Federal Reports

We audited the Columbus Metropolitan Housing Authority’s Housing Choice Voucher (HCV) Program. The audit was initiated based on our assessment of risks associated with public housing agencies’ HCV Program units and recent media attention and public concern about the conditions of subsidized housing properties. Our objective was to determine whether the physical condition of the Authority’s HCV Program units complied with the U.S. Department of Housing and Urban Development’s (HUD) and its own requirements.The Authority did not always ensure that its HCV Program units met HUD’s housing quality standards (HQS). Specifically, we reviewed a sample of 84 units that had passed a recent HQS inspection and determined that 48 units had 248 deficiencies. More than 56 percent of the 48 units had 67 deficiencies that existed before the Authority’s last inspection. In addition, the Authority did not consistently stop housing assistance payments (HAP) to owners for uncorrected unit deficiencies. It also did not ensure that its contractors (1) categorized deficiencies as life threatening, requiring corrective actions within 24 hours and (2) conducted the required number of quality control inspections in 2022. Further, the Authority did not comply with HUD’s reporting and data collection requirements of the Lead Safe Housing Rule (LSHR) for cases of children with elevated blood lead levels (EBLL).These conditions occurred because the Authority’s current contractor did not thoroughly inspect units in a consistent manner. Additionally, the Authority relied on its contractor to perform both HQS and quality control inspections of its program units without effectively overseeing the contractor’s performance. Further, the Authority did not ensure that its (1) current contractor’s information system properly transferred data to the Authority’s information system regarding stop payments and (2) former and current contractors complied with the Authority’s policies and procedures for stopping HAP. The Authority also lacked adequate oversight to ensure that its (1) former and current contractors properly categorized 24-hour life-threatening deficiencies and (2) current contractor performed the appropriate number of quality control inspections. In addition, the Authority did not update its policies and procedures to align with HUD’s EBLL requirements and relied on the State health department to initiate contact and facilitate the sharing of information for cases of children with EBLLs. As a result, families participating in the Authority’s HCV Program resided in housing units that were not always decent, safe, and sanitary. Based on our statistical sample, we estimate that over the next year, the Authority will pay owners nearly $36 million in housing assistance for units that do not meet HQS. Further, (1) the Authority paid ineligible or unsupported HAP totaling $15,427 to owners for units with uncorrected deficiencies and (2) HUD and the Authority lacked assurance that owners appropriately addressed their responsibilities under the LSHR for cases of children with EBLLs in a timely manner.We recommend that the Director of HUD’s Cleveland Office of Public Housing require the Authority to (1) provide evidence that the owners corrected the outstanding unit deficiencies; (2) support that HAP was appropriately stopped or recover or repay from non-Federal funds $15,427 in housing assistance that was not properly stopped; (3) implement controls over its inspections, stop payments for uncorrected deficiencies, and quality control reviews; (4) work with its contractor to ensure that the contractor’s inspectors receive training on how to properly identify and categorize life-threatening deficiencies; and (5) develop and implement policies and procedures to ensure that owners follow the requirements of the LSHR. Additionally, we recommend that the Director of HUD’s Cleveland Office of Public Housing work with HUD’s Office of Lead Hazard Control and Healthy Homes to provide technical assistance to the Authority’s staff to develop and implement procedures and controls for managing cases of children with EBLLs to ensure compliance with the LSHR, including collaborating with public health departments to identify cases of EBLL in children under 6 years of age under its HCV Program and updating its policies and procedures accordingly.

To better understand the coordination of Veterans Health Administration (VHA) maternity care services for women veterans, the VA Office of Inspector General (OIG) conducted a national survey of VHA Maternity Care Coordinators’ (MCCs) reported staffing, duties, and challenges. While the OIG found that all VHA facilities had a designated MCC, the MCCs at 40 percent of VHA facilities reported having insufficient time for their duties. MCCs reported that time designated for MCC duties, patient caseloads, and collateral duties were barriers to sufficient time. MCCs who reported patient caseloads within or below the Office of Women’s Health recommended guideline were more likely to report sufficient time for care coordination duties than those who reported caseloads higher than the recommended guideline.Timely access to maternity care was a common concern reported by facility MCCs. The OIG was concerned that 50 percent of MCCs surveyed reported challenges for scheduling routine prenatal visits within the first trimester, and more than a third (38 percent) cited difficulties expediting appointments for high-risk patients or those seeking care in later pregnancy. Barriers to timely access were primarily attributed to community maternity care provider availability and delays related to facility community care processes.Billing was the top area for improvement in VA maternity care as identified by approximately 80 percent of the MCCs surveyed. Additionally, approximately one in five MCCs identified need for additional patient education resources, including childbirth preparation, lactation support, and parenting classes.The OIG made two recommendations to the Under Secretary for Health regarding review of designated time, caseload, and collateral duties for MCCs to determine if additional staffing resources are needed; and facility community care referrals to ensure timely access to maternity care.

The independent public accounting firm of Brown & Company CPAs and Management Consultants, PLLC, under contract with OIG, audited Help America Vote Act (HAVA) grants administered by the Tennessee Secretary of State, totaling $34.64 million.

The OIG conducted this review to determine to what extent VBA identified veterans potentially eligible for prior disability claim readjudication and retroactive benefits under the National Defense Authorization Act (NDAA) and identified two missed populations. Of the approximately 86,894 veterans in the first dataset with NDAA diseases in their VHA medical records, about 36,125 were entitled to approximately $836.8 million in unpaid benefits. A VA senior management advisor stated VHA records were not involved in readjudication determinations because VBA did not have ready access to VHA diagnosis data. For the second dataset identified through Camp Lejeune service records, the OIG reviewed claims for 226 veterans and estimated 102 were entitled to about $7.5 million in benefits. VA concurred with two of the OIG’s three recommendations to improve methodologies for identifying eligible veterans and to send outreach letters, improve claims processors’ identification of claims possibly warranting readjudication, and update procedures to include veterans’ medical records.Nehmer v. US Department of Veterans Affairs was a 1986 class-action lawsuit in which Vietnam veterans and their survivors alleged VA had improperly denied their compensation claims for service-connected disabilities caused by herbicide exposure during military service. In 1991, VA was required to readjudicate claims filed by Vietnam veterans. When regulations add new presumptive diseases of service connection, VA must search its records to find eligible claimants and award benefits, without requiring action by the claimant. The 2021 NDAA added three diseases (bladder cancer, hypothyroidism, and parkinsonism) that carry presumptive service connection due to herbicide exposure during the Vietnam War. In 2021, VBA stated VA would review claims for Nehmer eligibility from approximately 70,000 veterans and survivors in its implementation of the NDAA, and additional veterans might be identified through other document reviews. This review highlights deficiencies in fully identifying affected veterans.

The Federal Emergency Management Agency’s (FEMA) Region IV has a process for identifying and evaluating single sites damaged by multiple disasters, which it followed in administering Public Assistance in fiscal year 2022 for three federally declared weather-related events in Kentucky. Specifically, Region IV uses a geographic information system tool (the tool) that incorporates historical information and allows FEMA to create and maintain a visual electronic record, or representation, of prior weather damage. This tool ensured damages were being claimed or attributed to the applicable declaration. The visual representation produced by the tool can be used throughout various phases of the Public Assistance grant program process, including preliminary damage assessment, site inspection, project worksheet (or project) formulation, and eligibility review.