Federal Reports

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the leadership performance and oversight by Veterans Integrated Service Network (VISN) 1: VA New England Healthcare System in Bedford, Massachusetts, covering leadership and organizational risks and key processes associated with promoting quality care. This inspection also focused on COVID-19: Pandemic Readiness and Response; Quality, Safety, and Value; Medical Staff Credentialing; Environment of Care; Mental Health: Suicide Prevention; Care Coordination: Inter-facility Transfers; and Women’s Health: Comprehensive Care.Most of the VISN’s executive leadership team had worked together since 2018; however, the Chief Medical Officer had served in an acting capacity since October 2020. Employee satisfaction survey scores indicated that leaders were engaged and promoted a culture of safety where employees felt safe bringing forward issues and concerns. Patient experience survey scores were higher than VHA averages. The OIG’s review of access metrics and clinical vacancies identified potential organizational risks at select facilities, with wait times over 20 days and clinical vacancies in certain specialties.The OIG issued five recommendations for improvement in three areas:(1) Medical Staff Credentialing• Physician credentials file review and appointment approval(2) Mental Health• Designated mental health professional to serve on state suicideprevention council or workgroup(3) Women’s Health• Quarterly program updates to VISN leaders• Staff education gap assessments and development of educational material• VISN-level support staff availability

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In February 2021, the Office of the Chief Information Officer (OCIO) identified funding risks with the development contract under which HUD contracted for Federal Housing Administration (FHA) Catalyst’s development. In response, HUD officials took steps to slow FHA Catalyst spending on the contract while awaiting approval for additional contract funds. Despite efforts to slow project spending, it was not enough to prevent funding shortfalls before the contract’s base year end. Poor contract oversight enabled OCIO to exhaust funds before the end of the base year, which stopped work on FHA Catalyst. Additionally, several issues also hindered FHA Catalyst development activities. As of August 2021, HUD had resumed FHA Catalyst development work at limited capacity. As of October 2021, HUD estimated that it would complete FHA Catalyst development in March 2025.

The attached report presents the results of an integrated audit of the Department of Homeland Security’s (DHS’) consolidated financial statements for fiscal years 2021 and 2020 and internal control over financial reporting as of September 30, 2021. This audit is required by the Chief Financial Officers Act of 1990, as amended by the Department of Homeland Security Financial Accountability Act (October 16, 2004).