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Breastfeeding: Some Strategies Used to Market Infant Formula May Discourage Breastfeeding; State Contracts Should Better Protect Against Misuse of WIC Name

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Millions of U.S. mothers and infants each year forgo the health benefits of breastfeeding and rely on infant formula. Infants who are breastfed are less likely to develop infectious diseases and chronic health problems, such as diabetes and asthma, while breastfeeding mothers are less likely to develop certain types of cancer. Recognizing the health benefits of breastfeeding for infants and mothers, the U.S. Department of Health and Human Services' Healthy People 2010 campaign has recommended that more U.S. infants be breastfed and that babies be breastfed for longer periods of time. According to the U.S. Department of Agriculture (USDA), the U.S. would save a minimum of $3.6 billion in health care costs and indirect costs, such as parents' lost wages, if breastfeeding increased to meet these Healthy People goals. Breastfeeding rates are particularly low among infants who participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). WIC is administered by the USDA's Food and Nutrition Service (FNS) in cooperation with state and local agencies. The program provides free food and infant formula to improve the health and nutritional well-being of low-income women, infants, and young children. Nearly half of infants born in the U.S. receive benefits through WIC. Although formula manufacturers agree that breastfeeding is best, they market infant formula as an alternative for mothers who do not exclusively breastfeed. A congressional committee asked us to review the potential impact of infant formula marketing on breastfeeding rates, especially for infants in the WIC program. We answered the following questions: 1) What are the estimated breastfeeding rates for infants in the general population and for infants on WIC, and how do these rates compare to recommended breastfeeding rates? 2) How is infant formula ...
Date: February 8, 2006
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Additional Information about the Scope and Limits of Sanction Data Provided in Recent GAO Report on Temporary Assistance for Needy Families

Description: Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO followed up on its previous report on the scope and limits of the Temporary Assistance for Needy Families (TANF) program's 1998 sanction data, focusing on: (1) whether the number of full-family sanctions in an average month in 1998 can be annualized and used to determine the impact full-family sanctions had that year on caseload size; and (2) what constitutes the combined number of full-family and partial sanctions in an average month during 1998."
Date: June 14, 2000
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department

Welfare Reform: GAO's Recent and Ongoing Work on DOT's Access to Jobs Program

Description: Correspondence issued by the General Accounting Office with an abstract that begins "Without adequate transportation, welfare recipients face significant barriers in moving from welfare to work. Three-fourths of welfare recipients live in central cities or rural areas, while two-thirds of the new jobs are in the suburbs. For many of these new jobs, access to public transportation facilities, such as buses or subways, is limited or nonexistent. To address this issue, the Department of Transportation (DOT) implemented the Job Access and Reverse Commute program. GAO's previous reviews of this program found that, although it would help support the reform of the welfare system by providing transportation resources to welfare recipients, DOT needed to improve several aspects of the program. GAO made several recommendations to enhance DOT's evaluation of the program and to promote coordination with other agencies. GAO reported that in 1999 and 2000, DOT had implemented the recommendations and had taken steps to refine its grant selection process. GAO plans to issue a report on the Job Access program in December 2001, and, in 2002, GAO expects to report on grantees' experiences in implementing their Job Access projects."
Date: August 17, 2001
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department

Summary of Proposals to Address Income Eligibility Requirement for Federal Foster Care Reimbursement

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "Twelve of the 14 proposals we identified would eliminate means testing altogether as a requirement for states to receive federal funding to help pay for the costs associated with supporting children in foster care. Two other proposals would link means testing to a different benchmark. Half of the proposals would mitigate a potential increase in federal costs due to the elimination of means testing by either changing the rate of federal reimbursements, capping federal funding, or both. Additionally, half would attempt to mitigate the potentially negative effects of lowering the reimbursement rate on states by, for example, allowing states to access additional funding in the event of an unanticipated increase in foster care placements. All five proposals that specify how states should use any foster care maintenance savings they incur would require states to reinvest these savings in child welfare services that benefit all children at risk of neglect or abuse."
Date: March 25, 2013
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Home Energy Assistance for Low-Income Occupants of Manufactured Homes

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "In 2005, the most recent year for which complete data were available, occupants of older manufactured homes paid over twice as much on average per square foot for energy---$1.75 per square foot as compared with $0.87---as was paid by occupants of detached homes. Annual energy expenditures for older manufactured homes--about 906 square feet on average--were about $1,369, compared with detached homes--about 2,919 square feet on average--were about $2,060. Energy expenditures--both per square foot and annually--varied significantly by region reflecting regional differences in the types and costs of fuels commonly used to heat and cool homes, income levels, and climate, among other things. In 2005, LIHEAP provided more assistance on a per square foot basis--about $0.33 per square foot--to occupants of older manufactured homes than to those of detached homes--about $0.20 per square foot. However, this assistance covers slightly less of the annual energy expenditures of occupants of older manufactured homes than occupants of detached homes--15 and 17 percent, respectively. Based on our analysis of EIA's RECS data, we estimate that about 3 percent of LIHEAP funds--about $57 million--spent in 2005 were used to assist occupants of older manufactured homes."
Date: August 24, 2012
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Incapacitated Adults: Improving Oversight of Federal Fiduciaries and Court-appointed Guardians

Description: A publication issued by the Government Accountability Office with an abstract that begins "Today's hearing is on the appointment and oversight of guardians. As people age, they often reach a point when they are no longer capable of handling their own finances or have difficulty making other decisions for themselves. To ensure that federal cash payments received by incapacitated adults are used in their best interest, the Social Security Administration (SSA), Department of Veterans Affairs (VA), and other federal agencies assign a responsible third party or fiduciary to oversee these benefits. SSA and VA can designate spouses, other family members, friends, and organizations to serve as fiduciaries. Similarly, when state courts determine that adults are incapacitated, they have the authority to grant other persons or entities--guardians--the authority and responsibility to make financial and other decisions for them. Incapacitated adults are vulnerable to financial exploitation by fiduciaries and guardians, so these arrangements are not without risk. In 2010, we identified hundreds of allegations of abuse, neglect, and exploitation by guardians in 45 states and the District of Columbia between 1990 and 2010. At that time, we reviewed 20 of these cases and found that guardians had stolen or otherwise improperly obtained $5.4 million from 158 incapacitated victims, many of whom were older adults. To protect against financial exploitation, state courts as well as federal agencies are responsible for screening prospective guardians and federal fiduciaries, respectively, to make sure suitable individuals are appointed. They are also responsible for monitoring the performance of those they appoint. This statement today is based on our recent report on this topic. It will cover (1) SSA and VA procedures for screening prospective federal fiduciaries, and state court procedures for screening prospective guardians; (2) SSA and VA monitoring of federal fiduciary performance, and state court monitoring of ...
Date: September 22, 2011
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Foster Care: Increases in Adoption Rates

Description: Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO determined the source of information states used to derive both the fiscal year (FY) 1998 and the base numbers of finalized foster care adoptions, and identified factors that contributed to the increases in foster care adoptions in 5 states--Connecticut, Florida, Illinois, Iowa, and Texas."
Date: April 20, 1999
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department

Guardianships: Cases of Financial Exploitation, Neglect, and Abuse of Seniors

Description: A letter report issued by the Government Accountability Office with an abstract that begins "As individuals age, some become incapable of managing their personal and financial affairs. To protect these individuals, state laws provide for court appointment of guardians, who may be professionals or family members, to protect the incapacitated person's personal and/or financial welfare. State and local courts are responsible for overseeing guardians. In addition, federal agencies may appoint a representative payee, in some cases, the guardian, to manage federal benefits on behalf of incapacitated adults. Previous GAO reports have found that poor communication between state courts and federal agencies may allow guardians to continue abusing their victims. GAO was asked to (1) verify whether allegations of abuse by guardians are widespread; (2) examine the facts in selected closed cases; and (3) proactively test state guardian certification processes. To verify whether allegations are widespread, GAO interviewed advocates for seniors and reviewed court documents. To examine closed criminal, civil or administrative cases with a finding of guilt or liability in the past 15 years, GAO reviewed court records, interviewed court officials, attorneys and victims, and reviewed records from federal agencies. To test state guardian certification, GAO used fictitious identities to apply for certification in four states. GAO's results cannot be projected to the overall population of guardians or state certification programs."
Date: September 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Reported Y2K Readiness of State Employment Security Agencies' Unemployment Insurance Benefits and Tax Systems

Description: Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on year 2000 readiness of State Employment Security Agencies' (SESA) unemployment insurance benefits and tax systems and determined the reported status of whether these systems have been independently verified and validated for year 2000 compliance. GAO also determined whether SESAs have submitted contingency plans for continuity of business operations."
Date: October 28, 1999
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department

Department of Defense Policies on Accommodating Children with Special Needs in Child Care Programs

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "DOD officials stated that their policy is to accommodate children with special needs unless those accommodations fundamentally alter the nature of the program. However, DOD does not centrally collect or maintain data on accommodation decisions; instead they are kept at the installation level. Two services--Army and Air Force--have begun or plan to collect specific data at the service level to monitor and track services to children with special needs across their installations by 2013. Further, the services have different definitions of special needs, although officials told us DOD is working on a standard definition. According to OSD officials, each service has established an assessment process to determine how to accommodate children with special needs in DOD's child care programs. This assessment process is the primary means through which parents can address concerns related to finding appropriate child care for their children with special needs, as well as to help identify support and outreach programs for the family. The National Defense Authorization Act for Fiscal Year 2010 created the Office of Special Needs, which is responsible for enhancing and improving support for families of children with special needs. Although DOD officials stated that this office does not have an oversight role or enforcement authority over DOD child care, the Office of Special Needs and OSD have coordinated on some activities to better serve the DOD population of children with special needs. Additionally, DOD contracts with Kids Included Together to support the work of its child care staff in accommodating children with special needs and offers other services to help child care staff and parents deal with behavioral problems and other issues. Representatives of national disability organizations said that military parents of children with special needs face challenges accessing DOD ...
Date: January 16, 2013
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

TANF: State Approaches to Screening for Domestic Violence Could Benefit from HHS Guidance

Description: A letter report issued by the Government Accountability Office with an abstract that begins "The Temporary Assistance for Needy Families (TANF) program introduced specific work requirements and benefit time limits. However, the Family Violence Option (FVO) requires states that adopt the FVO to screen TANF clients for domestic violence and grant waivers from program requirements for clients in domestic violence situations. TANF also allows the use of TANF funds for marriage and responsible fatherhood programs. Given states' broad discretion in implementing the TANF program, including most aspects of the FVO and marriage and responsible fatherhood programs, this report examines (1) how states identify victims of domestic violence among TANF recipients, (2) how states address domestic violence among TANF recipients once they are identified, and (3) the extent to which states spend TANF funds on marriage and responsible fatherhood programs, and how, if at all, these programs are addressing domestic violence."
Date: August 16, 2005
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Guardianships: Collaboration Needed to Protect Incapacitated Elderly People

Description: A letter report issued by the Government Accountability Office with an abstract that begins "As people age, some become incapable of managing their personal and financial affairs. To protect these people, state laws provide for court appointment of guardians to act on their behalf. In many cases federal programs provide these incapacitated people financial benefits. GAO was asked to examine: (1) what state courts do to ensure that guardians fulfill their responsibilities, (2) what guardianship programs recognized as exemplary do to ensure that guardians fulfill their responsibilities, and (3) how state courts and federal agencies work together to protect incapacitated elderly people."
Date: July 13, 2004
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Elder Justice: Stronger Federal Leadership Could Help Improve Response to Elder Abuse

Description: Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses ending elder abuse, neglect, and exploitation. Each day, news reports cite instances of older adults across the U.S. being abused and denied needed care, often by those they depend on the most. Neglect and abuse often go hand in hand with financial exploitation, which can rob older adults of the life savings and property they count on to support them in old age. In addition to the physical, psychological, and economic harm elder abuse inflicts on older adults, it can impose an economic burden on all Americans, increasing public expenditures on health care and the demand for a range of supportive services. A 2009 study estimated that 14.1 percent of non-institutionalized older adults nationwide had experienced some form of elder abuse in the past year. In all likelihood, this underestimated the full extent of elder abuse, however, because older adults who are highly cognitively impaired may be underrepresented in this study. States are primarily responsible for protecting older adults from abuse, neglect, and exploitation. In each state, an Adult Protective Services (APS) program aims to identify, investigate, resolve, and prevent such abuse. On the federal level, two statutes establish the government's role and responsibility with regard to elder justice in general--the Older Americans Act of 1965 (OAA) and the Elder Justice Act of 2009 (EJA). The OAA requires the Administration on Aging (AoA) in the Department of Health and Human Services (HHS) to administer formula grants to state agencies on aging for elder abuse awareness and prevention activities and lays out AoA's responsibilities to provide leadership, disseminate information, collect data, and support research in the elder justice area. The EJA authorizes funding for state APS programs and calls for federal leadership and coordination in the ...
Date: March 2, 2011
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Child Welfare: Federal Oversight of State IV-B Activities Could Inform Action Needed to Improve Services to Families and Statutory Compliance

Description: Testimony issued by the Government Accountability Office with an abstract that begins "For federal fiscal year 2004, state and local child protective services staff determined that an estimated 872,000 children have been victims of abuse or neglect. Title IV-B subparts 1 and 2 authorize a wide array of child welfare services with some restrictions on states' use of funds. This testimony discusses: (1) how states used Title IV-B dollars to serve families under subparts 1 and 2; (2) the extent that federal oversight ensured state compliance with spending requirements under subpart 1; and (3) what the research said about the effectiveness of service states have provided to families using Title IV-B funds. This testimony was primarily based on a 2003 report (GAO-03-956)."
Date: May 23, 2006
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Residential Facilities: State and Federal Oversight Gaps May Increase Risk to Youth Well-Being

Description: Testimony issued by the Government Accountability Office with an abstract that begins "Nationwide, federal funding to states supported more than 200,000 youth in facilities seeking help for behavioral or emotional challenges in 2004. Recent federal reviews and investigations highlighted maltreatment in some facilities, resulting in hospitalizations and deaths. This testimony discusses (1) what is known about incidents that adversely affect youth well-being in residential facilities, (2) the extent that state oversight ensures youth well-being in these facilities, and (3) the factors that affect the ability of federal agencies to hold states accountable for youth well-being in residential facilities. This testimony is based on GAO's ongoing work, which included national surveys to state agencies of child welfare, health and mental health, and juvenile justice for the year 2006. GAO achieved an 85 percent response rate for each of the three surveys. The work also included site visits to four states (California, Florida, Maryland, and Utah) and discussions with the Departments of Education (Education), Justice (DOJ), and Health and Human Services (HHS). Interim work related to this testimony was completed between November 2006 and March 2008, in accordance with generally accepted government auditing standards."
Date: April 24, 2008
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Child Welfare: States Face Challenges in Developing Information Systems and Reporting Reliable Child Welfare Data

Description: Testimony issued by the General Accounting Office with an abstract that begins "To better monitor children and families served by state child welfare agencies, Congress authorized matching funds for the development of statewide automated child welfare information systems (SACWIS) and required that the Department of Health and Human Services (HHS) compile information on the children served by state agencies. This testimony is based on our July 2003 report and addresses the following: (1) states' experiences in developing child welfare information systems and HHS's role in assisting in their development, (2) factors that affect the reliability of data that states collect and report on children served by their child welfare agencies and HHS's role in ensuring the reliability of those data, and (3) practices that child welfare agencies use to overcome challenges associated with SACWIS development and data reliability. For the July 2003 report, we surveyed all 50 states and the District of Columbia regarding their experiences developing and using information systems and their ability to report data to HHS. We also reviewed a variety of HHS documents and visited five states to obtain firsthand information. Finally, we interviewed HHS officials and child welfare and data experts and reviewed relevant literature."
Date: November 19, 2003
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department

Child Welfare: HHS Actions Would Help States Prepare Youth in the Foster Care System for Independent Living

Description: Testimony issued by the Government Accountability Office with an abstract that begins "Congress passed the Foster Care Independence Act of 1999 (FCIA), which doubled annual federal funds for independent living programs to $140 million. This testimony discusses (1) states' FCIA funding allocations, (2) services provided and remaining challenges, (3) state coordination of programs to deliver services, and (4) the states and the Department of Health and Human Services' (HHS) Administration for Children and Families' (ACF) progress toward meeting program accountability requirements. This testimony is primarily based on our 2004 report on FCIA (05-25), with updated information from our 2007 testimony on state child welfare challenges (07-850T). To conduct the 2004 work, we surveyed state independent living coordinators, conducted 4 state site visits, and reviewed states' plans and annual reports. Updated information from our 2007 testimony was taken primarily from a 2006 survey of state child welfare directors."
Date: July 12, 2007
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Guardianships: Little Progress in Ensuring Protection for Incapacitated Elderly People

Description: Testimony issued by the Government Accountability Office with an abstract that begins "The Senate Special Committee on Aging asked GAO to follow up on its 2004 report, Guardianships: Collaboration Needed to Protect Incapacitated Elderly People, GAO-04-655. This report covered what state courts do to ensure that guardians fulfill their responsibilities, what exemplary guardianship programs look like, and how state courts and federal agencies work together to protect incapacitated elderly people. For this testimony, GAO agreed to (1) provide an overview and update of the findings of this prior work; (2) discuss the status of a series of recommendations GAO made in that report; and (3) discuss the prospects for progress in efforts to strengthen protections for incapacitated elderly people through guardianships. To complete this work, GAO interviewed lawyers and agency officials who have been actively involved in guardianship and representative payee programs, and spoke with officials at some of the courts identified as exemplary in the report."
Date: September 7, 2006
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Residential Programs: Selected Cases of Death, Abuse, and Deceptive Marketing

Description: Testimony issued by the Government Accountability Office with an abstract that begins "In October 2007, GAO testified before the Committee regarding allegations of abuse and death in private residential programs across the country such as wilderness therapy programs, boot camps, and boarding schools. GAO also examined selected closed cases where a youth died while enrolled in one of these private programs. Many cite positive outcomes associated with specific types of residential programs. However, due to continuing concerns about the safety and well-being of youth enrolled in private programs, the Committee requested that GAO (1) identify and examine the facts and circumstances surrounding additional closed cases where a teenager died, was abused, or both, while enrolled in a private program; and (2) identify cases of deceptive marketing or questionable practices in the private residential program industry. To develop case studies of death and abuse, GAO conducted numerous interviews and examined documents from eight closed cases from 1994 to 2006. GAO used covert testing along with other investigative techniques to identify, for selected cases, deceptive marketing or questionable practices. Specifically, posing as fictitious parents with fictitious troubled teenagers, GAO called 14 programs and related services. GAO did not attempt to evaluate the benefits of private residential programs and its results cannot be projected beyond the specific programs and services that GAO reviewed."
Date: April 24, 2008
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Child Welfare: Improved Federal Oversight Could Assist States in Overcoming Key Challenges

Description: Testimony issued by the General Accounting Office with an abstract that begins "Title IV-B of the Social Security Act, comprised of two subparts, is the primary source of federal funding for services to help families address problems that lead to child abuse and neglect and to prevent the unnecessary separation of children from their families; however, a number of challenges exist that impair states' ability to deliver and track these services. This testimony is based on findings from three reports issued in 2003 and addresses the following: (1) states' use of Title IV-B funds in providing a wide array of services to prevent the occurrence of abuse, neglect, and unnecessary foster care placements, as well as in providing other child welfare services; (2) factors that hinder states' ability to protect children from abuse and neglect; and (3) the Department of Health and Human Services' (HHS) role in helping states to overcome these challenges. Findings are based on multiple methodologies, including a survey to child welfare directors on states' use of Title IV-B funds; an analysis of nearly 600 exit interview documents completed by staff who severed their employment from 17 state, 40 county, and 19 private child welfare agencies; and a survey of all 50 states and the District of Columbia regarding their experiences in developing and using information systems and their ability to report data to HHS. In each case, GAO also conducted multiple site visits to selected states and interviewed child welfare experts and HHS headquarters and regional officials."
Date: January 28, 2004
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department

Welfare Reform: States' Implementation and Effects on the Workforce Development System

Description: Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed states' efforts to implement welfare reform, focusing on: (1) what is known about the effectiveness of various approaches for moving welfare recipients into jobs; (2) how states are implementing welfare reform; (3) the status of those leaving welfare; and (4) the challenges that lie ahead as welfare reform continues to evolve."
Date: September 9, 1999
Creator: United States. General Accounting Office.
Partner: UNT Libraries Government Documents Department