Federal Reports

Objective: To (1) evaluate internal controls over the accounting and reporting of administrative costs by the Michigan Disability Determination Services (MI-DDS) for Fiscal Years (FY) 2017 and 2018, as well as indirect costs for FY 2016; (2) determine whether the administrative costs claimed on the most recently submitted Form SSA-4513 were allowable and properly allocated; (3) reconcile funds drawn down with claimed costs; and (4) assess the general security controls environment.Note: 2 of 23 recommendations not published (sensitive).

The VA Office of Inspector General (OIG) conducted a healthcare inspection at the facility to assess concerns about the diagnosis and treatment of anemia and coordination of a colonoscopy for a patient who subsequently died.The patient had iron-deficiency anemia. The OIG found the primary care provider evaluated and effectively treated the anemia with iron supplements.In 2017, the patient developed a blood clot, which required anticoagulant treatment. In 2018, the patient developed an abnormal heart rhythm and remained on an anticoagulant. The OIG determined that the anticoagulant was managed appropriately and did not clinically affect the patient’s anemia.Late 2020, the patient was admitted to the facility with rectal bleeding and weakness. The patient received a blood transfusion and gastroenterology evaluation. The patient had no further symptoms and was discharged. An outpatient colonoscopy was scheduled.One day later, the patient was readmitted for dizziness. Laboratory testing indicated possible heart muscle damage. Cardiology staff recommended an anemia workup and blood transfusions as needed. The hospitalist discontinued the anticoagulant and requested gastroenterology staff perform the colonoscopy during the admission. The patient had no further symptoms for two days.The morning before a scheduled colonoscopy, the patient experienced chest pain and was transferred to the intensive care unit. Cardiology staff recommended a cardiac catherization but requested gastroenterology staff first determine the cause of and treat the patient’s bleeding. Two days later, gastroenterology staff performed the colonoscopy and treated the source of the bleeding. The following day, towards the end of the cardiac catheterization, the patient developed cardiac arrest, and could not be resuscitated.The OIG found the timing of the patient’s colonoscopy to be clinically appropriate. Providers evaluated the patient across two hospital admissions and adjusted the timing of the colonoscopy to meet the patient’s clinical needs.

VA has one of the largest acquisition functions in the federal government; its contracting officers obligated approximately $36.9 billion in fiscal year 2020 alone. A warrant gives federal contracting officers the authority to obligate taxpayer dollars. VA’s contracting officers help serve our nation’s veterans by procuring the goods and services required for their care and support.However, there have been long-standing concerns with VA’s contracting officer warrant program. Since 2015, the VA Office of Inspector General (OIG) has issued multiple reports in which warranted contracting officers exceeded their authority or made decisions that put veterans and VA facilities, resources, and information systems at risk. In addition, VA’s acquisition management has been included on the Government Accountability Office’s high-risk list. The OIG conducted this review to determine whether VA had an effective contracting officer warrant program.The OIG found that while VA’s contracting officer warrant program complied with Federal Acquisition Regulation requirements, opportunities exist to strengthen the program. VA lacked assurance that all contracting officer warrants were justified and necessary. Additionally, VA did not have sufficient data to effectively staff and distribute contracting officers’ workload. The OIG also found that additional guidance would be useful in determining when and how to reinstate warrants to individuals with past performance issues. Improved consistency in other areas, such as warrant board procedures, officer selection, and warrant transferability, would also strengthen the program.The OIG made three recommendations to strengthen VA’s warrant program, to include assessing the warrant justification template, determining whether to implement additional formalized procedures to monitor contracting officer workload, and increasing the consistency and standards of practices.

The coronavirus pandemic negatively impacted the oversight and assistance that Regions 9 and 10 provide to the tribal drinking water systems under their purview, as well as the capacity of these systems to provide safe drinking water. The pandemic also underscored the limitations of both EPA resources and tribal drinking water system resiliency. As a result, tribal drinking water systems may be unable to operate safely and comply with drinking water regulations. Access to safe and clean water is critical at all times, but even more so during pandemic situations.