Federal Reports

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.

This report contains information about recommendations from the OIG's audits, evaluations, reviews, and other reports that the OIG had not closed as of the specified date because it had not determined that the Department of Justice (DOJ) or a non-DOJ federal agency had fully implemented them. The list omits information that DOJ determined to be limited official use or classified, and therefore unsuitable for public release.The status of each recommendation was accurate as of the specified date and is subject to change. Specifically, a recommendation identified as not closed as of the specified date may subsequently have been closed.

To manage its aging fleet while supporting financial and environmental sustainability strategies from its 10-year Delivering for America plan, the Postal Service is investing $9.6 billion to electrify its delivery vehicles and install related charging infrastructure at hundreds of facilities. As $3 billion of this investment stems from congressional funds, it is essential for the Postal Service to capture cost savings as it executes its strategies to further strengthen the financial sustainability of this critical public service. Accordingly, the Postal Service has opportunities to leverage a wide range of financial incentives (from government agencies, utility companies, and carbon markets) that encourage the transition to electric vehicles.