The United States and Costa Rica: Partners in Democracy and Security

Office of the Spokesperson

Secretary of State Antony J. Blinken is traveling to San Jose on June 1-2, 2021, to a meeting of the Central American Integration System (SICA) convened by Costa Rican President Carlos Alvarado Quesada.  In Costa Rica, he will meet with President Alvarado and Foreign Minister Rodolfo Solano Quirós to discuss the strong U.S.-Costa Rica partnership and to advance collaboration on regional and global issues, including migration, counternarcotics, human rights, and climate change.

A Relationship Based on Shared Values and Commitments

  • Costa Rica, a strong democracy of more than five million people with deep ties to the United States, is important to key U.S. goals in the region and is committed to continued close cooperation with the United States. It has an open trade and investment climate, and recently became the 38th member of the OECD. It is also one of the strongest and most reliable voices in Latin America on human rights and rule of law, and has been a superb partner in the fight against transnational crime and drug trafficking.
  • The United States is Costa Rica’s top trading partner, accounting for around 40 percent of both imports and exports. The United States is also Costa Rica’s top source of foreign direct investment, reaching $1.92 billion in 2019 (70% of total FDI) .  There are currently more than 200 U.S. companies in Costa Rica that collectively employ more than 94,000 people, or nearly 84 percent of all jobs created by multinational companies in Costa Rica.
  • Costa Rica is a champion of human rights and democratic norms across the region, including through its active role in the Organization of American States (OAS). Costa Rica has condemned fraudulent parliamentary elections in Venezuela and supported the OAS resolution calling for electoral reform in Nicaragua. Additionally, Costa Rica hosts more than 450,000 Nicaraguans, including 110,000 people who fled Nicaragua after the 2018 political crisis, many of whom are currently seeking refugee status in Costa Rica. Costa Rica also hosts nearly 30,000 Venezuelan migrants and refugees. The Costa Rican government has extended several additional protections, work permits, and travel documentation to some segments of this population, a valuable humanitarian response to Venezuelans and Nicaraguans who cannot return to their country of origin given continued instability.
  • Prior to the COVID-19 pandemic, approximately 120,000 private American citizens, including many retirees, resided in the country; more than 1.4 million American citizens visited Costa Rica annually. Pre-pandemic, more than 1,100 Costa Ricans studied at U.S. institutions of higher education annually. More than 8,000 U.S. students study in Costa Rica every year, and Costa Rica is the number one destination in Latin America for U.S. study abroad programs.
  • Costa Rica is a valuable counter-narcotics partner. In 2020, Costa Rican security services seized more than 71 metric tons of drugs, including a record 18.6 metric tons found in commercial containers. U.S.-donated interceptor vessels, as well as equipment and training provided to the Costa Rican Coast Guard, along with joint operations, led to a record number of maritime seizures in 2020.
  • The United States has partnered with Costa Rica in an effort to bring the COVID-19 pandemic to a swift end. U.S. assistance of more than $4 million to Costa Rica includes personal protective equipment, medical supplies, hygiene supplies to support in-person education, and mobile hospitals.

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    In U.S GAO News
    Technical assistance refers to programs, activities, and services provided by federal agencies to strengthen the capacity of grant recipients and to improve their performance of grant functions. Technical assistance can improve the performance or management of grant program recipients. Technical assistance includes the improvement of grant outcomes, grant management, grantee compliance, project monitoring and evaluation, and interactions with stakeholders. The technical assistance provided by the selected agencies—the Department of Education (Education), the Department of Health and Human Services' Administration for Children and Families (ACF), and the Department of Labor's Employment and Training Administration (ETA)—is designed to align with the requirements of each agency's grant programs and the individual grantee's needs. The types of technical assistance provided by agencies varied and included a range of delivery methods shown below. Types of Technical Assistance Provided by Selected Agencies Education tailors its approach to provide technical assistance to grantees based on recipients' needs and their efforts to obtain technical assistance. According to ACF, some grant programs have extensive, dedicated technical assistance that is grant specific, while other grant programs share technical assistance resources provided by multiple technical assistance centers. ACF's technical assistance can be based on program office oversight of the grantees that includes financial and internal control reviews and site visits. For ETA, state and local grantees administer ETA-funded programs throughout the country and technical assistance plays a role in ensuring these programs' successful implementation. According to ETA officials, technical assistance activities are based on grant program objectives. The 10 grant programs GAO reviewed evaluated technical assistance, collected feedback from recipients of the technical assistance, and incorporated feedback into technical assistance. For example, a School Safety National Activities evaluation of one of its national centers included targets for multiple performance measures and the actual performance for each measure. These measures included the percentage of milestones achieved and the percentage of technical assistance and dissemination products and services deemed to be high quality by an independent review panel. The overall goal of technical assistance is to enhance the delivery of agency programs and help ensure grantee compliance. GAO was asked to review issues related to technical assistance for grants at Education, ACF, and ETA. This report (1) describes how Education, ACF, and ETA provide technical assistance to grantees; and (2) examines to what extent these agencies evaluate the technical assistance. For this review, GAO selected 10 grant programs from the three agencies based on fiscal year 2018 funding information and the purpose of the grant. GAO reviewed documents and interviewed agency officials about the technical assistance provided, the provider and recipient of technical assistance, and the amount obligated in fiscal year 2018 for the 10 grant programs reviewed. GAO also reviewed documents and interviewed agencies about the extent to which they evaluated technical assistance, whether they gathered feedback from the recipients of technical assistance, and whether feedback was included in the evaluations for the 10 grant programs reviewed. For more information, contact Michelle Sager at (202) 512-6806 or SagerM@gao.gov.
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  • Department of Defense: Eating Disorders in the Military
    In U.S GAO News
    The Department of Defense (DOD) screens for eating disorders for all applicants entering into the military but does not specifically screen servicemembers for eating disorders after entrance. However, after joining the military, servicemembers receive annual health screenings, and medical personnel may be able to diagnose eating disorders during in-person physical exams. Service branch behavioral health specialists told GAO that DOD medical personnel are trained to notice signs of eating disorders, such as changes in vital signs and emaciated appearance. DOD is examining ways to improve its screening of eating disorders in the military and recently expanded the available research funding for eating disorders in its Peer-Reviewed Medical Research Program (PRMRP). DOD provides health care services to approximately 9.5 million eligible beneficiaries, including services to treat those diagnosed with eating disorders, through TRICARE, DOD’s regionally structured health care system. Servicemembers can obtain these services at military treatment facilities—referred to as direct care—or receive care purchased from civilian providers—referred to as purchased care. DOD officials told us that the specialized level of care necessary to treat eating disorders is available to TRICARE beneficiaries through purchased care, rather than direct care. The Defense Health Agency (DHA), which oversees the TRICARE program, uses two contractors to develop regional provider networks. According to the two TRICARE contractors’ data for purchased care, as of spring 2020, there were 166 eating disorder facilities located in 32 states throughout the country and the District of Columbia. The facilities vary by geographic location, population served, and level of treatment provided: Geography: About half of the 166 facilities (79) are located in the following five states: California (24), Florida (18), Illinois (15), Texas (13), and Virginia (nine).  Population: Of the 166 eating disorder facilities, over three-quarters provide treatment to both adult (132 facilities) and child and adolescent (132 facilities) populations. Level of Treatment: Most facilities provide inpatient hospitalization programs, which are for serious cases requiring medical stabilization (81 facilities); partial hospitalization, which are day programs providing treatment 5 to 7 days a week (133 facilities); or intensive outpatient programs, which are treatment programs providing therapy 2 to 6 days a week (107 facilities). About one-fifth of the facilities (35) provide residential treatment services, which are living accommodations providing intensive therapy and 24-hour supervision. TRICARE contractors have met with some challenges entering into contracts with eating disorder treatment facilities in certain areas of the country, according to DHA officials and both contractors. However, both contractors told GAO they consider it their responsibility to ensure beneficiaries receive the care they need regardless of the location of the facility. No access-to-care complaints related to eating disorder treatment were reported by TRICARE beneficiaries, according to the most recent DHA data for years 2018 through 2019. Eating disorders are complex conditions affecting millions of Americans and involve dangerous eating behaviors, such as the restriction of food intake. They can have a severe impact on heart, stomach, and brain functionality, and they significantly raise the risk of mortality. Many with eating disorders also experience co-occurring conditions such as depression. Research has yielded a range of estimates of the number of servicemembers with an eating disorder, due to differences in research methods. For example, a 2018 DOD study concluded that servicemembers likely experienced eating disorders at rates that are comparable to rates in the general population, while other survey-based research suggested the number of servicemembers with eating disorders may be higher than those with a medical diagnoses of such disorders. The potential effects that eating disorders can have on the health and combat readiness of servicemembers and their dependents underscores the importance of screening and treating this population. GAO was asked to provide information on eating disorders among servicemembers and their dependents. To describe how DOD screens for eating disorders among servicemembers, GAO reviewed DOD policies related to health screening and interviewed behavioral health specialists from the military branches. To understand approaches and challenges with implementing screening in a military environment, any planned or ongoing DOD-sponsored research related to this topic, and available eating disorder treatment, GAO interviewed representatives from the Eating Disorder Coalition, Uniformed Services University of Health Sciences, and the University of Kansas. To describe how DOD provides eating disorder treatment to servicemembers and their dependents, GAO interviewed DHA officials and TRICARE contractors and reviewed the TRICARE policy manual to identify the types of eating disorder diagnoses and treatments that are covered through direct and purchased care. GAO received data from the two TRICARE contractors related to the availability of eating disorder treatment services as of spring 2020. For more information, contact Sharon Silas at (202) 512-7114 or Silass@gao.gov.
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    In Crime Control and Security News
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  • Retirement Security: Older Women Report Facing a Financially Uncertain Future
    In U.S GAO News
    In all 14 focus groups GAO held with older women, women described some level of anxiety about financial security in retirement. Many expressed concerns about the future of Social Security and Medicare benefits, and the costs of health care and housing. Women in the groups also cited a range of experiences that hindered their retirement security, such as divorce or leaving the workforce before they planned to (see fig.). Women in all 14 focus groups said their lack of personal finance education negatively affected their ability to plan for retirement. Many shared ideas about personal finance education including the view that it should be incorporated into school curriculum starting in kindergarten and continuing through college, and should be available through all phases of life. Women Age 70 and Over by Marital Status Note: Percentages do not add up to 100 percent due to rounding. Individual women's financial security is also linked to their household where resources may be shared among household members. According to the 2016 Survey of Consumer Finances, among households with older women, about 23 percent of those with white respondents and 40 percent of those with African American respondents fell short of a measure of retirement confidence, indicating their income was not sufficient to maintain their standard of living. The likelihood of a household reporting high retirement confidence rose in certain cases. For example among households of similar wealth, those with greater liquidity in their portfolio and those with defined benefit plan income were more likely to report high retirement confidence. Older adults represent a growing portion of the U.S. population and older women have a longer life expectancy, on average, than older men. Prior GAO work has found that challenges women face during their working years can affect their lifetime earnings and retirement income. For example, we found women were overrepresented in low wage professions, paid less money than their male counterparts during their careers, and were more likely to leave the workforce to care for family members. Taken together, these trends may have significant effects on women's financial security in retirement. GAO was asked to report on the financial security of older women. This report examines (1) women retirees' perspectives on their financial security, and (2) what is known about the financial security of older women in retirement. GAO held 14 non-generalizable focus groups with older women in both urban and rural areas in each of the four census regions. GAO also analyzed data from three nationally representative surveys—the 2019 Current Population Survey, the Health and Retirement Study (2002-2014 longitudinal data), and the 2016 Survey of Consumer Finances. For more information, contact Charles Jeszeck at (202) 512-7215 or jeszeckc@gao.gov.
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