December 3, 2021

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Readout of Meeting between U.S. Deputy Attorney General Lisa O. Monaco and United Kingdom Home Secretary Priti Patel

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<div>Deputy Attorney General Lisa Monaco of the U.S. Department of Justice, together with colleagues from the National Security Division and the Criminal Division, met yesterday with UK Home Secretary Priti Patel in Washington, DC, to further strengthen law enforcement and national security cooperation.</div>
Deputy Attorney General Lisa Monaco of the U.S. Department of Justice, together with colleagues from the National Security Division and the Criminal Division, met yesterday with UK Home Secretary Priti Patel in Washington, DC, to further strengthen law enforcement and national security cooperation.

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  • Maternal Mortality and Morbidity: Additional Efforts Needed to Assess Program Data for Rural and Underserved Areas
    In U.S GAO News
    What GAO Found Nationwide data from the Centers for Disease Control and Prevention's (CDC) Pregnancy Mortality Surveillance System from 2011-2016, the most recent data available at the time of GAO's review, indicate that deaths during pregnancy or up to 1 year postpartum due to pregnancy-related causes—are higher in rural areas compared to metropolitan areas. See figure. CDC data also showed higher mortality in underserved areas (areas with lower numbers of certain health care providers per capita). Pregnancy-Related Mortality Ratios in Rural and Metropolitan Areas, 2011-2016 Note: Micropolitan areas include counties with populations of 2,500 to 49,999. Noncore areas include nonmetropolitan counties that do not qualify as micropolitan. GAO also analyzed the most recent annual data available from the Agency for Healthcare Research and Quality for 2016-2018 on severe maternal morbidity (SMM)—unexpected outcomes of labor and delivery resulting in significant health consequences. Nationwide, these data showed higher estimated rates of SMM in metropolitan areas (72.6 per 10,000 delivery hospitalizations) compared to rural areas (62.9 per 10,000). CDC and another Department of Health and Human Services (HHS) agency, the Health Resources and Services Administration (HRSA), fund several maternal health programs that aim to reduce maternal mortality and SMM, including some that target rural or underserved areas. CDC and HRSA collect program data, such as the percentage of women who received postpartum visits, to track progress in improving maternal health, but they do not systematically disaggregate and analyze program data by rural and underserved areas. By taking these actions, CDC and HRSA could help better ensure that program funding is being used to help address any needs in these areas. HHS has taken actions to improve maternal health through its funding of various programs and releasing an action plan in 2020. HHS also has two workgroups that aim to coordinate across HHS agencies on maternal health efforts, such as program activities that aim to reduce maternal mortality and SMM. Officials from HHS's two workgroups said they coordinated in developing the action plan, but they do not have a formal relationship established to ensure ongoing coordination. Officials from one of the workgroups noted that they often have competing priorities and do not always coordinate their efforts. By more formally coordinating their efforts, HHS's workgroups may be in a better position to identify opportunities to achieve HHS's action plan goal for reducing maternal mortality and objectives that target rural and underserved areas. Why GAO Did This Study Each year in the United States, hundreds of women die from pregnancy-related causes, and thousands more experience SMM. Research suggests there is a greater risk of maternal mortality and SMM among rural residents and that underserved areas may lack needed health services. GAO was asked to review maternal mortality and SMM outcomes in rural and underserved areas. This report examines, among other objectives, what is known about these outcomes; selected CDC and HRSA programs that aim to reduce these outcomes, as well as actions to collect and use relevant data; and the extent to which HHS is taking actions to improve maternal health and monitoring progress on its efforts. GAO analyzed HHS data, agency documentation, literature, and interviewed officials from a non-generalizable sample of three states and stakeholders to capture various perspectives.
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  • VA Health Care: Budget Formulation and Reporting on Budget Execution Need Improvement
    In U.S GAO News
    The Department of Veterans Affairs (VA) estimates it will serve 5.4 million patients in fiscal year 2006. Medical services for these patients are funded with appropriations, after consideration by Congress of the President's budget request. VA formulates the medical programs portion of that request. VA is also responsible for budget execution--using appropriations and monitoring their use for providing care. For fiscal years 2005 and 2006, the President requested additional funding for VA medical programs, beyond what had been originally requested. GAO was asked to examine for fiscal years 2005 and 2006 (1) how the President's budget requests for VA medical programs were formulated, (2) how VA monitored and reported to Congress on its budget execution, and (3) which key factors in the budget formulation process contributed to requests for additional funding. To do this, GAO analyzed budget documents and interviewed VA and Office of Management and Budget (OMB) officials.The formulation of the President's budget requests for VA medical programs for fiscal years 2005 and 2006 was informed by VA's comparison of its cost estimate of projected demand for medical services to its anticipated resources. VA projected about 86 percent of its costs using an actuarial model that estimated veterans' demand for health care. To project the costs of long-term care (about 10 percent of the funds for VA medical programs in each of these years) and the remaining medical care costs (about 4 percent), separate estimation approaches were used that did not rely upon an actuarial model but used other methods instead. The agency anticipated resources based on prior year appropriations, guidance from OMB, and other factors. For both fiscal years, VA officials told GAO that projected costs--calculated from the actuarial model and other approaches--exceeded anticipated resources and that they addressed the difference in budget requests for those years with cost-saving policy proposals and management efficiencies. Although VA staff closely monitored budget execution and identified problems for fiscal years 2005 and 2006, VA did not report this information to Congress in a sufficiently informative manner. VA closely monitored the fiscal year 2005 budget as early as October 2004, anticipating challenges managing within its resources. However, Congress did not learn of these challenges until April 2005. VA initially planned to manage within its budget for fiscal year 2005 by delaying some spending on equipment and nonrecurring maintenance and drawing on funds it had planned to carry over into 2006. Instead, the President requested additional funds from Congress for both fiscal years 2005 (a $975 million supplemental appropriation in June 2005) and 2006 (a budget amendment of $1.977 billion in July 2005). Congress included in the 2006 appropriations act a requirement for VA to submit quarterly reports regarding the medical programs budget status during this fiscal year. These reports have not included some of the measures that would be useful for congressional oversight, such as patient workload measures to capture costs and the time required for new patients to be scheduled for their first primary care appointment. Unrealistic assumptions, errors in estimation, and insufficient data were key factors in VA's budget formulation process that contributed to the requests for additional funding for fiscal years 2005 and 2006. Unrealistic assumptions about how quickly cost savings could be realized from proposed nursing home policy changes contributed to the additional requests, as did computation errors measuring the estimated effect of one of these changes. Insufficient data in VA's initial budget projections also contributed to the additional funding requests. For example, VA underestimated the cost of serving veterans returning from Iraq and Afghanistan, in part because estimates for fiscal year 2005 were based on data that largely predated the Iraq conflict and because according to VA, the agency had challenges for fiscal year 2006 in obtaining data from the Department of Defense.
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  • Stabilizing Iraq: Factors Impeding the Development of Capable Iraqi Security Forces
    In U.S GAO News
    The National Strategy for Victory in Iraq articulates the desired end-state for U.S. operations in Iraq: a peaceful, united, stable, and secure Iraq, well integrated into the international community, and a full partner in the global war on terrorism. Developing capable Iraqi security forces is a critical component in U.S. efforts to achieve this important goal. Since 2003, the United States has provided $15.4 billion to develop Iraqi military and police forces. DOD has also asked for an additional $5.8 billion in its fiscal year 2007 supplemental request and fiscal year 2008 Global War on Terror budget request to continue U.S. efforts to develop Iraq forces and transition security responsibilities to them. This testimony discusses the (1) results of U.S. efforts to develop Iraqi security forces, and (2) factors that affect the development of effective Iraqi security forces. This testimony is based on GAO's issued reports and ongoing work on U.S. efforts to stabilize Iraq. Although we reviewed both classified and unclassified documents, the information in this statement is based only on unclassified documents.As of February 2007, DOD reported that it had trained and equipped 327,000 Iraqi security forces--a substantial increase from the 142,000 reported in March 2005. The Iraqi security force level is double that of the 153,000-strong U.S.-led coalition currently in Iraq. While the Iraqi security forces are increasingly leading counterinsurgency operations in Iraq, they and the coalition have been unable to reduce the levels of violence throughout Iraq. Enemy-initiated attacks per day have increased from about 70 in January 2006 to about 160 in December 2006. Several factors affect the development of effective Iraqi security forces and help explain why the reported growth in Iraqi security forces has not decreased violence. First, the Iraqi security forces are not a single unified force with a primary mission of countering the insurgency in Iraq. About 40 percent of the Iraqi security forces have a primary mission of counterinsurgency--specifically, the Iraqi army. The other major component--the Iraqi police--has civilian law enforcement as its primary mission. Second, high rates of absenteeism and poor ministry reporting result in an overstatement of the number of Iraqi security forces present for duty. The Ministry of the Interior does not maintain standardized reports on personnel strength. As a result, DOD does not know how many coalition-trained police the ministry still employs or what percentage of the 180,000 police thought to be on the payroll are coalition trained and equipped. Third, sectarian and militia influences have divided the loyalties of Iraqi security forces. In November 2006, for example, the Director of the Defense Intelligence Agency stated that the Ministry of Interior and the police were heavily infiltrated by militia members of the Badr Organization and Mahdi Army. According to the 2007 National Intelligence Estimate on Iraq, sectarian divisions have eroded the dependability of many Iraqi army units. Fourth, as we previously reported, Iraqi units remain dependent upon the coalition for their logistical, command and control, and intelligence capabilities. As of December 2006, the coalition was providing significant levels of support to the Iraqi military, including fuel and ammunition. The extent of these problems cannot be fully assessed without detailed information on the readiness of each Iraqi unit. While DOD captures this information in its Transition Readiness Assessments (TRAs), it does not provide this critical information to Congress. These data provide information on capabilities and gaps in Iraqi units' manpower, equipment, and training levels, and as of late 2006, assess each unit's operational effectiveness. Congress needs this information to make informed appropriations decisions and engage in meaningful oversight. Despite repeated attempts over many months, we have yet to be provided the TRA information we are seeking.
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  • Veterans Health Care: Agency Efforts to Provide and Study Prosthetics for Small but Growing Female Veteran Population
    In U.S GAO News
    The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) provides veterans with prosthetic services to assist with their mobility, vision, and hearing needs. The proportion of prosthetics VHA provided to female veterans has been small compared to the share provided to male veterans. However, in fiscal years 2015 to 2019, this proportion grew from 6.8 percent to 7.9 percent and accounted for about $889.1 million of the $15.4 billion total cost of prosthetics. Artificial limbs comprised a relatively small number of the total prosthetics VHA provided to veterans in fiscal years 2015 to 2019; however, veterans who use artificial limbs have complex needs and are significant users of health care services. VHA provided prosthetic services to a small but growing female veteran amputee population (almost 3 percent of veteran amputees in fiscal year 2019), who were generally younger than male veteran amputees. VHA has established an individualized patient care approach in its Amputation System of Care that seeks to address the prosthetic needs of each veteran, including accounting for gender-specific factors. VHA officials said that using a standardized, multidisciplinary approach across VA medical facilities also helps them incorporate the concerns and preferences of female veterans. For example, veterans are provided care by a team that includes a physician, therapist, prosthetist (clinician who helps evaluate prosthetic needs and then designs, fabricates, fits, and adjusts artificial limbs), and other providers as needed. Female veteran amputees GAO spoke with at one VA medical facility said they were satisfied with their VHA care. They also noted a lack of commercially available prosthetic options that VHA providers can use to meet women's needs. Examples of Female Veterans' Artificial Limb Prosthetics Women are generally studied less than their male counterparts in prosthetic and amputee rehabilitation research. VHA designated prosthetics for female veterans a national research priority in 2017, and has funded eight related studies as of May 2020: four pertain to lower limb amputation, three pertain to upper limb amputation, and one pertains to wheelchairs. VHA officials noted the importance of this research priority and the ongoing challenge of recruiting study participants due to the small female veteran population. VHA researchers said they employ various tactics to address this challenge, such as using multi-site studies and recruiting participants from the non-veteran population. Women are the fastest growing veteran subpopulation, with the number of female veterans using VHA health care services increasing 29 percent from 2014 to 2019. Female veterans accounted for an estimated 10 percent of the total veteran population in fiscal year 2019. They are eligible to receive a full range of VHA health care services, including obtaining prosthetics. House Report 115-188 included a provision for GAO to review VHA's prosthetic services for female veterans. This report examines 1) trends in prosthetics provided by VHA to female veterans; 2) characteristics of the female veteran population with limb loss and how VHA provides prosthetic services to these veterans through its Amputation System of Care; and 3) VHA's research efforts and the challenges that exist in studying prosthetics for female veterans with limb loss. GAO analyzed VHA documents, as well as data from fiscal years 2015 to 2019 on prosthetics and veterans with amputations. GAO interviewed agency officials from VHA central office and officials and female veteran amputees at two VA medical facilities selected for expertise in amputation care and prosthetics research activities. In addition, GAO interviewed VHA researchers conducting studies on prosthetics for female veterans. GAO provided a draft of this report to VA. VA provided general and technical comments, which were incorporated as appropriate. For more information, contact Jessica Farb at (202) 512-7114 or farbj@gao.gov.
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    In Space
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  • Congress Urged to Adopt Judicial Security Measures
    In U.S Courts
    Citing the recent fatal attack at the home of a federal judge in New Jersey and increasing threats against federal judges, the Judiciary has asked Congress to enact a package of safety measures that would improve security at judges’ homes and at federal courthouses.
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  • Mississippi Prison’s Deputy Warden Charged with Civil Rights Offense for Beating Inmate
    In Crime News
    The Justice Department announced yesterday that a federal grand jury indicted Melvin Hilson, 49, currently a deputy warden at the Mississippi State Penitentiary, for repeatedly striking an inmate and knocking him to the ground, resulting in injury to the inmate.
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  • Louisiana Doctor Indicted for Illegally Dispensing Over One Million Doses of Opioids and for $5.1 Million Health Care Fraud Scheme
    In Crime News
    A federal grand jury in New Orleans, Louisiana, returned an indictment today charging a Louisiana physician for his role in distributing over 1,200,000 doses of Schedule II controlled substances, including oxycodone and morphine, outside the scope of professional practice and not for a legitimate medical purpose, and for maintaining his clinic for the purpose of illegally distributing controlled substances. Today’s indictment also charges the physician with defrauding health care benefit programs, including Medicare, Medicaid, and Blue Cross and Blue Shield of Louisiana, of more than $5,100,000, given that the opioid prescriptions were filled using health insurance benefits.
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  • Joint Press Statement by U.S. Attorney General Merrick Garland and European Commissioner for Justice Didier Reynders
    In Crime News
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  • The United States Takes Actions Against Supporters of the Illegitimate Maduro Regime’s Fraudulent Elections
    In Crime Control and Security News
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  • Company President and Employee Arrested in Alleged Scheme to Violate the Export Control Reform Act
    In Crime News
    Assistant Attorney General for National Security John C. Demers, Audrey Strauss, the Acting U.S. Attorney for the Southern District of New York, and Jonathan Carson, Special Agent in Charge of the New York Field Office of the U.S. Department of Commerce, Office of Export Enforcement (OEE), announced the arrests today of Chong Sik Yu, a/k/a “Chris Yu,” and Yunseo Lee.  Yu and Lee are charged with conspiring to unlawfully export dual-use electronics components, in violation of the Export Control Reform Act, and to commit wire fraud, bank fraud, and money laundering.  Yu and Lee were arrested this morning and are expected to be presented later today before U.S. Magistrate Judge Kevin Nathaniel Fox in Manhattan federal court.
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  • Justice Department Files Sexual Harassment Lawsuit Against Massachusetts Property Manager
    In Crime News
    The Department of Justice announced today that it has filed a lawsuit alleging that a property manager in Chicopee, Massachusetts violated the Fair Housing Act by subjecting female tenants to sexual harassment.
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  • Two Members of the Nine Trey Gangster Bloods Gang Plead Guilty to RICO Conspiracy
    In Crime News
    Yesterday, two Georgia men and members of the Nine Trey Gangster national criminal organization pleaded guilty to Racketeer Influenced Corrupt Organization (RICO) conspiracy.
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