Reports & Testimonies

Community health centers provide outpatient health care in places where there aren't enough doctors or hospitals. In 2021, health centers served over 30 million people, regardless of their ability to pay. We testified on our prior work in this area. Health centers received $15.8 billion in grants from the federal Community Health Center Fund in FYs 2011-2017, with most of the funds paying for their...

Cybercrimes—such as online identity theft, credit card fraud, and ransomware attacks—are multiplying in frequency and scale around the globe. The Departments of State, Justice, and Homeland Security are working with foreign nations to help combat these technology-driven crimes. Collaboration activities include information sharing with foreign partners on current threats and providing cyber training to foreign law enforcement. But as the lead agency responsible for foreign...

The National Institute of Standards and Technology faces major challenges recruiting and retaining its highly specialized scientific and technical workforce. Such challenges include a dwindling candidate pool and difficulty recruiting a diverse workforce. In a previous report, we identified effective workforce planning strategies to aid recruiting and retention. NIST has partially implemented many of the best practices we identified, such as using incentive payments and...

There's still a lot of work to do to modernize the financial management systems at FEMA, Immigration and Customs Enforcement (ICE), and the Coast Guard within the Department of Homeland Security. FEMA and ICE are in the planning phases of their modernization efforts. The Coast Guard has begun using a new financial management system—part of a larger $510 million modernization effort—but it's not working as...

The federal government has provided about $4.6 trillion to help the nation respond to and recover from the COVID-19 pandemic. As part of our ongoing and comprehensive review of this response and recovery, we regularly report on federal COVID-19 spending. This snapshot updates the status of COVID-19 funding that we discussed in a prior testimony, and includes spent funds, funds that remain available, and more...

Incidents of domestic terrorism increased by 357% between 2013 and 2021. The FBI and the Department of Homeland Security are charged with collaborating to prevent domestic threats. Although they work together to counter threats, the agencies may need to update their current agreements to specify how they should collaborate to better address the constantly evolving threat of domestic terrorism. In addition, neither agency regularly assesses...

As part of our comprehensive look at the events of January 6, 2021, we examined how federal agencies identified potential threats, and how they used this information to prepare for and respond to the Capitol attack. We found that all 10 federal agencies that we examined identified potential threats of violence before January 6, but some agencies either didn't follow their established policies or procedures...

The nation's veterans and their families rely on Veterans Affairs for health care and disability benefits. We testified on our body of work covering VA's longstanding challenges in: Ensuring that veterans get the health care they need Managing supply chains and VA's acquisition workforce to ensure VA medical centers get needed medical supplies Administering disability benefits to ensure that veterans get appropriate, timely compensation Securing...

In 2010, the Office of Management and Budget began an effort to reduce the number of duplicative or outdated federal data centers. Legislation and other OMB efforts have followed. Our progress review found: Agencies closed 58 data centers in FY 2021 Agencies expected to close 78 centers in FY 2022 22 of 24 agencies met their savings goals for FY 2021, identifying $612 million in...

The federal government needs a highly skilled and specialized workforce to carry out many of its missions, including cybersecurity or acquisitions. Federal agencies look to the Office of Personnel Management for guidance on closing gaps in the skills and experience of their workforces. But OPM has similar gaps of its own that could prevent it from helping other agencies. OPM has taken steps to address...

The Federal Bureau of Prisons is responsible for the custody and care of inmates in its facilities. As inmates reenter society, some face challenges such as getting IDs or accessing health care. Federal law requires the Bureau to create procedures to help inmates apply for federal and state benefits—like Medicaid—when they are released. But the Bureau hasn't assessed whether its health care reentry policies and...

According to IRS estimates, taxpayers—people and businesses—collectively pay about 85% of the total taxes they owe. The difference between what taxpayers owe and what they pay on time is known as the tax gap, which IRS estimated to be $496 billion per year for tax years 2014-2016. In this snapshot, we identify factors—such as the complexity of tax laws—that contribute to the gap. We also...

Employers that hold a special certificate from the Department of Labor can pay people with disabilities wages below the federal minimum wage. We found that about 120,000 workers were employed under these certificates, with half earning less than $3.50 an hour. DOL oversees the certificate program, in part, by reviewing employers' applications and ensuring that they pay workers the correct wages. However, DOL has no...

The Veterans Health Administration provides health care services for more than 9 million veterans. During the COVID-19 pandemic, VHA found itself short-handed and needed to hire more clinical staff—such as doctors and nurses—quickly. VHA modified its hiring practices to allow new clinical staff to start work before finishing some time-consuming tasks like fingerprint checks and physical exams. But VHA's main hiring system doesn't accurately track...

In 2016, Congress set deadlines for the Environmental Protection Agency to review health and environmental impacts of certain chemicals already in use, starting initially with 10 chemicals. It also required EPA to determine the safety of certain new chemicals before they can be manufactured. We found that EPA: Missed most deadlines for reviews of existing chemicals since 2016 Typically met the deadline less than 10%...

The Veterans Health Administration provides health care to over 9 million veterans. It is responsible for ensuring that its providers are qualified, competent, and suitable to provide care. The Drug Enforcement Administration requires VHA medical centers to get a waiver before employing anyone with a controlled substance-related felony conviction whose job gives them access to such substances. But VHA doesn't have a waiver policy and...

Charter schools are publicly-funded schools that are governed by independent organizations. The Department of Education awards "Charter Schools Program" grants to help open or expand charter schools across the nation. We reviewed charter schools that received funds from these grants between 2006-2020. The schools generally had higher student enrollment growth compared to similar charter schools that did not receive a grant. We also found that...

The Department of Education gives grants to schools and organizations to help disadvantaged students—including students with disabilities—prepare for, enroll in, and graduate from college. The Student Support Services program is its only college access program whose target population specifically includes students with disabilities. But Education does not collect complete information about the disability status of the students helped through the program. As a result, it...

The U.S. Department of Agriculture offers subsidized crop insurance to protect farmers from financial losses, such as from poor harvests and declines in market prices. This snapshot identifies changes Congress could make to the program to reduce its costs. We have previously suggested that Congress: Reduce subsidies to high-income participants by creating an income limit Adjust compensation to insurance companies to better align with market...

Institutional Review Boards (IRBs) assess the ethics and safety of research studies involving human subjects, such as behavioral studies or clinical trials for new drugs or medical devices. Health and Human Services oversees about 2,300 U.S.-based IRBs through routine or for-cause inspections to assess if they are following federal laws when reviewing research. But few IRBs are inspected. For example, one HHS agency aims to...