Federal Reports

The purpose of the Office of Inspector General (OIG) Care in the Community (CITC) healthcare inspection program is to evaluate various aspects of care delivered in Veterans Health Administration (VHA) community-based outpatient clinics (CBOCs) and through non-VA healthcare providers. In fiscal year 2022, the OIG reviewed eight Veterans Integrated Service Networks (VISNs), VISNs 1, 2, 5, 6, 8, 12, 19, and 20, which are responsible for oversight of care provided by their associated medical facilities, CBOCs, and non-VA providers.To examine VISN oversight and the care provided in CBOCs and by non-VA providers, the OIG reviewed VHA requirements and Joint Commission standards and evaluated core processes in the following six areas of administrative and clinical operations:1. Leadership: oversight and management of care in the community2. Environment of care: emergency management of CBOCs3. Care coordination: congestive heart failure management4. Primary and mental health care: diagnostic evaluations for depression and alcohol use disorder5. Quality of care: home dialysis care6. Women’s health: mammography services by community providersWomen’s health was a congressionally mandated review, and the OIG will report the results of the evaluation of mammography services by community providers in a separate publication to provide stakeholders with a more comprehensive picture of regional VHA challenges and ongoing efforts in this area of women’s healthcare services.The OIG issued seven recommendations for improvement in two areas:1. Care coordination• Care coordination needs documented in the Community Care Coordination Plan note• Consults acted on no later than two business days after receipt• Appointments scheduled in a timely manner• Three attempts made to retrieve medical documentation from non-VA providers2. Quality of care• Initial and annual dialysis program home visits• Processes to monitor delivery of non-VA home dialysis• VISN dialysis council

In accordance with the Government Performance and Results Modernization Act of 2010, this report presents the results of ED OIG's work over fiscal year 2023 in meeting its performance goals.

The objective of our inspection was to determine whether the Department appropriately approved requests for alternate assessment waivers and waiver extensions for School Year (SY) 2021–2022. We found that the Department generally appropriately approved 21 of 22 requests for alternate assessment waivers and waiver extensions for SY 2021–2022. One request should only have been partially approved because it included a subject for which a waiver should not have been granted since prior year assessment participation rates were not met. While we noted that some requests did not fully meet all applicable requirements, we found that the related deviations were minor, the Department's rationale for concluding requirements were met, when provided, was reasonable, or we did not believe the deviations rose to a level that would warrant disapproval of the requests. We identified areas where the Department could strengthen its process, to include providing sufficient clarification and guidance to Office of Elementary and Secondary Education Office of School Support and Accountability Assessment Team staff performing the reviews on what constitutes acceptable State responses to certain requirements and how to adequately document determinations when exercising professional judgment so that a clear basis for the determination is provided. This would provide for greater consistency and less subjectivity in its treatment of State waiver requests.

The objectives of our audit were to determine whether (1) Long Island Business Institute’s (LIBI) career pathway programs met the program eligibility requirements set forth in section 484(d)(2) of the Higher Education Act of 1965, as amended (HEA); (2) students enrolled in LIBI’s career pathway programs met the student eligibility requirements set forth in section 484(d)(1)(A) of the HEA; and (3) LIBI excluded from students’ enrollment statuses and costs of attendance the component of its career pathway programs that enables a student to attain a high school diploma or its recognized equivalent. We found that all six of LIBI’s career pathway programs satisfied all seven of the program eligibility requirements in section 484(d)(2) of the HEA. Additionally, LIBI’s records showed that all 111 students included in our sample met the student eligibility requirements in section 484(d)(1)(A) of the HEA. Finally, LIBI properly excluded the high school completion component of its career pathway programs from the enrollment statuses and costs of attendance for all 111 students (100 percent) included in our sample.

This report details KPMG’s audit of trust funds financial statements from the Bureau of Trust Funds Administration for fiscal years 2023 and 2022.