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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
VHA provides outpatient services to veterans at community-based outpatient clinics (CBOCs) nationwide. The VA OIG conducted this review to assess contract oversight of staffing and appointment cancellation performance measures at five Loma Linda Healthcare System CBOCs in California.
The OIG found that VA leaders in the Loma Linda healthcare system did not ensure contractor compliance with performance standards for staffing or for the number of appointments canceled by the clinics during FYs 2022 and 2023. Specifically, Loma Linda officials did not effectively monitor contractor-staffed primary care Patient Aligned Care Teams to ensure contract compliance. The contractor did not meet required staffing levels at any of the five contracted CBOCs for at least 22 of 24 months in FYs 2022 and 2023; two CBOCs were noncompliant 100 percent of the time, and the remaining three were noncompliant more than 90 percent of the time.
The contractor also did not consistently meet the appointment cancellation performance standard regarding appointments canceled by clinics at contracted CBOCs. In FYs 2022 and 2023, all five CBOCs under the contract were noncompliant with appointment cancellation standards at least 79 percent of the time, and two CBOCs were noncompliant 100 percent of the time. Finally, the OIG found that the contracting officer’s attempt to recover government funds associated with using VA personnel to cover shortages at the contracted clinics was insufficient.
Contract noncompliance occurred, in part, because the assistant director did not provide effective oversight of the contracting officer’s representative (COR) or the CBOC nurse coordinator. The OIG also found that the assistant director did not effectively coordinate with the COR and the contracting officer to ensure that the contractor’s contingency plan requirement was sufficiently enforced during staffing shortages. The OIG made nine recommendations for VA to improve oversight of CBOC contracts.
The U.S. Nuclear Regulatory Commission (NRC) does not have an adequate process for managing, tracking, and monitoring staff qualification records. The OIG found that NRC offices use inconsistent information-gathering methods, driven by changes in management’s workforce planning and individual office preferences for using separate information systems. As a result, the NRC may face reduced efficiency in retrieving qualification records and may lack full visibility into staff qualification gaps─factors that could adversely impact the agency’s ability to carry out its mission. Additionally, the OIG found that refresher training is tracked informally, with many staff relying on personal reminders to complete mandatory requirements. This informal approach exists because the NRC lacks a structured, agency-wide system for managing refresher training. The absence of such a system could result in decreased staff productivity, non-compliance with safety and security requirements, and lower employee morale and retention. Refresher training is essential for maintaining up-to-date knowledge, skills, and safety practices, which are critical to ensuring that staff can perform their duties effectively and safely. This report makes three recommendations to improve the NRC’s process for managing, tracking, and monitoring its qualification programs.
Orphaned Wells Program Office and the State of Kansas Have Opportunities To Improve Spending of Infrastructure Investment and Jobs Act Orphaned Wells Funding