Recommendation: The Under Secretary for Health should establish steps for communicating to VA's actuarial consultant information on data quality, including any limitations, used in the actuarial modeling that informs VA's community care budget estimates. (Recommendation 1)

Agency: Department of Veterans Affairs
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: The Under Secretary for Health should establish further steps for assessing and communicating to stakeholders the degree of overall uncertainty associated with actuarial projections for community care that inform the community care budget estimates. (Recommendation 2)

Agency: Department of Veterans Affairs
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: The Secretary of Labor should, in consultation with the Small Business Administration and the Department of the Treasury, immediately provide information to state unemployment agencies that specifically addresses the Small Business Administration's Paycheck Protection Program loans, and the risk of improper payments associated with these loans. (Recommendation 1)

Agency: Department of Labor
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: The Commissioner of Internal Revenue should consider cost-effective options for notifying ineligible recipients on how to return payments. (Recommendation 2)

Agency: Department of the Treasury: Internal Revenue Service
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: The Administrator of the Small Business Administration should develop and implement plans to identify and respond to risks in the Paycheck Protection Program to ensure program integrity, achieve program effectiveness, and address potential fraud, including in loans of $2 million or less. (Recommendation 3)

Agency: Small Business Administration
Status: Open

Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: In the absence of efforts to develop a plan, we urge Congress to take legislative action to require the Secretary of Transportation to work with relevant agencies and stakeholders, such as the Departments of Health and Human Services and Homeland Security, and members of the aviation and public health sectors, to develop a national aviationpreparedness plan to ensure safeguards are in place to limit the spread of communicable disease threats from abroad while at the same time minimizing any unnecessary interference with travel and trade. (Matter for Consideration 1)

Agency: Congress
Status: Open

Comments: When we determine what steps the Congress has taken, we will provide updated information.

Recommendation: To provide agencies access to Social Security Administration's more complete set of death data, we urge Congress to provide the Department of the Treasury with access to the Social Security Administration's full set of death records, and to require that the Department of the Treasury consistently use it. (Matter for Consideration 2)

Agency: Congress
Status: Open

Comments: When we determine what steps the Congress has taken, we will provide updated information.

Recommendation: To help ensure that federal funding is targeted and timely, we urge Congress to use GAO's Federal Medical Assistance Percentage formula for any future changes to the Federal Medical Assistance Percentage during the current or any future economic downturn. (Matter for Consideration 3)

Agency: Congress
Status: Open

Comments: When we determine what steps the Congress has taken, we will provide updated information.

Recommendation: The Administrator of the General Services Administration, in coordination with the Secretaries of Defense and Homeland Security, should jointly revisit and assess the extent to which the criteria in the 2018 NIA code Memorandum of Agreement, including criteria for closing NIA codes, meet long-term visibility needs for high visibility events and account for the needs of users, such as FEMA, other agencies, and the Congress. At a minimum, the agreement should include criteria that take into account the roles of the federal agencies involved in response and recovery and provide a process that ensures consistent consideration and implementation of the criteria. (Recommendation 1)

Agency: General Services Administration
Status: Open

Comments: The General Services Administration (GSA) and the Department of Defense (DOD) concurred with the recommendation and the need to regularly review the memorandum of agreement (MOA) and make revisions as applicable. The Department of Homeland Security (DHS) did not respond to the recommendation. In August 2019, GSA, DHS, and DOD revised the agreement, but the revisions did not fully address the recommendation. The revisions included a change to one criterion for closing National Interest Action (NIA) codes--adding consistent decline in contract actions as a criterion and removing the criterion that relied on alternative tracking methods at agencies. However, the revisions to the MOA did not include changes that provide a process to ensure consistent implementation of criteria, or address long-term visibility needs, or account for the needs of users. In July 2020, a DHS official stated that DOD and DHS had conducted an annual review of the MOA and determined no changes were necessary, and that DOD and DHS would consider potential updates to the MOA during their next annual review. GSA officials clarified that, in terms of updating the MOA, GSA is the servicing agency and does not have the authority to determine the criteria for establishing, extending, or end-dating NIA codes. GSA officials stated, and DHS officials agreed, that DHS and DOD determine the criteria for whether a NIA code needs to be established, extended, or end-dated.

Recommendation: The Administrator of the Office of Federal Procurement Policy should provide additional clarification on how contracting officers should determine whether offerors reside or primarily do business in a disaster area for the purposes of a local area set-aside contract. (Recommendation 4)

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

Comments: The Office of Federal Procurement Policy concurred with this recommendation. In September 2019, officials identified the Emergency Acquisition Guide as a vehicle to address this recommendation. The Emergency Acquisition Guide, last updated in 2011, is intended to assist the federal contracting community with planning and carrying out procurement activities during contingency events. However, officials did not provide details on how this recommendation would be incorporated or provide time frames for when the guide would be updated. As of July 2020, Office of Federal Procurement Policy staff had not provided an update on implementation of this recommendation.

Recommendation: The Commandant of the Coast Guard should establish a formal process to solicit input from officials directly involved in the agency's response and recovery following a disaster and to share that input with the Emergency Support Function Leadership Group. (Recommendation 8)

Agency: Department of Homeland Security: United States Coast Guard
Status: Open

Comments: The US Coast Guard concurred with this recommendation. In its agency response, the Coast Guard stated that it was reviewing its current policies and processes to update its After Action Report Policy or to identify and implement other policy improvements. As of July 2020, these actions were still in progress.

Recommendation: The FEMA Administrator should take the lead to work together with the Coast Guard and the U.S. Army Corps of Engineers to revise the mission assignment policy and related guidance to better incorporate consideration of contracting needs, such as demobilization, and to ensure clear communication of coordination responsibilities related to contracting. (Recommendation 9)

Agency: Department of Homeland Security: Directorate of Emergency Preparedness and Response: Federal Emergency Management Agency
Status: Open

Comments: The Federal Emergency Management Agency (FEMA) concurred with the recommendation. In its response, FEMA stated it would work with its federal partners and develop mission assignment project management tools and training. In addition, FEMA is planning to develop a Mission Assignment Project Manager Guide to provide guidance to address the issues GAO identified. As of July 2020, FEMA indicated it would develop a new project plan and timeline for completing these actions in the winter of 2020.

Recommendation: The FEMA Administrator should assess its workforce needs—including staffing levels, mission needs, and skill gaps—for contracting staff, to include regional offices and DART; and develop a plan, including timelines, to address any gaps. (Recommendation 10)

Agency: Department of Homeland Security: Directorate of Emergency Preparedness and Response: Federal Emergency Management Agency
Status: Open

Comments: The Federal Emergency Management Agency (FEMA) concurred with this recommendation. In its official response, FEMA stated it would take actions to address this recommendation, including hiring contractor support and additional Cadre of On-Call Response/Recovery Employees. As of August 2020, these actions were still in progress. FEMA officials indicated that its workforce assessment was expected to be complete in December 2020.

Recommendation: The Secretary of DOL should develop and publish a multi-year strategic research plan for evaluation of its employment and training programs that includes assessing the completeness and results of efforts to coordinate among E&T programs to address overlap and fragmentation. In developing this plan, DOL should also consult with other federal agencies and key stakeholders on ways to address gaps in information on how multiple programs are serving the employment and training needs of specific populations, such as Native Americans, youth, and refugees. (Recommendation 1)

Agency: Department of Labor
Status: Open

Comments: DOL agreed with this recommendation. The agency noted that it actively plans and makes public the research and evaluation topics for these evaluations, but it did not identify a timeline or measures it would take to augment these basic steps. DOL also stated that it will consult with stakeholders regarding the employment and training needs of specific populations. We will consider closing this recommendation when DOL completes these efforts.

Recommendation: The Deputy Secretary of the Department of Homeland Security should develop a mechanism that aligns processes and information sources for collecting R&D project data from DHS components to ensure that the information can be collected, integrated and result in a comprehensive accounting of R&D projects DHS-wide. (Recommendation 2)

Agency: Department of Homeland Security: Office of the Secretary: Office of the Deputy Secretary
Status: Open

Comments: As of September 2020, DHS reported that S&T was revising the related DHS Directive to improve R&D project data collection and that detailed procedures for the data collection would be described in an associated guidance document. DHS further reported that S&T would be coordinating with the Undersecretary for Management, and meeting with DHS components regarding the data collection efforts. We will continue to monitor DHS's efforts to implement this recommendation.

Recommendation: The Deputy Secretary of the Department of Homeland Security should direct Office of the Chief Financial Officer program officials to ensure that S&T take steps to more fully incorporate leading practices, such as those included in DHS's budget preparation guidance, into R&D milestones. (Recommendation 3)

Agency: Department of Homeland Security: Office of the Secretary: Office of the Deputy Secretary
Status: Open

Comments: As of September 2020, S&T reported preparing Budget Justification documents, which will include key milestones for R&D projects, and indicated that the documents will be reviewed by the DHS Office of the Chief Financial Officer. We will continue to monitor DHS's efforts related to this recommendation.

Recommendation: The Deputy Secretary of the Department of Homeland Security should develop standard processes and procedures for collecting and analyzing customer feedback, applicable to components conducting R&D, for improving the usefulness of existing customer feedback mechanisms to assess R&D efforts and for implementing such mechanisms where absent. (Recommendation 4)

Agency: Department of Homeland Security: Office of the Secretary: Office of the Deputy Secretary
Status: Open

Comments: As of September 2020, DHS stated that a new DHS Directive and Instruction is being developed related to R&D customer and program feedback. This recommendation remains open, and we will continue to monitor DHS's efforts to address it.

Recommendation: The Chief of Naval Operations should clarify workforce planning policies to identify circumstances in which federal civilian employees and private sector contractors may serve in operational roles and what the benefits and limitations are of using federal civilians and private sector contractors as alternative workforces. (Recommendation 1)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Chief of Naval Operations should, after clarifying workforce planning policies, apply the revised policies to evaluate the use of alternative workforces (including federal civilian employees and private sector contractors) for future unmanned system operators. (Recommendation 2)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Commandant of the Marine Corps should clarify workforce planning policies to identify circumstances in which federal civilian employees and private sector contractors may serve in operational roles and what the benefits and limitations are of using federal civilians and private sector contractors as alternative workforces. (Recommendation 3)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Commandant of the Marine Corps should, after clarifying workforce planning policies, apply the revised policies to evaluate the use of alternative workforces (including federal civilian employees and private sector contractors) for future unmanned system operators. (Recommendation 4)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Commander, Naval Air Systems Command, in coordination with the Deputy Commandant of the Marine Corps for Combat Development and Integration, should update the Marine Corps personnel requirements associated with the RQ-21 Blackjack UAS based on the most current and enduring concept of operations and utilize the updated requirements in planning for UAS squadron personnel requirements. (Recommendation 5)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Commander, Naval Air Systems Command, should update the life cycle cost estimate for the RQ-21 Blackjack UAS to make adjustments as appropriate after updating the personnel requirements for the system. (Recommendation 6)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Deputy Chief of Naval Operations for Warfare Systems (N9), in coordination with the Deputy Commandant for Aviation, should prioritize continued efforts to fully evaluate policies for operating and maintaining UAS of different sizes and capabilities, such as group 3 UAS--to include establishing completion time frames, determining whether reductions to personnel requirements could be accomplished, and identifying any associated cost savings and the benefits to the UAS squadrons' ability to complete missions--and update such policies as needed. (Recommendation 7)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Secretary of the Navy should clarify overarching goals for unmanned systems' personnel requirements, including related priority levels for resourcing purposes, and communicate them to requirements planners and budget decision makers. (Recommendation 8)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. However, it has not fully implemented it as of November 2019.

Recommendation: The Chief of Naval Personnel and the Deputy Commandant for Manpower and Reserve Affairs should assess civilian supply, demand, and wages in the commercial drone industry and use the results to inform retention approaches, including the use of special and incentive pays for UAS operators. (Recommendation 9)

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. DOD has not fully implemented it as of November 2019.

Recommendation: The Deputy Commandant for Aviation and the Deputy Commandant for Manpower and Reserve Affairs should examine the use of additional human capital flexibilities that could improve the career satisfaction and retention of experienced UAS operators and maximize their availability to squadrons. Such flexibilities could include authorizing available special and incentive pays; permitting UAS operators to extend their enlistments to serve longer within squadrons; ensuring the availability of career- and promotion-enhancing opportunities for professional military education; considering the use of a potential insignia device for operators; or extending UAS operator contract lengths. (Recommendation 10)

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. DOD has not fully implemented it as of November 2019.

Recommendation: To improve internal controls over the Forest Service's budget execution processes, the Chief of the Forest Service should (1) design, document, and implement a comprehensive system for administrative control of funds and (2) submit it for review and approval by USDA before issuance, as required by the USDA Budget Manual. (Recommendation 3)

Agency: Department of Agriculture: Forest Service
Status: Open

Comments: The Forest Service generally agreed with this recommendation and stated that its financial policies concerning budget execution have been revised to address our concerns with allotments, unliquidated obligations, commitments, and administrative control of funds as prescribed by OMB Circular A-11. Further, the Forest Service stated that it has undertaken an in-depth review of its unliquidated obligations and modified the certification process to comply with the USDA requirement. However, the Forest Service has not yet provided support for the review and approval of the administrative control of funds by USDA and OMB. GAO will continue to follow up on the status of this recommendation.

Recommendation: To improve internal controls over the Forest Service's budget execution processes, the Chief of the Forest Service should develop, document, and implement a process and related control activities to reasonably assure that standard operating procedures and desk guides (1) clearly refer to guidance in the Directive System for allotments, reimbursable agreements, and review of unliquidated obligations and (2) are reviewed and approved by responsible officials prior to use. (Recommendation 11)

Agency: Department of Agriculture: Forest Service
Status: Open

Comments: The Forest Service generally agreed with this recommendation and stated that it has made significant progress to address this recommendation. Specifically, the Forest Service stated that its financial policies concerning budget execution have been revised to address allotments, unliquidated obligations, commitments, and administrative control of funds as prescribed by OMB Circular A-11. Further, the Forest Service stated that it has undertaken an in-depth review of its unliquidated obligations and modified the certification process to comply with the USDA requirement. However, as of August 2020, the Forest Service has not provided support for the training provided to implement the revised procedures. GAO will continue to follow up on the status of this recommendation.

Recommendation: The Director of OMB should continue to provide ongoing technical assistance that significantly contributes to agencies making their own determinations about their DATA Act reporting requirements and monitor agency submissions. (Recommendation 1)

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

Comments: OMB stated in January 2020 that it believes that the assistance it has previously provided to help agencies make their own reporting determinations fulfills the recommendation's intent. However, because we continue to identify instances where agencies had not submitted these data, we continue to believe that OMB needs to follow up with agencies that are not submitting quarterly data to find out why they are not reporting. It also needs to update its list of agencies required to report.

Recommendation: The Director of OMB should clarify and align existing guidance regarding the appropriate definitions agencies should use to collect and report on Primary Place of Performance and establish monitoring mechanisms to foster consistent application and compliance. (Recommendation 2)

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

Comments: OMB has issued or contributed to guidance documents that are intended to help agencies collect and report on "Primary Place of Performance." We believe that providing specific examples of how agencies should approach challenging situations when reporting on this data element for grants would provide further clarity.

Recommendation: The Secretary of the Treasury should reasonably assure that ongoing monitoring controls to help ensure the completeness and accuracy of agency submissions are designed, implemented, and operating as designed. (Recommendation 4)

Agency: Department of the Treasury
Status: Open
Priority recommendation

Comments: In September 2019, Treasury officials stated that they are working to formalize a process for monitoring agency submissions. This process will include (1) emailing agencies prior to submission deadlines to remind them of the approaching submission deadlines; (2) following up with agencies that do not submit required data by the submission deadline and offering technical assistance as needed; and (3) forwarding a list of non-compliant agencies to OMB. GAO will continue to monitor Treasury's efforts to establish monitoring controls to help ensure the completeness and accuracy of the data.

Recommendation: The Secretary of the Treasury should disclose known data quality issues and limitations on the new USAspending.gov. (Recommendation 5)

Agency: Department of the Treasury
Status: Open
Priority recommendation

Comments: As of January 2020, Treasury has made progress by disclosing limitations related to unreported spending, among other things. Treasury is planning a major update to the USAspending.gov website to include more information about known data quality issues. Treasury plans to make this update to the website in the coming months and has an internal target date of June 2020 for completion. When completed, this action will help users make more informed decisions about how to interpret and use the data provided on the website.

Recommendation: The Administrator of RHS should develop and implement a plan for ongoing monitoring, including testing and evaluation, of the obligation tool using relevant data. (Recommendation 1)

Agency: Department of Agriculture: Rural Housing Service
Status: Open

Comments: In June 2019, RHS said that implementing the recommendation would require information technology funding.

Recommendation: The Administrator of RHS should develop controls to check the reasonableness of rental assistance agreement amounts calculated by the obligation tool. (Recommendation 2)

Agency: Department of Agriculture: Rural Housing Service
Status: Open

Comments: In June 2019, RHS said that implementing the recommendation would require information technology funding.

Recommendation: The Administrator of RHS should develop controls to ensure that RHS uses the inflation rates from the President's economic assumptions in developing budget estimates. (Recommendation 3)

Agency: Department of Agriculture: Rural Housing Service
Status: Open

Comments: In June 2019, RHS said it would incorporate the recommended controls into the fiscal year 2021 budget cycle.

Recommendation: The Administrator of RHS should provide guidance to Rural Development state offices that specifies that prior to obligating funds, staff are to review information related to a property's mortgage servicing status. (Recommendation 4)

Agency: Department of Agriculture: Rural Housing Service
Status: Open

Comments: In June 2019, RHS said it was working toward providing the recommended guidance to Rural Development state offices.

Recommendation: The Secretary of Defense should direct the Office of the Under Secretary of Defense (Comptroller) to provide guidance in the DOD Financial Management Regulation on the timing of when DOD managers should use available tools to help ensure that monthly cash balances are within the upper and lower cash requirements.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation and plans to update guidance in Volume 2B, Chapter 9, Paragraph 090103 4.j. of the DOD Financial Management Regulation. The draft guidance provided by DOD stated that "Components should consider leveraging the aforementioned available cash management tools when cash execution is trending below/above plan for more than three consecutive months of execution." In August 2020, DOD told us that after coordination within DOD, they estimate the final guidance related to our recommendation will be included in the DOD Financial Management Regulation guidance by April 2021.

Recommendation: To better understand the available opportunities for collecting inmate health care utilization data, BOP should conduct a cost-effectiveness analysis of potential solutions, and take steps toward implementation of the most effective solution.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In 2018, BOP contracted with a management consulting firm to improve organizational alignment and strengthen data analytics capabilities. This firm is also examining data analytics solutions and by late March 2020 is expected to make recommendations to BOP to support a request for purchase (RFP) for the most cost-effective one. BOP anticipates the RFP will then follow within the subsequent three months. This contracting work is a positive step that should help BOP identify the most cost-effective solution to collect health care utilization data. BOP is still in the early stages of implementing this action, therefore it is too soon to assess whether its efforts will fully address GAO's recommendation. However, once these actions are completed, BOP could be better positioned to find a solution for collecting the needed data.

Recommendation: To better understand the available opportunities for controlling health care costs, BOP should implement its guidance to conduct "spend analyses" of BOP's health care spending, using data sources already available

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In 2018, BOP contracted with a management consulting firm to identify opportunities to improve organizational alignment and strengthen data analytics capabilities. As part of this effort, BOP also contracted with a health care finance expert, who began working with BOP Health Services Division in June 2019. The expert has met with subject matter experts across disciplines to identify reliable sources for medical cost data, including medical activities data, staffing data, and medical cost data to support conducting spend analyses. BOP expects this effort to be completed by late spring 2020. This contracting work is a positive step toward implementing BOP's spend analysis guidance; however, since BOP has not yet completed this effort, it is too soon to assess whether BOP's efforts will fully address GAO's recommendation. Once BOP has completed this effort, it could be better positioned to identify opportunities for controlling health care costs.

Recommendation: To determine the actual or likely effectiveness of its ongoing or planned health care cost control initiatives, BOP should evaluate the extent to which its initiatives achieve their cost control aim.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In 2018, BOP contracted with a management consulting firm to identify opportunities to improve organizational alignment and strengthen data analytics capabilities. As part of this effort, BOP also contracted with a health care finance expert, who began working with BOP Health Services Division in June 2019. BOP is working with this expert to validate existing financial data sources and apply a standardized cost accounting model to evaluate the cost effectiveness of key health care cost control initiatives. According to BOP, the model is being developed in phases with the initial phase expected to be completed by late March 2020. The second phase of the model is scheduled to launch in October 2020. This is a positive step that will better position BOP to evaluate its health care cost control initiations. Since BOP has not yet completed this effort, it is therefore too soon to assess whether its efforts will fully address GAO's recommendation. However, once BOP has completed this effort, it could help BOP evaluate the effectiveness of its health care cost control initiatives.

Recommendation: To enhance its strategic planning for and implementation of health care cost control efforts, BOP should incorporate elements of a sound planning approach and (1) establish a means of measuring progress toward and effectiveness of its activities for its current strategic objectives and goals related to controlling health care costs; and (2) identify the resources and investments necessary for implementation of its planned health care cost control initiatives.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In October 2018, BOP initiated a contract with an external group of public administration experts to examine BOP's organizational structure and its lines of authority. The group completed its study and issued a report in October 2019, which included recommendations for BOP. According to BOP, the Health Services Division is in the process of creating a Strategic Plan Advisory Group, which will implement recommendations in the October 2019 report, and will establish a 2020-2025 Strategic Plan. The Strategic Plan Advisory Group will also evaluate metrics, including those related to financial performance that will, according to BOP, enable it to identify the resources and investments to help control health care costs. This action is a positive step that could help BOP enhance its strategic planning for and implementation of health care cost control efforts. However, BOP is in the early stages of implementing this recommendation; thus it is too soon to assess if BOP will find the most effective method for enhancing its strategic planning.

Recommendation: To improve the reliability and utility of its Federal Medical Center mission analyses, BOP should document the analyses and findings that underlie its recommendations.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: In June 2017, BOP agreed with GAO's recommendation. However, BOP decided to end the Federal Medical Center mission analyses process. Instead, in September 2018 BOP established a Medical Referral Center (MRC) Executive Advisory Board, made up of BOP's Health Services Division leadership and wardens from all seven MRCs. According to BOP, the Board plans to develop and implement dashboard metrics by the end of calendar year 2020 to monitor essential functions at the centers, which it hopes will improve management of the inmate health care system. In the meantime, BOP reports that the Board has already developed and implemented the MRC pipeline patient dashboard, which permits the MRC wardens to monitor incoming patients in advance of arrival and to maximize the best patient care and housing until treatment is complete. In addition, the Board has developed and implemented the Memory Disorder Unit at one if its MRCs. This resulted in BOP making more efficient use its inpatient beds, as inmates that were housed in community hospitals could return to a BOP inpatient setting. While these steps might not fulfill the recommendation as worded, they have already resulted in some improvements to the utility of the MRCs, and therefore the intent of the recommendation. We will continue to monitor progress on this effort to ensure BOP develops and implements the metrics as planned.

Recommendation: To improve the collection of complete and consistent personal care services data and better ensure CMS can effectively monitor the states' provision of and spending on Medicaid personal care services, CMS should better ensure that personal care services data collected from states through T-MSIS and MBES comply with CMS reporting requirements.

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

Comments: The Centers for Medicare & Medicaid Services (CMS) concurs with GAO's recommendation. In December 2017, CMS cited ongoing efforts related to claims data submitted by states through T-MSIS, CMS's new claims reporting system. Efforts included validation checks of personal care service claims to ensure that key data are not missing or incorrect. In addition, CMS stated it was working with the states to address concerns that are identified with the quality of claims data submitted. However, as of March 2020, CMS had not reported that it had addressed inaccurate state reporting of expenditures through CMS's expenditure reporting system, Medicaid Budget and Expenditure System (MBES). Complete implementation of the recommended action will better ensure state reporting of claims and expenditures is accurate and will allow CMS to effectively perform key management functions.

Recommendation: To improve the collection of complete and consistent personal care services data and better ensure CMS can effectively monitor the states' provision of and spending on Medicaid personal care services, CMS should develop plans for analyzing and using personal care services data for program management and oversight.

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

Comments: The Centers for Medicare & Medicaid Services (CMS) concurred with this recommendation. However, as of March 2020, CMS had not developed a plan for analyzing and using personal care services data as GAO recommended in January 2017. Developing a plan for analyzing and using personal care services data for program management and oversight is an important step CMS needs to take to improve the oversight and management of personal care services.

Recommendation: In order to improve the accuracy of the information included in the O&M budget justification material submitted to Congress and provide complete information to review the military services' fuel consumption spending requests, the Secretary of Defense should direct the Under Secretary of Defense (Comptroller), in consultation with the military services and DLA, to report complete fuel consumption information to Congress, to include actual and estimated fuel volume and actual O&M base obligations for fuel consumption spending separate from O&M Overseas Contingency Operations obligations. This information could be provided as part of DOD's annual O&M budget justification materials, or through other reporting mechanisms.

Agency: Department of Defense
Status: Open

Comments: DOD non-concurred with this recommendation. As of July 2020, DOD had not taken any action to implement the recommendation. DOD stated that it agreed that including additional fuel consumption detail could be useful information, but that it would be difficult and labor intensive to implement a system to separate base from OCO data for several reasons, including its use of legacy financial management systems that cannot easily distinguish between base and OCO execution data.

Recommendation: To address weaknesses in the department's financial management systems modernization efforts, the Secretary of HUD should direct the Chief Financial Officer to work with the Chief Information Officer in managing subsequent initiatives to define a high-level depiction of the IT systems anticipated in the future state, a description of the operations that must be performed and who must perform them, and an explanation of where and how the operations are to be carried out.

Agency: Department of Housing and Urban Development
Status: Open

Comments: In its comments on our draft report, HUD neither agreed nor disagreed with our recommendations, but noted that it planned to improve management practices and IT governance for future modernization efforts. In April 2019, HUD reported that the Office of the Chief Information Officer and Office of the Chief Financial Officer had collaborated through an IT technical assessment initiative, identifying four primary financial management modernization initiatives remaining from the New Core Program. In July 2020, HUD officials, including the Deputy Chief Financial Officer, provided a roadmap that defined a high-level depiction of the financial management systems anticipated in the future state. However, the department had not yet completed more detailed plans that (1) identify operations that must be performed and who must perform them and (2) explain where and how operations are to be carried out. We will continue to monitor HUD's efforts to address this recommendation.

Recommendation: To address weaknesses in the department's financial management systems modernization efforts, the Secretary of HUD should direct the Chief Financial Officer to work with the Chief Information Officer in managing subsequent initiatives to develop comprehensive plans for scope, schedule and cost.

Agency: Department of Housing and Urban Development
Status: Open

Comments: In its comments on our draft report, HUD neither agreed nor disagreed with our recommendations, but noted that it planned to improve management practices and IT governance for future modernization efforts. In April 2019, HUD reported that the Office of the Chief Information Officer and Office of the Chief Financial Officer had identified a need to pursue financial management systems modernization. As of July 2020, the department had begun taking action to address this recommendation. Specifically, HUD planned to integrate loan and property management into its current financial management shared service and had begun planning for how to modernize its budget formulation and cost accounting systems. For the budget formulation effort, HUD had developed high-level plans for the scope of the program, planned an implementation schedule, and estimated on the cost for implementation and operating and maintaining the system for two years. We will continue to monitor HUD's efforts to address this recommendation.

Recommendation: To address weaknesses in the department's financial management systems modernization efforts, the Secretary of HUD should direct the Chief Financial Officer to work with the Chief Information Officer in managing subsequent initiatives to ensure requirements are fully documented and traceable.

Agency: Department of Housing and Urban Development
Status: Open

Comments: In its comments on our draft report, HUD neither agreed nor disagreed with our recommendations, but noted that it planned to improve management practices and IT governance for future modernization efforts. In March 2017, the department reported that the Chief Financial Officer and the Chief Information Officer intended to partner on future departmental financial management systems modernization efforts to fully document requirements and trace requirements to the functionality in the modernized system. In April 2019, HUD reported that the Office of the Chief Information Officer and Office of the Chief Financial Officer had identified a need to pursue financial management systems modernization in 4 areas previously identified for the New Core program. As of July 2020, HUD was in the early phases of planning for modernization in these areas. According to officials from the Office of the Chief Financial Officer, the department intended to address this recommendation for budget formulation modernization by developing applicable plans and artifacts for managing requirements from the department's project planning and management framework. However, that effort has not yet started. We intend to continue to follow up on HUD's actions.

Recommendation: The Secretary of HUD should also direct the Deputy Secretary to ensure that the Chief Information Officer takes action to improve IT governance control activities used for monitoring programs and identifying needed corrective actions, and strengthen investment oversight by improving coordination with stakeholders and alignment among IT modernization efforts.

Agency: Department of Housing and Urban Development
Status: Open

Comments: In its comments on our draft report, HUD neither agreed nor disagreed with our recommendations, but noted that it planned to improve management practices and IT governance for future modernization efforts. Since 2016, HUD has revised its IT governance boards, which provide oversight of all its IT investments, including financial management initiatives, several times. While the department has not yet completed those improvement efforts, HUD updated its project planning and management framework to tailor requirements and artifacts for different program types. According to an official from the Office of the Chief Financial Officer, updates to the requirements for shared services projects incorporated lessons learned from the New Core program. In April 2019, HUD reported that the Office of the Chief Information Officer and Office of the Chief Financial Officer had identified a need to pursue financial management systems modernization in 4 areas previously identified for the New Core program. Officials from both offices have described improvements in their coordination and collaboration on efforts to plan for modernization. We intend to continue to follow up on HUD's actions to ensure that planned improvements to governance and oversight mechanisms are effectively implemented and institutionalized.

Recommendation: To promote further transparency in measuring the federal government's progress against deficit reduction targets required under current law, the Director of the Office of Management of Budget should identify and publicly report the total amount of actual reductions in budget authority government-wide each year as a result of sequestration or the reduction of discretionary spending limits under BBEDCA.

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

Comments: In September 2018, OMB staff maintained their position of disagreement with this recommendation as summarized in our April 2016 report. As of January 2020, OMB has not provided any plans to implement this recommendation.

Recommendation: To help ensure that agencies report consistent and comparable data on federal spending, the Director of OMB, in collaboration with the Secretary of the Treasury, should provide agencies with additional guidance to address potential clarity, consistency, or quality issues with the definitions for specific data elements including Award Description and Primary Place of Performance and that they clearly document and communicate these actions to agencies providing this data as well as to end-users.

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

Comments: OMB has taken some actions to address this recommendation related to procurement awards, such as adopting a shorter character limit for the "Award Description" element and providing additional guidance for the "Primary Place of Performance" element. However, it needs to provide additional guidance for these data elements related to grant awards to ensure collection of consistent and comparable information.

Recommendation: To ensure that HHS workforce efforts meet national needs, the Secretary of Health and Human Services should develop a comprehensive and coordinated planning approach to guide HHS's health care workforce development programs--including education, training, and payment programs--that (1) includes performance measures to more clearly determine the extent to which these programs are meeting the department's strategic goal of strengthening health care; (2) identifies and communicates to stakeholders any gaps between existing programs and future health care workforce needs identified in the Health Resources and Services Administration's workforce projection reports; (3) identifies actions needed to address identified gaps; and (4) identifies and communicates to Congress the legislative authority, if any, the Department needs to implement the identified actions.

Agency: Department of Health and Human Services
Status: Open

Comments: In December 2016, HHS indicated that the agency had not yet taken steps to implement a comprehensive workforce planning effort. Officials said that for the FY2018 cycle, HHS had planned to expand its group developing legislative proposals to include budget issues and gaps that warrant attention. While it did not do so during that cycle, officials indicated that they would recommend this broader approach to workforce planning for future budget and legislative cycles. In an update presented in HHS's FY2021 budget justification, HHS did not address efforts to develop a comprehensive and coordinated planning approach to guide HHS's health care workforce development programs. Instead, it described its current legislative and budget development effort and proposal to restructure CMS Graduate Medical Education (GME) programs into a discretionary grant program. It noted that such a restructuring would allow the Department to set expectations for program performance in CMS GME and allow the kind of tracking HRSA has been able to implement in the Children's Hospital GME program and its Teaching Hospital GME program. It noted that Congress had not responded to this request. However, this recommendation stands on its own and is separate from any legislative efforts to modify how federal GME funds are distributed. Whether or not legislation is enacted to implement a consolidated federal GME grant program, HHS should take action to develop a comprehensive and coordinated planning approach. Such action is important for HHS to assure that federal programs fully meet workforce needs. Further, the CARES Act of 2020 requires HHS to develop a comprehensive and coordinated strategic plan for HHS health workforce programs. We will be monitoring HHS's implementation of this requirement to determine if it satisfies the intent of this recommendation.

Recommendation: To ensure that resources are being efficiently applied to meet the National Guard counterdrug program's objectives, the Secretary of Defense should direct the National Guard Bureau in consultation with the Deputy Assistant Secretary of Defense for Counternarcotics and Global Threats to subsequently collect and use performance information to help inform funding distribution decisions to state programs and to conduct oversight of the training offered by the counterdrug schools.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with our recommendation and stated that it would collect and use performance information to evaluate the effectiveness of each state program to provide support and to meet its objectives. DOD also stated that it would take steps to assist states with any needed corrective-action plans. While the National Guard counterdrug program has begun collecting performance information in its annual assessments of state programs and counterdrug schools, it has not yet incorporated the information into its funding distribution decisions. In January 2020, DOD officials indicated that responsibility for implementing this recommendation was assigned to the Counterdrug Advisory Counsel and Threat Based Resourcing Model Target Team for action. They estimated a completion date of December 2020.

Recommendation: To help agencies decide whether to use ESPCs to consolidate federal data centers, the Director of the Office of Management and Budget should document, for the purposes of scoring ESPCs, (1) what qualifies as energy-related savings and (2) the allowable proportion of energy and energy-related cost savings.

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

Comments: In July 2020, GAO requested information on the status of the recommendation. We will update the recommendation's status when information is received from OMB.

Recommendation: To help ensure contracting officers carry out the requirements of Section 802, the Secretary of Defense, Secretary of State, and Administrator of USAID should revise the processes and guidance governing management reviews of procurements to ensure that such reviews assess whether contracting officers are complying with the provisions of Section 802.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with GAO's recommendation. Following a May 2015 Federal Acquisition Regulation update to reflect the requirements of Section 802 of the National Defense Authorization Act for Fiscal Year 2013, the Office of Defense Procurement and Acquisition Policy drafted supplementary information for an update of the agency's Procedures, Guidance, and Information (PGI) that was considered and rejected by Defense Acquisition Regulation Council. In July 2019, the Office of Defense Pricing and Contracting reported that new PGI guidance would be drafted that will require management reviews to consider compliance with Section 802 requirements included in the Federal Acquisition Regulation. As of August 2020, we have been unable to determine the status of this guidance.

Recommendation: Because ROI provides insights on the productivity of a program and is one important factor in making resource allocation decisions, the Commissioner of Internal Revenue should calculate actual ROI for implemented initiatives, compare the actual ROI to projected ROI, and provide the comparison to budget decision makers for initiatives where IRS allocated resources.

Agency: Department of the Treasury: Internal Revenue Service
Status: Open

Comments: No executive action taken as of December 2019. While IRS agreed that having actual ROI data for implemented initiatives would be useful, it did not believe it was feasible to produce such estimates, as GAO recommended in June 2014. GAO maintains that IRS should be able to provide some information on past initiatives, such as whether funds requested were used in the manner originally proposed. As of December 2016, IRS officials reported there is no timeline for full implementation. Comparing projected ROI to actual ROI can help hold managers and IRS accountable for the funding received.

Recommendation: To improve the consistency, comprehensiveness, and transparency of information provided to Congress and policymakers on the federal investment in export promotion programs, the Secretary of Commerce, as chair of the TPCC, should report in its National Export Strategies on how resources are allocated by agency and aligned with priorities.

Agency: Department of Commerce
Status: Open
Priority recommendation

Comments: The Export Enhancement Act [15 U.S.C. Section 4727(c)] states that the Trade Promotion Coordinating Committee's (TPCC) strategies should establish a set of priorities for federal export promotion activities and propose a unified federal trade promotion budget that supports the plan. In written comments on GAO's report, the Director of the TPCC Secretariat generally concurred with the recommendation on behalf of the Secretary. Nevertheless, the Director noted the TPCC's limited authority over budget reporting and resource allocations and gave examples of some challenges they faced, including shifts in the political and budgetary landscape and how different Administrations and Congresses have emphasized different priorities over time. In the years following GAO's 2013 report, the TPCC has not issued any National Export Strategies (NES), except in 2016; however this 2016 NES did not include any budget information on how resources were allocated by agency and aligned with the strategy's priorities. In August 2020 Commerce officials told GAO they had collected budget information from TPCC agencies related to trade promotion activities (FY19 actual and FY20 requested). They noted that the budget categories and agencies from which it was collected reflected changes in Administration priorities and new Congressional mandates. However, they said this information has not been transmitted to Congress.

Recommendation: To address weaknesses in DCOE's strategic plan, the Secretary of Defense, through the Director of TMA, should direct the DCOE director to revisit and revise as necessary the organization's goals for completing statutorily required responsibilities.

Agency: Department of Defense
Status: Open

Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.

Recommendation: To address weaknesses in DCOE's strategic plan, the Secretary of Defense, through the Director of TMA, should direct the DCOE director to require the directorates to align their day-to-day activities to support DCOE's mission and goals.

Agency: Department of Defense
Status: Open

Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.

Recommendation: To address weaknesses in DCOE's strategic plan, the Secretary of Defense, through the Director of TMA, should direct the DCOE director to improve the performance measures in the plan to enable DCOE to determine if achievement of each measure fully supports attainment of its associated goal.

Agency: Department of Defense
Status: Open

Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.

Recommendation: To ensure that DCOE obligations are properly classified and recorded in accordance with OMB guidance, the Secretary of Defense, through the Office of the Assistant Secretary of Defense (Health Affairs) (ASD(HA)), should direct TMA to develop written procedures with detailed steps to be performed for ensuring proper classification and recording of obligations in TMA's financial management systems.

Agency: Department of Defense
Status: Open

Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.

Recommendation: To ensure that DCOE obligations are properly classified and recorded in accordance with OMB guidance, the Secretary of Defense, through the ASD(HA), should direct TMA to assign responsibility for updating and maintaining procedural guidance and systems codes to assure consistency with annual OMB guidance.

Agency: Department of Defense
Status: Open

Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.

Recommendation: To strengthen accountability and transparency in FHA's management of the Fund, Congress may wish to consider clarifying (1) the definition of the Fund's capital ratio--specifically, whether the denominator of the ratio was intended to be the amortized insurance-in-force; (2) the definition of the phrase "established target subsidy rate" used in HERA; and (3) the nature and extent of information that FHA should be reporting on subsidy rates pursuant to HERA, recognizing that subsidy rates are generally only reestimated once a year under current budget processes.

Agency: Congress
Status: Open

Comments: As of October 2019, Congress had not acted on this matter for consideration.

Recommendation: To address USPS's financial viability in the short term, Congress may wish to consider providing financial relief to USPS, including modifying its retiree health benefit cost structure in a fiscally responsible manner. Congress may also wish to consider any and all options available to reduce USPS costs, including revising the statutory framework for collective bargaining to ensure that binding arbitration takes its financial condition into account. At the same time, to facilitate making progress in difficult areas, Congress may wish to consider establishing (1) a panel of independent experts, similar to a BRAC-like commission, to coordinate with USPS and stakeholders to develop a package of proposed legislative and operational changes needed to reduce costs and address challenges to USPS's business model and (2) procedures for the review and approval of these proposals by the President and Congress. These proposals could focus on adapting delivery and retail services to declining mail volumes; making postal operations, networks, and workforce more cost-efficient; and generating new revenue.

Agency: Congress
Status: Open

Comments: As of March 2020, Congress has taken no action on this matter.

Recommendation: The Congress may wish to consider broadening IRS's ability to use math error authority (MEA), with appropriate safeguards against misuse of that authority.

Agency: Congress
Status: Open

Comments: Congress has expanded IRS's math error authority in certain circumstances, but not as broadly as we suggested in February 2010. Section 208 of division Q of the Consolidated Appropriations Act, 2016 (Public Law 114-113 enacted in December 2015) gave IRS the authority to use math error authority if (1) a taxpayer claimed the Earned Income Tax Credit, Child Tax Credit, or the American Opportunity Tax Credit (AOTC) during the period in which a taxpayer is not permitted to claim such credit as a consequence of either having made a prior fraudulent or reckless claim; or (2) a taxpayer omitted information required to be reported because the taxpayer made prior improper claims of the Child Tax Credit or the AOTC. In addition, Congress expanded math error authority for the First-Time Homebuyer Credit in November 2009. While expanding math error authority is consistent with what we suggested in February 2010, we maintain that a broader authorization of math error authority with appropriate controls would enable IRS to correct obvious noncompliance, would be less intrusive and burdensome to taxpayers than audits, and would potentially help taxpayers who underclaim tax benefits to which they are entitled. If Congress decides to extend broader math error authority to IRS, controls may be needed to ensure that this authority is used properly such as requiring IRS to report on its use of math error authority. The Administration also requested that Congress expand IRS's math error authority as part of the President's budget proposal for fiscal year 2021. Specifically, the Administration requested authority to correct a taxpayer's return in the following circumstances: 1) the information provided by the taxpayer does not match the information contained in government databases; 2) the taxpayer has exceeded the lifetime limit for claiming a deduction or credit; or 3) the taxpayer has failed to include with his or her return certain documentation that is required by statute. As of January 2020, the Congress had not provided IRS with such authority. We continue to believe that Congress should broaden IRS's math error authority with appropriate safeguards in order to help reduce the tax gap, which is the difference between tax amounts that taxpayers should have paid and what they actually paid .