Federal Reports

We determined that CISA and FEMA could better ensure program efforts are mutually reinforcing; they did not have compatible policies, procedures, and other means to operate across component boundaries; and CISA did not regularly update and monitor written agreements with Energy Sector partners. Increased coordination between CISA and FEMA could improve the outcomes of their efforts. Further, without a comprehensive framework for Energy Sector activities, DHS risks losing important data that would strengthen Energy Sector relationships, programs, and outcomes. We made three recommendations to improve CISA’s and FEMA’s coordination efforts to ensure Energy Sector resilience. The Department concurred with all three recommendations.

This report is classified. To obtain further information about this Classified Report, please contact the OIG Office of Counsel at OIGCounsel@oig.treas.gov, (202) 927-0650, or by mail at Office of Treasury Inspector General, 1500 Pennsylvania Avenue, Washington DC.

The VA Office of Inspector General (OIG) assessed the oversight and stewardship of funds by the VA Cincinnati Healthcare System. The review team looked at four areas to determine if appropriate controls and oversight were in place for open obligations oversight, purchase card use, Medical/Surgical Prime Vendor–Next Generation (MSPV-NG) program use, and pharmacy operations. The team reviewed data from fiscal years 2019 through 2021. The report includes the below findings:• Reviews were not completed for nine inactive obligations from a judgmental sample of 20 obligations that totaled about $7.2 million from September 30, 2021.• The healthcare system did not comply with VA policy for three of the 36 sampled transactions (about 8 percent), totaling about $10,200.• The healthcare system did not meet the formulary utilization goal recommended by the VA Medical Supplies Program Office (MSPO) to purchase 90 percent of formulary items from the MSPV-NG prime vendor.• Pharmacy efficiency could be improved by narrowing the gap between observed and expected drug costs.The OIG made eight recommendations to the healthcare system director: ensure finance office staff review inactive open obligations and pharmacy invoice reconciliations, develop a plan to work with the prime vendor to address having adequate stock for system needs, submit MSPV-NG waiver requests and obtain approval before purchasing formulary items from nonprime vendor sources, ensure logistics staff and contracting officer’s representatives use tools to inform the MSPO and Strategic Acquisition Center of prime vendor performance concerns and challenges, create formal processes for achieving efficiency targets and use data to make business decisions, prepare and implement a plan to increase inventory turnover closer to the VHA-recommended level, and develop a plan to complete facility-based inventory audits of noncontrolled drug line items.

Due to the risk of employee exposure to toxic vapors, gases, dust, or oxygen deficiency, the Tennessee Valley Authority (TVA) Office of the Inspector General (OIG) performed an evaluation of TVA’s Respiratory Protection Program at nonnuclear facilities. The objective of this evaluation was to determine if selected respiratory protection procedures were being performed at nonnuclear facilities.The OIG determined some respiratory protection procedures were not being performed as required. Specifically, we determined some (1) requirements were not being met for training, fit tests, facepiece seal protection, and respirator storage and (2) employees were delinquent on medical evaluation requirements.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program (CHIP) report highlights the results of a focused evaluation of Veterans Health Administration (VHA) facilities’ medication management related to remdesivir use. The report describes medication management-related findings from healthcare inspections performed at 34 VHA medical facilities during fiscal year 2021. Each inspection involved interviews with key staff and reviews of clinical and administrative processes.The OIG found that VHA met many elements of expected performance, including the availability of staff to receive remdesivir shipments. However, the OIG found that VHA did not consistently provide patient/caregiver education for remdesivir or report adverse events to the Food and Drug Administration in accordance with Emergency Use Authorization requirements.Given the FDA’s approval of remdesivir for use in adult patients hospitalized with COVID-19, the OIG made no recommendations related to the Emergency Use Authorization requirements. However, because VHA facility staff continue to administer other medications under emergency use authorizations, the OIG issued one recommendation related to informing patients and caregivers when the medication is not FDA-approved; the option to refuse the medication; and the known risks, benefits, and alternatives prior to administration.