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    Subject Term: "Territories and possessions"

    5 publications with a total of 10 open recommendations
    Director: Persons, Timothy M
    Phone: (202) 512-6412

    5 open recommendations
    Recommendation: The Secretary of Health and Human Services should direct the Commissioner of the Food and Drug Administration to consolidate information from individual diagnostic test labels and make this information available in a form that enables users to more readily compare information across tests.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: In August 2017, officials from the Department of Health and Human Services told us that the Food and Drug Administration is working to consolidate and make available on its website information for Zika virus diagnostic tests that have emergency use authorization.
    Recommendation: The Secretary of Health and Human Services should direct the Commissioner of the Food and Drug Administration to require manufacturers to list the identity of comparator assays on their diagnostic test labels.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: In August 2017, officials from the Department of Health and Human Services told us that the Food and Drug Administration plans to recommend to sponsors of Zika virus diagnostic tests that they provide a description of the comparator assay.
    Recommendation: The Secretary of Health and Human Services should direct the Director of Centers for Disease Control and Prevention to establish a transparent process to provide CDC diagnostic tests, upon request, to manufacturers that are in the final stages of diagnostic test authorization.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: In August 2017, officials from the Department of Health and Human Services told us that the Centers for Disease Control and Prevention (CDC) Technology Transfer Office is working to establish a transparent process that ensures CDC diagnostic tests can be provided to manufacturers.
    Recommendation: The Secretary of Health and Human Services should direct the Director of Centers for Disease Control and Prevention to include information on CDC-developed tests distributed to or shared with public health laboratories on CDC's website, including laboratory developed tests.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: In August 2017, officials from the Department of Health and Human Services told us the Centers for Disease Control and Prevention (CDC) provides information on CDC-developed diagnostic tests on the Food and Drug Administration?s (FDA) website. CDC stated that their website will feature a direct link to FDA information on CDC-developed tests. CDC will continue to explore additional outlets for publication of information on CDC-developed diagnostic tests.
    Recommendation: The Secretary of Health and Human Services should direct the Director of Centers for Disease Control and Prevention to provide details such as collection records, dates, and data limitations on posted and disseminated mosquito distribution maps to better inform mosquito control experts and the general public.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: In June 2016, the Centers for Disease Control and Prevention (CDC) published a report on the distribution of the mosquitos that can transmit Zika virus and other viruses in the United States. This report included new county collection records, collection dates, and summary maps for each species of mosquitos. In August 2017, officials from the Department of Health and Human Services told us the CDC is planning to update the mosquito distribution information on their website by the end of 2017, and it will include the underlying model predictions and country collection records.
    Director: Carolyn L. Yocom
    Phone: (202) 512-7114

    1 open recommendations
    Recommendation: To ensure the appropriate level of Medicaid program integrity oversight in the territories, the Acting Administrator of CMS should reexamine CMS's program integrity strategy and develop a cost-effective approach to enhancing Medicaid program integrity in the territories. Such an approach could select from a broad array of activities, including--but not limited to--establishing program oversight mechanisms, such as requiring territories to establish a Medicaid Fraud Control Unit or working with them to obtain necessary exemptions or waivers from applicable program oversight requirements; assisting territories in improving their information on Medicaid and CHIP program spending; and conducting additional program assessments of program integrity as warranted.

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

    Comments: CMS has plans that may enhance Medicaid program integrity in the territories, but as of September, 2016, they have not yet been implemented. In May 2016, CMS notified all territories regarding the requirement to create a Medicaid Fraud Control Unit (MFCU) or seek a waiver of this requirement. As of September, 2016, according to CMS, Puerto Rico has indicated interest in establishing a MFCU, American Samoa and Guam have requested a waiver to the MFCU requirement, the Commonwealth of the Northern Mariana Islands has indicated interest in seeking a waiver, and the agency is working with the United States Virgin Islands regarding its response to this requirement. CMS intends to conduct comprehensive reviews of program integrity activities in the territories during fiscal year 2017, which have the potential to strengthen program integrity. Although these planned activities have the potential to strengthen program oversight, they have not yet been implemented. As of September 2016, no territory has established a MFCU or been granted a waiver to this requirement and comprehensive program integrity reviews will not occur until fiscal year 2017.
    Director: Jacqueline M. Nowicki
    Phone: (617) 788-0580

    2 open recommendations
    Recommendation: Based on GAO's review, the Secretary of Education should direct the Office of Special Education Programs to increase transparency regarding the timeliness of due process hearing decisions for Congress and better target its monitoring and technical assistance to states, revise its performance measure to collect information from states on the amount of time that extensions add to due process hearing decisions.

    Agency: Department of Education
    Status: Open

    Comments: : In April 2017, Education reported that it had developed and implemented a plan to monitor states with 10 or more fully adjudicated hearings in a given year where at least 75 percent of the decisions are issued with extended timelines. Specifically, the agency reported it was actively monitoring 6 states meeting these criteria. It would also provide technical assistance to states, as appropriate, to facilitate more timely resolution of due process disputes. Education also reported that it would gather information on the burden and cost of revising its performance measure, however, as of June 2017, it had not provided documentation that it had done so. While these are positive steps, we will consider closing this recommendation when Education's revises its performance measure on the timeliness of due process hearing decisions.
    Recommendation: Based on GAO's review, the Secretary of Education should direct the Office of Special Education Programs to assist its oversight of dispute resolution, take steps to improve the comparability of parental involvement data while minimizing the burden to states, and use the data for better management decision making. Steps to consider could include establishing and requiring that states follow standard data collection and analysis procedures.

    Agency: Department of Education
    Status: Open

    Comments: In FY15, Education reported that the IDEA Data Center, in relation to the parent involvement portion of the audit, has continued review of APR [need to spell out] indicator B8 to collect information related to data collection methods, results, and improvement activities for the indicator summary for OSEP. It also began reviewing existing sources for information on how parent data are collected and best practices/ exemplars that are publicly available. In April 2017, Education reported it would direct Parent Technical Assistance Centers and other Education-funded centers to work together to develop and disseminate materials to assist states in analyzing and using parental involvement data to improve the provision of special education services. We believe this effort could help individual states improve methods for analyzing and using parental involvement data. However, we await documentation that such materials were developed and distributed. Also, it is unclear how it would improve the comparability of parental involvement data across states and allow Education to accurately assess states' performance on this IDEA indicator.
    Director: Currie, Christopher
    Phone: (404)679-3000

    1 open recommendations
    Recommendation: In order to help build and maintain a national biosurveillance capability in a manner that accounts for the particular challenges and opportunities of reliance on state and local partnerships, we recommend the Homeland Security Council direct the National Security Staff to take the following action as part of its implementation of our previous recommendation for a national biosurveillance strategy: Ensure that the national biosurveillance strategy (1) incorporates a means to leverage existing efforts that support nonfederal biosurveillance capabilities, (2) considers challenges that nonfederal jurisdictions face in building and maintaining biosurveillance capabilities, and (3) includes a framework to develop a baseline and gap assessment of nonfederal jurisdictions' biosurveillance capabilities.

    Agency: Executive Office of the President: Homeland Security Council
    Status: Open

    Comments: In June 2010, GAO recommended a national biosurveillance strategy to provide a framework for building and maintaining a national biosurveillance capability. In October 2011, building on that recommendation, we called for such a strategy to address key challenges we identified in state and local biosurveillance by accounting for the need to leverage nonfederal resources. In July 2012, the White House released the National Strategy for Biosurveillance. A strategic implementation plan was to be published within 120 days of strategy issuance. The July 2012 strategy did not adequately address the issues we raised related to state and local biosurveillance and acknowledged but did not meaningfully address the need to leverage nonfederal resources. As of March 14, 2013 the implementation plan has not been released.
    Director: Ragland, Susan
    Phone: (202)512-9471

    1 open recommendations
    Recommendation: The Secretary of the Interior should direct the Deputy Assistant Secretary for Insular Affairs to develop a framework for OIA employees to use in conducting site visits to help ensure objectives are achieved, to assure that relevant information is shared with responsible officials, and to allow more efficient and effective monitoring of issues.

    Agency: Department of the Interior
    Status: Open

    Comments: On May 24, 2017, the Department of Interior (DOI) sent out an email to its staff showing the dissemination of the new format required for completing trip reports by the staff of the Office of Insular Affairs (OIA). The new format requires staff to include travel justification (i.e., purpose/objective, location, and travel period) and trip report (i.e., meetings, site visits, results, and next steps, as applicable.) The intent of the recommendation is for DOI to have a framework that includes (1) status of required single audit reports; (2) the progress of actions to resolve reported internal control weaknesses; and (3) current needs for technical assistance, capacity building, and staff level expertise. Further, the intent of GAO's recommendation is that this information be integrated into a comprehensive monitoring process. We did not see these elements included in DOI's new format. We will continue to monitor the agency's actions to address this recommendation.