To alert the audit community to changes in professional standards, we periodically issue Professional Standards Updates (PSU). These updates highlight the effective dates of recently issued standards and guidance related to engagements conducted in accordance with Government Auditing Standards. PSUs contain summary information only, and those affected by a change should refer to the respective standard or guidance for details.

This supplement is a companion to GAO's report entitled, HEALTH CARE ACCESSIBILITY: Further Efforts Needed to Address Barriers for People with Disabilities, GAO-26-107120. The purpose of this supplement is to provide an "Easy Read" version of the report. Easy Read is a way some groups make their written information easier to understand. For example, Easy Read documents use short sentences and plain language. In this report, GAO found that people with disabilities face barriers related to accessibility in health care. Potential barriers include the design of medical settings and equipment, technology, communication with providers, and lack of training. The U.S. Department of Health and Human Services (HHS) does not collect national-level data from people with disabilities about health care barriers related to disability and , which it could use to help improve accessibility. HHS inspects some aspects of accessibility and performs different kinds of reviews to make sure health care organizations are following disability laws. In 2024, HHS updated accessibility requirements. However, the agency has not taken certain steps to ensure that health care organizations follow the new requirements and improve accessibility. GAO made five recommendations in this report to address HHS's data collection and oversight of accessibility for people with disabilities.

What GAO Found Medicare payments to hospitals to support graduate medical education (GME) for physicians are capped by the number of residents. As of September 2025, the Centers for Medicare & Medicaid Services (CMS) allocated 600 of the 1,000 new Medicare-funded positions to hospitals from three annual distributions. To date, about half of the 393 hospitals that applied received new positions. Percentage of Hospitals Receiving New Residency Positions Under Section 126, 2023–2025 Note: Figure represents the 393 hospitals that applied for or received residency positions in at least one of the first three annual distributions of Section 126 of the Consolidated Appropriations Act, 2021. Hospitals that received positions in the first three distributions were similar to hospitals that applied for and did not receive positions. For example, nearly all were in geographically urban areas and most applied to expand existing residency programs that had been approved to train residents for over 10 years. In addition, about half of hospitals that received positions applied to train more residents in primary care specialties. Further, hospitals that received positions were generally larger in terms of their resident cap and total Medicare GME payments in 2023, compared to other hospitals that applied but did not receive positions. Selected stakeholders identified benefits of these additional positions, such as expanded training opportunities and increased physician services in their communities. For example, one rural hospital expanded its family medicine program which allowed it to implement a resident mentoring approach; another hospital expanded outpatient training, enabling residents to follow patients in later care, according to representatives. Selected stakeholders also described how CMS’s decision to distribute positions by prioritizing applications with the highest health care provider shortages may have disadvantaged some hospitals. In addition, stakeholders said funding challenges, such as up-front costs of new residency programs, also affected hospitals’ decisions to apply for new positions. Why GAO Did This Study Communities across the U.S., and rural areas in particular, face a growing risk of having too few physicians to meet health care needs. In 2023, Medicare paid about $22 billion to support GME residency positions at over 1,400 hospitals. Section 126 of the Consolidated Appropriations Act, 2021 requires CMS to distribute 1,000 new Medicare-funded GME residency positions to qualifying hospitals through permanent increases in their resident caps. The law requires CMS to distribute these positions in at least five annual distributions, with the first of these positions being available for use in 2023. The new positions are expected to cost about $1.8 billion over the first 9 years. The law also includes a provision for GAO to study the implementation of this process. This report describes the number of hospitals that applied for and received additional positions, their characteristics, and benefits and challenges identified by selected stakeholders related to the distribution of these additional positions. GAO analyzed hospital application data submitted to CMS for the first three annual distributions from 2023 through 2025; Medicare Cost Reports; and residency program data from the Accreditation Council for Graduate Medical Education. GAO also reviewed CMS documentation and public comments on CMS rulemaking and interviewed officials from CMS and the Health Resources and Services Administration. GAO also interviewed 14 stakeholders, including those representing hospitals and physicians, and seven selected hospitals that received new positions under Section 126. For more information, contact Leslie V. Gordon at GordonLV@gao.gov.

What GAO Found People with disabilities may encounter barriers related to accessibility in the U.S. health care system; these barriers can affect the quality of their care. GAO analyzed research literature on health care accessibility and conducted interviews with stakeholders and identified the following potential barriers. Types of Potential Barriers to Accessibility in Health Care Described by Literature and Selected Stakeholders The Department of Health and Human Services (HHS) does not collect national-level data on the accessibility of health care from people with disabilities. GAO analyzed 12 HHS population health surveys. One survey included a question on bias, but none covered other barriers to accessibility. HHS has established goals to increase the accessibility of health care through data collection, but officials stated that they do not have plans to collect related national-level data. Such plans would better position HHS to accurately identify barriers and evaluate the effects of HHS regulations that cover nondiscrimination in health care. Within HHS, the Centers for Medicare and Medicaid Services (CMS) and Office of Civil Rights (OCR) oversee aspects of health care organizations’ compliance with federal laws, but oversight related to accessibility has been limited. Specifically, CMS (1) uses an on-site inspection process to ensure that organizations participating in Medicare comply with health and safety standards and (2) inspects some aspects of accessibility. OCR investigates some accessibility issues through compliance reviews and from complaints. But it does not routinely share information on the results of its compliance reviews or complaint investigations. Sharing these results could broaden the impact of OCR’s efforts to other health care organizations. In 2024, HHS amended its regulations, adding accessibility requirements, and HHS’s current strategic plans state that accessibility is a priority. However, these plans do not include details or time frames for achieving this priority. As a result, HHS may not take appropriate steps to ensure that health care organizations meet accessibility requirements and some people with disabilities may continue to face barriers to obtaining health care. Why GAO Did This Study Millions of adults in the U.S. report having some form of a disability, such as a condition that affects vision, movement, hearing, or mental health. Federally funded programs such as Medicare pay for health services, including for people with disabilities. Although federal laws prohibit these programs from discrimination on the basis of disability, people with disabilities may face barriers to obtaining health care. GAO was asked to review federal efforts, including data collection and oversight, to ensure the accessibility of health care for people with disabilities. This report examines (1) barriers to accessible health care that people with disabilities may face, (2) HHS data collection efforts on the accessibility of health care, and (3) related HHS oversight. GAO reviewed relevant federal laws, regulations, and HHS policies and guidance; examined peer-reviewed literature on barriers to accessible health care published between 2013 and 2024; analyzed HHS accessibility-related data collection efforts; and conducted a nongeneralizable survey of 1,194 adults with disabilities. GAO also interviewed HHS officials and representatives from nine disability associations and research groups and two accrediting organizations.

What GAO Found As of school year 2024–25, the Department of Defense Education Activity (DODEA) operated 160 schools that served nearly 70,000 military-connected students around the world. These schools included Bahrain Elementary School and Bahrain Middle High School. The Bahrain Community Schools are located on the island Kingdom of Bahrain in the Middle East, just outside of Naval Support Activity Bahrain (see figure). The schools are part of DODEA’s Europe Region. Figure: Countries with Schools in DODEA’s Europe Region, Including Bahrain In school year 2024–25, the majority (86 percent) of the Bahrain Community Schools’ nearly 600 students were children of active-duty servicemembers, DOD civilian employees, and DOD contractors. The remaining 14 percent included tuition-paying Americans and foreign nationals. The Bahrain Community Schools’ campus includes an academic building with a wing for each school, science laboratories, a library, three art studios, and a cafeteria-theater. The Navy leases the campus from a private entity on behalf of DODEA. In Fall 2024, it modified the lease to allow for improvements needed to bring the property into compliance with DOD facilities standards, such as new fire suppression and security systems. Like other DODEA schools, the Bahrain Community Schools offered a variety of academic and extracurricular opportunities for students in school year 2024-25. For example, high school students enrolled in 13 in-person Advanced Placement courses, participated in seven competitive sports, and were in 26 extracurricular clubs. While local athletic competition was limited, some DODEA travel funding was available for teams to compete against other DODEA schools in Europe. For the same year, nearly all (98 percent) of the Bahrain Community Schools’ staff positions were filled as of September 1. This staffing rate exceeded the DODEA-wide average of 96 percent, in part due to the enhanced recruitment and retention strategies available to Bahrain as a designated hardship location. For example, applicants who accept positions in Bahrain receive a 20-percent cost of living allowance and additional incentives. Some parents from both of GAO’s parent discussion groups expressed frustration over delayed communication regarding security events that had prompted school lockdowns in recent years. However, installation leaders explained that communication during security events must be carefully vetted by senior leaders to assure safety. Installation and school leaders all agreed that the safety and security of DODEA students was of utmost importance during such incidents. Finally, about 9 percent of students at the Bahrain Community Schools received special education services in school year 2024-25, and some of these students had educational needs that exceeded the schools’ designated resource levels. School leaders and school staff told GAO that they were committed to providing every student with a high-quality education, including those eligible for special education. Installation leaders said they were taking steps to better screen families before they arrived in Bahrain to ensure that their educational needs aligned with available school resources. Why GAO Did This Study As DOD has reported, access to a high-quality education can enhance military-connected students’ well-being. However, some media reports have described parent concerns about DODEA’s schools in Bahrain that ranged from many teacher vacancies to poor communication. The Joint Explanatory Statement accompanying the Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 includes a provision for GAO to examine the administration of these schools. This report provides information on the Bahrain Community Schools, including student population, facilities, academic and extracurricular opportunities, staffing, communication efforts, and special education. GAO analyzed DODEA’s data on student enrollment, course offerings, staffing, and special education enrollment for school years 2022–23 through 2024–25, the three most recently completed school years at the time of GAO’s review. GAO also interviewed DODEA officials and visited the Bahrain Community Schools in person. There, GAO interviewed school and installation leaders and conducted four discussion groups—two with teachers and two with parents. GAO also reviewed relevant agency policies and procedures. For more information, contact Jacqueline Nowicki at NowickiJ@gao.gov.

What GAO Found Mexican transnational criminal organizations are a major supplier of the top two illicit synthetic drugs involved in overdose deaths in the U.S.—fentanyl and methamphetamine. To supply these drugs to U.S. users, these organizations source and purchase precursor chemicals primarily from China, using payment methods such as electronic funds transfers and virtual currency; produce or oversee the production of fentanyl and methamphetamine in clandestine labs in Mexico; and smuggle the drugs across the U.S.-Mexico border and supply them to U.S.-based drug trafficking groups. Local drug trafficking groups sell these drugs to users through e‑commerce platforms, online marketplaces, mobile applications, and social media using payment methods such as cash, peer-to-peer payment applications, and virtual currency, according to Financial Crimes Enforcement Network (FinCEN) and Drug Enforcement Administration (DEA) reports. Transnational criminal organizations launder the illicit proceeds from synthetic drug sales using methods such as bulk cash smuggling (moving physical currency across international borders), funnel accounts (bank accounts that collect deposits from members of the criminal network in multiple locations), trade-based money laundering (using goods in trade transactions to disguise the movement of illicit funds), virtual currency (exchanging bulk cash for virtual currency), and Chinese money laundering networks. Chinese money laundering networks are largely decentralized and use both underground-banking mechanisms (which bypass formal banking channels) and other laundering methods within banking systems to convert, move, and obscure illicit proceeds for a fee. Mexican transnational criminal organizations are increasingly using these networks in part because their laundering schemes have lower costs than other organizations, according to law enforcement officials. To combat drug trafficking and related money laundering, federal agencies coordinate and share information with each other and with state, local, and international partners through task forces, working and advisory groups, colocation, and other information-sharing channels. These mechanisms help agencies share resources and expertise, prevent overlapping investigations, and combine unique authorities. In addition, starting on January 20, 2025, the administration began instituting a variety of new policies, including some aimed at combating the flow of synthetic drugs into the U.S. For example, Executive Order 14159 requires the Departments of Justice and Homeland Security to jointly establish Homeland Security Task Forces in all 50 states to end the presence of cartels and transnational criminal organizations in the U.S. Agencies reported that it is too early to assess the full impact of these policies. Why GAO Did This Study Mexican transnational criminal organizations have fueled the U.S. synthetic drug crisis, contributing to hundreds of thousands of overdose deaths over the last 5 years, according to the Centers for Disease Control and Prevention. These organizations dictate the flow of nearly all illicit drugs into the U.S. They generate billions of dollars in profits from the sale of synthetic drugs and must launder those profits, often with the help of professional criminal money launders. Since 2019, FinCEN and other federal agencies have intensified efforts to combat illicit finance related to synthetic drug trafficking. Additionally, within the Department of Justice, the DEA, Federal Bureau of Investigation, and United States Attorneys’ Offices have investigated and prosecuted cases related to these activities. GAO added drug misuse to its High-Risk List in 2021; the list highlights vulnerable areas across the federal government. The Preventing the Financing of Illegal Synthetic Drugs Act contains a provision for GAO to study the trafficking of synthetic drugs into the U.S. and related illicit financing activity. This report describes (1) how Mexican transnational criminal organizations source, produce, and distribute synthetic drugs; (2) how these organizations launder their proceeds; and (3) information-sharing and coordination efforts by federal agencies to combat synthetic drug trafficking and related money laundering. GAO reviewed federal agency documents and reports, recent executive orders, and recent court cases involving synthetic drug trafficking. GAO also interviewed federal agency officials, industry representatives, and other stakeholders with relevant expertise. For more information, contact: Michael E. Clements clementsm@gao.gov or Triana McNeil mcneilt@gao.gov.

What GAO Found An estimated 38 percent (about 6,000) of the nation’s public libraries have at least one building system, such as heating, ventilation, and air conditioning (HVAC), in poor condition, according to GAO’s survey of libraries. An estimated 61 percent, or 9,800 libraries, have at least one building system or feature that poses a potential health or safety concern. Library size and physical accessibility were most frequently cited as potential concerns. For example, librarians we spoke with, and survey respondents, mentioned small library buildings can have inaccessible areas, obstructed walkways, and overcrowding. Shower Curtains Used Inside Library to Protect Books from Roof Leaks (left), and One of Several Damaged Air Conditioning Units (right) While the total cost to repair public library facilities nationwide is unknown, an estimated 70 percent (about 11,200 libraries) have a backlog of deferred maintenance and repair, according to GAO’s survey. According to budget forecasts and planned projects, an estimated 70 percent of libraries also expect deferred maintenance to persist or increase in the next 3 years. One librarian estimated needing about $60,000 for a new HVAC, and another librarian estimated more than $225,000 in construction costs for building repair needs, including for asbestos removal. An estimated 39 percent, or 6,200 libraries, had a deferred maintenance backlog of more than $100,000 each. An estimated 71 percent of public libraries cited construction costs, such as labor and materials, and limited funding availability, as key challenges to addressing maintenance and repairs. An estimated 90 percent of libraries use local funding to address maintenance and repairs. However, reliance on local funding, particularly for small town rural libraries and libraries in high-poverty areas, can also pose challenges to addressing facility repair needs. For example, these areas may have less population and a more limited funding base, as well as fewer resources to apply for grants, provide required matching funds, or fundraise. Why GAO Did This Study Beyond lending books, public libraries provide public spaces to host community programs and serve as voting sites and emergency centers. However, many libraries are in aging buildings, and their building systems may need repair or replacement to serve community needs. While the federal Institute of Museum and Library Services (IMLS), supports library programs and services, libraries are prohibited from using IMLS funds for building construction and repairs. The Joint Explanatory Statement accompanying the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2024, included a provision for GAO to study the availability and conditions of library facilities. This report examines the reported physical conditions of library facilities and the estimated cost and challenges to addressing facility repair needs, among other objectives. GAO conducted a nationally representative survey of about 16,400 public libraries in 50 states, the District of Columbia, and four territories. The survey results can be found in the “Additional Data” link of GAO’s website. GAO also visited 21 public and two tribal libraries in seven states and territories; reviewed data on estimated costs to address facility repair needs; and interviewed officials from IMLS; local and tribal libraries; state library administrative agencies; and other library stakeholders, including the American Library Association; Association of Tribal Archives, Libraries, and Museums; Association of Rural and Small Libraries; and Urban Libraries Council. For more information, contact David Marroni at marronid@gao.gov.

What GAO Found All levels of government have a role in preparing for and responding to disasters, with the Federal Emergency Management Agency (FEMA) leading the federal response. It has been nearly 20 years since the Post-Katrina Emergency Management Reform Act of 2006 required actions—such as the development of a national preparedness system—to address shortcomings in the nation’s disaster response system. Federal, state, and local governments, however, continue to face challenges preparing for and responding to large-scale disasters. Recent disasters, such as Hurricanes Helene and Milton in 2024, the Los Angeles wildfires in early 2025, and the July 2025 flooding in Texas, demonstrate the need for government-wide action to deliver assistance effectively. The federal government provides extensive support to state and local governments for disaster preparedness and response. For example, FEMA provides preparedness grants, training, and technical support to strengthen state and local emergency management capabilities. FEMA and other federal agencies, such as the U.S. Army Corps of Engineers and the Environmental Protection Agency, also supplement state and local efforts during disaster response (see figure). U.S. Army Corps of Engineers Debris Removal Efforts After 2025 Los Angeles Wildfires GAO analyzed selected states’ assessments of their disaster response capabilities and found that capability levels varied widely. Federal, state, and local officials GAO interviewed also emphasized the variation in capabilities at the state and local level—including challenges for rural or less resourced jurisdictions, even if they are within a well-resourced state. GAO has previously reported on challenges with FEMA and other federal agencies’ disaster assistance and added Improving the Delivery of Disaster Assistance to GAO’s High-Risk list in February 2025 to highlight the recommendations GAO has made to improve federal disaster efforts. Congress and the President have signaled an interest in reforms to FEMA. For example, the President signed Executive Orders in January and March 2025, respectively, establishing a FEMA Review Council to recommend improvements to FEMA and requiring review and revision of response and preparedness policies. Broader reform of FEMA’s mission, structure, or operations may address long-standing challenges with federal disaster efforts. Given the current levels of federal support and wide variation in state and local response capabilities, officials at the federal and state levels provided the following considerations for policymakers for communicating and implementing any such changes: Clear communication and guidance. States raised concerns about the uncertainty of the future of FEMA’s role. For example, state officials said it is challenging to plan in the absence of clear, consistent, and accurate guidance and emphasized the importance of consistent messaging about any changes, including technical assistance and training. GAO’s work following Hurricane Katrina also emphasized the importance of communicating clear roles and responsibilities. Time to prepare. Given that state and local governments rely on significant federal disaster support, federal and state officials emphasized the need for adequate time for these entities to prepare for any changes in disaster response roles.  Catastrophic or widespread disasters. Federal officials underscored that there will always be catastrophic disasters for which even the most well-equipped states would require some level of federal financial or other support. Federal-level coordination. FEMA also plays a vital role as the coordinating agency for the federal response to disasters. For example, FEMA has the statutory authority to assign other federal agencies to perform disaster response tasks that those agencies might not otherwise have authority to perform. Why GAO Did This Study GAO was asked to review long-standing challenges and emerging issues in federal response efforts for recent disasters, including Hurricanes Helene and Milton, the 2025 Los Angeles wildfires, and the July 2025 Texas floods. In September 2025, GAO issued the first report in a series on disaster response, focusing on the federal response workforce. This second report in the series provides information on federal disaster preparedness and response assistance provided before and during recent disasters, variation in state and local response capabilities, and considerations for potential changes to disaster response roles. GAO analyzed information from interviews conducted with federal agencies involved in disaster response and state and local governments impacted by disasters in recent years. Additionally, GAO analyzed preparedness assessments for the 10 states that received major disaster declarations for these recent disasters. To provide information on preparedness and response assistance, we summarized data on FEMA’s obligations for these disasters and amounts awarded through selected FEMA preparedness grants. For more information, contact Chris Currie at CurrieC@gao.gov.

What GAO Found The Consolidated Appropriations Act, 2022, contains a provision, codified at 18 U.S.C. § 2243(c), making it unlawful for someone, while acting in their capacity as a federal law enforcement officer, to knowingly engage in a sexual act with an individual who is under arrest, under supervision, in detention, or in federal custody. According to a 2022 Department of Justice (DOJ) report, consent is not a defense to a violation of 18 U.S.C. § 2243(c) and therefore federal law enforcement officers are automatically liable if they engage in the prohibited conduct. Generally, DOJ's Civil Rights Division and the 94 U.S. Attorneys' Offices throughout the country prosecute sexual offenses committed by federal law enforcement officers. According to DOJ data, there were no cases filed and no violations (criminal convictions) pursuant to 18 U.S.C. § 2243(c) in fiscal year 2025. Similarly, as GAO reported in its prior two reports on this topic, there were also no cases filed and no violations in fiscal year 2023 and 2024. As GAO noted in its prior reports, there are several factors that could explain why there have been no cases filed and no violations as of September 30, 2025. First, according to the 2022 DOJ report noted above, federal law enforcement officers committing criminal sexual acts against individuals under arrest, under supervision, in detention, or in federal custody may be prosecuted under other criminal statutes. Prosecutors must assess whether certain statutes apply to a case, based on the facts and circumstances of the case and the relevant case law in their jurisdiction. Second, individuals cannot be charged for prohibited conduct that occurred prior to the provision's effective date of October 1, 2022, and it can take several years from the time of an alleged incident to the filing of a criminal case to a disposition of the criminal case. Finally, according to an official from DOJ's Office on Violence Against Women, many victims do not report sexual abuse immediately due to a variety of factors, including fear of retaliation. The official also noted that there is a high rate of underreporting of sex offenses in general, particularly when it involves victims in custody or detention, where victims are reluctant to report "the police to the police." Why GAO Did This Study The Consolidated Appropriations Act, 2022, includes a provision for GAO to report on violations of 18 U.S.C. § 2243(c) committed between October 1, 2022, and September 30, 2023, and then to report annually thereafter. GAO issued two reports addressing this topic, the first covering fiscal year 2023 in October 2023, and the second covering fiscal year 2024 in October 2024. This report provides information on the number of cases filed by DOJ and the number of violations of 18 U.S.C. § 2243(c) during fiscal year 2025. To address this objective, GAO requested and received data from DOJ on charges and convictions pursuant to 18 U.S.C. § 2243(c), and interviewed officials from EOUSA. GAO also interviewed DOJ officials to understand how they report cases filed and violations in their data system and assessed the reliability of that data. For more information, contact Gretta Goodwin at goodwing@gao.gov.

What GAO Found The Federal Home Loan Bank (FHLBank) System consists of 11 federally chartered FHLBanks that support liquidity by making loans to member financial institutions (including banks) in the U.S. As of June 2025, 93 percent of banks (approximately 4,100) were members of an FHLBank, allowing them to obtain liquidity via secured loans. GAO’s analysis found that the FHLBanks generally serve as a reliable and consistent source of funding for banks of all sizes throughout the financial cycle. They can also play a key role in the health of small banks (those with $10 billion or less in assets). This has been the case despite concerns raised in some academic and other literature that FHLBank lending could exacerbate periods of financial stress—for example, by masking problems at troubled member banks or increasing resolution costs when a member bank fails. Banks’ FHLBank borrowing trends. From 2015 through June 2025, most U.S. banks were FHLBank members and obtained secured loans at least once. Banks’ total outstanding borrowing (as of quarter-end) ranged from $189 billion to $804 billion during this period. Although most active FHLBank members maintained relatively consistent FHLBank borrowing, a small number of large banks (with more than $10 billion in assets) drove substantial increases in aggregate borrowing at the onset of the COVID-19 pandemic in 2020 and during the March 2023 liquidity crisis. For example, large banks were responsible for 97 percent of the increased borrowing in the first quarter of 2023. However, median FHLBank borrowing as a share of median total assets generally stayed within a consistent range from 2015 through June 2025, including for large banks. This suggests that their overall reliance on FHLBank loans during stress periods was largely unchanged. Total Outstanding Federal Home Loan Bank Borrowing, Jan. 2015–June 2025 Outcomes associated with FHLBank borrowing. GAO’s econometric models, which controlled for bank health, macroeconomic factors, and economic cycles, found that higher FHLBank borrowing by a bank was generally associated with positive outcomes for the bank. From 2015 through 2024, higher FHLBank borrowing was associated with (1) increases in real estate lending and (2) lower likelihood of being flagged as a problem bank or of failing or closing voluntarily. These results were largely driven by small banks, which make up 97 percent of banks in GAO’s analysis. Policymaker considerations for potential changes to FHLBank lending. GAO reviewed suggestions for reform from academic, industry, and government sources, such as involving federal banking regulators in lending decisions and changing how FHLBank loans are priced. In discussion groups, interviews, and written comments, stakeholders noted that while these changes could help address certain concerns, each carried potential unintended consequences for markets, member banks (especially smaller ones), and consumers. GAO found that in some cases, the suggested changes would duplicate existing authorities or practices. The FHLBanks, Federal Housing Finance Agency (which oversees FHLBanks), and the federal banking regulators have mechanisms to communicate during periods of financial stress. The bank failures and related liquidity stress of March 2023 highlighted challenges to timely coordination between the FHLBanks and the Federal Reserve Banks. Since then, they have taken steps to improve their coordination. These include conducting joint tabletop exercises and ongoing discussions to help shared members reallocate collateral during emergencies. In January 2025, the FHLBank System and the Federal Reserve System also established a joint working group to improve routine interoperability between the two systems. These efforts are ongoing and, in some cases, are in early stages, with expected completion in late 2025 or 2026. Continued commitment to these coordination efforts will be important to ensure readiness for future financial stress, when member banks may need to reallocate collateral to access additional liquidity. Why GAO Did This Study The FHLBank System supports liquidity by making billions of dollars in loans to member banks. Federal banking regulators oversee individual banks’ safety and soundness and promote financial stability. The 12 district Federal Reserve Banks also lend to banks and may act as a lender of last resort. Substantial FHLBank lending to three large banks that failed in 2023 renewed questions about FHLBanks’ lending role and communication with banking regulators and Federal Reserve Banks during times of stress. GAO was asked to review the role of FHLBanks during financial crises. This report examines (1) banks’ FHLBank borrowing trends from 2015 through June 2025; (2) associations between FHLBank borrowing and outcomes; (3) policy considerations for potential changes to FHLBank lending; and (4) communication among FHLBanks and relevant federal agencies during periods of financial stress. GAO reviewed literature from 2007 through mid-2024; analyzed bank financial reports, FHLBank membership data, and economic indicators; and examined documentation from the FHLBanks, banking regulators, and the Federal Housing Finance Agency. GAO also held seven discussion groups with a total of 30 academics, researchers, and industry group representatives (selected for their relevant knowledge and diverse views) and interviewed representatives of FHLBanks, federal regulators, and a nongeneralizable sample of 10 member banks (selected to reflect varying asset sizes) that borrowed from FHLBanks during recent periods of financial stress. For more information, contact Jill Naamane at naamanej@gao.gov.

What GAO Found The Department of State and U.S. Agency for International Development (USAID) have funded and implemented projects to combat forced labor and sex trafficking, including some projects in countries affected by armed conflict. From fiscal year 2020 through fiscal year 2024, State and USAID obligated about $437 million for anti-trafficking projects. This included funding for projects in conflict-affected countries such as Ukraine, Moldova, Romania, and Ethiopia. However, a January 2025 executive order paused U.S. foreign development assistance. In April 2025, State began a reorganization, and in July 2025, the Secretary of State announced that USAID had ceased providing foreign assistance. As a result, during the first two quarters of fiscal year 2025, State had no new obligations and de-obligated $1.4 million and USAID obligated $1 million and de-obligated about $1.1 million from anti-trafficking projects. As of September 2025, some of State’s anti-trafficking programming remained. Agency officials said that, going forward, State planned to focus on producing its required annual Trafficking in Persons Report—a report describing the anti-trafficking efforts of the United States and foreign governments. Officials from agencies and implementing partner organizations identified challenges affecting anti-trafficking project implementation in conflict-affected countries. They also identified opportunties to strengthen project implementation in any future efforts. Stakeholders Identified Challenges and Opportunities to Strengthen Implementation of Anti-Trafficking Projects in Conflict-Affected Countries Challenges to Implementation Opportunities to Strengthen Implementation · Prioritization of humanitarian aid over anti-trafficking efforts · Increased vulnerabilities to trafficking in conflict-affected countries · Changing trafficking patterns in conflict-affected countries · Impaired prevention and awareness among vulnerable populations · Interrupted access to conduct protection activities · Limited program management flexibility to adapt to changing circumstances in conflict · Difficulties in coordinating and partnering with local and international stakeholders · Limited local partner capacity to conduct anti-trafficking efforts · Corruption and evidence requirements for prosecuting trafficking cases · Continue U.S. policy emphasis on anti-trafficking efforts · Build local partner capacity through training, technology, and best practices · Allow implementing partners greater flexibility to adapt when conflict interrupts planned anti-trafficking activities · Facilitate coordination among international and local anti-trafficking partners · Provide additional funding for anti-trafficking programming Source: GAO analysis of discussion group responses. | GAO-26-107406 Note: We held eight discussion groups with a total of 47 stakeholders from December 2024 to March 2025. Stakeholders included U.S. agency officials managing anti-trafficking projects and representatives of organizations implementing projects in Ukraine, Romania, Moldova, and Ethiopia. Why GAO Did This Study Human trafficking is a global threat that armed conflict exacerbates. Russia’s invasion of Ukraine in 2022 prompted widespread concern about trafficking in Ukraine and other conflict-affected countries. This report is one of several engagements GAO initiated in response to a provision in the Consolidated Appropriations Act, 2023. This report describes State and USAID funding for anti-trafficking projects globally and in four conflict-affected countries—Ukraine, Moldova, Romania, and Ethiopia. Among other objectives, this report also describes challenges and opportunities to strengthen implementation of anti-trafficking projects in conflict-affected countries. GAO analyzed agency documentation and funding data and interviewed and analyzed discussion responses from 47 agency officials and representatives from implementing partner organizations from eight discussion groups held from December 2024 to March 2025. For more information, contact Chelsa Kenney at kenneyc@gao.gov.

What GAO Found According to key metrics, air service at airports of all sizes dropped sharply in 2020 with the onset of the COVID-19 pandemic. While larger airports have rebounded to some extent, the recovery has lagged for smaller airports, including nonhub airports (i.e., airports that have less than 0.05 percent of annual U.S. commercial enplanements but have more than 10,000 annual enplanements). For example, the average number of daily departures per route for nonhub airports was 19 percent lower in 2024 than in 2018. Average Daily Departures per Route for Nonhub Airports Before (2018), During (2020), and After (2024) the COVID-19 Pandemic (Calendar Years) Note: Nonhub airports have less than 0.05 percent of annual U.S. commercial enplanements but have more than 10,000 annual enplanements. The Department of Transportation (DOT) administers two federal programs that support air service to small communities. The Essential Air Service (EAS) program provides subsidies to airlines serving eligible communities to help support air service. The Small Community Air Service Development Program (SCASDP) provides grants to eligible communities not receiving EAS-subsidized service that can be used to jumpstart new air service. However, GAO found the demand for SCASDP grants has continued to exceed the support SCASDP offers. GAO also previously reported that SCASDP grants did not fully fund the revenue guarantees that reduce airlines’ financial risk to initiate new air service. Further, while SCASDP grants provide funding for revenue guarantees for up to 3 years, airport representatives and other stakeholders GAO interviewed identified ongoing funding as needed for maintaining service. The FAA Reauthorization Act of 2024 gave DOT some additional flexibilities to amend existing grants to small communities if circumstances change, and to consider grant applications for the same project from the community in a shorter time frame. Certain nonhub airports that do not receive subsidized air service through EAS (non-EAS nonhub airports) have faced challenges securing and maintaining air service. For example, some of these airports reported an increased need to pay airlines for service, as airlines have shifted to using larger planes and scaled back service to some smaller communities to reduce their operating costs. Representatives of selected non-EAS nonhub airports told GAO they have leveraged various sources of funding to provide airlines revenue guarantees to help secure new air service. However, representatives of several selected airports stressed the difficulty of providing ongoing funding to maintain air service, particularly once any funding from SCASDP has been exhausted. Why GAO Did This Study Access to air service provides a vital connection to the national transportation system and can be an important driver of economic growth. However, smaller communities have experienced declining scheduled passenger air service for several decades. The smaller airports impacted by air service declines include certain nonhub airports that have not regained pre-pandemic service levels. The FAA Reauthorization Act of 2024 includes a provision in statute for GAO to study challenges that certain nonhub airports face. This report describes (1) changes in key metrics for air service at nonhub airports from 2018 through 2024; (2) the extent to which SCASDP can help non-EAS nonhub airports secure and maintain air service; and (3) challenges selected non-EAS nonhub airports have identified, and how these airports have addressed the challenges. GAO analyzed flight data reported to DOT for key metrics, including average daily departures per route, from calendar year 2018 through calendar year 2024. GAO interviewed DOT officials and reviewed relevant statutes and grant documentation, including grant applications and awards for SCASDP from fiscal year 2018 through fiscal year 2023 (the most recent award cycle). Finally, GAO selected seven non-EAS nonhub airports based on factors such as changes in air service. GAO interviewed representatives of these airports about challenges they have faced and their efforts to address those challenges, and GAO conducted site visits to four of the airports. GAO also interviewed state aviation officials in four states where selected airports are located as well as aviation stakeholders. For more information, contact Derrick Collins at CollinsD@gao.gov.

What GAO Found The Navy has suffered significant losses from 13 fires on ships undergoing maintenance since 2008. The Navy investigated these fires, including one on board the USS Bonhomme Richard in 2020. Based on actions taken since that fire, the Navy has improved fire safety and culture in the Navy and among contractors—contributing to no major fires since 2020. However, staffing shortages threaten progress and oversight. GAO found that key organizations responsible for fire safety oversight have personnel shortages. Such shortages limit the Navy’s oversight of fire safety standards and add a burden for sailors who are balancing other duties. Image of the July 2020 Major Fire Aboard the USS Bonhomme Richard Further, the Navy did not fully assess challenges with contractor oversight. In reviewing the Navy’s key oversight tools, GAO found that these tools do not effectively address contractor compliance with fire safety standards during ship maintenance periods: Corrective Action Requests. The Navy uses these requests to bring contractors into compliance with contract requirements. But this process does not incorporate monetary penalties to address persistent issues. As a result, the Navy issued many requests related to fire safety, including a severe warning prior to the USS Bonhomme Richard fire, but fire safety issues continued. Quality Assurance Surveillance Plans. These plans are a tool through which the Navy assesses monetary penalties. The Navy’s guidance and its quality assurance surveillance plans for the six ships GAO reviewed did not assess penalties for noncompliance with contractual safety standards. Progress Payment Retention Rates. The Navy generally pays contractors as maintenance work is completed, retaining some payment until the work is done. The Navy’s continued use of a reduced retention rate implemented in response to the COVID-19 pandemic reduces the effectiveness of this tool. Liability. The Navy has not adjusted its limitation on ship repair contractor liability for major losses since 2003. Inflation and the increased complexity and cost of ship maintenance mean that the limit is proportionally less than when established, placing increase financial risk on the government in the event of a loss, such as a major fire. Why GAO Did This Study Fire is a significant risk for Navy ships undergoing maintenance. A 2020 fire found to be caused by arson on board the USS Bonhomme Richard resulted in the ship’s decommissioning, decades earlier than planned. This report assesses (1) the extent to which Navy actions taken following the USS Bonhomme Richard fire addressed contractor compliance with fire safety standards, and (2) the Navy’s use of various contracting tools for ensuring contractor accountability and compliance with fire safety standards. GAO reviewed Navy actions based on lessons learned from the USS Bonhomme Richard fire. GAO also selected six nonnuclear surface ships undergoing major repair by four different contractors at four domestic maintenance centers, and analyzed Navy documentation of contractor compliance with fire safety standards. Additionally, GAO visited three regional maintenance centers and toured five ships.

What GAO Found Federal Aviation Administration (FAA) air traffic controllers help ensure the safety of U.S. air travel. However, lapses in appropriations in the 2010s, and the COVID-19 pandemic, resulted in reduced controller hiring and increased attrition. In response, FAA has increased hiring every year since 2021. Nevertheless, at the end of fiscal year 2025, FAA employed 13,164 controllers, about 6 percent fewer than in 2015. Between fiscal years 2015 and 2024, total flights using the air traffic control system increased by about 10 percent to 30.8 million. FAA uses a standardized process to hire controllers that begins with evaluating applicants’ performance on an aptitude test or their prior experience as an air traffic controller. Applicants must also meet medical and security standards and succeed at multiple types of training. However, FAA’s processes for hiring and training controllers result in substantial attrition (see fig.). This occurs due to a limited portion of the population having the required aptitude, and the length and complexity of the processes—which can take 2-6 years. Specifically, the medical clearance process can take some applicants 2 years to complete. In response to these challenges, FAA has taken steps to accelerate the process, including adding resources to the medical clearance process and streamlining application review. Attrition Across the FAA’s Processes for Hiring Air Traffic Controllers Without Prior Experience, Fiscal Years 2017-2022 GAO also found that FAA does not consistently assess its processes to recruit, hire, and train air traffic controllers. Specifically, FAA does not have performance goals for these processes and their resulting impact. Such goals help ensure accountability for achieving specific and measurable results. GAO also found that while FAA is taking steps to improve its collection of data on recruiting, hiring, and training, it does not consistently use these data to assess the results of its efforts and inform decision-making. Doing so could help FAA understand the performance of its processes, make the changes that would have the greatest effect on controller staffing, and keep otherwise qualified applicants on the track to becoming certified controllers. Why GAO Did This Study FAA, within the Department of Transportation, manages over 80,000 flights daily. FAA air traffic controllers perform this essential job that requires highly specialized skills and training. Over the last 10 years, FAA has faced staffing shortages at critical facilities. GAO was asked to review FAA’s processes for hiring air traffic controllers. This report (1) describes the size and composition of the air traffic control workforce and changes since fiscal year 2015; (2) describes the processes FAA uses to recruit, hire, and train new controllers; (3) examines the steps FAA has taken to address challenges associated with recruiting, hiring, and training controllers; and (4) evaluates how FAA has assessed its efforts to hire air traffic controllers. To address these objectives, GAO used FAA data to develop a dataset covering individuals from application through certification and used the data to analyze attrition in the controller hiring process. GAO also reviewed FAA documentation; visited the FAA training academy in Oklahoma City and air traffic control facilities near Chicago; Seattle; and Washington, D.C.; interviewed FAA officials and aviation industry stakeholders; and compared FAA’s efforts to assess its hiring processes with leading practices for evidence-based decision-making.

What GAO Found The U.S. Postal Service (USPS) plays a critical role in the nation's communications and commerce. Federal law requires USPS to "provide adequate and efficient postal services at fair and reasonable rates and fees" and to "serve as nearly as practicable the entire population of the United States." USPS has long been expected to fulfill those requirements while being financially self-sufficient by covering its expenses with revenue from the sale of its products and services. However, USPS's financial viability has been on GAO's High Risk List since 2009 due to its poor financial condition, which has been driven in part by declining mail volumes and rising costs. USPS has lost money every fiscal year since 2007. Its net losses have totaled approximately $118 billion from fiscal years 2007 through 2025. Its productivity also has declined—a trend that has contributed to its cost pressures. USPS has been able to continue operating by increasing its debt and unfunded liabilities. At the end of fiscal year 2024, USPS's unfunded liabilities and debt totaled 206 percent of its annual revenue, compared with 82 percent in fiscal year 2007. USPS's key costs are related to employee compensation and benefits, which represented about 76 percent of USPS's total operating expenses in fiscal year 2024. In March 2021, USPS introduced Delivering for America, a 10-year strategic plan intended to modernize its network and products to bring about financial sustainability. The strategic plan includes significant changes to many aspects of USPS operations, including its processing, transportation, and delivery networks. USPS has implemented a range of cost-cutting and revenue-enhancing measures as part of Delivering for America, but additional strategies are constrained by statutory, regulatory, contractual, and political issues. While some key stakeholders have expressed support for Delivering for America's goals and strategies, some have expressed concerns that USPS's implementation of the plan (1) has not achieved projected cost savings and (2) has lowered service performance in some areas. Additionally, the Postal Service Reform Act of 2022 (PSRA) was signed into law on April 6, 2022. PSRA is the first major legislative change to USPS since Congress passed the Postal Accountability Enhancement Act (PAEA) in 2006. PSRA provisions had immediate and long-term effects on USPS's finances and operations, such as repealing the requirement for USPS to prefund retiree health benefits and codifying 6-day-a-week mail delivery. Nevertheless, USPS's business model will remain unsustainable without Congress making difficult, fundamental policy decisions. Why GAO Did This Study This primer updates GAO's 2021 Primer on Postal Issues (GAO-21-479SP). Since GAO issued the original primer, USPS began implementing its 10-year strategic plan, Delivering for America, and Congress passed the Postal Service Reform Act of 2022. In addition, USPS released an updated plan in 2024, which summarized progress made over the preceding 3 years and the evolution of its major strategies. This primer will help readers familiarize themselves with key issues confronting USPS by providing straightforward answers to common questions. It also identifies topics for Congress to consider when determining the future of USPS. For readers interested in a more detailed discussion, a list of related GAO products is included at the end of each section.