A recent program honoring the 25th anniversary of a landmark case allowing women to enroll in the Virginia Military Institute (VMI) also celebrated a broader theme: Justice Ruth Bader Ginsburg’s decades-long effort to remove gender bias from state and federal laws.
The virtual program, co-sponsored by the U.S. Supreme Court Historical Society and the American College of Trial Lawyers, described the culmination of legal actions undertaken by Ginsburg when she was a lawyer for the American Civil Liberties Union (ACLU). The VMI case, and Ginsburg’s fight for women’s rights, also are featured in an article on the Women’s History Month page.
Speakers in the March 3 program about VMI included two lawyers who argued the Supreme Court case and two of Ginsburg’s former law clerks.
Justice Ginsburg “created an area of law virtually by herself and did it brilliantly,” said Paul Bender, a former U.S. deputy solicitor general who in 1996 successfully argued to allow women at VMI. “There’s probably more to be done, but she’s not around to do it anymore.”
Ginsburg, who died last year, recalled in a 2015 interview that “the law books of the country and the states were just riddled with gender-based classifications.” Many discriminatory laws, she said, were justified as protecting women.
In Reed v. Reed, a 1971 decision in which Ginsburg co-wrote the plaintiff’s brief, the Supreme Court for the first time ruled that a woman had been denied equal protection under the 14th Amendment because of her sex. A year later, she co-founded the ACLU Women’s Rights Project.
By 1980, when she joined the U.S. Court of Appeals for the District of Columbia Circuit, Ginsburg had argued six gender-bias cases before the Supreme Court. Gradually, the justices subjected discriminatory laws to increased levels of constitutional scrutiny.
During the anniversary event, Theodore Olson, who represented VMI, said he argued that an alternative women-only military program, the Virginia Women’s Institute for Leadership, was determined by some experts to offer “a better education in a single-sex environment.”
The Supreme Court voted 7-1 to end VMI’s male-only admission policy, and Ginsburg was assigned the role of drafting the opinion.
“The justice was thrilled to be able to draft this opinion for the court, after bringing case after case as a young advocate to establish gender equality before the high bench,” said Lisa Beattie Frelinghuysen, a law clerk under Ginsburg in 1996. “This was a very exciting opportunity for her.”
In her opinion, Ginsburg stated that VMI’s admission policy violated the 14th Amendment’s Equal Protection Clause.
“[G]eneralizations about ‘the way women are,’ estimates of what is appropriate for most women, no longer justify denying opportunity to women whose talent and capacity place them outside the average description,” Ginsburg wrote. “Such classifications may not be used, as they once were … to create or perpetuate the legal, social, and economic inferiority of women.”
With the VMI ruling, government-funded single-sex schools came to an end.
“It’s the capstone of her legacy on gender equality,” said Deborah Jones Merritt, an Ohio State University law professor who served as a law clerk for Ginsburg, while she was an appellate judge, and later for Justice Sandra Day O’Connor. “She knew that the two hardest hurdles for gender equality would be the military and single-sex education. In VMI, you really have the marriage of the two areas that were going to be the hardest to overcome.”
Ginsburg’s decades-long crusade for gender equality, and her elevation to the Supreme Court, mirrored the civil rights campaign for African Americans that climaxed with Brown v. Board of Education.
“She became the leading (and very successful) litigator on behalf of women’s rights—the Thurgood Marshall of that cause, so to speak,” wrote Justice Antonin Scalia, Ginsburg’s personal friend and the lone dissenter in the VMI case.
Frelinghuysen recalled that Ginsburg and she were invited to attend a program at VMI about 20 years after the landmark ruling.
“She did a talk at VMI, and we met with some of the first women cadets, as well as the current women cadets,” Frelinghuysen said. “She was very interested in how these cases actually affected the people involved in them. It was wonderful to … hear their gratitude, thanking her for opening the doors for them to pursue their dreams.”
- Army Corps of Engineers: Workforce Planning Follows Most Leading Practices but Could Be Enhanced with Additional ActionsBy Sam NewsDecember 10, 2021What GAO Found The U.S. Army Corps of Engineers (Corps) has a large civilian workforce that is highly specialized. The Corps faces workforce challenges, such as recruiting and retaining employees, due to competition from the private sector and other agencies. To address its civilian workforce challenges, the Corps implemented three successive strategic human capital plans during fiscal years 2010 through 2018. The most recent plan—developed in fiscal year 2017—addressed challenges in four stages: (1) planning, (2) recruiting, (3) developing, and (4) sustaining the workforce. For example, to address planning challenges, the Corps established an annual agency-wide assessment of workload-to-workforce capacity, competency, and balance. For fiscal year 2019, instead of developing a formal human capital plan, in late 2018, the Corps conducted an in-depth analysis of its workforce challenges that identified priority workforce initiatives and associated metrics for addressing these challenges. From fiscal year 2010 to fiscal year 2019, the Corps experienced changes to its workforce diversity, professional development, recruitment, and retention. For example, the percentage of employees identifying as Hispanic or Latino and White decreased from fiscal year 2010 to fiscal year 2019, while the percentage of employees identifying as Multiracial increased during the same period. Gender demographics remained the same each year, at 68 percent male employees and 32 percent female employees. Extent to Which the U.S. Army Corps of Engineers (Corps) Has Implemented Leading Practices for Strategic Workforce Planning Strategic workforce planning leading practice Implementation status Determine critical skills and competencies needed to achieve current and future programmatic results ● Develop workforce planning strategies designed to address gaps in critical skills and competencies ● Build administrative and other capabilities to support workforce planning strategies ● Monitor and evaluate progress toward human capital goals and programmatic results ● Involve top management, employees, and other stakeholders in strategic workforce planning ◒ Legend: Generally implemented ●; Partially implemented ◒ Source: GAO-04-39; GAO analysis of Corps documents and interviews.׀ GAO-22-104054 The Corps has generally implemented four of five leading practices of strategic workforce planning (see table). For example, the Corps generally implemented the leading practice of determining critical skills and competencies in part by conducting its annual agency-wide workforce assessment. However, the Corps only partially implemented the leading practice of involving top management in strategic workforce planning. Specifically, the Corps has not ensured that its top management set the overall direction and goals of workforce planning; top management has not updated the Corps' strategic human capital plan since fiscal year 2017. In May 2020, Corps officials told GAO that a draft updated plan was under review. However, as of October 2021, the plan had not yet been approved. By finalizing and distributing agency-wide an updated human capital plan, the Corps would be better positioned to address its capacity and preparedness challenges and manage its current and future workforce. Why GAO Did This Study The Corps' civilian workforce accounts for about 98 percent of its 35,000 civilian and military employees. According to Corps documentation, workforce challenges affect the agency's ability to maintain the capacity to meet mission requirements and preparedness to meet current and future challenges. GAO has identified strategic human capital management as a government-wide high-risk area, including the need to improve talent management activities. GAO was asked to review the Corps' civilian workforce. For fiscal year 2010 through 2019, this report (1) describes the Corps' activities and tools for addressing civilian workforce challenges, (2) describes changes in the Corps' civilian workforce, and (3) examines the extent to which the Corps has followed leading practices for strategic workforce planning. GAO reviewed the Corps' civilian workforce planning documents and interviewed officials in headquarters and field offices about their activities; analyzed Corps workforce data from the Defense Civilian Personnel Data System; and compared Corps workforce planning activities to leading practices identified by GAO.[Read More…]
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- Iraqi-U.S. Cost-Sharing: Iraq Has a Cumulative Budget Surplus, Offering the Potential for Further Cost-SharingBy Sam NewsAugust 25, 2021Since 2003, the United States has reported obligating $642 billion for U.S. military operations in Iraq and provided about $24 billion for training, equipment, and other services for Iraqi security forces. To assist Congress in overseeing efforts to encourage the Iraqi government to contribute more toward the cost of securing and stabilizing Iraq, this report provides information on (1) the amount and availability of Iraq's budget surplus or deficit, (2) the amount of Iraq's financial deposit balances, and (3) the extent to which Iraq has spent its financial resources on security costs. To conduct this audit, GAO analyzed Iraqi financial data, reviewed U.S. and Iraqi documents, and interviewed U.S. and Iraqi officials.GAO analysis of Iraqi government data showed that Iraq generated an estimated cumulative budget surplus of $52.1 billion through the end of 2009. This estimate is consistent with the method that Iraq uses to calculate its fiscal position. Adjusting for $40.3 billion in estimated outstanding advances as of September 2009 reduces the amount of available surplus funds to $11.8 billion. In April 2010, a senior Ministry of Finance official stated that advances should be deducted from the budget surplus because they are committed for future expenditures or have been paid out. According to this official and Board of Supreme Audit reports on Iraq's financial statements, advances include funds for letters of credit, advance payments on domestic contracts, and other advances. However, Iraq's Board of Supreme Audit has raised concerns that weaknesses in accounting for advances could result in the misappropriation of government funds and inaccurate reporting of expenditures. Furthermore, the composition of some of these advances is unclear; about 40 percent of the outstanding advances through 2008 are defined as "other temporary advances." Under the terms of a February 2010 International Monetary Fund (IMF) arrangement, Iraq agreed to prepare a report on its outstanding advances, which will identify those advances that are recoverable and could be used for future spending, and set a time schedule for their recovery. This Iraqi report is to be completed by September 30, 2010. Another means of assessing Iraq's fiscal position is to examine its financial deposit balances. Iraqi government data and an independent audit report show that, through the end of 2009, Iraq had accumulated between $15.3 billion and $32.2 billion in financial deposit balances held at the Central Bank of Iraq, the Development Fund for Iraq in New York, and state-owned banks in Iraq. This range reflects a discrepancy between the amount of government-sector deposits reported by the Central Bank of Iraq to the IMF and the amount that the Ministry of Finance asserts is available for government spending. In November 2009, the Ministry of Finance reclassified $16.9 billion in state-owned banks as belonging to state-owned enterprises and trusts, leaving $15.3 billion of $32.2 billion available to the Iraqi government for other spending. The IMF is seeking clarification on the amount of financial deposits that is available for government spending. Under the terms of Iraq's 2010 arrangement with the IMF, the Ministry of Finance is required to complete a review of all central government accounts and return any idle balances received from the budget to the central Iraqi Treasury by March 31, 2010. As of August 2010, according to the IMF, this review was still under way. Iraqi government data show that Iraq's security ministries--the Ministries of Defense and Interior--increased their spending from 2005 through 2009 and set aside about $5.5 billion for purchases through the U.S. Foreign Military Sales program. However, over this 5-year period, these ministries did not use between $2.5 billion and $5.2 billion of their budgeted funds that could have been used to address security needs. The administration is requesting $2 billion in additional U.S. funding in its fiscal year 2011 budget request to support the training and equipping of Iraq's military and police. GAO believes that Congress should consider Iraq's available financial resources when reviewing the administration's fiscal year 2011 budget request and any future funding requests for securing and stabilizing Iraq. Also, GAO recommends that the Departments of State and the Treasury work with the Iraqi government to further identify available resources.[Read More…]
- Man Sentenced to 151 Months in Prison for Knowingly Receiving Child Sexual Abuse Material Through Dark Web SitesBy Sam NewsSeptember 1, 2021An Illinois man was sentenced today in the Southern District of Illinois to 151 months, or 12 and a half years, in prison for knowingly receiving child sexual abuse material over the internet[Read More…]
- Virtual Currencies: Additional Information Could Improve Federal Agency Efforts to Counter Human and Drug TraffickingBy Sam NewsJanuary 10, 2022What GAO Found This is a public version of a sensitive report that GAO issued in September 2021. Therefore, this report omits sensitive information and data on selected federal agencies' activities to counter human and drug trafficking, associated use of virtual currency, and related challenges. Virtual currency is increasingly used illicitly to facilitate human and drug trafficking, according to GAO's review of agency documentation and data and interviews with officials. For example, the number of suspicious activity reports filed with the Financial Crimes Enforcement Network (FinCEN) that involve virtual currency and drug trafficking increased fivefold (from 252 to almost 1,432) from calendar year 2017 to 2020. However, in a sensitive version of this report, GAO found that data from selected federal agencies on virtual currency use for human and drug trafficking may not be consistently captured. Consequently, agencies may lack complete data when assessing or reporting on the illicit use of virtual currency in human and drug trafficking. In that report GAO made nine recommendations to selected agencies to enhance their data collection practices. Example of Virtual Currency Kiosk, Which May Be Used in Human and Drug Trafficking Selected federal agencies have taken actions to counter the illicit use of virtual currency in human and drug trafficking but face challenges. For example, FinCEN and the Internal Revenue Service (IRS) oversee virtual currency entities. FinCEN imposes requirements for operators of virtual currency kiosks that are used to exchange virtual currencies for cash and are found in various locations such as convenience stores (see fig.). While kiosk operators are required to register with FinCEN, they are not required to routinely report the specific locations of their kiosks. This limits federal agencies' ability to identify kiosks in areas that have been designated as high risk for financial crimes and could involve human and drug trafficking. Reviewing registration reporting requirements and taking appropriate action, as needed, to better identify individual kiosk locations by operator could help FinCEN and IRS identify high-risk kiosk operators to monitor for compliance, while also improving information law enforcement has available to identify potentially illicit transactions. Why GAO Did This Study Virtual currencies are an emerging payment method for transactions, such as retail purchases. Virtual currency's anonymizing features can attract criminals' use to avoid detection when paying for illicit activities, such as human and drug trafficking. Thus, policy makers, regulators, and law enforcement have identified virtual currency, human trafficking, and drug trafficking as priority areas of concern. GAO was asked to review the use of virtual currency to facilitate sex and drug trafficking. This report examines (1) the use of virtual currency for human and drug trafficking and the extent to which U.S. agencies collect data on these topics; and (2) the extent to which U.S. agencies have taken steps to counter human and drug trafficking facilitated by virtual currency and challenges these agencies face. GAO analyzed data, reviewed documentation, and interviewed relevant officials at selected federal agencies.[Read More…]
- Small Business Research Programs: Agencies Should Further Improve Award TimelinessBy Sam NewsOctober 14, 2021What GAO Found Most federal agencies that participate in the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs did not consistently issue timely awards to small businesses in fiscal year 2020. The Small Business Administration's (SBA) SBIR/STTR policy directive recommends that most agencies issue such awards within 180 days of the closing date of the solicitation. On the one hand, timeliness across agencies has improved since fiscal year 2017. Agencies issued 69 percent of awards within the recommended time that year, compared to 82 percent of awards that we reviewed for fiscal year 2020. On the other hand, only nine of the 29 participating agencies were consistently on time in fiscal year 2020, meaning they issued at least 90 percent of their awards within 180 days. This lack of timeliness dates back at least 5 years: 20 agencies were routinely late during that period, issuing fewer than 90 percent of their awards on time for 3 or more of the 5 fiscal years since 2016 (see figure). Total Number and Value of Late Awards Issued by Routinely Late Agencies Nearly all of the agencies that were routinely late in issuing awards to small businesses have taken some steps to address risks to the timeliness of their awards. Such risks included not having standardized proposal review procedures and a lack of dedicated staff to issue awards. Agencies have taken some steps to improve timeliness by, for example, streamlining proposal reviews and the award contracting process. However, they have not fully addressed risks they identified or evaluated steps already taken and may continue to issue late awards until they do so. Although the Department of Defense (DOD) has taken some steps to improve timeliness, it has not established a required pilot program. According to officials, DOD has not done so, in part, because it would be too difficult to standardize practices across the department. GAO found that 12 of the 13 DOD participating agencies are not consistently issuing timely awards to small businesses. Without addressing the pilot program requirements, or by not reporting to Congress if the requirements are infeasible, DOD may be missing an opportunity to obtain technologies more quickly, as well as sustain small businesses that can provide such technologies. Why GAO Did This Study SBIR and STTR participating agencies awarded over $3 billion to small businesses in fiscal year 2020 to develop and commercialize new technologies. Timely issuance of these awards can affect the speed with which small businesses receive funds and begin work, according to the SBA. SBA's SBIR/STTR policy directive provides time frames for notification and award issuance—90 days for award notification and 180 days for award issuance. The Fiscal Year 2019 National Defense Authorization Act (NDAA) included a provision for GAO to review the timeliness of award notification and issuance. The Fiscal Year 2021 NDAA conference report included a provision for GAO to review instances of agencies not following through with awards. This report, GAO's third, examines, among other things: (1) agencies' timeliness in notification and issuance, (2) the extent to which agencies have addressed risks to award timeliness, and (3) the extent to which DOD established a pilot program to improve timeliness. GAO analyzed SBIR and STTR award data, reviewed documentation, interviewed SBA officials, and sent a questionnaire to all 29 participating agencies and select small businesses.[Read More…]
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- Justice Department Files Lawsuit Against the State of Texas to Protect Voting RightsBy Sam NewsNovember 4, 2021The U.S. Justice Department announced today that it has filed a lawsuit against the State of Texas and the Texas Secretary of State over certain restrictive voting procedures imposed by Texas Senate Bill 1, which was signed into law in September 2021. The United States’ complaint challenges provisions of Senate Bill 1 under Section 208 of the Voting Rights Act and Section 101 of the Civil Rights Act of 1964.[Read More…]
- Statement of Attorney General Merrick B. Garland on World Elder Abuse Awareness DayBy Sam NewsJune 15, 2021U.S. Attorney General Merrick B. Garland today made the following statement in honor of World Elder Abuse Awareness Day:[Read More…]
- Texas Man Arrested for COVID-19 Relief SchemeBy Sam NewsDecember 14, 2021A Texas man was arrested today for allegedly fraudulently obtaining over $3.3 million in Paycheck Protection Program (PPP) loans guaranteed by the Small Business Administration (SBA) under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.[Read More…]
- Military Personnel: Perspectives on DOD’s and the Military Services’ Use of Borrowed Military PersonnelBy Sam NewsNovember 18, 2020Policies on the use of borrowed military personnel vary among military services. Borrowed military personnel refers to military personnel used for duties outside their assigned positions, such as security protection. DOD policy acknowledges that there may be instances in which military personnel can be used to appropriately satisfy a near-term demand but that DOD must be vigilant in ensuring that military personnel are not inappropriately utilized, particularly in a manner that may degrade readiness. Additionally, the Army and the Marine Corps have their own policies that describes how military personnel may be used on a temporary basis. DOD and the Army, Navy, and Air Force do not centrally track their use of borrowed military personnel, nor do they assess any impacts of that use on the readiness of units and personnel to accomplish their assigned missions. According to DOD and Army officials, the relatively limited use of borrowed military manpower, their limited impacts on readiness, and the existence of other readiness reporting mechanisms serve to obviate the need to collect and analyze this information centrally—especially given the resources that would be required to establish and maintain such a reporting process. The House Armed Services Committee has questioned whether DOD continues to divert servicemembers from their unit assignments to perform nonmilitary functions that could be performed by civilian employees. House Report 116-120, accompanying a bill for the National Defense Authorization Act for Fiscal Year 2020 included a provision for GAO to assess the levels and impacts of borrowed military personnel. This report examines DOD's and the military services' policies on the use of borrowed military personnel, the tracking and reporting of their use of borrowed military personnel, and any impacts of that use on readiness. For more information, contact Cary Russell at (202)512-5431 or RussellC@gao.gov.[Read More…]
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- Military Child Care: Off-Base Financial Assistance and Wait Lists for On-Base CareBy Sam NewsDecember 1, 2020The Department of Defense (DOD) has reviewed the financial assistance it provides for off-base child care services and taken steps to standardize this assistance across the military services. Specifically, in August 2018, representatives of each service agreed to work toward a goal of standardizing the only element of the fee assistance calculation that varies among the services—the maximum provider rate. DOD officials said that they assess progress toward this goal each year, but have not set a definite deadline for full standardization. With respect to assistance for off-base child care at high-cost duty stations, DOD's 2020 report on its child care programs states that the Air Force, Marines, and Navy review high-cost locations annually, and the services may approve increased provider rate caps for specific high-cost locations. In addition, it states that the services may grant waivers allowing increased fee assistance for individual families experiencing hardship. DOD has also assessed factors that contribute to wait lists for on-base child care. According to DOD’s report, DOD found that wait lists are the result of a myriad of factors, including staff shortages and facility conditions that vary across service locations. Officials said DOD has worked for several years to analyze and address wait lists. In 2017, DOD launched a web portal that consolidates child care data across the services and in August 2019, DOD officials began monthly monitoring of wait list data from this portal. These data allowed DOD to identify four geographic regions and six additional locations that account for the majority of wait lists, and focus their efforts on addressing the issues affecting these regions and locations, according to the report. DOD officials said that any requests for additional resources to help address wait lists must be handled through the individual services’ budgeting processes. DOD offers child care in a variety of on- and off-base settings for children of military families. In fiscal year 2020 these child care programs received nearly $1.2 billion in federal funds; in addition, parents pay a portion of the costs. The National Defense Authorization Act for Fiscal Year 2020 required DOD to report on elements of its financial assistance to off-base child care providers and wait lists for on-base child care, and included a provision for GAO to review DOD's report. This report describes DOD's assessment of (1) financial assistance provided to off-base child care providers, and (2) its efforts to reduce wait lists for child care at military bases. GAO reviewed DOD's report on this assessment, interviewed DOD officials, and reviewed relevant federal law. For more information, contact Kathryn A. Larin at (202) 512-7215 or email@example.com.[Read More…]
- Aircraft Noise: Better Information Sharing Could Improve Responses to Washington, D.C. Area Helicopter Noise ConcernsBy Sam NewsJanuary 7, 2021According to Federal Aviation Administration (FAA) data for 2017 through 2019, over 50 helicopter operators conducted approximately 88,000 helicopter flights within 30 miles of Ronald Reagan Washington National Airport (D.C. area), though limited data on noise from these flights exist. According to operators, these flights supported various missions (see table below). While the number of flights has decreased slightly over the 3 years reviewed, it is unknown whether there has been a change in helicopter noise in the area. For example, most stakeholders do not collect noise data, and existing studies of helicopter noise in the area are limited. D.C. area airspace constraints—such as lower maximum altitudes near urban areas—combined with proximity to frequently traveled helicopter routes and operational factors may affect the noise heard by residents. Federal Aviation Administration (FAA)-Reported Helicopter Flights Conducted in the Washington, D.C. Area by Operator Mission, 2017–2019 Operator mission Number of flights Military 32,890 (37.4 percent) Air medical 18,322 (20.9 percent) Other aviation activity 13,977 (15.9 percent)a State and local law enforcement 12,861 (14.6 percent) Federal law enforcement and emergency support 5,497 (6.3 percent) News 4,298 (4.9 percent) Source: GAO analysis of FAA data. | GAO-21-200 Note: In this table, we refer to the Washington, D.C. area as including the area within 30 miles of Ronald Reagan Washington National Airport. aIncludes 666 flights for which FAA could not identify an operator or mission based on available historical records. FAA and operators reported taking steps to address public concerns about helicopter noise in the D.C. area. FAA receives and responds to complaints on helicopter noise from the public through its Noise Ombudsman and has recently developed online forms that improve FAA's ability to identify and respond to helicopter noise issues. Operators reported using FAA-recommended practices, such as flying at maximum altitudes and limiting night flights, to address helicopter noise in the D.C. area, but such practices are likely not feasible for operators with military, law enforcement, or air medical evacuation missions. FAA's and operators' approach to addressing these issues in the D.C. area is impeded because they do not consistently or fully share the information needed to do so. According to nearly all the operators we interviewed, FAA has not communicated with operators about helicopter noise or forwarded complaints to them. Similarly, operators often receive noise complaints from the public—some complaints are not directed to the correct operator—but do not typically share these complaints with FAA. As a result, operators have not consistently responded to residents' inquiries about helicopter noise and activity. By developing a mechanism for FAA and operators to share information, FAA could help improve responses to individual helicopter noise concerns and determine what additional strategies, if any, are needed to further address helicopter noise. Helicopter noise can potentially expose members of the public to a variety of negative effects, ranging from annoyance to more serious medical issues. FAA is responsible for managing navigable U.S. airspace and regulating noise from civil helicopter operations. Residents of the D.C. area have raised concerns about the number of helicopter flights and the resulting noise. GAO was asked to review issues related to helicopter flights and noise within the D.C. area. Among its objectives, this report examines: (1) what is known about helicopter flights and noise from flights in the D.C. area, and (2) the extent to which FAA and helicopter operators have taken action to address helicopter noise in the D.C. area. GAO reviewed statutes, regulations, policies, and documents on helicopter noise. GAO analyzed (1) available data on helicopter operations and noise in the D.C. area for 2017 through 2019, and (2) FAA's approach to responding to helicopter complaints. GAO also interviewed FAA officials; representatives from 18 D.C. area helicopter operators, selected based on operator type and number of flights; and 10 local communities, selected based on factors including geography and stakeholder recommendations. GAO recommends that FAA develop a mechanism to exchange helicopter noise information with operators in the D.C. area. FAA agreed with GAO's recommendation. For more information, contact Heather Krause at (202) 512-2834 or KrauseH@gao.gov.[Read More…]
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- Medicaid Long-Term Services and Supports: Access and Quality Problems in Managed Care Demand Improved OversightBy Sam NewsDecember 16, 2020At the state and federal levels, GAO found weaknesses in the oversight of Medicaid managed long-term services and supports (MLTSS), which assist individuals with basic needs like bathing or eating. Through various monitoring approaches, six selected states identified significant problems in their MLTSS programs with managed care organization (MCO) performance of care management, which includes assessing beneficiary needs, authorizing services, and monitoring service provision to ensure quality and access to care. State efforts may not be identifying all care management problems due to limitations in the information they use to monitor MCOs, allowing some performance problems to continue over multiple years. Performance Problems in Managed Care Organization (MCO) Care Management, Identified by Selected States GAO found that the Centers for Medicare & Medicaid Services' (CMS) oversight of state implementation of its 2016 requirements, and of access and quality in MLTSS more broadly, was limited. This hinders the agency's ability to hold states and MCOs accountable for quality and access problems beneficiaries may face. Oversight did not detect quality and access problems. GAO identified cases where CMS learned about problems not through its regular oversight, but instead from beneficiary complaints, media reports, or GAO. CMS officials said that states had not reported these problems to the agency. Lack of national oversight strategy and assessment of problems in MLTSS. Weaknesses in oversight reflect a broader area of concern—namely, that CMS lacks a strategy for oversight. CMS also has not assessed the nature and extent of access and quality problems across states. Without a strategy and more robust information, CMS risks being unable to identify and help address problems facing beneficiaries. As of July 2020, CMS had convened a new workgroup focused on MLTSS oversight, though the goals and time frames for its work were unclear. An increasing number of states are using managed care to deliver long-term services and supports in their Medicaid programs, thus delegating decisions around the amounts and types of care beneficiaries receive to MCOs. Federal guidance requires that MLTSS programs include monitoring procedures to ensure the appropriateness of those decisions for this complex population, which includes adults and children who may have physical, cognitive, and mental disabilities. GAO was asked to review care management in MLTSS programs. Among other things, this report examines state monitoring of care management, and CMS oversight of state implementation of 2016 requirements related to MLTSS quality and access. GAO examined documentation of monitoring procedures and problems identified in six states selected for variation in program age and location. GAO reviewed federal regulations and oversight documents, interviewed state and federal Medicaid officials, and assessed CMS's policies and procedures against federal internal control standards. GAO is making two recommendations to CMS to (1) develop a national strategy for overseeing MLTSS, and (2) assess the nature and prevalence of MLTSS quality and access problems across states. CMS did not concur with the recommendations. GAO maintains the recommendations are warranted, as discussed in this report. For more information, contact at (202) 512-7114 or firstname.lastname@example.org.[Read More…]
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