Federal Reports

Veterans can appeal a VBA compensation benefits decision. Decision review operations centers (DROCs) are responsible for appeals processing. DROC staff must be designated and trained to decide complex appeals.This review assessed a March 2022 hotline allegation that a DROC was not designating or training the appropriate staff to decide complex appeals. After reviewing three samples of complex appeals, the OIG substantiated that some staff from each of the three DROCs did not meet all requirements and estimated that 1,200 complex appeals were decided by undesignated staff.The OIG found that VBA’s Office of Administrative Review did not monitor completed appeals to ensure they were decided by designated staff and further estimated that 400 complex appeals were assigned by the work routing system to undesignated staff because the system required manual updates for staff designations.The OIG made four recommendations to the acting under secretary for benefits.

Following the SolarWinds breach discovery in 2020, CISA improved its ability to detect and mitigate risks from major cyberattacks, but work remains to safeguard Federal networks. CISA coordinates Federal agencies’ defense against cyberattacks, but the SolarWinds response revealed that CISA did not have adequate resources — backup communication systems, staff, or secure space — to effectively respond to threats.

The VA Office of Inspector General (OIG) reviewed the Opioid Safety Initiative (OSI) oversight processes at the VA Northern California Health Care System (facility).In an effort to evaluate the effectiveness of OSI oversight processes at the Veterans Health Administration (VHA), the OIG reviewed data of numerous providers across VHA. Several providers assigned to the facility’s Sacramento VA Medical Center were identified as prescribing “high dose” opioids. The OIG conducted a review of opioid therapy management practices by patient aligned care team providers (providers) and supervisors (supervisors) at the facility, in addition to facility and Veterans Integrated Service Network (VISN) oversight processes for opioid therapy.The OIG determined that supervisors ensured that providers received training on OSI. Facility providers and supervisors implemented safe opioid therapy prescribing practices, including completing informed consents. Facility providers and supervisors completed risk mitigations for patients receiving opioid therapy, including state prescription drug monitoring and urine drug screens. For calendar year 2021, facility completion rates for patients prescribed opioid therapy met or exceeded the VISN performance goal for informed consents (97 percent), state prescription drug monitoring (99 percent), and urine drug screens (89.8–93.9 percent).Facility providers had knowledge of VHA recommendations for a pain assessment to be completed every three months, with a completion rate of 73.6 percent over the last 100 days during the inspection.Facility and the VISN had staff, committees, and teams as required to provide oversight and support integration of the OSI into primary care.The facility did not have a required policy providing local guidance on state prescription drug monitoring and the facility pain management policy provided outdated guidance. The Facility Director concurred with the OIG’s two recommendations related to creating and updating the policies.