Federal Reports

The VA Office of Inspector General (OIG) examined whether the Veterans Health Administration (VHA) implemented data collection and reporting systems to report on the supply of COVID-19 vaccines to VA medical facilities and doses administered to VA employees and veterans enrolled in VA’s healthcare system (approximately 9.5 million individuals). Although essential for national reporting, tracking VA vaccine data is difficult because VA does not have a centralized national pharmacy inventory management system to track vaccine supply at facilities.Although VHA staff swiftly developed data collection systems, the review team determined the reliability of COVID 19 vaccine data could be improved in several areas. The team determined that Pharmacy Benefits Management Services staff did not verify vaccine supply data from facilities, which are manually entered and prone to error; vaccination data in key systems were inconsistent and contained inaccuracies due to inadequate validation and user error; VHA staff at some VA medical facilities initially lacked system access to enter employee vaccination data; and the dashboard VHA developed to consolidate vaccine data contained unvalidated data. Accurate data are needed not only to schedule and prioritize COVID-19 vaccinations but also to report the percentages of vaccinated veterans and employees to the Centers for Disease Control and Prevention. Inaccurate vaccine data also increase the risk of COVID-19 vaccine theft.VA concurred with the OIG’s three recommendations (one in principle), including developing processes for verifying medical facility vaccine supply data and for monitoring the use of tools to minimize data entry errors and ensuring the consolidated dashboard data are reliable, accurate, and complete. These strategies also will help VA track COVID-19 vaccinations for other populations, including unenrolled veterans (around 10 million as of June 2021), veterans’ spouses and caregivers, and other federal agency employees.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of Veterans Health Administration facilities’ selected Women’s Health (WH) program requirements. This evaluation focused on provision of care requirements, oversight of program and monitoring of performance improvement data, and assignment of required staff.This report describes WH-related findings from healthcare inspections initiated at 36 Veterans Health Administration medical facilities from November 4, 2019, through September 21, 2020. Each inspection involved interviews with facility leaders and staff and reviews of clinical and administrative processes. The OIG reviewers evaluated meeting minutes and other relevant documents. The results in this report are a snapshot of Veterans Health Administration performance at the time of the fiscal year 2020 OIG reviews.The OIG found general compliance with many of the selected requirements. However, the OIG identified weaknesses with:• provision of 24/7 gynecologic care coverage,• assignment of at least two women’s health primary care providers for each community-based outpatient clinic,• women veterans health committee core members and reporting to clinical executive leaders,• assignment of a full-time women veterans program manager who is free of collateral duties, and• designation of maternity care coordinators.

Our objective for this report was to alert the company to specific Human Resources functions that require prompt company action.We found that the Human Resources department does not have enough staff to effectively recruit, screen, hire, and onboard new employees, which will likely hinder the company’s plans to build its workforce by as much as 21 percent over the next year. Human Resources managers told us the labor market is tight and the department faces difficulty competing for top talent acquisition candidates against other companies that may offer more opportunities for remote work and greater schedule flexibility. Even with additional talent acquisition staff, the company expects to require help from third-party recruiting agencies to help during periodic hiring surges such as those associated with new funding for major infrastructure projects. As of October 2021, however, the Human Resources department has not yet filled a key talent acquisition position for a Director who will also serve as the Contracting Officer’s Technical Representative. In this role, the Director will oversee the contracts and verify that third-party agencies are targeting and recruiting high-quality candidates. Further, the company relies heavily on cumbersome manual hiring processes, which when addressed, will likely improve its ability to quickly identify and hire the thousands of workers it anticipates needing to execute the company’s recovery and growth strategies. The Human Resources department is actively recruiting for all positions required to meet the company’s immediate needs, but it will take several months to be in a position where it is able to fully support all hiring, including for positions needed to execute projects funded by the Infrastructure Investment and Jobs Act. We recommended that the company explore and develop meaningful solutions to address competitive barriers to attracting executive talent. Additionally, we recommended that the company fill the position responsible for overseeing third-party recruiting contracts.

This report responds to a request from U.S. Representative Lizzie Fletcher, 7th Congressional District of Texas, to evaluate select mail delivery and customer service operations and determine if internal controls are effective at the Ashford West and Westbury Stations in Houston, TX. Representative Fletcher’s June 2021 request specifically mentioned lost mail and the removal of drive-up collection boxes.The two stations are in the Postal Service’s Texas 2 District in the Southern Area and have a combined 116 city routes. Staffing at the stations includes 130 full-time city carriers, 58 part-time city carriers, 15 full-time clerks, and 4 part-time clerks.

Our initial objective for this management advisory report was to assess the extent to which the company is evaluating the risks associated with operating service on tracks on the Del Mar bluffs. Because a service disruption in San Clemente in September 2021 involved similar issues along the same route and occurred during our work, we also performed a limited review of company actions in response to that event.We found that the company met its regulatory obligations in response to Del Mar, San Diego, bluff failures along the Pacific Surfliner route by complying with speed restrictions and track outages enforced by the host railroad. Additionally, the company proactively responded to reports of unsafe track conditions in San Clemente, California, by suspending rail service until it could complete an internal review and seek its own assurances that it was safe to resume operations.The company, however, is not participating in regional stakeholder working groups focused on understanding and planning both short- and long-term mitigation options to address events like the Del Mar bluff failures. Going forward, Amtrak should consider designating company personnel to participate in ongoing discussions with stakeholders.