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By act of Congress the Public Printer of the U.S. Government Printing Office is authorized to determine the form and style of Government printing. The Style Manual is the product of many years of public printing experience, and its rules are based on principles of good usage and custom in the printing trade. Essentially, the Style Manual is a standardization device designed to achieve uniform word and type treatment, and aiming for economy of word use. The Style Manual has served Federal printers since 1894, and with each new edition, the traditions of printing and graphic arts are carried forward into new technologies.

The Plain Language Action and Information Network (PLAIN) is a community of federal employees dedicated to the idea that citizens deserve clear communications from government. We first developed this document in the mid-90s. We continue to revise it every few years to provide updated advice on clear communication. We hope you find this document useful, and that it helps you improve your writing - and your agency's writing - so your users can: - find what they need, - understand what they find; and - use what they find to meet their needs. We've divided the document into five major topics, although many of the subtopics fit within more than one topic. We start with a discussion of your audience because you should think about them before you start to write your document or your web content. In fact, you should start to think about them before you start to plan. From there we move to organization, because developing a good organization is important during your planning stage. Next, we discuss writing principles, starting at the word level and moving up through paragraphs and sections. This is the most extensive topic. We follow principles of writing documents with principles of writing for the web. We conclude with a short discussion of testing techniques.

The guide has been designed to help the citizens of this nation learn how to protect themselves and their families against all types of hazards. It can be used as a reference source or as a step-by-step manual. The focus of the content is on how to develop, practice, and maintain emergency plans that reflect what must be done before, during, and after a disaster to protect people and their property. Also included is information on how to assemble a disaster supplies kit that contains the food, water, and other supplies in sufficient quantity for individuals and their families to survive following a disaster in the event they must rely on their own resources.

Appendix A to Part 1191 - Americans with Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities This document contains scoping and technical requirements for accessibility to buildings and facilities by individuals with disabilities under the Americans with Disabilities Act (ADA) of 1990. These scoping and technical requirements are to be applied during the design, construction, and alteration of buildings and facilities covered by titles II and III of the ADA to the extent required by regulations issued by Federal agencies, including the Department of Justice and the Department of Transportation, under the ADA.

GAO-11-853. The Rail Safety Improvement Act of 2008 (RSIA) overhauled requirements for how much time certain freight railroad workers can spend on the job (called "hours of service"). Changes included limiting the number of consecutive days on duty before rest is required, increasing minimum rest time from 8 to 10 hours, and requiring rest time to be undisturbed. RSIA also provided for pilot projects and waivers. RSIA's changes became effective for freight railroads in July 2009. GAO was asked to assess (1) the impact of these changes on covered train and engine (T&E) employees, including implications for fatigue, (2) the impact of the changes on the rail industry, and (3) actions the Federal Railroad Administration (FRA) has taken to oversee compliance with hours of service requirements and implement RSIA provisions for pilot projects and waivers. To perform this work, GAO analyzed covered employee work schedules and used models to assess fatigue, surveyed the railroad industry, analyzed FRA inspection and enforcement data, and interviewed federal and railroad officials as well as fatigue and sleep experts. According to GAO's analysis of covered employee work schedules, RSIA's requirements led to changed work schedules, increased rest time, and reduced risk of fatigue for covered T&E employees. RSIA's consecutive work day limits and rest requirements contributed to work schedule changes and increases in rest time. Increased rest time also led to equivalent decreases in the hours that covered employees worked. Overall, GAO found, using an FRA-validated fatigue model, that the time covered employees spent working at a high risk of fatigue-- a level associated with reduced alertness and an increased risk of errors and accidents--decreased by about 29 percent for employees of class I railroads (those with the largest revenues) and by about 36 percent for employees of selected class II railroads (those with smaller revenues). GAO's analysis also shows that there are further opportunities to reduce fatigue risk. Specifically, RSIA's changes did not result in material decreases in night work, yet scientific literature and GAO's analysis show night work represents a major factor in fatigue risk. As might be expected from changes aimed at improving safety by reducing covered employee fatigue, the railroad industry reported that RSIA's hours of service changes had operational and administrative effects on it, some of which increased some railroads' one-time or ongoing costs. GAO did not determine how RSIA's changes affected railroads' earnings; but the act took effect as the economy was starting to recover from the recession that began in late 2008. Through its industry survey and interviews, GAO found that RSIA's changes affected railroad operations, including changes to crew and train schedules and increases in staffing levels. Railroad officials GAO spoke with attributed these changes to RSIA's consecutive work day limits and rest requirements, both of which acted to reduce people's availability to work. To maintain operations while complying with the law, railroad officials told GAO they, among other things, hired new employees or brought employees back from furlough. GAO estimated that adding people--120 to 500 each by some class I railroads--increased these railroads' annual costs by $11 million to $50 million. Administrative effects reported by railroads included a need for railroads to revise their hours of service timekeeping systems.

GAO-12-8. Threats to federal information technology (IT) infrastructure and systems continue to grow in number and sophistication. The ability to make federal IT infrastructure and systems secure depends on the knowledge, skills, and abilities of the federal and contractor workforce that implements and maintains these systems. In light of the importance of recruiting and retaining cybersecurity personnel, GAO was asked to assess (1) the extent to which federal agencies have implemented and established workforce planning practices for cybersecurity personnel and (2) the status of and plans for governmentwide cybersecurity workforce initiatives. GAO evaluated eight federal agencies with the highest IT budgets to determine their use of workforce planning practices for cybersecurity staff by analyzing plans, performance measures, and other information. GAO also reviewed plans and programs at agencies with responsibility for governmentwide cybersecurity workforce initiatives. Federal agencies have taken varied steps to implement workforce planning practices for cybersecurity personnel. Five of eight agencies, including the largest, the Department of Defense, have established cybersecurity workforce plans or other agencywide activities addressing cybersecurity workforce planning. However, all of the agencies GAO reviewed faced challenges determining the size of their cybersecurity workforce because of variations in how work is defined and the lack of an occupational series specific to cybersecurity. With respect to other workforce planning practices, all agencies had defined roles and responsibilities for their cybersecurity workforce, but these roles did not always align with guidelines issued by the federal Chief Information Officers Council and National Institute of Standards and Technology (NIST). Agencies reported challenges in filling highly technical positions, challenges due to the length and complexity of the federal hiring process, and discrepancies in compensation across agencies. Although most agencies used some form of incentives to support their cybersecurity workforce, none of the eight agencies had metrics to measure the effectiveness of these incentives. Finally, the robustness and availability of cybersecurity training and development programs varied significantly among the agencies. For example, the Departments of Commerce and Defense required cybersecurity personnel to obtain certifications and fulfill continuing education requirements. Other agencies used an informal or ad hoc approach to identifying required training. The federal government has begun several governmentwide initiatives to enhance the federal cybersecurity workforce. The National Initiative for Cybersecurity Education, coordinated by NIST, includes activities to examine and more clearly define the federal cybersecurity workforce structure and roles and responsibilities, and to improve cybersecurity workforce training. However, the initiative lacks plans defining tasks and milestones to achieve its objectives, a clear list of agency activities that are part of the initiative, and a means to measure the progress of each activity. The Chief Information Officers Council, NIST, Office of Personnel Management, and the Department of Homeland Security (DHS) have also taken steps to define skills, competencies, roles, and responsibilities for the federal cybersecurity workforce. However, these efforts overlap and are potentially duplicative, although officials from these agencies reported beginning to take steps to coordinate activities. Furthermore, there is no plan to promote use of the outcomes of these efforts by individual agencies.

GAO-11-616 - Federal Crisis: Review of Federal Reserve System Financial Assistance to American International Group, Inc. In September 2008, the Board of Governors of the Federal Reserve System (Federal Reserve Board) approved emergency lending to American International Group, Inc. (AIG)--the first in a series of actions that, together with the Department of the Treasury, authorized $182.3 billion in federal aid to assist the company. Federal Reserve System officials said that their goal was to avert a disorderly failure of AIG, which they believed would have posed systemic risk to the financial system. But these actions were controversial, raising questions about government intervention in the private marketplace. This report discusses (1) key decisions to provide aid to AIG; (2) decisions involving the Maiden Lane III (ML III) special purpose vehicle (SPV), which was a central part of providing assistance to the company; (3) the extent to which actions were consistent with relevant law or policy; and (4) lessons learned from the AIG assistance. To address these issues, GAO focused on the initial assistance to AIG and subsequent creation of ML III. GAO examined a large volume of AIG-related documents, primarily from the Federal Reserve System--the Federal Reserve Board and the Federal Reserve Bank of New York (FRBNY)--and conducted a wide range of interviews, including with Federal Reserve System staff, FRBNY advisors, former and current AIG executives, AIG business counterparties, credit rating agencies, potential private financiers, academics, finance experts, state insurance officials, and Securities and Exchange Commission (SEC) officials. Although GAO makes no new recommendations in this report, it reiterates previous recommendations aimed at improving the Federal Reserve System's documentation standards and conflict-of-interest policies. While warning signs of the company's difficulties had begun to appear a year before the Federal Reserve System provided assistance, Federal Reserve System officials said they became acutely aware of AIG's deteriorating condition in September 2008. The Federal Reserve System received information through its financial markets monitoring and ultimately intervened as the possibility of bankruptcy became imminent. Efforts by AIG and the Federal Reserve System to secure private financing failed after the extent of AIG's liquidity needs became clearer. Both the Federal Reserve System and AIG considered bankruptcy issues, although no bankruptcy filing was made. Due to AIG's deteriorating condition in September 2008, the Federal Reserve System said it had little opportunity to consider alternatives before its initial assistance. As AIG's troubles persisted, the company and the Federal Reserve System considered a range of options, including guarantees, accelerated asset sales, and nationalization. According to Federal Reserve System officials, AIG's credit ratings were a critical consideration in the assistance, as downgrades would have further strained AIG's liquidity position. After the initial federal assistance, ML III became a key part of the Federal Reserve System's continuing efforts to stabilize AIG. With ML III, FRBNY loaned funds to an SPV established to buy collateralized debt obligations (CDO) from AIG counterparties that had purchased credit default swaps from AIG to protect the value of those assets. In exchange, the counterparties agreed to terminate the credit default swaps, which were a significant source of AIG's liquidity problems. As the value of the CDO assets, or the condition of AIG itself, declined, AIG was required to provide additional collateral to its counterparties.

Congress passed the Older Americans Act (OAA) in 1965 in response to concern by policymakers about a lack of community social services for older persons. The original legislation established authority for grants to States for community planning and social services, research and development projects, and personnel training in the field of aging. The law also established the Administration on Aging (AoA) to administer the newly created grant programs and to serve as the Federal focal point on matters concerning older persons. Although older individuals may receive services under many other Federal programs, today the OAA is considered to be the major vehicle for the organization and delivery of social and nutrition services to this group and their caregivers. It authorizes a wide array of service programs through a national network of 56 State agencies on aging, 629 area agencies on aging, nearly 20,000 service providers, 244 Tribal organizations, and 2 Native Hawaiian organizations representing 400 Tribes. The OAA also includes community service employment for low-income older Americans; training, research, and demonstration activities in the field of aging; and vulnerable elder rights protection activities. This book offers an unofficial compilation of the OAA, an outline of changes made to the OAA at the most recent reauthorization (2006), a set of frequently asked questions (FAQs) about the OAA and other related sources of information/data. This book is intended to serve as a resource for professionals working in aging services.

GAO - 12-151, Dodd-Frank Act Regulations, addresses The Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) which requires or authorizes various federal financial regulators to issue hundreds of rules to implement reforms intended to strengthen the financial services industry. GAO is required to annually study financial services regulations. This report examines (1) the regulatory analyses, including cost-benefit analyses, financial regulators have performed to assess the impact of selected final rules issued pursuant to the Dodd-Frank Act; (2) how financial regulators consulted with each other in implementing the selected final rules to avoid duplication or conflicts; and (3) what is known about the impact of the final rules. GAO examined the 32 final Dodd-Frank Act rules in effect as of July 21, 2011; the regulatory analyses conducted for 10 of the 32 rules that allowed for some level of agency discretion; statutes and executive orders requiring agencies to perform regulatory analysis; and studies on the impact of the Dodd-Frank Act. GAO also interviewed regulators, academics, and industry representatives. Federal financial regulators are required to conduct a variety of regulatory analyses, but the requirements vary and none of the regulators are required to conduct benefit-cost analysis. All financial regulators must analyze the paperwork burden imposed by their rules and consider the impact of their rules on small entities as part of their rulemaking process. The Commodity Futures Trading Commission and the Securities and Exchange Commission are also required under their authorizing statutes to consider certain benefits and costs of their rules. As independent regulatory agencies, the federal financial regulators are not subject to executive orders requiring federal agencies to conduct detailed benefit-cost analysis in accordance with a guidance issued by the Office of Management and Budget (OMB). Financial regulators are not required to follow OMB's guidance, but most told GAO that they attempt to follow the guidance in principle or spirit. GAO's review of regulators' rulemaking policies and 10 final rules found inconsistencies in the extent to which OMB's guidance was reflected. GAO recommends that to the extent the regulators strive to follow OMB's guidance, they should take steps to more fully incorporate the guidance into their rulemaking policies and ensure that it is consistently followed. Although federal financial regulators have coordinated their rulemaking, they generally lacked formal policies to guide these efforts. The Dodd-Frank Act establishes interagency coordination requirements for certain agencies and for specific rules or subject matters. However, for other rules, the regulators have discretion as to whether interagency coordination should occur. The Financial Stability Oversight Council (FSOC) is tasked with facilitating coordination among member agencies but, to date, has played a limited role in doing so beyond its own rulemakings as it continues to define its role. Several regulators voluntarily coordinated with each other on some of the rules GAO reviewed. However, most of the regulators, including the Bureau of Consumer Financial Protection, lacked written protocols for interagency coordination, a leading practice that GAO has previously identified for interagency coordination. GAO recommends that FSOC work with the financial regulators to develop such protocols for Dodd-Frank Act rulemaking.

The Department of Justice has assembled this official version of the 2010 ADA Standards for Accessible Design (2010 Standards) to bring together the information in one easy-to-access location. It provides the scoping and technical requirements for new construction and alterations resulting from the adoption of revised 2010 Standards in the final rules for Title II (28 CFR part 35) and Title III (28 CFR part 36).

GAO-12-65. The extent to which the federal and state governments regulate the death care industry-funeral homes, cemeteries, crematories, pre-need funeral plans, and third party sales of funeral goods-varies, as does the extent to which regulation has changed since GAO last reported on the regulation of the death care industry in 2003. The Federal Trade Commission (FTC) continues to annually conduct undercover shopping at various funeral homes to test compliance with the Funeral Rule. Of the over 2,400 funeral homes that the FTC shopped since 1996, the FTC reported an overall compliance rate of about 85 percent. With respect to state regulation, consistent with GAO's findings in 2003, the way in which states regulate the industry varies across industry segments and states. Also, the extent to which state regulators reported that they had specific rules or regulations for each industry segment in both 2003 and 2011 varied. Most consistent across states in both years was reporting that there were specific rules or regulations for funeral homes (94 and 95 percent in 2003 and 2011, respectively). In contrast, 77 percent of state regulators of cemeteries reported that their states had specific rules or regulations for cemeteries in 2003, and 88 percent reported this in 2011. Certain state regulators also reported that their states made various statutory or regulatory changes since 2003, primarily to clarify legislation or regulation or to enhance consumer protections, and that they believe these changes strengthened their regulatory program to varying degrees. State regulators reported that these changes came about for a variety of reasons, including accounts of desecration of human remains or proposals from state agencies and industry groups. Media reports have identified instances of desecration of graves and human remains at cemeteries, and in one instance, reported that bodies were removed from graves and the sites resold. Allegations have also surfaced about the mismanagement of pre-need plans that are designed to provide consumers the opportunity to fund funeral and cemetery arrangements before they are needed. The FTC's Funeral Rule requires that, among other things, funeral providers give consumers lists that disclose the cost of funeral goods and services before they enter into funeral transactions. Proposed legislation introduced in March 2011 would increase the federal government's role in regulating the industry by, among other things, requiring that the FTC regulate aspects of cemetery operations. GAO was asked to review the regulation of the death care industry. This report discusses (1) how federal and state governments regulate the industry and how regulation has changed since 2003 and (2) state regulators' views on the need for additional regulation. GAO reviewed FTC's Funeral Rule and interviewed officials representing the FTC and national industry and consumer associations; surveyed state officials to gather data on state regulation of the death care industry; and, where possible, compared the results of the 2011 surveys with those of similar surveys GAO conducted in 2003. The response rate for our 2011 surveys ranged from 78 to 84 percent. GAO also reviewed laws and regulations. GAO is not making any recommendations in this report.

This is the 2011 revision of Government Auditing Standards, commonly referred to as the "Yellow Book." Contains the auditing standards promulgated by the Comptroller General of the United States. Includes the professional standards and guidance, commonly referred to as generally accepted government auditing standards (GAGAS), which provide a framework for conducting high quality government audits and attestation engagements with competence, integrity, objectivity, and independence. These standards are for use by auditors of government entities and entities that receive government awards and audit organizations performing GAGAS audits and attestation engagements. This revision supersedes the 2007 revision. It contains the following major changes from the 2007 revision that reinforce the principles of transparency and accountability and provide the framework for high-quality government audits that add value: 1) A conceptual framework for independence was added to provide a means for auditors to assess their independence for activities that are not expressly prohibited in the standards. This more principles-based approach to analyzing independence provides the framework for auditors to assess the unique facts and circumstances that arise during their work; 2) This revision drops discussion surrounding certain AICPA Statements on Auditing Standards (SAS) and Statements on Standards for Attestation Engagements (SSAE) requirements that were incorporated by reference and included in the 2007 revision, as the standards have converged in those areas; and, 3) The definition of validity as an aspect of the quality of evidence has been clarified for performance audits. Effective with the implementation dates for the 2011 revision of Government Auditing Standards, GAO is also retiring Government Auditing Standards: Answers to Independence Standard Questions (GAO-02-870G, July 2002). This revision of the standards has gone through an extensive deliberative process, including public comments and input from the Comptroller General's Advisory Council on Government Auditing Standards. The Advisory Council generally consists of about 25 experts in financial and performance auditing and reporting drawn from federal, state, and local government; the private sector; and academia. The views of all parties were thoroughly considered in finalizing the standards. The 2011 revision of Government Auditing Standards will be effective for financial audits and attestation engagements for periods ending on or after December 15, 2012, and for performance audits beginning on or after December 15, 2011. (GAO-12-331G). YELLOW Book.

GAO-11-700. Cyclone Nargis hit Burma's impoverished Irrawaddy Delta on May 2, 2008, leaving nearly 140,000 people dead or missing and severely affecting about 2.4 million others, according to the UN. The Burmese military government initially blocked most access to the affected region; however, amid international pressure, it slowly began allowing international aid workers entry into the region. Since 1997, the United States has imposed sanctions to prohibit, among other things, the exportation of financial services to Burma and transactions with Burmese officials. In response to a congressional mandate, GAO (1) described the assistance UN and U.S. agencies have provided in response to Cyclone Nargis, (2) assessed USAID actions to help ensure funds are used as intended and do not benefit sanctioned entities, and (3) described the challenges responders experienced and the lessons learned. GAO reviewed financial and program documents; interviewed U.S., UN, and nongovernmental organization (NGO) officials; and traveled to Thailand and Burma. UN and U.S. agencies provided about $335 million for emergency response and recovery activities after Cyclone Nargis. Of that total, 11 UN agencies obligated roughly $288 million for assistance in various sectors, including food, health, water and sanitation, and agriculture. The U.S. government provided about $38 million of the UN's total as part of its roughly $85 million in obligations for emergency response and longer-term recovery activities. Of the $85 million U.S. response, the U.S. Agency for International Development (USAID), which led U.S. efforts, obligated about $72 million. The Department of Defense obligated about $13 million to procure and deliver emergency relief supplies. USAID took actions to help ensure U.S. funds were used as intended and did not benefit sanctioned entities, but had some monitoring weaknesses. USAID took actions prior to the delivery of assistance, including selecting partners experienced in working with USAID and in Burma and providing extra guidance to help ensure funds were not misused. To monitor assistance, USAID has conducted some site visits. However, USAID's monitoring contains little financial oversight and we found that two grantees charged USAID for unapproved international travel. Also, in some cases site visits were not sufficiently documented. USAID relies on external audits of grantees, but relevant USAID staff were not aware of audit findings related to one grantee's cash payments to villagers in Burma. The grantee subsequently addressed the audit findings. Lastly, U.S. and UN agencies said they examined reports of misuse of assistance in their programs and found no evidence that assistance had been misused. GAO's review of 16 after-action reports from donors, NGOs, and UN agencies, showed that those responding to Cyclone Nargis experienced similar challenges and developed lessons learned in four main areas: access, coordination, implementation, and limited in-country disaster response capacity. Responders found it difficult to reach affected areas because the Burmese government limited their travel and the infrastructure was poor. Responders also had difficulty coordinating between headquarters and field offices for several reasons, including limited telecommunication services. A U.S. report highlighted coordination challenges amongst U.S. agencies, stating that agencies' conflicting agendas resulted in difficulties related to the appropriateness, timing, procurement, and distribution of aid. Implementation challenges include supplies that were incompatible with local conditions, such as medicines with instructions printed in non-Burmese languages and difficulties monitoring aid.

GAO-12-86. On April 20, 2010, an explosion of the Deepwater Horizon oil rig leased by BP America Production Company (BP) resulted in a significant oil spill. GAO was requested to (1) identify the financial risks to the federal government resulting from oil spills, particularly Deepwater Horizon, (2) assess the Coast Guard's internal controls for ensuring that processes and payments for spill-related cost reimbursements and claims related to the spill are appropriate, and (3) describe the extent to which the federal government oversees the BP and Gulf Coast Claims Facility cost reimbursement and claims processes. We issued status reports in November 2010 and April 2011. This is the third and final report related to these objectives. We obtained and analyzed data on costs incurred from April 2010 through May 2011 and claims submitted and processed from September 2010 through May 2011. We reviewed relevant policies and procedures, interviewed officials and staff at key federal departments and agencies, and tested a sample of claims processed and cost reimbursements paid for compliance with internal controls. Both the individual circumstances of the Deepwater Horizon incident, as well as the overall framework for how the federal government responds to oil spills, present a mix of evolving, but as yet uncertain, financial risks to the federal government and its Oil Spill Liability Trust Fund (Fund). The extent of financial risks to the federal government from the Deepwater Horizon is closely tied to BP and the other responsible parties. BP established a $20 billion Trust to pay for individual and business claims and other expenses. As of May 31, 2011, BP has paid over $700 million of federal and state government costs for oil spill cleanup. Federal agency cleanup and restoration activities are under way and agencies continue to incur costs and submit them for reimbursement. However, the full extent of these costs, particularly those related to environmental cleanup, may not be fully realized for some time. As cleanup costs continue to mount, it is possible that expenditures from the Fund will reach the $1 billion total expenditure per incident cap. Expenditures were over $626 million on May 31, 2011. If these amounts reach the total expenditure cap of $1 billion, the Fund can no longer be used to make payments to reimburse agencies' costs (or to pay valid individual or business claims if not paid by the responsible parties). At that point, government agencies would no longer be able to obtain reimbursement for their costs. In November 2010, GAO suggested that Congress may want to consider setting a Fund per incident cap based on net expenditures (expenditures less reimbursement), rather than total expenditures. Finally, GAO found the federal government's longer-term ability to provide financial support in response to future oil spills is also at risk because the Fund's primary source of revenue, a tax on petroleum products, is scheduled to expire in 2017. GAO's testing of the Coast Guard's internal controls over Deepwater Horizon claims processed and cost reimbursements processed and paid showed that adjudicated claims processed and costs reimbursed were appropriate and properly documented. In November 2010, GAO made four recommendations regarding establishing and maintaining effective cost reimbursement policies and procedures for the Fund.

GAO-11-652. The President issued Homeland Security Presidential Directive (HSPD) -9 in 2004 to establish a national policy to defend the food and agriculture systems against terrorist attacks, major disasters, and other emergencies. HSPD-9 assigns various emergency response and recovery responsibilities to the Departments of Agriculture (USDA), Health and Human Services (HHS), Homeland Security (DHS), and others. In addition, Emergency Support Function (ESF) -11 addresses the federal food and agriculture response during emergencies and is coordinated by USDA. GAO was asked to evaluate (1) the extent to which there is oversight of federal agencies' overall progress in implementing HSPD-9; (2) the steps USDA has taken to implement its HSPD-9 responsibilities for response and recovery and challenges, if any; and (3) the circumstances under which USDA has coordinated an ESF-11 response and challenges it faces, if any. GAO reviewed key documents; surveyed states; and interviewed agency, state, and industry officials. There is no centralized coordination to oversee the federal government's overall progress implementing the nation's food and agriculture defense policy-- HSPD-9. At one time, the White House Homeland Security Council and DHS took steps to gather and coordinate information about agencies' efforts to implement HSPD-9, but no agency currently does so. Officials from the National Security Staff--which now supports the Homeland Security Council--told GAO that they will be looking for an opportunity to conduct an interagency review of HSPD-9, and DHS officials stated that Homeland Security Council leadership is important to ensure the success of their coordination efforts. Federal standards for internal control call for agencies to employ such activities as top-level review to help ensure that management's directives are carried out and to determine if agencies are effectively and efficiently using resources. Because there is no centralized coordination to oversee agencies' overall HSPD-9 efforts, the nation may not be assured that these crosscutting agency efforts are effective at reducing the vulnerability to, and impact of, major emergencies. USDA agencies have taken steps to implement the department's HSPD-9 response and recovery responsibilities. However, various challenges remain, such as critical research gaps, which could impede recovery from high-consequence plant diseases that could devastate the nation's production of economically important crops. Also, USDA does not have a department-wide strategy for setting its priorities and allocating resources for implementing its numerous HSPD-9 responsibilities. Without such a strategy, USDA cannot be assured that its agencies are making progress to align with departmental priorities and that its HSPD-9 responsibilities are met. Since 2007, USDA has coordinated the federal ESF-11 response for about 28 natural disasters, including hurricanes and floods. Although USDA and state officials GAO met with identified factors that contributed to the success of USDA's response--such as having a single USDA coordinator to facilitate communication during ESF-11 emergencies--they also identified some challenges. For example, federal agencies' responsibilities for disposing of animal carcasses following an emergency are unclear, which delayed previous disposal efforts and could pose a public health risk. Also, USDA has not consistently prepared after-action reports that summarize what went well and what needed improvement during an emergency response.

Americans seem to be increasingly concerned with decisions about death and dying. Why is a subject once thought taboo now so frequently aired by the popular media, debated in academic forums and professional societies, and litigated in well-publicized court cases? Perhaps it is because death is less of a private matter than it once was. Today, dying more often than not occurs under medical supervision, usually in a hospital or nursing home. Actions that take place in such settings involve more people, and the resolution of disagreements among them is more likely to require formal rules and means of adjudication. Moreover, patients dying in health care institutions today typically have fewer of the sources of nonmedical support, such as family and church, that once helped people in their final days. Also important, no doubt, are the biomedical developments of the past several decades. Without removing the sense of loss, finality, and mystery that have always accompanied death, these new developments have made death more a matter of deliberate decision. For almost any life-threatening condition, some intervention can now delay the moment of death. Frequent dramatic breakthroughs-insulin, antibiotics, resuscitation, chemotherapy, kidney dialysis, and organ transplantation, to name but a few-have made it possible to retard and even to reverse many conditions that were until recently regarded as fatal. Matters once the province of fate have now become a matter of human choice, a development that has profound ethical and legal implications. Moreover, medical technology often renders patients less able to communicate or to direct the course of treatment. Even for mentally competent patients, other people must usually assist in making treatment decisions or at least acquiesce in carrying them out. Consequently, in recent years there has been a continuing clarification of the rights, duties, and liabilities of all concerned, a process in which professionals, ethical and legal commentators, and-with increasing frequency-the courts and legislatures have been involved. Thus, the Commission found this an appropriate time to reexamine the way decisions are and ought to be made about whether or not to forego life-sustaining treatment. For example, may a patient's withdrawal from treatment ever be forbidden? Should physicians acquiesce in patients' wishes regarding therapy? Should they offer patients the option to forego life-sustaining therapy? Does it make any difference if the treatment has already been started, or involves mechanical systems of life support, or is very costly?