Federal Reports

We determined that the Federal Emergency Management (FEMA) Region II (Region II) and New York State’s Division of Homeland Security Emergency Services (DHSES) have not adequately monitored or timely closed hundreds of projects, awarded at $578.8 million, for 7 disasters we reviewed.  We recommended that Region II and DHSES address the procedural controls in the closeout process in order to be adequately prepared for the large number and complexity of the next wave of projects ready for closeout.  We made four recommendations that will help strengthen internal controls to improve oversight of the PA grant program.  FEMA concurred with all four of our recommendations.

The VA Office of Inspector General (OIG) conducted a national review to evaluate specific elements of colonoscope reprocessing at 10 multispecialty community-based outpatient clinics (CBOCs). The OIG reviewed training oversight and documentation, colonoscope reprocessing, and environmental monitoring in sterile processing areas.Colonoscopy carries some risk with the possibility of infection acquired from improperly cleaned medical devices. The Veterans Health Administration (VHA) requires specific training during initial orientation with monthly continuing education for Sterile Processing Services (SPS) staff to maintain technical knowledge. Facility SPS chiefs are responsible for oversight of staff training.The OIG determined that CBOC SPS staff reprocessed and tracked colonoscopes and monitored the environment according to VHA requirements.The OIG identified deficiencies in training and oversight of SPS staff. The OIG found that 50 percent of SPS employees who were required to complete initial training within 90 days did not complete it in the required time frame. Service chiefs at 70 percent of the CBOCs did not ensure that training documentation was complete. The OIG determined that SPS supervisors did not ensure that SPS staff received continuing education at 20 percent of the CBOCs.The OIG made two recommendations to the Under Secretary for Health related to initial SPS training and continuing education.

The VA Office of Inspector General (OIG) assessed VA’s oversight of the Medical/Surgical Prime Vendor-Next Generation (MSPV-NG) Program, under which prime vendors maintain inventories of medical and surgical supplies and restock medical facilities when needed. Specifically, the OIG examined whether medical facility-level staff verified the accuracy of distribution fees invoiced by the prime vendors, and national- and Veterans Integrated Service Network-level staff provided proper oversight of this activity.In February 2016, VA’s Strategic Acquisition Center awarded four MSPV-NG contracts with a cumulative value of about $4.6 billion to prime vendors for medical and surgical supplies. VA pays prime vendors for requested products plus a distribution fee to cover the costs associated with managing medical facilities’ inventories. Medical facilities paid approximately $25.4 million in MSPV-NG distribution fees during fiscal year 2018, according to an official from VHA’s Procurement and Logistics Office.The OIG found VA controls were not sufficient to ensure VA medical facility staff accurately reviewed, verified, or certified distribution fee invoices for the MSPV-NG program. VA also did not ensure staff at medical facilities accurately established and applied the on-site representative rates and paid fees based on annual facility purchases. The MSPV-NG pricing schedule establishes fee rates for on-site representatives based on annual facility purchase amounts. VA establishing a flat fee rate will help mitigate on-site representative fee rate disparities, but in the interim VA still needs to ensure facilities reconcile rate disparities that have occurred and continue to occur.The OIG made 10 recommendations designed to improve oversight of verification and certification of distribution fee invoices and ensure the accuracy of on-site representative fees.