Unexpended Fund Balance in the Indian Health Service Water and Sanitation Facility Construction Program

GAO examined the Indian Health Service's (IHS) Water and Sanitation Facility Construction (WSFC) Program to determine whether: (1) IHS budgeting procedures can be changed to reduce the amount of appropriated funds needed for facility construction in a given year; (2) IHS allocation and obligation procedures are contributing to the size of the unexpended balance; (3) IHS is receiving more funds than it can effectively use for WSFC; (4) Congress should consider different ways of providing funds to IHS for WSFC; and (5) the use of the memorandum of agreement by IHS as an obligating document is legal.