What GAO Found In 2021, the Federal Highway Administration issued a final rule—the “dig once” rule—establishing new broadband infrastructure regulatory requirements for state departments of transportation that receive federal-aid highway program funding. These requirements included (1) identifying a broadband utility coordinator, (2) establishing certain processes to register and notify internet service providers and other entities, and (3) coordinating initiatives with state and local plans. Broadband utility coordinator. In GAO’s national survey, 46 of 52 respondents reported their state department of transportation had identified a coordinator. Registration and notification. Over half of survey respondents reported their state had fully established processes to (1) register internet providers and other entities, and (2) electronically notify them of the state transportation improvement program. A few respondents noted barriers to implementing the processes, including limited availability of experienced staff, IT difficulties, and challenges engaging providers in the processes. Survey Respondents’ Reported Progress Establishing Registration and Notification Processes Required by the Federal Highway Administration, as of May 2025 Coordination. In responding to questions related to regulatory requirements for coordination,46 of 52 survey respondents reported coordinating broadly with federal, state, or local agencies to facilitate broadband infrastructure deployment in federal-aid highway rights-of-way. For example, one respondent reported that the broadband utility coordinator and a county utility committee exchanged details on planned highway and broadband projects at the utility’s monthly meeting. Survey respondents and stakeholders GAO interviewed said the rule’s effects on broadband deployment were not well known. However, a few respondents, state officials, provider representatives, and other stakeholders cited the overall goals of “dig once” as reasons for optimism. Specifically, they were optimistic about the potential for benefits such as reduced excavation and traffic disruptions, lower project costs, and greater broadband access. Why GAO Did This Study Installing the infrastructure necessary to expand broadband access can be costly. “Dig once” policies encourage coordination between broadband projects and road projects, which can minimize excavations and save money. GAO was asked to review the implementation status of the Federal Highway Administration’s 2021 “dig once” rule that established regulatory requirements to facilitate broadband infrastructure deployment, as required by statute. This report describes states’ progress implementing certain “dig once” rule requirements and states’ views on the effects of the rule on broadband deployment. To address these objectives, GAO surveyed all 52 broadband utility coordinators or other appropriate contacts (50 states, Puerto Rico, and Washington, D.C.). GAO reviewed applicable statutes, regulations, and Federal Highway Administration documentation. GAO also interviewed or obtained written responses from Federal Highway Administration and National Telecommunications and Information Administration officials, and representatives from four broadband industry and state government associations, which GAO selected to obtain a cross section of stakeholder interests. For three selected states, GAO reviewed documents; interviewed state department of transportation and broadband office officials; and interviewed representatives of five internet service providers. GAO selected these states to reflect a range of factors, based on information including survey responses and experience with broadband deployment projects in federal-aid highway rights-of-way since the final rule took effect. For more information, contact Andrew Von Ah at vonaha@gao.gov.

What GAO Found The Department of Housing and Urban Development (HUD) reports national estimates of the number and characteristics of people using homeless shelters. These estimates are based on data from about 400 Continuums of Care (CoC), which are planning bodies that coordinate homelessness services within a defined geographic area. CoCs manage shared databases that service providers in their area use to collect data on the people they serve. Each year, CoCs submit aggregated data from these databases to Abt Associates, a consulting firm that processes and analyzes the data for HUD. Abt works with CoCs to identify and resolve data quality issues and determines whether the data meet HUD’s standards (see figure). For CoCs with unusable data and shelters that do not collect data, Abt uses statistical methods to generate estimates. HUD’s Process for Collecting Data on Shelter Use HUD’s process for assessing data quality lacks transparency, making it difficult to assess the reliability of its estimates. Abt staff review each CoC’s data to determine whether they should be included in national estimates of people using shelter programs. However, HUD has not defined which specific data quality issues render a CoC’s data unusable. Instead, according to Abt staff, these decisions are based on their professional judgment. The Office of Management and Budget’s guidelines issued in response to the Information Quality Act require agencies to provide sufficient transparency about their data and methods so that published information can be substantially reproduced. GAO reviewed HUD and Abt data and documentation and was unable to replicate HUD’s data usability determinations. Greater transparency in HUD’s review process could increase confidence in the reliability of its homelessness data. HUD has taken steps to improve the quality of aggregated CoC data by offering tools and technical assistance directly to CoCs. Staff at most of the 14 CoCs GAO interviewed said these resources were helpful and that their data quality was improving. However, when HUD determines that a CoC’s data are not usable, it does not communicate the rationale to the CoC. As a result, CoCs may be unsure about how to best improve their data and may devote limited resources to issues that may not result in better data quality. Why GAO Did This Study Hundreds of thousands of people experience homelessness in the U.S. each year, but developing quality data on homelessness has long been a challenge. High-quality information on homelessness can help policymakers and service providers more effectively target programs and allocate resources. GAO was asked to review how HUD collects and analyzes data on people experiencing sheltered homelessness.This report (1) describes HUD's process for estimating the number and characteristics of people who use shelter programs, (2) examines HUD’s process for assessing data quality and creating estimates, and (3) assesses HUD’s efforts to address data quality issues that may affect those estimates. GAO reviewed HUD data from fiscal years 2021 and 2022 (the most recent available) and documentation and interviewed agency officials. GAO also reviewed HUD guidance and interviewed staff from a nongeneralizable sample of 14 CoCs (out of about 400), selected to reflect variation in location and data quality, and conducted site visits to two of these CoCs.

What GAO Found Organ transplantation is the leading treatment for patients with severe organ failure, but as of May 2025, more than 100,000 individuals remained on the national waiting list. The Department of Health and Human Services (HHS) has overseen organ allocation services since 1984, using the same contractor to do so, until recently. In 2024, HHS entered into contracts to assess weaknesses in organ allocation services, as part of a modernization initiative. The assessments target issues, including inequitable organ allocation and insufficient investigation of serious events, such as beginning to recover organs before patient death. However, HHS has not yet developed detailed plans for the next initiative phase, including how it will make reforms to address identified weaknesses. Doing so is crucial to improving HHS’s ability to provide organs to critically ill patients. Organ Transplants from Deceased Donors, Percent by Type, 2024 Note: Data show organ transplant types reported by the Organ Procurement and Transplantation Network. In 2024, there were 41,119 organ transplants from deceased donors in the United States. HHS has not assessed the risks associated with its contractor providing supplementary services outside of its HHS contract, and charging a related monthly fee, to transplant programs. Services include, for example, analytics to help transplant programs manage their waiting lists. In fiscal year 2024, the contractor received about $9.6 million from transplant programs paying the fee. These supplementary services and fee raise several concerns, including whether the services should be provided as part of the contractor’s agreement with HHS and that transplant programs may be paying the fee without realizing it is optional. Assessing the risks associated with this contractor activity, and making changes as appropriate, would better position HHS to ensure it is effectively overseeing its contractor, which has a crucial role in ensuring lifesaving organs are provided to patients effectively and safely. In 2021, HHS formed a coordination group to improve the organ transplantation system, overseen by two of its agencies. However, the group’s action plan does not include specific, actionable steps with milestone completion dates and measures to gauge success of actions taken. Including these elements, consistent with the group’s charter, would better enable HHS to improve the organ transplantation system through its agencies’ collaborative efforts. Why GAO Did This Study Congress and others have raised concerns about systemic issues with organ allocation services, such as the data reliability of the organ matching IT system. In March 2023, HHS announced a modernization initiative to improve organ allocation services. The Securing the U.S. Organ Procurement and Transplantation Network Act includes a provision for GAO to review the organ transplantation system. This report examines, in part, HHS’s efforts to assess weaknesses in organ allocation services as part of its modernization initiative; the extent to which HHS assesses supplementary services and the fee charged to transplant programs by the contractor; and coordination across HHS. To conduct this work, GAO reviewed agency and contractor documentation and interviewed officials and representatives from HHS, the contractor, and non-federal groups involved in the organ transplantation system, including providers and patients, among others.