October 19, 2021

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Tennessee Department of Human Services Agrees to Pay $6.8 Million to Resolve False Claims Act Liability in Connection with SNAP Quality Control

11 min read
<div>The Tennessee Department of Human Services (TDHS) has agreed to pay the United States $6,854,416 to resolve allegations that it violated the False Claims Act in its administration of the U.S. Department of Agriculture’s (USDA) Supplemental Nutrition Assistance Program (SNAP). Until 2008, SNAP was known as the Food Stamp Program. </div>
The Tennessee Department of Human Services (TDHS) has agreed to pay the United States $6,854,416 to resolve allegations that it violated the False Claims Act in its administration of the U.S. Department of Agriculture’s (USDA) Supplemental Nutrition Assistance Program (SNAP). Until 2008, SNAP was known as the Food Stamp Program. 

More from: August 5, 2021

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  • Public Health: Federal Programs Provide Screening and Treatment for Breast and Cervical Cancer
    In U.S GAO News
    The Centers for Disease Control and Prevention (CDC) operates the National Breast and Cervical Cancer Early Detection Program (the Early Detection Program) to provide cancer screening and diagnostic services to people who are low-income and uninsured or underinsured. For those screened under the program who require treatment, the Breast and Cervical Cancer Prevention and Treatment Act of 2000 (the Treatment Act) allows states to extend Medicaid eligibility to individuals not otherwise eligible for Medicaid. GAO analysis of CDC data show that the Early Detection Program screened 296,225 people in 2018, a decrease from 550,390 in 2011 (about 46 percent). The largest decrease occurred from 2013 to 2014 (see figure). According to a CDC-funded study, the number of people eligible for the Early Detection Program decreased from 2011 through 2017, by about 48 percent for breast cancer and about 49 percent for cervical cancer. CDC officials attributed these declines in screening and eligibility, in part, to improved access to screening under the Patient Protection and Affordable Care Act (PPACA). For example, PPACA required health plans to cover certain women's preventive health care with no cost sharing. Number of People Screened by CDC's Early Detection Program, 2011-2018 GAO analysis of Centers for Medicare & Medicaid Services' (CMS) data found that, in 2019, 43,549 people were enrolled in Medicaid under the Treatment Act to receive treatment for breast or cervical cancer, a decrease from 50,219 in 2016 (13.3 percent). Thirty-seven states experienced a decrease in Medicaid enrollment under the Treatment Act during this time period, 13 states experienced an increase, and one state had no change. CMS officials noted that Medicaid expansion to adults with incomes at or below 133 percent of the federal poverty level under PPACA (the new adult group) is a key factor that contributed to these enrollment trends. CMS officials said that, in Medicaid expansion states, there were some people who previously would have enrolled in Medicaid based on eligibility under the Treatment Act who instead became eligible for Medicaid in the new adult group. The CMS data show that total enrollment under the Treatment Act in Medicaid expansion states decreased by 25.6 percent from 2016 to 2019. In contrast, total enrollment under the Treatment Act in non-expansion states increased by about 1 percent during this time period. According to the CDC, tens of thousands of people die each year from breast or cervical cancer. Early screening and detection, followed by prompt treatment, can improve outcomes and, ultimately, save lives. Federal programs, like CDC's Early Detection Program, are intended to improve access to these services. GAO was asked to examine the implementation of the Early Detection Program and the states' use of Medicaid under the Treatment Act. This report provides information on the number of people who were 1) screened through the Early Detection Program and 2) enrolled in Medicaid under the Treatment Act. GAO analyzed CDC data on the number of people screened by the Early Detection Program from calendar years 2011 through 2018—the most recent available. GAO also analyzed CMS Medicaid enrollment data from 2016 through 2019—the most recent available. Additionally, GAO reviewed a 2020 study funded by CDC that examines the number of people eligible for the Early Detection Program from 2011 through 2017. Finally, GAO interviewed CDC and CMS officials and reviewed relevant CDC and CMS documents. For more information, contact John E. Dicken, (202) 512-7114, dickenj@gao.gov.
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  • Persian Gulf: U.S. Agencies Need to Improve Licensing Data and to Document Reviews of Arms Transfers for U.S. Foreign Policy and National Security Goals
    In U.S GAO News
    The United States uses arms transfers through government-to-government Foreign Military Sales (FMS) and direct commercial sales (DCS) to support its foreign policy and national security goals. The Departments of Defense (DOD) and State (State) have authorized arms worth billions of dollars to six Persian Gulf countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). The United States established the Gulf Security Dialogue (GSD) to discuss security issues with these countries. GAO was asked to determine (1) the dollar value and nature of U.S. arms transfers authorized for the Gulf countries' governments, (2) the extent to which U.S. agencies documented how arms transfers to Gulf countries advanced U.S. foreign policy and national security goals, and (3) the role of the GSD. To conduct this work, GAO analyzed U.S. government regional plans, arms transfer data from fiscal years 2005 to 2009, case-specific documentation for fiscal years 2008 and 2009, and program guidance; and interviewed officials in Bahrain, Saudi Arabia, and the UAE. GAO cannot determine the total value of authorized arms transfers to the governments of Gulf countries in part because State's DCS database also includes arms transfers authorized for U.S. military units stationed in those countries. GAO's review of State's database determined that at least $6 billion of the $21 billion of authorized transfers between fiscal years 2005 and 2009 were for U.S. military units in Gulf countries. In addition, some license values were counted twice. State's database system does not have the capability to separate authorizations by end-user or separate multiple authorizations that cover the same equipment. Consistent with statutory requirements, State included this data in reporting all license authorizations to Congress. In contrast, GAO could determine that the DOD-administered FMS program authorized about $22 billion in arms transfers to the six Gulf countries. Authorized transfers included air and missile defense systems, with the UAE and Saudi Arabia accounting for over 88 percent of total FMS authorizations. State and DOD did not consistently document how arms transfers to Gulf countries advanced U.S. foreign policy and national security goals for GAO selected cases. State assesses arms transfer requests against criteria in the Conventional Arms Transfer policy, including interoperability with the host nation and the impact on the U.S. defense industrial base. Additionally, DOD assesses FMS requests for significant military equipment against criteria in DOD policy, such as the impact on the recipient's force structure and the ability to monitor sensitive technology. GAO's analysis of 28 arms transfer authorizations--15 DCS and 13 FMS--found that State did not document how it applied its criteria to arms transfers, while DOD could not provide documentation on its review of release of technology for 7 of 13 FMS authorizations. Due to a lack of complete documentation, we cannot verify if U.S. agencies consistently reviewed authorizations. When established in 2006, GSD was intended to enable multilateral cooperation on six security-related topics between the United States and six Gulf countries, but it instead operates as a bilateral forum between the United States and five Gulf countries due to the preference of these countries. Saudi Arabia does not participate in GSD, but discusses security concerns at other forums. According to U.S. officials, GSD's agenda has evolved to focus on regional security and other concerns specific to the country participants. GAO recommends that (1) State take steps to improve the clarity and usefulness of DCS license data, and (2) State and DOD document their reviews of arms transfer requests. State and DOD agreed with the recommendations, but State noted that it would need additional resources to improve DCS reporting.
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  • Military Spouse Employment: DOD Should Continue Assessing State Licensing Practices and Increase Awareness of Resources
    In U.S GAO News
    According to estimates from Department of Defense (DOD) survey data, roughly one-quarter of military spouses who were in the workforce and in career fields that required credentials (state licenses or certifications) were unemployed in 2017. In that same year, about one-quarter of spouses who were employed in credentialed career fields were working outside their area of expertise, and about one in seven were working part-time due to a lack of full-time opportunities—two potential indicators of underemployment. Employment outcomes for military spouses may also vary due to other factors, including their partner's rank and frequent moves, according to DOD survey data and GAO's literature review. In February 2020, the Defense State Liaison Office, which works on key issues affecting military families, assessed states' use of best practices that help military spouses transfer occupational licenses. For example, the Liaison Office found that 34 states could increase their use of interstate compacts, which allow spouses in certain career fields, such as nursing, to work in multiple states without relicensing (see figure). However, the Liaison Office does not plan to continue these assessments, or assess whether states' efforts are improving spouses' experiences with transferring licenses. As a result, DOD may not have up-to-date information on states' actions that help spouses transfer their licenses and maintain employment. Assessment by the Defense State Liaison Office of Number of States Using Interstate Compacts to Improve Military Spouse Employment DOD and the military services use a range of virtual and in-person outreach to promote awareness of employment resources among military spouses. For example, officials GAO interviewed at installations said they promoted resources through social media and at orientation briefings. Nonetheless, GAO found that inconsistent information sharing across DOD and with external stakeholders who help spouses with employment hindered the effectiveness of outreach. For instance, officials from two services said they do not have methods to regularly exchange outreach best practices or challenges, while officials from another service said they have quarterly staff calls to share lessons learned. Without strategies for sharing information among internal and external stakeholders, DOD may miss opportunities to increase spouses' awareness of available resources, and improve their employment opportunities. There were over 605,000 spouses of active duty servicemembers in the U.S. military as of 2018. These spouses may face conditions associated with the military lifestyle that make it challenging to start or maintain a career, including frequent moves and difficulties transferring occupational licenses. House Armed Services Committee Report 116-120 accompanying the National Defense Authorization Act for Fiscal Year 2020 included a provision for GAO to review several matters related to military spouse employment. This report examines (1) selected employment outcomes for military spouses, (2) DOD's efforts to evaluate states' licensing policies for spouses, and (3) DOD's outreach efforts to promote awareness of employment resources. GAO reviewed DOD documentation and 2017 survey data (most recent available), relevant literature, and federal laws; interviewed DOD and military services officials and relevant stakeholders; and spoke with staff at six military installations selected based on the numbers of servicemembers, among other factors. GAO is making two recommendations to DOD to continue assessing and reporting on states' efforts to help military spouses transfer occupational licenses, and to establish information sharing strategies on outreach to military spouses about employment resources. DOD concurred with both recommendations. For more information, contact Elizabeth Curda at (202) 512-7215 or curdae@gao.gov.
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  • COVID-19: Urgent Actions Needed to Better Ensure an Effective Federal Response
    In U.S GAO News
    The COVID-19 pandemic has resulted in catastrophic loss of life and substantial damage to the global economy, stability, and security. According to federal data, the U.S. had an average of 116,000 new COVID-19 cases per day from November 1 through November 12, 2020. Between January 2020 and October 2020, at least 237,000 more deaths occurred from all causes, including COVID-19, than would normally be expected, according to data from the Centers for Disease Control and Prevention (CDC). Further, while the economy has improved since July 2020, many people remain unemployed, including both those temporarily laid off and those who have permanently lost their job (see figure). Also, more households have become seriously delinquent on mortgage payments during the pandemic. In addition, GAO’s review of academic studies suggests the pandemic will likely remain a significant obstacle to more robust economic activity. Number of Unemployed Workers Permanently Losing Jobs and on Temporary Layoff, January 2019 through October 2020 In response to the pandemic and its effects, Congress and the administration have taken a series of actions to protect the health and well-being of Americans. However, as the end of 2020 approaches, urgent actions are needed to help ensure an effective federal response on a range of public health and economic issues. Medical Supplies While the Department of Health and Human Services (HHS) and the Federal Emergency Management Agency (FEMA) have made numerous efforts to mitigate supply shortages and expand the medical supply chain, shortages of certain supplies persist. In September 2020, GAO reported that ongoing constraints with the availability of certain types of personal protective equipment (PPE) and testing supplies remain due to a supply chain with limited domestic production and high global demand. In October 2020, GAO surveyed public health and emergency management officials from all states, the District of Columbia, and U.S. territories (hereafter states) and found the following: Testing supplies. Most states reported no shortages of swabs or transport media, but about one-third to one-half reported shortages in other types of testing supplies (see figure). State-Reported Testing Supply Shortages, as of October 2020   GAO surveyed officials in the 50 states; Washington, D.C.; and the five U.S. territories and received responses from 47 of the 56 locations, representing 41 states; Washington, D.C.; and all five territories. Not all states responded to every question. PPE. The majority of states that responded were mainly able to fulfill requests for supplies from organizations and entities within their states. However, availability constraints continue with certain PPE, such as nitrile gloves. Supplies for future vaccine needs. About one-third of states that responded stated that they were “greatly” or “completely” concerned about having sufficient vaccine-related supplies to administer COVID-19 vaccines. An additional 21 states indicated that they were moderately concerned. In September 2020, GAO recommended that HHS, in coordination with FEMA, should further develop and communicate to stakeholders plans outlining specific actions the federal government will take to help mitigate supply chain shortages for the remainder of the pandemic; immediately document roles and responsibilities for supply chain management functions transitioning to HHS, including continued support from other federal partners, to ensure sufficient resources exist to sustain and make the necessary progress in stabilizing the supply chain; and devise interim solutions, such as systems and guidance and dissemination of best practices, to help states enhance their ability to track the status of supply requests and plan for supply needs for the remainder of the pandemic response. HHS and the Department of Homeland Security disagreed with these recommendations, noting, among other things, the work that they had done to manage the medical supply chain and increase supply availability. In November 2020, HHS repeated its disagreement with GAO’s recommendations and noted its efforts to meet the needs of states. In light of the surge in COVID-19 cases, along with reported shortages, including GAO’s nationwide survey findings, GAO underscores the critical imperative for HHS and FEMA to implement GAO’s September 2020 recommendations. Vaccines and Therapeutics In a recent GAO report (GAO-21-207), GAO found that there has been significant federal investment to accelerate vaccine and therapeutic development, such as through Operation Warp Speed, a partnership between the Department of Defense and HHS that aims to accelerate the development, manufacturing, and distribution of COVID-19 vaccines and therapeutics. Separately, Emergency Use Authorizations (EUA), which allow for the emergency use of medical products without Food and Drug Administration (FDA) approval or licensure provided certain statutory criteria are met, have also been used for therapeutics. As of November 9, 2020, FDA had made four therapeutics available to treat COVID-19 through EUAs. In that report, GAO recommended that FDA identify waysto uniformly discloseinformation from its scientific review of safety and effectiveness data when issuing EUAs for therapeutics and vaccines. By doing so, FDA could help improve the transparency of, and ensure public trust in, its EUA decisions. HHS neither agreed nor disagreed with the recommendation, but said it shared GAO’s goal of transparency. COVID-19 Testing Guidance HHS and its component agencies have taken several key actions to document a federal COVID-19 testing strategy and provide testing-related agency guidance. However, this guidance has not always been transparent, raising the risk of confusion and eroding trust in government. In particular, while it is expected that guidance will change as new information about the novel virus evolves, frequent changes to general CDC testing guidelines have not always been communicated with a scientific explanation. GAO recommends that HHS ensure that CDC clearly discloses the scientific rationale for any change to testing guidelines at the time the changeis made. HHS concurred with this recommendation. Types of COVID-19 Testing Approaches Nursing Home Care In September 2020, the Coronavirus Commission on Safety and Quality in Nursing Homes (established by the Centers for Medicare & Medicaid Services (CMS) in June 2020) made 27 recommendations to CMS on topics such as testing, PPE, and visitation. CMS released a response to the commission that broadly outlined the actions it has taken to date, but it has not fully addressed the commission’s recommendations or provided an implementation plan to track and report progress toward implementing them. While CMS is not obligated to implement all of the commission’s recommendations, the agency has not indicated any areas where it does not plan to take action. GAO recommends that CMS quickly develop a plan that further details how it intends to respond to and implement, as appropriate, the commission’s recommendations. HHS neither agreed nor disagreed with this recommendation and said it would refer to and act upon the commission’s recommendations, as appropriate. In addition, the Department of Veterans Affairs (VA) partners with state governments to provide nursing home care to more than 20,000 veterans in over 150 state veterans homes. In March 2020, VA instructed its contractor to stop in-person inspections due to concerns about COVID-19. As of September 2020, these inspections had not resumed, leaving veterans at risk of receiving poor quality care. Additionally, VA does not collect timely data on the number of COVID-19 cases and deaths occurring at each state veterans home, hindering its ability to monitor and take steps to mitigate the spread of COVID-19 in these homes. GAO recommends that VA (1) develop a plan to resume inspections of state veterans homes, which may include using in-person, a mix of virtual and in-person, or fully virtual inspections, and (2) collect timely data on COVID-19 cases and deaths in each state veterans home. VA concurred with both recommendations. Economic Impact Payments The CARES Act included economic impact payments (EIP) for eligible individuals to address financial stress due to the pandemic. As of September 30, 2020, the Department of the Treasury (Treasury) and the Internal Revenue Service (IRS) had disbursed over 165.8 million payments to individuals, totaling $274.7 billion. According to IRS data, more than 26 million non-filers—individuals who do not normally file a tax return and may be hard to reach—received a payment (see figure). However, everyone that was supposed to receive a payment was not reached. Starting in September 2020, IRS sent notices to nearly 9 million individuals who had not yet received an EIP. Number of Filers and Non-Filers Issued an Economic Impact Payment, as of September 30, 2020 Treasury and IRS officials did not plan to track and analyze the outcomes of their EIP notice mailing effort until 2021. The lack of timely analysis deprives Treasury and IRS of data they could use to assess the effectiveness of their notice strategy and redirect resources as needed to other outreach and communication efforts. GAO recommends that Treasury, in coordination with IRS, should begin tracking and publicly reporting the number of individuals who were mailed an EIP notification letter and filed for and received an EIP, and use that information to inform ongoing outreach and communications efforts. Treasury agreed with this recommendation. Unemployment Insurance The CARES Act created three federally funded temporary programs for unemployment insurance (UI) that expanded benefit eligibility and enhanced benefits. In its weekly news releases, the Department of Labor (DOL) publishes the number of weeks of unemployment benefits claimed by individuals in each state during the period and reports the total count as the number of people claiming benefits nationwide. DOL officials told GAO that they have traditionally used this number as a proxy for the number of individuals claiming benefits because they were closely related. However, the number of claims has not been an accurate estimate of the number of individuals claiming benefits during the pandemic because of backlogs in processing a historic volume of claims, among other data issues. Without an accurate accounting of the number of individuals who are relying on these benefits in as close to real time as possible, policymakers may be challenged to respond to the crisis at hand. GAO recommends that DOL (1) revise its weekly news releases to clarify that in the current unemployment environment, the numbers it reports for weeks of unemployment claimed do not accurately estimate the number of unique individuals claiming benefits, and (2) pursue options to report the actual number of distinct individuals claiming benefits, such as by collecting these already available data from states. DOL agreed with the recommendation to revise its weekly news releases, and partially agreed with the recommendation to pursue options to report the actual number of distinct individuals claiming benefits. Tax Relief for Businesses To provide liquidity to businesses during the pandemic, the CARES Act included tax measures to help businesses receive cash refunds or other reductions to tax obligations. Some taxpayers need to file an amended income tax return to take advantage of these provisions; at the same time, IRS faces an increase in mail and paper processing delays due to the pandemic, which may delay the timely processing of this paperwork and issuance of these refunds. GAO recommends that IRS update its form instructions to include information on its electronic filing capability for tax year 2019. IRS agreed with this recommendation. Program Integrity Although the extent and significance of improper payments associated with COVID-19 relief funds have not yet been determined, the impact of these improper payments, including those that are the result of fraud, could be substantial. For example, numerous individuals are facing federal charges related to attempting to defraud the Paycheck Protection Program (PPP), UI program, or other federal programs, and many more investigations are underway. To address the risk of improper payments due to fraud and other causes, GAO previously recommended the following: The Small Business Administration (SBA) should develop and implement plans to identify and respond to risks in the PPP to ensure program integrity, achieve program effectiveness, and address potential fraud. The Office of Management and Budget (OMB), in consultation with Treasury, should issue timely guidance for auditing new and existing COVID-19-related programs, including Coronavirus Relief Fund payments, as soon as possible. Audits of entities that receive federal funds are critical to the federal government’s ability to help safeguard those funds.Also, Congress should amend the Social Security Act to explicitly allow the Social Security Administration to share its full death data with Treasury for data matching to prevent payments to ineligible individuals. GAO maintains that implementing these recommendations fully is critically important in order to protect federal funds from improper payments resulting from fraud and other risks. In this report, GAO also identifies new concerns about the timely reporting of improper payments for COVID-19 programs. The COVID-19 relief laws appropriated over a trillion dollars that may be spent through newly established programs to fund response and recovery efforts, such as SBA’s PPP. However, unlike the supplemental appropriations acts that provided for disaster relief related to the 2017 hurricanes and California wildfires, the COVID-19 relief laws did not require agencies to deem programs receiving these relief funds that expend more than a threshold amount as "susceptible to significant improper payments." In addition, based on OMB guidance, improper payment estimates associated with new COVID-19 programs established in March 2020 may not be reported until November 2022, in some instances. GAO is making two recommendations: OMB should develop and issueguidance directingagencies to include COVID-19 relief funding with associated key risks, such as changes to existing program eligibility rules, as part of their improper payment estimation methodologies, especially for existing programs that received COVID-19 relief funding. SBA should expeditiously estimate improper payments and report estimates and error rates for PPP due to concerns about the possibility that improper payments, including those resulting from fraudulent activity, could be widespread. GAO is also suggesting that Congress consider, in any future legislation appropriating COVID-19 relief funds, designating all executive agency programs and activities making more than $100 million in payments from COVID-19 relief funds as “susceptible to significant improper payments.” Aviation Assistance and Preparedness GAO identified concerns about efforts to monitor CARES Act financial assistance to the aviation sector. Treasury’s Payroll Support Program (PSP) provides $32 billion in payroll support payments and loans to help the aviation industry retain its employees. While recipients have begun submitting required compliance reports, Treasury has not yet finalized a monitoring system to identify and respond to the risk of noncompliance with PSP agreement terms, potentially hindering its ability to detect program misuse in a timely manner. GAO is recommending that Treasury finish developing and implement acompliance monitoringplan that identifies and responds to risks in the PSP. Treasury neither agreed nor disagreed with this recommendation, but committed to reviewing additional measures that may further enhance its compliance monitoring and ensure that PSP funds are used as intended. In June 2020, GAO suggested that Congress take legislative action to require the Secretary of Transportation to work with relevant agencies, such as HHS, the Department of Homeland Security, and other stakeholders, to develop a national aviation-preparedness plan to limit the spread of communicable diseasethreats and minimize traveland trade impacts. GAO originally made this recommendation to the Department of Transportation in December 2015. GAO urges Congress to take swift action to require such a plan, without which the U.S. will not be as prepared to minimize and quickly respond to ongoing and future communicable disease events. As of November 12, 2020, the U.S. had over 10.3 million cumulative reported cases of COVID-19 and about 224,000 reported deaths, according to federal agencies. The country also continues to experience serious economic repercussions. Four relief laws, including the CARES Act, were enacted as of November 2020 to provide appropriations to address the public health and economic threats posed by COVID-19. As of September 30, 2020, of the $2.6 trillion appropriated by these acts, the federal government had obligated a total of $1.8 trillion and expended $1.6 trillion of the COVID-19 relief funds, as reported by federal agencies. The CARES Act included a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report examines the federal government’s continued efforts to respond to and recover from the COVID-19 pandemic. GAO reviewed data, documents, and guidance from federal agencies about their activities and interviewed federal and state officials. GAO also sent a survey to public health and emergency management officials in the 50 states, Washington, D.C., and the five U.S. territories regarding medical supplies. GAO is making 11 new recommendations for agencies that are detailed in this Highlights and in the report. GAO is also raising one matter for congressional consideration. For more information, contact A. Nicole Clowers at (202)512-7114 or clowersa@gao.gov.
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  • Architect of the Capitol: Efforts Have Begun to Update Cannon House Office Building’s Renovation Cost and Schedule Estimates
    In U.S GAO News
    What GAO Found The Architect of the Capitol (AOC) has substantially completed three of five planned phases to renovate the Cannon House Office Building (Cannon project). AOC completed Phase 0 utility work; the Phase 1 work to renovate the building's west side, the Phase 2 work to renovate the building's north side; and work is underway on Phase 3 of the building's east side. Cannon House Office Building, Washington, D. C. From 2009 to 2018, AOC consistently estimated the project cost at $753 million, In 2014, GAO found that AOC's cost estimate of $753 million reflected several of GAO's leading practices for high-quality, reliable cost estimates, including that AOC had conducted a risk and uncertainty analysis. GAO found that AOC's cost estimating policies and guidance did not require a quantitative risk and uncertainty analysis nor the reporting of the resulting confidence level of the estimate. GAO made recommendations for AOC to incorporate leading practices into agency guidance and submit confidence levels of cost estimates to Congress. AOC implemented our recommendations. In January 2018, AOC updated its analysis of risks by undertaking an integrated cost-schedule risk analysis. AOC's 2018 analysis arrived at the same conclusion as its earlier analysis—that the project's estimated $753 million total cost was adequate to complete the project. However, AOC's 2018 analysis indicated that inaccurate estimates of costs for risk mitigations, unknown risks, and optimistic assumptions about the effect of risk mitigations on the project's cost and schedule could affect its total cost. AOC updated the analysis in December 2019 and estimated the project cost at $890 million. Two unknown risks materialized after the December 2019 estimate: the effect of COVID-19 and the January 2021 security events–their impact on the project is uncertain. In its March 2021 project summary, AOC reported that a revised budget would be formulated after the completion of an analysis in December 2021. Toward this end, in May 2021, AOC began updating its integrated cost-schedule risk analysis, with the aim of more accurately determining the extent to which the project's costs are increasing and its estimated cost at completion. Why GAO Did This Study In its Cannon project, the AOC intends to preserve the historic character while improving the functionality of the 113 year-old Cannon Building—the oldest congressional office building—as well as address deterioration to the building and its components. The project—nearing year 7 of its planned 10-year duration—is being implemented in five sequential phases with an initial phase (Phase 0) for utility work and four subsequent phases (Phases 1 through 4) to renovate the north-, south-, east-, and west-facing sides of the building. Each phase is scheduled around a 2-year congressional session. This statement describes: (1) the status of the Cannon project and (2) changes to the project's estimated cost at completion. This statement is based on GAO's prior reports in 2009 and 2014 and ongoing monitoring of the project. To monitor the project, GAO has been observing the ongoing construction, attending project meetings, and analyzing AOC documents.
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  • Provincial Reconstruction Teams in Afghanistan and Iraq
    In U.S GAO News
    U.S.-led Provincial Reconstruction Teams (PRT) are designed to help improve stability in Afghanistan and Iraq by increasing the host nation's capacity to govern; enhancing economic viability; and strengthening local governments' ability to deliver public services, such as security and health care. PRTs are a means of coordinating interagency diplomatic, economic, reconstruction, and counterinsurgency efforts among various U.S. agencies in Afghanistan and Iraq. PRTs are intended to be interim structures; after a PRT has achieved its goal of improving stability, it may be dismantled to allow traditional development efforts to occur. In Afghanistan, the first PRTs were created in 2002 with the mission of facilitating security and reconstruction by helping the central government extend its authority to the provinces. Since then, PRTs have expanded their purpose to include strengthening local governance and community development. In Iraq, PRTs were initiated in 2005 with the mission to increase the capacity of provincial and local governments to govern effectively and, for newer embedded PRTs (ePRT), to support moderates and assist in the military's counterinsurgency efforts. To accomplish their missions, PRTs engage in and fund a variety of activities, such as developing the capacity of local governments through engagement with local stakeholders; promoting budget execution, business development, agriculture, public health initiatives, and governance; and supporting the delivery of basic social services. This report describes (1) the organization, staffing, and funding for PRTs in Afghanistan and (2) the organization, staffing, and funding for PRTs in Iraq. It excludes information marked "Sensitive but Unclassified" in our September 26, 2008, report on PRTs. Due to broad congressional interest in issues related to Iraq and Afghanistan, we completed this report under the Comptroller General's authority to conduct evaluations on his own initiative.Afghanistan, as of May 2008, the United States was leading 12 of 26 PRTs and 13 other coalition countries were leading the remaining 14 PRTs. All PRTs in Afghanistan are under ISAF's operational command, but individual nations, including the United States, lead PRTs and determine their size and structure. U.S.-led PRTs in Afghanistan are led by DOD and are composed primarily of U.S. military personnel. As of April 2008, 10 of the 12 U.S.-led PRTs included 88 or more military personnel--the majority of whom provide security and other support for the PRTs--and 3 civilian personnel from State, USAID, and USDA. The total number of U.S. government personnel assigned to U.S. PRTs in Afghanistan increased slightly from 1,023 personnel in 2007 to 1,055 personnel in 2008--which includes 1,021 military personnel from DOD and 34 civilian personnel from State, USAID, and USDA. DOD is responsible for paying nearly all of the costs associated with operating PRTs, such as providing their security and life support. However, DOD officials reported that DOD does not track PRT operating costs separately from other operational costs for Afghanistan. State, USAID, and USDA do not reimburse DOD for its support to civilian PRT officials in Afghanistan. PRTs have one source of programmatic funding available for projects in Afghanistan. PRT commanders can approve the use of funds for projects under DOD's Commander's Emergency Response Program (CERP) up to $25,000 per project. PRTs in Afghanistan may also coordinate with other U.S.-funded programs, including other commanders' CERP projects and USAID programs, such as the Local Governance and Community Development project. In Iraq, as of August 2008, the United States was leading 28 of 31 PRTs and other coalition countries were leading 3 PRTs. As of August 2008, three types of U.S.-led PRTs were operating in Iraq: 11 PRTs at the provincial level of government; 13 ePRTs embedded with U.S. brigade combat teams and operating in local governments in Baghdad, Anbar, Babil, and Diyala provinces; and 4 Provincial Support Teams (PST), which are smaller PRTs that cannot be based in the intended province due to security concerns. According to State and DOD officials, the number of personnel assigned to PRTs and ePRTs in Iraq increased from an estimated 100 to 125 personnel in early 2007 to about 450 in July 2008. This increase was the result of the Administration's decision in January 2007 to create ePRTs and to increase the size of PRTs in support of The New Way Forward. DOD and civilian agencies have staffed the PRTs with a mix of U.S. government employees--permanent and temporary--and contractors. State reimburses DOD for some operating costs of ePRTs and most PRTs, based on a quarterly estimate for each PRT member. State's reimbursements do not cover the costs of PRT security and transportation provided by the U.S. military. According to DOD, as of April 2008, State had reimbursed $11 million to DOD for operating costs--$5.9 million for fiscal year 2007 and $5.1 million for the first quarter of fiscal year 2008. State had also obligated $125 million for PRT movement security from September 2005 through May 2008 for PRTs in Iraq that are not embedded with U.S. military units or do not have access to military movement assets.
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