Recommendation: To implement DOD guidance requiring the military departments to prepare readiness and Operation and Maintenance (O&M) budget impact assessments during drawdown planning, the Secretary of Defense should direct the Secretaries of the military departments to develop guidance that assigns responsibility for the preparation of impact assessments and includes direction on how such assessments should be conducted as part of drawdown planning.

Agency: Department of Defense
Status: Open

Comments: In commenting on the draft report, DOD concurred with the recommendation. As of August 2018, we are in the process of following up with the department to determine the current status.

Recommendation: To implement DOD guidance requiring the military departments to prepare readiness and O&M budget impact assessments during drawdown planning, the Secretary of Defense should direct the Director, DSCA, to develop an internal control mechanism to determine whether the military departments have completed the required impact assessments before moving forward with drawdown planning and execution.

Agency: Department of Defense
Status: Open

Comments: In commenting on the draft report, DOD concurred with the recommendation. As of August 2018, we are in the process of following up with the department to determine the current status.

Recommendation: To better position the Coast Guard to effectively plan its Arctic operations, the Commandant of the Coast Guard should develop measures, as appropriate, for gauging how the agency's actions have helped to mitigate the Arctic capability gaps.

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

Comments: In June 2016, we reviewed and reported on the U.S. Coast Guard's efforts in the Arctic. We found that the Coast Guard had taken actions to implement its Arctic strategy and conduct Arctic operations, which may help the Coast Guard to better understand and mitigate identified Arctic capability gaps. Further, we found that the Coast Guard was tracking, or had plans to track, its various activities in the Arctic, but that it had not developed measures to systematically assess how its actions have helped to mitigate Arctic capability gaps. We recommended that the Coast Guard develop measures, as appropriate, for gauging how the agency's actions have helped to mitigate the Arctic capability gaps. Since that time, the Coast Guard updated its Arctic strategy in April 2019. In February 2020, Coast Guard officials stated that they are revising the implementation plan for its Arctic Strategy and are working on a framework tool to measure the impacts of its actions in the Arctic. According to Coast Guard officials, they expect the implementation plan to include actionable items that can be measured and the framework tool to include outcome and success measures. In July 2020, officials estimated that the implementation plan would be finalized by the end of fiscal year 2020. Further, the Coast Guard issued a contract in August 2019 to help develop the framework tool by the end of fiscal year 2020. Officials stated that the tool may require revisions before it is finalized and implemented and that throughout fiscal year 2021 they will test, evaluate, and adjust the framework tool, as appropriate. To fully address this recommendation, the Coast Guard will need to finalize the development of its measures to gauge how its actions have helped to mitigate Arctic capability gaps, which we will continue to monitor.

Recommendation: To better position the Coast Guard to effectively plan its Arctic operations, the Commandant of the Coast Guard should design and implement a process to systematically assess the extent to which actions taken agency-wide have helped mitigate the Arctic capability gaps for which it has responsibility.

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

Comments: In June 2016, we reviewed and reported on the U.S. Coast Guard's efforts in the Arctic. We found that the Coast Guard had taken actions to implement its Arctic strategy and conduct Arctic operations, which may help the Coast Guard to better understand and mitigate identified Arctic capability gaps. Further, we found that the Coast Guard was tracking, or had plans to track, its various activities in the Arctic, but that it had not systematically assessed how its actions have helped to mitigate Arctic capability gaps. We recommended that the Coast Guard design and implement a process to systematically assess the extent to which actions taken agency-wide have helped mitigate the Arctic capability gaps for which it has responsibility, so that it will better understand the status of these gaps and be better positioned to effectively plan its Arctic operations. Since that time, the Coast Guard updated its Arctic strategy in April 2019. In February 2020, Coast Guard officials stated that they are revising the implementation plan for its Arctic Strategy and are working on a framework tool to measure the impacts of its actions in the Arctic. Officials estimated that the implementation plan would be finalized by the end of fiscal year 2020. Further, the Coast Guard issued a contract in August 2019 to help develop the framework tool by the end of fiscal year 2020. Officials stated that the tool may require revisions before it is implemented and utilized for assessment of its progress. In July 2020, Coast Guard officials stated that they plan to test, evaluate, and adjust the framework tool, as appropriate, throughout fiscal year 2021. To fully address this recommendation, the Coast Guard will need to assess how its actions have helped to mitigate Arctic capability gaps, and provide documentation that identifies the progress it has made in helping to mitigate Arctic capability gaps and its plans to systematically assess progress, which we will continue to monitor.

Recommendation: To address the limitations of existing distribution performance metrics, the Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology and Logistics, in conjunction with TRANSCOM, to revise guidance to ensure that a customer wait time standard is established and used for the Marine Corps.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. In September 2016, the Marine Corps established a Customer Wait Time (CWT) standard and developed CWT metrics that are in alignment with DOD policy. These changes were to be incorporated into Marine Corps policy through their normal Service procedures. As of August 2020, the Marine Corps has the CWT standard included in its new policy document, but the policy is going through internal coordination and is still in draft at this time. Current timeframe for publication is January 2021. Once we confirm the CWT standard is in the issued policy, we will close the recommendation.

Recommendation: To better ensure the credibility of IRIS assessments by enhancing their timeliness and certainty, the EPA Administrator should require the Office of Research and Development, should different time frames be necessary, to establish a written policy that clearly describes the applicability of the time frames for each type of IRIS assessment and ensures that the time frames are realistic and provide greater predictability to stakeholders.

Agency: Environmental Protection Agency
Status: Open
Priority recommendation

Comments: As of March 2020, we have not seen a formal written memo from the IRIS program laying out this information - in detail - publicly, or how timelines for assessments are influenced by various criteria. While IRIS program staff have discussed this issue, no written guidance has been created. Such communication from the IRIS Program, as well as more frequent updates of the timelines for chemicals currently in assessment and projected starting dates for every chemical listed as "under assessment" is needed.

Recommendation: To ensure that current and accurate information on chemicals that EPA plans to assess through IRIS is available to IRIS users--including stakeholders such as EPA program and regional offices, other federal agencies, and the public--the EPA Administrator should direct the Office of Research and Development to annually publish the IRIS agenda in the Federal Register each fiscal year.

Agency: Environmental Protection Agency
Status: Open

Comments: As of March 2020, EPA's Integrated Risk Information System (IRIS) Program has established the priority chemicals it is working on, and has published some timelines via the IRIS Program Outlook document. However, this information has not been published as an agenda in the Federal Register.

Recommendation: To establish accountability for meeting the programs' goal of increasing the participation of traditionally underrepresented groups in the highway construction workforce, the Secretary of Transportation should direct the FHWA Administrator to create and implement an oversight mechanism that (1) holds states accountable for meeting federal training criteria and (2) clearly stipulates how FHWA will assess state program effectiveness, including what type of program achievement data states are to submit and how such data will be used. This oversight mechanism should include assessing the effectiveness of its division offices in overseeing state activities.

Agency: Department of Transportation
Status: Open

Comments: FHWA has taken initial steps to implement a mechanism for state oversight, which includes collecting program implementation information from each state. FHWA plans to convene a working group to review this information and provide feedback to states on their programs. FHWA officials then anticipate sharing best practices and essential requirements for the program through webinars and other technical assistance. As of August 2019, FHWA has gathered information from states and is in the early stages of implementing this oversight mechanism.

Recommendation: In light of the need for accurate and complete information on children's access to health services under Medicaid and CHIP, the requirement that states report information to CMS on certain aspects of their Medicaid and CHIP programs, and problems with accuracy and completeness in this state reporting, the Administrator of CMS should work with states to identify additional improvements that could be made to the CMS 416 and CHIP annual reports, including options for reporting on the receipt of services separately for children in managed care and fee-for-service delivery models, while minimizing reporting burden, and for capturing information on the CMS 416 relating to children's receipt of treatment services for which they are referred.

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

Comments: In August 2019, CMS stated that the agency's long-term plan is to use the Transformed Medicaid Statistical Information System (T-MSIS) to analyze information on children's receipt of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services. As of June 2020, CMS had developed a new CMS-416 reporting form that gives states the option of having CMS calculate the measures for the report using T-MSIS. CMS stated that it intends to implement this option for states for fiscal year 2020 CMS-416 reports, which are due in April 2021. As of August 2020, the new CMS-416 form was undergoing Paperwork Reduction Act review. CMS is also exploring using T-MSIS to generate the Core Set of Children's Health Care Quality Measures for Medicaid and CHIP, some of which are included in the CHIP annual report. As of June 2020, CMS had begun a pilot test to generate five of the Core Set measures using 2018 T-MSIS data. GAO considers this recommendation open and will continue to monitor CMS's progress towards its long-term goal of using T-MSIS to monitor children's receipt of EPSDT services.

Recommendation: To support the triennial review program's goal of having grantees consistently meet more federal requirements, the Secretary of Transportation should direct the FTA to ensure that additional outcome and quality performance measures are balanced with the existing measures for assessing the timeliness of the triennial review program so that one priority is not emphasized at the expense of others.

Agency: Department of Transportation
Status: Open

Comments: Federal Transit Administration (FTA) anticipates adding a performance measurement, called reduction in repeat findings, that relates to assessing the quality of the review. This has been added to FTA's new Quality Review program focused on improving its Triennial Review program.

Recommendation: To develop timely chemical risk information that EPA needs to effectively conduct its mission, the Administrator, EPA, should require the Office of Research and Development to re-evaluate its draft proposed changes to the IRIS assessment process in light of the issues raised in this report and ensure that any revised process periodically assesses the level of resources that should be dedicated to this significant program to meet user needs and maintain a viable IRIS database.

Agency: Environmental Protection Agency
Status: Open
Priority recommendation

Comments: As of February 2020, EPA officials indicated that the IRIS Program had almost completed internal review of a "Handbook for Developing IRIS Assessments," intended to guide staff through the sequential stages of the IRIS assessment process and ensure consistency across assessments. The Handbook, when finalized and used by staff, codifies the agency's effort to reevaluate their assessment process, but doesn't address the resources that should be dedicated to the IRIS Program. A workforce plan that includes both staff and budget resources consistent with user needs is necessary. As we reported in March 2019, the program has made strides utilizing project management software and project management techniques that enable the IRIS Program to better plan assessment schedules and utilize staff. However, we also reported in March 2019 that the President's budget requests since fiscal year 2018 have repeatedly cut the budget by as much as 40 percent for the Health and Environmental Risk Assessment (HERA) area, of which IRIS is a part. While these cuts were not enacted by Congress, the President's fiscal year 2021 budget request again cuts the HERA program by 34 percent, or approximately $12.7 million dollars. These cuts could have an impact on the IRIS program's ability to meet EPA program and regional office needs, if enacted by Congress.