WASHINGTON (AP) — The Biden administration is stepping up criticism of Israel for not doing enough to improve humanitarian conditions in Gaza as a 30-day deadline looms for Israeli officials to meet certain requirements or risk potential restrictions on military assistance.

State Department spokesman Matthew Miller on Monday gave Israel a "fail" grade in terms of meeting the conditions for an improvement in aid deliveries to Gaza laid out in a letter last month to senior Israeli officials from Secretary of State Antony Blinken and Defense Secretary Lloyd Austin.

He said there were still roughly nine days until the deadline expires, but that limited progress so far has been insufficient.

“As of today, the situation has not significantly turned around,” Miller told reporters. “We have seen an increase in some measurements. But if you look at the stipulated recommendations in the letter — those have not been met.”

A day before the U.S. election, the Biden administration called out its close ally, with support for Israel a key issue for many voters and the humanitarian crisis for Palestinians also a factor for many in the race. Former President Donald Trump and Vice President Kamala Harris have been competing for Muslim and Arab American voters and Jewish voters in battleground states like Michigan and Pennsylvania.

Among other conditions, Austin and Blinken's letter from mid-October said that Israel must allow in a minimum of 350 trucks a day carrying desperately needed food and other supplies for Palestinians besieged by more than a year of war between Israel and Hamas. By the end of October, an average of just 71 trucks a day were entering Gaza, according to the latest U.N. figures.

“The results are not good enough today,” Miller said. “They certainly do not have a pass. … They have failed to implement all the things that that we recommended. Now, that said, we are not at the end of the 30-day period.”

He would not say when asked what the U.S. would do when the deadline comes up next week, just that “we will follow the law.”

Blinken spoke Monday with Israeli Defense Minister Yoav Gallant, urging additional steps to “substantially increase and sustain humanitarian aid” to civilians in Gaza, according to a State Department readout of their call.

Similarly, Austin has been reinforcing “how important it is to ensure that humanitarian assistance can flow and flow faster into Gaza” in calls with Gallant, said Maj. Gen. Pat Ryder, Pentagon press secretary.

The Israeli military body in charge of humanitarian aid to Gaza, known as COGAT, said it had evacuated 72 patients from hospitals in northern Gaza to other medical facilities Monday and had brought medical supplies as well as fuel, food, water and units of blood.

The head of UNICEF, the U.N. agency for children, said over the weekend that “the entire Palestinian population in North Gaza, especially children, is at imminent risk of dying from disease, famine, and the ongoing bombardments.”

Miller also said the U.S. is looking into a decision by the Israeli government to end an agreement facilitating the work of the U.N. agency for Palestinian refugees, known as UNRWA, which is the main aid provider in Gaza.

It followed the passage of Israeli laws last week to sever ties with UNRWA, a move that Blinken and Austin opposed in their letter.

The Israeli Foreign Ministry said in a statement Monday that it has notified the U.N. of the cancellation of an agreement dating back to 1967 that facilitates UNRWA’s work. It said UNRWA “is part of the problem in the Gaza Strip and not part of the solution.”

Israel alleges that UNRWA has been infiltrated by Hamas, which the agency denies and says it takes measures to ensure its neutrality.

U.N. Secretary-General Antonio Guterres reiterated that UNRWA is essential and there is no alternative to its work in the Palestinian territories, spokesman Stephane Dujarric said.

At the same time, Miller said the U.S. is "deeply concerned" by a recent escalation in attacks by Israeli settlers on Palestinians in the West Bank, including several cars being torched overnight just a few kilometers (miles) away from the Palestinian Authority's headquarters and attacks on Palestinians harvesting olives, their livestock and other property.

“These violent actions cause intense human suffering for Palestinians and they threaten Israel’s security,” Miller said. “It is critical that the government of Israel deter extremist settler violence and take measures to protect all communities from harm in accordance with its international obligations.”

He noted that the U.S. has since the beginning of the year imposed sanctions against Israeli groups and people implicated in violence against Palestinian civilians and warned of more to come.

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AP reporters Ellen Knickmeyer and Lolita C. Baldor in Washington and Edith M. Lederer at the United Nations contributed.