Federal Reports

The VA Office of Inspector General (OIG) conducted a review at the Ioannis A. Lougaris VA Medical Center in Reno, Nevada. The review proactively identified and evaluated declining performance metrics that could affect quality of care and patient safety. The OIG selected the facility because, according to Strategic Analytics for Improvement and Learning data, quality performance significantly declined over a 12-month period at a rate faster than other VA facilities. In addition to leaders’ awareness of, and response to, negative performance trending, the review examined performance in six quality measure domains—Access, Performance Measures, Mental Health, Emergency Department Throughput, Patient Experience, and Employee Satisfaction. The OIG did not find evidence of large-scale system or process deficits such as dysfunctional organizational or communication structures. Two conditions were identified that possibly established the basis for the facility’s performance measure decline from October 1, 2017, through September 30, 2019. Leaders and managers acknowledged losing focus on some care processes as their attention was diverted to new or priority initiatives. The facility also lacked consistently effective structures and processes for oversight, communication, and follow-up of performance measures and related activities, so the loss of focus and decline in some measures was not identified timely. The OIG found staffing, pay issues, and inefficient processes that may have contributed to some of the decline. This review assisted the OIG to understand underlying issues and processes that may contribute to significant performance deficits, which will, in turn, permit the OIG to further develop and refine tools to provide a more effective and proactive approach to other OIG oversight products. The OIG made one recommendation for the Facility Director to ensure that mechanisms to report and follow up on performance deficits were well defined and disseminated to staff, and that monitors were in place to confirm functionality.

Our objective was to answer questions on the Social Security Administration's (SSA) implementation of iPaySSA.

Our objective was to determine whether the Social Security Administration (SSA) could effectively determine the accuracy of Supplemental Security Income (SSI) recipients' reports of separation from individuals whose income could affect their eligibility for payments.

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

We audited the costs claimed by the by the State of West Virginia, Division of Natural Resources (Division), under grants awarded by the U.S. Fish and Wildlife Service (FWS) through the Wildlife and Sport Fish Restoration Program. The audit included claims totaling approximately $46.2 million on 29 grants that were open during the State fiscal years that ended June 30, 2017, and June 30, 2018. The audit also covered the Division’s compliance with applicable laws, regulations, and FWS guidelines, including those related to the collection and use of hunting and fishing license revenues and the reporting of program income.We found that the Division complied, in general, with applicable grant accounting and regulatory requirements. The Division, however, did not report barter transactions on the financial reports to the FWS as required. In addition, the Division and the FWS did not complete a required reconciliation of their respective real property inventories. The FWS concurred with our three recommendations and will work with the Division to implement corrective actions.

We audited costs claimed by the Alabama Department of Conservation, Marine Resources Division (Department), under grants awarded by the U.S. Fish and Wildlife Service (FWS) through the Wildlife and Sport Fish Restoration Program (WSFR). The audit period included claims totaling $5.1 million on 23 grants that were open during the State fiscal years that ended September 30, 2017, and September 30, 2018. The audit also covered the Department’s compliance with applicable laws, regulations, and FWS guidelines, including those related to collecting and using fishing license revenues and reporting program income.We found that the Department generally ensured that grant funds and State fishing license revenue were used for allowable fish activities and complied with applicable laws and regulations, FWS guidelines, and grant agreements. We noted, however, the Marine Resources Division purchased items with grants funds that were unallowable, and we questioned $3,112 ($2,334 Federal share) in ineligible costs associated with these purchases. We also found that the Department overdrew $5,164 ($3,873 Federal share) from a grant because the Department failed to appropriately report program income. We further determined the Department did not comply with Digital Accountability and Transparency Act of 2014 requirements by not reporting subawards greater than $25,000 on USASpending.gov.The FWS concurred with all five recommendations and will work with the Department to implement them. Based on the Department’s and FWS’ responses, we considered Recommendation 2 resolved and implemented and Recommendations 1 and 3 – 5 resolved but not implemented.