To identify what actions exist to address these issues, GAO reviewed and updated prior work, including recommendations for executive action and matters for congressional consideration.

This report discusses the new areas identified in GAO’s 2019 annual report; the progress made in addressing actions GAO identified in its 2011 to 2018 reports; and examples of open actions directed to Congress or executive branch agencies.

To call attention to these opportunities, Congress included a provision in statute for GAO to identify and report on federal programs, agencies, offices, and initiatives—either within departments or government-wide—that have duplicative goals or activities. GAO also identifies areas that are fragmented or overlapping and additional opportunities to achieve cost savings or enhance revenue collection.

The federal government continues to face an unsustainable long-term fiscal path caused by an imbalance between federal revenue and spending. While addressing this imbalance will require difficult policy decisions, opportunities exist in a number of areas to improve this situation, including where federal programs or activities are fragmented, overlapping, or duplicative.

Note: All estimates of potential savings are dependent on various factors, such as whether action is taken and how it is taken. Actual savings may be less, depending on costs associated with implementing the action, unintended consequences, and the impact of other factors that could/should be controlled for. For estimates of potential financial benefits, GAO developed the notional estimates, which are intended to provide a sense of potential magnitude of savings. Notional estimates have been developed using broad assumptions about potential savings which are rooted in previously identified losses, the overall size of the program, previous experience with similar reforms, and similar rough indicators of potential savings.

Military and Veterans Health Care (2012-15) : The Departments of Defense (DOD) and Veterans Affairs (VA) need to improve integration across care coordination and case management programs to reduce duplication and better assist servicemembers, veterans, and their families.

IRS Strategic Workforce Planning (2019-07) : The Internal Revenue Service should address its fragmented human capital activities to improve its strategic workforce planning so it can better meet challenges to achieving its mission.

Medicare Payments by Place of Service (2016-30) : Medicare could have cost savings if Congress were to equalize the rates Medicare pays for certain health care services, which often vary depending on where the service is performed.

Disability and Unemployment Benefits (2014-08) : Congress should consider passing legislation to prevent individuals from collecting both full Disability Insurance benefits and Unemployment Insurance benefits that cover the same period.

Defense Headquarters (2012-34) : The Department of Defense could review and identify further opportunities for consolidating or reducing the size of headquarters organizations.

DOE’s Treatment of Hanford’s Low Activity Waste (2018-17) : The Department of Energy may be able to reduce certain risks by adopting alternative approaches to treating a portion of its low-activity radioactive waste.

While Congress and executive branch agencies have made progress toward addressing actions that GAO has identified since 2011, further steps are needed. GAO estimates that tens of billions of additional dollars could be saved should Congress and executive branch agencies fully address the remaining 396 open actions, including the new ones identified in 2019. Addressing the remaining actions could lead to other benefits as well, such as increased public safety, better homeland and national security, and more effective delivery of services. For example:

Significant progress has been made in addressing many of the 805 actions that GAO identified from 2011 to 2018 to reduce costs, increase revenues, and improve agencies’ operating effectiveness. As of March 2019, Congress and executive branch agencies have fully addressed 436 actions (54 percent) and partially addressed 185 actions (23 percent). This has resulted in approximately $262 billion in financial benefits. About $216 billion of these benefits accrued between 2010 and 2018 and $46 billion are projected to accrue in future years. These are rough estimates based on a variety of sources that considered different time periods and utilized different data sources, assumptions, and methodologies.

GAO’s 2019 annual report identifies 98 new actions that Congress or executive branch agencies can take to improve the efficiency and effectiveness of government in 28 new areas and 11 existing areas. For example:

With the release of this report, GAO is concurrently releasing the latest updates to these resources.

Areas and actions in the spreadsheet can be sorted and filtered by the year identified, mission, area name, implementation status, and implementing entities (Congress or executive branch agencies). The spreadsheet additionally notes which actions are also GAO priority recommendations--those recommendations GAO believes warrant priority attention from the heads of departments or agencies.

GAO's Action Tracker , a publicly accessible website, allows Congress, executive branch agencies, and the public to track the government's progress in addressing the issues we have identified. GAO's Action Tracker includes a downloadable spreadsheet containing all actions.

This report is based upon work we previously conducted in accordance with generally accepted government auditing standards or our quality assurance framework. See appendix I for more information on our scope and methodology.

For each area, we suggest actions that Congress or executive branch agencies could take to reduce, eliminate, or better manage fragmentation, overlap, or duplication, or achieve other financial benefits. In addition to identifying new areas and actions, we continue to monitor the progress Congress and executive branch agencies have made in addressing actions we previously identified (see text box).

This report is our ninth in the series, and it identifies 28 new areas where a broad range of federal agencies may be able to achieve greater efficiency or effectiveness.

In eight annual reports issued from 2011 to 2018, we presented more than 300 areas and more than 800 actions for Congress or executive branch agencies to reduce, eliminate, or better manage fragmentation, overlap, or duplication; achieve cost savings; or enhance revenues. [3] Congress and executive branch agencies have partially or fully addressed 621 (77 percent) of the actions we identified from 2011 to 2018, resulting in about $262 billion in financial benefits. We estimate tens of billions more dollars could be saved by fully implementing our open actions. [4]

Meanwhile, Congress and executive branch agencies have opportunities to contribute toward fiscal sustainability and act as stewards of federal resources. One way is to take action to reduce, eliminate, or better manage fragmentation, overlap, or duplication; achieve cost savings; or enhance revenues. To call attention to these opportunities, Congress included a provision in statute for us to identify and report to Congress on federal programs, agencies, offices, and initiatives—either within departments or government-wide—that have duplicative goals or activities. [2] As part of this work, we also identify additional opportunities to achieve greater efficiency and effectiveness that result in cost savings or enhanced revenue collection.

The federal government continues to face an unsustainable long-term fiscal path caused by an imbalance between federal revenue and spending, primarily driven by health care spending and interest on debt held by the public (net interest). [1] Addressing this imbalance will require difficult policy decisions about long-term changes to both spending and revenue. Acting soon to mitigate this imbalance would help to minimize the disruption to individuals and the economy.

This report was prepared under the coordination of Jessica Lucas-Judy, Director, Strategic Issues, who may be reached at (202) 512-9110 or lucasjudyj@gao.gov , and J. Christopher Mihm, Managing Director, Strategic Issues, who may be reached at (202) 512-6806 or mihmj@gao.gov . Specific questions about individual issues may be directed to the area contact listed at the end of each summary.

Legend: * = Legislation is likely to be necessary to fully address all actions in this area.

Legend: * = Legislation is likely to be necessary to fully address all actions in this area.

The Office of Management and Budget, relevant agencies, and Congress can address inconsistent oversight, ineffective coordination, and inefficient use of resources caused by the fragmented federal approach to food safety. ( GAO-17-74 , GAO-15-180 )

The Departments of Defense (DOD) and Veterans Affairs (VA) need to improve integration across care coordination and case management programs to reduce duplication and better assist servicemembers, veterans, and their families. ( GAO-12-129T )

To better manage fragmentation in service delivery, the Social Security Administration should explore options for better connecting transition-age youth receiving Supplemental Security Income (SSI) to vocational rehabilitation services. ( GAO-17-485 )

The Department of Health and Human Services should coordinate with federal agencies, including the Department of Veterans Affairs, to improve the effectiveness and oversight of fragmented federal funding for physician graduate medical education, which cost the federal government $14.5 billion in 2015. ( GAO-18-240 )

The Department of Defense should assign a single organization responsibility for ensuring that common solutions for Global Positioning System (GPS) receiver card modernization efforts are collected and shared among hundreds of programs. ( GAO-18-74 )

Table 7 shows selected areas where Congress and executive branch agencies can take action to achieve other benefits, such as increased public safety, better homeland and national security, and more effective delivery of services.

a GAO developed the notional estimates, which are intended to provide a sense of potential magnitude of financial benefits. Notional estimates have been developed using broad assumptions about potential benefits which are rooted in previously identified losses, the overall size of the program, previous experience with similar reforms, and similar rough indicators of potential benefits. GAO generally determines the notional label (“millions” vs. “tens of millions” vs. “hundreds of millions”) using a risk-based approach that takes into account such factors as the possible minimum and maximum values of the financial benefits estimate (where available), the quality of the data underlying those values, the certainty of those values, and/or the rigor of the estimation method used.

Note: All estimates of potential financial benefits are dependent on various factors, such as whether action is taken and how it is taken. Actual benefits may be less, depending on costs associated with implementing the action, unintended consequences, and the impact of other factors that could and should be controlled for. The individual estimates in this table should be compared with caution, as they come from a variety of sources, which consider different time periods and utilize different data sources, assumptions, and methodologies.

Legend: * = Legislation is likely to be necessary to fully address all actions in this area.

Legend: * = Legislation is likely to be necessary to fully address all actions in this area.

Medicare could have cost savings if Congress were to equalize the rates Medicare pays for certain health care services, which often vary depending on where the service is performed. ( GAO-16-189 )

The Centers for Medicare & Medicaid Services should take steps to avoid paying more than necessary for clinical laboratory tests. ( GAO-19-67 )

Congress could consider limiting the subsidy for premiums that an individual farmer can receive each year from the Federal Crop Insurance program, reducing the subsidy, or some combination of limiting and reducing these subsidies and making changes to the program to reduce its delivery costs. ( GAO-17-501 , GAO-12-256 )

The Social Security Administration (SSA) needs data on pensions from noncovered earnings to better enforce offsets and ensure benefit fairness, which could result in cost savings if enforced both retrospectively and prospectively, according to the Congressional Budget Office (CBO) and SSA. Congress could consider giving the Internal Revenue Service the authority to collect the necessary information. Estimated savings would be less if SSA only enforced the offsets prospectively as it would not reduce benefits already received. ( GAO-05-786T )

Congress should consider passing legislation to prevent individuals from collecting both full Disability Insurance benefits and Unemployment Insurance benefits that cover the same period. ( GAO-12-764 )

Unless the Department of Energy can demonstrate demand for new Advanced Technology Vehicles Manufacturing loans and viable applications, Congress may wish to consider rescinding all or part of the remaining credit subsidy appropriations. ( GAO-14-343SP )

The Department of Defense could review and identify further opportunities for consolidating or reducing the size of headquarters organizations. ( GAO-12-345 , GAO-13-293 , GAO-14-439 , GAO-15-10 )

The Department of Energy (DOE) may be able to reduce certain risks by adopting alternative approaches to treating a portion of its low-activity radioactive waste. ( GAO-17-306 )

We identified potential financial benefits associated with many open areas with actions directed to Congress and the executive branch. These benefits range from millions of dollars to tens of billions of dollars. For example, DOD could help achieve its initial cost savings target of $2 billion by managing its commissaries better, potentially saving millions of dollars. In another example, IRS could collect over a million dollars annually in additional tax revenues by clarifying whether transfers of unclaimed savings from employer-based plans to states are distributions and should be subject to tax withholding. Table 6 highlights examples of areas where additional action could potentially result in financial benefits of $1 billion or more.

b Other agencies include all federal agencies with fiscal year 2018 outlays not listed above. There are more than 100 actions directed to these other agencies.

a Treasury’s percentage of fiscal year 2018 outlays includes interest payments on the national debt as well as costs associated with administering its bureaus, including the Internal Revenue Service.

A significant number of open actions are directed to 10 agencies that made up about 95 percent of federal outlays in fiscal year 2018. Figure 4 highlights agencies with open actions as well as their fiscal year 2018 share of federal outlays.

a “Other federal entities” reflects open actions directed to the following federal entities: The Executive Office of the President, National Security Council, Office of the Director of National Intelligence, Office of National Drug Control Policy, Office of Science and Technology Policy, Homeland Security Council, Consumer Financial Protection Bureau, Federal Reserve, U.S. Commission on International Religious Freedom, Railroad Retirement Board, the Committee on STEM Education, Federal Communications Commission, Assistant to the President for National Security Affairs, Broadcasting Board of Governors—U.S. Agency for Global Media, Consumer Product Safety Commission, Federal Deposit Insurance Corporation, and National Credit Union Administration.

Note: The total number of open actions in this figure (453) does not equal the total number of open actions directed to executive branch agencies (337) as of March 2019. Individual actions are counted multiple times when they are directed to more than one federal department or agency. Open actions include actions that are partially addressed, not addressed, and new actions introduced in this 2019 annual report.

We also directed 797 actions to executive branch agencies, including 92 new actions identified in 2019. As shown in figure 3, these actions span the government and are directed to dozens of federal agencies. Five of these agencies, DOD, HHS, IRS, OMB, and DHS, have at least 25 open actions. Of the 797 actions, 337 (42 percent) remained open as of March 2019.

In our 2011 to 2019 annual reports, we directed 106 actions to Congress, including the six new congressional actions we identified in 2019. Of the 106 actions, 59 (56 percent) remained open as of March 2019. Appendix V has a full list of all open congressional actions.

Congress has used our work to identify legislative solutions to achieve cost savings, address emerging problems, and find efficiencies in federal agencies and programs. Our work has contributed to a number of key authorizations and appropriations. In addition, congressional oversight of agencies’ efforts has been critical in realizing the full benefits of our suggested actions addressed to the executive branch, and it will continue to be critical.

Congress and executive branch agencies have made progress toward addressing the 903 total actions we have identified since 2011. However, further steps are needed to fully address the 396 actions that are partially addressed, not addressed, or new. [10] We estimate that tens of billions of dollars in additional financial benefits could be realized should Congress and executive branch agencies fully address open actions, and other improvements can be achieved as well. [11]

Our suggested actions, when implemented, often result in benefits—for instance, more effective and equitable government; improvements in major government programs or agencies; and increased assurance that programs comply with laws and that funds are legally spent. The following examples illustrate these types of benefits.

Note: The estimates in this report are from a range of sources, including GAO, executive branch agencies, CBO, and the Joint Committee on Taxation. Some estimates have been updated since GAO’s 2018 report to reflect more recent analysis.

DOE reported savings of $1.2 billion from selling crude oil from the reserve in fiscal years 2017 and 2018, with potential for over $8.4 billion in total sales through 2025 according to CBO.

Savings of about $1.6 billion from fiscal years 2013 through 2025, according to GAO analysis of agency estimates. This includes about $862 million expected to accrue in fiscal year 2019 or later.

Savings of an estimated $2.5 billion from fiscal years 2012 through 2017, and billions in additional savings could potentially accrue in the future according to agency estimates.

Nine agencies migrated commodity IT areas to shared services in response to OMB’s 2012 guidance to review their portfolios and identify duplicative, low-value, and wasteful investments, contributing to savings.

Savings of approximately $2.5 billion from fiscal years 2013 through 2022, of which $1.5 billion has accrued and $1 billion is expected to accrue in fiscal year 2019 or later according to CBO.

Congress has taken steps to increase the minimum adjustment made for differences in diagnostic coding patterns between Medicare Advantage plans and traditional Medicare providers.

United States Forces Korea conducted a series of consultations with the military services to evaluate the costs and benefits associated with tour normalization, and DOD decided not to move forward with the full tour normalization initiative because it was not affordable.

Cost savings and avoidances of $4.2 billion from fiscal years 2011 through 2019, based on GAO analysis of agency reported data. This includes about $468 million expected to accrue in fiscal year 2019, according to agency plans.

The 24 federal agencies participating in the Office of Management and Budget’s (OMB) data center consolidation and optimization efforts have taken steps to consolidate over 6,200 data centers as of August 2018.

Savings of as much as $5.4 billion from July 2013 through June 2018, according to GAO estimates.

The Department of Housing and Urban Development made improvements to increase the recoveries from disposing of properties it receives when loans default, such as by selling these loans and increasing property inspections and oversight of contractors disposing of these properties.

The Department of the Treasury (Treasury) updated its analysis of estimated future expenditures for the Making Home Affordable program, reducing the estimated lifetime cost of the program.

Congress amended the audit procedures applicable to certain large partnerships to require that they pay audit adjustments at the partnership level. e

Increased revenue of about $12.9 billion in fee collections over a 10-year period beginning in fiscal year 2014 and continuing through fiscal year 2023, according to CBO and other estimates.

Congress passed the Bipartisan Budget Act of 2013, which modified the passenger security fee from its current per enplanement structure ($2.50 per enplanement with a maximum one-way-trip fee of $5.00) to a structure that increases the passenger security fee to a flat $5.60 per one-way-trip. d

The Department of Education changed its estimation approach for calculating the cost of Income-Driven Repayment (IDR) plans, allowing the agency to transfer unused funds to the Treasury.

Congress allowed the Volumetric Ethanol Excise Tax Credit to expire at the end of 2011, which eliminated duplicative federal efforts directed at increasing domestic ethanol production. c

Savings of approximately $36.8 billion in 2016 and 2017, and tens of billions of additional savings could potentially accrue in the future according to agency estimates.

The Department of Health and Human Services (HHS) changed processes to curtail some problematic methods used to determine spending limits for Medicaid Demonstrations, restricted the amount of unspent funds states can accrue and carry forward to expand demonstrations, and could further reduce federal spending by addressing other problematic methods.

Congress passed the Weapon Systems Acquisition Reform Act of 2009, which implemented a number of GAO’s recommendations for how the Department of Defense (DOD) develops and acquires weapon systems. GAO highlighted the need for additional action in this area in its 2011 report. Since then, DOD has followed more best practices for these acquisitions. b

Savings of approximately $44.5 billion from fiscal year 2015 through fiscal year 2023, of which $19.8 billion has accrued and $24.7 billion is expected to accrue in fiscal year 2019 or later, according to the Congressional Budget Office (CBO).

Note: In calculating these totals, we relied on individual estimates from a variety of sources, which considered different time periods and utilized different data sources, assumptions, and methodologies. These totals represent a rough estimate of financial benefits and have been rounded down to the nearest $1 billion.

As a result of steps Congress and executive branch agencies have taken to address our open actions, we have identified approximately $262 billion in total financial benefits, including $83 billion identified since our last report. About $216 billion of the total benefits accrued between 2010 and 2018, while approximately $46 billion are projected to accrue in 2019 or later, as shown in figure 2. [8]

As we have reported, it frequently takes multiple years for actions to be fully addressed, in part because many of the actions involve significant issues that require action from multiple agencies. Thus, more recommendations are implemented over time. For example, as of March 2019 executive branch agencies had addressed 88 percent of the actions introduced in the 2013 report, compared to 20 percent of the actions introduced in the 2018 report. [7]

c Of the 69 “other” actions, GAO categorized 42 as “consolidated or other” and 27 as “closed-not addressed.” GAO no longer assesses actions categorized as “consolidated or other” and “closed-not addressed.” In most cases, “consolidated or other” actions were replaced or subsumed by new actions based on additional audit work or other relevant information. GAO generally categorizes actions as “closed-not addressed” when the action is no longer relevant due to changing circumstances.

b In assessing actions suggested for the executive branch, GAO applied the following criteria: “addressed” means implementation of the action needed has been completed; “partially addressed” means the action needed is in development or started but not yet completed; and “not addressed” means the administration, the agencies, or both have made minimal or no progress toward implementing the action needed.

a In assessing actions suggested for Congress, GAO applied the following criteria: “addressed” means relevant legislation has been enacted and addresses all aspects of the action needed; “partially addressed” means a relevant bill has passed a committee, the House of Representatives, or the Senate during the current congressional session, or relevant legislation has been enacted but only addressed part of the action needed; and “not addressed” means a bill may have been introduced but did not pass out of a committee, or no relevant legislation has been introduced. Actions suggested for Congress may also move to “addressed” or “partially addressed,” with or without relevant legislation, if an executive branch agency takes steps that address all or part of the action needed. At the beginning of a new congressional session, GAO reapplies the criteria. As a result, the status of an action may move from partially addressed to not addressed if relevant legislation is not reintroduced from the prior congressional session.

Congress and executive branch agencies have made consistent progress in addressing many of the actions we have identified since 2011, as shown in table 4. As of March 2019, they had fully addressed 436 (54 percent) of the actions we identified from 2011 to 2018. See GAO’s online Action Tracker for the status of all actions.

11. Higher Education Assistance : In November 2016, GAO identified six new actions to help the Department of Education improve its income-driven repayment plan budget estimates.

10. Employment and Training Programs : In March 2019, GAO identified a new action to help the Department of Labor evaluate whether actions to manage fragmentation and overlap among employment and training programs are working.

9. Tax Fraud and Noncompliance : In July 2018, GAO identified six new actions to help IRS combat tax fraud and noncompliance and save tens of millions of dollars annually.

8. U.S. Currency : In March 2019, GAO identified a new action to potentially reduce the cost of coin production by millions of dollars annually.

7. Government Satellite Program Costs : In July 2018, GAO identified a new action to help the Department of Defense make more informed decisions on using commercial spacecraft to host government sensors and communications packages, which could lead to considerable cost savings.

6. Government-wide Improper Payments : In May 2018, GAO identified two new actions to help the federal government address the long-standing problem of improper payments.

5. Identity Theft Refund Fraud : In June 2018, GAO identified four new actions to help the Internal Revenue Service (IRS) prevent refund fraud associated with identity theft.

4. Financial Regulatory Structure : In March 2018, GAO identified five new actions to help reduce fragmentation and improve collaboration among federal financial regulators.

3. Department of Veterans Affairs Medical Facility Construction : In July 2018, GAO identified three new actions to improve the accuracy of project budgets and better manage project delays and cost increases.

2. Strategic Petroleum Reserve : In May 2018, GAO identified two new actions to help the federal government potentially realize savings by examining the optimal size of the Strategic Petroleum Reserve.

1. Prepositioning Programs : In January 2019, GAO identified two new actions to help fully implement joint oversight of the Department of Defense’s prepositioned stocks programs and to reduce fragmentation.

In addition to these 28 new areas, we identified 33 new actions related to 11 existing areas presented in our 2011 to 2018 annual reports (see table 3). [6] Appendix IV provides more detailed information about these new actions.

28. Federal Student Loan Default Rates: Strengthening accountability for schools with high student loan default rates could help protect both borrowers and the billions of dollars of federal student aid the government distributes each year.

27. Coast Guard Shore Infrastructure: The Coast Guard should employ models to predict the outcome of shore infrastructure investments and analyze trade-offs to potentially save millions of dollars.

26. Prior Authorization in Medicare: The Centers for Medicare & Medicaid Services should take steps to continue prior authorization, a payment approach that could potentially save millions of dollars in unnecessary Medicare spending.

25. Medicare Clinical Laboratory Payments: The Centers for Medicare & Medicaid Services should take steps to avoid paying more than necessary for clinical laboratory tests, which could save Medicare over a billion, or potentially billions of dollars.

24. Medicaid Spending Oversight: The Centers for Medicare & Medicaid Services needs to improve how it identifies and targets risk in overseeing Medicaid expenditures to potentially save hundreds of millions of dollars.

23. Tax Treatment of 401(k) Transfers: Clarifying whether transfers of unclaimed savings from employer-based plans to states are distributions and should be subject to tax withholding could result in the Internal Revenue Service collecting over a million dollars annually in additional tax revenues if these transfers constitute taxable events.

22. Inland Waterways Construction: The U.S. Army Corps of Engineers should seek ways to more efficiently use available funding for inland waterways construction to potentially save tens of millions of dollars annually.

21. Disaster Response Contracting: The Federal Emergency Management Agency could make more cost-effective contracting decisions through better use of advance contracts and improved acquisition planning.

20. Department of Energy Environmental Liability: The Department of Energy could potentially avoid spending billions of dollars by developing a program-wide strategy to improve decision-making on cleaning up radioactive and hazardous waste.

19. Foreign Military Sales Administrative Account: Congress could enhance federal revenue by at least tens of millions of dollars annually through expanding the definition of allowable expenses authorized to be covered by the Foreign Military Sales administrative account, thereby likely reducing the need to cover these expenses with other appropriated funds.

18. DOD Installation Support Services: The Department of Defense could expand its use of intergovernmental support agreements to obtain military installation support services and potentially save millions of dollars annually.

We also present 11 areas where Congress or executive branch agencies could take action to reduce the cost of government operations or enhance revenue collections for the U.S. Treasury (see table 2). Appendix III provides more detailed information about these new areas.

17. SNAP Employment and Training: To ensure an efficient use of workforce development resources, the U.S. Department of Agriculture should help states better leverage existing resources for their Supplemental Nutrition Assistance Program employment and training programs.

16. Patent Licensing at Federal Labs: The Department of Commerce could help federal agencies and laboratories more successfully license federal inventions to the private sector by addressing fragmentation of information on comparable licenses.

15. Federal Research: Implementing leading practices for collaboration to better manage fragmentation could help agencies improve their research efforts to maintain U.S. competitiveness in quantum computing and synthetic biology.

14. U.S. Security Assistance to the Caribbean: The Department of State should establish an initiative-wide planning and reporting mechanism to better manage fragmentation and potential overlap of security assistance activities in Caribbean countries.

13. State’s Internal Communication Regarding Cuba Incidents: The Department of State should better manage fragmentation of information by revising its policies to ensure appropriate internal communication of relevant incidents that may involve injury, loss of life, or destruction of property at, or related to, U.S. missions abroad.

12. Coordination of Overseas Stabilization Efforts: To reduce the risks associated with fragmentation, overlap, and duplication, the Departments of State and Defense and the U.S. Agency for International Development should document their agreement to coordinate U.S. stabilization efforts through formal written guidance and agreements that address key collaboration practices.

11. Alignment of Foreign Assistance Strategies: Guidance from the Department of State would help agencies that provide foreign assistance align strategies and identify and better manage fragmentation.

10. Department of Homeland Security’s Office of Strategy, Policy, and Plans: Clearer roles and responsibilities for the Department of Homeland Security’s Office of Strategy, Policy, and Plans would enhance the department’s efficiency and reduce the risks associated with fragmentation in the development of department-wide and crosscutting strategies, policies, and plans.

9. Chemical Terrorism: The Department of Homeland Security should develop a strategy and implementation plan for its chemical defense programs and activities to better manage these fragmented efforts.

8. DOD Adverse Medical Events: The Department of Defense needs to improve the systems and processes it uses to track the most serious adverse medical events to reduce and better manage fragmentation, fully understand why such events occurred, and identify what actions are needed to prevent similar incidents.

7. IRS Strategic Workforce Planning: The Internal Revenue Service should address its fragmented human capital activities to improve its strategic workforce planning so it can better meet challenges to achieving its mission.

6. Foreign Asset Reporting: Congress should take steps to address overlap in foreign asset reporting requirements—which could potentially generate cost savings—while agencies should improve collaboration to help mitigate burdens faced by U.S. individuals living abroad.

5. Federal Shared Services: The Office of Management and Budget and the General Services Administration could better position themselves to achieve their cost savings goal of $2 billion over 10 years and reduce inefficient overlap and duplication by strengthening their implementation of selected federal shared services reform efforts.

4. Defense Health Care Reform: The Department of Defense could potentially save millions of dollars by resolving weaknesses in its planning efforts to reform the administration of military treatment facilities.

3. DOD Document Services: The Department of Defense should take actions to better manage fragmentation in its document services functions to potentially save millions of dollars annually.

2. Defense Agency Human Resources Services: The Department of Defense should address fragmentation and overlap among providers of human resources services to increase effectiveness and efficiency and potentially save millions of dollars.

1. Arsenic in Rice: To avoid unnecessary and potentially inefficient duplicative efforts, the Food and Drug Administration and the U.S. Department of Agriculture should improve coordination of their efforts to develop methods for detecting contaminants in food, including arsenic in rice.

This report presents 98 new actions that Congress or executive branch agencies could take across 28 new areas. [5] Of these 28 new areas, 17 concern fragmentation, overlap, or duplication in government missions and functions (see table 1). Appendix II provides more detailed information about the 17 new areas.

Appendixes

Appendix I: Objectives, Scope, and Methodology

Section 21 of Public Law 111-139, enacted in February 2010, requires us to conduct routine investigations to identify federal programs, agencies, offices, and initiatives with duplicative goals and activities within departments and government-wide.[12] This provision also requires us to report annually to Congress on our findings, including the cost of such duplication, with recommendations for consolidation and elimination to reduce duplication and specific rescissions (legislation canceling previously enacted budget authority) that Congress may wish to consider. Our objectives in this report are to (1) identify potentially significant areas of fragmentation, overlap, and duplication and opportunities for cost savings and enhanced revenues that exist across the federal government; (2) assess to what extent have Congress and executive branch agencies addressed actions in our 2011 to 2018 annual reports; and (3) highlight examples of open actions directed to Congress or key executive branch agencies. For the purposes of our analysis, we used the term “fragmentation” to refer to circumstances in which more than one federal agency (or more than one organization within an agency) is involved in the same broad area of national need and there may be opportunities to improve how the government delivers these services. We used the term “overlap” when multiple agencies or programs have similar goals, engage in similar activities or strategies to achieve them, or target similar beneficiaries. We considered “duplication” to occur when two or more agencies or programs are engaged in the same activities or provide the same services to the same beneficiaries.[13] This report presents 17 new areas of fragmentation, overlap, or duplication where greater efficiencies or effectiveness in providing government services may be achievable. The report also highlights 11 other new opportunities for potential cost savings or revenue enhancements. To identify what actions, if any, exist to address fragmentation, overlap, and duplication and take advantage of opportunities for cost savings and enhanced revenues, we reviewed and updated our prior work and recommendations to identify what additional actions Congress may wish to consider and agencies may need to take. For example, we used our prior work identifying leading practices that could help agencies address challenges associated with interagency coordination and collaboration and with evaluating performance and results in achieving efficiencies.[14] To identify the potential financial and other benefits that might result from actions addressing fragmentation, overlap, or duplication, or taking advantage of other opportunities for cost savings and enhanced revenues, we collected and analyzed data on costs and potential savings to the extent they were available. Estimating the benefits that could result from addressing these actions was not possible in some cases because information about the extent and impact of fragmentation, overlap, and duplication among certain programs was not available. Further, the financial benefits that can be achieved from addressing fragmentation, overlap, or duplication or taking advantage of other opportunities for cost savings and enhanced revenues were not always quantifiable in advance of congressional and executive branch decision-making. In addition, the needed information was not readily available on, among other things, program performance, the level of funding devoted to duplicative programs, or the implementation costs and time frames that might be associated with program consolidations or terminations. Appendix VI provides additional information on the federal programs or other activities related to the new areas of fragmentation, overlap, duplication, and cost savings or revenue enhancement discussed in this report, including budgetary information when available. We assessed the reliability of any computer-processed data that materially affected our findings, including cost savings and revenue enhancement estimates. The steps that we take to assess the reliability of data vary but are chosen to accomplish the auditing requirement that the data be sufficiently reliable given the purposes for which it is used in our products. We review published documentation about the data system and inspector general or other reviews of the data. We may interview agency or outside officials to better understand system controls and to assure ourselves that we understand how the data are produced and any limitations associated with the data. We may also electronically test the data to see whether values in the data conform to agency testimony and documentation regarding valid values, or we may compare data to source documents. In addition to these steps, we often compare data with other sources as a way to corroborate our findings. For each new area in this report, specific information on data reliability is located in the related products. We provided drafts of our new area summaries to the relevant agencies for their review and incorporated these comments as appropriate. Assessing the Status of Previously Identified Actions To examine the extent to which Congress and executive branch agencies have made progress in implementing the 805 actions in the approximately 300 areas we have reported on in previous annual reports on fragmentation, overlap, and duplication, we reviewed relevant legislation and agency documents such as budgets, policies, strategic and implementation plans, guidance, and other information between April 2018 and March 2019. We also analyzed, to the extent possible, whether financial or other benefits have been attained, and included this information as appropriate. (See discussion below on the methodology we used to estimate financial benefits.) In addition, we discussed the implementation status of the actions with officials at the relevant agencies. Throughout this report, we present our counts as of March 2019 because that is when we received our last updates. The progress statements and updates are published on GAO’s Action Tracker. We used the following criteria in assessing the status of actions: In assessing actions suggested for Congress, we applied the following criteria: “addressed” means relevant legislation has been enacted and addresses all aspects of the action needed; “partially addressed” means a relevant bill has passed a committee, the House of Representatives, or the Senate during the current congressional session, or relevant legislation has been enacted but only addressed part of the action needed; and “not addressed” means a bill may have been introduced but did not pass out of a committee, or no relevant legislation has been introduced. Actions suggested for Congress may also move to “addressed” or “partially addressed” with or without relevant legislation if an executive branch agency takes steps that address all or part of the action needed. At the beginning of a new congressional session, we reapply the criteria. As a result, the status of an action may move from partially addressed to not addressed if relevant legislation is not reintroduced from the prior congressional session.

In assessing actions suggested for the executive branch, we applied the following criteria: “addressed” means implementation of the action needed has been completed; “partially addressed” means the action needed is in development or started but not yet completed; and “not addressed” means the administration, the agencies, or both have made minimal or no progress toward implementing the action needed. Since 2011, we have categorized 69 actions as “other” and are no longer assessing these actions. We categorized 42 “other” actions as “consolidated or other.” In most cases, “consolidated or other” actions were replaced or subsumed by new actions based on additional audit work or other relevant information. We also categorized 27 of the “other” actions as “closed-not addressed.” Actions are generally “closed-not addressed” when the action is no longer relevant because of changing circumstances. Methodology for Generating Total Financial Benefits Estimates In order to calculate the total financial benefits resulting from actions already taken (addressed or partially addressed) and potential financial benefits from actions that are not fully addressed, we compiled available estimates for all of the actions from GAO’s Action Tracker, from 2011 through 2018, and from reports identified for inclusion in the 2019 annual report, and linked supporting documentation to those estimates. Each estimate was reviewed by one of our technical specialists to ensure that estimates were based on reasonably sound methodologies. The financial benefits estimates came from a variety of sources, including our analysis, Congressional Budget Office estimates, individual agencies, the Joint Committee on Taxation, and others. Because of differences in time frames, underlying assumptions, quality of data and methodologies among these individual estimates, any attempt to generate a total will be associated with uncertainty that limits the precision of this calculation. As a result, our totals represent a rough estimate of financial benefits, rather than an exact total. For actions that have already been taken, individual estimates of realized financial benefits covered a range of time periods stretching from 2010 through 2025. In order to calculate the total amount of realized financial benefits that have already accrued and those that are expected to accrue, we separated those that accrued from 2010 through 2018 and those expected to accrue between 2019 and 2025. For individual estimates that span both periods, we assumed that financial benefits were distributed evenly over the period of the estimate.[15] For each category, we summed the individual estimates in order to generate a total. To account for uncertainty and imprecision resulting from the differences in individual estimates, we present these realized savings to the nearest billion dollars, rounded down. There is a higher level of uncertainty for estimates of potential financial benefits that could accrue from actions not yet taken because these estimates are dependent on whether, how, and when agencies and Congress take our recommended actions. As a result, many estimates of potential savings are notionally stated using terms like millions, tens of millions, or billions, to demonstrate a magnitude without providing a more precise estimate. Further, many of these estimates are not tied to specific time frames for the same reason. In order to calculate a total for potential savings, with a conservative approach, we used the minimum number associated with each term.[16] To account for the increased uncertainty of potential estimates and the imprecision resulting from differences among individual estimates, we calculated potential financial benefits to the nearest $10 billion, rounded down, and presented our results using a notional term. This report is based upon work GAO previously conducted in accordance with generally accepted government auditing standards. Generally accepted government auditing standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives.

Appendix II: New Areas in Which GAO Has Identified Fragmentation, Overlap, or Duplication

This appendix presents 17 new areas in which we found evidence of fragmentation, overlap, or duplication among federal government programs.

1. Arsenic in Rice

To avoid unnecessary and potentially inefficient duplicative efforts, the Food and Drug Administration and the U.S. Department of Agriculture should improve coordination of their efforts to develop methods for detecting contaminants in food, including arsenic in rice. Quick Look Potential Benefit Improved management of resources Implementing Entity Food and Drug Administration and U.S. Department of Agriculture Link to Actions GAO identified one action each for FDA and USDA to improve coordination on methods to detect contaminants in food. See GAO’s Action Tracker. Related GAO Product GAO-18-199 Contact Information Steve Morris at (202) 512-3841 or morriss@gao.gov Arsenic, an element in the earth’s crust, can be harmful to human health and may be present in water and certain foods. The Department of Health and Human Services’ (HHS) Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA) work to address food safety risks. FDA’s responsibilities for rice include regulatory and research programs; USDA’s include research programs. In March 2018, GAO found that FDA and USDA’s Federal Grain Inspection Service (FGIS) and Agricultural Research Service (ARS) coordinated on the development of detection methods for arsenic in rice to a limited extent. Officials from FDA and FGIS told GAO that they began to coordinate in March 2016, when they discovered they were each working independently to adapt a digital test kit used for detecting arsenic in drinking water so that it can be used to detect arsenic in rice. FGIS suspended work on the effort after about nine months. ARS researched a different method to detect arsenic in rice, and ARS did not coordinate with FDA to develop this method because, according to ARS officials, the agencies are trying to meet different needs with their research. The strategic plans of FDA and of USDA’s ARS and FGIS show a shared interest in developing detection methods for foodborne contaminants, including arsenic in rice. However, neither FDA nor USDA has a mechanism to coordinate this work. Instead, according to FDA and USDA officials, they coordinate on an informal basis. GAO has shown in prior work that many of the meaningful results that the federal government seeks to achieve, such as those related to protecting food and agriculture, require the coordinated efforts of more than one federal agency. Because of risks to the economy and to public health and safety, GAO has identified transforming federal oversight of food safety as a high-risk area. GAO has also noted in prior work that interagency mechanisms to coordinate programs that address crosscutting issues may reduce potentially inefficient duplicative efforts. GAO recommended in 2018 that FDA and USDA develop a mechanism to coordinate the development of methods to detect contaminants in food, including arsenic in rice. In its comments, HHS generally agreed with the recommendation and stated that FDA agreed that such a mechanism would be worthwhile. USDA also generally agreed with the recommendation and stated that the USDA Office of the Chief Scientist will facilitate this effort. Better coordinating methods to detect contaminants in food, including arsenic in rice, could help FDA and USDA better manage their resources and avoid engaging in unnecessary and potentially inefficient duplicative efforts. During the course of the engagement, GAO found that FDA and USDA avoided duplicating their efforts to develop detection methods for arsenic in rice through informal discussions once their research efforts were underway. However, FDA and USDA do not proactively plan their shared research interest in developing such methods; therefore, the potential exists for engaging in potentially inefficient duplicative efforts in the future. Because the risk of duplication—and potential inefficiencies—is dependent on the specifics of future projects, GAO cannot develop an estimate of savings that would result from taking this action. Table 21 in appendix VI provides additional program information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report to HHS and USDA for review and comment. HHS had no comments. USDA noted, among other actions, that ARS would discuss common research needs with FDA and FGIS at the beginning of the 2021-2025 ARS food safety research program cycle. Such action may be responsive to GAO’s recommendation if it includes discussions about the development of methods to detect contaminants in food. GAO will continue to monitor USDA’s and FDA’s activities to determine whether the planned discussions lead to improved coordination in this area. Related GAO Product Food Safety: Federal Efforts to Manage the Risk of Arsenic in Rice. GAO-18-199. Washington, D.C.: March 16, 2018.

2. Defense Agency Human Resources Services

The Department of Defense should address fragmentation and overlap among providers of human resources services to increase effectiveness and efficiency and potentially save millions of dollars. Quick Look Potential Benefit Millions of dollars and more effective and efficient delivery of human resources services Implementing Entity Department of Defense Link to Actions GAO identified three actions to DOD to address inefficiencies related to human resources services provided by defense agencies. See GAO’s Action Tracker. Related GAO Product GAO-18-592 Contact Information Elizabeth Field at (202) 512-2775 or fielde1@gao.gov The Department of Defense (DOD) relies on six providers for human resources (HR) services—three military departments, the Defense Finance and Accounting Service (DFAS), the Defense Logistics Agency (DLA), and the Washington Headquarters Service (WHS). These providers develop vacancy announcements, screen potential candidates, and process personnel actions, among many other services. In September 2018, GAO found that these entities provided fragmented and overlapping services to customers. For example, DOD officials reported that all six provide some similar HR services to personnel employed by one customer, the Defense Security Cooperation Agency, depending on the location, rank, or other characteristics of the staff. GAO identified negative effects of these issues. First, defense organizations that use more than one HR services provider pay overhead costs for each provider, resulting in unnecessary expenses and inefficiencies. Second, DOD officials stated that over 800 fragmented learning management information technology (IT) systems store and record training records across the department, which are costly to maintain. Third, the HR services providers use inconsistent performance information regarding hiring, thereby limiting DOD’s ability to assess what changes, if any, need to be made to hiring practices. Specifically, DFAS, DLA, and WHS differed in how they measure and report performance data, such as time-to-hire measures, which limits customers’ ability to make informed choices about selecting a HR services provider. In January 2018, DOD established the Human Resources Management Reform Team to initiate key reform efforts within the department. According to the team’s charter, the team will work to modify HR processes and move toward enterprise service delivery of HR services, which DOD expects to reduce costs. Team members said they would initially focus on high-priority challenges, such as pursuing the optimal IT systems, such as learning management systems, for DOD HR services department-wide and identifying legislative and regulatory changes needed to streamline processes and procedures. After making progress in these areas, the team plans to review service delivery across the department and determine the most effective and efficient system. However, GAO identified limitations in how the team was planning and managing its work. Specifically, the reform team had not required the use of consistent performance measures and had not set clear time frames for some of its work. Further, the reform team lacked key pieces of information, such as data on overhead costs. GAO recommended that DOD (1) collect information on the overhead costs charged by all DOD HR services providers, (2) identify time frames and deliverables for adopting optimal IT solutions for HR and implementing the most effective and efficient means of HR service delivery, and (3) require that all DOD HR providers adopt consistent time-to-hire measures. DOD concurred, stating that the department is on track to achieve substantial savings through its reform team efforts. Addressing these issues could help DOD provide a more effective, economical, and efficient HR service delivery model. DOD could not provide a cost savings estimate for learning management system reform or a comprehensive list of related IT systems. GAO identified 100 IT systems that DOD could consider. The total cost of these systems in fiscal year 2017 exceeded $300 million, and about half of the systems cost over $1 million. By eliminating even one of these more costly systems, DOD could reasonably be expected to save $1 million or more, depending on DOD’s analysis and subsequent actions. Table 22 in appendix VI provides additional program information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to DOD for review and comment. DOD officials stated that the department would continue to review the most effective and efficient means of HR service delivery. DOD officials also provided GAO an update on these recommendations, including estimated milestones through fiscal year 2020. Related GAO Product Defense Management: DOD Needs to Address Inefficiencies and Implement Reform across Its Defense Agencies and DOD Field Activities. GAO-18-592. Washington, D.C.: September 6, 2018

3. DOD Document Services

The Department of Defense should take actions to better manage fragmentation in its document services functions to potentially save millions of dollars annually. Quick Look Potential Benefit Millions of dollars annually Implementing Entity Department of Defense Link to Actions GAO identified five actions to address fragmentation and overlap. See GAO’s Action Tracker. Related GAO Product GAO-19-71 Contact Information Elizabeth Field at (202) 512-2775 or fielde1@gao.gov During fiscal years 2010 through 2015, the Department of Defense (DOD) reported spending an annual average of $608 million on document services, which include printing, copying, and related activities. Multiple DOD components have a role in providing document services. The Defense Logistics Agency (DLA) is DOD’s single manager for printing and high-speed, high-volume duplicating and the preferred provider for document conversion and automation services. Other components, including the military services, also maintain some of these capabilities. In October 2018, GAO found that DOD had taken some steps to achieve efficiencies in its document services, but identified four areas where gains may be possible. First, DOD customers were obtaining printing and duplicating services from DLA, as required by DOD policy, but were also obtaining services directly from the Government Publishing Office and from in-house print facilities, citing concerns about DLA’s quality, cost, and timeliness. DOD had not assessed whether DLA’s single manager role was the most effective and efficient model for providing the services. Second, DOD had not developed a department-wide approach to acquiring print devices, and DOD components used at least four different contract sources to acquire print devices, with costs that varied widely for similar devices. GAO analyzed a selection of standard print device pricing and vendor quotes for similar devices across the contracts and found that consolidating procurements of print devices could potentially reduce DOD’s costs. However, DOD had not assessed which acquisition approach represented the best value. Third, DOD could not demonstrate that it had achieved its goals for reducing the number of print devices, which it had estimated would result in savings of millions of dollars annually. DOD lacked adequate internal controls, such as reporting procedures, and it did not assign responsibility for monitoring the department’s progress in meeting these goals. Fourth, DOD may be able to realize additional savings from further consolidating DLA facilities beyond those already identified, but DLA did not have the complete data it would need to do so. As of October 2018, DLA planned to close 74 of 112 printing facilities in the United States. DLA generally consolidated or retained facilities based on whether they provided mission specialty services that could not be easily outsourced. GAO analysis found that DLA planned to retain facilities that were responsible for less than 5 percent of the total revenue for certain types of mission specialties, which suggests that further consolidations may be possible. GAO also found that DLA did not have revenue data on all of its mission specialties to inform any future consolidation decisions. GAO made five recommendations, including that DOD assess whether DLA’s single manager role for printing and duplication services and its current approach to obtaining print devices provides the best value; implement controls and assign responsibility to monitor actions to reduce the number of print devices; and evaluate opportunities to further consolidate DLA facilities. DOD concurred with the recommendations and identified specific actions to address them. DOD could potentially achieve cost savings and gain other efficiencies by implementing GAO’s recommendations, which would help manage fragmentation in its document services. For example, DOD estimated that reducing the number of its print devices would save millions of dollars annually. Implementing additional controls and assigning oversight responsibilities to monitor progress on reducing the number of print devices would better enable DOD to achieve its cost savings goals. Table 23 in appendix VI provides additional program information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to DOD for review and comment. DOD agreed with the accuracy of the information presented in this section. DOD also provided technical comments, which GAO incorporated as appropriate. Related GAO Product Document Services: DOD Should Take Actions to Achieve Further Efficiencies. GAO-19-71. Washington, D.C.: October 11, 2018.

4. Defense Health Care Reform

The Department of Defense could potentially save millions of dollars by resolving weaknesses in its planning efforts to reform the administration of military treatment facilities. Quick Look Potential Benefit Millions of dollars Implementing Entity Department of Defense Link to Actions GAO identified three actions to reduce or better manage duplicative functions and improve efficiencies in the administration of the military treatment facilities. See GAO’s Action Tracker. Related GAO Product GAO-19-53 Contact Information Brenda S. Farrell at (202) 512-3604 or farrellb@gao.gov In fiscal year 2017, the Department of Defense (DOD) provided health care to 9.4 million beneficiaries, including servicemembers, retirees, and their families. In September 2013, DOD established the Defense Health Agency (DHA) to create a more integrated Military Health System and achieve cost savings at headquarters-level organizations. These organizations have responsibilities that generally involve oversight, direction, and control of subordinate organizations or other units. According to DOD, there are approximately 679 military treatment facilities (MTFs) including military hospitals, ambulatory care clinics, and dental clinics. In fiscal year 2017, Congress directed that the administrative responsibility for the MTFs transfer from the military departments to the Director of the DHA. This transfer will include management responsibilities, among other things, and shall be completed no later than September 30, 2021. Congress also directed that the Secretary of Defense develop an implementation plan for the transfer of administration of the MTFs that includes certain elements, such as DOD’s efforts to eliminate duplicative activities and reduce headquarters-level military, civilian, and contractor personnel of the headquarters activities within the Military Health System. In October 2018, GAO found that DOD excluded 16 operational readiness and installation-specific medical functions, including dental care and substance abuse programs, from the planned transfer to DHA. DOD did not provide any analysis or documentation regarding the decision to exclude these 16 functions. However, senior-level officials from the Assistant Secretary of Defense for Health Affairs and DHA acknowledged that transferring the dental care function, for example, from the military departments to DHA could potentially reduce duplicative activities and result in more efficiencies. DOD also has not conducted a comprehensive review to validate headquarters-level personnel requirements needed to accomplish its mission and performance objectives, including the least costly mix of personnel (i.e., military, civilian, and contract). DOD policy states that personnel requirements are driven by workload and shall be established at the minimum levels necessary to accomplish mission and performance objectives. GAO recommended that DOD (1) define and analyze the 16 operational readiness and installation-specific medical functions not included in the planned transfer to the DHA for duplication; (2) validate headquarters-level personnel requirements; and (3) identify the least costly mix of personnel. DOD concurred and stated it was assessing the 16 functions previously identified for exclusion from transfer to DHA and personnel requirements, including an extensive review of the personnel requirements for the management structure of the DHA. In March 2019, DOD officials stated that DOD continues to take action to address GAO’s recommendations, to include implementing congressional direction to address specific medical functions and addressing personnel requirements and mix. However, as GAO previously stated in the report, DOD needs to identify the least costly mix of military, civilian, and contractors once it has validated requirements for DHA. GAO will continue to monitor DOD’s progress for addressing these recommendations. Taking these actions should help DOD and congressional decision makers understand how this significant reform effort will improve effectiveness and efficiency in the administration of the MTFs. Taking these actions could also potentially achieve millions of dollars in savings. For example, GAO calculated that for one of the functions not being considered, a savings of even 1 percent could amount to millions of dollars in savings in the administration of the MTFs. Table 24 in appendix VI provides additional program and budgetary information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to DOD for review and comment. DOD officials provided technical comments, which GAO incorporated as appropriate. Related GAO Product Defense Health Care: DOD Should Demonstrate How Its Plan to Transfer the Administration of Military Treatment Facilities Will Improve Efficiency. GAO-19-53. Washington, D.C.: October 30, 2018.

5. Federal Shared Services

The Office of Management and Budget and the General Services Administration could better position themselves to achieve their cost savings goal of $2 billion over 10 years and reduce inefficient overlap and duplication by strengthening their implementation of selected federal shared services reform efforts. Quick Look Potential Benefit Reduce duplicative efforts, cut costs, and modernize aging IT systems Implementing Entity Office of Management and Budget Link to Actions GAO identified four actions to improve OMB implementation of shared services initiatives with GSA. See GAO’s Action Tracker. Related GAO Product GAO-19-94 Contact Information Tranchau (Kris) T. Nguyen at (202) 512-2660 or nguyentt@gao.gov The federal government can reduce duplicative efforts and free up resources for mission-critical activities by consolidating mission-support services that multiple agencies need—such as payroll or travel—with a smaller number of providers so they can be shared among agencies. According to the Office of Management and Budget (OMB), the federal government spends more than $25 billion annually on core mission-support services that are common across agencies, such as human resources (HR) and financial management. OMB and the General Services Administration (GSA) are responsible for overseeing a strategic, government-wide framework for improving the effectiveness and efficiency of shared services. The Office of Personnel Management estimated that implementation of shared services for HR, including payroll, resulted in more than $1 billion in government-wide cost savings and cost avoidance between fiscal years 2002 and 2015. However, these results have not been consistent across shared services migration efforts, according to OMB and others who have observed these migrations. In 2018, OMB and GSA introduced a new marketplace model meant to better meet the needs of customers and service providers by offering more choices for purchasing shared services. In March 2019, GAO identified weaknesses with the implementation of the new marketplace that may limit its success. For example, OMB and GSA designed a payroll initiative called NewPay to determine how well the new marketplace model works. However, GAO found that they do not have a plan to monitor NewPay’s implementation. OMB and GSA also did not identify or document some key roles and responsibilities. A monitoring plan which includes performance goals and milestones and a process for documenting key roles could help OMB and GSA avoid gaps in service or costly delays as agencies transition to the new model for obtaining shared services. GAO also found that OMB and GSA have not updated provider information for prospective customers on available shared services, pricing, and performance. Without up-to-date information on providers, it will be time consuming and difficult for potential customers to compare providers. Finally, GAO found that OMB and GSA set a cost-savings goal of $2 billion over 10 years based on reforms to the shared services governance structure and marketplace for federal agencies. However, they do not have a process for collecting and tracking data to assess their progress toward that goal. This information is necessary for OMB and GSA to determine progress and help identify areas for improvement. GAO recommended that OMB’s Shared Services Policy Officer should work with GSA to (1) finalize a monitoring plan for the implementation of NewPay, (2) document key decision-making roles and responsibilities, (3) develop a process to provide information to customers on services, pricing, and performance to help minimize the challenges of transitioning to shared services on key stakeholders, and (4) implement a process for collecting and tracking cost-savings data that would allow them to assess progress toward their cost-savings goal. As of March 2019, OMB staff did not comment on GAO’s recommendations, but noted that OMB may update its shared services policy in the future. Taking these steps should help OMB and GSA strengthen their approach to implementing shared services reform so that they are better positioned to achieve cost savings and reduce inefficient overlap and duplication. Table 25 in appendix VI provides additional program and budgetary information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to OMB for review and comment. OMB did not provide comments on this report section. Related GAO Product Streamlining Government: OMB and GSA Could Strengthen Their Approach to Implementing a New Shared Services Plan. GAO-19-94. Washington, D.C.: March 7, 2019.

6. Foreign Asset Reporting

Congress should take steps to address overlap in foreign asset reporting requirements—which could potentially generate cost savings—while agencies should improve collaboration to help mitigate burdens faced by U.S. individuals living abroad. Quick Look Potential Benefit Cost savings from reduced reporting and improved agency coordination Implementing Entity Congress, the Departments of Treasury and State, and the Social Security Administration Link to Actions GAO identified one matter for Congress and three actions to manage overlap and fragmentation. See GAO’s Action Tracker. Related GAO Product GAO-19-180 Contact Information James R. McTigue, Jr. at (202) 512-9110 or mctiguej@gao.gov Some people subject to U.S. tax obligations have used offshore accounts to hide income and evade taxes. According to a number of international tax policy experts, revenue losses due to such offshore noncompliance are in the billions of dollars annually. The passage of the set of statutory provisions known as the Foreign Account Tax Compliance Act (FATCA) in 2010 sought to reduce tax evasion by creating greater transparency and accountability for offshore assets potentially subject to U.S. taxation (Subtitle A of title V of the Hiring Incentives to Restore Employment Act, Public Law 111-147). In April 2019, GAO found that overlapping statutory requirements resulted in duplicative reporting of foreign asset information by individuals subject to the requirements. Specifically, the Internal Revenue Service (IRS) and Financial Crimes Enforcement Network (FinCEN)—both within the Department of the Treasury (Treasury)—collect duplicative foreign financial account and other asset information from certain individuals with U.S. tax filing obligations. GAO determined that in tax years 2015 and 2016, close to 75 percent of filers who reported information on foreign accounts and other assets on their tax returns (more than 270,000 each year) also filed a separate form with FinCEN. These overlapping requirements increase the compliance burden on these filers, in terms of cost and time, and add complexity, potentially resulting in confusion and inaccurate or unnecessary reporting. Modifying the statutes governing the requirements can address these issues and reduce costs to the government to process and store foreign financial asset information. GAO also found that some U.S. individuals living abroad faced challenges accessing financial services after FATCA was enacted. In some cases, foreign financial institutions closed existing accounts or denied opportunities to open new accounts due to increased costs and other risks posed under FATCA reporting requirements. Individuals living abroad have driven an increased demand for Social Security Numbers (SSN) to meet their U.S. tax obligations or obtain foreign financial services; these include individuals who might not possess an SSN because their parents did not obtain one for them as a minor, often because the parents left the United States when the child was young. However, these individuals encountered problems obtaining SSNs, due in part to difficulties obtaining documentation required to be submitted with SSN applications and mail times of 3 to 6 months—depending on the country’s mail service—to receive a Social Security card after an application is processed. Effects of FATCA implementation—such as reduced access to foreign financial services—contributed to individuals’ decisions to renounce their U.S. citizenship since FATCA was enacted. According to the Department of State (State) data, annual approvals of renunciations increased from about 1,600 to 4,449—or nearly 178 percent—between 2011 and 2016, attributable in part to these challenges. Although Treasury previously worked with State to address the loss of access to financial services resulting from FATCA, some individuals living abroad continue to face these challenges, including difficulties obtaining SSNs. Treasury lacks ongoing mechanisms to coordinate efforts with State and the Social Security Administration (SSA) to address them. Without collaborative mechanisms to monitor and share information and establish cross-agency solutions, efforts to address these challenges will be fragmented. GAO suggested that Congress consider amending the Internal Revenue Code, Bank Secrecy Act of 1970, and other statutes, as needed, to address overlap in foreign financial asset reporting requirements for purposes of tax compliance and detection and prevention of financial crimes. GAO cannot yet estimate potential cost savings from implementing this action because the amount of savings will be dependent on the specifics of how Congress chooses to amend the reporting requirements. GAO also made three recommendations—one each to Treasury, State, and SSA—to establish collaborative mechanisms to address ongoing issues that individuals living abroad encounter from FATCA reporting requirements, with efforts led by Treasury. These actions should help the U.S. government coordinate otherwise fragmented efforts to mitigate burdens faced by individuals affected by FATCA implementation. State and SSA concurred with GAO’s recommendations, while Treasury neither agreed nor disagreed. Later this year, GAO will obtain information on how these agencies plan to implement the recommendations. Table 26 in appendix VI provides additional program and budgetary information related to this issue area. Agency Comments and GAO's Evaluation GAO provided a draft of this report section to Treasury, State, and SSA for review and comment. Treasury and State had no comments on this report section. SSA provided technical comments, which GAO incorporated as appropriate. Related GAO Product Foreign Asset Reporting: Actions Needed to Enhance Compliance Efforts, Eliminate Overlapping Requirements, and Mitigate Burdens on U.S. Persons Abroad. GAO-19-180. Washington, D.C.: April 1, 2019.

7. IRS Strategic Workforce Planning

The Internal Revenue Service should address its fragmented human capital activities to improve its strategic workforce planning so it can better meet challenges to achieving its mission. Quick Look Potential Benefit Improved ability to identify and develop the workforce needed for the future Implementing Entity Internal Revenue Service Link to Actions GAO identified two actions to improve IRS’s strategic workforce planning activities. See GAO’s Action Tracker. Related GAO Product GAO-19-176 Contact Information James R. McTigue, Jr. at (202) 512-9110 or mctiguej@gao.gov In recent years, the Internal Revenue Service (IRS) faced a number of challenges, such as declining budgets, increasing responsibilities, and evolving risks with regard to protecting taxpayer information. IRS’s workforce—consisting of nearly 78,000 full-time equivalents as of fiscal year 2017—is key to addressing these challenges. Cultivating a well-equipped, diverse, flexible, and engaged workforce requires strategic human capital management. In March 2019, GAO found that IRS has scaled back strategic workforce planning activities, such as developing an inventory of skills, identifying skills gaps, and attrition forecasting. Since 2011, IRS’s Human Capital Office has decided to largely abandon these activities because of resource constraints and because attrition has left it with fewer staff with strategic workforce planning skills. Activities to support workforce planning and skills assessments shifted to the individual business divisions and program offices and became increasingly fragmented. This fragmentation puts IRS at greater risk for inefficient duplication of effort in human resources activities. It could also lead to failure to effectively identify and retain personnel with critical skills and experience and hiring staff that may not serve the agency’s current and future needs. In light of a number of indicators, such as high rates of retirement eligibility and declining employee satisfaction, IRS determined in 2016 that this approach is unsustainable and took steps to improve its strategic workforce planning capabilities. For example, IRS developed a five-phase workforce planning initiative. The five phases of the initiative are to (1) conduct enterprise strategy and planning, (2) conduct workforce analysis, (3) create a workforce plan, (4) implement the workforce plan, and (5) monitor and evaluate the results. IRS also took related actions, such as issuing policy to outline an agency-wide approach to workforce planning, and establishing a Workforce Planning Council with business unit representatives. However, implementation of the initiative was on hold as of November 2018 due to a number of issues, including the need to redirect personnel resources to implementing Public Law 115-97—commonly referred to as the Tax Cuts and Jobs Act—and need to integrate systems to aid in workforce planning analysis. IRS officials could not provide an estimated completion date for any of the five phases. In addition, IRS had not assessed which mission critical occupations have the highest risk for skills gaps. According to IRS officials, the agency is pursuing new contract support to assist with developing a skills inventory and identify where significant skills gaps may exist. Once contractor support efforts are underway, IRS officials told GAO the agency will be better positioned to provide an estimated completion date for the five phases. GAO recommended actions IRS can take to fully implement the workforce planning initiative. GAO also recommended that IRS develop a work plan or other mechanism to prioritize and schedule skills assessments for mission critical occupations at the highest risk of skills gaps, such as those areas where key activities have been scaled back. IRS agreed with these recommendations. Fully implementing these recommendations will help IRS address fragmentation of human capital planning efforts and could aid in developing an inventory of its workforce, competency, and staffing requirements and in identifying and addressing skills gaps in mission critical occupations. Table 27 in appendix VI provides additional program information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to IRS for review and comment. IRS provided technical comments, which GAO incorporated as appropriate. Related GAO Product Internal Revenue Service: Strategic Human Capital Management is Needed to Address Serious Risks to IRS’s Mission. GAO-19-176. Washington, D.C.: March 26, 2019.

8. DOD Adverse Medical Events

The Department of Defense needs to improve the systems and processes it uses to track the most serious adverse medical events to reduce and better manage fragmentation, fully understand why such events occurred, and identify what actions are needed to prevent similar incidents. Quick Look Potential Benefit Increased efficiency and to better understand and potentially prevent serious adverse medical events Implementing Entity Department of Defense Link to Actions GAO identified one action to help DOD better track serious adverse medical events. See GAO’s Action Tracker. Related GAO Product GAO-18-378 Contact Information Debra Draper at (202) 512-7114 or draperd@gao.gov Each year, military hospitals and clinics report thousands of adverse medical events—unintended health care incidents that may or may not result in harm to the patient. The most serious type of adverse medical event is called a sentinel event, which can result in unexpected death or serious physical or psychological harm to the patient. For every sentinel event that occurs in a military clinic or hospital, referred to as military treatment facilities, officials are required to prepare a root cause analysis (RCA) report, which is intended to identify the factors that caused or contributed to the sentinel event, as well as corrective actions. Military treatment facilities report sentinel events and submit their corresponding RCA reports to the Department of Defense’s (DOD) Defense Health Agency (DHA), which tracks this information to determine whether system-wide patient safety improvements are needed. In April 2018, GAO reported that DOD has a fragmented process for tracking sentinel events and their RCA reports, which impedes DHA’s ability to ensure that it has received complete information. DHA’s adverse medical event reporting system lacks the ability to track RCA reports, so the military services (Army, Navy, and Air Force), the National Capital Region (NCR), and DHA each maintain their own tracking records for sentinel events and RCA reports. (NCR is the entity within DHA that manages military treatment facilities within the Washington D.C. area.) Due to these fragmented tracking efforts, DHA reconciles its information on sentinel events and RCA reports through monthly emails to the military services and NCR—a time-consuming, inefficient process that relies on the military services’ cooperation. Despite DHA’s reconciliation efforts, GAO identified discrepancies with reported sentinel events as well as missing RCA reports—for example, 75 sentinel events (out of 796) were missing their required RCA reports between 2013 and 2016. Because of these discrepancies, DHA lacks critical information about why a sentinel event may have occurred and how to prevent similar incidents in the future. GAO recommended that DHA improve its system to track sentinel events and RCA reports and require that the military services and NCR communicate reasons an RCA may not be completed. DHA concurred and reported that it has a new tool to help track these reports. However, the new tool requires any corrections or additional information to be submitted via email, which may perpetuate previous inefficiencies. DOD has yet to fully address the recommendation as of February 2019. Reporting and tracking of sentinel events and RCA reports provides critical information that can be used to improve the Military Health System. By reducing and better managing fragmentation in its system for tracking sentinel events, DOD can increase efficiency in tracking these events and RCA reports and potentially improve the completeness and reliability of patient safety data and its ability to identify and implement system-wide improvements. Although GAO believes this recommendation would lead to greater efficiency and potentially better, safer care, the cost of integrating these systems is unknown because DOD has not begun this process. Additionally, potential cost savings would likely be impacted by the purchase or development of a centralized tracking system and staff time needed for training. Table 28 in appendix VI provides additional program information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to DOD for review and comment. DOD provided technical comments, which GAO incorporated where appropriate. DOD officials told GAO they are currently exploring options for a comprehensive and integrated system for tracking and monitoring sentinel events, with a goal of implementing the new system in 2021. Related GAO Product DOD Health Care: Defense Health Agency Should Improve Tracking of Serious Adverse Medical Events and Monitoring of Required Follow-up. GAO-18-378. Washington, D.C.: April 26, 2018.

9. Chemical Terrorism

The Department of Homeland Security should develop a strategy and implementation plan for its chemical defense programs and activities to better manage these fragmented efforts. Quick Look Potential Benefit Improved support, guidance, integration, and coordination of DHS’s chemical defense efforts Implementing Entity Countering Weapons of Mass Destruction Office Link to Actions GAO identified one action for the Countering Weapons of Mass Destruction Office to better integrate DHS chemical defense efforts. See GAO’s Action Tracker. Related GAO Product GAO-18-562 Contact Information Christopher P. Currie at (404) 679-1875 or curriec@gao.gov The Department of Homeland Security (DHS) manages several programs and activities designed to prevent and protect against domestic attacks using chemical agents. In December 2017, DHS consolidated some chemical defense programs and activities by establishing a Countering Weapons of Mass Destruction Office. In August 2018, GAO reported that some DHS components had programs that focused on chemical defense, such as the Science and Technology Directorate’s (S&T) chemical hazard characterization efforts. Others had chemical defense responsibilities as part of their broader missions, such as U.S. Customs and Border Protection (CBP), which is responsible for interdicting chemical agents at the border. GAO found that DHS had not fully integrated and coordinated its chemical defense programs and activities. Several components—including CBP, U.S. Coast Guard, the Office of Health Affairs, and S&T—had separately conducted similar activities, such as acquiring chemical detectors or assisting local jurisdictions with preparedness, without DHS-wide direction and coordination. As components carry out chemical defense activities, DHS risks missing the opportunity to leverage resources and share information that could lead to greater effectiveness in addressing chemical threats. Given the breadth of DHS’s chemical defense responsibilities, a strategy and implementation plan would help the Countering Weapons of Mass Destruction Office (1) mitigate the risk of fragmentation among DHS programs and activities, and (2) establish goals and identify resources to achieve these goals, consistent with the GPRA Modernization Act of 2010. In 2012, DHS started to develop a strategy and implementation plan for all chemical defense activities, from prevention to recovery. DHS officials stated the 2012 effort was not completed because of leadership changes and competing priorities. In August 2018, GAO recommended that the Countering Weapons of Mass Destruction Office develop a strategy and implementation plan to help DHS guide, support, integrate, and coordinate chemical defense programs and activities. DHS concurred with the recommendation and estimated that it will complete this effort by September 2019. In January 2019, the Assistant Secretary for Countering Weapons of Mass Destruction stated that his office was taking actions to implement this recommendation. In December 2018, the Countering Weapons of Mass Destruction Act of 2018, H.R. 7213, was enacted into law (Public Law 115-387). The act statutorily establishes the Countering Weapons of Mass Destruction Office and outlines its authorities. The responsibilities of the office include developing departmental policy and strategy to plan for, detect, and protect against attacks using, or other specified illicit conduct involving, unauthorized chemical, biological, radiological, and nuclear materials, devices, or agents. Developing a strategy and implementation plan consistent with provisions of the act would help the Countering Weapons of Mass Destruction Office better manage chemical defense programs and activities. Further, such a strategy and plan would help mitigate duplication, overlap, and fragmentation risks and DHS would be positioned to further define its chemical defense capability and provide a roadmap for addressing any identified gaps. Other GAO work has also informed the organization efforts of the Countering Weapons of Mass Destruction Office. It includes testimony before Congress in December 2017 emphasizing, among other things, the importance of using key mergers and organizational transformation practices to help ensure that lessons learned from other reorganizations are considered during consolidation implementation efforts. Table 29 in appendix VI provides additional program and budgetary information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to DHS for review and comment. DHS did not provide comments on this report section. Related GAO Product Chemical Terrorism: A Strategy and Implementation Plan Would Help DHS Better Manage Fragmented Chemical Defense Programs and Activities. GAO-18-562. Washington, D.C.: August 22, 2018. Homeland Security: DHS’s Chemical, Biological, Radiological, and Nuclear Program Consolidation Efforts. GAO-18-284T. Washington, D.C.: December 7, 2017. Homeland Security: DHS’s Chemical, Biological, Radiological, Nuclear and Explosives Program Consolidation Proposal Could Better Consider Benefits and Limitations. GAO-16-603. Washington, D.C.: August 11, 2016.

10. Department of Homeland Security’s Office of Strategy, Policy, and Plans

Clearer roles and responsibilities for the Department of Homeland Security’s Office of Strategy, Policy, and Plans would enhance the department’s efficiency and reduce the risks associated with fragmentation in the development of department-wide and crosscutting strategies, policies, and plans. Quick Look Potential Benefit Improved efficiency and more effective policies Implementing Entity Department of Homeland Security Link to Actions GAO identified two actions for the Department of Homeland Security to better define roles and responsibilities and develop corresponding processes and procedures, for the Office of Strategy, Policy, and Plans. See GAO’s Action Tracker. Related GAO Product GAO-18-590 Contact Information Chris Currie at (404) 679-1875 or curriec@gao.gov The Department of Homeland Security (DHS) has long faced challenges building a cohesive department, an issue GAO has designated as high risk. DHS management has made significant progress addressing the problem, but issues remain. DHS’s Office of Strategy, Policy, and Plans (PLCY) is intended to support cohesiveness by, among other things, coordinating department-wide and crosscutting policy and strategy. For a number of years, questions have been raised about the office’s efficacy and engagement with DHS operational components. Section 1902 of the National Defense Authorization Act for Fiscal Year 2017 (NDAA), enacted in December 2016, codified PLCY’s organizational structure. Implementation of the act required organizational changes designed to respond to certain challenges the office had identified to its ability to perform effectively. In September 2018, GAO found that PLCY has encountered challenges leading and coordinating efforts to develop, update, or harmonize policies that affect multiple DHS components. For example, officials from one operational component said they were tasked with leading a department-wide policy development effort they believed was outside their area of responsibility and expertise. Officials in another operational component stated that components sometimes coordinate among themselves, but that policy development could be more effective and efficient if PLCY took the role of convener and facilitator to ensure the department-wide perspective is present and all relevant stakeholders participate. PLCY faces these challenges in large part because DHS does not have clearly defined roles and responsibilities with accompanying processes and procedures to help PLCY lead and coordinate policy in a predictable, repeatable, and accountable manner. Standards for Internal Control in the Federal Government states that management should establish an organizational structure, assign responsibility, and delegate authority to achieve the entity’s objectives. DHS had been working to develop a delegation of authority, which involves reaching agreement about PLCY’s roles and responsibilities and clearly documenting them. However, according to PLCY officials, that effort stalled because of changes in department leadership. Pursuant to the NDAA, PLCY is to be headed by an Under Secretary appointed by the President with the advice and consent of the Senate. The President nominated an Under Secretary on February 25, 2019. In addition, according to PLCY officials, as of March 2019, all Assistant Secretary positions within PLCY were filled. GAO recommended that DHS should finalize a delegation of authority or similar document that clearly defines PLCY’s mission, roles, and responsibilities relative to DHS’s operational and support components. GAO also recommended that DHS create corresponding processes and procedures to help implement the mission, roles, and responsibilities defined in the delegation of authority or similar document to help ensure predictability, repeatability, and accountability in department-wide and crosscutting strategy and policy efforts. DHS concurred with these recommendations and estimated it will publish a comprehensive delegation of authority by June 30, 2019, and corresponding implementing documentation, including processes and procedures, and other guidance, by September 30, 2019. According to PLCY officials, as of March 2019 PLCY had made progress toward finalizing the delegation of authority and expected to publish it by June 30, 2019. These officials also stated that PLCY has instituted many cross-component efforts to more clearly define its roles and responsibilities. Until PLCY’s roles and responsibilities for policy are more clearly defined and corresponding processes and procedures are in place, PLCY is likely to continue to be limited in its effectiveness in driving policy, resulting in inefficiencies and a continuing risk of fragmentation across DHS. While taking these actions may reduce the risk of future inefficiencies, GAO has not estimated the potential for savings because the specific actions the agency might take, resulting changes in process, and timing of implementation are unknown. Table 30 in appendix VI provides additional program information related to this issue area. Agency Comments and GAO’s Evaluation GAO provided a draft of this report section to DHS for review and comment. DHS provided technical comments, which GAO incorporated as appropriate. Related GAO Product Homeland Security: Clearer Roles and Responsibilities for the Office of Strategy, Policy, and Plans and Workforce Planning Would Enhance Its Effectiveness. GAO-18-590. Washington, D.C.: September 19, 2018.

11. Alignment of Foreign Assistance Strategies

Guidance from the Department of State would help agencies that provide foreign assistance align strategies and identify and better manage fragmentation. Quick Look Potential Benefit More effective foreign assistance Implementing Entity Department of State, in collaboration with other agencies Link to Actions GAO identified one action to State to provide guidance for strategy development. See GAO’s Action Tracker. Related GAO Product GAO-18-499 Contact Information David Gootnick at (202) 512-3149 or gootnickd@gao.gov The U.S. government provides foreign assistance for activities ranging from promoting democracy and better health to building the capacity of local security forces. These foreign assistance activities are provided by more than 20 U.S. agencies and are managed, in part, through a variety of federal strategies at the global, regional, and country level. In July 2018, GAO looked at 52 strategies us