What GAO Found The Department of Veterans Affairs (VA) allows eligible veterans to receive health care from community providers through the Veterans Community Care Program. Since 2020, GAO has made several recommendations to improve access to the Veterans Community Care Program in areas also highlighted by the 2025 Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (Dole Act). As of February 2026, VA has not fully implemented GAO’s recommendations. For example: Timely appointment scheduling. In 2020, GAO found that most Veterans Health Administration (VHA) facilities from the region included in its review did not have the recommended number of staff needed to manage community care referrals, creating potential risks to timely scheduling. GAO recommended that VHA assess community care staffing needs to identify and address any risks. VHA agreed with this recommendation and is working to enable its staffing tool to identify and report such risks, according to officials. GAO also recommended that VHA establish a wait time measure for community care appointments and align its performance metrics. VHA disagreed with this recommendation but has defined time frames for some steps. VHA has not fully implemented these recommendations. The Dole Act requires VA to take action on its staffing model and performance metrics to ensure timely care for veterans. Referral coordination and communication. In 2025, GAO reported that VHA facilities had mixed results in implementing the Referral Coordination Initiative, which aimed to improve referral coordination and streamline appointment scheduling. VHA had not documented key elements of the initiative in policy, which may contribute to inconsistences in implementation and limit staff and veterans’ understanding of community care options. GAO recommended that VHA include this initiative in its national policy. VHA concurred in principle with the recommendation, but has not yet implemented it. GAO also reported in 2025 that the Office of Integrated Veteran Care, which VHA created to improve coordination of community care, did not always clearly communicate information to its facilities. GAO recommended that VHA ensure this information is clearly communicated. VHA concurred with this recommendation but has not yet implemented it. The Dole Act also requires VA to review facilities’ processes for making such referrals. GAO also has ongoing work on VHA’s Caregiver Support Program. Preliminary results show that VHA responded to challenges caregivers reported with accessing in-person support by implementing a virtual therapy program. VHA also established goals to assess the effectiveness of its outreach efforts. These include a goal to increase program enrollment by 15 percent each fiscal year, which it met in fiscal year 2025. However, VHA has not set quantitative targets and time frames for its other goals. Doing so would better position VHA to assess its efforts and make any needed adjustments. The Dole Act also includes provisions addressing caregivers’ access to and awareness of VHA’s Caregiver Support Program. Why GAO Did This Study The Dole Act authorized significant expansions of health care programs for veterans and support for their caregivers. These programs are administered by VHA. An increasing number of veterans receive their care from providers outside of VHA facilities through the Veterans Community Care Program; in 2024, about 3.1 million veterans received such care. VHA also provides services and support to nearly 100,000 caregivers of veterans who suffered serious injuries in the line of duty through its Caregiver Support Program. Concerns have been raised about the mental health of veterans’ caregivers who often provide around the clock care that enables veterans to live at home and help with their recovery. GAO has a large body of work related to aspects of the community care and caregiver programs, both of which were addressed in the Dole Act. This statement summarizes recommendations and related work on the Community Care program. It is based on three GAO reports issued from 2020 through 2025 (GAO-20-643, GAO-25-106678, and GAO-25-107212). This statement also includes preliminary results from GAO’s ongoing work examining VA’s efforts to provide mental health support to caregivers. To do this work, GAO reviewed VHA documents on its caregiver program and interviewed VHA officials, program staff, and participating caregivers at four selected VHA facilities. For more information, contact Sharon M. Silas at silass@gao.gov.

What GAO Found The Department of Health and Human Services (HHS) administers sexual risk avoidance education (SRAE) grants to states and other entities, such as community organizations. SRAE is a type of sexual health education that focuses on abstaining from non-marital sexual activity and other risky behaviors, such as alcohol use. SRAE programs are typically provided to youths aged 10 to 19 in schools during the day. Stakeholders, such as sexual health educators GAO interviewed, had various perspectives on whether SRAE was effective, medically accurate and complete, or culturally appropriate. GAO identified one peer-reviewed study on SRAE, which concluded it was effective for some outcomes. HHS collects and reviews information of sufficient coverage and quality to assess SRAE grantees’ adherence to medical accuracy and cultural appropriateness program requirements. For example, HHS has a contractor-led process in place to review the medical accuracy of proposed program curricula. HHS also reviews information in grant applications that describe how grantees plan to serve certain populations and ensure program materials are culturally and linguistically appropriate. HHS’s Medical Accuracy Review Process for Sexual Risk Avoidance Education Grantees’ Selected Curricula HHS has assessed SRAE program results through a number of studies. For example, one study examined if implementation features—such as a non-school setting—were associated with intentions to delay sexual initiation. HHS also uses performance measures to assess whether grantees are meeting program objectives. However, HHS only has near-term goals for three of its performance measures. These are related to program reach and implementation. For example, its near-term goal for measuring the number of youth who attend a program session is to maintain the previous year’s number. HHS does not have near-term goals related to measuring youth outcomes and program experiences, such as the percent of participants that plan to abstain from sex. According to HHS officials, it is piloting additional near-term goals for another pregnancy prevention program it manages and intends to adapt them for SRAE programs. However, the early results of this effort had not identified any near-term goals for performance measures related to youth outcomes and experiences. Setting near-term goals for these measures will help HHS more effectively assess the performance of SRAE grantees in influencing participants’ behavior intentions and their experiences in the programs over time. Why GAO Did This Study Preventing unintended pregnancies and sexually transmitted infections among youth is an important public health goal. Although the overall U.S. birth rate for youth aged 15 to 19 years has steadily declined since the early 1990s, it has remained higher than that of comparable high-income countries. Youth pregnancy can have high health and economic costs for the parents, their children, and society more generally. Sexual health education aims to provide youth with the knowledge and skills they need to protect themselves from these potential health and economic risks. GAO was asked to examine issues related to SRAE. This report examines perspectives on the effectiveness, medical accuracy, and cultural appropriateness of SRAE; HHS’s use of information to assess grantee adherence to statutory and HHS requirements regarding medical accuracy and cultural appropriateness; and how HHS assesses the results of its SRAE programs. GAO reviewed relevant published literature and HHS documentation, including procedures, grant applications, and performance measure documentation. GAO also interviewed HHS officials, and non-generalizable samples of 14 SRAE grantees in five states and eight stakeholders, including national advocacy organizations, professional medical or health associations, sexual health educators, and an academic researcher.

What GAO Found The Department of Energy’s (DOE) Office of Environmental Management (EM) manages cleanup of hazardous and radioactive waste through capital asset projects and operations activities. Capital asset projects have defined start and end points, whereas operations activities are typically routine or reoccurring. As of August 2025, EM estimated costs for the most expensive capital asset projects ranging from $69 million to $18.5 billion, and costs for the most expensive operations activities ranging from $1 billion to $177 billion. EM’s data indicated that combined costs for the most expensive capital asset projects increased by more than $2 billion, and combined costs for the most expensive operations activities increased by about $75 billion since GAO last reported in 2022. EM officials said that these cost increases were already known to the agency and accounted for in previous life-cycle cost estimates that were communicated to Congress. As of May 2025, EM estimated that the remaining cleanup work at all its sites would cost more than half a trillion dollars. EM has seen cost increases and schedule delays due to multiple factors, and the office struggles to maintain complete documentation and reconcile data discrepancies. Specifically, key project documents are not consistently accessible for headquarters review in DOE’s project management database. These documents could provide valuable information on reasons behind increases and recommendations to address underlying issues. Similarly, EM faces challenges providing current cost and schedule information for operations activities that is consistent across headquarters and sites, and EM officials could not easily coordinate to reconcile the inconsistencies. Ensuring availability of complete project information and improving coordination to address the accuracy and consistency of cost and schedule information will help EM manage its projects and activities, report more accurate information to Congress, and provide support to sites. Even if EM improves the completeness and consistency of information on its projects and activities, its cost and schedule estimates may still reflect significant uncertainty. EM officials from several sites told GAO that final cleanup remedies at their sites still need to be determined, which may increase costs and schedules. GAO has reported that significant cost and schedule savings are still possible on several cleanup projects and activities. Table: Potential Savings Identified for Selected Office of Environmental Management Capital Asset Projects and Operations Activities Grouting closed tanks at Hanford $18 billion Grouting remaining low-activity waste at Hanford up to $210 billion Optimizing transuranic waste shipments $700 million Optimizing high-level waste treatment at Hanford Tens of billions Source: GAO analysis of Department of Energy data. | GAO-26-107820 Why GAO Did This Study EM is responsible for the cleanup of sites and facilities contaminated from decades of nuclear weapons production and nuclear energy research. GAO has identified DOE’s project management and environmental liability—or expected cleanup costs—as High-Risk areas. The department’s management and oversight record has left DOE vulnerable to fraud, waste, abuse, and mismanagement, and its expected future cleanup costs have ballooned over the last several decades. Senate Report 118-58 includes a provision for GAO to provide a biennial report on the status of EM’s major projects and operations activities. This report (1) describes the status of EM's largest capital asset projects and operations activities, including changes since GAO’s 2022 report; and (2) examines challenges and opportunities to improve the performance of EM's largest capital asset projects and operations activities. GAO analyzed documents and data and compared information with DOE and EM requirements for managing projects and operations activities. GAO also interviewed EM officials.

What GAO Found Statutory Maintenance of Equity (MOEquity) requirements generally prohibited states and districts from disproportionately cutting funds from districts or schools serving high percentages of low-income students. Beginning in July 2021, the Department of Education provided guidance and technical assistance to help states and districts meet these requirements as part of receiving certain COVID-19 relief funding. Education officials said they developed and refined this guidance in real time. As a result, the agency did not develop internal written procedures for its staff to use when providing related technical assistance. Federal oversight and performance principles and practices note the importance of internal guidance and written documentation to ensure consistency. Without these, Education could not ensure states received consistent information on implementing MOEquity. Moreover, the risk of inconsistently applying guidance may increase with staff turnover, which Education said occurred during MOEquity implementation. Selected State and District Maintenance of Equity Requirements GAO's analysis of six states' data found that districts generally identified their poorest schools; however, Education lacked reliable data on how states implemented the state MOEquity requirements to identify their poorest districts. On average, high-poverty schools had more factors associated with need—for example, free or reduced-price lunch eligibility and students with disabilities—than other schools. However, because MOEquity required schools to be identified by district rather than statewide, MOEquity-identified high-poverty schools in a district were not always the poorest schools in the state. GAO could not determine if states paid appropriate districts or the total amounts paid in supplemental payments because of data reliability issues, such as duplicative or missing data. Education could not explain the data issues or provide documentation of data reliability procedures. Without reliable data, neither GAO nor Education could assess whether MOEquity requirements fully achieved their intended results. Selected states and districts described challenges implementing MOEquity—e.g., staff capacity issues and limited access to data—and expressed interest in lessons learned, but Education officials said they did not document and share them because the agency does not have procedures ensuring it does so and it was not a priority at the time. Yet, Education officials noted that MOEquity provided an opportunity to inform how they may handle similar situations going forward. Key practices for effectively managing federal efforts include identifying and applying lessons learned for future decision making. Doing so limits the chance of recurrence of failures or difficulties. Absent a way to ensure Education identifies, documents, and shares lessons learned, insights from such efforts may be limited or lost. Why GAO Did This Study To receive certain funds under the American Rescue Plan Act of 2021, states and districts generally agreed to not make certain cuts. These include disproportionately cutting funds from districts or schools serving high percentages of economically disadvantaged students for fiscal years 2022 and 2023. GAO was asked to examine MOEquity implementation. This report addresses (1) how Education assisted states and districts in complying with MOEquity requirements; (2) what data show about state and district implementation of MOEquity; and (3) what challenges states and districts faced in implementing MOEquity and what lessons Education learned. GAO reviewed relevant federal laws and analyzed Education's MOEquity guidance and data. GAO also interviewed Education officials, as well as officials from seven states. GAO selected states for varied approaches to implementing MOEquity. In three of these states, GAO interviewed officials from districts that received the most supplemental funding. GAO also analyzed school-level data from six of these states that had reliable data for this analysis.

What GAO Found The National Nuclear Security Administration (NNSA) is overseeing the design or construction of 28 major construction projects—each estimated to cost $100 million or more—that collectively are estimated to cost more than $30 billion. Since GAO’s 2023 report, cumulative cost and schedule overruns have increased for NNSA’s portfolio of major projects in the execution phase (which have approved cost and schedule baselines). Specifically, as of June 2025, NNSA’s cumulative cost overrun for the portfolio had increased from $2.1 billion in 2023 to $4.8 billion, and the cumulative schedule delay increased from 9 years to 30 years (see figure). Cumulative Cost and Schedule Overruns for NNSA’s Portfolio of Major Projects in Execution Phase, 2023–2025 Two of NNSA’s 16 major projects in the execution phase—the Uranium Processing Facility (UPF) Main Process Building and UPF Salvage and Accountability Building at the Y-12 National Security Complex—are responsible for about 80 percent of the cumulative cost overrun and 40 percent of the cumulative schedule delay. However, seven other major projects in this phase have incurred or expect to incur a cost overrun of more than 20 percent compared with their originally approved cost baselines. According to NNSA documents and officials, cost or schedule overruns for major projects in the execution phase were often associated with inadequate project management by NNSA’s management and operating (M&O) contractors; poor performance by vendors or subcontractors overseen by M&O contractors; or increased costs of equipment, materials, or vendors. Of the 12 NNSA major projects in the definition phase (which do not yet have cost and schedule baselines), eight are either on hold, implementing design changes, experiencing design challenges, or assessing the effect of these issues on their cost and schedule estimates; and four have identified critical technologies and have met milestones for maturing these technologies, according to project documents and officials. Why GAO Did This Study NNSA—a separately organized agency within the Department of Energy (DOE)—plans to invest tens of billions of dollars in major construction projects to modernize the research and production infrastructure supporting the nuclear weapons stockpile. Senate Report 117-130, accompanying a bill for the National Defense Authorization Act for Fiscal Year 2023, includes a provision for GAO to review NNSA’s major projects on a biennial basis. GAO assessed (1) the performance of NNSA’s portfolio of major projects in the execution phase, and (2) the development and maturity of project designs and critical technologies for projects in the definition phase. This report also includes summaries of NNSA’s 28 major projects. GAO collected and analyzed data on NNSA’s 28 major projects and interviewed officials. GAO analyzed information on cost and schedule performance for 16 projects in the execution phase. GAO also collected information on the status of design and technology maturity for 12 projects in the definition phase. GAO’s review excluded major projects that did not have approved preliminary cost and schedule estimates or were not subject to certain DOE acquisition requirements.

What GAO Found The Centers for Medicare & Medicaid Services (CMS) implemented the voluntary Medicare Part D Premium Stabilization Demonstration (Demonstration) in 2025 to stabilize beneficiary monthly premiums and enrollment in Part D standalone prescription drug plans. Nearly all plan sponsors opted to participate. Without the Demonstration, GAO’s analysis of CMS data showed that, if beneficiaries in standalone drug plans in 2024 remained in their plan in 2025, their monthly premium would have nearly doubled, on average. In addition, monthly premiums for 37 percent of these beneficiaries would have increased by more than $40 (see figure). If these premium increases had taken effect, CMS officials expected widespread changes in enrollment for beneficiaries in standalone drug plans, which could disrupt beneficiaries’ access to their medications. Potential Monthly Part D Standalone Premium Increases for Beneficiaries from 2024 to 2025, Absent Part D Demonstration Notes: Results indicate how premiums could have changed if beneficiaries in standalone Part D plans in 2024 had remained in the same plan or were transferred to another one in 2025. Results are weighted based on 2024 enrollment of beneficiaries who were not eligible for the low-income subsidy. To stabilize premiums with the goal of stabilizing enrollment in standalone drug plans, CMS (1) reduced beneficiary premiums in 2025 by up to $15 and then (2) limited each plan’s premium increases to $35 from 2024 to 2025. CMS also provided additional protection for plan sponsors in 2025. For 2026, CMS provides smaller premium reductions and allows for greater premium increases. Collectively, CMS officials estimated that the Demonstration would cost a total of $9.8 billion in 2025 and 2026. The Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation (ASPE), through an agreement with CMS, designed an evaluation framework to be used to determine whether the Demonstration achieved its goals. GAO’s analysis of CMS data showed that average premiums in standalone drug plans increased from $42 in 2024 to $43 in 2025 under the Demonstration for beneficiaries not eligible for the low-income subsidy. In addition, enrollment in these plans increased by 2 percent from 2024 to 2025, while the percentage of all Part D enrollees in standalone plans remained at 42 percent. However, an evaluation is necessary to determine the extent to which changes such as these were due to the Demonstration and not to other factors, such as changes to the Part D drug benefit. ASPE officials told GAO that they plan to continue their evaluation efforts in fiscal year 2026. GAO received a copy of the finalized evaluation framework in January 2026. Why GAO Did This Study The Medicare Part D program provides voluntary outpatient prescription drug coverage to beneficiaries, including those enrolled in standalone drug plans. The Inflation Reduction Act of 2022 required significant changes to the Part D drug benefit, some of which took effect in 2025. CMS reported in July 2024 that increased variation in plan sponsors’ expected costs for providing drug coverage in 2025 could lead to substantial premium increases for beneficiaries. CMS subsequently announced in July 2024 the Demonstration for standalone drug plans, using its authority under section 402 of the Social Security Amendments of 1967 as amended. GAO was asked to review the legality of the Demonstration and issued a legal decision in May 2025 concluding that this Demonstration, as implemented for 2025, was consistent with this statutory authority. GAO was also asked to review other aspects of the Demonstration. This report describes CMS’s (1) implementation of the Demonstration, and (2) plan to evaluate the Demonstration. GAO reviewed CMS documents, such as those about the development and evaluation of the Demonstration, and CMS data on premiums for Part D standalone drug plans. In its analysis of standalone drug plan premiums, GAO focused on beneficiaries who were not eligible for the low-income subsidy and, therefore, were required to pay plan premiums. GAO also interviewed CMS and ASPE officials, Part D plan sponsors, and organizations representing Medicare beneficiaries. For more information, contact John E. Dicken at dickenj@gao.gov.

What GAO Found The Department of Defense (DOD) works to ensure a healthy, resilient defense industrial base. DOD has identified risks to the industrial base, including an overreliance on foreign suppliers. Biomanufacturing is potentially key to mitigating such risks. Biomanufacturing is a type of production that uses biologically derived components, such as living cells or microorganisms to create and produce new materials. According to DOD officials biomanufacturing has the potential to create material for a wide range of applications, such as explosives, body armor, and solvents to maintain weapon systems. Biomaterials can also expand or create new defense capabilities or replace other products and components that are critical to DOD with materials that are domestically sourced, cheaper, and safer. Notional Biomanufacturing Process Biomanufacturing development evolves over a multi-stage process. It starts with producing small quantities of materials through work in laboratories and advances to commercial-scale production through testing and demonstration. As projects scale up, researchers need appropriately sized and equipped facilities for each stage. Notional Biomanufacturing Development Stages and Production Quantities   DOD’s Office of Industrial Base Policy and the Office of the Under Secretary of Defense for Research and Engineering (OUSD (R&E)) identified that the U.S. does not have sufficient infrastructure necessary to support the advancement of promising biotechnology projects from the laboratory to commercial production and to establish new supply chains, particularly pilot-scale facilities. Since 2021, DOD has invested $965.2 million across three initiatives designed to support promising biotechnology projects and establish domestic biomanufacturing supply chains. These efforts include: investing in biomanufacturing projects developed in military department laboratories to further mature into products that the warfighter can use, collaborating with industry and other partners to build a network of biomanufacturing facilities across the U.S., and providing support for industry partners to plan and construct commercial-scale production facilities in the U.S. for biomaterials with both defense and commercial applications. DOD’s plans for supporting biomanufacturing in the future are pending but DOD’s forthcoming biotechnology roadmap will provide more insights. In the meantime, DOD plans to end two of the three initiatives after fiscal years 2027 and 2028, respectively. In addition, other efforts are many years away from being operational. Congress required DOD to develop the roadmap and include general strategic investment priorities, goals, funding requirements, and milestones for its biotechnology efforts. OUSD (R&E) expects to complete this roadmap by September 2026, which should provide more insight into its future investments. GAO will continue to monitor DOD’s progress toward completing this roadmap. Why GAO Did This Study A House Report accompanying a bill for the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 includes a provision for GAO to review DOD’s investments in biotechnology and biomanufacturing. In addition, the final bill includes a provision for GAO to evaluate a roadmap of DOD’s biotechnology efforts once DOD has completed it. This report describes DOD’s recent efforts to accelerate its use of biotechnology and strengthen the domestic biomanufacturing industrial base. To do this work, GAO reviewed DOD documents and data, conducted a site visit to an Army biomanufacturing facility that was constructed with support from one of the biomanufacturing initiatives, and interviewed agency officials. For more information, contact William Russell at russellw@gao.gov.

What GAO Found The Periodically Listing Updates to Management (PLUM) Reporting website, maintained by the Office of Personnel Management (OPM), publishes data on politically appointed and career senior positions for all executive branch agencies and certain legislative branch agencies. As of July 2025, the website reported information on 10,540 positions across 171 federal entities (including agencies, boards, commissions, and other organizations). GAO found that although OPM had procedures in place to help ensure the quality of data published on the website, the data did not include all elements required by the act. For example, GAO found at least seven federal entities were missing from the data, as well as at least 130 presidentially appointed, Senate-confirmed positions. Additionally, unique identifier numbers used for tracking appointees’ movement within the federal workforce were not applied consistently in the data. GAO also found instances of errors and inconsistencies in the data, such as duplicative positions. Complete and accurate data would help Congress and the public identify and track individuals holding senior positions. Example of a Duplicative Position on the 2025 PLUM Reporting Website GAO found that the PLUM Reporting website, and OPM’s efforts to implement the website, only partially addressed three key practices for transparently reporting government data and certain relevant statutory requirements. GAO found: OPM did not proactively engage members of the public to solicit information on how they used and valued the website. OPM has not yet made the PLUM Reporting data available through its agency data inventory, though it has plans in place to do so. OPM did not fully describe the data and their known limitations. Non-governmental stakeholders cited concerns with the website including data timeliness, missing positions or errors, and a lack of potentially useful information. Stakeholders also suggested ways to make the website more valuable to users. By better engaging users and publicizing data quality limitations, OPM can improve the usefulness of the PLUM Reporting website and the data’s value as a transparency tool. Why GAO Did This Study Information about the federal government’s senior leaders is a critical tool for the public and Congress to understand who is serving in roles with significant decision-making authority and improve oversight. The PLUM Act of 2022 required OPM to establish a website, referred to as the PLUM Reporting website, to report data on senior positions. The act includes provisions for GAO to review implementation of the act. This report reviews (1) actions OPM took to ensure federal entities reported data on senior positions that met relevant quality requirements, and (2) the extent to which the PLUM Reporting website addressed key practices for transparently reporting government data and relevant statutes. GAO analyzed PLUM Reporting data for potential errors and compared data against other information on senior political appointees. GAO reviewed OPM documents and interviewed OPM officials about their efforts to ensure data quality. GAO also interviewed eight stakeholders from academia and civil society organizations about their experience using the website and data. Finally, GAO assessed the website against GAO criteria for data transparency.

What GAO Found Joint military bases are installations with more than one military service. For example, at Joint Base San Antonio, the Air Force is the lead service, and the Army is the supported service. Eleven of the 12 joint bases received less funding in fiscal years 2018 through 2022 than the Department of Defense’s (DOD) facility sustainment funding goal. However, DOD was unable to obtain data on how this funding was allocated to specific components on joint bases and therefore was unable to determine if the impact of funding below DOD’s goal led to disparities in facility conditions between lead and supported military services on bases. Joint base senior leaders whom GAO surveyed stated that facility management offices do not receive sufficient funding to keep facilities in good working order. During site visits to five joint bases, GAO observed examples of facility degradation due to deferred maintenance (see fig.). Broken Aircraft Hangar Roof Tiles on Joint Base Pearl Harbor-Hickam DOD has issued numerous guidance documents for joint base facility management, but senior joint base officials expressed confusion about how responsibilities for funding joint base facilities are allocated between the military services. Joint bases have multiple, ongoing cost-sharing disputes between the military services involving projects totaling over a billion dollars, and these disputes have not been resolved through DOD’s formal oversight structure. In July 2025, DOD finalized a department instruction that adds more detail regarding facility funding responsibilities on joint bases and could improve officials’ understanding of this issue. GAO found that all joint bases with available workforce data have facility management workforce shortages and that workforce requirements have not been reassessed to reflect increasing workloads as military units on joint bases have grown. Improving the availability of data on facility funding and reassessing workforce requirements could help DOD to address risks to unit missions from facility degradation on joint bases. Why GAO Did This Study DOD consolidated 26 installations into 12 joint bases over a decade ago to increase readiness, reduce duplication of efforts, and generate cost savings and efficiencies. However, DOD has faced challenges in sustaining its facilities on its 12 joint bases. On joint bases, the lead and supported military services share responsibility for managing facilities and supporting missions. The Joint Explanatory Statement accompanying the National Defense Authorization Act for Fiscal Year 2023 includes a provision for GAO to assess sustainment of facilities on joint bases. This report addresses, among other things, the extent to which DOD (1) met its funding goal for joint base facility sustainment in fiscal years 2018 through 2022, (2) assessed funding levels for supported component facilities on joint bases, (3) provided guidance and oversight to facility management offices for joint base facility maintenance, and (4) determined whether joint base facility management offices have sufficient workforces to meet their responsibilities. GAO conducted site visits to five joint bases, surveyed senior leaders at all 12 joint bases (with a 100 percent response rate), analyzed facility investment and workforce data, and reviewed applicable guidance.

What GAO Found Behavioral health issues, including substance misuse, mental health, and suicide affect millions of people in the U.S., representing a serious risk to public health. The Substance Abuse and Mental Health Services Administration (SAMHSA), within the Department of Health and Human Services (HHS), received $8.5 billion in supplemental appropriations in fiscal years 2020 and 2021 to address behavioral health needs related to the COVID-19 pandemic. Of the $8.5 billion in COVID-19 supplemental funding for behavioral health, SAMHSA awarded approximately $8.3 billion in grants to recipients including Tribes and tribal organizations, states, territories, and non-governmental organizations for projects beginning in fiscal years 2020 through 2025. Supported activities from the awards included community mental health services and programs to address substance use and mental health issues during the COVID-19 pandemic. SAMHSA used about $195 million for internal purposes that included administrative costs. As of July 2025, recipients had spent about $6.9 billion of the $8.3 billion. About $1.4 billion remained unspent. Of the remaining unspent funds, about $616.5 million were available for awardees to spend. About $787.7 million of the unspent funds were no longer available for awardees to spend because the planned project period for those awards had ended or the awards were terminated. Additionally, according to SAMHSA, of the $1.6 billion SAMHSA awarded in fiscal year 2021 through July 2025 to create and support the 988 Lifeline, SAMHSA awarded a total of about $1.2 billion for six cooperative agreements to a network administrator, Tribes and tribal organizations, states, territories, and 988 Lifeline contact centers to implement, expand, and support the 988 Lifeline. The 988 Lifeline provides free and confidential emotional support to people in suicidal or emotional distress via call, text, and chat. According to SAMHSA, the agency uses cooperative agreements, a type of federal assistance similar to grants, for funding when the federal government expects to have substantial involvement in a program, along with the recipient. SAMHSA used about $400 million for additional grants, internally for staffing and program management, and other activities to support the 988 Lifeline. As of July 2025, recipients had spent about $906.3 million of the $1.2 billion. About $298.9 million remained unspent. Of these unspent funds, about $22 million were no longer available to be spent as the funds had been awarded to a project that had ended. SAMHSA also hired additional staff—some of them temporary—to manage increased administration responsibilities connected with the COVID-19 supplemental funding and established a new office to support the 988 Lifeline. To monitor the use of the COVID-19 supplemental and 988 Lifeline funding, SAMHSA officials said they followed the same grant program monitoring processes used for all SAMHSA grants. These processes included award recipients collecting and reporting performance measurement data to SAMHSA, as well as submitting performance progress and financial reports to SAMHSA on a regular basis, such as quarterly or annually. Why GAO Did This Study The additional COVID-19 supplemental appropriations in fiscal year 2021 more than doubled SAMHSA's budget from the preceding year, and the 988 Lifeline funding further increased SAMHSA's budget during this period. In light of these large increases in SAMHSA's funding, GAO was asked to examine the use of COVID-19 and 988 Lifeline funding and adjustments SAMHSA made to accommodate this influx of funding. This report provides information on the funding SAMHSA received and distributed related to COVID-19 and the 988 Lifeline. To conduct this work, GAO reviewed SAMHSA evaluation plans and progress reports, and obtained and analyzed spending data as of July 2025, the most recent period for which data were available at the time of our review. GAO also conducted an interview with and obtained written responses from SAMHSA officials about how SAMHSA managed the COVID-19 supplemental and 988 Lifeline funding. For more information, contact Alyssa M. Hundrup at hundrupa@gao.gov.

What GAO Found The Substance Abuse and Mental Health Services Administration (SAMHSA) leads federal efforts to advance behavioral health. This includes providing grant funding and technical assistance to states and behavioral health providers to implement behavioral health prevention and treatment programs. Selected SAMHSA state and provider awardees said they made various changes to continue delivering behavioral health services during the COVID-19 pandemic. Examples of Selected State and Provider Awardees’ Changes to Behavioral Health Services During the COVID-19 Pandemic SAMHSA also provided technical assistance and flexibilities to assist awardees with grant administration and program implementation during the COVID-19 pandemic, according to agency documentation, as well as agency officials, selected state and provider awardees, and national associations. For example: SAMHSA provided one-on-one assistance, connected awardees with one another and with partners, and disseminated resources including webinars and published documents; nearly all selected awardees found this support helpful during the COVID-19 pandemic. SAMHSA provided grant administration flexibilities to help awardees meet pandemic needs. For example, SAMHSA extended COVID-19 supplemental funding project periods for its mental health and substance use block grants to allow awardees additional time to complete grant-funded activities. SAMHSA, in partnership with other federal agencies, provided program flexibilities to help awardees deliver services during the COVID-19 pandemic. Such flexibilities included allowing clinicians to prescribe certain medication to treat opioid use disorder via telehealth. Why GAO Did This Study Behavioral health conditions, which include mental and substance use disorders, affect millions of people in the U.S. and these numbers continue to grow. The COVID-19 pandemic exacerbated needs for behavioral health services and affected service availability and delivery. In fiscal years 2020 through 2023, SAMHSA awarded over $32 billion in grant funding to support behavioral health services. This included approximately $8.3 billion in COVID-19 supplemental funding that SAMHSA awarded to help grant awardees address behavioral health needs due to the pandemic. The Consolidated Appropriations Act, 2023, includes a provision for GAO to review SAMHSA programs and activities to support the continued provision of behavioral health services during the COVID-19 pandemic. Among other topics, this report describes how selected SAMHSA awardees provided services during the COVID-19 pandemic and how SAMHSA assisted awardees to support their response to the pandemic. GAO reviewed documentation and interviewed officials from seven states and one territory (which we refer to collectively as selected states) and 16 behavioral health providers about experiences during the COVID-19 pandemic from January 2020 through May 2023. GAO selected states to obtain a mix of geographic regions, among other criteria, and selected two providers from each state to reflect receipt of certain SAMHSA grants. GAO also reviewed agency documentation, interviewed SAMHSA officials, and interviewed representatives from four national associations with behavioral health expertise. For more information, contact Alyssa M. Hundrup at HundrupA@gao.gov.

What GAO Found The National Science Foundation (NSF) has 21 research infrastructure projects funded through its Major Research Equipment and Facilities Construction (MREFC) and Research and Related Activities accounts, as of July 2025. This includes 13 major projects ($100 million or more) and eight midscale projects ($20 million to $100 million) at various stages of design, construction, and implementation. While all of these research infrastructure projects remained within their NSF-authorized total cost since GAO’s June 2024 report, several have experienced schedule delays or scope changes. Specifically, as of July 2025, four of the seven major projects in construction reported delays of 4 to 27 months relative to schedules GAO reported in June 2024 (see table below). NSF attributed delays to numerous factors, such as labor shortages, contractor underperformance, and budgetary uncertainty. Further, NSF reported reductions in scope for two of these projects, as well as three of eight midscale projects. Status of NSF’s Major Research Infrastructure Projects Under Construction, as of July 2025 Project Authorized cost Estimated completion Scope reduction Antarctic Infrastructure Recapitalization Program $155.4 million August 2029   -   Vera C. Rubin Observatory $571 million January 2026 ▲ 10 months - Antarctic Infrastructure Modernization for Science $410.4 million May 2027 ▲ 4 months ✓ Regional Class Research Vessels $400 million April 2029 ▲ 27 months ✓   Large Hadron Collider High Luminosity Upgrade Program       ATLAS Detector $82.8 million December 2028 ▲ 5 months - CMS Detector $88 million June 2028 ▼ 1 month - Leadership-Class Computing Facility $457.4 million March 2028 - Total $2,165 million     Legend: ATLAS = A Toroidal Large Hadron Collider Apparatus; CMS = Compact Muon Solenoid; ▲ = increase since June 2024; ▼ = decrease since June 2024; ✓ = scope reduced since June 2024. Source: GAO analysis of National Science Foundation (NSF) information. | GAO-26-107842 NSF considers several factors when selecting and awarding new research infrastructure projects. Specifically, NSF examines the scale and maturity of the proposed project, the availability and stability of annual appropriations, and external economic conditions. NSF has two separate processes for selecting major and midscale projects. Major facilities undergo an extensive, multiphase review and selection process, including consultation with the National Science Board. Midscale projects undergo a merit review and selection process led by NSF. Why GAO Did This Study Modern and effective research infrastructure, including facilities and equipment, is critical to maintaining U.S. global leadership in science and engineering. NSF provides funding for the design, construction, and operations of this infrastructure. This infrastructure spans a wide range of projects, from oceanographic research vessels to telescopes and supercomputers. The Consolidated Appropriations Act, 2024 includes a provision for GAO to review projects funded from NSF's MREFC account. This is the eighth report in this series and builds on GAO’s previous work. This report describes (1) the cost and schedule performance for NSF’s major and midscale projects funded through the MREFC account and (2) NSF’s process for selecting which projects receive MREFC funding and the key factors that contribute to NSF’s ability to select new projects. GAO examined NSF policies and documents for projects that were in design, construction, and implementation and interviewed agency officials. For more information, contact Hilary Benedict at benedicth@gao.gov.

What GAO Found Since 2016, the Department of Defense (DOD) has been developing the National Background Investigation Services (NBIS)—an IT system for conducting background investigations for most federal agencies and over 13,000 industry organizations that work with the government. DOD originally expected NBIS to be complete in 2019, but repeated delays have hindered deployment. GAO has also found that the previous NBIS cost estimate and schedules were unreliable. After missing multiple targets, DOD’s Defense Counterintelligence and Security Agency (DCSA) paused NBIS development in 2024 to revise its approach. In 2025, it developed a new cost estimate and changed its approach to scheduling. GAO reviewed DCSA’s 2025 NBIS cost estimate and found it to be reliable because it at least substantially met four characteristics of a reliable cost estimate. DOD now projects spending an additional $2.2 billion on NBIS development through fiscal year 2031, which is in addition to $2.4 billion previously spent on NBIS and legacy systems through fiscal year 2024. A reliable cost estimate should help prevent unexpected cost overruns and provide needed visibility. GAO also found that DCSA continues to lack a reliable schedule for NBIS. The program’s schedule showed improvements, substantially meeting two characteristics of a reliable schedule. However, it only partially met the credible and well-constructed characteristics. For example, a risk analysis can help the program prioritize those risks that may lead to delays. Not having a reliable schedule is likely to continue to affect the NBIS program’s ability to meet milestones, including the goal to complete development in fiscal year 2027. Assessment of Department of Defense’s 2025 NBIS Cost Estimate and Schedule Against Best Practices Continued prioritization of NBIS development will be critical to successfully implement government-wide personnel vetting reforms and address persistent challenges. For example, GAO has found federal agencies have not met timeliness goals for nearly all phases of the security clearance process. In particular, average times for initial Top Secret clearances have consistently trended longer from fiscal year 2022 to 2025. Sustained leadership attention is key to fully deploying the NBIS system and achieving personnel vetting reform. Why GAO Did This Study U.S. government personnel vetting processes, such as background investigations, rely on IT systems to process data on millions of federal employees and contractor personnel. DOD has been developing NBIS as the new IT system for personnel vetting since 2016. In 2018, the government initiated a major reform of personnel vetting to better protect national security called Trusted Workforce 2.0. GAO placed the personnel vetting process on its High-Risk List in the same year. This statement discusses (1) the reliability of DCSA’s 2025 cost estimate for the NBIS program, (2) the extent to which the NBIS program has met scheduling best practices, and (3) the importance of NBIS to achieve personnel vetting reforms under Trusted Workforce 2.0. This statement is based on GAO’s analysis of DCSA’s 2025 cost estimate and schedule, prior GAO reports on NBIS from December 2021 through September 2025, and ongoing work assessing NBIS development. To perform prior and ongoing work, GAO analyzed information on NBIS from DCSA and interviewed knowledgeable officials.

What GAO Found Paid preparers have differing levels of skills, education, and expertise. Tax practitioners include enrolled agents, certified public accountants, attorneys, and other individuals who possess some level of qualification or credentials issued by either Internal Revenue Service (IRS) or states. All other paid preparers without professional credentials are considered unenrolled preparers. While all paid preparers are required to have and use a Preparer Tax Identification Number (PTIN) and are subject to various requirements in the Internal Revenue Code, IRS only has the authority to regulate the practice of tax practitioners. Generally, unenrolled preparers are not subject to IRS regulation, including testing and education requirements. Number and Type of Credentials Held by Paid Preparers for 2025 In prior work, GAO found that paid preparers can make serious errors on the tax returns they prepare. In addition, GAO’s prior work indicates that unenrolled preparers can make errors at a higher rate than taxpayers who prepare their own returns or who use other categories of paid preparers. When paid preparers make errors, taxpayers may overpay and lose out on tax benefits. Alternatively, when preparers understate tax liabilities, taxpayers may be subject to penalties and the government may collect less revenue. GAO has previously reported that IRS uses various tools, including outreach and education, civil and criminal investigations, and penalties to oversee all paid preparers and bring them into compliance. For example, IRS’s Refundable Credits Return Preparer Strategy program identifies preparers who were potentially noncompliant with due diligence requirements and encourages them to comply. Actions IRS may take range from issuing warning letters and phone calls to preparers to more serious actions such as audits of preparers’ clients and IRS staff visits to preparers. IRS conducts civil and criminal investigations of abusive tax schemes, including those involving paid preparers. Paid preparers may be subject to penalties for noncompliance with certain requirements in the Internal Revenue Code. Why GAO Did This Study During fiscal year 2024, more than half of all individual taxpayers used a paid preparer, according to IRS data. Paid preparer errors can lead to billions of dollars in improper claims of refundable tax credits and can have negative consequences for individual taxpayers. GAO was asked to examine IRS’s ability to oversee preparers. This report describes what GAO and other IRS oversight groups have previously reported on IRS’s oversight of paid preparers and recommended to improve its efforts. GAO reviewed the Internal Revenue Code, relevant regulations and case law, information on paid preparer credentials, GAO’s previous issued work on paid preparer topics, and reports by other IRS oversight groups. Additionally, GAO analyzed data on numbers of preparers with a current PTIN and interviewed IRS officials.

What GAO Found Since January 2025, the President has issued several directives for federal agencies to restrict hiring and reduce the size of the federal government’s workforce (see figure below for examples). However, agencies were still allowed to hire new staff for certain positions, including those related to national security and public safety. Timeline of Selected Directives and Government-wide Guidance on Federal Workforce Changes, January to June 2025 Data reported by major federal agencies showed that from January to June 2025, staffing declined at nearly all of them. Across these agencies, about 134,000 employees (or 6 percent of the workforce) separated during this period, while about 66,000 employees (including temporary employees) were hired. Agencies reported that another roughly 144,000 employees were approved for a deferred resignation program and would end their federal employment by the end of 2025. The Office of Personnel Management (OPM) has updated how it reports federal workforce data. OPM has broad responsibilities for collecting and sharing workforce data. In January 2026, the agency launched a website with new features and more frequent data releases to make workforce data more accessible and useful for Congress and others. Why GAO Did This Study GAO was asked to provide quarterly updates on workforce changes at the 24 federal Chief Financial Officers (CFO) Act agencies. This report (1) provides information on workforce changes at CFO Act agencies from January to June 2025, and (2) describes actions OPM has taken to modernize how it reports workforce data. To address these objectives, GAO collected data from CFO Act agencies on workforce changes during this period, and information from OPM on updates to how it collects and presents agency data. GAO will provide updates to the information in this product in future reports on these issues. For more information, contact Dawn G. Locke at LockeD@gao.gov.