You are given two reports by the government agency.  

Report 1:
For over a decade, each of VA’s 170 medical centers used VHA’s legacy MSPV program to order medical supplies, such as bandages and scalpels. Many of those items were purchased using the Federal Supply Schedules, which provided medical centers with a great deal of flexibility. However, as we reported in 2016, this legacy program prevented VHA from standardizing items used across its medical centers and affected its ability to leverage its buying power to achieve greater cost avoidance. Standardization is a process of narrowing the range of items purchased to meet a given need, such as buying 10 varieties of bandages instead of 100, in order to improve buying power, simplify supply chain management, and provide clinical consistency. In part because of the legacy MSPV program’s limited standardization, VHA decided to transition to a new iteration, called MSPV-NG. The transition to MSPV-NG has been a major effort, involving the MSPV- NG program office, stakeholders from the VHA’s Procurement and Logistics Office and VA’s Strategic Acquisition Center (SAC)—a VA-wide contracting organization—and logistics and clinical personnel at every medical center. The program also includes hundreds of new contracts with individual supply vendors and a new set of prime vendor contracts to distribute the supplies. VA’s goals for the MSPV-NG program include (1) standardizing requirements for supply items for greater clinical consistency; (2) demonstrating cost avoidance by leveraging VA’s substantial buying power when making competitive awards; (3) achieving greater efficiency in ordering and supply chain management, including a metric of ordering 40 percent of medical centers’ supplies from the MSPV-NG formulary; and (4) involving clinicians in requirements development to ensure uniform clinical review of medical supplies. VHA launched the MSPV-NG program in December 2016, but allowed a 4-month transition period. After April 2017, medical centers could no longer use the legacy program. MSPV-NG now restricts ordering to a narrow formulary. VHA policy requires medical centers to use MSPV- NG—as opposed to other means such as open market purchase card transactions—when purchasing items that are available in the formulary. Leading hospital networks we spoke with have similar goals to VA in managing their supply chains, including clinical standardization and reduced costs. These hospital networks reported they analyze their spending to identify items purchased most frequently, and which ones would be the best candidates to standardize first to yield cost savings. The hospitals’ supply chain managers reported establishing consensus with clinicians through early and frequent collaboration, understanding that clinician involvement is critical to the success of any effort to standardize their medical supply chain. By following these practices, these hospital networks have reported they have achieved significant cost savings in some cases, and the potential for improved patient care, while maintaining buy-in from their clinicians. VHA’s implementation of the MSPV-NG program—from its initial work to identify a list of supply requirements in early 2015, through its roll-out of the formulary to medical centers in December 2016—was not executed in line with leading practices. Specifically, VHA lacked a documented program strategy, leadership stability, and workforce capacity for the transition that, if in place, could have facilitated buy-in for the change throughout the organization. Further, the initial requirements development process and tight time frames contributed to ineffective contracting processes. As a result, VHA developed an initial formulary that did not meet the needs of the medical centers and has yet to achieve utilization and cost avoidance goals. VA made some changes in the second phase of requirements development to address deficiencies identified in the initial roll out. Key among these was to increase the level of clinical involvement, that is, to obtain input from the doctors and nurses at VA’s individual medical facilities. Despite changes aimed at improving implementation, the agency continues to face challenges that prevent the program from fully achieving its goals. VA did not document a clear overall strategy for the MSPV-NG program at the start and has not done so to date. About 6 months after our initial requests for a strategy or plan, a VHA official provided us with an October 2015 plan focusing on the mechanics of establishing the MSPV-NG formulary. However, this plan was used only within the VHA Procurement and Logistics Office and had not been approved by VHA or VA leadership. Leading practices for organizational transformation state that agencies must have well-documented plans and strategies for major initiatives (such as MSPV-NG) and communicate them clearly and consistently to all involved—which included VHA headquarters, the SAC, and all 170 medical centers. Without such a strategy, VA could not reasonably ensure that all stakeholders understood VHA’s approach for MSPV-NG and worked together in a coordinated manner to achieve program goals. In our November 2017 report, we recommended that the Director of the MSPV-NG program office should, with input from SAC, develop, document, and communicate to stakeholders an overarching strategy for the program, including how the program office will prioritize categories of supplies for future phases of requirement development and contracting. VA agreed with this recommendation and reported it would have a strategy in place by December 2017. Leadership instability and workforce challenges also made it difficult for VA to execute its transition to MSPV-NG. Our work has shown that leadership buy-in is necessary to ensure that major programs like MSPV- NG have the resources and support they need to execute their missions. Due to a combination of budget and hiring constraints, and lack of prioritization within VA, the MSPV-NG program office has never been fully staffed and has experienced instability in its leadership. As of January 2017, 24 of the office’s 40 positions were filled, and program office officials stated that this lack of staff affected their ability to implement certain aspects of the program within the planned time frames. In addition, since the inception of MSPV-NG, the program office has had four directors, two of whom were acting and two of whom were fulfilling the director position while performing other collateral duties. For instance, one of the acting MSPV-NG program office directors was on detail from a regional health network to fulfill the position, but had to abruptly leave and return to her prior position due to a federal hiring freeze. In our November 2017 report, we recommended that VHA prioritize the hiring of a MSPV- NG program director on a permanent basis. VA agreed with this recommendation and indicated a vacancy announcement will be posted by the end of 2017. The MSPV-NG program office initially developed requirements for items to be included in the formulary based almost exclusively on prior supply purchases, with limited clinician involvement. The program office concluded in its October 2015 formulary plan that relying on data from previous clinician purchases would be a good representation of medical centers’ needs and that clinician input would not be required for identifying which items to include in the initial formulary. Further, rather than standardizing purchases of specific categories of supplies—such as bandages or scalpels—program officials told us they identified medical and surgical items on which VA had spent $16,000 or more annually and ordered at least 12 times per year, and made those items the basis for the formulary. Officials said this analysis initially yielded a list of about 18,000 items, which the program office further refined to about 6,000 items by removing duplicate items or those that were not considered consumable commodities, such as medical equipment. This approach to requirements development stood in sharp contrast to those of the leading hospital networks we met with, which rely heavily on clinician input to help drive the standardization process and focus on individual categories of supplies that provide the best opportunities for cost savings. Based on the requirements developed by the program office, SAC began to issue competitive solicitations for the 6,000 items on the initial formulary in June 2015. Medical supply companies had responded to about 30 percent of the solicitations as of January 2016. As a result, according to SAC officials, they conducted outreach and some of these companies responded that VHA’s requirements did not appear to be based on clinical input and instead consisted of manufacturer-specific requirements that favored particular products instead of broader descriptions. Furthermore, SAC did not solicit large groups of related items, but rather issued separate solicitations for small groups of supply items—consisting of three or fewer items. This is contrary to industry practices of soliciting large groups of related supplies together. Therefore, according to SAC officials, some medical supply companies told them that submitting responses to SAC’s solicitations required more time and resources than they were willing to commit. By its April 2016 deadline for having 6,000 items on the formulary, SAC had been working on the effort for over a year and had established competitive agreements for about 200 items, representing about 3 percent of the planned items. Without contracts for the items on the formulary in place, VA delayed the launch of the MSPV-NG program until December 2016 and SAC began establishing non-competitive agreements in the last few months before the launch of MSPV-NG. As shown in figure 1, these non-competitive agreements accounted for approximately 79 percent of the items on the January 2017 version of the formulary. While this approach enabled the MSPV-NG program office to establish the formulary more quickly, it did so at the expense of one of the primary goals of the MSPV-NG program—leveraging VA’s buying power to obtain cost avoidance through competition. Once VA’s MSPV-NG initial formulary was established in December 2016, each medical center was charged with implementing it. According to logistics officials we spoke with at selected medical centers, they had varying levels of success due, in part, to incomplete guidance from the program office. Without clear guidance, many medical centers reported they were unable to find direct matches or substitutes on the MSPV-NG formulary for a substantial number of items they routinely used, which negatively impacted utilization rates for the initial formulary. In our November 2017 report, we recommended that the Director of the MSPV- NG program office provide complete guidance to medical centers for matching equivalent supply items. VA agreed with this recommendation and indicated it would provide this guidance to medical centers by December 2017. According to SAC, as of June 2017, only about a third of the items on the initial version of the formulary were being ordered in any significant quantity by medical centers, indicating that many items on the formulary were not those that are needed by medical centers. Senior VHA acquisition officials attributed this mismatch to shortcomings in their initial requirements development process as well as with VA’s purchase data. VA had set a target that medical centers would order 40 percent of their supplies from the MSPV-NG formulary, but utilization rates were below this target with a nationwide average utilization rate across medical centers of about 24 percent as of May 2017. Specifically, Chief Supply Chain Officers—who are responsible for managing the ordering and stocking of medical supplies at six selected medical centers—told us that many items they needed were not included in the MSPV-NG formulary. As such, we found that these six medical centers generally fell below VA’s stated utilization target. As shown in figure 2, among the six selected medical centers we reviewed, one met the target, while the remaining five were below 25 percent utilization. Instead of fully using MSPV-NG, the selected medical centers are purchasing many items through other means, such as purchase cards or new contracts awarded by their local contracting office, in part, because they said the formulary does not meet their needs. These approaches run counter to the goals of the MSPV-NG program and contribute to VA not making the best use of taxpayer dollars. Greater utilization of MSPV-NG is essential to VA achieving the cost avoidance goal of $150 million for its supply chain transformation effort. Under the legacy MSPV program, the National Acquisition Center tracked cost avoidance achieved by comparing prices for competitively-awarded MSPV supply contracts with prices available elsewhere. However, VHA officials stated that they are not currently tracking cost avoidance related specifically to MSPV-NG. In our November 2017 report, we recommended that the VHA Chief Procurement and Logistics Officer, in coordination with SAC, should calculate cost avoidance achieved by MSPV-NG on an ongoing basis. VA agreed with this recommendation and reported it would develop a new metric to measure cost avoidance by June 2018. In Phase 2 of MSPV-NG, the program office has taken some steps to incorporate greater clinical involvement in subsequent requirements development, but both its requirements development and SAC’s contracting efforts have been hampered by staffing and schedule constraints. In the fall of 2016, the program office began to establish panels of clinicians to serve on MSPV-NG integrated product teams (IPT) assigned to the task of developing updated requirements for the second phase of the formulary. Program officials said they had difficulty recruiting clinicians to participate. We found that slightly more than half (20 of the 38) of the IPTs had begun their work to review items and develop updated requirements by the time the MSPV-NG program launched in December 2016. Staff on the IPTs had to complete their responsibilities by the end of March 2017 while simultaneously managing their regular workload as physicians, surgeons, or nurses. By early March 2017, the IPTs still had about 4,200 items to review. Faced with meeting this unrealistic time frame, the MSPV-NG program office had 9 IPT members travel to one location—with an additional 10 members participating virtually—to meet for 5 days to review the remaining items. Members told us that this time pressure limited the extent to which they were able to pursue the goal of standardizing supplies, and that their review ended up being more of a data validation exercise than a standardization review. VHA ultimately met this compressed timeline, but in a rushed manner that limited the impact of clinician involvement. In our November 2017 report, we recommended that the VHA Chief Procurement and Logistics Officer use input from national clinical program offices to prioritize its requirements development and standardization efforts beyond Phase 2 to focus on supply categories that offer the best opportunity for standardization and cost avoidance. VA agreed with this recommendation and stated it is in the process of finalizing guidance that will detail the importance of involving the national clinical program offices in MSPV-NG requirements development and standardization efforts. The SAC plans to replace the existing Phase 1 non-competitive agreements with competitive awards based on the Phase 2 requirements generated by the IPTs, but it may not be able to keep up with expiring agreements due to an unrealistic schedule. Because they were made on a non-competitive basis, the Phase 1 agreements were established for a period of 1 year. In order to keep the full formulary available, the SAC director said the staff must award 200 to 250 contracts before the Phase 1 agreements expire later this year. SAC officials acknowledged that it is unlikely that they will be able to award the contracts by the time the existing agreements expire. According to SAC officials, they are in the process of hiring more staff to deal with the increased workload. Further, the SAC division director told us that they canceled all outstanding Phase 2 solicitations in September 2017 due to low response rates, protests from service-disabled veteran-owned small businesses, and changes in overall MSPV-NG strategy. In our November 2017 report, we recommended that the MSPV-NG program office and SAC should establish a plan for how to mitigate the potential risk of gaps in contract coverage while SAC is still working to make competitive Phase 2 awards, which could include prioritizing supply categories that are most likely to yield cost avoidance. VA agreed with this recommendation and indicated it has developed a plan to mitigate the risk of gaps in contract coverage with short- and mid-term procurement strategies to ensure continued provision of medical and surgical supplies to VHA facilities. The department also stated that it plans to replace the current MSPV-NG contract and formulary process with a new approach where the prime vendor would develop the formulary. However, VA will likely face challenges in this new approach until it fully addresses the existing shortcomings in the MSPV-NG program. Chairman Roe, Ranking Member Walz, and Members of the Committee, this concludes my prepared statement. I would be pleased to respond to any questions that you may have at this time. If you or your staff have any questions about this statement, please contact Shelby S. Oakley at 202-512-4841 or OakleyS@gao.gov. In addition, contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this statement. Individuals who made key contributions to the report on which this testimony is based are Lisa Gardner, Assistant Director; Emily Bond; Matthew T. Crosby; Lorraine Ettaro; Michael Grogan; Jeff Hartnett; Katherine Lenane; Teague Lyons; Roxanna Sun; and Colleen Taylor. This is a work of the U.S. government and is not subject to copyright protection in the United States. The published product may be reproduced and distributed in its entirety without further permission from GAO. 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 Report 2:
Names for Navy ships traditionally have been chosen and announced by the Secretary of the Navy, under the direction of the President and in accordance with rules prescribed by Congress. For most of the 19 th century, U.S. law included language explicitly assigning the Secretary of the Navy the task of naming new Navy ships. The reference to the Secretary of the Navy disappeared from the U.S. Code in 1925. The code today (10 U.S.C. §8662) is silent on the issue of who has the authority to name new Navy ships, but the Secretary of the Navy arguably retains implicit authority, given the location of Section 8662 in subtitle C of Title 10, which covers the Navy and Marine Corps. In discussing its name-selection process, the Naval History and Heritage Command—the Navy's in-house office of professional historians—cites the above-mentioned laws and states the following: As with many other things, the procedures and practices involved in Navy ship naming are as much, if not more, products of evolution and tradition than of legislation. As we have seen, the names for new ships are personally decided by the Secretary of the Navy. The Secretary can rely on many sources to help him reach his decisions. Each year, the Navy History and Heritage Command (NHHC) compiles primary and alternate ship name recommendations and forwards these to the Chief of Naval Operations by way of the chain of command. These recommendations are the result of research into the history of the Navy and by suggestions submitted by service members, Navy veterans, and the public. Ship name source records at NHHC reflect the wide variety of name sources that have been used in the past, particularly since World War I. Ship name recommendations are conditioned by such factors as the name categories for ship types now being built, as approved by the Secretary of the Navy; the distribution of geographic names of ships of the fleet; names borne by previous ships that distinguished themselves in service; names recommended by individuals and groups; and names of naval leaders, national figures, and deceased members of the Navy and Marine Corps who have been honored for heroism in war or for extraordinary achievement in peace. In its final form, after consideration at the various levels of command, the Chief of Naval Operations signs the memorandum recommending names for the current year's building program and sends it to the Secretary of the Navy. The Secretary considers these nominations, along with others he receives, as well as his own thoughts in this matter. At appropriate times, he selects names for specific ships and announces them. While there is no set time for assigning a name, it is customarily done before the ship is christened. The ship's sponsor─the person who will christen the ship─is also selected and invited by the Secretary. In the case of ships named for individuals, an effort is made to identify the eldest living direct female descendant of that individual to perform the role of ship's sponsor. For ships with other name sources, it is customary to honor the wives of senior naval officers or public officials. A July 2012 Navy report to Congress on the Navy's policies and practices for naming ships (see next section) states the following: Once a type/class naming convention [i.e., a general rule or guideline for how ships of a certain type or class are to be named] is established, Secretaries can rely on many sources to help in the final selection of a ship name. For example, sitting Secretaries can solicit ideas and recommendations from either the Chief of Naval Operations (CNO) or the Commandant of the Marine Corps (CMC), or both. They can also task the Naval Heritage and History Command to compile primary and alternate ship name recommendations that are the result of research into the history of the Navy's battle force or particular ship names. Secretaries also routinely receive formal suggestions for ship names from concerned citizens, active and retired service members, or members of Congress. Finally, Congress can enact provisions in Public Law that express the sense of the entire body about new ship naming conventions or specific ship names. Regardless of the origin of the recommendations, however, the final selection of a ship's name is the Secretary's to make, informed and guided by his own thoughts, counsel, and preferences. At the appropriate time—normally sometime after the ship has been either authorized or appropriated by Congress and before its keel laying or christening—the Secretary records his decision with a formal naming announcement. On July 13, 2012, the Navy submitted to Congress a 73-page report on the Navy's policies and practices for naming ships. The report was submitted in response to Section 1014 of the FY2012 National Defense Authorization Act ( H.R. 1540 / P.L. 112-81 of December 31, 2011). The executive summary of the Navy's report is reprinted here as Appendix A . Rules for giving certain types of names to certain types of Navy ships have evolved over time. Attack submarines, for example, were once named for fish, then later for cities, and most recently for states, while cruisers were once named for cities, then later for states, and most recently for battles. State names, to cite another example, were given to battleships, then later to nuclear-powered cruisers and ballistic missile submarines, and are now being given to attack submarines. The Naval History and Heritage Command states the following: "How will the Navy name its ships in the future? It seems safe to say that the evolutionary process of the past will continue; as the fleet itself changes, so will the names given to its ships. It seems equally safe, however, to say that future decisions in this area will continue to demonstrate regard for the rich history and valued traditions of the United States Navy." The July 2012 Navy report to Congress states that "US Navy ship-naming policies, practices, and 'traditions' are not fixed; they evolve constantly over time." The report also states that "Just as [ship] type naming conventions change over time to accommodate technological change as well as choices made by Secretaries, they also change over time as every Secretary makes their own interpretation of the original naming convention." There have been numerous exceptions to the Navy's ship-naming rules, particularly for the purpose of naming a ship for a person when the rule for that type of ship would have called for it to be named for something else. The July 2012 report to Congress cites exceptions to ship naming rules dating back to the earliest days of the republic, and states that "a Secretary's discretion to make exceptions to ship-naming conventions is one of the Navy's oldest ship-naming traditions." The report argues that exceptions made for the purpose of naming ships for Presidents or Members of Congress have occurred frequently enough that, rather than being exceptions, they constitute a "special cross-type naming convention" for Presidents and Members of Congress. This CRS report continues to note, as exceptions to basic class naming rules, instances where ships other than aircraft carriers have been named for Presidents or Members of Congress. Some observers have perceived a breakdown in, or corruption of, the rules for naming Navy ships. Such observers might cite, for example, the three-ship Seawolf (SSN-21) class of attack submarines— Seawolf (SSN-21), Connecticut (SSN-22), and Jimmy Carter (SSN-23)—which were named for a fish, a state, and a President, respectively, reflecting no apparent class naming rule. The July 2012 Navy report to Congress states the following: "Current ship naming policies and practices fall well within the historic spectrum of policies and practices for naming vessels of the Navy, and are altogether consistent with ship naming customs and traditions." For ship types now being procured for the Navy, or recently procured for the Navy, naming rules (and exceptions thereto) are summarized below. The July 2012 Navy report to Congress discusses current naming rules (and exceptions thereto) at length. On December 14, 2016, the Navy named the first of its 12 planned next-generation ballistic missile submarines Columbia (SSBN-826), in honor of the District of Columbia. The 12 planned boats are consequently now referred to as Columbia -class or SSBN-826 class boats. The Navy has not stated what the naming rule for these ships will be. Given the selection of Columbia as the name of the lead ship, possibilities for the naming rule include (but are not necessarily limited to) cities, capital cities, or states and federal districts and territories. It is also possible that the name Columbia will turn out to be an exception to the naming rule for the class. The current USS Columbia (SSN-771)—a Los Angeles (SSN-688) class attack submarine that was named for Columbia, SC; Columbia, IL; and Columbia, MO —entered service in 1995 and will reach the end of its 33-year expected service life in 2028, at about the time that construction of SSBN-826 is scheduled to be completed. If the service life of SSN-771 is extended for several years, it would remain in service after the commissioning of SSBN-826. This would create an issue to be resolved, since 10 U.S.C. §8662(a) states, "Not more than one vessel of the Navy may have the same name." One possible step for resolving such an issue would be to change the name of SSBN-826 to something else, such as District of Columbia —a step that could be viewed as somewhat similar to the below-discussed instance in which the name of the Los Angles-class submarine SSN-705 was changed from Corpus Christi to City of Corpus Christi (see " Congressional Responses to Announced Navy Ship-Naming Decisions " below). Virginia (SSN-774) class attack submarines are being named for states. An exception occurred on January 8, 2009, when then-Secretary of the Navy Donald Winter announced that SSN-785 would be named for former Senator John Warner. Another exception occurred on January 9, 2014, when then-Secretary of the Navy Ray Mabus announced that SSN-795, the second of the two Virginia-class boats procured in FY2015, would be named for Admiral Hyman G. Rickover, who served for many years as director of the Navy's nuclear propulsion program. As of May 6, 2019, the Navy has announced names for all Virginia-class boats through SSN-801, the second of two Virginia-class boats procured in FY2018. A total of 30 Virginia-class boats have been procured through FY2019, of which 26 have been named for states. (Two were named for people and the two procured in FY2019 have not yet been named.) The Navy's shipbuilding plan calls for procuring three additional Virginia-class boats in FY2020 and two per year FY2021 and subsequent years. The 26 state-named Virginia-class boats procured through FY2018, together with the additional Virginia-class boats planned for procurement in FY2020 and subsequent years and the 17 existing state-named Ohio (SSBN-726) class SSBNs and cruise missile submarine (SSGNs), could make for a total of more than 50 boats starting around FY2022. Thus, starting around FY2022, the Navy might run out of state names for Virginia-class boats, and consequently might need to either amend the Virginia-class naming rule or begin making a series of exceptions to the rule. The July 2012 Navy report to Congress states that "while carrier names are still 'individually considered,' they are now generally named in honor of past US Presidents." Of the 14 most recently named aircraft carriers (those with hull numbers 67 through 80), 10 have been named for U.S. Presidents and 2 for Members of Congress. The Navy is currently procuring Gerald R. Ford (CVN-78) class carriers. On January 16, 2007, the Navy announced that CVN-78, the lead ship in the CVN-78 class, would be named for President Gerald R. Ford. On May 29, 2011, the Navy announced that CVN-79, the second ship in the class, would be named for President John F. Kennedy. On December 1, 2012, the Navy announced that CVN-80, the third ship in the class, would be named Enterprise . The Navy made the announcement on the same day that it deactivated the 51-year-old aircraft carrier CVN-65, also named Enterprise . CVN-80 is the ninth Navy ship named Enterprise . CVN-80 was procured in the FY2018 budget, which Congress considered in 2017. If CVN-80, like most Navy ships, had been named at about the time of procurement, or later, rather than in 2012, it would have been named by the current Secretary of the Navy, Richard Spencer. The July 2012 Navy report to Congress, which was produced when Ray Mabus was the Secretary of the Navy, states that Secretary [of the Navy Ray] Mabus values the ability to consider [aircraft] carrier names on an individual, case‐by‐case basis, for two reasons. First, it will allow a future Secretary to name a future fleet aircraft carrier for someone or something other than a former President. Indeed, Secretary Mabus has a particular name in mind. With the scheduled decommissioning of USS Enterprise (CVN 65), perhaps the most famous ship name in US Navy history besides USS Constitution will be removed from the Naval Vessel Register. Secretary Mabus believes this circumstance could be remedied by bestowing the Enterprise's storied name on a future carrier. Prior to the naming of CVN-80, the most recent carrier that was not named for a President or Member of Congress was the second of the 14 most recently named carriers, Nimitz (CVN-68), which was procured in FY1967. Destroyers traditionally have been named for famous U.S. naval leaders and distinguished heroes. The July 2012 Navy report to Congress discusses this tradition and states more specifically that destroyers are being named for deceased members of the Navy, Marine Corps, and Coast Guard, including Secretaries of the Navy. Exceptions since 2012 (all of which involve Arleigh Burke [DDG-51] class destroyers) include the following: On May 7, 2012, the Navy announced that it was naming DDG-116 for a living person, Thomas Hudner. On May 23, 2013, the Navy announced that it was naming DDG-117 for a living person, Paul Ignatius, and that it was naming DDG-118 for the late Senator Daniel Inouye, who served in the U.S. Army during World War II. On March 31 and April 5, 2016, it was reported that the Navy was naming DDG-120 for a living person, former Senator Carl Levin. On July 28, 2016, the Navy announced that it was naming DDG-124 for a living person, Harvey C. Barnum Jr. On July 11, 2018, Secretary of the Navy Richard Spencer announced that the Navy was expanding the name of the destroyer John. S. McCain (DDG-56) to include a living person, Senator John S. McCain III (for additional discussion, see the next section below). On May 6, 2019, the Navy announced that it was naming DDG-133 for a living person, former Senator Sam Nunn, who had served in the Coast Guard from 1959 to 1960, and in the Coast Guard Reserve from 1960 until 1968 (for additional discussion, see the section following the next section). As of May 6, 2019, the Navy had announced names for all DDG-51 class destroyers procured through DDG-131, the second of three DDG-51s procured in FY2019, and DDG-133, one of three DDG-51s requested for procurement in FY2020. On July 11, 2018, Secretary of the Navy Richard Spencer announced that the Navy was expanding the name of the destroyer John. S. McCain (DDG-56), originally named for Admiral John S. "Slew" McCain (1884-1945) and his son, Admiral John S. "Jack" McCain, Jr. (1911-1981), to also include Senator John S. McCain III, the grandson of Admiral John S. McCain and the son of Admiral John S. McCain, Jr. DDG-56 was procured in FY1989 and was commissioned into service on July 2, 1994. John S. McCain III served as a Member of the House of Representatives from 1983 to 1987, and as a Senator from 1987 to 2018. Among his committee chairmanships, he was the chairman of the Senate Armed Services Committee from January 3, 2015, until his death on August 25, 2018. He was the Republican Party candidate for President in 2008. On May 6, 2019, the Navy announced that it was naming DDG-133 for former Senator Sam Nunn. Nunn served in the Coast Guard from 1959 to 1960, and in the Coast Guard Reserve from 1960 until 1968. He was a Senator from 1972 to 1997. During his time in the Senate, he was, among other things, the Chairman of the Senate Armed Services Committee from January 1987 to January 1995. The Navy in 2017 initiated a new program, called the FFG(X) program, to build a class of 20 guided-missile frigates (FFGs). The Navy wants to procure the first FFG(X) in FY2020, the second in FY2021, and the remaining 18 at a rate of two per year in FY2022-FY2030. As of May 6, 2019, the Navy had not announced a naming rule for this planned new class of ships. Previous classes of U.S. Navy frigates, like Navy destroyers, were generally named for naval leaders and heroes. Littoral Combat Ships (LCSs) were at first named for U.S. mid-tier cities, small towns, and other U.S. communities. The naming rule was later adjusted to regionally important U.S. cities and communities. An exception occurred on February 10, 2012, when the Navy announced that it was naming LCS-10 for former Representative Gabrielle Giffords. Another exception occurred on February 23, 2018, when President Trump, in a press conference with Australian Prime Minister Malcolm Turnbull, announced that an LCS would be named Canberra , in honor of HMAS Canberra (D33), an Australian cruiser named for the capital city of Australia that fought alongside U.S. Navy forces World War II and was scuttled after being damaged by Japanese attack in the Battle of Savo Island on August 9, 1942. The Navy has identified the LCS to be named Canberra as LCS-30. A previous U.S. Navy ship, the gun cruiser Canberra (CA-70), which served from 1943 to 1947 and again from 1956 to 1970, was similarly named in honor of HMAS Canberra . There is also a current HMAS Canberra (L02), an amphibious assault ship (i.e., helicopter carrier) that entered service in 2014 and now serves as the flagship of the Australian navy. The situation of LCS-30 and L02 sharing the same name will presumably not violate 10 U.S.C. §8662(a)—which states that "not more than one vessel of the Navy may have the same name"—because 10 U.S.C. §8662 is a statute governing the naming of U.S. Navy ships and L02 is not a U.S. Navy ship. As of May 6, 2019, the Navy had posted or announced names for all LCSs up through LCS-30, plus LCS-32, LCS-34, LCS-36, and LCS-38. The Navy also announced on October 9, 2018, that one additional LCS would be named for Cleveland, OH, but the Navy did not specify which LCS would receive this name. A total of 35 LCSs have been procured through FY2019. In addition to LCSs 1-30, 32, 34, 36, and 38, the Navy has identified the 35 th LCS as LCS-31. As of May 6, 2019, this ship was listed by the Navy as having no name. The Navy does not want to procure any more LCSs beyond the 35 that have been procured. If no additional LCSs are procured beyond the 35 that have been procured, LCS-31 will be the last LCS to be named. Given the Navy's October 9, 2018, announcement that one additional LCS would be named for Cleveland, OH, it is possible the Navy will name LCS-31 for Cleveland. Amphibious assault ships (LHAs), which look like medium-sized aircraft carriers, are being named for important battles in which U.S. Marines played a prominent part, and for famous earlier U.S. Navy ships that were not named for battles. The Navy announced on June 27, 2008, that the first LHA-6 class amphibious assault ship, LHA-6, would be named America , a name previously used for an aircraft carrier (CV-66) that served in the Navy from 1965 to 1996. The Navy announced on May 4, 2012, that LHA-7, the second ship in the class, LHA-7, would be named Tripoli , the location of famous Marine battles in the First Barbary War. The Navy reaffirmed this name selection with a more formal announcement on May 30, 2014. On November 9, 2016, the Navy announced that the third ship in the class, LHA-8, will be named Bougainville , the location of a famous World War II campaign in the Pacific. San Antonio (LPD-17) class amphibious ships are being named for major U.S. cities and communities (with major being defined as being one of the top three population centers in a state), and cities and communities attacked on September 11, 2001. An exception occurred on April 23, 2010, when the Navy announced that it was naming LPD-26, the 10 th ship in the class, for the late Representative John P. Murtha. Another exception occurred on May 2, 2018, when the Navy announced that it was naming LPD-29, the 13 th ship in the class, for Navy Captain Richard M. McCool, Jr., who received the Medal of Honor for his actions in World War II and later served in the Korean and Vietnam wars. As of May 6, 2019, the Navy had not announced a name for LPD-30, which was funded in FY2018, and which is to be the first of a new version, or flight, of the LPD-17 class design called the LPD-17 Flight II design. On January 6, 2016, then-Secretary of the Navy Ray Mabus announced that the Navy's new oilers will be named for "people who fought for civil rights and human rights," and that the first ship in the class, TAO-205, which was procured in FY2016, will be named for Representative John Lewis. The ships in this class consequently are now referred to as John Lewis (TAO-205) class ships. The Navy wants to procure a total of 20 John Lewis-class ships. On July 28, 2016, it was reported that the Navy would name the second through sixth ships in the class (i.e., TAOs 206 through 210) for Harvey Milk, Earl Warren, Robert F. Kennedy, Lucy Stone, and Sojourner Truth, respectively. All these names were later posted by the Navy for these ships. The Navy's 14 Lewis and Clark (TAKE-1) class cargo and ammunition ships were named for famous American explorers, trailblazers, and pioneers. The Navy announced on October 9, 2009, that the 13 th ship in the class was being named for the civil rights activist Medgar Evers. The Navy announced on May 18, 2011, that the 14 th ship in the class would be named for civil rights activist Cesar Chavez. Expeditionary Fast Transports (EPFs), which until May 2011 were being procured by the Army as well as by the Navy, were at first named for American traits and values. In December 2009, the naming rule for EPFs was changed to small U.S. cities. At some point between December 2010 and October 2011, it was adjusted to small U.S. cities and counties. As of May 6, 2019, the Navy had posted names for all EPFs through EPF-12, which was procured in FY2016. A 13 th EPF was funded by Congress in FY2018, and a 14 th was funded by Congress in FY2019. The Navy's two Expeditionary Transport Docks (ESDs 1 and 2) and its Expeditionary Sea Bases (ESB 3 and higher) are being named for famous names or places of historical significance to U.S. Marines. Two of these ships have been named for living persons—ESD-2, which was named John Glenn , and ESB-4, which was named for Hershel "Woody" Williams. On November 4, 2017, Secretary of the Navy Richard Spencer announced that the third ESB (ESB-5), which was procured in FY2016, would be named for Marine Corps Vietnam veteran and Medal of Honor recipient Lance Corporal Miguel Keith. This was Spencer's first announced naming of a Navy ship. A fourth ESB (ESB-6) was procured in FY2018, and a fifth (ESB-7) was procured in FY2019. Navy plans calls for procuring a total of six ESBs. On March 12, 2019, the Navy announced that that TATS-6, the first ship in a new class of towing, salvage, and rescue ships (TATSs), would be named Navajo, "in honor of the major contributions that the Navajo people have made to the armed forces," and that ships in this class will be named for prominent Native Americans or Native American tribes. It has been a long time since ships named for certain states were last in commissioned service with the Navy as combat assets. While there is no rule requiring the Navy, in selecting state names for ships, to choose states for which the most time has passed since a ship named for the state has been in commissioned service with the Navy as a combat asset, advocates of naming a ship for a certain state may choose to point out, among other things, the length of time that has transpired since a ship named for the state has been in commissioned service with the Navy as a combat asset. In its announcement of April 13, 2012, that the Navy was naming the Virginia class attack submarines SSNs 786 through 790 for Illinois, Washington, Colorado, Indiana, and South Dakota, respectively, the Department of Defense stated, "None of the five states has had a ship named for it for more than 49 years. The most recent to serve was the battleship Indiana, which was decommissioned in October 1963." The July 2012 Navy report to Congress states the following: "Before deciding on which names to select [for the five submarines], [then-]Secretary [of the Navy Ray] Mabus asked for a list of State names that had been absent the longest from the US Naval Register...." In its announcement of November 19, 2012, that the Navy was naming the Virginia class attack submarine SSN-791 for Delaware, the Department of Defense quoted then-Secretary Mabus as saying, "It has been too long since there has been a USS Delaware in the fleet...." A Navy News Service article about the Navy's September 18, 2014, announcement that the Virginia class attack submarine SSN-792 was being named for Vermont stated that "This is the first ship named for Vermont since 1920[,] when the second USS Vermont was decommissioned." A Navy News Service article about the Navy's October 10, 2014, announcement that the Virginia class attack submarine SSN-793 was being named for Oregon stated that the previous USS Oregon "was a battleship best known for its roles in the Spanish American War when it helped destroy Admiral Cervera's fleet and in the Philippine-American War; it performed blockade duty in Manila Bay and off Lingayen Gulf, served as a station ship, and aided in the capture of Vigan." A Navy News Service article about the Navy's January 19, 2016, announcement that the Virginia-class attack submarine SSN-801 was being named for Utah stated, "The future USS Utah will be the second naval vessel to bear the name; the first, a battleship designated BB-31, was commissioned in 1911 and had a long, honorable time in service.... While conducting anti-gunnery exercises in Pearl Harbor, BB-31 was struck by a torpedo and capsized during the initial stages of the Japanese attack [on December 7, 1941]. She was struck from the Navy record Nov. 13, 1944 and received a battle star for her service in World War I." The Navy's naming announcements for Virginia-class submarines have reduced the group of states for which several decades had passed since a ship named for the state had been in commissioned service with the Navy as a combat asset, and for which no ship by that name is currently under construction. This group used to include Illinois, Delaware, Vermont, Oregon, and Montana, but Virginia-class attack submarines have now been named for these states. (See the Virginia-class attack submarine naming announcements of April 13, 2012; November 19, 2012; September 18, 2014; October 10, 2014; and September 2, 2015, respectively.) As shown in Table 1 , the three states for which the most time now appears to have passed since a ship named for the state has been in commissioned service with the Navy as a combat asset, and for which no ship by that name is currently under construction, are Kansas, Arizona, and Oklahoma. As of May 6, 2019, it has been more than 97 years since the decommissioning on December 16, 1921, of the battleship Kansas (BB-21), the most recent ship named for the state of Kansas that was in commissioned service with the Navy as a combat asset. As discussed earlier in the section on rules for naming SSNs, starting around FY2022, the Navy might run out of state names for Virginia-class boats, and consequently might need to either amend the Virginia-class naming rule or begin making a series of exceptions to the rule. The Navy historically has only rarely named ships for living persons, meaning (throughout this CRS report) persons who were living at the time the name was announced. The Navy stated in February 2012 that The Navy named several ships for living people (ex. George Washington, Ben Franklin, etc.) in the early years of our Republic. The Naval History and Heritage Command (NHHC) believes that the last ship to be named by the Navy in honor of a living person prior to [the aircraft carrier] CARL VINSON (CVN-70) was the brig JEFFERSON (launched in April 1814). Between 1814 and November 18, 1973, when President Nixon announced the naming of CARL VINSON, NHHC does not believe that any ships had been named for a living person by the Navy as NHHC does not have records that would indicate such. The July 2012 Navy report to Congress, noting a case from 1900 that was not included in the above passage, states that the practice of naming ships in honor of deserving Americans or naval leaders while they are still alive can be traced all the way back to the Revolutionary War. At the time, with little established history or tradition, the young Continental Navy looked to honor those who were fighting so hard to earn America's freedom. Consequently, George Washington had no less than five ships named for him before his death; John Adams and James Madison, three apiece; John Hancock, two; and Benjamin Franklin, one. The practice of naming ships after living persons was relatively commonplace up through 1814, when a US Navy brig was named in honor of Thomas Jefferson. However, after the War of 1812, with the US Navy older and more established, and with the list of famous Americans and notable naval heroes growing ever longer, the practice of naming ships after living persons fell into disuse. Indeed, the only exception over the next 150 years came in 1900, when the Navy purchased its first submarine from its still living inventor, John Philip Holland, and Secretary of the Navy John D. Long named her USS Holland (SS 1) in his honor.... [In the early 1970s], however, Department of the Navy leaders were considering the name for CVN 70. Secretary of the Navy John Warner knew the 93 rd Congress had introduced no less than three bills or amendments (none enacted) urging that CVN 70 be named for in honor of Carl Vinson, who served in the House for 50 years and was known as the "Father of the Two-Ocean Navy." Although Secretary Warner felt Congressman Vinson was more than worthy of a ship name, the former Congressman was still alive. Naming a ship for this giant of naval affairs would therefore violate a 160-year old tradition. After considering the pros and cons of doing so, Secretary Warner asked President Richard Nixon's approval to name CVN 70 for the 90-year old statesman. President Nixon readily agreed. Indeed, he personally announced the decision on January 18, 1974.... In hindsight, rather than this decision being a rare exception, it signaled a return to the Continental Navy tradition of occasionally honoring famous living persons with a ship name. Since then, and before the appointment of current Secretary [now then-Secretary] of the Navy Ray Mabus, Secretaries of the Navy have occasionally chosen to follow this new, "old tradition," naming ships in honor of still living former Presidents Jimmy Carter, Ronald Reagan, George H.W. Bush, and Gerald R. Ford; Secretary of the Navy Paul Nitze; Navy Admirals Hyman G. Rickover, Arleigh Burke, and Wayne E. Meyer; Senators John C. Stennis and John Warner; and famous entertainer Bob Hope. Moreover, it is important to note that three of these well-known Americans—Gerald R. Ford, John C. Stennis, and Bob Hope—were so honored after Congress enacted provisions in Public Laws urging the Navy to do so. By its own actions, then, Congress has acknowledged the practice of occasionally naming ships for living persons, if not outright approved of it. In other words, while naming ships after living persons remains a relatively rare occurrence—about three per decade since 1970—it is now an accepted but sparingly used practice for Pragmatic Secretaries [of the Navy] of both parties. For them, occasionally honoring an especially deserving member of Congress, US naval leader, or famous American with a ship name so that they might end their days on earth knowing that their life's work is both recognized and honored by America's Navy-Marine Corps Team, and that their spirit will accompany and inspire the Team in battle, is sometimes exactly the right thing to do. As shown in Table 2 , since the naming of CVN-70 for Carl Vinson in 1974, at least 21 U.S. military ships have been named for persons who were living at the time the name was announced. Eight of the 21 were announced between January 2012 and March 2016, including three announced in 2012 and four announced in 2016. In four of the six most-recent instances, the ships were named for current or former Members of Congress. The most recent instance occurred on May 6, 2019, when the Navy announced that it was naming the destroyer DDG-51 for former Senator Sam Nunn. (For further discussion of that naming action, see the earlier section on names for destroyers.) A June 15, 2017, blog post states the following: Four [past U.S. Navy] ships have been named for Confederate officers: the [ballistic missile submarine/attack submarine] USS Robert E. Lee (SSBN-601[/SSN-601]) [commissioned 1960; decommissioned 1983], the [ballistic missile submarine] USS Stonewall Jackson (SSBN-634) [commissioned 1964; decommissioned 1995], the [submarine tender] USS Hunley (AS-31) [commissioned 1962; decommissioned 1994], and the [submarine tender] USS Dixon (AS-37) [commissioned 1971; decommissioned 1995]. H. L. Hunley built the Confederate submarine that sank with him on board before it engaged in combat. A subsequent Confederate submarine was built and named for him. Commanded by George Dixon, the CSS Hunley carried out the world's first submarine attack when it struck the [sloop-of-war] USS Housatonic in February1864. Currently in the fleet is the [Ticonderoga (CG-47) class Aegis cruiser] USS Chancellorsville (CG-62) [commissioned 1989], named for Lee's greatest victory over the U.S. Army. Chancellorsville also was the battle in which Gen. Thomas "Stonewall" Jackson was mortally wounded by friendly fire. The purpose of erecting monuments and naming U.S. ships after Confederates—enemies of the United States—seems to be to recognize their perceived status as noble warriors rather than to remember the cause for which they waged war: the dissolution of the United States to preserve the "peculiar institution" of human slavery. This view of history is not shared by millions of Americans who see the monuments to Confederates as glorifying, even justifying the "lost cause" and the enslavement of humans. Other ships have been named for enemies [of the United States], probably because they were considered "noble warriors" too. [The ballistic missile submarine] USS Tecumseh (SSBN-628) [commissioned 1964; decommissioned 1993] and [the harbor tug] USS Osceola (YTB-129) [commissioned 1938; sold for scrapping 1973] were named after American Indian leaders who fought wars against the United States. Regarding the Chancellorsville , the Navy states that the cruiser is The first U.S. Navy ship named for a Civil War battle fought just south of the Rappahannock and Rapidan Rivers in Virginia (1–5 May 1863). Gen. Robert E. Lee, CSA, who led the Confederate Army of Northern Virginia, held Gen. Joseph Hooker, USA, who commanded the Union Army and Department of the Potomac, in position while Lt. Gen. Thomas J. Jackson, CSA, enveloped the Union right flank, surprising and rolling up the Federal's right. Lee's victory, combined with the urgent need to relieve pressure on Vicksburg, Miss., prompted the South's thrust into Pennsylvania that summer, resulting in the pivotal Battle of Gettysburg. An August 16, 2017, press report states the following: As America churns through a bloody debate over the place Confederate monuments occupy in the modern day United States, a Navy cruiser named in honor of a Confederate Civil War victory is unlikely to see its named changed, a service official said Wednesday [August 16]. The guided-missile cruiser Chancellorsville [CG-62] was commissioned in 1989 and derives its name from an 1863 battle considered to be the greatest victory of Confederate Gen. Robert E. Lee.... But a Navy official speaking on the condition of anonymity Wednesday said that even though the Chancellorsville is named after a Confederate victory, the name comes from a battle, not an individual, and soldiers on both sides died. The week-long battle resulted in major casualties for both sides—13,000 Confederates and 17,000 Union troops, according to the National Parks [sic: Park] Service. The Navy official did say, however, that there remains a chance the ship's crest could be altered. The predominance of gray in the ship's crest speaks to "General Robert E. Lee's spectacular military strategies and his dominance in this battle," according to the ship's website. An inverted wreath also memorializes the Confederacy's second-best known general, Stonewall Jackson, who was mortally wounded in the battle. While the rupture of the country during the Civil War is reflected in the crest, it also features Jackson's order to "press on." "Maybe that is worth re-looking at or redoing," the official said. "There's a fine line." In recent years, the Navy on a few occasions has announced names for ships years before those ships were procured. Although announcing a name for a ship years before it is procured is not prohibited, doing so could deprive a future Secretary of the Navy (or, more broadly, a future Administration) of the opportunity to select a name for the ship. It could also deprive Congress of an opportunity to express its sense regarding potential names for a ship, and create a risk of assigning a name to a ship that eventually is not procured for some reason, a situation that could be viewed as potentially embarrassing to the Navy. As noted earlier, the July 2012 Navy report to Congress states the following: At the appropriate time—normally sometime after the ship has been either authorized or appropriated by Congress and before its keel laying or christening—the Secretary records his decision with a formal naming announcement. At the end of the above passage, there is a footnote (number 3) in the Navy report that states the following: Although there is no hard and fast rule, Secretaries most often name a ship after Congress has appropriated funds for its construction or approved its future construction in some way—such as authorization of either block buys or multi-year procurements of a specific number of ships. There are special cases, however, when Secretaries use their discretion to name ships before formal Congressional approval, such as when Secretary John Lehman announced the namesake for a new class of Aegis guided missile destroyers would be Admiral Arleigh Burke, several years before the ship was either authorized or appropriated. In connection with the quoted footnote passage immediately above, it can be noted that the lead ship of the DDG-51 class of destroyers was named for Arleigh Burke on November 5, 1982, about two years before the ship was authorized and fully funded. Recent examples of Navy ships whose names were announced more than two years before they were procured include the following: The destroyer Zumwalt (DDG-1000). On July 4, 2000, President Bill Clinton announced that DDG-1000, the lead ship in a new class of destroyers, would be named Zumwalt in honor of Admiral Elmo Zumwalt Jr., the Chief of Naval Operations from 1970 to 1974, who had died on January 2, 2000. At the time of the naming announcement, Congress was considering the Navy's proposed FY2001 budget, under which DDG-1000 was scheduled for authorization in FY2005, a budget that Congress would consider in 2004, which was then about four years in the future. The aircraft carrier Enterprise (CVN-80). As noted earlier, on December 1, 2012, the Navy announced that CVN-80, the third Gerald R. Ford (CVN-78) class aircraft carrier, would be named Enterprise . At the time of the announcement, CVN-80 was scheduled for procurement in FY2018, the budget for which Congress was to consider in 2017, which was then more than four years in the future. (CVN-80 was in fact procured in FY2018.) The ballistic missile submarine ( SSBN-826 ) Columbia . As noted earlier, on July 28, 2016, it was reported that the first Ohio replacement ballistic missile submarine (SSBN-826) will be named Columbia in honor of the District of Columbia. This ship is scheduled for procurement in FY2021, the budget for which Congress is to consider in 2020, which in July 2016 was about four years in the future. Three John Lewis (TAO- 205) class oilers. As noted earlier, on July 28, 2016, it was reported that the Navy would name the second through sixth John Lewis (TAO-205) class oilers (i.e., TAOs 206 through 210) for Harvey Milk, Earl Warren, Robert F. Kennedy, Lucy Stone, and Sojourner Truth, respectively. In 2016, these five ships were scheduled for procurement in FY2018, FY2019, FY2020, FY2021, and FY2022, respectively, the budgets for which Congress has considered or will consider in 2017, 2018, 2019, 2020, and 2021, respectively. Thus, using the procurement dates that were scheduled in 2016, the name for TAO-208 ( Robert F. Kennedy ) was announced about three years before it was to be procured, the name for TAO-209 ( Lucy Stone ) was announced about four years it was to be procured, and the name for TAO-210 ( Sojourner Truth ) was announced about five years before it was to be procured. As discussed in the CRS report on the TAO-205 class program, the first six ships in the TAO-205 class are being procured under a block buy contract that Congress authorized as part of its action on the FY2016 defense budget. The procurement of each ship under this contract remains subject to the availability of appropriations for that purpose. Members of the public are sometimes interested in having Navy ships named for their own states or cities, for earlier U.S. Navy ships (particularly those on which they or their relatives served), for battles in which they or their relatives participated, or for people they admire. Citizens with such an interest sometimes contact the Navy, the Department of Defense, or Congress seeking support for their proposals. An October 2008 news report, for example, suggested that a letter-writing campaign by New Hampshire elementary school students that began in January 2004 was instrumental in the Navy's decision in August 2004 to name a Virginia-class submarine after the state. The July 2012 Navy report to Congress states the following: In addition to receiving input and recommendations from the President and Congress, every Secretary of the Navy receives numerous requests from service members, citizens, interest groups, or individual members of Congress who want to name a ship in honor of a particular hometown, or State, or place, or hero, or famous ship. This means the "nomination" process is often fiercely contested as differing groups make the case that "their" ship name is the most fitting choice for a Secretary to make. Members of the public may also express their opposition to an announced naming decision. The July 2012 Navy report to Congress cites and discusses five recent examples of ship-naming decisions that were criticized by some observers: the destroyer DDG-1002 (named for President Lyndon Johnson), the Littoral Combat Ship LCS-10 (named for former Representative Gabrielle Giffords), the amphibious ship LPD-26 (named for late Representative John P. Murtha), the auxiliary ship TAKE-13 (named for Medgar Evers), and the auxiliary ship TAKE-14 (named for Cesar Chavez). Congress has long maintained an interest in how Navy ships are named, and has influenced or may have influenced pending Navy decisions on the naming of certain ships, including but not limited to the following: One source states that "[the aircraft carriers] CVN 72 and CVN 73 were named prior to their start [of construction], in part to preempt potential congressional pressure to name one of those ships for Admiral H.G. Rickover ([instead,] the [attack submarine] SSN 709 was named for the admiral)." There was a friendly rivalry of sorts in Congress between those who supported naming the aircraft carrier CVN-76 for President Truman and those who supported naming it for President Reagan; the issue was effectively resolved by a decision announced by President Clinton in February 1995 to name one carrier (CVN-75) for Truman and another (CVN-76) for Reagan. One press report suggests that the decision to name CVN-77 for President George H. W. Bush may have been influenced by a congressional suggestion. Section 1012 of the FY2007 John Warner National Defense Authorization Act ( H.R. 5122 / P.L. 109-364 of October 17, 2006), expressed the sense of the Congress that the aircraft carrier CVN-78 should be named for President Gerald R. Ford. The Navy announced on January 16, 2007, that CVN-78 would be named Gerald R. Ford . In the 111 th Congress, H.Res. 1505 , introduced on July 1, 2010, expressed the sense of the House of Representatives that the Secretary of the Navy should name the next appropriate naval ship in honor of John William Finn. The measure was not acted on after being referred to the House Armed Services Committee. On February 15, 2012, the Navy announced that DDG-113, an Arleigh Burke (DDG-51) class destroyer, would be named John Finn . Section 1012 of the FY2012 National Defense Authorization Act ( H.R. 1540 / P.L. 112-81 of December 31, 2011) expressed the sense of Congress that the Secretary of the Navy is encouraged to name the next available naval vessel after Rafael Peralta. On February 15, 2012, the Navy announced that DDG-113, an Arleigh Burke (DDG-51) class destroyer, would be named Rafael Peralta . The July 2012 Navy report to Congress states that every Secretary of the Navy, regardless of point of view [on how to name ships], is subject to a variety of outside influences when considering the best names to choose. The first among these comes from the President of the United States, under whose direction any Secretary works... Secretaries of the Navy must also consider the input of Congress.... Given the vital role Congress plays in maintaining the Navy-Marine Corps Team, any Secretary is sure to respect and consider its input when considering ships names. Sometimes, the Secretary must also balance or contend with differences of opinion between the President and Congress. The Navy suggests that congressional offices wishing to express support for proposals to name a Navy ship for a specific person, place, or thing contact the office of the Secretary of the Navy to make their support known. Congress may also pass legislation relating to ship names (see below). Congress can pass legislation regarding a ship-naming decision that has been announced by the Navy. Such legislation can express Congress's views regarding the Navy's announced decision, and if Congress so desires, can also suggest or direct the Navy to take some action. The following are three examples of such legislation: S.Res. 332 of the 115 th Congress is an example of a measure that appears to reflect support for an announced Navy ship-naming decision. This measure, introduced in the Senate on November 15, 2017, and considered and agreed to without amendment and with a preamble by unanimous consent the same day, summarizes the military career of Hershel "Woody" Williams and commemorates the christening of ESB-4, an expeditionary sea base ship named for Williams (see " Legislative Activity in 115th and 116th Congress .") H.Res. 1022 of the 111 th Congress is an example of a measure reflecting support for an announced Navy ship-naming decision. This measure, introduced on January 20, 2010, and passed by the House on February 4, 2010, congratulates the Navy on its decision to name a naval ship for Medgar Evers. H.Con.Res. 312 of the 97 th Congress is an example of a measure that appears to reflect disagreement with an announced Navy ship-naming decision. This measure expressed the sense of Congress that the Los Angeles (SSN-688) class attack submarine Corpus Christi (SSN-705) should be renamed, and that a nonlethal naval vessel should instead be named Corpus Christi . (Los Angeles-class attack submarines were named for cities, and SSN-705 had been named for Corpus Christi, TX.) H.Con.Res. 312 was introduced on April 21, 1982, and was referred to the Seapower and Strategic and Critical Materials subcommittee of the House Armed Services Committee on April 28, 1982. On May 10, 1982, the Navy modified the name of SSN-705 to City of Corpus Christi . On April 12, 2013, then-Secretary of the Navy Ray Mabus announced that LPD-27, a San Antonio (LPD-17) class amphibious ship, would be named for Portland, OR. LPD-27 is to be the third Navy ship to bear the name Portland. The first, a cruiser (CA-33), was named for Portland, ME. It was commissioned into service in February 1933, decommissioned in July 1946, and maintained in reserve status until struck from the Navy list in March 1959. The second, an amphibious ship (LSD-37), was named for both Portland, ME, and Portland, OR. It was commissioned into service in October 1970, decommissioned in October 2003, and stricken from the Naval Vessel Register in March 2004. An April 18, 2013, press release from Senator Angus King stated that "U.S. Senators Susan Collins and Angus King today sent a letter to Ray Mabus, the Secretary of the Navy, asking that the USS Portland [LPD-27], a new San Antonio-class amphibious transport dock ship named after the city of Portland, Oregon, also be named in honor of Portland, Maine, consistent with the long history and tradition of U.S. Navy ships bestowed with the name USS Portland." In reply, the Navy sent letters dated April 24, 2013, to Senators Collins and King that stated the following in part: In addition to [the ballistic missile submarine] USS MAINE (SSBN 743), Secretary [of the Navy Ray] Mabus recently honored the state of Marine through his naming of [the expeditionary fast transport ship] USNS MILLINOCKET (JHSV 3) [now called T-EPF 3] which was christened last weekend and will proudly represent our Nation as part of the fleet for decades to come. The Secretary of the Navy has tremendous appreciation for the state of Maine, its citizens and the incredible support provided by them to our Navy and our Nation. However, Oregon is the only state in our Nation that does not currently have a ship in the fleet named for the state, its cities or communities. Secretary Mabus named LPD 27 after Portland, Oregon, to correct that oversight and acknowledge the support and contributions made by the men and women of Portland and Oregon. As noted elsewhere in this report, on October 10, 2014, the Navy announced that it was naming the Virginia-class attack submarine SSN-793 for Oregon. A May 21, 2016, Navy blog post about the ship's christening states that "LPD-27 will be the third Navy ship named Portland, honoring both the Oregon seaport and Maine's largest city." That statement is not correct, as the Navy confirms that LPD-27 is named solely for Portland, OR. A July 5, 2017, Navy News Service report states correctly that "LPD 27 is named for the city of Portland, Oregon, and follows the World War II heavy cruiser CA 33 and the amphibious ship LSD 37 as the third U.S. Navy ship to bear the name Portland." LPD-27 is scheduled to be commissioned in Portland, OR, on April 21, 2018. Table 3 shows past enacted provisions going back to the 100 th Congress regarding future ship-naming decisions. All of these measures expressed the sense of the Congress (or of the Senate or House) about how a future Navy ship should be named. Table 4 shows past examples of proposed bills and amendments regarding future ship-naming decisions going back to the 93 rd Congress. Some of these measures expressed the sense of the Congress about how a Navy ship should be named, while others would mandate a certain name for a ship. Although few of these measures were acted on after being referred to committee, they all signaled congressional interest in how certain ships should be named, and thus may have influenced Navy decisions on these matters. S.Con.Res. 10 of the 115 th Congress was introduced in the Senate on March 21, 2017; no further actions for the measure are listed at Congress.gov. The text of S.Con.Res. 10 as introduced was as follows: CONCURRENT RESOLUTION Expressing the sense of Congress that the Secretary of the Navy should name the next nuclear powered submarine of the United States Navy the "USS Los Alamos". Whereas the people of Los Alamos and the Navy have a 74-year relationship that continues from the Manhattan Project through the creation of a nuclear Navy and into the current ocean-borne leg of the strategic nuclear triad of the United States; Whereas the contributions of the people of Los Alamos and surrounding communities allowed the Navy to keep its offensive edge from World War II, through the Cold War, continuing to the emerging conflicts as of the date of adoption of this resolution; Whereas Captain "Deke" Parsons was one of the first residents of Los Alamos and, along with Laureate Ramsey, oversaw the safe delivery, assembly and loading of the nuclear bomb that led to the surrender of Japan in World War II; Whereas the people of Los Alamos and surrounding communities played a critical role in designing the nuclear portion of the first nuclear weapon to enter the arsenal of the Navy, known as the Regulus, along with atomic depth bombs, torpedoes, rockets, and even next generation weapon systems like the B61–12 precision-guided nuclear bomb; Whereas the people of Los Alamos designed the warheads that armed the first generation Trident submarine-launched ballistic missiles of the Navy and the follow-on Trident II missile warheads used by the Navy; Whereas the research into nuclear energy conducted by Los Alamos during World War II advanced the technical basis for the development of the nuclear propulsion systems of the Navy used aboard Los Angeles, Seawolf, Ohio, and Virginia Class submarines along with multiple naval aircraft carriers today; Whereas the people of Los Alamos and Los Alamos National Laboratory host United States Naval Academy midshipmen every year to provide hands-on scientific and engineering experience working to solve real world challenges in national security, thereby directly contributing to the development of future Navy leadership; Whereas the people of Los Alamos carry the solemn responsibility to assess the sea-based nuclear deterrent carried aboard Navy fleet ballistic missile submarines; Whereas naming a submarine Los Alamos will recognize and continue to forge the longstanding relationship between the Navy and Los Alamos; Whereas the year 2018 will mark the 75th anniversary of Los Alamos National Laboratory; and Whereas the distinctive service and contributions from the people of Los Alamos to the Navy merits naming a vessel that embodies the heritage, service, fidelity, and achievements of the residents of Los Alamos and surrounding communities in partnership with the United States Navy: Now, therefore, be it Resolved by the Senate (the House of Representatives concurring), That it is the sense of the Congress that the Secretary of the Navy should name the next nuclear powered submarine of the United States Navy as the "USS Los Alamos". Appendix A. Executive Summary of July 2012 Navy Report to Congress This appendix reprints the executive summary of the July 2012 Navy report to Congress on the Navy's policies and practices for naming its ships. The text of the executive summary is as follows: Executive Summary This report is submitted in accordance with Section 1014 of P.L. 112-81 , National Defense Authorization Act (NDAA) for Fiscal Year 2012, dated 31 December 2011, which directs the Secretary of Defense to submit a report on "policies and practices of the Navy for naming vessels of the Navy." As required by the NDAA, this report: Includes a description of the current policies and practices of the Navy for naming vessels of the Navy, and a description of the extent to which theses policies and practices vary from historical policies and practices of the Navy for naming vessels of the Navy, and an explanation for such variances; Assesses the feasibility and advisability of establishing fixed policies for the naming of one or more classes of vessels of the Navy, and a statement of the policies recommended to apply to each class of vessels recommended to be covered by such fixed policies if the establishment of such fixed policies is considered feasible and advisable; and Identifies any other matter relating to the policies and practices of the Navy for naming vessels of the Navy that the Secretary of Defense considers appropriate. After examining the historical record in great detail, this report concludes: Current ship naming policies and practices fall well within the historic spectrum of policies and practices for naming vessels of the Navy, and are altogether consistent with ship naming customs and traditions. The establishment of fixed policies for the naming of one or more classes of vessels of the Navy would be highly inadvisable. There is no objective evidence to suggest that fixed policies would improve Navy ship naming policies and practices, which have worked well for over two centuries. In addition, the Department of the Navy used to routinely publish lists of current type naming rules for battle force ships, and update it as changes were made to them. At some point, this practice fell into disuse, leading to a general lack of knowledge about naming rules. To remedy this problem, the Naval History and Heritage Command will once again develop and publish a list of current type naming rules to help all Americans better understand why Secretaries of the Navy choose the ship names they do. This list will be updated as required.

Question: Write a one-page summary of the report 1.

Answer: VA spends hundreds of millions of dollars annually on medical supplies to meet the health care needs of about 7 million veterans. To provide a more efficient, cost-effective way for its medical centers to order supplies, the VA established the MSPV-NG program. The program's goals include involving clinicians in requirements development, leveraging buying power when making competitive awards, and consolidating supplies used across medical centers. VA began developing requirements in early 2015 and launched the program in December 2016. This testimony summarizes key information contained in GAO's November 2017 report, GAO-18-34 . Specifically, it addresses the extent to which VA's implementation of MSPV-NG has been effective in meeting program goals. GAO analyzed VA's requirements development and contracting processes, and identified key supply chain practices cited by four leading hospital networks. GAO also met with contracting and clinical officials at six medical centers, selected based on high dollar contract obligations in fiscal years 2014-2016 and geographic representation. The Department of Veterans Affairs (VA) established the Medical Surgical Prime Vendor-Next Generation (MSPV-NG) program to provide an efficient, cost-effective way for its facilities to order supplies, but its initial implementation did not have an overarching strategy, stable leadership, and workforce capacity that could have facilitated medical center buy-in for the change. VA also developed requirements for a broad range of MSPV-NG items with limited clinical input. Further, starting in June 2015, VA planned to award competitive contracts, but instead, 79 percent of the items available for purchase under MSPV-NG were added through non-competitive agreements. (See figure). As a result, the program did not meet the needs of medical centers, and usage remained below VA's 40 percent target. (See figure.) VA has taken steps to address some deficiencies and is developing a new approach to the program. However, VA will likely continue to face challenges in meeting its goals until it fully addresses these existing shortcomings. GAO made 10 recommendations in its November 2017 report, including that VA develop an overarching strategy, expand clinician input in requirements development, and establish a plan for awarding future competitive contracts. VA agreed with GAO's recommendations.