Federal Reports

What We Looked AtEstablished in 1982 at 5 low-activity control towers, the Federal Aviation Administration’s (FAA) Contract Tower (FCT) Program currently consists of 254 contract towers in 46 states operated by 3 contractors and the Air National Guard. Managing about 28 percent of the Nation’s air traffic control operations, contract towers constitute an essential part of the National Airspace System (NAS). Our audit objective was to assess the FCT Program’s cost effectiveness and safety record. We statistically grouped towers based on characteristics that affect air traffic controller and tower workloads. Specifically, we gathered and examined hours of operations, numbers of takeoffs and landings, types of aircraft handled, and runway configurations. Based on these characteristics, we used two statistical methods to group 351 air traffic control towers, consisting of 248 contract towers and 103 lower level FAA towers. Our methods produced groups containing a mixture of comparable FAA and contract towers. We determined the towers within each group were similar to each other and then analyzed and directly compared their cost and safety data. We reviewed cost and safety data between fiscal years 2015 and 2018 for the universe of 351 towers. What We FoundBetween fiscal years 2015 and 2018, contract towers were more cost effective per aircraft handled than comparable FAA towers, and that the safety records of contract and comparable FAA towers were similar. On average, contract towers used at least 47.6 percent fewer resources—or incurred lower controller staffing costs—per aircraft handled per year even though comparable FAA towers handled more total flights. Furthermore, while contract towers had statistically fewer safety events per aircraft handled, we do not believe the difference between these numbers and those of FAA’s towers is meaningful because, among other reasons, the numbers of safety related events across the NAS were very low relative to the total number of flights. RecommendationsWe are making no recommendations.

The report summarizes the FTC OIG’s activities and accomplishments during the first half of the FY 2020 reporting period.

The OIG conducted a review of VA’s planned launch of a new electronic health record (EHR) system at the Mann-Grandstaff VA Medical Center in Spokane, Washington. The facility was scheduled to be the first facility to implement the new EHR system on March 28, 2020, which VA postponed on February 10 to an unspecified date. The review focused on the EHR’s initial capabilities and the potential impact on patients’ access to care. The OIG found that facility leaders are planning for a 30 percent decrease in productivity as the system is tested and learned. Although the Office of Electronic Health Record Modernization (OEHRM) made efforts to evaluate and address productivity, facility leaders were not provided written guidance to address patients’ access to care during this less productive time. Facility leaders hired just more than 48 of 108 positions needed to support roll out and addressed access to primary care, but had a backlog of 21,155 community care consults (referrals) as of January 9, 2020. The OEHRM determined in July 2019 that not all new EHR capabilities would be available for the March go-live date. The OIG determined that facility staff would enact as many as 84 mitigations for 62 systems identified as moderate or high risk to address gaps at the go-live date. In particular, work-arounds were needed to address the removal of an online prescription refill capability—presenting patient safety risks. The OIG determined that going live with decreased capabilities that require mitigation strategies risks patient safety beyond that inherent in an EHR deployment. The OIG made four recommendations regarding productivity and capabilities to the Under Secretary for Health and OEHRM, two recommendations to the Veterans Integrated Service Network Director on facility support, and two recommendations to the Facility Director related to community care consults and timely medication refills.

VA faces tremendous challenges modernizing its electronic health records system and connecting it to a similarly implemented Department of Defense (DoD) system to create a comprehensive, lifetime health record for service members. The VA Office of Inspector General (OIG) examined whether infrastructure-readiness activities were on schedule to support the modernization initiative, starting with the system’s initially scheduled deployment on March 28, 2020, at the Mann-Grandstaff VA Medical Center (VAMC) in Spokane, Washington. The OIG found that critical physical and information technology infrastructure upgrades had not been completed at Mann-Grandstaff and associated facilities six months before the specified system deployment date, as guidance suggested. Even as recently as January 8, 2020, some infrastructure updates had yet to be completed, jeopardizing the then planned March 28 deployment. In April 2020, VA postponed going live without specifying a new date. The lack of important upgrades jeopardizes VA’s ability to properly deploy the new system and increases risks of delays to the overall schedule. Some needed infrastructure upgrades were not projected to be completed until months after going live. Infrastructure upgrades were not completed at Mann-Grandstaff on time primarily because VA had not completed initial comprehensive site assessments, developed specifications for infrastructure with appropriate monitoring mechanisms, and lacked adequate staffing. VA committed to the March 28 date without having the necessary information on the state of the medical center’s infrastructure. The OIG also found security vulnerabilities with some of the physical infrastructure at the Mann-Grandstaff VAMC. Damage to that infrastructure from unauthorized access could lead to loss of connectivity. The OIG made eight recommendations, including establishing an infrastructure-readiness schedule for future deployment sites that incorporates lessons learned from DoD’s experience and ensures projected milestones are realistic and achievable. The OIG also recommended ensuring the physical security of electronic health records infrastructure.