Federal Reports

SIGPR's 11th Quarterly Report to Congress

We conducted an attestation review of the U.S. Department of Housing and Urban Development’s drug control accounting for the fiscal year ended September 30, 2022. We performed this review pursuant to section 705(d) of Public Law 105-277, which requires National Drug Control Program agencies to submit to the Director of ONDCP a detailed accounting of all funds spent by the agencies for National Drug Control Program activities during the previous fiscal year and that the accounting be authenticated by agency Inspectors General before submission. We conducted our attestation review in accordance with attestation standards established by the American Institute of Certified Public Accountants and the standards applicable to attestation engagements contained in Government Auditing Standards, issued by the Comptroller General of the United States. Based upon our review, we are not aware of any material modifications that should be made to HUD’s Detailed Accounting Report and Budget Formulation Compliance Report in order for them to be in accordance with (or based on) ONDCP’s Circular, National Drug Control Program Agency Compliance Reviews, dated September 9, 2021.

The VA Office of Inspector General (OIG) evaluated allegations that VA North Texas Health Care System (VA North Texas) domiciliary substance use disorder treatment program (DOM SUD) staff placed patients on waitlists and failed to offer non-VA community residential care (community residential care) referrals, as required by the Veterans Health Administration (VHA).Domiciliary care is aligned under mental health residential rehabilitation treatment programs (MH RRTPs), which provide 24-hour treatment and rehabilitative services. VA North Texas includes a DOM SUD at the Dallas VA Medical Center (Dallas DOM SUD) and a DOM SUD at the Sam Rayburn Memorial Veterans Center in Bonham (Bonham DOM SUD).The OIG reviewed 15 VA North Texas DOM SUD consults placed for 10 patients and substantiated that staff placed patients on waitlists and failed to offer community residential care referrals. Failure to discuss alternative treatment options, including community residential care, may have contributed to patients’ increased risk of negative outcomes due to delayed access to DOM SUD services.The OIG also determined that the Veterans Integrated Service Network (VISN) 17 Chief Mental Health Officer lacked authority to ensure national MH RRTP policy adherence. Effective oversight is critical to ensuring efficiency of DOM SUD operations and patients’ access to care.The OIG found that the Bonham MH RRTP standard operating procedure was inconsistent with VHA’s scheduling requirements. Further, VA North Texas policy did not include the requirement for staff to ensure a Mental Health Treatment Coordinator (MHTC) assignment for patients awaiting MH RRTP admission.The OIG made two recommendations to the Under Secretary for Health related to VISN MH RRTP oversight and MHTC assignment procedures and three recommendations to the VA North Texas Director related to alternative treatment options when DOM SUD admission wait times exceed 30 days, management of community residential care referrals, and scheduling procedures.