Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection to assess allegations of delays in the receipt of patients’ colorectal cancer screening tests at the Phoenix VA Health Care System (facility) in Arizona. The OIG substantiated that 406 patient fecal immunochemical tests (FITs) were held in a non-VA warehouse due to an unpaid postage bill by the facility. The delay resulted in laboratory staff’s inability to process 403 (99 percent) FITs because they were outside the specimens’ 15-day stability period.The OIG did not substantiate a delay in further evaluation and care for the patients whose FITs were outside of the stability period and could not be tested or that patients’ personally identifiable information was not protected. The OIG found that facility staff’s plan for follow-up and efforts to ensure the patients received further evaluation and care were timely and thorough. The OIG did not identify adverse clinical outcomes for the 31 patients reviewed.After finding that patients had not recorded the specimen collection date (required to determine stability) on 86 percent of the delayed FITs, the OIG reviewed and identified concerns with the facility’s FIT processes. The OIG found the facility’s pre-printed FIT label did not include a space for the patient to record the date of collection, the laboratory manager and staff lacked knowledge and clarity about FIT stability, and primary care staff were unaware of the importance of the collection date.The OIG determined that facility and service line leaders missed opportunities to evaluate and resolve identified FIT labeling issues that were indicative of broader laboratory FIT processing failures. The OIG made two recommendations to the VISN Director related to oversight of laboratory FIT processing and three recommendations to the Facility Director related to ensuring compliance with FIT processes and ensuring specimen stability.

Audit Report for the FEC's FY 23 Annual FS Audit

The Office of the Inspector General contracted with the independent certified public accounting firm Ernst & Young LLP to audit: (1) the Social Security Administration’s (SSA) consolidated financial statements as of September 30, 2023 and the related notes to the consolidated financial statements; (2) the sustainability financial statements, including the statements of social insurance as of January 1, 2023 and the related notes to the sustainability financial statements; and (3) the statements of changes in social insurance amounts for the periods January 1, 2022 to January 1, 2023. The OIG also contracted with Ernst & Young to provide an opinion on internal control over financial reporting and report on compliance with laws, regulations, contracts, grant agreements, and other matters and to report on whether SSA’s financial management systems did not comply substantially with the requirements of the Federal Financial Management Improvement Act of 1996 (FFMIA). The contract requires that the audit be conducted in accordance with auditing standards generally accepted in the United States; Government Auditing Standards issued by the Comptroller General of the United States; and Office of Management and Budget (OMB) Bulletin No. 24-01, Audit Requirements for Federal Financial Statements. Those Standards and Bulletin require that Ernst & Young plan and perform the audits to obtain reasonable assurance about whether the financial statements are free from material misstatement and whether effective internal control over financial reporting was maintained in all material respects.

This report identifies three management challenges confronting AmeriCorps in fiscal year (FY) 2024 and beyond:· Improving financial management;· Prioritizing grant fraud prevention and detection in its programs; and· Modernizing and securing information technology.While it does not rise to the significance of a management challenge, we believe that AmeriCorps will be challenged in the future if American Rescue Plan (ARP) funding is not effectively used during FY 2024. We identified Effective Use of American Rescue Plan Funding as an emerging challenge, which is discussed later in this report.

In the audit of the Commission's financial statements for 2023 and 2022, we reported the following: - The Commission’s financial statements for fiscal years ending September 30, 2023 and 2022, were presented fairly, in all material respects, in accordance with U.S. generally accepted accounting principles; - Identified no material weaknesses in internal control over financial reporting and grant origination; and - Identified no instances of reportable noncompliance for fiscal year 2023 with provisions of applicable law, regulations, contracts, and grant agreements tested.

Each year, in compliance with Public Law 106-531, the Reports Consolidation Act of 2000, the Denali Commission Office of Inspector General issues a report summarizing what we consider the most serious management challenges facing the Commission.