Federal Reports

According to the Securing Our Agriculture and Food Act (SAFA), the program should provide oversight, lead policy initiatives, and coordinate with DHS components and Federal agencies. However, the Countering Weapons of Mass Destruction Office (CWMD) has not yet carried out a program to meet SAFA’s requirements. This occurred because CWMD believes it does not have clearly defined authority from the Secretary to carry out the requirements of the SAFA. In addition, since its establishment in December 2017, CWMD has not prioritized SAFA requirements but instead has focused its resources on other mission areas. As a result, CWMD has limited awareness of DHS’ ongoing efforts and cannot ensure it is adequately prepared to respond to a terrorist attack against the Nation’s food, agriculture, or veterinary systems. We made three recommendations to DHS’ CWMD to improve oversight, policy initiatives, and coordination of the Department’s efforts to protect the Nation’s food, agriculture, and veterinary systems.

We contracted this audit with Cotton & Company LLP, which found that FEMA did not ensure Lee County, Florida (the County) established and implemented policies, procedures, and practices to ensure it accounted for and expended PA program grant funds awarded to disaster areas in accordance with Federal regulations and FEMA guidance. Specifically, the County requested FEMA funding for $994,425 in unsupported force account labor, equipment, and materials; was unable to provide supporting documentation for $16,210 in costs incurred to operate an emergency shelter; did not maintain adequate documentation to support $267,452 in costs incurred for road repair services; did not include all required provisions in its contracts to obtain disaster recovery services related to Hurricane Irma; and had not evaluated the risk of subrecipients’ noncompliance with Federal requirements, obtained subrecipient audit reports, or developed plans for monitoring subrecipients. We made nine recommendations that, when implemented, should improve Lee County, Florida’s management of FEMA Public Assistance funds. FEMA concurred with all nine recommendations.

The OIG investigated an allegation that several minority-owned and small disadvantaged (8a) businesses may have coordinated their respective proposals to gain an unfair advantage in awards related to six contracts for technical support services at the U.S. Geological Survey (USGS).We found that these companies did not conspire to manipulate the bidding process as alleged. We found that the companies used the same consulting company to draft their respective proposals, which contained nearly identical language. The USGS ultimately did not accept any of the proposals.This is a summary of an investigative report we issued to the USGS Director.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Marion VA Medical Center and outpatient clinics in Illinois, Indiana, and Kentucky. The inspection covers key clinical and administrative processes that are associated with promoting quality care. This inspection focused on Leadership and Organizational Risks; Quality, Safety, and Value; Medical Staff Privileging; Environment of Care; Medication Management: Long-Term Opioid Therapy for Pain; Mental Health: Suicide Prevention Program; Care Coordination: Life-Sustaining Treatment Decisions; Women’s Health: Comprehensive Care; and High-Risk Processes: Reusable Medical Equipment. The executive leadership team had been working together for 17 months. Patient experience surveys indicated that patients appeared satisfied with their care. The OIG’s review of the medical center’s accreditation findings, sentinel events, and disclosures did not identify any substantial risk factors. The leadership team, specifically the Chief of Staff and Associate Director for Patient Care Services, had opportunities to improve their knowledge within their scopes of responsibility about Strategic Analytics for Improvement and Learning data and should continue to take actions to sustain and improve performance. The OIG issued 29 recommendations for improvement in eight areas: (1) Quality, Safety, and Value • Quality management activities • Utilization management processes (2) Medical Staff Privileging • Professional practice evaluations • Provider exit review forms (3) Environment of Care • Infection prevention procedures • Health information protection (4) Medication Management • Pain screening • Risk assessment • Urine drug testing • Informed consent • Patient follow-up • Pain Management Committee activities (5) Mental Health • Safety plans • Staff training (6) Care Coordination • Treatment notes (7) Women’s Health • Required staffing • Access to care and emergency contraceptives • Women Veterans Health Committee membership (8) High-Risk Processes • Required administrative processes • Staff training

In accordance with guidance from the Office of Management and Budget, we reviewed the “Payment Integrity” section in the U.S. Department of the Interior’s Agency Financial Report (AFR) for fiscal year (FY) 2019. Our objective was to determine whether the Department met the requirements of the Improper Payments Elimination and Recovery Act of 2010 (IPERA) and accurately and completely reported on improper payments in its AFR and accompanying materials.We found that the Department complied with all applicable IPERA reporting requirements for FY 2019, namely the first two requirements of six. We did not consider the four remaining IPERA reporting requirements applicable for this reporting period because the Department did not identify any programs that were susceptible to significant improper payments.We identified a minor reporting error. Specifically, the Department reported in its FY 2019 APR that it had risk assessed 93 programs when it had only risk assessed 86. Seven of the programs reported for FY 2019 were risk assessed in FY 2018. However, this reporting error does not change our determination that the Department complied with the requirement.

Due to the risk of personnel injury from arc flash hazards, we performed an evaluation to determine if (1) TVA’s arc flash procedures were being performed as required, (2) required personal protective equipment (PPE) was available and properly maintained, and (3) required training was completed. We determined some requirements of TVA’s arc flash procedure were not being performed. Specifically, we determined (1) some arc flash hazard analyses were not complete, reviewed timely, updated, or verified and submitted for record; (2) some identified arc flash hazards were not communicated accurately to workers; and (3) arc flash hazards were not consistently documented. In addition, we determined arc flash training needs improvement. Specifically, we determined (1) not all personnel assigned arc flash training had completed the training curriculum, (2) TVA’s identified population of individuals required to have arc flash training was incomplete and not a reliable indicator as to who is required by the Occupational Safety and Health Administration to receive the training, and (3) TVA does not require retraining at the frequency suggested by industry guidance. Also, while PPE was generally available and in good condition, PPE management practices could be improved.

HHS is one of the largest contracting agencies in the Federal Government and in fiscal year 2019 awarded contracts totaling approximately $27 billion, of which $7 billion related to Centers for Medicare & Medicaid Services (CMS) contracts. Congress has expressed concerns about and the media has reported on CMS's awarding of contracts for strategic communications services. Separately, OIG had begun preliminary work to review the strategic communications services contracts during CMS Administrator Seema Verma's tenure. Based on this preliminary work, we conducted an audit of these CMS contracts.