Federal Reports

This report describes specific instances of harm to hospice beneficiaries and identifies vulnerabilities in CMS's efforts to prevent and address harm. In past work, the Office of Inspector General (OIG) raised a number of concerns about the care provided to Medicare beneficiaries. As part of a recent portfolio, OIG found that hospices did not always provide needed services to beneficiaries and sometimes provided poor quality care. Hospice care can provide great comfort to beneficiaries, their families, and caregivers at the end of a beneficiary's life. Medicare hospice beneficiaries have the right to be free from abuse, neglect, and other harm. When hospices cause harm or fail to take action when harm is caused by others, beneficiaries are deprived of these basic rights. This report is the second in a two-part series addressing hospice quality of care. The companion report identifies risks posed to Medicare beneficiaries from hospice deficiencies.

The Postal Inspection Service is a participating agency of the Department of Justice (DOJ) Asset Forfeiture (AF) Program. The intent of the DOJ AF Program is to allow the DOJ’s participating agencies to receive proceeds and use them to pay the costs associated with forfeitures, including the cost of managing and disposing of property, satisfying valid liens, and other claims. Our objective was to determine whether deposits and expenditures for the Postal Inspection Service Asset Forfeiture Fund (AFF) complied with Postal Inspection Service policies and procedures.

This report presents the results of our self-initiated audit of Delivery and Customer Service Issues – College Station, New York, NY. College Station is in the New York District of the Northeast Area. This audit was designed to provide U.S. Postal Service management with timely information on potential delivery and customer service risks at College Station.

We audited the Housing Authority of the County of Los Angeles’ intergovernmental agreements due to our Public and Indian Housing Intergovernmental Agreements Auditability Survey. The objective of that review was to identify public housing agencies with intergovernmental agreements for potential external reviews due to a previous audit (audit report 2018-LA-1008), which identified the Housing Authority of the City of Los Angeles as not always following U.S. Department of Housing and Urban Development (HUD) requirements and its intergovernmental agreement when it managed its legal services with the City of Los Angeles. Our audit objective was to determine whether the Authority executed and administered its intergovernmental agreements in compliance with HUD requirements, its own policies and procedures, and the terms of its agreements.The Authority generally executed and administered its intergovernmental agreements in compliance with HUD requirements, its own policies and procedures, and the terms of the agreements. In addition, it generally ensured that program expenses for supplemental law enforcement services were adequate in accordance with the terms of its agreements and HUD requirements. However, the Authority did not ensure that its agreements were updated to include the current HUD requirements.We recommend that the Director of HUD’s Los Angeles Office of Public Housing require the Authority to change its intergovernmental agreements for supplemental law enforcement services to include the current HUD requirements.

FEMA’s December 2017 Eligibility Determination of Cobra contract costs for its Public Assistance (PA) program was unsound. Federal regulations and FEMA policy require all costs claimed under the PA program to be necessary and reasonable to accomplish the work properly and efficiently. FEMA conducted an analysis of the Cobra contract rates and determined that contract costs were reasonable and eligible for the PA program. However, FEMA did not evaluate the actual time and materials costs incurred under the contract for reasonableness, and its analyses of the contract rates for labor, equipment, and other costs were not always logical, complete, and supported. As a result, FEMA approved a PA grant and reimbursed millions of dollars for Cobra contract costs based on an unsound eligibility determination. We made one recommendation that, when implemented, will correct the deficiencies with FEMA’s evaluation of cost reasonableness of Cobra contract costs. FEMA concurred with our recommendation and described the corrective actions necessary to address the issues we identified in our report. Specifically, FEMA will update its October 2018 Public Assistance: Reasonable Cost Evaluation Job Aid and the Public Assistance Program and Policy Guide to include additional guidance specific to Time and Materials contracts. FEMA is also conducting additional analyses of the actual time and material costs to determine the reasonability and eligibility of Cobra contract costs for PA funding.