Recommendation: The OHS Director should require Head Start grantees to document that water provided to children has been tested for lead. OHS could determine various ways that are feasible and efficient for grantees to satisfy this requirement; for example, verification could be done through OHS' current grantee data collection or monitoring processes. (Recommendation 1)

Agency: Department of Health and Human Services
Status: Open

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

Recommendation: The Assistant Secretary for the Administration for Children and Families should direct OCC and OHS to develop an agreement with EPA on their roles and responsibilities in implementing the Memorandum of Understanding on Reducing Lead Levels in Drinking Water in Schools and Child Care Facilities. For example, these agreements may include the ways in which guidance and information will be shared with states and Head Start grantees, such as through webinars or email, and how frequently. (Recommendation 2)

Agency: Department of Health and Human Services
Status: Open

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

Recommendation: The Assistant Administrator of the Office of Water should develop an agreement with HHS's Offices of Child Care and Head Start on their roles and responsibilities in implementing the Memorandum of Understanding on Reducing Lead Levels in Drinking Water in Schools and Child Care Facilities. For example, these agreements may include the ways in which guidance and information will be shared with states and Head Start grantees, such as through webinars or email, and how frequently. (Recommendation 3)

Agency: Environmental Protection Agency
Status: Open

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

Recommendation: The Assistant Administrator of the Office of Water should direct the Office of Water to specify how it will track progress toward the outcomes of the Memorandum of Understanding on Reducing Lead Levels in Drinking Water in Schools and Child Care Facilities and determine how it will regularly monitor and update the MOU. For example, the Office of Water could develop performance measures for each of the MOU's outcomes. In addition, the Office of Water could submit annual reports on progress toward achieving the MOU's outcomes or it could plan to update the agreement at specific intervals. (Recommendation 4)

Agency: Environmental Protection Agency
Status: Open

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

Recommendation: The Assistant Secretary for Elementary and Secondary Education should improve the usability of Education's websites to ensure that the states and school districts can more easily find and access federal guidance to address lead in school drinking water, by taking actions such as clarifying which links contain guidance; highlighting new or important guidance; improving their websites' search function; and categorizing guidance. (Recommendation 5)

Agency: Department of Education
Status: Open

Comments: The Department of Education agreed with this recommendation. The agency said it would identify and include an information portal dedicated to enhancing the usability of federal resources related to testing for and addressing lead in school drinking water. Also, Education said it is interested in increasing coordination across all levels of government and it shares the view expressed in our report that improved federal coordination, including with EPA, will better enhance collaboration to encourage testing for lead in school drinking water. In 2019, Education said it planned to complete work on this recommendation by January 1, 2020. We will consider closing this recommendation when these efforts are complete.

Recommendation: The Assistant Secretary for Elementary and Secondary Education should collaborate with EPA to encourage testing for lead in school drinking water. This effort could include disseminating EPA guidance related to lead testing and remediation in schools or sending letters to states to encourage testing in all school districts that have not yet done so. (Recommendation 7)

Agency: Department of Education
Status: Open
Priority recommendation

Comments: The Department of Education agreed with this recommendation. Education stated it has held multiple meetings with the Environmental Protection Agency (EPA) and stated that it plans to hold a virtual meeting with EPA to share information and resources about safe drinking water and raise awareness of the importance of testing for lead. Education also stated it is developing a timeline to conduct additional collaboration activities with EPA. Education officials said they are considering joining an EPA-led Memorandum of Understanding to, among other things, encourage schools to test drinking water for lead. We will consider closing this recommendation when these efforts are complete.

Recommendation: The Director of IHS should implement a targeted, resource-efficient method to identify additional eligible Indian homes that may have existing deficiencies to include in IHS's Home Inventory Tracking System (HITS). (Recommendation 1)

Agency: Department of Health and Human Services: Public Health Service: Indian Health Service
Status: Open

Comments: In August 2018, IHS's Division of Sanitation Facilities Construction issued a memo to its Area Directors directing them to identify additional eligible Indian homes that may have existing deficiencies to include in HITS. The memo directed Area Offices to use existing staffing resources to leverage their annual efforts to gather sanitation needs data, in collaboration with tribes, to identify any additional homes. In December 2019, IHS officials stated that, as a result of implementing the 2018 memo, Area Directors had increased the number of eligible homes that they identified in 2019. We will continue to monitor the results of IHS's actions.

Recommendation: The Director of IHS should implement a mechanism to indicate in HITS whether each home with a deficiency level of 0 has been assessed. (Recommendation 2)

Agency: Department of Health and Human Services: Public Health Service: Indian Health Service
Status: Open

Comments: As of December 2019, IHS had developed a mechanism in HITS to indicate whether a home currently classified as deficiency level (DL) 0 had been assessed. IHS stated that it has eliminated the category of DL 0 from HITS; in its place, it created a new category of "Pending Assessment" for those homes that are in HITS but that have not been assessed. IHS also came up with a way to prioritize the homes in the Pending Assessment category based on their eligibility to receive assistance from IHS. Homes currently in HITS that have a DL 0 and received service through the Sanitation Facilities Construction Program from 2015 through today will be reassigned a DL 1 to indicate the deficiencies are only associated with routine operations and maintenance. IHS stated that the changes to HITS have been implemented and shared a proposal of how it will distribute the former DL 0 homes across the new categories. We will evaluate IHS's actions after they are complete.

Recommendation: The Director of IHS should reassess the point distribution across the Sanitation Deficiency System scoring factors as part of its program guidelines update, in light of trade-offs between funding projects that address the most severe sanitation deficiencies and projects that meet other needs. (Recommendation 3)

Agency: Department of Health and Human Services: Public Health Service: Indian Health Service
Status: Open

Comments: As part of its reassessment of the point distribution across the scoring factors, in 2018 and 2019 IHS consulted with tribes and analyzed various options for changing the point distribution. We have asked IHS to provide additional information about its reassessment efforts. We will evaluate IHS's actions after we receive the additional information.

Recommendation: The Assistant to the Secretary of Agriculture for Rural Development should implement a scoring factor that awards points for proposed Native American program grant projects that address health risks from a lack of access to safe drinking water and wastewater disposal, as it does with the Colonias grant program. (Recommendation 4)

Agency: Department of Agriculture
Status: Open

Comments: As of January 2020, USDA stated it would prefer to use its discretionary points under its existing regulations to implement this scoring factor instead of making a regulation change to do so. USDA stated that using existing flexibility in the regulations could meet the intent of the recommendation more quickly than by permanently changing the regulation. USDA stated that it has established policy guidance to states that addresses scoring for projects with health and sanitation risks. We will monitor the actions that USDA has taken in response to this recommendation and evaluate them when complete.

Recommendation: The Director of IHS, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 7)

Agency: Department of Health and Human Services: Public Health Service: Indian Health Service
Status: Open

Comments: As of December 2019, IHS had reviewed the 2011 task force report and summarized actions taken and challenges associated with implementing the remaining recommendations. IHS stated that it anticipated discussing its summary with the other members at a future tribal infrastructure task force meeting. We will evaluate IHS's actions when they are complete.

Recommendation: The Administrator of EPA, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 8)

Agency: Environmental Protection Agency
Status: Open

Comments: As of June 2020, EPA had discussed the 2011 task force report with the other member agencies to identify and implement additional actions to increase collaboration at the national level. EPA published a summary matrix of relevant funding sources on the task force website and compiled a draft document summarizing actions the task force member agencies have taken to implement recommendations from the 2011 report. We will continue to monitor EPA's actions in response to this recommendation.

Recommendation: The Assistant to the Secretary of Agriculture for Rural Development, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 9)

Agency: Department of Agriculture
Status: Open

Comments: In July 2019, the task force member agencies met to discuss the status of the recommendations in the 2011 task force report. The agencies each agreed to compile information about the actions they had taken and consider new actions in 2020. USDA stated in December 2018 that the task force agencies had made progress in developing efficiencies in environmental review processes and with online tribal resources and training, in addition to other areas. We will evaluate USDA's actions after the task force has compiled all actions taken in response to the 2011 report and evaluated what further actions or responses should be conducted.

Recommendation: The Deputy Assistant Secretary of the Department of Housing and Urban Development's Office of Native American Programs, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 10)

Agency: Department of Housing and Urban Development
Status: Open

Comments: As of December 2019, the task force members had agreed to jointly consider the actions they have taken from the 2011 report and to discuss additional actions they could take to increase collaboration at the national level. We will evaluate HUD's actions once they are complete.

Recommendation: The Commissioner of Reclamation, in cooperation with other members of the tribal infrastructure task force, should review the 2011 task force report and identify and implement additional actions to help increase the task force's collaboration at the national level. (Recommendation 11)

Agency: Department of the Interior: Bureau of Reclamation
Status: Open

Comments: In April 2018, Reclamation met with other members of the task force and the agencies reviewed and discussed the 2011 task force report recommendations. As of December 2019, the task force members had agreed to jointly consider the actions they have taken from the 2011 report and to discuss additional actions they could take to increase collaboration at the national level. We will evaluate the agency's actions once they are complete.

Recommendation: The Director of IHS, in cooperation with other members of the tribal infrastructure task force, should direct IHS area offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 12)

Agency: Department of Health and Human Services: Public Health Service: Indian Health Service
Status: Open

Comments: As of December 2019, IHS headquarters hosted a meeting that included staff from IHS Areas, EPA headquarters, and EPA regions to discuss additional mechanisms to increase collaboration, including best practices for identifying projects for joint funding collaborations. In addition, IHS and the other tribal infrastructure task force members agreed to jointly draft a memo for distribution to their field offices that would include contact information for other member agencies and encourage interagency coordination. We will evaluate IHS's remaining actions to satisfy this recommendation when they are complete.

Recommendation: The Assistant to the Secretary of Agriculture for Rural Development, in cooperation with other members of the tribal infrastructure task force, should direct USDA state offices to identify and pursue additional mechanisms to increase their collaboration. (Recommendation 13)

Agency: Department of Agriculture
Status: Open

Comments: In December 2018, USDA stated that it would send a memo to its state directors and program directors encouraging them to coordinate with tribal governments, IHS, EPA, and other members of the tribal infrastructure task force on funding infrastructure projects. As of December 2019, task force members had drafted a joint memo to distribute to their field offices encouraging additional coordination. We will evaluate USDA's actions in response to this recommendation once they are complete.

Recommendation: The Assistant Administrator for Water should direct EPA's Office of Water to amend its Safe Drinking Water Act and Clean Water Act inspection guidance documents to add questions on strategic workforce planning topics--such as the number of positions needed in the future, skills needed in the future, and any potential gaps in water operator positions. (Recommendation 1)

Agency: Environmental Protection Agency
Status: Open

Comments: In June 2020, EPA Office of Water said that it had revised guidance for conducting Sanitary Surveys for drinking water plants, adding questions related to workforce needs to the "utility management" section of the guidance manual (see Sanitary Survey Learner's Guide (https://www.epa.gov/sites/production/files/2019-08/documents/sanitary_survey_learners_guide_508_8.27.19.pdf), which includes questions on strategic workforce planning topics in section 14.7. As the recommendation applies to wastewater utilities, EPA did not provide an update. In August 2020, EPA officials stated that they plan to incorporate strategic planning questions into its existing guidance documents. According to EPA, it has taken other actions to support the water workforce by announcing a "Water Workforce Initiative," the goal of which is to provide federal leadership and increase public awareness of water sector careers. We will continue to follow-up with EPA Office of Water to determine what actions have been taken in the wastewater area to add questions on workforce issues in inspection guidance.

Recommendation: The Assistant Administrator for Water of EPA's Office of Water should require states to report available information about lead pipes to EPA's Safe Drinking Water Information System (SDWIS)/Fed (or a future redesign such as SDWIS Prime) database, in its upcoming revision of the LCR. (Recommendation 1)

Agency: Environmental Protection Agency
Status: Open
Priority recommendation

Comments: As of July 2020 there has been no change in the status of this recommendation. In July 2019, EPA said that the 2016 America's Water Infrastructure Act (AWIA) requires EPA to conduct an assessment of the costs to replace lead service lines and that EPA would conduct this assessment (a survey) in 2020. In a previous update, EPA said that it would consider GAO's recommendation to require states to report available information about lead pipes along with those of other stakeholders as part of the development of the revisions to the Lead and Copper Rule. EPA officials estimated that the agency would publish a proposal for the revisions in 2019.

Recommendation: The Assistant Administrator for Water of EPA's Office of Water should require states to report all 90th percentile sample results for small water systems to EPA's SDWIS/Fed (or a future redesign such as SDWIS Prime) database, in its upcoming revision of the LCR. (Recommendation 2)

Agency: Environmental Protection Agency
Status: Open
Priority recommendation

Comments: As of July 2020 there has been no change in the status of this recommendation. In July 2019, EPA said that it would consider GAO's recommendation to require states to report all 90th percentile sample results for small systems along with those of other stakeholders as part of the development of the revisions to the Lead and Copper Rule. EPA officials estimated that a proposal for the revisions would be published in 2019.

Recommendation: The Assistant Administrator for Water of EPA's Office of Water and the Assistant Administrator of EPA's Office of Enforcement and Compliance Assurance should develop a statistical analysis that incorporates multiple factors--including those currently in SDWIS/Fed and others such as the presence of lead pipes and the use of corrosion control--to identify water systems that might pose a higher likelihood for violating the LCR once complete violations data are obtained, such as through SDWIS Prime. (Recommendation 3)

Agency: Environmental Protection Agency
Status: Open
Priority recommendation

Comments: As of July 2020 there has been no change in the status of this recommendation. In July 2019, EPA stated that the agency developed a Lead and Cooper Rule (LCR) violation reporting tool that is updated and distributed to the EPA regional offices on a quarterly basis. This tool, according to EPA, enhances national oversight by fostering closer engagement with the regional offices to continuously assess any new water systems violating the LCR. EPA has stated that the agency has also developed, and shared with its regional offices, an internal resource to make ad hoc assessments of water systems, nationwide, that would benefit most from assistance with lead service line replacements or (for water systems without lead service lines) corrosion control treatment installation/re-optimization. According to EPA, this internal resource takes a multi-factor approach that considers historical action level exceedance occurrences and information on additional factors (for which information is already available through regulatory development efforts for the LCR long-term revisions or internet search engine queries). These additional factors include the number of lead service lines known to be present in a given water system; the proportion of a system's service connections that are served by lead service lines; and potential technical, managerial, and financial capacity challenges experienced by that system. Although EPA has made progress in addressing the recommendation, GAO will leave this recommendation open until SDWIS Prime is implemented.

Recommendation: To take advantage of opportunities to collect UCMR data on additional unregulated contaminants, Congress should consider amending SDWA to give EPA the flexibility to select more than 30 contaminants for monitoring under the UCMR program if high-priority contaminants, such as those on the Contaminant Candidate List (CCL) or contaminants of emerging concern, can be included at minimal cost, with minimal additional burden on public water systems, and while using analytical methods that EPA is already employing.

Agency: Congress
Status: Open

Comments: As of July 2020, Congress has not taken action to address this matter; we will continue to monitor actions and provide updated information when it becomes available.

Recommendation: To optimize the ability of the UCMR data to support regulatory determinations, Congress should consider adjusting the statutory time frames for the UCMR and regulatory determinations cycles so that EPA can use the UCMR data to support regulatory determinations in the same cycle.

Agency: Congress
Status: Open

Comments: As of July 2020, Congress has not taken action to address this matter; we will continue to monitor actions and provide updated information when it becomes available.

Recommendation: To improve EPA's ability to oversee the states' implementation of the Safe Drinking Water Act and provide Congress and the public with more complete and accurate information on compliance, the Administrator of EPA should resume data verification audits to routinely evaluate the quality of selected drinking water data on health-based and monitoring violations that the states provide to EPA. These audits should also evaluate the quality of data on the enforcement actions that states and other primacy agencies have taken to correct violations.

Agency: Environmental Protection Agency
Status: Open
Priority recommendation

Comments: As of July 2020 there has been no change in the status of this recommendation. EPA, as of September 2019, had not resumed data verification audits to routinely evaluate the quality of the data states provide to the agency. The Safe Drinking Water Information System (SDWIS) Prime and the Compliance Monitoring Data Portal (CMDP) will replace the data verification audits in the future. EPA has made SDWIS Prime available through incremental interim releases to state drinking water agencies for exploring and testing but does not expect to fully release it until mid-2020. However, as of August 2019, SDWIS Prime was unavailable while EPA awaited progress on the SDWIS Modernization Project plan. According to EPA, the CMDP will enable utilities and laboratories to report data electronically to primacy agencies with fewer errors and in a more efficient manner; but it is not clear when it will be fully operational. According to data provided by EPA in September 2019, 10 states were using CMDP to varying degrees. EPA information identified another 6 states that plan to transition to CMDP between September and December 2019, 2 states that plan to transition in 2020, and 12 others that may transition in the future. In the meantime, EPA indicated that the agency will complete nine file reviews in 2019 to verify data in agencies that do not currently use CMDP. EPA's actions may improve its ability to oversee states' implementation of the act and provide more complete and accurate information on compliance, but because EPA's systems to replace data verification audits are not yet fully in place, we are keeping this recommendation open.

Recommendation: To improve EPA's ability to oversee the states' implementation of the Safe Drinking Water Act and provide Congress and the public with more complete and accurate information on compliance, the Administrator of EPA should work with the states to establish a goal, or goals, for the completeness and accuracy of data on monitoring violations. In setting these goals, EPA may want to consider whether certain types of monitoring violations merit specific targets. For example, the agency may decide that a goal for the states to completely and accurately report when required monitoring was not done should differ from a goal for reporting when monitoring was done but not reported on time.

Agency: Environmental Protection Agency
Status: Open

Comments: As of July 2020 there has been no change in the status of this recommendation. EPA is developing the Safe Drinking Water Information System (SDWIS) Prime, with several efforts underway as of September 2019 as we noted under recommendation 1, but until it is fully operational, EPA will not be able to work with states to establish a national goal for the quality of monitoring violations. EPA noted in 2017 that it expected SDWIS Prime to enable the agency and primacy agencies to better understand the nature of system violations and consider developing goals for monitoring and reporting violations. However, according to EPA, SDWIS Prime will not be released until mid-2020. EPA indicated plans to modify the Annual Public Water System Supervision (PWSS) Program Review requirements but the agency states that it is dependent on approval by the Office of the Inspector General. Despite the ongoing delays to address the call in the recommendation for establishing new goals, we are keeping this recommendation open while EPA continues its efforts to implement SDWIS Prime.