Secretary Antony J. Blinken Remarks at the Virtual Kenya-U.S. Interagency Clean Energy Event

Antony J. Blinken, Secretary of State

Washington, D.C.

Recorded on April 9, 2021

MR MEASSICK:  Secretary Blinken, the embassy is delighted to have this unique opportunity to engage with you on clean energy.  Kenya is not only a leader in the region, but also poised to become a global leader for clean energy and climate action.  Currently, 90 percent of Kenya’s power is generated from renewable sources with 40 percent generated from geothermal, 45 percent from hydropower, and the remainder from wind and solar.

Our assistance facilitated over 3 million off-grid and on-grid connections for homes and businesses across the country, bringing electricity to over 10 million Kenyans for the first time.  This virtual tour will provide you with a glimpse of the nearly $600 million in U.S. financing across geothermal, wind, and solar renewable energy investments.

MS JAIN:  I’m Vibhuti Jain, regional managing director for Africa at the U.S. International Development Finance Corporation, or DFC.  I am pleased to introduce you to Kipeto Wind Farm, a transaction that will begin operations this spring.  Kipeto will deliver 100 megawatts of clean energy to the Kenyan people, powering a quarter million households.  This Power Africa project was made possible in partnership with Kenyan, international, and American investors with financing and insurance from DFC.

MS WALKER:  I’m Lisa Walker, energy office director for Power Africa, a U.S. Government-led initiative to connect 60 million new homes and businesses across sub-Saharan Africa to clean, reliable energy, leveraging the expertise and the resources of 170 public and private sector partners.  In Kenya as elsewhere, it’s the missions that drive results.  I’m pleased to introduce you to Powerhive, a U.S.-owned innovator in the Kenyan mini-grid space and one of our partners.

MR MEASSICK:  The companies we support are located in national parks and on privately owned community land, but they conduct their business in a socially and environmentally responsible way.  They build tunnels for wildlife to pass through their site.  They are partnering with the local community who benefit from the revenue.  And with the access to electricity, women no longer need to cut down trees for firewood.

While Kenya has aggressively connected households and businesses in the national grid, increasing access from 23 percent to 75 percent of the population over the last eight years, currently 40 percent of rural areas are still not covered by the grid.  That’s primarily because it is too expensive to extend the grid to those remote areas in the near term.

The U.S. Government has a unique opportunity to affirm our global leadership and commitment to major climate action.

SECRETARY BLINKEN:  Greetings.

MS FERTIK:  Greetings, Mr. Secretary.  How are you?

MR NAMUNJE:  Hello.

MR HORNOR:  Hello.

SECRETARY BLINKEN:  Very well.  Good to see you all.

MR NAMUNJE:  Yes.  How are you?

MS FERTIK:  All right.

SECRETARY BLINKEN:  Thanks so much for doing this.  Really appreciate it.

MR HORNOR:  A pleasure.

MR NAMUNJE:  Thank you.

MS FERTIK:  And hello, Secretary Blinken.  It is truly an honor to welcome you virtually to Kenya for a conversation today on U.S.-Kenya partnerships for clean energy.  My name is Emily Fertik and I’m the Information Officer here at the U.S. Embassy in Nairobi.  And with me today, as you have just met, are leaders from the two companies that you have heard about in the introductory video.

To my immediate left is Dr. Kenneth Namunje, Chairman of the Board of Kipeto Energy.  Dr. Namunje has been instrumental in the development of the Kipeto Wind Farm project.  He has worked with local and national stakeholders to ensure that it becomes a reality.

And to my far left, Mr. Chris Hornor, President and CEO of Powerhive.  Mr. Hornor, who hails from California, has been an entrepreneur and pioneer of consumer renewable energy products for well over a decade in East Africa.

Mr. Secretary, allow me to turn it over to you to start our conversation with a few opening remarks.

SECRETARY BLINKEN:  Well, Emily, thank you very much, and thank you for bringing us all together.  And Dr. Namunje, Mr. Hornor, really appreciate you joining me for this conversation.  And to everyone at your companies as well who’ve helped to make this possible, thank you, thank you, thank you.

I’m really eager to ask some questions about your work and Kenya’s clean energy sector, because I think a lot can be learned from the progress your companies and the country have made toward providing sustainable energy to the Kenyan people.  There are lessons there that go well beyond Kenya.

I am pleased and proud that we’ve been a strong supporter of this effort.  We invested in your companies.  That includes financial support, like the $230 million in loans that the Development Finance Corporation provided to Kipeto and – Wind Farm, but also technical support like the kind Power Africa gives to Powerhive to help build the 23 mini grids.

These and other American investments in Kenyan hydropower, solar, wind projects have helped Kenya reach a point where – this is remarkable – more than 90 percent of its electricity now comes from renewable energy sources.  And the country is on track to provide universal energy access by 2022.  That’s obviously very good for the Kenyan people, it’s good for the Kenyan economy; it’s also good for the planet, and so I think there’s something very powerful going on.

The only way we’re going to address the climate crisis is by reducing the world’s carbon emissions, and that means, ultimately, clean and renewable energy.  So we need to help more countries do what Kenya has done and we need to raise our ambitions on climate more broadly.  Our administration, the Biden-Harris administration, is committed to reclaiming America’s leadership on this front.  As you know, on day one, President Biden rejoined the Paris Agreement, and we will meet our domestic commitments.

But here’s what we know:  Delivering at home is not enough, and that’s exactly why President Biden has worked to raise ambition and increase resilience at the global level, including through the Leaders Summit, and it’s also why, as Secretary, I’m ensuring climate change is at the center of our diplomacy.  Anything less will fail to address this emergency.  And of course, in that effort we have the remarkable secret-but-not-so-secret weapon of Secretary John Kerry leading our efforts around the world.

As we’re taking these steps, there are two lessons that I at least take from the progress that you and others have made in Kenya.  One is that governments need to collaborate more with the private sector.  Your success has proven that investing in sustainable energy can be both effective and profitable.  The second lesson I take from this is how important it is to meet a range of needs at different scales.  On the one hand, we need massive projects like Kipeto, which will provide energy to 250,000 households on the grid.  We also need smaller-scale projects like Powerhive, which will reach low-income communities that have never had electricity before.  We can meet our sustainability goals without writing off communities that are harder to reach, and that way they can access the opportunities enabled by energy access as well.

So this gets me – it’s a long way of getting to what I really want to come to, which are some questions, because we want to learn from your experience and your insights.  So a couple of questions if it’s all right to both of you, and the first is:  Tell us about the impact that loans and capital investments have on starting up these ventures.  What role do they play, and in your experience at least, how critical are they to being able to move forward?

MS FERTIK:  Dr. Namunje, let me start with you.

MR NAMUNJE:  Thank you.  Thank you, Secretary Blinken.  I’ll say that with the support of the DFC granting us $233 million, enabled the project to reach financial close.  And I would also say that through Power Africa, the U.S. Government helped us to develop our biodiversity action plan, which really focuses on minimizing the possible human-wildlife contact around the Kipeto site.  And I would also say that the private sector has done its part as well because our international equity shareholder in Kipeto called Actis has more than half of its investment base comprising of American investors, including a significant contribution from the pension fund of American civil servants.  I would also say, like, for instance, GE has supplied our highly efficient wind turbine, which is a 1.7-megawatt turbine.

And so in short, I would say that the U.S. Government assisted in financing and has supported us to meet our compliance to the highest international environmental and social standards, which underpins also the technology capacity that the project is built on.  Yeah, yeah.

SECRETARY BLINKEN:  Great.

MS FERTIK:  And Mr. Hornor?

MR HORNOR:  Thank you for having me, Mr. Secretary.  So Powerhive was started in 2011, and around 2015 we became Kenya’s first privately licensed utility offering clean, renewable energy sources to now over – close to 6,000 households.  And early in our development, we received about a half a million dollars from the U.S. Government, which helped us to spur economic development and create jobs and create businesses that would not only put money into the pockets of our customers, but also allows – allowed us to innovate in new businesses that would also sort of surround the mini grids that we developed.

So today, with that investment, we’ve been able to start a chicken business which is putting a lot of money into the pockets of our customers.  We’re now one of the leading chicken producers in Kenya.  And from that, we’ve also now created a whole electric mobility platform also based on U.S. R&D and things that we’ve done there.  So we’re pretty excited about these early developments that the U.S. Government helped in terms of that early investment to try innovative new things that has led to some pretty remarkable progress.

SECRETARY BLINKEN:  Well, it’s really good to hear that from both of you and looking at different angles of this, because I think that what we can do in government is help to be a catalyst for the work of the private sector.  Our greatest strength in the United States is the private sector, but the government, I think, has a vital role to play in, as I said, being a catalyst and being a partner.  And the strength of these public-private partnerships in various ways, whether it’s through something as large as the DFC or whether it’s through smaller loans or guarantees or insurance, seems to be potentially the real difference maker in our ability to get things done.  So I’m really glad to hear that.

Another question is this.  Meetings like President Biden’s Leaders Summit on Climate I think are also important ways to learn from each other, to compare experience, to compare best practices, to hear what’s worked, what hasn’t worked.  And so what I’m curious about is whether, in your experience, you have business ideas or innovations around green energy that we should be exploring in the United States or, for that matter, sharing elsewhere.

MS FERTIK:  Dr. Namunje, your ideas, please.

MR NAMUNJE:  Thank you, Secretary Blinken.  So I’ll say that Kenya is a model for clean energy generation in Africa with around about 90 percent of our power coming from non-fossil fuel sources.  But the next challenge for Kenya and the U.S. is the impact of the variability of clean energy resource from the grid through investment in battery storage.  And we know that the U.S. is a global leader in battery storage technology.

So we then ask Kipeto shareholders, Actis and Craftskills, which I chair both.  Craftskills is a local share partner.  We’re actually exploring opportunities on how to integrate battery storage into the wind farm with the support of the U.S. Trade and Development Agency.  And so I’ll say that this is an area that we would love to engage with U.S. companies on and how to make this move on, and that’s an opportunity that is there.

MS FERTIK:  Mr. Hornor, I know you’ll have more ideas.

MR HORNOR:  So I’m fortunate.  I’m one of the handful of U.S. companies based in Kenya that are really leading the charge in terms of off-grid and sort of distributed generation and storage for communities in this sector.  So when I look at sort of the knowledge that we have actually developed and gained through the last – coming up to 10 years in creating highly efficient solar-powered solutions that combine electric mobility and other sort of agricultural practices, we think that when we look in particular especially on the sector we’re developing here around mobility, working with companies in Detroit and figuring out some of the best technology that’s coming out of these areas would be incredibly valuable to us.

So given that they’re a huge cost center, I think there’s a lot we could do to collaborate and not only bring some of our sort of learnings there but also learn from some of our partners in the U.S. that we’d love to sort of work with in more details.  So it’s – as we look at sort of northern California and other places that are being hit by climate change, some of these distributed generation plus storage and efficient distribution systems that are not connected to a bigger grid I think are going to be really important lessons that we can learn to reduce the cost for maintenance of some of these remote areas of the United States even.  So there’s some interesting sort of synergies I think we can – we’ll see.

SECRETARY BLINKEN:  Well, go ahead Emily.

MS FERTIK:  I was going to turn it right back over to you, Mr. Secretary, if you would like to wrap up our conversation with closing remarks.

SECRETARY BLINKEN:  Yes.  And thank you both, because I think when it comes to climate and energy, we’re all feeling increasingly the fierce urgency of now.  And to your point, Mr. Hornor, just what so many different communities in the United States are experiencing in terms of the effects of climate change are, of course, increasingly acute.  And that just emphasizes the need to act, but to act in a smart, informed way, based on experience, based on sharing ideas, best practices, knowledge.

And so much of that is actually being accumulated by companies like yours and endeavors that you’re engaged in in different ways.  And so finding ways to make sure we’re having the sharing of ideas, of information, that we’re bringing people together in government, across governments, in the private sector, NGOs – all of that is very much, I think, part of the solution.

And what I have seen in looking at what you’ve been doing, watching the video, hearing both of you, it strikes me that Powerhive and Kipeto are really excellent examples of how the United States is promoting partnerships with U.S. firms and, in this case, advancing Kenya’s leadership – not just in Africa but really beyond – for sustainable, renewable energy.  And that’s going to be a powerful example and a powerful lesson, I think, for the entire world, because we’re seeing that Kenya is not only a leader in the region but is poised to become a global leader for clean energy and climate action.

So I’ve got to just tell you we’re very pleased to be working with partners in Kenya to affirm global leadership and commitment to major climate action.  So for today, just thank you for coming and sharing your thoughts.  But for every day, thank you for what you’re doing, because you’re making climate action real; you’re making access to energy real, including for underserved communities.  And I think that’s going to have a powerful, positive impact going forward.  So it’s a pleasure to get to spend at least a few minutes with both of you, and I look forward to hearing more in the days and weeks ahead.

MS FERTIK:  Mr. Secretary and Dr. Namunje and Mr. Hornor, thank you all for your time.  And thank you for a truly thoughtful conversation today on the opportunities for expanding clean energy in Kenya.  Thank you all and have a good day.

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    An estimated 1.9 million children received child care subsidies in fiscal year 2017, representing approximately 14 percent of all children estimated to be eligible under federal rules – and 22 percent of all children estimated to be eligible under state rules -- in an average month. These figures are from the Department of Health and Human Services' (HHS) analysis of fiscal year 2017 data, the most recent year for which such analysis is available. Generally, fewer families qualify for subsidies under state eligibility rules than under federal eligibility rules since most states use flexibility provided by HHS to set their income eligibility limits below the federal maximum. Health and Human Services’ Estimated Number of Children Eligible Under Federal and State Rules, and Estimated Number Receiving Child Care Subsidies, Fiscal Year 2017 GAO found that the extent to which children who meet federal child care eligibility requirements also meet state eligibility requirements varies by state as does the share of eligible children who receive Child Care and Development Fund (CCDF) subsidies. Under state requirements, the CCDF subsidy receipt rate ranged from 5 percent to 32 percent of eligible children. Under federal requirements, the CCDF subsidy receipt rate ranged from 4 percent to 18 percent of federally eligible children. According to HHS estimates, among families who met federal child care eligibility criteria, children from lower-income families were more likely to receive child care subsidies compared to children from higher-income families. These estimates also showed that preschool-age children were more likely to receive subsidies compared to older, school-age children and that Black children were more likely to receive subsidies compared to children of other races / ethnicities. As reported in previous GAO work, states have varied strategies for managing their wait lists. Some states have a single statewide list while others have sub-state lists that allow sub-state areas to have their own policies. Some states conduct full or partial eligibility determinations prior to placing families on wait lists, and many states require periodic reviews of their wait lists. According to state administrators GAO interviewed, the strategies that states use to manage their wait lists pose certain challenges. For example, state administrators told GAO that sub-state lists can contain duplication, making state-wide estimates of families in need difficult. And administrators told GAO that maintaining up-to-date contact information is challenging, in part due to insufficient technology. The Coronavirus Disease 2019 (COVID-19) pandemic has impacted child care in several ways, including cost, eligibility and subsidy receipt, according to some members of the National Association of State Child Care Administrators (NASCCA). These members told GAO that despite initial declines in the number of families receiving subsidies, some states are seeing their child care costs increase due to, for example, more school-age children using full-day care; increased expenses for additional health and safety measures; paying for more absences and for parent co-pays; and families applying for subsidies for relative care. NASCCA members noted that some states have made changes to policies to help families and providers. To help families access child care, some states have increased income eligibility for subsidies to 85 percent of the state median income; temporarily waived work requirements to receive subsidies; and covered family fees for parents when a family must quarantine due to a COVID-19 exposure. Changes to some state policies aimed at helping providers include providing funds to providers to help with increased costs, such as personal protective equipment (PPE) and additional cleaning supplies; paying providers based on their pre-COVID-19 level authorized enrollments; and raising the state's provider reimbursement rate to help providers cover overhead costs. The federal child care subsidy program known as CCDF is one of the primary sources of federal funding dedicated to assisting low-income families with child care who are working or participating in education and training. Funding for CCDF, which is administered by HHS at the federal level, comes from two funding streams: discretionary funding in the form of block grants authorized by the Child Care and Development Block Grant (CCDBG Act) of 1990, as amended, and mandatory and matching funding authorized under section 418 of the Social Security Act. CCDF was appropriated more than $8 billion in federal funds in 2019. For more information, contact Kathryn Larin at (202) 512-7215 or larink@gao.gov.
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  • GAO Comments on AICPA Proposed SAS – Inquiries of the Predecessor Auditor Regarding Fraud and Noncompliance With Laws and Regulations
    In U.S GAO News
    This letter provides GAO's response to the American Institute of Certified Public Accountants' (AICPA) Auditing Standards Board's (ASB) exposure draft, Proposed Statement on Auditing Standards – Inquiries of the Predecessor Auditor Regarding Fraud and Noncompliance With Laws and Regulations. GAO provides standards for performing high-quality audits of governmental organizations, programs, activities, and functions and of government assistance received by contractors, nonprofit organizations, and other nongovernmental organizations with competence, integrity, objectivity, and independence. These standards, often referred to as generally accepted government auditing standards (GAGAS), are to be followed when required by law, regulation, agreement, contract, or policy. For financial audits, GAGAS incorporates by reference the AICPA's Statements on Auditing Standards (SAS).
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  • Interagency Council on Homelessness: Governance Responsibilities Need Further Clarification
    In U.S GAO News
    The United States Interagency Council on Homelessness (USICH) consists of representatives from 19 federal agencies—including a Chair and Vice-Chair—on its governing Council and a full-time staff led by an Executive Director. The Executive Director has led most day-to-day operations, including hiring and managing staff, preparing budget requests, working with private-sector groups, drafting strategic plans, developing performance goals, and drafting agendas for the Council's quarterly meetings. Council members have quarterly meetings to discuss and consider homelessness issues and review the efforts of the Executive Director and USICH staff. Actions taken at Council meetings held from December 2017 through March 2020 included electing the Chair and Vice-Chair, appointing the Executive Director, and approving the USICH strategic plan and activities of interagency working groups. USICH staff also informed the Council of their performance results during the quarterly meetings. Some roles and responsibilities for the governance of USICH, such as the types of matters that require Council approval, are not fully defined or documented. Recent Council Chairs told GAO they generally did not have a clear understanding of their roles and responsibilities and generally based them on their predecessors' activities. For example, the 2019 Chair stated he saw his responsibilities as preparing and chairing quarterly Council meetings and acting as the Council's external spokesperson, but there were no written procedures detailing these responsibilities. The 2019 Chair also stated that he had no involvement in overseeing the USICH budget or operations, staff, and interagency working groups. Standards of Internal Control for the Federal Government state that for an entity's objectives to be achieved the responsibilities and delegations of authority should be clearly established. At its quarterly meeting held in March 2020, the Council approved a charter that addresses voting mechanics, performance evaluations for the Executive Director, and the authority of the Executive Director to oversee personnel. But the charter does not fully clarify the Council's responsibilities in other areas, such as the responsibilities of the Council Chair, types of matters that would require approval by Council vote, and actions that are within the Executive Director's delegated authority. Additional clarity and documentation in these areas may assist the Council in securing a fuller understanding of its oversight role and responsibilities. The mission of USICH is to coordinate the federal response to homelessness and create partnerships with the private sector and state and local governments to reduce and end homelessness. The joint explanatory statement related to the Consolidated Appropriations Act, 2019 includes a provision for GAO to review the management and governance structure of USICH, including the Council's ability to oversee the Executive Director and USICH operations. This report (1) describes the structure and practices for USICH operations and (2) evaluates the extent to which roles and responsibilities for the governance of USICH have been defined and documented. GAO focused primarily on the 2017–2020 time frame and analyzed agency documentation (such as Council meeting transcripts, and USICH's strategic plan and performance reports) and interviewed Council members, current and former Executive Directors, and staff from member agencies. GAO is recommending that the Council further clarify and document its roles and responsibilities for matters requiring the Council's approval, the role of the Council Chair, and actions within the Executive Director's delegated authority. The Council concurred with the recommendation. For more information, contact Alicia Puente Cackley, (202) 512-8678, cackleya@gao.gov.
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  • VA Disability Benefits: Process for Identifying Conditions Presumed to be Service Connected and Challenges in Processing Complex Gulf War Illness Claims
    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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  • Defense Health Care: Actions Needed to Define and Sustain Wartime Medical Skills for Enlisted Personnel
    In U.S GAO News
    What GAO Found The military departments have not fully defined, tracked, and assessed wartime medical skills for enlisted medical personnel. The departments have defined these skills for 73 of 77 occupations. However, among other issues, the Army and the Air Force have not defined skills for numerous highly-skilled subspecialties that require additional training and expertise, such as Army Critical Care Flight Paramedics. Subspecialty personnel are key to supporting lifesaving medical care during deployed operations. The Army does not consistently track wartime medical skills training for enlisted medical personnel in its official system. The military departments are not able to fully assess the preparedness of enlisted medical personnel because, according to officials, they have not developed performance goals and targets for skills training completion. As a result, the military departments lack reasonable assurance that all enlisted medical personnel are ready to perform during deployed operations. The Department of Defense (DOD) has not fully developed plans and processes to sustain the wartime medical skills of enlisted medical personnel. While the Defense Health Agency (DHA) has initiated planning efforts to assess how the military departments' three primary training approaches sustain readiness (see figure), these efforts will not fully capture needed information. For example, DHA's planned metrics to assess the role of military hospitals and civilian partnerships in sustaining readiness would apply to a limited number of enlisted occupations. As a result, DHA is unable to fully assess how each training approach sustains readiness and determine current and future training investments. Approaches to Train Enlisted Medical Personnel's Wartime Medical Skills DOD officials have identified challenges associated with implementing its training approaches. For example, DOD relies on civilian partnerships to sustain enlisted medical personnel's skills, but DOD officials stated that licensing requirements and other issues present challenges to establishing and operationalizing civilian partnerships. DOD has not analyzed or responded to such risks, and may therefore be limited in its ability to sustain wartime medical skills. Why GAO Did This Study DOD has over 73,000 active-duty enlisted medical personnel who must be ready to provide life-saving care to injured and ill servicemembers during deployed operations, using their wartime medical skills. Senate Report 116-48 accompanying a bill for the National Defense Authorization Act for Fiscal Year 2020 included a provision for GAO to review DOD's efforts to maintain enlisted personnel's wartime medical skills. This report examines, among other objectives, the extent to which (1) the military departments have defined, tracked, and assessed enlisted personnel's wartime medical skills, and (2) DOD has developed plans and processes to sustain these skills and assessed risks associated with their implementation. GAO analyzed wartime medical skills checklists and guidance; reviewed plans for skills sustainment; and interviewed officials from DOD and military department medical commands and agencies, and nine inpatient military medical treatment facilities.
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  • Small Business Innovation Research: Three Agencies Made Awards to Businesses Majority-Owned by Investment Companies and Funds
    In U.S GAO News
    Under the Small Business Innovation Research (SBIR) program, participating agencies can make awards to small businesses majority-owned by multiple venture capital operating companies, hedge funds, or private equity firms (investment companies and funds). In fiscal years 2019 and 2020, four of the 11 agencies participating in the program received proposals from small businesses majority-owned by investment companies and funds (i.e., qualified small businesses), and three of the four made awards to such small businesses. Specifically, the Department of Health and Human Services' National Institutes of Health (NIH), the Department of the Navy within the Department of Defense (DOD), and the Department of Education made a combined 45 awards worth $31.6 million to qualified small businesses during this period. As in previous years, NIH made the most awards and awarded the most funds to qualified small businesses in fiscal years 2019 and 2020. The Department of Energy's Advanced Research Projects Agency-Energy opened its SBIR awards to qualified small businesses, but did not issue any awards to them during fiscal years 2019 and 2020. Since 2011, when qualified small businesses became eligible for SBIR awards, participating SBIR agencies have considered whether to allow qualified small businesses to participate in the program. Consistent with what GAO found in December 2018, in fiscal years 2019 and 2020, agencies cited several reasons for not allowing qualified small businesses to participate in their SBIR program. For example, officials at the National Aeronautics and Space Administration and the Department of Homeland Security said that they did not pursue the option because qualified small businesses have not expressed much interest in their SBIR programs. In contrast, two component agencies within DOD—the Departments of the Navy and the Air Force—decided to allow qualified small businesses to receive awards and the Department of the Army within DOD was considering doing so. For example, Air Force program officials told us they found that providing SBIR funding to qualified small businesses would expand the Air Force's investment in cutting-edge technologies with both commercial and military uses. NIH—the agency that has made the majority of awards to qualified small businesses—has continued to make awards to qualified small businesses in its SBIR program, as these businesses are subject to the same standard reporting requirements as all other SBIR award recipients. NIH officials also noted that SBIR recipients provide information on specific project impacts, such as technology transfer and commercialization activities, and NIH cited development of a long-release capsule for medication as an example of a successful outcome from an award to a qualified small business. The SBIR program enables federal agencies to support research and development (R&D) projects carried out by small businesses. Participating agencies are required to spend a certain percentage of their extramural R&D obligations on their SBIR program each year. Eleven federal agencies participate in the SBIR program. To qualify for SBIR awards, a small business must meet certain ownership and other eligibility criteria. The Small Business Act, as amended, authorizes agencies to allow participation in their SBIR programs by qualified small businesses. Upon providing a written determination to the Administrator of the Small Business Administration (SBA)—the agency that oversees the SBIR program—and specified congressional committees, agencies may make SBIR awards to qualified small businesses. The Small Business Act, as amended, includes a provision for GAO to conduct a study of the impact of requirements relating to the involvement of investment companies and funds in the SBIR program and submit a report to Congress regarding the study every 3 years. GAO's first review covered fiscal years 2013 and 2014, and in December 2018, GAO issued its second report on this issue, for fiscal years 2015 through 2018. This third report addresses (1) SBIR participating agencies' awards to small businesses that are majority-owned by multiple investment companies and funds in fiscal years 2019 and 2020 and (2) reasons participating agencies cited for allowing or not allowing the participation of qualified small businesses in the SBIR program. GAO reviewed agencies' data on the participation of qualified small businesses and conducted interviews with or obtained written answers from program managers from the 11 participating agencies and SBA. For more information, contact Candice N. Wright at (202) 512-6888 or wrightc@gao.gov.
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  • Combating Wildlife Trafficking: Agencies Work to Address Human Rights Abuse Allegations in Overseas Conservation Programs
    In U.S GAO News
    U.S. agencies primarily use Leahy vetting as the enforcement mechanism to prevent U.S. funding for combating wildlife trafficking from supporting human rights abuses. Statutory provisions commonly referred to as "Leahy Laws" prohibit the U.S. government from using certain funds to assist units of foreign security forces where there is credible information they have committed a gross violation of human rights. The Department of State (State) and the U.S. Agency for International Development (USAID) generally consider park rangers to be foreign security forces that are authorized to search, detain, arrest, or use force against people, and thus subject to Leahy vetting, according to agency officials. State or USAID may provide funding to the Department of the Interior's Fish and Wildlife Service (FWS) that it then uses to support park ranger activities. In those instances, FWS submits the candidates' applications to State for Leahy vetting. According to a State official, Leahy approval of a security force unit is good for 1 year, and State must vet individuals again if their unit continues to receive support from State or USAID funding sources. Both U.S. agencies and implementing partners took a variety of steps in response to recent allegations of human rights abuses by overseas park rangers. For example, a State official in the Central Africa region told GAO that while the Democratic Republic of the Congo embassy's vetting program has very strict control mechanisms, the International Narcotics and Law Enforcement Affairs Bureau requested quarterly reports to facilitate a review of all assistance to park rangers to ensure that any reported activities were vetted according to Leahy Laws. USAID officials told GAO that in addition to continuing Leahy vetting, the agency's response included strengthening human rights training and conducting a site visit to a park in the DRC where human rights abuses had allegedly occurred. According to officials, the visit involved speaking with beneficiaries to further understand the allegations and efforts to assess root causes, mitigate impacts, and stop future occurrences, including making referrals to appropriate law enforcement authorities if warranted. FWS officials also stated that they take seriously allegations that U.S implementing partners have supported park rangers who have committed human rights abuses. Since June 2019, the Department of the Interior has approved no new awards to the World Wildlife Fund (WWF)—one of the implementing partners which has supported park rangers alleged to have committed human rights abuses. Moreover, the International Affairs program within FWS has put all new funding on hold since September 2019, pending a departmental review. Agencies are also implementing various changes in response to congressional directives on safeguarding human rights. For example, State officials told GAO that they have added language to all notices for countering wildlife trafficking awards that requires implementing partners to include social safeguards plans in their projects. The plans will articulate an understanding of how their work could negatively affect local communities. USAID officials stated that USAID has included provisions in new agreements with FWS that require adherence to the congressional directives. FWS officials also confirmed that they are cooperating with USAID in these efforts. Implementing partners—WWF, the Wildlife Conservation Society (WCS), and African Parks (AP)—have all conducted investigations to address allegations of human rights abuses by park rangers, according to officials from these organizations. They have also developed grievance mechanisms to report human rights abuses. For example, WWF has received 50 complaints in roughly the past year related to its project work, according to WWF representatives. WWF has responded to complaints of human rights abuses through this mechanism by reporting the allegations to relevant authorities and meeting with community representatives. U.S. agencies provide training and equipment for park rangers overseas to combat wildlife trafficking. From fiscal years 2014 through 2020, the U.S. government provided approximately $554 million to undertake a range of activities through federal agencies and in cooperation with implementing partner organizations in the field. Multiple non-governmental organization and media reports, however, have alleged that organizations that have received U.S. funds have supported park rangers engaged in combating wildfire trafficking who have committed human rights violations since the mid-2000s. GAO was asked to review human rights protection mechanisms related to U.S. efforts to combat wildlife trafficking. This report examines 1) what enforcement mechanisms agencies have to prevent U.S. funded efforts to combat wildlife trafficking from supporting human rights abuses and how they implement them, and 2) how agencies and implementing partners address allegations of human rights abuses. GAO spoke with agency officials and implementing partner representatives locally in person and overseas by phone, and collected and analyzed information related to program implementation. For more information, contact Kimberly Gianopoulos at (202) 512-8612 or gianopoulosk@gao.gov.
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  • 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.
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