Federal Reports

o Since 2017, DHS has continued to make progress in meeting its Digital Accountability and Transparency Act of 2014 (DATA Act) reporting requirements, but challenges remain. To enable more effective tracking of Federal spending, DHS must continue to take action to accurately align its budgetary data with the President’s budget, reduce award misalignments across DATA Act files, improve the timeliness of financial assistance reporting, implement and use government-wide data standards, and address risks to data quality. Without these actions, DHS will continue to experience challenges in meeting its goal of achieving the highest possible data quality for submission to USAspending.gov. We made five recommendations to help strengthen DHS’ controls for ensuring complete, accurate, and timely spending data. The Department concurred with all five recommendations.

As part of our annual audit plan, we performed an audit of costs billed to the Tennessee Valley Authority (TVA) by Thalle Construction Company, Inc. (Thalle) for construction and modification services for civil projects and coal combustion product management under Contract No. 10061. The contract provided for TVA to compensate Thalle for work on either a cost reimbursable, target cost estimate (TCE), or fixed price basis. Our audit objectives were to determine if (1) costs were billed in compliance with the terms and conditions of the contract and (2) tasks were issued using the most cost efficient pricing methodology. Our scope included about $16.2 million in costs billed to TVA from May 20, 2015, through December 20, 2018. This included about $14.7 million for fixed price projects, $1.3 million for TCE projects, and $186,000 for cost reimbursable projects. In summary, we determined:Thalle overbilled TVA $78,414 on a TCE project, including (1) $24,716 for ineligible costs billed and (2) $53,698 in overstated TCE cost savings.Thalle overbilled TVA $70,751 in equipment costs on cost reimbursable projects, including (1) $54,755 in overbilled TVA Equipment Support Services equipment rental costs and (2) $15,996 in overbilled costs for Thalle owned equipment.The use of fixed price or unit rate payment terms on projects caused TVA to pay at least $2.1 million more than it would have if cost reimbursable payment terms had been used for those projects. Additionally, we determined the unit rate payment terms used by TVA to compensate Thalle were not provided for in the contract's terms and conditions.We also noted several opportunities to improve contract administration by TVA.(Summary Only)

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 Edward Hines, Jr. VA Hospital and multiple outpatient clinics in Illinois. The inspection covers key clinical and administrative processes that are associated with promoting quality care. This inspection focused on Leadership and Organizational Risks; Quality, Safety, and Value; Medical Staff Privileging; Environment of Care; Medication Management: Long-Term Opioid Therapy for Pain; Mental Health: Suicide Prevention Program; Care Coordination: Life-Sustaining Treatment Decisions; Women’s Health: Comprehensive Care; and High-Risk Processes: Reusable Medical Equipment. The executive leadership team had worked together for five months at the time of the OIG site visit. The medical center director position had been vacant for five months; the Associate Director had served as acting Director since October 2019. Selected patient experience survey scores generally reflected similar or higher ratings than the VHA average; however, female veterans reported less positive specialty care experiences than female patients nationally. The OIG determined that opportunities exist to improve the institutional disclosure process and considered the vacant director position a vulnerability. Executive leaders were generally knowledgeable within their scopes of responsibilities about data used in Strategic Analytics for Improvement and Learning quality measures and should continue to take actions to sustain and improve performance. The OIG issued 23 recommendations for improvement in six areas: (1) Quality, Safety, and Value • Committee processes • Peer review processes • Utilization management processes (2) Medical Staff Privileging • Professional practice evaluations • Provider exit review processes (3) Environment of Care • Expired supplies • Environmental cleanliness (4) Medication Management • Pain screening • Behavior risk assessment • Urine drug testing • Informed consent • Patient follow-up (5) Mental Health • Staff training (6) High-Risk Processes • Bioburden testing • Traffic restriction • Climate control • Staff training • Competency assessments