Federal Reports

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policy providing local guidance on state prescription drug monitoring and the facility pain management policy provided outdated guidance.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.

Deputy Inspector General for Audits, Evaluations, and Special Projects’ Testimony before the Committee on Financial Services Subcommittee on Oversight and Investigations, U.S. House of Representatives, March 8, 2023

Roll-up of the Independent Review of 4003(b) Loan Recipients’ Validation Memos Audit Memorandum Number SIGPR-A-22-003-17

Our objective was to identify the remaining Department Active Directories, which have not been reviewed by the Office of Inspector General (OIG), and summarize past OIG work related to the management of Active Directories. We found that a lack of adequate Active Directory security reviews caused similar issues across multiple Department bureaus and that the Department does not have a policy for regular Active Directory security reviews. Without effective security reviews, deficiencies will likely continue to exist within the Department, providing threat actors with additional potential attack paths to undermine the sensitive data and applications that are supported by Active Directories.

VA must submit an annual report to Congress documenting its capacity to provide specialized treatment comparable to that available as of October 9, 1996, for veterans with spinal cord injuries and disorders, traumatic brain injury, blindness, prosthetics and sensory aids, or mental health issues. Congress legislated this requirement to ensure that the decentralization of the Veterans Health Administration’s field management structure in the late 1990s did not adversely affect VA’s ability to care for veterans with disabilities. Each year, the VA Office of Inspector General (OIG) is required to report to Congress on the accuracy of VA’s special disabilities capacity report. While the review found nothing that would lead the OIG to believe the information in the fiscal year (FY) 2021 capacity report was not fairly stated and accurate, it did identify some minor errors and data omissions that have persisted from the OIG’s FY 2020 review. For example, VA is unable to report mental health capacity data comparable to that from 1996 as required by law because of changes in how treatment outcomes of veterans with mental illness are defined and tracked. The capacity report also does not capture data on the services veterans receive through community care or changes in bed capacity at VA’s centers for spinal cord injuries and disorders. Congress would be better served by modernizing the reporting metrics to assess VA’s capacity to provide care for these veterans. The under secretary for health concurred with the OIG’s report.