Federal Reports

FEMA did not use its SFM initiative to ensure that Public Assistance (PA) funds were obligated in accordance with Federal, Department, and component requirements. Specifically, FEMA obligated PA funds for 83 projects from fiscal years 2017 through 2019 that we reviewed, even though the subrecipients did not need the funding until after 180 days, which made them eligible for incremental obligation under SFM. This occurred because FEMA did not provide adequate oversight to its Regions. FEMA relied on the Regions’ decisions to determine whether subrecipients’ projects were eligible for SFM funding, without ensuring there was sufficient supporting documentation to validate the determinations. This increases the risk of projects being over obligated. As a result, FEMA is not meeting the intent of SFM, which is to better manage resources in the Disaster Relief Fund to fulfill present and future disaster funding requirements. We made two recommendations that, when implemented, should improve FEMA’s management and oversight of the Disaster Relief Fund. FEMA concurred with the recommendations.

Mark Hernandez, a psychiatrist based in Miami, Florida, Brian Dublynn, Vice President of Safe Haven Recovery Inc, and medical marketer, Jennifer Sanford, pleaded guilty in United States District Court for the Southern District of Florida on August 17, 2021, to conspiracy charges related to a health care fraud investigation. The defendants conspired to defraud private health companies by causing Safe Haven, a substance abuse treatment facility in Miami, along with several clinical laboratories, to submit false and fraudulent claims to health insurance plans for addiction treatment services that were not provided as billed and laboratory tests that were not medically necessary. As a result of the scheme, Amtrak’s insurance providers were fraudulently charged approximately $86,130. The three defendants will be sentenced at a future date.

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 VA Western Colorado Health Care System in Grand Junction. The inspection covered key clinical and administrative processes associated with promoting quality care. It focused on Leadership and Organizational Risks; COVID -19 Pandemic Readiness and Response; Quality, Safety, and Value; Registered Nurse Credentialing; Mental Health: Emergency Department and Urgent Care Center Suicide Risk Screening and Evaluation; Care Coordination: Inter-facility Transfers; and High-Risk Processes: Examining the Management of Disruptive and Violent Behavior.When the OIG conducted the virtual review, the executive leadership team had worked together for three months. The acting Associate Director for Patient Care Services had covered the role since September 2020. Employee satisfaction survey results identified opportunities for the Associate Director for Patient Care Services to provide a safe culture at work. Patient experience survey scores generally reflected higher care ratings than the VHA average. The OIG’s review of the healthcare system’s accreditation findings, sentinel events, and disclosures did not identify any substantial organizational risk factors. Executive leaders were generally knowledgeable about selected data used in Strategic Analytics for Improvement and Learning models and should continue to take actions to sustain and improve performance.The OIG issued four recommendations for improvement in three areas:(1) Quality, Safety, and Value• Review of aggregated data• Implementation and monitoring of recommended improvement actions(2) Registered Nurse Credentialing• Primary source verification of registered nurses’ licenses(3) High-Risk Processes• Disruptive behavior committee meeting attendance

Beginning in FY 2017, independent auditors have been unable to render an opinion on the consolidated financial statements of AmeriCorps and the National Service Trust. The audits resulted in disclaimers of opinion and identified numerous material weaknesses that remained uncorrected. In lieu of financial statements audits for FY 2020, the OIG engaged CliftonLarsonAllen LLP (CLA) to assess AmeriCorps’ progress in resolving two areas of material weakness: AmeriCorps’ internal control program (ICP) and the National Service Trust Liability Model.Our auditors found that AmeriCorps’ internal control program testing was substantially incomplete and that key controls in many areas could not be tested due to a combination of internal and external limitations. In addition, because AmeriCorps did not complete the planned corrective actions for significant aspects of the Trust Model, we rescoped the objectives to focus on the process by which AmeriCorps validated the underlying data about member enrollment, terms of service, and entitlement to education awards. The audit found that AmeriCorps’ review process was flawed in design and could not support its stated conclusion about the accuracy of the data used in the Trust Model.AmeriCorps agreed with our recommendations to develop policies and procedures and update narratives and testing attributes to properly reflect its current ICP operations. AmeriCorps also agreed to renew focus on the FY 2019 financial statement audit recommendations and to develop and implement a detailed corrective action plan that aligns directly to the Trust Model recommendations. In addition, AmeriCorps agreed to assess and document errors and corrections in the Trust Model. AmeriCorps Management’s Response can be found in Appendix C of the report.