GAO Reports
Here's a look at Government Accountability Office reports
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Quadrennial Homeland Security Review: Improvements Needed to Meet Statutory Requirements and Engage Stakeholders
WASHINGTON, May 7 (TNSrep) -- The Government Accountability Office issued the following report:
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Quadrennial Homeland Security Review: Improvements Needed to Meet Statutory Requirements and Engage Stakeholders
Fast Facts
The U.S. faces constantly-evolving threats--e.g., terrorism and cyberattacks. Every 4 years, the Department of Homeland Security must examine and, as needed, update the nation's homeland security strategy to ensure it's consistent with national and departmental plans and priorities.
DHS didn't meet legal requirements for the 2023 review. For example, the review's report
... Show Full Article
WASHINGTON, May 7 (TNSrep) -- The Government Accountability Office issued the following report:
* * *
Quadrennial Homeland Security Review: Improvements Needed to Meet Statutory Requirements and Engage Stakeholders
Fast Facts
The U.S. faces constantly-evolving threats--e.g., terrorism and cyberattacks. Every 4 years, the Department of Homeland Security must examine and, as needed, update the nation's homeland security strategy to ensure it's consistent with national and departmental plans and priorities.
DHS didn't meet legal requirements for the 2023 review. For example, the review's reportwas late. Also, stakeholders told us they weren't consulted before the report was drafted, if at all.
We recommended that DHS document its processes and procedures for the review to ensure it addresses all requirements--including timely reporting and engaging all stakeholders.
Highlights
What GAO Found
GAO found that the Department of Homeland Security (DHS) did not fully meet 10 of the 21 identified statutory requirements for the 2023 Quadrennial Homeland Security Review and accompanying report. Among other elements, DHS did not fully meet requirements for prioritizing missions, providing a budget plan to meet those missions, and issuing the report by the established time frame. For example, DHS was to issue the report every 4 years beginning in fiscal year 2009, however, DHS did not issue a report for 9 years following issuance of its 2014 report. As a result, DHS drafted a new strategic plan during that time without affirming the homeland security priority missions through the review. DHS officials could not explain why DHS did not fully meet the statutory requirements because there is limited documentation of the steps taken for conducting the review. The figure below depicts phases for conducting the review, but DHS documentation does not have details on the processes and procedures for conducting each phase. Developing and documenting processes and procedures for conducting the review could better position DHS to meet all statutory requirements and use timely information in planning its efforts to address constantly evolving homeland security threats.
Phases for Conducting the 2023 Quadrennial Homeland Security Review
GAO found that DHS has processes to use the report as a foundation for making annual resource decisions. Specifically, DHS has internal guidance for using it to inform its strategic plan and budget. However, the effectiveness of this guidance and use of the report depends on DHS issuing the report prior to its Strategic Plan. Not issuing the report on time could lead to a strategic plan that does not take into account the most recent homeland security environment. Additionally, DHS is statutorily required to consult with certain stakeholders, including other federal agencies and state agencies, when conducting the review. DHS states in its 2023 report that DHS's success in accomplishing its missions depends on partnerships with these stakeholders, but stakeholders GAO contacted said they generally do not use the report. Developing and documenting processes and procedures for engaging stakeholders may help ensure that DHS solicits and incorporates meaningful input from all stakeholders. It could also result in a better understanding of all stakeholders' roles and responsibilities in their partnerships with DHS.
Why GAO Did This Study
Homeland security threats continue to evolve and include challenges ranging from terrorist attacks to natural disasters. This situation underscores the need for DHS to periodically examine and strengthen the nation's homeland security strategy.
The Implementing Recommendations of the 9/11 Commission Act require that every 4 years DHS--in consultation with other stakeholders--conduct a Quadrennial Homeland Security Review, which is a comprehensive examination of the nation's homeland security strategy.
GAO was asked to assess DHS's 2023 review and report. This report assesses the extent to which (1) DHS met statutory requirements and (2) DHS and its stakeholders use the report to execute their homeland security roles.
GAO analyzed relevant statutes and documentation of the review and report. GAO also interviewed stakeholders, including representatives of eight DHS component agencies; three other federal agencies, such as the Department of Defense; and 11 external stakeholders, such as state agencies.
Recommendations
GAO recommends that DHS develop and document processes and procedures for (1) conducting the Quadrennial Homeland Security Review to ensure it meets all statutory requirements in future reviews and (2) engaging stakeholders, including when and how to engage stakeholders in the review. DHS concurred with our recommendations.
Recommendations for Executive Action
Agency Affected Recommendation Status
Department of Homeland Security The Secretary of Homeland Security should develop and document processes and procedures for conducting the QHSR to meet all statutory requirements, including those for (1) QHSR risk assessments and (2) required time frames. (Recommendation 1).
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Homeland Security The Secretary of Homeland Security should develop and document processes and procedures for engaging stakeholders, including when and how to engage stakeholders, in the QHSR. (Recommendation 2).
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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Original text here: https://www.gao.gov/products/gao-25-107269
Commuter Rail: Most Systems Struggling to Recover Ridership Following the COVID-19 Pandemic
WASHINGTON, May 7 (TNSrep) -- The Government Accountability Office issued the following report:
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Commuter Rail: Most Systems Struggling to Recover Ridership Following the COVID-19 Pandemic
Fast Facts
During the COVID-19 pandemic, many riders stopped using public transit. Commuter rail, an alternative to driving between suburbs and city centers, was hit particularly hard.
As of December 2024, a majority of the nation's 31 commuter rail systems were running at close to pre-pandemic levels. But most systems continued to face lower ridership and higher operating costs. Increases in federal
... Show Full Article
WASHINGTON, May 7 (TNSrep) -- The Government Accountability Office issued the following report:
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Commuter Rail: Most Systems Struggling to Recover Ridership Following the COVID-19 Pandemic
Fast Facts
During the COVID-19 pandemic, many riders stopped using public transit. Commuter rail, an alternative to driving between suburbs and city centers, was hit particularly hard.
As of December 2024, a majority of the nation's 31 commuter rail systems were running at close to pre-pandemic levels. But most systems continued to face lower ridership and higher operating costs. Increases in federalfunding since 2019 helped offset lower fare revenue.
Some commuter rail systems have tried to adapt, including by extending service hours. Some plan to seek other revenue sources--e.g., additional state or local funding--as COVID-19 relief funds run out.
Metrolink Rail Station at Union Station in Los Angeles, California
Highlights
What GAO Found
Commuter rail is a transit alternative to driving between suburban communities and city centers. Industry-wide data show that the nation's 31 commuter rail systems as a whole are providing service above pre-pandemic levels, but significant variation exists by system. GAO's analysis of data from the Department of Transportation (DOT) shows that service at 19 systems was near or above pre-pandemic levels from July through December 2024. However, service at five systems remains more than 25 percent below pre-pandemic levels, and service at the remaining seven systems varies between 8.5 and 23.7 percent below. DOT data also show that ridership for most systems continues to lag behind service levels, though substantial variation also exists. At six systems, ridership from July through December 2024 had recovered or nearly recovered from 2019 levels but were below 2019 levels for the remaining 25 systems. Officials from some of the 10 systems GAO interviewed identified ways they have adapted service to attract riders and better meet changing passenger needs. These adaptations include expanding operations beyond traditional commuting hours, offering free fares and flexible passes for certain passengers (e.g., youth passes), and strategically expanding and adapting service based on community needs and feedback.
Data from GAO's survey of commuter rail systems show that fare revenue from riders was 31 percent lower in fiscal year 2023 for all systems, compared to 2019. To help offset this reduction in fare revenue, commuter rail systems reported increases in the percentage of their total funding comprised of federal, local, or other sources. COVID-19 relief funding comprised a significant portion of the 2023 increase in federal funding (see figure). As of February 2025, officials from 15 of 22 systems that responded to GAO's request said they did not have any COVID-19 funding remaining.
Commuter Rail Systems' Total Funding by Source, Fiscal Years 2019, 2023
Note: Other funding can include funding from fees paid to use existing track, sale of assets, parking fees, or other sources.
The vast majority of systems also reported increased operating costs in fiscal year 2023 compared to 2019, with a 28 percent increase in nominal operating costs across all systems. According to officials GAO interviewed and GAO's analysis, inflation contributed substantially to the increase in costs. Beyond inflation, officials also said that labor and material costs contributed to higher operating costs, which are affecting systems' ability to plan and implement projects necessary for future operations.
Why GAO Did This Study
Roughly 5 years after the start of the COVID-19 pandemic, transit agencies report that it has significantly affected how individuals use and prioritize public transit in their daily activities. Many rail systems historically operated to serve passengers riding to and from city centers. Commuter rail was particularly affected by the pandemic and related increased telework. In response to the pandemic, Congress provided over $69 billion in relief funding to the transit industry. The federal public health emergency ended in 2023.
GAO was asked to provide an update to its 2021 report on the status of commuter rail systems' operations and funding. This report examines how, since the COVID-19 pandemic, (1) commuter rail service and ridership have changed; and (2) funding sources and operating costs for these systems have changed.
GAO analyzed DOT service and ridership data from January 2019 through December 2024 for the nation's 31 commuter rail systems. GAO also collected and analyzed funding and cost data for these systems for fiscal year 2023 using a web survey and compared these data to fiscal year 2019 data.
GAO also reviewed relevant federal statutes and guidance and interviewed DOT officials, industry association representatives, and a nongeneralizable sample of 10 transit agencies operating commuter rail systems. These agencies were selected based on ridership levels and whether the agencies offered multiple transit modes, among other things.
For more information, contact Andrew Von Ah at vonaha@gao.gov.
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Original text here: https://www.gao.gov/products/gao-25-107511
Highway Funding: Information on Variables for Potential New Formula Grant Programs
WASHINGTON, May 6 (TNSrep) -- The Government Accountability Office issued the following report:
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Highway Funding: Information on Variables for Potential New Formula Grant Programs
Fast Facts
Each year, the Department of Transportation distributes billions of dollars to Tribes, states, and localities to build and repair road infrastructure. Most of these funds are distributed by formula grant programs, which use variables to calculate how much money recipients receive.
As Congress develops new surface transportation legislation, it could create new formula programs. We surveyed current
... Show Full Article
WASHINGTON, May 6 (TNSrep) -- The Government Accountability Office issued the following report:
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Highway Funding: Information on Variables for Potential New Formula Grant Programs
Fast Facts
Each year, the Department of Transportation distributes billions of dollars to Tribes, states, and localities to build and repair road infrastructure. Most of these funds are distributed by formula grant programs, which use variables to calculate how much money recipients receive.
As Congress develops new surface transportation legislation, it could create new formula programs. We surveyed currentrecipients and others, who suggested multiple variables that Congress could consider using to distribute funding in potential formula programs.
These variables included bridge condition, vehicle miles traveled, and road fatality rates.
Highlights
What GAO Found
Each year, the federal government distributes billions in funding through federal highway formula grant programs (commonly referred to as formula programs) to Tribes and states to build highway infrastructure and for other purposes. These grants are distributed to recipients using statutory formulas and may be used to build and repair infrastructure and facilitate the movement of people and goods. GAO interviewed 31 selected highway program funding recipients, subrecipients, and stakeholders and then surveyed them to gauge their level of support for variables that could be used in formulas to distribute funding through potential new highway formula programs.
Most of the 28 survey respondents supported 27 variables that could be used to distribute funding for potential new programs. Almost all the supported variables related to infrastructure condition, freight movement and economic vitality, safety, and system reliability. Specifically, respondents supported variables such as total lane miles, vehicle miles traveled, and bridge condition. While selected funding recipients, subrecipients, and stakeholders identified and rated variables that could be used, they generally did not support creating new federal highway formula programs.
GAO found that federal data sources are available and can be used to measure 22 of the 27 supported variables. Most of the data are maintained by the Department of Transportation, primarily as part of its Transportation Performance Management program and the annual Highway Statistics Series. Of the five supported variables for which GAO did not identify a federal data source, agency officials noted privacy concerns or no requirement to collect such data, among other reasons for not collecting the data.
Photo of Interstate 5, Los Angeles, California
Why GAO Did This Study
The Infrastructure Investment and Jobs Act authorized and appropriated over $300 billion in funding for highway formula programs for fiscal years 2022 through 2026. As Congress deliberates about what to include in the next surface transportation authorization, it may create new formula programs, which it has done in some prior surface transportation authorizations.
GAO was asked about variables that could be used for potential new federal highway formula programs. This report describes: (1) the views of selected stakeholders with expertise and federal highway funding recipients on variables that could be used for potential new federal highway formula programs and (2) federal data that could measure these variables.
GAO reviewed applicable federal statutes and regulations, notices, and fact sheets to understand which variables are used to distribute funding under current highway formula programs. GAO used interviews and a survey to elicit views from selected federal highway funding recipients, subrecipients, and stakeholders. Specifically, GAO asked 31 interviewees to identify variables that could be used in formulas for potential new federal highway programs, and then surveyed them, receiving responses from 28 on their support for 96 suggested variables. GAO selected a non-generalizable mix of funding recipients, such as Tribes and state departments of transportation, based on their location. GAO also reviewed federal datasets and interviewed relevant agency officials to determine the availability of federal data to measure variables identified by interviewees.
For more information, contact Elizabeth Repko at repkoe@gao.gov.
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Original text here: https://www.gao.gov/products/gao-25-107097
Veterans' Community Care: VA Needs Improved Oversight of Behavioral Health Medical Records and Provider Training
WASHINGTON, May 5 (TNSrep) -- The Government Accountability Office issued the following report:
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Veterans' Community Care: VA Needs Improved Oversight of Behavioral Health Medical Records and Provider Training
Fast Facts
Medical providers at the VA can refer veterans to behavioral health providers outside VA for treatment of conditions like depression. These providers should send medical records back to VA after caring for a veteran. Such exchanges help ensure that a veteran receives coordinated care.
We found that VA doesn't monitor whether these records are sent back, and a significant
... Show Full Article
WASHINGTON, May 5 (TNSrep) -- The Government Accountability Office issued the following report:
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Veterans' Community Care: VA Needs Improved Oversight of Behavioral Health Medical Records and Provider Training
Fast Facts
Medical providers at the VA can refer veterans to behavioral health providers outside VA for treatment of conditions like depression. These providers should send medical records back to VA after caring for a veteran. Such exchanges help ensure that a veteran receives coordinated care.
We found that VA doesn't monitor whether these records are sent back, and a significantportion of the medical records were missing for the referrals we reviewed.
We recommended VA improve its monitoring of these exchanges, as well as whether these outside providers have taken training on treating veterans.
Highlights
Why This Matters
Increasingly, veterans seeking health care have been referred by Department of Veterans Affairs (VA) medical centers to community providers outside VA. The quality of the care those veterans receive can be affected by how successfully community and VA providers exchange medical records, as well as community providers' ability to understand the unique needs of veterans.
GAO Key Takeaways
Veterans used over 350,000 referrals to receive behavioral health services (e.g., psychotherapy for depression) from community providers in fiscal years 2021 through 2023. Many veterans who were cared for by community providers later returned to VA medical centers for further care. To coordinate this care, community providers must send medical documentation (e.g., diagnoses, prescriptions, progress notes) to VA after the veteran's initial and final visits for each referral.
VA does not monitor whether these medical record exchanges are completed across all medical centers. But we found that 33 percent of these referrals were missing records for initial visits, when we reviewed the data that VA has readily available. Further, no such data are available for final visits, so the extent to which those exchanges are completed is unknown.
Likewise, VA is not monitoring the extent to which community providers complete any of eight core trainings on opioid safety, suicide prevention, and other veteran-centric topics. We found that about 2 percent of the community providers with a behavioral health referral from fiscal years 2021 through 2023 had completed one or more of these trainings.
Medical Records for Behavioral Health Referrals, Fiscal Years 2021 Through 2023
How GAO Did This Study
We analyzed VA data on its behavioral health referrals from fiscal years 2021 through 2023 and community providers' completion of core trainings. We reviewed VA's medical record exchange guidance, and interviewed VA officials, staff from five VA medical centers, and representatives from three veteran service organizations.
Recommendations
We are making five recommendations to VA, including for it to establish goals and performance measures and monitor the extent to which medical documentation exchanges and core community provider trainings have been completed.
VA concurred with one recommendation and concurred in principle with the other four recommendations, as discussed in the report.
Recommendations for Executive Action
Agency Affected Recommendation Status
Veterans Health Administration The VHA Under Secretary for Health should ensure that IVC develops guidance for VA medical centers' efforts in obtaining final medical documentation after all visits provided to a veteran under each referral have been completed. (Recommendation 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The VHA Under Secretary for Health should ensure that IVC establishes goals and related performance measures for VA medical centers in obtaining initial and final medical documentation from community providers. (Recommendation 2)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The VHA Under Secretary for Health should ensure that IVC establishes a process for regularly using performance information for VA medical centers in obtaining initial and final medical documentation from community providers to assess its progress toward established goals. (Recommendation 3)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The VHA Under Secretary for Health should ensure that IVC establishes and monitors goals and related performance measures for community providers' completion of core trainings and ensures that community providers complete the required training course. (Recommendation 4)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The VHA Undersecretary for Health should direct IVC to take steps to ensure that it and its contractors communicate clear and accurate information to community providers regarding IVC's core trainings, including whether training is recommended or required. (Recommendation 5)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
See All 5 Recommendations
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Original text here: https://www.gao.gov/products/gao-25-106910
Nonprofit Drug Companies: Information on Funding, Drug Types, Challenges, and Reported Effect
WASHINGTON, May 1 (TNSrep) -- The Government Accountability Office issued the following report:
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Nonprofit Drug Companies: Information on Funding, Drug Types, Challenges, and Reported Effect
Fast Facts
Nonprofit drug companies in the U.S. aim to lower drug prices or ease shortages. They are supported by donations and revenue from sales and set their prices at a level to cover their expenses.
Three of the 7 companies we reviewed currently have products on the market, including surgical injections and a nasal spray to reverse drug overdoses. One uses long-term purchasing contracts with
... Show Full Article
WASHINGTON, May 1 (TNSrep) -- The Government Accountability Office issued the following report:
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Nonprofit Drug Companies: Information on Funding, Drug Types, Challenges, and Reported Effect
Fast Facts
Nonprofit drug companies in the U.S. aim to lower drug prices or ease shortages. They are supported by donations and revenue from sales and set their prices at a level to cover their expenses.
Three of the 7 companies we reviewed currently have products on the market, including surgical injections and a nasal spray to reverse drug overdoses. One uses long-term purchasing contracts withhospitals and a back-up supply to provide drugs that are in shortage.
Company representatives we spoke to said they had trouble finding large donations to fund their work and are concerned about their tax-exempt status.
Highlights
What GAO Found
Nonprofit drug companies have more recently emerged as an alternative model to for-profit drug companies. While both bring brand-name and generic drugs to market in the U.S., nonprofit drug companies do not focus on achieving certain profit margins, and their drug development efforts are funded in large part by donations, which are not taxed, unlike for-profit companies. In this report, GAO describes seven nonprofit drug companies.
* Five focused their missions on lowering drug prices or making drugs available for specific patients (such as uninsured women), or both. Two focused their missions on ensuring a steady supply of generic drugs.
* Three received funding only from their company founders to support their efforts, two received funding only from organizations, and two received funding from both sources.
* All three companies with drugs on the market--Civica, Medicines360, and Harm Reduction Therapeutics--received funding in the form of grants or loans from organizations to support their drug development and other related work. These organizations included hospitals, charitable organizations, and a for-profit drug company.
* The companies' current and planned drugs varied and included drugs with a variety of clinical uses.
Company representatives described challenges obtaining funding and expressed concerns about maintaining their tax-exempt status. Representatives from six companies described challenges obtaining enough funding for drug development. For example, representatives from one company described challenges obtaining enough funding from charitable organizations able to donate grants large enough to develop a drug, which the representatives attributed to the limited availability of large grants. Representatives from five companies expressed concerns about maintaining their tax-exempt status when using revenue from their drug sales to support their operations. One drug company reported a concern that revenue from its drug sales could be considered business income unrelated to the company's charitable purpose by the Internal Revenue Service (IRS) and thus taxable. IRS officials told GAO the agency has not taken a position on whether the sale of lower-priced drugs or the sale of drugs to specific patients, for example, serves a charitable purpose. Further, they told GAO that the agency has no set percentage or threshold amount of unrelated business taxable income that would result in the loss of an organization's tax-exempt status.
Representatives from the three companies with drugs on the market described the effect of their ongoing efforts. For example, one company sold a new drug-device combination product at a discounted price to certain hospitals and health centers, and another one provided a steadier supply of generic injectable drugs in shortage to hospitals compared to other manufacturers, according to representatives from the two companies. Representatives from some of the hospitals and the health center GAO spoke with generally agreed with the drug companies' assessments of their effect.
Why GAO Did This Study
In addition to rising drug prices, the U.S. has experienced ongoing drug shortages. Understanding the role that nonprofit drug companies could have in addressing these issues is an interest of Congress and researchers.
The Consolidated Appropriations Act, 2023, includes a provision for GAO to review what is known about nonprofit drug companies. This report describes (1) their missions, funding sources, and drug types; (2) challenges they reported; and (3) reported effect of their efforts.
GAO defined a nonprofit drug company as an entity that primarily operates to develop, manufacture, and distribute drugs for the U.S. market and that has a federal tax-exempt status. GAO identified seven companies that met its definition.
To describe their missions, drugs, challenges, and effect, GAO interviewed representatives from all seven companies and reviewed company documents and studies. GAO interviewed three hospitals, one distributor, and one health center that purchase drugs from the companies about their experiences. GAO selected them based on recommendations from nonprofit drug company representatives and research. GAO interviewed Department of the Treasury and IRS officials about a reported tax-exempt status challenge.
For more information, contact John Dicken at dickenj@gao.gov.
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Original text here: https://www.gao.gov/products/gao-25-107153
