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    Subject Term: "Program coordination"

    11 publications with a total of 41 open recommendations including 4 priority recommendations
    Director: Cristina Chaplain
    Phone: (202) 512-4841

    2 open recommendations
    Recommendation: Congress should consider requiring the NASA Administrator to direct the Exploration Systems Development organization within the Human Exploration and Operations Mission Directorate to establish separate cost and schedule baselines for work required to support SLS and EGS for Exploration Mission 2 and establish separate cost and schedule baselines for each additional capability that encompass all life cycle costs, to include operations and sustainment. (Matter for Consideration 1)

    Agency: Congress
    Status: Open

    Comments: When we determine what steps the Congress has taken, we will provide updated information.
    Recommendation: Exploration Systems Development should no longer dual-hat individuals with both programmatic and technical authority responsibilities. Specifically, the technical authority structure within Exploration Systems Development should be restructured to ensure that technical authorities for the Offices of the Chief Engineer and Safety and Mission Assurance are not fettered with programmatic responsibilities that create an environment of competing interests that may impair their independence. (Recommendation 1)

    Agency: National Aeronautics and Space Administration: Human Exploration and Operations Mission Directorate: Exploration Systems Development Division
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Katherine Iritani
    Phone: (202) 512-7114

    2 open recommendations
    Recommendation: To achieve a better understanding of the effect of certain Personal care services (PCS) services on beneficiaries and a more consistent administration of policies and procedures across PCS programs, the Acting Administrator of CMS should collect and analyze states' required information on the impact of the Participant-Directed Option and Community First Choice programs on the health and welfare of beneficiaries as well as the state quality measures for the Participant-Directed Option and Community First Choice programs.

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

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To achieve a better understanding of the effect of certain PCS services on beneficiaries and a more consistent administration of policies and procedures across PCS programs, the Acting Administrator of CMS should take steps to harmonize requirements, as appropriate, across PCS programs in a way that accounts for common risks faced by beneficiaries and to better ensure that billed services are provided.

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

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Gregory C. Wilshusen
    Phone: (202) 512-6244

    22 open recommendations
    Recommendation: To assist CISOs in carrying out their responsibilities, the Director of OMB should issue guidance for agencies' implementation of the FISMA 2014 requirements to ensure that (1) senior agency officials carry out information security responsibilities and (2) agency personnel are held accountable for complying with the agency-wide information security program. This guidance should clarify the role of the agency CISO with respect to these requirements, as well as implementing the other elements of an agency-wide information security program, taking into account the challenges identified in this report.

    Agency: Executive Office of the President: Office of Management and Budget
    Status: Open

    Comments: The Office of Management and Budget (OMB) partially concurred with this recommendation, but does not intend to directly issue guidance as recommended. Instead, we are reviewing the relevant OMB memoranda that officials believe address the intent of the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with the FISMA 2014, the Secretary of Commerce should define the CISO's role in department policy for ensuring that plans and procedures are in place to ensure recovery and continued operations of the department's information systems in the event of a disruption.

    Agency: Department of Commerce
    Status: Open

    Comments: The Department of Commerce concurred with the recommendation, stating that the department's policy documents are expected to be updated by the end of the 4th Quarter in 2017. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the senior information security officer (SISO) is defined in department policy in accordance with FISMA 2014, the Secretary of Defense should define the SISO's role in department policy for ensuring that information security policies and procedures are developed and maintained.

    Agency: Department of Defense
    Status: Open

    Comments: The Department of Defense (DOD) did not concur with our recommendation, nor has it provided evidence that it has implemented the recommendations.
    Recommendation: To ensure that the role of the SISO is defined in department policy in accordance with FISMA 2014, the Secretary of Defense should define the SISO's role in department policy for ensuring that the department has procedures for incident detection, response, and reporting.

    Agency: Department of Defense
    Status: Open

    Comments: The Department of Defense (DOD) partially concurred with our recommendation, but has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the SISO is defined in department policy in accordance with FISMA 2014, the Secretary of Defense should define the SISO's role in department policy for oversight of security for information systems that are operated by contractors on the department's behalf.

    Agency: Department of Defense
    Status: Open

    Comments: The Department of Defense (DOD) partially concurred with our recommendation, but has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Energy should define the CISO's role in department policy for ensuring that subordinate security plans are documented for the department's information systems.

    Agency: Department of Energy
    Status: Open

    Comments: The Department of Energy concurred with the recommendation, and estimates completion by March 1, 2018. The Department decided in April 2017 to make significant updates to its Cyber Security Program, and estimates it will take up to nine months to gain departmental concurrence, complete revisions, and close this recommendation. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Energy should define the CISO's role in department policy for ensuring that all users receive information security awareness training.

    Agency: Department of Energy
    Status: Open

    Comments: The Department of Energy concurred with the recommendation, and estimates completion by March 1, 2018. The Department decided in April 2017 to make significant updates to its Cyber Security Program, and estimates it will take up to nine months to gain departmental concurrence, complete revisions, and close this recommendation. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Energy should define the CISO's role in department policy for ensuring that the department has a process for planning implementing, evaluating, and documenting remedial actions.

    Agency: Department of Energy
    Status: Open

    Comments: The Department of Energy concurred with the recommendation, and estimates completion by March 1, 2018. The Department decided in April 2017 to make significant updates to its Cyber Security Program, and estimates it will take up to nine months to gain departmental concurrence, complete revisions, and close this recommendation. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Energy should define the CISO's role in department policy for ensuring that plans and procedures are in place to ensure recovery and continued operations of the department's information systems in the event of a disruption.

    Agency: Department of Energy
    Status: Open

    Comments: The Department of Energy concurred with the recommendation, and estimates completion by March 1, 2018. The Department decided in April 2017 to make significant updates to its Cyber Security Program, and estimates it will take up to nine months to gain departmental concurrence, complete revisions, and close this recommendation. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Energy should define the CISO's role in department policy for oversight of security for information systems that are operated by contractors on the department's behalf.

    Agency: Department of Energy
    Status: Open

    Comments: The Department of Energy concurred with the recommendation, and estimates completion by March 1, 2018. The Department decided in April 2017 to make significant updates to its Cyber Security Program, and estimates it will take up to nine months to gain departmental concurrence, complete revisions, and close this recommendation. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Energy should define the CISO's role in department policy in the periodic authorization of the department's information systems.

    Agency: Department of Energy
    Status: Open

    Comments: The Department of Energy concurred with the recommendation, and estimates completion by March 1, 2018. The Department decided in April 2017 to make significant updates to its Cyber Security Program, and estimates it will take up to nine months to gain Departmental concurrence, complete revisions, and close this recommendation. However, the Department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Health and Human Services should define the CISO's role in department policy for ensuring that plans and procedures are in place to ensure recovery and continued operations of the department's information systems in the event of a disruption.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: The Department of Health and Human Services concurs with our recommendation but has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Attorney General should define the CISO's role in department policy for ensuring that information security policies and procedures are developed and maintained.

    Agency: Department of Justice
    Status: Open

    Comments: The Department of Justice concurs with our recommendation but has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Attorney General should define the CISO's role in department policy for ensuring that plans and procedures are in place to ensure recovery and continued operations of the department's information systems in the event of a disruption.

    Agency: Department of Justice
    Status: Open

    Comments: The Department of Justice concurs with our recommendation but has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of State should define the CISO's role in department policy for ensuring that the department has procedures for incident detection, response, and reporting.

    Agency: Department of State
    Status: Open

    Comments: The Department of State (State) concurred with this recommendation. We are currently reviewing the evidence provided by State to determine whether the role of the CISO has been defined in its policy to for ensuring that State has procedures for incident detection, response, and reporting.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Transportation should define the CISO's role in department policy for ensuring that subordinate security plans are documented for the department's information systems.

    Agency: Department of Transportation
    Status: Open

    Comments: The Department of Transportation concurred with the recommendation and is currently updating its Cybersecurity Policy. The Department plans to be complete by June 29, 2018. However, the department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the CISO is defined in department policy in accordance with FISMA 2014, the Secretary of Transportation should define the CISO's role in department policy for ensuring that security controls are tested periodically.

    Agency: Department of Transportation
    Status: Open

    Comments: The Department of Transportation concurred with the recommendation and is currently updating its Cybersecurity Policy. The Department plans to be complete by June 29, 2018. However, the department has not yet provided sufficient evidence that it has implemented the recommendation.
    Recommendation: To ensure that the role of the senior agency information security officer (SAISO) is defined in agency policy in accordance with FISMA 2014, the Administrator of the Environment Protection Agency should define the SAISO's role in agency policy for ensuring that subordinate security plans are documented for the department's information systems.

    Agency: Environmental Protection Agency
    Status: Open

    Comments: The Environmental Protection Agency (EPA) concurred with our recommendation. We are currently reviewing the evidence provided by EPA to determine whether the role of the SAISO has been defined in its policy to for ensuring that subordinate security plans are documented for the agency's information systems.
    Recommendation: To ensure that the role of the SAISO is defined in agency policy in accordance with FISMA 2014, the Administrator of the Environment Protection Agency should define the SAISO's role in agency policy for ensuring that plans and procedures are in place to ensure recovery and continued operations of the department's information systems in the event of a disruption.

    Agency: Environmental Protection Agency
    Status: Open

    Comments: The Environmental Protection Agency (EPA) concurred with our recommendation. We are currently reviewing the evidence provided by EPA to determine whether the role of the SAISO has been defined in its policy to ensure recovery and continued operations of the agency's information systems in the event of a disruption.
    Recommendation: To ensure that the role of the SAISO is defined in agency policy in accordance with FISMA 2014, the Administrator of the Environment Protection Agency should define the SAISO's role in agency policy in the periodic authorization of the department's information systems.

    Agency: Environmental Protection Agency
    Status: Open

    Comments: The Environmental Protection Agency (EPA) concurred with our recommendation. We are currently reviewing the evidence provided by EPA to determine whether the role of the SAISO has been defined in agency policy for the periodic authorization of the department's information systems.
    Recommendation: To ensure that the role of the SAISO is defined in agency policy in accordance with FISMA 2014, the Administrator of the National Aeronautics and Space Administration should define the SAISO's role in agency policy for oversight of security for information systems that are operated by contractors on the agency's behalf.

    Agency: National Aeronautics and Space Administration
    Status: Open

    Comments: The National Aeronautics and Space Administration (NASA) concurred with our recommendation. We are currently reviewing the evidence provided by NASA to determine whether the role of the SAISO has been defined in agency policy for oversight of security for information systems that are operated by contractors on NASA's behalf.
    Recommendation: To ensure that the role of the CISO is defined in agency policy in accordance with FISMA 2014, the Administrator of the Small Business Administration should define the CISO's role in agency policy for ensuring that personnel with significant security responsibilities receive appropriate training.

    Agency: Small Business Administration
    Status: Open

    Comments: The Small Business administration (SBA) concurs with our recommendation but has not yet provided sufficient evidence that it has implemented the recommendation.
    Director: Rebecca Gambler
    Phone: (202) 512-8777

    1 open recommendations
    Recommendation: To better ensure DSOs' and students' compliance with OPT requirements, and strengthen efforts to identify and assess potential risks in OPT, the Director of ICE should direct SEVP to develop and distribute guidance to DSOs on how to determine whether a job is related to a student's area of study and require DSOs to provide information in SEVIS to show that they took steps, based on this guidance, to help ensure that the student's work is related to the area of study.

    Agency: Department of Homeland Security: United States Immigration and Customs Enforcement
    Status: Open

    Comments: As of April 2015, SEVP has made progress in developing employment guidance to support DSOs in determining whether a job is related to a student's area of study and requiring DSOs to provide such information in SEVIS. SEVP stated that it has drafted such guidance and it is being reviewed by SEVP subject matter experts. In addition, SEVP stated that it is developing information requirements for DSOs to attest that they adhered to the new employment guidance document in SEVIS, which requires system enhancements. In May 2016, the new STEM OPT regulation went into effect and, among other things, SEVP officials stated that it requires much greater detail on the scope of the employment and how it is related to the earned degree. As of October 2016, SEVP expects that non-STEM guidance on field of study will be finalized by the second quarter of fiscal year 2017.
    Director: Maurer, Diana C
    Phone: (202) 512-9627

    3 open recommendations
    including 2 priority recommendations
    Recommendation: To promote coordination as a practice to help avoid overlap, the Secretary of Homeland Security, the Attorney General, and the Director of ONDCP should work through the Information Sharing and Access Interagency Policy Committee (ISA IPC) or otherwise collaborate to develop a mechanism, such as performance metrics related to coordination, that will allow them to hold field-based information-sharing entities accountable for coordinating with each other and monitor and evaluate the coordination results achieved.

    Agency: Department of Justice
    Status: Open
    Priority recommendation

    Comments: The Department of Justice (DOJ), in coordination with the Department of Homeland Security (DHS) and the Office of National Drug Control Policy (ONDCP), has made progress toward addressing GAO's April 2013 recommendation but has not included all of the relevant field-based information sharing entities in its efforts. Through their involvement in an interagency policy committee within the Executive Office of the President, DHS, DOJ, and ONDCP have developed a mechanism to hold state and urban area fusion centers, Regional Information Sharing System (RISS) centers, and High Intensity Drug Trafficking Area (HIDTA) Investigative Support Centers accountable for coordinating their analytical and investigative activities. However, the agencies have not fully addressed the action because DOJ's Federal Bureau of Investigation's (FBI) Joint Terrorism Task Forces (JTTF) and Field Intelligence Groups (FIG), two of the five field-based entities included in GAO's April 2013 report, have not participated in the assessment on which the mechanism is based. In December 2015, DHS developed a field-based partners report in which DHS, DOJ and ONDCP reported data for state and urban area fusion centers, RISS centers, and HIDTA Investigative Support Centers. These data were focused on field-based collaboration, including governance, colocation, and other information sharing, analytic, and deconfliction-focused topics. However, the report did not include data for DOJ's JTTFs or FIGs. DOJ has noted that JTTFs and FIGs are different from the other entities because JTTFs are operational law enforcement investigative entities and FIGs provide intelligence support to FBI Field Offices. However, GAO's April 2013 report identified areas in which the missions and activities of JTTFs and FIGs overlapped with those of the other entities and that coordination with other field based entities was important to prevent unnecessary overlap and potential duplication. Considering the exclusion of two of the five entities, the agencies do not have a collective mechanism that can hold FIGS and JTTFs accountable for coordinating with the other field-based information sharing entities and allow the agencies to monitor progress and evaluate results across entities. Such a mechanism can help entities maintain effective relationships when new leadership is assigned and avoid unnecessary overlap in activities, which in turn can help entities to leverage scarce resources. As of March 2017, DOJ had provided no new updates. GAO will continue to monitor DOJ's progress in this area.
    Recommendation: To help identify where agencies and the field-based entities they support could apply coordination mechanisms to enhance information sharing and reduce inefficiencies resulting from overlap, the Secretary of Homeland Security, the Attorney General, and the Director of ONDCP should work through the ISA IPC or otherwise collaborate to identify characteristics of entities and assess specific geographic areas in which practices that could enhance coordination and reduce unnecessary overlap, such as cross-entity participation on governance boards and colocation of entities, could be further applied. The results of this assessment could be used by the agencies to provide recommendations or guidance to the entities to create coordinated governance boards or colocate entities, which can result in increased efficiencies through shared facilities and resources and reduced overlap through coordinated or collaborative products, activities, and services.

    Agency: Department of Justice
    Status: Open
    Priority recommendation

    Comments: The Department of Justice (DOJ), in coordination with the Department of Homeland Security (DHS) and the Office of National Drug Control Policy (ONDCP), has made progress toward addressing GAO's April 2013 recommendation but has not included all of the relevant field-based information sharing entities in its efforts. The three agencies have taken the necessary steps to assess the extent to which practices that can enhance coordination are being implemented at state and urban area fusion centers, Regional Information Sharing System (RISS) centers, and High Intensity Drug Trafficking Area (HIDTA) Investigative Support Centers through their involvement in an interagency policy committee within the Executive Office of the President. However, the assessment did not include DOJ's Federal Bureau of Investigation's (FBI) Joint Terrorism Task Forces (JTTF) or Field Intelligence Groups (FIG), two of the five field-based entities included in GAO's April 2013 report. In December 2015, DHS, DOJ, and ONDCP developed a field-based partners report in which DOJ and ONDCP collected and reported data elements for RISS centers and HIDTA Investigative Support Centers similar to those DHS uses in its annual fusion center assessment. These data were focused on field-based collaboration, including governance, colocation, and other information sharing, analytic, and deconfliction-focused topics. However, the report did not include data for DOJ's FBI JTTFs or FIGs. A collaborative assessment of where practices that enhance coordination can be applied to reduce overlap, collaborate, and leverage resources for all five field-based information-sharing entities would allow the agencies to provide recommendations or guidance to the entities on implementing these practices. As of March 2017, DOJ had provided no new updates. GAO will continue to monitor DOJ's progress in this area.
    Recommendation: To help ensure that an assessment of practices that could enhance coordination and reduce unnecessary overlap is shared and used to further enhance collaboration and efficiencies across agencies, the Program Manager, with input from the ISA IPC collaborating agencies, should report in the Information Sharing Environment (ISE) annual report to Congress the results of the assessment, including any additional coordination practices identified, efficiencies realized, or actions planned.

    Agency: Office of the Director of National Intelligence: Office of the Program Manager--Information Sharing Environment
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information. Status last updated August 31, 2017.
    Director: Powner, David A
    Phone: (202) 512-9286

    2 open recommendations
    Recommendation: The Secretary of Transportation should designate a senior agency official who has departmentwide responsibility, accountability, and authority for geospatial information issues. The Secretary of Transportation direct the designated senior official for geospatial information to prepare, maintain, publish, and implement a strategy for advancing geographic information and related geospatial data activities appropriate to its mission.

    Agency: Department of Transportation
    Status: Open

    Comments: In July 2016, a Transportation official told GAO that the department had completed a draft of the geospatial strategic plan that month. According to a Transportation official, as of March 1, 2017, the draft was under review. On September 8, 2017, a Transportation official stated that the department plans to issue the plan by November 1, 2017.
    Recommendation: To improve OMB oversight of geospatial information and assets, and minimize duplication of federal geospatial investments, the Director of OMB should develop a mechanism, or modify existing mechanisms, to identify and report annually on all geospatial related investments, including dollars invested and the nature of the investment.

    Agency: Executive Office of the President: Office of Management and Budget
    Status: Open

    Comments: OMB has made progress in developing a way to identify and report annually on all geospatial-related investments, but has not completed its efforts. In March 2014, the Federal Geographic Data Committee (FGDC) issued its National Geospatial Data Asset (NGDA) Management Plan. The plan was developed in conjunction with OMB officials. One of the objectives of the plan is to develop and apply a standard definition of a geospatial investment in order to facilitate reporting on budgeted geospatial data investments, due to the fact that different definitions are being used by OMB, the FGDC community, and individual agencies. There are two supporting actions for this objective. The first action was completed with the finalization and issuance of the FGDC's Geospatial Investment Definitions for Tracking and Reporting Geospatial Investment Costs document in April 2016. The document contains a set of geospatial definitions with specific examples for each. The second action is for the geospatial community to apply the definitions in submissions to OMB during the annual federal government budget planning and reporting process. According to FGDC officials, they expect this to be challenging for a number of reasons, including the need for agencies to determine how they can align their investment tracking systems to accommodate the new definitions and the extent to which agencies will be able to use a common reporting capability. As a result, a two-pronged approach is being used. First, FGDC developed a reporting method using the theme implementation plans to support federal geospatial data investment tracking. For example, in February 2017, an official provided an implementation plan from January 2017 which included an estimate of the amount of time federal employees spent on NGDA work, and reported this as a percentage of full-time equivalents. Second, OMB worked with FGDC to revise geospatial investment reporting guidance found in OMB Circular No. A-11. Starting with fiscal year 2018 allocations (Circular No. A-11 revised July 2016), agencies are required to report on annual aggregated geospatial data investments of $100,000 or greater using the Marketplace feature of the Geospatial Platform. According to an agency official, this approach leverages existing, federal government-wide reporting methods already in place and minimizes the potential for agencies to implement separate, potentially duplicative reporting mechanisms that are not integrated with existing OMB reporting procedures. According to OMB officials as of September 7, 2017, OMB anticipates that since fiscal year 2018 will be the first year of implementation, some agencies may have challenges identifying and reporting their data. As a result, OMB states that the content and completeness of the reported information will need to be evaluated prior to determining its fitness and application for overseeing geospatial investments.
    Director: Williamson, Randall B
    Phone: (206)287-4860

    3 open recommendations
    including 2 priority recommendations
    Recommendation: To ensure that servicemembers have equitable access to the military services' wounded warrior programs, including the RCP, and to establish central accountability for these programs, the Secretary of Defense should establish or designate an office to centrally oversee and monitor the activities of the military services' wounded warrior programs to include the following: (1) Develop consistent eligibility criteria to ensure that similarly situated recovering servicemembers from different military services have uniform access to these programs; (2) Direct the military services' wounded warrior programs to fully comply with the policies governing care coordination and case management programs and any future changes to these policies; (3) Develop a common mechanism to systematically monitor the performance of the wounded warrior programs--to include the establishment of common terms and definitions--and report this information on a biannual basis to the Armed Services Committees of the House of Representatives and the Senate.

    Agency: Department of Defense
    Status: Open
    Priority recommendation

    Comments: DOD did not concur with our part (1) of our recommendation to develop consistent eligibility criteria, explaining that the three military department secretaries should have the ability to control entrance criteria into their wounded warrior programs and that varying eligibility criteria have not resulted in noticeable differences in access to these programs by recovering servicemembers or their families. In attachments to a memo dated April 8, 2014, DOD provided an update on progress made to implement parts (2) and (3) of the DOD-specific recommendation made in GAO-13-5. Regarding part (2), DOD reported that budget constraints had delayed its plan to conduct oversight visits to 63 service sites over a 12-month period to ensure that military wounded warrior programs were operating in compliance with DOD Recovery Coordinator Program policy. DOD stated that the Warrior Care Policy office, in coordination with the military service branches, had intended to begin these oversight visits and interviews in September 2013; that as of March 2014, five sites had been reviewed; and that results of the compliance visits would be available upon completion. Regarding part (3) of the recommendation, DOD's memo stated that DOD and VA continue work on developing policies on clinical and non-clinical care coordination. It also noted that interagency metrics for monitoring complex care coordination performance were under development by the DOD/VA Interagency Care Coordination Committee. Further, DOD stated that because the Joint Executive Council publishes an annual report, that reporting the progress in developing common terms and definitions used by wounded warrior programs to congressional committees would be of limited value. As of October 2016, when we determine what additional steps the agency has taken to implement this recommendation, we will update this information.
    Recommendation: To ensure that persistent challenges with care coordination, disability evaluation, and the electronic sharing of health records are fully resolved, the Secretaries of Defense and Veterans Affairs should ensure that these issues receive sustained leadership attention and collaboration at the highest levels with a singular focus on what is best for the individual servicemember or veteran to ensure continuity of care and a seamless transition from DOD to VA. This should include holding the Joint Executive Council accountable for (1) ensuring that key issues affecting recovering servicemembers and veterans get sufficient consideration, including recommendations made by the Warrior Care and Coordination Task Force and the Recovering Warrior Task Force; (2) developing mechanisms for making joint policy decisions; (3) involving the appropriate decision-makers for timely implementation of policy; and; (4) establishing mechanisms to systematically oversee joint initiatives and ensure that outcomes and goals are identified and achieved.

    Agency: Department of Defense
    Status: Open
    Priority recommendation

    Comments: As of October 2016, under the joint DOD/VA Interagency Care Coordination Committee, the departments have made progress to improve nonclinical care coordination procedures, primarily through the development of two initiatives?the Lead Coordinator initiative (in which a single care coordinator serves as the primary point of contact for a recovering servicemember) and through the use of a single, interagency care plan (ICP) for each recovering servicemember. As of March 2016, the departments were continuing the national rollout of the Lead Coordinator initiative and had trained nearly 3,700 DOD and VA personnel on the new process. In addition, DOD and VA continued the development of the ICP initiative, which will depend upon their ability to electronically exchange the information needed to implement servicemembers' care plans. In December 2015, DOD awarded a contract to support the ICP and to create electronic interoperability with VA. The departments anticipate testing their ability to exchange information digitally in June 2016 and achieving full operational capability by September 2016. We will continue to monitor progress to implement the joint Lead Coordinator and the ICP care coordination initiatives.
    Recommendation: To ensure that persistent challenges with care coordination, disability evaluation, and the electronic sharing of health records are fully resolved, the Secretaries of Defense and Veterans Affairs should ensure that these issues receive sustained leadership attention and collaboration at the highest levels with a singular focus on what is best for the individual servicemember or veteran to ensure continuity of care and a seamless transition from DOD to VA. This should include holding the Joint Executive Council accountable for (1) ensuring that key issues affecting recovering servicemembers and veterans get sufficient consideration, including recommendations made by the Warrior Care and Coordination Task Force and the Recovering Warrior Task Force; (2) developing mechanisms for making joint policy decisions; (3) involving the appropriate decision-makers for timely implementation of policy; and; (4) establishing mechanisms to systematically oversee joint initiatives and ensure that outcomes and goals are identified and achieved.

    Agency: Department of Veterans Affairs
    Status: Open

    Comments: As of October 2016, under the joint DOD/VA Interagency Care Coordination Committee, the departments have made progress to improve nonclinical care coordination procedures, primarily through the development of two initiatives?the Lead Coordinator initiative (in which a single care coordinator serves as the primary point of contact for a recovering servicemember) and through the use of a single, interagency care plan (ICP) for each recovering servicemember. As of March 2016, the departments were continuing the national rollout of the Lead Coordinator initiative and had trained nearly 3,700 DOD and VA personnel on the new process. In addition, DOD and VA continued the development of the ICP initiative, which will depend upon their ability to electronically exchange the information needed to implement servicemembers' care plans. In December 2015, DOD awarded a contract to support the ICP and to create electronic interoperability with VA. The departments anticipate testing their ability to exchange information digitally in June 2016 and achieving full operational capability by September 2016. We will continue to monitor progress to implement the joint Lead Coordinator and the ICP care coordination initiatives.
    Director: Iritani, Katherine M
    Phone: (206)287-4820

    2 open recommendations
    Recommendation: In light of the need for accurate and complete information on children's access to health services under Medicaid and CHIP, the requirement that states report information to CMS on certain aspects of their Medicaid and CHIP programs, and problems with accuracy and completeness in this state reporting, the Administrator of CMS should establish a plan, with goals and time frames, to review the accuracy and completeness of information reported on the CMS 416 and CHIP annual reports and ensure that identified problems are corrected.

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

    Comments: In September 2016, CMS said that it was taking new steps to review data on children's access and quality of care by reviewing required reports that evaluate states' Medicaid managed care plans; however, these reports do not represent a consistent set of measures used by all states that CMS can use for oversight purposes. Accurate, complete, and reliable data for both Medicaid and CHIP are necessary for CMS's oversight of children's access to services. GAO considers this recommendation open.
    Recommendation: In light of the need for accurate and complete information on children's access to health services under Medicaid and CHIP, the requirement that states report information to CMS on certain aspects of their Medicaid and CHIP programs, and problems with accuracy and completeness in this state reporting, the Administrator of CMS should work with states to identify additional improvements that could be made to the CMS 416 and CHIP annual reports, including options for reporting on the receipt of services separately for children in managed care and fee-for-service delivery models, while minimizing reporting burden, and for capturing information on the CMS 416 relating to children's receipt of treatment services for which they are referred.

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

    Comments: In September 2016, CMS said that it had changed the instructions for completing the CMS 416 to provide more detailed guidance for states on capturing required information on the total number of children who were referred for treatment services. However, CMS is not planning to require states to submit information on whether children received the treatment services for which they were referred. We maintain that having ability to monitor receipt of treatment services, receipt of services in managed care separate from fee-for-service, and having data from all states is important to CMS oversight. GAO considers this recommendation open.
    Director: Crosse, Marcia G
    Phone: (202)512-3407

    1 open recommendations
    Recommendation: To help ensure that FDA's overseas offices are able to fully meet their mission of helping to ensure the safety of imported products, the Commissioner of FDA should ensure, as it completes its strategic planning process for the overseas offices, that it develops a set of performance goals and measures that can be used to demonstrate overseas office contributions to long-term outcomes related to the regulation of imported products and that overseas office activities are coordinated with the centers and Office of Regulatory Affairs (ORA).

    Agency: Department of Health and Human Services: Food and Drug Administration
    Status: Open

    Comments: In August 2017, FDA reported that it remains committed to strengthening its efforts and systematically monitoring and evaluating the overseas offices' contributions to the agency's mission and objectives. FDA also stated that it is making significant progress in several areas by enhancing strategic planning and analysis, refining the Office of International Program's (OIP) performance metrics, and designing a monitoring and evaluation plan. For example, FDA stated it has developed a framework with refined performance metrics to distinguish and assess the distinct contribution of OIP and its foreign offices towards program objectives and broader agency goals. FDA said that the performance metrics will track and monitor the quantity, quality, and timeliness of activity outputs and intermediate outcomes resulting from OIP's work. The measures have been standardized and defined, and will be further disaggregated to enable various levels of analyses, including distinguishing the unique efforts by foreign offices and product type. According to FDA, it plans to roll out its performance framework, related metrics, and monitoring and evaluation processes in fiscal year 2018. FDA said it anticipates that its performance measures, enhanced monitoring, and increased sharing of best practices across foreign offices and FDA headquarters will facilitate tracking of performance, allow greater accountability, and provide a foundation for continuous improvement. GAO will continue to monitor FDA's progress.
    Director: Williamson, Randall B
    Phone: (206)287-4860

    1 open recommendations
    Recommendation: To help DOD obtain reasonable assurance that all active and Reserve component servicemembers to whom the PDHRA requirement applies are provided the opportunity to have their health concerns identified, the Assistant Secretary of Defense for Health Affairs and the military services should take steps to ensure that PDHRA questionnaires are included in DOD's central repository for each of these servicemembers.

    Agency: Department of Defense
    Status: Open

    Comments: In its comments to this report, the Department of Defense (DOD) concurred with this recommendation. On October 2009, DOD's Force Health Protection and Response Office sent a memo to each of the military service Surgeons General emphasizing the need for the post-deployment health reassessment (PDHRA) to be offered to all service members who are eligible to complete the assessment. In 2010, DOD's noted that the services would work with the Armed Forces Health Surveillance Center (AFHSC) repository to ensure PDHRAs are submitted correctly, without transmission errors. DOD's 2011 case records showed that the Air Force and Army had developed data verification processes to ensure that AFHSC received PDHRAs. Further, the Defense Medical Data Center (DMDC) had planed to create a file consisting of the date of deployment for deployed personnel, and that the file would be available to the services in order to match DMDC with data from each of the service-specific systems, in accordance to requirements. In September 2011, although DMDC and the services had agreed to match rosters of deployed service members, there were still inconsistencies in deployment dates. In March 2012, DOD was still verifying data inconsistencies which, until resolved, leads to inaccurate reporting based on errors in the deployment dates.
    Director: Williams, Orice M
    Phone: (202)512-5837

    2 open recommendations
    Recommendation: The Secretary of the Department of Homeland Security should direct FEMA to take steps to ensure that its rate-setting methods and the data it uses to set rates result in full-risk premiums rates that accurately reflect the risk of losses from flooding. These steps should include, for example, verifying the accuracy of flood probabilities, damage estimates, and flood maps; ensuring that the effects of long-term planned and ongoing development, as well as climate change, are reflected in the flood probabilities used; and reevaluating the practice of aggregating risks across zones.

    Agency: Department of Homeland Security
    Status: Open

    Comments: As of January 2017, FEMA is taking steps to verify the accuracy of flood probabilities by collecting and analyzing data from flood insurance studies. FEMA is also continuing to monitor the completion of these studies to determine when a statistically valid amount of data is available so that it can better assess flood risk. To verify the accuracy of damage estimates, FEMA is collecting data required to revise its estimates of flood damage and is undertaking studies to determine factors beyond flood water depth that contribute to flood damage. FEMA will incorporate that information into its rate-setting methodology as the necessary data becomes available. To verify the accuracy of flood maps, FEMA continues to reassess flood risk, evaluate coastal flood maps, and update its overall map inventory. To ensure that flood probabilities reflect long-term and ongoing planned development and climate change, FEMA is working with the Technical Mapping Advisory Committee to ensure the best available information on flood probabilities is used for rate-setting. In addition, as FEMA collects information on flood probabilities, it will conduct analyses to evaluate the practice of classifying risk across zones.
    Recommendation: The Secretary of the Department of Homeland Security should direct FEMA to ensure that information is collected on the location, number, and losses associated with existing and newly created grandfathered properties in NFIP and to analyze the financial impact of these properties on the flood insurance program.

    Agency: Department of Homeland Security
    Status: Open

    Comments: To assess the impact of grandfathered properties on the NFIP, as of January 2017, FEMA has begun to develop a process to obtain current zone designations for all existing policyholders. In addition, FEMA is requiring zone determination data to be updated as flood maps change. According to FEMA, this will allow officials to determine which policyholders are grandfathered but will not allow the determination of a property-specific rate in all circumstances.