Federal Reports

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The audit report includes two findings that address weaknesses in the District’s internal control processes. The audit found that the District lacked adequate controls over its competitive bidding and inventory processes. The auditors provided four recommendations to address the findings, including a recommendation that the Universal Service Administrative Company, the USF administrator, recover E-Rate program funds in the amount of $39,985.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements

Congress directed the VA Office of Inspector General (OIG) to review Veterans Health Administration’s (VHA) progress in developing a comprehensive staffing model. While VHA reported staffing models exist for all occupations, VA plans to develop the first iteration of staffing models that will determine staffing requirements by FY 2022. Limited staffing resources were reported as a barrier to staffing models.VA and VHA define staffing models differently, and the associated program office directors reported inconsistent staffing model roles and responsibilities. The governance of staffing models could be improved.Validated staffing models can provide consistency in how staffing requirements are determined, which can then be used to inform VHA’s budget and workload analysis. However, most facilities used facility-developed methods to determine requirements and prioritized staffing within the constraints of available budgets.Veterans integrated service network (VISN) directors were generally satisfied with the quality of staff hired during the pandemic and hoped the flexibilities used for hiring would become permanent. Although VA and VHA reported net increases in VHA staffing levels during the pandemic, the reported increases differed making it difficult to quantify pandemic hiring.The OIG made three recommendations to the VHA Under Secretary for Health to coordinate with VA to1. review the roles, responsibilities, and number of staff required for VA and VHA offices involved in the development, validation, and implementation of staffing models, and ensure that staffing model-related efforts are prioritized and supported;2. evaluate the status of, and provide a timeline for, the development, validation, and implementation of VHA staffing models for all occupations; andevaluate the status of, and provide a timeline for, implementation of HR Smart-related requirements referenced in VA and VHA policy, with a specific focus on authorizations, vacancies, budgeted positions, and unbudgeted requirements at the facility, VISN, and national levels.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Montana VA Health Care System. The inspection covered key clinical and administrative processes associated with promoting quality care. It focused on Leadership and Organizational Risks; COVID-19 Pandemic Readiness and Response; Quality, Safety, and Value; Registered Nurse Credentialing; Medication Management: Remdesivir Use in VHA; Mental Health: Emergency Department and Urgent Care Center Suicide Risk Screening and Evaluation; Care Coordination: Inter-facility Transfers; and High-Risk Processes: Management of Disruptive and Violent Behavior.The healthcare system had vacancies in two of the five key leadership positions, with the Quality Management Officer serving as acting Assistant Director and acting Associate Director of Patient Care Services. Survey results indicated opportunities to improve employee attitudes toward leaders, the workplace, and workgroup relationships. Patient experience survey results highlighted opportunities for improvement in outpatient settings. Review of the healthcare system’s accreditation findings, sentinel events, and disclosures did not identify any substantial organizational risks. The executive leaders were generally knowledgeable about select data used in Strategic Analytics for Improvement and Learning models and should continue to take actions to sustain and improve performance.The OIG issued eight recommendations for improvement in four areas:(1) Quality, Safety, and Value• Systems redesign and improvement program reporting structure• Surgical work group processes• Action item implementation and monitoring(2) Registered Nurse Credentialing• Primary source verification of registered nurses’ licenses(3) Mental Health• Suicide prevention training(4) High-Risk Processes• Disruptive behavior committee attendance• Disruptive behavior training

The Office of the Inspector General included an audit of TVA’s Federal Sustainability Report and Implementation Plan (SRIP) in its FY 2021 Audit Plan, based on the reputational risk of disseminating inaccurate information to the public. The objective of the audit was to determine if information in TVA’s SRIP has been validated prior to being disseminated to the public in accordance with any best practices. We found TVA did not perform procedures to validate data used to calculate nine of the ten metrics reported in the FY 2020 SRIP. TVA validated data for the greenhouse gas emissions information included in the report, but at most, performed reviews for reasonableness for the remaining nine metrics reported and calculated by TVA’s Environment and Energy Policy group or subject matter experts.