safety of automated technologies will likely persist in DOT's workforce. Automated technologies in planes, trains, and passenger vehicles are in use today and likely to become increasingly widespread. While these technologies hold promise, accidents involving them demonstrate potential safety challenges. DOT is responsible for overseeing the safety of all modes of transportation. This report addresses: (1) stakeholders' perspectives on the skills required to oversee automated technologies; (2) the extent to which DOT has identified and assessed the skills it needs to oversee these technologies; and (3) the extent to which DOT has developed strategies to address any gaps in skills. GAO reviewed relevant literature and DOT workforce planning documents, and interviewed DOT human capital officials, selected modal administrations, and stakeholders, including transportation associations and technology developers. GAO selected modal administrations based in part on the prevalence of automated technologies. GAO is making four recommendations, including that DOT: (1) assess skill gaps in key occupations involved in overseeing automated technologies and (2) regularly measure the progress of strategies implemented to close skill gaps. DOT concurred with three recommendations and partially concurred with one on measuring progress. GAO clarified this recommendation and believes its implementation is warranted. For more information, contact Heather Krause at (202) 512-2834 or krauseh@gao.gov.
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  • National Science Foundation: COVID-19 Affected Ongoing Construction of Major Facilities Projects
    In U.S GAO News
    What GAO Found Since GAO's April 2020 report on the status of the National Science Foundation's (NSF) major facilities projects, the Large Hadron Collider High Luminosity Upgrade program began construction, and it along with the four other major facilities projects in construction (see figure), have weathered schedule delays associated with the COVID-19 pandemic. To partially account for increased costs associated with the pandemic, such as the cost of paying project staff while work is paused, NSF has authorized $38.9 million in total project cost increases to the award recipients constructing three of the five projects: $18.9 million for the Daniel K. Inouye Solar Telescope, $10.0 million for the Vera C. Rubin Observatory, and $10.0 million for Regional Class Research Vessels. Because the pandemic is ongoing and its full effects are not yet known, NSF expects to make further adjustments to the cost and schedule of all five major projects in construction. Design work on an additional major facility project continued without significant interruption from the pandemic. Further, NSF made awards to begin the agency's first three mid-scale research infrastructure projects. National Science Foundation Major Facilities Projects in Construction NSF has fully implemented GAO's prior recommendation on information sharing among award recipients and has drafted guidance or taken other steps towards addressing GAO's three remaining recommendations. To enhance information sharing among award recipients, NSF added a section to its terms and conditions in its major facilities agreements that encourages awardees to share information among awardees and participate in a knowledge management program. Why GAO Did This Study NSF supports the design, construction, and operations of science and engineering research infrastructure such as telescopes and research vessels. These projects include major facilities that cost over $100 million to construct or acquire, and mid-scale research infrastructure projects. Over the past 5 fiscal years, NSF has received over $1 billion in appropriations for these projects. Prior GAO reports reviewed NSF's oversight of the projects, its cost estimating and schedule policies, and the project management expertise of its oversight workforce. Senate Report 115-275, Senate Report 114-239, and House Report 114-605 included provisions for GAO to review and report annually on projects funded from NSF's Major Research Equipment and Facilities Construction account. This report, the fourth, examines (1) the cost and schedule performance of NSF's ongoing major facilities and mid-scale research infrastructure projects and (2) the extent to which NSF has implemented prior GAO recommendations related to its management of major facilities. GAO reviewed NSF and award recipient documents for the projects. GAO examined policies and procedures to identify efforts to implement recommendations and interviewed NSF officials for clarifying information.
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    In U.S GAO News
    GAO has reported on the Department of Veterans Affairs' (VA) use of research to identify and add new illnesses to its list of presumptive conditions for both Gulf War Illness and Agent Orange—a tactical herbicide used extensively during the Vietnam Era. VA entered into agreements with the National Academy of Sciences to assess the link between certain exposures and illnesses experienced by veterans, and uses the Academy's findings to inform its lists of presumptive conditions. GAO also reported in 2017 that VA did not have a single set of uniform criteria to define Gulf War Illness (a case definition) that could improve research, clinical diagnosis, and treatment of Gulf War veterans. GAO recommended that VA prepare and document a plan to develop a single case definition. In response, VA convened a group of subject matter experts from VA and the Department of Defense to create a multi-step plan to develop a case definition. According to VA, it is in the final stages of the plan and will bring together experts in 2021 to review new research and work toward delineating a definition. Further, according to VA, the department continues to support research on conditions related to Gulf War service as well as Agent Orange exposure and will use the findings to consider future presumptive conditions. In 2017, GAO reported on challenges that VA faced in processing complex, presumptive disability claims for veterans who served in the Gulf War—claims that were being denied at higher rates than other disability claims. At the time of GAO's review, VA officials stated that Gulf War Illness claims may be denied at a higher rate, in part, because they are not always well understood by VA staff, and veterans sometimes do not have medical records to adequately support their claims. The challenges we identified included: Inconsistent requests for disability medical exams. VA claims processors can request that a veteran undergo a disability medical exam to help determine whether the conditions in the claim exist and are linked to service. GAO found that claims processors were inconsistent in asking for an exam, in part, due to confusion about the guidance. VA issued training on the topic and in April 2017 completed a review of Gulf War claims to assess the effectiveness of the training and help ensure future consistency. Inconsistent disability medical exam reports. Veterans Health Administration disability medical examiners did not always complete medical exam reports properly and sometimes offered a medical opinion when one was not necessary. GAO recommended that VA require all examiners to complete Gulf War medical exam training before conducting these exams, and VA implemented this recommendation. Since our 2017 report, VA has allowed contracted medical examiners to complete these exams, and in 2018 GAO found VA was not monitoring whether all contractors completed required training. GAO recommended VA improve its oversight of training, but the department has not fully implemented this recommendation from GAO's 2018 report. VA provides disability compensation to millions of veterans with service-connected disabilities. Veterans are generally entitled to these benefits if they can prove their injuries or illnesses were incurred or aggravated by active military service. For certain claims, VA presumes a condition is due to a veteran's service. For example, VA can provide benefits to any veteran with certain symptoms, from respiratory disorders to gastrointestinal issues, who served in Southwest Asia from 1990 to the present, without the veteran needing to prove cause. GAO refers to these as Gulf War Illness claims. In 2017, GAO issued Gulf War Illness: Improvements Needed for VA to Better Understand, Process, and Communicate Decisions on Claims ( GAO-17-511 ), which identified needed improvements in VA's processing of Gulf War Illness claims. In 2018, GAO issued Agent Orange: Actions Needed to Improve Accuracy and Communication of Information on Testing and Storage Locations ( GAO-19-24 ). This statement summarizes information from these reports on how VA determined certain presumptive conditions and challenges VA faced with processing Gulf War Illness claims. In GAO's 2017 report, it recommended that VA develop a plan to establish a single case definition of Gulf War Illness and make Gulf War Illness training mandatory for medical examiners. VA implemented the recommendations. For more information, contact Elizabeth Curda at (202) 512-7215 or curdae@gao.gov.
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  • Priority Open Recommendations: Board of Governors of the Federal Reserve System
    In U.S GAO News
    What GAO Found In April 2020, GAO identified eight priority recommendations for the Federal Reserve. Since then, the Federal Reserve has implemented five of those recommendations. As of April 2021, the remaining open three priority recommendations for the Federal Reserve involve the following areas: Collaborating with other financial regulators to communicate with banks that have third-party relationships with fintech lenders about using alternative data in underwriting. Communicating uncertainties surrounding stress testing, including capital ratio estimates. Communicating uncertainties surrounding stress testing, including tolerance levels for key risks, and the degree of uncertainty in projected estimates. The Federal Reserve's continued attention to these issues could improve its ability to more effectively oversee risks to consumers and the safety and soundness of the U.S. banking system. Why GAO Did This Study Priority open recommendations are GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Daniel Garcia-Diaz at (202) 512-8678 or garciadiazd@gao.gov.
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