Federal Reports

The Postal Reorganization Act of 1970, as amended, established the Board of Governors (Board), which is generally comprised of nine governors appointed by the President of the United States, the postmaster general, and the deputy postmaster general. There was a full Board throughout fiscal year (FY) 2023. The Board reviews the U.S. Postal Service’s practices and policies and establishes objectives and goals in accordance with Title 39 of the U.S. Code. In FY 2023, the Board incurred $470,020 in salaries, travel, meeting fees, and professional service expenses. The Office of the Board of Governors’ policy requires annual audits of the Board’s expenses.

The VA Office of Inspector General (OIG) conducted an inspection at the VA Central Ohio Healthcare System (facility) in Columbus to review an allegation that implementation of the new electronic health record (EHR) led to a prescription backlog. While reviewing the allegation, the OIG determined facility leaders took timely and sustainable steps to manage the issue. However, the OIG identified other facility and national pharmacy-related patient safety issues.The OIG found implementation of the new EHR at the facility, despite known pharmacy-related patient safety and usability issues, contributed to ongoing patient safety risks and usability challenges at the facility. The new EHR contributed to pharmacy-related patient safety issues nationally as a software coding error resulted in inaccurate medication and allergy information transmission from new EHR sites to legacy EHR sites. Affected patients were not notified of their risk of harm and the OIG remains concerned for their safety. The OIG learned VHA communicated recommendations to providers to mitigate the risk of harm to affected patients; however, the recommendations were non-sustainable. Additionally, the new EHR's operational inefficiencies required increased clinical pharmacist staffing and development of workarounds and educational materials to complete pharmacy processes. The inefficiencies also led to pharmacy staff burnout, job dissatisfaction, and decreased morale.The OIG made three recommendations to the Deputy Secretary related to resolution of patient safety and usability issues. The OIG made six recommendations to the Under Secretary for Health. One recommendation focuses on accurate patient medication data and three recommendations address patient and provider awareness and evaluation of the risk of harm related to data transmission issues. Another recommendation is related to pharmacy staffing, and one focuses on the underlying technical and functional issues requiring workarounds and educational materials to perform pharmacy operations.

The objective of the audit was to determine whether the Mississippi Department of Education (MDE) implemented selected components of its statewide accountability system in accordance with Mississippi’s approved State plan and any approved amendments. Our audit covered MDE’s processes for implementing selected components of Mississippi’s statewide accountability system based on accountability data for school years 2017–2018, 2018–2019, and 2021–2022. The selected components were (1) establishment of long-term goals for improved academic achievement, (2) indicators used to measure student academic achievement and school success, (3) annual meaningful differentiation, and (4) identification of low-performing schools and schools with low-performing student subgroups. Our audit also covered the funding and support services that MDE provided to LEAs with schools identified in the fall of 2022 as needing comprehensive support and improvement (CSI), targeted support and improvement (TSI), and additional targeted support and improvement (ATSI). We found that MDE generally implemented the long-term goals, indicators, annual meaningful differentiation, and identification of low-performing schools’ components of its statewide accountability system in accordance with Mississippi’s approved State plan and amendment. However, its implementation of several aspects of the accountability system deviated from the plan. In several cases, the changes warranted the Department’s review and approval; however, MDE implemented the changes without (1) submitting amendments to the Department or (2) waiting for the Department to approve the amendments. In addition, found that MDE did not always calculate indicator scores, perform annual meaningful differentiation, and identify schools for CSI in accordance with Mississippi’s approved State plan and amendment. We also determined that MDE provided funding and additional support to all 236 Mississippi public schools that it identified in the fall of 2022 as needing additional support based on accountability data for school years 2017–2018, 2018–2019, and 2021–2022. Lastly, as noted in the “Other Matters” section of our report, MDE did not take corrective actions that were responsive to the Mississippi Office of the State Auditor’s recommendations for ensuring the accuracy and completeness of graduation rate data used in Mississippi’s statewide accountability system.

CSO tank construction delays may increase taxpayer costs to complete the cleanup remedy at the Gowanus Canal Superfund site and prolong community exposure to contaminants.

We audited costs claimed by the Wyoming Game and Fish Department under WSFR grants awarded by FWS and had no findings.

The AmeriCorps Office of Inspector General (AmeriCorps OIG) investigated an allegation that Teach for America (TFA) improperly exited an AmeriCorps member (member) for Compelling Personal Circumstances (CPCs) who allegedly provided a fictitious reason for a CPC exit in order to participate in a teacher strike and still earn her education award.

The new electronic health record (EHR) includes a scheduling system intended to enhance efficiency and user experience, minimize disruptions in the delivery of care, and standardize workflows that improve patient access. Having a scheduling system that routes patients to the appropriate providers in a timely manner is critical for the Veterans Health Administration (VHA) to effectively provide care for veterans. The VA Office of Inspector General (OIG) issued this management advisory memorandum to address the concern that scheduling system challenges experienced during deployment of the new EHR at smaller VA medical facilities could be exacerbated at larger, more complex medical centers.While VA has delayed additional EHR deployments until it is confident in the system’s functionality, the deployment at the Captain James A. Lovell Federal Health Care Center (Lovell FHCC) proceeded as planned. Lovell FHCC is the first large, complex VA facility to use the EHR, and the implementation presents an immediate challenge in connection with the scheduling system. This memo, provided to VHA ahead of that implementation, was meant to assist in determining whether additional actions are warranted prior to or during future deployments to mitigate scheduling system concerns.These concerns include the need for additional staffing and overtime to meet or exceed pre-deployment appointment levels, displaced appointment queue functionality, challenges related to providers and schedulers sharing information, inaccurate patient information, difficulties changing appointment type, and the inability to automatically mail appointment reminder letters. At facilities currently relying on the EHR, these issues have resulted in inconsistent workarounds and additional work, increasing the risk for scheduling errors. Consequently, at future go-live facilities, assessing staffing levels and overtime usage prior to deployment and preparing staff with approved workflow best practices may help to reduce employee resistance and facilitate successful adoption of the system.