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    Results:

    Subject Term: "Health risks"

    5 publications with a total of 8 open recommendations including 1 priority recommendation
    Director: Cary Russell
    Phone: (202) 512-5431

    3 open recommendations
    Recommendation: To better position combatant commanders to implement the requirements of DOD Instruction 4715.19 if burn pits become necessary and to assist in planning for waste disposal in future military operations, the Secretary of Defense should direct the combatant commanders of U.S. Africa Command, U.S. European Command, U.S. Pacific Command, and U.S. Southern Command to establish implementation policies and procedures for waste management. Such policies and procedures should include, as applicable, specific organizations within each combatant command with responsibility for ensuring compliance with relevant policies and procedures, including burn pit notification, and, when appropriate, monitoring and reporting on the use of burn pits.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To better understand the long-term health effects of exposure to the disposal of covered waste in burn pits, the Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology, and Logistics to, in coordination with the Secretary of Veterans Affairs, specifically examine the relationship between direct, individual, burn pit exposure and potential long-term health-related issues. As part of that examination, consider the results of the National Academies of Sciences, Engineering, and Medicine's report on the Department of Veteran Affairs registry and the methodology outlined in the 2011 Institute of Medicine study that suggests the need to evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic disease, with particular attention to the collection of data at the individual level, including the means by which that data is obtained.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To better understand the long-term health effects of exposure to the disposal of covered waste in burn pits, the Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology, and Logistics to take steps to ensure United States Central Command and other geographic combatant commands, as appropriate, establish processes to consistently monitor burn pit emissions for unacceptable exposures.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: J. Alfredo Gómez
    Phone: (202) 512-3841

    1 open recommendations
    Recommendation: To enhance HHS's ability to protect public health from the impacts of climate change, the Secretary of HHS should direct CDC to develop a plan describing when it will be able to issue climate change communication guidance to state and local health departments, to better position relevant officials to effectively communicate about the risks that climate change poses to public health and address requirements of the Climate Ready States and Cities Initiative.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: As of December 2016, CDC has taken steps to start developing a communications strategy, and expects this process to include the development of guidance for public health officials to help them more effectively communicate about the health effects of climate change. CDC expects the strategy to be completed by the fall of 2017.
    Director: Trimble, David C
    Phone: (202) 512-3841

    1 open recommendations
    Recommendation: To ensure that NNSA's investments in plutonium research facilities and capabilities result in an operationally effective and affordable solution, the Secretary of Energy should continue efforts to assess how plutonium research and other capability needs and stockpile requirements have changed, if at all, since the needs were revalidated in 2008, and develop a plan to appropriately meet the nation's near-term and longer-term plutonium needs.

    Agency: Department of Energy
    Status: Open

    Comments: As of June 2017, NNSA is taking some actions to assess plutonium research and stockpile needs and to plan for meeting near-term and longer-term plutonium needs, but it is not certain whether these actions will address GAO's recommendation. As a result, the recommendation remains open. Since making this recommendation, GAO has conducted additional, related work (published as GAO-16-585), and NNSA's responses to recommendations made in GAO-16-585 may help satisfy this earlier recommendation. In response to recommendations for GAO-16-585, NNSA stated that it would take a number of actions related to assessing plutonium research needs and planning for longer-term needs as part of two projects: the Chemistry and Metallurgy Research Replacement (CMRR) project and the Plutonium Modular Approach. NNSA stated that it would update the CMRR requirements document to clarify the relationship between CMRR's research capabilities and NNSA's overall plutonium strategy, estimating it would complete this action by the end of 2017. NNSA stated that it has initiated the analysis of alternatives for the Plutonium Modular Approach, which will include identifying requirements related to meeting plutonium needs. NNSA has not estimated a completion date for the analysis of alternatives. We will determine whether NNSA's actions satisfy this recommendation once the actions have been completed.
    Director: Gomez, Jose A
    Phone: (202) 512-3841

    2 open recommendations
    Recommendation: To enhance FDA's ability to use AERs and to oversee dietary supplement products, the Secretary of the Department of Health and Human Services should direct the Commissioner of FDA to incorporate a mechanism to collect information on when AERs are used to support and inform consumer protection actions (i.e., surveillance, advisory, and regulatory actions).

    Agency: Department of Health and Human Services
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will update this information.
    Recommendation: To enhance FDA's ability to use AERs and to oversee dietary supplement products, the Secretary of the Department of Health and Human Services should direct the Commissioner of FDA to establish a time frame for issuing final guidance for the draft (1) New Dietary Ingredient (NDI) guidance and (2) guidance clarifying whether a liquid product may be labeled and marketed as a dietary supplement or as a conventional food with added ingredients.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: Although FDA issued final guidance for distinguishing liquid dietary supplements from beverages in January 2014, it has not yet issued final guidance on new dietary ingredients (NDI). Once FDA completes the NDI guidance, we can close the recommendation.
    Director: Cosgrove, James C
    Phone: (202)512-7029

    1 open recommendations
    including 1 priority recommendation
    Recommendation: To increase D-SNPs' accountability and ensure that CMS has the information it needs to determine whether D-SNPs are providing the services needed by dual-eligible beneficiaries, especially those who are most vulnerable, the Administrator of CMS should conduct an evaluation of the extent to which D-SNPs have provided sufficient and appropriate care to the population they serve, and report the results in a timely manner.

    Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services
    Status: Open
    Priority recommendation

    Comments: As of October 2016, HHS has not implemented this recommendation. CMS noted that, in 2012, they conducted two independent reviews to evaluate how well SNPs, including D-SNPs, developed and implemented a quality improvement tool used to ensure that the unique needs of SNP enrollees are identified and addressed through the plan's care management practices. However, CMS has not conducted an evaluation of the extent to which D-SNPs have provided sufficient and appropriate care to the population they serve. In prior updates, CMS officials said that they were uncertain whether an evaluation of D-SNPs would be conducted in the future, since the likelihood of an evaluation would be dependent on availability of funding for an independent contract. However, they noted that, to the extent that CMS is able to develop solid care coordination outcome measures (which would be incorporated into the HEDIS requirements), that they expect these measures will serve as key indicators of D-SNP performance. For this recommendation to be closed as implemented, CMS will need to conduct an evaluation of the extent to which D-SNPs have provided sufficient and appropriate care to the population they serve.