Federal Reports

We audited the U.S. Department of Housing and Urban Development (HUD), Office of Public Housing Voucher Programs’ oversight of the Foster Youth to Independence Initiative (FYI). We audited the program early in its implementation to identify opportunities to improve the program’s design and effectiveness. Our audit objective was to determine the effectiveness of FYI.Opportunities exist to enhance oversight of the Foster Youth to Independence Initiative to improve program effectiveness. Specifically, HUD did not (1) implement strategies or provide guidance to maximize voucher utilization, (2) have assurance that youths were informed of supportive services or that the services were available for the duration of their participation, (3) include FYI in its annual risk assessment and did not have FYI program-specific risk assessment or monitoring policies and procedures, or (4) establish specific and measurable objectives for FYI or collect data that would allow it to assess the program’s overall effectiveness. These conditions occurred because the program was new, and HUD focused on providing housing vouchers to public housing agencies (PHA). Also, HUD was focused on the monitoring and use of CARES Act funds and relied on the PHAs and public child welfare agencies (PCWA) for program oversight of participant eligibility and supportive services. As a result, HUD lacked assurance that the $46.7 million allocated for FYI vouchers would be fully utilized to reach the vulnerable population it is intended to serve, improve the program participants’ self-sufficiency, and that the program was effective.We recommend that the Deputy Assistant Secretary for Public Housing Voucher Programs (1) develop and implement a plan to assist PHAs in improving voucher utilization, including providing additional guidance to PHAs to improve coordination between PHAs and PCWAs to improve voucher utilization and limit barriers to leasing; (2) require PHAs to document that they informed FYI participants at program entry of their eligibility for supportive services for the duration of the program; (3) For each youth referred, require PHAs to obtain PCWA certification that the PCWA will provide or secure access to supportive services.; (4) include FYI in its voucher risk assessment and develop and implement monitoring policies, procedures, and controls; and (5) establish and implement methods to regularly assess the effectiveness of the program in preventing and ending youth homelessness and improving participants self-sufficiency, which could include performance metrics and periodic studies performed by the Office of Policy Development and Research (PD&R).

As part of its IIJA oversight role, the OIG will assess whether the EPA is using its roughly $60 billion in IIJA funds in accordance with congressionally designated purposes. OIG oversight will focus on the execution of IIJA funds, the efficiency and effectiveness of the programs receiving IIJA funds, and the detection and prevention of fraud, waste, and abuse.

The OIG evaluated allegations that staff at the Richard L. Roudebush VA Medical Center (facility) provided inadequate alcohol withdrawal management in the Emergency Department for a patient who died approximately two days after discharge, inadequately responded to the patient’s urgent care needs, and failed to provide posttraumatic stress disorder (PTSD) care. During the inspection, the OIG also identified concerns related to discharge care coordination, leaders’ failure to consider an institutional disclosure, and adequacy of primary care assessments and documentation regarding the patient’s alcohol use and safe transport.The OIG substantiated that Emergency Department staff mismanaged the alcohol withdrawal care of the patient, and that a medical support assistant inadequately responded to the patient’s report of “bad” withdrawal symptoms and lack of transportation to the Emergency Department. It was not substantiated that facility staff failed to provide PTSD care.Facility leaders had not established procedures for care coordination of patients discharged from the Emergency Department. The extent of family member involvement in the patient’s discharge planning could not be determined because of the absence of documentation and conflicting reports.Although the OIG determined an institutional disclosure should have been considered following the patient’s adverse clinical outcome, facility leaders told the OIG that it was not considered because internal reviews did not warrant that action.A nurse practitioner failed to thoroughly assess the patient’s substance use, schedule follow-up, and discuss immediate safety concerns.The OIG made seven recommendations to the Facility Director related to a review of the patient’s care, evaluation of the Emergency Department alcohol withdrawal management protocol, consideration of written Emergency Department discharge planning and care coordination guidance, consideration of institutional disclosure, establishment of administrative staff protocol for urgent care needs, and primary care procedures for management of intoxicated patients.