The protection of American citizens overseas, including the provision of emergency services, is one of State’s primary functions. Providing these services is the responsibility of Consular Affairs and is carried out by embassies and consulates. Emergency services available to American citizens overseas include dealing with arrests, death cases, financial or medical emergencies, welfare and whereabouts inquiries, and victims of crimes. State also assists victims of terrorism, kidnapping, child abduction, and child abuse. In addition to providing assistance to American citizens in need of emergency services, State also provides routine services, including issuing citizenship documentation; overseeing federal benefit payments to American citizens living in foreign countries; providing information on absentee voting; and notarizing documents. These activities are referred to as American Citizen Services, or ACS, both in Washington, D.C., and at embassies and consulates. Before U.S. citizens can receive assistance, they must first provide proof of U.S. citizenship. In cases where there is uncertainty about citizenship, State regulations indicate that consular officers should err on the side of providing services until U.S. citizenship can be determined. While U.S. citizens may seek assistance from State regarding American citizens overseas, the Privacy Act of 1974 limits what written, oral, and electronic information State can share about these citizens. Among the protections the Privacy Act established for individuals, subject to certain exceptions, federal agencies, including State, are required to seek consent from a U.S. citizen before disclosing information held in a system of record regarding that person. Only after consent is received may information regarding a U.S. citizen be shared with family or friends, as well as other U.S. government agencies or private entities. Exceptions include instances in which State deems that an American citizen’s health and safety are in jeopardy. Within Consular Affairs, the directorate of Overseas Citizen Services in Washington, D.C., is charged with protecting and providing services to U.S. citizens abroad. Consular Affairs also has responsibility for several other activities, including issuing passports and visas (see fig. 1). Within the Overseas Citizen Services, the Office of American Citizens Services and Crisis Management is responsible for providing emergency and routine services to U.S. citizens, and assistance during major crises such as the 2006 Lebanon evacuation. The Office of American Citizens Services and Crisis Management is organized according to regional divisions that cover Africa; East Asia Pacific; Europe; Near East, South, and Central Asia; and the Western Hemisphere. Overseas, emergency services are provided by State’s 267 embassies and consulates in 174 countries. Emergency assistance and some basic consular services are also provided by 46 consular agencies, which are an extension of existing embassies and consulates and generally service locations that are far from a post but where a large number of U.S. citizens live or visit. For example, Mexico has 14 consular agencies in addition to its embassy in Mexico City and 9 consulates. Approximately 5,000 people work in consular sections at posts overseas, according to Consular Affairs. Of these consular positions overseas, approximately 1,450 are FSOs, 3,000 are LES, and the remaining 550 are in other positions. Each post has a consular section that assists American citizens with services including routine and emergency services, and most consular sections also issue nonimmigrant visas. The ACS sections of these posts employ a variety of consular staff—FSOs, LES, employed family members, consular associates, consular agents, and Regional Consular Officers—to assist American citizens. Each consular section must have at least one FSO who provides management and oversight to the section and administers certain emergency services that only an FSO can provide, such as issuing a passport or a report of death. LES perform much of the routine and administrative services provided by the section, and often assist FSOs with emergency services. In addition to FSOs and LES, some posts also employ family members and consular associates. Consular agencies are not assigned an FSO; rather they are assigned a consular agent, which is a noncareer appointee of the Foreign Service, who acts under the supervision and direction of the consular officer at the supervisory post. The provision of emergency services overseas, as well as the support provided by Overseas Citizens Services in Washington, D.C., is funded through a mixture of sources including limited direct appropriations and various fees collected by State. According to State, for fiscal year 2008, Consular Affairs collected revenues exceeding $2 billion of which it retained just over $1 billion for its operating costs, with the remainder of the funds provided to the Department of the Treasury or shared with other bureaus in State. The majority of funding for Consular Affairs comes from consular service fees, specifically Machine Readable Visa fees. These fees are collected and retained by Consular Affairs to fund consular operations domestically and overseas, and to fund part of the operations of the regional bureaus. Consular Affairs was unable to provide us the amount of funding that specifically supports ACS operations both domestically and overseas because ACS costs are integrated into Consular Affairs’ and the regional bureaus’ total costs and not broken out separately. State provides an extensive range of around-the-clock services to Americans in need of emergency assistance overseas. State also provides emergency information, through several means, to American travelers citizens living abroad on travel and other information of concern, and maintains a warden system for disseminating information, which is particularly important in countries with poor communications infrastructure. State provides a variety of services to assist American citizens who face emergencies while traveling or living abroad, including assistance to citize involving deaths, arrests, financial and medical assistance, accidents and crimes, and inquiries into the welfare and whereabouts of citizens. Assistance in death cases: According to State, providing assistance fo next of kin of a deceased American citizen abroad is one of the most important and difficult tasks for FSOs abroad. Since 2003, State has reported more than 48,000 death cases involving Americans abroad, wit more than 4,500 of those deaths attributed to nonnatural causes. FSOs are required to endeavor to notify next of kin of the death of an American h citizen abroad as soon as possible and issue the report of death. State regulations and training highlight the need to provide effective service, but also to exhibit empathy and understanding for the next of kin, who may be unfamiliar with the foreign laws governing death and the disposition of remains. State guidance indicates that FSOs should attempt to comply with the family’s wishes to the extent possible, but must also comply with local regulations and laws, as well as U.S. laws, governing the identification of remains, the disposition of remains, and autopsies. For example, in the event that the death is a result of homicide, suicide, or an accident, the host country is responsible for investigating the death. In addition, posts assist with and facilitate the disposition of the deceased’s remains, while instructions and funds for this activity are the exclusive responsibility of the deceased’s next of kin or legal representative. Assistance to arrestees: FSOs are charged with helping to maintain the legal and human rights of American citizens arrested and detained abroad, although American citizens may not be accorded the same rights and judicial processes they would receive under the U.S. judicial system. According to State data, approximately 25,000 American citizens worldwide were arrested overseas from fiscal year 2003 through 2008. The host country is generally required to inform a detained U.S. citizen of his right to consular notification and to perform such notification if requested if it is a party to the Vienna Convention on Consular Relations or has a bilateral treaty with the United States. For some countries, consular notification is required regardless of the U.S. detainee’s wishes, and consular officers are typically granted the right to visit. Furthermore, State regulations require each post to initially visit or contact the citizen as soon as possible following consular notification or information about the arrest from another source, and visit prisoners after sentencing every 6 months; develop information on the judicial process of each country; and maintain an up-to-date list of attorneys who have indicated a willingness to represent American citizens. During our visit overseas, we observed an FSO and an LES visit incarcerated American citizens on two occasions. They asked prisoners about their health, gave them vitamins, and asked if they needed assistance from the post. In one instance, a prisoner requested a new passport and the officer completed the application during the visit. Medical assistance: State may provide medical emergency loans to an American citizen in need of emergency medical or dietary assistance if the individual is destitute or incarcerated and cannot receive medical assistance. For example, in some countries prisoners must pay for medical assistance as well as food. According to State, approximately 5,300 citizens were provided emergency medical and dietary assistance loans from fiscal year 2003 through 2008. In addition, in circumstances where a citizen is critically injured or ill overseas and a local physician determines the citizen is stable for travel, consular officers assist families in arranging medical transportation and provide information regarding the policies and procedures for evacuating a citizen to the United States. State data show that over 5,000 American citizens received medical evacuations between fiscal years 2003 and 2008. For example, at one consulate we observed an FSO and an LES assist in the arrangement of a medical transport to the United States for a citizen who was injured in a traffic accident. Both the FSO and the LES worked with medical and local police officials to coordinate the medical transport and settle any demands with the other parties involved in the accident. Financial assistance: State provides loans to destitute American citizens to return to the United States.